Structural comparison of a translated dental attitude questionnaire: a factor analytic study

Abstract In 1984 the Dental Attitude Questionnaire (DAQ). an instrument for assessing various aspects of a person's attitude toward oral health care, was presented by Stockwi-xl & Banting. The DAQ consists of six content scales. Cynicism. Health Concern, Motivation, Oral Function, Social Aesthetic and Susceptibility, and two validity scales, Halo and Infrequency. A Dutch translation was presented in 1986 by Key index words: Hoogstraten & Broers. In order to replicate the factor analysis on the original DAQ as reported by Stockwell & Banting the present study was undertaken. The results show a change in factor structure from a three factor solution to a two factor solution. A confirmatory factor analysis shows that the original three factor structure of the DAQ is not present in the data collected with the translated version. To account for this change, some possible reasons are discussed.     

Tobacco cessation interventions by Swedish dental hygienists--a questionnaire study

The aim of the study was to investigate tobacco cessation interventions by Swedish dental hygienists and their perception of the importance of tobacco cessation to oral health. A questionnaire was mailed to 400 randomly selected dental hygienists (DH) in Sweden. The questions covered such topics as tobacco cessation interventions, perceived barriers, and their perception of the importance of tobacco cessation in relation to caries, gingivitis, periodontitis and dental implants. The response rate was 57%. Tobacco habits were routinely recorded by 94% of the respondents. 52% of the dental hygienists reported time constraints, 50% reported insufficient competence and 43% answered that they had lack of experience to work with tobacco cessation. All respondents perceived tobacco cessation to be an important determinant of treatment outcomes in patients with dental implants and periodontitis. Bivariate analysis showed an association between training courses in tobacco cessation and tobacco cessation interventions (OR 3.25, CI 95% 1.80-5.85). A logistic multivariate regression model disclosed two other factors significantly correlated with tobacco cessation interventions: competence (OR 2.4, 95% CI 1.16-4.85), and experience (OR 2.1, 95% CI 1.06-4.28). The analyses were adjusted for age, length of undergraduate training course, and dental care organization. The dental hygienists considered tobacco cessation to be very important in patients with periodontitis and in those with dental implants. Most of the DH in this study undertook some tobacco cessation interventions, though not extensive; the main barriers reported were lack of time, competence and experience.     

Patient attitudes and expectations of dental implant treatment--a questionnaire study

The aim of the present study was to evaluate patient attitudes and expectations relative to dental implant treatment. A questionnaire was mailed to all 400 patients that had received dental implant treatment at a large multi-specialist clinic during 2008. The questionnaire included questions relative to the reasons for dental implant treatment, if the patient earlier had considered dental implants, expectations of the treatment, discomfort during and after surgery, and how the patient perceived the esthetic outcome. The response rate was 61% (114 men/130 women). The stated reason for tooth loss was in 50% of the patients periodontitis,19% caries, 8% accidents,13% other reasons, and 10% no stated reason. Almost all patients (96%) were satisfied with the esthetic appearance and also regarding the information of the treatment (94%). Regarding the time between surgery and completion of prosthetic work, 79% (n = 192) found it to be reasonable. 71% (n = 170) thought the cost was what they had expected. 47% of the patients experienced the implant surgery better than expected and 48% as expected. In conclusion, the present study revealed that almost all patients were satisfied with the function and esthetics of the dental implant reconstruction and most patients were also satisfied regarding the costs and treatment duration.     

Current understanding of clinical governance: a study of dental health care providers

OBJECTIVE: To quantify what dental care providers understand by clinical governance and how it may impact on their activities. DESIGN: A self-completed questionnaire administered to attendees at two postgraduate courses. RESULTS: A total of 71 forms were completed, a response rate of 88%. The majority of those responding recognised that clinical governance would impact in clinical areas of activity. However, nearly a third felt that any legislation would not affect receptionists or dental surgery assistants. Over 30% of respondents failed to keep records of any mistakes that occurred in their practices, a feature that is central to risk management. While overall the respondents felt that clinical governance would help to raise standards, there was also the fear that it would lead to increased litigation. CONCLUSION: There is at present a lack of understanding of clinical governance and how it will impact on the profession. If GDPs are to sustain public and political confidence in their clinical practice the issue of clinical governance must be embraced by the profession.     

Self-assessment of dental conditions: validity of a questionnaire

In order to determine the validity of dental data obtained from a questionnaire, 100 subjects randomly selected from 2383 respondents were examined clinically. The quality of dental status was ordered in four groups for the number of missing and replaced teeth and for denture status. For the number of missing and replaced teeth, the observed agreement between the clinical diagnosis and the questionnaire answers was 65% for both the maxilla and the mandible, and the agreement estimated by Kappa was 0.52. However, the disagreement was not randomly distributed, since reporting of better dental status than the actual one was much more common than reporting of poorer status. Regarding denture status, the agreement between self-assessment and clinical diagnosis was good; all removable dentures in situ at the clinical examination were reported by the subjects as some kind of denture, although not always the correct type. The results of the study indicate that the use of self-assessment might be reasonable when measuring denture status, and that self-assessment of the number of missing and replaced teeth is a biased estimate of the clinical diagnosis. Thus appropriate action should be taken when using this type of data.     

Dentist's opinion about their dental education in Nijmegen,the Netherlands from 1990-1997

A questionnaire was sent to 328 dentists graduated from the University of Nijmegen in the period 1990-1998, to ask their opinion concerning the way they were prepared by dental education for their professional career. Comparison with similar data from Amsterdam Academic Centre for Dentistry has been carried out. The results show unanimity among graduates that they have been adequately prepared for the requirements in general dental practice as far as knowledge is concerned related to cariology, periodontology, crown and bridgework and dental radiology. They also have a positive assessment regarding other dental cognitive domains, except implantology. There is positive unanimity regarding their skills in various clinical areas. Shortcomings in dental education have been experienced in practice management and infection prevention, treatment of medically compromised patients, treatment of anxious patients and handicapped patients. Almost all responders have the opinion that they gained enough experience throughout their dental education to be competent to start their dental career independently. In general the Nijmegen graduates have a positive opinion concerning their dental education, although preparation for professional life could be strengthened in some specific areas. Comparison with ACTA-graduates shows that in both programmes the weakest areas are implantology and practice management.     

Validity of a risk-related patient-administered medical questionnaire for dental patients.

In this study the validity of a patient-administered risk-related medical questionnaire for dental patients was tested. The answers given on the questionnaire were compared with the results of a verbal history taken by a physician. This verbal history was considered the "gold standard." The sensitivity and specificity of the medical questionnaire appeared to be sufficiently high, and the kappa values of the separate questions were satisfactory. The questionnaire was found to be valid in the registration of medical problems in dental patients, but combination of the two methods is recommended.     

Development of a questionnaire measuring treatment concerns in regular dental patients

Abstract – Objectives: The aim of this study was to develop an instrument measuring core concerns about dental treatment guided by Reiss’ expectancy theory of fear. This would include the content domains of injury, somatic reaction and interpersonal concerns, to study the underlying factorial structure, and to determine the test quality of the resulting subscales. Methods: A total of 555 regular dental patients answered the item pool. Subsamples filled in the Dental Anxiety Scale (DAS) (n = 346) and the Anxiety‐Present Scale of the state‐form of the State‐Trait Anxiety Inventory (STAI‐S) (n = 187). A second sample (n = 89) was used to determine test‐retest reliability and bias for social desirability [Self Disclosure Scale of the Freiburg Personality Inventory (FPI)]. Results: Exploratory and confirmatory factor analyses identified a stable three‐dimensional structure underlying the items convergent to the content domains of interpersonal, injury and somatic reaction concerns. Internal consistencies of the resulting subscales were between α = 0.84 and α = 0.87, test‐retest reliabilities were from r_tt = 0.72–0.78. No evidence for a social desirability response bias was found. All subscales discriminated between patients with low and high dental trait anxiety at a level of P < 0.00001. Dental treatment concerns predicted 36% of variations in actual anxiety during treatment. Conclusions: The results suggest that the proposed instrument, namely the Dental Treatment Concerns Inventory, shows good test qualities according to construct, discriminant and predictive validity, and may be a promising tool for research and clinical applications.     

Adapting the German version of the dental environment stress questionnaire

Aims

To develop a German version of the Dental Environment Stress (DES) questionnaire, and to evaluate its reliability and validity.

Methods

The original English DES questionnaire was translated into German using a forward–backward translation process. To evaluate construct stability, a subgroup of dental students (n = 43) completed the DES twice (interval: 1 week). To evaluate how the DES responds to anticipated changes in stress, all dental students' (n = 64) DES scores and saliva cortisol levels administered from a clinical study were compared between holiday and term time. Furthermore, the Depression, Anxiety and Stress Scale (DASS) and a stress self-assessment were used to determine the validity of the DES. Reliability analyses were calculated using Kendall's tau correlations. To estimate reliability strength, correlation coefficients and intraclass correlations (ICCs) were used.

Results

Regarding construct stability, 24 of 25 DES items had at least moderate correlations, and most items showed strong correlations. Correlations for the seven subdomains were good (range: 0.778–1.000). The same was true for the total DES score (ICC: 0.944). Correlations for response to term-time stress were weaker and more varied. Validity analyses revealed fair correlations between the DES and students' self-assessment (Pearson's r = .592) and DASS score (Pearson's r = .392), suggesting satisfactory validity. Stress levels were quite similar between baseline and follow-up.

Conclusion

The German DES is a reliable tool for evaluating stress in dental students. Because it can be used to identify individual stressors in various categories, it might enable the detection of specific stress situations in educational situations and facilitate solutions (adjustment of curricula, tailored consulting services).     

Patient views on dental amalgam. An exploratory questionnaire

An introductory letter and a precoded questionnaire was sent to a large sample of the Dutch population in order to study their views on dental amalgam. Another sample was approached by interviewers to study the effect of non-response and a third sample was asked to complete a 'neutral' questionnaire so as to preclude any influence caused by the phrasing of the introductory letter and the questionnaire. It was found that the non-response did affect the results, while the phrasing of the letter did not. Based upon the comparison of the samples and taking the non-response into account, it is concluded that probably 17% of the Dutch population regard amalgam to be potentially harmful. At least 4-5% worry about their health because of amalgam fillings and 2-3% attribute existing health problems to amalgam. However, none of the respondents of the 'neutral' sample spontaneously reports amalgam as a causative factor for illness. The health problems mentioned by the respondents are diverse. Headache is mentioned most often, followed by fatigue and a metal taste.     

Electrochemical impedance spectroscopy in understanding the influence of ultrasonic dental scaling on the dental structure–dental filling interface

The purpose of this study was to investigate the effect of ultrasonic scaling on teeth restored with a light‐cured resin. Ultrasonic scaling is a very popular periodontal therapy among dentists, and used for the removal of dental plaque and calculus in order to reduce and eliminate inflammation. Given the fact that most ultrasonic devices are used at high frequencies to perform scaling, undesirable consequences, such as loss of adhesion and increase in surface roughness, may occur in teeth that have been restored with light‐cured resins. Electrochemical impedance spectroscopy (EIS) and scanning electron microscopy were used to investigate the effects of ultrasonic treatments at the dental material–hard dental tissue interface. After ultrasonic scaling, EIS measurements were performed on a human tooth that had been restored with a light‐cured resin filling. The data were analyzed and the influence of ultrasound was shown after visualization of the hard dental tissues and the dental material as equivalent electrical circuits. The study revealed, through EIS measurements, that ultrasonic scaling affected the resistance of the light‐cured resin filling and dentin, whereas the enamel was affected only slightly. Scanning electron microscopy revealed an increase in roughness of the dental material.