The effects of denturism: New Zealand dentists' response to competition.

The New Zealand Dental Act of 1988 allowed clinical dental technicians to deal directly with the public in fitting and supplying dentures. This study tested the hypothesis that dentists responded to competition from dental technicians by lowering their fees. The results indicate that there was no significant change in the fees charged by dentists for dentures. The apparent failure of deregulation to produce the expected outcome could be due to the competitive pressure imposed by dental technicians practicing illegally prior to 1988, to consumers' lack of information, or to barriers to "consumer search" imposed by the act itself.     

Dentistry. Open wide

The government's plan to invest 18 m Pounds to encourage dentists to do more NHS work is not likely to arrest the move towards private practice. Although health authorities are to be made accountable for delivering a dental strategy they will have no control over the work of dentists in their area. Dentistry remains out of line with the NHS's founding principle of providing free care at the point of access. The government has not addressed the problem of shortage of dentists in some areas. Dental hygienists and therapists should be allowed to undertake more routine work.     

Oral Health Care Availability in Health Centers of Mangalore Taluk,India

Background:

Community-oriented oral health programs are seldom found in India. When primary health care systems were in the 1980s, dentistry was not adequately included. This has left oral health far behind other health services.

Objectives:

To find the availability of dental professionals, infrastructure, equipment, and treatments provided in health centers of Mangalore taluk.

Materials and Methods:

A cross-sectional study was conducted among medical officers and dentists working in all the health centers of Mangalore taluk, using an interview schedule, the oral health care availability inventory (ORAI).

Results:

Among 23 health centers of Mangalore taluk, dental services were available at six health centers (26%) [two community health centers (CHCs) and four primary health centers (PHCs)]. Mouth mirrors, dental explorers, and extraction instruments were available at six health centers [two CHCs (100%) and four PHCs (19%)]. No health centers provided orthodontic tooth corrections, removal of impacted teeth, oral biopsies, and fabrication of removable dentures.

Conclusions:

Availability of dental services was limited in the health centers, and a vast majority of the rural population in Mangalore taluk did not have access to dental care.     

Hearing loss and the high speed dental handpiece.

A pure tone air conduction audiometric evaluation was administered to 137 dentists and 80 physicians. The physicians were found to have better hearing threshold levels, notably in the 4000HZ center frequency range. The left ear of right handed dentists showed a greater loss of hearing ostensibly related to proximity to the noise source. Dental specialists showed a loss pattern similar to those of the general dentists. The findings suggest that there may be a cause and effect relationship between hearing loss and use of the highspeed dental handpiece.     

Management of occupational exposures to potentially infectious materials in dentistry

OBJECTIVE: To evaluate whether post-exposure measures referred by dentists and dental assistants are in line with those recommended by Brazilian health authorities. METHODS: An epidemiological survey was carried out in a city of Southern Brazil, in 2003. Subjects (289 dentists and 104 dental assistants) were selected through random systematic sampling. Data were collected through self-reported questionnaires. RESULTS: Washing the exposure site was the most common measure taken by dentists (98.5%) and assistants (89.2%) after sustaining a percutaneous injury. More dentists asked the patients if they carried blood-borne viruses after sustaining a percutaneous injury (44.6%) than a splash to a mucous membrane (14.3%). Taking post-exposure prophylaxis, notifying the accident and requesting blood tests to patients were the least remembered and taken measures by dentists and assistants. After sustaining an occupational exposure to potentially infectious materials, 10.8% of dentists and 2.7% of dental assistants sought medical care. CONCLUSIONS: Based on the Brazilian Ministry of Health recommendations, post-exposure management among the study population was considered, in general, inadequate, especially among dental assistants.     

Urban/Rural Differences in Prosthetic Dental Service Rates

There have been few reports of relative rates of provision of dental health services in rural and urban settings, a comparative measure of access to care in these populations. One part of a statewide survey of active North Carolina general dentists (n=959, response rate=47%) was designed to quantify provision of prosthetic services. To determine contrasting rural and urban rates, responses were analyzed according to dentists'self-report of practice city size using analysis of covariance with percent of insured patients in the practice as the covariate. Mean per-patient-visit rates for crowns, fixed partial dentures, removable partial dentures, and extractions, as well as the distributions of treatment following tooth extraction, differed by city size, with practitioners in the smallest cities reporting treatment distributions reflecting more frequent loss of teeth and less frequent replacement. These differences in patterns of prosthetic care echo the limited existing information describing oral health status, provider supply, and receipt of care, all of which suggest that differential levels of access to care exist and lead to differences in oral health outcomes.     

Problems of dental diseases among young residents of the Archangelsk region

Dental examinations (according to WHO methods) were carried out in 447 youths aged 18-19 years, residents of Northern Russia, in Archangelsk before army service, and 500 students of Northern Medical University. Dental health of young people was characterized by high incidence and prevalence of caries (9.4.31%, CDL = 5.94), periodontal diseases, maxillodental abnormalities (72.18%), high percentage of lost teeth (8.75) in the CDL structure, poor oral hygiene (OHI-S index 3.68), and high level of need in all types of dental care, this demonstrating poor organization of health improving measures for young people before military service. Poor dental health in young people aged 18-19 years is one of the causes making them unfit for army service or fit with limitations (47 subjects for categories C, D in 1996-1998, 100-198 subjects annually for category B).     

Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment

Background  

The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them.     

Tooth loss,chewing ability and quality of life

Objectives Middle-aged and older adults are retaining teeth and avoiding dentures, which should impact quality of life. The aims of our study were to investigate tooth loss and chewing ability and their association with oral- and general-health-related quality of life and life satisfaction. Methods A random sample of 45- to 54-year-olds from Adelaide, South Australia, was surveyed by self-complete questionnaire in 2004–2005 (n = 879, response rate = 43.8%). Health-related quality of life was measured with the Oral Health Impact Profile 14-item version and EuroQol Visual Analogue Scale instruments and life satisfaction by the Satisfaction with Life Scale. Functional tooth units were recorded at oral examinations performed by calibrated dentists on 709 persons (completion rate = 80.7%). Results Number of functional teeth was positively associated with chewing ability (β = 0.31, P < 0.01). In multivariate analyses, controlling for number of functional teeth and other explanatory variables spanning dental visit pattern, dental behaviour, socio-demographics and socio-economic status, chewing ability was negatively associated with oral-health-related impacts (β = −0.37, P < 0.01) and positively associated with general health (β = 0.10, P < 0.05) and well-being (β = 0.16, P < 0.01). Conclusions Chewing ability was related to oral-health-related quality of life and general health, possibly reflecting the impact of chewing on food choice and enjoyment of meals and diet, and also indicated the importance of oral health to general well-being.     

Comparison of results of a dental questionnaire between from randomly sampled residents and patients of dental clinics in the same city

OBJECTIVES: The present study was undertaken to clarify the nature of sampling results with dental questionnaires between random sampling of subjects and of patients of dental clinics in the same city. METHODS: The first group comprised 900 subjects selected using the stratified random sampling based on different age groups. The sampling rate was set at 6.46% of the population database and the approach was a mail survey with random sampling. The second group comprised 240 subjects who were patients of 12 dental clinics. The questionnaire had a list of questions about oral health conditions, daily oral habits, daily activities and common eating habits. RESULTS: The response rates with the mailing method in the first group were 41.0% for male and 49.0% for female residents. The percentages who answered "Yes" to the questions, "Do you have gum swelling?" and "Have you ever received any instructions on tooth brushing from a professional?", were significantly (P < 0.05) lower than for patients from dental clinics. CONCLUSIONS: Dental patients had poor oral health habits and more oral diseases than residents, who visited dentists less frequently. It can be concluded that patients from dental clinics are inappropriate to use as samples to set a baseline for the general population in research evaluation of oral health.     

Evaluation of the impact on quality of life caused by oral health problems in adults and the elderly in a southeastern Brazilian city

The scope of this paper was to evaluate the prevalence of the impact of oral health problems on quality of life, and its association with socio-demographic and clinical variables and the use of dental services by adults and the elderly in Marechal Floriano. A cross-sectional study was conducted on a random sample of 237 participants. Data was collected by Municipal Community Health Agents using four questionnaires with items about the socio-demographic and oral health status of the participants, dental practice structure and oral health impact profile (OHIP-14). The greatest impact perception related to oral health problems was found in individuals over 40 years of age (OR= 2.37 IC 95%=1.375;4.098), those with a perceived need for removable partial dentures (OR= 2.771 IC 95%=1.488;5.162), and full removable dentures (OR= 2.292 IC 95%=1.305;4.026). The impact prevalence was of 35% and revealed an association with age and the perceived need for partial and full dentures. Subjective indicators must be used in conjunction with objective indicators to determine the population's treatment needs, thereby improving oral health and quality of life of the population.     

Association Between Dentist–Dental Hygienist Communication and Dental Treatment Outcomes

Communication between physician and patient is critical in all fields of medicine, and various types of communication exist in healthcare settings. Cooperation among healthcare professionals is thought to be essential in providing high-quality services. Dental hygienists are key team members in the provision of dental care, and are known to play an important role in the health of their patients. This study aimed to determine the effect of communication between dentists and hygienists on patient satisfaction. Study subjects were dentists, patients, and dental hygienists, and we examined how dentist–dental hygienist communication affected patient outcome indices. A significant difference was observed only for satisfaction in terms of meeting expectations (p = 0.035). Results for patient satisfaction indicated significant differences in explanatory behavior in dentist–dental hygienist evaluations (p = 0.001). The results showed improved health and reduced fear, indicating significant differences for the dentist–dental hygienist evaluations in explanation behavior (p = 0.016). Our evaluation of the effects of dentist–dental hygienist communication on patient outcomes indicated a significant correlation, suggesting that inter-professional communication in the field of dentistry affects patient satisfaction.     

Use of Complementary and Alternative Medicine for Work Related Musculoskeletal Disorders Associated With Job Contentment in Dental Professionals: Indian Outlook

Background

High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional therapy (CT) as a treatment modality for WRMSD

Method

Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression.

Result

A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (P<0.001). Of those with work-related musculoskeletal disorders, 35.5% (n=172) considered a career change for once, and 4.0% (n=19) reported having left dentistry.

Conclusion

Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders.     

Disparities in regular source of dental care among mothers of medicaid-enrolled preschool children

For mothers of Medicaid children aged 3 to 6 years, we examined whether mothers' characteristics and local supply of dentists and public dental clinics are associated with having a regular source of dental care. Disproportionate stratified sampling by racial/ethnic group selected 11,305 children aged 3 to 6 in Medicaid in Washington State. Mothers (n=4,373) completed a mixed-mode survey that was combined with dental supply measures. Results reveal 38% of mothers had a regular dental place and 27% had a regular dentist. Dental insurance, greater education, income, length of residence, and better mental health were associated with having a regular place or dentist for Black, Hispanic, and White mothers, along with increased supply of private dentists and safety net clinics for White and Hispanic mothers. Mothers lacking a regular source of dental care may increase oral health disparities disfavoring their children.     

基于基尼系数的吉林省口腔医疗机构人力资源公平性分析

目的通过对吉林省口腔医疗机构的人力资源现状的数据进行整理与分析,探讨存在的问题,为优化吉林省口腔医疗机构人力资源配置、提高口腔医疗机构卫生服务公平性、相关部门决策提供参考和依据。方法采用描述性分析、洛伦兹曲线和基尼系数,分析2020年吉林省口腔医疗机构人力资源配置公平性及其变化趋势。结果 2020年吉林省口腔医疗机构人力资源严重不足,非公立口腔医疗机构优于公立口腔医疗机构的公平性,配置较公平。各地方口腔医师人力资源分配相对公平。结论各地口腔医师分布较好,鼓励医师到各级口腔医疗机构出诊,非公立口腔医疗机构服务能力及整体素质有较大提升空间。     

A study of dental status and its contributing factors in mentally retarded persons institutionalized in welfare facilities]

Two hundred and forty-one mentally retarded persons, institutionalized in three private welfare facilities in Oita Prefecture, were assessed for dental status and tooth brushing ability. Information on their life style was also obtained by a questionnaire completed by their supervisors in the facilities. 1) Dental status of mentally retarded subjects was found to be inferior compared to the general Japanese population studied in the survey of dental disease in 1987 by the Ministry of Health and Welfare. Inferior dental status was characterized by a low score for filled teeth and a high score for missing teeth. 2) Both low tooth brushing ability and low intelligence quotient were associated with their poor dental status. 3) Discrepancy between supervisor assessment of tooth brushing ability and actual ability was observed. 4) Periodontitis was observed in young epileptics taking antiepileptic medication at a high rate. However there was no association between the taking of antiepileptic medication and missing teeth score. These results indicate a necessity for more active dental services including the teaching of tooth brushing and early treatment by dentists and supervisors.