Monitoring external forces that affect the practice of dentistry

Dealing with the varied and often changing requirements and regulations that affect every dental practice can be a daunting task for the dentist and dental staff. Knowing how and where to access accurate and timely information provides relief for the busy dental professional. This article explores the impact of regulatory mandates and government agency standards on dentistry and provides suggestions for simplifying the search for reliable information.     

Value gaps in dental practice: understanding how differences in core values can adversely affect the practice

BACKGROUND: The authors explore the importance of human values in dental practice, an area often overlooked as we struggle to deal with the everyday demands of treating patients and managing staff members. Such values are, however, fundamental to the success of any practice; therefore, it is important to understand their significance. CONCLUSIONS: Problems arise in dental practices when gaps develop between the values held by the various players involved (that is, between the entire dental team and patients, the dentist/owner's personal values and business goals, the dentist/owner and staff members, and the dental practice and any third-party funding organizations). PRACTICE IMPLICATIONS: By understanding the potentially damaging consequences of value gaps for practice viability, dental practice owners and managers can take steps to create a more harmonious workplace in which all parties strive to reach common goals.     

Building a profitable practice for the future

The success of the dental practice may be based in the skills of the dentist and staff, but it will take additional qualities to create the stand-out dental office. This practice will be dedicated to employee retention and training, outstanding customer service and attention from every staff member, and a focus on creating revenue through the best utilization of the dentist's time and staff experience. This successful office will also exercise cost containment and take advantage of marketing opportunities.     

Dentist Workforce Trends in a Primarily Rural State: Iowa: 1997–2007

BackgroundState dental boards maintain minimal demographic and practice characteristics about licensed dentists. The authors describe the creation and monitoring of an enhanced surveillance system concerning Iowa's dentists.MethodsThe Iowa Dentist Tracking System (IDTS) was used to collect demographic, educational, practice arrangement, office location and work hour data for all active Iowa dentists beginning in 1997. IDTS staff members add newly licensed dentists to the system as practice locations become available. They also contact each dental office semiannually by telephone to update this information. The IDTS Advisory Committee meets annually to review these data and monitor trends.ResultsThe Iowa dentist workforce was relatively stable from 1997 through 2007; however, a large number of dentists are expected to retire during the next decade, which could create a shortage of providers, especially in rural areas. Although the percentage of male and female dentists who practice part time (< 32 hours per week) decreased between 1997 and 2007, young female dentists are more likely than young male dentists to practice part time.ConclusionsIDTS is a workforce tracking model that can be used to understand trends at the community, regional and state levels. An aging dentist workforce in Iowa could put a strain on the public's ability to access dental care, especially in rural counties.Practice ImplicationsIn the development of workforce policy, workforce tracking systems such as IDTS provide additional information in considering the number of dentists, location, accessibility and potential productivity of a workforce.     

Evaluating restorative materials and procedures in dental practice

A wide variety of research methods are appropriate to general dental practice, including clinical trials of materials, assessment of materials and techniques, treatment trends, and assessment of behavior and attitudes, of dentists as well as patients. This paper will describe the use of practice-based networks to evaluate the effectiveness of materials and techniques in dental practice. Several practice-based research groups are presently in operation in the UK and the USA, generally carrying out evaluations of the handling of materials, but with increasing emphasis on the clinical evaluation of restorations. Use of the Dental Practice Board (of England and Wales) database has proved to be a fruitful source of data on the long-term outcome of restorations. Dental practice can provide the large pool of patients available for research. To utilize this pool of patients, dental practitioners and their support staff require training in collecting data.     

Patient satisfaction in four types of dental practice

There has been a significant growth in alternative types of dental practice. To determine satisfaction, patients were surveyed in urban private practices, a hospital dental clinic, a neighborhood health center, and a large group practice situated in a shopping center, using a 14-item survey and a 5-point rating scale. Patient satisfaction was related to the following factors in descending order: dentist, staff, efficiency, time-cost, and accessibility. Patients rated private practice most favorably for all factors with the exception of accessibility, which was rated highest for the shopping center practice. Patients rated the hospital least favorably for all factors with the exception of dentist, which was rated least favorably for the shopping center practice. Although private practices were the most favorably perceived, alternative types of practice were also highly rated and met specific patient needs. Satisfaction was greater for older patients, for patients with less education, and for white compared with black patients.     

A marketer's take on practice building

This article proposes a new method for increasing new patients in a dental practice. It augments the practice externally by increasing the dentist's presence in the local community through the following ways: (1) distributing a consumer dental product to local community groups such as emergency rooms, ambulances, and kids sports teams, (2) lecturing about dental trauma at local organizations, and (3) creating positive press about the dentist and his or her practice. The practice is also built internally by giving out CDPs to selected patients. By initiating this program, a dentist can substantially increase the number of new patients in his or her office. With the increase in new patients, the dentist will be able to raise fees, be more selective in the parts of dentistry he would like to perform, and become free from third-party payment. The dentist who appears focused on providing the best care to everyone in the community will shortly see new patients entering his or her practice. With this program, a dentist can focus on marketing and building the practice without the stigma frequently associated with these activities. The dentist now appears altruistic instead of driven to make more money by building the practice. This image, along with the contacts initiated in the program, will provide the dentist with a strong, very public image that will attract new patients.     

A national dental practice survey

The very high correlations from the dentist surveys reinforce the contention that the practice of dentistry is similar across this country without regard for geographic region). The dental school responses provide validation for the perceptions of the dentists surveyed regarding the important content in dental practice. The complete practice analysis report is available at http:// www.wreb.org.     

The impact of additional dental providers in the dental labor market on the income of private practice dentists

This study estimates the impact that the entrance of hypothetical allied dental professionals into the dental labor market may have on the earnings of currently practicing private practice dentists. A simulation model that uses the most reliable available data was constructed and finds that the introduction of hypothetical allied dental professionals into the competitive California dental labor market is likely to have relatively small effects on the earnings of the average dentist in California.     

The effects of continuing education in dental practice management

A representative sample of 122 Washington State general dental practices received continuing education in the efficient utilization of auxiliaries. Dentist and staff attended a two-day workshop where goals for change in delegation to auxiliaries, scheduling, and communication were developed. The continuing dental education was individualized, required the practice to set explicit goals for change, involved both the dentist and staff in the decision-making process, and included in-office follow-up and consulting. Evaluation of the course's effects demonstrated that such a course in practice management can have a positive effect on delegation to auxiliaries, practice output, and dentist income. Degree of participation varied considerably across the 113 practices that completed the continuing education. The positive results of the training were dependent upon the practice implementing the goals for organizational change that it had set. The effects of the continuing education take time to become apparent and are sequential with changes in delegation to auxiliaries occurring first and increases in volume of services and income occurring later.     

Australian dental practice surveys 1961–1981

A bstract — The paper presents a summary of trends at intervals over the years 1961–1981 from information collected by surveys with mailed questionnaires of dental practice in Australia. Responses represented approximately 40 per cent of the membership of the Australian Dental Association.
The major trends have been an increase in the relative number of dentists, with a wider distribution in the community; increases in the proportions of women, of specialists, partnerships, or salaried dentists in private practice; decrease in the number of working hours and patient appointments per dentist; relative increases in practice expenses; and relative reduction of net incomes of dentists.     

Role of the dental hygienist in the prosthodontic practice

Prosthodontic practices can benefit from the inclusion of a dental hygienist on the dental team. The dental hygienist can successfully complete procedures traditionally performed by the dentist. Delegation of these duties permits the dentist to spend time and energy on intricate procedures for which he or she has special expertise. The major modalities of responsibility that can be delegated include diagnostic data collection, educational and preventive services, and corrective therapy. It has been suggested that there is a need for expanding the duties of auxiliaries for prosthodontics in the future. It is our recommendation to use effectively the important auxiliary, the dental hygienist, in prosthodontic practice. For prosthodontic patients, the importance of the dental hygienist can be supported from two perspectives. First, the dental hygienist is formally educated in the oral and basic sciences and is qualified to perform intraoral procedures. Second, the dental hygienist is able to educate patients in regard to diet and oral hygiene habits. The dental hygienist's role in the prosthodontic practice has a potential that must not be overlooked. This opportunity, when provided, can be challenging, successful, and beneficial to the dentist, the patient, and the practice of prosthodontics.     

The independent practice of dental hygiene

Dental hygienists are health care professionals specially trained and licensed to provide preventive oral health care and information to patients. In 49 of the 50 states, dental hygienists practice their profession under some type of supervision by a dentist. They are prohibited by state law from practicing independently in their own dental hygiene offices. The independent practice of dental hygiene and the controversial issues concerning dentists and dental hygienists are the issues examined in this article.     

Teledentistry-assisted, affiliated practice for dental hygienists: an innovative oral health workforce model

The 2010 U.S. Patient Protection and Affordable Care Act (PPACA) calls for training programs to develop mid-level dental health care providers to work in areas with underserved populations. In 2004, legislation was passed in Arizona allowing qualified dental hygienists to enter into an affiliated practice relationship with a dentist to provide oral health care services for underserved populations without general or direct supervision in public health settings. In response, the Northern Arizona University (NAU) Dental Hygiene Department developed a teledentistry-assisted, affiliated practice dental hygiene model that places a dental hygienist in the role of the mid-level practitioner as part of a digitally linked oral health care team. Utilizing current technologies, affiliated practice dental hygienists can digitally acquire and transmit diagnostic data to a distant dentist for triage, diagnosis, and patient referral in addition to providing preventive services permitted within the dental hygiene scope of practice. This article provides information about the PPACA and the Arizona affiliated practice dental hygiene model, defines teledentistry, identifies the digital equipment used in NAU's teledentistry model, give an overview of NAU's teledentistry training, describes NAU's first teledentistry clinical experience, presents statistical analyses and evaluation of NAU students' ability to acquire diagnostically efficacious digital data from remote locations, and summarizes details of remote applications of teledentistry-assisted, affiliated practice dental hygiene workforce model successes.     

A survey of dental practice and equipment characteristics.

The aim of this study was to determine what would be regarded as essential equipment required for setting up a dental practice and the cost thereof. This information could be useful for the newly qualified dentist. Seventy five completed questionnaires returned from a randomly selected group of practising dentists were analysed to obtain this information. Equipment costs were obtained from a dental supply house and are tabulated. Guidelines recommended for setting up a practice include determining the type of service to be rendered, selecting the equipment required for this purpose, seeking expert financial advice and commencing the practice on a conservative basis with only the essential items of equipment.     

Supervision and practice of dental hygienists: report of ADHA survey

In 1986, the American Dental Hygienists' Association (ADHA) funded a study to examine demographic and practice data concerning the dental hygiene profession. The purpose of this survey was to establish a data base for the current practice of licensed dental hygienists in the United States. Information was collected on the type of supervision under which hygienists worked and the type of supervision they would prefer. Using a stratified random sampling technique, questionnaires were sent to licensed member and nonmember dental hygienists residing in the United States. A total of 9,110 hygienists received surveys and after a second mailing to nonrespondents, a total of 4,522 completed surveys were received, for a response rate of 49.6%. This survey indicates that hygienists' attitudes toward supervision are changing. Although the majority of hygienists still work in a private practice where a dentist is present and usually examines the patient, over half of the respondents prefer that the dentist's presence in the facility not be required. In examining practice behaviors, a collaborative relationship appears to exist between the hygienist and dentist when treating both new and recall patients. The collaborative relationship decreases with the dental hygienist demonstrating an increase in responsibility and independent decision making for recall patients. Traditional practice behaviors are also changing to include more comprehensive dental hygiene services, particularly by baccalaureate degree hygienists.     

Creating a viable practice vision

Vision guides the long-term development and growth of a dental practice. It provides focus and purpose to the dentist and team and creates clear goals for achieving practice growth and moving toward realizing the vision.     

Eye safety in operative dentistry - a study in general dental practice

AIM: In this safety conscious age all general dental practitioners should be promoting the use of eye protection. The aim of this study was to highlight the uptake of eye protection by all clinical staff and patients within the general dental practice setting, with regard to adequate protection and its use at appropriate times. METHOD: Questionnaires were sent to 200 GDPs, chosen at random, to accumulate information on the use of protection, the preferred methods of eye protection and any experience of ocular injury. FINDINGS: Eighty-seven per cent of GDPs wore eye protection routinely, but their choice of protection was not always adequate and not worn for all procedures. Forty-eight per cent of GDPs had experience of ocular trauma or infection which occurred during a variety of procedures; 75% of these injuries resulted from not wearing eye protection. In contrast less than half of the DNs and Hygienists use protection routinely, particularly when cleaning contaminated instruments. However, hygienists did wear eye protection for the majority of their patient work (96%). CONCLUSION: Eye protection use by all staff and patients is currently suboptimal to conform to published guidelines. Risks encountered within the dental environment do cause harm to the unprotected eye, which can be reduced or even eliminated by improving the uptake of suitable eye protection; several choices for eye protection are available. Each individual dentist is responsible for the uptake of eye protection for all persons in their surgery environment.     

Le regole di gestione dello studio odontoiatrico: rischio biologico e sicurezza sul lavoro

ObjectivesComprehensive continuing medical education programs in dentistry are difficult to achieve because of the extreme complexity of a dental practice and the multiple roles played by the dentist. As a result, dentists may not always be informed on one of the crucial points of their daily activity: professional risk management. The aim of this paper is to present up-to-date scientific data that can guide the dentist in this fundamental sector of dental practice.Materials and methodsProfessional risk is a key aspect of every job. Continuing education is essential to keep dentists abreast of the developments in this field, such as the introduction of specific laws. This article analyzes the various types of professional risk and their implications for office management to provide dentists with the fundamental concepts needed for safe, rational management of their dental practice.ConclusionsIn-depth understanding of the different types of professional risk and the appropriate distribution of duties between the members of the office staff constitute the basis for a safe, unflustered dental practice.     

Integrating hospital dentistry into the general dental practice

Societal trends and medical advances have resulted in increased numbers of physically and/or psychologically challenged individuals living within our communities. For some of these individuals, hospital dentistry with general anesthesia provides the only means by which general dental services may be provided. This paper presents considerations of significance to the general dentist wishing to incorporate outpatient hospital dentistry into his or her private practice.