Dental treatment and socioeconomic status in the period of 1981-1995

Between 1981 and 1995 the number of people in the Netherlands with a complete set of dentures fell by an average of 0.8 per cent per year. This means that the number of Dutch inhabitants with complete dentures dropped from 3.5 million in 1981 to 2.5 million in 1995. In general, relatively more people with a lower than with a higher socio-economic status have complete dentures. These socio-economic differences did not change in the period 1981-1995. In the same period, the number of consultations at which the dentist provided preventive treatment increased by 1 per cent per year. The results do not show any important differences in preventive aid between socio-economic groups. Changes in the reimbursement system for dental treatment, introduced on 1 January 1995, have led to a decrease of the number of dental consultations by people on a low income with non-private health insurance.     

Dental school vacant budgeted faculty positions: academic year 2000 - 2001.

The 1999 Report of the AADS President's Task Force on the Future of Dental School Faculty (1) drew attention to the situation dental schools are experiencing in attracting and retaining faculty. A year 2000 ADEA Association Report on faculty shortages indicated the number of vacant budgeted positions was approaching 400 (2). The year 2000 - 2001 ADEA survey of vacant budgeted positions indicates a further four percent increase in vacant budgeted positions. Over 73 percent of the vacancies were in the clinical sciences. Of identified full time faculty separations in the 2000-2001 ADEA Survey of Dental Educators (3), almost 34 percent were due to retirements; 33 percent were faculty moves to other schools; and a little over 18 percent were moves to enter private practice. Almost three percent of identified faculty separations were from deaths. It is anticipated that, with a further "graying" of an already aged dental school faculty, retirements will further exacerbate the problem of faculty vacancies and the ability to attract and retain new faculty. There is needed urgency in implementing strategies and recommendations provided in the 1999 President's Report and the 2000 Association Report.     

Dental infection control at the year 2000: accomplishment recognized.

OVERVIEW: Health care providers have strived to address the many elements necessary to achieve effective infection control. Historical progress in microbiology and hospital asepsis provided the foundation for advances in dental preventive practices. Evidence supporting the application of current practices includes a long history of scientific and clinical investigations, technological advances in equipment and materials, and periodic publication of updated recommendations by professional health care organizations. CLINICAL IMPLICATIONS: The routine application of precautions such as multiple aseptic procedures, latex gloves, masks, protective eyewear, clinic coats, automated instrument decontamination devices, time-efficient heat sterilization modalities, chemical disinfectants, waste management procedures and single-use disposable items have created a safer environment for dental personnel and patients alike.     

Trends in oral surgery in England and Wales 1991-2000

OBJECTIVE: To investigate trends in oral surgery in England and Wales 1991-2000. METHODS: Oral surgery procedure data were derived from Dental Practice Board and Department of Health Hospital Episode Statistics. RESULTS: There was a 6% increase in minor oral surgery (MOS) procedures, including ordinary extractions, extractions of special difficulty, apicectomies and third molar removals, carried out in the General Dental Services (GDS) but the number of third molars removed fell by 32% after 1997. General anaesthetics (GA) administered in the GDS fell by 77% and the number of sedations rose 54% after 1998. There was concentration of minor oral surgery in practices: in the year 2000, 88% of practitioners carried out less than five third molar removals. In the Hospital Dental Service (HDS) there was a 98% increase in day surgery, and a 53% decrease in ordinary admissions for minor oral surgery. HDS waiting times remained constant over the ten year period. CONCLUSIONS: The principal trends were substantial decreases in apicectomies, third molar removals after 1997 and GAs after 1998; increases in extractions of special difficulty and concentration of MOS in the GODS. Numbers of ordinary extractions did not change. In the HDS there was a large shift from in-patient to daycase provision which has facilitated expansion of maxillofacial surgery. This is an important example of NHS reconfiguration. Perhaps the most important implication of these changes concerns the place of MOS in vocational training.     

Consolidating human disease learning in the Dental Emergency Clinic

Introduction

Dental undergraduates typically learn and are assessed on aspects of human disease (HD) in the early part of their programme, but it is not until later in the programme that their HD knowledge is put into practice when they provide courses of treatment for numerous patients over multiple visits. The teaching of HD provides core knowledge on medical conditions and medications and is therefore essential in allowing newly graduated dentists to provide safe treatment for medically compromised patients or those taking medications. We wanted to examine the medical complexity of patients attending a university hospital dental emergency clinic to determine whether this was a suitable group that would help students to consolidate their HD learning in the context of a single visit where treatment was also provided.

Materials and Methods

We examined the medical history of 200 patients attending the dental emergency clinic in the University Dental Hospital, Cardiff, using a previous study as a benchmark. Anonymous data were collected using the medical history proforma, and included age, gender, medications, types and number of medical conditions/disorders.

Results

Patients attending the clinic were more medically complex than those in the comparator study and the demographics reflect wider population data showing increasing numbers of older patients with greater medical morbidity.

Discussion/Conclusions

The emergency dental clinic is the place where most patients are new to the hospital, have a dental history, medical history, investigations, diagnosis and treatment in a single visit, and offers excellent opportunities for consolidating HD learning in a one-stop clinical treatment episode, guided by suitable instructors.     

Dental infection control at the year 2000. Accomplishment recognized

OVERVIEW: Health care providers have strived to address the many elements necessary to achieve effective infection control. Historical progress in microbiology and hospital asepsis provided the foundation for advances in dental preventive practices. Evidence supporting the application of current practices includes a long history of scientific and clinical investigations, technological advances in equipment and materials, and periodic publication of updated recommendations by professional health care organizations. CLINICAL IMPLICATIONS: The routine application of precautions such as multiple aseptic procedures, latex gloves, masks, protective eyewear, clinic coats, automated instrument decontamination devices, time-efficient heat sterilization modalities, chemical disinfectants, waste management procedures and single-use disposable items have created a safer environment for dental personnel and patients alike.     

Report of the strategic review of the Dental Practice Board, 1990-2000

The Dental Practice Board has reviewed its strategy for the next 10 years. The review concludes that the DPB should continue with its current role and functions and to be managed within the public sector. There should however, be increased effort to improve efficiency and increased emphasis on monitoring and information. The review, which was carried out by the management of the DPB with the help of Ernst and Young Management Consultants under the general guidance of a joint management and board member committee, was adopted as DPB policy at the April, 1990, Board Meeting.     

Dental trauma in children and young adults visiting a University Dental Clinic

Abstract –  The aim of the study was to present the distribution of traumatic dental injuries in the permanent anterior teeth in 447 consecutively selected patients in the age interval of 6 to 25 years treated at the Department of Paediatric Dentistry at the University Dental Clinic in Rijeka, Croatia, in the period from 2001 to 2006. Data on age, gender, number of injured teeth and type of injury were taken from the dental records. Of all 447 consecutively selected patients with traumatic dental injury 56.2% were boys and 43.8% were girls with a male/female ratio 1.28:1 ( P  < 0.01). The highest frequency of tooth injuries occurred among 10- to 13-years-old children. Among 30.6% of the cases, two or more teeth were injured (38.6% in boys and 21.4% in girls). Traumatic injuries affecting teeth in the upper jaw were more frequent ( P  < 0.001). The most commonly affected teeth were the maxillary central incisors (42.4% of right central incisors and 38% of left central incisors). The most frequent injury was enamel and dentin fracture without pulpal involvement (38.7%). In conclusion, more attention should be paid to preventive measures.     

Dental education in Queensland I: the 1-3-1 model.

Dental education worldwide is under great pressure. This pressure is being driven not only by changing patterns of oral disease but also by economic factors both inside and outside universities. Technological advances and changing educational philosophies across the board also impact significantly on what we do and how we do it. This article outlines how the School of Dentistry at The University of Queensland is responding to these pressures within the context of local political, educational and economic realities. The so-called 1-3-1 model that has been adopted involves one year of basic science, three years of applied dental science and one year of extramural clinical practice. This model represents a partnership with the Queensland Department of Health and will: Involve dental education and the Dental School in the provision of health care to the community. Place the Dental School in a position to influence the delivery and quality of oral health care in the population and to assume some of the responsibility for it. Provide a wide range of clinical and community experiences for students prior to graduation. Allow the adoption of modern teaching methods such as Problem Based Learning (PBL) in Years II-IV with all the additional benefits e.g. communication skills. Provide an extended clinical period for the acquisition and development of clinical and technical skills prior to graduation. Be cost-effective both to the university and the health service. Allow for outside input without compromising the knowledge and research base. It is recognised that while the 1-3-1 model may meet the demands of a large, decentralised state such as Queensland, it may not be suitable for all institutions. In this context diversity in approach is one of the strengths of dental education, nationally and internationally.     

Changes in oral health in adults. Results of studies performed in 1983 and 1995

In 1995 a dental survey among adults aged 25-54 years was performed in 's-Hertogenbosch (The Netherlands). Aim was to study trends in oral health after 1983, a year in which a similar study was performed in the same city. Caries data were obtained by clinical examination only. The percentage of edentulous persons in the sample decreased with about 50% between 1983 and 1995. In 1995 in all age categories of dentate persons, the mean number of FT was higher, and the mean numbers of DT and MT were lower than in 1983. In persons with a natural dentition under the age of 35 the mean number of DMFT decreased significantly. It was concluded that oral health in adults living in 's-Hertogenbosch, as measured by caries prevalence, treatment level of caries and percentage of edentulous persons, improved significantly between 1983 and 1995. It is supposed that the trends found in 's-Hertogenbosch are indicative of changes in oral health in The Netherlands.     

The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist

The purpose of this study was to evaluate the treatment outcome of initial endodontic treatment and nonsurgical retreatment performed by an endodontic specialist in his private office. A total of 2,000 teeth were examined clinically and radiographically and the results were analyzed statistically by Pearson or Fisher's Exact test and multivariate logistic regression. The multivariate analysis evaluated joint associations among various factors, using logistic regression models. The dependent variable for this analysis was the dichotomous outcome: healed versus disease. The overall endodontic success rate was 91.45%, and the healed rate was significantly higher for initial endodontic treatments than for nonsurgical retreatments; teeth without lesion than for those with lesions; teeth treated without complications than for those with complications; recall period of 18-24 months than for other periods, and teeth with final coronal restoration than for those without. Of the 1376 teeth treated in the initial endodontic treatment sample, the success rate was 94.0%. Multivariate analysis identified the presence of procedural complications (file breakage, perforation and flare-up), as well as the absence of the restorations at follow-ups as the significant predictors of outcome, showing lower rates of success. Of the 624 teeth in the nonsurgical retreatment sample, 85.9% were successful. Stepwise logistic regression analysis revealed that preoperative radiolucency was a strong statistically significant factor to determine lower rates of success than in its absence. Two additional variables (age and tooth type) were found to have a significant influence on the outcome of the retreatment sample. A higher healed rate was observed for the 50-59 years age groups than others, while multirooted (molars) teeth revealed a significantly lower percentage of success than pre-molars and anterior teeth.     

Root canal treatment in the General Dental Service 1948-1987

Endodontic treatment has been available under NHS Regulations since its inception in 1948, and details of the incidence of treatment carried out is available from the Dental Estimates Board, Eastbourne. These records are analysed to show that, among other trends, the amount of root canal treatment provided has increased to a peak in 1984, with highest incidence in the 21-30 age group, and in single rooted anterior teeth.