Patterns of antifungal prescribing in general dental practice

OBJECTIVE: To examine the current practice of antifungal prescribing by GDPs in the United Kingdom.Design A postal questionnaire circulated to a random selection of 400 dentists. OUTCOME MEASURES: The questionnaires were analysed and the responses expressed as absolute and relative frequencies. RESULTS: Responses to the questionnaire were received from 297 (74.3%) GDPs. Nystatin was the most popular choice of antifungal agent that GDPs would use, followed by miconazole, amphotericin B and fluconazole. The likelihood of use of miconazole was positively linked to recent date of graduation. Lack of knowledge regarding contraindications and problems with azole antibiotics was found in a significant minority of practitioners (36%). CONCLUSIONS: The present study indicates that azole antifungal agents (especially miconazole) are becoming more widely used by GDPs, but that knowledge regarding potential problems with their use is sub-optimal. Nystatin remains the most popular choice of antifungal agent.     

Antibiotic prophylaxis patterns of Finnish dentists performing dental implant surgery

Background. The peri-operative use of prophylactic antibiotics in clinically healthy patients undergoing dental implant surgery is very common in Finland. While antibiotics are prescribed with the hope of preventing both local and systemic complications, their application and utilization is not uniform. Objective. The aim of this study was to assess the variation in prescribing patterns among Finnish dentists performing dental implant placement operations. This study also aimed to examine the possible relationship between early implant removal and the use of the prophylactic antibiotics in Finland. Materials and methods. The National Institute for Health and Welfare in Finland granted permission to access the Finnish Dental Implant Register. The peri-operative antibiotic prophylaxis prescribing patterns were assessed in a total of 110 543 dental implant placement procedures and 1038 dental implant removal operations performed in Finland between April 1994 and April 2012. Results. A total of 61 different antibiotics or combinations were prescribed peri-operatively during implant placements in Finland between 1994–2012. Phenoxymethylpenicillin was the most commonly prescribed drug (72.2%). No statistically significant difference in early implant removal rates could be found between patients who had or had not received peri-operative prophylaxis. However, patients who had received peri-operative prophylaxis had statistically significant longer implant survival rates. Conclusion. There is a variation in antibiotic prescribing patterns among Finnish dentists placing dental implants. The results suggest that the use of prophylactic antibiotics has little effect on the prevention of primary implant surgery-related complications and, hence, success rates.     

Prevention-oriented practice of Iranian senior dental students

OBJECTIVES: To investigate self-reported preventive practice of Iranian senior dental students in dental caries management. SUBJECTS AND METHODS: To obtain an estimated sample size of 250 subjects, seven state dental schools were selected based on a stratified random sampling approach. All the senior dental students (n = 327) were asked to voluntarily fill in a self-administered pre-tested questionnaire during the spring term in 2005. In the questionnaire two hypothetical patient cases (a high-risk and a low-risk patient) were presented and the students were asked to express their conceptions on a five-point Likert scale about including each of nine given alternatives in the patients' treatment plans. The respondents' self-reported oral self-care (OSC), preventive knowledge, attitude towards prevention and self-perceived competency in giving preventive care were also assessed. Chi-squared test and logistic regression model served for statistical analyses. RESULTS: A total of 270 students filled in the questionnaire (response rate = 82%). Acquiring high scores of preventive practice as assessed by patient cases was found to be more frequent among those reporting recommended OSC (P = 0.007) and those with higher attitude scores (P < 0.001). Also, those reporting being competent in giving preventive care had higher scores of preventive practice compared with the others (P = 0.02). In the regression model, recommended OSC (P = 0.05, OR = 1.9) and positive attitudes towards preventive dentistry (P = 0.001, OR = 3.3) showed significant association with acquiring highest scores of preventive practice. CONCLUSION: To improve their preventive practice in the future, more emphasis should be placed on the dental students' own oral health behaviour and attitudes related to it.     

Dentists' attitudes and practice regarding smoking

Dentists are a potentially valuable source of community education about the health effects surrounding tobacco use. The aims of this study were to provide Australian data on dentists' current practice regarding discussing smoking with patients, dentists' perceptions of the barriers to discussing smoking with patients and dentists' interest in discussing smoking with patients. A postal survey of all dentists who were members of the Hunter Branch of the Australian Dental Association in New South Wales was conducted. Dentists generally reported quite high levels of current activity regarding smoking. The majority of dentists reported asking at least some of their patients whether or not they smoked. Dentists reported that they discussed the possible oral effects of smoking with at least some of their smoking patients. Furthermore, they told at least some of their patients with smoking related disease that smoking may have contributed to their problems. Dentists identified a number of difficulties involved in helping patients quit smoking. These findings may be used to help guide future research and practice in involving dentists further in discussing smoking with patients.     

Preventive practice of Mongolian dental students

To investigate the preventive practice of Mongolian dental students, in relation to their knowledge of preventive care, self-perceived competency, oral self-care, and dental health status, a questionnaire was distributed to all (n = 79) clinical-year students of The Dental School of the Mongolian National Medical University. Dental students' reported preventive practice was explained by their knowledge of preventive care (P = 0.002) and self-perceived competency (P = 0.002), whereas their study-year, oral self-care, and dental health status, expressed as the Tissue Health Index (THI), remained statistically non-significant in the linear regression model. This explained 28% of the variation in the parameters examined. In logistic regression analysis, a student's study year (OR = 2.5), knowledge of preventive care (OR = 1.1), and THI (OR = 1.8) were related to their highest scores on preventive practice. Preventive practice among Mongolian dental students could be improved by increasing their knowledge, particularly in modern methods for caries-prevention such as fluoride, sealants, and xylitol. Preventive methods should be integrated into all topics of the dental curriculum and the learning environment should support such training for future oral health professionals.