Service-mix in general dental practice in Japan: A survey in a suburban area

Overseas investigations have reported the amount and variety of dental services provided. An understanding of the current service-mix in private general practice is important in the anticipation of the future practice of dentistry. The main purpose of this study was to describe the service-mix of private general practitioners in Japan, which was recorded using the Australian Dental Association Dental Procedure Code. Some comparisons with previous studies were offered. The youngest age group and adolescents formed only a small percentage of the total patients, while the greatest percentage of patients occurred in the 45–64 year age group. The services provided were mainly restorative, diagnostic, advanced restorative and endodontic services. Preventive services represented a minority of dental activity, especially for young patients. Periodontic and orthodontic services were also remarkable for their low percentage in all age groups. In comparison with an Australian study, the percentage of preventive services was considerably lower. Movement toward a preventive emphasis in Japanese dentistry requires a change in the clinical model, de-emphasizing biomedical and aetiological approaches and placing greater emphasis on the patient and factors affecting dental practice.     

Service-mix in general dental practice in Australia

An understanding of the current service-mix in private general practice in Australia and the factors that may influence its distribution is important in the anticipation of the future practice of dentistry. The present study aimed to describe service-mix, to investigate the association of service-mix with characteristics of presenting patients, and to identify and discuss a number of factors which may be influencing change in service-mix. Service-mix was dominated by restorative, diagnostic and preventive services and a limited number of services accounted for most service provision or dentist time. Both the broad areas of service and more frequently provided services were related to age of presenting patients. Service-mix appears to be changing over time. Changing needs and expectations of patients and philosophies and technologies available to dentists are among factors that push or pull service-mix in new directions. However, changing service-mix and practitioner variation require considerably more exploration.     

Service-mix provided to patients in Australian private practice

Service-mix can reflect changes in demographic factors, oral health, patient demand and treatment philosophies. The aim of this study was to compare service-mix by patient age in 1988 with baseline data from 1983. A weighted, stratified random sample of dentists in Australia was surveyed by mailed questionnaire in 1983 and again in 1988. Service-mix was dominated by restorative, diagnostic and preventive areas. Comparing 1988 with 1983, there were significant increases for diagnostic, preventive, advanced restorative, orthodontic and general areas. Patterns across patient age groups and between years indicated younger patients were being provided with increased preventive services (patients aged 5–11, 25–44 years) and decreased restorative services (patients aged 5–11, 12–17 years), while older patients were being provided with reduced prosthodontic services (patients aged 25–44, 45–64 years), but increased restorative services (patients aged 45–64, 65+ years) and advanced restorative services (patients aged 25–44, 45–64 years).These patterns of service-mix have implications for dental education, research and service delivery.     

Survey of dental practice/dental education in Victoria. Part III. Trends in general dental practice

The responses of practising dentists in regard to clinical time spent and demand trends in dental practice were combined with recent graduates' views of the emphasis given to various disciplines during their undergraduate training in order to provide information which might assist the undergraduate curriculum review. The greatest proportion of clinical time spent by general practitioners on various clinical disciplines was reported to be restorative, preventive, diagnostic and endodontic services. There was evidence to suggest that there is an increasing demand for a broad range of clinical services, particularly in country locations, and that general practitioners appear to be expanding their range of services, including those traditionally offered by specialists. Highest increasing demand over the past five years were for recent advances in 'aesthetic dentistry', endodontics, preventive services, orthodontics, periodontics and fixed prosthodontics. High rates of referral were reported only for fixed orthodontics and major oral surgery. Almost twice as many practitioners overall reported an increase (44 per cent) rather than a decrease (26 per cent) in volume of patients over the last five years. This trend was much more evident in country practices, however, with 55 per cent and 22 per cent compared with Melbourne city, 37 per cent and 29 per cent, increasing and decreasing, respectively. Although dental educators are challenged to ensure that graduates are adequately prepared clinically to meet the demands of dental practice there is mounting pressure to support the introduction of an intern year prior to full registration.     

A survey of the pattern of private general dental practice in Queensland, 1992

In 1987 all non-specialist ADA member private practitioners in Queensland were invited to participate in a survey to determine the number of the various types of permanent restorations placed in one week and the percentage breakdown of the time they devoted to the various areas of dentistry. Results of that survey were published in 1989. The survey with a few minor changes was repeated in 1992. Results show that there has been little change in the pattern of practice over the five years with restorative dentistry still taking a very large proportion of respondents' time and similar materials being used. The dental workforce appears to be relatively stable with low rates of overseas and interstate migration. There is evidence of an increasing number of women dentists in the workforce and this is emphasized by a breakdown of the current undergraduate enrolment.     

Reasons for taking radiographs in general dental practice

This survey investigated the reasons why general dental practitioners take radiographs. 179 (54%) dentists responded and provided information for 2359 patients who were radiographed during a specified week. Of those patients aged less than 15 yr, 62% were radiographed primarily for orthodontic purposes and 22% for caries. In older age groups, caries was the predominant reason for taking radiographs but endodontic assessment assumed increasing importance with age and accounted for 37% of radiographs in patients aged more than 45 yr. Only 8% of patients were radiographed for periodontal reasons. These findings are discussed with respect to the changing pattern of disease and treatment provided in general dental practice.     

A survey of the pattern of private general dental practice in Queensland

All non-specialist ADA member private practitioners in Queensland were invited to participate in a survey to determine the number of the various types of permanent restorations placed in one week and the percentage breakdown of the time they devoted to the various areas of dentistry. Final year dentistry students at the University of Queensland were asked to estimate the projected breakdown of their time in future practice. Results showed that amalgam is still by far the most commonly used material followed by composite resin and glass ionomer cement and that restorative dentistry accounts for the bulk of the practitioners' time. Students' estimations of the work mix were in agreement with those of the practitioners.     

Use of panoramic radiographs in general dental practice in England

The rapid growth in the use of panoramic radiographs provoked this survey of the reasons why general dental practitioners in Avon take such views. Of the 193 dentists who responded, 42 (22%) took one or more panoramic radiographs during a specified week. A total of 195 patients, 8% of those x-rayed, had a panoramic radiograph taken either alone or in combination with other views. Panoramic radiographs were stated to have been taken primarily for the diagnosis of caries (48%) and surgical (24%), periodontal (20%), orthodontic (20%) and endodontic/apical assessment. These findings are discussed with respect to published guidelines on the use of panoramic radiographs and the teaching of radiology in dental schools.     

Prosthodontic management of older severe hypodontia patients in general dental practice: A case series

Although a detailed understanding of the etiology of hypodontia is lacking, there is a need for awareness among dental professionals of the social and psychological consequences of severe hypodontia, as well as knowledge of those affected by hypodontia have ongoing dental treatment needs. Although, there may be a need for immediate referral of children to different specialists for optimal multidisciplinary treatment planning, most older patients with severe hypodontia can be treated by general practitioners. Practitioners therefore need to be aware of the ramifications of the condition and be capable of providing adequate oral health care for these patients and referring them for additional services when necessary. A case-report series is used to illustrate routine prosthodontic treatments that can be offered to older patients in general dental practice.     

Results of a dental fear survey in Japan: implications for dental public health in Asia

The purpose of this investigation was to initiate the study of dental fear in Japan. 415 college students, aged 18-22 yr were surveyed. A standardized questionnaire which has been used in the United States was translated into Japanese and was administered to the students. More than 80% of those surveyed reported some dental fear. Six to 14% of the students reported extreme fear of the dentist. The majority of the subjects admitted that they delayed making dental appointments due to fear. Muscle tension was the most common physiological symptom reported. The dental drill and needle were the most fear-provoking stimuli.     

Association between perception of dentist oversupply and expectations of dentistry: a survey of dental graduates in Japan

Background: The perception that there is a surplus of dentists may be an opportunity to explore attractive career options in dentistry in Japan. Methods: A self-administered questionnaire was mailed to 2,114 graduates of a private dental school in Japan. We asked about the perception of oversupply, rated by a visual analogue scale, work environment factors, potential areas of dentistry and necessary medical subjects for their dental practice. The association of a strong perception of dentist oversupply with work environment factors, dental areas and medical subjects was examined by multivariate logistic regression analyses. Results: The response rate was 66%, and data from 1,203 community dentists were analysed. Most respondents (76%) perceived either a strong or very strong surplus of dentists. A very strong perception was significantly associated with work environment factors, including practising in large cities and earning the second lowest of four levels of annual income, but no further associations were found with either the number of patients treated or with the other two ranges of income. This perception was negatively associated with the number of necessary medical subjects, specifically otorhinolaryngology, but no significant association was seen with the number of potential areas of dentistry. Conclusions: The negative correlation between the aspiration to acquire medical knowledge and the perception of dentist oversupply under the circumstance of the possibly excessive perception among community dentists invites further research on the benefits of teaching oral medicine to graduate entry students to build future working satisfaction.Key words: Perception of surplus, dental practice, dental education, oral medicine     

A survey on the preference for continuing professional dental education amongst general dental practitioners who attended the 26th Asia Pacific Dental Congress

AIMS: To identify the subjects of interest and to examine the modes as well as means of study for continuing professional dental education amongst general dental practitioners who attended the 26th Asia Pacific Dental Congress, 28 May-1 June 2004, Hong Kong. METHODS: A total of 381 general dental practitioners as the registered conference delegates from Hong Kong, Mainland China and other Asia-Pacific regions were randomly selected for the present survey. The survey was conducted through face-to-face interviews by a group of practising dentists in Hong Kong. RESULTS: Overall, orthodontics and prosthodontics were the most popular subjects for clinical degree programmes, whilst oral implantology and cosmetic dentistry were the highly preferred subjects for continuing education courses. Concerning the preferred mode of study for degree programmes, the part-time study mode was chosen by 68.3% of the participating dentists. A didactic teaching approach was preferred by most of the participants (81.7%) for postgraduate study. The majority of the interviewees (76.5%) were interested in a proposed clinical degree programme to be offered jointly by The University of Hong Kong and a leading university in the Mainland. Overall, there was no marked difference in the preference for continuing dental education amongst the respondents from Hong Kong, Mainland China and other Asia-Pacific regions. CONCLUSIONS: The present survey shows the currently preferred specialty areas and subjects for continuing professional dental education amongst the general dental practitioners who attended the 26th Asia Pacific Dental Congress, with didactic teaching as the most preferred mode of study on a part-time basis.     

Survey of dental practice/dental education in Victoria Part I. Questionnaire/general aspects

A questionnaire was designed to canvass the opinions of dentists registered with the Dental Board and resident in the State of Victoria, with a view to assessing the present undergraduate curriculum in relation to clinical dental practice. All respondents were requested to provide information about age, sex, registration, type/location of practice and qualifications. The questionnaire sought opinions from all respondents regarding the priority to be given to basic sciences and medical sciences as well as the introduction of topics not presently included in the undergraduate course. Questions were also posed in relation to physical assessment of applicants for the dental course, the timing of introduction to clinical procedures and the desirability of an intern year (Section A). Other sections were designed to ascertain the current trends and busyness of general dental practice (Sections B and C) and of restricted/specialist practice (Sections C and E), the views of recent graduates and postgraduates with respect to the appropriateness of their training for clinical practice (Sections D and F, respectively) and, in a separate questionnaire, the perceived views of graduating students with respect to their training for registration as dentists. The results of the survey were prepared in the form of four papers, namely, General aspects (Part I). Recent graduates/graduating students (Part II), Current trends in general dental practice (Part III) and Specialist dental practice (Part IV). This paper deals with the results of Section A of the survey which, it is suggested, need to be considered in any review of the curriculum.     

Computer use in private dental practice in Australia, 1991

There was a 70 per cent response to a mail questionnaire to a 1:3 sample of Australian Dental Association members in private practices (n = 1931). Computers were used by 37 per cent of practices. Main computer applications used were for: accounting (84%); patient billing (80%); word processing (79%); and patient recall (61 %). External bureau services were used by 4 per cent of practices with most computers being in-house (single terminal 66%; multiple terminal 33%). The more dentists in a practice, the more likely was a computer to be used. Principal users were secretary/receptionists. Service and software were the most important factors in choice of computer system. Many practice computer users (67%) also had a Personal Computer at home compared with only 36 per cent of the non-users. Many respondents indicated the need for continuing education in computers (67% users; 61% non-users). More than half of the non-users indicated future use of computers for accounting, billing and recall. There has been a considerable increase in the use of computers in private practice (37%) since the Australian Dental Association Dental Practice Survey in 1983/84 (9%).     

Are Polish and Swedish dental graduates adequately prepared for dental practice in the UK? A discussion of the transferability of general dental practitioners in Europe

In the context of European Union harmonization, this article compares the systems of training for general dental practice in three European countries, the UK, Sweden and Poland. A UK perspective is adopted and the question as to whether dentists who have qualified in Poland or Sweden are adequately prepared for practice in the UK is explored. The paper is a result of discussion between providers of dental training in the three study countries. Key similarities, strengths and weaknesses are identified and issues pertinent to the transferability of general dental practitioners within Europe are raised.