Changing image of dental practice

Health planners considering the future delivery of oral health care for ealth planners considering the future delivery of oral health care for the public must include a re-evaluation of their traditional image of the dental practice setting. Issues reviewed are: the decreasing dentist-to-population ratios, increasing numbers of part-time practitioners, marked growth in the size of dental establishments (including "dental spas"), anticipated continuing limitation of governmental financial support despite the ongoing needs of the poor and minority populations, growing numbers of adult individuals with special health care needs who have "aged out" of Medicaid dental coverage, as well as the increasing demand for dental services by the greater numbers of older populations, most of whom lack adequate dental insurance.     

Changing patterns in dental education in Latin America.

The unsatisfactory dental health situation in the majority of the Latin American population, presently not covered by existing dental services, led to a serious questioning of the educational process directed to prepare human resources in dentistry. At the present time, many dental schools in Latin America are trying to find and implement new teaching methods, different curriculum patterns, and even seeking to define new professional and non-professional profiles, in order to meet the tremendous challenge that requires the formation of a different type of dental health personnel capable of introducing definite changes in the way dentistry is conceived and performed in order to cover the needs of a constantly growing population.     

Characteristics of employment and job satisfaction in nontraditional dental hygiene practice settings

Little is known concerning the employment characteristics of hygienists practicing in nontraditional settings. Respondents were identified through screening (n = 38,380) a listing of the entire population of hygienists licensed in the United States. The screening identified 1,301 hygienists practicing in nontraditional settings. These hygienists were mailed comprehensive questionnaires; completed questionnaires were returned by 84.3 percent of the hygienists. Data were collected describing hygienists' reasons for seeking employment in nontraditional settings, their sources of information concerning job opportunities in nontraditional settings, benefits, and job satisfaction. The main source of information concerning employment opportunities in nontraditional settings was "word of mouth." Hygienists were motivated to seek employment in nontraditional settings primarily by a desire for a more challenging position and personal satisfaction. The hygienists were overwhelmingly satisfied with all aspects of nontraditional employment except opportunities for advancement. Respondents were found to receive standard benefits similar to those of employees in other industries.     

General dental practitioners' knowledge of and attitudes towards the employment of dental therapists in general practice

OBJECTIVE: To investigate general dental practitioners' knowledge of and attitudes towards dental therapists, to ascertain the likelihood of their employment in general dental practice, what client groups they would be likely to treat, and to identify the main perceived barriers to their employment in general dental practice. METHOD: Postal questionnaire. SETTING: General dental practitioners in the county of West Sussex. SAMPLING: All dentists holding a contract to provide general dental services in West Sussex were contacted. Final sample size was 200. KEY FINDINGS: Thirty eight per cent of dentists said they would employ a therapist if legislation allowed. Main perceived barriers were cost, lack of knowledge and dentists' acceptance. CONCLUSIONS: In general dentists had a favourable attitude towards dental therapists, although there was a real lack of knowledge about their permitted duties. Most dentists felt therapists should treat children and people with special needs.     

Cardiological (pharmaco)therapy and dental practice

In recent years much progress has been made in the treatment of acute coronary syndromes, heart failure and cardiac rhythm disturbances. Polypharmacy including two antiplatelet drugs (aspirin and clopidogrel) is common in many patients after a percutaneous coronary intervention using a 'stent'. Discontinuation of these drugs for invasive dental treatment may result in coronary rethrombosis. However, in many patients with coronary artery disease, a temporal pause in the use of aspirin appears safe and may decrease the risk of bleeding after a dental procedure. An increasing number of patients with heart failure and/or life threatening rhythm disturbances receive an implantable cardioverter defibrillator (ICD). Such a device, equipped with a left ventricular lead, also stimulates the left ventricle in case of delayed electrical conduction (e.g. a left bundle branch block). This so called cardiac resynchronization therapy decreases morbidity and mortality in selected patients. ICDs are safe in the dental office even in case of discharge. In patients with prosthetic heart valves, endocarditis prophylaxis according to the current guidelines is recommended before invasive dental treatment. Dentists are advised to contact the Dutch Thrombosis Service to discuss the dose of oral ancicoagulants and the required INR value. In case of urgent and/or extended dental procedures, admittence to a hospital must be considered to secure optimal therapy.     

Hygienist employment and the presence of periodontal notations in general dental practice patient records

Available data suggest that the provision of periodontal ly related services in general dental practices is low. However, studies indicate that the employment of dental hygienists is associated with increased provision. One method of measuring is by examination of notations in patient treatment records. As part of a project assessing the effectiveness of professional education in changing the provision of periodontal services, 2280 records, comprising 60 randomly selected records of dentate adult patients who had received a dental examination in the previous 6 months were audited in each of 38 practices, 13 of which employed hygienists. Entries of a periodontal nature were classified under 3 categories: diagnostic, preventive and treatment. The presence or absence of each item on each record was recorded. Diagnostic services were notated infrequently overall, but practices employing hygienists had a significantly lower number of records with no diagnostic notations. Preventive items were more frequently notated in practices employing hygienists. Treatment items were most frequently notated in both types of practices. Overall, 13 of the 23 items were recorded significantly more frequently in practices employing hygienists.     

International employment in clinical practice: influencing factors for the dental hygienist

Purpose: To assess demographics, job characteristics, geographical regions, resources and commitment, which influence dental hygienists seeking international clinical practice employment opportunities. Methods: Questionnaires were mailed to a convenience sample of members of the Dental Hygienists’ Association of the City of New York. Statistical analyses were conducted and frequency distributions and relationships between variables were calculated. Results: Seventy‐two percent of respondents reported that they are or may be interested in working overseas. Italy and Spain (67%) were the regions of most interest. Salary (65%) was cited as the most influencing factor in selection, whereas non‐compliance with the equivalency to Occupational Safety and Health Administration standards (74%) was the most frequently perceived barrier. Multiple language fluency was statistically significant (0.003) regarding interest in overseas employment. Conclusion: Policy makers, employers and educators need to be aware of these findings should recruitment be a possibility to render urgently needed oral hygiene care in regions where there is a perceived shortage of dental hygienists.