Dentists

Aim  To determine the attitude of Spanish general dentists in relation to dental extraction in patients with heart valve prostheses subjected to acenocoumarol anticoagulation.Material and methods  A telephone survey was made of Spanish general dentists, asking about the indicated approach in the case of performing dental extractions in patients with heart valve prostheses subjected to acenocoumarol (Sintrom®) anticoagulation.Results  Of the 271 dentists answered, 175 were male (64.6%) and 96 were female (35.4%), with a mean professional experience of 20.17 ± 9.3 years. A total of 228 dentists (84.1%) indicated the need to refer the patient to a specialist for establishing the required approach, while 43 dentists (15.9%) did not consider such a measure to be necessary. Among this latter group of 43 dentists, 26 (60.5%) considered that acenocoumarol should be withdrawn or replaced by low-molecular weight heparin, while 17 (39.5%) were of the opinion that the anticoagulation regimen should not be modified. In relation to the international normalized ratio, 36 (83.7%) did not consider it necessary to request this parameter. As regards the prevention of endocarditis, 11 (25.6%) specified the need for prophylaxis, although only eight (72.7%) did so correctly. There were no statistically significant differences in behaviour in relation to either gender or years of professional experience.Conclusions  This study identifies a lack of knowledge on the part of the dentists regarding the approach to dental extraction in patients with heart valve prostheses subjected to anticoagulation. Due educational measures therefore should be reinforced among these professionals.

Diabetes has become an epidemic and the incidence of undiagnosed diabetes is growing at an alarming rate. Diabetes is an associated risk factor for chronic periodontitis and has several other oral symptoms including dry mouth and oral infection. Expanding the role of the dentist may prove to be an efficient method of early detection and management of diabetes. The aim of this paper is to critically analyse the literature and determine whether screening for undiagnosed diabetes mellitus is within the dentist's scope of practice. A PubMed/Google Scholar/Google literature search was conducted of papers published in the English language in the years 1980-2013. Over 140 articles were examined. Reference lists of key articles were also sourced and analysed. The most pertinent articles are presented in this review. Screening for diabetes mellitus in the dental office should only be carried out for high-risk patients in order for such screenings to be cost-effective. Dentists have an et...

Objectives: This study assessed the geographic distribution of dentists in Kentucky, determined socioeconomic correlates of practice location, estimated the future availability of dental providers, and made policy recommendations that could improve access to oral health care in Kentucky and other rural states.Methods: Dentists' addresses were mapped using a geographic information system. Poisson regression modeling and geospatial analyses were conducted using SAS v9.1 (SAS Institute, Cary, NC, USA) and ArcGIS v9.2 (Environmental Systems Research Institute Inc., Redlands, CA, USA), respectively. Data on the number of dentists (n = 2,391) per county (n = 120) were used for the regression models. Explanatory variables included: per capita income, 2006 intercensal population estimates, percent adults with six or more teeth removed, percent population uninsured, physician-to-population ratios, and region type. A simulation model was used to project dentist-to-population ratios to the year 2016.Results: The dental workforce analysis revealed disparities in the distribution of dentists between rural, urban, and Appalachian Kentucky counties. Dentists were more likely to be found practicing in areas with higher income and higher physician-to-population ratios. Compounding this geographic maldistribution, our projections suggest that the number of dentists per unit population will decrease over time in the near future, likely widening this disparity in rural and underserved areas.Conclusions: These results show present and widening workforce disparities in rural and socioeconomically depressed counties in Kentucky. Understanding the geographic distribution of dentists and the socioeconomic correlates of their practice locations may inform workforce development and reimbursement policies for the goal of improving access to oral health care in these areas.

The University of Minnesota School of Dentistry launched its new dental therapy program in September 2009 after the Minnesota state legislature had authorized the training and practice of a dental therapist in May of the same year. The creation of this mid-level dental provider is seen as a workforce solution to help address the problem of access to dental care experienced by some members of our society. However, there is a lack of consensus and even controversy in organized dentistry about dental therapy, one of the mid-level provider models. This study explored the attitudes and perceptions of dental school faculty members who have been tasked to prepare these new dental therapists to do their work. Focus groups were conducted with a randomly selected group of faculty members, the results of which were used to develop a survey of faculty members in all departments of the school. A total of 151 faculty members responded to the survey: 68 percent of these respondents were fifty-one ...

Job stress is common in health care professionals in the west. Less is known about its prevalence in Middle Eastern countries. To determine job stress, its sources and its effect on health care professionals in northern Jordan. A simple random sample of 101 physician specialists, 126 dentists, 52 general practitioners and 123 pharmacists in northern Jordan completed a socio-demographic questionnaire, the General Health Questionnaire, and addressed structured questions about job stress. Descriptive statistics and multivariate analyses were used to describe and compare participants, and a binary logistic regression was used to identify factors associated with stress and reported health problems. Of the 402 health care professionals, 27% reported high levels of stress. Prevalence was highest among general practitioners (33%), then dentists (30%) and pharmacists (25%). The lowest stress was among physician specialists (12%). Factors associated with the highest stress were being a genera...

The Pacific AIDS Education and Training Center (PAETC) developed and tested over time a curriculum to meet the changed HIV/AIDS-related needs of dental health professionals. The objective of this study was to evaluate the HIV-related knowledge, attitudes/beliefs, and behaviors among the participants of a CE training course based on this curriculum, both before and six weeks after the completion of the course. The project recruited 106 participants who were dental health professionals over a ten and a half year period (1992-2003). The dental participants consisted of 79 percent dentists and 21 percent dental hygienists or dental assistants. The sample was 67 percent male, 33 percent female, 45 percent Caucasian, and 24 percent Asian. An adapted questionnaire was used before and after the training to assess the educational needs of the participants and evaluate the success of the program in meeting those needs. Approximately 81 percent of the participants completed both questionnaires...

Fifty-three years ago, M. M. House devised a classification of patients on the basis of how they behaved in response to the prospect of becoming edentulous and on how they subsequently adapted to wearing complete dentures. Although House's system was an important contribution, it failed to consider the dentist's emotional reaction to a patient's behavior as part of an understanding

To determine the ethical problems faced by dental practitioners, a cross-sectional survey was conducted in Bapuji Dental College and Hospital, College of Dental Sciences and private dental clinics in the city of Davangere. A questionnaire with close-ended questions on eight scenarios was administered to the 135 study participants. In the case of scenario 1, 81.4% of the participants said that the doctor had violated the principle of truthfulness. As for scenario 2, less than 50% of the participants replied that the doctor had breached ethical principles. In case scenario 3, 93% felt that the doctor should have taken the physician's opinion before extracting a tooth. Most dental practitioners faced ethical dilemmas because of the lack of awareness, and there is a need to introduce certain programmes to promote knowledge of ethics.

Objective:  To determine if interproximal reduction of teeth (IPR) is perceived differently by orthodontists and general dentists. Materials and Methods:  A Web-based survey containing statements about IPR was developed and randomly distributed to orthodontists and general dentists. Results:  The majority of orthodontists and general dentists strongly agreed that IPR is a minimally invasive procedure that poses little risk for the development of interproximal decay. However, general dentists were more likely to perform post-IPR polishing and to apply topical fluoride than are orthodontists (P < .0001). A greater percentage of orthodontists strongly believed that the esthetic and occlusal benefits of IPR outweigh the potential risk of tooth decay when IPR was performed (P < .0001). A greater percentage of general dentists were hesitant to perform IPR, despite research supporting that IPR has little negative effect on the health of teeth. Conclusions:  The results of this study ...

Hepatitis B and C in doctors and dentists in Nigeria ... IO OLUBUYIDE, SO OLA, B. ALIYU, OO DOSUMU1, JT AROTIBA2, OA OLALEYE3, GN ODAIBO3, SO ODEMUYIWA3 and F. OLAWUYI4 ... From Departments of Medicine, 1Restorative Dentistry, and 2Oral & Maxillofacial ...

Aim To investigate the attitudes of general dental practitioners (GDPs) and endodontists in the UK towards management of fractured endodontic instruments.Methodology A questionnaire was sent to 330 systemically selected GDPs and all endodontists working in the UK (170). It was accompanied by a covering letter explaining the aims of the study and indicating that all the information given would remain confidential. Those who did not respond to the first mailing were sent another two mailings. Data were analysed using chi-square test at P ≤ 0.05.Results The overall response rate was 75%. Only 18.5% of respondents reported that they would retrieve instruments located in the apical third of root canals with a significantly higher proportion of endodontists (25.9%) compared with that of GDPs (14%) doing so. A significantly higher proportion of endodontists (98.5%) used ultrasonics for removal of fractured instruments compared with GDPs (75.8%). The most common complication of fractured instrument retrieval was thought to be excessive removal of dentine (67%). The majority of respondents (88.5%) reported that they would leave the unsuccessfully removed file in situ and obturate the root canal.Conclusion Both endodontists and GDPs were aware of the limitations of root canal anatomy when removal of fractured instruments was considered. Excessive removal of dentine, the most common complication associated with the removal process, suggests the need for more conservative techniques. Both endodontists and GDPs demonstrated a conservative approach when management of fractured instruments failed. Further studies regarding attitudes of GDPs and endodontists towards some specific aspects of fractured instruments management are required.

This study explores how dentists explain the concept of social responsibility and its relationship to issues affecting access to oral health care by vulnerable segments of the population. Analysis of open-ended interviews with thirty-four dentists, including dental educators, and administrators and officials of dental public health programs in Canada and the United States revealed that four main themes-economics, professionalism, individual choice, and politics-influenced the respondents' sense of social responsibility in dentistry. There was a belief that social responsibility in dentistry is dominated by economic imperatives that impact negatively on the policies and practices directing access to care. Yet, despite the highly critical stance on dentistry as a business, there was practical recognition of the economic realities of dental practice. Nevertheless, those who focused on social responsibility as a professional obligation highlighted the privileges of self-governance a...

In line with findings throughout Australia, rural, remote and Indigenous Western Australians suffer from a higher burden of oral disease and have less access to dental practitioners and care than their urban and non-Indigenous counterparts. With workforce projections indicating an increase in the shortage of dental practitioners, especially in rural and remote areas, the Centre for Rural and Remote Oral Health (CRROH) in Western Australia set out to establish a sustainable programme to service such increasingly disadvantaged populations. Via the vertical integration of education, service and research CRROH pioneered a sustainable model to deliver much needed oral health services to some of Western Australia's most remote areas, while primarily focused on addressing the oral health needs of Indigenous Australians. One of the key lessons from the programme has been the development of a strong clinical governance framework and a support network to sustain services in remote locatio...

Clinical success of ceramic laminate veneers depends on material selection, bonding procedures, controlled laboratory steps, and enamel preservation. Enamel preservation is the most critical because excessive tooth preparation can expose dentin reducing bond strength, which is a factor that can cause a decrease in long-term clinical success. The proposed technique based on carefully treatment planning developed between clinician and dental technician helps to maximize enamel preservation, which is an important element for clinical success.

The Australian Dental Council is responsible for the assessment of overseas-qualified dentists seeking to practice dentistry in Australia. The aim of this paper is to reflect on the Council's assessment and examination process through the experiences and perceptions of overseas-qualified dentists in Australia. Qualitative methods were used. Life stories of 49 overseas-qualified dentists from 22 nationalities were analysed to discern significant themes and patterns. We focused on their overall as well as specific experiences of various stages of the examination. The analysis was consistent with a hermeneutic phenomenological approach to social scientific research. Most participants referred to 'cost' of the examination process in terms of lost income, expenses and time. The examination itself was perceived as a tough assessment process. Some participants seemed to recognise the need for a strenuous assessment due to differences in patient management systems in Australia c...

The purpose of this study was to determine the prevalence of and risk factors for neck pain in dentists of Tehran province and to analyze the association of neck pain with individual and occupational characteristics. Following ethical approval, a cross sectional study was conducted on 300 randomly selected dentists at Tehran city. Different questionnaires were used to collect personal and occupational characteristics as well as the prevalence and risk factors of neck pain. The Iranian validated version of visual analogue scale and neck disability questionnaires were also used to assess the pain intensity and functional disability of neck, respectively. Point, last month, last year and lifetime prevalence of neck pain were 19.3%, 27.3%, 29.9% and 34.7%, respectively. The prevalence of neck pain was significantly correlated with regular exercise, general health condition and having an assistant (P< 0.05 in all instances) and was not significantly correlated with body mass index, ag...

As a signatory to the World Health Organisation 2003 Framework Convention on Tobacco Control, Malaysia has policies in place and funded 300 public Quit clinics. Unfortunately, government dentists are not included to run tobacco dependence treatment. A cross-sectional exploratory survey was carried out to seek Malaysian dentists' opinion on their knowledge, perception and willingness to conduct tobacco dependence treatment. Participation was voluntary from those who attended a specially designed one-day, four-module workshop on tobacco cessation intervention. Data were collected using the Audience-Response-System equipment which tracked immediate responses covering four domains namely: smoking as a public health problem, smoking as an addiction, the role of dentists in the programme and confidence in conducting smoking cessation in the clinic. Sample comprised more female dentists (73.5%), mean age 33.6 (SD 8.99) years and with more than 3 years working experience. Findings indic...

This article discusses caries management by risk assessment for children age 0-5. Risk assessment is the first step in a comprehensive protocol for infant oral care. The program includes opportunities to establish a "dental home" and provide guidance for improved health outcomes. Risk assessment forms, instructions for use, and guidance-related education points have been included. Collaboration among all health professionals regarding early and timely intervention to promote children's oral health and disease prevention is emphasized.

In comparison with people in other occupations, dentists and dental hygienists are at increased risk of developing work-related musculoskeletal disorders, including carpal tunnel syndrome. An important risk factor in dental practice is forceful pinching, which occurs during dental scaling. Ergonomically designed dental instruments may help reduce the prevalence of MSDs among dental practitioners. In the authors' study, 24 dentists and dental hygienists used 10 custom-designed dental scaling instruments with different handle diameters and weights to perform a simulated scaling task. The authors recorded the muscle activity of two extensors and two flexors in the forearm with electromyography, while thumb pinch force was measured by pressure sensors. Handle designs of periodontal instruments had significant (P < .05) effects on hand muscle load and pinch force during a manual scaling task. The instrument with a large diameter (10 millimeters) and a light weight (15 grams) required the least amount of muscle load and pinch force. There was a limit to the effect of handle diameter, with diameters larger than 10 mm having no additional benefit; however, the study did not identify a limit to the effect of reducing the weight of the instrument, and therefore instruments lighter than 15 g may require even less pinch force. The results from this study can guide dentists and dental hygienists in selection of dental scaling instruments.