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Objective: The study aimed to analyse the usefulness of signalling waiting times to citizens on the websites of public primary oral healthcare providers in Finland. Finnish laws require this signalling. Material and methods: We gathered data with two cross-sectional surveys in 2021. One electronic questionnaire was for Finnish-speaking citizens in Southwest Finland. The other was for public primary oral healthcare managers (n = 159). We also gathered data on 15 public primary oral healthcare providers' websites. For the theoretical framework, we combined the agency and signalling theories. Results: Of the citizen respondents (n = 411), 57% knew about the waiting time signalling on the websites. The respondents considered waiting time a high-priority criterion in choosing a dentist, but they rarely searched for information anywhere on the choice of a dentist, wanting to visit the dentist they had earlier visited. The quality of signalled waiting times was low. One out of five managers (response rate 62%) answered that signalled waiting times were based on speculation. Conclusions: Waiting times were signalled to comply with the legislation rather than to inform citizens and to reduce information asymmetry. Further research is needed to acquire information on rethinking waiting time signalling and its desired goals. [ABSTRACT FROM AUTHOR]

The population in many countries is becoming more diverse. The number of people from foreign backgrounds is growing in Finland as well. The aim of this study was to better understand how the foreign background of a patient affects the dentist's work. The research was carried out as a semi-structured interview. Six dentists from Helsinki municipality public dental care were interviewed between December 2019 and January 2020. After the interviews were transcribed verbatim, two members of the research group read individually the interviews to find emerging themes. The most common problems that arose in the interviews were problems within communication and interpretation. Periodontal diseases and the importance of self-care in treating them were observed to be unfamiliar to many foreign-background patients. The dentists also noticed different expressions of pain among foreign-background patients compared with native Finnish patients. The interviewed dentists thought that the length of time a patient had lived in Finland affected the experienced difficulties and the prejudice that the patients and dentists faced. In this qualitative research, we were able to identify some of the common difficulties that the dentists experience while treating patients from foreign backgrounds, despite the small number of participants. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the experiences, attitudes and knowledge of child abuse and neglect (CAN) among dentists, dental hygienists and dental nurses in Finland., Material and Methods: A web-based CAN survey was sent to 8500 Finnish dental professionals, covering demographic characteristics, dental education, suspicion of CAN, actions taken and reasons for inaction as well as training on CAN issues. The chi-squared (χ 2 ) test was used to analyse associations., Results: In total, 1586 questionnaires with valid data were completed. Among respondents, 25.8% had received at least some undergraduate training and 36.3% had received postgraduate training on child maltreatment issues. In addition, 43% of respondents had at least one suspicion of CAN at some point during their career. Of those, 64.3% did not refer to social services. Training positively associated with the identification of CAN and referral frequencies. Uncertainty about an observation (80.1%) and a lack of knowledge regarding procedures (43.9%) were the most frequently reported barriers., Conclusions: Finnish dental professionals need more education on child abuse and neglect issues. Competence related to CAN is fundamental to their skills given that all dental professionals regularly work with children and are obligated to report their concerns to proper authorities.

Objective:The work of a health care leader is demanding; in order to cope, leaders need motivation and support. The occurrence of intrinsic factors called career anchors (combination of one’s competence, motives and values) could be a contributing factor in dentist leaders’ career decisions. The aim of our study was to identify dentist leaders’ career anchors and their association to dentist leaders’ retention or turnover of the leadership position. Material and methods:Materials were gathered in 2014 via an electronic questionnaire from 156 current (Leaders) or former (Leavers) Finnish dentist leaders. Career anchor evaluation was conducted by the questionnaire and scoring-table taken from Edgar Schein’s Career Anchors Self-Assessment. Both the most and the least important career anchors were detected by the highest and lowest scores and their occurrence reported as percentages. Associations between career anchor scores and tendency to stay were analyzed with logistic regression. Results:‘Technical/Functional Competence’ and ‘Lifestyle’ were most frequently reported as the most important and ‘Entrepreneurial Creativity’ and ‘General Managerial Competence’ as the least important career anchors. However, a higher level of ‘General Managerial Competence’ anchor was most significantly associated with staying in a leadership position. Instead, ‘Pure Challenge’ and ‘Lifestyle’ decreased the odds to stay. Conclusions:The knowledge of the important and essential career anchors of dentist leaders’ and individuals’ could perform crucial part in career choices and also in planning education, work opportunities and human resource policies promoting retention of dentist leaders and probably also other health care leaders. [ABSTRACT FROM PUBLISHER]

Objective: Few studies of patient harm and harm-prevention methods in dentistry exist. This study aimed to identify and characterize dental patient safety incidents (PSIs) in a national sample of closed dental cases reported to the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland.Materials and Methods: The sample included all available fully resolved dental cases (n = 948) during 2000-2012 (initiated by the end of 2011). Cases included both patient and next of kin complaints and notifications from other authorities, employers, pharmacies, etc. The cases analyzed concerned both public and private dentistry and included incident reports lodged against dentists and other dental-care professionals. Data also include the most severe cases since these are reported to Valvira. PSIs were categorized according to common incident types and preventability and severity assessments were based on expert opinions in the decisions from closed cases.Results: Most alleged PSIs were proven valid and evaluated as potentially preventable. PSIs were most often related to different dental treatment procedures or diagnostics. More than half of all PSIs were assessed as severe, posing severe risk or as causing permanent or long-lasting harm to patients. The risk for PSI was highest among male general dental practitioners with recurring complaints and notifications.Conclusions: Despite some limitations, this register-based study identifies new perspectives on improving safety in dental care. Many PSIs could be prevented through the proper and more systematic use of already available error-prevention methods. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate cooperation between dentists and denturists in Finland, particularly in relation to perceived competition between the two professions. From a representative sample of 350 private dentists and 253 denturists, 68% returned acceptably filled-in questionnaires dealing with competition and cooperation with other healthcare professionals. Dentists referred their patients significantly (P < 0.001) less often to denturists (26.2%) than denturists did to dentists (94.1%). Those who referred their patients to members of the other profession also received patients from the other profession significantly (P< 0.001) more often than those who did not (60.7% vs 16.7% among dentists; 90.0% vs 44.4% among denturists). Denturists saw themselves as competing with dentists (56.0%) significantly (P< 0.001) more often than dentists did with denturists (29.2%). Dentists practicing in small towns or rural areas cooperated more often with denturists than did those practicing in more urban areas. Among denturists, the likelihood of referring patients to dentists was associated with younger age and fewer clinical working hours. It was concluded that cooperation between dentists and denturists was common. Oral healthcare professionals who referred their patients to the other profession also benefited by receiving more patients on referral from them. Dental services provided by denturists are limited, which may explain their greater willingness to cooperate with dentists. [ABSTRACT FROM AUTHOR]

One thousand Finnish people aged 20 years and more were interviewed to investigate how people perceive dentists' yellow page advertisements and which attributes they find attractive. Each subject was asked to identify the advertisement that captured his/her attention the most and which one least from a double-page spread of dentists' yellow page ads. The subjects were then asked to give the reason for the decisions, which was duly recorded. Various characteristics of the ads were recorded. In the analyses the five most commonly attractive and the five most commonly unattractive ads were compared with all the others shown to the subjects. The five most commonly chosen attractive advertisements were larger and had less text density than the others (P < 0.001). In contrast, use of frames decreased by fourfold the probability of being chosen. The subjects most often reported use of pictures or photograph, clarity of the ad, and large size as the reasons for choosing their favorite ad. Commonly expressed reasons for disliking an ad were small print, being boring or uninformative, and an unclear or muddled look. All three ads designed by advertising professionals were among the five most commonly attractive, whereas all five most commonly unattractive ads were planned by dentists themselves. Dentists plan their yellow page advertisements alone much too often. This results in ads that consumers do not necessarily distinguish from the mass of others. Consumers appreciated use of a picture or photograph and a clear message in large ads. Common criticisms were small print and a boring, uninformative, or unclear appearance. [ABSTRACT FROM AUTHOR]

Studies in the Scandinavian countries have shown that orthodontists run an equal or even greater risk of contracting dermatitis compared to other dental personnel. The aim of the study was to find out whether the self-reported occupation-related health problems of general dental practitioners and orthodontists differ from those of office employees in Finland. The subjects were 147 general dentists, 81 orthodontists and 99 office employees (77% women and 23% men). The data were collected using a mailed questionnaire. Within the past year, 42% of the subjects had had occupational health problems, while 51% had experienced symptoms in the previous year or earlier. The complaints of hand dermatoses, musculoskeletal, as well as respiratory symptoms were significantly more common among women than among men. Musculoskeletal complaints were the most common symptoms in all occupational groups, but the odds ratio of having them were significantly higher for dental professionals compared to office employees. The frequency of self-reported hand dermatoses was 42% for dental professionals and 26% for office employees, but the difference did not reach statistical significance. The odds of having hand dermatoses were higher for atopic subjects and for women. Orthodontists did not differ from general practitioners in respect of any of the complaints reported. Materials used in dentistry were mentioned as the cause of symptoms by 49 (21.5%) of the dental professionals. The present results show an increased risk of self-reported musculoskeletal symptoms for the dental professionals. Also, a tendency towards increased occurrence of skin symptoms was noted for the dental professionals compared to office employees of this study. [ABSTRACT FROM AUTHOR]

Objective: The aim was to investigate how leading dentists and their superiors view oral health care quality, as they are in key positions to pursue high-quality care., Materials and Methods: We interviewed five leading dentists and three of their superiors from Southern Finland via semi-structured telephone interviews including themes based on the Institute of Medicine's six quality dimensions. The material was analysed using theory-driven content analysis., Results: Participants divided safety into occupational, instrumental and patient safety and considered timeliness as timing treatment clinically correctly. They also linked timeliness to patient-centeredness with wider opening-hours and quick access to care. Effective care was considered as a prerequisite for efficiency. Participants saw effectiveness as treating the illness, not the number of treatment measures. Leading dentists took survival time of fillings and cost per operation as a measurement of efficiency, and the superiors measured efficiency by the number of treated patients or visits. The leading dentists considered the equal treatment of patients, whereas the superiors took the amount of care provided with public resources and co-workers into consideration., Conclusions: The participants shared similar views of oral health care quality which should enable cooperation. Observed minor differences relate to professional background and leading positions.

Dentists' selection of measures for assessing oral health risk factors for young adults, in relation to their oral health status and to those dentists' characteristics, was studied in one administrative unit of the Finnish public oral health service. A random selection (n = 239) was made of all young adults born in the period 1966-71 and clinically examined during 1994. On the original oral health records of those selected, all notes were scrutinized concerning the most recent clinical examination and treatment course; in total 208 (87%) records. We found that assessment of risk factors to oral health was rare. The patient's diet had been recorded as assessed in 7% of all cases, use of fluoride in 8%, and oral hygiene habits in 14%. No salivary tests were performed; nor was patients' use of tobacco assessed. No correlation was detected between measures used by these dentists and their patients' oral health status (DMFT and DT scores, number of approximal incipient lesions, and number of healthy sextants by CPITN). The oral health status impelled only slightly assessments by bite-wing radiographs. Fewer than half (44%) of the dentists performed and recorded any kind of assessment measure; 4% assessed diet, hygiene, and use of fluoride for all their patients in our sample. A dentist's gender showed no correlation with number of measures used; younger dentists tended to perform and record assessments slightly more often than did older dentists, but in all age groups there were those who had not done this. The practice of risk-factor assessment should be more widespread and standardized, contributing to needs-based treatment and allocation of resources. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the quality of oral health record-keeping in public oral health care in relation to dentists' characteristics. A random computerized selection of 239 subjects, born in 1966-71 and clinically examined during 1994 in an administrative unit of the public oral health service in southern Finland, included 4-5 cases per dentist, the number of dentists being 50. Data concerning actual clinical examinations and treatment courses carried out in public dental clinics came from original oral health records. Criteria for assessment of oral health record entries were based on Finnish health legislation and detailed instructions of health authorities. The results showed that each patient's identity was available in 90% of documents. Recordings concerning continuity of comprehensive care were infrequent; a questionnaire concerning each patient's up-to-date health history was in only 26% of the oral health records. Notes concerning each patient's bite and function of the temporomandibular joint were in 37% of the records, notes about oral soft tissues were in 11%, and the check-up interval was recorded in 21%. Recording of indices on periodontal and dental status varied greatly; the community periodontal index of treatment need was found in 93% and the index of incipient lesions in 16% of the records. Female dentists and dentists younger than 37 years tended to record more information. Dentists should be encouraged to better utilize the options offered by oral health records for individual treatment schemes. [ABSTRACT FROM AUTHOR]

Objectives: To investigate Finnish dentists' knowledge on and means of recording, detecting and diagnosing erosive tooth wear (ETW). Treatment options and possible differences in treatment decisions between general and specialized dentists were also evaluated., Materials and Methods: An electronic questionnaire was sent by e-mail to 3664 Finnish dentists. Respondents' gender, age, work experience, field of specialty, and practice location were requested. The questionnaire also included a patient case where the dentists were asked about their choice of treatment. Statistical analyses were performed using means, proportions, and cross tabulations., Results: Response rate was 24% ( n  = 866). Almost all respondents (98.0%) recorded ETW in patient files, but only 4.1% used a detailed scoring system. Of the respondents, 64.4% usually found the cause of ETW. Use of carbonated beverages (84.3%), energy drinks (57.0%), and reflux disease (53.1%) were reported to be probable causes. The majority of the respondents (80.9%) usually assessed patient's dietary history while 1.9% evaluated saliva secretion rate. When asked about treatment decisions of ETW patients, the differences between general dentists and specialized dentists were not as obvious as hypothesized., Conclusions: This study suggests that the Finnish dentists who participated in this survey are able to detect and/or diagnose erosive tooth wear, but there is variation in recording it. The differences in treatment decisions between general dentists and specialized dentists seem to be moderate. The treatment practices for ETW are not established and further research to create clinical guidelines seems to be needed.

Background: Few data are available on dental patient safety (PS), as most PS studies have focused on other activities in health care., Objective: To detect types and causes of dental PS incidents (PSIs), including adverse events (AEs) and near misses (NMs), in Finnish dental care., Material and Methods: Altogether 1041 privately or publicly employed dentists in southern Finland completed a structured questionnaire using an internet-based system (Webropol) in 2010., Results: Nearly one third of the dentists reported some PSI in the previous 12 months. Of the 872 reported events, 53% were classified as AEs, 45% as NMs and 2% remained unclassified. Nearly half of the PSIs had occurred during some form of dental treatment. One third of the AEs were related to dental equipment, devices and supplies. Most of the reported AEs resulted in little or no permanent harm to patients. However, 13% of AEs were considered as serious enough to potentially cause severe harm or did in fact cause permanent harm., Conclusions: Reported dental PSIs in Finland are in many respects similar to those reported in other countries. Compared to all annual dental visits in Finland, severe dental AEs seem to be relatively rare. Less severe AEs and NMs are not uncommon, especially in dental surgery, endodontic and restorative treatment. The results of this retrospective study, however, reveal more about incident types than their true prevalence and that further studies on dental PS are needed.

The aim of the study was to evaluate the coverage of and time used for caries preventive actions by patient and by dentist's characteristics in relation to caries status and orthodontic treatments in patients from birth to 18 in public dental care in Helsinki City Health Department, Finland. Data on caries prevention for the age groups 0- to 18-year-olds in 1999 were analyzed in relation to patient age, caries status, orthodontic care, and dentist's characteristics. Our study comprised a total of 48,040 patients treated by 140 dentists. Main outcome measures were the coverage of and time used for repeated caries prevention performed during visits following the check-up visit. Nine percent of those under age 6 received repeated caries prevention, 29% of the 6- to 15-vears-olds and 24% of the 16- to 18-year-olds. Nineteen percent in the no-caries group (DMFT/dmft = 0) and 36% in the high-caries group (DMFT/dmft > 0 and DT + dt > or = 3) received repeated caries prevention. The average time a dentist used in repeated caries prevention was 3.6 min (s 3.1: median 2.8; range 0.2-15.4 min) for those in the no-caries and 8.1 (s 6.2; median 7.3; range 0.0-31.8 min) for those in the high-caries group. In each category of caries status, the average time used for repeated caries prevention was shorter for those not under orthodontic treatment. In conclusion, the variation in dentists' caries-preventive treatment practices is wide showing both over- and underuse of caries-preventive actions as judged by needs of patients.

The aim of this study was to identify differences and similarities between the Nordic countries in dentists' use of dental amalgam as a restorative material, and also their knowledge and attitudes about amalgam from health, environmental, ethical, economic and social points of view. Procedures for handling amalgam waste were also studied. A random sample of 250 dentists was drawn from the national registers of authorized dentists in each country in late autumn 1997. At the beginning of 1998, a questionnaire was sent to all the dentists in the study group. The response rate was 77.6% in Denmark, 73.2% in Finland, 78.8% in Norway, and 84.0% in Sweden. In Finland and Sweden the use of dental amalgam had almost ceased, particularly for younger patients, while in Norway and especially in Denmark it was still widely used. Dentists' knowledge of the environmental effects of amalgam was confused, but most dentists had installed amalgam separators in their dental units by 1998. The majority of dentists in each country wanted to keep dental amalgam as a restorative material even in the future, and they did not want to ban the import of mercury to their home countries. Most dentists considered amalgam to be a health risk for at least some patients, and a great majority (from 76% in Sweden to 94% in Norway) considered composite as a possible odontological risk to patients. Since a majority of the dentists considered both amalgam and composites possibly harmful to patients, efforts to develop better alternatives to amalgam should continue.

To improve the continuing education system, a group of dentists who had made little use of continuing education courses offered by the Finnish Dental Society was identified, and their opinions were mapped out and compared with those of dentists who had taken part in the systematic continuing education program. A pretested questionnaire was sent to these respective groups of 725 and 533 dentists, giving 82% and 72% return rates. A fifth of the dentists in service had never made use of the continuing education courses. Compared with all working 30-65-year-old dentists, male dentists, dentists under 35, and dentists working in rural area were over-represented in the group that had taken little part in continuing education. The dentists who had participated in systematic continuing education had also taken part in education organized by others twice as frequently as the control group. Both survey groups reported that they regularly read two professional periodicals on the average. There were only minor differences in the answers of the two groups as to whether they would be interested in participating in courses free of charge. The need for continuing education in orthodontics dominated among employed dentists, whereas self-employed dentists most frequently perceived a need in prosthodontics. Continuing education was generally considered necessary and useful but somewhat expensive.