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Antimicrobial resistance (AMR) is assigned as a menace by the WHO (World Health Organization) where diseases resulting from multidrug-resistant bacteria are refractory to treatment as a result of a scarcity of new antibiotics in the queue. Antibiotic stewardship program is one of the worldwide strategies to advertise responsible use of antibiotics to halt AMR. The world has started facing a postantibiotic era without immediate and integrated action. Common infections which were treatable for decades can once again kill. The dentistry contributions towards antibiotic resistance are substantial. Approximately 10% of all common antibiotics are prescribed by dentists. Antimicrobial stewardship is a policy that can assist us in addressing the problems of antibiotic resistance. It is a framework that promotes the truly sustainable use of antimicrobials in dentistry. It refers to the approach which is multifaceted and incorporates policies, and guidelines along with surveillance, reports of prevalence and education, and audit of practice for reducing prescribing, adopted by health care organizations. The prime strategy is to improve clinical results while mitigating unintended consequences such as toxicity, pathogenic organism selection, and resistance emergence. Such issues should be centralized and the ongoing need to identify and convert "responsible usage" into context-specific and time-specific behavior. The importance of the antibiotic stewardship program, its team, and their action has become a challenge for the dental hospital but along with it, there are numerous opportunities to achieve the goal. [ABSTRACT FROM AUTHOR]

Introduction: Oral lesions are present in approximately 30% of the population worldwide. Although the mouth is an anatomical region that can be easily accessed for direct visual examination, most dentists of dental surgeons have reported difficulties in the diagnosis and management of oral diseases. The primary aim of this study was to assess the completeness of referral forms of the patients referred by dentists from the primary care basic health units to an Oral Medicine service. The secondary aim was to analyze if the complexity of the cases justify the referral to a specialist. Methods: Data from 131 referral forms of patients referred from June 2014 to April 2016 were retrieved from the records. The referral's completeness analysis comprised two stages. Stage 1 mainly comprised patient and applicant's information. In the Stage 2, the documents were scored according to amount of information, including the description of the lesion characteristics and the procedures required for the patients' diagnosis and management. The referral was considered justifiable if some procedures not available at primary care were required for diagnosis or treatment. Results: Five (9.8%) referral forms were considered well filled. Diagnosis agreement was 71.4%. Regarding the need of referral, 40,6% of the cases (n = 50) could be settle at the primary care. Conclusion: In conclusion, few referral forms had high-quality information and the many cases could be managed at primary care health services. [ABSTRACT FROM AUTHOR]

Background and Overview. A 9-year-old girl underwent comprehensive resection and rehabilitation of a central giant cell granuloma that required phased interprofessional collaborative care to optimize treatment decisions and outcome. Case Description. The interprofessional treatment team included an oral and maxillofacial surgeon, maxillofacial prosthodontist, dentist, orthodontist, and speech-language pathologist, and treatment spanned 9 years. Treatment included surgical resection of a central giant cell granuloma and obturation with a removable interim prosthesis. After adequate growth and development, the patient then underwent a surgical free-tissue transfer reconstruction by using virtual surgical planning, followed by dental implant placement and a transitional restoration, subsequent orthodontic therapy, and eventual definitive rehabilitation with an implant-retained fixed hybrid prosthesis. Conclusions and Practical Implications. The interprofessional phased and collaborative treatment facilitated an optimal functional and esthetic process in a young patient with transitional and definitive treatments that considered long-term quality-of-life implications. [ABSTRACT FROM AUTHOR]

This study investigated the use of scientific evidence and the practice of evidence-based dentistry (EBD) among dentists working in Brazil. An online questionnaire was emailed to dentists registered with Brazilian state dental councils. The questionnaire assessed the demographic, educational, and work characteristics of the sample, along with habits in reading scientific articles and other updating resources. Data were analyzed descriptively and by using Bonferroni, Kruskal-Wallis, ANOVA, and T-test statistical methods (α = 0.05). A total of 795 responses were received between June, 2015 and January, 2016. The response rate was not calculated because it was not possible to determine precisely how many dentists received these e-mails. Over 77% of the responding dentists completed postgraduate training. They referred mainly to books, scientific or clinical journals, conferences, and short-term courses for updating their knowledge. Dentists who reported having a habit of reading scientific journals (60.9%) showed a preference for reading case reports, clinical research articles, and literature reviews. Most dentists (77.5%) reported changing their clinical behaviors or procedures based on information gleaned from journal articles. The types of articles that led them to change their clinical practices were primarily clinical research articles and case reports. Working in the public sector was also associated with a lower prevalence of a habit of reading scientific journals and practicing EBD (i.e., self-reported practice). The results suggest that dentists are interested in reading journal articles, especially those addressing clinical outcomes, and that there is room for improving the practice of EBD, particularly in the public sector. [ABSTRACT FROM AUTHOR]

Dentistry is represented to the US public in large part by the various professional associations, which speak for the interests of general and specialized dentists, mostly in private proprietary practice. Unfortunately, the interests of dental professional associations may often be in conflict with those of the public. To resolve this continued disparity, it behooves the dental leadership to become more involved with the overall health care system than continuing to enhance the economic interests of the profession without sufficient regard for the world-wide burden of unmet dental needs. An assessment of policy failures is provided with some recommendations for greater involvement of organized dentistry in the integration of oral and general health care. Dentistry must recommit itself to being a health profession rather focusing on the business aspects of health care. Another aspect to be considered is a reorganization of the American Dental Association to better represent the oral health care workforce. [ABSTRACT FROM AUTHOR]

Background. The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. Methods. We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. Results. Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P = .001). Conclusions. Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. Practical Implications. From these authors' definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists. [ABSTRACT FROM AUTHOR]

Background: Against the background of well-described associations between oral and general health, collaboration between dentists and general practitioners (GP) is crucial to provide therapeutic and preventive patient care. However, in the German health system, GPs and dentists are organizationally separated, implying that interprofessional collaboration can only occur informally and on a voluntary basis. Given the scarce evidence of interprofessional collaboration between dentists and GPs, an explorative study was conducted. This paper outlines the findings of this study with regard to GPs' and dentists' experiences and expectations of interprofessional collaboration.Methods: Semi-structured interviews were conducted with GPs (n = 15) and dentists (n = 13) from three structurally different regions in Baden-Wurttemberg, Germany. The interview guide included questions on occasions, expectations and experiences of interprofessional collaboration. The interviews were transcribed verbatim and analysed using qualitative content analysis according to Mayring.Results: Both GPs and dentists reported perceived knowledge deficits of the other profession with regard to medication, particularly anticoagulants and bisphosphonates, as well as systemic and general respectively dental diseases. Expectations regarding the scope of collaboration diverge: whereas dentists were interested in extending collaboration, most GPs saw no need for collaboration.Conclusions: The perceived medical knowledge deficits of the other profession as well as divergent expectations concerning the scope of collaboration hinder profound and regular interprofessional collaboration between GPs and dentists. These perceived knowledge deficits may be rooted in the separate education of dentists and GPs in Germany. Fostering interprofessional education is a promising way to improve cooperation between GPs and dentists in the long term. [ABSTRACT FROM AUTHOR]

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]

Background: India may face a danger of immediate spread of Ebola Virus Disease (EVD) if it enters the subcontinent. Preparedness for such a condition is a part of its prevention. Dentists form a sizeable chunk of healthcare in India and may help in augmenting the health care team at the time of such outbreaks. This paper details the development and evaluation of a specially tailored program for dental students and faculty for imparting knowledge on EVD and its prevention strategies. Aim: To assess the knowledge score for EVD and its prevention after attending a specially tailored program. Materials and Methods: A multidisciplinary team was selected for content development and providing an insight on the topic. The program was attended by students and faculty members of Manav Rachna Dental College. The knowledge of the attendees about EVD was assessed at the end of the program through a structured questionnaire. The response rate was 96%. Result: According to the knowledge score attained, 52.4% of the participant had good knowledge level and 2.8% had poor knowledge level. There was no significant difference in knowledge scores between the participants having prior knowledge and those having no previous knowledge about the disease (p = 0.135). Conclusion: High response rate and good knowledge level attained by most of the participants established evidence of a successful program. [ABSTRACT FROM AUTHOR]

This first article in the series will define special care dentistry, who requires it and why? It considers recent legislation and its impact on the primary care practitioner, including reasonable adjustments to the way in which dental care is delivered. It offers practical tips to encourage access to the dental practice and transfer to the dental chair and advice on techniques to aid access to the oral cavity for patients with a range of impairments. [ABSTRACT FROM AUTHOR]

Complaints or claims against dentists by dissatisfied patients usually consist of three parts: the dentist did not perform the treatment as s/he should have done; the dentist did not inform the patient properly about the risks involved with the treatment; the dentist did not keep records. In most cases it is not too difficult for a judge or dental board member, if necessary with the aid of an expert witness, to decide whether the treatment was indeed below standard. The same applies to dentist's record keeping. The recrimination concerning the information given is something else. This deals with the extent of the duty to inform a patient as well as the proof that sufficient information was given. These difficulties do not only appear in court, but also in dental surgeries. This article will focus on the evolution in the jurisprudence concerning the duty to inform patients about risks as well as on the recently changed guidelines of the General Dental Council (GDC) regarding informed consent. Finally some simple tests will show that informing patients about risks does not have to be a risky and time consuming business for the dentist. [ABSTRACT FROM AUTHOR]

This series provides an overview of current thinking in the more relevant areas of oral medicine for primary care practitioners, written by the authors while they were holding the Presidencies of the European Association for Oral Medicine and the British Society for Oral Medicine, respectively. A book containing additional material will be published. The series gives the detail necessary to assist the primary dental clinical team caring for patients with oral complaints that may be seen in general dental practice. Space precludes inclusion of illustrations of uncommon or rare disorders, or discussion of disorders affecting the hard tissues. Approaching the subject mainly by the symptomatic approach — as it largely relates to the presenting complaint — was considered to be a more helpful approach for GDPs rather than taking a diagnostic category approach. The clinical aspects of the relevant disorders are discussed, including a brief overview of the aetiology, detail on the clinical features and how the diagnosis is made. Guidance on management and when to refer is also provided, along with relevant websites which offer further detail. [ABSTRACT FROM AUTHOR]

Objective To provide reliability and validity data on a computerised dental anxiety scale (the Smiley Faces Program or SFP) for children using faces as a response set.Setting Five schools across Derby, Newcastle-upon-Tyne and Shropshire.Subjects and method The SFP was completed by 464 children (mean age 10.8 years). For validity purposes, 241 children also completed two other children's dental anxiety measures (the Modified Child Dental Anxiety Scale and the Dental Fear Survey). For test-retest purposes 100 of the children completed the SFP two weeks later.Results The SFP demonstrated good internal consistency (α = 0.8), test-retest reliability was good and significant correlations were found between the SFP and the other measures. The children rated the local anaesthetic and drill as the most anxiety-provoking items.Conclusion This study suggests that the SFP is a valid and reliable measure for assessing children's trait dental anxiety and may help encourage dentists to formally assess dental anxiety. [ABSTRACT FROM AUTHOR]

This series provides an overview of current thinking in the more relevant areas of oral medicine for primary care practitioners, written by the authors while they were holding the Presidencies of the European Association for Oral Medicine and the British Society for Oral Medicine, respectively. A book containing additional material will be published. The series gives the detail necessary to assist the primary dental clinical team caring for patients with oral complaints that may be seen in general dental practice. Space precludes inclusion of illustrations of uncommon or rare disorders, or discussion of disorders affecting the hard tissues. Approaching the subject mainly by the symptomatic approach — as it largely relates to the presenting complaint — was considered to be a more helpful approach for GDPs rather than taking a diagnostic category approach. The clinical aspects of the relevant disorders are discussed, including a brief overview of the aetiology, detail on the clinical features and how the diagnosis is made. Guidance on management and when to refer is also provided, along with relevant websites which offer further detail. [ABSTRACT FROM AUTHOR]

This series provides an overview of current thinking in the more relevant areas of oral medicine for primary care practitioners, written by the authors while they were holding the Presidencies of the European Association for Oral Medicine and the British Society for Oral Medicine, respectively. A book containing additional material will be published. The series gives the detail necessary to assist the primary dental clinical team caring for patients with oral complaints that may be seen in general dental practice. Space precludes inclusion of illustrations of uncommon or rare disorders, or discussion of disorders affecting the hard tissues. Approaching the subject mainly by the symptomatic approach — as it largely relates to the presenting complaint — was considered to be a more helpful approach for GDPs rather than taking a diagnostic category approach. The clinical aspects of the relevant disorders are discussed, including a brief overview of the aetiology, detail on the clinical features and how the diagnosis is made. Guidance on management and when to refer is also provided, along with relevant websites which offer further detail. [ABSTRACT FROM AUTHOR]

Parashos P, Morgan MV, Messer HH. Response rate and nonresponse bias in a questionnaire survey of dentists. Community Dent Oral Epidemiol 2005; 33: 9–16.© Blackwell Munksgaard, 2005(a) To report on response rate and nonresponse bias of a questionnaire survey of dentists. (b) To make recommendations for future questionnaire survey research in dentistry.A questionnaire was mailed to a stratified systematic sample of 908 Australian dentists. The strategy included three mailings, a final telephonic contact, university stationery, paid reply envelopes and personalized correspondence. Nonresponse bias was assessed by comparing responses to a simple‘yes/no’ question from each contact (late responders), and by comparing demographic information (nonresponders).The response rate achieved was 87% and there was no evidence of nonresponse bias based on practice location or year of graduation. The cumulative proportions of‘yes/no’ responses essentially remained constant after each contact, but significantly more late responders answered in the negative to the test question than did early responders. The telephonic contact aided in the identification of nonparticipants and ineligible units.The current survey indicates that differences in data between early and nonresponders can occur despite there being no demographic differences. Therefore, assessment of nonresponse bias based on demographic data alone would seem to be insufficient. Questionnaire survey research must first be based on sound sampling techniques, and then on achieving as high a response rate as possible using the many incentives available. [ABSTRACT FROM AUTHOR]

Ståhlnacke K, Söderfeldt B, Unell L, Halling A, Axtelius B. Changes over 5 years in utilization of dental care by a Swedish age cohort. Community Dent Oral Epidemiol 2005; 33: 64–73.© Blackwell Munksgaard, 2005The purpose of this study was to investigate the temporal development of the utilization of dental care, in relation to socio-economic factors and also considering perceived oral health, attitudes to dental care, dental anxiety, care organisation and changes in the way that dental care is paid for. A conflict model was used as a theoretical framework.In 1992, a mail questionnaire was sent to all 50-year-old persons in two counties in Sweden,Örebro andÖstergötland, as part of a cross-sectional study. This study group numbered 8888 persons. In 1997, the same population was sent a new questionnaire. There were 5363 persons who completed the questionnaire in both 1992 and 1997. Changes in utilization of dental care were analysed.An increase in personal expenditure for care was obvious, 42% paid more in 1997 compared with 1992. In the study, 7% had prolonged their time since most recent visit and 12% had less frequent visits. In regression models, education, occupation, place of residence, country of birth, marital status, gender, dental anxiety, having poor perceived oral health and poor general health were associated with utilization. Care organisation factors showed there was a greater probability of having higher utilization and higher cost of care when private practitioners provided the care.Small changes in the utilization of dental care occurred during this study time. Inequality in utilization existed and socio-economic factors affected utilization as well as health perception and dental anxiety. Changes in the cost of care did not affect utilization appreciably, probably because of a selected population with high price elasticity. Having a private care provider compared with one in the public system affected the probability of having higher utilization and higher cost for care. [ABSTRACT FROM AUTHOR]

The article presents information on the role of patient record as an essential component of the delivery of competent and quality oral health care. It includes reviews of current literature, recommendations of the American Dental Association and current record-keeping by pediatric dental residency programs, dental schools and pediatric dental practitioners, and consultation with experts in risk management. The patient record provides all privileged parties with the history and details of patient assessment and communications between dentist, patient and caregiver, as well as specific treatment recommendations, alternatives, risks and care provided. It is an important legal document in third party relationships.

Carisolv is a minimally invasive method for softening and removing dentine caries. A new, modified Carisolv gel has been developed in order to optimise the efficiency if its chemical caries dissolution. The aim of the present study was to compare the caries removal efficiency of the original gel with that of the new gel, which contains almost double the concentration of sodium hypochlorite. Ten dentists treated 202 cavities in 170 patients; 104 cavities were randomised to the new gel and 98 to the original gel. Their mean treatment times for caries removal were 6.7±4.1 min and 7.6±4.2 min, respectively (P>0.05). In close-to-pulp lesions, constituting 32% of the cavities, the mean times for caries removal were 9.0±7.0 min and 11.6±4.4 min for the new and original gels, respectively (P<0.01). Questionnaires revealed that 81% of the patients preferred chemomechanical treatment to drilling. In conclusion, the improved efficiency of the modified Carisolv gel did reduce the time for caries removal in deep lesions. However, it still needs more time than conventional drilling. [ABSTRACT FROM AUTHOR]

Though the effectiveness of film and strip type tooth-whitening agents on the bleaching of tooth has been confirmed, there have been few studies on their influence on restorative materials. The purpose was to investigate the effect of tooth-whitening film and strip on the changes in color and surface roughness of dental resin composites. The composites used were Filtek Supreme (3M ESPE), Point 4 (Kerr), and Spectrum TPH (Dentsply). Specimens were prepared 10 mm in diameter and 1 mm in thickness. Film type (Night Effect, Crest; Simply White Night, Colgate) and strip type (Whitestrips Professional, Crest; Claren, LG) agents were used, and bleaching procedures were performed for 2 weeks according to the manufacturers’ recommendations. Color was measured according to the CIELab color scale with a spectrophotometer. Color difference (ΔE*ab) and surface roughness (Ra) were measured. After bleaching, the ΔE*ab values were 0.90–1.67, which was too small to be perceptible (<3.3). The increase in Ra values was significant in some composite-whitening agent combinations (P<0.01), however the value was less than 0.30 μm after bleaching. Therefore the change in surface roughness was clinically insignificant. We conclude that the influence of tooth-whitening film and strip on the color and surface roughness of dental resin composites was negligible. [ABSTRACT FROM AUTHOR]

The first National Health Interview Survey to collect data on children, 6 to 11 years of age, with attention deficit disorder (ADD) and/or learning disability (LD) provided specific information on: (1) the widespread demographic distribution of children with ADD and LD, (2) related health conditions, (3) use of special education programs, and (4) the extensive use of health care services. The underlying reality was the increasing need for information because dental practitioners provide services to many of these children in their communities. [ABSTRACT FROM AUTHOR]

Objective: The study was done to determine the quantity of orthodontics and the type of appliance used for orthodontic treatment by general dentist. Materials and Methods: A total of 410 dentists completely participated in the study. The study included questions to know the positive effects of orthodontic treatment done by general dentists and their opinions and qualities regarding the provision of treatment. Statistical Analysis: Statistical analysis was done using SPSS version of 16.0 was used at p ≤ 0.05. Results: One forty six (35.6%) dentists answered that they practice orthodontic treatment to their patients, of which most were providing removable appliances (39.5%). There was a significant difference between the groups toward the benefits of orthodontic treatment according to experience of service and locality. General dentist were providing this treatment mainly in the mixed dentition period i.e. 96(65.8%). Most of the participants gave positive response regarding expansion of their syllabus related to orthodontics. Conclusion: A significant difference in response to the benefits of the treatment were seen according to experience and are of practice and most of the participants showed positive response increasing their courses in orthodontics at undergraduate level. [ABSTRACT FROM AUTHOR]

The purpose of the present report is to establish to what extent dental anxiety is expressed by young adults with a long history of regular dental care, to analyze whether expressions of dental anxiety vary during young adulthood in response to different dental care delivery programs, and to study which factors might account for existing expressions of dental anxiety. The study comprised 697 persons who participated in a longitudinal study on alternative dental care programs, running from the youngsters' 16th to their 19th yr. At the end, Corah Dental Anxiety Scale (DAS) was applied through self-completed questionnaires. Overall DAS- mean was 7.26; women expressed more anxiety than men (7.73; 6.78). Significant association between anxiety expressed at the end and at the start of the study indicated that dental anxiety was probably present at an early age. No association was found with utilization of dental services. A multiple regression analysis indicated early expressed dental anxiety and negative self assessment of dental health as important predictors for dental anxiety, while sex, negative assessment of gingival health, and dental program were of less importance, altogether explaining 22% of the DAS score variation. The risk group concept currently employed by the Public Child Dental Health Services might be extended to include expressions of dental anxiety. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the periodontal conditions in 372 35-44-yr-old and 537 noninstitutionalized 65-74-yr-old Hong Kong Chinese who were examined clinically for loss of attachment, recession, probing depth, calculus, and bleeding after probing. Community Periodontal index (CPI) data and treatment need indications were compiled from index teeth or their substitutes. The prevalence of loss of attachment varied considerably in both cohorts according to the definition of the threshold (≥6,≥9, and ≥12 mm, respectively). The mean numbers of teeth with loss of attachment at the ≥6-mm threshold and at higher thresholds were small. In both age cohorts. about one-fifth of subjects had probing depths ≥6-mm, while at the ≥9-mm threshold only 2-3% were so affected. Although recession was an important component of loss of attachment in the younger cohort, in the older cohort the prevalence and extent of recession were greater than for probing depths at thresholds ≥4 mm. All subjects had one or more teeth with calculus, bleeding, or both, most teeth being so affected. Eighty-four of the 537 65-74-year old subjects were excluded either because of edentulousness or because extractions indicated for the remaining teeth would have rendered the subjects edentulous. The distribution of subjects according to their highest CPJ score was remarkably similar for the two cohorts. No subjects in either age group were assessed as "healthy" (CPJ code 0) or had "bleeding only" (code 1) as their highest score. While most subjects scored CPI code 2 or 3 as their highest score, only 17% of the younger and I 15% of the older cohort scored Community Periodontal Index of Treatment Needs (CPITN) code 4. Differences in the mean number of sextants affected by CPI codes between the two cohorts were mainly due to a greater number of excluded sextants in the older cohort. CPI findings for 35 44-yr-olds differed little from those reported in 1984. [ABSTRACT FROM AUTHOR]

The aim of this investigation was to examine the relationship between the dental status of tooth surfaces, as recorded during the 1978 Adult Dental Health Survey, and the treatment dental attenders subsequently received. A year after the survey, almost twice as many surfaces had been filled than were predicted on the basis of the survey. After 3 yr, this had risen to a 3.5-fold difference. Despite this, 59% of the restorative need identified by the survey criteria remained unmet by the end of the 1st yr; 46% was unmet by the end of the 3rd yr. A surface that received a filling for the first time was three times more likely to have been identified as in need of filling during the survey than a surface which was refilled. These findings cast doubt upon the usefulness of the epidemiological survey as a tool for predicting restorative treatment, and show that maintenance of previous fillings was particularly poorly forecast by the survey data. [ABSTRACT FROM AUTHOR]

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented. [ABSTRACT FROM AUTHOR]

This article focuses on a manual related to epidemiology and diagnosis of oral mucosal diseases and conditions. The manual provides a systematic approach to the collection and reporting of comparable data on the most common oral diseases and conditions for use in planning and evaluating oral health programmes and in identifying important research potentials. It also provides a basis for standard, detailed classification and coding of all oral conditions and diseases, irrespective of their rare or frequent occurrence. The manual is intended for dentists and physicians who may need to conduct surveys and who are not specialists in oral diagnosis or epidemiology.

The age and maintenance of dentures, and denture-cleaning habits, were studied by an interview survey. The material represented nation-wide the Finnish population aged ≥15 years old, and there were 957 interviewees, of whom 328 were denture wearers. In total, 45% of the upper and 40% of the lower dentures were over 10 years old. More than one-third of the dentures more than 5 years old had never been maintained during that time. Individuals whose dentures had been made and fitted by dental technicians visited dentists less frequently than individuals whose dentures had been made by dentists. Over 80% of the denture wearers reported cleaning their dentures by brushing at least once a day, and women cleaned them more frequently than men. The present findings suggest that denture wearers should be a special target group for dental health education, for the development of the latter, and for the development of dental health care services in the future. [ABSTRACT FROM AUTHOR]

The longevity of dental restorations is an important health concern for the patient, the dentist, and the various forms of insurance systems. In this article several methods of evaluating survival time are described and the different ways of presenting the findings of survival studies are discussed. It is stated that only longitudinal studies are appropriate to give an exact insight in the longevity of restorations. A large amount of information is available in dental records and the way these data can be analysed is presented in this paper. It appears that Cox's proportional hazard model is the appropriate way of demonstrating the influence of several factors on the survival rate. An example is provided of the results from a recent survival study of crowns in The Netherlands. [ABSTRACT FROM AUTHOR]

The National Clinical Assessment Service (NCAS), an NHS organisation that assesses doctors and dentists referred to them because of perceived difficulties, has produced a report describing data arising from its first 4 years, showing that male doctors were referred to the service considerably more often than female doctors. Despite women accounting for 42% of the general practitioner medical workforce and 37% of the medical hospital and community (H&C) workforce in 2004, only 13% of GPs and 20% of H&C NCAS referrals were women. When the H&C data were split into specialties, women were under-S represented proportionally in all specialties. This paper offers a review of possible reasons for these gender differences and in doing so contributes to the debates concerning problems in performance and also the costs of employing a growing proportion of women doctors. Firstly, it hypothesises that the NCAS data may be non- representative of similar agency data, but finds that in disciplinary organisations of various types around the world, men are consistently over-represented. Secondly, it suggests that perhaps men are referred to such agencies more often than women because their employers are more lenient on women. There is no evidence for this, and it requires primary research to investigate it further. Finally, it considers gender differences in the attributes, beyond technical skills, that underpin a good doctor-patient relationship and finds that, on these attributes, women usually excel over men. In addition, far fewer women are disciplined for addiction. The implications of this for education and rehabilitation are considered. It concludes that any analysis of the economic costs of employing a greater proportion of female doctors must take into account the higher costs of men's litigation, discipline and retraining. [ABSTRACT FROM AUTHOR]

In previous articles, we have considered how to formulate a research question and choose an appropriate methodological approach to answer that question, including the use of evidence-based research instruments or measurement scales. In this article, we put this information together in the form of a research proposal and consider how to obtain funding for the research project, as well as fulfil ethical requirements. [ABSTRACT FROM AUTHOR]

Care pathways have been used in a variety of ways: firstly to support quality improvement through standardising clinical processes, but also for secondary purposes, by purchasers of healthcare, to monitor activity and health outcomes and to commission services. This paper describes a secondary use of dental care pathways: to commission and monitor performance of primary dental care services. Findings of a project involving three dental practices implementing a system based on rating patients according to their risk of disease and need for care are outlined. Data from surgery-based clinical databases and interviews from commissioners and providers are reported. The use of both process and outcome key performance indicators in this context is discussed, as well as issues which arise such as attributability of outcome measures and strategic approaches to improving quality of care. [ABSTRACT FROM AUTHOR]

The author reflects on the various aspects of negotiation, treatment and consent in the dental practice. The author recalls the time the phrase, safe sex, came to prominence after discovering the aetiology of HIV infection and AIDS. Also tackeld are the factors that holds the ability to gain valid informed consent to a particular treatment plan.

A clarification to a letter regarding the requirement for a display of an automated external defibrillator (AED) at the dentist's office in the state of New York that was published in the January 1, 2012 issue is presented.

The article reports on the low level of dentists' confidence in the status of the healthcare sector in Great Britain.

The article presents an excerpt from a paper written by dentist Pierre Fauchard in 1746. The paper cites Fauchard's view that people who love sugar rarely have good teeth. Fauchard states that most people with poor teeth. The excerpt comes from "The Surgeon Dentist or Treatise on the Teeth," translated by Lilian Lindsay.

ObjectiveTo provide reliability and validity data on a computerised dental anxiety scale (the Smiley Faces Program or SFP) for children using faces as a response set.SettingFive schools across Derby, Newcastle-upon-Tyne and Shropshire.Subjects and methodThe SFP was completed by 464 children (mean age 10.8 years). For validity purposes, 241 children also completed two other children's dental anxiety measures (the Modified Child Dental Anxiety Scale and the Dental Fear Survey). For test-retest purposes 100 of the children completed the SFP two weeks later.ResultsThe SFP demonstrated good internal consistency (α= 0.8), test-retest reliability was good and significant correlations were found between the SFP and the other measures. The children rated the local anaesthetic and drill as the most anxiety-provoking items.ConclusionThis study suggests that the SFP is a valid and reliable measure for assessing children's trait dental anxiety and may help encourage dentists to formally assess dental anxiety. [ABSTRACT FROM AUTHOR]

The article discusses the situations where people are taking care of their teeth themselves. It cites a case where a pensioner was reported to have taken out her teeth because she could not find a dentist. Such sort of dentistry has been termed as Do It Yourself (DIY) dentistry. This article evaluates the advantages of DIY dentistry. The enticing thing about DIY is that it seems like such a good solution at the time. It has the allure of being economic, easy to organize and convenient. But for those, who have ever tried it, it is not that straightforward.

This article reports that the General Dental Council (GDC) has published new guidance for local Practitioner Advice and Support Schemes. Practitioner Advice and Support Schemes are voluntary schemes, organized and run by local clinicians, which are designed to detect and address problems of poor professional performance in dentists. The GDC's new guidance describes the respective roles of the GDC and Practitioner Advice and Support Schemes and provides a model scheme, based on examples of best practice, that anyone who is setting up a new scheme can use.

This article presents a list of several events related to clinical care. 26th Annual Meeting of the American Society for Bone and Mineral Research will be held on September 2004 in Seattle. Annual Meeting of the Academy of Dental Materials will be held Geneva, Switzerland. 84th General Session & Exhibition of the IADR will be held on June 28July 1, 2006 in Brisbane, Australia.

Presents information on conferences and exhibitions on dental medicine and practice in England and India from March 2004 to May 2004. Neuro-disability and dentistry conference in London; Restorative dentistry seminar in London; Medicare conference in India; British Dental Conference in Bournemouth.