Search

Aim: To test a theoretical model based on Cohen's dental profession factors (training; practitioner attitudes; geography) to investigate practitioners' willingness to treat adolescents with learning disabilities (LD) in primary dental care., Participants: A sample of all 537 primary care dentists working in a mainly urban area of Northern Ireland and a more rural area of Scotland., Main Outcome Measure: Willingness to treat adolescents with LD., Method: Questionnaire survey of demographic profile, undergraduate education, current knowledge, attitudes towards individuals with LD and willingness to treat this patient group. A path analytical approach (multiple meditational model) was used., Results: Three hundred dentists participated giving a valid response rate of 61%. Undergraduate education and current knowledge (training) strengthened a social model perspective promoting positive attitudes and willingness to treat adolescents with LD. Undergraduate education and current knowledge about disability did not significantly contribute to dentists whose attitudes were underpinned by the medical model of disability. Therefore geography (rural or urban location) was not an influential factor in willingness to treat adolescents with LD. This does not exclude the possibility that area of work may have an influence as a consequence of undergraduate university attended., Conclusion: This model identifies the importance of undergraduate and continuing dental education with regard to modifying professional attitudes (social and clinical factors) to assist practitioners treat adolescents with LD and provide them with inclusive dental services in primary dental care.

The Corah Dental Anxiety Scale (CDAS) has been used extensively in epidemiology and clinical research. It is brief and is claimed to have good psychometric properties. However, it does not include any reference to local anaesthetic injections, a major focus of anxiety for many. Also, the multiple choice answers for three of the four questions are not clearly in order of severity of anxiety as the CDAS intends. The answers differ among the questions thus making them difficult to compare. They include descriptions of physiological reactions and anxiety, confusing two loosely related components of the experience. The Modified Dental Anxiety Scale (MDAS) described, added a question on anxiety about oral injections. New multiple choice answers, in clear order of anxiety and the same for each question, were provided. Twenty five dental personnel all confirmed independently the order of the multiple choice answers for the MDAS. They disagreed among themselves however, about the appropriate sequence for the answers denoting intermediate anxiety in the CDAS. Therefore the CDAS, unlike the MDAS, can provide meaningful measures only of extremely high or extremely low dental anxiety. Of 1392 subjects tested, 13 per cent expressed extreme anxiety about injections on the MDAS but were only 'fairly' or less anxious about drilling. Thus, the CDAS, unlike the MDAS, must overlook subjects very afraid of injections only. Data confirm the high reliability and validity of the MDAS and provide norms for phobic and nonphobic subjects.

This study was conducted to measure levels of work pressure, job satisfaction and further factors related to occupational stress in community dental service staff in north Wales. The occupational stress indicator and a modified version of the dental work stress inventory were completed by 44 community dental service staff in March 1991. The community dental service staff showed poor levels of job satisfaction and psychosomatic indicators of stress. The perception of control of the individual's working practices was highly influenced by organisational demands. The best predictor of job satisfaction was perceived control followed by work pressures. The dental surgery assistants scored more unfavourably than their dental colleagues on most measures. Dentists consider clinical matters their greatest stress while dental surgery assistants were concerned principally with their working conditions such as pay levels and working hours. The study reflects a somewhat unhappy work situation for community dental service staff which may be temporary and in response to new administrative systems being introduced. A further in-depth assessment of staff is indicated to show whether these results are situation dependent or indicate a more permanent state.