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The author argues for increased regulation of dental support organizations (DSOs) in the U.S. as the increasing popularity of the DSO model may lead to significant violations in corporate dentistry practice. Topics discussed include the classic sole practitioner owner-dentist model of private dentistry practice, the corporate practice of dentistry doctrine, and the contractual dispute between dentists and DSO in the court case Penny v. OrthAlliance DSO.

Purpose: The aim of the present study was to evaluate the recommendations relating to the use of approximal cleaning aids given by dental hygienists and dentists, the self-care practices in a Swedish population and the ability to remove dental plaque. Materials and Methods: A structured questionnaire was randomly distributed to 500 dental hygienists and 500 dentists and a similar questionnaire was distributed to 1000 randomly selected individuals, divided equally into the following age groups: 15 to 20, 21 to 40, 41 to 60 and > 60 years. A clinical examination evaluating the ability to remove approximal dental plaque was also carried out in a total of 60 regular users of approximal cleaning aids. Plaque was scored before and after cleaning with a toothpick, dental floss or an interdental brush. Results: The response rate was 82%, 79% and 68% for the three groups. The results reveal that dental hygienists give more detailed information about a majority of the aspects that are related to the use of approximal cleaning aids compared with dentists (P < 0.01 or P < 0.001). The majority of the dental staff give recommendations to children and adolescents firstly to prevent dental caries and to older individuals to improve periodontal health. The use of different approximal cleaning aids on a daily basis varied with respect to age group (2% to 42%); dental floss dominated in the younger age groups and interdental brushes in the two oldest groups. In the clinical study, the largest plaque reduction was produced by the interdental brush (83%), followed by toothpicks (74%) and dental floss (73%). Conclusions: The present study indicated the importance of individual recommendations related to the use of approximal cleaning aids. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the treatment outcome of implant-supported single-tooth replacements performed by dental students as part of their undergraduate dental curriculum after a mean follow-up period of 10 years (range: 7.5 to 12 years). Materials and methods: A total of 51 patients were consecutively treated by dental students with 55 implants supporting single crowns. The treatment was performed under supervision of dentists and oral and maxillofacial surgeons, all with special knowledge about oral implantology. Survival of implant crown, survival of implant, probing depth, bleeding on probing and peri-implant marginal bone level change were evaluated at the end of the follow-up period. In addition, biological and technical complications during the entire follow-up period were assessed. Results: A total of 45 patients with 49 implants were available at the end of the study. The survival of the implant crowns as well as the implants was 94%. The mean probing depth at patient level was 4.8 mm. The probing depth varied between 2 and 10 mm at the individual site. The mean bleeding on probing score was 0.57 at patient level and absence of bleeding around all sites of the implants was rarely observed. The mean bone level change was -0.14 mm (range: 1.2 to -1.1 mm) during the first year of loading and 0.16 mm (range: 1.4 to -1.8) after 10 years at patient level. Five episodes of peri-implant inflammation due to excess cement were registered in five patients. Moreover, a fistula was observed at two implants in two patients. Finally, five technical complications occurred in five patients. Conclusions: Implant-supported single-tooth replacements performed by dental students as part of their undergraduate dental curriculum were characterised by high survival rates as well as few biological and technical complications. It seems acceptable to include implant therapy in the clinical undergraduate dental curriculum, provided a focus remains on straightforward cases with substantial supervision by trained dentists and oral and maxillofacial surgeons. [ABSTRACT FROM AUTHOR]

Purpose: The role of demographic, socioeconomic and psychological factors that influence the subjective assessment of dental needs has been the subject of contemporary dental research. The aim of this study was to determine the relationship between self-reported and clinically diagnosed dental needs, with the view of understanding the factors that affect subjective assessments of dental problems. Materials and Methods: A random sample of 130 subjects, aged 21 to 63 years, was selected from the non-academic staff members of the Athens University of Economics and Business. Data were obtained for 92% (120 participants) of the sample by a questionnaire-based interview and a clinical examination. The questions concentrated on the demographic and socioeconomic characteristics and the ratings of oral health, the perceived need, oral functional impacts and the level of satisfaction with the appearance. In the clinical examination, the oral health status of the participants was thoroughly recorded. Results: A strong relationship was detected with the presence of caries, badly broken and missing teeth, and self-reported need for care. Embarrassment due to one's dental health was also associated with the perceived need, although satisfaction with the appearance was not. Neither demographic and socioeconomic status nor self-rated oral health was significantly associated with a currently perceived dental problem. Conclusion: Perceived need for dental care is affected by parameters other than demographic and socioeconomic status (i.e. parameters that are associated with the presence of symptoms and/or impacts on everyday life). Therefore, functional and psychological impacts of the disease seem to be as important, if not more, as the clinical indicators while estimating the dental needs. [ABSTRACT FROM AUTHOR]

This section presents concise educational articles for practising dentists. The series aims to educate practitioners regarding statistics and methods of conducting and interpreting research. [ABSTRACT FROM AUTHOR]

This section presents concise educational articles for practising dentists. The series aims to educate practitioners regarding statistics and methods of conducting and interpreting research. [ABSTRACT FROM AUTHOR]

For patients with complex dentofacial problems, orthodontic treatment is often not enough to obtain optimal esthetic and functional results. This case report demonstrates the treatment of a patient with skeletal anteroposterior discrepancy through an interdisciplinary approach and emphasizes the importance of collaboration with other dental disciplines to achieve the desired esthetic results. [ABSTRACT FROM AUTHOR]

Aim: To (1) determine if there are different preferences among general dentists, a combined group of dental specialists, and orthodontists concerning whether a patient with congenitally missing lateral incisors should have the teeth restored or if the canines should be orthodontically moved into the position of the missing teeth; (2)determine the role that esthetics and function of the final result has on the respondents' treatment preferences; and (3)compare the respondents' opinions about treatment preferences to their rankings of esthetics reported in part 1. Methods: The questionnaire accompanied the photographic evaluation in part 1. Percentages were computed and chi-squares were used to compare response patterns. Results: Compared to orthodontists, a significantly greater percentage of general dentists and combined dental specialists would restore the lateral incisors and would do so primarily for esthetic reasons. Interestingly, for those dental professionals who responded that the missing teeth should be restored, many did not rank any photograph of a restorative option as the best option. Conclusions: Dental professionals should attempt to eliminate their personal opinions when recommending treatment options for a congenitally missing maxillary lateral incisor because discrepancies exist between the treatment result judged as most esthetic and the one most likely to be recommended. [ABSTRACT FROM AUTHOR]

Despite the continued debate regarding the need for keratinized mucosa around dental implants, most clinicians are in agreement that keratinized peri-implant soft tissues are clinically desirable. The quantity of available keratinized mucosa in a proposed implant site can vary significantly due to local anatomy and/or previous surgical procedures. In many instances a minimal zone of keratinized tissue is noted prior to implant placement in the posterior regions, and in other instances, surgical incisions necessary for implant placement may reduce or eliminate what keratinized mucosa exists. Peri-implant concerns related to an absence of keratinized tissue, and often observed throughout the maintenance phase of treatment, can include tissue mobility, mucosal 'pouching', gingival hyperplasia, gingival fistulas, and gingivitis. Schroeder has postulated that the establishment of a circumferential sealing effect by a dense connective tissue collar at the site of implant penetration into the contaminated environment of the oral cavity was a pre-requisite for long-term implant success (Schroeder et al, 1981). Knowledge and treatment of the peri-implant tissues will continue to be an area in which the unique expertise of the periodontist is sought and valued in the partnership with restorative dentists. Surgically reconstructing keratinized tissue at the time of implant placement minimizes treatment time and reduces total expense for the patient, improves patient comfort relative to plaque control and professional maintenance, reduces marginal tissue recession, improves esthetics, and facilitates restorative procedures. This two-part article series will focus on a variety of periodontal plastic surgical techniques designed to increase the zone of keratinized mucosa around non-submerged dental implants at the time of implant placement. Specifically, this installment will elaborate on vascularized versus non-vascularized flaps. [ABSTRACT FROM AUTHOR]

Editor's Note: With the increasing exposure to television advertisements by contingency fee lawyers, appealing to those who may think they have been injured, promising lottery-size awards ("And it won't cost you anything, if we don't win"), the public has responded by increasing the number of malpractice suits already clogging the court dockets. But this is only part of the story. Many more suits are filed than actually tried. Most are settled by insurance companies for nuisance value, since it costs more to fight them than settle. California is literally a gold mine and the lawyers know this, particularly in highly litigious cases involving obstetrics and gynecology, surgery, and whiplash claims and other orthopedic problems. It is common knowledge that insurance companies build the malpractice costs into the premiums paid by the medical and dental profession. The risk-management costs have escalated exponentially for all fields, and orthodontics and orthognathic surgery have not been spared. This poignant article by Dr Woodside shows the financial, emotional, and psychological trauma for an orthodontist, even when the orthodontic treatment was excellent, and clearly at or above standard of care. Doctor, you, too, can be sued! This is no longer an American phenomenon, but is growing like a cancer around the globe. It behooves the orthodontist to follow the fundamental risk-management procedures of informed consent, complete records, progress reports, and constant communication with the patient, parents, and referring dentists. [ABSTRACT FROM AUTHOR]

Die Kassenzahnärztlichen Vereinigungen sorgen für die Sicherstellung einer flächendeckenden und wohnortnahen zahnärztlichen ambulanten Versorgung. Diese wird seit Jahrzehnten insbesondere von Einzelzahnärzten, von Berufsausübungsgemeinschaften und von Praxisgemeinschaften sowie seit dem Jahre 2015 auch von Medizinischen Versorgungszentren sichergestellt. Seit einiger Zeit ist jedoch festzustellen, dass die Geschäftsaktivitäten von sog. Private-Equity-Gesellschaften im zahnärztlichen Bereich stark zugenommen haben. Insbesondere kaufen diese als versorgungsfremde Investoren Vertragskrankenhäuser und Zahnarztpraxen auf, um letztere in MVZ umzuwandeln und zu betreiben. Dadurch besteht jedoch die Gefahr, dass durch eine profitorientierte Einflussnahme die Unabhängigkeit medizinscher Entscheidungen beeinträchtigt wird. Um dieser Entwicklung entgegenzuwirken, hat der Gesetzgeber kurzfristig Regelungen geschaffen, die im Rahmen des nachfolgenden Beitrages dargestellt werden sollen. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Pain is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This clinical investigation evaluated the effect on subgingival surfaces of three instruments: hand instruments and ultrasonic instruments with modified and unmodified inserts. Ten operators (five dentists and five dental hygienists) performed randomly assigned operative procedures. Pocket depth, instrument limit, and instrument efficiency were evaluated for each type of instrument. The results indicated that there are advantages to using modified ultrasonic inserts for scaling and root planing. [ABSTRACT FROM AUTHOR]

Clinical success of resin-bonded fixed partial dentures is primarily dependent on their long-term retention. Retention rates of resin-bonded prostheses placed in 66 patients treated by three dentists in private practice were evaluated in the present study. Seventy-seven resin-bonded fixed partial dentures were followed over a period of 1 year to 11 years. Thirty (39%) became dislodged, but nine were successfully rebonded; thus there were 21 failures (27%). Prosthesis location and operator expertise minimally influenced the longevity of these restorations, but the luting agents tested in this sample had a profound impact on retention. Debonding rates were excessive for some materials tested. whereas other agents proved to be predictable. Modifications in preparation design That enhanced resistance form were also likely contributors to improved retention rates. [ABSTRACT FROM AUTHOR]

Many dentists routinely make panoramic radiographs of edentulous patients who request replacement dentures. A study was conducted in patients who attended a Jordanian dental school seeking a new set of dentures. Patients who had at least one set of complete dentures and were treated elsewhere, were included in this study. Any patient whose clinical findings suggested a need for further radiographic study was excluded. Of 286 patients (572 edentulous arches), only three were found to have impacted molars that required extraction and altered the treatment plan. The use of radiography in dentistry generates a large expense and there are risks of radiation hazards. The routine use of radiographs for patients who wear complete dentures and need replacement dentures should be discouraged. A thorough history must be obtained and a careful clinical examination must be performed for the diagnosis and treatment planning. [ABSTRACT FROM AUTHOR]

The article presents the author's viewpoint on the expected trends in dentistry in the 21st century. He says that no decline is expected for the demand of dental services in the 21st century. But the character of dental practice will change gradually. More emphasis is likely to be put on maintenance of the natural dentition with optimal esthetics, function and health. There will be more adult orthodontics, periodontics, implants and dental care for handicapped, while the demand for prosthetic and restorative dentistry may decline. He opines that there will be an increasing demand on dentists for community education and for involvement in total patient health care. Further he infers that dentistry has a bright future scientifically and economically in providing service to others.

The article discusses the value of performance appraisals and review (PAR) systems in dental offices. It states that dentists are facing a challenge of increasing productivity to counter the escalating cost and competition. It suggests that the desired productivity could be achieved by making full use of the potential of each employee. It proposes that a system of performance appraisal which could identify the outputs and goals of individual should be applied. It recommends that the system should be incorporated with a feedback system so that employees can relate personal performance to the review. However, it warns that dentist should address several considerations like well defined, written philosophies and goals and target before instituting a PAR system.

The article focuses on the ethics in dentistry. It notes that the dentist-patient relationship has been based mainly on the options given to the patients by the dentists relative to the procedures to be done since the fact that many dental procedures are elective. It mentions that despite the choices presented before the patients, often the options are being denied from the patients as dentists patronize the decisions to which the denial causes the patients the notion that their rights have been violated by their dentist.

The article presents the study which aims to asses the effect of pulpotomy on young teeth of different age groups. Two methods were used in the assessment namely the radiographic assessment and the sensitivity test in which indicates that pulp connective issue heals like any other connective tissue. The result through clinical observation found that very young carious teeth had worse prognosis, following pulputomy than mature teeth and the inflammatory process develops more readily in the age group.

The article outlines the criteria for ideal equipment in an ergonomically designed facility. It is said that a dental chair must offer complete body, head, arm and leg support for the patient and consider the comfort and efficiency of dental chairs which might easily be misconstrued as a help to dental operating efficiency. It is stated that the operator's stool should be uncombered in all positions to help operators in maintaining correct postures as procedures are carried out. The assistant's stool must have a wider base than the operator's stool to attain stability.

Background and objectives: Inequalities in oral health among New Zealanders persist, with Māori and poor families experiencing a high proportion of oral disease, which manifests mainly as dental decay. Dental caries experience in Northland children is the highest in the country, and there is no fluoridated water supply. The aim of this study was to determine whether a supervised toothbrushing programme can improve oral health-related quality of life. Methods: This was a quasi-experimental study involving 335 10-13-year-old New Zealand children with high caries experience from 5 Northland schools. All children completed an oral health-related quality of life questionnaire (the CPQ11-14) at baseline. Half of the children (those from Kaitaia Intermediate; N = 159) participated in a supervised toothbrushing session each school day, and the remainder served as the control group (N = 176). Questionnaires were completed again at the end of the school year, 9 months later. Effect sizes were calculated based on the change in oral health- related quality of life from baseline to follow-up. Results: An in-school supervised toothbrushing programme was successfully implemented. Children in the toothbrushing group had higher CPQ11-14 scores (representing poorer OHRQoL) at baseline than those in the control group (13.6 and 12.7, respectively). At follow- up, they had lower scores than those in the control group (9.4 and 10.6, respectively; P <0.001; effect size = 0.4). Overall, OHRQoL improved for both groups, but the largest improvement was observed among those in the toothbrushing group, with a moderate effect size. Conclusion: A supervised toothbrushing programme successfully implemented in a Northland schoolled to improved oral-health-related quality of life among participants. [ABSTRACT FROM AUTHOR]

This study compared the number of patients treated per year by general dentists and dental hygienists in solo practice and by those employed by a large group practice. Information on the annual number of patient visits to solo general dental practitioners comes from the 2013 American Dental Association (ADA) Survey of Dental Practice. Patient visits were divided by 2.5 to estimate the number of patients treated annually. The data on group practices come from HealthPartners (HP) of Minnesota, a large not-for-profit medical and dental Health Maintenance Organization that accepts insurance contracts based on global budgets and is financially at risk. In 2013, solo general dentists averaged 1,350 patients, while the average HP general dentist treated 2,052 patients. HP general dentists thus treated over 700 more patients annually than did solo practitioners. This large difference has major implications for the future of the dental delivery system and dental education. This article was written as part of the project "Advancing Dental Education in the 21st Century." [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to assess the knowledge and practice of informed consent among dental practitioners in Hyderabad city, Pakistan. Study Design: Descriptive cross sectional survey. Setting: Liaquat University of Medical and Health Sciences, Isra University and Dental practitioners working at private Dental clinics in Hyderabad city. Period: This study was conducted over period of six months from November 2015 to April 2016. Material and Method: This study used self-administered structured questionnaire, consist of ten questions to assess the knowledge and practice of dental practitioners towards informed consent. Data was collected by visiting offices of the study participants at their work place or through email and courier with prepaid envelope where needed. The participants were sent two reminders at the interval of fifteen days to return the filled survey form. The responses were represented in form of percentages. The t-test was used to determine the association between the knowledge and qualification, clinical experience, and age. A significance level of p<0.05 was considered as statistically significant. Results: Our response rate was 86% (103). Majority of the dentist merely knows the meaning of informed consent and overall had poor knowledge (mean score 7.84 + 2.44). The analysis showed that years of clinical practice and qualification was statistically significant with mean knowledge score (p < 0.01). The verbal form of consent was most preferred method of obtaining informed consent that accounted for 82% of study participants. 89% of dentist obtained informed consent from parents when treating their children. Conclusions: From this study, it can be concluded that vast majority of dentist are unaware of informed consent process and their basic requirement. Although majority of dentist believe that informed consent play an important role in routine dental practice yet many of them did not use written form of informed consent. Our results would help the educators and policy makers to develop educational instruction on bioethics with special emphasis on informed consent. [ABSTRACT FROM AUTHOR]

Background: As primary health care (PHC) centers in Saudi Arabia provide standardized preventive and curative oral health care (OHC) services, challenges remain. In addition, evidence of determinants of OHC seeking behavior is unknown. The aim of this study was to identify common challenges faced by patients seeking OHC in PHC centers and assess determinants of demand for OHC in Riyadh. Methods: After institutional approval and piloting, 320 adult patients were sampled at two large PHC centers in October 2015. Using a modified version of General Practice Assessment (GAPQ) and New York State Department of Health (NYSDOH) Questionnaires, information about cumulative number of visits to a dentist, patient profiles, provider characteristics, and challenges were collected. We used descriptive statistics to summarize data and employed ordinal regression for analyzing extent of effects of challenges and determinants of demand for OHC. Results: Oral health condition was reported to be good in 31 % of the patients, very good in 25 % of the patients, and fair in 20 % of the patients. More than half (53 %) of patients visited a dentist in the past 12 months once, 20 % twice, and 25 % at least three times. High cost of private clinic and unavailability of dentists were reported as the most common difficulties in seeing a dentist. Patients who were very satisfied with dental care and treatment plan, those with less than excellent oral health conditions and male patients had less number of cumulative visits to a dentist compared with patients with less satisfaction, patients with perceived excellent oral health, and female patients respectively. Conclusions: Our findings provide a strong evidence of challenges faced by patients and determinants of demand for OHC seeking behavior. The findings can inform policy maker not only in patient satisfaction of OHC, but also implications on facilities and health care systems. We conclude with recommendations for future research, especially on oral health preventive measures in PHC centers that correct inherent dental problems and other underlying challenges. [ABSTRACT FROM AUTHOR]

Copyright of Acta Stomatologica Croatica is the property of Acta Stomatologica Croatica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article profiles dental care provider Oak Park Dental Group which discusses the values in the work place such as respect, professionalism and quality, uniqueness of their office and the contribution of each dental team member.

Background: Oral health care needs assessment is frequently restricted to clinical measures. Combining normative assessment, behavioural propensity, oral health-related quality of life and information of family living conditions may provide a better comprehensive approach of adolescent's oral health needs assessment. The aim of this study was to compare normative methods of dental caries need with the sociodental approach in 12-year-old adolescents according to family's living conditions in a deprived community in Brazil. In addition, dental caries need assessment using the normative method and the sociodental approach was compared between adolescents living in different living conditions. Methods: A cross-sectional survey was conducted in the Manguinhos community in the city of Rio de Janeiro, Brazil. A weighted sample of 159 participants was randomly selected to represent the population of 2004 12-year-old adolescents. Socioeconomic characteristics and living conditions of the family were assessed using the Family Development Index (FDI). Oral health-related quality of life (OHRQoL) was assessed using the generic and CS-Child-OIDP, and adolescent's propensity to adopt oral health promoting behaviours was verified through interviews. Dental caries and treatment need were assessed normatively by clinical oral examinations (DMFT Index) and adolescents were classified into two groups (non severe or severe caries). The sociodental approach included clinical measures of caries, propensity to adopt oral health promoting behaviors and OHRQoL. Families were classified based on the FDI as 'not severe', 'severe' and 'very severe'. Measures of caries, OHRQoL and propensity outcomes were compared between FDI groups using Chi-square and Kruskal-Wallis tests. In addition, dental treatment needs using normative method and sociodental approach were compared for the whole sample and according to FDI groups. Results: Dental caries, OHRQoL and lower propensity needs were positively associated with FDI severity. The percentages of adolescents with normative dental needs from families with 'very severe', 'severe' and 'not severe' FDI were 59.3, 48.4 and 17.2 % (P < 0.05). Using the sociodental approach, the treatment needs for the three FDI groups decreased to 8.8, 13.6 and 8.6 %, respectively (P < 0.05). Conclusions: Using a combination of sociodental approach and the index of family living conditions was useful for defining dental care priorities in adolescents living in deprived communities and can optimise the use of resources in dental services. [ABSTRACT FROM AUTHOR]

Introduction The aim of the study was to test the hypothesis that a further education programme relating to nickel-titanium rotary instrumentation ( NTRI), with the concurrent activation of social/professional networks amongst all general dental practitioners ( GDPs) in a public dental service in Sweden, would increase the adoption rate and improve root-filling quality. Material and method To activate the networks, the GDPs at the 25 clinics elected training coaches from amongst themselves. The coaches were educated by a specialist and were then free to organise and conduct the training of the local GDPs. However, collective hands-on training and discussions were mandatory. Lectures were held by an endodontist. The rate of adoption and root-filling quality was evaluated just before and 6 months after the education. Statistical tests were performed with chi-square using a 95% confidence interval. Results Nickel-titanium rotary instrumentation was adopted by 88%. Excellent root fillings (score 1) increased from 45% to 59% ( P = 0.003). The rate of poor-quality root fillings (score 4 and score 5) was not affected. The quality ratio (score 1/score 5) increased from 5.36 (118/22) to 9.5 (133/14). Eleven dentists (17%) at nine different clinics produced 49% of the poor-quality root fillings (score 4 and score 5). Seventy-three per cent of these dentists stated that they had adopted NTRI. Conclusions The introduction of NTRI will increase the adoption rate and the frequency of good-quality root fillings. However, it will not overcome the problems associated with dentists producing a low-quality level, even if a local professional network is activated. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To gather baseline data about different prosthodontic treatments provided by the dental practitioners belonging to various specialties of dentistry, residing in Karachi, Pakistan. METHODOLOGY: A total of 150 self-designed-structured anonymous questionnaire in English language were included. The questionnaire comprised of three sections which included questions regarding the age, gender, years of experience and type of dental practice, the number of patients treated in a month by the GDP for different dental prosthesis and questions regarding the perceived change in the provision of dental prosthesis. Descriptive statistics and analysis of the collected data was performed using Statistical Package for Social Sciences (SPSS) version 21 (SPSS, Chicago, Illinios, USA). RESULTS: Alarge number of respondents (84.6%) reported that the number of complete denture prosthesis provided to the patients were either increasing or not changing. A total of 81.4% reported activity in RPDs to be either "increasing" or "not changing".With regard to the prosthesis supported by implants, very low number of respondents reported this practice was declining. [ABSTRACT FROM AUTHOR]

Today's digital technologies are affording dentists and laboratory technicians more control over material choices for creating restorations and fabricating dental prostheses. Digital processes can potentially enable technicians to create ideal marginal areas and account for the thickness and support of layering porcelain over substructures in the design process. In this case report of a restoration of a single central incisor, a number of issues are addressed that are central to using the newest digital technology. As demonstrated, shade selection is a crucial early step in any restorative case preparation. [ABSTRACT FROM AUTHOR]

The article looks at the risk allocation issues in state health care information technology (IT) procurements under the Patient Protection and Affordable Care Act (ACA). Topics discussed include changes in the Medicaid health insurance eligibility rules due to ACA, allocation of funds under the Federal Financial Participation (FFP) with Medicaid Management Information Systems (MMIS), and different risk allocation issues such as contract type, intellectual property rights and liability.

Introduction. Shade is one of the most important attributes when evaluating the success of a restoration. Several factors can influence the visual shade matching process, and therefore the outcome of the final restoration. Objectives. 1. to assess the importance of clinical experience on shade matching accuracy; 2. to assess the influence of two standard light sources on the ability to match shade tabs; 3. to identify the area in a VITA Classical shade guide where matching errors are most likely to appear. Methods. 28 subjects were enrolled in the study: 14 undergraduate dental students and 14 dentists. All subjects had passed the Ishihara blindness test previously. Participants had to match 16 pairs of tabs from two shade guides, under two versions of illuminants of a viewing booth: D50 and D65, on a neutral background, 0°/45° viewing geometry. Paired and independent samples t tests were used to investigate the significant differences between the groups. Results. The clinical experience had no significant influence on shade matching (p>0.05). According to participants' color discrimination competency, three groups were formed: superior competency, average competency and poor competency. The light source did not significantly influence the matching scores of subjects with superior or average color discrimination competency (p>0.05). However, in the group of subjects with poor competency the light source significantly influenced the results (p<0.05). Moreover, for the group of students the light source also influenced shade matching results (p<0.05). The most frequently mismatched tabs were C2 with D4 (11 subjects - 39.28%), B3 with B4 (11 subjects - 39.28%), B3 with A3.5 (8 subjects -28.57%). Conclusions. The light source was proved to influence the shade matching results for subjects with a low level of clinical experience and for subjects with poor competency in color discrimination. [ABSTRACT FROM AUTHOR]

Background: This study was planned to assess the dental caries status among disabled children as dental health is an integral part of general body health and this group is deprived of health care needs. Materials & Methods: A sample of 310 disabled children was gathered including 195- Hearing impaired, 115 - blind. Of which 226 were males and 84 were females. A study questionnaire was prepared to include demographic information and WHO oral health assessment form (1997) to record dental caries status.Data was analysed using student's test and ANOVA test was used at p⩽0.05. Results: The overall mean for DMFT scores for males and females was 2.11 (1.753) and 1.75 (1.275) respectively. Similarly overall mean for dft was 0.31 (0.254) for males and 0.27 (0.143) for females. Mean DMFT of blind students was more as compared to hearing impaired ones as 2.16 (2.005) and 1.80 (1.264) respectively. Age factor showed a significant increase in the mean DMFT scores with advancing age at p ⩽ 0.001. Conclusion: Overall mean scores of caries was very high and it increased with increasing age. Blind children experienced more caries then hearing impaired children in permanent, whereas it was opposite in primary dentition. So there is urgent need of both comprehensive and incremental dental care for this subgroup of population. [ABSTRACT FROM AUTHOR]

Objectives: Most studies on the provision of dental procedures have focused on Medicaid enrollees known to have inadequate access to dental care. Little information on private insurance enrollees exists. This study documents the rates of preventive, restorative, endodontic, and surgical dental procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI) in Milwaukee. Methods: We analyzed DDWI claims data for Milwaukee children aged 0-18 years between 2002 and 2008. We linked the ZIP codes of enrollees to the 2000 US Census information to derive racial/ethnic estimates in the different ZIP codes. We estimated the rates of preventive, restorative, endodontic, and surgical procedures provided to children in different racial/ethnic groups based on the population estimates derived from the US Census data. Descriptive and multivariable analysis was done using Poisson regression modeling on dental procedures per year. Results: In 7 years, a total of 266,380 enrollees were covered in 46 ZIP codes in the database. Approximately, 64 percent, 44 percent, and 49 percent of White, African American, and Hispanic children had at least one dental visit during the study period, respectively. The rates of preventive procedures increased up to the age of 9 years and decreased thereafter among children in all three racial groups included in the analysis. African American and Hispanic children received half as many preventive procedures as White children. Conclusion: Our study shows that substantial racial disparities may exist in the types of dental procedures that were received by children. [ABSTRACT FROM AUTHOR]

Objective: Preventive dental visits for preschool-aged children can result in better oral health outcomes, especially for children from lower income families. Many children, however, still do not see a dentist for preventive visits. This qualitative study examined the potential for the Extended Parallel Process Model (EPPM) to be used to uncover potential antecedents to parents' decisions about seeking preventive dental care. Methods: Seventeen focus groups including 41 parents were conducted. The focus group protocol centered on constructs (perceived severity, perceived susceptibility, perceived self-efficacy, and perceived response efficacy) of the EPPM. Transcripts were analyzed by three coders who employed closed coding strategies. Results: Parents' perceptions of severity of dental issues were high, particularly regarding negative health and appearance outcomes. Parents perceived susceptibility of their children to dental problems as low, primarily because most children in this study received preventive care, which parents viewed as highly efficacious. Parents' self-efficacy to obtain preventive care for their children was high. However, they were concerned about barriers including lack of dentists, especially dentists who are good with young children. Conclusions: Findings were consistent with EPPM, which suggests this model is a potential tool for understanding parents' decisions about seeking preventive dental care for their young children. Future research should utilize quantitative methods to test this model. [ABSTRACT FROM AUTHOR]

Objectives: Dental satisfaction is associated with continuity of dental care, compliance with dentist advice, and positive health outcomes. It is expected that people with higher dental fear might have less dental satisfaction because of more negative dental experiences. The objective of this study was to examine satisfaction and reasons for satisfaction with dental practitioners in Switzerland and variations by dental fear. Methods: A national sample of 1,129 Swiss residents aged 15-74 (mean = 43.2 years) completed a personal interview at their home with questions assessing dental fear, dental service use, general satisfaction with their dentist, and reasons for satisfaction or dissatisfaction. Results: Overall, 47.9 percent of participants responded that they were satisfied with their dentist and 47.6 percent that they were very satisfied. Satisfaction differed significantly by gender, language spoken, region of residence, and educational attainment. Greater dental fear was significantly associated with greater dissatisfaction with the dentist. The percentage of people who were very satisfied with the dentist ranged from 56.0 percent among people with no fear to 30.5 percent for participants with 'quite a lot' of fear but was higher (44.4 percent) for people who stated that they were 'very much' afraid of the dentist. The most common reasons attributed for satisfaction with dentists were interpersonal characteristics of the dentist and staff. People with 'quite a lot' of fear were found to endorse these sentiments least. Conclusions: Although higher dental fear was associated with more dissatisfaction with the dentist, the level of satisfaction among fearful individuals in Switzerland is still high. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this article is to examine the relationship between changes in household finances (wealth and income) and changes in dental utilization at the onset of the recent recession in a population of older Americans. Methods: Data from the Health and Retirement Study (HRS) were analyzed for US individuals aged 51 years and older during the 2006 and 2008 waves of the HRS. We estimated logistic models of a) starting and b) stopping dental use between 2006 and 2008 survey periods as a function of changes in household wealth and income, controlling for other potentially confounding covariates. Results: We found that only when household wealth falls by 50 percent or more were older adults less likely to seek dental care. Changes in household income and other changes in household wealth were not associated with changes in dental utilization among this population. Conclusions: Older Americans' dental care utilization appeared to be fairly resilient to changes in household finances; only when wealth fell by 50 percent or more did individuals decrease dental use. This finding might extend to other health-care services that are preventive, routine, and relatively inexpensive. [ABSTRACT FROM AUTHOR]

Dentistry has historically seen tobacco dependence as a medical problem. As a consequence, dentistry has not adopted or developed effective interventions to deal with tobacco dependence. With the expanded use of electronic dental records, the authors identified an opportunity to incorporate standardized expert support for tobacco dependence counseling during the dental visit. Using qualitative results from observations and focus groups, a decision support system was designed that suggested discussion topics based on the patient's desire to quit and his or her level of nicotine addiction. Because dental providers are always pressed for time, the goal was a three-minute average intervention interval. To fulfill the provider's need for an easy way to track ongoing interventions, script usage was recorded. This process helped the provider track what he or she had said to the patient about tobacco dependence during previous encounters and to vary the messages. While the individual elements of the design process were not new, the combination of them proved to be very effective in designing a usable and accepted intervention. The heavy involvement of stakeholders in all components of the design gave providers and administrators ownership of the final product, which was ultimately adopted for use in all the clinics of a large dental group practice in Minnesota. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to present the impact of demography and market dynamics on the organizational and technological development of dental practices in Bulgaria during the period of socio-economic transition from 1990 to 2010. Material and methods. Relevant data were gathered from the official registers of the Bulgarian Dental Association, National Health Insurance Fund, National Health Information Institute and research studies, published during the period 1990-2010. They were analysed and are discussed in this paper. Results. During the period there was a decrease in population of Bulgaria, from 8,149,468 in 2000 to 7,563,000 in 2010 and a movement from rural areas to cities. There was an aging population with an increase in oral health care needs at a time of decrease in the size of the national labour force and economic growth. Paradoxically, over the last 20 years, the number of dentists in Bulgaria increased by more than 50% from 1997 to 2008. The average age of dentists changed from 39.7 years in 1997 to 41.7 years in 2008. The number of group dental practices increased and the number of individual practices and group practices for specialized dental care and dental centres decreased. The utilization of dental services is currently "about half " that of the mean for all European Union Member States, which is over 80% per year. Conclusions. The growing number of elderly people who have retained their teeth suggests an increase in treatment needs. However, the decline in their purchasing power limits the demand for oral health care services. In order to meet this and other challenges Bulgarian dentists have started changing their traditional solo-practice to group-practice. [ABSTRACT FROM AUTHOR]

The aim of the current study was to compare personality traits, presence of oral myofunctional dysfunctions, and other parafunctional habits in bruxing and nonbruxing children. Fifty-four patients aged 10 to 15 years were seen at the Comprehensive Pediatric Dental Clinic and examined by dentists using the RDC/TMD; speech therapists and psychologists were included in the study. Patients were divided into two groups: bruxing (A) and nonbruxing (B). Mean age was 13.1 years, S.D. 1.6. No significant differences in age or gender were found between groups. Group A comprised 44.44% of the population and showed a high frequency of middle conscientiousness scores and low frequency of low neuroticism scores. Presence of TMD, unilateral chewing, and high tongue tip position at rest were all significantly higher. Frequency of oral habits was higher in bruxers, who showed significantly increased gum chewing, and lip, cheek, and object biting compared to nonbruxing controls. Bruxism is considered a risk factor for temporomandibular dysfunction (TMD). [ABSTRACT FROM AUTHOR]

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Cone beam computerized tomography (CBCT) information has become a necessary part of precise implant planning. Although not yet the standard of care, implant procedures that are restoratively driven can no longer be done precisely enough with conventional imaging modalities. Cosmetic dentists, because of the nature of the exacting procedures they perform, will find that planning and performing implant cases using CBCT will become the only way to manage their cases, both large and small. However, with this added precision comes added responsibility since the CBCT data volumes, no matter what size the field of view captured, dictate that clinicians re-educate themselves to be able to use this advanced imaging modality. In addition, they will encounter many anatomic and pathologic findings with which they may not be familiar. The re-education process is necessary to reduce the risk and liability that comes with adopting this amazing technology. [ABSTRACT FROM AUTHOR]