To assess the adoption of new endodontic technology in a population of Danish practitioners.
Members of the Copenhagen Dental Association (n = 1156) were approached with a questionnaire concerning the frequency of various endodontic procedures. Three options were available: often, occasionally and never. Responses were anonymous. The statistical analyses were performed as studies of association in two- or three-way contingency tables, and with Goodman-Kruskal's gamma-coefficient as the basic tool chosen.
Only data from general practitioners (GPs) in private practice were analysed (n = 956). The response rate was 72%. NiTi hand instruments were often used to negotiate canals by 18%, whilst 10% often used NiTi rotary systems. Electronic apex locators were often employed by 15%. Nineteen per cent reported that warm gutta-percha was often used. A majority (53%) often spend two sessions to instrument a molar, and 20% often needed three or more sessions to finish the shaping phase. To complete a treatment of a nonvital case most practitioners reported to use at least three appointments. Only 4% frequently applied rubber dam.
The adoption of new endodontic technology is at an early stage amongst Danish GPs. A new revised remuneration system might influence the rate of adoption, allowing the practitioners to act more rationally and produce a higher frequency of good-quality root fillings. Progress towards high quality endodontics might be hindered by the nonuse of rubber dam.
Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, MS F-10, 4770 Buford Highway, Atlanta, Ga. 30341, USA. JLCleveland@cdc.gov
The authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention's Guidelines for Infection Control in Dental Health-Care Settings-2003.
In 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists' demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling.
Responding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied.
Implementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education requirements and developing multiple modes of instruction may increase implementation of current and future Centers for Disease Control and Prevention guidelines.
Erratum In: J Am Dent Assoc. 2012 Dec;143(12):1289
OBJECTIVES: To develop a method of measuring dentists' attitudes towards radiation hazards and to describe their prevalence among Swedish general dental practitioners. METHODS: A questionnaire was mailed to 2000 randomly selected dentists listed in the register of the Swedish Dental Society, with a response rate of 69.3%. An index for measurements of attitudes towards radiation hazards was constructed. RESULTS: Those dentists who showed high concern at radiation hazards also restricted their use of X-ray examinations. Years in practice and attendance at extended (one-week) courses in oral radiology both had significant associations with risk attitude. Inexperienced dentists showed less concern for radiation hazards compared with those more experienced and were less scrupulous in their choice of radiographic procedures. Gender, working alone, in the public dental health services or in private practice had no significant association with attitude. Dentists who considered regulations laid down by the Swedish National Institute of Radiation Protection as wholly adequate had a high care attitude. CONCLUSIONS: It is possible to study the relationship between attitudes and clinical behaviour by postal survey. Experience and continuing education affect dentists' attitudes towards risk and these attitudes in turn influence their clinical behaviour.
OBJECTIVE: There is little information on antibiotic prescribing habits among dentists in general. In 1992 we reported a study among Norwegian dentists, and the present investigation was undertaken to find out if the patterns of antibiotic prescription had changed since then. MATERIAL AND METHODS: A total of 470 randomly selected dentists (10% of total) received a questionnaire and a letter describing the survey and 313 responded. RESULTS: Results indicated that 35% did not issue any prescriptions in a typical week, while 3% issued > or =5. Fifty percent reported that they might prescribe antibiotics when treating periodontal diseases, but only 3.4% reported the use of microbial diagnosis before selecting an antibiotic; 71% of the respondents reported use of antibiotics occasionally to prevent general complications of dental treatment; 80% prescribed antibiotics for prophylactic use if the patient revealed a history of endocarditis, while 5% reported never doing so. CONCLUSION: These findings are in concert with the results obtained 11 years ago, but indicating that dentists who had attended postgraduate courses on antibiotics prescribed such drugs more frequently. This was not statistically significant. However, it is of great concern that 5% never prescribed antibiotics when treating patients with a history of endocarditis, and that 20% did not know that amoxicillin was a penicillin. Such lack of knowledge may cause fatal results of therapy.
A survey was conducted to determine prescribing practices of general dental and medical practitioners regarding the use of antibiotics for prophylaxis.
A questionnaire with an accompanying letter was designed to investigate prescribing practices of general dentists and physicians. The survey encompassed demographic data, mechanisms to keep current with prophylactic practice, first- and second-line drugs prescribed with doses and directions, applicable medical conditions and dental procedures warranting antibiotic prophylaxis. Names were chosen randomly from provincial lists and ethics approval was granted. Responses were compared with 1997 American Heart Association (AHA) guidelines.
In all, 1,500 surveys were sent to each group, with a response rate of 32% of dentists and 17% of physicians. There was a significant difference (p
The Canadian Dental Association (CDA) and the American Academy of Pediatric Dentistry (AAPD) recommend that children visit the dentist by 12 months of age.
To report on how Manitoba"s general dental practitioners and pediatric dentists manage oral health in early childhood.
Mailed surveys that used the modified survey methods of Dillman were sent to 390 Manitoban general dental practitioners and pediatric dentists. The sampling frame was the Manitoba Dental Association"s Membership Registry, but only those dentists who consented to the release of their mailing information were contacted. Survey data were analyzed with Number Cruncher Statistical Software (NCSS 2007). Descriptive statistics, bivariate analyses and multiple regression analyses were done. A p value of
Dental treatment in children too young or too apprehensive to co-operate is often performed under sedation. The aim of this study was to survey the use of rectal and oral liquid and tablet benzodiazepine sedation in Swedish child dentistry, and estimation of treatment success. A questionnaire was sent to 500 randomly selected dentists (GPs) working in the Public Dental Health Service and all (77) specialists (PDs) working at paediatric dentistry clinics. Benzodiazepine sedation was used by 73% of the GPs and 97% of the PDs. Seven per cent of the GPs and 87% of the PDs had sedation sessions at least once a month. Of the GPs, 60% administered the sedation rectally, 7% orally in liquid form, and 39% orally in tablet form. For PDs, the corresponding figures were 97%, 78%, and 68%. Sixteen per cent of the GPs and 84% of the PDs used midazolam for rectal sedation. PDs rated rectal sedation better than the GPs (p
To examine changing patterns regarding restorative treatment criteria for dental caries.
A representative sample (n = 215) was drawn from all 15-year-olds receiving dental treatment in the Public Dental Service (PDS) in Oslo, Norway for each of the years 1979, 1989, 1993 and 1996. Information from clinical records and bitewing radiographs on caries treatment was collected. The results presented in this paper pertain to 198, 201, 209 and 208 subjects in each group.
The results revealed dramatic changes in the use of restorative treatment criteria. Only 16% of tooth surfaces were treated in 1996 according to the criteria from 1979. The number of sound surfaces was found to have increased by 39% whereas the number of filled surfaces was reduced by 92%. In spite of more stringent criteria for restorative treatment, the number of D4 lesions did not increase.
The practice of change in restorative treatment continued during the 17 years of study. Though the number of decayed surfaces appeared to be stable during the period, in reality, there was a reduction in caries occurrence during the first 10-year period (1979-1989). A conceptual model of dentists' caries-related treatment decisions outlined by Bader & Shugars may be used to explain parts of the rapid change in the criteria used in the PDS in Oslo.
The aim was to measure variations in threshold for operative treatment of approximal caries in permanent teeth and the use of restorative materials, compared with results from studies conducted in Norway in 1983 and 1995. In 2009, a precoded questionnaire was sent electronically to 3,654 dentists with E-mail addresses in the member register of the Norwegian Dental Association. The questions were related to caries, treatment strategies and choice of dental materials. Replies were obtained from 61% of the dentists after two reminders. Restorative treatment of approximal lesions confined to enamel, based on radiographic appearance, was proposed by 7% of the dentists, compared with 66% in 1983 and 18% in 1995. Younger dentists, significantly more often than older, would defer operative treatment of approximal lesions until the lesion was visible in dentine. While tunnel preparation most often was the preparation of choice in 1995 (47%), saucer-shaped preparation was most favoured in 2009 (69%). Tunnel preparation was only preferred by 4% of the dentists. Resin composite was the restorative material preferred by 95%, compared with 16% in 1995. The corresponding values for conventional glass ionomer cement (GIC) were 1 versus 22%, for resin-modified GIC 1 versus 7%, and for a combination of GIC and resin composite 2 versus 22%. Compomer was preferred by 1% of the respondents. The authors conclude that treatment concepts for approximal caries have changed considerably during the last 26 years. In 2009, only 7% of dentists reported that they would treat approximal caries operatively before the lesion reached dentine.
OBJECTIVE: To test the hypothesis that Swedish dentists schedule more mandibular third molars for prophylactic removal compared with UK dentists and oral surgeons. DESIGN: Clinical and radiographic information relating to a stratified sample of 36 disease-free mandibular third molars (equal distribution of males and females, patients' age, angular position and degree of impaction) was presented to 26 general dental practitioners (GDPs) and 10 oral surgeons in Sweden and 18 GDPs and 10 oral surgeons in Wales who were asked to decide whether or not the third molars should be removed. RESULTS: There was no evidence of any difference in mean number of molars scheduled for removal by the GDPs, but the Swedish oral surgeons scheduled significantly more third molars for removal than oral surgeons in Wales. CONCLUSION: The less interventionist approach among oral surgeons in the UK may reflect the development and application of authoritative guidelines in the UK and an extensive debate concerning appropriateness of prophylactic removal there.