A qualitative exploration of dental practitioners' knowledge, attitudes and practices towards HIV+ and patients with other 'high risk' groups

This paper expands upon a previous quantitative study which measured dentists' knowledge, attitudes and practices towards patients carrying blood-borne viruses in order to identify potential barriers to the provision of adequate dental treatment. Although some useful findings were obtained in that study, it was suggested that further qualitative work needed to be conducted in order to provide the opportunity for dental practitioners' to expand, reflect and justify their opinions and beliefs in more detail. The aim of this study is to present the results of such a qualitative investigation.

Barriers limiting dentists' active involvement in smoking cessation

PURPOSE

To assess the experience and attitudes of dental professionals towards smoking cessation and, in particular, to explore perceived barriers limiting their involvement in this area of practice.

MATERIALS AND METHODS

A combined quantitative and qualitative methodology was employed in South Essex, an area in South East England. In the first phase a questionnaire survey was conducted with all general dental practitioners on the South Essex Health Authority dental list to assess their current involvement in smoking cessation and their general attitudes to this area of clinical care. In the second phase, ten focus group interviews were conducted with dental teams to uncover in greater depth views towards smoking cessation and, in particular, the barriers preventing progress.

RESULTS

A 60% response rate (n = 149) was achieved for the postal questionnaire and 52 dental team members participated in the focus groups. The questionnaire survey revealed that the majority of the sample reported asking their patients about smoking (90%) and recording this information in their clinical notes (75%). However, a relatively low number indicated active involvement in assisting smokers to stop (30%) or referring them for more detailed support (24%). The focus groups uncovered a range of fundamental barriers limiting greater involvement in smoking cessation. The key issues included a fatalistic and negative concept of prevention; perceived lack of relevance of smoking cessation to dentistry; patient hostility; and organizational factors within the practice setting.

CONCLUSION

Future action to encourage the provision of smoking cessation in dental practices needs to address the range of barriers that currently limit involvement in this area of clinical practice.

Current issues in dental practice management. Part 3. Attracting and keeping patients

This paper, the third in a series of articles exploring some of the management issues facing dentists today, examines the importance of maintaining a motivated, well-trained and properly rewarded staff team.

Assessing cross infection prevention measures at the Dental Clinic, University College Hospital, Ibadan

The dental clinic is an environment where disease transmission occurs easily. Prevention of cross infection in the dental clinic is therefore a crucial aspect of dental practice and dental clinic workers must adopt certain basic routines while practising. This study evaluates basic routines in prevention of cross-infection in the dental clinic, University College Hospital Ibadan. The sample comprised 77 dental clinic workers, who completed closed-ended questionnaires. The questionnaires enquired into practices of the workers in the clinic as well as in the laboratories Physical inspection of dental equipment, instruments and materials was also carried out. The results highlight poor compliance of workers, especially the dental surgeons and students, with the hepatitis B vaccination programme of the Hospital. History to identify high risk individuals was often overlooked and was practised by less than 50% of the clinic workers. Barrier technique with the exception of the use of eye shield, was well practised by all the clinic workers. Aseptic technique was well practised in the dental clinic. Inadequate number of dental surgery assistants, faulty sterilizing equipment, poor monitoring of sterilization, coupled with inadequate number of instruments contributed to the poor success of prevention of contamination and instrument processing procedures. Less than 30% of dental surgeons and fewer than 50% of students discarded sharp materials into the yellow/sharp bin. Liquid waste was well disposed off through the drain for onward flow into the sewer, whilst the disposal of solid contaminated waste did not conform to stipulated international standard. The study found that successful infection control in the dental clinic was highly dependent on the dental surgery assistants, because highly technological equipment were lacking. The management/administration also plays an important role in the number of physical and human resources available and in the overall surveillance of nosocomial infections.

Perceived barriers and facilitators to dental treatment among female caregivers of children with and without HIV and their health care providers

PURPOSE

This study sought to identify barriers and facilitators to dental care among families of predominately low socioeconomic status having children with and without HIV.

METHODS

Twelve focus group sessions with African-American and Hispanic caregivers and 18 individual semistructured interviews with key informant health care providers were held at two sites: a hospital-based program (HBP) and a dental school-based program (DSBP), that provide pediatric dental services. SPSS Textsmart software was used to analyze qualitative data within and across group types and sites.

RESULTS

Focus group participants (n = 72, averaging 6 women per group) included: HIV-seropositive biological mothers of HIV-seropositive children (4 groups); HIV-seronegative caregivers of HIV-seropositive children (4 groups); and Medicaid-eligible, HIV-seronegative caregivers of HIV-seronegative children (4 groups). The most commonly expressed barrier to dental care across groups was poor interpersonal communication between dental staff and caregiver/child. HIV-seronegative groups cited health care delivery system factors as barriers to receiving dental care more frequently than HIV-seropositive caregivers who cited shame/anger and family illness as being more important. Common facilitators were positive communication and transportation assistance. Unique facilitators for HIV-seropositive groups were coordination of the dental visits with medical appointments at the HBP. Key informants acknowledged high stress in families having children with HIV/AIDS, cited dental fear among caregivers as a barrier to dental treatment adherence and reported that dental care seemed to be a low priority among many of these families.

CONCLUSIONS

Facilitators and barriers to care included factors in the family, dental care and health care delivery systems as well as interpersonal communication between the dental providers and the families.

Coaching: a progressive new paradigm

Coaching is a new and powerful activity that has tremendous capacity to foster human growth. It has applications in many areas of the dental profession. I urge you to explore the bibliography at the end of this article. There is great wisdom contained in these books.

Color perception among different dental personnel

This study investigated the differences in color perception among distinct groups of dental personnel. Four groups of dental personnel (10 dental technicians, 15 final-year dental students, 15 general practitioners and 10 prosthodontists) were asked to match seven test tabs of shades A1, A4, B2, B3, C2, C4 and D3 (Z100 shade guide, 3M Dental Products, St Paul, MN 55144, USA) against a standard Vita shade guide under similar lighting conditions. The results obtained were computed into L*a*b* values using a small-area colorimeter (Dental Colorimeter, Minolta Camera Pte Ltd). The data were analyzed using one-way ANOVA/post-hoc Scheffe's test at significant level p<0.05. The results showed significant differences in deltaE (color difference) between the dental technicians and the clinicians for shade C4. The significant difference that was observed in deltaE for dark shades between dental personnel was mainly contributed to a disparity in L* values. A significant difference in deltaL* was observed between dental technicians and prosthodontists for shade C4.

Investors in people: what is it all about?

Recently, there has been a proliferation of press releases from organizations recognized as Investors in People including the BDTA, the DPB, the BDA and many individual dental practices. Indeed, the number of dental practices recognized as Investors in People has more than doubled in the last six months. What is this sudden interest in Investors in People within the dental profession all about? This article is a guide to what the Investors in People (IiP) standard is, what relevance it has to dental practice and what benefits can be gained from working towards this standard. I have used my own experiences in gaining the standard in our dental practice to act as an example throughout the article.

Attitudes of the dental team to the provision of care for people with learning disabilities

The aim of this study was to report on the evaluation of an attitude scale for General Dental Practitioners (GDPs) and Dental Auxiliaries/Professionals Complementary to Dentistry (PCDs), to determine the reliability of the scale with these two groups and to note any inter-group differences. Seventy-four GDPs and 89 PCDs completed the self-administered questionnaires. The main outcome measures were reliability statistics, attitude scores, and factor analysis statistics. Reliability was satisfactory for both groups. PCDs scored consistently higher than GDPs on this attitude scale. Six factors were found to underlie the responses of GDPs, accounting for 62% of the variance. Seven factors were found to underlie the responses of PCDs, accounting for 65% of the variance. PCDs expressed more positive views about provision of care for patients with learning disabilities than did GDPs. Factor analysis revealed that GDPs were concerned about effectiveness of treatment and the stress related with treating patients with disabilities. PCDs appeared to be more concerned with the human rights of people with learning disabilities and how they fit into society.

Getting off to the right start in your new practice

Purchasing and starting up a new practice is one of the most important moves you will make in your career. Anticipating and responding effectively to day-to-day situations can help get you off to the right start in building the kind of practice you've always wanted.

Coaching for a winning dental team

In 1943, Abraham Maslow, the "father of humanistic psychology," formulated his "Hierarchy of Needs Theory." Maslow proposed people have needs that must be satisfied, and these needs will motivate until they are satisfied. The needs are arranged in a hierarchy or pyramid ranging from basic needs to higher needs with an individual needing to satisfy a lower need before a higher need can motivate. The five needs of the hierarchy are: physiological needs, safety needs, social needs, esteem needs, and self-actualization. This article discusses adaptation of the hierarchy of needs to the dental practice to motivate staff to perform at a higher level.