Adoption issues associated with a new periodontal screening tool: an online survey of Canadian dentists

OBJECTIVE

To determine barriers and facilitators associated with the acceptance of a new diagnostic screening tool for periodontitis.

METHODS

As part of a larger study to examine factors that affect the adoption of new technology by dentists, we piloted an online survey of Canadian dentists through an electronic newsletter produced by the Journal of the Canadian Dental Association. A new oral rinse that screens for the presence of periodontitis by estimating neutrophil abundance in saliva was used for illustrative purposes. The survey included questions about the types of patients for which the test would be beneficial, how the test might be incorporated into practice and how much the dentist would be willing to pay for the test.

RESULTS

As the survey was delivered through a new communication tool, the response rate was low. Nonetheless there appeared to be interest in new periodontal screening tools to complement existing diagnostic tests for periodontitis. The test was seen as a valuable educational tool for patients; however, the cost to administer the test was determined to be an issue.

CONCLUSIONS

Despite the low response rate, dentists were interested in new screening tests for periodontitis. A larger study with a more representative sample could provide valuable information for scientists who are interested in taking their research from the bench to chairside.

2013 survey of Australian orthodontists' procedures

AIM

This survey of Australian orthodontists was conducted to assess treatment preferences.

METHODS

Email invitations to participate in an online survey were sent to a total of 433 Australian Society of Orthodontists (ASO) members and 158 replies were received (36% response).

RESULTS

For Class II treatment, most practitioners preferred to wait and treat later but when early treatment was performed, the Twin Block was the most popular appliance. For fixed appliance treatment, the 0.022 inch slot was the most commonly used (73%) and the median treatment time was 20 months. The median extraction rate was 23% which was similar to that reported in a 2008 USA survey. Sequential plastic aligners were used by 73% of respondents and Temporary Skeletal Anchorage Devices were used by 77%. The most common research question clinicians would like answered related to retention.

CONCLUSION

The responses were similar Australia-wide but some areas of difference were revealed and discussed.

Dental radiography in New Zealand: digital versus film

Digital x-ray systems offer advantages over conventional film systems, yet many dentists have not adopted digital technology.

OBJECTIVES

To assess New Zealand dental practitioners' use of--and preferences for--dental radiography systems.

DESIGN

Cross-sectional survey.

SETTING

General and specialist dental practice.

PARTICIPANTS AND METHODS

Postal questionnaire survey of a sample of 770 dentists (520 randomly selected general dental practitioners and all 250 specialists) listed in the 2012 NZ Dental Council Register.

MAIN OUTCOME MEASURES

Type of radiography systems used by dentists. Dentists' experiences and opinions of conventional film and digital radiography.

RESULTS

The participation rate was 55.2%. Digital radiography systems were used by 58.0% of participating dentists, most commonly among those aged 31-40 years. Users of digital radiography tended to report greater satisfaction with their radiography systems than users conventional films. Two-thirds of film users were interested in switching to digital radiography in the near future. Reasons given by conventional film users for not using digital radiography included cost, difficulty in integrating with other software systems, concern about potential technical errors, and the size and nature of the intra-oral sensors.

CONCLUSION

Many dental practitioners have still not adopted digital radiography, yet its users are more satisfied with their radiography systems than are conventional film users. The latter may find changing to a digital system to be satisfying and rewarding.

Finishing and polishing procedures of composite restorations by Saudi dentists: a cross-sectional study

AIM

The purpose of this study was to assess the knowledge and practices of Saudi dentists in finishing and polishing composite restorations.

MATERIALS AND METHODS

A cross-sectional questionnaire-based study was conducted among 306 Saudi dentists from March to April 2012. The collected data were analyzed using Microsoft Excel 2010 program and descriptive statistics were obtained.

RESULTS

Completed questionnaires were returned by 191 participants, giving a response rate of 62.4%. 115 (65.7%) respondents are using fine diamond finishing burs for finishing occlusal surfaces, 82 (48%) used fine aluminum oxide finishing discs for finishing facial surfaces, 130 (76%) used diamond finishing strips for finishing interproximal surfaces.121 (63.4%) respondents were of the view that the type of filler content has a major influence in providing color stability to the composite restoration and 137 (72.1%) believed nano-composites provided enhanced color stability.

CONCLUSION

Dentists in Saudi Arabia are aware of the benefits of proper finishing and polishing of composite restorations. They however need to use finishing and polishing burs, disks, strips and pastes in a sequential series. Usage of composite polishing pastes and composite surface sealants should be emphasized in undergraduate curriculum.

NICE guidance on antibiotic prophylaxis to prevent infective endocarditis: a survey of clinicians' attitudes

BACKGROUND

Since the introduction of the National Institute for Health and Clinical Excellence (NICE) guideline (CG064) in 2008 recommending cessation of antibiotic prophylaxis (AP) against infective endocarditis (IE), low level prescribing persists in the UK and is a potential reason why there has been no significant change in the general upward trend in cases of IE.

AIM

To undertake a survey of dentists (Ds), cardiologists and cardiothoracic surgeons (C/CTSs) and infection specialists (ISs) to determine why this might be the case.

DESIGN

Internet questionnaire-based survey.

METHODS

A questionnaire was distributed by email to specialists via UK national societies.

RESULTS

A total of 1168 responses were received. All the specialist groups are aware of the guideline (99%). Ds are broadly satisfied, whereas C/CTSs are not. Most Ds follow the NICE guidance (87%), whereas many C/CTSs (39%) do not; ISs adopt a middle course (56%). Even amongst Ds, a significant proportion believe that patients with a prosthetic heart valve (25%) or previous history of IE (38%) should receive AP. A total of 36% of Ds have prescribed AP since March 2008 and many have undertaken procedures where AP has been prescribed by someone else. The majority of respondents (65%) feel that more evidence is required, preferably in the form of a randomized controlled trial.

CONCLUSION

Many patients perceived to be at high risk of IE are still receiving AP in conflict with current NICE guidance.

Use of electronic dental records in Brazil

This study aims to provide both a quantitative and a qualitative analysis of the usability of the most popular electronic dental records in Brazil regarding its clinical and administrative features. The softwares not only will be evaluated regarding their usage among the Brazilian dental professionals but also regarding their functionalities (present, used and desired) and the difficulties encountered by the dentists during their use.

Cross sectional: use of coolant for high-speed tooth preparation: a survey of pediatric dentist members of the American Academy of Pediatric Dentistry

PURPOSE

To report the findings of a survey to determine the educational experiences, opinions and clinical practices relative to the use of coolant during cavity preparation of pediatric dentist members of the American Academy of Pediatric Dentistry (AAPD) and to determine whether teaching policies influenced the type of coolant used in private practice.

METHODS

Four thousand fifty surveys were emailed to AAPD members and included questions regarding demographics and predoctoral, graduate, and current practice policies for the use of dry cutting.

RESULTS

Returned survey numbered 1730 for a response rate of 43%. Fifteen percent were taught the concept of dry cutting in their predoctoral programs and 34% in their specialty, programs. Sixty percent never or rarely prepare teeth without water coolant. Slightly more than 40% prepared teeth with air coolant alone. Patient behavior (25%) and sedation (21%) were reported as determining factors for cutting dry. Thirty-one percent of private practice clinicians and 34% of part time academics use dry cutting, while only 15% of full time academicians use the technique (P<0.0001).

CONCLUSIONS

Respondents tend to use the technique they were taught during their residency. Use of dry cutting was more likely to be utilized during sedations or general anesthesia to avoid airway compromise.

Postendodontic restoration: a survey among dentists in Switzerland

The purpose of this study was to evaluate the present opinions and the knowledge of Swiss general dentists about current strategies to restore endodontically treated teeth. Between 2009 and 2011, a 17-item questionnaire was given to 95 general dentists at the beginning of continuing education courses related to this topic. The majority of dentists indicated that they restore more than 30 endodontically treated teeth per year. The decision for placing an intracanal post was mainly based on the amount of remaining tooth substance and the type of tooth (anterior tooth, premolar, molar, or abutment for fixed dental prostheses). Most respondents strove for a retention depth of at least two-thirds of the root length and a form-congruent fit between post and post space preparation. In terms of post type, metallic posts were predominantely used, while an increasing application of glass-fiber posts was registered. Regardless of the type of post, composite cements were the most commonly used luting materials. The prevailing strategies for the restoration of endodontically treated teeth are in part in accordance with the current literature. Disagreements with the literature are related to the post length, the desired post fit and the fact that metal screw posts are apparently still in use.

Pulp exposures in adults--choice of treatment among Swedish dentists

This study comprises a survey of Swedish dentists'treatment preferences in cases of carious exposure of the dental pulp in adults.The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines.Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included.The final study sample comprised 412 participants.The dentists were presented with two case scenarios. In Case 1 a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14.The participants were asked to nominate their treatment of choice: pulp capping, partial pulpotomy or pulpectomy. For Case 1, 17 per cent of the respondents selected pulpectomy; the corresponding rate for Case 2 was 47 per cent. Female gender and age group 25-49 years were predictive of selection of less invasive treatment options. However, according to recent guidelines (2011) from the National Board of Health and Wellfare, Swedish dentists are recommended to elect pulpectomy prior to pulp capping/partial pulpotomy when confronted with a tooth having a cariously exposed pulp in adults.

Dentist's views on a province-wide campaign promoting early dental visits for young children

INTRODUCTION

The Canadian Dental Association recommends that children have their first visit to a dental professional no later than 12 months of age. In 2010, the Manitoba Dental Association launched the Free First Visit (FFV) program to increase access to early visits in the province. The purpose of the study reported here was to survey dentists about their views on the FFV program and to gain an understanding of their attitudes and practice patterns relating to the oral health of infants and toddlers and first dental visits.

METHODS

A survey was mailed to registered general and pediatric dentists in Manitoba according to a modified Dillman methodology. Dentists were asked about their views on the FFV, their knowledge of early childhood oral health and the timing of first dental visits. Descriptive statistics, bivariate analyses and logistic regression analyses were performed. A p value of 0.05 or less was considered significant.

RESULTS

The overall response rate was 63.2% (375 eligible responses out of 593 surveys mailed). The majority of respondents were men (255/373 [68.4%]), and most respondents were general dentists (355/372 [95.4%]). A total of 63.5% (231/364) felt that the FFV program improved access to care, 64.6% (223/345) believed that public awareness of young children's oral health has increased, and 76.2% (266/349) thought that the FFV initiative should continue past the planned end date of March 31, 2013. On average (± standard deviation), respondents thought that the first dental visit should occur at 18.1 ± 10.0 months, but in their practices, they actually recommended a slightly older age (18.9 ± 10.4 months). Compared with results from a previous survey, conducted in 2005, dentists who responded to this survey recommended that children have their first visit at a significantly younger age. A greater proportion of dentists reported seeing children 12-23 months of age in their practices than in the past (81.9% vs. 73.7%).

CONCLUSIONS

A majority of dentists who responded to the survey approved of the FFV program and thought it should continue. Although these dentists recommended early first dental visits, the average age recommended by respondents was 6 months later than the target age of 12 months. It appears that, over time, dentists are becoming more aware of prevention and management techniques relating to infants and toddlers.

Prescription of antibiotics in the dental practice: a survey of dentists in Switzerland

In dentistry, antibiotics are prescribed both for prophylactic and therapeutic purposes. Their unwarranted use, however, may lead to the selection of resistant microorganisms. The aim of this study was to evaluate the indications and the extent of antibiotic prescription by dentists in Switzerland. A questionnaire was sent to 800 dentists during the winter of 2008/2009. Responses to the questionnaire were received from 20% of them. Many respondents indicated that they tried to prescribe antibiotics in a selective and cautious manner. Nevertheless, uncertainties existed regarding the indications. For example, the frequency of prescribing an antibiotic when it was not absolutely necessary was related to the respondents' uncertainty regarding the correct diagnosis and therapy. Not surprisingly, two-thirds of the respondents would prefer to have precise guidelines for the use of these drugs.

Restorative Treatment Decisions for Deep Proximal Carious Lesions in Primary Molars

AIM

To assess clinicians' individual variables that might influence decision-making for the restoration of deep proximal carious lesions in primary molars.

METHODS

A pre-coded questionnaire that sought participants' treatment choices for a deeply carious second mandibular primary molar, as depicted in a simulated periapical radiograph, along with a specific clinical scenario, was distributed among a random sample of 157 dentists and 15 paediatric dentists. Participants were asked to answer questions. After combining the pulpotomy and pulpectomy treatment choices under a 'pulp therapy' category, a binary dependent variable was constructed. Logistic regression of the ratio of the participants who would restore the questioned tooth by a method in question, was run.

RESULTS

A total of 155 dentists (116 males and 39 females) completed the survey, giving a response rate of 90%. Of these 53% of dentists recommended pulpotomy followed by definitive restoration and 39% recommended removal of caries and restoration without pulp therapy. In the logistic regression model, males and graduates of English language undergraduate dental programs had higher probabilities of restoring without prior pulp therapy (p<0.03 and p<0.02, respectively). Compared with graduates of Asian programs, dentists who graduated from Eastern Europe and the Middle East, showed lower likelihoods of restoring the tooth without prior pulp therapy (p<0.01 and p<0.004, respectively). Dentists who treated an average of 6-16 child patients during a week had a lower probability of restoring the tooth without prior pulp therapy than those who were not currently involved in treating children (p<0.01). No other measured variables were associated with participant's treatment choices.

CONCLUSIONS

The lack of agreement among dentists regarding their optimal treatment recommendations for deep proximal carious lesions appears to be due mainly to inter-individual, educational, training and practice characteristic factors.

Pre- and postdoctoral dental education compared to practice patterns in special care dentistry

There has been limited research into the impact of predoctoral experiences and postdoctoral general dentistry residencies on the practice patterns of dentists in the care of patients with special or complex needs. This study was undertaken to determine if educational experiences with special populations had a relationship to practice patterns after graduation or residency. University of the Pacific alumni who graduated between 1997 and 2007 were surveyed regarding their pre- and postdoctoral dental education and their practice patterns for the care of patients categorized as medically compromised, frail elders, and developmentally disabled. Definitions for each patient category were provided. Alumni were asked about their practice setting and postdoctoral education. Thirty-one percent (n=526) of those surveyed responded. Regression analyses showed respondents not in private practice were more likely to have completed a postdoctoral general dentistry program (Advanced Education in General Dentistry or General Practice Residency) after dental school compared to respondents in private practice (p<0.001). Across all age groups, respondents not in private practice treated significantly more patients with developmental disabilities than those in private practice (p<0.001). Respondents not in private practice treated more medically compromised patients younger than age sixty-five compared to respondents in private practice (p<0.01). Interestingly, those in private practice treated significantly more patients over sixty-five who were also classified as medically compromised (p<0.05). Pacific alumni who completed postdoctoral training in general dentistry were found to practice more often in non-private practice settings. Alumni in non-private practice settings reported treating a higher percentage of medically compromised patients below age sixty-five than their counterparts in a typical private practice. The pre- and postdoctoral experiences of treating special needs populations appear to have a relationship to graduates' practice setting and patient population.

Changes in compliance with recommended infection control practices and affecting factors among dentists in Taiwan

Compliance with recommended infection control practices in East Asia has not been clearly documented. To investigate changes in compliance with recommended infection control practices over a eleven-year period and to identify affecting factors, two nationwide cross-sectional surveys of dentists in Taiwan were conducted in 1999 and 2010. An anonymous questionnaire that assessed characteristics of dentists and practices of recommended infection control guidelines was mailed. Results showed that all infection control practices surveyed had improved in 2010. Factors affecting compliance with wearing basic protective barriers in 2010 were being female (odds ratio [OR]=3.631, p<0.001), aged forty-one to fifty years (OR=3.991, p<0.05), treating twenty-one to thirty patients per day (OR=2.690, p<0.05), and having information sources from seminars and conferences (OR=2.659, p<0.05). Although infection control practices have improved over time, there is still much room to increase rates of wearing a head cap, protective eyewear, and a face mask and disinfecting impression materials. Providing correct information about disinfection and sterilization processes through the Internet might be effective in improving compliance.

Assessment of hepatitis B vaccination and compliance with infection control among dentists in Saudi Arabia

OBJECTIVE

To evaluate hepatitis B virus (HBV) vaccine coverage and the use of infection control among dentists in Saudi Arabia.

METHODS

This cross-sectional study was carried out during the Third International Conference at the King Abdulaziz University Faculty of Dentistry, held on March 2012 in Jeddah, Saudi Arabia. Saudi or expatriate dentists working in Saudi Arabia were included in the study. The questionnaires were designed to meet the objective of the study.

RESULTS

A total of 402 dentists of whom 176 (44%) were male and 226 (56%) female took part in this study. Their mean age was 37.4 years. In all, 246 (61%) were general dentists and 156 (39%) specialists. Four-fifths (80.5%) of them had been vaccinated. Almost half (48.5%) had experience of needle stick injury, but none reported having been infected with HBV. Among the vaccinated dentists, 186 (57.5%) had not been screened for HBV antibodies. Younger dentists were more particular about vaccination and more careful in using protective wear. There was an association between protective barriers and HBV vaccination, but there was no association between history of needle stick injury and vaccination.

CONCLUSION

Dental healthcare workers have a high risk of infection with HBV due to the nature of their work; so there should be a mandatory program to vaccinate dentists against HBV and to ensure application of protective measures during their practice.

Reasons and pattern of tooth extraction among patients presenting at a Nigerian semi-rural specialist hospital

BACKGROUND

Oral health is greatly influenced by health teeth.

OBJECTIVE

The study is to determine the reasons and pattern of tooth extraction in patients seeking care at the oral surgery/Dental clinic in Rasheed Shekoni Specialist Hospital, Dutse, Jigawa between January 2010 and December 2011.

METHODS

A retrospective review of records of dental extraction patients. Patients' records were analyzed for demographics, reason(s) for tooth extraction and tooth/teeth extracted.

RESULTS

During the 2 years study period, 349 patients (M:F = 1.3:1) aged 2-65 years (mean = 29.7 years +/- 11.5 SD) had extraction of 377 teeth. Dental caries and its sequelae (91.2%) was the most frequent reason for tooth extraction across all age groups, followed distantly by periodontal disease (3.2%) and recurrent pericoronitis (3.0%). The highest proportion of extraction occurred between age 21 to 30 years of age. Mandibular first molars were the most commonly extracted tooth due to dental caries, followed by maxillary first and mandibular second molars. Mandibular molars were by far the more frequently extracted than maxillary molars.

CONCLUSION

Dental caries and its sequelae was the main reason for removal of teeth in this section of Nigerian population. Therefore, there is urgent need to focus on the prevention and treatment of dental caries and its sequelae in order to maintain functional and healthy teeth throughout life.

Perception of dentine hypersensitivity and its management by a group of Nigerian dentists

BACKGROUND

Dentists need to be aware of the management of dentine sensitivity in view of its high prevalence.

OBJECTIVE

The study is to determine by questionnaire the perception of dentine hypersensitivity (DH) and its management by Nigerian Dentists.

METHOD

A structured questionnaire was used to collect data from 176 Nigerian Dentists who attended professional dental workshops in Lagos, Ife and Jos, Nigeria.

RESULTS

The majority (73.3%) of the responding dentists claimed to see patients with DH. Nearly half (45.1%) of the dentists mentioned cold as the commonest stimulus evoking pain in DH while 56.8% could correctly identified the hydrodynamic theory as the commonest theory of tooth hypersensitivity. Multifactorial aetiology identified as causing DH included tooth wear lesions, periodontal causes and bruxism. Treatment options suggested varies but non-invasive was mentioned more than the invasive techniques. Sensodyne toothpaste was the commonest desensitising paste mentioned. The knowledge of Nigerian Dentists was found to be associated with the specialty of the practitioners (p = 0.0004).

CONCLUSION

Dental Practitioners, especially the General Dental Practitioners should be enthusiastic in updating their knowledge of DH and the management. Prevention of DH by the Patients and the Dentists should be emphasised.

Implementation and experience of a new method for posterior vertical bite reconstruction using direct resin composite restorations in the private practice--a survey

OBJECTIVE

The purpose of the present survey was to evaluate the implementation and experience of a new method for posterior vertical bite reconstruction using direct resin composite restorations by private practitioners who attended a hands-on continuing education course on this technique.

MATERIALS AND METHODS

In the years 2007 and 2008, 17 1-day continuing education courses on vertical bite reconstruction in the worn dentition by using direct resin composite restorations were attended by 310 participants. A 13-item questionnaire was posted to all course participants in April 2009 seeking information on the acceptance, implementation and experience of the presented technique in the private practice.

RESULTS

A total of 97 (31%) questionnaires were returned, whereas 67% of the respondents had used the presented technique. Analysis of the overall experience and satisfaction with the placed resin composite restorations using visual analog scale (VAS) revealed a mean VAS score of 7.2 ± 1.7 (0 = maximal unsatisfied, 10 = maximal satisfied). The direct resin composite restorations were predominantly rated 'good' within the assessed criteria surface texture, anatomical form, marginal integrity, marginal discoloration and color match. Ninety-eight percent of the private practitioners stated that they would continue to carry out vertical bite reconstructions according to this technique. The three most frequently observed clinical problems were related to marginal discolorations, bulk fractures and adhesive failures.

CONCLUSION

The presented restoration method was well accepted by private practitioners who used this treatment approach at least once after course participation, even though some clinical problems were observed.

Repair or replacement of defective restorations by dentists in The Dental Practice-Based Research Network

BACKGROUND

The authors aimed to determine whether dentists in practices belonging to The Dental Practice-Based Research Network (DPBRN) were more likely to repair or to replace a restoration that they diagnosed as defective; to quantify dentists' specific reasons for repairing or replacing restorations; and to test the hypothesis that certain dentist-, patient- and restoration-related variables are associated with the decision between repairing and replacing restorations.

METHODS

This cross-sectional study had a consecutive patient and restoration recruitment design. Practitioner-investigators (P-Is) recorded data for consecutively seen restorations in permanent teeth that needed repair or replacement. The DPBRN is a consortium of dental practitioners and dental organizations in the United States and Scandinavia. The collected data included the primary reason for repair or replacement, tooth surface or surfaces involved, restorative materials used and patients' demographic information.

RESULTS

P-Is collected data regarding 9,484 restorations from 7,502 patients in 197 practices. Seventy-five percent (7,073) of restorations were replaced and 25 percent (2,411) repaired. Secondary caries was the main reason (43 percent, n = 4,124) for treatment. Factors associated with a greater likelihood of repairing versus replacing restorations (P < .05) included having graduated from dental school more recently, practicing in a large group practice, being the dentist who placed the original restoration, patient's being of an older age, the original restorative material's being something other than amalgam, restoration of a molar and the original restoration's involving fewer tooth surfaces.

CONCLUSIONS

DPBRN dentists were more likely to replace than to repair restorations. Secondary caries was the most common reason for repairing or replacing restorations. Certain dentist-, patient- and restoration-related variables were associated with the repair-or-replace decision.

CLINICAL IMPLICATIONS

The selection of minimally invasive treatment for an existing restoration is critical, as it may affect the longevity of the tooth.

Trends in material choice for direct restorations by final year students from University College Cork 2004-2009

Traditionally, undergraduate students in University College Cork (UCC) have been taught to use amalgam as the first choice material for direct restoration of posterior cavities. Since 2005 the use of composite resins has replaced amalgam as the first choice material. An audit was conducted of all direct restorations placed by final year students from UCC from 2004 until 2009. Results showed that over a six year period, final year UCC dental undergraduate students placed proportionately more direct composite resin restorations and significantly fewer amalgam restorations. The need for and undergraduate exposure to, provision of amalgam restorations may have to be revisited.

[Agreement analysis of subjective evaluation of orthodontic treatment outcome]

OBJECTIVE

To investigate the agreement of subjective evaluation of orthodontic treatment outcome and to analyze possible factors that may be related to it.

METHODS

As a randomized clinical trial, with Angle's classification as a stratification factor, our study contained 48 cases with integrity data, which were randomly extracted from 806 orthodontic treatment cases in Peking University School and Hospital of Stomatology during July 2004 and August 2008, and gathered post-treatment study casts, cephalometrics and photographs of the 48 cases as the research subjects. Similarly with Angle's classification as a stratification factor, the 48 cases were randomly divided into 4 groups. According to the monomial and combined subjects, 12 clinicians were asked to act as the raters to rank the 12 cases in each group.

RESULTS

Overall, there were 1 584 pairings between the raters in the examination of evaluation. The mean Spearman r was 0.565 3 ± 0.239 9. Grouping factor was related to the agreement of subjective evaluation (P<0.05). In the third trial item-Post-M+P, the correlations were the greatest among the judge-pairs (P<0.001). The other five items were at the same agreement level. The level of orthodontic treatment outcome was a factor that influenced the agreement level of subjective evaluation (P<0.05). The score stability of the patients, whose treatment duration was longer than 2.5 years, was significantly higher than that of the patients whose treatment duration was between 1.5 years and 2.5 years (P<0.05). The following factors, such as Angle's classification, age of patients and whether the teeth was extracted or not, were the insignificant factors (P>0.05).

CONCLUSION

The average correlations present a moderate agreement level. Grouping, experimental item, the length of treatment duration and the level of orthodontic treatment outcome are the factors that affect the agreement of subjective evaluation. Several factors including Angle's classification, age of patients and whether the teeth is extracted or not, do not affect the agreement of subjective evaluation.

[Consistency of the subjective evaluation of malocclusion severity by the Chinese orthodontic experts]

OBJECTIVE

To assess the consistency of the subjective evaluation of malocclusion severity by the Chinese orthodontic experts.

METHODS

Sixty-nine Chinese orthodontic experts subjectively evaluated the malocclusion severity for 120 cases which were selected randomly from 6 University orthodontic clinics by checking each case's pretreatment records including study cast, lateral head film, panoramic radiograph, facial photographs and patient chart. Each orthodontist was asked to independently rate the severity of every case into five grades: mild, mildly moderate, moderate, severely moderate and severe. Rating data was finally gathered to evaluate the intra-judge's reliability and the inter-judges' consistency.

RESULTS

Weighted Kappa test revealed that 8.33% orthodontists showed excellent intra-judge's reliability (Kappa ≥ 0.81), 78.33% orthodontists showed good intra-judge's reliability (Kappa ≥ 0.61) and 96.67% specialists displayed general intra-judge's reliability (Kappa ≥ 0.41). And intra-class correlation coefficient demonstrated a high level of inter-judges' consistency (r=0.989, P<0.01).

CONCLUSION

Good intra-judge's reliability and inter-judges' consistency can be demonstrated in the subjective evaluation of malocclusion severity by the Chinese orthodontic experts, which could the basis for establishing the objective grading system of malocclusion severity.

Awareness, knowledge and practice of evidence-based dentistry amongst dentists in Kuwait

This study assessed the awareness, knowledge and practice of evidence-based dentistry (EBD) amongst dentists working in the public sector in Kuwait. Of the 150 randomly selected dentists from all five health districts in Kuwait who had originally been approached, 120 participated by completing a pre-tested, self-administered questionnaire (80% response rate). Whereas 60.9% of the group stated that they practice EBD most of the time, fewer (40.8%) had a reasonable understanding of EBD based upon tested knowledge scores of EBD-related topics. Clinical decisions appeared to be mostly based on the clinician's own judgment (73.3%) rather than on evidence-based sources such as PubMed (28.3%) or the Cochrane Library (6.7%). A number of within-group differences were noted, with women (P<0.05), those working in a particular district (P<0.05), those with <10years' experience (P=0.05), those whose first dental qualification had been obtained in Kuwait (P<0.05), and those who had had any EBD training (P<0.05) showing greater knowledge of EBD. Training in EBD was felt necessary by a majority of the group, and this may be facilitated if dental centres have access to evidence-based sources to remove some of the possible barriers to implementation of EBD.

Periodontal practice and referral profile of general dentists in Nova Scotia, Canada

BACKGROUND

In contrast to an expected increase in demand for periodontal services with aging of the population, it appears that referrals to periodontists are declining.

OBJECTIVE

To determine the extent to which general dentists in Nova Scotia, Canada, provide periodontal and surgical implant therapies and to determine the factors influencing a dentist's decision to provide treatment or refer patients to a specialist.

METHODS

A cross-sectional survey study was performed. The survey questionnaire was mailed to all 443 general dentists practising in Nova Scotia in summer 2009. The questionnaire presented several clinical scenarios and asked respondents whether they would treat the patient in the office or refer to a specialist. The data were analyzed by logistic regression.

RESULTS

Of the 279 (63.0%) dentists responding to the survey, 272 (61.4% of the total) were eligible for inclusion in the analysis. The majority of dentists reported rendering nonsurgical periodontal therapy, including scaling (98.5%; 262/266), periodontal maintenance (95.9%; 255/266), and treatment for bruxism (95.1%; 252/265). The most common surgical procedures performed by dentists were frenectomy (29.4%; 78/265), gingivectomy (29.3%; 77/263) and crown-lengthening procedures (17.0%; 46/271). Eleven factors significantly influenced dentists' decisions to treat or refer patients. The most common criteria used in selecting a periodontist were satisfaction of previous patients, previous success with the treatment, and the personality of and good communications with the periodontist.

CONCLUSIONS

In this study, dentists reported rendering nonsurgical periodontal therapy on a wide scale, whereas their involvement in oral or periodontal and implant surgical therapies was limited.

Dental fear in children and adolescents: a comparison of forms of anxiety management practised by general and paediatric dentists

BACKGROUND. About 11% of children and adolescents suffer from dental fear. These young people run an increasing risk of undergoing more invasive treatments. AIM. We researched the management of dental anxiety in young patients by general and paediatric dentists as well as by trained and untrained dentists. DESIGN. Eight hundred dentists in Germany were interviewed via e-mail regarding their experience, treatment techniques, information material and complications during the treatment of fearful children. We also examined how difficult dentists judge the treatment of anxious children and how often they participate in continuing education courses. RESULTS. Paediatric dentists applied a greater spectrum of management techniques than general dentists. They used more often psychotherapeutic interventions and anxiety assessment questionnaires. Dentists who frequently attend in continuing education courses judged the treatment to be less difficult and also used psychotherapeutic interventions more often. CONCLUSIONS. German paediatric dentists and dentists who take continuing education courses utilise a broader range of techniques to manage dental anxiety. They may be eminently suited to treat children with severe forms of anxiety. Therefore, dentists who treat young patients should participate in education programmes so as to reduce both the anxiety of their patients and their own anxiety.

Routines for interocclusal appliance therapy among general dental practitioners in a Swedish county

The aims of this study were to investigate what kind of interocclusal appliances that were chosen among Swedish dentists when treating temporomandibular disorders (TMD), the clinical rationale for the treatment, the diagnoses that warranted the appliance treatment, the use of adjunct TMD treatments and prognostic considerations, and possible differences in these respects between children/adolescents and adults with TMD, and, finally, possible differences between private practitioners and general practitioners in the public dental service. During the 12-months-period April 2009-March 2010 all general dental practitioners in the county of Jönköping, Sweden, were asked to fill in a questionnaire when performing a TMD treatment with an interocclusal appliance. A total of 394 questionnaires were filled in and returned, 216 (55%) from dentists in public dental service and 178 (45%) from private practitioners. It was found that in 40% of the cases, no pre-treatment recording of the functional status in the masticatory system had been made. The commonest reasons for the treatment were bruxism, headache, and replacement of a previous appliance. Less than half of the appliances made were hard acrylic appliances. Some kind of adjunct therapy had been made in 22% of the cases treated in public dental service. The corresponding figure for those treated by private practitioners was 25%. Therapeutic jaw exercises was the commonest adjunct therapy followed by selective occlusal adjustment. In the vast majority of cases, the dentists judged the prognosis of the treatment to be good. It is concluded that a large number of appliances made to treat TMD were soft appliances, especially in public dental service. This reflects a possible overuse of soft appliances at the expense of hard acrylic appliances. Furthermore, in a large number of cases, the treatment was performed without any pre-treatment registrations, and adjunct therapies were rarely used. In all these respects,there is an improvement potential for the treatment of TMD in general dental practice.

The use of sedation in the dental outpatient setting: a web-based survey of dentists

There were 7276 e-mail requests sent to dentists in the United States and Canada requesting participation in a short web-based survey to update earlier information regarding the use of dental outpatient sedation. Participants were questioned regarding their use of dental outpatient sedation, including the frequency of use, type of sedation used, route ofadministration, medications used, physiologic monitoring employed, and availability qfantagonist medications and an automated external defibrillator In comparison to earlier studies, the use of outpatient dental sedation continues to change. The use of enteral sedation may be increasing, but now is differentiated by minimal and moderate sedation with different training requirements. The use of parenteral sedation by practitioners also appears to be increasing.

Correlation of awareness and practice of working postures with prevalence of musculoskeletal disorders among dental professionals

Over the last 20 years, a great many innovations have been introduced that are designed to reduce laborious activities; however, an unexpected consequence of these developments is a trend toward a sedentary lifestyle and prolonged static postures that are accompanied by musculoskeletal disorders (MSDs). MSDs have become a major issue of concern because the afflictions can be severe enough to disable professional careers. Although clinical dentistry is a field with immense potential for MSDs, only a few studies have investigated this issue. The present study was carried out addressing prevalence and awareness level of MSDs among 500 dental professionals from Central India. Also, the interrelationship between practices of working postures with occurrence of pain in different body parts were assessed using a structured questionnaire format. The results were statistically significant, and indicated that the prevalence of MSDs is high and that there is a dire need to enhance awareness regarding correct working postures. This study encompassed all factors that can be addressed as causes for MSDs among dentists.

Study of antibiotic prescribing among dental practitioners in Shiraz, Islamic Republic of Iran

Inappropriate prescribing of antibiotics by health care professionals is a worldwide concern. This study evaluated the knowledge and practices of dental practitioners in the city of Shiraz, Islamic Republic of Iran regarding their therapeutic use of antibiotics for patients with dentoalveolar infections. Of 219 (48.6%) dentists responding to the questionnaire more than 40% would prescribe antibiotics for localized fluctuant swelling and for problems for which antibiotics are not required according to good practice guidelines (acute pulpitis, chronic apical infection, periodontal abscess, chronic gingivitis, chronic periodontitis, pericoronitis and dry socket). A majority correctly prescribed antibiotics for acute periapical infection (77.2%), cellulitis (75.3%) and acute ulcerated gingivitis (63.0%). Amoxicillin was the most frequently prescribed antibiotic for all clinical conditions but there was a wide variation in dosage, frequency and duration for all antibiotics used. Guidelines on rational antibiotic use are needed for dental practitioners in the Islamic Republic of Iran.

Oral care for special needs patients: a survey of Nebraska general dentists

PURPOSE

The purpose of this survey was to assess the attitudes, behavior, and demographics of general dentists in Nebraska regarding their providing oral health care to patients with special health care needs (PSHCN).

METHODS

A 14-item questionnaire and accompanying cover letter were sent to 800 licensed general dentists in Nebraska. The survey asked for the dentists' demographic information and questions about their PSCHN. Responses to the questionnaire were tabulated, and percent frequency distributions for responses to each item were computed.

RESULTS

Of the 800 surveys sent, 371 (approximately 46%) were returned. Solo practitioners were more likely to report seeing PSCHN (P<.001). Most respondents see all ages, but approximately 10% see only PSCHN over 18-years-old. The most common reasons given to improve the practitioners' ability to care for PSCHN were improved reimbursement (approximately 35%) and more continuing education (approximately 36%).

CONCLUSIONS

These data indicate that most general dentists surveyed in Nebraska see special needs patients of all ages. The most common reasons for not seeing more special needs patients were the level of the patient's disease, the patient's behavior, and insufficient training/experience.

Application of geographic information systems to the analysis of private dental practices distribution in Western Australia

INTRODUCTION

Western Australia (WA), Australia's largest state, consists of approximately one-third of the country's landmass and has a population of approximately 2 million people. However, over 85% of this population live in a handful of urban centres with the majority (1.6 million) living in the state capital, Perth. Healthcare provision in this complex environment is difficult and a clear understanding of the distribution of the population and health service suppliers is critical to understanding and addressing the problem. The vast majority (80% or more) of oral health care in WA is provided by private practitioners on a fee-for-service basis. Although previous studies have examined the macro-level distribution of dentists, this study utilized a high acuity examination to examine the distribution of private dental practices in WA, especially in rural and remote areas.

METHODS

Dental practice locations were collected from open access sources and geo-coded. Population data were obtained from the Australian Bureau of Statistics and divided by census districts. The Index of Relative Socio-Economic Disadvantage (IRSD) was aggregated to census district level. Population and socio-economic data were then geo-coded using ArcGIS v9 (ESRI; Redlands, CA, USA). With Perth primary post office used as a central datum point, a sequence of maps at differing magnification was overlayed with a grid of latitude and longitude lines, or graticules.

RESULTS

Of the 602 dental practices mapped, 75% were within 32 km of the Perth General Post Office, and 95% were within 256 km. In metropolitan Perth, fewer dental practices were located in areas that have residents of lower socioeconomic status and the density of distribution of these practices was greatest in the inner city region.

CONCLUSION

This study highlights the complex nature of providing care to irregularly distributed populations in economic environments that are driven by factors not purely related to disease burden.

An investigation into the bitewing radiographic prescribing patterns of West Kent general dental practitioners

AIMS

The primary aims of the study were to investigate the use of bitewing radiography within primary dental care and adherence to guidelines on bitewing radiography by general dental practitioners (GDPs) in the West Kent Primary Care Trust (PCT) area. Within the overall aims, the study had objectives to investigate the use of radiographic guidelines, audit and caries risk assessment, the influence of private and National Health Service (NHS) practice, and the influence of the demographic profile of the GDPs on these variables.

METHODS

Data were gathered via a piloted self-completion questionnaire, circulated to all GDPs listed on the NHS Choices website as practising in the West Kent PCT area. Three mailings and follow-up telephone calls were used. The resulting data were entered into a statistical software database and, where relevant, statistically tested, using the chi-square test.

RESULTS

Of 223 GDPs, 167 responded (75%). GDPs with a high NHS commitment were significantly less likely to follow Faculty of General Dental Practice (UK) guidance on prescribing bitewing radiographs for adults (P<0.01) and children (P<0.05) than were mainly private GDPs. Mainly NHS GDPs were more likely 'always/mostly' to follow National Institute for Health and Clinical Excellence guidance (83 compared to 59) (P<0.05) and also to risk-assess patients (83 compared to 62). Only 115 (71%) had carried out a radio graphic audit or peer review in the preceding three years. Those with postgraduate qualifications were more likely (P<0.05) to carry out radiographic audit.

CONCLUSIONS

The study confirmed previous research reporting the under-use of radiography for caries detection and also the failure of some GDPs to comply with ionising radiation regulations. West Kent GDPs with a high NHS commitment were less likely to follow radiographic guidance than their private counterparts. This suggests that further efforts to disseminate information on radiographic guidelines and to educate GDPs are necessary to improve adherence with all aspects of radiography within general dental practice. Research into factors that influence GDPs' decision-making with regards to radiographic prescription may further inform the profession as to the best methods to lead to behavioural change. The dental profession and its regulators need to make a concerted effort to educate and inform GDPs so that this behaviour is modified.

An access to care study for the pre-surgical nasoalveolar molding and other treatments for cleft lip and palate

PURPOSE

This study is designed to ascertain whether a regional bias exists, as well as provide a reference to those seeking the various modalities used in pre-surgical intervention for cleft lip and palate either for their own patients or educational purposes.

METHODS

A survey was constructed using Survey Monkey and distributed via e-mail to American Academy of Pediatric Dentistry members. Approximately 3689 surveys were delivered consisting of 12 questions asking whether they provide pre-surgical intervention to cleft lip and palate patients, and what type of interventions they use.

RESULTS

A total of 572 members responded. Of the respondents, 480 reported they treat children affected by cleft lip and/or cleft palate. Of these, only 102 reported that they provide pre-surgical treatment. Pre-surgical nasoalveolar molding (PNAM) represented 29.2 percent of the interventions used and was most heavily concentrated in Texas. Other modalities used included the Latham appliance, lip adhesion/tacking, the passive appliance, and a category 'other' was included. Those checking 'other' most often described alveolar grafting prior to later surgical procedures than were of interest in this study. The University of Texas Health Science Center San Antonio had the largest number of respondents using the PNAM.

CONCLUSIONS

A very small proportion of pediatric dentists are providing pre-surgical intervention of any kind to patients with cleft lip and palate. However, those that are providing the service are spread around the country enough to consider PNAM as the standard of care for pre-surgical infant cleft treatment.

[Evaluation of crown-root restorations in non-vital teeth. Survey of dentists in the city of Abidjan]

Coronal-radicular restoration is the coronal reconstruction of an endodontically treated tooth, with a support on and in the root. The objective of this study is to assess the importance of the carried coronal-radicular restorations in the dental practice in Abidjan. It is about a prospective survey of 100 dental surgeons practicing in the city of Abidjan, pulled at random. The information was collected through a self-interview. As results, 79% of our population knows and performs coronal-radicular restorations especially in the absence of 3 dental walls but at a very low, less of 5/month for 90% of this population. The protocol of realization seems well known and followed for the majority of the pooled practitioners. However, we deplored often absence of radiography in the protocol and also the exclusive use of metal posts. In conclusion, the coronal-radicular restorations are much used in the daily practice in Côte d'Ivoire. The protocol for achieving this type of restoration seems well known and followed by the practitioners according to our study. However, as material all the dentists are still in the screw post (metal post). The adhesive technologies using fiber posts don't seem accessible to our people.

A survey to assess the provision of conscious sedation by general dental practitioners in the Republic of Ireland

AIM

To quantify and qualify how conscious sedation was used in general dental practice before the introduction of formal sedation teaching in the Republic of Ireland.

OBJECTIVES

1. To determine the extent of use of oral, inhalational and intravenous sedation; 2. to determine the training and experience of general dental practitioners providing conscious sedation; 3. to determine the perceived barriers to the practice of conscious sedation; and, 4. to gauge the level of interest in a postgraduate course in conscious sedation.

METHOD

Postal questionnaire sent to one general practitioner in seven, selected randomly from the General Dental Council register, in 2007.

RESULTS

Seventy six percent of respondents agreed that the provision of conscious sedation in general dental practice is important. However, the current provision of inhalation and intravenous sedation by respondents is low in comparison to provision in the UK. The main barrier to the use of conscious sedation in general dental practice appears to be lack of availability of training.

CONCLUSIONS

The data from this study indicated the need for postgraduate training in conscious sedation in Ireland and a need for increased awareness of the Dental Council Code of Practice on sedation.

Informational resources utilized in clinical decision making: common practices in dentistry

This study investigated current trends of Iowa dental practitioners with regard to acquisition and utilization of scientific information resources to support decision making in the clinical practice of dentistry. A survey questionnaire regarding the utilization of various sources of information to support clinical decisions was mailed in September 2009 to all dentists licensed and practicing in the state of Iowa. Dentists appointed full-time within the University of Iowa College of Dentistry were excluded from this study. Continuing education courses were the most frequently utilized and preferred information source by respondents, followed by print journals and consultation with other health care professionals. Practice patterns according to decade of dental school graduation as well as scope of practice were noted. The results of this study demonstrate that dental practitioners utilize a variety of evidence-based and non-evidence-based information resources to support decisions in clinical practice. The habits of newer graduates vary somewhat from those of earlier graduates; the habits of specialists vary from those of general practitioners.

Factors associated with Japanese dentists encouraging patients to use dental floss

OBJECTIVE

The objective of this study was to clarify to what extent Japanese dentists recommend dental floss and what factors influence dentists in encouraging their patients to use dental floss.

PARTICIPANTS

The subjects in this study were 291 dentists who were directors of dental clinics, selected by stratified sampling by age.

RESULTS

Dentists whose teachers at dental school had demonstrated dental flossing tended to recommend patients to use dental floss 2.2 (1.0-4.6: 95% CI) times more frequently compared with those who did not see demonstrations of flossing at dental school. Respondents who considered that using dental floss was very easy and easy, moderate, and difficult recommended patients to use dental floss 45.4 (11.2-183.9), 17.4 (6.6-45.8) and 5.9 (2.5-14.1) times more frequently, respectively, compared with those who considered it very difficult. Respondents who considered that using dental floss was effective, fairly effective or very effective in preventing dental caries recommended patients to use dental floss 3.8 (1.7-8.6), 3.8 (1.7-8.8) and 9.1 (3.6-23.0) times more frequently respectively, compared with those who considered it ineffective or only slightly effective.

CONCLUSIONS

The demonstration of the use of dental floss by teachers at their dental schools gave dentists a good impression and a positive opinion of dental flossing. This was closely associated with recommendations by dentists to their patients to use dental floss.

Clinical decision on pit and fissure sealing according to the occlusal morphology. A descriptive study

BACKGROUND

The objective of this descriptive study was to evaluate the clinical decision on sealing pits and fissures according to the occlusal morphology in patients with low individual caries risk (ICR).

MATERIALS AND METHODS

A total of 222 dentists, 86 affiliated to the French Society of Paediatric Odontology (SFOP) and 136 general practice dentists (GPs), answered the same questionnaire with illustrations of 4 occlusal surfaces of permanent molars: they indicated firstly if these were at risk and secondly the corresponding decision regarding sealing. This questionnaire assessed the decision on widening pits and fissures before sealing and the type of sealant material used. Multivariate logistic regression analyses were performed to identify the factors associated with the clinical decision to widen pits and fissures.

RESULTS

Sealing of at-risk teeth was indicated by 89% of dentists, whereas sealing of not at-risk occlusal surfaces was recommended by 46%. SFOP dentists were more prone to recommend pit and fissures sealants. The multivariate analyses demonstrated that only the type of material was associated with the clinical decision to widen pits and fissures. Forty eight percent of dentists choose the same material in all clinical situations.

CONCLUSION

The wide variations in sealant use and placement technique implies there is no apparent consensus among GP and SFOP dentists. Although the criteria are similar in numerous scientific societies, not all dentists are acting upon these recommendations.

Diabetes mellitus and periodontal health: dentists' knowledge

OBJECTIVES

There is a strong body of evidence to support the relationship between periodontal diseases and diabetes mellitus. Unless dental practitioners are aware of this link, they cannot apply the information to their daily practice. The aim of the study was, therefore, to evaluate the knowledge of dental practitioners concerning the effect of diabetes on periodontal health.

SUBJECTS AND METHODS

This was a cross-sectional survey of randomly selected dental practitioners in Kuwait. Participants were asked about specific periodontal complications which they believed that patients diagnosed with diabetes were more susceptible to.

RESULTS

A total of 220 dental practitioners (133 general dental practitioners and 87 dental specialists) participated in the study. Less than 60% of all study participants reported that tooth loss due to periodontal reasons and periodontal abscess were frequent among diabetic patients. Dental specialists, especially periodontists, were significantly more aware of periodontal complications associated with diabetes. Factors significantly associated with having knowledge about the effect of diabetes on periodontal health in logistic regression analysis were dentists who were older and those who were specialists.

CONCLUSIONS

The results of this study indicate that knowledge about the effects of diabetes on periodontal health among this sample of dental practitioners is generally low, and dentists may underestimate the outcomes of periodontal diseases in diabetic patients.

The assessment of infection control in dental practices in the municipality of São Paulo

OBJECTIVE

The goal of this study was to evaluate the infection control measures actually implemented by dental surgeons during dental practice, as patients and professionals are exposed to high biological risk in dental care environments.

METHOD

614 questionnaires (90.69%) were answered by professionals registered in updating or in post-graduate courses in the Municipality of São Paulo.

RESULTS

Out of surveyed professionals 30.62% admitted that surface protection barriers were not used, whereas 34.17% were using non ideal or outdated pre-disinfection practices. The autoclave was used by 69.38% of participants, although 33.80% were not monitoring control of the sterilization cycles. Chemical and biological indicators were not used simultaneously by 83.21% of respondents and were not employed on a daily or weekly basis by at least 81.75%. Dubious methods of sterilization were cited by 44.77%. Occupational accidents caused by cutting and piercing objects were reported by 47.88%; however, the biologic risk was underestimated by 74.15% of the professionals who suffered the accidents. Irritant solutions were used as an antiseptic agent by 18.55%.

CONCLUSIONS

Infection control measures reported by dental surgeons during their practices are deficient. It is necessary to educate, raise awareness of professionals, and promote constant updating courses on procedures which aim at improving safety of dental care.

A survey on regenerative surgery performed by Swiss specialists in periodontology with special emphasis on the application of enamel matrix derivatives in infrabony defects

This survey aimed to evaluate the common practice of regenerative periodontal surgery with special regard to the use of enamel matrix derivatives (EMD, Emdogain® ) by board-certified specialists in periodontology and non-certified, but active members of the Swiss Society of Periodontology (SSP). A cross-sectional postal survey of 533 dentists, representing all members of the SSP practising in Switzerland, was conducted. The questionnaire consisted of three sections, assessing: 1) general personal information regarding the practice setting and education, 2) general questions regarding periodontal surgery practices and 3) specific questions regarding the use of EMD. The information obtained was compared and differences between specialists and non-specialists were calculated. P-values smaller than 5% were considered significant. Sixty-nine percent of the specialists answered the questionnaire, compared to only 37.4% of the non-specialists (overall: 42.4%). In general, specialists performed surgeries more frequently, and presented a significantly higher percentage of EMD users than the non-specialists. The application guidelines were followed in general. Some differences were observed in application and selection criteria. The subjective perception of clinical success varied greatly among clinicians. Residual pockets were reported to be present in approximately one third of the defects after therapy. In conclusion, this survey revealed that EMD was used on a regular basis by dentists performing periodontal therapy. In addition, the answers by both groups generally corresponded well with the current available literature.

The use of rubber dam among Czech dental practitioners

Rubber dam is considered an ideal device for tooth isolation. Nevertheless, its usage is quite rare in the Czech Republic. The aim of this study was: firstly, to gather and evaluate information regarding the use of rubber dam by dentists in the Czech Republic and to compare it with other countries; secondly to find out whether there are any influencing factors as to rubber dam usage; and finally to find out frequency of rubber dam use separately in endodontic treatment and in placing fillings of different materials. A questionnaire-based survey was conducted. Dentists filled in the questionnaires during dental conventions, educational events, conferences and congresses. Rubber dam was routinely used by less than eight per cent of the respondents (n = 35); less than twenty-two per cent of the respondents (n = 97) used rubber dam occasionally, and more than seventy per cent of the respondents (n = 317) has never use it. The results showed that rubber dam is not used frequently in the Czech Republic. If rubber dam is used, then it is typically for endodontic treatment or composite fillings. There were several factors with a statistically significant influence on the usage of rubber dam, such as gender, length of professional career, percentage of direct payments, previous experience in using rubber dam, and undergraduate training in rubber dam use.

Self-reported knowledge and practice of American Heart Association 2007 guidelines for prevention of infective endocarditis: a survey among dentists in Hyperabad City, India

PURPOSE

To evaluate the knowledge and practice of the American Heart Association (AHA) 2007 guidelines among dentists in Hyderabad city, India, for the prevention of infective endocarditis (IE).

MATERIALS AND METHODS

A survey questionnaire was mailed to the dentists to assess their knowledge with regard to the antibiotic prophylaxis needed for specific cardiac conditions and the prophylaxis reasonable before various dental procedures in high-risk patients and the first-line and second-line antibiotic regimen prescribed.

RESULTS

Of the 190 registered dentists, 169 (88.94%) completed the questionnaire. The mean age of the population was 39.17 ± 8.23 years. The majority of the respondents correctly identified that having prosthetic cardiac valves, a previous history of IE illness and cardiac transplantation with subsequent cardiac valvulopathy are cardiac conditions requiring antibiotic prophylaxis. Prescription of first-line antibiotic drugs and second-line drug regimens corresponding to the current guidelines was correctly answered by only 56.21% dentists and 60.95% dentists, respectively.

CONCLUSION

A relatively low level of knowledge of the new guidelines was reported among dentists, reflecting the need for more continuing dental education programmes.

A cross-sectional survey investigating the care of the primary dentition by general dental practitioners working in Japan and England

OBJECTIVE

To compare treatment decisions about primary dentistry made by Japanese and English general dental practitioners (GDPs).

METHOD

Four clinical scenarios were used to ascertain the clinical opinions of GDPs about what treatment to offer a 6-year-old boy with a carious molar. The first and second scenarios were a single distal and a distalocclusal cavity in a vital tooth without pain. The third was a large distal-occlusal cavity in a non-vital tooth without pain. The fourth was large distal-occlusal cavity in a non-vital tooth with pain. The participants were 234 GDPs in Japan and 322 GDPs in England.

RESULTS

In the first scenario, 62.2% of Japanese GDPs preferred traditional restorative care compared with 34.7% of English GDPs. In the second scenario, Japanese participants were less likely to offer atraumatic treatment (16.5% vs. 34.9%). In the third scenario, Japanese dentists displayed a greater tendency to open the pulp chamber (55.2% vs. 7.6%). In the final scenario, 71% of Japanese GDPs would open the pulp chamber, whereas 50.3% of English GDPs favoured extraction.

CONCLUSION

Japanese and English GDPs differed substantially in their views about the best treatment for a young child with a carious molar.

[Oral cancer awareness of physicians and dentists in the Israeli army]

Oral cavity squamous cell carcinoma (OSCC) accounts for 2-3% of all body malignancies. The aim of this study was to asses the knowledge and awareness of general practitioners and the dental practitioners in the Israeli army to OSCC. Israeli's defense force's medical corps's dentists and physicians took part in this study. A questionnaire was constructed to obtain information about: Demographics, Knowledge concerning signs, symptoms and risk factors of oral cancer, Attitude on referral and knowledge transfer to patients, Satisfaction and need for farther guidance on the subject. The questionnaire was sent via E mail to all army physicians and dentists. 80% of the dentists and 35% of the physicians replayed. According to our study there is a knowledge gap between physicians and dentists in several areas: Physicians showed less awareness to the disease therefore, are less likely to do regular oral examinations. Physicians had less information about risk factors (especially alcohol) and are less likely to pass information about the risk factors to their patients. Suspicious lesions in the oral cavity were less recognized as such by physicians. This study shows the need to strengthen physicians' knowledge and awareness concerning oral cancer.

Oral and pharyngeal cancer control and early detection

Sixty-four standardized continuing education courses were given for dentists throughout the ten public health districts of the USA to determine if certain behaviors regarding oral and pharyngeal cancer (OPC) control could be modified. Questionnaires were obtained at baseline and at 6 months along with matched control groups. One thousand eight hundred two general dentists participated at baseline and 988 at a 6-month questionnaire follow-up. Analysis of the data indicated that continuing education courses had a positive influence on participants' oral cancer attitudes, knowledge, and behavior that potentially could make a difference on prevention, early detection, and ultimately OPC control.