Utilization of preventive dental practices by graduates of one U.S. dental school

Assessing oral cancer knowledge among dental students in South Carolina

BACKGROUND

Because South Carolina has the fourth highest mortality rate for oral cancer among the 50 states, dental students in the state must be knowledgeable about prevention and early detection of the disease.

METHODS

In 2002, the authors surveyed 163 students using a written questionnaire (response rate, 79.1 percent). The questionnaire included questions about oral cancer risk and nonrisk factors as well as oral cancer diagnostic signs, symptoms and examination procedures. The authors performed univariate and bivariate analyses (alpha < or = .025).

RESULTS

At least 93 percent of the students replied that tobacco, alcohol and previous oral cancer lesions were risk factors. One hundred six students (65 percent) knew that the most likely site for oral cancer is the ventrolateral border of the tongue. Students differed in their overall knowledge of risk factors (P = .002), nonrisk factors (P < .001) and diagnostic procedures (P < .001).

CONCLUSION

Although students' level of knowledge increased with academic year, educators and policy-makers need to place greater emphasis on oral cancer education and training in dental schools.

PRACTICE IMPLICATIONS

Morbidity and mortality are likely to be reduced if dentists know how to prevent and detect oral cancer.

Challenges of and strategies for changing prescribing practices of health care providers

Problems related to inappropriate prescribing practices of physicians in general are well recognized. Dietary fluoride supplements have been implicated as one of the contributing factors in an increase in dental fluorosis. Inappropriate prescribing practices of providers have been cited as a major factor in this implication. Numerous studies of physicians and dentists have documented a lack of knowledge and inappropriate prescribing practices regarding fluoride supplements. The purpose of this paper is to identify barriers to changing fluoride-prescribing practices of health care providers and to suggest strategies for implementing change. To increase optimal and appropriate use of fluoride supplements, educational interventions are necessary for all user groups--detail men and women, physicians, dentists, pharmacists, nurse practitioners, dental hygienists, and the public. In addition, environmental supports for the educational activities in the form of policy, regulation, standards of care, and guidelines are recommended for consideration.

Korean dental hygienists' knowledge and opinions about etiology and prevention of dental caries

OBJECTIVES

Because of their formal education Korean dental hygienists have the potential to be the primary source of information on caries prevention for patients and the general public, and influence the use and adoption of caries preventive procedures. The purposes of this study were to determine the knowledge and opinions about caries etiology and prevention among Korean dental hygienists, and to describe associated factors.

METHODS

A pre-tested, 20-item questionnaire was mailed to 1120 dental hygienists selected by stratified random sampling and allocated proportionately. A postcard reminder was sent to all dental hygienists after 1 week. Non-respondents were sent additional complete mailings after 3 and 7 weeks. The response rate was 77% (n=863).

RESULTS

Analysis of six factors thought to be related to knowledge about caries etiology and prevention showed that dental hygienists who were taught to provide oral health education and believe that it is desirable to practice oral health education during dental hygiene school and those employed in health centers were likely to be more knowledgeable about caries etiology and prevention than other hygienists (P<0.05). In regression analysis of the perceived effectiveness of caries preventive procedures, hygienists who provided oral health education during their formal training tended to rate caries preventive procedures as being more effective than other dental hygienists (P<0.05).

CONCLUSIONS

Overall, the results of this study suggest that most dental hygienists do not have up-to-date information on the etiology and prevention of dental caries, mechanisms of action of fluoride and effectiveness of preventive procedures. Efforts to increase the level of knowledge of Korean dental hygienists about caries prevention should focus on strategies to educate dental hygienists who have not been taught to provide oral health education, who do not have favorable opinions about the desirability of oral health education, and who had no experience with providing oral health education as part of their work, especially hygienists working in private clinics. Further, these efforts should include the revision of dental hygiene curricula and continuing education courses.

National survey of Korean dentists' knowledge and opinions: dental caries etiology and prevention

OBJECTIVE

Dentists have the potential to influence what their patients know and do regarding dental caries prevention. The practices of dentists and what they tell their patients are influenced, in part, by their own knowledge and opinions. The purposes of this study were to determine the level of knowledge and opinions about caries etiology and prevention among Korean dentists and to describe related factors.

METHODS

A pretested, 27-item questionnaire was mailed to 2,047 dentists, selected by a stratified random sampling allocated proportionately. A postcard reminder was sent to all dentists after one week. Nonrespondents were sent additional complete mailings after three, seven, and nine weeks. The response rate was 83 percent (n = 1,700 dentists).

RESULTS

Analysis of six factors thought to be related to knowledge about caries etiology and prevention showed that recent graduates and dentists who worked in public health centers were likely to be more knowledgeable about caries etiology and prevention than their counterparts (P < .05). In regression analysis of perceived effectiveness of caries-preventive procedures for children, recent graduates, males, and dentists who worked in public health centers tended to rate caries-preventive procedures more effective than other dentists (P < .05). Dentists who had experience with school-based preventive programs and dentists in rural areas were likely to rate caries-preventive procedures for adults more effective than other dentists (P < .05).

CONCLUSIONS

Overall, results of this study suggest that the majority of dentists do not know current information concerning etiology and prevention of dental caries, mechanisms of action of fluoride, and effectiveness of preventive procedures for children and adults. Efforts to enhance the level of knowledge and practices of Korean dentists about caries prevention should focus on strategies to educate older graduates and female dentists, especially those in private practice.

The need for health promotion in oral cancer prevention and early detection

OBJECTIVES

This review paper provides a rationale for using health promotion to help reduce morbidity and mortality due to oral cancers by identifying barriers to prevention and early detection of these cancers and discussing strategies for change.

METHODS

A literature review of the following areas was conducted: epidemiology of and risk factors for oral cancers; knowledge, opinions, and practices of health care providers and the public regarding prevention, early detection, and control of oral cancers; and policies and regulations that either enhance or act as barriers to the prevention and early detection of oral cancers.

RESULTS

Overall, the public is ill-informed about risk factors for and signs and symptoms of oral cancers and relatively few US adults have had an oral cancer examination. Further, health care providers are remiss in providing oral cancer examinations and detecting early oral cancers.

CONCLUSIONS

To achieve the 13 oral cancer objectives contained in "Healthy People 2000," health care providers and the public must know the risk factors for these cancers as well as their signs and symptoms. Further, health care providers need to provide oral cancer examinations routinely and competently. Equally important, the public needs to know that an examination for oral cancer is available and that they can request one routinely. Thus, a vigorous agenda that includes education, policy, and research initiatives is needed to enhance oral cancer prevention and early detection.

The public's oral health: the gaps between what we know and what we practice

Health for All by the Year 2000 is a theme developed in 1979 by the World Health Organization. The theme includes oral health and is being promoted throughout the world. The advances in dental research make it possible to improve oral health and, concomitantly, general health. With the appropriate use of science-based, preventive regimens, dental caries and periodontal diseases can be prevented or controlled. Further, major risk factors for oral and lip cancer are known; thus, it is possible to reduce the incidence of these diseases. Available technologies, however, are useful only when they are used by appropriate user groups as recommended. The gaps between what is known about preventing oral diseases and what is practiced are often extensive. This presentation explores differences between scientific knowledge about risk factors for oral diseases and preventive regimens and procedures, public and professional knowledge and practices, and professional support for improved oral health through the application of primary preventive procedures, often referred to as "science transfer". Barriers to the adoption of preventive regimens and practices are discussed. Strategies using health education and health promotion for narrowing these gaps are presented.

Pit and fissure sealants: another major cornerstone in preventive dentistry

Despite dramatic reductions in caries in fluoridated communities, the disease continues to occur during childhood and adolescence and there is a sustained caries susceptibility of pits and fissures. Pit and fissure sealants have been available to the dental profession for the past two decades. Closely following community water fluoridation, this use of adhesive technology is now recognized as a major cornerstone of modern preventive dentistry. However, the technique appears to have been slow in implementation by the dental profession. Recent expanded utilization of sealants in the public sector, particularly in Victoria, has increased the awareness of the procedure amongst the public and is heightening demand. A review of the pertinent literature and current trends in utilization of sealants is presented. The case is made for expanded utilization of sealants in both the public and private sectors of dental health care delivery in Australia.

Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The committee screened several hundred articles, citing 518 published papers. Some are present quality in research, others provide clinical interest, and some are identified as misleading. New techniques in pulp physiology and pathology are reported. Laser use and techniques in prevention, restorative dentistry, and materials use are reported. Epidemiology of selected diseases and the results of various formulations for treatment are cited. Diagnosis of craniomandibular dysfunction is well represented as well as references to literature reviews and other sophisticated scientific investigation. Research on adhesives is presented in respect to bonding agents for dentin and enamel. Several clinical studies are included, along with customary laboratory reports on several materials.