1
|
Shelley A, Horner K. General dental practitioner opinions on Selection criteria for dental radiography: a qualitative focus group study. Br Dent J 2023:10.1038/s41415-023-6052-x. [PMID: 37438478 DOI: 10.1038/s41415-023-6052-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 07/14/2023]
Abstract
Introduction In the UK, general dental practitioners are exposed to multiple sets of clinical guidelines, including those relating to selection of x-ray examinations. A focus group was convened to explore issues around current guidelines and how a future edition might be improved.Method A purposive sample of seven general dental practitioners in the North West of England took part in a focus group. A sound recording was transcribed and analysed by thematic content analysis.Results Nine themes arose from the discussion: awareness of the Selection criteria for dental radiography(SCDR); utility of the latest edition; presentation of a new edition; the format of a new edition; evidence base; practice standards and evidence levels; the General Dental Council and Care Quality Commission; radiation doses; and dissemination.Discussion Awareness of theSCDRwas high, although participants were not aware of its full contents. The document was regarded as practitioner unfriendly and participants preferred accessible flowcharts available online and through mobile devices. Participants assume that appraisal of evidence has been done appropriately and accounted for in producing recommendations. Participants used clinical guidelines to protect themselves from the threat of legal action and investigation by the regulator.Conclusion The authors make ten recommendations for the future production of guidelines.
Collapse
Affiliation(s)
- Andrew Shelley
- Shelley and Pope Dental Practice, 117 Stockport Road, Denton, Manchester, M34 6DH, United Kingdom.
| | - Keith Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, United Kingdom
| |
Collapse
|
2
|
Moreira NC, Leonardi-Dutra K, Feres MF, Colangelo EA, Balevi B, Matthews D, Flores-Mir C. Impact of Evidence-Based Dentistry Workshops on Educators’ Use of Evidence in Teaching and Practice: A Pilot Study. J Dent Educ 2018; 82:581-590. [DOI: 10.21815/jde.018.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 12/10/2017] [Indexed: 11/20/2022]
Affiliation(s)
| | | | | | | | - Ben Balevi
- Faculty of Medicine; University of British Columbia; Canada
| | - Debora Matthews
- Academic Affairs, Faculty of Dentistry; Dalhousie University; Canada
| | | |
Collapse
|
3
|
Dragan IF, Dalessandri D, Johnson LA, Tucker A, Walmsley AD. Impact of scientific and technological advances. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22 Suppl 1:17-20. [PMID: 29601675 DOI: 10.1111/eje.12342] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
Advancements in research and technology are transforming our world. The dental profession is changing too, in the light of scientific discoveries that are advancing biological technology-from new biomaterials to unravelling the genetic make-up of the human being. As health professionals, we embrace a model of continuous quality improvement and lifelong learning. Our pedagogical approach to incorporating the plethora of scientific-technological advancements calls for us to shift our paradigm from emphasis on skill acquisition to knowledge application. The 2017 ADEE/ADEA workshop provided a forum to explore and discuss strategies to ensure faculty, students and, ultimately, patients are best positioned to exploit the opportunities that arise from integrating new technological advances and research outcomes. Participants discussed methods of incorporating the impact of new technologies and research findings into the education of our dental students. This report serves as a signpost of the way forward and how to promote incorporation of research and technology advances and lifelong learning into the dental education curriculum.
Collapse
Affiliation(s)
- I F Dragan
- Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
| | | | - L A Johnson
- Faculty Affairs and Institutional Effectiveness (Informatics), University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - A Tucker
- Kings College London Dental Institute, London, UK
| | - A D Walmsley
- Restorative Dentistry, University of Birmingham, Birmingham, UK
| |
Collapse
|
4
|
St Paul A, Phillips C, Lee JY, Khan AA. Provider Perceptions of Treatment Options for Immature Permanent Teeth. J Endod 2017; 43:910-915. [DOI: 10.1016/j.joen.2017.01.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 11/17/2022]
|
5
|
Participant recruitment to FiCTION, a primary dental care trial - survey of facilitators and barriers. Br Dent J 2016; 217:E22. [PMID: 25415040 DOI: 10.1038/sj.bdj.2014.1009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To identify reasons behind a lower than expected participant recruitment rate within the FiCTION trial, a multi-centre paediatric primary dental care randomised controlled trial (RCT). SUBJECTS (MATERIALS) AND METHODS An online survey, based on a previously published tool, consisting of both quantitative and qualitative responses, completed by staff in dental practices recruiting to FiCTION. Ratings from quantitative responses were aggregated to give overall scores for factors related to participant recruitment. Qualitative responses were independently grouped into themes. RESULTS Thirty-nine anonymous responses were received. Main facilitators related to the support received from the central research team and importance of the research question. The main barriers related to low child eligibility rates and the integration of trial processes within routine workloads. CONCLUSIONS These findings have directed strategies for enhancing participant recruitment at existing practices and informed recruitment of further practices. The results help provide a profile of the features required of practices to successfully screen and recruit participants. Future trials in this setting should consider the level of interest in the research question within practices, and ensure trial processes are as streamlined as possible. Research teams should actively support practices with participant recruitment and maintain enthusiasm among the entire practice team.
Collapse
|
6
|
Hurst D. Multifaceted and mixed didactic-interactive methods are more effective ways to learn and change behaviour. Evid Based Dent 2016; 14:67-8. [PMID: 24071669 DOI: 10.1038/sj.ebd.6400944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
DATA SOURCES The following electronic databases were searched from 1986 to the present: Cochrane Library (Cochrane Database of Systematic Reviews, DARE and HTA Databases, and Cochrane CENTRAL Register of Controlled Trials), Medline In Process and Other Non-Indexed Citations and Medline (Ovid), Embase (Ovid), ERIC (CSA), Index to Theses (Expert Information Services), and ZETOC (British Library Electronic Table of Contents and conference proceedings). No language restrictions. STUDY SELECTION Randomised controlled trials or quasi-experimental designs were eligible which evaluated continuing professional development (CPD) interventions in dentistry (for dentists and professions complimentary to dentistry) on learning gains, behaviour change or patient outcomes. These could be compared against no intervention or another CPD intervention. There were no minimum follow up times. DATA EXTRACTION AND SYNTHESIS The following data were extracted by two reviewers: bibliographic details, settings, characteristics about participants, intervention and control conditions, outcome measures, findings and conclusions. Studies were grouped thematically according to the intervention, and the studies were quality assessed using a custom system based on the CONSORT statement. The results were reported in a narrative form and no attempt was made to combine them in a meta-analysis. RESULTS Ten studies were included. Eight studies were judged to be of high to moderately high quality. None of the studies measured patient outcomes, but a multifaceted black box intervention resulted in self-reported patient care and face-to-face contact to change antibiotic prescribing habits showed a change in clinician behaviour. The size of this effect for both of these is not reported here. There was some effect on knowledge but not on behaviour for courses and workshops, written material, computer-assisted learning and audit and feedback. CONCLUSIONS Multi-method and multi-phased dental CPD has potential for the greatest impact on practitioner behaviour.
Collapse
Affiliation(s)
- Dominic Hurst
- Department of Adult Oral Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, and Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
7
|
Isham A, Bettiol S, Hoang H, Crocombe L. A Systematic Literature Review of the Information-Seeking Behavior of Dentists in Developed Countries. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.5.tb06117.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Amy Isham
- Centre for Rural Health; University of Tasmania; Hobart Tasmania Australia
| | - Silvana Bettiol
- School of Medicine; University of Tasmania; Hobart Tasmania Australia
| | - Ha Hoang
- Centre for Rural Health; University of Tasmania; Hobart Tasmania Australia
| | - Leonard Crocombe
- Centre for Rural Health; University of Tasmania; Hobart Tasmania
- Australian Research Centre for Population Oral Health; School of Dentistry; University of Adelaide; Adelaide Australia
| |
Collapse
|
8
|
Bailey E, Tickle M, Campbell S. Patient safety in primary care dentistry: where are we now? Br Dent J 2014; 217:339-344. [DOI: 10.1038/sj.bdj.2014.857] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/09/2022]
|
9
|
Maupome G, Isyutina O. Dental Students’ and Faculty Members’ Concepts and Emotions Associated with a Caries Risk Assessment Program. J Dent Educ 2013. [DOI: 10.1002/j.0022-0337.2013.77.11.tb05624.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Gerardo Maupome
- Department of Preventive and Community Dentistry; Indiana University School of Dentistry
| | - Olga Isyutina
- Department of Preventive and Community Dentistry; Indiana University School of Dentistry
| |
Collapse
|
10
|
Jones C, Macfarlane TV, Milsom KM, Ratcliffe P, Wyllie A, Tickle M. Patient perceptions regarding benefits of single visit scale and polish: a randomised controlled trial. BMC Oral Health 2013; 13:50. [PMID: 24090395 PMCID: PMC3851473 DOI: 10.1186/1472-6831-13-50] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 09/26/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Single visit scale and polish is frequently carried out in dental practices however there is little evidence to support (or refute) its clinical effectiveness. The purpose of this research was to compare patient-reported outcomes between groups receiving a scale and polish at 6-, 12-, and 24-month intervals. Outcomes recorded included participants' subjective assessment of their oral cleanliness; the perceived importance of scale and polish for oral health and aesthetics; and frequency at which this treatment is required. METHODS A practice-based randomised control trial was undertaken, with a 24-month follow-up period. Participants were healthy adults with no significant periodontal disease (BPE codes <3) randomly allocated to three groups to receive scale and polish at 6-, 12-, or 24-month intervals. Patient-reported outcomes were recorded at baseline and follow-up. Oral cleanliness was reported using a 5-point scale and recorded by examiners blinded to trial group allocation. A self-completed questionnaire enabled participants to report perceived importance of scale and polish (5-point scale), and required frequency of treatment (6-point scale). The main hypothesis was that participants receiving 6-monthly scale and polish would report higher levels of oral cleanliness compared to participants receiving scale and polish at 12- and 24-month intervals. RESULTS 369 participants were randomised: 125 to the 6-month group; 122 to the 12-month group; and 122 to the 24-month group. Complete data set analysis was carried out to include 107 (6-month group), 100 (12-month group) and 100 (24-month group) participants. Multiple imputation analyses were conducted where follow-up data was missing. The difference in the proportions of participants reporting a 'high' level of oral cleanliness at follow-up was significant (Chi-squared P = 0.003): 52.3% (6-month group), 47.0% (12-month group) and 30.0% (24-month group). Scale and polish was thought to be important by the majority in each group for keeping mouths clean and gums healthy, whitening teeth, and preventing bad breath and tooth decay; there were no statistically significant differences between groups at follow-up. Most participants at follow-up thought that the frequency of scale and polish should be "every 6 months" or more frequently: 77.9% (6-month group), 64.6% (12-month group), 71.7% (24-month group); differences between groups were not statistically significant (Chi squared P = 0.126). The results suggest that participants in the 24-month trial group were more likely to choose a scale and polish interval of "once a year" or less frequently (OR 2.89; 95% CI 1.36, 6.13). CONCLUSIONS The majority of healthy adults regarded 6-monthly single-visit scale and polish as being beneficial for their oral health. Receiving the treatment at different frequencies did not alter this belief; and those with the longest interval between scale and polish provision perceived that their mouth was less clean. In the absence of a strong evidence base to support (or refute) the effectiveness of single-visit scale and polish, the beliefs and preferences of patients regarding scale and polish may be influential drivers for maintaining provision of this treatment.
Collapse
Affiliation(s)
- Clare Jones
- School of Dentistry, The University of Manchester, Coupland 3 Building, Oxford Road, Manchester M13 9PL, UK
| | - Tatiana V Macfarlane
- Division of Applied Medicine, School of Medicine and Dentistry, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Keith M Milsom
- School of Dentistry, The University of Manchester, Coupland 3 Building, Oxford Road, Manchester M13 9PL, UK
- Cheshire & Merseyside Centre, Public Health England, Chester, UK
| | - Philip Ratcliffe
- Woodlands Dental Practice, 493 Old Chester Rd, Dacre Hill, Birkenhead CH42 4NG, UK
| | - Annette Wyllie
- Martins Lane Dental Practice, 1-3 Martins Lane, Wallasey WIRRAL CH44 1BA, UK
| | - Martin Tickle
- School of Dentistry, The University of Manchester, Coupland 3 Building, Oxford Road, Manchester M13 9PL, UK
| |
Collapse
|
11
|
Sbaraini A, Carter SM, Evans RW, Blinkhorn A. How do dentists and their teams incorporate evidence about preventive care? An empirical study. Community Dent Oral Epidemiol 2013; 41:401-14. [PMID: 23356457 DOI: 10.1111/cdoe.12033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Accepted: 12/10/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To identify how dentists and their teams adopt evidence-based preventive care. METHODS A qualitative study using grounded theory methodology was conducted. We interviewed 23 participants working in eight dental practices about their experience and work processes, while adopting evidence-based preventive care. During the study, Charmaz's grounded theory methodology was employed to examine the social process of adopting preventive dental care in dental practices. Charmaz's iteration of the constant comparative method was used during the data analysis. This involved coding of interview transcripts, detailed memo-writing and drawing diagrams. The transcripts were analyzed as soon as possible after each round of interviews in each dental practice. Coding was conducted primarily by AS, supported by team meetings and discussions when researchers compared their interpretations. RESULTS Participants engaged in a slow process of adapting evidence-based protocols and guidelines to the existing logistics of the practices. This process was influenced by practical, philosophical, and historical aspects of dental care, and a range of barriers and facilitators. In particular, dentists spoke spontaneously about two deeply held 'rules' underpinning continued restorative treatment, which acted as barriers to provide preventive care: (i) dentists believed that some patients were too 'unreliable' to benefit from prevention; and (ii) dentists believed that patients thought that only tangible restorative treatment offered 'value for money'. During the adaptation process, some dentists and teams transitioned from their initial state - selling restorative care - through an intermediary stage - learning by doing and educating patients about the importance of preventive care - and finally to a stage where they were offering patients more than just restorative care. Resources were needed for the adaptation process to occur, including: the ability to maintain the financial viability of the practice, appropriate technology, time, and supportive dental team relationships. CONCLUSIONS The findings from this study show that with considerable effort, motivation and coordination, it is possible for dental practices to work against the dental 'mainstream' and implement prevention as their clinical norm. This study has shown that dental practice is not purely scientific, but it includes cultural, social, and economic resources that interfere with the provision of preventive care.
Collapse
Affiliation(s)
- Alexandra Sbaraini
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, NSW, Australia; Population Oral Health, Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | | | | | | |
Collapse
|
12
|
A primary care-based study on the treatment of pulpitis using a corticosteroid/antibiotic dressing. Br Dent J 2012. [DOI: 10.1038/sj.bdj.2012.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
13
|
How primary care dentists perceive and are influenced by research. Br Dent J 2011. [DOI: 10.1038/sj.bdj.2011.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
14
|
Hopper L, Morris L, Brocklehurst P, Tickle M. A qualitative investigation of the views of primary care dentists on participating in prospective studies in the North-West of England. Br Dent J 2011; 210:E18. [PMID: 21659986 DOI: 10.1038/sj.bdj.2011.429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2011] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is a poor understanding of to how to recruit and involve primary care dentists in clinical trials. AIM To use a qualitative paradigm to explore the views of primary care dentists towards participating in clinical trials and develop an understanding of the factors that facilitate and prevent their involvement. DESIGN, SETTING, SUBJECTS AND METHODS: An iterative approach was undertaken using a focus group (n = 6) followed by phased semi-structured interviews (n = 18). Data were analysed using thematic analysis and constant comparative analysis. FINDINGS The semi-structured interviews generated nine codes which were organised into three themes: technical issues for trials in primary dental care, practical issues for research in primary dental care and primary care dentists as research consumers. Overall, primary care dentists had a poor understanding of research methodology and clinical research. Barriers to participation included loss of clinical freedom and control, practice disruption, patient welfare, staff workload, financial loss and time. CONCLUSIONS Barriers to primary dental care research need to be overcome through appropriate protocols, funding, training and support. Joint working of primary dental care teams and academic researchers is essential, along with a constructive and open dialogue, if clinical trials are to be successfully undertaken in a practice environment.
Collapse
Affiliation(s)
- L Hopper
- Salford Primary Care Trust Dental Department, Walkden Gateway, 2 Smith Street, Walkden, Manchester, M28 3EZ.
| | | | | | | |
Collapse
|
15
|
Hurst D. Using new evidence is an innovation. So what? Evid Based Dent 2011; 12:66. [PMID: 21979761 DOI: 10.1038/sj.ebd.6400802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|