Orthodontic treatment planning by general dental practitioners

A survey on orthodontic services provided by general dental practitioners

The aim of this survey-based study was to recognize professional determinants that account for variations in the level of orthodontic services provided and which distinguish providers and nonproviders of orthodontic services. Multiple regression analysis revealed that four practitioner characteristics explained 43% of the variance in the number of orthodontic patients treated. Dentists who treated more orthodontic patients (1) treated more general practice patients, (2) frequently used multiple sources to keep up to date in orthodontics, (3) perceived their patient base to contain more children, and (4) were likely to have attended an orthodontic course. The null hypothesis that selected characteristics of dentists providing orthodontic services were no different from those of dentists not providing orthodontic services was rejected. The provision of orthodontic services was associated with a higher level of continuing orthodontic education and treating more general practice patients, especially children.

Orthodontic treatment and referral patterns: A survey of pediatric dentists, general practitioners, and orthodontists

OBJECTIVE

This study aims to assess the orthodontic diagnostic skills, referral patterns, and the perceptions of orthodontic benefits of pediatric and general dentists in comparison with orthodontists.

MATERIALS AND METHODS

Two online surveys were e-mailed to pediatric dentists, general dentistry practitioners, and orthodontists registered as members of the Saudi Dental Society and the Saudi Orthodontic Society. The surveys included questions about the type of orthodontic treatment provided, referral trends, and timing; presumed benefits associated with successful orthodontic treatment; and diagnosis and treatment plans of seven cases representing different malocclusions.

RESULTS

In total, 25 orthodontists, 18 pediatric dentists, and 14 general practitioners completed the survey. Only 38.8% of pediatric dentists and 7.1% of general practitioners reported that they practiced orthodontics clinically. The perceptions of the three groups toward the benefits of orthodontic treatment were comparable in the psychosocial areas. However, the orthodontists perceived significantly lesser effects of orthodontic treatment on the amelioration of temporomandibular disorder (TMD) symptoms. Pediatric dentists tended to rate the need and urgency of treatment higher, while general practitioners tended to rate the need of treatment lower. The selected treatment plans for three early malocclusion cases showed the greatest discrepancies between the orthodontists and the other two groups.

CONCLUSIONS

The orthodontists consistently and significantly downplayed the perceived benefit of orthodontic treatment to reduce TMD symptoms. Also, while there was a similarity in the diagnosis, there were notable differences in the proposed treatment approaches, perceived treatment need, and timing of intervention between the three groups of practitioners.

Factors influencing the adoption and implementation of teledentistry in the UK, with a focus on orthodontics

OBJECTIVES

Utilizing Rogers' diffusion of innovation theory, this study aims to develop a better understanding of the challenges faced in teledental projects, and outline the factors that impact upon the adoption and implementation of teledental projects, with a focus on orthodontics, thus attempting to provide an explanation for the low uptake in the UK, as well as to suggest factors to encourage success.

METHODS

A literature search was carried out to obtain information concerning teledentistry (and telemedicine) from both primary and secondary research sources. Using the relevant information obtained, Rogers' diffusion of innovation theory was used as a framework, which was subsequently applied to the key stakeholder groups of a healthcare organization.

RESULTS

The model describes five characteristics of an innovation: relative advantage, compatibility, complexity, trialability and observability. These attributes are discussed in the context of key stakeholder groups within a healthcare organization: clinicians, patients, hospital managers, and healthcare decision-makers and funders. Each stakeholder group is motivated by different values and experiences, which in turn influence their decision to adopt a new technology.

CONCLUSIONS

Implementing teledental applications necessitates full comprehension and consideration of the healthcare environment and also a commitment to completely integrate teledentistry within that environment. This is a process that demands strategic alignment with clinical and organizational goals, clinical engagement and strong political support. The challenges within each stakeholder group must be specifically targeted.

Orthodontic referrals via TeleDent Southwest

The information presented in this article must be interpreted with caution. Ideally the trial should have lasted longer because five of the seven participating dentists said they felt constrained from taking in more cases because access to TeleDent advice would cease before completion of all but the shortest of treatments. Second, the number of practitioners recruited into the trial was small, and the dentists chosen were highly selected. Third, almost all the data are based on the opinions of the participating dentists, and for three of the dentists the number of cases on which those opinions were based was small. Finally, it must be remembered that all United Kingdom NHS dentists are busy and work on a highly structured "time of service" payment system. Although the costs of hardware, software, line rental, and training were borne by the TeleDent project, there was no financial compensation for the time spent by dentists capturing images of their patient records and putting together the whiteboard and transmitting the information. There was a significant financial disincentive for using the system. Ideally, a long-term prospective randomized study of the effect of teledentistry advice on outcome of orthodontic treatment provided by general dental practitioners should be undertaken. The data collected in the current study supported the dentists' opinions that TeleDent SW enabled them to offer a better service for their patients and use specialist services more appropriately.

Attitudes of UK consultants to teledentistry as a means of providing orthodontic advice to dental practitioners and their patients

OBJECTIVE

To determine UK orthodontic consultants' attitudes to the provision of orthodontic advice to general dental practitioners by electronic means.

DESIGN

Questionnaire.

SETTING

Conducted by email and surface mail as appropriate in August 2000.

SUBJECTS

All those UK NHS orthodontic consultants contained in the membership lists of the Consultant Orthodontists Group of the British Orthodontic Society.

OUTCOME

An 86 per cent response was obtained from the 231 consultants.

RESULTS

More than half (58 per cent) of the consultants were interested in providing an electronic diagnostic service for the general dental practitioners in their locality and 70 per cent were in favour of further research into this possibility. Provided this was mediated through their GDP, only 26% would oppose consultant advice being given electronically from a centralized source.

CONCLUSIONS

A majority of UK orthodontic consultants support the concept of using teledentistry to make their advice more accessible to dentists and patients.

Orthodontic teaching practice and undergraduate knowledge in British dental schools

AIM

The aim was to survey current orthodontic teaching practice in the undergraduate syllabus at British dental schools and to test the abilities of undergraduate students according to the requirements of the GDC regulations.

MATERIALS AND METHODS

Information collected by means of a questionnaire sent to each dental school in 1998 was compared with similar data from 1994. The orthodontic knowledge and treatment planning ability of students was assessed by a multiple-choice examination paper completed by a random 10% sample of students from each dental school.

RESULTS

In 1998 on average 195 curriculum hours were devoted to orthodontics and each student treated five patients. The teaching of fixed appliances had increased considerably between 1994 and 1998. The average MCQ score was 58% (range 39-72%). Students scored well on questions that tested basic knowledge but much less well when they were required to apply that knowledge. Only three schools felt that it was realistic to expect undergraduates to formulate orthodontic treatment plans, as they are required to do by the GDC.

CONCLUSION

Results support the view that undergraduate orthodontic training should concentrate on diagnosis and recognition of problems rather than on providing limited exposure to treatment techniques.