What do patients take into account when they choose their dentist? Implications for quality improvement

Evaluation of the impact of orthodontists' smile with malocclusions on social media and professional credibility

OBJECTIVES

This study assessed laypeople's perceptions of orthodontist credibility based on malocclusions and whether these views affect their choice to seek treatment. Eye-tracking technology and questionnaires were utilized.

MATERIALS AND METHODS

Ninety-five lay raters, through eye tracking and a questionnaire, assessed 12 images of orthodontists with malocclusions. Malocclusions were categorized by the Index Of Treatment Need (IOTN) as grade 1 (near ideal), 3 (anterior crowding), and 5 (with diastemas). Fixation points were recorded, and credibility was gauged via questionnaires. A Mentimeter word cloud was generated.

RESULTS

IOTN 1 orthodontists were viewed as more credible than IOTN 3 (p < 0.001) and 5 (p < 0.001). Raters were more willing to receive treatment from IOTN 1 orthodontists. The focus for IOTN 1 was between eyes and mouth, while IOTN 3 and 5 were on the mouth. "Crooked teeth" and "spacing" were predominant in word clouds for IOTN 3 and 5.

CONCLUSION

Orthodontists with an IOTN grade 1 rating were perceived as more competent, reliable, and professional, thus making it more likely for laypeople to choose them as their preferred providers.

CLINICAL RELEVANCE

The smiles of professionals play a significant role in laypeople's decision to choose them as their orthodontist, and strategic utilization of social media can effectively deliver health information to a larger audience in a faster and more direct manner.

Patient Satisfaction With Dental Services

Patient satisfaction is an integral aspect of healthcare quality assessment, and it plays a crucial role in evaluating the effectiveness of healthcare services. This systematic review investigates patient satisfaction with dental services provided by public dental hospitals in rural and remote areas of Saudi Arabia. The study conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) standards. It involved a comprehensive search across multiple databases, including Medline, Cochrane, Embase, and CINAHL, with tailored search strategies for each database using MeSH terms and keywords. To ensure inclusivity, the search covered publications in both English and Arabic and included Google Scholar for gray literature. Inclusion criteria focused on empirical studies conducted in rural and remote public hospitals in Saudi Arabia, published between 2013 and January 2023, assessing patient satisfaction in oral or dental care for adult patients. Data screening and extraction followed a rigorous two-step process, and a narrative synthesis was used to analyze and summarize the findings. The findings reveal a complex landscape of patient satisfaction in these settings, with varying levels of contentment reported. While more than 50% of patients expressed satisfaction with the quality of dental care, significant challenges related to accessibility were evident. Patients residing in remote and rural areas often had to travel long distances to access dental clinics, resulting in dissatisfaction. Demographic factors, particularly education and age, were identified as significant influencers of patient satisfaction, with more educated individuals tending to be less satisfied. This study emphasizes the importance of continuous monitoring of patient satisfaction to enhance service delivery, particularly in public dental clinics serving remote and rural areas. Addressing issues related to access, availability, clinical quality, and effective communication is vital for improving patient satisfaction in these healthcare settings. The study concludes with recommendations for policymakers, including the development of quality assurance policies, cost mitigation strategies, and targeted interventions to address demographic disparities and enhance patient satisfaction with dental care services.

Signalling waiting times to citizens on public oral healthcare providers' websites

Objective: The study aimed to analyse the usefulness of signalling waiting times to citizens on the websites of public primary oral healthcare providers in Finland. Finnish laws require this signalling.Material and methods: We gathered data with two cross-sectional surveys in 2021. One electronic questionnaire was for Finnish-speaking citizens in Southwest Finland. The other was for public primary oral healthcare managers (n = 159). We also gathered data on 15 public primary oral healthcare providers' websites. For the theoretical framework, we combined the agency and signalling theories.Results: Of the citizen respondents (n = 411), 57% knew about the waiting time signalling on the websites. The respondents considered waiting time a high-priority criterion in choosing a dentist, but they rarely searched for information anywhere on the choice of a dentist, wanting to visit the dentist they had earlier visited. The quality of signalled waiting times was low. One out of five managers (response rate 62%) answered that signalled waiting times were based on speculation.Conclusions: Waiting times were signalled to comply with the legislation rather than to inform citizens and to reduce information asymmetry. Further research is needed to acquire information on rethinking waiting time signalling and its desired goals.

University Students' Satisfaction with the Quality of Primary Dental Healthcare Services and Dentists in Croatia: A Cross-Sectional Study

Measuring satisfaction can be an essential method for evaluating and improving healthcare quality. Therefore, this survey aimed to determine university students' satisfaction with dental care at the primary healthcare level and the factors that influence students' decisions when choosing a dental provider. A cross-sectional survey was conducted using a self-administered electronic questionnaire that assessed satisfaction with various aspects of dental care (patient-staff interaction, professional and technical competence, and administrative efficiency) on a 5-point Likert scale. A total of 806 students participated in the survey, of whom 56.6% were from a biomedical science background, and 43.4% from other scientific fields. Near-minimal differences were found between respondents studying in biomedical fields and those from other scientific fields, when evaluating satisfaction with dental services. More significant differences were found in the factors influencing their choice of dentist. The dentist's experience (p = 0.031), cost of service (p ≤ 0.001), office location (p = 0.034), waiting time (p = 0.029), qualifications (p = 0.033), and gender (p = 0.007) were more important for students pursuing one of the non-health-related majors. Overall, respondents were very satisfied with their dentists and the services provided. The highest satisfaction score was found on the "professional and technical competence" and "administrative efficiency" subscales, while the lowest satisfaction score was found on the "patient-staff interaction" subscale.

Socioeconomic Disparities in Iranians’ Preferences toward Dental Care Services: A Population-Based Survey

Background and Aims

Patients' perspectives and preferences are considered an essential influencing factor for healthcare utilization. This study is one of the first to investigate patient preference for dental services across socioeconomic and demographic indicators in Iran.

Materials and Methods

This cross-sectional study was conducted through telephone interviews with adult residents in Mashhad and Kerman cities. A representative sample was selected by stratified random sampling. A valid structured questionnaire was used for data collection, including people's preference toward dental care services in terms of dental settings, choosing a general or specialist dentist, prevention or treatment, and the preferable gender of the dentist. Factors potentially associated with preferences included gender, age, educational level, job, monthly income, house size, family number, insurance coverage, dental insurance, type of insurance, and social class in the city were investigated.

Results

1475 individuals participated in the study [response rate 63%]. Our findings showed higher preferences for private offices (50.6%), specialist dentists (76.2%), treatment services (40.8%), and no specific gender preference for the dentist (60.6%). Their preferences were significantly influenced by age range, social class, insurance status, dental insurance, and type of insurance. Income, household size, level of education, and job were not statistically significant with none of the preferences.

Conclusions

Socioeconomic and demographic factors' correlation with people's preferences was observed. Efforts are needed to promote preventive care demand in deprived regions. Moreover, increasing financial resources allocated to preventive care and covering preventive dental services in insurance plans are recommended.

Barriers to and facilitators of opioid prescribing by dentists in the United States: A qualitative study

BACKGROUND

Dentists in the United States frequently prescribe opioids for dental-related pain, although evidence shows superior efficacy of nonopioids for pain management. A national sample of US dentists was interviewed to understand the barriers and facilitators to opioid prescribing.

METHODS

Semistructured one-on-one telephone interviews were conducted with dentists sampled from the 6 regions of The National Dental Practice-Based Research Network. Responses were coded into the domains of the Capability, Opportunity and Motivation Model of Behavior. Potential behavior change interventions were identified for targeted themes.

RESULTS

Seventy-three interviews were qualitatively analyzed. Most of those interviewed were general dentists (86.3%) and on average (SD) were in practice for 24.3 (13.0) years. Ten themes were identified within the Capability, Opportunity and Motivation Model of Behavior. Dentists' knowledge of opioid risk, ability to identify substance use disorder behavior, and capability of communicating pain management plans to patients or following clinic policies or state and federal regulations were linked with judicious opioid prescribing. Dentists reported prescribing opioids if they determined clinical necessity or feared negative consequences for refusing to prescribe opioids.

CONCLUSIONS

Dentists' opioid decision making is influenced by a range of real-world practice experiences and patient and clinic factors. Education and training that target dentists' knowledge gaps and changes in dentists' practice environment can encourage effective communication of pain management strategies with patients and prescribing of nonopioids as first-line analgesics while conserving opioid use.

PRACTICAL IMPLICATIONS

Identified knowledge gaps in dentistry can be targets for education, clinical guidelines, and policy interventions to ensure safe and appropriate prescribing of opioids.

What Counts for the Old and Oldest Old?-An Analysis of Patient Criteria for Choosing a Dentist-Part II: Personal Characteristics and Soft Skills

Soft skills include communication skills and personality traits that are important when choosing a dentist, but other factors within the dental office also seem to be important for patients. The aim of this study is to evaluate factors that are important to people in a dentist as well as characteristics of the ideal dentist and to evaluate possible age-, gender-, and residence of living specific differences. A telephone survey with participants aged 35 years or older (ag—age group: ag 1: 35−50 years, ag 2: 70−84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to gender and age. Most of the participants (n = 298, 64.2%), regardless of their own gender, age, or place of residence did not care about the gender of the dentist. In general, the price of the treatment does not play a role in choosing the ideal dentist. Women differ significantly from men in their choice of dentist (ANOVA p < 0.001 (preference of non-smoker), ANOVA p < 0.001 (preference, that the dentist does not smell of smoke, importance of appearance (ANOVA p < 0.001) and psycho-social skills, etc.). As age increases, professional experience and psycho-social competencies are rated as important. With the increase in age, the mean value of the desired years of professional experience increases without significant differences between age groups. The importance of advanced training (ANOVA p < 0.001; Bonferoni correction: significant difference between ag 1 and ag 2 p < 0.001, and ag 1 and ag 3 p < 0.001) decreases with age. Especially for participants aged 70 to 84 years, a relationship of trust is important. Between the places of residence, statistical differences for almost all surveyed items were found (e.g., importance that the dentist speaks the patients’ native language ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig, Berlin and Mainz, and Leipzig and Mainz (each p < 0.001), dentist has a specialization ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig and Berlin and Mainz (each p < 0.001), etc.). Dentists should be trained to develop psycho-social skills to meet the special demands of the increasing older population.

What Counts for the Old and Oldest Old?-An Analysis of Patient Criteria for Choosing a Dentist-Part I: Awareness and Selection Criteria, Infrastructure, and Dental Office Equipment

Utilization of a dentist is influenced by many factors. The aim of this study is to present the factors relating to how patients become aware of a dentist, according to which criteria they select the dentist, and which factors in the infrastructure, equipment of dental offices, and human interactions are important for patients. A telephone survey with 466 participants (female 59.9%) in three age groups (ag 1: 35−50 years, ag 2: 70−84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to age, gender, and place of residence. Hardly any differences in the selection of the dentist and the selection criteria applied were found between the sexes, the age groups, or the places of residence. Recommendation seems to be the major aspect regarding how patients become aware of or select their dentist (n = 278, 65.6%), while modern technologies, e.g., the internet, play a subordinate role (n = 31, 7.3%). The unimportance of modern technologies increases significantly with the increase in age. As age increases, factors such as infrastructure (e.g., elevator available (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p < 0.001, ag 1 and ag 3 p < 0.001, and ag 2 and ag 3 p = 0.009); accessibility by wheelchair (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p = 0.006; and ag 1 and ag 3 p < 0.001); etc.) and dental office equipment become significantly important and influence the choice of dentist, while the importance of good parking facilities significantly decreased with age (ANOVA p = 0.003; Bonferoni correction: significant differences between ag 1 and ag 3 p = 0.004, and ag 2 and ag 3 p = 0.023). With increasing age, e.g., the importance of a television in the waiting room (ANOVA p = 0.012; Bonferoni correction: significant differences between ag 1 and ag 3 p = 0.014; and ag 2 and ag 3 p = 0.011), a modern waiting room (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 3 p < 0.001; and ag 2 and ag 3 p < 0.001) or the possibility to visualize the oral situation on a screen decreases significantly (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p < 0.001; ag 1 and ag 3 p < 0.001, and ag 2 and ag 3 p < 0.001). If dentists want to welcome and treat older people, they should adapt the accessibility, infrastructure and equipment of their practice to the needs of older people in order to be able to guarantee continuous lifelong dental care regardless of the need for assistance or care.

Identifying service quality gaps between patients and providers in a Native American outpatient clinic

Background

Native American communities in Montana reservations have reported low-level satisfaction in health services. This research explored if the services provided at a Blackfeet Indian Reservation outpatient clinic were designed to meet patient expectations.

Methods

Staff and patient interviews and surveys allowed service expectations to be assessed according to the clinic’s ability to meet those expectations. A total of 48 patients and ten staff members (83% of the staff at this clinic) participated in the study voluntarily.

Results

We found a disconnect between what patients anticipate for care and what staff think they are anticipating. We also found a discontent between what staff believes patients need versus what the patients feel is needed.

Conclusions

These gaps combine to increase the breach between patient expectations and perceptions of their healthcare services. With better insight that captures what patients are looking for from a service, the potential to meet those needs increases, and patients feel that their voice is respected and valued.

The "business" of dentistry: Consumers' (patients') criteria in the selection and evaluation of dental services

The dimensions of patient-centred care include not only clinical effectiveness and patient safety, but, importantly, the preferences of patients as consumers of healthcare services. A total of 249 participants were included in the study, with a balanced population proportional representation by age, gender, ethnicity and geographic region of New Zealand. An online questionnaire was used to identify participants’ decision-making process, and what factors and barriers for participants to seek dental treatment. Cross-tabulations, Spearman correlation analysis and Pearson Chi-Square analysis were used for the statistical analyses. Three most common reasons for visit were check-up (77%), clean (57%) and relief of pain 36%). A desire to treat a perceived problem was the most common encouraging factor to seek dental care. Cost was the most common barrier to seeking dental services. The majority of participants attended a private practice (84%), with convenience of location and referral from professionals the most likely to influence their choice. Participants felt the most important trait a dental practitioner could demonstrate was to discuss treatment options with them before any treatment. Dental check-up, teeth cleaning and relief of pain were the most common reasons for patients to choose dental services. Cost and ethnicity of the consumers had a significant impact on how dental services were perceived and sought. Dental practitioners may need to reorientate how they express value of oral health practice, not just in regard to communication with patients, but also with government funding agencies.

Patients’ Preferences for Dentist’s Nationality and Gender among Residents of Jeddah, Saudi Arabia

Introduction:

Several studies have shown that a dentist’s gender and nationality are important factors for patients when they choose their dentist. This topic is important in countries like Saudi Arabia, which is considered to be conservative and has many cultural boundaries that separate men from women in daily activities.

Aim:

This study aimed to investigate patient preference for a dentist’s gender among a sample population in Jeddah, Saudi Arabia.

Methods:

This cross-sectional study recruited 1,000 participants who completed a self-administered questionnaire. Data were analyzed using SPSS v.21.

Results:

A total of 46.2% of the participants had no particular gender preference for dentists in general, while 28.6% prefered male dentists and 25.2% prefered female dentists. Male and female participants had statistically significant differences in the selection of a dentist’s gender in general, with all participants tending to choose a dentist of the same gender as themselves. Previous personal experience and recommendations from friends were among the most influential factors in choosing dentists of a specific gender. In terms of preferences for dentists of a particular nationality, 45.6% had no preferences, while 28.4% preferred Saudi dentists.

Conclusion:

Although half of the Jeddah residents participating in our study had no preference for dentists of a particular gender or nationality, the other half had specific preferences.

Key Factors Correlations in Selecting Dental Services

The factors which influence patients in their choice of a dental care office has recently become more complex. Our objective was to assess the correlations between different key factors (demographic aspects, dentists’ professionalism, factors related to dental care offices) that influence the selection of a particular dental care office by adult patients.

An online questionnaire (self-administered survey) was applied to a random sample of 117 adult dental patients in private clinics in Bucharest, Romania. The survey consisted of 12 questions, and it was conducted during a 2-week period. All the collected data were subjected to statistical analysis.

The obtained results revealed statistically significant correlations between studied factors, i.e., elderly patients compared to younger patients considered the use of the state-of-the-art medical devices was important for the dental office (p=0.043, R=0.187). In comparison to women, male patients were searching more often information regarding the dental offices on social media (p=0.002, R=0.284); patients that attached more importance to the dentist’s professional degree were the ones that attached more importance to its reputation (p<0.001, R=0.381) and to the dental office location (p=0.022, R=0.211).

The results highlighted specific patterns in patients’ perception of factors related to the selection of dental offices, as also found in scientific literature.

The present study offers a perspective on how to improve dental care and patients’ oral health.

Patients' perceptions and preferences of oral and maxillofacial surgeons in a university dental hospital

Purpose

There is a lack of information regarding the dental patient's point of view of oral and maxillofacial surgeons (OMFSs). The aim of this study was to evaluate the perceptions and preferences of a group of university dental hospital patients for OMFSs.

Materials and methods

This study was based on patients' self-assessment using a questionnaire. A total of 530 patients were enrolled for the study. The patients' preferences regarding the surgeons' age, gender, religion, race and experience were determined and compared statistically.

Results

A total of 506 questionnaires were considered as complete and used in the analysis. Female patients preferred female practitioner more than male patients did (p=0.002), but no significant difference was found between male and female patients regarding preference for the age (p=0.464), ethnicity (p=0.926) and religion (p=0.261) of the OMFS. The educational status of the patients did not have an effect on the gender preference for the OMFS (p=0.114); however, educational status significantly affected the preferences for the ethnicity and religion of the practitioners (p=0.001).

Conclusion

Today patient expectations and perceptions take place in post graduate education programs. In this study we determined a wide range of different factors for choosing an OMFS. The diversity of these factors may affect the quality of the health service and thus must be considered in determining the content of oral and maxillofacial curriculum.

Quality management in healthcare: The pivotal desideratum

Health care is very complex sector and delivery of service is the fragmented care. Quality can be a common paradigm to address the need of all groups in health care. Quality improvement is the process approach to the organization's operational challenges. The initiative to address the quality in health care has become a global phenomenon. A quality revolution for delivery of service with patient at the center and services around it is the demand of the time. This article comprehensively reviews the quality management in health care service and aims to sensitize the health care professionals towards achieving total quality.