Analysis of the reliability of patient COVID-19 screening data compared against their actual test data

OBJECTIVES

This study aimed to evaluate the truthfulness of patients about their pre-appointment COVID-19 screening tests at a dental clinic.

METHODS

A total of 613 patients were recruited for the study from the dental clinic at the Faculty of Dentistry, Najran University, Saudi Arabia. The data collection was done in three parts from the patients who visited the hospital to receive dental treatment. The first part included the socio-demographic characteristics of the patients and the COVID-19 swab tests performed within the past 14 days. The second part was the clinical examination, and the third part was a confirmation of the swab test taken by the patient by checking the Hesen website using the patient ID. After data collection, statistical analysis was carried out using SPSS 26.0. Descriptive analysis was done and expressed as mean, standard deviation, frequency, and percentage (%). A cross-tabulation, also described as a contingency table, was used to identify trends and patterns across data and explain the correlation between different variables.

RESULTS

It was seen from the status of the swab test within 14 days of the patient's arrival at the hospital for the dental treatment that 18 (2.9%) patients lied about the pre-treatment swab test within 14 days, and 595 (97.1%) were truthful. The observed and expected counts showed across genders and diagnosis a statistically significant difference (p < 0.001), and there was no significant difference seen across different age groups (p = 0.064) of the patients.

CONCLUSIONS

Dental healthcare workers are worried and assume a high risk of COVID-19 infection as the patients are not truthful about the pre-treatment COVID-19 swab test. Routine rapid tests on patients and the healthcare staff are a feasible option for lowering overall risks.

Increasing Nonemployer Dental Establishments in New York State: A Component of a Changing Landscape

The increasing numbers of nonemployer dental establishments in the counties of New York State are a component of the evolving landscape for the delivery of dental services throughout the country. Limited attention has been directed to the more than 4,000 of these facilities in the state and the more than 43,000 in the nation. Increased attention needs to be directed to nonemployer facilities as the profession comes to terms with its economic concerns, legal challenges to delivery modalities and evolving population characteristics.

The preparedness of private dental offices and polyclinics for medical emergencies. A survey in Western Saudi Arabia

Objectives:

To assess preparedness for medical emergencies in private dental offices in Jeddah, Kingdom of Saudi Arabia (KSA).

Methods:

In this cross-sectional study, a survey was distributed to 70 dental offices and polyclinics in Jeddah, Saudi Arabia between October 2013 and January 2014. The questionnaire gathered information on the prevention of medical emergencies, the preparedness of the office personnel, and availability of emergency drugs and equipment.

Results:

For prevention, 92% (n=65) of the offices reported that they obtain a thorough medical history prior to treatment; however, only 11% (n=8) obtain vital signs for each visit. Using a preparedness percent score (0 to 100), the mean level of preparedness of the office personnel in all surveyed dental offices was 55.2±20. The availability of emergency drugs was 35±35, and equipment was 19±22.

Conclusion:

We found a deficiency in personnel training, availability of drugs, and emergency equipment in the surveyed dental clinics. More stringent rules and regulations for emergency preparedness must be reinforced to avoid disasters in these clinics.

Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management

STATEMENT OF THE PROBLEM

Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment.

MATERIALS AND METHODS

Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations.

RESULTS AND CONCLUSIONS

Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.

Dentists United to Extinguish Tobacco (DUET): a study protocol for a cluster randomized, controlled trial for enhancing implementation of clinical practice guidelines for treating tobacco dependence in dental care settings

BACKGROUND

Although dental care settings provide an exceptional opportunity to reach smokers and provide brief cessation advice and treatment to reduce oral and other tobacco-related health conditions, dental care providers demonstrate limited adherence to evidence-based guidelines for treatment of tobacco use and dependence.

METHODS/DESIGN

Guided by a multi-level, conceptual framework that emphasizes changes in provider beliefs and organizational characteristics as drivers of improvement in tobacco treatment delivery, the current protocol will use a cluster, randomized design and multiple data sources (patient exit interviews, provider surveys, site observations, chart audits, and semi-structured provider interviews) to study the process of implementing clinical practice guidelines for treating tobacco dependence in 18 public dental care clinics in New York City. The specific aims of this comparative-effectiveness research trial are to: compare the effectiveness of three promising strategies for implementation of tobacco use treatment guidelines-staff training and current best practices (CBP), CBP + provider performance feedback (PF), and CBP + PF + provider reimbursement for delivery of tobacco cessation treatment (pay-for-performance, or P4P); examine potential theory-driven mechanisms hypothesized to explain the comparative effectiveness of three strategies for implementation; and identify baseline organizational factors that influence the implementation of evidence-based tobacco use treatment practices in dental clinics. The primary outcome is change in providers' tobacco treatment practices and the secondary outcomes are cost per quit, use of tobacco cessation treatments, quit attempts, and smoking abstinence.

DISCUSSION

We hypothesize that the value of these promising implementation strategies is additive and that incorporating all three strategies (CBP, PF, and P4P) will be superior to CBP alone and CBP + PF in improving delivery of cessation assistance to smokers. The findings will improve knowledge pertinent to the implementation, dissemination, and sustained utilization of evidence-based tobacco use treatment in dental practices.

TRIAL REGISTRATION

NCT01615237.

Going green with eco-friendly dentistry

Eco-friendly dentistry is currently transforming the medical and dental field to decrease its affect on our natural environment and reduce the amount of waste being produced. Eco-friendly dentistry uses a sustainable approach to encourage dentists to implement new strategies to try and reduce the energy being consumed and the large amount of waste being produced by the industry. Many reasonable, practical and easy alternatives do exist which would reduce the environmental footprint of a dental office were it to follow the 'green' recommendations. Dentist should take a leading role in the society by implementing 'green' initiatives to lessen their impact on the environment. This article provides a series of 'green' recommendations that dentists around the world can implement to become a leading Stewards of the environment.

Expanded function allied dental personnel and dental practice productivity and efficiency

This study examined the impact of expanded function allied dental personnel on the productivity and efficiency of general dental practices. Detailed practice financial and clinical data were obtained from a convenience sample of 154 general dental practices in Colorado. In this state, expanded function dental assistants can provide a wide range of reversible dental services/procedures, and dental hygienists can give local anesthesia. The survey identified practices that currently use expanded function allied dental personnel and the specific services/procedures delegated. Practice productivity was measured using patient visits, gross billings, and net income. Practice efficiency was assessed using a multivariate linear program, Data Envelopment Analysis. Sixty-four percent of the practices were found to use expanded function allied dental personnel, and on average they delegated 31.4 percent of delegatable services/procedures. Practices that used expanded function allied dental personnel treated more patients and had higher gross billings and net incomes than those practices that did not; the more services they delegated, the higher was the practice's productivity and efficiency. The effective use of expanded function allied dental personnel has the potential to substantially expand the capacity of general dental practices to treat more patients and to generate higher incomes for dental practices.

Economic impact of dental hygienists on solo dental practices

The fact that a significant percentage of dentists employ dental hygienists raises an important question: Are dental practices that utilize a dental hygienist structurally and operationally different from practices that do not? This article explores differences among dental practices that operate with and without dental hygienists. Using data from the American Dental Association's 2003 Survey of Dental Practice, a random sample survey of U.S. dentists, descriptive statistics were used to compare selected characteristics of solo general practitioners with and without dental hygienists. Multivariate regression analysis was used to estimate the effect of dental hygienists on the gross billings and net incomes of solo general practitioners. Differences in practice characteristics--such as hours spent in the practice and hours spent treating patients, wait time for a recall visit, number of operatories, square feet of office space, net income, and gross billings--were found between solo general practitioners who had dental hygienists and those who did not. Solo general practitioners with dental hygienists had higher gross billings. Higher gross billings would be expected, as would higher expenses. However, net incomes of those with dental hygienists were also higher. In contrast, the mean waiting time for a recall visit was higher among dentists who employed dental hygienists. Depending on personal preferences, availability of qualified personnel, etc., dentists who do not employ dental hygienists but have been contemplating that path may want to further research the benefits and opportunities that may be realized.

Basic principles of dental office logistics: organizing dental supplies and equipment for optimal accessibility

To maximize office production, dentists should continuously perform treatment-related tasks throughout the workday. To this end, the office should logically organize and store dental instruments, disposables, materials, handpieces, and small equipment to optimize accessibility of these items at the moment when the dentist needs them. The office needs multiple copies of these items to prevent their inaccessibility during the workday due to breakdown, inventory depletion, or lack of a sterilized copy of the item when needed. Staff should know where all items are located in the office at all times to minimize the time needed to search for them. This article describes how to organize dental items in an office for optimal accessibility to the dentist during procedures.

Electronic dental records: start taking the steps

Converting paper patient records charts into their electronic counterparts (EDRs) not only has many advantages, but also could become a legal requirement in the future. Several steps key to a successful transition includes assessing the needs of the dental team and what they require as a part of the implementation Existing software and hardware must be evaluated for continued use and expansion. Proper protocols for information transfer must be established to ensure complete records while maintaining HIPAA regulations regarding patient privacy. Reduce anxiety by setting realistic dead-lines and using trusted back-up methods.

[Assessment of disinfection and sterilization processes in dental practice as an important factors in prevention of infections]

The dental health-care settings is an environment where disease transmission occurs easily. Prevention of cross infection is therefore a crucial aspect of dental practice and dental clinic stuffmust adopt certain basic routines while practicing. Infections may be transmitted in the dental operatory through direct contact with blood, oral fluids or other secretions; via indirect contact with contaminated instruments, equipment or environmental surfaces; or by contact with airborne contaminants present in either droplet splatter or aerosols of oral and respiratory fluids. Strategies to prevent dental patient infections have focused on disinfection and sterilization. This study evaluates basic routines in prevention of cross-infection in the dentistry. The sample comprised 100 dentists, who completed questionnaires. Based on inquires the conditions for disinfection and sterilization of medical devices were assessed. The following issues were taken into consideration: the way of disinfection and preparation of the disinfectants, the localization of disinfection, preparing to disinfection, washing and packing of dental devices, the frequency of disinfection, methods of sterilization and the monitoring system, type of sterilizers and the available cycles. The dental practices are well equiped to proceed the steam sterilization, but 33% of dentists don't know the available cycles in their autoclaves. Only 35% of them made sterilization process protocols. Very common are three failures of instruments disinfections: multiple use of disinfectant, adding of disinfectant, adding new instruments. There is still need for improvement in disinfection and sterilization in dental practice, especially including: monitoring and documentation of sterilization process, proper use of disinfectants according to manufactures instructions, frequent disinfection of surfaces which contact with patients. Dental stuff should take part in advanced training courses about disinfection and sterilization.

Management and marketing for the general practice dental office

This article reviews trends in the dental marketplace. Marketing is an essential element of dentistry. Communicating treatment options with patients is one aspect of marketing. Treatment planning helps patients understand the relationships between oral health, occlusion, temporomandibular joint function, and systemic health. Through marketing, dental practice owners inform patients of ever-changing treatment modalities. Understanding treatment options allows patients to make better, informed choices. More options leads to a higher level of care and more comprehensive dental treatment. Managing a practice requires tracking its financial health. Economic statistics measure the effect of management decisions that mark the direction of a dental practice.

Preparing the dental office for medical emergencies

Modern dental offices must be equipped to initiate prompt emergency care should the sudden need arise. With the elderly population in dental practices increasing, these emergencies will undoubtedly occur. This article discusses the basic emergency equipment the average dental office should possess to allow for an adequate initial response. It also discusses the policies and personnel needed for dealing with emergencies. Among the basic emergency equipment, an office should have syringes, an Ambu bag, a portable oxygen system, a sphygmomanometer (child and adult sizes), and an EKG/defibrillator. Emergency drugs that should be stocked include aromatic ammonia, aspirin, and nitroglycerine. The dentist should also develop a protocol and policy for his/her staff to follow when a medical emergency arise.

Dental establishment business activity in New York State counties at start of the millennium

Bureau of the Census reports for 2002 were used to develop business data for "average" dental establishments in each of the counties in New York State. On average, between 1997 and 2002, when compared to national information, the number of New York State dental establishments increased at a slower rate, had a smaller resident population per establishment, reported lower gross receipts, had fewer employees and paid lower salaries to employees.

Your practice is not your pension fund

I believe that in the not too distant future--in 10 to 20 years--the single-handed practice as we know it today will cease to exist. Even in today's market, 25% of practices have either closed due to an unsaleable commodity or have taken two to three years to sell and at a seriously reduced price. This thought alone should refocus the mind as we continue into the 21st century.

Wireless local area network for the dental office

Dental offices are no exception to the implementation of new and advanced technology, especially if it enhances productivity. In a rapidly transforming digital world, wireless technology has a special place, as it has truly "retired the wire" and contributed to the ease and efficient access to patient data and other software-based applications for diagnosis and treatment. If the office or the clinic is networked, access to patient management software, imaging software and treatment planning tools is enhanced. Access will be further enhanced and unrestricted if the entire network is wireless. As with any new, emerging technology, there will be issues that should be kept in mind before adapting to the wireless environment. Foremost is the network security involved in the installation and use of these wireless networks. This short, technical manuscript deals with standards and choices in wireless technology currently available for implementation within a dental office. The benefits of each network security protocol available to protect patient data and boost the efficiency of a modern dental office are discussed.

Tobacco cessation program: resources to help organize a dental office program

When dentists and dental office team members assist their patients in becoming tobacco free, they are eliminating causative/contributing factors for a number of oral conditions, including cancer and periodontal diseases. These tobacco cessation services, when successful, can also improve the outcome of dental treatment and at the same time add quality and years to patients' lives. Dental offices that would like to provide and document tobacco cessation services will find the University of Minnesota School of Dentistry web site www.umn.edu/ perio/tobacco a useful resource. For some tobacco-using patients who are interested in quitting, our Individual Counseling Clinic at (612) 626-0440 is a possible option, and referrals are welcome. For further information, please contact Dr. Stafne at stafn001@umn.edu.

Modern office design in the "information age"

This article reviews the process of reaching the goal of modernizing a new or existing endodontic office. Incorporating computer-based technologies in the office requires significant planning, best achieved by forming a technology goal that addresses budget, knowledge base, and infrastructure issues. Making the transition to the modern dental practice is expensive and time-consuming but also profitable and exciting. Soon, all dental offices will be using digital radiographic systems, video systems, and patient charting programs that use no paper documentation. As the computer familiarity and staff knowledge based increases with the growing use of computers in society overall, finding the office personnel able to harness the efficiency and power of the technology in the dental office will be easier. Through careful planning and formation of a reasonable technology goal, updating an old office or creating a new modern endodontic practice with the technologies and their patients can benefit.

A custom-fabricated device for chairside organization of multiple implant components

Organizing multiple and varied implant components in preparation for providing treatment for a patient with a complex implant prosthesis can be a challenge to even the most experienced practitioner. The many implant abutment component options available, especially when different sizes and types of abutments will be used in 1 arch, can create confusion for both dentist and assistant, hindering chairside efficiency. This article describes the fabrication and use of a custom chairside implant components organizer.