Practitioner Engagement in Activities of the National Dental Practice-Based Research Network (PBRN): 7-Year Results.

PURPOSE: To 1) quantify practitioner activities of the National Dental Practice-Based Research Network (Network) for which Continuing Education (CE) credits were received (study training, videos, webinars, meetings, and symposia); 2) quantify practitioner coauthoring Network publications and presentations; and 3) test whether practitioner characteristics were associated with participation in these activities. METHODS: A retrospective analysis of 4361 practitioners who enrolled in the Network between April 12, 2012 and October 12, 2018. RESULTS: Overall, 59% (n = 2586) of practitioners earned CE credit from the Network; among these, 68% (n = 1757) from a video, 38% (n = 993) attended an annual Network meeting, 31% (n = 798) due to training for a Network clinical study, 9% (n = 226) attended a national symposium, and 7% (n = 170) participated in a Network webinar. Members of 2 large group practices earned on average more CEs than practitioners from other practice settings. Four percent (n = 159) of practitioners coauthored a Network presentation or publication. Practitioners who received their dental degree before 2000, were general practitioners, or were members of 2 large group practices, were more likely to have coauthored a publication or presentation. CONCLUSION: This Network used a broad range of activities to engage community practitioners. These activities were successful in sustaining a high level of practitioner engagement in clinical research and its relevance to everyday clinical practice.

Oral-cancer knowledge, practice, and attitude assessment of dentists in Upper Egypt: A cross-sectional study.

The aims of this study were to investigate the knowledge, attitude, and practice of dentists in Upper Egypt with regard to oral cancer (OC). Out of 1,200 licensed dental practitioners list, 424 dentists were randomly selected from three governorates in Upper Egypt (Minia, Assuit, and Sohag). The sample size was calculated using the equation considering the knowledge of dentists about OC, confidence level, and margins of error; then, an additional number of dentists were added to guard against nonresponse. Data were collected by face-to-face interview using 44 items divided into four sections; first part demonstrates sociodemographic. The second part concerned with the knowledge about OC clinical presentation and diagnosis (12 multiple-choice questions) as well as its risk factors (17 close-end questions). The third part consists of six questions focused on the practice of participants, and finally, the last part measures attitude of dentists. The chi-square test was used to compare between the two or more proportions. A correlation was used for describing the relationship or association between two mutually numerical dependent variables. p < 0.05 was considered to indicate significance. Rate of response was 94.3%. The overall knowledge level in the current study was 31.8%. The awareness about OC risk factors was high especially, smoking tobacco and alcohol consumption. Also, over 80% of dentists identified family history and human papillomavirus (HPV) as risk factors. Only 37.5% of participants performed regular screening of oral mucosa, and 26.5% reported lymph-node examination. Regarding attitude, only one quarter of dentists attended continuing educating programs about OC. A statistically significant relation (p < 0.0001) between knowledge level and most demographic variables was detected. There was a fair positive correlation (r = 0.47) between practice and knowledge scores. A predominant trouble among dentists in Upper Egypt was regarding OC knowledge and practice. Continues education and training programs are highly recommended.

Understanding continuous professional development participation and choice of mid-career general dental practitioners.

OBJECTIVE: Participating in continuing professional development (CPD) activities is a requirement for dental practitioners to keep their skills and knowledge up to date. Understanding the ways dental practitioners engage with professional development and the impact on practice is not fully known (Eaton et al. 2011, http://www.gdc-uk.org/Aboutus/policy/Documents/Impact%20Of%20CPD%20In%20Dentistry.pdf). The aim of this study was to gain insights into the ways that dentists reflect on their professional development and what may be influencing their choices. METHOD: Empirical qualitative data were collected by semi-structured interviewing of five mid-career dentists. Using grounded theory, the data were analysed for themes about CPD choice and participation. RESULTS: Three themes were identified as influences to dentists' choices of CPD with pragmatic considerations of how new learning could benefit their patients and their practices. Dental practitioners were influenced by the requirements of external regulatory bodies which they did not consider to necessarily improve practice. CONCLUSION: Dentists working in primary care in the UK are undertaking CPD which is influenced by the pragmatic requirements of running a small business and to meet regulatory requirements. In this sample, dentists are not critically reflecting on their education needs when choosing their CPD activity. Protected learning time and organisational feedback and support are recommended as a way to promote more meaningful reflection on learning and to improve professional development.

Oral health workforce planning part 2: figures, determinants and trends in a sample of World Dental Federation member countries.

BACKGROUND AND AIM: A range of factors needs to be taken into account for an ideal oral health workforce plan. The figures related to dentists, specialists, auxiliaries, practice patterns, undergraduate and continuing dental education, laws/regulations, the attitudes of oral health-care providers and the general trends affecting the practice patterns, work conditions and preferences of oral health-care providers are among such determinants. Thus, the aim of the present study was to gather such information from a sample of World Dental Federation (FDI) member countries with different characteristics. METHODS: A cross-sectional survey study was carried out among a sample of FDI member countries between March 2, 2012 and March 27, 2012. A questionnaire was developed addressing some main determinants of oral health workforce, such as its structure, involvement of the public/private sector to provide oral health-care services, specialty services, dental schools, trends in workforce and compliance with oral health needs, and a descriptive analysis was performed. The countries were classified as developed and developing countries and Mann-Whitney U-tests and chi-square tests were used to identify potential significant differences (P > 0.05) between developed and developing countries. All data were processed in SPSS v.19. RESULTS: In the18 questionnaires processed, the median number of dentists (P = 0.005), dental practices (P = 0.002), hygienists (P = 0.005), technicians (P = 0.013) and graduates per year (P = 0.037) was higher in developed countries. Only 12.5% of developed and 22.2% of developing countries reported having optimal number of graduates per year. It was noted that 66.7% of developing countries had more regions lacking enough dentists to meet the demand (P = 0.050) and 77.8% lacked the necessary specialist care (P = 0.015). Although developing countries reported mostly an oversupply of dentists, regardless of the level of development most countries did not report an oversupply of specialists. Most developed countries did not feel that their regulations (87.5%) complied with the needs and demands of the population and most developing countries did not feel that their undergraduate dental education (62.5%) complied. Migrating to other countries was a trend seen in developing countries, while, despite increased numbers of dentists, underserved areas and communities were reported. DISCUSSION: The cross-sectional survey study suggests that figures related to optimum or ideal oral health workforce and fair distribution of the available workforce does not seem to be achieved in many parts of the world. Further attention also needs to be dedicated to general trends that have the capacity to affect future oral health workforce.

Current trends in endodontic treatment by general dental practitioners: report of a United States national survey.

INTRODUCTION: In the United States almost 70% of root canal treatment (RCT) is performed by general dentists (GPs), yet little is known about their treatment protocols. METHODS: A paper survey was mailed to 2000 United States GPs with questions about the types of endodontic cases treated, routine treatment protocols, use of newer technologies, and endodontic continuing education (CE). RESULTS: Completed surveys were returned by 479 respondents (24%). GPs who perform RCT (84%) reported providing anterior (99%), bicuspid (95%), and molar (62%) RCT and retreatment (18%). Rubber dam was used always (60%), usually (16%), sometimes (13%), and never (11%). Newer technologies used by GPs included digital radiography (72%), magnification (80%), electronic apex locator (70%), and nickel-titanium rotary instrumentation (74%). Compared with GPs with >20 years of experience, those in practice for ≤10 years were more likely to use rubber dam (P < .05), nickel-titanium rotary instrumentation (P < .001), apex locators (P < .001), and magnification (P < .01); in contradistinction, GPs in practice >20 years were more likely to perform retreatments (P < .05). Women were less likely to perform retreatment or molar RCT (both P < .05). GPs with >5 hours of CE were more likely to use rotary instrumentation (P < .001), irrigant activation devices (P < .01), and apex locators (P < .001) and perform molar RCT (P < .001) and retreatment (P < .05), but no more likely to use rubber dam. CONCLUSIONS: Recent GP graduates (≤10 years) were more likely to adopt new technologies and use rubber dam than those who practiced for >20 years. More experienced GPs were more likely to take on complicated cases than those with fewer years of practice. There was no association between hours of CE and compliance with rubber dam usage.

Factor analysis on implementation of domiciliary dental care in Metropolitan Tokyo.

The need for domiciliary dental care has increased with the aging of Japanese society. The Tokyo Metropolitan Government and Tokyo Dental Association conducted a survey of dental institutions within Tokyo in order to clarify which factors influenced implementation of domiciliary dental care by dental institutions. The proportion was significantly higher in (1) dentists in their 50s or older, (2) those working in cooperation with primary care physicians, (3) those providing dysphagia rehabilitation, (4) those who give information on prevention of aspiration pneumonia, (5) those who attended training on medical or domiciliary dental care for the elderly in need of nursing care, and (6) those who attended training workshops and seminars provided by the Tokyo Dental Association in 2010. In the logistic regression analysis, a significant odds ratio was obtained for the same items, excluding age. Attendance at training on medical or domiciliary dental care for the elderly in need of nursing care had the highest odds ratio. Those who attended any kind of training course implemented domiciliary dental care significantly more often. Training conducted by the Tokyo Metropolitan Center for Oral Health of Persons with Disabilities, Tokyo Dental Association, and local dental associations showed a significant odds ratio, with the highest by the Tokyo Dental Association. Traditionally, education on domiciliary dental care in the elderly is not provided at the college level. The present results indicate the importance of educating students with regard to the unique challenges such work poses. Attending seminars hosted by the Tokyo Dental Association also significantly influenced implementation of domiciliary dental care. This seems to be an important result, suggesting the effectiveness of training provided by dental associations with regard to the promotion of domiciliary dental care. This indicates the need for dental associations to provide such training throughout Japan.

An evaluation of CPD activity of dentists in Wales.

INTRODUCTION: Ongoing professional education is essential for dental professionals to maintain and update their clinical skills and knowledge. There is a current trend towards mandatory Continuing Professional Development (CPD) for dentists within Europe and beyond. Mandatory CPD will ensure high professional standards and enable mobilisation of the dental workforce within Europe. In 2002, the UK General Dental Council (GDC) implemented a system of mandatory CPD for dentists practicing in the UK. The Wales Deanery is situated in the School of Postgraduate Medical and Dental Education, Cardiff University. It provides verifiable CPD courses for dentists and dental care professionals (DCPs) currently practicing in Wales and has recorded professionals' attendance on these courses since 2001. The project aimed to investigate the CPD activity of dentists in Wales, using these data. METHODS: The Wales Deanery database holds data on the CPD courses undertaken by 1178 dentists working in Wales since 2001. A number of hypotheses were investigated using a variety of statistical methods. RESULTS: Dentists were undertaking significantly fewer hours of CPD in Mid and West Wales compared to the North and South of the principality. Sole practitioners were found to engage in less CPD than those in group practices, but these differences did not reach statistical significance. Dentists who employed a hygienist or therapist completed more hours of CPD than those who didn't employ either. There were no gender differences in engagement in CPD. CPD participation was consistently and significantly higher in mid and late career than in early career. CONCLUSIONS: This study provides a greater understanding of the CPD habits of the dental workforce in Wales. Practice staffing levels, location of practice and time since graduation were found to have the greatest impact on engagement in CPD activity. These findings will be used by the Deanery to inform future education provision for dental professionals in Wales.

Dental fear in children and adolescents: a comparison of forms of anxiety management practised by general and paediatric dentists.

BACKGROUND. About 11% of children and adolescents suffer from dental fear. These young people run an increasing risk of undergoing more invasive treatments. AIM. We researched the management of dental anxiety in young patients by general and paediatric dentists as well as by trained and untrained dentists. DESIGN. Eight hundred dentists in Germany were interviewed via e-mail regarding their experience, treatment techniques, information material and complications during the treatment of fearful children. We also examined how difficult dentists judge the treatment of anxious children and how often they participate in continuing education courses. RESULTS. Paediatric dentists applied a greater spectrum of management techniques than general dentists. They used more often psychotherapeutic interventions and anxiety assessment questionnaires. Dentists who frequently attend in continuing education courses judged the treatment to be less difficult and also used psychotherapeutic interventions more often. CONCLUSIONS. German paediatric dentists and dentists who take continuing education courses utilise a broader range of techniques to manage dental anxiety. They may be eminently suited to treat children with severe forms of anxiety. Therefore, dentists who treat young patients should participate in education programmes so as to reduce both the anxiety of their patients and their own anxiety.

The impact of a continuing education oral health program on providing services for young children by dentists, dental hygienists and dental assistants.

PURPOSE: The purpose of this study was to determine the impact of a 4 hour continuing education (CE) program on the oral health knowledge and behaviors of dentists, dental hygienists and dental assistants in providing oral health services to young children in West Virginia general dental practices. METHODS: A free CE program was provided for 92 general dentists, 123 dental hygienists and 37 dental assistants (n=252) at 4 sites across West Virginia. Participants completed a pre- and post-test on topics including the timing of the first dental exam, fluorides, xylitol, Alternative Restorative Technique (ART) and their practice pattern of caring for children under 3 years old. A 6 month follow-up questionnaire was mailed to participants to assess outcomes. RESULTS: Participants showed a 22% increase in knowledge from the pre-test to the post-test (p<0.001) for all questions except for ART, which showed no change. The majority of dentists and hygienists (89%) increased their comfort in providing services for children under 3 years old. Participants (80%) stated they would increase the number of children under 3 years old they examine, yet 6 months after the program only 42% responded affirmatively (p<0.001). At the time of the program, 62% reported that they currently examine children at 1 year of age, and there was no significant change 6 months later. While 54% responded that they would contact their local physicians about early oral health care, only 27% followed through. CONCLUSION: This program significantly increased the participants' knowledge and comfort level for providing infant and toddler oral health care. However, it did not motivate most to alter their practice behaviors to conform to national best practice guidelines.

Dental implant practice among Hong Kong general dental practitioners in 2004 and 2008.

OBJECTIVE: To describe the dental implant practice profile of Hong Kong general dental practitioners in 2008 and the trend since 2004. MATERIALS AND METHODS: A self-administered questionnaire was mailed to 630 dentists through systematic sampling of registered dentists. RESULTS: A total of 290 completed questionnaires were returned (response rate, 53%). Implant dentistry was practiced by 61% of the respondents. The survey also revealed that 84% of those respondents who own their private practice performed implant dentistry. About half of the dentists (49%) who performed implant dentistry placed or restored 5 or more implants per quarter. Among those dentists not practicing implant dentistry, the majority (85%) were interested in attending continuing education courses in dental implantology. CONCLUSION: There has been a significant increase in the number of general dental practitioners practicing implant dentistry in Hong Kong since 2004. By 2008, more than half of the general dental practitioners (61%) are practicing implant dentistry. Most of them not practicing implant dentistry expressed a desire to learn more about dental implants. This survey revealed a high demand for continuing professional development in implant dentistry in Hong Kong.

The periodontal examination profile of general dentists in Nova Scotia, Canada.

BACKGROUND: In this cross-sectional study we investigate the extent to which general dentists in Nova Scotia carry out periodontal examinations of their patients. In addition, factors that significantly influence performing a periodontal examination by a dentist are identified. METHODS: A survey questionnaire was mailed to all 443 general dentists practicing in the province of Nova Scotia in the summer of 2009. The survey included questions on demographics and the various components of the periodontal examination. Simple and multiple logistic regression tests were used to analyze the results. RESULTS: Of the 279 (63%) responses received, 272 (61%) responses were eligible to be included in the analyses. The majority of responders (94.8%) reported performing periodontal examinations of their patients. However, only 37.8% and 43.3% of the dentists reported performing full-mouth and selective probing depth measurements, respectively. Dentists who practiced in urban locations (P = 0.05), dentists whose practices were situated <5 km from a periodontist (P = 0.08), and dentists who planned to take a continuing education course in periodontal plastic surgery in the next 2 years (P = 0.07) were more likely to perform a periodontal examination. CONCLUSIONS: Although the majority of dentists in our study report performing periodontal examinations of their patients, only a small portion report recording complete probing depth measurements or using appropriate radiographs in their examinations. These practices could lead to an underestimation of diagnosis and treatment of periodontal disease.

Participation in continuing professional development by dental practitioners in Victoria, Australia in 2007.

BACKGROUND: Mandatory continuing professional development (CPD) was introduced in 2005 in Victoria, Australia to ensure that dental practitioners maintained their skills, knowledge and kept up-to-date with current topics in dentistry. The aim of this study was to investigate the participation, impact on practice and attitudes of Victorian dentists and dental specialists to CPD activities since the commencement of mandatory CPD. METHODS: A cross-sectional survey of a random sample of registered dentists and dental specialists (n = 895) was conducted from May to August 2008 using an anonymous, postal, self-administered questionnaire. RESULTS: The response rate was 66%. More than three quarters of practitioners believed mandatory CPD is a reasonable requirement for continued registration. Dentists reported attending an average of 30.9 h of certifiable clinical CPD whilst specialists attended an average of 33.2 h of certifiable clinical CPD over a 12-month period. Nearly three quarters of respondents reported changing their practice as a result of CPD activities, whilst one quarter attended CPD mainly to meet the mandatory requirements. CONCLUSIONS: Overall there was a positive attitude towards mandatory CPD and a high level of participation in CPD activities by Victorian dentists and specialists in 2007, although nearly half of the respondents attended <20 h of certified clinical CPD during 2007. A number of barriers exist, particularly for rural and female practitioners in accessing CPD, and further research is required to examine the benefits derived from mandatory CPD.

Assessing oral cancer early detection: clarifying dentists' practices.

OBJECTIVE: This study explores new methods for assessing in greater detail what dentists do when they perform oral cancer early detection examinations. It clarifies practice behaviors and opens opportunities to identify factors that facilitate thorough early detection examinations by clinicians and to assess the relative effectiveness of different examination procedures. METHODS: A 38-item survey instrument was e-mailed to dentists in a western US, multistate dental practice group. Questionnaires were received by 241 dentists, and 102 responded. An Oral Cancer Knowledge scale (0 to 14) was generated from correct responses on oral cancer general knowledge. An Oral Cancer Examination Thoroughness scale was calculated from the two dimensions of reported usage and frequency of procedures in oral cancer examinations. RESULTS: Nearly all responding dentists were in general practice (90%), with a median year of graduation from dental school of 1994. The Oral Cancer Knowledge scores ranged from 5 to 14 with a mean of 10.4. The mean Thoroughness of Examination score was 11.34 (range 0 to 20). The two scales were not statistically correlated (r = -0.015, P = 0.883). Statistically, recency of continuing education was significantly associated with knowledge (P = 0.0284) and appears to be marginally associated with thoroughness (P = 0.075). CONCLUSIONS: This study documents considerable variability in dentists' knowledge and thoroughness of examinations. The scales provide tools for future studies for improving understanding of early detection of oral cancer in clinical practice.

Resin-based composites and dentine-bonding agents. Which, who and why? A study in the East of Scotland.

AIMS: To determine which resin-based composite (RBC) and dentine-bonding agent (DBA) systems were most widely used by a random convenience sample of dentists in the East of Scotland, by whom they were used, and what influenced the dentists' choice when buying/using a particular RBC and DBA. METHODS: A cross-sectional questionnaire-based study was conducted from June to December 2006. A questionnaire was compiled and, following a short pilot and revision, 250 questionnaires were randomly distributed to dentists attending vocational training/general professional training study days, continuing education courses and various dental meetings. Data from the completed questionnaires were collated and analysed. RESULTS: A total of 138 questionnaires were returned, giving a response rate of 55%, of which 101 (73%) were from practitioners working within the General Dental Services, 20 (14%) from Community Dental Service dentists, and 17 (12%) from practitioners in the hospital dental service. The most popular RBC reported by respondents 43 (31%) was Z100 (3M UK, Bracknell, UK). The most common factors that influenced respondents' choice when buying an RBC were ease of use and availability, reported by 51 (37%) and 45 (33%) respondents, respectively. Prime & Bond (DENTSPLY DeTrey, Konstanz, Germany) was reported as the most popular DBA by 58 (42%) respondents. Overall, availability, reported by 61 (44%) respondents, was the most popular reason for choice of a DBA, followed by ease of use, reported by 52 (38%) respondents, and reliability, reported by 23 (17%) respondents. CONCLUSIONS: The most popular RBCs and DBAs used by respondents to this study and common reasons for their use were identified. However, it was found that, among those who responded, there was no discernible relationship between undergraduate training, year of qualification and choice of material. Further research is required to corroborate these findings and to identify the level of understanding of material science by dental clinicians.

Restorative treatment threshold reported by Iranian dentists.

OBJECTIVE: To study Iranian dentists' conceptions of the earliest stage to place a restoration on proximal caries lesions. BASIC RESEARCH DESIGN: A questionnaire survey was carried out among the participants of two annual dental meetings in Tehran, Iran, in December 2004 and July 2005. The questionnaire was filled in anonymously and returned during the meeting days. The questions covered two patient paper cases with schematic drawings of the radiolucency of proximal caries lesions according to bitewing radiographs from 20-year-old patients: one high-caries case and one low-caries case. Dentists' gender, age, working experience and place, and participation in continuing education served as background data. In total, 1,033 dentists completed the questionnaire, 63% were men. Statistical evaluation was by the Chi square test and logistic regression. MAIN OUTCOME MEASURES: Respondents were to select from four alternatives the earliest stage in the progression of a lesion at which they would intervene by restorative treatment. RESULTS: For the high-caries case, 77% of the respondents chose to restore a caries lesion confined to enamel; activity in continuing education was the strongest factor (OR = 1.4) to explain dentists' restoring a lesion no earlier than in dentine. For the low-caries case, 32% chose to restore a lesion in enamel. Restoring a lesion no earlier than in dentine was more likely (OR = 1.5) among female dentists. CONCLUSION: Iranian dentists seem to prefer early restorative intervention, which indicates a need to focus on the preventive aspects of caries treatment both in dental curricula and in continuing education.

Gender differences in dentists' working practices and job satisfaction.

OBJECTIVES: To describe the working practices and level of job satisfaction of male and female dentists. METHODS: A nationwide postal survey of all dentists holding an annual practising certificate in New Zealand (response rate 78.1%). RESULTS: The mean number of hours worked per week was 29.1 for female and 36.0 for male dentists. The main reason for part-time practice given by women was caring for children (cited by 67.2%) and for men was personal choice (cited by 63.6%). A greater proportion of females than males were employed on a salary or as an associate in practice rather than owning their own practice. Male dentists were more active in continuing education than females. The mean career satisfaction score for male respondents was 7.6 and for females 7.1 (P<0.001). Relatively more women than men had taken a career break, usually for child rearing. Two-thirds of women and one-third of men planned to retire from dentistry before 60 years of age. CONCLUSIONS: Male and female dentists differ in their working patterns and career satisfaction. There is a need for ongoing monitoring of the workforce, particularly as the gender distribution (and societal trends and expectations) continues to change.

Oral cancer and dentists: knowledge, attitudes, and practices in Italy.

The purpose of the survey was to assess through a mailed questionnaire the knowledge, attitudes, and behaviors regarding oral cancer and their relationship with different indicators in a random sample of 1000 dentists in Italy. Respondents know the major risk factors and only half identify the diagnostic procedures. One-third indicated the most common form and the early lesions and this knowledge was more likely in those graduated from dental school and attended a course on oral cancer in the previous year. Approximately two-thirds (64.8%) believed that they were prepared to perform an oral cancer examination and to palpate lymph nodes in patients' necks. Multiple logistic regression revealed that this positive attitude was significantly higher for those who graduated from medical school and for those who have attended a course on oral cancer in the previous year. Half of the dentists routinely perform an oral cancer examination on all patients and it was more likely by those graduated from dental school, those who know that squamous cell is the most common form of oral cancer and that an early oral cancer lesion usually is a small, painless red area, those who believed that they are prepared to perform an oral cancer examination and to palpate lymph nodes in patients' necks, those who have attended a course on oral cancer in the previous year, and those who claim they need information. The importance of health care professionals as communicators of public health messages should be emphasized.