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.

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.

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.

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.

Development and implementation of a dental office assessment program.

This paper summarizes steps taken by a large U.S. commercial dental plan to meet measurement challenges through development of a program designed to assess and improve the practices of dentists enrolled in a large preferred provider network. Data collected by trained evaluators who assessed 1,428 dental offices using a structured office assessment instrument were subjected to psychometric analysis by UCLA researchers. Results suggested that the optimal structure for an office assessment instrument consisted of 71 items organized into 10 scales (clusters of measures) reflecting key aspects of dental practice.

Office accreditation experiences with 3 accrediting agencies and suggestions for changes in private oral and maxillofacial surgery facility evaluations.

Historically, oral and maxillofacial surgeons have had considerable autonomy in operating their offices. Oral and maxillofacial surgeons have had a singular history of safety, training, and success in outpatient anesthesia in their offices. However, preventable patient morbidity and mortality in private office-based surgical facilities of a variety of professions have brought increased scrutiny to the office environment. The present report describes the experiences of 3 oral and maxillofacial surgeons with 3 accrediting agencies in obtaining office accreditation and offers recommendations to be considered for the future of our specialty in terms of private office certification.

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.

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.

The Impact of COVID-19 Related Lockdown on Dental Practice in Central Italy-Outcomes of A Survey.

The COVID-19 pandemic has affected lives and professions worldwide. We aimed to determine the behavior of dentists during the lockdown in Central Italy through an online survey. We demonstrated that the most frequent of urgencies, not otherwise manageable through telemedicine, was dental pulp inflammation. Although a statistically significant increase in the use of some of the personal protective equipment (PPE) from pre to during lockdown was shown, dentists were afraid of being infected during the dental procedures. Moreover, we showed that digital dentistry, telemedicine, use of the rubber dam, distancing of the appointments and further structural changes at the dental office are necessary to reduce the contagion among dentists and patients. No significant differences were shown between gender.

[Assessment of disinfection and sterilization processes in dental practice as an important factors in prevention of infections]. / Ocena prawidlowonci procesów dezynfekcji i sterylizacji w wybranych gabinetach stomatologicznych jako istotnych elementów zapobiegania zakazeniom.

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.

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.

How to implement a HIPAA compliance plan into a practice.

Under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, all dental offices are required to formulate policies and procedures to ensure and secure patient privacy of health information. This article reviews the essential points of such a plan and makes recommendations for implementation.

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.