Dentists' Awareness of Physical Therapy in the Treatment of Temporomandibular Disorders: A Preliminary Study.

Background: Physical therapy (PT) has been shown to be one of the most effective conservative treatments for temporomandibular disorders (TMD). Not all dentists are aware of the importance of the collaboration with physical therapists in the treatment of TMD pain. Objectives: To determine the awareness of dentists in Florida about the importance of PT for TMD pain and to create awareness related to collaborations. Methods: An online questionnaire was used. A contact list of dentists was obtained from the Florida Dental Association. The overall awareness and information on patient referral were presented per dentist specialty. Results: A total of 256 dentists completed the survey. Prior to the survey, 41% of the dentists reported not aware that PTs can treat TMD patients. Oral surgeons and orthodontists were more aware about PT compared to other specialties. After the survey, 81% of the dentists were more likely to refer their TMD patients to PT, and 80% were interested to know more about the benefits of collaborations. Conclusion: This study shows the lack of dentists' awareness in Florida about the benefits of PT for TMD treatment. This study increased the awareness of the surveyed dentists in Florida about the benefit from a multidisciplinary approach.

Validity of the Prescriber Information in the Danish National Prescription Registry.

The aim of this study was to measure the validity of the prescriber information recorded in the Danish National Prescription Registry (DNPR). The prescriber information recorded in the pharmacies' electronic dispensing system was considered to represent the prescriber information recorded in the DNPR. Further, the problem of validity of the prescriber information pertains only to non-electronic prescriptions, as these are manually entered into the dispensing system. The recorded prescriber information was thus validated against information from a total of 2000 non-electronic prescriptions at five Danish community pharmacies. The validity of the recorded prescriber information was measured at the level of the individual prescriber and the prescriber type, respectively. The proportion of non-electronic prescriptions with incorrect registrations was 22.4% (95% confidence interval (CI): 20.6-24.3) when considering individual prescriber identifiers and 17.8% (95% CI: 16.1-19.5) when considering prescriber type. When excluding prescriptions specifically registered as 'missing prescriber identifier', the proportions decreased to 9.5% (95% CI: 8.2-11.0) and 4.1% (95% CI: 3.2-5.1), respectively. The positive predictive values for the classification of prescriber types were in the range of 94.0-99.2%, while the sensitivity ranged between 64.6% and 91.8%. With a maximum of 14% non-electronic prescriptions of all prescriptions in the DNPR in 2015, this corresponds to correct classification of prescriber types in the DNPR of at least 97.5%. In conclusion, the prescriber information in the DNPR was found to be valid, especially in recent years. Researchers should be aware of the low sensitivity towards prescriptions from private practicing specialists.

Evaluations of dentists on a German physician rating Website: an analysis of the ratings.

BACKGROUND: Physician rating websites have been gaining in importance in both practice and research. However, no evidence is available concerning patients' ratings of dentists on physician rating websites. OBJECTIVE: The aim of this study is to present a comprehensive analysis of the ratings of dentists on a German physician rating website over a 2-year period. METHODS: All dentist ratings on a German physician rating website (Jameda) from 2012 and 2013 were analyzed. The available dataset contained 76,456 ratings of 23,902 dentists from 72,758 patients. Additional information included the overall score and subscores for 5 mandatory questions, the medical specialty and gender of the dentists, and the age, gender, and health insurance status of the patients. Statistical analysis was conducted using the median test and the Kendall tau-b test. RESULTS: During the study period, 44.57% (23,902/53,626) of all dentists in Germany were evaluated on the physician rating website, Jameda. The number of ratings rose from 28,843 in 2012 to 47,613 in 2013, representing an increase of 65.08%. In detail, 45.37% (10,845/23,902) of dentists were rated once, 43.41% (10,376/23,902) between 2 and 5 times, and 11.21% (2681/23,902) more than 6 times (mean 3.16, SD 5.57). Approximately 90% (21,324/23,902, 89.21%) of dentists received a very good or good overall rating, whereas only 3.02% (721/23,902) were rated with the lowest scores. Better ratings were given either by female or older patients, or by those covered by private health insurance. The best-rated specialty was pediatric dentistry; the lowest ratings were given to orthodontists. Finally, dentists were rated slightly lower in 2013 compared to 2012 (P=.01). CONCLUSIONS: The rise in the number of ratings for dentists demonstrates the increasing popularity of physician rating websites and the need for information about health care providers. Future research should assess whether social media, especially Web-based ratings, are suitable in practice for patients and other stakeholders in health care (eg, insurance providers) to reflect the clinical quality of care.

Purpose, structure, and function of the United States National Dental Practice-Based Research Network.

OBJECTIVE: Following a successful 2005-2012 phase with three regional practice-based research networks (PBRNs), a single, unified national network called "The National Dental PBRN" was created in 2012 in the United States to improve oral health by conducting practice-based research and serving dental professionals through education and collegiality. METHODS: Central administration is based in Alabama. Regional centres are based in Alabama, Florida, Minnesota, Oregon, New York and Texas, with a Coordinating Centre in Maryland. Ideas for studies are prioritized by the Executive Committee, comprised mostly of full-time clinicians. RESULTS: To date, 2763 persons have enrolled, from all six network regions; enrollment continues to expand. They represent a broad range of practitioners, practice types, and patient populations. Practitioners are actively improving every step of the research process, from idea generation, to study development, field testing, data collection, and presentation and publication. CONCLUSIONS: Practitioners from diverse settings are partnering with fellow practitioners and academics to improve clinical practice and meet the needs of clinicians and their patients. CLINICAL SIGNIFICANCE: This "nation's network" aims to serve as a precious national resource to improve the scientific basis for clinical decision-making and foster movement of the latest evidence into routine practice.

Role of the Chronic Dental Disease Scheme in Enhanced Primary Care: allied health or allied outlier?

This study aims to provide a comparative analysis of the Chronic Dental Disease Scheme (CDSS) and the Allied Health Profession (AHP) program as they related to the greater Enhanced Primary Care Scheme introduced by the Australian Government to manage patients with chronic and complex diseases. A retrospective analysis of data pertaining to Medicare items related to dentistry and the allied health professions were extracted from the Medicare Benefits Schedule database online, and formed the basis of this study. The highest proportion of services was provided in the state of New South Wales. There appears to be synergy in the utilisation of services with jurisdictions either overutilising or underutilising services. Costs to the Enhanced Primary Care Scheme under the CDSS model (fee for service) were up to 40 times more expensive compared with the AHP model (fee per visit). Costs and treatment associated with the CDSS experienced an increase of 13350% during the period 2007-08, coincident with an increase in subsidization. Reconstructive dentistry accounted for the majority of the increase. Gender disparities in dentistry were less distinct when compared with AHPs and were postulated to be due to males presenting with conditions that were more progressive requiring more invasive treatment. A comparative analysis indicates significant differences in costs, nature of treatment and the manner of remuneration between dentistry and the AHPs. A fee for service schedule as evidenced by the CDSS is dependent on the degree of financial incentive as indicated by patterns in utilisation over time. The amount of treatment considered necessary may be influenced by the level of subsidy with treatment that may not reflect disease management. The AHP model, which is based around a fee for visit schedule, is not without its deficiencies but has not experienced significant rises in cost compared with the CDSS.

Types of Canadian dentists who are more likely to provide dental implant treatment.

OBJECTIVE: We designed to determine the variables that influence the adoption rate of implant technology amongst Canadian dentists. METHODS AND MATERIAL: In this cross-sectional study, an anonymous survey questionnaire was sent to all licensed Canadian dentists, both general practitioners and specialists. A 3-part questionnaire accompanied by a postage prepaid envelope was sent to all licensed Canadian dentists. No second mailing was performed. The plan was to measure the effects of age, gender, language, type of specialties, ownership, association with other dentists, and the location of practice on the adoption of dental implant technology. RESULTS: The multivariate regression analyses indicate that the dentists' gender, province of practice, specialty, and whether they practice alone or in association with other practitioners are significant factors associated with the adoption of implant technology in providing both surgical and prosthetic aspects of implant therapy. Female dentists provided significantly less implant prostheses than their male counterparts (OR: 1.75, P < 0.05). Canadian dentists in Atlantic regions were significantly less likely than those in other provinces to surgically place an implant or restore implant prostheses (OR: 0.34, OR: 0.30). In addition, those dentists who owned their practices were 2.35 (P < 0.05) times more likely to provide implant prostheses. CONCLUSIONS: This study provides an evidence that the rate of adoption of implant technology among Canadian dentists depends mainly on practitioners' age, practice ownership, and their specialties.

A new clinical training scheme for overseas dentists under Tier 5.

Since the introduction of the Points Based Immigration System to the UK the opportunities for overseas trained dentists to train in the UK have been limited. This paper describes a new opportunity which has resulted from the Tier 5 Medical Training Initiative.

Dentistry in Japan should become a specialty of medicine with dentists educated as oral physicians.

In Japan, the population of elderly individuals (those sixty-five years of age and older) will increase to over 30 percent of the total population by 2030. The elderly commonly have chronic diseases that result in individuals being biologically and pharmacologically compromised. Dentists must have a reliable knowledge of basic clinical medicine for these individuals to be safely and effectively treated. The isolation of dental education from medical education may have been advantageous in the past for the development of dentistry as a profession; however, changes in people's life expectancy and lifestyles, as well as rapid advances in the biomedical sciences, require dentists to have a thorough foundation in biomedical science and clinical medicine not dissimilar from a physician in any other field of medicine. A reformation of dental education is necessary if optimum oral health care is to be provided for patients in the future. It is thus advocated that dentistry should become one specialty of medicine known as oral medicine, and we propose that the education of dentists should be modified to produce oral physicians.

Should dentists become 'oral physicians'? Yes, dentists should become 'oral physicians'.

In summary, a new designation for the dental profession is warranted, not because paramedical professionals have done it, but because the new designation is appropriate for what they are able to do. Moreover, it can be done now with little resistance or fanfare. As has been suggested by others, changing the name "dentist" to the name "oral physician" would result in several benefits: dentists' being recognized as providers of services such as tobacco-use cessation, oral cancer screenings, nutritional counseling and, most recently, as a major health care resource for dealing with bioterrorism; the public's visiting dental professionals for services other than traditional dental procedures; the profession's being more likely to teach and provide services outside of traditional dental procedures; third-party payers' being more likely to pay for services other than traditional dental procedures; the improvement in the public's oral health that would result from patients' visiting "oral physicians" for services other than traditional dental procedures.

Should dentists become 'oral physicians'? No, dentistry must remain dentistry.

Dentistry is not an allied health profession. It is not a paramedical profession. It is time that dentistry be recognized as the profession that offers patients some of the most complex surgery performed on the human body--namely, restorative dentistry and rehabilitation of the masticatory system. Dentistry is the only anatomically focused health care profession that is university-based and for which primary care responsibility is maintained by the profession. An inferiority complex about what it means to be a dentist has served only to confuse the public and bring us further from our goal of improving the health of all our patients. This inferiority complex is driven by the public and the medical profession, neither of which understands how dentistry fits into overall health care. It is essential that every academic health center have oral health education as an integrated part of health care education for dentists, physicians, nurses, allied dental personel, physical therapists, psychologists and all who receive university-based health care education. In this way, all the health professions and the public will see dentistry and oral health as essential to patients' overall health. The idea of emulating those who do not have the strength of basic-science education, practice complexity, surgical skills or community status by seizing a new title will not elevate the profession for the future. The public knows what a dentist is. It is our task to inform the public about the capabilities of dentists and the value of oral health and our profession. We can accomplish this best by assuring that our profession's name, "dentistry," is understood to represent one of the world's most accomplished surgical endeavors, one that is thoroughly integrated into the fabric of health care. Thus, good oral health will be thoroughly integrated into what it means to be healthy.