Cost-effectiveness analysis of two impression methods for the fabrication of mandibular complete dentures.

OBJECTIVES: To compare the cost and to evaluate cost-effectiveness of fabricating mandibular complete dentures (CDs) using two different impression methods. METHODS: A crossover randomized controlled trial including 27 edentulous participants was performed. Mandibular CDs were fabricated using two different impression methods, as follows: (i) conventional method using a custom tray border moulded with impression compound and silicone and (ii) simplified method using a stock tray and alginate. Cost analysis was performed from a clinical practitioner's perspective. The total cost included labor cost, which was calculated using the time spent by dentists and technicians in fabricating CDs and their hourly wages, and the material costs, which were calculated using purchase prices. To evaluate cost-effectiveness, we used general patient satisfaction as an indicator of effectiveness and calculated the incremental cost effectiveness ratio (ICER). ICER represents the cost per one unit of effectiveness. RESULTS: The trial was completed by 24 participants. The total cost was 43,904 Japanese Yen (JPY) (330.91 EUR / 395.78 USD) for the conventional method and 39,792 JPY (299.93 EUR / 358.70 USD) for the simplified method, and this difference was statistically significant (p<0.001). The ICER showed a cost of 633 JPY (4.77 EUR / 5.70 USD) for every one point change in general patient satisfaction. CONCLUSIONS: The results indicated that the total cost of the conventional method was significantly higher than that of the simplified method (p<0.001). CLINICAL SIGNIFICANCE: The conventional impression method for fabricating mandibular CDs, which took additional 633 JPY (4.77 EUR / 5.70 USD) for improvement of general satisfaction, is supposed to be clinically meaningful1.

Dental technology services and industry trends in New Zealand from 2010 to 2012.

OBJECTIVE: To provide a snapshot of the New Zealand dental technology industry and influencing factors. BACKGROUND: Developing an understanding of the commercial dental laboratory environment in New Zealand can provide insight into the entire dental industry. METHODS: A web-based survey was the primary method for data collection, with separate questionnaires used for dental laboratory owners and dental technician employees. RESULTS: The mean net income for dental laboratory owners in New Zealand was similar to that of the United Kingdom, at $40.50 per hour. Clinical dental technicians are the highest paid employees, with a mean of $33.49 per hour. The mean technical charge for complete dentures was $632.59; including clinical services, it was $1907.00. The mean charge for a porcelain-fused-to-metal (PFM) crown was $290.27. Dental laboratory owners expressed fear about the possibility of losing dental clients to overseas laboratories due to the availability and cheap charge of offshore work. Only 25.4% of dental laboratories surveyed had computer-aided design (CAD) facilities, and even fewer (7.9%) had computer-aided manufacturing (CAM) systems. CONCLUSION: Clinical dental technology appears to be prospering. The dental technology industry appears to be adapting and remains viable, despite facing many challenges.

A randomized trial on simplified and conventional methods for complete denture fabrication: cost analysis.

PURPOSE: This study aimed to quantify the costs of complete denture fabrication by a simplified method compared with a conventional protocol. MATERIALS AND METHODS: A sample of edentulous patients needing conventional maxillary and mandibular complete dentures was randomly divided into group S, which received dentures fabricated by a simplified method, and group C, which received conventionally fabricated dentures. We calculated direct and indirect costs for each participant including unscheduled procedures. This study assessed 19 and 20 participants allocated into groups S and C, respectively, and comparisons between groups were conducted by the Mann-Whitney and Student's t-test (α = 0.05). RESULTS: Complete denture fabrication demanded median time periods of 173.2 and 284.5 minutes from the operator for groups S and C respectively, and 46.6 and 61.7 minutes from the dental assistant (significant differences, p < 0.05). There was no difference between groups regarding postinsertion adjustments. Group S showed lower values for costs with materials and time spent by patients than group C during the fabrication stage, but not during adjustments. CONCLUSIONS: The median direct cost of complete denture treatment was 34.9% lower for the simplified method. It can be concluded that the simplified method is less costly for patients and the health system when compared with a conventional protocol for the rehabilitation of edentulous patients.

A survey of the sociodemographic and educational characteristics of oral health technicians in public primary health care teams in Minas Gerais, Brazil.

BACKGROUND: To describe some sociodemographic and educational characteristics of oral health technicians (OHTs) in public primary health care teams in the state of Minas Gerais, Brazil. METHODS: A cross-sectional descriptive study was performed based on the telephone survey of a representative sample comprising 231 individuals. A pre-tested instrument was used for the data collection, including questions on gender, age in years, years of work as an OHT, years since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. The descriptive statistic was developed and the formation of clusters, by the agglomerative hierarchy technique based on the furthest neighbour, was based on the age, years of work as an OHT, time since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. RESULTS: Most interviewees (97.1%) were female. A monthly income of USD 300.00 to 600.00 was reported by 77.5% of the sample. Having educational qualifications in excess of their role was reported by approximately 20% of the participants. The median time since graduation was six years, and half of the sample had worked for four years as an OHT. Most interviewees (67.6%) reported having participated in professional continuing educational programmes. Two different clusters were identified based on the sociodemographic and educational characteristics of the sample. CONCLUSIONS: The Brazilian OHTs in public primary health care teams in the state of Minas Gerais are mostly female who have had little time since graduation, working experience, and formal schooling sufficient for professional practice.

The impact of General Dental Council registration and continuing professional development on UK dental care professionals: (1) dental nurses.

OBJECTIVE: To investigate the impact of GDC registration and mandatory CPD on dental nurses' views, job satisfaction and intention to leave. DESIGN: Postal/online survey, conducted in parallel with a survey of dental technicians. SETTING: UK private and NHS practices, community services, dental hospitals. SUBJECTS AND METHODS: Representative sample of General Dental Council registrants. MAIN OUTCOME MEASURES: Job satisfaction; intention to leave profession (dependent variable in regression analysis). RESULTS: Eleven were ineligible (left profession, moved abroad); 267 (44% of those eligible) responded, all female. Respondents' mean age was 38.2 years (sd 10.74). The general principle of registration was endorsed by 67%, and compulsory registration by 51%, but the fee level by only 6%. Most nurses did not feel that registration had affected their view of dental nursing as a career (56%), their role (74%) or status (86%) within the dental team, or that CPD helped them to do their job better (76%). Fifty-six percent were not satisfied with their job, and 22% intended to leave the profession. Intention to leave was predicted by younger age and greater dissatisfaction with physical working conditions and opportunities to progress. CONCLUSIONS: Widely held criticisms regarding the costs and relevance of registration and CPD coupled with a potentially high level of attrition from the profession suggest a review of the fee and salary structure and greater financial support for CPD is warranted.

Estimating costs for shade matching and shade corrections of fixed partial dentures for dental technicians in Germany: a pilot investigation.

AIMS: To evaluate the additional operating expenses caused by shade matching by dental technicians in the dental practice and by color changes of fixed partial dentures. METHODS: A questionnaire was handed out to visitors of the 2010 ADT dental technician congress in Germany. Thirty-one completed questionnaires were evaluated. RESULTS: Mean costs caused by shade matching and shade correction per month were 1269$ (SD = 1278$; n = 25) and per unit of FPD 9.32$ (SD = 8.89$). CONCLUSIONS: An improvement of shade matching, shade communication and reproduction should be made in order to minimize the considerable economic damage for dental laboratories.

Activity and education of clinical dental technicians: a UK survey.

AIMS: This survey aimed to determine the clinical activity of clinical dental technicians (CDTs) in the UK and to establish their employment status, views of statutory registration and need for further education. Until 2006, this practise was illegal in the UK. MATERIALS AND METHODS: A postal questionnaire was sent to 128 members of the Clinical Dental Technicians' Association (CDTA) who had agreed to participate in this study. Analysis was conducted using standard non-parametric statistical tests and quantitative techniques. RESULTS: A response rate of 54% was achieved. Qualifications in clinical dental technology from George Brown College, Toronto, Canada were held by 68%, with 16% currently undergoing training and 16% neither qualified nor in training. The majority (90%) owned a laboratory with 61% stating they had between one and four dental surgeries on site. CDTs with Canadian qualifications tended to provide a wider range of procedures, coupled with patient lists and recall systems, compared to those not so qualified. Eighty-one percent welcomed the prospect of statutory registration with 82% indicating that it would enhance their professional profile. CONCLUSIONS: This small but significant survey gives some insight of the work which has been undertaken by CDTs for many years, albeit illegally. With appropriate training and education, and consequent GDC registration, CDTs will be in a position to make a positive contribution to the clinical care of patients.

Educational needs and employment status of Scottish dental technicians.

OBJECTIVE: To investigate the educational needs and employment status of dental technicians in Scotland. SUBJECTS: Two hundred and fifty dental technicians with postal addresses in Scotland. DESIGN: Structured questionnaire. RESULTS: An 83% response rate was achieved following three mailings. The majority of respondents were employed in commercial dental laboratories largely within the 'central belt' of Scotland, with 96% stating they were in full-time employment. Only 33% of these essential health-care workers were voluntarily registered with the Dental Technicians' Association, suggesting that a significant number had not felt it necessary or beneficial to do so. A lack of educational structure was identified, as was poor remuneration and an absence of opportunity for career progression. Although the prospect of continuing professional development was desirable, many respondents reported that they would be penalised financially for undertaking this and, in addition, may not be given the opportunity to pursue education because of lack of co-operation from their employer. Only 47% had attended an educational event within the preceding year, and of those who had not done this, a period of two-32 years had elapsed since any CPD involvement. Of the respondents, only 34% stated that any financial assistance had been available for educational purposes, with access to education being highlighted as problematic by 68%. A total of 64% of subjects felt they were out-of-date with professional education. CONCLUSIONS: This study highlights a number of real and potential problems in the field of education in dental technology. It is apparent that change within the structure of education and professional status, although largely welcomed, may be difficult to implement. The profession, as a whole, must realise that these changes in education and employment are not optional, and should be embraced as a positive step which will hopefully raise the profile and status of dental technicians throughout the UK.