Effect of Quality of Dental Health Services to Patient Satisfaction in Indonesia 2019: Importance-Performance Analysis

ABSTRACT Objective: To determine the effect of the quality of dental health services based on dimensions of empathy and responsiveness to patient satisfaction in urban and rural areas in Bone District, Indonesia. Material and Methods: This survey used an analytical observational method with a pilot pathfinder survey design. The total of participants included in this survey was 442, with 223 in the urban area and 219 in the rural area. This survey was held on 25 February - 1 March 2019. The Mann-Whitney test was applied, adopting a significance level of 5%. Results: Empathy and responsive dimensions in urban (3.58 ± 0.94 and 3.50 ± 0.94) and rural (3.43 ± 0.99 and 3.63 ± 0.86) areas were in the moderate category. The administration staff was able to complete administrative procedures, and the Dental assistant responded promptly to the patient's request and needs. Conclusion: The quality of empathy and responsiveness dimensions in dental treatment fall in the moderate category for urban and rural areas; this means that empathy and responsiveness dimensions in dental service in hospital/public health need to be improved.

A comparison of visual identification of dental radiographic and nonradiographic images using eye tracking technology.

OBJECTIVES: Eye tracking has been used in medical radiology to understand observers' gaze patterns during radiological diagnosis. This study examines the visual identification ability of junior hospital dental officers (JHDOs) and dental surgery assistants (DSAs) in radiographic and nonradiographic images using eye tracking technology and examines if there is a correlation. MATERIAL AND METHODS: Nine JHDOs and nine DSAs examined six radiographic images and 16 nonradiographic images using eye tracking. The areas of interest (AOIs) of the radiographic images were rated as easy, medium, and hard, and the nonradiographic images were categorized as pattern recognition, face recognition, and image comparison. The participants were required to identify and locate the AOIs. Data analysis of the two domains, entire slide and AOI, was conducted by evaluating the eye tracking metrics (ETM) and the performance outcomes. ETM consisted of six parameters, and performance outcomes consisted of four parameters. RESULTS: No significant differences were observed for ETMs for JHDOs and DSAs for both radiographic and nonradiographic images. The JHDOs showed significantly higher percentage in identifying AOIs than DSAs for all the radiographic images (72.7% vs. 36.4%, p = .004) and for the easy categorization of radiographic AOIs (85.7% vs. 42.9%, p = .012). JHDOs with higher correct identification percentage in face recognition had a shorter dwell time in AOIs. CONCLUSIONS: Although no significant relation was observed between radiographic and nonradiographic images, there were some evidence that visual recognition skills may impact certain attributes of the visual search pattern in radiographic images.

Treatment provided in the Public Dental Service in Finland in 2009.

OBJECTIVES: To analyse treatment measures provided in the Public Dental Service (PDS) and to discuss the therapy given against treatment needs as expressed in the national clinical epidemiological studies. METHODS: In 2009, the Chief Dentists of the PDS units collected data from their local registers on patients and treatment provided. Data were obtained from 166 PDS units (86%). Treatment patterns were compared between age groups, provider groups and geographical areas using chi-square tests. RESULTS: Altogether 8.9 million treatments were provided for 1.7 million patients. Examinations, restorative treatment and anaesthesia accounted for 61.3% of all treatments. Preventive measures (8.4%) and periodontal treatment (6.3%) were small proportions of the total. Prosthetic treatment was uncommon (0.5%). Working age adults received half of all treatments (53.2%), the young a third (36.4%) and the elderly 10.4%. Dental hygienists or dental assistants provided 29.7% of all treatment for children and adolescents, 11.1% for adults and 14.1% for the elderly. CONCLUSION: Relatively healthy children had plenty of examinations and preventive measures, and adults had mostly restorative care when their needs were more periodontal and prosthetic care, indicating that treatment given was not fully in line with needs.

Dental practitioner concepts of efficiency related to the use of dental therapists.

OBJECTIVES: Efficiency is concerned with producing maximum output with the minimum input, although what constitutes inputs and outputs within an organization is not always clear. Labour substitution is one method of achieving efficiency gains, although cost savings are found to be context dependent and may not be achieved in some situations. Because dental therapists (DTs) in England are permitted to work in dental practices, we set out to investigate how efficiency with respect to the use of DTs is conceptualized by practitioners to deepen our understanding of the potential for substitution to realize efficiency gains in dental practice. METHODS: Nine dental practices were selected using a purposive sampling methodology to give a range of practice size and DT employment arrangements. Semi-structured interviews were held with 26 dentists. Transcripts were coded and analysed thematically. RESULTS: Efficiency was perceived as optimum use of surgery time to generate intermediate outputs of (i) managing patient flow to give patient satisfaction and business cash flow and (ii) volume of work (procedures and numbers of patients). DT efficiency gains were evaluated according to whether lower labour costs were offset by a slower working pace and higher rate of failed appointments. Patient need and demand, and whether the practice had health improvement goals, influenced whether DTs were deemed to improve efficiency. CONCLUSIONS: Findings are in accord with skill mix reviews in wider health care that substitution may be effective in improving efficiency but this may be limited to particular situations where conditions are conducive. More studies are needed to explore these issues further in other dental practice contexts and with other groups of dental auxiliary.

Reliability analysis of visual examinations carried out by school-teachers and a dental assistant in the detection of dental caries.

AIM: This study aims to investigate the reliability of examinations performed by teachers and by a dental assistant in detection of cavitated surfaces. METHODS: A sample of 168 students, aged 5-14 years, attending a public school in Duque de Caxias, Rio de Janeiro, was examined by persons with three different training backgrounds: a dentist, a dental assistant, and schoolteachers. Examinations were performed in the school with the aid of a tongue blade under natural light. Kappa statistics were estimated to assess agreement between the observers. Sensitivity, specificity, and positive and negative predictive value tests helped validate observations performed by the group of laypersons. RESULTS: The findings suggest satisfactory agreement with the dentist, with kappa values of 0.730 and 0.781 for the teachers and the dental assistant, respectively. The absence of cavities was easily detected (specificity = 96%). More caution is required in positive results indicated by the teachers or the dental assistant because these were not always confirmed subsequently (sensitivity = 76%) by the dentist. CONCLUSION: The aid of untrained personnel in dental epidemiology was shown to be a valid alternative for a signposting role.

Prevalence and associated factors of musculoskeletal pain among the dental personnel in a dental school.

OBJECTIVE: To study the prevalence and associated factors of musculoskeletal (MS) pain among the dental personnel. In addition, impacts and treatment of MS pain were reported. MATERIAL AND METHOD: Random sampling of 390 participants from the name lists of dental personnel working in each department. Self-administered questionnaires were equally distributed to three groups of dental personnel namely clinical instructors, postgraduate students, and dental assistants. The present study was conducted as a survey in the Faculty of Dentistry, Mahidol University, Bangkok between December 2008 and January 2009. RESULTS: Three hundred and ninety questionnaires were delivered and 164 questionnaires were returned (response rate 42.5%). The participants with MS pain were 32 clinical instructors (20.3%), 52 postgraduate students (32.9%), and 74 dental assistants (46.8%). Their mean age was 33.0 +/- 9.1 years old. The MS pain found respectively was shoulder pain 72.2% (n = 114), neckpain 70.3% (n = 111), and low backpain 50.6% (n = 80). The participants with shoulder and neckpain were combined and defined as cervicobrachial pain. The associated factor of cervicobrachial pain was working status. Being a clinical instructor and postgraduate student were associated with cervicobrachial pain with OR being 4.7 [1.3, 7.1] and 4.6 [1.6, 13.4], respectively. The impacts of MS pain among the dental personnel included usage of pain relieving medication (34.8%), seeking medical evaluation (32.3%), reduction in working hours (27.2%), difficulty sleeping (22.8%), and work absence (10.8%), respectively. The treatments of MS pain utilized to alleviate those impacts were Thai traditional massage (51.9%), medication (28.5%), physical therapy (15.8%), acupuncture (7.6%), and alternative medicine (4.4%), respectively. CONCLUSION: Cervicobrachial pain was the most prevalent MS pain among the dental personnel and working status was associated with their MS pain problems. The impact of MS pain was predominantly usage of pain relieving medication. Thai traditional massage was the most utilized treatment.

Dental x-rays and the risk of thyroid cancer: a case-control study.

UNLABELLED: The thyroid gland is highly susceptible to radiation carcinogenesis and exposure to high-dose ionising radiation is the only established cause of thyroid cancer. Dental radiography, a common source of low-dose diagnostic radiation exposure in the general population, is often overlooked as a radiation hazard to the gland and may be associated with the risk of thyroid cancer. An increased risk of thyroid cancer has been reported in dentists, dental assistants, and x-ray workers; and exposure to dental x-rays has been associated with an increased risk of meningiomas and salivary tumours. METHODS: To examine whether exposure to dental x-rays was associated with the risk of thyroid cancer, we conducted a population-based case-control interview study among 313 patients with thyroid cancer and a similar number of individually matched (year of birth +/- three years, gender, nationality, district of residence) control subjects in Kuwait. RESULTS: Conditional logistic regression analysis, adjusted for other upper-body x-rays, showed that exposure to dental x-rays was significantly associated with an increased risk of thyroid cancer (odds ratio = 2.1, 95% confidence interval: 1.4, 3.1) (p=0.001) with a dose-response pattern (p for trend <0.0001). The association did not vary appreciably by age, gender, nationality, level of education, or parity. DISCUSSION: These findings, based on self-report by cases/controls, provide some support to the hypothesis that exposure to dental x-rays, particularly multiple exposures, may be associated with an increased risk of thyroid cancer; and warrant further study in settings where historical dental x-ray records may be available.

Musculoskeletal pain: prevalence, prevention, and differences among dental office personnel.

Data regarding the presence and specific region of musculoskeletal pain were collected as part of a study that surveyed more than 5,000 dental personnel, dentists, and dental auxiliaries. The magnitude of the overall study, which included all types of dental professionals, made possible identification of the prevalence of musculoskeletal pain and comparison of regions of pain among the different dental professionals.

Evaluación del desempeño de las auxiliares de odontología por empleadores / Performance evaluation of dental assistants by employers

Este estudio de carácter descriptivo, se realizó acerca del desempeño de auxiliares de odontología certificadas por la Universidad del Valle, en los años 1991, 1992 y 1993 de las categorias auxiliar de consultorio dental y auxiliar de higiene oral. Constituyeron la muestra cincuenta y dos auxiliares de un total de noventa egresadas. Para el análisis de la información, se tomó en cuenta, el concepto emitido sobre estas auxiliares por los odontólogos y directivos de las entidades públicas y privadas ubicadas en Cali. Se aplicaron dos instrumentos, uno fue autodiligenciado por los odontólogos y el otro se aplicó a directivos mediante una entrevista personal. Los resultados muestran que el concepto sobre conocimientos, destrezas y calidad humana de las auxiliares en la mayoria de los casos fué favorable. Estos resultados permitirán proponer cambios en los programas vigentes de auxiliares de la Escuela de Odontología y para programar cursos de educación permanente.

This descriptive study is about the achievement of the dental auxiliaries who graduated from the University of Valley of Cali. These dental assistants studied to be either auxiliaries in dental clinics and auxiliaries of oral hygiene in 1991, 1992 and 119. The sample consisted of the information about 52 dental assistants. To analyze the data, two facts were taken into account: the regard expressed by the dentists about their assistants and the regard expressed by the administrators on the same assistants. These assistants, the dentist and the administrators work in public institutions and private dental clinics in Cali. Two kinds of instruments were used to get the information. These first one consisted of a written questionnaire which was filled out by the dentists and the second was an oral questionnaire answered by the administrators. The results showed favorable approbation which involved good knowledge, skills and human quality. The results will help to propose changes to improve the present programs for dental assistants. Moreover, they will contribute in the design of new courses for the current and continous training.

Infection control in practice. Infection control and clinical efficiency: are they compatible?

A frequently expressed concern regarding infection control guidelines is that they require too much time, effort and expense. This paper will address those concerns by examining the relationship between infection control and clinical efficiency. Infection control procedures can be minimized if proper attention is given to the concept of Limited Surface Contamination. Adherence to a clearly defined Zone of Contamination is essential. Emphasis should be on prevention rather than elimination of contamination. By following well-established principles of Dental Assistant Utilization (DAU), or 'four-handed dentistry', clinical efficiency is enhanced and infection control improved. Proper infection control in the dental surgery is virtually impossible without the cooperation and involvement of a well-trained, committed dental chairside assistant.

Factors affecting dental surgery assistants' job satisfaction in general dental practice.

Reported studies suggested that job satisfaction, was low among non-operating dental auxiliaries. Clearly this might affect the quality of their work. The study reported in the present article evaluated dental surgery assistant (DSA) job satisfaction in general dental practices in the northwestern region of England. An initial qualitative study determined the factors that DSAs thought affected their job satisfaction and these were evaluated in a quantitative study. Although the majority of DSAs found their work satisfying and enjoyable, a number found some aspects unsatisfactory and changes are proposed which may improve the quality of their working lives.

Dental assistants' ability to select caries risk-children and to prevent caries.

A new model for dental care in children has been used since 1987 in a small-town clinic in the county of Blekinge in southern Sweden. The model is based on early screening of caries risk, performed by dental assistants. The purpose is to obtain an individual assessment of the need of preventive dental care among pre-school children, in order to prevent dental caries and gingivitis. The aim was to 1) evaluate the dental assistants' selection of caries risk children up to the age of three by comparing dental health variables in 4 yr olds in the test clinic with those for the whole county and 2) compare the time spent by the dentists and the dental assistants in the test clinic and in the whole county per child up to the age of four. 102 children participated. Specially trained dental assistants screened children likely to develop caries lesions using background factors combined with clinical examinations at ages 1, 2 and 3. A systematized form for questioning the parents was used. Individual caries prevention was given. Dental health and time spent were analyzed. The proportion of children with caries lesions at four years and a caries risk assessment up to the age of three was 11/19 = 0.58 (sensitivity). The proportion of children with no caries lesions at four years and no caries risk assessment up to the age of three was 82/83 = 0.99 (specificity). The proportion of children with no caries lesions at 4 yr of age in the test clinic was 81.4% compared to a county mean of 77.2%.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of new technologies in the training and utilization of dental auxiliaries in the US armed forces--Navy.

The dental health care requirements of Navy and Marine Corps personnel exceed the treatment capabilities of the Navy Dental Corps. Through the effective training and efficient utilization of the various categories of auxiliaries, members of the naval service have all essential care completed. The staff of the Dental Technicians School has developed a task-based/self-paced curriculum for the basic dental assisting course. In the task-based curriculum instruction is limited to the psychomotor domain. Background knowledge from the cognitive domain is included only to the extent that the information is needed to perform designated tasks. There are 229 tasks in the inventory of the 12 week basic dental assisting course. These are organized into 17 instructional modules covering all aspects of chairside dental assisting. Student evaluation is based on demonstrated performance of the tasks and is graded on a pass/fail standard. The new curriculum is believed to be unique in dental auxiliary education. Because of the highly successful results in improving the quality of graduates, the positive student enthusiasm and acceptance of task-based instruction and the overall revitalization of every dimension of the basic dental assistant training program, development teams have begun to convert the other three courses of instruction conducted at the Dental Technicians School to the task-based curriculum format.

[Intraoral UV irradiation in gingivitis and ulcerative stomatitis]. / Die intraorale UV-Bestrahlung bei Gingivitis und Stomatitis ulcerosa

The different specific and non-specific general effects of ultra-violet rays are discussed. Intro-oral ultra-violet irradiation is indicated in all ulcerous and ulcero-aphthous diseases of the gingiva and the remaining oral mucosa. The author's experience does not plead for other applications, e. g., in case of parodontopathia inflammata and parodontopathia dystrophica, which is sometimes recommedned. The technique of ultra-violet irradiation is described. It is emphasized that a stomatological nurse may give this treatment, which relieves the stomatologist