The feminization of dentistry and the perceptions of public service users about gender issues in oral health / A feminização da odontologia e as percepções dos usuários do serviço público sobre as questões de gênero em saúde bucal

Abstract It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to "active listening", while those who prefer to be cared for by male dentists highlight the attributes of "care integration" and "community guidance". In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.

Resumo Investigou-se a percepção dos usuários do serviço quanto à prática profissional dos dentistas, com base em diferenças de gênero. O Primary Care Assessment Tool (PCATool) foi aplicado a 900 usuários do Serviço Público de Curitiba, PR, Brasil. Sessenta clínicas odontológicas foram selecionadas usando amostragem aleatória, divididas entre unidades de Atenção Primária à Saúde (APS) convencional e unidades de APS com Estratégia Saúde da Família. Os atributos da APS no PCATool foram analisados. Uma questão foi adicionada acerca da preferência do usuário em relação ao gênero do dentista, gerando quatro díades derivadas da combinação do gênero do usuário/gênero do dentista (FF, FM, MM, MF). Os atributos foram ligados às díades pelo teste t para amostras independentes. Por regressão logística, as díades foram relacionadas a 23 fatores referentes aos cuidados ampliados na APS. Muitos usuários mostraram preferência por dentistas mulheres. Esses tendem a avaliar melhor os cuidados de saúde primários quanto à "escuta ativa e qualificada", enquanto aqueles que preferem ser atendidos por homens destacam os atributos de "integração do cuidado" e "orientação comunitária". Em outros fatores e atributos estudados, não há diferença entre o atendimento prestado por homens ou mulheres, independentemente da unidade.

Effect of gender on performance of undergraduate dental students at the University of Jordan, Amman.

The purpose of this study was to see if gender-based differences exist in the performance of dental students at the University of Jordan (UJ), Amman. The retrospective analysis included data from two groups of students: 413 fourth-year dental students (178 males and 275 females) from four consecutive years (2005 through 2008) and 357 fifth-year students (128 males and 229 females) who graduated in the years 2005 to 2008. The influence of gender on the results of the fourth-year students in six theoretical and six clinical courses and the cumulative GPAs of the fifth-year students were studied. In both theoretical and clinical fourth-year courses, multivariate analysis of variance (MANOVA) revealed significant main differences in raw scores between the two gender groups. Female students were significantly better in five theoretical courses. In clinical courses, female students outscored male students in pediatric dentistry and prosthodontics, male students outperformed female students in conservative dentistry and orthodontics, and no significant gender differences were seen in oral surgery and fixed prosthodontics. The cumulative GPAs of the female graduated students were significantly higher than those of the male students. The results showed a significant relationship between gender and academic performance of dental students for these classes. The reasons for these findings should be further investigated.

Occupational exposure in dentistry and miscarriage.

BACKGROUND: Information on the reproductive effects of chemical exposures in dental work is sparse or inconsistent. AIM: To investigate whether dental workers exposed to acrylate compounds, mercury amalgam, solvents or disinfectants are at an increased risk of miscarriage. METHODS: The study was conducted among women dental workers and a comparison group of workers occupationally unexposed to dental restorative materials. Information on pregnancies was obtained from national registers and outpatient units of hospitals. Data on occupational exposure were obtained using postal questionnaires. The final study population included 222 cases of miscarriage and 498 controls (births). An occupational hygienist assessed exposure to acrylate compounds, disinfectants and solvents. Exposure to other agents was assessed on the basis of the questionnaire data. Odds ratios (ORs) and confidence intervals (CIs) were estimated using conditional logistic regression. RESULTS: The ORs adjusted for confounding factors were increased for moderate-exposure and high-exposure categories of mercury amalgam (OR 2.0, 95% CI 1.0 to 4.1 and OR 1.3, 95% CI 0.6 to 2.5, respectively). The risk was slightly increased for the highest-exposure category of 2-hydroxyethylmethacrylate (OR 1.4, 95% CI 0.7 to 2.6) and polymethylmethacrylate dust (OR 1.4, 95% CI 0.8 to 2.4). A slightly increased risk was also detected for likely exposure to organic solvents (OR 1.4, 95% CI 0.8 to 2.3) and disinfectants (OR 1.5, 95% CI 0.9 to 2.7). CONCLUSIONS: No strong association or consistent dose-response relationship was observed between exposure to chemical agents in dental work and the risk of miscarriage. A slightly increased risk was found for exposure to mercury amalgam, some acrylate compounds, solvents and disinfectants. These findings indicate that the possibility of a weak association between exposure to these agents and an increased risk of miscarriage cannot be excluded.

Gender differences in career and practice patterns of PGD-trained dentists.

This study compares differences by gender in the practice patterns and professional activities of general dentists, specialists, and dentists with Advanced Education in General Dentistry (AEGD) or General Practice Residency (GPR) training. The UCLA School of Dentistry surveyed a random sample of 6,725 dentists graduating from dental school in 1989, 1993, and 1997 as part of an evaluation of the impact of federal funding on postgraduate general dentist (PGD) programs. The survey asked about current practice, services referred and provided, and professional activities. Of the 2,029 dentists (30 percent) who responded, 49 percent were general dentists with no specialty training; 7 percent had AEGD training; 20 percent had GPR training; and 24 percent had specialty training. General dentists were more likely to be in private practice (p < 0.05). AEGDs, specialists, and females were more likely to report faculty positions as a secondary occupation. General dentists were more likely to be practice owners than AEGD- or GPR-trained dentists. The mean number of patients seen was highest for specialists. Females reported fewer patients than males, and this difference was significant for GPR-trained dentists. With respect to services, GPR-trained dentists reported significantly more biopsy procedures, conscious sedation, periodontal surgery, and implants than general dentists. AEGD-trained dentists reported more conscious sedation than general dentists. GPR dentists were more likely to volunteer time than general dentists without specialty training. PGD training appears to result in different types of employment and specific practice patterns that strengthen primary care dentistry. We further conclude that there are gender differences in the types of practice, patients seen, and services provided. These findings occur in addition to training differences.

Survey of U.S. dentists' knowledge and opinions about oral pharyngeal cancer.

BACKGROUND: Oral pharyngeal cancer constitutes the most life-threatening of all dental and craniofacial conditions. The U.S. five-year survival rate of 52 percent for these cancers is one of the lowest and has not changed in decades. METHODS: The authors mailed a pretested survey to 7,000 randomly selected general dentists. They obtained information on 3,200 dentists' levels of knowledge about oral pharyngeal cancer risks and diagnostic procedures for providing an oral cancer examination, as well as about related opinions and interest in continuing education, or CE, courses on the topic. The authors carried out analyses using unweighted data; they used both bivariate and logistic analytical techniques and evaluated at a significance level of P < or = .01. RESULTS: Based on responses to 14 questions, the average knowledge of oral cancer risks score was 8.4. About one-half of dentists surveyed knew the two most common sites of intraoral cancer and that most oral cancers are diagnosed at a late stage. CONCLUSIONS: The reported knowledge of these dentists regarding oral cancer suggests that they are not as knowledgeable as they could be about cancer prevention and early detection and that they recognize these deficiencies. Most of the dentists were interested in oral cancer CE. CLINICAL IMPLICATIONS: Dentists need to know where in the mouth to look and what types of lesions to look for to provide a comprehensive oral cancer examination.

La participación de las mujeres en la odontología (primer parte) / The participation of women in dentistry (first part)

La incursión de las mujeres en el mundo de la odontología es presentada, así como los antecedentes que lo permitieron

Current understanding of clinical governance: a study of dental health care providers.

OBJECTIVE: To quantify what dental care providers understand by clinical governance and how it may impact on their activities. DESIGN: A self-completed questionnaire administered to attendees at two postgraduate courses. RESULTS: A total of 71 forms were completed, a response rate of 88%. The majority of those responding recognised that clinical governance would impact in clinical areas of activity. However, nearly a third felt that any legislation would not affect receptionists or dental surgery assistants. Over 30% of respondents failed to keep records of any mistakes that occurred in their practices, a feature that is central to risk management. While overall the respondents felt that clinical governance would help to raise standards, there was also the fear that it would lead to increased litigation. CONCLUSION: There is at present a lack of understanding of clinical governance and how it will impact on the profession. If GDPs are to sustain public and political confidence in their clinical practice the issue of clinical governance must be embraced by the profession.

Agreement between practitioners concerning removal of asymptomatic third molars.

OBJECTIVE: To investigate and compare agreement within two groups of dental practitioners, family dentists and oral surgeons, in their decisions regarding removal of asymptomatic mandibular third molars. SUBJECTS: Ten oral surgeons and 18 family dentists from South Wales with experience ranging from 5 to 28 years. METHODOLOGY: Participants were presented with periapical radiographs of 36 asymptomatic, mandibular third molars and were informed of the age and gender of the patients and the degree of eruption of the third molars. Participants were asked to indicate whether they thought that the third molar should be removed or not. The degree of agreement between participants was measured by kappa indices for multiple raters. RESULTS: The kappa indices were 0.14 for the oral surgeons and 0.09 for the family dentists, indicating poor agreement beyond chance. Although in most cases the participants decided not to remove the third molar, they did so inconsistently, that is, they did not make this decision on the same cases. There were also differences in the inclination of the participants to suggest removal of the 36 third molars. CONCLUSION: Poor inter-observer agreement suggested that treatment decisions regarding asymptomatic third molars are based more on subjective beliefs and habitual practices than on rational decision making.

Epidemiological profile of graduates of the Wits Dental Faculty 1927-1995.

The Wits dental school was first proposed in 1921 but had no premises until a private dental clinic was taken over in 1924 by the University, the same year that the Bachelor of Dental Surgery regulations were agreed to. In 1925 the first dental students registered and a year later, in 1926, the first seven lecturers in dental surgery were appointed. Since the first two graduates in 1927, 1916 dentists have graduated from the school as have 63 oral hygienists. Of the dentists 116 are female and 127 are black, Chinese, coloured or Indian. Regarding postgraduate qualifications, 346 have been awarded by the University on behalf of the dental school. This paper describes patterns in numbers of graduates, proportions registered in South Africa and contrasts registered South African dental school graduates with registered graduates from outside the country. It is clear that the Wits dental school has made a major contribution to South African society.

The careers of women dentists in the university.

Since 1866 when Lucy Beaman Hobbs graduated from the Ohio College of Dental Surgery as the first woman dentist in the world, many women have followed her example. In this paper, the first to be given in the Symposium, 'Women In Dentistry - Any Room At The Top?', the place of women dentists in universities is discussed. In many countries, despite the rapid growth in the proportion of women compared with men qualifying in dentistry, men still hold the majority of senior university posts. Evidence supports this observation and suggestions are given as to the reasons why it may persist.