Implementation of dental specialty centers: a descriptive analysis of the current status in the Brazilian territory

ABSTRACT This study aimed to assess the current implementation status of Dental Specialty Centers (Centros de Especialidades Odontológicas - CEO) in Brazil. The sample included CEOs implemented up to November 2015 in the 27 Brazilian federative units. Data were obtained directly from the database of the Informatics Department of the Brazilian Unified Health System, according to the National Registry of Health Facilities (NRHF) of Dental Specialty Centers of all Brazilian regions. Primary care data were also collected from the cities with implemented CEOs, including coverage status of the Family Health Strategy (FHS) and number of Oral Health Teams (OHT) I and II, at 2 collection periods (January 2006 and November 2015). There were 1019 CEOs implemented in Brazil, which were unequally distributed among the Brazilian states, with prevalence of implementation of CEOs type II (n=503, 49.4%). The statistical analysis showed significant difference between the three types of CEO (I, II, and III) and the variables of coverage rate (FHS) and number of teams (OHT I, OHT II) at both data collection periods. Although presenting an evolutionary aspect in the implementation of CEOs, the implementation of medium-complexity care in Brazil is disorganized.

Implementation of dental specialty centers: a descriptive analysis of the current status in the Brazilian territory.

This study aimed to assess the current implementation status of Dental Specialty Centers (Centros de Especialidades Odontológicas - CEO) in Brazil. The sample included CEOs implemented up to November 2015 in the 27 Brazilian federative units. Data were obtained directly from the database of the Informatics Department of the Brazilian Unified Health System, according to the National Registry of Health Facilities (NRHF) of Dental Specialty Centers of all Brazilian regions. Primary care data were also collected from the cities with implemented CEOs, including coverage status of the Family Health Strategy (FHS) and number of Oral Health Teams (OHT) I and II, at 2 collection periods (January 2006 and November 2015). There were 1019 CEOs implemented in Brazil, which were unequally distributed among the Brazilian states, with prevalence of implementation of CEOs type II (n=503, 49.4%). The statistical analysis showed significant difference between the three types of CEO (I, II, and III) and the variables of coverage rate (FHS) and number of teams (OHT I, OHT II) at both data collection periods. Although presenting an evolutionary aspect in the implementation of CEOs, the implementation of medium-complexity care in Brazil is disorganized.

Finishing and polishing procedures of composite restorations by Saudi dentists: a cross-sectional study.

AIM: The purpose of this study was to assess the knowledge and practices of Saudi dentists in finishing and polishing composite restorations. MATERIALS AND METHODS: A cross-sectional questionnaire-based study was conducted among 306 Saudi dentists from March to April 2012. The collected data were analyzed using Microsoft Excel 2010 program and descriptive statistics were obtained. RESULTS: Completed questionnaires were returned by 191 participants, giving a response rate of 62.4%. 115 (65.7%) respondents are using fine diamond finishing burs for finishing occlusal surfaces, 82 (48%) used fine aluminum oxide finishing discs for finishing facial surfaces, 130 (76%) used diamond finishing strips for finishing interproximal surfaces.121 (63.4%) respondents were of the view that the type of filler content has a major influence in providing color stability to the composite restoration and 137 (72.1%) believed nano-composites provided enhanced color stability. CONCLUSION: Dentists in Saudi Arabia are aware of the benefits of proper finishing and polishing of composite restorations. They however need to use finishing and polishing burs, disks, strips and pastes in a sequential series. Usage of composite polishing pastes and composite surface sealants should be emphasized in undergraduate curriculum.

Status of the dental health care workforce in Shanghai, China.

OBJECTIVES: The status of the dental health care workforce in Shanghai was investigated in order to support and improve regional planning of this workforce. METHODS: Questionnaires were used to survey all dental medical units in Shanghai. Data were collected on the quantity, structure and levels of dental health personnel. RESULTS: A total of 852 dental medical units and 3,218 dentists were identified in Shanghai. The ratio of dentists to population is 1 : 5,201. CONCLUSIONS: Presently, the total dental health workforce in Shanghai is relatively sufficient, but its distribution is inequitable because there are fewer dental health personnel employed in the suburbs. Moreover, the structure of the dental health workforce in Shanghai is inequitable and specialists in preventive dentistry are lacking. The results of this study can be applied to help Shanghai achieve the rational distribution and efficient utilisation of the dental health workforce available.

Therapies most frequently used for the management of bruxism by a sample of German dentists.

STATEMENT OF PROBLEM: At present, there is little information available on how practicing dentists manage bruxism patients with respect to conservative, reversible techniques as compared to irreversible techniques. PURPOSE: The purpose of this study was to determine the most commonly applied therapies used for the management of bruxism by German general dentists (GDs) and dental specialists. In addition, efforts were made to gather information on the knowledge and opinion of GDs and specialists regarding the role of occlusal interferences, in particular, on the development of sleep bruxism. MATERIAL AND METHODS: A 13-item questionnaire was developed and mailed to all active members of the statutory dental insurance providers of the German North Rhine (n=5500; 2006 roster) and the German Westphalia-Lippe area (n=4984; 2006 roster). Group differences were statistically analyzed using chi-square tests for the qualitative variables and Mann-Whitney U tests for the quantitative variables (α=.05). RESULTS: Occlusal splints were by far the most frequently prescribed therapy for the management of bruxism, followed by relaxation techniques, occlusal equilibration, physiotherapy, and prosthodontic reconstruction. The occlusal stabilization splint with canine protected articulation was the splint type most often prescribed, whereas respondents used unadjusted soft splints for approximately 8% of their bruxism patients. Comparison of the opinions of all responding practicing dentists with that of experts in regard to the statement that "sleep bruxism is caused by occlusal interferences" showed a significant difference between the 2 groups (P=.021). Eighty-five percent of the experts disagreed with this statement, and only 47.7% of the practicing dentists had the same opinion as the experts. CONCLUSIONS: Most practicing dentists seem to concur with current scientific recommendations, and express the opinion that the management of bruxism should predominantly be conservative and reversible; however, the findings of the present survey reveal diverse differences between GDs and dental specialists concerning the most frequently prescribed therapies. Moreover, the discrepancies detected in some areas, such as the use of irreversible techniques or the use of unadjusted soft splints, emphasize the need to more promptly transfer new knowledge in the field of bruxism from researchers to practicing dentists.

A survey on German dentists regarding the management of craniomandibular disorders.

The purpose of the present investigation was to identify the most frequent therapies and, in particular, the prescription patterns for occlusal splints for the management of craniomandibular disorders (CMDs) used by German general dentists and specialists. Additionally, the knowledge and opinion of the practising dentists were examined. All active members of the statutory dental insurance providers of the German North Rhine (n = 5,500) and the Westphalia-Lippe area (n = 4,984) were surveyed with a questionnaire by mail. Results indicated that occlusal splints were the first-choice therapy followed by physiotherapy and occlusal equilibration. In the preceding year, both general dentists and specialists made 30 occlusal splints on average. With regard to high-quality evidence-based recommendations, some statistically significant discrepancies between general dentists and specialists were detected. On the basis of the present data, it seems useful to consider intensifying the topic of CMDs and orofacial pain in future undergraduate dental curricula and in postgraduate training.

Factors influencing the career aspirations and preferred modes of working in recent dental graduates in Wales.

INTRODUCTION: In England and Wales, National Health Service (NHS) primary dental care services are now commissioned on a local basis. In planning for the future, it is important that commissioning authorities have a clear understanding of the perspectives of recent dental graduates: vocational dental practitioners (VDPs). OBJECTIVES: This study investigated the career aspirations and preferred modes of working of VDPs in Wales. METHODOLOGY: Data were collected via a postal questionnaire, comprising 37 closed and open questions, mailed to all 59 VDPs in Wales. RESULTS: A total of 53 (90%) VDPs participated, of whom 47 saw their future in general dental practice: 5, 35, and 7 indicating a preference to work in the NHS, mixed (NHS and private), and private sector, respectively. None selected the Community Dental Service as their preferred vocation. More than half of all respondents intended to undertake a postgraduate qualification within the next five years and 22 wished to specialise. Of the 53 VDPs, 44 were concerned that lack of NHS contracts would limit where they could practise, and agreed that family and other social commitments were a significant influence on choice of practice location. Access to high-quality premises and continuing professional development were agreed as important by 41 VDPs. A majority (37) agreed that private dentistry was an attractive alternative to NHS dentistry. Of the respondents, 38 (22 females, 16 males) expected to work part-time at some point in the future and 14 said they would consider a career outside dentistry. Only nine VDPs agreed that they would be happy working in a single-handed practice and even fewer (six) indicated they would be happy working for a corporate body. CONCLUSIONS: Numerous factors impact on the career aspirations of VDPs. These factors have been quantified in this study, and healthcare-commissioning bodies need to be aware of them when planning future dental care provision in Wales.

Residency training in dental public health: assessment of status, needs, and issues.

The opportunities for public health training have declined over the years while the need for public health skills is likely to increase. This paper reports the results of a project, sponsored by the Health Resources and Services Administration, which answers the question of "how best to invest in the dental public health education system so as to fulfill the profession's responsibilities to protect and improve the oral health of individuals and society." An information base on dental public health education, practice, and specialization was developed from an extensive review of the literature and a survey of dentists concerning employment and practice requirements for public health dentists. An advisory group considered this information, met to discuss the issues involved in dental public health training, and provided advice to the project staff. Based on the information gathered as part of the project, recommendations were made to: (1) develop a grant program to support advanced education in dental public health; (2) increase the competencies of dentists who are working in public health positions and not eligible for board certification via off-site residencies; (3) develop model programs in areas of great need, such as general public health, management, policy, prevention, environmental health and research, that in conjunction with a basic public health core, could satisfy the eligibility requirements of the American Board of Dental Public Health; (4) develop student loan forgiveness programs for dentists and dental hygienists working in public health; and (5) develop additional credential recognition programs for dental public health workers.