Exploring collaboration reasons and leadership styles in Dutch primary oral healthcare practices.

AIMS: To outline the extent to which practice owners in Dutch oral healthcare practices (OHPs) use a directive and supportive leadership styles, to map out which goals practice owners in Dutch OHPs consider most important when choosing collaboration within the practice and to identify the reasons why oral healthcare professionals choose to engage in collaborative practice. MATERIALS AND METHODS: A survey involving 802 general dental practitioners, dental hygienists, and prevention assistants was conducted. The questionnaire covered, among other subjects, leadership styles and reasons for collaboration. Data analysis included descriptive statistics, chi-square tests, one-way ANOVA, linear regression, and logistic regression. RESULTS: Compared to employees, practice owners ascribe to themselves more characteristics of both directive and supportive leadership. The most frequently mentioned reasons for choosing a practice form that involves collaboration were the possibilities to provide the best care and the desire to focus on prevention. Healthcare providers chose to work in a collaborative practice for several reasons, which were associated with profession, age and gender. CONCLUSIONS: The degree of directive and supportive leadership among practice owners in dental care practices in the Netherlands showed a strong correlation. The most frequently mentioned reasons for choosing collaboration were related to healthcare content.

Longitudinal patterns of provided oral healthcare services to Dutch young patients: An observational study.

General dental practitioners (GDPs) differ in the preventive and curative care they provide to their young patients. This may be related to variation in the caries risk of patients, but also to differing opinions among GDPs about 'proper care'. Longitudinal data offers the possibility to make care patterns of GDPs comparable and to reveal possible treatment variation between GDPs. GDPs who participated in this study delivered data on the oral healthcare services (OHS) they provided to young patients during the period 2013-2017. Subsequently, data from patients who received regular OHS for 4 to 5 years were used in the analyses. Based on this, longitudinal preventive and curative care patterns were distinguished. Patients were divided into 3 preventive care patterns: no prevention, occasional prevention, and regular prevention. Furthermore, 3 curative care patterns were distinguished: no curation, curation in 1 year, and curation in several years. These care patterns were then combined. In addition, patients were classified into caries risk categories based on the caries-related treatments they received over a 2-year period: low (no procedures), elevated (1 procedure), and high (2 or more procedures). The caries risk based on the first 2 years and the last 2 years in the dataset were combined into a longitudinal caries risk profile. The most frequent combined care pattern (35.8%) was no curation and occasional or regular prevention. The most common longitudinal caries risk profile was low at beginning and end (45.2%). Dental practices varied considerably in the distribution of curative and preventive care patterns. Thereby, no relationship was shown between curative care patterns and provided preventive care. There was also a large spread in the provided OHS within the various caries risk profiles. These diversities indicated treatment variation between GDPs, which is unwarranted if less or more care is provided than necessary.

Perception of recently graduated Dutch dentists of their education.

INTRODUCTION: The curriculum of the three dental schools in the Netherlands consists of a three-year bachelor's and three-year master's course. The education programmes focus inter alia on clinical dental reasoning, thinking and acting scientifically, general oral healthcare activities, and communication and (inter)professional cooperation. This study examined how recently graduated dentists, in the light of their work experience, evaluate their education in retrospect. MATERIALS AND METHODS: All 1074 dentists who graduated between 2012 and mid-2017 were invited by e-mail to answer a web survey. Of those, 314 (29%) took part in the study. RESULTS: The majority of dentists were positive about their knowledge of general and clinical oral healthcare fields when they graduated (70% and 68%, respectively). Fewer dentists were satisfied with their skills in terms of some specific procedures (50%) and clinical professional areas (33%). By far, the majority (85%) were satisfied with the educational skills of their teachers. The majority (70%) felt that their education fitted in well with their professional practice. Nevertheless, 60% thought a year's trainee work experience would be a good idea. The overall evaluation of dentists who have their own practices was less positive than those who do not. CONCLUSION: Knowledge and skills relating to managing a practice were not sufficiently addressed in the programme. The introduction of a practical internship would be desirable, preferably during the education. But when they look back, the majority of recently graduated dentists in the Netherlands are generally positive about the education they received.

Work situation and prospects of recently graduated dentists in the Netherlands.

INTRODUCTION: Dentists who have graduated recently from a Dutch dental school work mainly in the Netherlands, where collaboration and differentiation are relevant factors. Furthermore, the Netherlands face regional undersupplies of dentists. The objective of this study was to describe choices and aims of recently graduated dentists for the near future. MATERIALS AND METHODS: An invitation for the web questionnaire was sent by e-mail to 945 dentists who had graduated from a Dutch dental school between 2013 and 2017, of whom 230 (24.3%) participated in the survey. RESULTS: Approximately three quarters (77%) of the recently graduated dentists worked as a general dentist in a practice of some else, primarily in urban areas. The choice for a practice was affected by location, earnings, and the opportunity to gain experience. Furthermore, the career choices were affected most by the desired length of the working week and financial security. The narrow majority (53%) of the recently graduated dentists believed that in 5 years they will be practice owner; 49% expected to be a differentiated dentist. Furthermore, 41% believed they will work in a smaller municipality. DISCUSSION: Although recently graduated dentists seem receptive to work in smaller municipalities, the peripheral regions are conceivably less appealing. Practice ownership conceivably is an option for the near future for a narrow majority of the recently graduated dentists. CONCLUSION: Recently graduated dentists have different preferences regarding their work situation in 5 years.

Developments in oral health care in the Netherlands between 1995 and 2018.

BACKGROUND: Over the past several decades, changes in legislation and regulations have been implemented in oral health care in the Netherlands. In 1995, for example, a major transformation in the funding of oral health care was implemented, after which most oral health care for adults was no longer covered by national insurance. In 1997, the Individual Healthcare Professions Act, in which the authorizations of care providers were described, was established. The Healthcare Quality, Complaints and Disputes Act, established in 2016, concerns the accountability of professional behavior. Regulations concerning employment have changed several times since 1995. These changes have affected the work and practice situation of oral health care providers. METHODS: Data from many publicly available sources were gathered and combined with internal reports mainly derived from the Data Stations project of the Royal Dutch Dental Association. This project was established in 1995 and, since its initiation, 6716 dentists have participated an average of 6.7 times. RESULTS: Between 1995 and 2018, nearly all professional groups in oral health care increased, particularly those of dental hygienists and prevention assistants. The number of dental practices decreased, but practices got larger in terms of dental units, number of patients, and personnel. The percentage of inhabitants visiting oral health care professionals remained unchanged, but the type of care provided moved towards more prevention. Oral health care providers exploited new opportunities to enhance and express their professional behavior. CONCLUSIONS: Oral health care in the Netherlands has evolved in recent years toward more collaboration in teams, and professions have established institutions to promote the quality and safety of care. Greater emphasis has been placed on prevention of dental diseases. These processes were influenced by new legislation and regulations, demographic changes within professional groups, and other social developments.

Preferred and actual retirement age of oral and maxillofacial surgeons aged 55 and older in the Netherlands: a longitudinal study from 2003 to 2016.

BACKGROUND: In workforce planning for oral and maxillofacial surgeons in the Netherlands, it is important to plan timely, as these dental specialists are required to earn both medical and dental degrees. An important factor to take into account in workforce planning is the outflow of the profession through retirement. In the workforce planning in the Netherlands, it was assumed that retirement plans are a predictor for the actual moment of retirement. The purpose of this study was to investigate this assumption. METHODS: A standardised survey to investigate the work activity and retirement plans of oral and maxillofacial surgeons was conducted seven times between 2003 and 2016. With some minor variations, in every edition, all oral and maxillofacial surgeons aged 55 years and older who did not indicate to be retired in an earlier edition were invited to participate. The data of all seven editions was analysed to investigate what factors influence the actual retirement age. For the analyses of the data, ANOVA and linear regression were employed. RESULTS: The response rate was at least 80% in all editions. For all editions combined, 185 surgeons were invited one or more times, of whom 170 responded at least once. Between 2003 and 2016, the mean preferred retirement age increased from 63.7 to 66.7. Two thirds of the respondents who participated in more than one edition had revised their preferred retirement age upwards. Regarding the difference between preferred and actual retirement age, 45% of the oral and maxillofacial surgeons retired at a higher age than originally preferred and another 14% was still working at the age the originally preferred to retire. Linear regression shows that preferred retirement age is associated with sex and the number of working hours and that actual retirement age is associated with preferred retirement age, earlier preference to decrease working hours and working in non-academic hospitals. CONCLUSION: Altogether, it seems that in this group the preferred retirement age has some predictive value, but the oral and maxillofacial surgeons tend to retire at a higher age than they originally preferred to.

Collecting standardised oral health data via mobile application: A proof of concept study in the Netherlands.

FDI World Dental Federation, founded as Fédération Dentaire Internationale, has taken the initiative to develop the Oral Health Observatory, a mobile application to conduct oral health surveys worldwide. The aim is to collect reliable standardized international data on oral health and oral health care via a network of dentists. A proof of concept study project was set up in the Netherlands to test the methodology and to validate the approach. Data about caries, gingivitis, oral self-care and oral health related quality of life were analysed and compared to datasets validated in other studies. The Android app embeds three questionnaires addressing oral health history, status and patient behaviour. One questionnaire was completed by the patient and two by the dentist. The proof of concept study involved two phases: in the first phase, five dentists, regular participants in KNMT-surveys, evaluated the usability of the app; after the first phase, the app was adjusted for a second phase. For this phase an extra 15 dentists were recruited from a group of 20 other dentists: five of them declined to participate. Attention was paid to ensuring there was a proportional representation of gender, age and region. In the second phase the five first and 15 new participants collected data on up to a maximum of 38 patients. Data from this 653 patients correspond with results from previously published surveys on the prevalence of caries and gingivitis in the Netherlands. Hence demonstrating an association between caries and gingivitis with oral self-care, problems eating and experiencing oral pain. This proof of concept study shows that the app makes it possible to collect reliable information on oral health in a short period of time. Both dentists and patients evaluated the methodology as user-friendly. Altogether, the results of this proof of concept study are promising.