Differences in the Ratios of General and Dental Specialists in Europe.

BACKGROUND: The European Economic Area (EEA) is composed of member states with a multitude of different regions. This study aimed to analyse the ratios of general dentists and dental specialists to the total population and the proportion of dental specialists to general dentists in 24 European countries and to explore specific intranational differences within 2 countries: France and Germany. METHODS: Available official documents and webpages from the United Kingdom and 23 of the 30 countries comprising the EEA were analysed. Data were expressed as absolute values, ratios of general dentists and dental specialists in the total of population, and percentages of dental specialists/dentists. The Mann-Whitney U test was used to clarify the main ratios that distinguish France from Germany, and cluster analysis was employed to determine similar areas. RESULTS: Significant differences were found between countries, with Ireland and Austria having the lowest ratio of dentists and Romania and Greece having the highest. The Czech Republic, the Netherlands, France, and Denmark had the lowest ratios of dental specialists to the total population. Lithuania, Sweden, and Germany had the highest number of dental specialists. Orthodontists were the most numerous specialists (5.0% of dentists), followed by oral surgeons (2.7%). In France, differences between departments were pronounced and associated with the presence of dental schools and per capita income. In Germany, only the correlation between per capita income and the density of oral surgeons was significant. CONCLUSIONS: Diverse ratios of general dentists and dental specialists to the total population and the proportion of dental specialists to general dentists were discovered within the examined countries, and their maximum values were 2.5, 5.7, and 4.1 times the minimum values, respectively. Differences were even found within the same country, as was the case in France and, to a lesser extent, in Germany.

Avaliação da retenção do conhecimento, do grau de confiança e dos erros de compreensão dos acadêmicos de odontologia / Evaluation of knowledge retention, degree of confidence and erros of undertanding of dental students

Objetivo: avaliar a retenção de conhecimento (RC), o grau de confiança (GC) e a identificação dos erros de aprendizado (EA) dos acadêmicos de um curso de Odontologia. Métodos: neste estudo, foram avaliados 39 alunos dos níveis finais de um curso de Odontologia, os quais responderam 40 questões retiradas de provas anteriores do Exame Nacional de Desempenho dos Estudantes (Enade), através de uma plataforma virtual. Es-tas foram divididas em quatro áreas: Formação Geral (FG); Saúde Coletiva (SC); Clínica Odontológica (CO); e Especialidade Odontológica (EO). Resultados: analisando os resultados, observou-se que a área do saber que obteve melhor média de acertos foi a de CO (com 59,4), seguida das questões de FG (com 48,5). A área que obteve menor média de acertos foi a de SC (com 36,4). O GC foi analisado através de um questionário em que o aluno relatava se estava ou não confiante perante a questão respondida. Em relação ao erro, percebeu--se que a única área na qual os alunos erraram as questões, mas estavam confiantes, foi a de SC. Em relação ao acerto, a única área em que os alunos acertaram as questões, mas não se demonstraram confiantes para acertar, foi a de FG.Conclusão: percebe-se que, dentre as áreas avaliadas, a SC foi a que apresentou pior média de acertos. (AU)

Objective: the present study evaluated the knowledge retention, degree of confidence and identification of learning errors of dental students. Methods: 39 senior dental students (last year) responded 40 questions from previous exam from the ENADE (National Student Performance Exam) using a virtual platform. Questions were divided into four areas: General Formation (GF); Collective Health (CH); Dental Clinic (DC) and Dental Specialty (DE). Results: it was observed that the area of knowledge that obtained the best average was DC, with 59.4, following by GF questions, with 48.5. The area with the lowest average was that of CH, with 36.4. The degree of confidence was analyzed through a questionnaire, where the student reported whether or not she/he was confident about the answers. Regarding the error, it was noticed that the only area where the students answered the questions but were confident was that of CH. Regarding the hit, the only area where students got the questions right but were not confident to get it right was that of GF. Conclusion: among the evaluated areas, CH was the one with the worst average of correct answers.(AU)

Specialized dental care for people with disabilities in Brazil: profile of the Dental Specialty Centers, 2014. / Atenção odontológica especializada para pessoas com deficiência no Brasil: perfil dos centros de especialidades odontológicas, 2014.

OBJECTIVE: To describe the oral health care services for people with disabilities treated within the Dentistry for Patients with Special Needs (PSN) specialty. METHODS: This was a cross-sectional study with data from the Program for Improving Access and Quality of Dental Specialty Centers (PMAQ-CEO) in 2014. RESULTS: Of the total of 932 services evaluated, 89.8% did provide care for PSNs, 30.4% had physical accessibility, 59.7% provided referral to hospital care and most guaranteed complete treatment. Only a third of the Dental Specialty Centers planned 40 or more hours a week for providing clinical care to PSNs. CONCLUSION: The care network for people with disabilities is being formed but, even with specific financial incentives, it has limitations. Services need to eliminate physical and attitudinal barriers to ensure universal accessibility. Protocols based on risk classification are necessary, prioritizing care at DSCs for complex cases not attended to in Primary Care and organizing the dental health care network for people with disabilities.

Investigation of Turkish dentists' clinical attitudes and behaviors towards the COVID-19 pandemic: a survey study.

Currently, the whole world is under the threat of the COVID-19 pandemic, and dentists are at high risk. The aim of this study was to investigate what kind of precautions Turkish dentists take in dental clinics during the COVID-19 pandemic. The study population consisted of dentists in Turkey. An online questionnaire (23 questions-57 items) was sent to a sample of Turkish dentists from March 16 to March 20, 2020. The questionnaire comprised a series of questions about dentists' demographic characteristics, their concerns, and the measures taken in dental clinics against COVID-19. This study included a total of 1,958 Turkish dentists. A total of 1,274 (65.1%) were general dentists, and 684 (34.9%) were specialists. Five hundred twenty-two (26.7%) dentists attended an informational meeting on COVID-19. Of these dentists, 69.8% were aware of COVID-19 according to their self-assessed knowledge scores. More than 90% of the dentists were concerned about themselves and their families. Only 12% of the dentists wore an N95 mask. Although Turkish dentists took some precautionary measures, they did not take enough precautions to protect themselves, the dental staff, and other patients from COVID-19. As the number of COVID-19 cases increased, the measures taken slightly increased in dental clinics as well. Dentists are strongly recommended to take maximum precautions in the clinical setting. The guidelines about the COVID-19 pandemic should be sent to all dentists by the regional and national dental associations.

Investigation of Turkish dentists clinical attitudes and behaviors towards the COVID-19 pandemic: a survey study

Abstract Currently, the whole world is under the threat of the COVID-19 pandemic, and dentists are at high risk. The aim of this study was to investigate what kind of precautions Turkish dentists take in dental clinics during the COVID-19 pandemic. The study population consisted of dentists in Turkey. An online questionnaire (23 questions-57 items) was sent to a sample of Turkish dentists from March 16 to March 20, 2020. The questionnaire comprised a series of questions about dentists' demographic characteristics, their concerns, and the measures taken in dental clinics against COVID-19. This study included a total of 1,958 Turkish dentists. A total of 1,274 (65.1%) were general dentists, and 684 (34.9%) were specialists. Five hundred twenty-two (26.7%) dentists attended an informational meeting on COVID-19. Of these dentists, 69.8% were aware of COVID-19 according to their self-assessed knowledge scores. More than 90% of the dentists were concerned about themselves and their families. Only 12% of the dentists wore an N95 mask. Although Turkish dentists took some precautionary measures, they did not take enough precautions to protect themselves, the dental staff, and other patients from COVID-19. As the number of COVID-19 cases increased, the measures taken slightly increased in dental clinics as well. Dentists are strongly recommended to take maximum precautions in the clinical setting. The guidelines about the COVID-19 pandemic should be sent to all dentists by the regional and national dental associations.

Analysis of the supply of specialized oral health care services in the Brazilian National Health System: Brazil, 2014. / Análise da oferta de serviços na atenção especializada em saúde bucal no Sistema Único de Saúde, Brasil, 2014.

OBJECTIVE: to analyze the availability of public specialized dental care services at Dental Specialties Centers (CEO) in Brazil in 2014. METHODS: secondary data on the CEO ratio and dental surgeon ratio were analyzed by population as well as the adequacy of the quantity of complete dental consulting rooms per CEO type, the adequacy of the ratio between the working hours of dental auxiliaries /technicians and those of dental surgeons and the adequacy of the availability of recommended minimum specialties. Possible statistical differences between macro-regions were verified. RESULTS: we found a ratio of one CEO per 217,797 inhabitants and one dental surgeon per 26,811 inhabitants; 97% of CEOs had the recommended number of dental consulting rooms; 26% had equivalent working hours between dental auxiliaries /technicians and dental surgeons; 60% offered the recommended minimum specialties. CONCLUSION: there were limitations in the provision of National Health System specialized oral health care services as well as regional differences.

Produção especializada no SUS em capitais brasileiras com centros de especialidades odontológicas: uma análise descritiva / Specialized production in the unified health system in Brazilian capitals with dental specialty centers: a descriptive analysis

Centros de especialidades odontológicos (CEOs) são estabelecimentos de saúde de âmbito especializado que devem realizar uma quantidade mínima de procedimentos. Objetivos: descrever a produção odontológica especializada e reportar o cumprimento das metas nas capitais brasileiras com CEOs. Materiais e método: foi conduzido um estudo do tipo longitudinal retrospectivo, sendo realizada uma busca por CEOs cadastrados no Cadastro Nacional de Estabelecimentos de Saúde (CNES). A produção odontológica foi pesquisada no Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIASUS), de maio de 2015 a abril de 2016. Resultados: foram encontrados e considerados elegíveis para o presente estudo 59 CEOs, localizados em 19 capitais brasileiras e no Distrito Federal, sendo 48% CEOs tipo II. Cerca de 730 mil procedimentos especializados foram realizados durante os 12 meses avaliados. Uma taxa de 86% das metas foi cumprida, sendo que cirurgia foi à área com maior cumprimento (92%), seguida de periodontia (89%) e endodontia (76%). Uma das capitais apresentou apenas 33% das metas cumpridas. Três capitais não atingiram nenhuma das metas estabelecidas em procedimentos de endodontia. Conclusão: foi observada uma grande variação no cumprimento das metas entre as capitais com CEOs. Enquanto algumas capitais apresentaram elevado cumprimento das metas, outras exibiram dados preocupantes, principalmente nos procedimentos de endodontia. (AU)

Dental Specialty Centers (Centros de Especialidades Odontológicas ­ CEOs) are specialized health facilities that should perform a minimum number of procedures. Objectives: this study aimed to describe the specialized dental production and report the achievement of goals in Brazilian capitals with CEOs. Materials and method: a retrospective longitudinal study was performed with a search for the CEOs listed in the National Registry of Health Establishments. The dental production was searched in the Outpatient Information System of the Brazilian Unified Health System for the period from May 2015 to April 2016. Results: fifty-nine CEOs were found and considered eligible for the present study. They were located in 19 Brazilian capitals and in the Federal District, whereas 48% were CEOs Type II. Approximately 730 thousand specialized procedures were performed during the 12 months evaluated. A rate of 86% of goals was met and surgery presented the highest achievement (92%), followed by periodontics (89%) and endodontics (76%). One of the capitals achieved only 33% of the goals. Three capitals did not achieve any of the goals set for endodontic procedures. Conclusion: there was a great variation in the achievement of goals among capitals with CEOs. While some capitals showed high achievement of goals, others presented concerning data, especially for endodontic procedures. (AU)

The changing demographic profile of dentists and dental specialists in South Africa: 2002-2015.

INTRODUCTION: It is essential to have regular audits of the number of oral health personnel so that planning, delivery of services and training can be addressed. There has not been such an audit in South Africa (SA) for more than 10 years. AIM: To determine the demographic profile of dentists and dental specialists (DS) between 2002 and 2015. METHODS: A retrospective record-based study was used and all dentists and DS registered with the Health Professions Council of South Africa (HPCSA) from 2002 till 2015 were included. Demographic data, including gender, age, race, type of practice and geographical residence were recorded. RESULTS: There were 6,125 dentists and 481 DS registered with the HPCSA in 2015. The younger dentists tended to be Black and Asian women while older dentists were mostly White males. The majority of DS with maxillo-facial surgeons (30%), orthodontists (30%) and prosthodontists (17%). The number of dentists increased at around 2% per annum and the majority of the dentists and DS resided in the most metropolitan provinces of SA. Over the 13-year period, the number of female dentists almost doubled and the number of Coloured, Black and Asian/Indian dentists and DS increased sharply. CONCLUSION: The population to dentist ratio was fairly low, with the majority of dentists and DS residing in the three metropolitan provinces of SA. There has been a relatively sharp increase in the number of Coloured, Black and female dentists, which could be a result of increased admission of previously disadvantaged students to dental schools.

Long-term Evaluation of Treatment Planning Decisions for Nonhealing Endodontic Cases by Different Groups of Practitioners.

INTRODUCTION: The aim of this study was to investigate changes in treatment planning decisions among different practitioner groups over 7 years for teeth with apical periodontitis and a history of endodontic treatment. METHODS: A Web-based survey was sent to dentists in Pennsylvania in 2009 consisting of 14 cases with nonhealing periapical lesions and intact restorations without evidence of recurrent caries. Participants selected among 5 treatment options: wait and observe, nonsurgical retreatment (NSRTX), surgical retreatment (SRTX), extraction and fixed partial denture, or extraction and implant (EXIMP). In 2016, the identical survey was resent to the original 2009 participants. RESULTS: In 2009, 262 dentists participated in the survey. Two hundred one participants were general practitioners (GPs: 76.7%), 26 endodontists (ENDOs: 9.9%), and 35 other specialists (prosthodontics, periodontics, and oral surgery [SPECs]: 13.4%) (n = 262). EXIMP, NSRTX, and SRTX were fairly equally selected but with great variation between practitioner groups (χ2 = 173.49, P < .05). A subset group of 104 participants (SUB) (39.7% of the original participants) retook the survey in 2016 (69 GPs [66.3%], 15 ENDOs [14.0%], and 20 SPECs [19.7%]). Comparisons among practitioner groups were significantly different in SUB (n = 104) for 2009 (χ2 = 95.536, P < .05) and 2016 (χ2 = 109.8889, P < .05). Intragroup reliability between 2009 and 2016 revealed no significant differences between the overall treatment planning choices for all practitioners (GPs, ENDOs, or SPECs). Intrapractitioner reliability showed many treatment planning decision changes on an individual level. Chances that individuals changed their original decision were 47.8% (95% confidence interval, 45.2%-50.4%) and were significantly different among the 3 practitioner groups (GPs > SPECs > ENDOs [χ2 = 11.2792, P < .05]). No significant changes were observed in the decision for tooth saving versus replacement treatment options (P = .520). CONCLUSIONS: No significant differences were noted between current and past treatment planning decisions in regard to tooth preservation by endodontic retreatment versus tooth extraction and replacement. However, individual practitioners lacked consistency in their decision making over time.

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.

Current Status of Postdoctoral and Graduate Programs in Dentistry.

Advanced dental education has evolved in the context of societal needs and economic trends to its current status. Graduate programs have positioned their role in the context of health systems and health science education trends in hospitals, interprofessional clinical care teams, and dental schools and oral health care systems. Graduate dental education has been a critical factor in developing teams in trauma care, craniofacial disorders, pediatric and adult medicine, and oncology. The misalignment of the mission of graduate dental programs and the demands of private practice has posed a challenge in the evolution of programs as educational programs have been directed towards tertiary and indigent care while the practice community focuses on largely healthy affluent patients for complex clinical interventions. Those seeking graduate dental education today are smaller in number and include more international dental graduates than in the past. Graduate dental education in general dentistry and in the nine recognized dental specialties now includes Commission on Dental Accreditation (CODA) recognition of training standards as part of its accreditation process and a CODA accreditation process for areas of clinical education not recognized as specialties by the American Dental Association. Current types of programs include fellowship training for students in recognized specialties. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Career satisfaction and work-life balance of specialist orthodontists within the UK/ROI.

Objectives To investigate factors affecting career satisfaction and work-life balance in specialist orthodontists in the UK/ROI.Design and setting Prospective questionnaire-based study.Subjects and methods The questionnaire was sent to specialist orthodontists who were members of the British Orthodontic Society.Results Orthodontists reported high levels of career satisfaction (median score 90/100). Career satisfaction was significantly higher in those who exhibited: i) satisfaction with working hours; ii) satisfaction with the level of control over their working day; iii) ability to manage unexpected home events; and iv) confidence in how readily they managed patient expectations. The work-life balance score was lower than the career satisfaction score but the median score was 75/100. Work-life balance scores were significantly affected by the same four factors, but additionally were higher in those who worked part-time.Conclusions Orthodontists in this study were highly satisfied with their career and the majority responded that they would choose orthodontics again. Work-life balance scores were lower than career satisfaction scores but still relatively high. It is important for the profession to consider ways of maintaining, or improving, career satisfaction and work-life balance; including maintaining flexibility of working hours and ensuring that all clinicians have ready access to appropriate training courses throughout their careers (for example, management of patient expectations).

[Evaluating productivity targets achievement in Dental Specialty Centers from Maranhão State, Brazil, 2011]. / Avaliação do cumprimento das metas de produtividade em Centros de Especialidades Odontológicas no Maranhão, 2011.

OBJECTIVE: to evaluate productivity targets achievement (PTA) in Dental Specialty Centers (DSCs) from Maranhão State, Brazil. METHODS: this was an ecologic study using secondary data; an indicator for PTA was created for each subgroup of procedures. RESULTS: 25 DSCs were evaluated; the PTA was higher for basic procedures (n=19), followed by endodontics (n=11), oral surgery (n=9) and periodontics (n=8); the best results were obtained at DSCs type II; higher PTA was associated with financial anticipation (basic procedures) and higher Human Development Index, life expectancy and social exclusion rate (endodontics); lower PTA was associated with larger population (endodontics/oral surgery), adherence to the Pact for Health (periodontics/endodontics), larger number of specialties (periodontics) and bigger DSC (oral surgery). CONCLUSION: most DSCs did not achieve productivity targets, except for basic procedures; socioeconomic and health management characteristics of the municipalities were associated with the PTA; the DSCs characteristics explained little about the PTA.

Work-related Musculoskeletal Pain among Different Dental Specialists in United Arab Emirates.

INTRODUCTION: Dentists are at a very high risk of developing work-related musculoskeletal pain. The present study aimed at studying the prevalence of musculoskeletal pain among different dental specialists in the United Arab Emirates (UAE), and correlating the region of pain with the type of clinical work done by the specialists. MATERIALS AND METHODS: A sample of more than 100 dentists was chosen randomly from different emirates in UAE. An interview questionnaire was administered regarding the number of years of experience and the presence, region, duration, and type of musculoskeletal pain they experienced. RESULTS: Musculoskeletal pain is experienced by 83.3% of periodontists, 80% of conservative dentists, 77.8% of endodon-tists, 72.7% of orthodontists, 70% of oral surgeons, 63.6% of prosthodontists, 63% of general dental practitioners, and 50% of pedodontists. The results have also indicated that the region of experienced musculoskeletal pain does vary according to the specialty. From those dentists who experience work-related musculoskeletal pain, 80% of conservative dentists experience pain in neck and shoulders, 66.7% of periodontists, and 54.5% of orthodontists experience pain in the lower back region. More than 50% of endodontists experience pain in the neck and shoulders regions, and 39% of general dental practitioners who experience pain in the neck region. CONCLUSION: Preventive measures need to be taken to decrease the risk of dentists and dental specialists developing work-related musculoskeletal pain. CLINICAL SIGNIFICANCE: The prevalence and distribution of musculoskeletal disorders (MSDs) among registered general dental practitioners and dental specialists in UAE was not clearly documented. The study results indicated that the region that experienced musculoskeletal pain does vary according to the specialty.

Civil liability: characterization of the demand for lawsuits against dentists.

In light of the fact that dentists may be held civilly liable for their practice, it is important to understand the current situation of lawsuits filed against these professionals by studying current legal decisions and the literature. The objective of this study was to analyze the case law of the Court of Justice of São Paulo, Brazil, relative to the profile of patients and professionals, the most commonly involved specialties, the amounts litigated and the court decisions pertaining to civil liability lawsuits against dentists. In an inductive approach, a single researcher screened and collected civil liability rulings by accessing the Court's website, and following a statistical-descriptive procedure and an indirect observation technique. The most frequently involved specialty was prosthodontics. However, oral and maxillofacial surgery was related to a higher incidence of damages awarded to settle claims and to higher damage amounts. The dentist was found guilty in 44.32% of the cases researched. Pecuniary damages ranged between R$ 485.50 and R$ 12,530.00, and non-pecuniary damages ranged between R$ 2,500.00 and R$ 70,000.00. Most lawsuits were filed by women against male dentists. An increase in the relative number of lawsuits against companies versus individuals was observed.

The use of the BDA Case Mix Model to assess the need for referral of patients to specialist dental services.

BACKGROUND: Access to health services is a right for every individual. However, there is evidence that people with disabilities face barriers in accessing dental health. One of the reasons associated with this is the unclear referral pathway existing in the Irish dental health service. The appropriate assignment of patients to relevant services is an important issue to ensure better access to healthcare. This is all the more pertinent because there are only a few trained dental practitioners to provide dental treatment for people with disabilities, as well as even fewer qualified specialists in special care dentistry. AIMS: The aim of this part of the study was to assess the use of the BDA Case Mix Model to determine the need for referral of patients to specialist dental services, and to determine any association between patient complexity and the need for adjunct measures, such as sedation and general anaesthesia for the management of people with disabilities and complex needs. METHODOLOGY: A retrospective analysis of dental records using the BDA Case Mix Model.Results The results showed that patients with different levels of complexities were being referred to the special care dentistry clinic at the Dublin Dental University Hospital. The results also showed that the need for supportive adjunct measures such as sedation and general anaesthesia was not necessarily the main reason for referring patients to specialist services. The assessment with the BDA Case Mix Model was comprehensive as it looked at many factors contributing to the cases' complexity. Not all categories in the Case Mix Model had significant association with the need for an adjunct.Conclusion The BDA Case Mix Model can be used to measure the need for supportive adjunct measures, such as sedation and general anaesthesia.

Dental therapy practice patterns in Minnesota: a baseline study.

OBJECTIVES: A chronic shortage of dentists, the importance of oral health, and the lack of access to care led to the introduction of a new oral health practitioner in Minnesota, the dental therapist. Dental therapy graduates from the University of Minnesota have been in practice since 2012. To date, there has been no formal study of how they have been incorporated into dental practice. The purpose of this study was to obtain baseline knowledge of dental therapists' practice patterns in Minnesota and determine if dentists' patterns of work changed after a dental therapist was employed. METHODS: Four dental practices were sampled purposefully to obtain various practice types and geographic locations within Minnesota. Secondary data were collected from practice management software databases in each practice between January-March, 2015. Data were used to describe the work undertaken by dental therapists, the types of patients seen and payer mix. Additionally, data from 6 months before and after employment of the dental therapist were collected to determine whether dentists' practice patterns changed after a dental therapist was employed. RESULTS: Dental therapists were employed full-time, seeing an average of 6.8 patients per day. No distinct pattern emerged with regard to ages of patients seen by dental therapists. Dental therapists saw up to 90% of uninsured patients or patients on public assistance. Restorative services across practices comprised an average of 68% of work undertaken by dental therapists. Dentists delegated a full range of procedures within the dental therapy scope of practice indicating trust and acceptance of dental therapists. Dentists in two practices began to take on more complex dental procedures after a dental therapist joined the practice. CONCLUSION: Dental therapists are treating a high number of uninsured and underinsured patients, suggesting that they are expanding access to dental care in rural and metropolitan areas of Minnesota. Dentists appear to have an adequate workload for dental therapists and are delegating a full range of procedures within their scope of practice. Dentists performed fewer restorative and preventive procedures after a DT was hired.

[Reimbursement of public dental care in Germany, the United Kingdom, Hungary and Poland]. / A fogászati ellátás finanszírozása Németországban, az Egyesült Királyságban, Magyarországon és Lengyelországban.

INTRODUCTION: Dental treatments have the highest rate among medical interventions and their reimbursement is also significant. AIM: The aim of the study was to compare the outcome of the reformed healthcare system process on public dental services in four European countries. METHOD: Assessment base for the comparison of reimbursement of dental treatments and dental fee schedules provided by the health insurance funds were used. The following indicators were examined: the ratio of public dental services and the main oral health indicators. Among dental fee schedules, reimbursement of general dental activity, prevention, operative dentistry, endodontic and oral surgery were selected. RESULTS: The lowest value of population to active dentist ratio was found in Germany (population to active dentist ratio: 1247) and the highest in Hungary (population to active dentist ratio: 2020). Oral health indicators showed significant differences between the West-European and East-European countries. On the other hand, the ratio of completely edentulous people at the age of 65yrs did not show great variations. Reimbursement of public dental treatments indicated significantly higher value in Germany and the United Kingdom compared to the other countries. CONCLUSIONS: Reimbursement of public dental services varies considerably in the selected European countries.

Civil liability: characterization of the demand for lawsuits against dentists

Abstract In light of the fact that dentists may be held civilly liable for their practice, it is important to understand the current situation of lawsuits filed against these professionals by studying current legal decisions and the literature. The objective of this study was to analyze the case law of the Court of Justice of São Paulo, Brazil, relative to the profile of patients and professionals, the most commonly involved specialties, the amounts litigated and the court decisions pertaining to civil liability lawsuits against dentists. In an inductive approach, a single researcher screened and collected civil liability rulings by accessing the Court's website, and following a statistical-descriptive procedure and an indirect observation technique. The most frequently involved specialty was prosthodontics. However, oral and maxillofacial surgery was related to a higher incidence of damages awarded to settle claims and to higher damage amounts. The dentist was found guilty in 44.32% of the cases researched. Pecuniary damages ranged between R$ 485.50 and R$ 12,530.00, and non-pecuniary damages ranged between R$ 2,500.00 and R$ 70,000.00. Most lawsuits were filed by women against male dentists. An increase in the relative number of lawsuits against companies versus individuals was observed.