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1.
Spec Care Dentist ; 41(2): 210-217, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33382104

RESUMO

AIM: To compare the geriatric dentistry curricula between Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs. METHODS: A 108-item survey was developed to assess residents' didactic and clinical experiences pertaining to geriatric patients. Surveys were mailed in 2018 to all AEGD (N = 89) and GPR (N = 180) program directors. Statistical analysis consisted of descriptive and bivariate analyses with the chi-square test, Fisher's exact test, and the Wilcoxon rank sum test (alpha = .05). RESULTS: Twenty-four AEGD and fifty-eight GPR directors completed surveys (response rate = 30%). Seventy-one percent of responding programs reported mandatory didactic training pertaining to frail and functionally dependent geriatric adults. Ninety-nine percent of respondents reported that residents provided treatment to geriatric patients; however, they were less likely to perform procedures on frail and functionally dependent patients. Only 15% of respondents provided nursing home care. Considering all patient encounters, responding GPR programs were more likely than AEGD programs to treat patients using IV bisphosphonates (63% vs 25%; P < .01), undergoing chemotherapy (48% vs 16%; P = .02), and undergoing head and neck radiation therapy (55% vs 25%; P = .02). CONCLUSION: A majority of responding AEGD and GPR programs reported providing educational experiences pertaining to geriatric patients; however, GPR programs reported treating more medically complex patients than AEGD programs.


Assuntos
Medicina Geral , Internato e Residência , Adulto , Idoso , Currículo , Educação de Pós-Graduação em Odontologia , Odontologia Geral , Humanos , Inquéritos e Questionários , Estados Unidos
3.
J Can Dent Assoc ; 86: k5, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33326365

RESUMO

INTRODUCTION: Evidence-based practice (EBP) is an expectation of medical professionals and is positively received in the dental community. Investigations of evidence-based dentistry (EBD) have discussed its use in broad terms and daily clinical practice, but there is only limited information about its use and barriers with respect to particular dental specialities. METHODS: A cross-sectional questionnaire was developed to survey implementation and obstacles to EBP; EBD specific to periodontics; and preferences for types of dissemination of evidence. The target population was active general dentists in Nova Scotia (n = 446). An email link to the questionnaire was distributed to dentists, and reminders were sent 4 and 10 days later. RESULTS: The response rate was limited (16.6%). Most respondents were comfortable evaluating the growing body of research, although many reported use of low-level evidence, including that from other health professionals or expert opinion. A common barrier to use was insufficient time. Respondents who found strong evidence for certain periodontal procedures were more likely to refer these procedures, which included tissue regeneration and periodontics related to endodontics. On-site lecture-based dissemination was preferred by most respondents. CONCLUSION: General evidence-based concepts and use were similar to EBD results reported elsewhere, although external validity is limited by our low response rate and narrow target population. Specific data related to periodontics may be useful in directing a modified questionnaire to a broader target population. Respondents who are truly interested in EBD and responded to our questionnaire may ultimately benefit the most from our results, where further educational opportunities can be tailored to overcome the identified barriers and aid in more effective translation of evidence-based periodontal decisions in a general dental practice.


Assuntos
Odontólogos , Periodontia , Atitude do Pessoal de Saúde , Estudos Transversais , Odontologia Geral , Humanos , Papel Profissional , Inquéritos e Questionários , Pesquisa Médica Translacional
4.
Community Dent Health ; 37(3): 229-234, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32673473

RESUMO

OBJECTIVE: To describe dentists' perceptions of their professional roles, including the reasons why they make, accept or decline patient referrals within primary dental care in England. BASIC RESEARCH DESIGN: Qualitative semi-structured interviews, conducted via Skype, telephone or face-to-face. Transcripts were analysed using thematic analysis and typologies were developed. PARTICIPANTS: Ten general dental practitioners (GDPs) and 12 community dentists working in England. RESULTS: Five main themes were identified: professional independence, the nature of dental care, the business of dentistry, obscure rules and 'no man's land'. This final theme described a notional gap between GDPs' and community dentists' responsibilities towards vulnerable people, who were perceived by participants to include frail older people, anxious and socially marginalised adults and children with high levels of disease. Three typologies of dentists were generated. 'Entrepreneurs' felt no allegiance to the National Health Service and no obligation to treat vulnerable patients. 'Altruistic carers' were committed to caring for exceptionally deserving patients. 'Pragmatic carers' tried to provide relational dental care (time and emotional support) for vulnerable patients but encountered discouraging systemic barriers. CONCLUSION: Dentists' perceptions of their roles may influence whether and how they provide access to primary dental care for vulnerable people through referral systems. Access issues may exacerbate the oral health inequalities experienced by vulnerable groups. Based upon the findings, approaches are proposed that may encourage and enable the dental workforce to support vulnerable people actively to receive primary dental care.


Assuntos
Odontólogos , Papel Profissional , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Criança , Assistência Odontológica , Inglaterra , Odontologia Geral , Humanos , Encaminhamento e Consulta , Medicina Estatal
5.
Acta Odontol Scand ; 78(7): 547-552, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32401091

RESUMO

Objective: To reduce the gap between what can be achieved in endodontic treatments and the observed treatment outcome among general dental practitioners, the present study set out to assess the status of the endodontic practices as regards to knowledge and self-assessed skills among general dental practitioners in Sweden and Norway.Material and method: The questionnaire was sent to 1384 general dental practitioners. It contained questions regarding access to continuing education in endodontics, sources of knowledge for clinical management of patients, post-operative follow-ups, self-assessed success-rate, and the initial diagnosis impact on the outcome of endodontic treatments.Results: The response rate was 61.4%. Almost half estimated their endodontic success-rate to be 90%. About two-thirds of the respondents did not know, or did not believe, that the initial diagnosis could affect the outcome of their endodontic treatments. Respondents who did not believe the diagnosis could impact the outcome were more likely to estimate their success rate as the highest (p<.001). Less than half performed post-operative follow-ups a year after treatment. A third of the respondents had not attended any continuing endodontic education.Conclusion: Dentists who do not receive regular feedback on their treatments may lack insight into their own shortcomings. If this is combined with insufficient knowledge and understanding it may result in sub-par endodontic treatments being performed. It is important to have reliable ways to communicate current endodontic knowledge and to establish robust methods that may help dentists accurately assess their own performance in endodontics.


Assuntos
Odontólogos , Endodontia , Tratamento do Canal Radicular , Seguimentos , Odontologia Geral , Humanos , Noruega , Padrões de Prática Odontológica , Papel Profissional , Inquéritos e Questionários , Suécia , Resultado do Tratamento
6.
Br Dent J ; 228(8): 581-585, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32332955

RESUMO

General dental practice in the United Kingdom has been in a state of unrest for over two decades, with practitioners having been confronted by two contract changes. The latest contract change of 2006 resulted in much disquiet, and services continue to be piloted in order to develop a contract that satisfies the needs of both government and the profession. Within this context, this paper explores the issues surrounding the present situation. To date, the profession has expanded service provision into the private market which has resulted in an exaggerated inverse care provision. This could be perceived as a move towards a retail philosophy and away from healthcare. In order to restore an equitable balance of care provision, the authors present possible solutions that could satisfy both parties.


Assuntos
Odontologia Geral , Saúde Bucal , Assistência à Saúde , Governo , Humanos , Reino Unido
7.
Br Dent J ; 228(7): 537-545, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32277213

RESUMO

Aims To assess the management of chronic periodontitis (CP) in general dental practices based in the West Midlands against the British Society of Periodontology (BSP) guidelines and determine whether this varies between NHS, private and mixed sector practices. To examine general dental practitioners' (GDPs') attitudes towards the management of periodontitis, the implementation of the BSP guidelines and explore their suggestions for improved management of the disease.Materials and methods A semi-structured telephone interview was conducted with eight dentists to construct an online questionnaire. Using the NHS Choices database, the practice managers of 30 dental practices were contacted and asked to distribute the online questionnaire to all GDPs within their practice.Results One hundred and three GDPs completed the questionnaire; several dentists indicated their management would not align with the BSP recommendations. Dentists do not believe the BSP guidelines are easy to implement in NHS practice.Discussion Areas where dentists are falling short of the BSP guidelines include periodontal charting, indications for root surface debridement (RSD) and antimicrobials. These topics should be highlighted to dentists. Dentists would prefer NHS remuneration to reflect the time and effort spent, better access to secondary care and increased awareness of periodontal diseases among patients.Conclusion This study identifies clear areas where dentists are not following the BSP guidelines and provides insight from a GDP's perspective to improve the management of CP in practice.


Assuntos
Periodontite Crônica , Odontólogos , Atitude do Pessoal de Saúde , Periodontite Crônica/terapia , Odontologia Geral , Humanos , Papel Profissional , Inquéritos e Questionários
8.
Br Dent J ; 228(6): 459-463, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32221450

RESUMO

Introduction Studies across the health service reveal benefits of teamwork and barriers to its optimal use. Drawing upon the established Maturity Matrix Dentistry method, the Skills Optimisation Self-Evaluation Toolkit (SOSET) was developed to enable the whole dental team to critically review how they address skill-mix in delivery of patient-centred oral healthcare in their practice. This paper outlines the development of the SOSET and explores its usefulness to general dental practice teams.Methods Research literature and interview data from general dental practice teams were coded for high-level factors (positive and negative) influencing teamwork. We used this coding to identify skill-mix domains, and within each, define criteria. The SOSET process was refined following consultations with dental professionals and piloting.Results Eighty-four papers were coded and 38 dental team members were interviewed across six sites. The SOSET matrix was developed containing nine domains reflecting the use of skill-mix, each containing six development-level criteria. The domains addressed factors such as team beliefs on skill-mix and knowledge of team members' scope of practice, patient demand, the business case, staffing and training, and the practice premises. The process was piloted in 11 practices across South Wales, and feedback was received from 92 staff members. Results showed that the SOSET process was straightforward, that the whole team could contribute to discussion and that it would be used to improve practice. Following piloting, four domains were merged into two new domains, and the number of criteria within all domains was reduced and the wording simplified (seven domains, with four criteria each).Conclusion We used a systematic and rigorous process to develop the SOSET to support dental teams to progress their teamwork practices. Its usefulness was demonstrated in the pilot. The SOSET is now being offered to general dental practices across Wales.


Assuntos
Autoavaliação Diagnóstica , Odontologia Geral , Humanos , Equipe de Assistência ao Paciente , Recursos Humanos
10.
Br Dent J ; 228(5): 366-370, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32170258

RESUMO

Introduction Restoring complex tooth wear (TW) cases is technically challenging and not well-remunerated under the NHS General Dental Service (GDS) contract. Therefore, numbers of referrals to secondary care are increasing, but these are often rejected as dental hospitals have a high workload. This may make it difficult for patients with TW to access appropriate care unless paying privately, which may be costly for them.Aim The aim of this investigation was to understand how general dental practitioners (GDPs) in Leeds manage complex TW cases.Methods A postal questionnaire was designed and piloted before postal distribution to all GDPs with a Leeds postcode (n = 289). Non-responders were sent reminders to complete the questionnaire. The questionnaire included questions on the place of qualification and experience of the dentists, their management of an example complex TW case and the potential barriers to management of similar cases. The resulting data were statistically tested using Kruskal-Wallis and Mann-Whitney tests.Results A total of 148 (51%) responded to the questionnaire. There was low confidence in restoring complex TW cases with a mean score of 4.65 out of 10 (0 being not confident at all and 10 being very confident). Only 30 respondents (21%) reported that they would treat complex TW cases under the current NHS GDS contract, and 90 (62%) reported that they had experienced difficulty referring these cases to hospital. Kruskal-Wallis testing showed increased confidence in restoring by those with a diploma or MSc (p = 0.004 and p = 0.014 respectively). Mann-Whitney testing showed those undertaking a higher percentage of NHS work were less likely to restore these cases (U = 2,100; p = 0.02).Conclusion These results suggest that Leeds patients with complex TW may have difficulty in accessing appropriate care under the current NHS GDS contract. The results highlight the benefits of postgraduate education on confidence in restoring complex TW cases.


Assuntos
Odontologia Geral , Desgaste dos Dentes , Atitude do Pessoal de Saúde , Odontólogos , Humanos , Papel Profissional , Encaminhamento e Consulta , Inquéritos e Questionários
11.
Int J Dent Hyg ; 18(3): 220-227, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32069383

RESUMO

OBJECTIVES: Dental hygienists (DHs) have an important role in the treatment of patients with periodontitis. The objective of the current qualitative interview study was to gain understanding about personal and organizational factors that influence best-evidenced DH practice in the treatment of periodontitis. METHODS: Data were obtained by interviewing Swedish DHs, who had been engaged in a preceding clinical field study on evidence-based periodontal therapy. Qualitative content analysis was used for analysis. Data sampling was terminated after 18 interviews, when deemed that sufficient amount of information had been gained. RESULTS: In the analysis of the interview data, a main theme was identified as "I know what to do, but I do as I usually do; DHs' ambivalence between theory and practice in the treatment of patients with periodontitis." The results elucidated that the DHs were well aware of "what to do" in order to offer their patients adequate periodontal care, but this knowledge was not congruent with how they usually worked. Established routines and culture at the clinic, DHs' predetermined beliefs about lack of motivation and ability to cooperate among patients, lack of time and reflection, economic demands in care and lack of interest and support by co-working dentists were barriers to best-evidenced DH practice in periodontal care. CONCLUSIONS: The results elucidate the complexity of best-evidenced DH practice in the treatment of periodontal patients and indicate needs for quality improvement of the periodontal care provided in general dental practice, by actions taken on both individual/professional and organizational levels.


Assuntos
Higienistas Dentários , Periodontite , Odontologia Geral , Humanos , Pesquisa Qualitativa , Suécia
12.
J Dent Educ ; 84(4): 397-408, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32053257

RESUMO

Oral health care is the most prevalent unmet health care need among all U.S. children age 17 and under in the U.S., and this includes those with special health care needs (SHCN). Children with SHCN experience unique barriers to receiving oral care including challenging behaviors, inadequate insurance coverage, and a lack of trained dentists. Despite the need for specialized training to successfully provide dental care to children with SHCN, few dental programs offer the necessary educational preparation. The Nova Southeastern University College of Dentistry was funded by the Health Resources and Services Administration to prepare pediatric and Advanced Education in General Dentistry (AEGD) dental residents in the care of children, adolescents, and adults with SHCN. The purpose of this paper is to describe the didactic and clinical training program and to provide data on the program's impact.


Assuntos
Transtorno do Espectro Autista , Clínicas Odontológicas , Adolescente , Adulto , Criança , Educação em Odontologia , Odontologia Geral , Humanos , Odontopediatria , Estados Unidos
13.
BMC Oral Health ; 20(1): 47, 2020 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-32041598

RESUMO

BACKGROUND: Evidence concerning periodontal practice in Eastern European countries is scarce. The aim of the present study was to investigate periodontal risk knowledge, patient management and self-perceived confidence among General Dentists (GDs) from five Eastern European regarding their provision of periodontal care. METHODS: GDs from Belarus, Lithuania, Macedonia, Moldova and Romania participated in a questionnaire survey. Power calculations were used to identify the sample size for each country. The structured questionnaire included several domains of inquiry. The socio-demographic domain inquired about dentist's age, gender and years of clinical experience. The dental practice domain inquired about practice location, practising or not practising in a group practice and having or not having a periodontist or a dental hygienist in the practice. The distributions of answers across-countries were compared employing one way ANOVA (comparison of means) or Chi square test (comparison of proportions). For each country, the predictors of the study outcomes: a summative knowledge score for periodontal risks and dentist's confidence level were identified employing either linear or logistic multiple regression models. RESULTS: The sample comprised 390 Belarussian, 488 Lithuanian, 349 Macedonian, 316 Moldovan, and 401 Romanian GDs. The majority of GDs (~ 80%) practiced in urban areas. Age and gender distributions differed significantly among countries. Significant across-country differences were found regarding working/not working in a group practice, having/not having access to a periodontist/dental hygienist and in proportions of patients receiving periodontal treatments or being referred to specialists. None of Macedonian patients nor the majority of Moldovan patients (78%) were referred to periodontists. There were also significant across-country differences in diagnosis, patient management and periodontal knowledge. Only in the Lithuanian cohort were dentists' confidence levels associated significantly with their knowledge. In all countries, taking a medical history was a consistent and significant predictor of having higher periodontal knowledge score. Except in Belarus, periodontal risk assessment was a significantly consistent predictor of certainty levels associated with the provision of periodontal treatments. CONCLUSIONS: There were substantial differences among GDs in the five countries regarding diagnosis, dentist's confidence and management of periodontal patients.


Assuntos
Odontólogos/psicologia , Odontologia Geral/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Padrões de Prática Odontológica , Atitude do Pessoal de Saúde , Feminino , Humanos , Lituânia , Masculino , Moldávia , República de Belarus , Romênia , Inquéritos e Questionários
14.
Aust Dent J ; 65(1): 90-95, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31814141

RESUMO

OBJECTIVES: To examine the efect of age and gender on dental services provided by dentists in Australia, and compare with previous estimates across the period 1983-1984 to 2013-2014. METHODS: Data were collected by mailed survey from a random sample of Australian dentists. Private sector dentists were the focus of the analysis. Data were weighted to the age and sex distribution of Australian practising dentists. RESULTS: The analysis was based on service logs collected from n = 211 dentists. Adjusted results (rate ratio, 95% CI) showed male dentists had higher endodontic rates (1.7, 1.0-2.9) than female dentists. Dentists aged 40-49 years had higher restorative rates (1.6, 1.1-2.2) but lower preventive rates (0.5, 0.3-0.9) than those aged 20-29 years. Diagnostic services were lower for dentists aged 40-49 to 60+ years (0.8, 0.6-0.9), while denture services were higher for dentists aged 40-49 (11.1, 2.5-48.5) to 60+ years (6.4, 1.2-33.3). Crowns were higher for dentists aged 40-49 (2.4, 1.0-5.6) and 50-59 years (2.9, 1.3-6.6). Diagnostic and preventive services were consistently higher across 1983-1984 to 2013-2014. CONCLUSIONS: Younger dentists provided higher rates of diagnostic and preventive services. Over a 30-year period, there was a consistent trend towards higher provision of diagnostic and preventive services.


Assuntos
Coroas , Odontólogas , Adulto , Austrália , Assistência Odontológica , Odontólogos , Feminino , Odontologia Geral , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Odontológica , Distribuição por Sexo , Inquéritos e Questionários , Adulto Jovem
15.
Acta Odontol Scand ; 78(3): 223-228, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31726901

RESUMO

Objective: As journal impact factors (IFs) can be artificially inflated by excessive journal self-citation practices, research quality evaluation based solely on IF ranking may be manipulated and, therefore, ethically challenged. This study aimed to analyze the longitudinal development of journal self-citation rates (SCRs) and IFs in dental literature and to determine possible confounders.Methods: Twenty-eight journals with scope within general dentistry and (sub)specialties listed in 1997-2016 Journal of Citation Reports® were scrutinized. The following information was retrieved: publication year, total number of citations, number of self-citations, IF, corrected IF, and SCR.Results: Endodontic journals had the highest SCR (median = 35.3, IQR = 21.6-47.5), journals related to periodontics had the lowest (median = 14.7, IQR = 8.9-25.5). Periodontics had the highest IF (median = 2.1, IQR= 1.7-2.8) and general dentistry had the lowest (median = 0.9, IQR = 0.7-1.2). SCR significantly decreased over time (p < .0001) by 1 unit per year. Additionally, 1 unit increase in corrected IF resulted in 15.2 units decrease in SCR. IFs significantly increased 0.06 units per year (p < .000).Conclusions: Overall, favourable changes in citation metrics have been observed for dental journals during the 20-year observation period. SCR significantly decreased per observation year whereas IFs significantly increased, indicating a healthy publishing environment in the dental literature. SCR was regulated both by time and corrected IF.


Assuntos
Bibliometria , Odontologia/estatística & dados numéricos , Fator de Impacto de Revistas , Publicações Periódicas como Assunto , Periodontia/estatística & dados numéricos , Odontologia Geral , Humanos , Editoração
16.
Eur J Dent Educ ; 24(2): 233-242, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31845456

RESUMO

BACKGROUND: Self-assessment is an important introspective skill that dental professionals will utilise throughout their professional career. Its value lies in its ability to help individuals identify areas of strengths and weakness, and subsequently seek further development of professional skills where needed. The aim of this study was to investigate the correlation between self-assessed confidence and the assessment grade of final year dental students based on the professional attributes and competencies of newly qualified dentists outlined by the Australian Dental Council (ADC). METHODS: Ethical approval was obtained prior to distribution of a questionnaire with 45 statements to final year dental students. The survey was created based on the learning outcomes of the ADC guidelines in the domains of "scientific and clinical knowledge" and "patient care." Participants indicated their level of self-assessed confidence by marking "X" on a visual analogue scale (VAS) from zero ("No Confidence") to 10 cm ("Very Confident"). The assessment grade was based on OSCE, viva voce, case report and written paper. RESULTS: A total of 58 (71.6%) dental students participated in the survey. The reported self-assessed confidence over two domains were under "patient care": clinical information gathering 8.92 ± 1.07 cm (range =3.94-10.0 cm: n = 58; 100%), clinical diagnosis and management planning 8.26 ± 1.34 cm (range =0.50-9.95 cm: n = 55; 94.8%), clinical treatment and evaluation, 6.07 ± 1.69 cm (range =0-10.00 cm: n = 55; 94.8%), and "scientific and clinical knowledge": 6.98 ± 1.58 cm (range =0-10.00 cm: n = 58; 100.0%). Within these categories, high confidence was reported for routine dental care (caries management and preventive care) whilst lower confidence was reported for the management of oral medicine and pathologies, dental emergencies, trauma, paediatric dentistry and prosthodontics. Correlation between the assessment grade and the overall score of self-assessed confidence is low positive (r = .225) and not statistically significant (n = 46; P = .132, Spearman'sρ). CONCLUSIONS: The final year dental students appear to have good overall self-assessed confidence in core areas of general dentistry. However, confidence seems to be over-estimated when compared with summative assessment.


Assuntos
Educação em Odontologia , Estudantes de Odontologia , Austrália , Criança , Competência Clínica , Odontologia Geral , Humanos
17.
Dent Clin North Am ; 64(1): 229-240, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31735228

RESUMO

General dentists usually serve as first-line providers for pediatric patients and the gateway to their oral health. Even though general dentists are trained to be able to treat children, dental education instruction can vary greatly. These differences heavily influence the individual practitioner's knowledge base and comfort level in providing care to this vulnerable population. It is important for general dentists to be able to identify the presence of pediatric oral lesions. This article provides an overview of common pediatric oral lesions that general dentists may encounter in everyday practice.


Assuntos
Assistência Odontológica para Crianças , Odontopediatria , Atitude do Pessoal de Saúde , Criança , Odontólogos , Educação em Odontologia , Odontologia Geral , Humanos , Saúde Bucal , Padrões de Prática Odontológica , Populações Vulneráveis
18.
Eur J Dent Educ ; 24(1): 109-120, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31618492

RESUMO

INTRODUCTION: In the United Kingdom, policy and guidance changes regarding the role of dental therapists (DTs) were implemented in recent years with a view to changing dental care to a more preventive-focussed, teamwork approach. However, success in the adoption of this model of working has been varied. AIMS: Adopting a realist approach, our aim was, to examine the use of DTs in general dental practices in Wales, exploring what works, why, how and in what circumstances. MATERIALS AND METHODS: The research comprised two stages. (a) A structured literature search, dual-coding papers for high-level factors describing the conditions or context(s) under which the mechanisms operated to produce outcomes. From this, we derived theories about how skill-mix operates in the general dental service. (b) Six case studies of general dental practices (three with a dental therapist/three without a dental therapist) employing a range of skill-mix models incorporating semi-structured interviews with all team members. We used the case studies/interviews to explore and refine the theories derived from the literature. RESULTS: Eighty-four papers were coded. From this coding, we identified seven theories which reflected factors influencing general dental practices within three broad contexts: the dental practice as a business, as a healthcare provider and as a workplace. We tested these theories in interviews with 38 dental team members across the six care studies. As a result, we amended five of the theories. CONCLUSION: Our analysis provides theory about outcomes that DTs may facilitate and the mechanisms that may assist the work of DTs within different contexts of general dental practice.


Assuntos
Assistência Odontológica , Odontologia Geral , Pessoal de Saúde , Humanos , Reino Unido , Local de Trabalho
19.
Acta odontol. Colomb. (En linea) ; 10(Supl. Covid-19): 33-46, 20200000. graf, graf, graf, graf, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1141080

RESUMO

Objetivo: analizar los datos epidemiológicos y las medidas generales en la práctica odontológica tomadas por Colombia y Uruguay durante la pandemia por la COVID-19. Métodos: este trabajo es una revisión de la literatura. Se consultaron las bases de datos "PubMed", "Scielo" y el motor de búsqueda "Google Scholar". También se consultaron bases de datos de libre acceso como google, our world in data y las páginas oficiales de la Organización Mundial de la Salud, el Ministerio de Salud de Colombia, el Instituto Nacional de Salud y el Ministerio de Salud Pública de Uruguay. Se realizó un análisis descriptivo del comportamiento epidemiológico y de las medidas tomadas en la práctica odontológica en los dos países. Resultados: en Colombia, a diario, se presentan más de 3.000 casos nuevos y más de 100 muertes. Lo contrario ocurre en Uruguay, que ha logrado disminuir las tasas de contagio y de muertes, presentando menos de 10 casos y ninguna muerte diaria. Los profesionales de la salud han incrementado su lucha; los odontólogos se encuentran expuestos por su proximidad al momento de la atención, en el contacto con saliva, sangre y la generación de aerosoles, por lo que han modificado los protocolos de bioseguridad buscando prevenir los contagios asociados a la prestación de servicio. Conclusiones: Uruguay ha tenido un comportamiento ejemplar ante la pandemia; en Colombia los resultados son preocupantes dado el crecimiento exponencial. En ambos países la práctica odontológica se ha visto afectada y se han implementado nuevos protocolos para proteger a profesionales y pacientes.


Objective: Analyze the epidemiological data, general and dental practice measures taken by Colombia and Uruguay in the face of the COVID-19 pandemic. Methods: This study is a review. We search in the databases "PubMed", "Scielo" and in the search engine "Google Scholar". Also, were consulted the free databases like google, our world in data and the official pages of the World Health Organization, Ministry of Health of Colombia, The National institute of health and the Ministry of public Health of Uruguay. A descriptive analysis of the epidemiological behavior and the measures taken of dental practice in both countries was done. Results: Colombia had more than 3,000 new cases and more than 100 deaths daily. The opposite occurs in Uruguay, which has managed to decrease the infection and death rates, presenting less than 10 cases and no daily deaths. The struggles experienced by health professionals has increased, dentists are exposed, by their proximity at the time of care, to contact with saliva, blood and the generation of aerosols, therefore, they have modified the biosafety protocols, seeking to prevent infections associated with the practice. Conclusions: Uruguay has an exemplary behavior; in Colombia these results are worrying with an exponential growth. In both countries, dental practice has been affected and new protocols have been implemented that seek to protect the professionals and patients.


Assuntos
Humanos , Masculino , Feminino , Infecções por Coronavirus , Odontologia Geral , Epidemiologia , Assistência Odontológica , Crescimento Exponencial , Protocolos , Pandemias
20.
Br Dent J ; 227(11): 977-983, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31844227

RESUMO

Introduction The extent to which initial therapy has been provided prior to referral for periodontal disease remains unclear despite guidance provided by the British Society of Periodontology.Aim This audit aimed to assess the information given in the referral letter, how this compared to patients' perception of treatment received, the referrers' reports of treatment provided and findings at consultation. The gold standard was taken from the British Society of Periodontology referral criteria which states that all patients should undergo initial periodontal therapy prior to referral.Method Data were collected via questionnaires from 100 randomly selected patients referred for periodontal treatment from patients at consultation and subsequently from the referring practitioners.Results All 100 patients had incomplete referrals with 12 patients having Basic Periodontal Examination (BPE) scores corresponding to those at consultation. Eighty-five patients reported receiving oral hygiene instructions (OHI) and 91 patients root surface debridement (RSD), prior to referral. Twenty-five dentists participated in the survey and reported spending more time providing initial therapy than the patients.Discussion and conclusion Most patients reported having undergone initial periodontal treatment, however, the extent was at variance to the referrers' reports. BPE scores were inaccurate and the majority of referrers failed to provide a diagnosis, with incorrect terminology used. The study highlights the need for improving the management of periodontal disease in primary care.


Assuntos
Odontologia Geral , Doenças Periodontais , Assistência Odontológica , Humanos , Periodontia , Encaminhamento e Consulta
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