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1.
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
2.
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
3.
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
4.
Prim Dent J ; 8(3): 64-74, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31666174

RESUMO

In 2019, in a world of instant gratification, what are the expectations of patients and dentists? Is training sufficient to meet these expectations? Decision-making in dentistry impacts the treatment choices patients are given, and may influence the outcomes of such treatment. It is therefore important to ensure as much standardisation as possible. In order to achieve this, it is important to know the current standard and the views of dentist as this will influence dental treatment planning. Clinical Relevance: This paper captures the treatment planning dilemmas of dentists, specifically of those in their Foundation training year, in order to aid targeting of training and development. Objective Statement: To understand treatment decisions of general dental practitioners and specialists.


Assuntos
Assistência Odontológica/organização & administração , Serviços de Saúde Bucal/organização & administração , Odontólogos/psicologia , Odontologia Geral , Medicina Geral , Odontologia Geral/organização & administração , Humanos
5.
Br Dent J ; 227(10): 875-880, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31758122

RESUMO

This is the second in a two-part series that aims to summarise answers to common questions facing dentists in general practice. The first part of this series is entitled 'Periodontal care in general practice: 20 important FAQs - Part one' (Br Dent J 2019;226: 850-854) and contains the first set of ten FAQs.


Assuntos
Medicina Geral , Doenças Periodontais , Odontólogos , Odontologia Geral , Humanos
7.
Br Dent J ; 227(7): 618-620, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31605073

RESUMO

Discusses the different worlds of undergraduate periodontal treatment compared to its management in general dental practice via the experience of two newly qualified dentists. Considers difficulties newly qualified dentists may face implementing their knowledge and training into everyday NHS practice and strategies to overcome these early hurdles.


Assuntos
Odontólogos , Odontologia Geral , Atitude do Pessoal de Saúde , Humanos , Inquéritos e Questionários
8.
Br Dent J ; 227(7): 626-627, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31605075

RESUMO

Periodontal disease is prevalent in many patients who attend general dental practice. However, the population is generally unaware of the disease until there is either the prospect of losing their teeth, not being able to have orthodontic treatment or advanced restorative treatment. Most patients should, however, have their condition managed within primary dental care, and clinical studies have shown that non-surgical treatment is a highly effective method of periodontal therapy. Treatment of periodontal diseases involves monitoring the response to initiated treatment and reacting accordingly. A general practitioner's, or hygienist's, decision to treat or refer would largely depend on the clinician's ability (determined by their training and experience) and financial implications within the constraints of the NHS or other care plans. This referral may be to a more experienced practitioner, a specialist or to a teaching institution.


Assuntos
Doenças Periodontais , Periodontia , Assistência Odontológica , Odontologia Geral , Humanos , Encaminhamento e Consulta
9.
Niger J Clin Pract ; 22(10): 1365-1371, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607725

RESUMO

Objective: Orofacial pain (OFP) is a unique group of dental conditions with focus on chronic nonodontogenic pain affecting mouth, jaws, and face. The aim of this study is to investigate the knowledge of dentists in Saudi Arabia toward OFP assessment. Materials and Methods: An English language questionnaire containing 20 close-ended questions was used to capture data. The questionnaire included diagnostic criteria and clinical symptoms and signs of various OFP conditions. It was distributed to general dental practitioners (GDP) and dental specialists in four major provinces in Saudi Arabia. Results: A total of 318 questionnaires were completed by 163 males and 155 females. Most participants were GDPs (193/318) and the remaining were specialists from different dental specialties. A majority of participants were not able to diagnose neuropathic OFP or neurovascular/vascular OFP conditions (33% and 28.6%, respectively). On the other hand, only 40.3% were confident enough to diagnose different types of temporomandibular disorders. The results also showed that graduates from non-Saudi programs had significantly higher self and knowledge assessment score (59.8% and 43.4%, respectively) compared with graduates from Saudi programs (39.9% and 22.6%, respectively). The dental specialists had higher self-assessment scores compared with GDPs (48% vs. 43.7%). Overall, there was a weak positive correlation between self-assessment and knowledge assessment (20.2%). Conclusion: This study demonstrates a higher OFP knowledge and confidence for dental specialists compared with GDPs. However, this difference does not necessarily translate into more competencies in clinical practice. Therefore, the implementation of OFP courses in dental schools' curricula may benefit future dentists and improve patients' care.


Assuntos
Competência Clínica/normas , Odontólogos/psicologia , Educação em Odontologia , Dor Facial/diagnóstico , Odontologia Geral/educação , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Currículo , Avaliação Educacional/métodos , Dor Facial/etiologia , Dor Facial/fisiopatologia , Feminino , Humanos , Masculino , Neuralgia/diagnóstico , Medição da Dor , Arábia Saudita , Faculdades de Odontologia , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico
10.
J Am Dent Assoc ; 150(10): 890-892, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31561763
11.
Br Dent J ; 227(6): 519-523, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31562453

RESUMO

During the late Victorian and Edwardian period, the local landowner, the 7th Earl De La Warr, instigated the development of the rural Sussex village of Bexhill into the fashionable seaside resort of Bexhill-on-Sea. Famous at the time for the introduction of mixed bathing and the first motor races to be held in the United Kingdom, the resort had a population of around 15,000 people by 1914. The Edwardian period was the highlight of Bexhill-on-Sea's popularity as a resort for the rich and famous. The town became incorporated as a borough in 1902 and the first motor races in the country took place along the promenade. Early in its development, Bexhill-on-Sea had attracted dentists mainly from the nearest town, Hastings. By the turn of the century, however, dentists were being drawn from further afield. Using primary sources such as census records, local directories, newspapers and the dental register and journals, the ebb and flow of general dental practitioners into the glamorous coastal resort is described. The family origins, qualifications and other characteristics of these dentists are discussed.


Assuntos
Odontólogos , Família , Odontologia Geral , Humanos , Reino Unido
12.
Br Dent J ; 227(5): 387-391, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31520042

RESUMO

Introduction Child abuse and neglect present a significant global concern, therefore, it is imperative that dental professionals can identify children at risk. Previous literature has suggested that general dental practitioners (GDPs) do not feel adequately trained to do so and that there is a gap between the suspicion of abuse and onward referral.Aims To assess the experience of paediatric safeguarding reporting among GDPs in Greater Manchester and investigate the current barriers to reporting safeguarding concerns.Methods An anonymous questionnaire was distributed via email to a sample of general dental practices in Greater Manchester.Results Thirty-six questionnaires were completed, giving a 36% response rate. Fifty-eight percent of respondents had received undergraduate training and 83% had received postgraduate training. Eighty-one percent felt that GDPs require further training and support. Fifty-eight percent of GDPs had been suspicious of at least one case of child abuse or neglect, however, only 28% had completed an onwards referral. Common barriers to reporting included: fear of violence to the child; lack of certainty of diagnosis; and lack of confidence in their suspicions.Conclusion Barriers to the referral of suspected cases of abuse or neglect are still commonly reported. There is a strong demand for further child protection training among GDPs.


Assuntos
Maus-Tratos Infantis , Odontologia Geral , Atitude do Pessoal de Saúde , Criança , Bem-Estar da Criança , Humanos , Encaminhamento e Consulta , Inquéritos e Questionários
13.
Br Dent J ; 227(5): 419-425, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31520047

RESUMO

During the late Victorian and Edwardian period, the local landowner, the 7th Earl De La Warr, instigated the development of the rural Sussex village of Bexhill into the fashionable seaside resort of Bexhill-on-Sea. Famous at the time for the introduction of mixed bathing and the first motor races to be held in the United Kingdom, the resort had a population of around 15,000 people by the outbreak of the Great War. This 30-year period also coincides with the development of dentistry from an apprenticed trade to the beginnings of a regulated profession. There has been little previous research into the lives of those who entered the profession in the early stages of its development. Using primary sources, such as census records, local directories and newspapers, as well as the dental register and journals, the ebb and flow of general dental practitioners into the rapidly growing coastal resort from 1880 is described. The family origins, qualifications and entrepreneurial nature of these dentists are discussed.


Assuntos
Odontólogos , Odontologia Geral , Humanos , Reino Unido
15.
Br Dent J ; 227(3): 223-227, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31399681

RESUMO

Aim To determine the prevalence of restoration overhangs in a general dental practice and investigate if these are associated with an increase in the rate of alveolar bone loss locally.Methods Historical dental records were randomly and anonymously selected from the records of patients in a general dental practice. The most recent bitewing radiographs were examined and any overhangs were recorded along with location. Sequential bitewing radiographs were examined so that the restored tooth with an overhang could be compared over time with a similar but unrestored tooth which acted as a control.Results A total of 111 dental records were audited and an overhang was observed in 67 cases. The prevalence of overhangs was greatest on upper molar teeth. Bone loss was calculated from 35 historical sets of bitewing radiographs over a period of up to 25 years. The mean bone loss on the unrestored control teeth was 0.06 mm/year and on the teeth adjacent to the overhangs it was 0.16 mm/year. This difference of 0.1 mm/year was statistically significant (paired t-test, P = 0.01). There was no significant difference between males and females. The mean size of the overhang was 0.9 mm (range 0.4-2.0 mm) with the bigger overhangs being associated with greater bone loss; however, not all ledges were associated in bone loss.Conclusions Restoration overhangs can be associated with increased bone loss and larger overhangs may be most problematic, although other factors are involved as not all ledges caused bone loss.


Assuntos
Perda do Osso Alveolar , Amálgama Dentário , Restauração Dentária Permanente , Feminino , Odontologia Geral , Humanos , Masculino , Prevalência
16.
Eur J Dent Educ ; 23(4): 498-506, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31373742

RESUMO

INTRODUCTION: General dentistry is the most common area of practice, and new dentists must have the competency and skills to safely deliver patient care. In New Zealand (NZ), completion of a 5-year Bachelor of Dental Surgery (BDS) degree enables graduates to register with the Dental Council in NZ. This necessitates that the clinical component of the curriculum in final year dentistry (BDS5) transparently delivers learning opportunities and evaluates competency for independent practice. A review of the BDS5 Clinical Practice course was undertaken in 2015 and a revised curriculum introduced in 2016. CURRICULUM: We present a BDS5 curriculum for a Clinical Practice course that is learner focused with emphasis on comprehensive patient-centred care, competency and professional practice. Learning opportunities and assessment processes are described alongside teacher training. These changes have provided students scaffolding to support clinical and professional development, and accommodate different learning preferences. The outcomes align with the competency requirements of the NZ regulatory body for registration as a general dental practitioner. Since its introduction 3 years ago, ongoing feedback from students and staff has been positive and indicates the curriculum is effective in achieving its objectives. CONCLUSIONS: This curriculum provides a firm foundation for students transitioning to independent clinical practice in the community and supports the professional development of clinical teachers. It may also be translated to other areas of health education to ensure the delivery of quality holistic patient care.


Assuntos
Profissionalismo , Currículo , Odontologia , Odontologia Geral , Humanos , Nova Zelândia
17.
PLoS One ; 14(8): e0219931, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31430291

RESUMO

OBJECTIVE: In the last 30 years, innovations in oral healthcare (OHC), such as advanced restorative techniques, shifts towards preventive and evidence-based care and changes in patients' expectations, have increased the complexity of clinical decision-making in OHC. Little is known about the perspectives of general dental practitioners (GDPs) on the value of providing preventive, patient-centred and evidence-based OHC. This study aimed to explore the range of perspectives present amongst GDPs on OHC. METHOD: Q-methodology was used to explore perspectives among 78 GDPs working in the Netherlands. Participants were asked to sort 50 statements representing three central domains in OHC: i.) restorative versus preventative OHC, ii.) disease-centred versus patient-centred OHC and iii.) expertise-based versus evidence-based OHC. Opinion statements about delivering OHC were formulated on the basis of published literature and input from OHC professionals. By-person factor analysis was used to reveal clusters of communality in statement rankings, which were interpreted and formed perspectives on OHC. RESULTS: Four perspectives, explaining 47% of variance, on OHC were identified amongst GDPs: 'the patient-focused dentist who values prevention', 'the outcome-oriented dentist who values learning from colleagues', 'the team player with ultimate care responsibility' and 'the dentist who considers oral health the responsibility of the patient.' CONCLUSION: Q-methodology can be effectively used to describe the different perspectives that GDPs have on the challenges of preventive, patient-centred and evidence-based OHC. GDPs should not be seen as a homogenous group; rather they have different views and approaches to the care they provide. This has implications for health systems; awareness of the heterogeneity of practitioners' perspectives can potentially be used to develop bespoke quality of care improvement strategies that constructively engage with each of these different groups.


Assuntos
Atitude do Pessoal de Saúde , Odontologia Baseada em Evidências , Odontologia Geral , Odontologia Preventiva , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
18.
Quintessence Int ; 50(8): 612-623, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428749

RESUMO

OBJECTIVES: The purpose of this article was to propose guidelines for dental practitioners facing the dilemma whether to treat, follow up, or disregard random asymptomatic radiographic findings. DATA SOURCES: Searches performed in MEDLINE, Cochrane, and EMBASE databases were followed by a manual search. Related data incorporated by experts included recommendations on asymptomatic root canal treatment, quality of the root canal, and restoration relative to outcome. Evidence tables were developed following quality and inclusion criteria assessment. RESULTS: The initial search retrieved 2,796 MEDLINE, 542 EMBASE, and 152 Cochrane articles, for a total of 3,490 potential articles. After duplicates were removed, 2,946 articles remained. Articles not related to the topic and not meeting eligibility criteria were excluded, resulting in 44 studies included in this scoping review. CONCLUSIONS: The proposed guidelines provide easy access to existing information in endodontics. The findings are common and possess clinical and medico-legal importance.


Assuntos
Cavidade Pulpar , Endodontia , Odontologia Geral/normas , Humanos , Guias de Prática Clínica como Assunto , Tratamento do Canal Radicular
19.
Dent Mater ; 35(10): 1506-1513, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31421955

RESUMO

OBJECTIVES: The aim of this retrospective methodology study was to investigate the influence of using different definitions for restoration failure and inclusion criteria on restoration longevity expressed in AFR. METHODS: EPF from fifteen general dental practices were used for collecting the data for this study. From the EPF, 321,749 composite restorations placed in 52,245 patients by forty-seven GDPs between January 2000 and December 2011 were included. Kaplan-Meier statistics were applied and mean AFRs over 2, 5 and 10 years were calculated. The effect on the AFR of using different levels of failure: based on Claims data (CD), Success (SUC), Survival (SUR) and different inclusion criteria of tooth/restoration variables were reported. RESULTS: Highest AFRs were found for level CD, in which every intervention was considered as failure, and the lowest AFRs for level SUR in which repairs and an endodontic treatments were not considered as a failure. AFRs increased when the observation period prolonged especially for SUR, followed by SUC and CD. An overview of long-term survival studies showed a wide variation in study design, performed clinical examination (USPHS criteria or GDP), number of restorations included, description of restoration failure and found AFRs for CD, SUC and SUR. SIGNIFICANCE: Using failure criteria, Success and Survival, in future clinical studies would enable a better comparison of studies as well as demonstrate the impact of more conservative restorative intervention protocols on patient care.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Resinas Compostas , Falha de Restauração Dentária , Odontologia Geral , Humanos , Estudos Retrospectivos
20.
Braz Dent J ; 30(4): 374-379, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340228

RESUMO

Antibiotic resistance is a growing public health concern. Antibiotics continue to be prescribed by some clinicians to resolve dental pain even though research indicates that antibiotics are not effective for treating conditions such as irreversible pulpitis. The objective of this study was to determine the extent to which current research and evidence around irreversible pulpitis has been translated into dental practice and the gaps in dentists' knowledge. An on-line clinical vignette format survey questionnaire about treatment of irreversible pulpitis was distributed to the members of the Academy of Operative Dentistry and Academy of General Dentistry (US based international dental bodies). Their responses were recorded and evaluated. A total of 403 dentists participated in the survey. Over a third (39.3%) indicated they would prescribe antibiotics for symptomatic irreversible pulpitis in a permanent tooth occurring without any signs of systemic infection. The rest indicated they would not prescribe antibiotics; most of them would prescribe an analgesic combined with pulpectomy. Those who had undertaken advanced education training achieved a significantly higher mean knowledge score compared to those with just a primary dental degree (p=0.011). Similarly, full or part time academicians had a higher mean knowledge score than the clinicians who work only in private practice (p=0.014). Some dentists continue to prescribe antibiotics inappropriately for alleviating pain due to irreversible pulpitis. Antibiotic prescribing practices of dentists with advanced education or academic engagement were better as compared to the other participants. There is clear evidence of antibiotic over-prescribing for irreversible pulpitis which needs to be addressed urgently.


Assuntos
Antibacterianos , Pulpite , Odontólogos , Odontologia Geral , Humanos , Odontalgia
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