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1.
Braz Oral Res ; 33: e115, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939497

RESUMO

The aim of this study was to investigate how Brazilian dentists perceive and manage dentin hypersensitivity (DH) in their clinical routine. A 13-item questionnaire-based survey was developed and sent electronically to a convenience sample of dentists. The questionnaire assessed the personal and dental practice characteristics of the sample, the occurrence of DH in their daily clinical practice, and management strategies. The data were analyzed descriptively and together with the chi-square test (a = 0.05). A total of 353 responses were obtained from September 2017 to March 2018. Of all the respondents, 62% were females, 49.9% reported fewer than five years of dental practice, and 70.5% were self-identified as private practitioners. Most of the dentists reported an estimated frequency (30-60%) of patients with DH in their practice. The most frequently cited (91.79%) trigger of DH was air blast and/or scratching with a probe. The first-choice strategy to manage DH was a dentin desensitizer (48.16%). The number of years in clinical practice did not influence DH relapse frequency (p = 0.76) significantly, or consider DH treatment as a problem (p = 0.22). The present findings indicate that, regardless of clinical experience, dentists in Brazil still consider DH management a challenge in their daily dental practice. In addition, the results suggest that guidelines should be developed to disseminate the available knowledge regarding this condition in ways that may influence decision-making processes among practitioners.


Assuntos
Sensibilidade da Dentina/terapia , Gerenciamento Clínico , Padrões de Prática Odontológica/estatística & dados numéricos , Brasil , Tomada de Decisão Clínica , Dessensibilizantes Dentinários/uso terapêutico , Odontólogos/estatística & dados numéricos , Feminino , Humanos , Masculino , Inquéritos e Questionários
2.
BMC Oral Health ; 20(1): 23, 2020 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-31996198

RESUMO

BACKGROUND: This study, by using a variable-controlled survey model, sought to compare clinical decisions made by dentists with different clinical backgrounds in South Korea regarding teeth with apical periodontitis and to identify factors that influenced decision-making. METHODS: A questionnaire with 36 questions about identical patient information, clinical signs, and symptoms was filled out by participants. Each question referred to a radiograph that had been manipulated using computer software in order to control tooth-related factors. Participants were instructed to record their demographic information and choose the ideal treatment option related to each radiograph. Simple and multivariable logistic regression analyses (p < .05) were used to investigate factors related to the decision to extract the tooth. We divided factors into dentist-related factors (gender, years of experience, and professional registration) and tooth-related factors (tooth position, coronal status, root canal filling status, and size of the periapical radiolucency). Dentists were categorized into three groups, based on professional registration: general dental practitioners (GDPs), endodontists, and other specialists. Simple logistic regression analysis (p < .05) was used to evaluate the tooth-related factors influencing extraction, depending on the dentists' specialty. RESULTS: Participants mostly preferred saving the teeth over extraction. This preference was highest among the endodontists, followed by other specialists and GDPs. Extractions were significantly preferred for molars, teeth with previous root canal fillings, and those with apical lesions greater than 5 mm. CONCLUSIONS: This study suggests that dentists' decision-making regarding teeth with apical periodontitis was associated with their work experience and specialty and influenced by tooth position, root canal filling status, and size of the apical lesion. CLINICAL RELEVANCE: This survey revealed that clinical decision-making related to teeth with apical periodontitis was affected by dentists' specialty and work experience and by tooth-related factors, such as tooth position, root canal filling status, and size of the apical lesion.


Assuntos
Tomada de Decisão Clínica/métodos , Odontólogos/psicologia , Periodontite Periapical , Padrões de Prática Odontológica/estatística & dados numéricos , Tratamento do Canal Radicular , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite Periapical/diagnóstico , Periodontite Periapical/terapia , República da Coreia , Inquéritos e Questionários
3.
Am J Orthod Dentofacial Orthop ; 156(3): 312-325, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474261

RESUMO

INTRODUCTION: This aim of this paper is to describe and identify the practitioner and patient characteristics that are associated with treatment recommendations for adult anterior open bite patients across the United States. METHODS: Practitioners and patients were recruited within the framework of the National Dental Practice-Based Research Network. Practitioners were asked about their demographic characteristics and their treatment recommendations for these patients. The practitioners also reported on their patients' dentofacial characteristics and provided initial cephalometric scans and intraoral photographs. Patients were asked about their demographic characteristics, previous orthodontic treatment, and goals for treatment. Four main treatment groups were evaluated: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. Extractions were also investigated. Predictive multivariable models were created comparing various categories of treatment as well as extraction/nonextraction decisions. RESULTS: Ninety-one practitioners (mostly orthodontists) and 347 patients were recruited from October 2015 to December 2016. Increased aligner recommendations were associated with white and Asian patients, the presence of tongue habits, and female practitioners. TADs were recommended more often in academic settings. Recommendations for orthognathic surgery were associated with demographic factors, such as availability of insurance coverage and practitioner race/ethnicity, and dentofacial characteristics, such as anteroposterior discrepancies, more severe open bites, and steeper mandibular plane angles. Extraction recommendations were largely associated with severe crowding and incisor proclination. CONCLUSIONS: Both doctor and patient demographic factors, as well as dentofacial characteristics, were significantly associated with treatment recommendations for adult anterior open bite patients.


Assuntos
Mordida Aberta/terapia , Ortodontia Corretiva/estatística & dados numéricos , Ortodontistas/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Idoso , Cefalometria , Feminino , Humanos , Incisivo , Masculino , Mandíbula , Pessoa de Meia-Idade , Mordida Aberta/diagnóstico por imagem , Mordida Aberta/epidemiologia , Aparelhos Ortodônticos/estatística & dados numéricos , Ortodontia Corretiva/instrumentação , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos , Inquéritos e Questionários , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Técnicas de Movimentação Dentária/estatística & dados numéricos , Estados Unidos/epidemiologia
4.
Braz Oral Res ; 33: e076, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31432927

RESUMO

The aim of this study was to assess the frequency of opioid analgesics prescribed by Brazilian dentists, potential regional differences and their association with socioeconomic and health-related factors. Data for all opioid prescriptions by dentists was obtained from the 2012 database of the National Controlled Substances Management System, regulated by the Brazilian Health Surveillance Agency. The number of defined daily doses (DDD) and DDDs per 1,000 inhabitants per day for each Brazilian state were calculated as the primary outcomes. DDDs were compared by regions and Brazilian states. Spearman's rho correlation coefficient was used to determine the influence of the states' characteristics, such as the Human Development Index; poverty; education; number of dentists per 100,000 inhabitants; visit to the dentist; dental care plan; good or very good oral health; number of pharmaceutical establishments per 100,000/inhabitants; and ability to get all prescribed medications. Data analysis was performed using IBM SPSS Statistics 25.0. A total of 141,161 prescriptions for opioids analgesics by 36,929 dentists were recorded, corresponding to 658,855 doses of opioids dispensed in 2012. The most commonly dispensed opioids were codeine associated with paracetamol (83.2%; n = 117,493). The national DDDs per 1,000 inhabitants per day was 0.0093 (range: 0.0002-0.0216). DDD per 1,000 inhabitants per day was positively associated to visits to dentists (rs = 0.630; P < 0.001) and inversely associated to poverty (rs = -0.624; p = 0.001). There are significant differences in opioid prescriptions in dentistry among the Brazilian states. These differences may be associated with non-clinical factors.


Assuntos
Analgésicos Opioides/uso terapêutico , Assistência Odontológica/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Acetaminofen/uso terapêutico , Brasil , Codeína/uso terapêutico , Estudos Transversais , Uso de Medicamentos/estatística & dados numéricos , Humanos , Farmácias/estatística & dados numéricos , Valores de Referência , Fatores Socioeconômicos , Estatísticas não Paramétricas , Tramadol/uso terapêutico
5.
BMC Oral Health ; 19(1): 179, 2019 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387573

RESUMO

BACKGROUND: Screening for medical conditions (MCs) of public health importance is a first step in disease prevention and control. Prior studies in the United States found oral health care providers (OHCPS) embrace screening for increased risk of medical conditions in the dental setting. Our objectives were to assess Saudi Arabian (SA) dentist's attitudes, willingness and perceived barriers towards implementing screening for MCs into their dental practices. METHODS: A self-administered, 5-point Likert Scale (1 = very important/willing to 5 = very unimportant/unwilling) questionnaire was given to a convenience sample of 190 practicing dentists. Friedman nonparametric analysis of variance was used to compare responses within each question. RESULTS: Of the 143 responding dentists the mean age was 31 years; 102 (71%) were men. The majority felt it was important for a dentist to screen for cardiovascular disease (98.6%), hypertension (97.9%), diabetes (97.9%), human immunodeficiency virus (HIV) (97.9%), and hepatitis C virus (98.6%). Respondents were willing to refer a patient to a physician (97.9%); send samples to an outside laboratory (96.1%); conduct screening that yields immediate results (96.2%); and discuss results immediately with the patient (93.7%). Respondents were willing to measure/collect blood pressure (67.2%); weight and height (63.7%); and finger stick blood (54.6%). The whole responding dentists (100%) reported time as an important barrier. Respondents were significantly more willing to refer a patient for consultation than send samples to an outside laboratory (mean ranks: 2.32, 2.81, P < 0.001); significantly more willing to measure blood pressure than take oral fluids for salivary diagnostics (mean ranks 2.22, 2.75, p = 0.003). Insurance was significantly (P < 0.05) less important barrier than time, cost, patients' willingness or liability (mean ranks 3.56, 2.63, 3.00, 2.79, 3.02, respectively). CONCLUSIONS: The majority of dentists in this study reported positive attitudes towards and willingness to perform medical screenings in their practice. Time was an important factor.


Assuntos
Atitude do Pessoal de Saúde , Assistência Odontológica/métodos , Odontólogos/psicologia , Programas de Rastreamento/métodos , Padrões de Prática Odontológica/estatística & dados numéricos , Adulto , Estudos Transversais , Serviços de Saúde Bucal , Odontólogos/estatística & dados numéricos , Feminino , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Arábia Saudita , Inquéritos e Questionários
6.
Acta Odontol Scand ; 77(8): 617-623, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31271077

RESUMO

Objectives: To collect information on endodontic treatment procedures among dentists in the public dental service (PDS) in Western Norway and relate this information to their work experience. Materials and methods: A survey comprised of 35 questions related to personal information, frequency of endodontic treatment, endodontic procedures and treatment principles was distributed electronically to 187 dentists in PDS in two counties of Western Norway. Results: The response rate was 74%, and 130 dentists participated. Among them, 57.0% had completed their education less than 13 years ago, and almost all were below 39 years old (95%). The majority (81.0%) had graduated in Norway. Stepwise caries excavation in primary and permanent teeth and direct pulp capping in primary teeth were more frequently performed by dentists with less than 13 years from graduation. Routine use of rubber dam was high among the responders (87%). However, use of rubber dam and master-cone radiograph uptakes were more frequent among the younger dentists. The majority used rotary instrumentation systems, and almost all participants followed the current guidelines for use of antibiotics in endodontics. Conclusions: In general, dentists in PDS follow the current endodontic treatment guidelines. However, it seems that the more recently graduated dentists perform more endodontic procedures and tend to adhere more to the taught principles regarding rubber dam use and radiograph uptakes.


Assuntos
Endodontia , Padrões de Prática Odontológica , Adulto , Odontólogos , Endodontia/estatística & dados numéricos , Humanos , Noruega , Padrões de Prática Odontológica/estatística & dados numéricos , Inquéritos e Questionários
7.
BMC Oral Health ; 19(1): 112, 2019 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200689

RESUMO

BACKGROUND: Few published reports have presented concordance between treatment choices selected by dentists in hypothetical clinical scenarios and treatment choices made by the same dentists in actual clinical practice. The aim of the current cross-sectional study, conducted within the Management of Dental Hypersensitivity (MDH) study, was to assess the potential value of practitioners' questionnaire responses regarding their typical treatment provided for management of dentin hypersensitivity (DH), by evaluating agreement between these responses and subsequently-observed recommendations recorded during actual clinical examinations. METHODS: A total of 171 practitioners enrolled in the National Dental Practice-Based Research Network completed both a questionnaire and a clinical study regarding methods they use to treat dental hypersensitivity. The questionnaire solicited first-, second- and third-choice products when prescribing or recommending management of dentin hypersensitivity. Agreement was calculated for first-choice products/recommendations and for inclusion in the top three choices, as identified by the practitioners, from 11 listed treatment options. Overall percent agreement and Cohen's kappa statistic were calculated, with associated 95% confidence intervals (CI). Associations between practitioner characteristics and agreement were also evaluated. RESULTS: For individual treatment modalities, percentage agreement ranged from 63 to 99%, depending on the specific item. Percentage agreement between typical treatment and actual treatment for each practitioner's top three treatment modalities, as a combined grouping, ranged from 61 to 100%. When these same agreement pairings were quantified to account for agreement above that expected by chance, kappa values were poor to low. CONCLUSIONS: Concordance between hypothetical clinical scenarios and treatment choices made by the same dentists in actual clinical practice showed moderate to high levels of percentage agreement, but Cohen's kappa values suggested relatively low levels of agreement beyond that expected by chance. This analysis adds to the larger work of the network which has now observed a wide range of agreement between hypothetical and actual care, depending upon the specific diagnosis or treatment under consideration. Questionnaire data for DH might serve as a useful adjunct to clinical data regarding treatment recommendations, but agreement was not sufficiently high to justify use of questionnaires alone to characterize patterns of treatment for this particular condition.


Assuntos
Sensibilidade da Dentina/diagnóstico , Sensibilidade da Dentina/prevenção & controle , Odontólogos , Padrões de Prática Odontológica/estatística & dados numéricos , Inquéritos e Questionários , Tomada de Decisão Clínica , Estudos Transversais , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
8.
Asian Pac J Cancer Prev ; 20(5): 1531-1536, 2019 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-31128059

RESUMO

Background: Oral cancer signifies a public health concern of international importance. Early detection of oral cancer can improve the prognosis and the 5-year survival rate. Objective: The aim of this study was to assess the level of oral cancer knowledge, opinion, attitudes and practices among dentists working at the primary oral health care centers in Kuwait. Methods: In this cross-sectional study, self-reported questionnaire was distributed to the dentists working at the primary oral health care centers in Kuwait. A total of 289 dentists participated in the present study. The questionnaire included 23- questions on oral cancer knowledge, opinion, attitudes and practices. Results: The mean age of the dentists was 35.2 ± 10.9 years. Approximately, all dentists (99.7%) were aware of the major risk factors that were most likely associated with oral cancer. Overall, majority of the participants knew the most common form of oral cancer (80.6%), most common site (80.3%) and the likely lesions associated with oral cancer occurrence (87.9%). A large number of dental practitioners (81%) would routinely refer a patient with a suspicious lesion to a specialist. Nearly one-third (32%) reviewed their patients' oral cancer risk factors. Approximately two-thirds (62%) assessed the use of tobacco in their practice. Almost, all (92.4%) were interested in attending continuing education courses on oral cancer. Conclusions: Majority of the participants presented good knowledge about various aspects of oral cancer. More continuing education programs on risk factors and diagnosis of oral cancer should be organized to train the dentists. Oral cancer screening should be a routine procedure for the high risk patients at the primary oral health care centers in Kuwait.


Assuntos
Odontólogos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Bucais/diagnóstico , Padrões de Prática Odontológica/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Kuweit , Masculino , Saúde Bucal , Fatores de Risco , Autorrelato , Inquéritos e Questionários
9.
Pediatr Dent ; 41(2): 127-131, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992110

RESUMO

Purpose: Dental caries affects 23 percent of U.S. children aged two to five years old. 1 Stainless steel crowns (SSCs) are used for extensive caries and offer greater longevity than other restorations; however, disparity exists between pediatric and general dentists in restoration type provided. The purpose of this study was to evaluate utilization of stainless steel crowns among pediatric and general dentists by reviewing insurance claims. Methods: Data were obtained from a commercial dental insurance claims data warehouse from more than 50 dental insurance plans and multiple carriers in the United States for children 12 years old and younger. Data were examined for treatment of the primary dentition using SSCs or direct restorations. A generalized linear mixed effects model tested differences in the utilization of SSCs by general dentists (GDs) versus pediatric dentists (PD). Results: The data included 107,487 GDs and 5,395 PDs. The records included 2,555,726 claims for direct restorations and 440,423 claims for SSCs. PDs are more likely to place SSCs compared to GDs (odds ratio equals 3.2; P<0.0001). Conclusions: Pediatric dentists are more likely to restore carious primary dentitions with stainless steel crowns than general dentists. Perhaps increased training at the dental undergraduate level and access to more continuing education courses for general dentists would increase the utilization of SSCs.


Assuntos
Coroas , Odontologia Geral/estatística & dados numéricos , Odontopediatria/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Aço Inoxidável , Criança , Pré-Escolar , Humanos , Lactente , Estados Unidos
10.
Acta Odontol Scand ; 77(6): 434-438, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30835605

RESUMO

Objective: The purpose of this study was to investigate endodontic infection prevention and control routines among general dental practitioners in Sweden and Norway. Materials and methods: A questionnaire was sent by email to 1384 general dental practitioners employed in Sweden and Norway. The participants were asked questions concerning different aspects of infection prevention and control during endodontic treatment; use of rubber dam, sealing of rubber dam, antibacterial solutions, and use of hand disinfectant and gloves. Results: The response rate was 61.4% (n: 819). 96.9% reported routinely using rubber dam during endodontic treatment. 88.3% reported always, or sometimes, sealing the area between rubber dam and tooth. Most disinfected the endodontic operative field, but the antibacterial solutions used varied. 11.9% did not use gloves at all during treatment, and 10.5% did not use hand disinfectant during treatment. Conclusions: Most of the general dental practitioners took measures to establish and maintain aseptics during endodontic treatment, which infers an awareness of the importance of endodontic infection prevention and control. But the results were self-reported and there may be a gap between claimed and actual behaviour. Further studies using observation methodologies are needed to assess how infection control routines are performed in everyday clinical practice.


Assuntos
Endodontia , Odontologia Geral/estatística & dados numéricos , Controle de Infecções/métodos , Preparo de Canal Radicular , Tratamento do Canal Radicular , Adulto , Endodontia/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Padrões de Prática Odontológica/estatística & dados numéricos , Inquéritos e Questionários , Suécia
11.
J Dent Educ ; 83(4): 474-482, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30745348

RESUMO

The Isovac system was introduced into the Virginia Commonwealth University dental curriculum with the intention that it would be used as a substitute when the dental dam could not be placed. The aim of this study was to determine the usage and factors that influenced dental students' decisions to use the dental dam or Isovac. All third-and fourth-year dental students (n=210) were asked in 2017 to complete a 26-item survey. The survey asked about students' operative procedures completed using the dental dam and Isovac, their own and their patients' preferences, basic dental dam knowledge, full-time and adjunct faculty recommendations of method, importance of factors influencing their decisions, and anticipated dental dam use after graduation. Comments were also allowed. A total of 164 students responded to the survey, for a 78% response rate. Of the respondents, 58% said they used the Isovac only when they could not use the dental dam. Among the eight general practice groups in which students are educated in delivery of comprehensive dental care, preference was significantly different for placement of Class II restorations. Overall, the students' dental dam knowledge was low, and the knowledge results were not associated with its use. According to the students, recommendations by full-time and adjunct faculty members were significantly different. Factors ranked by importance from greatest to least for determining which isolation method to use were as follows: moisture control, procedure, patient comfort, application time, ease of placement, and attending faculty. Student comments overwhelmingly favored dental dam usage if a dental assistant was available. This study found that dental dam and Isovac use was not standardized among the general practice groups and faculty. Student education, faculty calibration, and increased use of trained dental assistants are required to ensure education is consistent among all general practice groups.


Assuntos
Equipamentos Odontológicos , Diques de Borracha , Estudantes de Odontologia/psicologia , Equipamentos Odontológicos/estatística & dados numéricos , Humanos , Padrões de Prática Odontológica/estatística & dados numéricos , Diques de Borracha/estatística & dados numéricos , Sucção/instrumentação , Inquéritos e Questionários
12.
Rev Saude Publica ; 53: 15, 2019 Jan 31.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30726496

RESUMO

OBJECTIVE: To evaluate whether characteristics of health services, oral health team and dental surgeon are associated with provision of dental care for children up to five years old in Brazilian Primary Health Care. METHODS: A cross-sectional study was conducted with data from 18,114 oral health teams in Brazil, evaluated in 2014 by the National Program for Access and Quality Improvement in Primary Care. The study outcome was the proven performance of dental procedures on children up to five years old. Statistical analysis was performed by Poisson regression based on a hierarchical model, where the first level was composed of service organization variables, the intermediate level composed of unit planning characteristics, and the proximal level composed of variables related to dental surgeon characteristics. RESULTS: Prevalence of dental care performed by oral health teams was 80.9% (n = 14,239). Scheduled appointments and activities of education in health were positively associated with the outcome, as well as planning and programming activities for the population and monitoring and analysis of oral health indicators. Complementary training in public health, continuing education activities and career plan were variables related to dental surgeons associated with the service provision. CONCLUSIONS: One fifth of health units in Brazil do not provide dental care for children in early childhood. Health units' well-structured organization and planning protocols are associated with the provision of this service, as well as better employment relationship and graduate activities for dental surgeons.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Brasil , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Distribuição de Poisson
13.
Pediatr Dent ; 41(1): 25-30, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30803473

RESUMO

Purpose: The purposes of this study were to investigate prescribing patterns of antibiotics for the management of common pediatric oral infections, and to and identify the independent predictors of antibiotic preference across different groups of dental practitioners in Massachusetts, USA. Methods: A cross-sectional survey assessed antibiotic prescribing practices of general dentists, pediatric dentists, endodontists, and oral surgeons based on a series of clinical scenarios where antibiotic coverage may be warranted. Results: The appropriate therapeutic management of patients with facial cellulitis occurred across all clinical groups. Endodontists were least likely to prescribe antibiotics for patients with irreversible pulpitis, and those with pulpal necrosis with associated parulis. Seventy-four percent of respondents prescribed antibiotics for patients suffering from pericoronitis and trismus. Conclusion: With the exception of the management of facial cellulitis, adherence to published guidelines for the prescription of antibiotics is low. Specifically, antibiotics are being prescribed too often for patients with tooth pain or localized abscesses and infrequently when the systemic spread of infection is less obvious, such as with trismus but no fever. Universally promulgated guidelines formulated by professional bodies may lead to improved adherence and a reduction in negative outcomes resulting from the overprescription of antibiotics.


Assuntos
Antibacterianos/uso terapêutico , Padrões de Prática Odontológica/estatística & dados numéricos , Estudos Transversais , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Massachusetts , Odontopediatria/estatística & dados numéricos , Odontopatias/tratamento farmacológico
14.
J Dent ; 82: 38-44, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711602

RESUMO

OBJECTIVES: Although stress is prevalent amongst dentists, there is a paucity of data on the impact of stressors on dentists' clinical performance. To address this gap in the literature, the aim of the present study was to explore the role of time pressure, representing one common stressor, on dentists' radiographic diagnostic performance. METHODS: Forty dentists were randomised to examine and provide a radiographic report on two sets of radiographs (six bitewings in each set) under two conditions on a cross-over basis: time-pressure vs. no-time-pressure. The radiographic report of an experienced consultant was considered the gold standard against which participants diagnostic decisions were compared to calculate sensitivity and specificity. Participants rated their stress after each experimental condition using a 100 mm visual analogue scale (VAS). RESULTS: The VAS scores for stress were significantly higher in the time pressure condition vs. no time pressure condition (mean: 55.78 versus 10.73, p < 0.0001), indicating that the time pressure acted as a source of stress. Dentists' diagnostic performance was affected; the sensitivity was significantly lower under time pressure (median: 0.50 versus 0.80, p < 0.0001), but by contrast, the median diagnostic specificity was 1.00 under both conditions. CONCLUSIONS: Time pressure negatively impacts one aspect of dentists' diagnostic performance, namely sensitivity (increased diagnostic errors and omissions of pathology), which can potentially affect patient safety and the quality of care delivered. However, time pressure was found to have less influence on diagnostic specificity. CLINICAL SIGNIFICANCE: The present study demonstrated a significant deterioration of dentists' diagnostic performance (sensitivity) under time-pressure when examining bitewing radiographs. Diagnostic errors may put patient safety at risk, with patients potentially being harmed if pathology is missed. Such errors can have medicolegal implications on the dentists' practice.


Assuntos
Odontólogos , Diagnóstico , Estresse Ocupacional , Padrões de Prática Odontológica , Tempo , Adulto , Tomada de Decisões , Odontólogos/psicologia , Odontólogos/estatística & dados numéricos , Diagnóstico por Imagem/psicologia , Diagnóstico por Imagem/normas , Feminino , Humanos , Pessoa de Meia-Idade , Estresse Ocupacional/psicologia , Padrões de Prática Odontológica/estatística & dados numéricos , Distribuição Aleatória
15.
Curr Diabetes Rev ; 15(1): 67-73, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29852874

RESUMO

OBJECTIVES: The study was conducted to assess the utilization of medical and dental services by dental patients at two dental school hospitals and to approximate the number of patients having no known previous diagnosis of type 2 diabetes but are at high risk of acquiring it. METHODS: A cross-sectional study was conducted at two dental school hospitals in India. A 20-item questionnaire was administered as interviews among the dental patients aged 35 to 55 years. Data was collected on past dental and medical visits, medical history, family history relevant to diabetes, cardiovascular health, BMI and waist circumference (measured). RESULTS: A total of 413 adult patients (males 61.26%, females 38.74%) participated in the surveys. The mean age was 43.06 years. Results revealed that nearly 50% did not have a medical or a dental visit in the last 1 year, 33% had Cardiovascular Diseases (CVD). Among those who did not have medical visit in last one year 45% had BMI >25 kg, 55% had waist circumference above the normal range and 38% were at high risk of diabetes. CONCLUSION: The high number of patients without a medical visit in the past year or more, as well as the high levels of diabetes risk indicators, affirms the need for dentists to perform chair-side screenings for diabetes. These results suggest the need for additional training among dental students to improve early detection and identification of high-risk patients to minimize potential morbidity due to diabetes.


Assuntos
Odontólogos/estatística & dados numéricos , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Visita a Consultório Médico/estatística & dados numéricos , Papel do Médico , Adulto , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Estudos de Viabilidade , Feminino , Humanos , Índia/epidemiologia , Masculino , Programas de Rastreamento/normas , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Padrões de Prática Odontológica/estatística & dados numéricos , Fatores de Risco , Inquéritos e Questionários
16.
Dent Traumatol ; 35(1): 27-32, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30318843

RESUMO

BACKGROUND/AIM: Dental trauma is a public health issue with a high prevalence in children. The aim of this study was to evaluate the level of knowledge of dentists in Rio Grande do Sul, Brazil, of the management of traumatic dental injuries, using the International Association of Dental Traumatology (IADT) Guidelines as a reference. MATERIALS AND METHODS: An electronic questionnaire investigating personal and professional characteristics and 12 questions about dento-alveolar trauma, was sent to all registered dentists of the Regional Council of Dentistry of Rio Grande do Sul (n=14 753). The respondents were grouped according to the sociodemographic and professional profiles and the data were evaluated by the Student-T test or one-way ANOVA, with Tukey's post-hoc, with α = 5%. RESULTS: A total of 1414 dentists responded to the survey (9.59% response rate). The overall mean self-reported knowledge of dental trauma was 5.87 ± 1.57, of a maximum possible score of 12. Some factors associated with a higher knowledge of the IADT guidelines were: female gender, previous clinical experience, years from qualification, self-reported knowledge, and academic postgraduate degree. Dentists who are specialized in endodontics (6.58 ± 1.63) and pediatric dentistry (6.05 ± 1.44) achieved higher levels of knowledge on dental trauma. Analysis of the characteristics (gender, location, and proportion of specialists) of the respondents confirmed that they were representative of the target population. CONCLUSION: The overall level of knowledge of dentists from Rio Grande do Sul of the IADT guidelines is moderate. These results highlight the need for continuing education on dento-alveolar trauma in this population.


Assuntos
Fidelidade a Diretrizes , Conhecimentos, Atitudes e Prática em Saúde , Guias de Prática Clínica como Assunto , Padrões de Prática Odontológica/estatística & dados numéricos , Traumatismos Dentários/diagnóstico , Traumatismos Dentários/terapia , Adulto , Brasil , Feminino , Humanos , Masculino , Inquéritos e Questionários
17.
Acta Odontol Scand ; 77(2): 150-157, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30422025

RESUMO

OBJECTIVE: The present study aims to gain knowledge about the dentist's use and choice of digital extraoral imaging methods, panoramic radiography and cone beam computed tomography (CBCT). MATERIALS AND METHODS: A questionnaire sent to 2481 dentists within the Swedish Dental Society contained questions about the panoramic technique and CBCT technique used, education, clinic size and type of service. The response rate was 53%. RESULTS: The study showed that 61% of the Swedish dentists had access to panoramic techniques and that 84% used a direct digital sensor, while 6% used storage phosphor plate techniques. Around 8% of the Swedish dentists had access to CBCT. It was also observed that group practices had two times higher odds of having panoramic equipment compared with solo practices. Approximately 40% of the dentists had undergone postgraduate education in oral radiology during the last 5 years. Dental nurses and dental hygienists exposed 92% of the panoramic radiographs and 75% of the CBCTs. Thirty per cent of those clinics with access to a panoramic unit exposed >30 panoramic radiographs per month and 56% of the clinics having access to CBCT did more than 75 examinations per year. CONCLUSIONS: Today 61% of Swedish dentists have access to panoramic radiography and 8% have access to CBCT. There is a greater likelihood of having access if the dentist works in the public dental health service or in a group practice and if the dentist has undergone any postgraduate course in oral radiology.


Assuntos
Atitude do Pessoal de Saúde , Odontologia Geral/métodos , Padrões de Prática Odontológica/estatística & dados numéricos , Radiografia Dentária Digital/normas , Tomografia Computadorizada de Feixe Cônico , Odontólogos/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Radiografia Dentária Digital/métodos , Radiografia Panorâmica , Inquéritos e Questionários , Suécia
18.
J Prosthodont ; 28(2): 122-130, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30412320

RESUMO

PURPOSE: Some crowns returned from the laboratory are clinically unacceptable, and dentists must remake them. The objectives of this study were to: (1) quantify the remake rate of single-unit crowns; and (2) identify factors significantly associated with crown remakes and intraoral fit. MATERIALS AND METHODS: Dentists participating in the National Dental Practice-Based Research Network recruited patients needing crowns and documented fabrication techniques, patient characteristics, and outcomes. Crowns were considered clinically acceptable or rejected. Also, various aspects of the clinical fit of the crown were graded and categorized as 'Goodness of Fit (GOF).' Dentist and patient characteristics were tested statistically for associations with crown acceptability and GOF. RESULTS: More than 200 dentists participated in this study (N = 205) and evaluated 3750 single-unit crowns. The mean age (years) of patients receiving a crown was 55. The remake rate for crowns was 3.8%. The range of rejection rates among individual practitioners was 0% to 42%. Most clinicians (118, or 58%) did not reject any crowns; all rejections came from 42% of the clinicians (n = 87). The most common reasons for rejections were proximal misfit, marginal errors, and esthetic failures. Fewer years in practice was significantly associated with lower crown success rates and lower fit scores. GOF was also associated with practice busyness and patient insurance status, patient gender (dentists reported better fit for female patients), and patient ethnicity. CONCLUSIONS: The crown remake rate in this study was about 4%. Remakes and crown GOF were associated with certain dentist and practice characteristics.


Assuntos
Coroas , Planejamento de Prótese Dentária , Padrões de Prática Odontológica/estatística & dados numéricos , Tomada de Decisões , Estética Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Estados Unidos
19.
J Prosthodont ; 28(2): 113-121, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28273692

RESUMO

PURPOSE: The purpose of this questionnaire was to ask general dentists in private practice in the state of Iowa about the extent and scope of their prosthodontic practice. MATERIALS AND METHODS: A 22-item questionnaire was developed and tested on 5 general dentists. The Iowa Dental Association agreed to electronically distribute the survey to all general practice dentists in their database. After three rounds, a total of 289 responses were received from the 996 general dentists in the database. RESULTS: The average age of the respondents was 50.3 ± 13.2 years (range 28 to 78 years), and 56.3% were in solo practice. The respondents stated that 68.1% had made at least one set of complete dentures and 88.9% had made a removable partial denture (RPD) in the last 3 months, while 76.4% had restored a least one implant in the last 3 months and 11.6% had surgically placed one. Nearly 20% of the respondents had a digital impression scanner in their office. There was a statistically significant difference between the dentists who had made complete dentures in the past 3 months and those who had not with regard to age, gender, and years in practice (p < 0.05 for all instances). No significant difference was found between the general dentists who had made an RPD in the past 3 months and those who had not. Compared to their counterparts, general dentists who had an AEGD or GPR training (p = 0.0312), whose primary practices were in cities of 50,000+ (p = 0.0065), or had a digital scanner (p = 0.0062) and a CAD/CAM milling machine (p = 0.0504) in their office were more likely to have restored an implant in the last 3 months. Furthermore, the general dentists who had surgically placed an implant in the last 3 months were more likely to be male (p = 0.0301) or have a digital impression scanner (p < 0.0001) and/or a CAD/CAM milling machine (p = 0.0007) in their office. CONCLUSIONS: The majority of general dentists in this survey are still making complete and partial removable dentures, and a majority is using implants, while only a minority is surgically placing them. PRACTICAL  IMPLICATIONS: Although Iowa general dentists are carrying out sophisticated procedures such as implant placement and restoring implants, as well as using digital technology, there is still a need for removable prosthodontic services in their practices. Therefore, these skills will still need to be taught in dental school.


Assuntos
Padrões de Prática Odontológica/estatística & dados numéricos , Prostodontia/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Iowa , Masculino , Pessoa de Meia-Idade , Prática Privada , Área de Atuação Profissional , Inquéritos e Questionários
20.
J Prosthodont ; 28(2): e622-e626, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28314082

RESUMO

PURPOSE: To evaluate the use of implant-supported overdentures (IOD) and implant-supported fixed dental prostheses (IFDP) in patients with edentulous mandibles among international prosthodontists. MATERIALS AND METHODS: A questionnaire was sent by e-mail to all clinically active prosthodontists in the International College of Prosthodontists with questions related to implant treatment of the edentulous mandible performed in 2015. RESULTS: One hundred and sixteen prosthodontists from 33 countries responded to the questionnaire. The vast majority of the responding prosthodontists was faculty or worked in private practice, and the great majority had performed treatment with mandibular implant-supported dental prostheses; however, two thirds of the respondents reported that <20% of the implant patients in their clinic had received treatment related to edentulous mandibles. The majority reported using 2 implants (84%), while 13% used 4 for overdenture retention. There were great variations regarding retention systems used for mandibular IODs; the most common was individual Locator attachments. Cost was considered the most common reason to choose mandibular IOD, There was a wide variation of materials used for mandibular IFDPs. The most common combination included milled titanium frameworks and acrylic resin teeth. CONCLUSIONS: This survey, completed by 116 prosthodontists from 33 countries, showed that implant treatment for edentulous mandibles is common, but there was great variation among the respondents regarding amount of treatments performed, design, and materials used for the implant prostheses.


Assuntos
Prótese Dentária Fixada por Implante/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Padrões de Prática Odontológica , Revestimento de Dentadura/estatística & dados numéricos , Humanos , Arcada Edêntula/terapia , Mandíbula , Padrões de Prática Odontológica/estatística & dados numéricos , Inquéritos e Questionários
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