Occupational effects on the family well-being of dentists in Lithuania: a survey of dentists.

BACKGROUND AND OBJECTIVE: Work-related commitments unavoidably interfere with the dentist's everyday life. Therefore, the objective of our study was to assess the impact that a dentist's occupation might have on the family well-being. MATERIAL AND METHODS: The questionnaire was sent to all (N=2449) licensed dentists registered in the Lithuanian Dental Association (response rate, 68.2%). The data were analyzed by means of multiple logistic regression analysis. RESULTS: Most dentists reported difficulties in reconciliation of their professional activities and family life, i.e., insufficient time to spend with a family, necessity to reduce family leisure activities, neglected duties to the family, limited time for hobbies, and work-related anxiety and nervousness at home. These hazardous occupational effects were mainly related to long working hours, which negatively affected all areas of family life. CONCLUSIONS: Occupational hazards, particularly long working hours of dental practitioners, had negative effects on all areas of the dentist's family life. Although dentists frequently faced difficulties in reconciliation of their professional activities and their family interests, in general, they had quite a harmonious family life. The findings suggest that the focus should be on finding the ways to reduce working hours in order to facilitate the reconciliation of a successful dental practice and family life. Additionally, there might be other effective means, e.g., to cope with stress or to develop better working and leisure time management skills.

Factors influencing permanent teeth eruption. Part one--general factors.

Variation in the normal eruption of teeth is a common finding, but significant deviation from established norms should alert the clinician to take some diagnostic procedures in order to evaluate patient health and development. Disturbance in tooth eruption time could be a symptom of general condition or indication of altered physiology and craniofacial development. The aim of this review is to analyze general factors that could influence permanent teeth eruption. The articles from 1965 to 2009 in English related to topic were identified. 84 articles were selected for data collection. Although permanent teeth eruption is under significant genetic control, various general factors such as gender, socioeconomic status, craniofacial morphology, body composition can influence this process. Most significant disturbance in teeth emergence is caused by systemic diseases and syndromes.

[Private or public dental care? Patients' perception and experience in Lithuania]. / Privati ar valstybine odontologine gydymo istaiga? Lietuvos pacientu nuomone ir patirtis.

SUMMARY OBJECTIVE: To compare demographic and social groups of patients, their satisfaction with services in public and private dental institutions. MATERIAL AND METHODS: A random sample of 3000 Lithuanian residents was selected; 1801 participants answered a postal questionnaire. The response rate was 60.0%. Univariate analysis, chi(2) criterion, z-test, and multiple logistic regression were used to evaluate the association between institution type, demographic and social characteristics of the respondents. RESULTS. Less than half of Lithuanian residents (41.2%) visited public dental institutions, 35.9%--private, 25.9%--both. They preferred private dental sector due to better quality of service, public--due to closeness to residence or being the treatment place of acquaintances. Patients visiting public institutions required cheaper treatment, while patients visiting private institutions--qualitative, though more expensive, using modern technologies. The number of dental visits in the past year was lower in public institutions than in private ones. The majority of patients treated in public, private, and both institutions were satisfied with dental services. The least satisfied were visiting both institutions. More respondents with secondary and lower education used public services as compared to those with higher education. Urban population visited public institutions more often than rural population. Respondents with a monthly income of less than 500 Lt for one family member used public dental services more often than those receiving a higher income. Older patients visited public dental institutions more often than younger ones. CONCLUSIONS. More Lithuanian residents are treated in public dental institutions (up to 67.1%) than in private. Older, receiving lower income patients preferred public institutions. The majority of patients in public clinics as well as in private sector are satisfied with the service. Those who visited both types of institutions were least satisfied with dental services.

Who is thought to be a "reliable dentist"? - Lithuanian dentists' opinion.

THE AIM: To find out which attributes, according to Lithuanian dentists, are the most important for a "reliable dentist". MATERIALS AND METHODS: All the 140 participants of republican dentists' conference were given a questionnaire. The response rate was 64,3%. The answers about the importance of dentist's attributes were presented on a 5-point Likert scale. The statistical data analysis, using the chi2 criterion was carried out. RESULTS: The importance of behaviour during painful and unpleasant procedures, painless treatment and ability to control stressful situations was emphasized by 87%, 83% and 76% of respondents. To add, qualification, communication skills, ability to answer patient's questions clearly, respecting patient's confidentiality were accentuated as well by 78%, 82%, 84% and 74% of dentists. Although, gender was not an essential quality for 78% of respondents, 62% of them reported that dentist's age was very important. Those, who are over 30, emphasized the value of erudition (chi2=0.464; p<0.01), punctuality (chi2=25.467; p=0.001), specialization (chi2=15.808; p<0.05), low treatment cost (chi2=17.393; p<0.05) more significantly than their younger colleagues. No need to wait for a dentist's appointment was appreciated more by respondents, whose work experience is over 30 years (chi2=20.601; p<0.05). CONCLUSIONS: Most Lithuanian dentists emphasized the importance of pain management, painless treatment, behaviour during painful and unpleasant procedures, communication skills and ability to answer patient's questions clearly, which are vital for a "reliable dentist".

Validity and reproducibility of cephalometric measurements obtained from digital photographs of analogue headfilms.

UNLABELLED: The emerging market of digital cephalographs and computerized cephalometry is overwhelming the need to examine the advantages and drawbacks of manual cephalometry, meanwhile, small offices continue to benefit from the economic efficacy and ease of use of analogue cephalograms. The use of modern cephalometric software requires import of digital cephalograms or digital capture of analogue data: scanning and digital photography. The validity of digital photographs of analogue headfilms rather than original headfilms in clinical practice has not been well established. Digital photography could be a fast and inexpensive method of digital capture of analogue cephalograms for use in digital cephalometry. AIM: The objective of this study was to determine the validity and reproducibility of measurements obtained from digital photographs of analogue headfilms in lateral cephalometry. MATERIAL AND METHODS: Analogue cephalometric radiographs were performed on 15 human dry skulls. Each of them was traced on acetate paper and photographed three times independently. Acetate tracings and digital photographs were digitized and analyzed in cephalometric software. Linear regression model, paired t-test intergroup analysis and coefficient of repeatability were used to assess validity and reproducibility for 63 angular, linear and derivative measurements. RESULTS AND CONCLUSIONS: 54 out of 63 measurements were determined to have clinically acceptable reproducibility in the acetate tracing group as well as 46 out of 63 in the digital photography group. The worst reproducibility was determined for measurements dependent on landmarks of incisors and poorly defined outlines, majority of them being angular measurements. Validity was acceptable for all measurements, and although statistically significant differences between methods existed for as many as 15 parameters, they appeared to be clinically insignificant being smaller than 1 unit of measurement. Validity was acceptable for 59 of 63 measurements obtained from digital photographs, substantiating the use of digital photography for headfilm capture and computer-aided cephalometric analysis.

Factors related to job satisfaction among Lithuanian dentists.

UNLABELLED: The objective of this study was to evaluate the level of overall job satisfaction among Lithuanian dentists, to explore the satisfaction with different work environmental factors and relate it to overall job satisfaction. MATERIAL AND METHODS: All (N=2449) Lithuanian Dental Chamber members were sent a questionnaire. It comprised a 5-point Likert scale structured questions that were developed according to the Dentist Satisfaction Survey. RESULTS: The level of overall job satisfaction among Lithuanian dentists was 4.06 (95% CI 4.03-4.10) out of 5 of Lickert scale. The least satisfying work areas was social security (2.64, 95% CI 2.59-2.69) and income (2.79, 95% CI 2.74-2.84); the most satisfying area was patient (3.75, 95% CI 3.71-3.78) and professional relations (3.83, CI 3.79-3.87). Reasonable working hours (OR 6.71; 95% CI 1.19-37.75), satisfaction with professional evaluation and appreciation (OR 2.31; 95% CI 1.62-3.30) and income (OR 1.88; 95% CI 1.22-2.89) had the most significant positive impact on dentists' overall job satisfaction. CONCLUSIONS: In general, Lithuanian dentists experience great job satisfaction. Postgraduate studies, not limited possibility for professional development has most positive impact for dentists' overall job satisfaction and work environmental factors are less important for it. Findings of this study show the issues that need special attention to increase the level of job satisfaction among Lithuanian dentists and thus improve all dental care system.

Occupational hazards of dental profession to psychological wellbeing.

OBJECTIVE: The aim of this study was to examine self perceived psychological wellbeing of Lithuanian dentists and to relate complains of well being to occupational hazards of dental profession. MATERIALS AND METHODS: All dentists (2449) registered in Lithuanian Dental Chamber license registry were approached by post questionnaire which included structured questions regarding occupational hazards and their effects on self perceived psychological wellbeing. RESULTS: Overall majority (95.1%) of Lithuanian dentists reported that dental profession influences their general health and more than a half (52.4%) experienced health complains on either a frequent or very frequent basis. Substantial numbers of Lithuanian dentists reported work related stress, fatigue, nervousness and anxiety. Tension before work and awakenings at night were frequent complains. Of all, 94.2% of respondents indicated that long working hours affect their general health and 41.7% were bothered by this condition on a frequent or very frequent basis. Although less than 10% of dentists indicated overwork, they indicated that long working hours influence their psychological wellbeing. CONCLUSION: Substantial numbers of Lithuanian dentists reported different impairment of their psychological well-being. These complains were related to occupational hazards of dental profession.

A scanning electron microscopic study of debris and smear layer remaining following use of AET instruments and K-flexofiles.

AIM: To compare in vitro the cleanliness of root canal walls following automated or manual instrumentation. METHODOLOGY: Thirty extracted human maxillary central incisors, maxillary and mandibular canines and premolars with single root canals were used in this study. The teeth were divided into two groups. In group 1 (20 teeth) automated canal preparation was performed using Anatomic Endodontic Technology (AET). In group 2 (10 teeth) manual instrumentation was performed with K-Flexofiles. Irrigation was performed using alternately 3.00% NaOCl and 18% EDTA, followed by rinsing with saline. The roots were split longitudinally into halves and the canals examined using a scanning electron microscope. The presence of debris and smear layer was recorded at coronal, middle and apical thirds of root canals using a four-step scoring scale. Mean scores for debris and smear layer were calculated and statistically analysed for significance (P<0.05) between and within groups, using the Mann-Whitney-Wilcoxon and Friedman nonparametric tests. RESULTS: At coronal and middle thirds the root canals prepared with manual instrumentation had significantly less surface debris on the canal walls compared with canals prepared with AET (p<0.05). At apical third root canals prepared with manual instrumentation had significantly more debris compared with AET group. The amount of smear layer was greater in the apical than in the coronal and middle thirds of the root and significantly less amount was in the AET group (P<0.05). CONCLUSIONS: Complete cleanliness was not achieved by any of the techniques and instruments investigated. It may be inferred that the choice between AET and hand instrumentation should be based on factors other than the amount of root canal debridement, which does not vary high significantly according to the instruments used.

Is dental treatment experience related to dental anxiety? A cross-sectional study in Lithuanian adolescents.

OBJECTIVE: The study aimed to estimate the relationship between dental anxiety and past dental treatment experience in Lithuanian adolescents and to examine a possible influence of gender and area deprivation on dental anxiety. MATERIAL AND METHODS: A total of 885 adolescents in 22 randomly pre-selected areas were clinically examined and completed a questionnaire regarding dental anxiety. Dental anxiety was estimated using the Corah's Dental Anxiety Scale (DAS). Past invasive dental treatment experience was defined as the number of extracted and filled teeth. RESULTS: The total mean (SD) score of the DAS was 10.07 (3.20). High levels of dental anxiety were reported in 11.3% of Lithuanian adolescents. The mean (SD) DAS score among adolescents who had no treatment experience was 9.51 (3.02), whereas adolescents who had treatment experience, had significantly higher mean (SD) DAS score, i.e. 10.25 (SD 3.23). CONCLUSIONS: The past dental treatment experience and dental anxiety were related in Lithuanian adolescents. Adolescents with no past invasive dental treatment experience were less anxious than those who had such experience. Girls reported higher dental anxiety than boys, while area deprivation had no effect on dental anxiety.

Chemomechanical caries removal for children.

Pain is still an actual problem in dentistry, and a usage of anaesthetics can be still limited, so new ways of caries treatment are still being searched in order to ease this process both to a patient and a doctor. Efficiency of chemomechanical tooth treatment to children was studied. 30 children within two age groups of 3-6 and 7-13 years took part in this research, and their teeth with caries were treated in two different ways--chemomechanical and traditional. Teeth with the same class of cavities were treated. There are presented records about the need of anaesthetics' usage, cleaning duration and patients' complaints in this study. Results show that chemomechanical treatment could be as effective as traditional one, causes less pain and lowers the need for anaesthetics. There was noticed less removal of solid tissue cleaning carious cavity.

Dental treatment needs in Lithuanian adolescents.

The aims were to estimate dental treatment needs of 15-16-year-olds in Lithuania and to relate a number of background factors such as gender, urbanization and residency to possible differences in dental treatment needs. A total of 885 adolescents in 22 randomly pre-selected areas were clinically examined. The following criteria of dental treatment needs were used: tooth with primary caries, secondary caries, tooth which needs a non-operative treatment, tooth with trauma, which needs a restorative treatment, and tooth which needs either an endodontic treatment, a crown or an extraction. Only 7.7 % of all participants had all their teeth sound. The treatment due to primary caries was the most required dental treatment modality among Lithuanian adolescents. Significantly fewer teeth required treatment due to other aforementioned reasons. Significant differences in most dental treatment needs between boys and girls were found, whereas in relation to urbanization and area of residency the differences were less pronounced.

Dental restorations quality in Lithuanian adolescents.

The aims were to estimate the quality of dental restorations in Lithuanian adolescents and to relate differences in quality of restorations to gender, urbanization and residency. A total amount of 885 adolescents in 22 randomly pre-selected areas were clinically examined. The California Dental Association Quality Evaluation System was used for the assessment of the quality of dental restorations. 60.35 % of all restorations were not acceptable and had to be changed. 47.58 % of them must be replaced because of not acceptable anatomic form. Only in 8.9 % of participants all their fillings were considered as satisfactory, while in 24.8 % of adolescents all their fillings had to be changed. Regarding the reasons for the need to replace restorations substantial differences among different geographical regions were found, whereas in relation to gender and urbanization the differences were less pronounced.

Needs for prosthetic treatment in Vilnius population at the age over 45 years old.

AIM OF THE STUDY. The aims of the study was to evaluate needs for prosthetic treatment among middle-aged and elderly population in Vilnius, to find out rates of edentulism among Vilnius inhabitants and to ask them about their approach to personal oral hygiene. MATERIALS AND METHODS. This cross-sectional study was approved by Lithuanian Bioethics Committee and carried out by one investigator. Our study was performed in period from 2008 to 2012. We have examined and interviewed 634 patients in the principle of free choice (randomized selection). Quantity of remaining teeth and previous prosthetic treatment was assessed. RESULTS. According to questionnaire previous prosthetic treatment was attached for 204 (43.8%) male and 262 (56.8%) female patients, total 466 (73.5%) of all subjects involved into our research, 168 (26.5%) never had a prosthetic treatment. During examination we found, that 219 (34.5%) of all examined persons were treated with removable prosthesis, 180 (28.4%) treated with fixed prosthesis and for 67 (10.6%) both: fixed and removable kinds of prosthesis were attached. Toothless jaws were found in 26.5% (n = 168) of population. We found 179 (28.2%) edentulous maxillas and 168 (26.5%) mandibles. CONCLUSIONS. The intensity of tooth loss in the middle-aged and eldery population of Vilnius city significantly increases with age. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Consolidation in oral health perceptions starts before age 50, suggesting early intervention before that age.

Standards for permanent teeth emergence time and sequence in Lithuanian children, residents of Vilnius city.

BACKGROUND. Up-to-date population specific standards on the timing and sequence of emergence of the permanent teeth are essential in planning medical care for children. To the best of authors' knowledge, data about emergence time of permanent teeth in Lithuanian children has not been provided. OBJECTIVE. To provide the first standards of permanent teeth emergence time and sequence in Lithuanian children, citizens of Vilnius. MATERIAL AND METHODS. In a cross-sectional study, data were collected from 3596 Lithuanian children, 4 to 16 years of age in randomly selected kindergartens and secondary schools of Vilnius city. During dental examination all erupted permanent teeth, except third molars, were recorded. MiniTab15 statistical software was used to calculate clinical eruption time of permanent teeth. Different comparisons were made to detect inter-jaw, inter-gender and inter-population differences. RESULTS. The earliest teeth to erupt in both genders are lower central incisors around the age of six. The first stage of mixed dentition ends with the eruption of upper lateral incisors around the age of 8 in boys and a half of year earlier in girls. Second transitional period starts after the emergence of first premolars or lower canine in girls and upper first premolar in boys at the age of 9.5. The last tooth to erupt in both genders is the upper second molar at the age of twelve. No significant differences have been found between right and left sides in either jaw. Lower permanent teeth tended to emerge significantly earlier than the upper ones, except for premolars and first molars. Girls preceded boys by 4 to 5 months on average. Lithuanian children on average showed earlier emergence time, especially in premolars, but resemble German and Finnish populations more closely. CONCLUSIONS. No significant asymmetry in permanent teeth emergence time has been found in either jaw. Lower permanent teeth, showed earlier clinical eruption than in the upper jaw in both genders. Lithuanian girls were clearly advanced in permanent teeth emergence than compared to boys. Lithuanian children showed earlier permanent teeth emergence time, especially in premolar region, than children from other countries.

Factors influencing face aging. Literature review.

The aim of this review is to analyze different factors which can affect natural face aging by delaying or expediting the process. Various studies shows that different factors such as ultraviolet light, gravity, habits, teeth loss may affect face appearance during aging. The articles from 1959 to 2011 related to topic were identified. 47 articles were selected for data collection.

Self-reported occupational health issues among Lithuanian dentists.

This article describes the second phase of a large study of Lithuanian dentists' health, and focuses on self-reported physical health complaints, general health state and associations between the two. In 2006, a postal questionnaire survey of all (N=2,449) licensed dentists registered with the Lithuanian Dental Association was conducted, obtaining a response rate of 68.2%. Fatigue (94.7%) and back pain (91.0%) were the most prevalent physical complaints reported, and they were also the most likely to become chronic among all physical disorders. Hypertension, joint diseases and allergy were the most prevalent diagnosed and treated diseases during the previous 12 months. Only half of the surveyed Lithuanian dentists (50.4%) rated their health as satisfactory. Logistic regression revealed that fatigue (Odds Ratio: 0.52; 95%CI: 0.29-0.94), headache (OR: 0.62; 95%CI: 0.42-0.90), hand problems (OR: 0.62; 95%CI: 0.44-0.87), chest pain (OR: 0.51; 95%CI: 0.40-0.64) and musculoskeletal complaints (OR: 0.41; 95%CI: 0.28-0.60) had a significant negative impact on dentists' self-reported general health. Overall, this study suggests that Lithuanian dentists do experience a certain amount of occupationally-related health problems. It is therefore important to increase health knowledge on occupational hazards and also to emphasize the importance of early diagnosis and treatment for these disorders in Lithuania, as elsewhere.

Self-perceived mental health and job satisfaction among Lithuanian dentists.

The aim of this study was to document dentists' self-perceived mental health complaints and job satisfaction, and to assess any correlations between the two. A postal questionnaire survey was mailed to all (N=2,449) licensed dentists registered with the Lithuanian Dental Association. The questionnaire investigated dentists' mental health and job satisfaction during the previous year (overall response rate: 68.2%). The majority of respondents (80.7%) reported being satisfied with their job. Self-perceived lack of self-esteem (OR: 0.59, 95% CI: 0.43-0.82), loneliness (OR: 0.72, 95% CI: 0.53-0.98), and especially depression (OR: 0.52, 95% CI: 0.35-0.77) had a high negative impact on dentists' job satisfaction. Nervousness (89.2%) and burnout (83.6%) were the most prevalent mental complaints and they also tended to be the most chronic of all reported mental disorders. Increasing age significantly reduced the possibility of nervousness or depression and increased the possibility of being satisfied with dental practice. Increasing working hours increased the risk of burnout, anxiety and loneliness. Overall, this study suggests that the majority of Lithuanian dentists are satisfied with their job and also enjoy their professional lives. However, a considerable proportion still reported impairment of mental health which influenced their levels of job satisfaction.

Factors influencing the caries decline in Lithuanian adolescents--trends in the period 1993-2001.

The study aimed to relate a number of factors to the numbers of decayed, missing and filled teeth (DMFT) in 12- and 15-yr-olds examined and interviewed in 1993 and 2001. A total of 1250 children in 1993 and 935 in 2001 were clinically examined and completed a detailed questionnaire on dental health-related topics. Factors were related to the DMFT count applying multiple regression analysis. From 1993 to 2001, the mean DMFT decreased approximately 30% in both age cohorts. Despite an observed improvement in dental health in Lithuanian children, the number of Lithuanian children reporting frequent sugar consumption, brushing teeth irregularly and visiting the dentist only in case of emergency was still high compared with Western countries. The DMFT values were related to the fluoride content in the drinking water, oral hygiene, residency and year of examination.

1.1 Student selection and the influence of their clinical and academic environment on learning.

Student selection and recruitment play a vital role in the successful outcome of dental education. To identify key issues and practices in selection and recruitment, the group assessed current processes, philosophies and practices from a range of different educational systems, although it was not possible to gather data from all countries or continents within the timeframe provided. Furthermore, the group explored the effect of the educational learning environment on the successful outcome of teaching dental students. It is clear that a wide variety of practices and philosophies exist and are used in different parts of the world. Measuring the success of any given process used for student selection remains a challenge. In some parts of the world, certain practices have become an integral part of the tertiary educational system, and have been applied in a similar way by many or all of the dental schools in that country. In other countries, methods vary from one dental school to another, often reflecting differences in the structure and philosophy of the educational system. There was great variation in the combinations of selection criteria used and in student recruitment strategies. However, it was clear that there was much to be gained by learning from the experiences of other dental schools in student selection. Lessons learned, best practices and philosophies used and supporting value systems proved to be very helpful for benchmarking the processes used. In the discussion of student selection, a number of important questions were raised which deserve further thought and reflection both in the ongoing debate and as part of the ever-changing world of dental education. Important new matters that require more debate and research include: a) ethical issues, including the nature of funding from the student perspective, and the concern that in some regions dentistry may become a profession only for the elite or wealthy students. b) Health standards of students entering dental school. c) How realistic is the applicant's sense of dentistry as a profession? d) How accurate is the students' sense of their career opportunities and the employment market upon graduation? Finally, the over-arching question remains, how valid, reliable and predictable are existing selection practices? Will it be practical and meaningful to standardize methods used, or will exchanging ideas as part of this global debate assist the thought process of dental leaders to improve selection practices by learning from the experiences of other schools in different parts of the world? The processes of open debate, sharing ideas and opinions and identifying sound practices across the globe is a powerful catalyst for developing innovative answers to the complex problems posed by student selection and recruitment. A 'virtual' global process with wide input from as many dental schools as possible should improve the efficacy of student selection, and allow dental educators to identify the 'potential' of prospective students and predict more accurately dental student outcomes. The debate that we have started will certainly contribute to providing a knowledge base which dental educators will be able to draw on when reviewing selection processes in their own schools.