Current Issue : January - March Volume : 2014 Issue Number : 1 Articles : 5 Articles
Background: Aim was to compare clinical findings with x-ray findings using dental panoramic radiography (DPR).\r\nIn addition, type and frequency of secondary findings in x-rays were investigated.\r\nMethods: Patients were selected on the basis of available DPRs (not older than 12 months). No therapeutic\r\nmeasures were permitted between the DPR and the clinical findings. The clinical findings were carried out by\r\nseveral investigators who had no knowledge of the purpose of the study. A calibrated investigator established the\r\nx-ray findings, independently and without prior knowledge of the clinical findings. The evaluation parameters for\r\neach tooth were: missing, healthy, carious, restorative or prosthetically sufficient or insufficient treatment. Type and\r\nfrequency of additional findings in the DPR were documented, e.g. quality of a root canal filling and apical changes.\r\nResults: Findings of 275 patients were available. Comparison showed a correspondence between clinical and\r\nradiographic finding in 93.6% of all teeth (n = 7,789). The differences were not significant (p > 0.05). Regarding\r\ncarious as well as insufficiently restored or prosthetically treated teeth, respectively there were significant differences\r\nbetween the two methods (p < 0.05). The DPRs showed additional findings: root fillings in 259 teeth and 145 teeth\r\nwith periapical changes.\r\nConclusions: With reference to the assessment of teeth, there was no difference between the two methods.\r\nHowever, in the evaluation of carious as well as teeth with insufficiently restorative or prosthetic treatment, there\r\nwas a clear discrepancy between the two methods. Therefore, it would have been possible to have dispensed with\r\nx-rays. Nevertheless, additional x-ray findings were found...
Background: Dental amalgam is a source of elemental and inorganic mercury. The safety of dental amalgam in\r\nindividuals remains a controversial issue. Urinary mercury concentrations are used to assess chronic exposure to\r\nelemental mercury. At present, there are no indications of mercury-associated adverse effects at levels below 5 Ã?µg\r\nHg/g creatinine (Cr) or 7 Ã?µg Hg/L (urine). The purpose of the present study is to determine the overall urinary\r\nmercury level in the Canadian general population in relation to the number of dental amalgam surfaces.\r\nMethods: Data come from the 2007/09 Canadian Health Measures Survey, which measured urinary mercury\r\nconcentrations in a nationally representative sample of 5,418 Canadians aged 6ââ?¬â??79 years. Urinary mercury\r\nconcentrations were stratified by sex, age, and number of dental amalgam surfaces.\r\nResults: The overall mean urinary mercury concentration varied between 0.12 Ã?µg Hg/L and 0.31 Ã?µg Hg/L or 0.13 Ã?µg\r\nHg/g Cr and 0.40 Ã?µg Hg/g Cr. In general, females showed slightly higher mean urinary mercury levels than men.\r\nThe overall 95th percentile was 2.95 Ã?µg Hg/L, the 99th percentile was 7.34E Ã?µg Hg/L, and the 99.9th percentile was\r\n17.45 Ã?µg Hg/L. Expressed as Ã?µg Hg/g Cr, the overall 95th percentile was 2.57 Ã?µg Hg/g Cr, the 99th percentile was\r\n5.65 Ã?µg Hg/g Cr, and the 99.9th percentiles was 12.14 Ã?µg Hg/g Cr. Overall, 98.2% of participants had urinary mercury\r\nlevels below 7 Ã?µg Hg/L and 97.7% had urinary mercury levels below 5 Ã?µg Hg/g Cr. All data are estimates for the\r\nCanadian population. The estimates followed by the letter ââ?¬Å?Eââ?¬Â should be interpreted with caution due to high\r\nsampling variability (coefficient of variation 16.6%-33.3%).\r\nConclusions: The mean urinary mercury concentrations in the general Canadian population are significantly lower\r\nthan the values considered to pose any risks for health...
Background: Role-substitution describes a model of dental care where Dental Care Professionals (DCPs) provide\r\nsome of the clinical activity previously undertaken by General Dental Practitioners. This has the potential to increase\r\ntechnical efficiency, the capacity to care and reduce costs. Technical efficiency is defined as the production of the\r\nmaximum amount of output from a given amount of input so that the service operates at the production frontier\r\ni.e. optimal level of productivity. Academic research into technical efficiency is becoming increasingly utilised in\r\nhealth care, although no studies have investigated the efficiency of NHS dentistry or role-substitution in high-street\r\ndental practices. The aim of this study is to examine the barriers and enablers that exist for role-substitution in\r\ngeneral dental practices in the NHS and to determine the most technically efficient model for role-substitution.\r\nMethods/design: A screening questionnaire will be sent to DCPs to determine the type and location of rolesubstitutive\r\nmodels employed in NHS dental practices in the United Kingdom (UK). Semi-structured interviews will\r\nthen be conducted with practice owners, DCPs and patients at selected sites identified by the questionnaire. Detail\r\nwill be recorded about the organisational structure of the dental team, the number of NHS hours worked and the\r\nclinical activity undertaken. The interviews will continue until saturation and will record the views and attitudes of\r\nthe members of the dental team. Final numbers of interviews will be determined by saturation.\r\nThe second work-stream will examine the technical efficiency of the selected practices using Data Envelopment\r\nAnalysis and Stochastic Frontier Modeling. The former is a non-parametric technique and is considered to be a\r\nhighly flexible approach for applied health applications. The latter is parametric and is based on frontier regression\r\nmodels that estimate a conventional cost function.\r\nDiscussion: Maximising health for a given level and mix of resources is an ethical imperative for health service\r\nplanners. This study will determine the technical efficiency of role-substitution and so address one of the key\r\nrecommendations of the Independent Review of NHS dentistry in England...
Background: The bulk of service delivery in dentistry is delivered by general dental practitioners, when a large\r\nproportion of patients who attend regularly are asymptomatic and do not require treatment. This represents a\r\nsubstantial and unnecessary cost, given that it is possible to delegate a range of tasks to dental care professionals, who\r\nare a less expensive resource. Screening for the common dental diseases by dental care professionals has the potential\r\nto release general dental practitioner�s time and increase the capacity to care for those who don''t currently access\r\nservices. The aim of this study is to compare the diagnostic test accuracy of dental care professionals when screening\r\nfor dental caries and periodontal disease in asymptomatic adults aged eighteen years of age.\r\nMethods/design: Ten dental practices across the North-West of England will take part in a diagnostic test accuracy\r\nstudy with 200 consecutive patients in each practice. The dental care professionals will act as the index test and the\r\ngeneral dental practitioner will act as the reference test. Consenting asymptomatic patients will enter the study and\r\nsee either the dental care professionals or general dental practitioner first to remove order effects. Both sets of\r\nclinicians will make an assessment of dental caries and periodontal disease and enter their decisions on a record sheet\r\nfor each participant. The primary outcome measure is the diagnostic test accuracy of the dental care professionals and\r\nsensitivity, specificity, positive predictive value and negative predictive values will be reported. A number of clinical\r\nfactors will be assessed for confounding.\r\nDiscussion: The results of this study will determine whether dental care professionals can screen for the two most\r\nprevalent oral diseases. This will inform the literature and is apposite given the recent policy change in the United\r\nKingdom towards direct access....
Background: New dental schools have been established to train dentists in many parts of the world. This study\r\nexamines the future dental workforce from the first dental school in the United Arab Emirates [UAE]; the aim of this\r\nstudy was to explore the short and long-term career aspirations of the final year dental students in the UAE in\r\nrelation to their demography.\r\nMethod: Final year dental students of the Ajman Universityââ?¬â?¢s College of Dentistry (n=87) were invited to participate\r\nin a self-completion questionnaire survey. Descriptive analysis, chi-square tests, and binary logistic regression\r\nanalysis were carried out on career aspirations using SPSS v20.\r\nResults: Eighty-two percent of students (n=71) responded, the majority of whom were female (65%; n=46). Ethnicity\r\nwas reported as: ââ?¬Ë?other Arabââ?¬â?¢ (61%; n=43), ââ?¬Ë?Emiratiââ?¬â?¢ (17%, n=12), and ââ?¬Ë?Otherââ?¬â?¢ (21%, n=15). In the short-term, 41% (n=29)\r\nexpressed a desire to work in government training centres, with Emirati students significantly more likely to do so\r\n(p=0.002). ââ?¬Ë?Financial stabilityââ?¬â?¢ (80%; n=57) and ââ?¬Ë?gaining professional experienceââ?¬â?¢ (76%; n=54) emerged as the most\r\nimportant influences on their short-term career plans. The vast majority of students wished to specialise in dentistry\r\n(92%; n=65) in the longer term; logistic regression analysis revealed that the odds of specialising in the most popular\r\nspecialties of Orthodontics and Oral and Maxillofacial Surgery were less for the ââ?¬Ë?Otherââ?¬â?¢ ethnic group when compared\r\nwith ââ?¬Ë?Emiratiââ?¬â?¢ students (0.26; 95% CI 0.068-0.989; p=0.04). Almost three-quarters of the students overall (72%; n=51)\r\nintended to work full-time. ââ?¬Ë?High income/financial securityââ?¬â?¢ (97%; n=69), ââ?¬Ë?standard of livingââ?¬â?¢ (97%; n=69), ââ?¬Ë?work/life\r\nbalanceââ?¬â?¢ (94%; n=67), and ââ?¬Ë?professional fulfilmentââ?¬â?¢ (87%; n=62) were reported by the students as the most influential\r\nitems affecting their long-term professional career choices.\r\nConclusion: The findings suggest that students aspire to make a long-term contribution to the profession and there is\r\na high level of interest in specialisation with a desire to achieve financial stability and quality of life....
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