(9/186) Patterns of oral care in dental school and general dental practice.
This study compared patterns of oral care provided by predoctoral dental students for patients seeking treatment at the University of Washington (UW) with patterns reported for general dental offices by the Washington Dental Service (WDS). Dental care included about 5 million services provided to 880,317 patients by 2,803 WDS general dentists and about 45,600 dental services provided to 9,488 patients by 155 UW dental students during 1999. There was high fidelity between databases and randomly surveyed patient records for treatment provided in both UW (95 percent) and WDS (97 percent) populations. While patient age patterns were generally similar, UW students completed more procedures for young children and for adults older than seventy-four years but completed fewer procedures for age groups of from thirteen to eighteen and from forty-five to fifty-four than general dental offices. The relative mix of all services completed by UW and WDS providers was similar (ANOVA, P=0.82). Within categories of service, the percentage of total services completed by students compared to those submitted by community dentists to WDS was about the same for examinations, radiographs, fluoride and sealants, amalgams, composites, single crowns, and endodontics. The percentage of total procedures completed showed a greater emphasis by UW students on inlays/onlays, dentures, extractions, and periodontal maintenance, and lesser experience with implants, orthodontics, sedation, and emergency procedures than general dental offices. We conclude that the relative distribution of clinical services provided by UW dental students is comparable to those procedures reported to WDS by dental offices in the adjacent community. (+info)
(10/186) Electronic patient records for dental school clinics: more than paperless systems.
The Electronic Patient Record (EPR) or "computer-based medical record" is defined by the Patient Record Institute as "a repository for patient information with one health-care enterprise that is supported by digital computer input and integrated with other information sources." The information technology revolution coupled with everyday use of computers in clinical dentistry has created new demand for electronic patient records. Ultimately, the EPR should improve health care quality. The major short-term disadvantage is cost, including software, equipment, training, and personnel time involved in the associated business process re-engineering. An internal review committee with expertise in information technology and/or database management evaluated commercially available software in light of the unique needs of academic dental facilities. This paper discusses their deficiencies and suggests areas for improvement. The dental profession should develop a more common record with standard diagnostic codes and clinical outcome measures to make the EPR more useful for clinical research and improve the quality of care. (+info)
(11/186) Costs of providing dental services for children in public and private practices.
This study compares the costs of providing children's dental services in three practice settings: private practices, public mobile clinics, and public fixed clinics. Some 15,000 children were provided comprehensive dental care over a three-year period. Results indicate that costs per visit and per child were lowest in mobile clinics and highest in private practices. The differential was partially explained by differences in productivity but mostly by the fact that the price of services in public practices represented costs of production, whereas in private practices they represented market values. (+info)
(12/186) Comparison of orthodontic treatment outcomes in educational and private practice settings.
An accredited graduate orthodontic program provides advanced specialty education to meet standards of care mandated by the ADA, including both didactic and clinical components with defined outcome measures. To quantify these measures, the quality of care provided by graduate orthodontic students was compared to that of orthodontists in private practice. The quality of care was studied in two different delivery settings in the Columbus, Ohio, area-private practice orthodontists (PPO) and the OSU graduate orthodontic clinic (GOC). The Peer Assessment Rating (PAR) Occlusal Index was used as a measure of malocclusion severity and post-treatment occlusal outcome. Quality of care was measured using post-treatment PAR, percent PAR reduction, and treatment duration. At baseline, no differences were seen in the gender and pre-PAR scores of patients treated by the PPO and GOC, but statistically significant differences were seen in patients' pre-treatment age, race, and starting dentition. When the post-treatment occlusal results were compared, no statistically significant differences were seen in post-PAR scores and percent PAR reduction between the PPO and GOC. A statistically significant difference was seen in treatment duration (p = 0.002), which was longer in the PPO even after controlling for confounding factors such as pre-treatment age, gender, race, starting dentition, and treatment stages. Our conclusion is that there was no statistically significant difference in the occlusal outcome between the PPO and GOC, but there was a significant difference in the treatment duration. (+info)
(13/186) Factors associated with amalgam restorations in Taiwan.
OBJECTIVE: This study investigated the prevalence of and factors associated with amalgam restorations of posterior teeth in Taiwan. METHOD: The authors analyzed the dental data regarding direct restorations of posterior teeth from the National Health Insurance Research Database of 1997, which was the first nationwide data available. The chi-square test and analysis of variance was used to compare the characteristics of the teeth, patients, dentists, and dental treatment settings between amalgam and composite restorations. The multivariate analysis was applied to obtain the Generalized Estimating Equation estimation for associations of multiple factors with amalgam restorations, taking into account the intra-individual correlation of teeth restored. RESULTS: Amalgam was used in 53.3% of the direct restorations of posterior teeth. When all the important factors were assessed simultaneously, characteristics significantly associated with more amalgam restorations were: dentists aged 43 years and above, patients aged 1-22 years, primary molars, two- or three-surface cavity, regions with higher number of population served per dentist, and dental clinic. CONCLUSION: Doctors' age, patients' age, type of dental treatment settings, population served per dentist, type of tooth, and number of surfaces restored were significantly associated with amalgam restorations in Taiwan. (+info)
(14/186) Experience of 2 dental clinics registered to ISO 9002.
This paper describes the 3-year experience of managing 2 hospital-based dental clinics registered to ISO 9002:1994; it also examines the revision of previous quality management standards in 2 separate institutions to prepare for registration under the new ISO 9001:2000 standard. Daily equipment and process checks, combined with internal audits, were the backbone of the quality system at both locations. Corrective and protective actions had been underused, because of the partial duplication produced by 2 different institutionally mandated risk management and incident reporting systems. ISO 9002 registration provided both dental clinics with responsive quality systems, emphasizing patient satisfaction and providing measurable continuous quality improvement. (+info)
(15/186) Sociocultural influences upon preventive health behavior and attitudes towards dentistry.
One hundred eighty adults who presented for general dental care at an urban dental school clinic were interviewed and given epidemiological screening examinations. The findings presented include a profile of a clinic population with respect to ethnic identity, family income, education, nuclear family structure, and residence. The two major racial groups (black and white) are found to have highly significant differences in their perception of dental services and their experiences with dental disease and treatment. An assessment of dental health status indicates that whites were more likely to have filled teeth, and blacks, decayed or unfilled teeth. This relates to different patterns in seeking recent preventive dental services and a marked disparity in utilization early in life. Fear and anxiety about dental care, degree of orientation towards prevention and differences in exposure to preventive information varied with race. Consumerist orientation is examined in terms of willingness to criticize services, be cared for by auxiliary health workers and accept professional fees. The identification of diversity in perception and values with respect to dental health care is characterized as an element in developing understanding between providers and consumers. (+info)
(16/186) Self-reported mental illness in a dental school clinic population.
The purpose of this study is to assess the prevalence of mental illness in a university-based dental clinic population. Dentists routinely review the patient's medical history to identify any physical disease or condition that may impact dental treatment. Mental illness may also affect dental treatment and patient management. This study examined the degree to which patients seeking routine dental care report these diagnoses. Data was gathered from records of 508 consecutive new patients whose treatment plans were submitted for faculty approval. The patient's self-reported mental illness was obtained from the patient questionnaire and physical evaluation forms of the dental record. One hundred thirty-six patients (26.77 percent) reported at least one mental illness. Of all diseases and disorders recorded in the medical history, self-reported depression was second only to hypertension in frequency. Substance abuse, anxiety, anorexia, bulimia, insomnia, bipolar disorder, and post-traumatic stress disorder were also common findings. This study establishes the need for training of dental students to recognize and manage psychologically compromised patients. The dental curriculum must address these issues. (+info)