Routine oral examination: clinical performance and management by general dental practitioners in primary care.

Contains fulltext : 53333.pdf (publisher's version ) (Closed access)The aim of this clinical study was to explore the contents of routine oral examinations (ROE), carried out by Dutch general dental practitioners (GDPs), in relation to the oral health status of regularly attending patients. An observational study was performed, based on clinical case recording. Using The Data Station Project of the Dutch Dental Association as the study base, 215 GDPs were recruited, of whom 131 participated in the study. A clinical case-recording form was developed to document clinical behavior. The contents assessed concerned patient characteristics, contents of the ROE visit, diagnoses made, and clinical behavior in response to ROE findings. This study showed substantial variation in clinical behavior related to specific ROE domains, including patient history and record keeping, whereas GDPs acted consistently on other domains, such as clinical examination and recall length assessment. Furthermore, the ROE performance was more strongly associated with GDP characteristics than with patient characteristics. The mean ROE time was 10 min, and recall intervals were most frequently assigned at 6 months, irrespective of the oral condition. This study highlights a need for continuing education to promote risk-based oral screening. Further research is needed to identify factors responsible for the variation in GDP performance, just as research on clinical practice guideline implementation methods is warranted

Patient orientation and professional orientation of Dutch dentists

Contains fulltext : 64053.pdf (publisher's version ) (Closed access)By providing dental health care, dentists dedicate themselves to the preservation and/or improvement of oral health in their patients. By adequately carrying out this care providers' role, dentists will gain recognition, esteem and respect from both patients and colleagues. This analysis aims to assess the patient and professional orientation of dentists and investigate which of their personal and practice characteristics can be regarded determining for these two aspects of their role as care providers. In the year 2000, data was collected via a written questionnaire sent to a random, stratified sample of 790 dentists, of whom 607 (77%) responded. Multivariate regression analysis shows that the preventive treatment concept, professional satisfaction and the number of hours per week that household tasks are performed are positive determinants for dentists' patient orientation. Also, the longer dentists are active in their profession, the more patient oriented they will be, and with more hours per week support from oral hygienists they are less patient oriented. As for professional orientation, dentists' preventive treatment concept and their professional satisfaction can also be considered positive determinants. Furthermore, dentists are more profession oriented when their partner works in the practice, with more hours per week support from oral hygienist(s) and with more collaboration contacts with other care providers. Compared to men, women are on average less profession oriented. Among Dutch dentists, there exist clear differences in the way they take on their role as care providers with regard to patient orientation and professional orientation

Routine oral examination: differences in characteristics of Dutch general dental practitioners related to type of recall interval.

Contains fulltext : 48541.pdf (publisher's version ) (Closed access)OBJECTIVES: The aim of this study was to explore differences in behaviour (characteristics and opinions) among general dental practitioners (GDPs), using either a fixed (Fx) or an individualized recall interval (Iv) between successive routine oral examinations (ROEs). METHODS: In the year 2000, data were collected by means of a written questionnaire sent to a random stratified sample of 610 dentists of whom 521 responded, of which 508 (83%) were used for analysis. RESULTS: Two groups of GDPs were distinguished based on their answer to the question: 'Do you apply for all patients a fixed recall interval between two successive ROEs?' Fifty-one per cent of the GDPs (n=257) applied Fxs for all patients, generally for a period of 6 months. Ivs were applied by 49% (n=251) of GDPs, depending on the determination of specific patient characteristics. Logistic regression analysis showed that GDPs applying Fxs also used fixed periods between successive bitewing radiographs for all patients. Furthermore, dentists applying Ivs required more time to conduct an ROE, partly because of a more extensive periodontal screening. GDPs applying Fxs, adhered more to the opinion that a fixed recall regime (every 6 months, as existed before 1995) should be re-introduced, whereas the GDPs in support of Ivs were more in favour to support the opinion that the ROE is 'an excellent instrument for effective, individualized oral care'. CONCLUSIONS: Dutch GDPs differ in the way they deal with the determination of recall interval frequency. These are also specific differences in performance and opinions regarding ROE. With the changing prevalence of oral diseases and the skewed distribution within populations, further research is advocated on consistent decision making to determine the most appropriate recall policy in preventing oral disease