CURRENT STATUS OF THE DENTAL PRACTICE IN BULGARIA. Meta-analysis.

The purpose of this study was to show the leading trends in dental practice and dental profession development after two decades of transition. Materials and methods: A systematic review of data was performed including analysis of secondary statistical data and benchmarking data from relevant publications. Results: The meta-analysis found that: The dentists/patients ratio decreased steadily; The dental surgeries’ development, in terms of new equipment, is observed; The use of support staff increased from 1996 to 2001, and decreased as on 2011; The utilization of dental services, compared to EU level is going down; The disproportion between new technologies implementation and lack of trained support staff utilization was evidenced; Long-term trend toward general versus specialize care was demonstratedConclusions: The extensive growth and irregular distribution of dental practices, along with the decrease of the dental services’ utilization shape the portrait of the dental profession and dental practice in Bulgaria by the end of the first decade of 21 century

Demography and market impacts on dental practices’ development in Bulgaria during the period of transition 1990-2010

Objective. The purpose of this study was to present the impact of demography and market dynamics on the organizational and technological development of dental practices in Bulgaria during the period of socio-economic transition from 1990 to 2010. Material and methods. Relevant data were gathered from the official registers of the Bulgarian Dental Association, National Health Insurance Fund, National Health Information Institute and research studies, published during the period 1990-2010. They were analysed and are discussed in this paper. Results. During the period there was a decrease in population of Bulgaria, from 8,149,468 in 2000 to 7,563,000 in 2010 and a movement from rural areas to cities. There was an aging population with an increase in oral health care needs at a time of decrease in the size of the national labour force and economic growth. Paradoxically, over the last 20 years, the number of dentists in Bulgaria increased by more than 50% from 1997 to 2008. The average age of dentists changed from 39.7 years in 1997 to 41.7 years in 2008. The number of group dental practices increased and the number of individual practices and group practices for specialized dental care and dental centres decreased. The utilization of dental services is currently “about half ” that of the mean for all European Union Member States, which is over 80% per year. Conclusions. The growing number of elderly people who have retained their teeth suggests an increase in treatment needs. However, the decline in their purchasing power limits the demand for oral health care services. In order to meet this and other challenges Bulgarian dentists have started changing their traditional solo-practice to group-practice

Self-reported psychological problems amongst undergraduate dental students: A pilot study in seven European countries

Aim - To map psychological problems amongst undergraduate dental students with a focus on different time points in clinical work in seven Eastern European and Scandinavian countries. Materials and Methods - A total of 1063 3rd‐ and 5th‐year dental students (response rate 70%) participated in this pilot study and completed a pre‐tested, structured questionnaire, which collected information on sociodemographic characteristics and self‐reported psychological problems. Data were analysed by bivariate and multivariate methods. Results - The majority of participants were female and were younger than male participants. Most participants, though more females than males, agreed that the clinical work of dentistry was psychologically difficult. Almost half of participants felt nervous before working with patients (N = 506, 48%) and experienced a lot of stress whilst working with patients (N = 488, 46%); almost one‐third (N = 287, 27%) felt anxious/worried after working with patients. Being a 3rd‐ and 4th‐year student (vs 5th‐year) reduced the odds for anxiety after working with patients; being a 3rd‐year student (vs 5th‐year) increased the odds for stress whilst working with patients. Studying in countries other than Norway reduced the odds for stress whilst working with patients. Less than good self‐perceived health, presence of psychological health complaints before starting dental education, female gender and lack of physical activity increased the odds for psychological problems. Conclusion - A high number of undergraduate dental students reported psychological problems in connection with clinical work. It is unlikely that “one size fits all”; therefore, further qualitative investigations on stressors in clinical learning environments should be done in order to design tailor‐made supportive strategies