Barriers to the adoption of the ART approach as perceived by dental practitioners in governmental dental clinics, in Tanzania

OBJECTIVES: This study aimed to determine the magnitude of the barriers to the practice of Atraumatic Restorative Treatment (ART) as perceived by dental practitioners working in pilot dental clinics, and determine the influence of these barriers on the practice of ART. MATERIAL AND METHODS: A validated and tested questionnaire on barriers that may hinder the practice of ART was administered to 20 practitioners working in 13 pilot clinics. Factor analysis was performed to generate barrier factors. These were patient load, management support, cost sharing, ART skills and operator opinion. The pilot clinics kept records of teeth extracted; teeth restored by conventional approach and teeth restored by ART approach. These treatment records were used to compute the percentage of ART restorations to total teeth treated, percentage of ART restorations to total teeth restored and percentage of total restorations to total teeth treated. The mean barrier scores were generated and compared to independent variables, using the t-test. The influence of barriers to ART-related dependent variables was determined using Pearson correlation coefficients. RESULTS: Mean barrier values were low, indicating low influence on ART practice. Female practitioners had higher scores on patient load than male practitioners (p = 0.003). Assistant Dental Officers had higher scores on cost sharing than Dental Therapists (p = 0.024). Practitioners working in urban clinics had higher mean scores on patient load than those who worked in rural clinics (p = 0.0008). All barrier factors were negatively correlated with ART practice indices but all had insignificant association with ART practice indices. CONCLUSION: The barriers studied were of low magnitude, with no significant impact on practice of ART in dental clinics in the pilot area.

Adaptación del niño a la consulta odontológica / Child adaptation to dental consultation

El artículo se refiere al manejo de la conducta del niño al inicio de su consulta dental, con el fin de armonizar la relación niño-odontólogo-padres, y promover así actitudes positivas del paciente hacia la práctica odontológica. Este trabajo es el resultado de consultas bibliográficas de autores como: López Jordi, Magnusson, McDonald y Pinkham, especialistas en materia odontológica, a través de las cuales se pudieron deducir las diferencias significativas entre las distintas causas del comportamiento del niño en la consulta odontológica. Se detallan las variables que influyen en la conducta del niño al inicio de su tratamiento odontológico, como son: el ambiente físico del consultorio, el odontólogo y su personal asistente, los padres, el niño y la primera visita al odontólogo. También se mencionan las técnicas básicas que facilitan al odontólogo el tratamiento clínico del paciente infantil, que permiten proporcionarle un ambiente acogedor y una relación afectiva y cariñosa, sobre la base de un abordaje psicológico realizado con conciencia, honestidad y criterio objetivo, además de tratar de lograr una adecuada comunicación entre el niño y el odontólogo