Gender shifts and effects on behavior guidance.

UNLABELLED: Women's presence in pediatric dentistry has dramatically increased over the past several decades. Women now comprise almost 50 percent of AAPD membership and almost 75 percent of new members. PURPOSE: The purpose of this investigation was to determine differences between male and female pediatric dentists relative to practice patterns and use of behavior guidance techniques (BGTs). METHODS: A web-based survey was sent to 511 pediatric dentists who had been recruited by the AAPD to participate in a series of surveys related to pediatric dentistry. RESULTS: Fifty-nine percent of dentists responded. Fifty-two percent of the respondents were male and 48 percent were female. Female respondents were significantly younger than male respondents. Males were more likely to own a practice and hold leadership positions in dentistry while females were more likely to work as faculty, staff dentists, or part-time in private practice. No significant differences were noted between the genders relative to the use of BGTs, though females tended to involve parents more and were more likely to report the use of protective stabilization in selected situations. Both genders reported that parenthood had an effect on their behavior guidance styles.

Evidence-based clinical recommendations on the prescription of dietary fluoride supplements for caries prevention: a report of the American Dental Association Council on Scientific Affairs.

BACKGROUND: This article presents evidence-based clinical recommendations for the prescription of dietary fluoride supplements. The recommendations were developed by an expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs (CSA). The panel addressed the following questions: when and for whom should fluoride supplements be prescribed, and what should be the recommended dosage schedule for dietary fluoride supplements? TYPES OF STUDIES REVIEWED: A panel of experts convened by the ADA CSA, in collaboration with staff of the ADA Center for Evidence-based Dentistry, conducted a MEDLINE search to identify publications that addressed the research questions: systematic reviews as well as clinical studies published since the systematic reviews were conducted (June 1, 2006). RESULTS: The panel concluded that dietary fluoride supplements should be prescribed only for children who are at high risk of developing caries and whose primary source of drinking water is deficient in fluoride. CLINICAL IMPLICATIONS: These recommendations are a resource for practitioners to consider in the clinical decision-making process. As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. Providers should carefully monitor the patient's adherence to the fluoride dosing schedule to maximize the potential therapeutic benefit.

Age and gender differences in the use of behavior management techniques by pediatric dentists.

PURPOSE: This study evaluated differences in the use of behavior management techniques among older and younger male and female pediatric dentists. METHODS: We surveyed all active members of the American Academy of Pediatric Dentistry residing in the U.S. and Canada. Responses were received from 2467 (59%). The survey contained items on age, gender, and use of behavior management techniques. RESULTS: Males respondents outnumbered females 2:1. Age categories were dichotomized as < 46 and > or = 46 years. Females constituted 53% of the younger group and 14% of the older group. Four gender/age categories were used. A minority indicated that they used hand-over-mouth and active immobilization of sedated patients. No significant differences by groups were seen for use of most basic behavior management techniques. Significant differences by gender/age distribution were seen for the use of non-verbal communication and advanced techniques. Most differences in anticipated changes in technique use were age-related. Most favored parental presence in the operatory, though older males were significantly less likely to allow parental presence for some procedures. CONCLUSIONS: Some statistically significant differences in the use of behavior management techniques exist between older and younger male and female pediatric dentists. Overall, however, the 4 gender/age groups report similar frequencies of use of the techniques surveyed in this study.

Evidence-based use of fluoride in contemporary pediatric dental practice.

Fluoride is an important and effective means of reducing the caries incidence in children. Multiple fluoride products are available to dentists for use with their patients at risk for dental caries. The purposes of this paper are to: (1) review clinically salient evidence, primarily systematic reviews and meta-analyses, for the effectiveness of fluoride options and, where possible, combinations of fluoride exposures; and (2) make recommendations to dental practitioners based on the available evidence for the use of these various approaches in contemporary practice, particularly regarding the use of multiple fluoride sources. The available data suggest that therapeutic use of fluoride for children should focus on regimens that maximize topical contact, preferably in lower-dose, higher-frequency approaches. Current best practice includes recommending twice-daily use of a fluoridated dentifrice for children in optimally fluoridated and fluoride-deficient communities, coupled with professional application of topical fluoride gel, foam, or varnish. The addition of other fluoride regimens should be based on periodic caries risk assessments, recognizing that the additive effects of multiple fluoride modalities exhibit diminishing returns.

A snapshot of the U.S. postdoctoral pediatric dentistry faculty workforce, 2002.

This study characterizes the faculty shortage in U.S. postdoctoral pediatric dentistry (PD) education. The objectives of the study were to determine: 1) the changes in PD faculty numbers and teaching loads between 1995 and 2002 for postdoctoral PD education, 2) current faculty age and training, and 3) distribution of faculty by age. A questionnaire was sent in 2002 to fifty-four programs, of which forty-six responded (85 percent). Dental school and residency mean class sizes increased in the seven-year study period from 82.8 to 91.8 and from 6.0 to 8.5, respectively. Full- and part-time mean faculty positions increased as did vacancies, the latter growing from 15 to 38.9 and changing during the period from 5 to 10.8 percent of available positions. About one-third of programs used general dentists to teach PD, while programs using foreign-trained educators grew from 4 to 13 percent. Twenty-nine percent of full-time and 27 percent of part-time faculty are fifty-five years or older, and young entry-level faculty, age twenty-five to twenty-nine, represent only 2 percent and 5 percent of full- and part-time faculty respectively. Faculty vacancies have increased along with numbers of students and residents, and the largest segment of PD faculty is within a decade of retirement age.