[Therapeutic prescription of antibiotics and NSAID's by dentists in the Netherlands]. / Therapeutisch voorschrijven van antibiotica en NSAID's door tandartsen in Nederland.

Late in 2015 the Royal Dutch Dental Association (KNMT) conducted a study of the therapeutic prescription of antibiotics and NSAIDs by dentists in general practice in the Netherlands and the factors influencing their decisions. Of the 1,087 dentists contacted 367 (34%) completed the online questionnaire. In the 4 weeks preceding the study they had prescribed an antibiotic to 1.3% of their patients on average. A fifth (20%) found it difficult to decide whether an anti-inflammatory drug is indicated and/or whether this should be an antibiotic or a NSAID. Questioned about medication decisions (whether or not antibiotics are indicated) in 11 fictional cases, 11% of respondents judged every case correctly. 39% undertreated, 24% overtreated and 26% both undertreated and overtreated. In the last two categories, dentists with non-Dutch degrees are overrepresented. More than half (55%) of the respondents say they need a guideline for prescribing antibiotics in dental treatment and 28% (also) need postgraduate education on this matter.

[A woman at the chair is nothing out of the ordinary. Dental practice by female dentists in the Netherlands.] / Een vrouw aan de stoel is heel gewoon. De beroepsuitoefening van vrouwelijke tandartsen in Nederland.

Women currently make up 40% of the dentist population in the Netherlands. On the basis of enrolment in educational programmes their share can be expected to grow to more than half. The literature shows gender differences in preferences regarding work setting and duration of the working week. Men and women also differ from each other with respect to the way dental care is provided. The presented data demonstrate an increase in the number of women working in dentistry and research data have confirmed the presumed differences between male and female dentists. Women are less likely to be the owner of a practice, women who do own a practice are more likely to collaborate with colleagues and have a shorter working week. With regard to providing dental care, women seem to be slightly more orientated to the individual patient and are more likely to pay attention to the patient's general health. Theories about work values provide explanations for these gender differences. Women's preference for collaboration accords with the general development in dental care to work in teams.

[The well-being of dentists following a complaint procedure]. / Het welbevinden van tandartsen na een klachtenprocedure.

It is known that a patient's complaint can have a serious impact on the well-being of dentists. But little is known on the nature and the extent of this impact. That's why in 2013 an anonymous survey was conducted among 955 dentists and dental specialists, for whom in the period mid-2008 to mid-2013 a complaint was handled through the Complaint Committee of the Royal Dutch Dental Association (KNMT). Altogether, 413 (43%) of them participated in the study. 71% of the respondents reported that the complaint had influenced their professional practice. 52% reported that it had (also) influenced their attitude towards colleagues and patients, and 60% (also) experienced an impact on their mental and/or physical condition. Altogether, 68% reported that they had unpleasant feelings and 75% stated that the treatment relationship with the patient was terminated as a result of the complaint.

[Evidence-based clinical practice guidelines in oral care 3. Support for the development of clinical practice guidelines]. / Evidencebased klinische praktijkrichtlijnen in de mondzorg 3. Draagvlak voor richtlijnontwikkeling in de mondzorg.

Support is an important factor in the implementation of clinical practice guidelines. Data from 5 studies from 1998 through 2013 offer insight into the support for clinical practice guidelines among dentists, orthodontists, dental hygienists and denturists in the Netherlands. In these, attitudes, opinions, knowledge and behaviour were seen as indicators of support. Dentists have an increasingly positive attitude towards clinical practice guidelines. The majority is aware of and uses at least 1 of the guidelines available to them and are in favour of the development of clinical practice guidelines. Orthodontists and dental hygienists have available few such guidelines, but the majority of both groups favour their development. Among denturists, who also have little experience with clinical practice guidelines, there are fewer supporters for their development. All in all, among caregivers in oral healthcare in the Netherlands, support for the use and development of clinical practice guidelines is growing.

[Dentists' judgement of the complaint procedure of the Royal Dutch Dental Association]. / De KNMT-klachtenregeling beoordeeld door tandartsen.

In 2013, to evaluate the functioning of the complaint procedure of the Royal Dutch Dental Association (KNMT), an anonymous, written survey was conducted among 955 dentists and dental specialists, for whom in the period mid-2008 to mid-2013 a complaint was handled. 413 (43%) participated in the study. 51% of them reported that the complaint was successfully mediated by the Regional Mediation Boards and the Specialist Mediation Board and 17% that the patient had withdrawn the complaint. For the remaining 32% the complaint was handled by the Central Complaint Committee, who determined that 13% was (partially) substantiated, 17% was not substantiated and 2% was settled. Generally, 79% of the dentists are (mostly) positive about the procedure of mediation, while 8% are neutral and 13% are dissatisfied about it. With regard to the complaints procedure this was 60%, 11% and 29% respectively. The judgment of the dentists about the Regional Mediation Boards and the Specialist Mediation Board and about the Central Complaints Committee is influenced by the success of the complaints procedure and by the impact of the complaint that was experienced. The emotional support of dentists during the complaints trajectory is one of the points requiring attention.

[The Data Stations project: a monitor of dental practice in The Netherlands]. / Project Peilstations: monitor van de tandheelkundige beroepsuitoefening in Nederland.

Since 1995 the Dutch Dental Association (NMT) has carried out research on, in particular, the non-clinical aspects of dental practice with the Data Stations project. At present, within this research project 5 studies are conducted on a regular basis: the Dental Consumption Study, the Dental Practice Study, the Omnibus Survey, the Young Dentist Study and the Quality of Oral Care Study. From the results of this research project it appears that during the last decades dentists have increasingly been working cooperatively. This is expressed in dental practices with more dentists and more staff workers, with more dental chairs and more patients. The length of the working week, however, has changed very little over the years. Among both young people and adults gradual changes have taken place in dental consumption during the period 1997-2011. By intensifying the collaboration with clinical dental researchers the scope of the research within this project can be expanded to include the quality of oral care and the effects of care which has been provided on oral health in The Netherlands.

The risk of blood exposure incidents in dental practices in the Netherlands.

OBJECTIVES: An awareness of the risk of blood-borne infections among dentists has been promoted by the Dutch Dental Association (NMT) as part of their quality and safety programme, and a nationally operating expert counselling centre was contracted to manage all reported incidents. METHODS: We analysed data on hepatitis B vaccination status, sex and age for all reported incidents recorded by this centre during 2008. We compared this with data collected at same time during a national survey to assess the performance of the centre. The number of blood exposure injuries among dentists and their assistants, and reporting behaviour, were also assessed. RESULTS: In 2008, 387 incidents were reported to the counselling centre. The percentage of high-risk incidents was 16, with a risk of hepatitis B, hepatitis C and HIV infections. In the hepatitis B cases, 12% had no or insufficient immunization. Eight per cent of those injured were unable to start HIV Post-Exposition Prophylaxis because they reported too late. Of the 1442 surveys sent, 487 (34%) were returned. Dentists estimated levels of hepatitis B vaccination at 98%. Thirty-two per cent reported to have had one or more injuries in their practice in 2008. Of these, 37% were counselled by the expert centre, 18% were counselled by others and 45% sought no medical attention. The performance of the counselling centre received a positive score (95%). A need for more information about vaccination and blood-borne infections in dentistry (52%) was reported. CONCLUSIONS: Nationwide data show blood exposure incidents occur frequently in dental settings, with a considerable number of high-risk incidents. Administering anaesthetics and cleaning-up are major risk factors. There is a need to intensify measures for safe working conditions in dental care settings in the Netherlands, irrespective of the type of dental practice.

[Recently graduated dentists: working situation and future plans]. / Werksituatie en toekomstplannen van recent afgestudeerde tandartsen.

The Dutch Dental Association (NMT) surveyed dentists who graduated in 2004, 2005 or 2006 concerning their work situation and plans for the future. They were also asked about their experiences at the start of their career In general, the recently graduated dentists did not face difficulties at the start of their professional life. Most dentists worked in the practice of a colleague, but the majority ultimately wanted to have their own practice. The latter applied more to men than women. Furthermore, there was a clear preference for working within a team and most of them planned to specialize in a specific branch of dentistry. The survey also revealed that the delegation of tasks to dental hygienists and prevention assistants was more or less taken for granted by recently graduated dentists.

[The restorative care index in children 2. Factors concerning the dentist]. / De restauratieve verzorgingsgraad bij de jeugd 2. Tandartsfactoren.

As part of a broader study of the restorative care index of 5- and 6-year-olds and 11- and 12-year-olds, a sample study was carried out among 1,361 dentists, who were surveyed by means of a web-questionnaire concerning this issue. In total 447 dentists (33%) filled in the questionnaire completely. Concerning the development of dental care of children, opinions differed widely: 46% of those questioned spoke of an increase in the incidence of caries during the past 5 years and 44% reported no change. Furthermore, dentists hold different views on the treatment of the primary dentition. There was no consensus of opinion about the necessity of treating caries in young children and there was a comparable lack of agreement about how and when treatment should be given. The majority of dentists express a need for support in their practice (possibilities for referral, protocols, informational material) concerning routine oral examination, the preventive and/or curative treatment of (young) children.

[The restorative care index in children 1. Factors concerning the child]. / De restauratieve verzorgingsgraad bij de jeugd 1. Patiëntgebonden factoren.

In 2007 a study was undertaken of the restorative care index of the teeth of children under the age of 18. The aim of this study was to gain insight into the factors associated with the restorative care index in children. Factors investigated were (post-) brushing, inspection frequency, sweets-consumption frequency, socio-economic status and treatment or lack thereof by a general practitioner or dentist who works in a clinic for child health care. This study made use of statistics assembled for an earlier study of children formerly covered by public health insurance in the municipality of The Hague and research carried out at child dental clinics. Socio-economic status and the level of oral care were correlated with dental quality. No patient-bound factors were significantly correlated with the level of care. There was however a positive correlation between the'type' of dentist (family dentist or dentist associated with a clinic for child dental care) and the chance of curative treatment (in the case of developing caries).

[Patient education in a dental practice]. / Voorlichting in tandartspraktijken.

Patient education is an important part of the care provided in a dental practice. Explanations concerning dental treatments is in the majority of practices exclusively the responsibility of the dentist. Information about oral hygiene and prevention is generally provided by oral hygienists and prevention assistants. It is striking that agreements are made concerning the form and content of patient education, the division of responsibilities and the use of teaching aids in only 39% of practices. It is possible that this has to do with the relatively few hours that oral hygienists and/or prevention assistants are active each week in the practice, and the judgement of the dentists that sufficient time has to be devoted to discussing a proposed treatment with the patient.

[Dentists on continuing dental education]. / Tandartsen over bij- en nascholing.

In support of its quality policy, the Dutch Dental Association (NMT) has undertaken a survey to examine dentists'views on continuing education, accreditation, and their postgraduate course attendance. In December 2004 a written questionnaire was sent to a sample of 710 dentists, of whom 504 (71%) responded. The data were analysed using SPSS. Most dentists (93%) attended one or more courses since January 2003. They tend to concentrate on a few subjects, mainly on clinical procedures. About half (45%) of the respondents are in favour of continuing education accreditation for dentists. Compared to opponents, supporters are more positive about continuing education in general and spend more time reading specialist literature. Furthermore, the greater part of dentists indicates that it is important to have some kind of quality mark for postgraduate courses.