The effect of washing water on bonding to etched enamel.

There is current concern about bacterial contamination of dental unit waterlines. This research hypothesized that the presence of increasing concentrations of bacteria in water used to wash etched enamel would result in a corresponding decrease in both shear bond strength (SBS) and critical surface tension (gammaC) of enamel. A further hypothesis was made that there is a correlation between SBS and gammaC. The effect of 3.5 ppm iodine in the water as a bacteriostatic agent was also assessed. Five groups of 10 samples of bovine enamel were etched, washed, and a resin composite bonded to them. The control group was washed with distilled water. Another group was washed with the dilute iodine solution. The remaining three groups used a different concentration of Escherichia coli DH5alpha as follows (in cfu mL(-1)): group 1: 10(2); group 2: 10(4); group 3: 10(6). Shear bond strength data were measured on an Instron testing machine at a crosshead speed of 1 mm min(-1). Adhesion data were (MPa): control: 24.6 +/- 6.0; with iodine: 20.8 +/- 2.7; group 1: 19.8 +/- 2.7; group 2: 13.5 +/- 3.0; group 3: 13.9 +/- 3.6. The F-test yielded a highly significant difference between control group, iodine group and group 1, compared with groups 2 and 3 (P < 0.0001). Tukey's Studentized Range Test was used for pairwise comparison testing between groups. Using a Cahn dynamic contact angle analyzer and linear regression analysis, the plots of surface tension versus costheta were extrapolated to costheta = 1 to give gammaC data for the control group and groups 1-3. In all cases reasonable linearity was observed (r2 > or = 0.87). Data (mN m(-1)) were: control group: 50.8; group 1: 45.1; group 2: 43.2; group 3: 39.5. The SBS and gammaC were then plotted against each other and linear regression analysis performed. It was concluded that increasing concentrations of bacteria in wash water decreased both SBS and gammaC and that a linear correlation (R2 = 0.84) was found between the values of these two parameters.

Employment of dental hygienists and registered dental assistants: highlights of the 1996 survey.

PURPOSE: The purpose of this study was to determine various employment characteristics of Minnesota's allied dental health workforce, specifically dental hygienists and registered dental assistants. METHODS: In 1995 and 1996, two questionnaires one-year period apart were mailed to all licensed dentists in the state, accompanied with a request that only one survey form per practice be returned. An estimated 73 percent and 65 percent of all practices reported in the two years respectively. RESULTS: Results suggest few changes over the two-year period. Information is reported on a wide variety of conditions, including practice configurations, workload distributions, turnover, salaries, and relative demand for hygienists and registered assistants. CONCLUSIONS: These studies provide a good baseline for future reports and suggest that, at present, patient demand is stable or strong, and that while an adequate supply of allied dental health workers is available statewide, some local supply problems exist.

Productivity in Minnesota dental practices with increased visits by older patients.

There is little scientific information on the economic impact of treating increased numbers of older adults, despite the current growth in this population. To assess the impact of patient age on dental practice productivity, we evaluated an economic production function that included the proportions of patient visits in two older age groups (61-69 years, 70+ years) as factors that might affect the dental service production process. We used data from 12,818 patient visits to 31 Minnesota dental practices enrolled in the Minnesota Dental Practice Analysis System (DPAS) between 1980 and 1984. Ordinary least squares multiple linear regression was used to detect potential associations between practice productivity, measured in standardized time and monetary outputs, and the proportions of visits by older patients. We found that increases in the proportion of visits by patients aged 70 years and older were associated with decreases in productivity when we controlled for differences in the mix of services used. Our results support the notion that dental practices may be less productive when providing services to older patients compared to younger patients. These findings may have implications for personnel and policy planning. Further investigation of this issue is warranted because of the limited number of practices included in the study.

Are dental practices less productive with older patients? Comparison of alternative output measures.

This study assessed the effects of increased visits by older dental patients on alternative measures of time- and dollar-based practice productivity. The Minnesota Dental Practice Analysis System was used for analysis of data from 31 practices (12,818 patients visits) reporting increased visits by older adults between June, 1980, and December, 1984. Results suggested that the productivity effects associated with older patient visits were highly dependent on the practice output measure selected. While increased visits by patients aged 70 and over were associated with increased monetary productivity per patient visit, time and monetary productivity per practice day were found to decline. An association between increased proportions of older patients visits and increased dentist minutes per visit appeared to account for this. This econometric analysis tends to support the notion that dental practices are less productive with older patients.

Economic impact of dental service utilization by older adults.

A total of 747 general dental practitioners--in Arizona, Colorado, Connecticut, Florida, and Minnesota--responded to a questionnaire in 1988 by completing a detailed productivity report of patient services performed during a specified period. The results, based on 11,909 patient visits and 22,712 dental procedures, indicated that stereotypes of older adults as underutilizers of dental care are incorrect. This finding and others, detailed within this article, indicate that older adults make up a substantial portion of regular patients and that their utilization of dental services should increase throughout 1990.

Infection control practices of Minnesota dentists: changes during 1 year.

In 1986, a survey of all licensed Minnesota dentists (N = 2,752) was conducted to determine current infection control practices. In 1987, the survey was repeated with a 45% random sample of all Minnesota dentists (N = 1,357) to monitor changes in such practices during 1 year. The findings indicate that dentists made dramatic changes in their routine use of barrier techniques and also, that rates of vaccination against hepatitis B increased decidedly. Younger dentists had higher vaccination rates and use of routine barrier techniques. Although dentists' reluctance to treat patients with AIDS decreased in frequency, some dentists still refuse to treat these patients. However, a substantial majority will treat patients with other infectious diseases.

Effectiveness of community preventive programs on improving oral health.

Although sizable community efforts in the United States have been made to educate children and adults about periodontal disease and its control, valid inferences regarding their effectiveness cannot be made because, for the most part, invalid methods of evaluation have been used. Confusion about these methods may exist because there has been little conviction that the available methods of control will stop the progress of periodontal pathology. Many recommended oral hygiene practices are probably applicable only to certain motivated individuals. An effective, comprehensive community-program for the prevention of periodontal disease remains to be developed. It is unlikely that sufficient sums of money and personnel could be diverted from the budgets of lesser-developed countries to initiate mass oral hygiene programs. Therefore, it appears that, organized community efforts appear to be promising only for the control of dental caries. However, it must be remembered that community fluoridation may not be applicable in many countries. Therefore, new strategies and vehicles to bring fluorides to all segments of the world's population are needed.