Survey Study among Dentist in Bulgaria to Develop a Model for Risk Management in Dental Practice.

Background: Quality control and risk management in the field of dental services is an important part of improving patient safety as well as that of the dentists. The introduction of a risk management model would simplify and facilitate this process. Aim: The aim of the study is to gather information about the structurе and organization of work processes in Bulgarian dental practices, which will serve as a basis for building a risk management model. Material and Methods. A survey was conducted among randomly selected dental associations in Bulgaria-Plovdiv, Sofia, Varna, and Burgas through an anonymized questionnaire, containing 30 questions. The respondents meet the main criteria, namely, to be dentists and to practice in Bulgaria. The study includes demographic data, information on the attitude of Bulgarian dentists towards issues related to quality management, and safety and risk in respect to dental practice. The results have been processed and analyzed through descriptive and graphical analysis using the statistical program SPSS 20.0. Results: A total of 103 Bulgarian dentists took part in the study, out of which 25.24% ± 4.28% have acquired a specialty. Women are 52.43% ± 4.92%, and men -47.57% ± 4.92%. The largest is the relative share of the respondents in the age range of 25-35 years -63.10% ± 4.75% and with work experience of 6-15 years -52.43% ± 4.92%. Most of the respondents do not define in writing the main tasks and activities -52.43% ± 4.92%, and do not use checklists in their practice -54.73%. The majority of the respondents do not hold regular meetings with their teams -50.49% ± 4.93%, as well as they do not conduct surveys among their patients -68.93% ± 4.56%. The majority of the respondents -41.75% ± 4.86% are guided by their personal judgment in respect to whether the written information provided to patients is comprehensible and accessible. The majority of dentists -45.63% ± 4.91% take informed consent only for expensive procedures in written and oral form -53.40% ± 4.92%. Out of all the respondents, 75.73% ± 4.22% have not analyzed the risk of slipping in their practices for the last two years. Conclusion: There is a lack of written definition of the main tasks and processes, as well as no use of checklists in the practices of most of the interviewed dentists. Meetings with teams are held irregularly. There is a lack of surveys among patients, as well as no objective feedback from patients regarding the comprehensibility of the information materials provided. Informed consent is obtained from patients mainly in written and oral form and only for costly manipulations. In the practices of most of the interviewed dentists, there has been no assessment of the risk of slipping and falling for the last 2 years.

Occlusal Indicators Used in Dental Practice: A Survey Study.

INTRODUCTION: The function of the masticatory apparatus is complete when the dentition is intact with contact between the individual teeth and proper occlusion with the antagonists. For years, occlusal contacts have been studied to determine their exact location and describing various materials and methods for their registration such as paper foil, silk, and Shimstock foil. For years, occlusal contacts have been studied to determine their exact location and describe various materials and methods for their registration such as paper foil, silk, shim stock foil, the T-Scan system, and more recently the OccluSense system. The primary aim of the study was at evaluating which of the occlusal indicators is the most commonly used in practice, and the secondary aim was whether dentists are willing to use digital methods to examine occlusion. MATERIALS AND METHODS: The main primary information of the survey was collected by sending electronically anonymous questionnaires to 2014 dentists, randomly selected from all regions of the country. 228 questionnaires were filled in and returned. To achieve the goal of the study, the self-developed questionnaire was created and tested to survey the opinion about the use of occlusal indicators in dental practice. Each questionnaire contains questions about the sociodemographic and professional status of the people in the group and their opinion about the positives and negatives and the effectiveness of occlusal indicators. RESULTS: The obtained results confirm the statement that the most frequently used occlusal indicator in dental practice is the articulation paper. Articulation foil and silk are used less frequently than articulation paper. Of the listed quality indicators, Shimstock foil is rarely used in practice. Of the indicated quantitative indicators, the T-Scan system is more used than the OccluSense system. In the era of rapid technology development, the opinion and desire of dentists to increasingly want to introduce in their clinical practice quantitative methods are the digital diagnosis of occlusion. CONCLUSION: In any dental practice, if technically possible, digital methods would be used, giving more accurate and reliable data on the registered occlusal contacts.

Root Development of Permanent Incisors and Mandibular Molars in Correlation with Treatment Plan.

BACKGROUND: The incisors and molars play a major role in the formation and function of permanent dentition. Much research has been devoted to investigating the eruption of teeth and their root development. AIM: To study the root development of permanent incisors and mandibular molars in correlation with treatment plan and proper treatment protocols. MATERIALS AND METHODS: The Demirjian's method was used to assess the root development of incisors and mandibular molars in children between 7 and 12 years old. RESULTS: In 7-year-old children most of the lower first mandibular molars (76%) had complete root length, but open apices. Eighty-two percent of the roots of the first mandibular molars of the 8-year-old children and 54% of these molars of the 9-year-old children were with open apices. The first mandibular molars had incomplete roots in the 10-year-olds (6%) and even in the 11-year-old children (4%). We detected Stage E in 32% of the 10-year-olds and in 24% of the 11-year-old children. Even in 12-year-old children we found Stage E in 4% of them from their panoramic X-rays. We detected complete root development in all of the children at the age of 12. CONCLUSIONS: Dental practitioners have to wait until the age of 10, 11 and even 12 to extract the first molars, when the furcation is formed. Proper clinical examination and diagnostic radiographs should be done before the beginning of the treatment of molars and incisors at the age between 7 and 12.

Aesthetic perception of dental fluorosis--opinions of dentists and non-specialists.

UNLABELLED: Aesthetic perception of the changes in teeth appearance is one of the factors that makes a person undertake a dental treatment. OBJECTIVE: The aim of this study was to survey dentists' and non-specialists' aesthetic perception of dental fluorosis. PATIENTS AND METHODS: We recruited 120 young people (age range 18-22 years with little knowledge of dental fluorosis and 120 randomly selected dentists. Evaluation of the abnormalities in the teeth aesthetic appearance was conducted using cards specially designed for the purpose. RESULTS: The results suggest that changes in dental fluorosis, even in the mildest forms, are perceived as deviations in the aesthetic appearance of teeth. Non-specialists are more tolerant towards the changes characteristic of mild dental fluorosis compared with their reaction to other conditions that result in deviations in the type of dentition as a whole. CONCLUSION: Further studies are needed to more precisely determine the role of aesthetic perception in determining the indications for the complex treatment of dental fluorosis.

Comparative study of dental caries and dental fluorosis in populations of different dental fluorosis prevalence.

INTRODUCTION: There is evidence that the prevalence of dental fluorosis in many countries has increased over the last three decades along with a noted decrease of dental caries. To date no comparative studies of dental caries and dental fluorosis have been conducted in Bulgaria reflecting the present-day conditions of life. AIM: To study comparatively the prevalence of dental fluorosis and dental caries and to establish what relationship, if any, there is between them. MATERIAL AND METHODS: We performed a comparative analysis of three epidemiological studies carried out in Plovdiv and Dimitrovgrad in 2004, 2005 and 2008. The hypothesis tested was that dental caries was less frequent in populations with higher prevalence of dental fluorosis (with predominance of mild fluorosis cases). Dental fluorosis was diagnosed using Dean's criteria, and dental caries was scored using the WHO criteria. The results were analysed using the alternative analysis and analysis of variance at a level of significance P < 0.05. RESULTS: The prevalence of dental fluorosis in the studied populations in Dimitrovgrad in 2004 was 56.99%, in Plovdiv in 2005--7.80%, and in 2008--23.18%. The comparison of the studies in Dimitrovgrad and Plovdiv in 2005 showed lower prevalence of dental caries and lower DMFT values in all age groups (P < 0.001) in Dimitrovgrad, where the prevalence of dental fluorosis was greater than that in Plovdiv (P < 0.001). The comparison between the studies in Plovdiv alone in 2005 and 2008 showed an increase in dental fluorosis in 2008 (P < 0.001). The prevalence of dental caries was higher in almost all groups, but the differences failed to reach statistical significance (P < 0.001). The DMFT index was higher in 2008 (P < 0.001) with the exception of some age groups. CONCLUSION: The higher prevalence of dental fluorosis does not necessarily lead to low prevalence of dental caries and low DMFT values in the specific population.