Treating patients with dry mouth: general dental practitioners' knowledge, attitudes and clinical management.

AIM: To assess primary care dental practitioners' knowledge, attitudes and clinical management of patients presenting with dry mouth. METHOD: A convenience sample of 200 dentists working in primary care in an NHS Health Board in Scotland was obtained. A questionnaire to assess knowledge, attitudes and clinical management of dry mouth patients was sent to all dentists on the NHS primary care service inventory. Ethical approval was obtained. RESULTS: Two hundred questionnaires were sent to the participants and 114 were returned, giving a valid response rate of 58%. Fifty percent were woman and 80% worked in the general dental service. Seventy-nine percent had been taught about xerostomia as undergraduates but only 21% had postgraduate educational experiences of dry mouth. The majority correctly stated that patients with Sjögren's syndrome would have an increased risk of dental caries, oral candidosis, frictional oral ulcers and squamous cell carcinoma. Participants had positive attitudes with regard to the importance of treating dry mouth; that it was not a trivial complaint; it affected patients' quality of life and their general health. The dentists were not confident to manage dry mouth patients. Knowledge, attitudes, confidence and intention to treat were affected by gender and type of primary care practice. Thirty-two percent of the variance of the intention to provide treatment was explained by working in the salaried dental service (SDS), confidence and attitudes regarding severity of the condition. CONCLUSIONS: Dentists working in the SDS had positive attitudes and increased confidence which were related to postgraduate educational experiences. Education at both undergraduate and postgraduate levels should be supported by clinical exposure to patients in order to improve dentists' confidence and competence to manage xerostomia and its complications.

Use of dental services: an analysis of visits, procedures and providers, 1996.

BACKGROUND: While many studies have provided data on Americans' access to dental care, few have provided a detailed understanding of what specific treatments patients receive. This article provides detailed information about the types of dental services that Americans receive and the types of providers who render them. METHODS: The authors provide national estimates for the U.S. civilian noninstitutionalized population in several socioeconomic and demographic categories regarding dental visits, procedures performed and the types of providers who performed them, using household data from the 1996 Medical Expenditure Panel Survey, or MEPS. RESULTS: Data show that while the combination of diagnostic and preventive services adds up to 65 percent of all dental procedures, the combination of periodontal and endodontic procedures represents only 3 percent. Additionally, while 81 percent of all dental visits were reported as visits to general dentists, approximately 7 percent and 5 percent of respondents who had had a dental visit reported having visited orthodontists or oral surgeons, respectively. CONCLUSION: MEPS data show the magnitude and nature of dental visits in aggregate and for each of several demographic and socioeconomic categories. This information establishes a nationally representative baseline for the U.S. population in terms of rates of utilization, number and types of procedures and variations in types of providers performing the procedures. These nationally representative estimates include data elements that describe specific dental visits, dental procedures and type of provider, and they offer details that are useful, important and not found elsewhere. PRACTICE IMPLICATIONS: By understanding these analyses, U.S. dentists will be better positioned to provide care and better meet the dental care needs of all Americans.