The program directors' perspective on the goals and objectives of advanced general dentistry training.

In September of 1991, all postgraduate general dentistry (PGD) program directors (Advanced Education in General Dentistry [AEGD] and General Practice Residency [GPR] directors [n = 325]) were surveyed to ascertain their opinions of the ideal goals and objectives of PGD programs. The response rate was 81.5 percent (n = 265). The directors rated the relative importance of various PGD program goals and objectives. The average of all the items rated was 3.4 on a scale ranging from 1 = unimportant to 4 = very important. The respondents identified several clinical and didactic subject areas that they considered very important including; infection control, CPR, dental and medical emergencies, diagnosing dentoalveolar trauma, diagnosing oral pathology, and assessment and treatment of patients with medical conditions. They also identified several training areas which were beyond the scope of a PGD program, e.g., research techniques, pediatric sedation, and selected advanced clinical procedures in dentistry (implantology and orthodontics) which require a long time to complete. In general, there was substantial agreement among the directors of different program types and sites as to the relative importance of various program goals. The largest differences were found among directors of programs from different sites, e.g., hospitals versus dental schools as opposed to directors from different program types, e.g., GPR versus AEGD. There is now a need to determine the relationship of these identified idealized goals and differences to program outcomes for the graduates of PGDs.

Patient satisfaction with dental care in a municipal hospital.

Quality assurance activities are an important part of a hospital dental department. This study reports the results of a patient satisfaction questionnaire distributed as part of the quality assurance activities at a municipal hospital. The results show patient satisfaction questionnaires are applicable to the hospital setting, patients report relative satisfaction with the care received, and they can identify specific areas of satisfaction and dissatisfaction. The number of visits, easy access and convenience to the clinic, and out-of-pocket payment for dental care are predictive of satisfaction with the dental care received at this clinic.

Polycythemia vera: dental management considerations.

This article presents a case of dental treatment in a patient with polycythemia vera. Polycythemia vera is an uncommon myeloproliferative disease that can have hematologic and surgical implications. The concerns and consequences of dental care in these patients are discussed and recommendations for dental treatment are given.

Why fear persists: health care professionals and AIDS.

KIE: Three reasons for the continuing fear of AIDS among health care professionals are suggested: the real risk of occupational exposure to the human immunodeficiency virus (HIV), the inadequacy of infection control measures to guarantee against HIV transmission, and the breakdown of communication between health care authorities and professionals because of differences in the two groups' values and goals. In order to address this fear without denying the problem or allowing it to compromise the quality of care, scientific and administrative authorities are urged to cultivate their credibility as experts by interpreting data conservatively while acknowledging inconsistencies, and small discussion groups are recommended as a mechanism for encouraging health professionals to voice their concerns and to recognize differing viewpoints.^ieng

Relationships among dental functional status, clinical dental measures, and generic health measures.

Current measures of dental health status are primarily clinical in nature and rely on clinical and radiographic assessment of the patient's dental health. Information about a patient's ability to perform usual activities related to good dental health--for example, chewing, speaking, and smiling--is not routinely collected. This study investigated what measures contribute to dental functional status, how they are related to traditional clinical measures, whether dental factors contribute to other generic measures of health, and the extent to which dental factors contribute to overall quality of life. Regression analyses of interview and clinical data from 159 dental patients show that while periodontal status and the number of dental symptoms do explain some of dental functional status, the clinical measures of decayed, missing, and filled teeth do not. Severity of medical condition is correlated with decayed/missing teeth and periodontal health. Quality of life is explained by medical functional status, perceived medical health, and perceived dental health. The dental functional status index may be useful in clarifying the relationship between dental health and overall health and quality of life measures.

Changing dentists' knowledge, attitudes, and behaviors relating to AIDS: a controlled educational intervention.

The efficacy of an educational intervention designed to improve dentists' knowledge, attitudes, and behaviors about acquired immune deficiency syndrome (AIDS) was tested. The intervention had three components: computerized feedback comparing participants' own knowledge, attitudes, and behaviors with those of fellow participants and with an ideal; periodic bulletins; and telephone conference calls with experts. The group receiving the educational package had better scores than a control group on outcomes of willingness to treat persons with AIDS; identification of human immunodeficiency virus lesions; knowledge of AIDS; and completeness of both intraoral and extraoral examinations. It was concluded that intervention is one approach to increasing dentists' positive response to the AIDS epidemic.

AIDS and dental practice.

Dental health care workers (DHCWs) can provide important diagnostic, treatment, and referral services for patients with AIDS and at risk for AIDS. They also have a responsibility to protect all patients in their practices, and themselves, from infectious disease transmission through the use of infection control. To determine the extent to which DHCWs are prepared to assume these responsibilities, a randomized survey of California DHCWs was conducted. Responses were obtained from 297 dentists, 128 hygienists, and 177 dental assistants. DHCWs who expressed a greater willingness to treat people with AIDS or HIV infection also practiced more thorough infection control. Respondents in all groups who perceived a greater percent of their patients to be at risk for AIDS were more likely to use infection control procedures (P less than .0001). They also were more willing to treat such patients (P less than .004) and were more likely to assess patients for AIDS by taking a thorough medical history (P less than .02) and sexual history (P less than .04). Since attitudes toward AIDS and perception of the percent of patients at risk in one's practice affect patient assessment and infection control procedures used by dental health care workers, educational programs designed to enhance DHCWs' response to the HIV epidemic should alert them to the extent of the problem and help them cope with their concerns.

Recent graduates' evaluation of their dental school education.

To assess recent dental graduates' perceptions about the adequacy of their education, a random sample of individuals who graduated between 1980 and 1982 was surveyed. The 362 respondents (56 percent response rate) indicated their perceived level of preparedness and the importance to practice of 75 topics in the dental school curriculum. The means for level of preparedness and importance to practice were plotted for each of the 75 topics. Those topics that new dentists believed to be underemphasized or overemphasized in the curriculum were identified. These findings have implications for planning curricular changes for dental education.

Dentist use patterns for pit and fissure sealants and topical fluorides.

A survey of 2,800 general dentists from six licensing regions was conducted to determine the current rate of pit and fissure sealants and topical fluoride use. The response rate was 56 percent. Seventy percent of general dentists used sealants on newly erupted secondary teeth and 20 percent of general dentists had never used sealants. Sixty-five percent of general dentists used topical fluorides on pedodontic patients at six-months intervals and 25 percent used them at one-year intervals. Dentists with more frequent use of sealants tended to be recent graduates who used new procedures, spent more practice time in pedodontics, came from the central region, had a hygienist in their practice, and belonged to the Academy of General Dentistry. Dentists with more frequent use of topical fluorides tended to perform frequent recall examinations. Those who performed frequent recall examinations were more likely to come from Florida and the Southeast, to believe caries spread rapidly, to be recent graduates, and to have a greater percentage of patients with insurance.