Survey results of reduced-fee and free-of-charge dental services by the membership of the Federation of Special Care Organizations in Dentistry.

In 1996, a questionnaire was mailed to all members of the Federation of Special Care Organizations in Dentistry (FSCO) in an attempt to learn more about their professional practices. Questions focused primarily on the amount of free and reduced-fee dentistry that the membership provided to the public. The questionnaire asked respondents to identify their field of practice; estimate the amount of time, the number of patients, and the monetary value of the dentistry provided; as well as to classify the types of patients to whom they provided these dental services for free or at reduced fees. Each of the FSCO respondents reported providing an average of $14,820 in free dentistry in 1995. Not surprisingly, the respondents reported treating a significant number of special-needs patients. Members also reported spending 31.0% of their clinical time working at reduced fees and 7.4% of the time working for free. This questionnaire revealed that the Federation of Special Care member respondents are donating a significant amount of dentistry and treating a large segment of special-needs patients.

Tuberculosis risk in the hospital dental practice.

Tuberculosis has re-emerged as a serious public health concern. Multidrug-resistant strains and an increase in the number of high-risk groups are posing a difficult problem for health care providers. The risk of TB transmission in hospital dental practices is potentially increasing. A 20-question survey was mailed to the membership of the American Association of Hospital Dentists, addressing various issues relating to tuberculosis. One hundred thirty-two surveys were analyzed. Twelve per cent of respondents reported at least one TB skin test conversion by a dental provider within the past year at their institution. Five respondents reported one dental provider contracting TB through patient contact. Oral TB was reported in 21 cases. Over 34% reported that active TB patients are not isolated to negative-pressure isolation rooms, 45% reported that patients are allowed to frequent public areas, and only 59% believed that drug compliance monitoring was adequate. Over 86% support TB screening in the Hospital Dental Practice. It was concluded that Hospital Dental Practice personnel may be at increased risk for exposure to TB. Dental providers must exercise strict TB prevention and employ meticulous referral and follow-up procedures for high-risk patients.

Effects of chlorhexidine during immunosuppressive chemotherapy. A preliminary report.

Immunosuppressive chemotherapy and bone marrow transplantation are increasingly used to treat and, in some cases, cure numerous malignant conditions. The systemic sequelae as a result of these immunosuppressive techniques lead to a host of oral and dental complications. The direct and indirect stomatotoxic effects lead to development of ulcerative, hemorrhagic, or infectious complications that potentially can lead to increased mortality and morbidity. Chlorhexidine was studied to evaluate its broad spectrum antimicrobial properties and to evaluate its effect on immunosuppression-induced mucositis. Our double-blind randomized study revealed that chlorhexidine versus controls had considerable effect in the bone marrow transplant cohort. Patients who received chlorhexidine while undergoing bone marrow transplantation were found to exhibit fewer and less painful mucositis lesions. This study supports prophylactic use of chlorhexidine in patients who undergo bone marrow transplantation.

Drug prescription practices of hospital dentists.

Surveys were sent to the membership of the American Association of Hospital Dentists to evaluate their prescribing practices. The 295 surveys that were evaluated revealed that current pharmacological interventions are directed primarily to the elimination of pain and infection. The respondents listed a wide variety of prescribed drug groups as well as numerous drugs within each drug group. Our respondents indicated that the future will necessitate a greater knowledge base in drug groups that today are not as widely used and recognized, such as antiviral and antifungal agents.

Medicare: trends in reimbursing hospital dental practices.

A survey of dentists working in hospitals found that dental procedures covered under Medicare are not equally reimbursed. Lack of uniform guidelines, appropriate interpretation and universal claim forms lead to problems. Most respondents favor medically adjunctive dental care in the national health care reform.