Do Waiting Times in Dental Offices Affect Patient Satisfaction and Evaluations of Patient-Provider Relationships? A Quasi-experimental Study

PURPOSE

Spending time in waiting rooms prior to dental visits is not uncommon for dental hygiene patients. The objectives were to determine if the length of a patients' waiting time affected their satisfaction with the appointment and their evaluation of their provider. In addition, the patient's level of education and whether the dental visit is a first visit will be examined to determine if these affected the outcome.

METHODS

Survey data were collected from 399 adult patients who came for regularly scheduled visits to a dental school clinic. The patients ranged in age from 19 to 93 years (mean=52 years; SD=16.9). For 29% of the patients, this visit was the first visit with this provider.

RESULTS

The patients whose providers were early (n=65) were more satisfied, more likely to plan to follow their provider's recommendation and evaluated their relationship with their provider more positively than patients whose providers were on time (n=283), while the patients in the "late" group (n=32) showed the most negative responses to all questions. Patients from higher educational backgrounds were most negative in their responses when their providers were late. Patients with a first visit whose providers were late had the most negative evaluations of the patient-provider relationship.

CONCLUSION

Long waiting times prior to a scheduled dental appointment have a negative effect on patients' satisfaction with their visit, the evaluations of the patient-provider relationship and the patients' intentions to return.

Reasons for patients' visits in the dental offices of Cracow in the years 2005-2006 and 2013-2014

INTRODUCTION

Caries is a serious health problem affecting the Polish population, mostly due to a low level of health awareness, which is reflected in irregular check-ups and a tendency for patients to visit the dentist only when they are already experiencing pain.

OBJECTIVE OF THE STUDY

to compare patients' reasons for visiting dental offices and the treatment they received during the years 2005-2006 and 2013-2014.

MATERIAL AND METHODS

Data was obtained from 495 medical files stored in 4 randomly selected dental offices in Cracow. Information was gathered on age, sex, place of residence, reasons for visiting the dentist, referrals, frequency of dental visits and procedures performed.

RESULTS

The study showed that women visited dental offices more frequently (56%) than men. The participants were aged between 1 and 91. The majority of the patients lived in large towns or cities (81.6%). Approximately 50% of the patients visited a dental office once a month. The study showed a significant increase in one-time visits (from 18.5% to 30.6%). The most frequent motivation for visiting a dental office was to receive conservative treatment, while the least common reasons were prophylaxis and tooth injuries.

CONCLUSIONS

Throughout the period under review, changes occurred in the profile of the patients who visited dental offices during these periods. One alarming trend was the significant increase in the number of patients who visited dental offices only once (12%). The main reason why patients visited dental offices did not change--more than 60% came to have caries treated but often after a single visit they did not continue the treatment despite needing to do so.

Occupational health problems among dentists in Moldavian Region of Romania

AIM

The aim of this study was to evaluate the occupational health problems among dentists in the Moldavian Region of Romania.

MATERIAL AND METHODS

Questionnaire-based study was conducted on 152 dentists aged between 25-65 years practicing in 6 counties the Moldavian Region of Romania. The questionnaire included questions related to the dentists' occupational health pathology. Data were statistically analyzed using SPSS 14.0 and chi-square test (p<0.05).

RESULTS

The majority of the dentists (91%) consider that they are exposed to an occupational risk and 41.8% of them experienced a percutaneus injury caused by sharp instruments in the last year.74.6% of the dentists are protected by vaccination against hepatitis B and 76.1% against influenza. 49.3% of the dentists reported eye injuries caused by solid particles (13.2%), blood splashes (14.7%) and/or chemicals (20,5%). Allergies associated to professional activity were reported by 76.1% of the dentists.

CONCLUSIONS

The dental staff must be informed in order to recognize, control and prevent the potential occupational hazards in the workplace.

Preventive attitudes towards infection transmission in dental offices in North-East Romania

AIM

The aim of this study was to evaluate the level of knowledge and the current attitudes towards infection control in the dental offices in the Northeast Romania.

MATERIAL AND METHODS

Questionnaire-based study conducted on 152 dentists aged between 25-65 years practicing in 6 Northeast Romania counties. The questionnaire included questions related to current infection control procedures and attitudes. Data were statistically analyzed using SPSS 14.0 and chi-square test (p<0.05).

RESULTS

The majority of the dentists (83.6%) consider that universities should provide a substantial education regarding infection control through postgraduate courses, but 7.2% of the respondents are not sure about their usefulness. The clinical decision related to patient's treatment is influenced by his infectious status for 67.8% of the dentists. Of these, 19.1% have over 20 years of practice and 48.0% are females. Almost all dentists (93.4%), regardless of gender (96.4% females and 87.8% males) undergo periodic testing for blood-borne viral infections (hepatitis B, C and HIV). Full protective equipment is used for all the patients by 86.2% of the dentists, while 12.5% use it only for the infectious ones. 65.2% of the dentists use steam sterilization equipment (autoclave), and 80,8% use dry heat. The majority of the dentists (82.6%) believe that the patient must always be informed about the adopted infection control measures, but 21.7% declare to do so only in some particular cases.

CONCLUSIONS

Dentists knowledge and attitudes towards infection control must be improved by educational interventions in order to adhere to the European standards.

Expanded function allied dental personnel and dental practice productivity and efficiency

This study examined the impact of expanded function allied dental personnel on the productivity and efficiency of general dental practices. Detailed practice financial and clinical data were obtained from a convenience sample of 154 general dental practices in Colorado. In this state, expanded function dental assistants can provide a wide range of reversible dental services/procedures, and dental hygienists can give local anesthesia. The survey identified practices that currently use expanded function allied dental personnel and the specific services/procedures delegated. Practice productivity was measured using patient visits, gross billings, and net income. Practice efficiency was assessed using a multivariate linear program, Data Envelopment Analysis. Sixty-four percent of the practices were found to use expanded function allied dental personnel, and on average they delegated 31.4 percent of delegatable services/procedures. Practices that used expanded function allied dental personnel treated more patients and had higher gross billings and net incomes than those practices that did not; the more services they delegated, the higher was the practice's productivity and efficiency. The effective use of expanded function allied dental personnel has the potential to substantially expand the capacity of general dental practices to treat more patients and to generate higher incomes for dental practices.

Economic impact of dental hygienists on solo dental practices

The fact that a significant percentage of dentists employ dental hygienists raises an important question: Are dental practices that utilize a dental hygienist structurally and operationally different from practices that do not? This article explores differences among dental practices that operate with and without dental hygienists. Using data from the American Dental Association's 2003 Survey of Dental Practice, a random sample survey of U.S. dentists, descriptive statistics were used to compare selected characteristics of solo general practitioners with and without dental hygienists. Multivariate regression analysis was used to estimate the effect of dental hygienists on the gross billings and net incomes of solo general practitioners. Differences in practice characteristics--such as hours spent in the practice and hours spent treating patients, wait time for a recall visit, number of operatories, square feet of office space, net income, and gross billings--were found between solo general practitioners who had dental hygienists and those who did not. Solo general practitioners with dental hygienists had higher gross billings. Higher gross billings would be expected, as would higher expenses. However, net incomes of those with dental hygienists were also higher. In contrast, the mean waiting time for a recall visit was higher among dentists who employed dental hygienists. Depending on personal preferences, availability of qualified personnel, etc., dentists who do not employ dental hygienists but have been contemplating that path may want to further research the benefits and opportunities that may be realized.

[Prosthetic rehabilitation: needs in Senegalese dental offices]

Knowledge of dental prosthetic needs will develop strategies for prevention and treatment through a package of individual, community and professional policies. The aim of this study was to evaluate prosthetic needs in Senegalese dental offices. The survey was conducted among people aged 15 years and more attending Senegalese dental clinics. The mean number of missing teeth was 4.4. Only 55.3% of the sample expressed the need for dentures and 81.8% had a diagnosed need for prosthesis. A statistically significant difference was noticed between the needs diagnosed and the expressed needs (p < 0.0001). Finally, this study reveals that the need for prosthetic treatment is real in the Senegalese dental offices.

Occupational violence against dental professionals in southern Nigeria

OBJECTIVE

To determine the prevalence of workplace violence in Oral healthcare centres against Nigerian dental professionals.

METHODS

A questionnaire-based cross-sectional survey of 175 randomly selected dental professionals working in Oral healthcare centres of University Teaching Hospitals in Southern Nigeria was conducted.

RESULTS

The survey response rate was 78.9%. The respondents were dentists (58.0%), dental nurses (18.1%), dental technologists (12.3%), dental therapists (8.0%) and dental record officers (3.6%). The prevalence of violence in Nigerian Oral healthcare centres was 31.9%. There was no statistically significant difference in the prevalence of violence against dentist and dental auxiliaries. Violence was often associated with long waiting time (27.3%), cancellation of appointment (13.6%), outcome of patient's treatment (11.4%), alcohol intoxication (9.1%), psychiatric patient (6.8%,) patient's bill (4.5%) and others (27.3%). Non-physical violence in form of loud shouting (50.0%) threat (22.7%), sexual harassment (6.8%) and swearing (2.3%) constituted the majority while physical violence in form of bullying and hitting constituted the remaining 18.2%. The main perpetrators of the violence were patients (54.5%) and patient's relatives/friends (18.2%). The expressed impact of violence among the respondents include fear (18.2%), impaired job performance (15.9%), psychological problems (13.6%) and off duty (9.1%). No impact was declared by 43.2% of respondents.

CONCLUSION

The prevalence of workplace violence in Oral healthcare centres against dental professionals in Southern Nigeria was significant and had a substantial effect on dental professionals' well-being thus necessitating urgent attention.

Mapping dental establishments in Oklahoma just before the recession

Census Bureau data indicate a continuing increase in the number and size of dental establishments in the period just prior to the recent recession. During this same period, the combination of a limited increase of the population in Oklahoma and limited proportional increase in the numbers of dentists and dental establishments resulted in decreases in population-to-dental facility ratios. The usual favorable expectations of an economic upswing after a recession for dental establishments may need to be tempered given these developments.

Wheelchair-accessible dental offices in Nagasaki, Japan

OBJECTIVE

To determine the proportion of dental offices in Nagasaki, Japan, that are wheelchair accessible and to identify factors related to the adoption of barrier-free designs within the study area.

METHODS

All 703 dental offices managed by members of the Nagasaki Prefecture Dental Association were studied. We evaluated the accessibility of the offices to wheelchair users and compared the percentage and adjusted odds ratio of the accessible dental offices according to dental office characteristics.

RESULTS

Of the respondents, 62% deemed their offices accessible. The percentage and adjusted odds ratio of accessible offices were significantly higher for offices offering more specialties, providing more frequent home visits, and with younger head dentists.

CONCLUSION

According to the self-reported results from dentists, more than one third of the dental offices in Nagasaki were not easily accessible by mobility-impaired persons. Dentists should the understand architectural and perceptual barriers faced by handicapped persons and the aged and consider barrier-free office designs for all patients.

Prevalence of oral lesions in the dental office

Comprehensive head and neck examinations provide the best opportunity to carefully evaluate the oral cavity for the presence of disease. For this study, 40 dental professionals in 20 dental offices in Northern Ohio received a three-hour standardization course on oral pathology, performed head and neck examinations on all adult patients over a three-week period, and recorded the presumptive identification of all observed oral lesions. Lesion-positive and lesion-negative patients were compared on patient age, gender, tobacco usage, denture status, and the type of provider (dentist or hygienist) making the observations. Providers performed head and neck examinations on 3,182 adults, 847 (26.7%) of whom had 1,073 lesions. Lesion-positive and negative patients were similar in terms of age and gender, although patients with lesions were almost twice as likely to use tobacco and more than 2.5 times as likely to wear dentures. Most lesions were classified as white (36.6%), followed by red (17%), ulcerated (14%), pigmented (14%), and soft tissue enlargements (12%). Leukoplakia and erythroplakia were observed in 1% of the screened adults, although patients were not aware of the presence of these conditions. Overall, the prevalence of lesions in dental patients (26.7%) was similar to national estimates (27.9%), but the prevalence of some specific lesions varied.

How does the keystone state compare nationally?

Census Bureau reports were used to develop data for "average" dental establishments in the Commonwealth of Pennsylvania with comparison to national averages. The need to monitor dental establishment activities beyond the confines of one's own practice is emphasized.

Dental establishment business activity in New York State counties at start of the millennium

Bureau of the Census reports for 2002 were used to develop business data for "average" dental establishments in each of the counties in New York State. On average, between 1997 and 2002, when compared to national information, the number of New York State dental establishments increased at a slower rate, had a smaller resident population per establishment, reported lower gross receipts, had fewer employees and paid lower salaries to employees.

Desigualdades nas condições de controle de infecção em consultórios odontológicos em município brasileiro

Analisar as condições de controle de infecção dos estabelecimentos de assistência odontológica do Município de Cariacica, Espírito Santo, Brasil. Dados relativos ao respondente, localização e tipo de estabelecimento, bem como às condições do ambiente, equipamentos e materiais, foram recolhidos mediante observação direta em todos os serviços odontológicos e em vinte estabelecimentos operados por "dentistas práticos". Para efetuar a análise, foi construído Índice de Controle de Infecção (ICI) composto de 19 variáveis, e quanto menor o seu valor, melhores as condições de controle. Foram observados 113 estabelecimentos. A condição nos estabelecimentos mantidos por dentistas não licenciados (médiaICI = 23,05, dp = 11,86) foi quatro vezes pior em relação ao melhor valor observado nos estabelecimentos particulares. Em condição intermediária, localizaram-se os serviços públicos (médiaICI = 16,27; dp = 6,96). Os serviços localizados nas regiões periféricas apresentaram condição quatro vezes pior. Observou-se profunda divisão nas condições sanitárias da assistência odontológica. Uma parcela significativa da população, que depende de assistência odontológica oferecida por estabelecimentos operados por "dentistas práticos", estava exposta a condições sanitárias de elevado risco à infecção cruzada.

The national survey of adverse reactions to dental materials in the UK: a preliminary study by the UK Adverse Reactions Reporting Project

OBJECTIVE

Dental treatment involves the use of a wide range of materials. Many of the dental materials or their components pose a potential risk to the patient and member of the dental team. Pre-market biocompatibility testing cannot guarantee absolute safety, making monitoring of materials likely to cause an adverse reaction essential. The prevalence of adverse reactions to dental materials amongst dental patients and staff has not been systematically monitored in the UK. This project aims to develop a systematic approach to the evaluation and monitoring of the extent and severity of adverse reactions to dental materials in the UK.

METHOD

Through the distribution of reporting forms to dental surgeries and laboratories in the UK, the ARRP has received 1,075 complete reports relating to adverse reactions seen or experienced by dental staff and patients.

RESULTS

The main findings were that different materials cause adverse reactions to different groups of people. The largest proportion of patient related adverse reactions were reported to be due to metals (n = 175). These were mainly amalgam associated oral lichenoid reactions (n = 124). Dental technicians reported acrylic resin as the causal factor of hand dermatitis in 61% (44 out of a total 72) of cases reported. Finally, dental surgery staff reported gloves as causing hand dermatitis in 75% of cases (398 out of a total 531).

CONCLUSIONS

Different dental materials affect different person groups depending on their exposure to the material. Dental staff are most at risk from an adverse reaction to latex gloves, whereas most reported reactions for patients were due to metals. For dental technicians the biggest danger of an adverse reaction was from acrylic resins. There is a need to continue to raise the awareness among dental professionals of the existence of the Adverse Reactions Reporting Project so as to overcome problems of under-reporting.

Pennsylvania dental establishments in 2001

Census Bureau reports for 2001 were used to develop data for "average" dental establishments in the counties of the state of Pennsylvania. There have been marked decreases in the number of residents per establishment and the proportional representation of smaller dental establishments (less than five employees) since 1980. Dental establishment "average" employee salaries ranged from $17,400 to more than $37,100 in the various counties. The need to monitor dental establishment activities beyond the confines of one's own facility is emphasized.

New York State--dental establishments--keep getting larger

Bureau of the Census data, through the end of the 1990s, indicate a continuing increase in the size of dental establishments. A review at the national, state and county levels document these developments for New York State.

Biological monitoring of sterilizers and sterilization failures in Norwegian dental offices in 1985 and 1996

It is essential that dental office sterilizers be regularly challenged with biological indicators (BIs) in order to prove that the test spores are being killed during sterilization. The aims of the study were to biologically monitor Norwegian dental office sterilizers and to identify factors contributing to sterilization failure. In 1985, participants received a packet containing: (i) 4 BI units; (ii) a set of instructions; (iii) a questionnaire concerning operation (including biological monitoring) of the office sterilizer(s), and (iv) a return-address envelope. In 1996, offices were sent (i) a survey which included demographic questions and inquiries concerning instrument sterilization processes; (ii) 2 sets of 3 BI units with instructions for their use on 2 different days; (iii) 1 control BI unit that was not to be processed, and (iv) a return-address envelope. Both private and public offices participated. Response rate to the 1996 study was 60%, which was 9.1% of all dental offices in Norway. Testing results indicated a 6.3% overall sterilization failure rate. Three out of 163 steam autoclaves (SAs) (1.8% of total) and 14 out of 109 dry heat (DH) ovens (12.8% of total) failed. DH ovens were over 7 times more likely to fail BI testing than were SAs (chi2, P < 0.01). Demographic or hygiene procedural factors could not be correlated to sterilization performance (chi2, P > 0.05). The failure rate for SAs (n = 216) in 1985 was almost 5 times greater than in 1996 (8.8% vs 1.8%). Improvement in sterilizer performance during the decade may be related to issuance in 1986 of Norway's 1st infection control guidelines for dentistry and greater awareness of infection control practices and/or to increases over the previous 10 years in the number of postgraduate courses offered in infection control. The current Norwegian guidelines on infection control practices in public health services, including dentistry, recommend regular biological monitoring of sterilizers without specifying how often. There is a lack of information among Norwegian dentists as to how frequently dental office sterilizers should be regularly monitored by BI.

Indiana dentists surveyed for effectiveness of biological testing of heat sterilization units

The Indiana State Department of Health, Oral Health Services, randomly selected Indiana dentists to ascertain their compliance toward biological testing of heat sterilization units. Slightly more than 85 percent of the dentists surveyed were in compliance with the law regulating biological testing of heat sterilization units.

Work force trends that influence dental service capacity

Although the total number of active private dentists increased by 21.7 percent between 1982 and 1995, the number of active private part-time dentists increased by 104 percent, while the number of active private full-time dentists increased by 8 percent. Thus, the total number of hours active private dentists spent in the office has not increased to the same extent as the number of active private dentists. During the same period, however, the average number of hours spent treating patients increased, indicating that dentists are becoming more efficient in directing their office hours toward clinical dentistry. The distribution of active private part-and full-time dentists and the actual number of hours they spent in the dental office and spent treating patients provide a more complete picture of the capacity of the dental care delivery system than only looking at the increase in the total number of dentists.

Validation of a survey instrument to measure the extent to which physician and dentist office environments discourage smoking

The health professional's office environment has been identified as one of the potential influences on smoking behaviour of patients. This study compared characteristics of office smoking policies and environments of 30 physicians and 30 dentists using both telephone survey and site visit. The site visit was considered the 'gold standard'. The sequence of interview presentation was randomly reversed for half the physicians and half the dentists to control for order effects. Kappa estimates and two-way Analysis of Variance were used on categorical and continuous variables, respectively. The results show there was a high agreement between the two modes of surveying. Physicians and dentists do not differ in level of agreement and in the consistency of responses obtained by telephone and site visit. We conclude that a telephone survey is a valid method to obtain smoking-related information from health professional offices.

Transmission of infectious diseases in outpatient health care settings

Increased provision of health care in outpatient settings and concerns about occupational transmission of infections have focused attention on the risk of transmission of infectious diseases in ambulatory health care settings. In contrast to inpatient nosocomial infections, infections transmitted in outpatient settings are neither systematically monitored nor likely to be detected by routine qi surveillance. To better define the spectrum of such events, we reviewed the literature to identify cases and clusters of infections associated with outpatient health care. In this review, we identified and epidemiologically characterized 53 such reports that occurred from 1961 through 1990. Transmission occurred in general medical offices, clinics, and emergency departments (23); ophthalmologists' offices and clinics (11); dental offices (13); and alternative-care settings (six). Our findings suggest that inpatient infection-control practices should be extended to outpatient health care settings by assigning specific responsibility for infection control and by adapting surveillance methods and prevention measures.

[The characteristics of the occurrence and course of perimaxillary inflammatory processes based on the data from the work of a dental office in Burundi]

The development and course of inflammatory processes in the patients living in the Republic of Burundi develop on the patients' living conditions, nutrition, dentistry care status, etc. Patients with alimentary dystrophy of varying severity and with malaria should be administered, besides surgical and conservative treatment, vitamin therapy, diets, and antimalarial therapy.

An evaluation of radiographic equipment and procedures in 300 dental offices in the United States

As part of the development and testing of a dental practice quality assessment instrument, data were gathered regarding the radiological practices of a nationwide sample of 300 general dentistry offices. The distribution of assessment scores was compared for practice size (solo versus nonsolo) and practice age (1-19 years versus 20 or more years). Practice habits varied widely, from a high of 99% of the offices using a leaded apron to a low of 23% of the offices having a written policy regarding the use of ionizing radiation. Most offices successfully managed administrative items such as mounting and dating radiographs. However, for items such as radiographic exposure, tissue coverage, and radiographic interpretation, general performance was fair.