Changes In Dental Practice Research Articles

Implementation of Patient-Individualized 3D-Printed Models in Undergraduate Students' Education for Various Prosthetic Treatments: A Cross-Sectional Survey Study.

Due to rapid changes in dental practice, digital technologies have become prominent in undergraduate dental education at German universities in recent years. This shift has prompted a re-evaluation of content as well as teaching methods, particularly in courses where students are prepared for patient treatment. Traditional training on standardized models with resin teeth cannot cover the complexity of individual dental arch configuration encountered in patient situations. This study explores the use of 3D printing technology to create individualized models for prosthetic treatment simulations, aiming to evaluate students' feedback towards their experience with this training setting. First, the study describes the design and fabrication of individualized models with exchangeable teeth based on intraoral scans, mounted on connected plates with distance holders that can be fixed to standard phantom heads. Second, students provided feedback through a questionnaire, assessing various aspects such as the effectiveness of the 3D-printed models compared to traditional frasaco models for preparation exercises. The results indicated that the design of the realized models was feasible for preparation training (question no. 4: 93% positive rating) and showed positive perceptions of the 3D-printed models, with students finding them effective for preparation exercises and beneficial in bridging the gap between simulation and real patient situations (question no. 6: 69% positive rating). The study suggests that 3D printing technology offers a valuable tool in dental education, providing realistic and patient-specific scenarios for students to enhance their skills and readiness for clinical practice. Further improvements in material properties in hand with cost-effective approaches are essential for widespread implementation.

Awareness of possible complications associated with direct composite restorations: A multinational survey among dentists from 13 countries with meta-analysis

ObjectivesResin-based composites (RBCs) evolved into favoured materials for teeth restorations, marking a significant change in dental practice. Despite many advantages, RBCs exhibit various limitations in their physical and chemical properties. Therefore, we assessed the dentists' awareness of possible complications after direct composite restorations and their opinions about this material. MethodsThe online questionnaire was created in English in May 2023. A 16-item survey was dedicated to general dentists and specialists. The first section included four questions related to demographic characteristics. The second section comprised twelve questions and focused on awareness of potential side effects of composite restorations, the most crucial advantages and disadvantages of composite resins, and the frequency of experienced clinical complications after the application of composite materials. ResultsA total of 1830 dentists from 13 countries took part in the survey. Dentists most often declared awareness of low adhesion to the dentine (77.5 %) and, most rarely, solubility in oral fluids (42.6 %). Aesthetics was identified as the main advantage of composite fillings (79 %), followed by the possibility of repair (59 %) and adhesion to enamel (57 %). Polymerisation shrinkage was a major disadvantage for most countries (70 % overall). Analysing the declared potential clinical complications for all countries, statistically significant findings were obtained for marginal discolouration (OR=2.982, 95 % CI: 1.321–6.730, p-value=0.009) and borderline significance for secondary caries (OR=1.814, 95 % CI: 0.964–3.415, p-value=0.065). ConclusionsDentists value aesthetics and repairability but are aware of shrinkage and experience discolouration. The issue of toxicity and solubility seems to be the least known to dentists.Clinical significance: Dentists should use RBCs with critical caution due to possible side effects. Despite the undoubted aesthetics of direct composite restorations, it is necessary to remember potential clinical complications such as marginal discolouration or secondary caries.

Change is in the air…

Hoda Wassif discusses navigating change in dental practice, from leadership to implementation.

Evaluation of the knowledge levels of dentists and healthcare personnel regarding the changes in dental practice that had occurred during the COVID-19 pandemic

Aim: Coronavirus disease 2019 (COVID-19), which has been declared a pandemic by the World Health Organization, poses a great risk of transmission throughout society, especially among healthcare workers. The aim of this study was to evaluate the knowledge levels of dentists and healthcare personnel regarding the changes in dental practice that had occurred during the COVID-19 pandemic. Methods: An online questionnaire was sent to dentists and health personnel working in Diyarbakır, Turkey within the period from December 30, 2021 to January 6, 2022, using WhatsApp, e-mail, and special social platforms. The questionnaire was designed to identify the sociodemographic characteristics of the respondents and their awareness of new clinical procedures and of the changes in dental practice that had occurred during the COVID-19 pandemic. The data obtained from 239 dentists and healthcare personnel in Diyarbakır [118 (49.4%) female and 121 (50.6%) male; 177 dentists and 62 healthcare personnel] were evaluated. Results: Of the dentist participants, 12.7% reported that they did not perform active dental treatment during the COVID-19 pandemic due to their concerns about being infected by their patients with COVID-19 or their existing comorbidities (chronic diseases). Of the participants, 24.6% had acquired COVID-19. Most of the participants used personal protective equipment when conducting all types of dental procedures, including examinations. Conclusion: Dentists and healthcare personnel play an important role in controlling COVID-19 infection. It is very important to be aware of the possible transmission routes of COVID-19 in clinical applications, to use protective equipment during treatments, and to pay attention to personal hygiene. How to cite this article: Yılmaz UN, Eriş Derkuş F, Dündar Yılmaz B. Evaluation of the knowledge levels of dentists and healthcare personnel regarding the changes in dental practice that had occurred during the COVID-19 pandemic. J Med Dent Invest 2022;3:e221164. https://doi.org/10.5577/jomdi.e221164 Linguistic revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English. Checked for plagiarism: Yes

Modifications in Orthodontic Practice Post COVID Lockdown in Pakistan

OBJECTIVE: To assess the frequency of positive changes in orthodontic practice in Pakistani governmental and private workplaces after lifting of COVID-19 lockdown. METHODOLOGY: This cross sectional questionnaire-based study was carried out on 143 Pakistani orthodontic practitioners for the duration of 3 months. A well-constructed, computerized closed ended questionnaire was designed at an online website i.e., google drive and the link was circulated through social media and e-mail. Change in dental practice was assessed by comparing the results with CDC guidelines, keeping positive response cutoff 70%. Data was analyzed by using SPSS 22, Confounders, like educational qualification, gender and workplace were controlled through stratification. Post stratification Chi square Test was applied to assess the association of dentist's response with gender, educational level, age and workplace, keeping P value < 0.05. RESULTS: There were total 143 participants (80 female and 63 male) with age range from 23 to 56 years, with a mean age of 31.24 ± 6.82 years. Majority of the participants (75.52%) belonged to the age range of 23-33 years. Most of the orthodontists were post graduate trainees (66.4%). Out of all these participants, 67 were working at orthodontic OPD, 22 at private practice and 51 worked at both. 68.5% Implementation of positive modifications in dental practice were recorded. The chi square test results were significant (P <.05) for education and workplace of orthodontist. CONCLUSION: Most orthodontists have positively modified their dental practice post COVID-19 lockdown in Pakistan, by following WHO and CDC guidelines for Covid-19 to curtail spread of infection. KEYWORDS: Changes, Orthodontics, COVID

COVID-19 e as mudanças na prática odontológica/ COVID-19 and changes in dental practice

A Covid-19 é uma emergência de saúde global. O número de casos cresce de forma alarmante e reflete o alto índice de transmissibilidade do vírus causador da doença. A pandemia provocada pelo novo coronavírus impactou todos os âmbitos de serviços de saúde ao redor do mundo e na prática odontológica não foi diferente. Nesse contexto, os profissionais precisaram adaptar-se, frente às necessidades de atendimento, com cuidados de biossegurança ainda mais reforçados, para a proteção de pacientes, dentistas, técnicos e auxiliares. O objetivo deste trabalho é informar acerca da transmissão do vírus da Covid-19, atualizações nas normativas de biossegurança e cuidados de prevenção que viabilizem o atendimento clínico em Odontologia. Para tanto, foi realizada uma revisão de literatura utilizando artigos pesquisados nas plataformas PUBMED®, SCIELO® e LILACS®, além de Manuais de Biossegurança do ano de 2020 e 2021, correlacionando temas como a disseminação do vírus e o uso adequado de equipamentos de proteção individual. Após pesquisas, pôde-se concluir que novas diretrizes devem ser adotadas, como a utilização de equipamentos de proteção mais eficazes, priorizar atendimentos que evitem aerossóis, além da correta desinfecção do ambiente de trabalho, de modo a contribuir no combate à Covid-19.

Tratamiento de caries en época de COVID-19: Protocolos clínicos para el control de generación de aerosoles

La pandemia de la nueva enfermedad llamada COVID-19 requiere cambios importantes en la práctica dental. El coronavirus (SARS-CoV-2) está presente en secreciones de la nasofaringe y en la saliva de los pacientes infectados y las vías de transmisión del virus son por contacto directo con gotículas salivales o por aerosoles . La gran mayoría de los procedimientos dentales convencionales generan aerosoles y son fuente potencial de infección, por lo tanto, los pacientes y los profesionales de la odontología tienen un mayor riesgo de contaminación, especialmente considerando la atención de pacientes que sean portadores asintomáticos o que sean atendidos durante el período de incubación. Le corresponde al equipo odontólogico la misión de mantener un ambiente desinfectado y controlar la transmisión de esta enfermedad altamente contagiosa. En este sentido, además de los cuidados convencionales para todo el consultorio y aquellos recomendados por la Organización Mundial de la Salud contra el coronavirus, se deben implementar procedimientos adicionales a los protocolos de tratamiento diseñados para los pacientes pediátricos. Actualmente, la realización de procedimientos no invasivos, micro y mínimamente invasivos adquiere una connotación importante. Dichos tratamientos tienen en común el hecho de que se basan en los conceptos más modernos para el tratamiento de la caries, con un enfoque conservador y biológico, tienen una eficacia comprobada en el control de la enfermedad y lo más importante para el momento presente es que no requieren el uso de instrumentos rotatorios de alta velocidad o de la jeringa triple (ambas generadoras de bioaerosoles). Los aerosoles producidos por la turbina de alta rotación o por aparatos de ultrasonido pueden contaminar cualquier superficie expuesta del consultorio odontológico y dependiendo del tipo de superficie, la temperatura y la humedad del ambiente, el virus puede permanecer activo durante horas o inclusive días. Por lo tanto, todos los esfuerzos deben ser realizados para evitar los aerosoles.

Evaluating the Influence of COVID-19 Among Dental Practitioners After Lockdown.

Clinical activities at dental premises after the COVID-19 lockdown period or post-COVID-19 are likely to be a challenge for all practicing dentists. To assess the impact of the COVID-19 pandemic on dentists and change in dental practice following lockdown, a total of 1150 participants were approached through online survey forms registered on www.surveys.google. A link containing details of the questionnaire and a consent form was sent to dentists through emails and social media forums. The questionnaire included 3 domains comprising of seventeen questions. The first section focused on demographics. The second section inquired about the change in dental practice, that is, clinical hours, use of PPE, type of treatment, and patient flow. The third section investigated the impact of COVID-19 on dentistry. Means, standard deviation, and percentages were calculated using descriptive statistics. Chi-square was used to find an association between different variables. The response rate was 87%. Demographic factors revealed participants aged from 20.45 to 40.55 years. The data showed around 89.6% (896) of dentists have altered their clinical working hours post lockdown and, approximately, 59.7% (597) of dentists provided only emergency treatments. 88.1% (881) of the dentists wore PPE during dental procedures. Overall, a huge negative impact of the COVID-19 pandemic was observed among practicing dentists in terms of the dental supply chain, cost, and availability of dental equipment, treatment cost, and bill payments.COVID-19 pandemic compromised dental care. Though dentists were taking precautionary measures and have changed their practice according to the guidelines provided by the ADA and World Health Organization, they were still experiencing monetary loss due to decrease patient influx post lockdown.

Changes in dental practice in times of COVID-19: review and recommendations for dental health care

ABSTRACT The aim of this article was to discuss biosafety measures described in the main protocols for minimizing the risk of COVID-19 transmission during dental care. COVID-19 appeared in China in late 2019 and quickly spread to other countries. Factors inherent to dental practice, such as proximity to the patient, transmission through saliva and breath, and the generation of aerosols during procedures, place the dental team at the top of the list among the most vulnerable healthcare providers. Health authorities initially recommended only maintaining urgent and emergency care and suspending elective dental procedures. Currently, elective care is gradually being resumed and requires numerous adjustments to the environment and professional routine in terms of biosafety. Several methods had been recommended to prevent the spread of other infectious diseases prior to the outbreak of COVID-19. However, further modifications are needed for the waiting room, patient screening and flow, procedures, garments, and even in dental office itself. Thus, dental professionals need to be prepared to adopt the new recommendations in order to reduce the chance of disease transmission.

Assessment of Practical and Emotional Consequences of Novel Coronavirus Emergence on Clinical Dental Practice in Egypt: A Cross Sectional Study

Background: Novel COronaVIrus Disease 19 (COVID-19) outbreak has a great impact on every aspect of life. It caused an emergency status in the health system worldwide. In dentistry, it represents one of the challenges that most of the dentists and patients are facing. This survey was conducted to highlight the practical changes in dental practice created by COVID-19 emergence, and its impact on dentists’ feelings and concerns especially after Egyptian national administrative order of 15 March 2020 (Egypt Declared Partial Curfew). Methods: An anonymous online survey, formed of 23 questions, was sent to 293 dentists practicing in Egypt. Results: Almost all of the respondents (96.6%) closed or reduced their activity to urgent procedures only, 81.9% of patients canceled their appointments after 15 March 2020, and 75.1% of the dentists reported difficulties in finding Personal Protective Equipment. Also, 97.6% of the dentists reported worry of acquiring COVID-19 while working. When thinking about it, 44% of the participants reported anxiety, 28.7% concern, 16.4% fear, only 10.6% felt sad. They overall were worried about their professional future. Most of the dentists believed that some improvements could be effective. Conclusions: COVID-19 pandemic has high negative impact on dentists and dental practice in Egypt.

The Challenge of Dental Education After COVID-19 Pandemic - Present and Future Innovation Study Design.

The present work suggests research and innovation on the topic of dental education after the COVID-19 pandemic, is highly justified and could lead to a step change in dental practice. The challenge for the future in dentistry education should be revised with the COVID-19 and the possibility for future pandemics, since in most countries dental students stopped attending the dental faculties as there was a general lockdown of the population. The dental teaching has an important curriculum in the clinic where patients attend general dentistry practice. However, with SARS-CoV-2 virus, people may be reluctant having a dental treatment were airborne transmission can occur in some dental procedures. In preclinical dental education, the acquisition of clinical, technical skills, and the transfer of these skills to the clinic are extremely important. Therefore, dental education has to adapt the curriculum to embrace new technology devices, instrumentations systems, haptic systems, simulation based training, 3D printer machines, to permit validation and calibration of the technical skills of dental students.

Challenges faced by dental professionals during COVID-19- A cross sectional survey

Background: At the time of pandemics like COVID-19, dental professionals being one of the frontline workers must face a lot of challenges in workplace bringing about a lot of anxiety and stress. The purpose of this survey was to assess the physiological well-being of the dental professionals, the majority of challenges faced by them, , how they are dealing with it and what changes in their opinion could be implemented to be prepared in the wake of any future adversity.
 Methodology: We conducted a cross sectional survey via an online questionnaire that was sent to dentists in 4 different countries- India, US, UK, and Iran. The questionnaire comprised of closed ended questions grouped in broad categories of demographics, physiological well-being of dentists, Changes in dental practice during COVID-19 and Changes to be implemented post Covid-19. Descriptive analysis was performed to summarize the data with SPSS-19 software.
 Results: A total of 312 dentists (181 Males and 131 Females) from four countries responded to the study. Most of them (56.4 %) were in the age group of 30 to 40 years, 27.9 % in 25- 30 years, and 7.1% above 50 years. 47.5% dentists reported suffering from stress and anxiety due to the shutting down of their private dental practices. 72.5% dentists reported that they are worried about the operational and financial challenges to run their practice during Covid-19. 60% of the dentists had concerns due to the shortage of personal protective equipment. Most of the dental professionals (73.9%) are of the opinion that management of medical emergencies should be included in the dental curriculum, so that dentists can volunteer their services at the time of crisis and also can be well-prepared to take care of their patients.
 Conclusion: During the COVID-19 pandemic, dentists like medical professionals must face a lot of ethical and moral dilemma along with dealing with the operational challenges. The present study draws our attention to the fact that despite having faced pandemics like SARS, health professions like dentistry still need a lot of preparedness and requires modifications to face any such challenges in future.

Misinformation about COVID-19 and Dentistry on the Internet

<p><strong>Background and Objective: </strong>The COVID-19 pandemic to-date has no treatment or vaccine and protection from the viral illness is only possible by acting upon valid and reliable information. The dentists are considered to be the most vulnerable profession due to proximity with the patient, and this also puts dental patients at risk. Internet is one of the primary sources of information, therefore this study aimed to evaluate the accuracy of the online available information using validated instruments. <strong>Methods:</strong> The following terms were searched on google.com “Coronavirus and dentistry”, “COVID-19 and dentistry” and “SARS COV 2 and dentistry”. The first fifty results for each search term were evaluated. Eighteen of the websites did not meet inclusion criteria so 132 websites were critically analyzed by Health on the Net Foundation Code of Conduct (HON code) and the Journal of the American Medical Association (JAMA) benchmark. Also, the websites were categorized according to content type. <strong>Results:</strong> A total of 6 (4.54%) websites had the HON code seal, and the JAMA benchmark showed that 14 (10.6%) did not fulfill any of the requirements. Another 69 (52.3%) links had fulfilled all the requirements but 65 (94.2%) of these websites were either links to research journals or guidelines published by dental associations, universities or government organizations, and usually not accessed by the general public. <strong>Conclusion: </strong>The information available to the dentists is satisfactorily accurate and reliable, but the nonhealth personnel need to be aware of the quality of information they read. The dentists should provide information to the patients about accessing reliable online sources for information and the expected changes in dental practice. The government should regulate health information on the internet to curb apprehension associated with dental treatment and viral pandemic.</p>

Knowledge of primary care professionals about fluoride topics.

Scientific evidence on the benefits of fluoride was responsible for an important change in dental practice. Individual and collective actions have been planned to impact the epidemiology of oral health. However, questions around this topic persist, making discussions and researches still necessary. In this regard, the aim of this study was to verify the fluoride-related knowledge of pediatricians (PP) and dentists (DS) working in primary care, comparing related aspects such as its multiple sources of intake and dental fluorosis. A group of PP and DS answered as self-administered questionnaire related to fluoride knowledge. PP group presented a lower level of adherence (34%) in comparison to the DS group (70%). Fluoride-related topics were learnt at undergraduate courses by 95,95% of dentists and 38.46% of pediatricians. Ninety-two per cent of DS and 78.57% of PP claimed to know the clinical aspects of dental fluorosis. Pediatricians tend to indicate the use of fluoridated dentifrices at any age but advise less about the right amount to be placed on the toothbrush in comparison to DS. Dentists and pediatricians presented limited fluoride-related knowledge. Continued education/training is encouraged and necessary at this level in order to deliver the benefits of fluoride use to populations.

Embracing Change In Dental Practice To Deliver Better Health Outcomes- A Type 2 Diabetes Screening and Oral Health Pilot Program

Disadvantaged communities carry the highest burden of disease with respect to oral and general health. Diabetes is a growing chronic-condition in Australia with those living in regional or lower socio-economic areas at a higher risk of developing diabetes and experiencing the associated complications. Oral and periodontal disease has been linked to diabetes. Within the community dental clinic we aimed to determine the feasibility of screening for diabetes and reduce the burden of both diseases. All patients presenting to the community dental clinic of the Colac Area Health Service were given the opportunity to participate in a Diabetes screening assessment. Adults who consented completed the Australian Type 2 Diabetes Risk Assessment (AUSDRISK) with those at high risk offered an HbA1c blood test. Six hundred and seventy patients were invited to participate. Seventy-five reported confirmed diabetes and 125 were currently being monitored by their general practitioner. Ninety-six of the remaining 470 eligible patients declined to participate (participation rate 80%). The AUSDRISK was completed by 371 patients (n=3 incomplete) and identified 56 (15%) as low risk, 123 (33%) at intermediate risk and 192 (52%) at high risk. Following HbA1c blood testing, 14 patients were in the high risk range (>6.0%). The high risk category according to the AUSDRISK included 31% emergency patients, an average of 25 (IQR 19-29) Decayed Missing or Filled Teeth, 49% with early signs of periodontal disease, 73% aged 55 years or older, 48% male, 36% had a direct relative with diabetes, 18% had hypertension, 29% currently smoked and 75% had waist measurements >90 cm for men and 80cm for women. The study demonstrated that 68% of patients willing to participate in the study presenting to the community dental clinic had either confirmed diabetes, were being tested by their general practitioner or were in a high risk category (AUSDRISK).

Variations in self-reported provision of services by general dentists in private practice

Variations in dentists' provision of services have been documented, but information about contributing factors is limited. The authors used responses to a 2003 survey of general dentists in private practice in California (46 percent response rate; 3,098 dentists included in the final sample) to assess variations in service provision and its correlates. They used logistic regressions to assess the correlation of various characteristics with the self-reported percentage of time spent providing services. The results show variations in services provided by general dentists in private practice. Multiple factors, including the dentist's sex, region of practice, employment of hygienists, patients' race and population income in the area of practice were significantly and independently associated with provision of services. The survey results reflect practice variations that existed before the latest economic downturn, which resulted in a loss of jobs and medical and dental insurance. The data serve as the baseline for future studies of changes in dental practice and for assessing the impact of the 2010 health care reform legislation on dental practice. Practice Implications. Improvements in oral health care, the recent economic decline and health care reform may lead to changes in dental practice and in the dental workforce.

The Use of an Evidence-Based Portfolio in the Management of Change in Dental Practice

In this paper the author gives his opinion about the problems of getting practices to change systems in order to institute clinical governance. There are many reasons why practices need to change and for this change to be monitored. This paper explains the need for change and the use of the evidence-based portfolio, which is produced by candidates for the Membership of the Faculty of General Dental Practice (UK) [MFGDP(UK)] examination. It can also be produced by individuals who are not taking the MFGDP(UK) examination in conjunction with the Faculty of General Dental Practice (UK)'s key skills programme. It provides a mechanism for demonstrating change and for assessing the quality of care provided by a general dental practice. The author concludes that the evidence-based portfolio will enable a practitioner to apply clinical governance in a practical way.

The facilitating factors and barriers influencing change in dental practice in a sample of English general dental practitioners

The objective of this study was to investigate the barriers and facilitators to change in dental practices among a sample of general dental practitioners (GDPs) from three regions of England. In-depth face-to-face interviews with 60 GDPs were undertaken. The sample was selected from a group of 317 GDPs who had completed a questionnaire in the first phase of this study. The participants were selected to reflect diversity regarding the number and extent of self-reported changes reported in the questionnaire, and personal and practice characteristics. Of the 92 attempted contacts, 60 (65%) of the interviews were successfully completed. The interview schedule formed the basis of the interview. All the interviews and notes were transferred on to NUD*IST QSR version 4, a qualitative analysis package. No single factor was identified as being more important than another in facilitating change. The main facilitators for change were: financial factors, regular patient attendance, particularly a core patient group, staff loyalty, having regular staff meetings and open communication and having access to peer support. The main barriers to change were the reverse of the facilitators plus not having a financial stakehold in the practice. A range of factors were identified as influencing change in general dental practice. These include GDPs' attitudes and experience of change, patient factors, organisational issues, contact with peers and access to appropriate training courses.

What are the factors and barriers leading to change in how dentists practise their dentistry?

Aim The objective of this study was to investigate the barriers and facilitators to change in dental practices among a sample of general dental practitioners (GDPs) from three regions of England. Method In-depth face-to-face interviews with 60 GDPs were undertaken. The sample was selected from a group of 317 GDPs who had completed a questionnaire in the first phase of this study. The participants were selected to reflect diversity regarding the number and extent of self-reported changes reported in the questionnaire, and personal and practice characteristics. Of the 92 attempted contacts, 60 (65%) of the interviews were successfully completed. The interview schedule formed the basis of the interview. All the interviews and notes were transferred on to NUD*IST QSR version 4, a qualitative analysis package. Results No single factor was identified as being more important than another in facilitating change. The main facilitators for change were: financial factors, regular patient attendance, particularly a core patient group, staff loyalty, having regular staff meetings and open communication and having access to peer support. The main barriers to change were the reverse of the facilitators plus not having a financial stakehold in the practice. Conclusions A range of factors were identified as influencing change in general dental practice. These include GDPs' attitudes and experience of change, patient factors, organisational issues, contact with peers and access to appropriate training courses.

Analysis of Age Dependency of Permanent Tooth Loss Based on Repeated Observations.

Two problems impede the study of age dependency of tooth loss rate using dental radiographs. One is that the exact time of tooth loss is often unknown. The other is that major causes of tooth loss are assumed to result from tooth extraction by dentists. Recently dentists have avoided performing tooth extraction as summarily as in years past due to developments in dental technique and increased concern on oral health. The effect of these changes in dental practice cannot be ignored on the estimation of tooth loss probability. We devised a modification of survival analysis taking into account these two problems by using data consisting of repeated observations for each individual. A flexible statistical model allowing for individual variation in tooth loss hazard was adopted. The proposed method was shown to be valid by a Monte Carlo simulation study in which the true parameters describing age-dependency of tooth loss probability were given. We illustrated our method by applying it to actual tooth loss data from 1,284 panoramic radiographs from 642 patients obtained in a daily clinical practice where each patient underwent panoramic examination at least twice. The age-dependency of tooth loss probability for all kinds of teeth were estimated. The smaller variance of tooth loss hazard between individuals is observed on the molars compared with those of other kinds of teeth.