Dental Organizations Research Articles

Repair or replacement of defective restorations by dentists in The Dental Practice-Based Research Network

The authors aimed to determine whether dentists in practices belonging to The Dental Practice-Based Research Network (DPBRN) were more likely to repair or to replace a restoration that they diagnosed as defective; to quantify dentists' specific reasons for repairing or replacing restorations; and to test the hypothesis that certain dentist-, patient- and restoration-related variables are associated with the decision between repairing and replacing restorations. This cross-sectional study had a consecutive patient and restoration recruitment design. Practitioner-investigators (P-Is) recorded data for consecutively seen restorations in permanent teeth that needed repair or replacement. The DPBRN is a consortium of dental practitioners and dental organizations in the United States and Scandinavia. The collected data included the primary reason for repair or replacement, tooth surface or surfaces involved, restorative materials used and patients' demographic information. P-Is collected data regarding 9,484 restorations from 7,502 patients in 197 practices. Seventy-five percent (7,073) of restorations were replaced and 25 percent (2,411) repaired. Secondary caries was the main reason (43 percent, n = 4,124) for treatment. Factors associated with a greater likelihood of repairing versus replacing restorations (P < .05) included having graduated from dental school more recently, practicing in a large group practice, being the dentist who placed the original restoration, patient's being of an older age, the original restorative material's being something other than amalgam, restoration of a molar and the original restoration's involving fewer tooth surfaces. DPBRN dentists were more likely to replace than to repair restorations. Secondary caries was the most common reason for repairing or replacing restorations. Certain dentist-, patient- and restoration-related variables were associated with the repair-or-replace decision. The selection of minimally invasive treatment for an existing restoration is critical, as it may affect the longevity of the tooth.

Planning dental services using the methods of marketing

Aim. To justify the use of marketing methods in the activities of dental institutions. Methods. During the period 2008-2011 conducted was a sociological survey of 857 patients with detailed clinical examination; eight predictive models were developed. Used were variational statistics, regression analysis, mathematical modeling, expert method. Results. 171 (27.0%) men and 460 (73.0%) women went to seek care in commercial dental institutions. 267 (33.0%) men and 459 (67.0%) women went to seek care in state dental institutions. The referability of women to dentists was higher in both cases (p 0.05). Women aged 20-29 years preferred to go to commercial dental institutions (32.0±2.3%), than to the state ones (17.0±1.8%, p 0.001), while men, on the contrary, went to the state (37.0±2.4%) rather than commercial dental institutions (20.0±2.0%, p 0.001). At the age of 30-39 years the women went to state dental institutions (33%) more frequently than to commercial dental institutions (29%), while men - mostly to commercial dental institutions (26%) compared with the state (17%). Among the reasons for seeking dental treatment in a commercial organization the first one is the lack of queues at the reception: to surgeons 46.1±1.7%, therapists 58.3±1.7% and orthopedists 60.0±1.85%; the second place is held by a convenient patient schedule: for the profile of surgery 34.2±1.6%, therapy - 26.7±1.5%, orthopedics - 22.0±1.4%, and the contribution of other causes did not exceed 10.0±1.0%. Proposed were eight prognostic models in the form of regression analysis equations for complex evaluation of the influence of factors, which determine the choice of a health care institution, and the referral to the therapist-dentist, surgeon-dentist, orthopedist-dentist, and orthodontist both in public and private health care organizations. Conclusion. Prognostic matrices, calculated using the formulas of mathematical analysis, can be used when planning outpatient dental care, justifying the required number of dentists’ positions in the state and commercial dental organizations.

CSCW Based Dental Clinic Image &amp; Video Signal Processing

The collaborative system for medical image and video analysis used via Internet provides convenience and efficiencies for dental clinic. The CSCW based dental clinic image &amp; video signal processing technology can provide doctors located in different hospitals to achieve a cooperative diagnosis through the dental images tools, telemedicine, and electronic patient records (EPR) and video-conference. It would have very important application value and practical prospect in dental clinic healthcare processing and bring great benefits to small and medium dental clinical healthcare organizations.

Dentists’ use of caries risk assessment and individualized caries prevention for their adult patients: findings from The Dental Practice-Based Research Network

Few studies have examined dentists' subjective ratings of importance of caries risk factors or tested whether dentists use this information in treatment planning. This study tested several hypotheses related to caries risk assessment (CRA) and individualized caries prevention (ICP). Data were collected as part of a questionnaire entitled 'Assessment of Caries Diagnosis and Caries Treatment', completed by 547 practitioners who belong to The Dental Practice-Based Research Network (DPBRN), a consortium of participating practices and dental organizations. Sixty-nine percent of DPBRN dentists perform CRA on their patients. Recently graduated dentists, dentists with busier practices, and those who believe a dentist can predict future caries were the most likely to use CRA. The association between CRA and individualized prevention was weaker than expected (r = 0.21). Dentists who perform CRA provide ICP to 57% of their patients, compared with 42% for dentists who do not perform CRA. Based on their responses to radiographic and clinical scenarios in the questionnaire, dentists who use CRA appear to use this information in restorative decisions. A substantial percentage of DPBRN dentists do not perform CRA, and there is not a strong linkage between its use and use of individualized preventive regimens for adult patients. More progress in the implementation of current scientific evidence in this area is warranted.

Methods Used by Accredited Dental Specialty Programs to Advertise Faculty Positions: Results of a National Survey

The various reasons for the current and projected shortages of dental faculty members in the United States have received much attention. Dental school deans have reported that the top three factors impacting their ability to fill faculty positions are meeting the requirements of the position, lack of response to position announcement, and salary/budget limitations. An electronic survey sent to program directors of specialty programs at all accredited U.S. dental schools inquired about the number of vacant positions, advertised vacant positions, reasons for not advertising, selection of advertising medium, results of advertising, and assistance from professional dental organizations. A total of seventy-three permanently funded full-time faculty positions were reported vacant, with 89.0 percent of these positions having been advertised in nationally recognized professional journals and newsletters. Networking or word-of-mouth was reported as the most successful method for advertising. The majority of those responding reported that professional dental organizations did not help with filling vacant faculty positions, but that they would utilize the American Dental Association's website or their specialty organization's website to post faculty positions if they were easy to use and update.

The effects of personality types on turnover intention and job retention

Objectives: To deter job migration and to facilitate a more efficient personnel management system, a personality type analysis tool, such as MBTI and Enneagram, may be considered. These tools can facilitate better recognition of talent among prospective employees, as well as more efficient allocation of tasks for greater job satisfaction. Methods: This study conducted direct interviews with dental hygienists currently employed at two major dental organizations, which operate the largest networks of clinics across the greater metropolitan area. Results : First, in terms of number of turnover experiences, the Head Type showed lower task satisfaction, whereas the Body Type exhibited greater task satisfaction. Second, the Head Type showed greater job satisfaction compared to the other types. Third, the SJ Type, often considered the traditionalist in terms of long-term employments, exhibited greater tendencies toward long-term commitment with one employer. Fourth, dental hygienists, in terms of long-term employment, are negatively affected by task satisfaction, and positively affected by job satisfaction. Conclusions: It is thought to be considerable to use personality type analysis tools in clinical human resource management.

Preferences for caries prevention agents in adult patients: findings from the dental practice-based research network.

To identify factors that are significantly associated with dentists' use of specific caries preventive agents in adult patients, and whether dentists who use one preventive agent are also more likely to use certain others. Data were collected from 564 practitioners in The Dental Practice-Based Research Network, a multi-region consortium of participating practices and dental organizations. In-office topical fluoride was the method most frequently used. Regarding at-home preventive agents, there was little difference in preference between nonprescription fluoride, prescription fluoride, or chlorhexidine rinse. Dentists who most frequently used caries prevention were also those who regularly perform caries risk assessment and individualize caries prevention at the patient level. Higher percentages of patients with dental insurance were significantly associated with more use of in-office prevention modalities. Female dentists and dentists with more-recent training were more likely to recommend preventive agents that are applied by the patient. Dentists who reported more-conservative decisions in clinical treatment scenarios were also more likely to use caries preventive agents. Groups of dentist who shared a common preference for certain preventive agents were identified. One group used preventive agents selectively, whereas the other groups predominately used either in-office or at-home fluorides. Caries prevention is commonly used with adult patients. However, these results suggest that only a subset of dentists base preventive treatments on caries risk at the individual patient level.

Age at and Reasons for the First Dental Visit

The ideal time for the first dental visit of a child as recommended by many professional dental organizations across the world is by the age of one year. The aim of this study was to survey the age and the most common causes for the first visit to the dental office, as well as the recommendations of dentists regarding this visit. The present study included 289 children visiting a dentist for the first time. The children were divided into 5 age groups and the reasons for the visit were categorized into 9 groups. The variables we assessed were the percentages of children in each age group and the reasons for the first visit to the dentist. Respondents to a questionnaire were 145 dentists. The survey included questions on gender, years of professional experience, specialty, ability to work with children and recommendations concerning the age of the first visit to the dentist. The greatest number of children making their first dental visit were in the 3-6 year-olds (51.90 percent) and the smallest number were the children younger than 1 year (1.73%). The most common reason for making this visit was caries and its complications (59.86%). The second most common reason was parents' decision to have a prophylactic examination of their child (26.99%). The number of dentists in this country that recommended that the first visit should be before the age of 1 year is small (17.93%). 39.31% of the respondents recommended that the first dental visit should take place between 1 and 2 years of age, and 31.03 percent between 2 and 3 years. It was only pediatric dentists that recommended a dentist appointment in the first year of life - 47.37%. This study found that it was the female dentists that predominantly admit and treat children in their dental practices. The results of the study show that in this country there is no established practice for children to make their first dental visit before they turn one year of age. The predominant cause to make the first visit is caries and its complications. It is necessary to work out recommendations on the age for the first visit to the pediatric dentist and related prophylactic measures.

Children's Oral Health: The Time for Change is Now

D uring my tenure as US Surgeon General, it was my privilege to work with leaders in the dental, public health, and research communities to generate Oral Health in America—A Report of the Surgeon General, which we published in 2000. We made several very strong recommendations in the report with the hope that they would stimulate action. Indeed, a Surgeon General’s worst nightmare is to produce a report that just sits on the shelf gathering dust. This special oral health issue of Academic Pediatrics is proof that that has not happened. Not only was there the very important follow-up workshop and conference, The Face of a Child in 2000, and the publication A National Call to Action to Promote Oral Health in 2003, but the intervening years have seen a growing movement to address the oral health needs of children. In particular, the American Academy of Pediatrics held a PEDS21 symposium, Oral Health in the 21st Century, where I spoke, followed by a national oral health summit in November 2008, where experts from leading medical, dental, and other organizations, family advocates, and federal agencies described progress in meeting the recommendations of the 2000 Surgeon General’s Report on oral health. Most importantly, the group discussed strategies to accelerate children’s access to oral health care services in America in light of epidemiologic evidence of increasing dental disease in some of our very youngest children. The papers in this issue summarize the strides that have been made since 2000 but also identify areas where we can—and must—redouble our efforts to assure progress. I commend the American Academy of Pediatrics, the Academic Pediatric Association, their collaborators in the public and private sectors, and the editors of Academic

The Relationship of Periodontal Disease to Diseases and Disorders at Distant Sites: Communication to Health Care Professionals and Patients

The body of research defining relationships among periodontal disease and certain systemic diseases and disorders has been expanding, and questions have been raised regarding what information should be conveyed to health care professionals and patients. Representatives from dentistry, medicine, the academic community and the insurance industry convened a two-day workshop July 23 and 24, 2007. The workshop participants achieved general consensus on a number of issues, including the need for greater cooperation between the health care professions. This cooperation should translate into improved clinical care as physicians refer patients for dental care, and dentists are proactive in regard to the general health of their patients. Communication to health care professionals requires a multifaceted approach that includes publication of research findings in medical and dental journals, cooperation among professional organizations and initiatives at the local level such as presentations at medical grand rounds. Dental schools should play a role in their health science centers. Communication with patients may improve through the use of targeted informational brochures in the offices of medical specialists, appropriate media campaigns and efforts led by local dental organizations. It is too early to provide specific recommendations regarding the treatment of periodontal disease to improve specific health outcomes, but dentists can become advocates for a general health promotion and disease prevention message. The lifestyles approach includes an improved diet, smoking cessation, appropriate hygiene practices and stress reduction. These strategies can improve oral and general health outcomes.

ADA's Sedation and Anesthesia Guidelines Pass: Will They Be Universally Accepted?

The American Dental Association's newly revised “Guidelines for the Use of Sedation and General Anesthesia by Dentists” and “Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students” overwhelmingly passed the ADA's 2007 House of Delegates by more than 92%. What was formerly defined as “anxiolysis” is now “minimal sedation.” Minimal sedation includes nitrous oxide-oxygen alone, or enteral minimal sedation alone, or a combination of the two. It is limited by the administration of no more than the maximum recommended dose for unmonitored home use of a single enteral sedative, with the possibility of giving another half-maximum dose later in the procedure, if needed, when the original effect begins to wane. There was little controversy associated with the minimal sedation guidelines. The parenteral moderate sedation guidelines, formerly called “parenteral conscious sedation,” and the deep sedation/general anesthesia practice guidelines had only minor changes and were not significantly debated at several preliminary open discussion meetings preceding the House vote. The only controversial section of the new guidelines involved a new entity called “moderate enteral sedation,” for which there had been no teaching or practice guidelines in the past. Because the old guidelines did not address this area, they merely cautioned against administering multiple doses of oral sedatives because of an increased risk for producing a level of sedation deeper than what the dentist intended. Moderate enteral sedation necessitates more training than needed for administering minimal enteral sedation because the dentist could be giving more than the maximum recommended dose contained in the FDA-approved labeling for unmonitored home use. It typically involves titration of an enteral sedative to an endpoint that may be a little deeper than that attained with minimal sedation, yet this level still must provide a margin of safety wide enough to make it “unlikely” that the patient will drift into deep sedation. The ADA's experts in sedation education believed that the following course content could adequately teach the necessary principles for dentists to administer enteral moderate sedation safely: 1. 24 Hours of didactic training. 2. Observation of at least 10 enteral moderate sedation cases, including at least 3 actual hands-on cases with no more than 5 students per teacher in an adequately equipped clinical facility, including the rescue of a patient from deep sedation. 3. Advanced cardiac life support training (typically 2 days) or an acceptable sedation emergency course with emphasis on airway management and ventilation. 4. Basic life support for the healthcare provider that includes training in positive pressure ventilation with a bag-valve-mask. 5. For additional safety, the course director must certify the competency of each dentist. A dentist cannot just sign up for the competency course, leave early, and still pass the course. 6. Finally, these are minimal teaching standards. Because the course director must certify the competency of each participant, additional hours may be required for teachers and their students to meet this requirement. The total number of hours and experiences in moderate enteral sedation are considerably more than the “mere 24 hours” of training that some dentists erroneously proclaim is the weak link in the guidelines. While these dentists argue that the didactic hours for moderate enteral sedation are too low or that the number of moderate enteral sedation cases observed or actually participated in by the student are too few, others have said that the new guidelines are much too rigorous. Who is right? The truthful answer is that we do not know for certain at this point. What we do know is that the educators believe that the guidelines are reasonable in all areas and that we should give them a chance to prove it. It is your editor's hope that when moderate enteral sedation courses are developed, the ADA community will receive feedback on whether competency can be attained with the recommended hours or whether they should be increased or reduced. Until then, I recommend that all dentists, dental organizations, state dental boards, and legislators universally accept the ADA guidelines as an integral part of their rules and regulations. The guidelines will surely change over the years as new technologies, techniques, drugs, and standards evolve. If the term “According to the Current ADA Guidelines” is written into the dental board's rules, they would not have to be reworded every time the guidelines are updated. We must realize that no additional amount of required hours of training or continuing education or stricter dental board rules will totally eliminate human errors or their dire consequences. Poor outcomes do not necessarily mean that the guidelines and rules are faulty or that they must be immediately changed. My hope is that universal acceptance of the ADA guidelines will lead to reasonable rules to increase the margin of safety for our patients without unnecessarily overregulating our profession.

Caries management: technical solutions to biological problems or evidence‐based care?

Caries-related clinical decision-making remains a centrepiece of clinical dentistry. However, the oral disease patterns are rapidly changing towards the better among major sections of the populations, most notably in the high-income countries. The caries decline is well documented among children and younger adults, and is gradually seen to trickle into middle and old age as well. Although it is tempting for the dental profession to take the credit for this development, the evidence points in a different direction. The major contribution of dentistry seems primarily related to changes in the treatment philosophies towards a less interventionist approach. This review aims to spur a further change in the diagnostic and treatment criteria used in the management of dental caries for the benefit of the oral health status of our patients. We must come to terms with the fact that our traditional core skills, our manual dexterity and technical competence, have less to offer to oral health than we have been accustomed to think. The dental schools and the professional dental organizations must carry the responsibility for promoting the necessary changes in the caries related clinical decision-making strategies to allow practicing dentists to provide appropriate oral health care to our populations.

Gerostomatologie - eine Herausforderung auch für den Öffentlichen Gesundheitsdienst

The dental services of the public health service (OGD) should not confine themselves to dental screening in kindergartens and schools but also turn their attention to the advancement of oral health in the special risk groups of the senior citizens. Although government resources are limited, new capacities could be gained by restructuring. Is it really prudent, in a lifetime perspective, for the OGD to solely focus on the oral health of youths while oral neglect in long-term care carries on unabated? A stronger support by the OGD of gerodontology should be instituted on its boards, publicised in health reports, and implemented in supervisory bodies for quality management of the long-term care facilities. An endorsement of the structures of long-term care insurance and training facilities would be desirable. The OGD could assist the fitter seniors through specific education to participate in dental prevention programmes and motivate physicians to inspect the oral cavity. Furthermore, recommendations regarding the structuring of geriatric dental care by the OGD would be helpful. The OGD is a vital partner to gerodontology. Therefore, further projects should be conducted in cooperation with dental organisations.

Developing a Consensus Framework for an Effective and Efficient Disaster Response Health System: A National Call to Action

Eighteen national organizations, representing medicine, dentistry, nursing, hospital systems, public health, and emergency medical services, have worked together to create a framework for a national and regional disaster response health system that is scalable, multidisciplinary, and seamless, and based on an all-hazards approach. In July 2005 and June 2006 the American Medical Association (AMA) and the American Public Health Association (APHA) convened the AMA/APHA Linkages Leadership Summit, with funding from the Centers for Disease Control and Prevention under the Terrorism Injuries: Information Dissemination and Exchange (TIIDE) program. As cofacilitators, James J. James, MD, DrPH, MHA, director of the AMA Center for Public Health Preparedness and Disaster Response, and Georges Benjamin, MD, FACP, FACEP(E), APHA executive director, met with leaders from 16 national medical, dental, hospital, nursing, hospital systems, public health, and emergency medical services organizations in Chicago (2005) and New Orleans (2006) to deliberate the deficiencies in the medical and public health disaster response system and the lack of necessary linkages between key components of this system: the health care, emergency medical services, and public health sectors. The goal was to reach consensus on a set of overarching recommendations to improve and sustain health system preparedness and to combine each organization's advocacy expertise and experience to promote a shared policy agenda. The full summit report contains 53 consensus-based recommendations, which will serve as the framework for a coordinated national agenda for strengthening health system preparedness for terrorism and other disasters. The 9 most overarching critical recommendations from the report are highlighted here. Although the summit report presents important perspectives on the subject of preparedness for public health emergencies, we must understand that preparedness is a process and that these recommendations must be reviewed and refined continually over time.

Effects of fluoridation of community water supplies for people with chronic kidney disease

Research on the effects of fluorides on oral healthhas been in existence for almost a century. Followingthe observation that communities with naturallyfluoridated drinking water had a lower incidence oftooth decay, many developed countries initiatedartificial water fluoridation programmes, wherebyfluoride is added to the reticulated water supply,such that it reaches approximately one part fluorideper million parts water (ppm) or 1mg fluoride per litreof water (mg/l). Recent reviews [1–5] summarizing theextensive fluoride literature have concluded that waterfluoridation reduces the prevalence of dental decay,and it is estimated that a median of six people need toreceive fluoridated water for one extra person to becaries-free [2]. Compared with other methods ofsystemic fluoridation (including fluoridated sugar,milk or salt, fluoride toothpastes, fluoride supple-ments), water fluoridation is argued to be the mostcost-effective, equitable and safe means to providecommunity-wide protection against tooth decay [6].As a result, artificial fluoridation of community watersupplies is currently supported by numerous interna-tional health and dental organizations, including theWorld Health Organization and the InternationalAssociation for Dental Research.However, while access to fluoridated drinkingwater has positive effects on dental health, thecharacteristics of fluoride metabolism mean thatfluoride consumption may have implications for thekidney. The calcified tissues in the human body contain99% of the body burden of fluoride and most of thisis non-exchangeable. Absorption of fluoride is rapidand extensive, with about 50% of the absorbedfluoride becoming associated with calcified tissueswithin 24h and the remainder being excreted in theurine. In infants and young children, the amount offluoride retained in calcified tissues is >50% of theingested daily amount. The renal clearance of fluorideis high, around 30–40ml/min in healthy adults [7].Fluoride is freely filtered by the glomerulus and thenundergoes a variable amount of tubular reabsorption.Fluoride excretion falls markedly in the presence ofan acid urine and is increased with higher rates ofurine flow [8–10]. Considering the pivotal role of thekidney in the body’s ability to metabolize fluoride,there have been surprisingly few attempts to synthesizestudies relating to the relationship between fluorideconsumption and kidney function. The most recentliterature reviews on the health effects of fluorideintake have contained limited discussion on thepotential impact on the kidneys [1–5].Recently there has been a resurgence of interest inthe artificial fluoridation of drinking water inAustralia, with efforts to expand the fluoridation ofpublic water supplies to the one remaining unfluori-dated capital city (Brisbane) and several unfluoridatedregional areas. With the renewed debate in Australiaregarding water fluoridation, questions have beenraised concerning the impact of fluoride consumptionfor the large proportion of the Australian populationaffected by chronic kidney disease (CKD). In thegeneral Australian community over age 25, there isevidence of at least one indicator of CKD (proteinuriaor reduced kidney function) in 16% of individuals[11]. However, CKD is frequently asymptomatic,and many afflicted individuals will have significantreduction of kidney function but no overt signs orsymptoms, and hence will be unaware they have thecondition.The United States National Kidney Foundationpublished a brief position statement on fluoridationof drinking water in the early 1980s [12], and concludedthat there was insufficient evidence to recommendthe use of fluoride-free drinking water for all peoplewith CKD. This position statement was reaffirmed in1998, but no new research or discussion was added.

Interest and Responsibility of ADA in Dental Licensure

Initial licensure is a critical milestone and point of entry to the profession; it should go without saying that the organization that represents more than 70% of professionally active dentists would care deeply about the process that determines the character of its future and defines its image in the eyes of the public. The American Dental Association's (ADA) documented history of activity and leadership on licensure issues and the organization's guiding documents (Strategic Plan, Current Policies, Principles of Ethics and Code of Professional Conduct and Constitution and Bylaws) all lend credence to the Association's role in the licensure process. ADA members, other dental organizations, private and governmental agencies, and the public recognize the ADA as an authority on matters relating to dentistry. These circumstances comprise the best available evidence supporting the important role of the ADA in facilitating communication, collaboration and consensus-building in the continuous enhancement of the licensure process to meet the needs of all stakeholders.

A transformação no mercado de serviços odontológicos e as disputas pelo monopólio da prática odontológica no século XIX

The article analyzes the process by which dentistry acquired the status of a profession. The setting is the mid-nineteenth-century United States, where the West's first professional dental organizations were founded, and the focus is on some aspects of the development of a dental market and on the professional disputes among practitioners of the dental trade, who wanted a monopoly within this field of knowledge. Certain outside factors played a major role in the emergence of the profession, including changes in patterns of sugar consumption (which spread dental caries disease throughout society) as well as the expansion of the dental service market. The subsequent proliferation of distinct groups of dental practitioners--both qualified and unqualified to practice dentistry--and their competition for a place in the dental market reflect the battle waged to establish jurisdiction in this field and the emergence of dentistry as a 'modern profession'.

Real-World Implementation of Evidence-Based Dental Practice

Fear of the unknown is well acknowledged as a human response rooted in the instinct for self preservation. Although this reaction may serve its purpose in certain specific contexts, it historically has proven to be a hindrance to progress in certain social domains. Ignorance in any form poses as a major obstacle of human progress via its thwarting effect on the intelligent response to what is not known. To vanquish ignorance is to gain insight and do away with fear. As the profession of dentistry continues to overcome its fear of the evidence-based approach to clinical practice via improved understanding and appreciation of this concept, so will its ability to implement its fundamentals. It can be said that through this gained insight will flow improved clinical evidence that in turn will facilitate better outcomes and increased patient trust and satisfaction. The profession’s informal reticence of the concepts of evidence-based practice the last few years has given way to the formal adoption of resolutions by state dental organizations and specifically by the American Dental Association in 2002:

A survey of preprocedural antiseptic mouth rinse use in Army dental clinics.

The objective of this project was to evaluate the use of preprocedural mouth rinses in Army dental clinics. Three hundred six-question surveys were distributed to 10 Army dental organizations throughout the United States and Germany during the period from March 2001 to March 2002. Two hundred fifty-four surveys were completed and returned. Simple mathematics were used to evaluate answers to the questionnaires. The 254 respondents included military dentists (n = 190), civilian dentists used by the military (n = 27), registered dental hygienists (n = 20), and military-trained dental hygiene technicians (n = 17). Eighty-four and one-tenth percent of respondents (n = 216) use preprocedural rinses in their practices to prevent possible disease transmission (n = 85) or to decrease chances of postoperative infection (n = 167). Chlorhexidine gluconate (n = 170) and phenol-based essential oil preparations (n = 84) are the most commonly used products. The perceived greatest benefits of preprocedural rinsing are to decrease oral bacterial load (38%), to decrease incidence of postoperative infection (21%), and to decrease aerosolization of bacteria (8.66%). Army dental clinics make extensive use of antimicrobial preprocedural rinses. Chlorhexidine and Listerine (Warner-Lambert Consumer Healthcare, Morris Plains, NJ) are the most commonly used products. Currently available literature appears to support the use of these products in preventing or diminishing the chances of postoperative infection.

The FDI World Dental Federation web-site

The FDI World Dental Federation web-site contains information about the organisation itself, about congresses and dental manufacturers, and has a special area for dental professionals. The authors feel that this web-site is an interesting and valuable electronic portal for general dental practitioners and dental researchers, as well as for national dental organisations. The site contains a tremendous amount of information. Some recommendations are offered to further improve this informative and well-constructed web-site.