General Dentists Research Articles

Online courses for dentist continuing education: A new trend after the COVID-19 pandemic

Background/purposeOnline courses have been widely used in all levels of education during the COVID-19 pandemic. This study explored the effectiveness of a dentist continuing education (DCE) course through the online devices in Taiwan. Materials and methodsThe practicing dentists who participated in the online course of dental radiation technology for DCE offered by the Taiwan Dental Association (TWDA) in October 2022 and in March 2023 were enrolled in this study. The composition of participating dentists was confirmed by the public inquiry system and their learning effectiveness was evaluated by a questionnaire-based survey after the online DCE class. ResultsAll participating dentists (132 in October 2022 and 117 in March 2023) obtained consistent good learning outcomes in this online DCE course. Of these 249 dentists, there were 170 (68.27%) males and 79 (31.73%) females, 127 (51.00%) dental specialists and 122 (49.00%) general dentists, as well as 50 (20.08%) hospital dentists and 199 (79.92%) clinic dentists. The participation rates for this course of practicing dentists in non-municipalities (4.70%), counties (3.88%), eastern region (8.08%), and outlying islands (3.60%) were much higher than those in municipalities (0.79%), cities (1.16%), and the western region including the northern region (0.88%), central region (1.96%), and southern region (1.94%), respectively. ConclusionThe participating dentists express positive feedback on the online DCE courses, and the online DCE courses can reduce the urban-rural gap in dental education resources. The use of online DCE courses in dental education will be a future trend.

Dentist-reported differences in services provided to patients with public vs. private dental insurance

IntroductionVariation in dentists’ provision of types of dental services based on patients’ insurance may impact population access to comprehensive care. The aim of this study was to describe differences in the types of services provided to adult patients with Medicaid versus private insurance among private practice general dentists.MethodsThe data source was a 2019 survey of private practice dentists in Iowa, and the study sample included general dentists with current or recent participation in Iowa’s Medicaid program for adults (n = 264). Bivariate analyses were used to compare differences in the types of services provided to privately insured and publicly insured patients.ResultsDentists reported the greatest differences in services provided to patients with public versus private insurance for prosthodontic procedures, including complete dentures, removable partial dentures, and crown and bridge services. Endodontic services were the least frequently provided category of services provided by dentists for both patient groups. Patterns were generally similar among both urban and rural providers.ConclusionAccess to dental care for Medicaid members should be evaluated not only on the proportion of dentists who see new Medicaid patients but also on the types of services dentists provide to this population.

Current endodontic practice and use of newer technologies in Australia and New Zealand.

This study investigated endodontic clinical preferences, adoption of newer technologies and information sources among dentists and endodontists. Dental and endodontic society members in Australia and New Zealand were surveyed online regarding their endodontic treatment preferences, armamentarium, information sources and continuing professional education (CPE) attendance. Complete responses were received from 71 endodontic specialists or postgraduates (Group E) and 139 general dentists (Group D). Most of Group E used dental operating microscopes (95.8%), endodontic cone-beam computed tomography (CBCT; 98.6%) and calcium silicate-based materials (CSBMs; 97.2%), significantly more (P < 0.001) than Group D (86.3% used loupes, <32% used CBCT for endodontics or CSBMs). Most respondents used dental dam always for endodontics (94.3%), electronic apex locators (EAL; 81.0%) and engine-driven nickel-titanium (NiTi) instruments (91.4%); Group E had more experience with engine-driven NiTi (P < 0.001). Endodontic CPE attendance was highest at dental association programs (P < 0.001) while hands-on NiTi training attendance was highest via commercial companies (P < 0.05). Online information sources were commonly used (38.8% of Group D, 59.2% of Group E). Dental dam, EAL and engine-driven NiTi were almost universally used. The endodontic group reported high adoption of newer endodontic technologies. Endodontic CPE and information sources should be further surveyed as online engagement evolves. © 2023 Australian Dental Association.

Decision Making in the Restoration of Endodontically Treated Teeth: Effect of Biomimetic Dentistry Training.

The restoration of endodontically treated teeth (ETT) is challenging as these teeth often present with structural deficiencies. Currently, there is no consensus regarding the final restoration choice. Historically, the full coverage crown was the universally selected treatment for endodontically treated teeth. With advances in adhesive and biomimetic dentistry, more minimally invasive treatment modalities have become a viable option. With this study, we aim to understand the restorative decision of the general dentist with or without additional training in biomimetic dentistry. Seventy-eight general dentists, with or without biomimetic training, were surveyed to determine their restorative preferences on five extracted posterior teeth, categorized according to volumetric loss of tooth structure, as indicated by the number of missing walls, the isthmus width, the presence or absence of marginal ridges, and cusps. CAD/CAM reconstructions were made with the teeth to analyze the volume of tooth loss and compare these with the survey results. Data were compared using the chi-squared test and Fisher's exact test. The frequency of responses recommending a crown and the volume of tooth loss were correlated using the Pearson test (p < 0.05). For all five teeth, survey responses showed a statistically significant difference in the restorative decision of full coverage versus alternative restorations, with biomimetic dentists selecting a direct restoration or inlay/onlay in lieu of a full coverage crown (n = 63, p < 0.05). The age of the participant did not have a significant impact on the restorative decision making process for these teeth. The biomimetic trained dentists showed a greater tendency to select a crown option only when the volume of tooth loss was greatest, otherwise their restorative decisions tended towards the conservative treatment options. This study also demonstrates a novel method of digitally developing a volume of tooth loss to compare against the visual interpretation of the volume of tooth loss.

Knowledge and application of antimicrobial photodynamic therapy among restorative dentist in Saudi Arabia

BackgroundThe aim was to identify the restorative dentist, knowledge and application of Antimicrobial photodynamic therapy (aPDT) in dental practice; and to provide an overview of the potential challenges faced by restorative dentists (RD) in Saudi Arabia. MethodsA 15-item cross sectional study questionnaire was distributed through online portal to assess the knowledge, and practice of RD towards aPDT and its practice. The questionnaire consisted of 3 sections, exploring the demographics of participants, knowledge, application and perception of aPDT using yes/no response and Likert scale. Response means, frequencies, and chi-square tests to compare subgroups based on gender, education level, and practice experience. ResultsOut of 500 participants, 375 completed the survey forms (75% response rate). The majority was male (68%) with a mean age of 46 years. Respondents demonstrated a moderate level of knowledge (60.5%). Only 33% expressed confidence in aPDT as a standalone treatment, while 67% showed limited referrals to specialists. However, 88.5% expressed interest in receiving training and attending workshops for aPDT therapy. Education and experience significantly influenced overall knowledge question responses (p = 0.031). ConclusionMajority of restorative dentists demonstrated a moderate understanding of the role of aPDT in dentistry. More than two thirds of respondents (77%) believed that aPDT is an effective adjuvant therapy. Increased experience (> 10 years) and education (Post-graduates) showed higher application of aPDT. The study reveals the potential for incorporating aPDT knowledge into restorative dental practices, particularly among general dentists

Evaluation of Yazd Dentist’s Knowledge, Attitude and Performance of Aesthetic Management of Anterior Composite Restorations in 2020

Introduction: Nowadays, due to the rapid development of new resin restorative materials and extensive media advertising concerning the importance and impact of a beautiful smile, there is an increased demand for the restoration of anterior teeth; thus, the beauty of smile is rendered as a major concern for patients and dentists.&#x0D; Methods: In this cross-sectional descriptive study, 165 general dentists in Yazd City, Iran were selected by random sampling. Of these, 158 dentists completed the study questionnaire, including 5 demographic items and 38 more items in three parts: knowledge, attitude and performance. Gleaned data were analyzed with SPSS 16 using T-test, one-way ANOVA, descriptive statistics (frequency/percentage).&#x0D; Results: In this study, 39.9% of dentists were male and 60.1% were female. There was no statistically significant correlation between the scores of attitude and knowledge with gender, age, history of activity, and the university of dentists' study (P&gt;0.05). Yet, a statistically significant correlation was observed between the average attitude scores of dentists who participated in training courses and the dentists who did not participate in training courses (P&lt;0.05).&#x0D; Conclusion: Based on the results of the present study, dentists had average knowledge and poor attitude regarding the aesthetic management of anterior composite restorations. However, participation in courses and workshops on aesthetic management of anterior composite restorations had a great impact on dentists' attitudes. Moreover, most dentists were not satisfied with the Dental School's training regarding anterior composite restorations.

Assessment of General Dentists' Knowledge and Confidence towards Dental Implants and their Perceptions regarding Undergraduate Education

Background:Dentists are the primary sources of information regarding dental implants. Thus, they are required to be knowledgeable to meet patients’ expectations.Objective:This cross-sectional study aims to evaluate dentists’ knowledge and confidence in dental implants and investigate their perceptions regarding their undergraduate education.Methods:The study utilized a voluntary anonymous questionnaire, distributed among dentists, and graduates of King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia. The questionnaire sections were: demographics, perception regarding undergraduate education, confidence, and knowledge assessment. Descriptive statistics and Chi-square test at a statistical significance of P-value &lt;0.05 were conducted.Results:The majority 75.5% reported sufficient theoretical information regarding implant dentistry during undergraduate education. However, only 12.2% reported sufficient clinical education. Limited participants had the chance to practice implant dentistry. About half of the participants 44.9% wished they were given this opportunity. Participants’ confidence in different procedures ranged between 45.9% and 82.6%. Survey participants reported adequate knowledge in treatment planning 82.7%, in prosthetics 92.9%, and 79.6% in surgical aspects. No association was found between gender and knowledge sections, treatment planning, prosthetic, and surgical aspects of implant dentistry. Respective P-values were 0.45, 0.14, and 0.09.Conclusion:Participants were interested to obtain more clinical experience in implant dentistry during undergraduate education. Thus, adjustments are suggested to optimize the quality of education to meet graduates’ expectations.

Knowledge, Attitude, and Practice towards Chelating Agents in Endodontic Treatment among Dental Practitioners.

The use of chelating agents (CAs) in the endodontic irrigation protocol is required to dissolve the inorganic components of the smear layer. We aimed to assess the knowledge, attitude, and practice of dental professionals regarding the use of CAs during root canal treatment. A cross-sectional anonymous online survey was conducted among specialized endodontists and general dentists who routinely perform endodontic treatment and work in government-funded or private clinics in Moscow. The 8 min survey consisted of four parts: basic demographic data, knowledge (five items), attitude (four items), and practice (five items). We collected 376 completed questionnaires; a majority of the respondents were general dentists (87.5%) and worked in private clinics (77.4%). Most respondents (83.5%) showed a fair knowledge of the CAs used in endodontics, while 16.5% showed a poor knowledge of the topic. Small yet significant differences were found between endodontists and general practitioners and between dentists employed by private and government-funded clinics. A majority of dental practitioners (83%) demonstrated a positive attitude towards the use of CAs in endodontic treatment, and there were no differences among the study subgroups. Almost a third of the respondents always used chelating solutions during endodontic treatment, while 17% of the respondents did not use them at all. There were significant differences in this parameter between dentists working in private and government-funded clinics. Practice significantly correlated with attitude towards chelating agents and with knowledge of the topic. In conclusion, dental practitioners demonstrated a fair knowledge of CAs. Despite a positive attitude, 71% of the respondents did not use CAs for all endodontic patients.

The Performance of Paralleling Technique and Bisecting Angle Technique for Taking Periapical Radiographs: A Systematic Review.

Periapical radiography is a routine radiographic procedure performed by dentists on a daily basis. It can be taken with two techniques, the paralleling technique (P tech) and the bisecting angle technique (B tech). This systematic review aimed to identify the relevant literature, compare the use of P and B techs across various dental specialties, and determine the most appropriate technique to be used for different purposes in taking periapical radiographs. In January 2023, we searched PubMed, Web of Science, Scopus, and Google Scholar to identify the studies that compared the two radiographic techniques. The search string was: (paralleling AND ("bisecting angle" OR "bisected angle")). Manual reference tracing was also performed to identify the studies potentially missed. After screening, 26 studies were included for the qualitative review. The 26 included studies were published between 1976 and 2021. Ten of the studies were about general dentistry (dental radiology in general applications), whereas another ten studies were related to endodontics, such as working length estimation. Most studies advocated the use of the P tech for general, endodontics, implantology, and other indications. B tech was advocated for patients with a low palatal height. More future studies are needed to evaluate their performance in different scenarios with standardized equipment and radiographic positioning.

Motivations and experiences among dentists in rural private practice: A qualitative study.

Despite the critical importance of access to dental care for rural residents and concerns about a shrinking rural dentist workforce, few studies have examined rural dentist motivations to practice in rural areas. The aim of this study was to explore practicing rural dentists' motivations and experiences qualitatively through semi-structured interviews to help inform and guide recruitment and retention efforts in rural areas. Dentists were included in the sample frame if they were general dentists in private practice and had a primary practice located in a rural Iowa county. Rural dentists with publicly available email addresses were contacted by email to participate. Semi-structured interviews were administered to 16 private practice general dentists. All interviews were audio recorded, transcribed, and coded using pre-set and emergent codes. Participants were most commonly male (75%), under age 35 (44%), white (88%), and practiced in a partnership arrangement (44%). The main codes regarding dentists' experiences and motivations to practice in a rural area included familiarity with a rural area, community, financial factors, and clinical care delivery. Having been raised in a rural area was a major influence in most dentists' decisions about where to locate. The importance of rural upbringing in this study underscores the need to consider rural upbringing in dental student admissions. Additional findings, such as financial benefits of a rural practice and other practice-related factors can be used to inform recruitment efforts.

Reliability assessment of the 2018 classification case definitions of peri-implant health, peri-implant mucositis, and peri-implantitis.

The purpose of this study was to evaluate the reliability and accuracy in the assignment of the case definitions of peri-implant health and diseases according to the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions. Ten undergraduate students, 10 general dentists, and 10 experts in implant dentistry participated in this study. All examiners were provided with clinical and radiographic documentation of 25 dental implants. Eleven out the 25 cases were also accompanied by baseline readings. Examiners were asked to define all cases using the 2018 classification case definitions. Reliability among examiners was evaluated using the Fleiss kappa statistic. Accuracy was estimated using percentage of complete agreement and quadratic weighted kappa for pairwise comparisons between each rater and a gold standard diagnosis. The Fleiss kappa was 0.50 (95% CI: 0.48 to 0.51) and the mean quadratic weighted kappa value was 0.544. Complete agreement with the gold standard diagnosis was achieved in 59.8% of the cases. Expertise in implantology affected accuracy positively (p<0.001) while the absence of baseline readings affected it negatively (p<0.001). Both reliability and accuracy in assigning case definitions to dental implants according to the 2018 classification were mostly moderate. Some difficulties arose in the presence of specific challenging scenarios.

Artificial intelligence in dentistry

Artificial intelligence (AI) has emerged as a transformative technology in various domains, and dentistry is no exception. This paper explores the applications and implications of AI in dentistry, highlighting its potential to revolutionize dental practices, enhance patient care, and improve treatment outcomes. The population of interest for this study comprises dental practitioners, researchers, and patients involved in dental care. Dentists are increasingly recognizing the value of AI in streamlining various tasks, such as diagnosis, treatment planning, and patient management. AI algorithms can analyze radiographic images, intraoral scans, and clinical data to assist in detecting and classifying dental diseases, including caries, periodontal conditions, and oral cancers. By leveraging machine learning techniques, AI systems can provide accurate and timely diagnoses, aiding dentists in making informed decisions and improving treatment efficacy. Sampling for this study involves selecting a representative sample of dental professionals from diverse geographical regions, ranging from general dentists to specialists, to comprehensively understand their perspectives and experiences with AI in dentistry. Patients receiving dental care were also included in the sample to gauge their perceptions of AI technologies and their impact on the quality of care received. The sampling technique employed was a combination of convenience sampling and purposive sampling.

Awareness of Ethical Principles, Professional Behavior, and Ethical Treatment of Patients Among Medical and Dental Students

As future healthcare professionals, medical and dentistry students have an ethical responsibility to establish higher standards of ethics and professionalism in their interactions with patients. Therefore, expanding their knowledge and awareness of ethical concepts, professional behavior, and ethical patient treatment is essential. The aim of this research was to gather information about general medicine and dentistry students' awareness of ethical concepts, professional behavior, and ethical patient treatment. The questionnaire included 16 questions divided into four sections. The study found that most students agreed with basic professional health ethical principles, and that there was no significant difference between the students' directions (general medicine or dentistry) and the year of study (first and fourth). In this research, general medicine and dental students, in general, indicated a good level of awareness of ethical principles, professional behavior, and ethical patient treatment.

Factors Affecting Water Quality and Sustainability in Dental Practices in Greece

Good water quality, achieved with environmentally friendly means, is essential in ensuring the safe operation of a dental practice. Our aim was to evaluate procedures and protocols used by dentists for water quality and sustainability. Greek dentists (n = 206) participated in this questionnaire-based study. Statistically significant results (p &lt; 0.05) have shown that (a) female dentists were more interested in additional information about water quality (87.5% vs. 71.8%), had water supply directly from the public network to the dental unit (68.8% vs. 73.8%), were more likely to disinfect surfaces between two appointments (97.7% vs. 88.0%) and were more likely to perform annual maintenance to the dental unit (66.3% vs. 57.9%). (b) More experienced dentists were also more likely to clean the waterline network of the unit with a large amount of fluid once a day (39.3–48.3%), had newer equipment, had more handpieces, and spent more time cleaning and disinfecting the unit (χ2 = 26.21). (c) Dentists who have studied abroad were more likely to perform less strict antiseptic protocols while believing that their practices are environmentally friendly (χ2 = 10.93). Dentists with some postgraduate education were more likely to have an assistant, know the active substance of the antiseptic, supply antiseptic to the handpieces automatically and maintain the dental unit annually (χ2 = 7.24). (d) Dentists who practiced general dentistry were less likely to have an assistant and performed less strict protocols while they cleaned suctions with a large amount of fluid less often (χ2 = 11.64). Dentists who practiced in a clinic (with employees) were more likely to have newer equipment, have an assistant and perform stricter water sustainability protocols. (e) Dentists with a higher annual income were also more likely to have an assistant, perform microbiological tests for the quality of the water of the unit, have a continuous water supply system and perform stricter protocols for water quality of the unit. Overall, less experienced (and younger) dentists are more informed about water quality legislation (27.6%) compared to more experienced and older dentists (13.2–17.5%). Gender, work experience, level of education and dental office characteristics are important factors determining water sustainability, waterlines, and equipment maintenance in dental practice. Dental associations should raise awareness regarding water quality and sustainability, investing in lifelong learning, while implementing protocols and green strategies.

The psychological toll of the COVID-19 pandemic on dental care providers in Iran: A multicenter cross-sectional study.

The COVID-19 pandemic affects social and psychological resources. Healthcare workers, especially dental personnel, are more at risk for mental issues due to anxiety, pressure, and frustration. This study assessed mental health outcomes during the COVID-19 epidemic among Iranian dental care providers, focusing on insomnia, anxiety, depression, and posttraumatic stress disorder (PTSD). In this multicenter cross-sectional survey, the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, and the Global Psychotrauma Screening were masured. Six hundred thirty-eight dental care providers (dental specialists, general dentists, dental hygienists, dental assistants, and dental students) from different parts of Iran (Tehran, Shiraz, Tabriz, and Mashhad) were investigated by the stratified sampling method. The univariate analysis was incorporated as independent in binary logistic regression models to analyze the data. In this study, the significance level was set at 0.05. Among all the participants, 42.8% were dental students or residents, 21.9% were general or specialist dentists, 18.7% were dental assistants, and 16.6% were nonclinicians. The prevalence of insomnia, anxiety, and depression was 31.3%, 40.8%, and 54.9%, respectively. The frequency of participants in the low, moderate, and high levels of PTSD resulting from LCA 56.6%,33.7%,and 9.7%, respectively. This study found a significant frequency of mental health issues among Iranian dentists. Females, participants whose relatives have COVID-19, and those with a higher workload were more likely to develop mental health symptoms. As mental problems among dental professionals might affect the quality of patient care, diagnostic, supportive, and therapeutic interventions should be taken.

The Digital Aesthetic Test Drive.

The burgeoning public interest in techniques to enhance a smile has led to demand on clinicians that require important steps in the pre-treatment approval process. Digital dentistry provides a new level of planning and visualisation, improving clinical risk assessment and patient engagement. Dentists must acquire a sound understanding of aesthetic design parameters, including physiologic limitations, and must match patient expectations with clinical reality. Digital design offers flexibility not obtainable with the conventional analogue wax up. Multiple versions of a design can be viewed in a 2D or 3D simulation and accommodated efficiently in CAD software, with 3D printed models generated from each design. The ability to use a test drive or mock-up based on a 3D digital analysis and design, has created a new standard of care for treatment planning, providing an accurate and reversible preview before any definitive dentistry is done. It also places the responsibility for understanding biologic limitations of care on the general dentist, with the risk that digital planning may over-promise if not matched with underlying hard and soft tissue conditions. It improves interdisciplinary and laboratory communication and increases the predictability of the proposed treatment. The result is greater patient satisfaction and an improved informed consent process.

Survival analysis of zirconia implant-supported, fixed complete dentures: A 5-year retrospective cohort study.

Existing data on the mid-term to long-term survival rates of zirconia implant-supported, fixed complete dentures (Zir-IFCDs) are lacking. The purpose of this retrospective clinical study was to assess the prosthetic survival rate in patients treated with Zir-IFCDs. The patient record system at the Dental College of Georgia (DCG), Augusta University was searched to identify all patients treated with Zir-IFCDs from 2015 through 2022 by the DCG graduate prosthodontic, general practice residency, and Advanced Education in General Dentistry (AEGD) programs. Reasons for replacement were grouped as failure of veneering porcelain, framework fracture, implant loss, patient-driven concerns, excessive occlusal wear, and other. A total of 67 arches were found that met the inclusion criteria, 46 maxillary and 21 mandibular. The median follow-up time was 8.5 months (interquartile range, 2.7 to 30.9 months). A total of 9 of the 67 arches were identified as having failed (4 maxillary, 5 mandibular), requiring replacement. Reasons for failure were as follows: 3 framework fractures, 2 implant losses, 2 patient-related concerns, 1 fracture of veneering porcelain, and 1 unknown. The combined survival rate (Kaplan-Meier, log-normal modeling) for Zir-IFCDs was 88.8% at 1 year and 72.5% at 5 years CONCLUSIONS: Based on the findings, the Zir-IFCDs investigated had a survival rate lower than that reported in similar studies, though higher than published results for metal-acrylic resin-IFCDs. The most common source of failure was fracture of the zirconia framework. Thickness of the zirconia framework, interocclusal space, cantilever length, occlusal force, and status of the opposing dentition may have been associated with framework failures and should be investigated further.

Evaluation of Dentists' Knowledge and Attitude towards COVID-19 in Sari in 2021

Introduction: Dental health professionals and patients are at high risk of COVID-19 exposure due to blood and saliva droplets generated during dental procedures. People’s adherence for infection control is affected by their knowledge, attitudes, and practices towards COVID-19. Considering that dental practice is one of the most dangerous professions in terms of exposure to the disease, this study examines the knowledge and attitudes of dentists regarding COVID-19 in north of Iran. Material and Methods: This descriptive study was based on questionnaires that were distributed among dentists in north of Iran. Demographic characteristics, knowledge of participants about COVID-19 and infection control measures and their attitudes were evaluated. The effect of pandemic on dentists’ life and quality of dental services were also investigated. Results: Totally, 125 dentists completed the questionnaire (99 general dentists and 26 specialists). The majority of participants (n=84, 67.2%) did not perform unnecessary dental procedures during the pandemic, and 114 (91.2%) of them changed their working hours. The most of contributors (N=207, 86%) focus on preventive care, not perform unnecessary treatments and reduce the treatment sessions at the lowest possible. Conclusion: The present study concluded that majority of the participants had good knowledge and positive attitude regarding dental care and related preventive measures in the pandemic period. Although, it is suggested that dental health professionals continue to strengthen knowledge and improve attitude by health training programs.

The "Dedicated" C.B.C.T. in Dentistry.

This position statement represents a consensus of an expert committee composed by the Italian Academy of General Dentistry (Accademia Italiana Odontoiatria Generale COI-AIOG) and Italian Academy of Legal and Forensic Dentistry (Accademia Italiana di Odontoiatria Legale e Forense OL-F) on the appropriate use of cone beam computed tomography (C.B.C.T.) in dentistry. This paper analyzes the use of C.B.C.T. in light of the rapid evolution of volumetric technologies, with the new low- and ultra-low-dose exposure programs. These upgrades are determining an improvement in the precision and safety of this methodology; therefore, the need of a guideline revision of the use of C.B.C.T. for treatment planning is mandatory. It appears necessary to develop a new model of use, which, in compliance with the principle of justification and as low as reasonably achievable (ALARA) and as low as diagnostically acceptable (ALADA), can allow a functional "Dedicated C.B.C.T." exam optimized for the individuality of the patient.

The use of oral benzodiazepines for the management of dental anxiety: a web-based survey of UK dentists

Background Oral benzodiazepines (OBZs) can facilitate treatment of dentally anxious patients and are widely used in countries such as Australia and the United States. Dentists in the UK prescribe them much less often.Aims To examine OBZ prescribing by dentists in the UK, including patterns of practice, barriers to use, and alternative anxiety management strategies.Methods An online mixed-methods survey was conducted utilising Qualtrics. Participants were recruited via the private Facebook group 'For Dentists, By Dentists' during April to June 2021. Quantitative data were analysed with descriptive statistics and qualitative data with thematic analysis.Results In total, 235 dentists participated, with 91% being general dentists. Half had previously prescribed OBZs, with 36% doing so in the last year. Only 18% were confident in their use. Diazepam was the anxiolytic preferred by respondents. Two-thirds of dentists who had never prescribed anxiolytics were interested in doing so in the future. Concerns about managing anxious patients with OBZs included: inadequate training; confusion about guidelines; medico-legal risk; and issues of general practitioners prescribing anxiolytics to dental patients unbeknown to their dentist.Conclusions A lack of confidence prescribing OBZs for anxiolysis exists among UK dentists. Guidelines should be clarified, and training provided.