Dental Clinic Patients Research Articles

치과의원 내원환자들의 긍정적 구전과 치과 의료서비스 품질 및 고객만족도 분석

치과 의료계의 국 내외 여건변화 및 의료소비자들의 의료지식 향상에 따른 기대수준과 욕구 증대는 치과의료산업의 경쟁심화를 가져왔다. 이러한 치과의료 환경 변화에 적극적으로 대처하기 위해서는 치과의료 마케팅 전략구축에 노력할 필요가 있다. 따라서 본 연구는 치과의원 내원환자들의 긍정적 구전과 치과 의료서비스 품질 및 고객만족도 관계를 검증하여 치과의료 현장에서 적용할 수 있는 효율적인 마케팅 전략 개발에 필요한 근거를 제공하고자 한다. 이를 위해 서울, 경기에 소재하고 있는 6개 치과의원을 대상으로 2010년 3월 22일부터 4월 9일까지 3주에 걸쳐 실시하였다. 분석 결과는 다음과 같다. 긍정적 구전 경험 대상자의 치과 의료서비스 품질 인식(p<.001)과 고객만족도(p<.001)는 비 구전 경험 대상자에 비해 높은 것으로 나타났다. 긍정적 구전 경험자의 치과 의료서비스 품질 인식과 고객만족도는 정적 상관관계(r=.852, p<.001)가 있는 것으로 나타났다. 긍정적 구전 경험자에서 치과 의료서비스 품질 인식과 고객만족도가 일반적 특성 중 연령(p<.01, p<.001)과 치과이용 경력(p<.01, p<.05)에서 높게 인식됨을 확인하였다. 본 연구 결과는 긍정적 구전 유발을 위한 대상자별 차별화된 마케팅전략 수립에 있어 실증적 근거자료로 활용될 것이라 사료된다. Dental health care in modern society has gradually been developing with patients'expectation, desire, and medical knowledge according to the changes in the medical industry. Dental marketing strategy is necessary to construct a better dental health environment in order to cope with customers' changes and desire. The purpose of this study was to evaluate the positive comments by word-of-mouth experience, quality of dental clinic service and customer satisfaction among dental patients. The study surveyed 5oo subjects being treated at 6 dental clinics in Seoul and Gyeonggi province. It was conducted from March 22 to April 9, 2010. The subject groups with a positive experience through word - of - mouth who had a perception about the quality of dental clinic service (p<.001) and customer satisfaction (p<.001) were higher than other groups who had no comments on their dental treatment and clinics. The results showed that there was a correlation(r=. 852, p<.001) between the positive comments by word-of- mouthabout the quality of dental clinics service and customer satisfaction. The perception of dental clinic service and patients' satisfaction with positive comments by word of mouth was highly recognized by older and more experienced patients of dental treatment. Therefore, the results suggest that empirical information on important factors about strategic marketing lead to positive comments by word of mouth experience for patients in dental clinics.

Form and semantics of communication in dental encounters: oral health, probability and time

The purpose of this article is twofold. First, it introduces a new method for capturing the intricacy of communication in contemporary healthcare encounters. The method, termed 'form analysis', was developed from the systems theory of Niklas Luhmann. It is hoped that the paper will introduce form analysis as a new method to help understand complex communications in health systems. Second, the paper demonstrates an application of form analysis in communications in dental encounters. Data were collected through 36 observed encounters between five dentists and 20 patients in UK NHS primary and secondary care dental clinics. The study found a range of semantic forms relevant for these encounters, three of which are discussed at length in this article. The forms of communications illustrate how the dichotomy of dental professional and patient perspectives transforms into complex, non-linear observations about oral health. Dentistry, it seems, remains up to date not only through the emergence of new technologies, but also through reflexivity in observing and assessing oral health. These observations are exposed to the contingency of clinical decisions and the temporal aspects of the clinical system.

Evaluation of Outcomes for Tobacco Cessation Counseling in the Dalhousie University Dental Hygiene Curriculum

As part of their curriculum, senior dental hygiene students at Dalhousie University Faculty of Dentistry provide tobacco cessation counseling (TCC). This study was conducted to evaluate the effectiveness of the TCC didactic curriculum and its clinical extensions. Research methods included a comprehensive literature search, an assessment of available resources related to TCC, and a structured telephone interview. The interview, consisting of ten summative questions, was conducted to determine the current tobacco use status of clients who had been counseled by a dental hygiene student for tobacco cessation. A target population of 132 subjects was extracted from axiUm, Dalhousie University dental clinic's patient database. The population represented clients who had TCC from 2001 to 2008. The investigators wanted to know if the client was 1) advised to quit tobacco use; 2) informed of the health risks of using tobacco; 3) still using tobacco; 4) taught self-examination techniques for oral cancer; and 5) if any post-counseling follow-up was initiated. A convenience size of fifty-one subjects was obtained. Survey results, along with the assessment of resources, revealed that the current TCC program needed improvement. As a result of the research, changes were implemented aimed at improving the effectiveness of the TCC program, and recommendations were made for further changes to enhance the overall program effectiveness.

Attitudes about rapid Oral HIV screening test in dental clinics

Purpose : The aim of this stud�� was to evaluate the patient's and dentist's perspective and knowledge on rapid human immunodeficiency virus screening test in dental setting. Material and Methods: In March 2009, 100 patients and 100 dentists at College of Dentistry, Yonsei University were provided an attitude assessment survey. Results : Results were analyzed for acceptance of testing and potential barriers. 94% of patients agreed to take a rapid HIV screening test and 77% of dentists were willing to provide the test to their patients. Also the current knowledge state of patients and dentists on HIV infection was not accurate as expected. Conclusion : Overall, dental clinic patients widely accepted the offer of rapid oral HIV screening. Rapid HIV screening test in the dental setting ran be an important option to increase the number of individuals who know their HIV status.

Overuse of non-prescription analgesics by dental clinic patients

BackgroundMany patients present to dental clinics for treatment of painful conditions. Prior to seeking treatment, many of these patients will self-medicate with non-prescription analgesics (NPA), and some will unintentionally overdose on these products. The objective of this study is to describe the use of NPA among dental patients.MethodsAll adult patients presenting to an urban dental clinic during a two-week period in January and February of 2001 were approached to participate in this research project. Trained research assistants using a standardized questionnaire interviewed patients. Patient demographics and the NPA usage over the 3 days preceding the office visit were recorded. We defined a supra-therapeutic dose as any dose greater than the total recommended daily dose stated on package labeling.ResultsWe approached 194 patients and 127 participated. The mean age of participants was 35.5 years, 52% were male. Analgesic use preceding the visit was reported by 99 of 127 patients, and most (81/99) used a NPA exclusively. Fifty-four percent of NPA users were taking more than one NPA. NPA users reported using ibuprofen (37%), acetaminophen (27%), acetaminophen/aspirin combination product (8%), naproxen (8%), and aspirin (4%). Sixteen patients reported supra-therapeutic use of one or more NPA (some ingested multiple products): ibuprofen (14), acetaminophen (3), and naproxen (5).ConclusionNPA use was common in patients presenting to a dental clinic. A significant minority of patients reported excessive dosing of NPA. Ibuprofen was the most frequently misused product, followed by naproxen and acetaminophen. Though mostly aware of the potential toxicity of NPA, many patients used supra-therapeutic dosages.

P.8.a.013 An independent clinician group of excellence to improve psychiatric clinical trials in France

Chronological age estimation from the dental parameters is becoming increasingly important. The London atlas of tooth development is the most recent developed method and represents a modification of the previous older methods.The aim of this study was to evaluate the accuracy of the London atlas for the dental age estimation in the Portuguese population.The study sample included 736 radiographic images (498 females and 238 males) of Portuguese origin, patients of Dental Clinic of Superior Institute of Health Sciences Egas Moniz and Dental Medicine Faculty, University of Lisbon. The age range of the individuals was between 3 and 24 years. Estimated age was compared with the chronological age using the paired t-test.The results showed that there was no statistically significant difference between left and right side of the jaw (p > 0.05). Both sides showed an average overestimation of age by one month approximately. Moreover, the significant difference between chronological and estimated age was not observed in the females. However, the significant difference was observed in a sample coming from males (right: p = 0.008; left: p = 0.003).Our results showed that the London atlas can be potentially used as a tool for age estimation. However, the difference between sexes clearly suggests that separate charts should be made for each sex. Further studies, which will have as a final goal the development of a new method for age estimation using dental parameters, are needed.

The presenting complaints of low income adults for emergency dental care: an analysis of 35,000 episodes in Victoria, Australia.

This study examined the mix of presenting problems faced by a large diverse dental service treating low-income Australian adults and provides a basis for communities to understand and manage demand for dental services. A retrospective analysis in a state-wide multi-centre dental health service. Data for all patients (in all public adult dental clinics in the state of Victoria during May-Aug 2005) who used the emergency services in a 12 week period were recorded and analysed. A triage question tree was developed and embedded into a neural network based computer triage tool. Approximately 52% of low income adults presenting for emergency treatment required treatment on the day of triage. The main problem was with natural teeth (89.6%). Of those with natural teeth problems, 41.3% had pain disturbing their sleep patterns and 14.7% had experienced a swelling. Metropolitan patients accessed the services 2.3 times more than rural patients. These data clearly highlight that there is significant opportunity to reduce nearly 48% of on-day demand for emergency dental care through the application of appropriately clinical based triage.

Patients' Attitudes about Rapid Oral HIV Screening in an Urban, Free Dental Clinic

The 2006 Centers for Disease Control recommendations for routine HIV screening in all health care settings could include dental clinics an important testing venue. However, little is known about patients' attitudes regarding the routine use of rapid oral HIV screening at an urban free dental clinic. This pilot study seeks to evaluate the patient perspective on rapid HIV screening in this setting. In June 2007, patients at a free dental clinic in Kansas City, Missouri, were provided an attitude assessment survey prior to their dental visit. This dental clinic serves a diverse patient population consisting of approximately 37% white, 47% black, 6% Hispanic, 4% Asian, and 1% Native American uninsured patients. Results were analyzed for acceptance of testing and potential barriers. Of the 150 respondents, 73% reported they would be willing to take a free rapid HIV screening test during their dental visit. Overall, 91% of Hispanics, 79% of Caucasians, and 73% of African American patients reported they would be willing to be screened. Patients with a history of multiple prior screening tests for HIV were more likely to agree to oral rapid HIV screening in the dental clinic. The majority (62%) reported that it did not matter who provided them with the screening result, although some (37%) preferred their dentist above any other provider. Low self-perception of risk (37%) and having already received screening elsewhere (24%) were the main reasons for not accepting a free, rapid HIV screening. Overall, dental clinic patients widely accepted the offer of rapid oral HIV screening. Rapid HIV screening in the dental clinic setting is a viable option to increase the number of individuals who know their HIV status.

A questionnaire survey on the effect of the sound of dental drills on the feeling of patients in dental clinics

A questionnaire survey on the effect of the sound of dental drills on the feeling of patients in dental clinics

Emergency Dental Clinic Patients in South Devon, their Anxiety Levels, Expressed Demand for Treatment under Sedation and Suitability for Management under Sedation

To assess the anxiety levels of patients attending two salaried dental service emergency clinics, their expressed demand for treatment under sedation, and their medical suitability for dental sedation. A questionnaire survey, incorporating the Modified Dental Anxiety Scale (MDAS) and assessment of American Society of Anesthesiologists' (ASA) physical status classification, of all adult patients attending two emergency dental clinics in Torquay and Newton Abbot. 513 patients returned questionnaires. Only five declined to take part in the study. The mean MDAS for patients attending the two emergency dental clinics was 14.09 (SD 6.04) and 41.9% of patients were classified as dentally anxious (MDAS >15). A preference for treatment under sedation was expressed by 56.3%, of all patients, of whom 50.5% were classified as ASA 1 (without health problems) and would have been suitable for sedation in primary dental care. The reported dental anxiety levels of patients attending the two emergency dental clinics were found to be much higher than those found by previous studies in general dental practice and at dental school emergency clinics. There was a high expressed demand for treatment under sedation. Further studies are needed to assess the levels of dental anxiety seen at other dental emergency clinics and a health needs assessment to determine need as opposed to expressed demand.

The Need for Tobacco Education: Studies of Collegiate Dental Hygiene Patients and Faculty

The need for inclusion of comprehensive tobacco control education/training for health care providers continues to be stressed in publications addressing cessation services. The dental appointment presents an excellent opportunity to provide tobacco interventions to basically healthy people on regular intervals. The purpose of this study was twofold: 1) to assess the need (stage of change and concomitant need for tobacco cessation intervention) of dental hygiene patients at a Midwest dental hygiene clinic, and 2) to assess and compare the level of tobacco intervention education currently being offered by dental hygiene educators in a Midwestern state. Patients (n=426) of a collegiate dental health clinic completed a survey that assessed the level and type of tobacco cessation intervention patients might require. A statewide sample of dental hygiene faculty (n=97) were surveyed to determine the attitudes, perceived barriers, and current practices in tobacco education offered in their programs. Of patients who currently smoked (34.5 percent), 24.7 percent indicated being in the Action stage of change; 14.2 percent were in Preparation; 22.2 percent were in Contemplation; and 29 percent were in Precontemplation. Although faculty indicated tobacco education was very important (5.03 on 1-6 scale), they felt only moderately confident delivering tobacco education (3.18 on a 1-5 scale). Only 16 percent to 35 percent of faculty reported that their curriculum included brief motivational interviewing, pharmacotherapies, or setting-up a private practice tobacco control program. The results strongly suggest the need for a comprehensive, competency-based tobacco curriculum to enhance and expand existing dental hygiene programs.

Coexistent Concerns

University dental clinic professionals identified increasing numbers of patients with complex problems and generated 2 research questions: (1) Are there significant health and social concerns within the dental clinic population that indicate the need for high-risk screening and social work services?; and (2) How do age, gender, and income influence health and social concerns in this population? This exploratory descriptive cross-sectional study employed a brief self-report survey in a clinic waiting area. Logistic regression was used to understand the influence of age, gender and income on the existence of specific concerns. Results indicate that caregiving, finances and health are issues for 1/3 of the participants and that 44% endorsed 2 or more concerns. These findings were used to develop a routine high-risk screening tool for dental clinic patients and social work services within the clinic; they suggest that community clinics with dental services are an important place for identifying complex unmet needs.

The impact of a brief tobacco-use cessation intervention in public health dental clinics

Public health dental clinic patients use tobacco at disproportionately high rates. The purpose of this study was to evaluate a tobacco-use cessation program delivered via public health dental practitioners. Two public health dental clinics participated in this quasiexperimental design study. First, all patients in one clinic who used tobacco (n = 178) received usual care. Next, the authors trained all practitioners to conduct a tobacco-use assessment and provide a brief cessation intervention. Subsequently, all patients in both clinics who used tobacco (N = 190) received the intervention. All enrolled patients had an income at or below the federal poverty level. The authors conducted follow-up assessments at six weeks and three and six months after enrollment. Differences in self-reported quitting by condition between participants in the two groups were significant across all endpoints. Patients in the intervention group were more likely to quit than those receiving usual care (15.5 versus 4.3 percent) and after 12 months (18.8 versus 4.6 percent). Controlling for enrollment differences between patients in the two groups (age, race/ethnicity, time to first cigarette after waking), the authors found that differences between groups were significant for quitting at three months (P < .05; odds ratio [OR] = 4.85; 95 percent confidence interval [CI] = 1.20, 19.60), and six months (P < . 01; OR = 5.25; 95 percent CI = 1.35, 20.36). The results of this study suggest the viability and effectiveness of delivering a tobacco intervention to low-income smokers via public dental practitioners. A randomized clinical trial is warranted. The potential reach of public health dental clinics is great. Because of the high percentage of tobacco-using patients in these clinics, the public health impact of a program such as the one reported here would be significant.

Correlation between patient satisfaction and dental clinic credibility in regular dental check-ups in Japan

The aim of this study was to investigate the relationship between dental clinic credibility and patient satisfaction with regular dental check-ups, to compare the level of satisfaction of patients who had regular check-ups with those who did not, and to identify factors associated with regular dental checkups. Thirty-nine private dental clinics in 17 prefectures throughout Japan participated in this study. A total of 9024 questionnaires were distributed to the patients at these clinics, and patients returned the questionnaires using a pre-paid envelope (response rate 56.8%). The questionnaires consisted of items related to patient demographics and 11 items concerning the level of patient satisfaction with the dental clinic. Using multiple logistic regression analysis, the strongest correlation was found between dental clinic credibility in regular checkups and the technical competence of the dentist. The responses to those items concerning making an appointment, and the cleanliness and neatness of the waiting room were different between patients who had regular check-ups and those who did not. To investigate the factors that encourage regular dental check-ups, correlation of factors with regular check up experience were analyzed. Multivariate-adjusted odds ratios indicated a strong association between regular dental check ups and both the technical competence of the dental hygienist and the cost of treatment.

Factors Influencing Use of Dental Services in Rural and Urban Communities: Considerations for Practitioners in Underserved Areas

Individuals' utilization of dental services depends upon an array of factors, including access to care, financial restrictions, attitudes toward dental care, and dental fear. These factors, in turn, may vary across geographic locations and demographic groups. The goals of this study were to assess the use of dental services in both rural and urban areas of Kentucky and to examine challenges facing practitioners in rural areas. Individuals sampled from a rural population and patients in rural and urban dental clinics completed questionnaires about use of dental services, self-rated dental health, and dental fear. While these variables were strongly interrelated, differences emerged across locations. Patients in the urban area reported having more dental insurance but not better dental health. Patients in more rural areas reported seeking more emergency dental treatment but not more dental fear. While these factors are important considerations across locations, dental practitioners in rural areas in particular should be aware of barriers to dental care facing individuals in these areas. They have unique opportunities to provide education to their patients regarding the importance of dental care and the role of oral health in overall physical health.

Hypertension in a Dental School Patient Population

Patient records were retrospectively reviewed to investigate the incidence of hypertensive patients seen at a U.S. dental school. This research was conducted to create an awareness of the current problems in diagnosing and treating hypertensive patients in the dental environment. Nine hundred and seventy-six records of patients seen between January 1, 1999 and January 1, 2000 were reviewed. Five hundred records that met specific study criteria related to health history, medications used, recorded blood pressure, and other criteria were selected for the study. Factors examined included demographic data consisting of age, sex, and ethnicity; history of hypertension; Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure classification; control of hypertension; and medications used. The data demonstrated that 32 percent of the patients were hypertensive, 49 percent of whom were unaware of their high blood pressure prior to their dental visit. Nearly 9 percent of the hypertensive patients with elevated blood pressure had to be immediately sent for medical consult before they could receive dental treatment. The average blood pressure of the hypertensive patients was systolic 145.6 and diastolic 87.9 with a range of 110 to 240 systolic, 60 to 135 diastolic. Of the diagnosed patients, 41.9 percent were taking antihypertensive medication for their condition, and 13 percent were taking two or more medications. Nearly one third of a sample of 500 dental school clinic patients had high blood pressure in this retrospective study. This study demonstrates that it is crucial that dental providers take blood pressure readings for screening, monitoring of hypertensive patients, and appropriate dental care.

Cooperation during dental treatment: the Children's Fear Survey Schedule in Japanese children.

The aim of this study was to evaluate dental fear and cooperation during dental treatment using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). From the behaviour assessment of regular patients of the Pediatric Dental Clinic in Niigata University Dental Hospital (aged 5-12 years old), the patients were classified into two groups: uncooperative and cooperative. CFSS-DS questionnaires were sent to a total of 295 patients, 186 of which were returned, 61 from the uncooperative group and 125 from the cooperative group. In the uncooperative and the cooperative groups, the CFSS-DS mean total scores were 31.79 and 24.02 (P < 0.05), respectively, and the ratios of the patients whose scores were equal to or more than 35 were 36.1 and 11.2%, respectively. Fear of 'injections' and 'the dentist drilling' had high scores in both groups. The results indicated that there are many uncooperative patients with low dental fear and cooperative patients with high dental fear.

Pain and immunologic response to root canal treatment and subsequent health outcomes.

This study examined the effects of pain and stress associated with a dental procedure, root canal treatment (RCT), on natural killer cell cytotoxicity (NKCC) and the subsequent development of symptoms of upper respiratory illness during the following month. Patients (N = 33) were recruited from those scheduled for RCT appointments. Subjects for a non-RCT comparison group (N = 14) were also recruited from dental clinic patients. Peripheral blood was drawn by use of an indwelling catheter three times: just before RCT, 30 minutes after injection of a local anesthetic, and 30 minutes after RCT (a parallel time course was followed for the comparison group.) Blood was assayed for cortisol and NKCC. Subjects completed a health diary in the month after RCT. Patients showed a significant increase in NKCC between baseline and RCT and a significant decrease from RCT to after RCT, whereas the comparison group did not. The NKCC following the RCT was negatively correlated with the pain level during RCT (r = -0.48, p < .01) and pain levels 2 and 6 hours after RCT (r = -0.43, p < .05; r = -0.44 p < .05, respectively). The patient group reported significantly more illness episodes 2 weeks after RCT than the comparison group (Wilcoxon rank sum = 4.78, p = .03). Discriminant function analysis correctly classified 88% of the subjects into the illness category using predictor variables of post-RCT NKCC, stress, and pain levels during RCT (F(3,21) = 8.23, p < .001). Transitory changes in NKCC associated with pain and stress may be implicated in the development of infectious disease episodes after an acute stressful event.

Study on the systemic diseases and systemic conditions of the patients in the private dental clinics

Study on the systemic diseases and systemic conditions of the patients in the private dental clinics

Oral Chlamydia trachomatis in patients with established periodontitis.

Periodontitis is considered a consequence of a pathogenic microbial infection at the periodontal site and host susceptibility factors. Periodontal research supports the association of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Bacteroides forsythus, and periodontitis; however, causality has not been demonstrated. In pursuit of the etiology of periodontitis, we hypothesized that the intracellular bacteria Chlamydia trachomatis may play a role. As a first step, a cross-sectional study of dental school clinic patients with established periodontitis were assessed for the presence of C. trachomatis in the oral cavity, and in particular from the lining epithelium of periodontal sites. C. trachomatis was detected using a direct fluorescent monoclonal antibody (DFA) in oral specimens from 7% (6/87) of the patients. Four patients tested positive in specimens from the lining epithelium of diseased periodontal sites, one patient tested positive in healthy periodontal sites, and one patient tested positive in the general mucosal specimen. In conclusion, this study provides preliminary evidence of C. trachomatis in the periodontal sites. Planned studies include the use of a more precise periodontal epithelial cell collection device, the newer nucleic acid amplification techniques to detect C. trachomatis, and additional populations to determine the association of C. trachomatis and periodontitis.