Specialized Dental Clinics Research Articles

The influence of location, services, and community culture on patient loyalty with satisfaction as intervening variables in Spirit Dental Clinic Lubuk Pakam – Deli Serdang

Patient satisfaction is one of the main indicators of health facility standards. Improving the quality of service is absolutely necessary in order to face the era of globalization. The research location was conducted at the Spirit Dental Clinic Pratama Special Dental Clinic, which is located at Jln. Border No. 21 Lubuk Pakam, Deli Serdang. The time of the study was carried out in July – August 2021. The population in this study were all patients who came for treatment at the Spirit Dental Clinic Pratama Special Dental Clinic in July – August 2021. The sample was part of the population consisting of several members of the population. The sample in this study were patients who came for treatment to the Spirit Dental Clinic Pratama Special Dental Clinic for 2 months, namely from July to August 2021 and obtained a total sample of 100 respondents by accident. Based on the results of the research and discussion that have been described, the following conclusions are drawn: Location affects patient loyalty at the Spirit Dental Clinic Pratama Special Dental Clinic, meaning that the better the location of the dental and oral health service provider, the patient's loyalty will increase. Service affects patient loyalty at the Spirit Dental Clinic Pratama Special Dental Clinic, meaning that the better the services provided by dental and oral health service providers, the patient's loyalty will increase. Community culture affects patient loyalty at the Spirit Dental Clinic Pratama Special Dental Clinic, meaning that the better the community culture for dental and oral health services, the patient's loyalty will increase. Location affects satisfaction at the Spirit Dental Clinic Pratama Special Dental Clinic, meaning that the better the location of the dental and oral health service provider, the satisfaction will increase.

The Influence of Location, Services and Community Culture on Patient Loyalty with Satisfaction as Intervening Variables in Spirit Dental Clinic Lubuk Pakam – Deli Serdang

Patient satisfaction is one of the main indicators of health facility standards. Improving the quality of service is absolutely necessary in order to face the era of globalization. The research location was conducted at the Spirit Dental Clinic Pratama Special Dental Clinic, which is located at Jln. Border No. 21 Lubuk Pakam, Deli Serdang. The time of the study was carried out in July – August 2021. The population in this study were all patients who came for treatment at the Spirit Dental Clinic Pratama Special Dental Clinic in July – August 2021. The sample was part of the population consisting of several members of the population. The sample in this study were patients who came for treatment to the Spirit Dental Clinic Pratama Special Dental Clinic for 2 months, namely from July to August 2021 and obtained a total sample of 100 respondents by accident. Based on the results of the research and discussion that have been described, the following conclusions are drawn: Location affects patient loyalty at the Spirit Dental Clinic Pratama Special Dental Clinic, meaning that the better the location of the dental and oral health service provider, the patient's loyalty will increase. Service affects patient loyalty at the Spirit Dental Clinic Pratama Special Dental Clinic, meaning that the better the services provided by dental and oral health service providers, the patient's loyalty will increase. Community culture affects patient loyalty at the Spirit Dental Clinic Pratama Special Dental Clinic, meaning that the better the community culture for dental and oral health services, the patient's loyalty will increase. Location affects satisfaction at the Spirit Dental Clinic Pratama Special Dental Clinic, meaning that the better the location of the dental and oral health service provider, the satisfaction will increase.

Psychosocial Impacts of Malocclusion among Adolescents in Kedah, Malaysia: A Qualitative Study

Dental malocclusion can affect the psychological and social aspects of adolescents. However, the knowledge of this condition has been limited in the Malaysian population. This study aims to explore the psychosocial impacts of dental malocclusion among adolescents in Kedah state, Malaysia. A qualitative study was conducted at two public specialized dental clinics. Focus group discussion (FGD) and in-depth interview (IDI) were conducted among adolescents aged between 11 and 19 years, who received orthodontic treatment for moderate to severe dental malocclusion. All the FGD and IDI sessions were video-recorded, transcribed verbatim, and translated into English. The thematic analysis method was used for the data analysis. A total of 32 adolescents participated in six sessions of FGD and five sessions of IDI. Four themes emerged from the data analysis: (i) pressure to seek treatment, (ii) negative feelings about one’s dentofacial image, (iii) negative influences on interpersonal relationship, and (iv) negative impacts on school performance. The findings indicate that adolescents with dental malocclusion had been receiving pressure from different parties and generally had low self-esteem, which eventually affected their relationship with family and friends and their involvement in school activities. Therefore, public education and interdisciplinary collaboration to address their psychosocial needs are required.

Factors associated with conducting planning for secondary oral health care services in Brazil

BackgroundPlanning in health services specifically aims to improve the health status of a given population, guaranteeing access with equity and justice, as well as streamlining the response of the health system to the needs perceived by the community. This research aims to identify the factors associated with planning Specialized Dental Clinics (SDCs).MethodsSecondary data were used from the external evaluation of the database of the first National Program for Access and Quality Improvement of SDCs (NPAQI–SDCs) and the informed Outpatient Information System of the Unified Health System (OIS/UHS), which contains data on the specialized dental procedures performed at SDCs. It consisted of a quantitative study in which Pearson chi-square statistical tests (p < 0.05) and a multivariate logistic regression were applied with odds ratio (OR) estimate.ResultsThe results indicated that the realization of planning in SDCs was associated with lower coverage of the Oral Health Team of the Familiy Health Strategy in a municipality (OR = 1.4; 95% CI: 1.0–1.9, p = 0.049), additional training for managers (p = 0.038), the practice of self-assessment (OR = 8.2; 95% CI: 5.8–11.6; p = 0.000) and meeting service production targets (OR = 1.9; 95% CI: 1.2–3.2; p = 0.011).ConclusionThe results indicate that the work processes of the SDCs, especially with regard to service management, are essential to the proper functioning of the service and the practice of planning is linked to the technical capacity and commitment of service managers.

Evaluation of oral care protocols practice by dentists in Rio de Janeiro towards HIV/AIDS individuals

BackgroundThe aim of this study was to evaluate the dentists’ knowledge and practice regarding HIV positive individuals’ oral care in Rio de Janeiro State.MethodsDentists from Rio de Janeiro State (n = 242) answered an electronic questionnaire on biosafety procedures, oral manifestations of AIDS, and knowledge of HIV infection. Collected information was stratified by gender, and data were analyzed using Chi-square and t tests.ResultsFrom the 14 oral manifestations investigated, oral candidiasis, necrotizing ulcerative gingivitis, and hairy leucoplakia were more associated with HIV, with no differences between the responses from men and women. Above 85% of the participants would be concerned about becoming infected with HIV after a needle/ sharp object injury and more than 80% of them were willing to be tested for HIV. However, significantly more women (98.8%), compared to men (91.3%), said they knew that HIV/ AIDS patients can contaminate dental care professionals, p = 0.007. There was a significant difference in the answers for the questions: “Are there special dental clinics for treatment of HIV/AIDS patients in Brazil?” (p = 0.044), and “Do the negative HIV tests surely indicate that the persons are free of viruses?” (p = 0.005). Significant differences between men and women were also observed regarding use of disposable mask (p = 0.01), and cap (p < 0.0001).ConclusionMost dentists who participated in the study presented a good knowledge on the care of HIV/ AIDS individuals, including biosafety protocols and in terms of the oral manifestations commonly associated to AIDS.

Trends in performance indicators and production monitoring in Specialized Dental Clinics in Brazil

This study aimed to assess time trends in production and performance indicators in secondary dental care services in the Brazilian Unified National Health System (SUS) from 2008 to 2018. A time series study was conducted, based on production data from the Specialized Dental Clinics (CEOs in Portuguese) obtained from the Ambulatory Information System of the SUS. The monitoring indicator was assessed as the proportion of clinics that met the monthly target set for each specialty (primary care, endodontics, surgery, periodontics). Dental services' performance was defined as poor for those that met only one or no targets in the four dental specialties. The time series were analyzed by the decomposition method, considering the components trend, seasonal variation, and random variation. All the analyses were performed for Brazil as a whole and for each of the country's five major geographic regions. A decline was seen in Brazil as a whole in the proportion of clinics that met the primary care targets. There were upward trends in the proportion of compliance with the targets for surgery and periodontics in Brazil as a whole. Important differences were seen between the regions of Brazil in the proportion of compliance with the targets, with the worst performance for the clinics in the North and Northeast regions. Time trends showed an improvement in the services for Brazil as a whole, while emphasizing the importance of assessing the country's regions and the need for constant monitoring of these indicators.

CHRONIC SUPPURATIVE OSTEOMYELITIS IN A PATIENT WITH AUTISM SPECTRUM DISORDER: CHALLENGES IN CLINICAL MANAGEMENT

The present study reports the challenges faced during the diagnosis and treatment of chronic suppurative osteomyelitis in a patient with autism spectrum disorder (ASD). A 23-year-old woman intern in a special care institution attended the special care dental clinic of the authors with an unusual periodontal lesion involving tooth 47. Tooth extraction was performed with curettage of the surrounding structures for histopathologic examination. Microscopic examination diagnosed an aggressive juvenile periodontitis leading to suppurative osteomyelitis. Based on the pathologic report, a tomographic examination was performed and revealed the extension of the bone destruction as well as bone sequestrum. The patient was referred for surgical approach under general anesthesia to remove all necrotic and infected bone. After 1 year of the diagnosis the patient still under treatment without complete resolution of the lesion.

Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users.

The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user’s perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws.

장애인전문치과와 일반치과 의료진들의 장애인에 대한 태도 비교

The aim of this research is to compare the attitude toward the special needs of dental staffs between the special dental clinic (SDC) and the general dental clinic (GDC). Surveys were done on 21 dental staffs (7 dentists and 14 dental hygienists) of SDC and 47 dental staffs (10 dentists and 37 dental hygienists) of GDC. Attitudes were rated on a questionnaire with the five-point Likert scale. Mann-Whitney test was utilized for statistical analysis. In SDC, more female dentists and dental staffs who have relatives with disability were working. Dental staffs of SDC showed that the more experience they had, the more positive attitudes toward the communication with the patients with special needs (p<0.05). Dental staffs of SDC represented more active attitudes toward the oral health promotion, treatment, research and volunteering (p<0.05). In conclusion, dental staffs who have personal motivation were working in SDC and the experience of dental treatment to the patients with special needs influenced the dental staffs' attitudes toward them. In future, a research about the attitude toward the disabled with more exact scale should be followed.

Serviços odontológicos especializados nas cidades médias não metropolitanas do estado do Paraná, entre 2003 e 2010: estudo exploratório

Objective: to describe the evolution of the provision of specialized dental services in medium-sized non-metropolitan cities of the State of Parana, following the implementation of Specialized Dental Clinics (CEO). Methods: a descriptive study was developed, using secondary data from the Outpatient Information System of the Brazilian Unified Health System (SUS). We identified the supply characteristics and evolution of specialized services performed between 2003 and 2010. Data were analyzed using descriptive statistics and simple linear regression. Results: the best relationship between structure available in CEOs / inhabitant occurred in Ponta Grossa and Maringa. We identified a reduction in the number of extractions in the cities studied, except in Ponta Grossa where we also found a reduction in the number of endodontic treatments. Casacavel was the only city showing an inverse trend between the provision of extractions (reduced) and root canal fillings (increased) following CEO implantation. Conclusion: the results suggest that incre

Midazolam Is Associated With Delay in Recovery and Agitation After Ambulatory General Anesthesia for Dental Treatment in Patients With Disabilities: A Retrospective Cohort Study

Some patients with intellectual disabilities (IDs) who undergo total intravenous anesthesia (TIVA) have complications associated with the anesthesia such as prolonged recovery. The purposes of this study were to estimate the frequency of TIVA complications among patients with IDs and to identify factors associated with TIVA complications. This study was designed as a retrospective cohort study. Study samples were selected from the clinical records of patients with IDs who underwent ambulatory general anesthesia in a special dental clinic at the Okayama University Hospital, Okayama, Japan. Predictor variables were patient background, anesthesia-related variables, and dental treatment. Outcome variables were delayed recovery and the complication of agitation. Factors affecting delayed recovery and complications were examined with multivariable analysis. We enrolled 106 cases (81 male and 25 female patients) in this study. The mean age was 23.9 years. Serious complications were not observed in any cases. The amount of intravenous midazolam was an independent determinant of delayed recovery. Oral midazolam contributed to delayed recovery, although it is very useful for induction in patients with a high level of fear. Oral midazolam and a younger age were independent predictors of agitation. Intravenous midazolam may not have an advantage in ambulatory general anesthesia. Oral midazolam contributes to delayed recovery and is an independent predictor of agitation.

P-882 - Oral health audit of a cohort of mental health service users in the UK

Access to oral health services is a basic right. It is recognized that psychiatry patients have a greater risk for dental problems. This is often due chaotic lifestyles, avoidance of health care and inability to engage with treatment. To this end the department of health has recommended this group of patients warrants particular attention. To ensure basic oral health promotion in this group, identify implementations to facilitate this promotion and access to oral health care. Specifically to assess need for special dental clinics, automatic recall reminders or support for registering with a dental practitioner. To assess the need for and access to basic oral health care among a group of psychiatric in patients in Mersey Care NHS Trust. Audit tool was a questionnaire, researcher administered, developed from British Society for Disability and Oral Health guidelines (2000). From a sample of 97 service users, 80 participated. 51% had not been to a dentist in over a year, 56% were not registered with a dentist, 12.5% did not own a toothpaste, 51% brushed less than once a day, 71% smoked, 56% felt they needed treatment and 45% had oral side effects from prescribed psychotropic medication. Oral health within service users of mental health services should be a priority. Oral health promotion should be encompassed within the care we provide, steps to promote better oral health should include the provision of toothbrushes on admission, teethbrushing advice, frequency of brushing and registration with dentists should be addressed.

Avaliação da oferta e utilização de especialidades odontológicas em serviços públicos de atenção secundária na Bahia, Brasil

This study aimed to evaluate the utilization of dental services in four specialized dental clinics in Bahia State, Brazil, and to identify associated factors. This was an evaluative study in which the quantitative stage focused on a cross-sectional analysis of secondary data from the Outpatient Information System of the Unified National Health System and the qualitative component was based on 20 semi-structured interviews with coordinators and managers, in addition to on-site observation of health services. The study showed good results in the supply of these services from the health professionals' perspective, but with a low utilization rate. The low utilization rate reveals access barriers in the health services themselves, like the lack of performance standards and goals by specialty, lack of patients (who are not replaced), and different technologies used by each specialist. The results suggest the need for studies that analyze different forms of services organization that would have allowed greater utilization of the available supply, with pay differentials, linkage to primary care, and adjustment of the supply to the population's health needs.

Satisfação dos usuários assistidos nos Centros de Especialidades Odontológicas do Município do Recife, Pernambuco, Brasil

This study evaluated patient satisfaction at four specialized dental clinics in Recife, Pernambuco State, Brazil. Data were collected through a standardized self-applied individual questionnaire with 272 patients, to evaluate user satisfaction with public dental services. The findings indicated a positive evaluation on most dimensions, except for accessibility. Significant differences were observed between the services on the following dimensions: patient-dentist relationship (p = 0.001); patient-dental assistant relationship (p = 0.007); effectiveness (p = 0.014) accessibility/waiting time (p = 0.018); physical environment/reception room cleanliness (p = 0.004); acceptability (p = 0.029); and effectiveness/tooth appearance (p = 0.029), effectiveness/chewing capacity (p < 0.001). In conclusion, most users were satisfied with the dental care, and satisfaction differed between services.

치위생과 학생들의 장애인에 대한 인식도에 관한 조사연구

본 연구는 장애인 구강관리를 담당할 치위생과 학생들의 교육 방향성을 제시하고, 장애인에 대한 건전한 인식도를 높이고자, 전남지역에 소재한 3개 대학 치위생과 학생 538명을 대상으로 설문조사를 실시하였다. 장애인에 대한 태도 및 장애인 구강관리에 대한 태도를 조사한 결과 친구나 가족 중에 장애인이 있는 경우나, 장애시설에서 봉사활동 또는 구강보건활동 경험이 있는 경우는 장애인에 대해 긍정적인 태도를 보이는 것으로 조사되었고, 특히 장애인 구강보건활동 경험이 있는 경우에는 장애인 구강보건에 더욱 긍정적인 태도를 내타내었다. 이에 장애인 접촉의 기회를 늘려 장애인과의 거리감을 좁히고, 장애인 구강관리에 더욱 긍정적이고 적극적인 태도를 형성하는 것이 필요하다고 하겠으며, 뿐만 아니라 장애인 환자 진료 시 가장 문제점이 되는 의사소통의 어려움, 장애인 치료에 대한 경험부족, 장애인 치료에 대한 지식 부족 등을 해결하기 위해서는 87.5%가 교육이 필요하다 하였고 교육의 형태는 이론과 실습의 병행 교육이 필요하다고 했다. 또한 국가에서도 장애인 구강보건에 대한 체계적인 정책을 수립하여 장애인 구강건강프로그램을 개발하고 장애인 진료에 소요되는 많은 시간과 노력에 보상할 수 있는 의료보험제도개발 등이 필요하다고 사료된다. The purpose of this study was to investigate consciousness about the disabled on dental hygiene students and search for course of dental hygiene education as oral health care with the disabled. The subjects in this study were 538 dental hygiene students from three college in Jeonnam province. For statistical analyses of collected data, the descriptive analyses and chi-square were adopted. The obtained results were as follows. Seniors showed positive attitude about the disabled and dental service of the disabled(p<0.05). The common types of contact the disabled were physical Cerebral palsy and inner disabled were rarely. The problems are difficulty in communication, short of clinical experience in dental service of the disabled, noncooperation of the disabled, short of knowledge in dental service of the disabled. To dental service of the disabled, demand as necessity of education was 87.5%, theory and practice at the same time was 68.0% in pattern of education. Finally, 49.5% of respondents observed special dental clinic to utilization pattern of dental service of the disabled.

Comparison of Internet Searches for Specialized Dental Clinics in Japan and United States

This study investigated the present status of specialized dental treatment that was sought on the Internet by people in Japan and the United States. Searches on Yahoo! Japan and Yahoo! America were performed using “dental clinic” and specific specialties, for example, sports dentistry, orthodontics, periodontics, dental implant, as keywords. The magnitude of search results progressed in the order of sports dentistry, orthodontics, dental implant, and others in Japan. In the United States, the order of search results was oral surgery, sports dentistry, dental implant, and others. Regarding combinations of specialties, the most frequent found combination was dental implant and cosmetic dentistry in Japan. In the United States, it was a combination of cosmetic dentistry and sports dentistry. These findings showed that people were frequently interested in sports dentistry, cosmetic dentistry and dental implants in both countries. It is necessary to display these specialties on the dental clinic homepage in order to attract the interest of potentials in both countries.

Dental Care for Physically or Mentally Challenged at Public Dental Clinics

Recently, local administration bureaus have established a number of dental clinics and centers for the physically or mentally challenged (PMC) in collaboration with local dental associations. The aim of this study was to investigate dental treatment and general supportive care for the PMC in dental clinics in Tokyo. A dental clinic for the PMC located in northwestern Tokyo in a district with a population of about 680,000 was selected for the study. The variables studied based on dental records included total number of patients, type of disability, medical history, systemic condition, age, treatment regimen and type of general supportive care. The largest group of new patients was under 9 years of age. The highest total number of patients visiting the clinic belonged to the 60-69-year-olds group and the 70-79-year-olds group. We also investigated type of disability in patients treated under intravenous sedation at time of dental treatment. The most common condition was dementia resulting from Alzheimer's disease (42.74%), autism, cerebral palsy or mental retardation, in descending order. The percentage of patients referred from other medical institutions was 17.4%, including those from private dental clinics and Dental University Hospitals. Type of disability in patients transferred from other medical institutions included developmental disorders (28.2%), senile defects (26.9%), chronic and psychiatric diseases (44.9%). The number of patients who located and visited the clinic by themselves greatly exceeded the number transferred by request. This suggests that a permanent system should be put in place offering public specialized dental clinics where the PMC many obtain treatment.

Dental utilization in relation to type of dental care coverage among patients at a special dental clinic

Dental utilization in relation to type of dental care coverage among patients at a special dental clinic

Dental care of HIV‐infected patients: attitudes and behavior among Danish dentists

The aims of the study were to study Danish dentists' attitudes and behavior with regard to providing dental care to HIV-infected persons and to look for explanatory variables for the dentists' attitudes and behavior. Two hundred and twenty-eight Danish dentists responded to a questionnaire on dental treatment of HIV-infected patients and related problems (response rate: 91.2%). The dentists' attitudes differed a great deal from the current national policy as to where HIV-infected patients should be treated and with regard to the possibility of being tested for HIV anonymously. 64% of the dentists favored the idea of referral of HIV-infected patients to special dental clinics for routine dental treatment, and 93% disapproved of the idea that infected individuals themselves should decide whether they wish to inform their dentist or doctor of seropositivity. Older dentists were more reluctant to treat HIV-infected individuals than younger. Other differences with regard to a number of demographic variables were not found. No difference in attitude towards HIV-infected persons was found when compared to that towards HBV-infected individuals. The reluctance towards treatment of HIV-infected persons was present irrespective of any subsidy for an extra cost for treatment of HIV-infected patients.