This summary of clinical guideline 19 from NICE includes recommendations for patients of all ages (both dentate and edentulous patients) and covers primary care received from NHS dental staff (dentists, independent contractors contracting within the NHS, dental hygienists and therapists) practising in England and Wales. The guideline takes into account the potential of the patient and the dental team to improve or maintain the quality of life and to reduce morbidity associated with oral and dental disease. The guideline does not cover intervals between dental examinations that are not routine dental recalls; that is, intervals between examinations related to ongoing courses of treatment, or part of current dental interventions, nor does it cover emergency dental interventions, or intervals between episodes of specialist care.
Dental hygienists' contribution to total gross billings and production, measured in standard production minutes, was studied in 13 private practices that employed hygienists. Hygienists' treatment accounted for one fourth of total production and one eighth of all gross billings. These results, together with analyses of the use of available time, the range of procedures performed by hygienists, and the rate of return for these procedures, illustrate the utility of this type of information when assessing the possibility of changes in the dental hygiene profession. In the past five years, the literature concerning dental hygienists has included a number of contributions that focus on the status of and possible changes in the practice of dental hygiene. These contributions have discussed the general future of dental hygiene,1-3 and the specific issues of professionalism,4-6 advocacy,7-8 and legal and political activity and knowledge.9-11 In addition, several discussions of new forms of dental hygiene practice also have appeared in the hygiene literature, 12-17 as well as in the general dental literature.18-20 Finally, surveys of dental hygienists have been reported frequently.21-30 The content of this growing body of literature indicates that the profession of dental hygiene currently is undergoing an internal examination, and that several educators and practitioners are advocating the acceptance of increased responsibility by hygienists.(ABSTRACT TRUNCATED AT 250 WORDS)
Dental caries is a disease that recently has undergone, and may still be undergoing, dramatic changes in distribution of incidence and prevalence. The most recent epidemiologic data available have been reviewed in this paper to illustrate that caries is becoming a disease primarily of pits and fissures, with less differentiation than previously acknowledged between fluoridated and fluoride‐deficient areas. The present distribution of caries suggests that prevention may be accomplished more effectively through targeted sealant programs than through currently popular mass preventive programs. Existing information can be used to identify logical target groups for sealant programs, and age specific tooth eruption and caries attack information can be used to design delivery methods. Although the adoption of targeted sealant programs represents a departure from the traditional mass approach to prevention in dental programs, the present‐day caries distribution requires that the initiation of such programs be given serious consideration. At the very least program administrators are encouraged to invoke the planning‐implementation‐evaluation process. Current programs should be evaluated carefully in view of today's disease patterns and the clinical significance of the results achieved. The content, design, and timing of future community‐based programs should reflect individualized community diagnosis and the application of new epidemiologic data as well as a careful evaluation of the results achieved by current preventive procedures.
Dentists' attitudes about the importance of formal training in a variety of skills were assessed as a part of the Pew Health Professions Commission initiative to help health professional schools prepare for the future. Through a telephone survey with a 54 percent participation rate, attitudes of a national sample of practitioners were determined concerning the importance of training in 16 competencies that reflect skills, attitudes, and behaviors identified by the commission. Most respondents indicated that competency in treating and preventing disease, practicing ethically, communicating with patients, applying problem solving techniques, and continuing to learn were very important. Conversely, less than half of dentists indicated that competency in managing information, responding to cultural diversity, supporting community agencies, and working in managed care settings were very important. The opinions of graduates since 1980 about their own training in the competencies tended to mirror their ratings of importance. These results demonstrate the continuing need for dental educators to consider prevailing opinion of practicing professionals as a part of any evaluation or planning effort.
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