Philip Rh Newsome

Patient Management: A review of patient satisfaction: 2. Dental patient satisfaction: an appraisal of recent literature

This paper examines the way patient satisfaction is perceived in the dental literature. The majority of studies carried out since the early 1980s concentrate on patient perceptions of various service quality attributes and the role that sociodemographic variables play in determining satisfaction. Recent work concerning attribution theory suggests that two concepts, duty and culpability, may be central to explaining this process.

competency-based learning: Competency-based education in a clinical course in conservative dentistry

The conceptual difference between a competency-based education and an education based upon a conventional dental curriculum is, perhaps, the starting point for the development of new curricula. The two systems are not, in themselves, exclusive. There is common ground to be found, and the concept of combining instruction with competency-based learning experiences is emerging in recent publications. This paper describes a competency-based approach applied to a clinical course in conservative dentistry. The learning outcomes of the fourth-year dental students in the new course were assessed using methods that included continuous clinical assessments, student presentations and peer-group reflective evaluations, patient management reviews, a clinical progress examination, the range and amount of work completed, and a written examination and viva voce. Different weightings were given to various elements of the assessment. A formal student assessment of the course rated it as being satisfactory.

Restorative Management of the Worn Dentition: 3. Localized Posterior Toothwear

This is the second paper in a four-part series detailing the relative merits of the treatment strategies, clinical techniques and dental materials for the restoration of health, function and aesthetics for the dentition. In this paper the management of wear in the anterior dentition is discussed, using three case studies as illustration.

Oral diagnosis and treatment planning: part 1. Introduction

A good manageable treatment plan does not just happen, but comes about as the natural consequence of taking carefully considered steps. History taking and clinical examination are two of the most important aspects of the patient assessment process, and complement each other to such an extent that it is impossible to build a satisfactory treatment plan without combining and collating information from the two procedures.

Assessment of endodontically treated teeth adjacent to proposed implant sites.

Many partially dentate dentitions are now being restored using dental implants; but assessment of endodontically treated teeth adjacent to the proposed implant sites has seldom been reported. Assessment criteria are given for sound- and endodontically compromised teeth to ensure adequate preimplant preventive and restorative treatment and to minimize the chances of failure of dental implants adjacent to these teeth. Cases are used to illustrate pitfalls in the treatment planning process.

Patient Management: A review of patient satisfaction: 1. Concepts of satisfaction

Against a background of growing consumerism, satisfying patients has become a key task for all healthcare providers. This paper reviews current conceptual models of consumer satisfaction, including the one most dominant in the marketing literature — disconfirmation theory.

Current issues in dental practice management. Part 1. The importance of shared values.

There can be few who would argue with the notion that the nature of dental practice in the United Kingdom has changed dramatically over the last couple of decades. A variety of factors, including new clinical techniques, growing consumerism, a much greater awareness of health-related and well-being issues in the public at large, as well as a marked deregulation within the dental profession, the development of vocational training and recently mandatory lifelong learning, the growing number of females working in the profession, and an increasing reluctance of young dentists to finance dental practices have all combined to create an environment which has enabled and encouraged a move away from traditional forms of dental care delivery. Instead, there has been considerable growth in independently-funded practice and a commensurate growth in the number of practices operating under a corporate body umbrella of one form or another.1 Currently there are 27 corporate bodies registered with the General Dental Council (GDC) with the likelihood of more in the future given the proposed GDC review. This will no doubt take into consideration European law, under which the restriction within the Dentists Act on the number of corporate bodies is likely to be untenable. Although they still have only a small share of the dental market—with 4% of all dentists in the UK in 19992— they have expanded rapidly from a small base. The data available at the time the paper was written indicate that the global total of fees earned from dentistry in the UK in the financial year 2001/2002 was almost £3 billion, of which £1.9 billion (64%) came from NHS fees3 and £1.1 billion (36%) from private fees. Of this £1.9 billion received in NHS fees in 2001/2002, £0.55 billion were paid by patients who were not exempt from charges, bringing the total amount actually paid out of patients’ pockets for dental treatment to £1.65 billion. Compare these figures with 1996/1997 when NHS fees stood at £ 1.6 billion (71%) and private fees at £0.6 billion (29%) and it can be seen that while the size of the whole market has grown NHS fees have risen by around 18% while private sector fees have gone up by 64% during the same period. It can not be said therefore that NHS dentistry has disappeared, although it is clear that access to NHS dentistry has been and may still be difficult in some parts of the country.4 The Department of Health in England has responded by developing ‘access centres’ and in the recently published Options for Change5 sets out sweeping proposals to revitalise NHS dentistry and delegate decisions over funding to a local level. It is far from clear what the consequences of these changes will be. How ever, one possible scenario is that in many parts of the UK, although relief of pain, prevention and restoration of function will be funded by the NHS, other than in ‘special circumstances’ such as after trauma and inherited conditions ‘cosmetic embellishment’ will not be funded. In which case, ever increasing public interest in personal appearance may well lead to further growth in private dentistry. Against a background of change and uncertainty, this series of articles explores some of the issues facing dentists coming to terms with working in this brave new world. This first part examines an aspect of dental practice that is seldom discussed openly and yet is of such fundamental importance that it is the cornerstone of all successful practices and the main fault line in unsuccessful ones, namely the nature and strength of practice values.

Rotational path of insertion for removable partial dentures with an anterior saddle.

The provision of removable partial dentures remains a viable treatment modality for many partially dentate patients. Replacing missing anterior teeth with a removable partial denture using a rotational path of insertion provides improved retention and appearance. The use of a rotational path of insertion also provides additional retention for a removable partial denture restoring combined anterior and posterior bounded saddles. Two case reports demonstrate the use of the rotational path of insertion for partial denture design.

Summary of: An audit of dental prescriptions between clinics and dental laboratories

Aim To discover the quality of written instructions from dentists to dental technicians and the nature of non-compliant prescriptions. Method An audit of laboratory prescription compliance was conducted within an NHS Trust Dental Teaching Hospital to determine the level of communication between dentists and dental technicians. One hundred and fifty prescriptions were audited from dental undergraduates and qualified dentists throughout the different departments. Results A total of two-thirds of prescriptions were considered non-compliant and failed to meet relevant ethical and legal guidelines. This problem was seen throughout all departments and at all professional levels. Conclusion A breakdown in communication between dentists and technicians through the use of prescriptions is evident even within a close working environment.

Current issues in dental practice management. Part 3. Attracting and keeping patients.

This paper, the third in a series of articles exploring some of the management issues facing dentists today, examines the importance of maintaining a motivated, well-trained and properly rewarded staff team.