The best dental practice

QUALITATIVE questions about dentistry are often asked. For example: what constitutes good dental practice? Who decides whether a practitioner is performing well? Who lays down the guidelines? Who takes action to rectify the unacceptable level of dental care? These questions and many more are rightly being asked within the profession amongst colleagues and often today by the public, our patients.
What constitutes good dental care has been chiefly a prerogative of the dental profession.

But a concentration upon the technical aspects of need, such as levels of dental technology, precludes giving sufficient attention to the attitudes and behaviour of patients and any assessment of need should include their perceptions.

Aspects of good dental care that would be identified and proposed by patients may not necessarily be the same as those proposed by the dentist. Major differences in emphasis in the concepts of quality have been identified between the perspectives expressed by the providers and users of health services.

Whilst the professional emphasis is on technical skills and freedom in prescribing care, patients place emphasis on responsiveness and politeness from the dentist, along with relief from symptoms or improvement in oral function.

A survey was carried out asking patients to evaluate the criteria of good dental practice proposed by both patients and dentists. The criteria originated by patients were: the dentist’s skills, caring dentist,
sterilisation/hygiene, understanding with children, explanation of procedures, good appointment system, and dentist qualification.

The criteria originated by dentists were: pleasant décor and surroundings, friendly staff, pain-free dentistry, cost, seen in an emergency, up-to-date equipment and good practice image.
A total of 344 patients evaluated 14 criteria of good dental practice. Questionnaires containing the seven pairs of criteria randomly assigned by a computer were drawn up with each pair containing one patient and one dentist criterion. Patients were asked to indicate their presence. The number of times each criterion was preferred was scored and ranked.

The three highest-ranked criteria were explanation of procedures, sterilisation/hygiene and dentist’s skills (all criteria proposed by patients), whilst the three lowest ranked criteria were up-to-date equipment, pleasant décor and surroundings and good practice image (all criteria are proposed by dentists).

Many factors influence whether an individual is satisfied with the dental care they receive. Amongst those identified has been the technical competence of the dentist, the characteristics of the practice, cost of treatment, the attitude of the receptionist and the practice’s cross-infection control procedures.

Additionally, levels of patient satisfaction have been shown to influence rates of use of medical services and levels of compliance with advice. If a patient’s expectation of good dental practice are met by the dentist, then they will be more satisfied.

Finally, I challenge the Consumer Associations to explore the option of the systematic collection of consumer feedback to give the dentist a clearer idea of what his/her patients want and to encourage public discussion on same. In this way we can all play a part in improving the practice of dentistry in Guyana.

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