Dr. Ronald E. Goldstein talks about esthetic care

Article Abstract:

In the second of three interviews concerning esthetic dentistry (a dental specialty that strives to improve the quality of the smile), Dr. Ronald Goldstein discusses the role of the office staff in the specialty. Receptionists should genuinely enjoy seeing people's smiles improve with treatment, and should set a positive, enthusiastic tone in the office and in the telephone interview that precedes the first appointment. The hygienist, often underutilized in esthetic dentistry, should transfer the office philosophy to the patient. The best such professional in Dr. Goldstein's memory was one who read as much as he did and was actively involved in answering patients' questions. The hygienist is particularly well-situated to emphasize the value of home hygiene. The dental assistant, who helps the dentist during surgery, should have the same excellent communication skills as all other staff members and can provide a much-needed alternate perspective concerning the patient's dental needs. She can subtly indicate areas of potential concern to the dentist. The dental technician should be of top quality and may be involved in a personal way, through meeting each patient. A treatment coordinator in an office of esthetic dentistry plans patients' appointments throughout their treatment course, and carries out follow-up. This job may be done by another staff member on a part-time basis. The initial patient appointment can require several hours for a full examination, including X-rays, casts, and photography; if consultants need to be called in, more than one visit may be necessary. The patient group most ideal for esthetic dentistry is that made up of people between 35 and 45; men and women in approximately equal proportions now seek it out. Formerly, the patient load was primarily female. As people live longer, older people also seek out esthetic dentistry. The sad case is related of a wealthy man who did not want to spend the money necessary for esthetic dentistry to improve his crippled father's smile. (Consumer Summary produced by Reliance Medical Information, Inc.)

Interview, Goldstein, Ronald E.

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Treating TM disorders

Article Abstract:

Temporomandibular disorders (TMD) affect the region of the temporomandibular joint, the jaw joint. TMDs are now considered to take two forms: disorders that originate in the joint capsule, and disorders that originate outside the joint capsule; for instance, in the jaw muscles. Results are presented from surveying five large dental professional groups, with a special interest in the disorder, concerning the development and treatment of TMD. Questionnaires were distributed to the practitioners regarding the symptoms, causes, and diagnosis of TMD. Of 4,000 questionnaires mailed, slightly more than 1,400 were returned. Results showed that TMD remains a controversial subject, although the importance of trauma and stress in causing the condition seems agreed upon. Major trauma can occur when the jaw is injured or when difficult extractions or prolonged dental procedures are performed. Stress causes muscle fatigue and pain. TMD is characterized by pain, joint noise, and joint dysfunction. Gum chewing, whether frequent or infrequent, is believed to contribute to TMD. Three quarters of the respondents thought that occlusive (bite) problems contribute to TMD, but the professional groups differed in the type of malocclusion they thought was most likely to be implicated. Treating joint clicks was seen as most valuable by half the members of two groups; 86 percent of the members of another group did not consider it important. The necessity of obtaining X-ray views of the temporomandibular joint was also viewed differently by different groups. Newer diagnostic methods, such as sonography and thermography, were not overwhelmingly popular and as many as half the respondents said they did not know whether these tests were valuable. In general, a great discrepancy was found between the scientific literature and the knowledge of the respondents concerning disorders of the temporomandibular joint. Clinicians are urged to become more familiar with current approaches to this problem. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Diagnosis, Temporomandibular joint disorders

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A profile of women dentists

Article Abstract:

Although overall enrollment in dental schools has declined during the last 10 years, the number of women entering dentistry has increased. Before 1960, one percent of the dentists in the United States were women. Although their number had grown to more than 8,000 in 1985, women made up only about five percent of the total dentist population. This percentage is expected to increase because more women are enrolling in dental school: about one-third of first year dental students in 1988-1989 were women. Job satisfaction and the preferred practice settings of women dentists had not been surveyed. To address this issue, 2,000 randomly selected female dentists practicing in the United States were sent a 32-item questionnaire regarding employment status, practice characteristics, income, career satisfaction, and related issues. Fifty-four percent of the subjects responded. Of these, 31 percent finished dental school before 1980, the remainder graduated in the 1980s. Fifteen percent had completed a general dental practice residency, and 14 percent had received advanced specialty training. Their average age was 36. Seventy percent were married, and 47 percent of these were married to health professionals, mostly dentists. Fifty-five percent had no children. Most practiced general dentistry, with 47 percent practicing between 30 and 39 hours per week. Women with more children, worked less. Salaries fell within a broad range, with 33 percent earning $25,000 to $49,999 per year, and 28 percent earning more than $100,000. Forty-nine percent reported that they were very satisfied with their practice setting; satisfaction increased with salary. Most dentists who practiced with their spouses reported satisfaction. Most working relationships with staff and other dentists were rated as excellent or good by the respondents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Surveys, Women dentists

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