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Browsing by Author "Clark, David B."
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Item A Manpower Study of Orthodontic Specialists for the State of Indiana(1992) Clark, David B.; Roberts, W. Eugene; Arbuckle, Gordon R.; Garner, LaForrest D.; Garetto, Lawrence P.; Shanks, James C.Dental manpower has been studied at national, state and local levels.2, 4, 6, 11, 14, 15, 17-19 Manpower studies of orthodontic specialists also have been conducted,1, 5, 13, 16 but there has been no recent manpower study relative to orthodontic specialists in Indiana. The purpose of this study was to evaluate the busyness and distribution of orthodontic specialists in Indiana and project the need for orthodontists. In early 1990 a survey questionnaire was mailed to Indiana orthodontists. A telephone survey of orthodontic receptionists/appointment clerks was conducted during the same time period to obtain a separate source of data relative to practice busyness and to help evaluate the reliability of the mailed survey questionnaire. The distribution of orthodontists was evaluated by comparing the state population-to-orthodontist ratio to county and regional ratios. The response rate of the mailed survey questionnaire was 91 percent. The ages of orthodontists were evenly distributed with the exceptions of the 46-50 year age group and groups approaching retirement ages. The perceived level of busyness was low with a busyness index of 1.32. A relatively short wait was necessary to examine and start new patients, and few reported a waiting list. There was a high response emphasizing no need for additional orthodontists. Seventy percent felt that they were not busy enough; 99 percent reported that they would like more patients; and many desired large numbers of additional patients (41 or more). A large number of orthodontists had satellite offices or were considering establishing satellite offices with an insufficient patient base listed as the primary reason. There was a significant difference between the number of additional patients desired based on the age of the orthodontist. More orthodontists reported that patient loads were remaining the same or declining rather than increasing. The present data did not support the premise that the number of patients started was less than that seen in previous studies, suggesting that the low perception of busyness may be related to other factors such as a more recent decline in patient load, improved efficiency, decreased profitability or a combination of these or other factors. The telephone survey differed significantly from the mailed survey questionnaire indicating a possible bias in the survey questionnaire. A geographic maldistribution of orthodontists in Indiana was found. A slight increase in the number of orthodontists over the next decade would be necessary to maintain the present population-to-orthodontist ratio. However, the declining child population, representing the majority of orthodontic patients, will require a reduction in the number of orthodontists to maintain the present adjusted population-to-orthodontist ratio or patient-to orthodontist ratio over the next two decades.Item Assessment of Osteoporosis Risk Factors in the Female Dental Patient: A Demographic Study(1996) Becker, Angela R.; Garetto, Lawrence P.; Arbuckle, Gordon R.; Clark, David B.; Roberts, W. Eugene; Shanks, James C.Osteoporosis has become a major public health problem as the size of the elderly population has continued to increase. While it is unclear as to the exact relationship between systemic bone disease and the craniofacial skeleton, the dental implications of osteoporosis could include dental implant failure, decreased residual ridge height, and unsuccessful orthodontics or oral surgery procedures. While these concerns remain speculative, it is important for dentists to recognize patients who exhibit high risk for osteoporosis. The purpose of this study was to evaluate risk factors for osteoporosis exhibited by female dental patients at Indiana University School of Dentistry and to assess this risk among the various dental specialty subpopulations. Based on general population averages, we hypothesized that approximately 20 percent of the female patients were at high risk for osteoporosis and that differences would be found among the various dental subpopulations. We also hypothesized that the number of teeth present would decrease as the risk for osteoporosis increased. A 12 question survey assessment tool was devised and administered to 220 female dental patients 18 years and older. This survey asked the patient to report selected vital statistics, menstrual status, and other aspects of lifestyle. The average overall age of the patients was 48.2±1.1 years. Of the 220 subjects, 34 percent exhibited serious risk factors for osteoporosis. The orthodontic subpopulation contained the fewest number of patients at high risk for osteoporosis (6 percent). However, they were also the youngest group (33.9±2.0). The complete denture subpopulation had the highest number of patients at high risk for osteoporosis (53 percent) and was the oldest (60.0±2.3). There was a trend for number of teeth to decrease as the risk for osteoporosis and age increased. We also found that in women who had taken hormone replacement therapy for at least five years, there was no association between number of teeth and years postmenopause. However, women who had very little or no hormone replacement therapy, there was a strong correlation for number of teeth retained to decrease as the number of years postmenopause increased (r=0.6). We concluded that there is a difference in dental subpopulations for osteoporosis risk. The clinical implications are that osteoporosis risk is much higher in specific classes of dental patients. Clinicians treating these patients must recognize the need to refer high risk patients for appropriate medical assessment.