Community dental service--four years on

In July 2000, the first group of graduates entered compulsory community dental service. The aim of this study was to document the experiences of the community dentists four years on. A cross-sectional, descriptive study was carried out among 232 community dentists. A structured questionnaire divided into nine sections: demography, the allocation process, accommodation & living conditions, dental clinic facilities - equipment and materials, work environment, income, sense of achievement, intellectual fulfillment. Forty five per cent of the sample (n = 105) responded, 51% were male and the mean age of the sample was 24.8 years. Of the responadents 47% could speak the local language; nearly a quarter (24%) felt that the allocation process was not handled efficiently and 30% said that they needed more information about their placement posting. Sixty per cent were placed within 20km of the nearest town; 11% did not have access to telephone or fax and 47% were provided with accommodation. Thirty five per cent described the condition of the clinics operating as poor. A fifth of the respondents (21%) indicated that they did not have full sets of instruments. Eight per cent did not have an autoclave and 7% a high-speed hand piece. Fifty one per cent did not have oxygen and nearly two thirds (58%) of the clinics did not have any emergency equipment. Seventy one per cent reported that the equipment broke down often and 65% that it was not fixed promptly. Nearly all (90%) indicated that they would welcome a short course that might assist them to repair broken down equipment. Eighty five per cent reported that they enjoyed their work environment. Seventy per cent had no supervision, but more than a third felt confident enough to work without it. Although 80% felt that their professional competence had improved, an equal number indicated that they have lost some of their clinical competence in one or other area. Despite the fact that 65% reported that there were many opportunities to improve their clinical skills, more than half felt that they were over-skilled for the job. Eighty per cent of the respondents indicated the year was fulfilling and worthwhile. Problem areas centred on the adequacy of the information provided prior to allocation, high cost of accommodation, break down of equipment and lack of basic restorative materials. It is gratifying to note that there have been many improvements since the initial intake of community dentists in 2000, but there remains a few areas that still need to be addressed.