Do educational methods affect students' ability to remove artificial carious dentine? A randomised controlled trial

This trial aimed to evaluate the influence of two educational methods on students' ability to remove artificial carious dentine. Traditional lecture and lecture plus a live demonstration of artificial carious tissue removal were compared in a blind two‐parallel‐group design. Twenty‐six students were randomly divided into two groups, and their skills were evaluated according to the following criteria: time spent on the dentine excavation procedure (in min), students' perceived confidence in conducting the procedure (graded assessed on a scale from 0 to 10), and the outcome of artificial carious tissue removal, evaluated by measuring the residual dyed artificial carious dentine layer (in μm). Statistical analyses were carried out using a t‐test to compare the students' confidence and time spent on the procedure, and a two‐way ANOVA was used to compare residual artificial decayed dentine with educational methods and tooth region (incisal, medium, and cervical thirds) as factors. There were no differences between the methods regarding excavation time (P = 0.898) and students' confidence (P = 0.382). The residual artificial carious dentine results showed that the educational method (P < 0.001) and cavity region (P < 0.001) were statistically significant, as was their interaction (P = 0.040). The lecture plus live demonstration group presented the best results for artificial caries removal. Although there were no differences between the two groups for the cervical region, the best results for the lecture plus live demonstration group was in the other two‐thirds of the tooth.     

Examining the effects of early patient care and biomedical science integration on predoctoral dental student competence and confidence

Introduction

Our study investigates early experiential learning as a method of curricular integration by allowing students to begin their clinical experience in the first year of the programme, as well as distributing biomedical classes throughout the predoctoral dental school curriculum.

Materials and Methods

This study utilises a quasi-experimental design with two different groups, Standard Curriculum Group and Integrated Curriculum Group, n = 87. Data were collected from 2017 to 2021.

Results

We found that, on average, it took 608 h less for the participants in an integrated curriculum group to reach clinical competence in comparison to peers who did not experience the same methods of integration in their programme. These data were collected through daily faculty evaluations of students' progression as well as participants' own self-assessment. Our results indicate that participants in the Integrated Curriculum Group also experienced a positive effect on their confidence in their ability to apply the biomedical sciences to patient care.

Discussion/Conclusion

Our findings demonstrate that predoctoral dental programmes may be able to bring about positive outcomes for students' clinical confidence and competence by providing patient care opportunities early in the programme and sequencing the biomedical sciences throughout the curriculum. As such, it appears that early experiential learning may be a viable option for curricular integration that can have a positive effect on both students' confidence in their clinical abilities and their progression to clinical competence.     

Adapting the German version of the dental environment stress questionnaire

Aims

To develop a German version of the Dental Environment Stress (DES) questionnaire, and to evaluate its reliability and validity.

Methods

The original English DES questionnaire was translated into German using a forward–backward translation process. To evaluate construct stability, a subgroup of dental students (n = 43) completed the DES twice (interval: 1 week). To evaluate how the DES responds to anticipated changes in stress, all dental students' (n = 64) DES scores and saliva cortisol levels administered from a clinical study were compared between holiday and term time. Furthermore, the Depression, Anxiety and Stress Scale (DASS) and a stress self-assessment were used to determine the validity of the DES. Reliability analyses were calculated using Kendall's tau correlations. To estimate reliability strength, correlation coefficients and intraclass correlations (ICCs) were used.

Results

Regarding construct stability, 24 of 25 DES items had at least moderate correlations, and most items showed strong correlations. Correlations for the seven subdomains were good (range: 0.778–1.000). The same was true for the total DES score (ICC: 0.944). Correlations for response to term-time stress were weaker and more varied. Validity analyses revealed fair correlations between the DES and students' self-assessment (Pearson's r = .592) and DASS score (Pearson's r = .392), suggesting satisfactory validity. Stress levels were quite similar between baseline and follow-up.

Conclusion

The German DES is a reliable tool for evaluating stress in dental students. Because it can be used to identify individual stressors in various categories, it might enable the detection of specific stress situations in educational situations and facilitate solutions (adjustment of curricula, tailored consulting services).     

A proposal for a problem‐oriented pharmacobiochemistry course in dental education

Problem‐oriented learning is an effective method of learning that increases students' learning motivation, improves the relationship amongst students and results in open‐minded discussions. In this study, a new problem‐oriented pharmacobiochemistry course related to ‘oxidative metabolism of drugs by cytochrome P450 (CYP450) systems’ was designed. Students were divided into seven groups. Three keywords related to drug interaction through CYP450 were provided to each group in order for them to conduct research on the information given. After 1 month, the groups attended a session under the supervision of a tutor to solve a simulated problem case that was designed using the keywords. At the end of the integrated course, a multiple‐choice examination was given. The success rate of 76 students who attended the course was found to be significantly higher than the success rate of the students who received the lecture‐based course only (P < 0.0001). A questionnaire containing 20 items (Cronbach's alpha: 0.92) was administered to the students to learn about their perception regarding this educational model. The questionnaire was evaluated using the Likert scale. Student feedback was very positive, with fourteen answers rated as ‘agree’ and the remaining six rated as ‘strongly agree’. Students thought that the problem‐oriented model was very enjoyable and useful in regard to dental education. Based on these results, we conclude that this course model may help achieve an integrated curriculum for dental school programmes.     

Technique Acquisition in the Use of Two Thermoplasticized Root Filling Methods by Inexperienced Dental Students: A Microcomputed Tomography Analysis

IntroductionLimited endodontic experiences in dental schools suggest the need for easy-to-learn techniques. Therefore, two simplified root filling methods were assessed for adequacy and expediency when performed by inexperienced students.MethodsEight students were trained (45-minute lecture and 90-minute practice) in use of ProTaper Obturators (PTO) and System-B/Calamus (SBC). They subsequently filled the root canals in two extracted, single-rooted teeth per method (n = 32). Canals were preshaped and prefitted with obturators and master cones. The volume of root-filling voids determined by microcomputed tomography imaging in 1-mm increments, time to complete fillings, and students' responses in questionnaires were analyzed (independent-sample t test and Mann-Whitney U test).ResultsPTO had a significantly smaller void volume in the apical 6 mm of canals (P < 0.001), required significantly shorter time (P < 0.001), and was perceived as easier to learn and use but less likely to be favored after graduation than SBC.ConclusionThese results suggested that the PTO root filling method was particularly suitable for teaching when endodontic experiences available for students are limited.     

Perceptions of D.M.D. student readiness for basic science courses in the United States: Can online review modules help?

There can be a disconnect between the level of content covered in undergraduate coursework and the expectations of professional‐level faculty of their incoming students. Some basic science faculty members may assume that students have a good knowledge base in the material and neglect to appropriately review, whilst others may spend too much class time reviewing basic material. It was hypothesised that the replacement of introductory didactic physiology lectures with interactive online modules could improve student preparedness prior to lectures. These modules would also allow faculty members to analyse incoming student abilities and save valuable face‐to‐face class time for alternative teaching strategies. Results indicated that the performance levels of incoming U.S. students were poor (57% average on a pre‐test), and students often under‐predicted their abilities (by 13% on average). Faculty expectations varied greatly between the different content areas and did not appear to correlate with the actual student performance. Three review modules were created which produced a statistically significant increase in post‐test scores (46% increase, P < 0.0001, n = 114–115). The positive results of this study suggest a need to incorporate online review units in the basic science dental school courses and revise introductory material tailored to students’ strengths and needs.     

Use of information and communication technology amongst New Zealand dental students

Although international studies have shown an increasing use of information and communication technology (ICT) amongst dental students, there are no published studies specific to New Zealand (NZ). The aim of this research was to identify device ownership and academic utilisation patterns amongst New Zealand dental students, including preferences and perceptions, and barriers to use. All currently enrolled dental students (322) were invited to complete a 15‐item questionnaire. Data were statistically analysed in SPSS version 20.0. Qualitative data were analysed using a general inductive technique. The participation rate was 78.6% (N = 253 of 322). The majority of respondents personally owned laptop computers (98%) and smartphones (80.2%). A total of 10.8% of participants used a desktop computer everyday for academic purposes, whilst 78.7% used a laptop computer daily, and 54.7% a smartphone. New Zealand dental students demonstrated a high usage of ICT for their coursework with varied use of different online resources. The most frequently used online resources were search engines, social networking sites and lecture slides provided on Blackboard ^® . A high perceived value was placed on both audio podcasts and video podcasts despite the high value also placed on the traditional lectures. Although most participants (84.5%) felt that their ICT knowledge was adequate to meet academic requirements, a small number (1.6%) did not agree.     

Impact of the Hall technique for preformed metal crown placement on undergraduate paediatric dentistry experience

The Hall technique, a novel method of placing preformed metal crowns (PMCs) without local anaesthesia or tooth preparation, was introduced to our undergraduate dental curriculum in 2009. This study aimed to describe student experience of, and attitudes towards, PMCs before and after exposure to this new technique. Clinical data were extracted from student logbooks to determine the number of PMCs placed for cohorts graduating in 2005 (n = 55), 2009 (n = 61) and 2010 (n = 75). Five focus groups were also conducted with 29 final‐year dental students. Students graduating in 2005, 2009 and 2010 had placed a mean (range) of 0.03 (0–1), 0.63 (0–5) and 1.15 (0–9) PMCs, respectively. The proportion of students who had placed a PMC increased significantly from only 1.9% in 2005 to 75% in 2010 (P < 0.05, ANOVA). Students reported some positive experiences of the Hall technique. However, concern over perceived lack of future clinical support, an anticipated increase in time and financial pressures, and the ease of use of glass‐ionomer cement as an alternative were described as potential barriers to PMC use. Findings suggest that the introduction of the Hall technique has had a marked impact on the use of PMCs as a treatment modality for carious primary teeth.     

Perceptions of the dental profession: a comparative analysis through scale development

Dentistry is a science‐based profession that has a close interaction with people and society. However, despite this close interaction, perceptions of the dental profession by both patients and dental professionals have received little research attention. The purpose of this study was to compare the perceptions of dentists, dental students, and patients toward the dental profession through the development and testing of the Dental Profession Perceptions Scale (DPPS). The DPPS contains a total of 17 items measured on a 5‐point Likert response scale. The DPPS showed excellent internal reliability (Cronbach's α = 0.92) and test–retest reliability (r = 0.93). Explanatory and confirmatory factor analyses of the DPPS showed that dentists’, dental students’, and patients’ perceptions of the dental profession could be grouped according to ‘status’, ‘human’, and ‘scientific’ factors. There were no statistically significant differences between participants’ DPPS total or sub‐scale scores according to dental group, gender, or income. The DPPS developed can be used in future studies as a psychometrically sound measuring tool. Further studies should examine the factors that may affect the perceptions of the dental profession in different societies and cultures.     

Oral health‐related quality of life,measured using the five‐item version of the Oral Health Impact Profile,in relation to socio‐economic status: a population survey in Sweden

Oral health‐related quality of life (OHRQoL) is an important patient‐reported outcome measure in dental research. This study was conducted to analyse the association between OHRQoL, as measured using the five‐item version of the Oral Health Impact Profile (OHIP‐5), and different socio‐economic indices. A national survey of randomly selected adult individuals in Sweden (n = 3,500) was performed using telephone interviews. The questions asked for the purpose of this study were defined by the items of the OHIP‐5, just as questions were asked regarding socio‐economic variables, including education, income, and economic resources. Poor OHRQoL, as identified by an OHIP‐5 score of 3 or higher on at least two of the five items, was statistically significantly associated in multivariate analysis with low income (OR = 1.84) and having no economic resources (OR = 2.19). The statistical models were adjusted for age, gender, ethnicity, marital status, dental‐care utilization, dental anxiety, and smoking. The OHIP‐5 may be used in larger epidemiological surveys because it demonstrates the ability to discriminate for a range of important areas of measurement in dental public health, including social determinants.     

Virtual patient instruction for dental students: can it improve dental care access for persons with special needs?

An interactive, virtual‐patient module was produced on compact disc (CD‐ROM) in response to the critical need to increase dental students' clinical exposure to patients with developmental disabilities. A content development team consisting of dental faculty members, parents of children with developmental disabilities, an individual with a developmental disability, and educational specialists developed the interactive, virtual‐patient module. The module focused on a young man with congenital deafblindness presenting as a new patient with a painful molar. Students were required to make decisions regarding clinical interactions throughout the module. Differences in both comfort and knowledge level were measured pre‐ and post‐module completion, as well as the dental students' overall satisfaction with the learning experience. Significant results were obtained in students' perceived comfort and knowledge base. Participants reported overall satisfaction using the modules. This study demonstrated that an interactive, multi‐media (CD‐ROM), virtual patient learning module for dental students could be an effective tool in providing students needed clinical exposure to patients with developmental disabilities.     

Instructional Design for Assessment of Dental Esthetic Treatment Needs in a Indian Undergraduate School: A Randomised Controlled Trial

In the recent years esthetic dentistry has been the area of focus amongst the public. Esthetics is an important dimension in dental practice and the upcoming dentists need to be enabled to demonstrate their competencies for an efficient clinical outcome. The purpose of this study was to institute a cultural change within traditional didactic dental education towards student centred learning to cope up with the accelerating pace of medical technological change and achieving positive impact on patient care and patient satisfaction. Intervention that was considered for the project included David Merrill’s first principles of instruction. A randomized controlled trial was conducted with all the students from four cohorts of final year dental undergraduate students, divided into an intervention group (n = 40) and a control group (n = 40). A professional assessment questionnaire is used to evaluate the relationship between the students and professional’s assessment of esthetic treatment needs. The results of the study indicated that the ranking of the most and least noticeable dental features differed significantly (p = 0.0061) between the intervention and non intervention group and the indicates the intervention group to be in better agreement with professional assessment than the non intervention group of students with z value of 2.7435. The relative agreement between intervention group of undergraduate students and the professional assessment of esthetic treatment need shows the importance of intervention of Merrill’s first principles of instruction in learning, emphasising the significance of PBL and therefore indicating a positive impact on successful esthetic treatment for patients.

     

Students' attitudes and knowledge on pain and pain management in paediatric dentistry—An observational study

Introduction

The dental and dental hygienist educational programs prepare students with knowledge on children's prophylactic pain treatment and pain management. Observing the students' understanding could help educational efforts to be more student oriented. The aim was to evaluate dental and dental hygienist students' knowledge and attitudes on pain prevention and pain management in children and adolescents, applying a multidimensional questionnaire previously used on general dental practitioners.

Materials and Methods

Three hundred and four dental and dental hygienist students at Swedish universities were eligible for the survey. Written and oral information was given about the study's aim, methods, anonymity and voluntary participation. The multidimensional questionnaire included 47 closed questions.

Results

The total responding rate was 65.4%; dental students 61.1% and dental hygienist students 92.8%. The total mean of knowledge and attitudes, beneficial for the treating of patient pain, varied between 57.1% and 83.3%. The biggest knowledge gap was identified regarding the items: Children under 2 years of age experience less pain than children over 2 years undergoing similar treatment(34.3%), The dentist is better suited than the parent to judge if a child is in pain (29.4%), and usually the child's pain experience diminishes when the parents are present (24.2%).

Conclusion

Dental and dental hygienist students reported vastly spread knowledge and attitudes regarding pain prophylactic and pain management in children and adolescents, as measured by a multidimensional questionnaire previously used on GDPs. Knowledge on students' understanding of the young patient's pain could help educational efforts to be more student oriented. The questionnaire must be further modified and more extensively tested to meet each participating students' program level.     

Assessing short and long‐term educational impact of visits to hospice via a combination of qualitative methods

While qualitative methods have gained considerable recognition in medical education research, employing multiple qualitative data sources in assessing long‐term educational impact is rare. Utilising in‐depth data analysis method to six cross‐sectional cohorts (2004–2009) of students’ reflection papers (n = 213), this article demonstrates how students experienced subtle but important shifts in their attitudes (including personal, professional and spiritual domains) after making field visits to a hospice centre as part of the Special Needs Dentistry module. For retrospective assessment of learning retention, a pilot focus group was conducted with three junior faculty members who participated in the field visits to a hospice during their own undergraduate training. A subsequent focus group was conducted with graduates of the 2008 (n = 8) cohort using a refined discussion guide arising from the analysis of pilot group results. Graduates were unanimous in stating that the visits had sown ‘seeds’ in their minds and hearts, seeds which started to grow after they completed dental school and began to practice. This is demonstrative of the long‐term positive educational impact of the pedagogical design that entailed a special site visit coupled with post‐visit debrief and written reflection.     

Epidemiological aspects of dental trauma associated with maxillofacial injures: Ten years of clinical experience in Trieste,Italy

Background/Aims

The prevalence of dental injuries in patients with facial fractures is relevant. Epidemiologically, dental trauma in association with facial fractures generally affects the age group between 20 and 40 years old, with a higher prevalence in males. The aim of this retrospective study was to identify the incidence and etiology of dental trauma associated with facial fractures over a 10-year period.

Methods

From January 2009 to April 2019, among 381 patients with facial fractures, 353 were included in this study. Age, gender, trauma etiology, injured teeth and dental treatment were investigated.

Results

From 353 patients, with a mean age of 49.7 ± 19.9 years, 247 (70%) were males and 106 (30%) were females. Accidental falls were the most common type of injury (n = 118, 33.4%), followed by road accidents (n = 90, 25.5%), assaults (n = 60, 17%) and sports trauma (n = 37, 10.5%). Fifty-five subjects (15.60%) had dental injuries associated with facial fractures. Of the 145 teeth involved, 48 (33.1%) were diagnosed with luxation, 22 teeth (15.2%) were avulsed, 11 teeth (7.5%) suffered a concussion and there were 10 (6.8%) alveolar wall fractures.Uncomplicated enamel-dentin fracture was the more frequent hard tissue injury (n = 21, 14.5%), followed by complicated crown-root fracture (n = 10, 6.9%), infraction (n = 8, 5.5%), enamel fracture (n = 3, 2%) and complicated enamel-dentin fracture (n = 3, 2%). There was a peak in incidence between 21 and 40 years (42%). Males had a significantly higher risk of facial fractures with dental injury (75%). Maxillary incisors and canines (62.8%) were the most affected teeth.

Conclusions

There was a high prevalence of dental injuries associated with facial fractures. Maxillary incisors were the most injured teeth, with a higher prevalence in males.     

An epidemiological scoring system for tooth wear and dental erosive wear

Background: The prevalence and severity of tooth wear and dental erosion is rising in children and there is no consensus about an index to be employed. Aim: To assess the reliability of an epidemiological scoring system dental wear index (DWI) to measure tooth wear and dental erosive wear. Design: An epidemiological cross‐sectional survey was conducted to evaluate and compare tooth wear and dental erosion using the dental wear index and erosion wear index (EWI). The study was conducted with randomised samples of 2,371 children aged between 4 years and 12 years selected from the State of São Paulo, Brazil. Records were used for calculating tooth wear and dental erosion; the incisal edge and canine cusp were excluded. Results: As the schoolchildren's ages increased the severity of primary tooth wear increased in canines (P = 0.0001, OR = 0.34) and molars (P = 0.0001, OR = 2.47) and erosion wear increased in incisal/occlusal (P = 0.0001, OR = 5.18) and molars (P = 0.0001, OR = 2.47). There was an increased prevalence of wear in the permanent teeth of older schoolchildren, particularly on the incisal/occlusal surfaces (P = 0.0001, OR = 7.03). Conclusion: The prevalence of tooth wear and dental erosion increased as age increased in children. The epidemiological scoring system Dental Wear Index is able to measure both tooth wear and dental erosive wear. This index should be used to monitor the progression of non‐carious lesions and to evaluate the levels of disease in the population.     

Compliance of Saudi dental students with infection control guidelines

The aim of this study was to investigate compliance of dental students in a Saudi dental school with recommended infection control protocols. A pilot‐tested questionnaire concerning various aspects of infection control practices was distributed to 330 dental students. The response rate was 93.9% (n = 311). About 99% of students recorded the medical history of their patients and 80% were vaccinated against hepatitis B. The highest compliance (100%) with recommended guidelines was reported for wearing gloves and use of a new saliva ejector for each patient. Over 90% of the respondents changed gloves between patients, wore face masks, changed hand instruments, burs and handpieces between patients, used a rubber dam in restorative procedures and discarded sharp objects in special containers. A lower usage rate was reported for changing face masks between patients (81%), disinfecting impression materials (87%) and dental prosthesis (74%) and wearing gowns (57%). Eye glasses and face shield were used by less than one‐third of the sample. The majority of students were found to be in compliance with most of the investigated infection control measures. Nevertheless, further education is needed to improve some infection control measures including vaccination for Hepatitis B virus (HBV), wearing eye glasses, gowns and face shields and disinfecting impression materials and dental prostheses.