The confidence of undergraduate dental students when carrying out prosthodontic treatment and their perception of the quality of prosthodontic education

Introduction

Despite the falling number of edentulous patients within the UK, there is still a large demand for the provision of removable prostheses. On qualification, dentists should have the knowledge and skills to provide these prostheses, but previous studies have shown that final‐year dental undergraduate confidence in treating denture patients is lacking.

Aim

To explore undergraduate dental student confidence whilst carrying out prosthodontic treatment, and to explore their perceptions of the quality of their prosthodontic education.

Method

An anonymous questionnaire was distributed to all (n=203) dental undergraduates in Years 3 to 5 at the University of Bristol. The questionnaire utilised a range of data collection methods including confidence interval ranked responses and qualitative measures. The data were analysed using SPSS.

Results

The response rate was 51%. Undergraduate perception of confidence increased throughout the years of study (P<.001). There was also an increase in the number of partial and complete denture cases treated as students progressed through the course (P<.001). Overall, students were satisfied with their prosthodontic teaching, although students thought that too much time was allocated to laboratory teaching, and that increasing their clinical experience would be most beneficial in increasing their confidence levels.

Conclusion

Student confidence in carrying out prosthetic treatment increased as students progressed through the course, and confidence levels would be increased further with increased clinical experience.     

Dental status and oral health‐related quality of life. A population‐based study

Oral health‐related quality of life (OHRQoL) is associated with tooth wear and tooth loss. This study investigated the association between OHRQoL and dental status (in terms of natural dentition, partial or complete dentures, or edentulism). Sixteen hundred and twenty‐two persons who participated in a large‐scale Dutch dental survey were interviewed. Dentate persons (n = 1407) were additionally invited for a clinical examination (response rate: 69%). Dental status was based upon the combined data from this clinical examination and the questionnaire (seven dental status groups were defined). OHRQoL was measured by the Dutch translation of the short version of the Oral Health Impact Profile, the OHIP‐NL14. Kruskal–Wallis tests and Mann–Whitney U tests were used to investigate differences in OHRQoL between the dental status groups. For all OHIP‐NL14 scales, differences in OHRQoL were found between the dental status groups (all P‐values <0·001). The Mann–Whitney U tests revealed no differences between persons with a complete natural dentition and persons with a fixed prosthetic replacement. The latter group, however, did show a significantly better OHRQoL as compared to persons with a removable partial denture. Surprisingly, edentulous persons with an overdenture had a more impaired OHRQoL than edentulous persons with non‐supported complete dentures. The results demonstrated that impaired dental status is associated with deteriorations in OHRQoL, especially concerning functional limitations, physical pain and social disability.     

Dental student self‐assessment of a medical history competency developed by Oral and Maxillofacial Surgery Faculty

Purpose

To develop a standardized competency exam to evaluate dental student knowledge of patients with complex medical histories. Analysis was performed to determine if there is a difference between dental student self‐assessment of the exam compared to oral surgery faculty. The overall goal is to enhance student comprehension of advanced medical patients in the pre‐doctoral oral and maxillofacial surgery clinic and make changes based on student responses.

Methods

The exam took place in a simulation laboratory containing two‐way mirrors where the student could not see the evaluator. Three standardized patients (trained actors) were given different medical history scenarios to learn prior to the exam. Students were randomly assigned to interview one patient. The graders consisted of senior and junior level faculty. In real time (live) randomized manner, faculty assessed each student using a standardized rubric to assign a score of 1 to 4. Immediately afterwards, students assessed their own performance using the same scale.

Results

Students gave themselves significantly higher grades (P < 0.001) on the exam (10.7 ± 0.12) compared to the faculty (9.2 ± 0.17). There was no significant difference in student (P = 0.16) or faculty assessment (P = 0.29) between the three different medical scenarios. There was no significant difference between faculty in assessment of student performances (P = 0.16).

Conclusion

These results suggested that students overestimated their performance compared to the faculty assessment. This could be due to that students assessed their performance based on memory and self‐confidence; that exceeds their expectations. Internal calibration of student performances and faculty grading using standardized criteria may produce more accurate and reliable outcomes in student scoring.     

Problem-based Learning in Undergraduate Dental Education: Faculty Development at the University of Southern California School of Dentistry

The University of Southern California School of Dentistry (USCSD) seeks to educate oral health professionals with a balanced curriculum covering health promotion, risk assessment and disease prevention, diagnostics, treatments, and therapeutics. Based on critical analyses of a 5-year educational demonstration project, the USCSD proposed to use problem-based learning (PBL) to achieve its goals. Among the many changes required to convert a traditional dental educational curriculum to PBL, none is more important than that of faculty development. To achieve this, the USCSD Curriculum Subcommittee on Faculty Development, Mentoring, and Evaluation has designed and implemented a series of workshops to train its faculty as facilitators. There are four Core Skills Workshops: PBL Process Workshop, Facilitation of Learning Workshop, Student Assessment and Feedback Workshop, and PBL in the Clinical Environment.     

Orthodontic treatment need,self‐esteem,and oral health‐related quality of life among 12‐yr‐old schoolchildren

The aim of this study was to investigate the association between orthodontic treatment need and oral health‐related quality of life (OHRQoL) among 12‐yr‐old children. The study also assessed whether self‐esteem modifies and/or moderates this relationship. Cross‐sectional data on 406 schoolchildren aged 12 yr were analyzed. Data on socio‐economic and demographic characteristics, dental pain, self‐esteem, and OHRQoL were collected using validated questionnaires. Orthodontic treatment need was assessed, through dental examinations, using the dental aesthetic index (DAI). Multiple negative binomial regression and path analysis were used to estimate the association of orthodontic treatment need and self‐esteem with OHRQoL. A modifying effect of self‐esteem on the relationship between DAI and OHRQoL was observed. Self‐esteem did not mediate the abovementioned relationship. Children with lower scores of self‐esteem had worse OHRQoL among those with lower orthodontic treatment need (a DAI score of < 31). However, self‐esteem did not influence the association between DAI and OHRQoL in children with greater orthodontic treatment need (a DAI score of ≥ 31). Self‐esteem attenuated the impact of malocclusion on OHRQoL in children with minor or definite malocclusion, but not among those with severe or very severe malocclusion. Self‐esteem appears to buffer the impact of malocclusion on OHRQoL in children with minor orthodontic treatment need.     

The Use of Custom‐Milled Zirconia Teeth to Address Tooth Abrasion in Complete Dentures: A Clinical Report

A patient exhibited severe abrasion of resin posterior denture teeth including perforation of the denture base. New dentures were provided to explore the application of zirconia teeth for complete dentures. [Correction added to online publication 07 November 2012: “Zirconium” corrected to “Zirconia”.] Traditional denture procedures were combined with fixed prosthodontic CAD/CAM procedures to fabricate custom‐designed four‐tooth posterior segments in hollow crown form to reduce weight and with a retentive form for interlocking to the denture base. The new dentures were successful in reducing wear of the denture teeth over the short‐term follow‐up period.     

Face‐bow transfer in prosthodontics: a systematic review of the literature

An extensive search for randomised controlled clinical trials was accomplished to compare dental prostheses and occlusal splints constructed with or without face‐bow transfer, and question whether face‐bow transfer may present better clinical results than simpler approaches. Studies were identified by searching electronic databases (PubMed/MEDLINE, Latin American and Caribbean Literature on the Health Science, and Brazilian Bibliography of Dentistry). The keywords ‘dental articulator’, ‘semi‐adjustable articulator’, ‘face‐bow’, ‘jaw relation record’ and ‘occlusal splint therapy’ were used. The minimum inclusion requirements were (i) randomised controlled trials with patients of any age, (ii) comparison between dental prostheses or occlusal splints constructed with or without face‐bow transfer and (iii) assessment of clinician's time, number of occlusal contacts, patient satisfaction or masticatory function. The search resulted in the identification of 8779 articles. Subsequently, 8763 articles were excluded on the basis of title and abstract. By the end of the search phase, eight randomised controlled trials were considered eligible. Current scientific evidence suggests that face‐bow transfer is not imperative to achieve better clinical results in prosthodontics. Randomised clinical trials suggest that simpler approaches for the construction of complete dentures and occlusal splints may present acceptable results, while no clinical study has investigated its use in fixed and removable partial dentures.