Geriatric dentistry education in European dental schools

As the numbers of elderly adults continue to grow within European populations, the need for dental students to be trained in the management of geriatric patients becomes increasingly important. Many dental schools have developed training programmes in geriatric dentistry in response to the changing oral health needs of older adults. The purpose of this on-line survey was to identify the current status of geriatric dentistry education in European dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the Internet, and 194 dental schools in 34 European countries were invited to participate. Data from completed questionnaires were submitted to the investigators via email from 82 schools in 27 countries (42% response rate). Thirty-six percent of schools offered a specific geriatric dentistry course that included didactic teaching or seminar groups, 21% taught geriatric dentistry by means of organised presentations in the curriculum, and 36% taught the subject by occasional lectures. 7% of schools did not teach geriatric dentistry at all. A clinical component to the geriatric dentistry curriculum was reported by 61% of schools and 18% reported operating a specific geriatric dentistry clinic within the school. Of those providing clinical geriatric dentistry training, it was provided within the school in 45% of cases, with a further 29% of schools providing training both within the school and at a remote location. Seven percent of schools operated a mobile dental clinic for treating geriatric patients. Twenty-eight percent of schools had a geriatric programme director or a chairman of a geriatric section and 39% indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has clearly established itself in the curricula of European dental schools although the format of teaching the subject varies widely. It is of concern that geriatric dentistry was not taught at all in 7% of schools. No data are available concerning whether or not geriatric dentistry is taught in the 58% non-responding schools.     

The number one issue facing dentistry today

The hiring environment in dentistry will probably not improve significantly over the next few years. You should certainly encourage any dental organizations to support campaigns to attract individuals into dental staff positions through job awareness programs and new training schools or environments. Dentistry is an outstanding profession. Unfortunately, when your office is short staffed, you can not fully enjoy your practice.     

Current status of predoctoral geriatric education in U.S. dental schools

The elderly constitute the fastest growing segment of the U.S. population. Dental schools must educate dental students so that they are competent and confident in managing the treatment needs of elderly patients. Programs in geriatric dentistry have been developed in response to the changing oral health needs of growing numbers of older adults. The purpose of this online survey was to identify the current status of predoctoral geriatric dental education in U.S. dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the World Wide Web, and fifty-four US. dental schools were invited to complete the form. Data from completed questionnaires were submitted to the investigators via email. Following repeated phone calls and emails to urge school administrators to respond to the electronic questionnaire, a 100 percent response rate was achieved. All schools reported teaching at least some aspects of geriatric dentistry, and 98 percent had curricula that contain required didactic material. Sixty-seven percent of schools reported having a clinical component to geriatric dental teaching. Of these schools, the clinical content was required in 77 percent and elective in the rest. Thirty percent of schools reported a specific geriatric dentistry clinic within the school, and 11 percent had a remote clinical site. Sixty-three percent of schools have a geriatric program director or a chairman of a geriatric section. Over a third of schools indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has continued to expand over the last twenty years and has established itself in the U.S. predoctoral dental curriculum. The format of teaching the subject varies considerably among the dental schools. Although didactic teaching of geriatric dentistry has increased markedly in the last two decades, clinical experience, both intramurally and extramurally, did not keep pace.     

Dental school-based continuing education in tobacco use cessation counseling for oral health care providers

The role of health care providers in patient counseling for tobacco use cessation has gained increased attention in recent years. The present survey examined the activities of dental school continuing education departments in providing continuing education in tobacco use cessation counseling to oral health care personnel. A questionnaire was sent to the director of continuing education at all U.S. and Canadian dental schools. The results indicate that few continuing education programs have been or currently are being offered. Respondents to the survey perceived little interest in this topic among their target audiences. The reasons for the current situation and barriers to practitioner involvement are discussed.     

Mentoring: leadership, learning, legacy

As the dental profession develops over the next few decades, there will be identifiable changes in the demography of the profession. Enrollment trends reflect a growing number of women in dental schools and in the dental profession. There is an increasing number of dentists--men and women--from countries and cultures outside of the United States. The profession must be prepared to address the question of how to engage women--as well as minorities--in more active and visible roles in organized dentistry. The challenge is clear, and the outcome will provide an indicator to the strength of our professional associations in the future. Mentoring of women dentists is one effective way of creating a pathway to participation.     

Dental development in the midwest of America.

During the early nineteenth century, dentistry was just beginning its existence as a profession and emerging from a trade into a profession in the United States. Dental schools were being established to replace preceptorships as a means of training and members of the profession became aware of the need to draw up laws for the regulation of the professions. The Midwest of the United States participated in these changes and many of the dental practitioners of the Midwest started the reforms that ultimately led to the establishment of dentistry as a profession. Some of these originators and their contributions are reviewed.     

Predoctoral Implant Education in U.S. Dental Schools

PURPOSE: In 2002, a survey of American dental schools was conducted to determine the curricular structure, teaching philosophies, and materials used in predoctoral implant dentistry courses. MATERIALS AND METHODS: The questionnaire was mailed to the predoctoral implant dentistry director/chairperson of 54 U.S. dental schools. Of these, 38 schools returned the completed survey resulting in a response rate of 70%. RESULTS: Eighty-four percent of the respondents indicated that an implant dentistry course is part of their school's requirements. Seventy percent indicated that this course is offered by either the Restorative or Prosthodontics Department in the third year of the predoctoral dental curriculum. For 75% of the schools, the duration of the course ranged from 3 to 6 months (mean of 5.5 months), 57% reported offering between 11 and 20 lecture hours (mean of 20.4 hours), and less than half of the schools (41%) have prosthodontists teaching the predoctoral implant dentistry course. In 78% of the schools, a laboratory course is offered in conjunction with the implant course. The majority of the schools (88%) allow predoctoral students to restore implant cases clinically. Seventy-three percent require some of the implant-related laboratory work to be completed by the students and the single-tooth implant restoration is the most popular type of implant restoration for 78% of the schools. CONCLUSIONS: Predoctoral implant dentistry educational programs vary from school to school, yet a large percentage of schools agree on certain topics.     

Prevention of oral disease for long-term care and homebound elderly

Despite the fact that many oral diseases afflicting the long-term care or homebound elderly are preventable or treatable, many older people do not seek available treatment, or their oral health care needs are not being met. The dental profession must, therefore, increase the preventative dental awareness of elders and make preventative and treatment services more accessible to this population. Interdisciplinary training and collaborative efforts among the dental profession, medical profession and caregivers are necessary in preventing oral disease for this geriatric population, which would improve not just oral health, but overall systemic health as well, thereby improving their quality of life.     

Coping with the changing state of dental managed care

About 58 percent of the American population has some type of managed dental care that pays for some, not all, dental care needs. Unlike the medical profession, the dental profession has not been devoured by managed care, but there is no question that managed care plans are here to stay. The various types of managed care programs are changing every day. The trend is for DHMOs and dental indemnity programs to decrease, DPPOs and dental referral programs to increase and dental reimbursement programs to grow slowly as more organizations become aware of their benefits. Plans vary from excellent to poor in their service to patients and their dentists. We dentists must learn to live with them and to educate our patients about the advantages and disadvantages of each. I am pleased to observe that fee-for-service dentistry, although challenged, is still very alive and strong and serving the public with the same high quality and freedom of choice for which American dentistry has always been known.     

Current status of Geriatric Dentistry Educational Activities in U.S. dental schools

The current status of Geriatric Dentistry Educational Activities (GDEA) in U.S. dental schools is reported in this survey. Data were collected regarding faculty involvement in geriatric programs, didactic and clinical academic curricula, and other aspects of the ongoing activities in schools. Data were reported by 50 (88 percent) of the nation's 57 dental schools in continuing operation. Forty-two schools reported discrete GDEA at the time of the study. Seven of these schools had a formal division or department of geriatric dentistry. The survey indicated that educational qualification of GDEA coordinators had risen significantly in recent years. The mean number of didactic hours (29) of instruction in geriatric education available to students has also risen. Curriculum time and financial considerations were the primary obstacles to expansion of clinical geriatric activities. With the current economic constraints in dental education, present GDEA levels are unlikely to expand in the foreseeable future, unless governmental or private agencies recognize the importance of developing GDEA and increase their support.     

Reflections on the encouragement of altruism in dental education

Dental ethics and professionalism are often relegated to being taught on the coat‐tails of other disciplines, if they are taught at all. The assumption that students develop professionalism as a by‐product of other learned competencies in dentistry is well documented to be false, and yet, little has been done in many institutions to deal with this. This article seeks to propose that altruism should be championed in dental education and that traditional learning through the preaching of professional codes is not the appropriate way to achieve this. The environment of dental schools needs to be challenged and reformed so that altruism is promoted. If we fail to address declines in altruism in the dental profession, then damage to the professional status of dentistry is inevitable and the ability to fulfil the profession's social contract with society will be inhibited.     

The changing roles of the dentist and dental laboratory

There are growing pressures on the relationship between the profession and laboratories, including increased use of sophisticated prosthetic services, rapid evolution of materials, more "educated" patients, declining numbers of laboratory training programs and relatively reduced hours in dental schools in traditional prosthodontics subjects, and consolidation in the dental laboratory industry. Restorative services represent the greatest cost/value center in most practices, and the ADA's "Future of Dentistry Report" calls for the profession reasserting its "control" in this area. It is proposed instead that a partnership among the profession, laboratories, manufacturers, and education represents the most effective way to guide the emerging future of restorative dentistry for the benefit of patients and the concerned parties.     

Predoctoral Implant Dentistry Programs in US Dental Schools

Surveys of US dental schools over the last 20 years have reported a continual increase in the number and types of predoctoral and postdoctoral implant dentistry programs being taught. The purpose of the following article is to report on the results of a survey intended to update the status of predoctoral programs with respect to their curricular placement, departmental jurisdictions, and course contents. In June 1993, 54 US dental schools received the implant dentistry curriculum survey, and 50 of the schools (93%) returned responses. Results indicate that the trend toward implementation of more predoctoral implant dentistry programs has been sustained, with 86% of schools reporting the existence of implant curricula. This compares with 33% and 73% of US schools having such programs in 1974 and 1989, respectively. The major reasons that schools gave for not having implant dentistry courses for predoctoral students are a lack of curriculum time and scarce financial resources. The dental disciplines most frequently guiding such programs are oral surgery and periodontics. Schools offer varying degrees of lectures, laboratories, and clinical experiences in predoctoral implant dentistry, with the number of curriculum hours peaking in years three and four. General curricular topics most commonly include a historical overview of implant dentistry, diagnosis and treatment planning, classifications and types of dental implants, and surgical and prosthodontic procedures. Seventeen percent of schools require some form of undergraduate clinical implant dentistry exposure for all of their students.     

The influence of "new science" on dental education: current concepts, trends, and models for the future

Advances in all aspects of science and discovery continue to occur at an exponential rate, leading to a wealth of new knowledge and technologies that have the potential to transform dental practice. This "new science" within the areas of cell/ molecular biology, genetics, tissue engineering, nanotechnology, and informatics has been available for several years; however, the assimilation of this information into the dental curriculum has been slow. For the profession and the patients it serves to benefit fully from modern science, new knowledge and technologies must be incorporated into the mainstream of dental education. The continued evolution of the dental curriculum presents a major challenge to faculty, administrators, and external constituencies because of the high cost, overcrowded schedule, unique demands of clinical training, changing nature of teaching/assessment methods, and large scope of new material impacting all areas of the educational program. Additionally, there is a lack of personnel with adequate training/experience in both foundational and clinical sciences to support the effective application and/or integration of new science information into curriculum planning, implementation, and assessment processes. Nonetheless, the speed of this evolution must be increased if dentistry is to maintain its standing as a respected health care profession. The influence of new science on dental education and the dental curriculum is already evident in some dental schools. For example, the Marquette University School of Dentistry has developed a comprehensive model of curriculum revision that integrates foundational and clinical sciences and also provides a dedicated research/scholarly track and faculty development programming to support such a curriculum. Educational reforms at other dental schools are based on addition of new curricular elements and include innovative approaches that introduce concepts regarding new advances in science, evidence-based foundations, and translational research. To illustrate these reforms, the Marquette curriculum and initiatives at the University of Connecticut and the University of Texas Health Science Center at San Antonio dental schools are described in this article, with recognition that other dental schools may also be developing strategies to infuse new science and evidence-based critical appraisal skills into their students' educational experiences. Discussion of the rationale, goals/objectives, and outcomes within the context of dissemination of these models should help other dental schools to design approaches for integrating this new material that are appropriate to their particular circumstances and mission. For the profession to advance, every dental school must play a role in establishing a culture that attaches value to research/discovery, evidence-based practice, and the application of new knowledge/technologies to patient care.     

The development of geriatric curricula in U.S. dental schools, 1979-1984

When data from a 1984 survey of U.S. dental schools were compared with data from a similar survey of the same schools completed in 1979, an increase in the teaching of geriatric dentistry to dental students was observed. While more topics are being taught in more schools, the depth and coverage are variable. Multivariate analyses revealed that more topics were likely to be taught if a course in geriatrics existed, if the course had existed since 1979, and if the course director was a dentist. Factors associated with the establishment of a course between 1979 and 1984 were that the school was located in a state with a large geriatric population and that financial assistance for patients through state or local government was available.     

Teaching the use of resin composites in Canadian dental schools: how do current educational practices compare with North American trends?

The placement of resin composites in posterior teeth is now a common procedure in dental practice. The aim of this study was to investigate current teaching of this procedure in Canadian dental schools and to compare trends in teaching with those in the United States. This study complements other investigations in which we examined teaching of the use of posterior resin composites in dental schools in the United States, Ireland and the United Kingdom. A questionnaire was distributed by email to the faculty member in each of the 10 dental schools in Canada with responsibility for teaching the operative dentistry curriculum, including the placement of posterior resin composites. The response rate was 100%. More teaching of posterior resin composites was noted since the time of a survey in the late 1990s. The amount of teaching and clinical experience in the use of posterior resin composites in Canadian dental schools seems to be higher than in dental schools in the United States. As noted in surveys of other countries, variation among Canadian teaching programs was found to persist in relation to techniques and technologies used.     

A survey of dual-degree training opportunities at US dental schools

The purpose of this article is to describe access to information for the dual-degree dental scientist training programs (D.D.S.-D.M.D./Ph.D.) currently available for predoctoral students at U.S. dental schools. Given the ongoing shortage of dental faculty and the progressive emphasis on evidence-based dentistry, these programs will be instrumental in training future dental faculty. A comprehensive review of the institutional websites for all fifty-six U.S. dental schools was undertaken in January 2006. After identification of advertised dual-degree programs, a follow-up survey was sent to twenty-two dental schools that described the existence of a dual-degree dental scientist training program. The results of the survey and website review indicate that there are a number of programs in operation, but it is difficult to determine even basic features of these programs including curriculum structure, financial aid, and infrastructure support for students. Several current dental scientist trainee students were also contacted to discuss their programs in more detail. The insights derived from this investigation may assist dental school applicants, current predoctoral dental students, and administrators seeking to design or promote their existing dental scientist training programs.     

Teaching the placement of posterior resin-based composite restorations in Spanish dental schools

Objectives: In an area of esthetic dentistry such as posterior composites, in which new materials and techniques are being devolved continuously, it is important to confirm that dental students have a clear understanding of the basic principles of clinical application of this knowledge. Considering that the preparation of dental graduates in Spain may be of interest to competent dental authorities and employers with whom they can work worldwide, this study investigated the teaching of posterior composite restorations in Spanish dental schools. Study design: In late 2009⁄ early 2010, a questionnaire seeking information on the teaching of posterior composites was emailed to the professor responsible for teaching operative dentistry in each of the fifteen dental schools having complete undergraduate dental degree programs in Spain. Results: The response rate was 100%. Most investigated topics did not show noteworthy differences depending on whether the schools were public or private. Variations were found among Spanish dental schools in both the amount and content of the teaching programs concerning posterior composite restorations. Differences were recorded in the teaching of cavity design, contraindications to composite placement, indications for liners and bases, matrix and wedging techniques, composite and bonding systems, light curing and finishing procedures for composite restorations. More consistency was observed in teaching methods of moisture-control, indirect composites and amalgam bonding. Conclusions: As recommended in previously surveyed countries, efforts must be made to promote harmonization of dental curricula to make it easier for graduates to work elsewhere, and to ensure they meet the needs of their patients on entering independent practice. Key words:Aesthetic dentistry, composite restoration, dental education, teaching program, undergraduate dental student.     

Class I and Class II silver amalgam and resin composite posterior restorations: teaching approaches in Canadian faculties of dentistry

A 10-question survey was mailed to the 10 Canadian faculties of dentistry to determine current approaches to teaching undergraduates about silver amalgam and resin composite for posterior restorations in adults and children. Responses were received from all 10 pedodontic programs and from 8 of the 10 operative and restorative programs. The use of silver amalgam and posterior composite for restorations of primary and permanent teeth is covered in the curricula of all dental schools, but the relative emphasis on the 2 materials varies. In the operative and restorative programs, curriculum time devoted to silver amalgam is either greater than or equal to that devoted to posterior composite. Five of the 8 schools reported greater educational emphasis on silver amalgam for the permanent dentition; however, course directors noted that the preference among patients seen in clinics is tending toward composite restorations. Curricula appear designed to educate students about the optimal use of both materials. Requirements for performance of restorations during training generally do not specify the type of material; these requirements range from 60 restorations to 250 surfaces. Five of the 8 schools conduct clinical competency tests with both materials. The responses from the pedodontic programs were more diverse. The proportion of curriculum time devoted to each type of material in these programs ranged from less than 25% to more than 75%. Five schools reported more emphasis on silver amalgam, 3 schools reported equal emphasis, and 2 schools reported more emphasis on posterior composite. No clinical requirements were specified in any of the undergraduate pedodontic programs. Within some of the faculties, there were differences between the operative and restorative program and the pedodontic program with respect to emphasis on different materials for the posterior dentition.