Orthodontic training in pediatric dental residencies

The purpose of this study was to determine the amount and types of orthodontic training in pediatric dental residencies. A twenty-one-item survey was mailed to sixty directors of pediatric dental residencies. Follow-up surveys were sent to those who had not responded. Fifty-two surveys were returned for a response rate of 87 percent. Most programs provided forty-eight formal orthodontic course hours, one-half to one day of clinical orthodontic experience per week, and six to ten case starts for each resident. Most program directors anticipated this amount of experience would increase or stay the same in the future.Though most programs had an affiliated graduate orthodontic program, fewer than half of the programs had an orthodontist on faculty from the affiliated program (43 percent). As expected, orthodontic training varies with different program characteristics. The faculty members teaching orthodontics in pediatric dental residencies are often not from affiliated graduate orthodontic programs. Most program directors do not anticipate a decrease in the didactic or clinical components in the next five years.     

Patients with special health care needs in pediatric dental practices

PURPOSE: The objective of this study was to determine the involvement of pediatric dentists in practice in managing patients with special health care needs (SCHN) upon completion of training. METHODS: A questionnaire was developed, pilot tested, modified and sent to a randomly selected sample of 950 pediatric dentists in practice who were active and fellow members of the American Academy of Pediatric Dentistry. RESULTS: Fifty-one percent of the dentists responded. The majority were males between the ages of 41 and 50 years. Most practiced in communities with over 500,000 citizens. Most were trained in hospital-based programs, and 84% reported comprehensive didactic courses on SHCN patients during training. SCHN patients were routinely appointed in an integrated schedule in their practices. Seventy-one percent of responders continue to follow the patients after 21 years of age. Most had buildings and offices that were handicapped accessible. Patient profiles remained similar since initiating private practice with notable increases reported in the new and recall patients and patients with complicated medical histories categories. CONCLUSIONS: The results of this survey demonstrate the continuing involvement of pediatric dentists in private practice in scheduling and treating patients with special health care needs after the completion of training.     

Patients with special health care needs in general and pediatric dental practices in Ontario

The objective of this study was to determine the involvement of Ontario's general and pediatric dentists in providing care to patients with special health care needs (PSHCNs). A questionnaire was developed and sent to a randomly selected sample of general dentists and to all pediatric dentists in Ontario; response rates were 52% and 90%, respectively. Most general dentists and all pediatric dentists reported that they provided a full range of dental services to PSHCNs. Most (80%) general dentists treat PSHCNs of all ages, whereas 60% of pediatric dentists report only treating PSHCNs up to the age of 18 years. A majority of both groups report treating PSHCNs whose dental care is paid through various government-funded programs. Most general dentists received training in the treatment of PSHCNs in undergraduate dental school, and 40% reported taking continuing education courses in this area. Most pediatric dentists received this training during their advanced dental specialty training, and 29% reported taking continuing education courses in this area. The results of this survey appear to demonstrate that general and pediatric dentists in Ontario provide a full range of dental services to PSHCNs, treat patients with a variety of disabilities and of all ages and are interested in pursuing continuing education that focuses on the delivery of dental care to PSHCNs. However, the results may be inaccurate because of question design flaws and responder bias among the 52% of surveyed general dentists who returned their questionnaires.     

Federal role in dental public health: dental care for special populations

California is home to more than 70 dental clinics operated or funded by the U.S. government. They operate on annual appropriations from Congress to serve a specific population and regulations that specify the type of dental services provided are usually promulgated at the national level. Dental clinics have the challenge of creating a program that delivers high-quality care within these financial and programmatic constraints. In California, U.S. government appropriations are the main source of funding dental clinics of immigration services, the Veterans Administration, the Bureau of Prisons, the Coast Guard, and American Indian clinics. The evolution and current practices of these five dental public health programs are described.     

Focused care of pediatric patients in the dental office.

No dental text can adequately prepare the practitioner with the necessary expertise to treat all presentations or office complications that may arise in the therapy of children. There are times when consultation with the child's parent and pediatrician may answer necessary treatment-related questions. Most chronic conditions do not prevent needed treatment interventions. Any acute illness or exacerbation of a chronic disease should be cleared by the primary care physician before commencing dental treatment. The mainstay of safe practice requires that the dentist to maintain a basic level of understanding of what constitutes an emergency and that office staff receive basic training and are adequately supplied with emergency equipment. Dentists are cautioned to consult their state board or dental society as well as their insurance carrier as to what constitutes necessary emergency equipment in the office and to what level they are responsible for providing emergency care to their patients. There is a great difference within the dental field just as there is with medical specialties. All practitioners, however, are liable for any acts of consignment, and although the intention is not to dissuade anyone from providing assistance in an emergency, supportive care and an immediate call of 911 to activate the local EMS are important. In addition, maintaining a familiarity with the local hospital and emergency department capabilities as well as travel time and distance is also important. Routine reviews and updates on life-saving interventions and resuscitations are good general practice and will save lives.     

Female dental practitioners and care of special needs children

Increased numbers of female pediatric and general dentists are considered in terms of their potential to provide services for children (and adults) with special health care needs. Reviewed in this are: (1) practitioner work patterns; (2) increasing numbers of children in community residences; (3) the general need for dental services; (4) changing educational standards; and (5) practitioner willingness to provide care.     

Readability of pediatric health materials for preventive dental care

Background  

This study examined the content and general readability of pediatric oral health education materials for parents of young children.     

Accuracy of estimation of dental treatment need in special care patients

OBJECTIVES: To assess the ability of carers and dental professionals to estimate treatment need in a group of children and adults with special needs. METHOD: A retrospective study of a series of 103 special needs patients who had received restorative dental treatment under general anaesthetic was undertaken. The initial reason for attendance and the time lapse between first symptoms and decision to consult were established. The parent or carer was asked to estimate treatment need and to assess the degree of discomfort suffered by the patient. The dentist evaluated treatment need by means of a pre-operative treatment plan. These results were compared to actual treatment performed. RESULTS: Treatment need was severely underestimated by both carer and dentist. The degree of advanced pathology found in the population would suggest that pain suffered was also underestimated. CONCLUSIONS: Access of patients with special needs to dental care may be limited by the ability of their carers to evaluate their oral condition and/or by the persons inability to express their pain or discomfort.