Improving teamwork between students from two professional programmes in dental education

In Sweden, the National Board of Health and Welfare forecasts a decrease in dentists with 26% and an increase in dental hygienists with 47% until the year of 2023. This, together with changes in both epidemiology, especially of dental caries, and political priorities, calls for an effective and well‐developed cooperation between dentists and dental hygienists in future dentistry. Hence, the aim of this project was to investigate whether highlighting teamwork during the undergraduate studies of dental students and dental hygiene students could improve the students’ holistic view on patients as well as their knowledge of and insight into each other’s future professions. Thirty‐four dental students and 24 dental hygiene students participated in the study. At the beginning of their final year in undergraduate education, a questionnaire testing the level of knowledge of the dental hygienists’ clinical competences was completed by both groups of students. In addition, activities intending to improve teamwork quality included the following: (i) a seminar with a dentist representing the Public Dental Health Services in Sweden, (ii) dental students as supervisors for dental hygiene students, (iii) planning and treatment for shared patients and (iv) students’ presentations of the treatments and their outcomes at a final seminar. The project was ended by the students answering the above‐mentioned questionnaire for the second time, followed by an evaluation of the different activities included in the study. The knowledge of dental hygienists’ competences showed higher scores in almost all questions. Both groups of students considered the following aspects important: seminars with external participants, dental students acting as supervisors and planning and treating shared patients. By initiating and encouraging teamwork between dental students and dental hygiene students, it is possible to increase knowledge on dental hygienists’ competence and also to develop and strengthen a holistic view on patients and dental work, thereby preparing both groups of students for their professional life.     

Perceptions of Japanese and Canadian dental hygiene students towards their profession

Abstract: Objectives: The purpose of this study was to investigate perceptions towards the profession and level of self‐esteem of Japanese and Canadian dental hygiene students. Methods: Third year dental hygiene students enrolled in a Japanese and a Canadian dental hygiene programme were asked to participate in a survey study. An instrument was developed to obtain students’ opinions about the profession. The present study also explored dental hygiene students’ levels of self‐esteem, and the relationship with perceptions towards profession. Results: Scores for dimensions including ‘Motivation’, ‘Expectation’ and ‘Environment’ were significantly higher among the Canadian students over Japanese students. The level of explicit self‐esteem of the Canadian students was significantly higher than that of the Japanese students, and it was positively correlated with their expectations of the profession. Conclusions: There were significant differences in perceptions between Japanese and Canadian dental hygiene students. It is suggested that educational strategies should be planned to positively influence the students’ perceptions toward the profession and improve the level of self‐esteem.     

Perceived relevance of oral biology by dental students

Objectives: This study investigated the perception that dental students have regarding the relevance of oral biology (OB) to dental education and dentistry in general. Moreover, this study analysed students’ attitude towards OB learning approaches and resources. Methods: A questionnaire based on a Likert scale was used to survey pre‐clinical/second (BDS2)‐ and final/fifth (BDS5)‐year dental students at the School of Dentistry of the University of Birmingham (United Kingdom). In comparison, a small group of postgraduate specialist registrars were surveyed to evaluate the attitudes of practising dentists. Results: The results show that all study groups expressed a high level of perceived relevance of OB to dentistry. Students’ perception of OB for dental education, clinical training and practice also scored high. More than 40% of undergraduate students and about 55% of the postgraduates indicated a perceived change in their attitude towards OB with time characterised by increased appreciation of the subject. Lectures were considered as the most important teaching approach, whereas ‘group poster projects’ ranked lowest. Of the different study resources, lecture handouts received the overall highest importance score. Conclusions: The results indicate that dental students considered OB relevant for dental education and dentistry and suggest a positive attitude towards the subject. This study also suggested that dental students prefer teacher‐centred/led teaching rather than student‐directed learning of OB. The article addresses the role of OB and science‐related research projects within the dental curriculum and discusses that close integration of basic sciences with dental education may enrich dental education and overall learning experience.     

Caries assessment and restorative treatment thresholds reported by Swedish dentists.

The aim was to study any variability in approximal and occlusal caries diagnoses and restorative treatment decisions among Swedish dentists. The material consisted of a pre-coded questionnaire sent to a random sample of 923 dentists with 4 items concerning approximal and occlusal caries diagnosis and restorative treatment decisions. Responses were received from 651 (70.5%) dentists. In an adolescent with low caries activity and good oral hygiene, more than 90% of the dentists stated that they would not automatically restore a primary approximal caries lesion if its radiographic appearance did not show obvious progression in the outer 1/3 to 1/2 of the dentin. Moreover, 67% of the dentists would only consider immediate restorative treatment of an occlusal surface if obvious cavitation and/or radiographic signs of dentin caries could be observed. When diagnosing questionable occlusal caries, the dentists largely relied on the radiographic appearance. Concerning both approximal and occlusal caries, the threshold for restorative treatment differed between the metropolitan regions in Sweden, and younger more often than older dentists would postpone restorative treatment of approximal caries until the lesion had reached a relatively advanced stage of progression. The responses also showed that dentists in private practice would restore approximal caries at an earlier stage of progression than the dentists in the Public Dental Health Service.     

乌鲁木齐中学生口腔健康行为调查报告

目的调查新疆乌鲁木齐中学生对口腔健康知识的认知状况。方法对2105名中学生进行了问卷调查,内容包括口腔健康知识、态度与信念、就医行为、医疗级别等问题。建立SPSS13.0数据库并进行统计学分析。结果关于"口腔疾病对身体健康有无危害"这一问题89.5%的中学生持肯定态度,认为有一定危害。"当得知患有‘虫牙’后的态度"75.5%的中学生认为发现"虫牙"及时去看牙医,54.7%学生认为应该定期到医院进行口腔检查,74.3%的中学生选择综合医院的口腔科,56.2%选择口腔专科诊所,72.5%的中学生认为所选上述医院卫生条件好,70.6%认为质量有保证,57.5%从口腔专科医生获得口腔健康知识。结论乌鲁木齐中学生对口腔健康知识有一定的认识。但还存在一些不足,口腔健康教育工作应通过各种媒体的宣传、口腔医生等多方面的共同努力,使学生建立口腔知识的新观念,早期预防口腔疾病,拥有一副健康的牙牙合系统。     

Factors related to the willingness of Palestinian dentists to treat patients with blood‐borne diseases

This study aimed to explore, using groups of simulated patients, the willingness of Palestinian dentists to treat patients with blood‐borne diseases. Simulated patients conducted a telephone survey of a random sample of dentists registered with the Palestinian Dental Association. A random system was used to assign dentists to one of two groups, in which simulated patients randomly identified themselves with either human immunodeficiency virus (HIV) or hepatitis B virus (HBV) and asked for a dental appointment. Three‐hundred and four dentists (76%) responded to our telephone survey. Sixty‐six per cent accepted requests for appointments and 34% declined the appointment requests. Sixty‐eight per cent of the dentists declined appointment requests from patients with HIV and 32% declined appointments from patients with HBV. Dentist's gender, ‘blood‐borne disease type’, ‘place of private practice’, ‘country of graduation’ and ‘years since graduation’ were all significant predictors in the final logistic model. More than one‐third of our respondents declined appointment requests from patients with blood‐borne disease, two‐thirds of which were for patients who identified themselves as having HIV. Education and training programmes are needed to improve attitudes of dentists – especially female dentists, older dentists and dentists practising in northern governorates – towards patients with blood‐borne diseases.     

Agreement among dentists’ restorative treatment planning thresholds for primary occlusal caries,primary proximal caries,and existing restorations: Findings from The National Dental Practice-Based Research Network

ObjectivesThe aim of this study was to quantify the agreement among individual National Dental Practice-Based Research Network dentists’ self-reported treatment decisions for primary occlusal caries, primary proximal caries, and existing restorations.MethodsFive hypothetical clinical scenarios were presented: primary occlusal caries; primary proximal caries; and whether three existing restorations should be repaired or replaced. We quantified the probability that dentists who recommended later restorative intervention for primary caries were the same ones who recommended that existing restorations be repaired instead of replaced.ResultsDentists who recommended later restorative treatment of primary occlusal caries and proximal caries at a more-advanced stage were significantly more likely to recommend repair instead of replacement. Agreement among dentists on a threshold stage for the treatment of primary caries ranged from 40 to 68%, while that for repair or replacement of existing restorations was 36 to 43%.ConclusionsDentists who recommended repair rather than replacement of existing restorations were significantly more likely to recommend later treatment of primary caries. Conversely, dentists who recommended treatment of primary caries at an earlier stage were significantly more likely to recommend replacement of the entire restoration. Between-dentist agreement for primary caries treatment was better than between-dentist agreement for repair or replacement of existing restorations.Clinical implicationsThese findings suggest consistency in how individual dentists approach the treatment of primary caries and existing restorations. However, substantial variation was found between dentists in their treatment decisions about the same teeth.     

Oral health and oral diseases in pregnancy: a multicentre survey of Italian postpartum women

Background

The aim of this study was to explore the oral hygiene practices and oral health status of Italian postpartum women.

Methods

A self‐administered questionnaire assessed socio‐demographic information, oral hygiene habits and frequency of dental visits. All women received a thorough oral examination within five days after delivery. Logistic regression models were used to estimate odds ratios and 95% confidence intervals for exposures of interest and the presence of ‘severe’ periodontitis.

Results

Seven hundred and fifty women participated in the study; 99.1% brushed their teeth everyday and 59.9% visited the dentist annually. The mean frequency of sites with bleeding on probing was 16.1% and the median clinical attachment level was 2.1 mm. The mean caries experience score (DMFT) was 8. Severe periodontal disease was present in 21.9% of individuals. Patients who reported visiting a dentist only when in pain and women with three dental caries or more were significantly more likely to have periodontitis (OR: 1.6; 95% CI: 1.1–2.2; p < 0.05 and OR: 2.3; 95% CI: 1.5–3.5; p < 0.01, respectively).

Conclusions

Given the possible association between maternal and infant oral health, and between periodontal infection and general health, antenatal care providers should collaborate with dentists to encourage all pregnant women to comply with the oral health professionals' recommendations regarding appropriate dental brushing techniques and the importance of dental visits.     

Dental health of dentists' children in Mongolia

Summary. Objectives. To describe the dental health of dentists’ children, to evaluate its association with their dentist‐parents’ background and work‐related characteristics and to compare it with that of children in the general population in Mongolia. Design. Cross‐sectional survey, questionnaire‐based data. Subjects. Dentists’ children, aged 3–13 years. Sample. All dentists (n = 250) actively practising in the capital city of Mongolia. Results. The dentists’ children's dmft ranged from 0 to 12, and DMFT from 0 to 8; 50% were caries‐free. The younger the children, the higher was their total caries experience expressed as the sum of DMFT + dmft scores (r = ?0·22; P = 0·001). Dentist‐parents’ background and work‐related factors were not associated with their children's caries status (P > 0·05). When dentists’ children were compared with their counterparts at the population level, mean dmft for 6‐year‐olds was 2·6 for (urban) dentists’ children, 6·5 for children in the urban population and 0·9 for those in rural population of equivalent age. Mean DMFT for 12‐year‐olds were 1·0, 1·8 and 1·2, respectively, in the same three groups. In general, (urban) dentists’ children in all age groups had better dental health than did their urban counterparts at the population level. Among 5–7‐year‐olds, dentists’ children had worse dental health than did their counterparts in the rural population. Conclusions. Despite the dentists’ knowledge and awareness, their children demonstrated higher rates of dental caries than expected. This suggests that Mongolian dentists may have insufficient preventive orientation. In particular, the primary dentition of younger children seems to be poorly valued. In Mongolia, dentists should have better training and education in modern methods of caries prevention and their advantages. Appreciation and care of the primary dentition need to be improved at all levels of oral health promotion in Mongolia.     

Dental health behaviour in relation to caries status among medical and dental undergraduate students of Udaipur district,India

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2008.00346.x
Kumar S, Motwani K, Dak N, Balasubramanyam G, Duraiswamy P, Kulkarni S. Dental health behaviour in relation to caries status among medical and dental undergraduate students of Udaipur district, India. Abstract: Objective: To compare the caries status and oral hygiene behaviour of dental and medical students and to assess the influence of oral hygiene behaviour on the caries status. Methods: A questionnaire survey was conducted to assess the knowledge, attitudes and behaviour along with clinical examination to asses the caries status. A total of 403 dental and medical students enrolled with Rajasthan University of Health Sciences of Udaipur district, India were recruited in the study. Results: 56.4% of dental students brushed their teeth twice daily compared to 38.5% of medical students. There was no significant difference between the mean decayed components of males and females of dental stream, whereas among medical subjects, males had a higher decayed score than females (P = 0.012). The mean behaviour score obtained by dental students (19.38) was greater than that of medical students (18.34). Moreover, medical students presented a higher decayed, missing and filled teeth (DMFT) score (1.96) than dental students (1.16). Subjects who had a habit of brushing after every meal showed lower DMFT score (1.4) than those who brushed only once a day (1.64). Step‐wise linear regression analysis revealed that course of education and final behaviour score were the best predictors for the DMFT status. Conclusion: This study revealed significant differences between the oral hygiene behaviour and caries status of dental and medical students; furthermore, caries status was significantly influenced by the oral hygiene behaviour.     

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目的了解医学院校大学生口腔卫生相关知识与行为习惯,为制定大学生口腔健康教育方案提供依据。方法于2008年9月对中国医科大学199名在校大学生的口腔健康相关知识、行为等进行问卷调查。结果医学院校大学生的口腔保健知识欠缺,仅有25.1%的学生了解"牙菌斑"的概念,42.7%的学生能回答出"蔗糖致龋力最强";口腔保健意识较薄弱,如有龋坏牙齿,仅有68.3%的学生会去医院治疗;但口腔卫生习惯较好,有89.9%的学生每天刷牙≥2次,且口腔专业学生在口腔保健知识的知、信、行等方面显著好于非口腔专业学生。结论医学院校大学生口腔保健知识和保健意识缺乏,但愿意接受口腔健康知识教育,提示在医学院校开展口腔疾病健康教育是必要的。     

Differences in the assessment of restorative dental care

Caries diagnosis and assessment of restorations show a considerable variation between examiners. It can therefore be questioned whether a professional standard is available on this topic. In this study the judgement of general dental practitioners of the quality of restorative care and the number of adequately and inadequately treated teeth was compared to the judgement of dentists working in teaching institutes. Thirty general dental practitioners and 7 university dentists assessed occlusal photographs and bitewing radiographs of 20 patients with respect to the presence of caries and the quality of restorations. The general dental practitioners gave lower scores on a traditional schoolmark scale than the university dentists, but the latter scored more homogeneous. The agreement (Cohen's kappa) between pairs of examiners was similar for GDPs and experts. The expert group tended to have a more conservative attitude towards the level of restorative treatment to be judged. A univocal professional standard with respect to caries diagnosis and restoration assessment seems difficult to establish.     

Management Thresholds for Molars With Occlusal Noncavitated Caries Lesions

AimThere is sparse research on the effect of factors related to the dentist and patient in the caries management decision-making process. This in vitro study explored the influence of factors related to dentists and patients on the management decision of occlusal noncavitated caries lesions in children.Materials and methodsFive investigators in the specialties of dental public health (DPH), paediatric, prosthetic, and operative dentistry and a general dentist (GDP) participated in this study. Initially, the investigators were asked to independently assess the occlusal surfaces of 175 noncavitated permanent molars and choose a management recommendation using 2 caries risk patients’ scenarios. After 1 month, investigators were trained and calibrated to use the International Caries Detection and Assessment System (ICDAS) scoring system. Then, they examined the same teeth, recorded the highest/worst ICDAS score, and chose a management recommendation. Two weeks later, the investigators repeated the teeth examination using magnification loupes and again chose a management recommendation. The teeth were sectioned to study the relationship between the presence of caries and the management recommendations.ResultsFor the low– and the high–caries risk scenarios, ICDAS training increased the operative intervention by 20% to 27% and 14% to 22%, respectively, for both the GDP and the paediatric dentist (P < .0001). For the low–caries risk scenario, using the magnifying loupes increased the operative recommendations for the DPH, GDP, and the operative dentist by 5% to 23% (P < .05). Compared to the low–caries risk scenario, teeth for patients with high caries risk received more surgical interventions (9%-30%) at all examination conditions for the GDP and the paediatric and operative dentists (P < .0001).ConclusionsFor occlusal noncavitated caries lesions, enhancing dentists’ caries detection skills had a significant impact on decisions of surgical intervention. This also influenced the appropriateness of the treatment recommended for the different caries risk groups.     

Exploring the contributions of components of caries risk assessment guidelines

Abstract – Objective: To examine the relative contribution of current caries activity, past caries experience, and dentists’ subjective assessment of caries risk classifications. Methods: Administrative data from two dental plans were analyzed to determine dentists’ risk classification, as well as current caries activity and previous caries experience at the time of the classification. The performance of these predictors in identifying patients who would experience subsequent caries was then modeled using logistic regression. Results: In both plans, current caries activity alone had relatively low sensitivity and high specificity in identifying patients who would experience subsequent caries. Sensitivity improved, but at the cost of specificity when previous caries experience was included in the models. Further improvement in sensitivity accrued when dentists’ subjective assessment was included, but performance was different in the two plans in terms of false‐positives. Conclusions: Consideration of previous caries experience tends to strengthen the predictive power of caries risk assessments. Dentists’ subjective assessments also tend to improve sensitivity, but overall accuracy may suffer.     

Dentists' use of caries risk assessment and individualized caries prevention for their adult patients: findings from The Dental Practice-Based Research Network

Riley JL, Gordan VV, Ajmo CT, Bockman H, Jackson MB, Gilbert GH, for The Dental PBRN Collaborative Group. Dentists’ use of caries risk assessment and individualized caries prevention for their adult patients: findings from The Dental Practice‐Based Research Network. Community Dent Oral Epidemiol 2011; 39: 564–573. © 2011 John Wiley & Sons A/S Abstract – Objectives: Few studies have examined dentists’ subjective ratings of importance of caries risk factors or tested whether dentists use this information in treatment planning. This study tested several hypotheses related to caries risk assessment (CRA) and individualized caries prevention (ICP). Methods: Data were collected as part of a questionnaire entitled ‘Assessment of Caries Diagnosis and Caries Treatment’, completed by 547 practitioners who belong to The Dental Practice‐Based Research Network (DPBRN), a consortium of participating practices and dental organizations. Results: Sixty‐nine percent of DPBRN dentists perform CRA on their patients. Recently graduated dentists, dentists with busier practices, and those who believe a dentist can predict future caries were the most likely to use CRA. The association between CRA and individualized prevention was weaker than expected (r = 0.21). Dentists who perform CRA provide ICP to 57% of their patients, compared with 42% for dentists who do not perform CRA. Based on their responses to radiographic and clinical scenarios in the questionnaire, dentists who use CRA appear to use this information in restorative decisions. Conclusion: A substantial percentage of DPBRN dentists do not perform CRA, and there is not a strong linkage between its use and use of individualized preventive regimens for adult patients. More progress in the implementation of current scientific evidence in this area is warranted.     

A 57-year Follow-up Study of Occlusion

OBJECTIVE: To analyze occlusal changes between the ages of 8 and 65 years in 18 persons with normal occlusion at the age of 8 (N-group), to describe their attitudes toward dental esthetics and their experiences regarding their dentition. MATERIAL AND METHODS: The N-group is considered as the reference group in comparison with malocclusion groups that will be presented in subsequent articles. Documentation is based on intraoral photographs and personal interviews. RESULTS: In general, the occlusal changes were moderate. The probands were all satisfied with their teeth and tooth position. They were all examined at regular intervals by their dentists and practiced generally good oral hygiene. The average number of missing teeth was 1.4 (0-6) and the number of prosthodontically -restored or replaced teeth was 6.4 (0-24). Fifteen persons reported well-positioned teeth to be important. However, 17 found that visibly poor oral hygiene, discolored or missing teeth or the "total impression", to be more important than malpositioned front teeth. CONCLUSIONS: Generally speaking, occlusal changes were moderate and satisfaction with the dentition was good. Discolored or missing teeth and poor oral hygiene were found to be the most disturbing negative traits with respect to dental esthetics.     

Influence of examiner's clinical experience in detecting occlusal caries lesions in primary teeth

PURPOSE: The purpose of this study was to evaluate the effect of examiner's clinical experience in detecting occlusal caries lesions in primary teeth using visual inspection and the diode laser fluorescence (LF) method. METHODS: Eighty-seven suspected occlusal sites in 50 exfoliated or extracted primary molars were evaluated via the visual inspection and LF (DIAGNOdent) by 3 last-year dental students, 3 recent graduate dentists, and 3 pediatric dentistry specialists. After the examination, the teeth were cut and evaluated in stereomicroscope. Sensitivity, specificity, and accuracy were calculated, and the values were compared using the McNemar change test at the enamel and dentin caries lesion thresholds. The means of Cohen's kappa values among the different groups of examiners were compared with the ANOVA and Student-Newman-Keuls test. RESULTS: At the enamel caries lesions threshold, there was no difference in accuracy among the different groups of examiners using both the methods. At the dentin caries threshold, however, the students achieved the worst results using visual inspection. Nevertheless, regarding visual inspection, the dental students presented higher sensitivity and lower specificity than the other examiner groups at both thresholds. When using the LF method, there was no significant difference among the parameters, and the interexaminer agreement was higher. CONCLUSIONS: Detecting caries lesions with the laser fluorescence device presents lower variation with respect to the examiner's experience.     

Dental beliefs: factor structure of the revised dental beliefs survey in a group of regular dental patients

The aim of this study was to investigate the factor structure of the revised dental beliefs survey (DBS‐R) in a group of regular dental patients. The study group consisted of 278 patients (mean age 54 yr), 61% of whom were women. The DBS‐R item mean value was 1.6. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were performed. The initial PCA among the 28 DBS‐R items showed four factors with eigenvalues of > 1 explaining 67% of the total variance. Five different CFA models were tested. The final model revealed a four‐factor solution with one second‐order factor (i.e. a hierarchical CFA). Thus, the latent second‐order variable, ‘dental beliefs’, explains the variance from all DBS‐R items through the four first‐order factors labeled ‘ethics’, ‘belittlement’, ‘communication and empathy’, and ‘control and anxiety’. The results suggest a somewhat different factor structure of DBS‐R than previously reported for dental‐fear patients. Hence, the underlying factor structure of the DBS‐R may differ between different patient groups. The results point towards the use of the original 28‐item DBS‐R and interpreting the scale as measuring an overall construct of ‘dental beliefs’ and thus patients’ attitudes and feelings related to dentists and dentistry.     

成都市1～3岁低龄儿童龋齿患病与家庭口腔卫生行为调查

目的：调查成都市1~3岁低龄儿童的龋患情况及家庭口腔卫生行为习惯。方法：选取成都市5所幼儿园1~3岁儿童共计1000名作为研究对象,对其进行口腔卫生检查,根据是否患龋分为病例组与对照组。向2组儿童发放调查问卷,了解其口腔卫生习惯相关情况,对比、分析调查结果。采用SPSS 20.0软件包对数据进行统计学分析。结果：共有331名儿童患龋,患龋率为33.10%。病例组与对照组儿童在性别、低体重儿、胎龄、病史、父母最高学历、主要抚养人方面相比,差异均无统计学意义（P>0.05）;2组在年龄分布、喂养方式、家庭年收入方面比较,差异均有统计学意义（P<0.05）。除家长使用牙线和家长刷牙频率2项外,2组儿童的其他家庭口腔卫生行为（定期检查牙、儿童吃甜食频率、儿童睡前进食频率、家长吃甜食频率）相比,差异均有统计学意义（P<0.05）。多因素分析结果显示,年龄、家庭年收入、含奶瓶睡觉、定期检查乳牙、儿童吃甜食频率、儿童睡前进食频率均是低龄儿童患龋的影响因素（P<0.05）。结论：成都市低龄儿童的龋患率较高,低龄儿童患龋与家庭口腔卫生行为有显著相关性,是低龄儿童患龋的因素之一。建立良好的家庭口腔卫生行为习惯,有助于降低低龄儿童龋齿的发生风险。