General hospital residency for dental undergraduates

A one-week full-time general hospital residency for a final year of 81 dental undergraduates has been greeted by the majority of students as being an invaluable experience. Such a residency programme could be structured to provide dental students with an even broader medical perspective during their training and thus allow for a greater clinical maturity on graduation. The present programme is outlined and discussed.     

Factors influencing candidates' choice of a pediatric dental residency program

The goal of this study was to identify the factors and program characteristics that influenced the program ranking decisions of applicants to pediatric dentistry residency programs. A questionnaire was sent to the first-year resident class in 2005 with a response rate of 69.2 percent (n=260). Approximately 55 percent were female (104/180) and 61 percent were non-His-panic white (110/180). The respondents reported that they applied to an average of nine programs, of which five were ranked. Most applicants were interested in a program that had a hospital component with a duration of two years. A program's ability to prepare the resident for an academic career was a minimal influence for 48.6 percent (87/179), and 57.5 percent (103/179) were not interested in a master's or Ph.D. degree. Factors associated with program ranking included modern clinical facilities, high ratio of dental assistants and faculty to residents, availability of assistants for sedation and general anesthesia cases, availability of a salary or stipend, and amount of clinical experience. Important non-clinical factors included hospitality during the interview, geographic location, and perceived reputation of the program. Opportunity to speak with the current residents in private, observing the interaction between residents and faculty, and touring the facilities were also highly considered. These findings may help program directors tailor their interviews and programs to suit the needs of applicants.     

Clinical productivity indicators for a dental general practice residency program

Management of clinical productivity is an essential activity in the dental general practice residency GPR program. Because productivity is a relative term, indicators of clinical productivity must be developed to evaluate current performance. This article presents a 3-year study of clinical productivity in a two-resident GPR program. Productivity indicators are developed and analyzed for this program and for application to other GPR programs.     

The dental profession's commitment to quality assurance

Although the phrase quality assurance has only recently been used in the health care field, it is clear that the concept is far from new. As has been described, early efforts by the American Dental Association in licensure and accreditation of professional educational programs were directed toward providing the consumer of health care services confidence in the quality of care being rendered. Such programs serve as a strong foundation upon which current work can build ongoing and future efforts. This current effort is a logical step along the path that was defined many years ago by the dental profession. Although current projects in dental quality assurance are exciting and new, the commitment to assuring the American public of the highest possible quality of dental care is not new. The goal of the American Dental Association remains unchanged: patients entering the dental health care system must be able to do so with confidence that they will receive quality care.     

The New York State postgraduate fifth-year dental residency as a new licensure path: concerns for public protection

The recently enacted law creating an alternative pathway to dental licensure in New York state is benchmark legislation. Along with the positive effects of dental education that may ensue, the author has serious concerns that the strongly emotional and political debate occurring during the bill's consideration obscured important considerations for public safety and the erosion of standards for licensure in New York. In addition, this pathway has potential to negatively affect freedom of movement and licensure by credentials for practice in other jurisdictions.     

Integrating dental screening and fluoride varnish application into a pediatric residency outpatient program: clinical and financial implications

Delivery of preventive oral health services (POHS) has been embraced by many pediatric andfamily medical practices in North Carolina (NC). The outcome of implementing a state-wide Medicaid-supported oral health prevention initiative, "Into the Mouth of Babes Varnish and Screening Program (IMB), in an academic medical residency setting is described Retrospective chart audit of encounterforms and collection of administrative records related to POHS provided by pediatric medical residents for Medicaid recipients less than 3 years of age at the University of North Carolina pediatric continuity care clinic over 31 months were examined A total of 1,081 visits and 655 patients were documented during the study period accountingfor 36.6% of all children aged 6-36 months seen in the clinic during the period of this study. Thirty-eight percentof the patients received one or more IMB follow-up visits. Twenty-nine (4.4%) children were reported to have one or more carious teeth and 94 children (14.1%) were referred to a dentist. The IMB program provides an oral screening, parent oral health counseling and application of fluoride varnish to the teeth at the medical appointment by non-dental personnel. Following a cost/revenue analysis it was concluded that a preventive oral health initiative in an academic setting provides an additional access to oral health preventative services for underserved children and contributes to the financial viability of the clinic.     

Chemoprophylaxis of prosthetic joint patients during dental treatment: a decision-utility analysis.

A decision-analytic model and a cost effectiveness analysis was performed on 1 million hypothetic prosthetic joint patients undergoing dental treatment, to determine the most cost-effective strategy to prevent late prosthetic joint infections. The cost per quality-adjusted life-year saved (QALY) was determined for three preventive strategies: no prophylaxis, oral penicillin, and oral cephalexin. The UCLA Pain-Walking-Function-Activity Scale was used to obtain quality-of-life adjustments (utility assessment) for the study population. Costs were derived from 70 patients hospitalized between July 1, 1982, and June 30, 1986, at the UCLA Center for Health Sciences. The most cost-effective preventive strategy was the no prophylaxis alternative ($196,500/QALY). However, by recommending a 1-day strategy of oral cephalexin only to those dental patients at high risk for late prosthetic joint infections rather than a 3-day regimen to all patients, the cost effectiveness improved from $1.1 million/QALY to $446,100/QALY while maintaining a low risk of death (0.38 deaths per 10(6) dental visits).