General dentists and special needs patients: does dental education matter?

Special needs patients are one of the underserved dental patient groups in the United States. This study investigates whether undergraduate dental education about special needs patients affects general dentists' a) professional behavior, b) practice characteristics, and c) attitudes concerning special needs patients. Data were collected from 208 general dentists (178 male/30 female; average age: 49.85 years) who were members of the Michigan Dental Association. The more the respondents agreed that dental education had prepared them well, the more likely they were to treat various types of special needs patients and to set up their practices so they could treat them and the more they liked treating these patients. In conclusion, most general dentists did not think their undergraduate dental education had prepared them well to treat special needs patients. However, the better they reported to have been educated, the more likely they were to treat special needs patients. Given the access to care problems for many special needs patients, it seems crucial to revise dental curricula and provide more didactic and clinical education concerning the treatment of special needs patients.     

What skeletal and dental characteristics do TMD patients have in common?

The purpose of this study was to determine if there are any common skeletal or dental characteristics among TMD patients that may be of diagnostic value. Thirty charts of orthodontic patients with pretreatmentTMD symptoms were selected at random.Gender, age, sex, ethnicity, SNA, SNB, ANB,Wits, interincisal angle, missing teeth, prior orthodontic treatment, crossbites, Angle's Class and maxillary and mandibular length were tabulated and analyzed for patterns. The results revealed a clear pattern of excessive mandibular length relative to maxillary length.     

Does school-based dental screening for children increase follow-up treatment at dental school clinics?

The purpose of this study was to evaluate the effectiveness of a screening program and referral system in stimulating dental attendance of children in need of treatment at Bapuji Dental College and Hospital of Davangere, India. A total of fourteen schools in the Davangere area were selected randomly and divided into two groups: seven schools that had a dental screening program (study group, n=2100 children), and seven schools that did not have one (control group, n=2400 children). The attendance rate by members of the study group was determined during the three-month period from the date of initiating the school screening program. During this same period the students who visited the college from the control group underwent a dental examination. Chi-square tests were used to test the difference between different variables. The response rate for seeking treatment was 31 percent for the study group (34.2 percent for males; 26.2 percent for females) and 10 percent for the control group (9.6 percent for males; 10.5 percent for females). In both the groups, the treatment need was highest for dental caries (study group=36.3 percent, control group=11.1 percent) and least for fluorosis (study group=21.2 percent, control group=1.2 percent). The study demonstrated that screening and motivation significantly improved the percentage of school children who sought dental care.     

Could dental school teaching clinics provide better care than regular private practices?

Dental school clinics (DSC) consist of unlicensed dental students delivering care under the supervision of licensed dental professionals. Care delivery is slow due to inexperience of the provider and the series of supervisory checks that are necessary. Cost of care to the patient is less. To date, there has been no evaluation of the benefits of receiving care in a DSC beyond reduced fees. Research has shown the value of teaching hospitals in medicine, and the purpose of this article was to evaluate the total sum of benefits (the value proposition) of receiving dental care in a DSC.     

Is there an association between weight and dental caries among pediatric patients in an urban dental school? A correlation study

Obesity in the young is a public health priority. The prevalence of overweight children in the United States has risen almost threefold in the last two decades. An association between weight and oral health has been suggested in adults, whereas evidence supporting this association in children is controversial at best. The aim of our study was to evaluate the association between weight and dental caries in a random prospective cohort of children at their initial visit at an urban dental school. One hundred and thirty-five children were recruited in a four-month period. The DS/ds index was used to assess caries, and BMI percentile was calculated based on age and gender-adjusted published scales. Correlation analyses, linear, and multivariate regression including age, gender, and BMI were calculated with a significance threshold of p>0.05. No correlation between dental decay in obese and non-obese children was detected (p=0.99). These findings support recent U.S. population-based literature that reports an inverse association between caries and weight in certain pediatric groups. Nevertheless, the impact of interventions to address the epidemic in the dental setting has not been investigated. As part of a health care team, dental students should be exposed to the changing demographics and sequelae of overweight in children.     

My way or the highway: do dental patients really have autonomy?

Ethical dilemmas arise when it is not possible to simultaneously optimize conflicting values, each of which independently is worthy. This paper analyzes three cases where patients' autonomy is in conflict with dentists' professional judgments about their own practice patterns and what is in the best interests of patients' oral health. The hierarchy of values proposed by Ozar and Sokol is a valuable aid in addressing such dilemmas, but the dentist must still engage in a detailed analysis of the situation.     

Malaysian dental graduates' competence in holistic care: what do graduates and employers think?

The purpose of this study was to explore the University of Malaya (UM) dental graduates' competence in holistic care in real settings from the employers' and graduates' perspectives. A self-administered questionnaire consisting of ten domains was sent to thirty senior dental officers of the Ministry of Health (MOH) and 164 UM graduates. In this article, nineteen major competencies that best represent the graduates' competence in the provision of holistic care are discussed. Each competency was rated on a scale of 1 (very poor) to 4 (very good) and was categorized as "poor and of major concern" (if less than 60 percent of respondents scored good or very good), "satisfactory and of minor concern" (60-69 percent), or "excellent" (70 percent and above). One hundred and six out of 164 graduates (64.6 percent) and twenty-nine out of thirty employers (96.7 percent) responded. Overall, the employers rated the graduates lower than what the graduates rated themselves on all items. While the graduates felt they were excellent and satisfactory in sixteen out of nineteen items (84.2 percent), the employers felt they were poor in fourteen out of nineteen (73.7 percent). Both groups agreed that the graduates were excellent in communication, but poor in life-saving skills, obtaining patient's family and psychosocial histories, and recognizing signs and symptoms (not intraoral) indicating the presence of a systemic disease. In conclusion, although the graduates felt competent in the majority of the holistic care competencies, the employers had some reservations over such claims. Outcomes of the study led to recommendations to incorporate longer community-based learning hours, an improved behavioral science component, a module for special care patients, and multidepartmental collaborative teachings in the new integrated program aimed for implementation in 2011.     

Eye-tracking in dentistry: what do children notice in the dental operatory?

Clinical Oral Investigations - To determine, using eye-tracking technology, (i) what children notice the most when they look at images of dental operatories and (ii) the effect of distractors on...     

Acquiring psychomotor skills in operative dentistry: do innate ability and motivation matter?

Objective: The acquisition of psychomotor skills is a key competence in the practice of dentistry, and innate abilities and motivation have been shown to influence motor performance. However, the explicit integration of these factors into the design of research projects about skill acquisition in dentistry has been limited. Therefore, the purpose of this study was to provide a comprehensive analysis of how dental students’ abilities and motivation affected their performance in an operative task. Methods: A longitudinal study with two cohorts of dental students was conducted in laboratory classes forming part of an operative technique course. A range of standardised psychometric tests was used to assess different abilities before completing a cavity preparation on Frasaco teeth. This was followed immediately by completion of an Intrinsic Motivation Inventory. Results: Low but statistically significant correlations (P < 0.05) were found between dental performance and psychomotor ability (r = 0.22), and also dental performance and motivation (r = 0.19). A significant difference (P < 0.05) was found in the grades obtained for the cavity preparation exercise in one cohort between students with higher levels of psychomotor ability compared with those with lower levels (Tracing scores) (P < 0.05). No significant differences in grades obtained for the cavity preparation exercise were found between students with higher and lower levels of motivation. Conclusion: Both innate psychomotor ability and motivation showed only weak positive associations with dental performance on cavity preparation exercises. Our study suggests that student‐related factors only provide limited information to explain differences in performance or to be useful as specific predictors of future performance by individuals.     

Issues and considerations in dental implant occlusion: what do we know, and what do we need to find out?

Implant dentistry continues to struggle with what are the appropriate occlusal concept(s) for implant-supported restorations. The biological and mechanical consequences of the loading environment leads to establishing and maintaining an implant interface in a wide variety of bone quality and quantity, implant and prosthesis designs. To the restorative dentist, the role of occlusion is more focused on extending the service life of the restoration and the connecting abutment(s) than protecting the osseous integration of the implant(s). This study reviews the relevant issues regarding implant occlusion along with implant and prosthesis design in order to provide optimal patient care.     

Assessment in dental VT... can we do better?

During the VT year the VDP and the trainer could choose to progressively check and complete each of the competencies listed and using the skills evaluation document make the appropriate record. Any areas of further training needs would be identified and a learning plan implemented. The whole process would be supervised by the VT advisor group who could be the resource for further training or support in conjunction with the VDP and trainer. This would be a self evaluation with external validation by the trainer and advisor group similar to the AEGD model in the USA. This would be an assessment that was valid, reliable and feasible as identified by Freeman. The use of a skills evaluation procedure would be similar to a LEP which would support the validity of the process. A record of completion of each key skill (competency) could be made using the supplied paper work and presented periodically as a log of achievement to the VT Advisor group. Of course the whole process also relies on the fact that the trainers need to be competent themselves in using practice based assessment, and an appropriately resourced pilot programme will be needed to make this an effective tool in assessing the overall competency of new graduates in vocational training.     

How do we measure shortages of dental hygienists and dental assistants?: Evidence from California: 1997–2005

BACKGROUND: The authors examined the labor market for registered dental hygienists (RDHs) and dental assistants (DAs) in California from 1997 to 2005 to determine whether there was a shortage in either market. METHODS: This analysis used economic indicators interpreted within an economic framework to investigate trends in labor force numbers and market-determined wages for RDHs and DAs. Rising inflation-adjusted mean wages indicated a labor shortage, while declining inflation-adjusted mean wages indicated a labor surplus. RESULTS: From 1999 to 2002, the wages for RDHs increased 48 percent and then stabilized, indicating a shortage had occurred, after which the market achieved equilibrium. Wages for DAs increased 13.9 percent from 1997 to 2001, but then declined from 2001 to 2005, indicating a shortage that then became a surplus. The market for DAs may not have stabilized. CONCLUSIONS: Wages increased for RDHs and DAs, suggesting that labor shortages occurred in both markets. The large supply response in the market for DAs resulted in wages declining after their initial rise. PRACTICE IMPLICATIONS: Tracking the local labor markets for RDHs and DAs will enable dental professionals to respond more efficiently to market signals.     

Emerging scientific advances: how do they enter dental curricula and the profession?

What is meant by emerging scientific advances? In brief, this terminology is equivalent to new research findings, however, the term "research" is often associated with scientific investigations that have very limited direct clinical relevance. Unfortunately, basic dental research and dental clinical practice have, in many instances, been considered to have nonoverlapping spheres of existence. The existence of mutually exclusive domains is rapidly changing with considerable translational activities between basic research investigation and clinical application developing. There is a growing emphasis at a national level for the importance of moving basic biomedical research laboratory findings into clinical patient-related applications to realize improvements in health based on the research findings. Ultimately, new approaches to diagnose, treat, and prevent disease will be available and represent the translation of the best scientific evidence into clinical applications. It is critical at this time to prepare our dental graduates to be members of the dental profession who will understand the implications that new scientific advances will have on their approach to patient care. The patterns and practices of oral health care delivery will undergo major changes during the careers of our new dental graduates. They need to be prepared to respond to these changes to the benefit of their patients.     

Stop smoking advice for patients who smoke: feasible in the dental practice?

Smoking may cause periodontal diseases and raises the chance of getting oral cancer. The Dutch Guideline for the Treatment of Tobacco Addiction recommends that dental professionals explicitly advise all patients who smoke to stop smoking. In 12 dental practices a study was made of how the guidelines could be implemented. The strategy consisted of a patient protocol for minimal, one-time cessation advice or for more intensive supervision, a patient leaflet, centralized training for the dental team, and repeated monitoring with feedback on the patients' experience of the behaviour that they have been advised to follow. Before the training and again 3 months after, professionals (n = 38) and an a-select sample of smoking patients (n = 197) completed questionnaires. A majority of patients was receptive to cessation advice of a dentist (95%) or counseling (68%). After 3 months it appeared that patient behaviour as reported by patients with respect to all points of the patient protocol had significantly improved.