Radiology requirements in United States dental hygiene programs

A survey of accredited dental hygiene programs in the United States revealed little standardization of requirements for dental radiology. However, most programs satisfied suggested minimum guidelines for didactic instruction in radiology. Six programs had no preclinical laboratory requirements, and seven had no clinical requirements. An area of concern was the high percentage of programs in which classmates exposed one another to ionizing radiation for training purposes.     

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.     

Human resource planning in orthodontics

Content and background of the Capacity report 2001 for orthodontics in the Netherlands are discussed. The final conclusion of this report is that there is a yearly need of an input of 12 to 15 residents into postgraduate orthodontic programs. At the moment capacity of postgraduate training programs in the Netherlands is 4.5 resident yearly. Discussion is focussed on the advantages and disadvantages of the model used for the calculated estimations. More research on certain aspects of treatment need and demand is necessary. Implementation of the outcome will be a complex process for every party in the orthodontic field.     

Advanced general dentistry program directors' attitudes and behaviors regarding pediatric dental training for residents

The oral health of children became a more prominent concern with the U.S. surgeon general's report on oral health in America in 2000. The purpose of our study was 1) to assess General Practice Residency (GPR) and Advanced Education in General Dentistry (AEGD) (here jointly referred to as advanced general dentistry [AGD] programs) directors' current behaviors with regard to pediatric training of residents and 2) to assess their attitudes about which components of pediatric oral health training should be included in AGD programs. A twenty-one item survey was mailed to all GPR and AEGD programs accessed through the American Dental Association website. Seventy percent of directors (N=187) completed and returned the survey. Responses indicated that AGD residents receive adequate clinical exposure to pediatric patients and provide much-needed services to uninsured, underinsured, and underserved people. Although clinical training in pediatric treatment was high, didactic hours focused on pediatric treatment did not seem commensurate with clinical activity. Program directors indicated strong attitudinal support for teaching residents many components of pediatric oral health care, although most directors have concerns over increasing didactic hours spent on pediatric oral health due to already crowded curricula. Approximately 88 percent of directors said that they would implement a pediatric oral health module in their curricula if they had access to one.     

Incidental findings arising with cone beam computed tomography imaging of the orthodontic patient

Cone beam computed tomography (CBCT) of orthodontic patients is a diagnostic tool used increasingly in hospital and primary care settings. It offers a high-diagnostic yield, short scanning times, and a lower radiation dose than conventional computed tomography. This article reports on four incidental findings-that appear unrelated to the scan's original purpose-arising in patients for whom CBCT was carried out for orthodontic purposes. It underlines the need for complete reporting of the data set.     

Effect of multimedia information sequencing on educational outcome in orthodontic training

The aim of this research was to compare the effectiveness of hierarchical sequencing (HS) versus elaboration sequencing (ES) models in improving educational outcome of clinical knowledge when using instructional multimedia programs in postgraduate orthodontic training. Twenty-four postgraduate and 24 undergraduate dental students participated in this study. The postgraduates were following an orthodontic speciality training programme. The undergraduates were fourth- and fifth-year dental students. Twelve instructional multimedia modules were developed, six logically sequenced (LS) discussing six different orthodontic topics. Another six modules on identical topics were sequenced according to one macro-sequencing (MS) model. The implemented MS model was either HS or ES. The only difference between LS and MS modules was the adopted sequencing model. All participants were assigned into consistent pairs of students and were randomly divided into a test and a control group. In each pair, one student studied the LS module (control group) while the other studied the MS version (test group). Pre- and post-evaluation tests of each pair of participants were performed to measure knowledge, understanding and application of each participant with regard to the discussed topic. A multilevel analysis was conducted to assess the estimated effect of the different sequencing models. The level of significance was set at 0.05. At baseline, no significant differences (P > 0.05) were found in pre-test scores between groups. The HS model showed a significant effect on the scores achieved (P = 0.05). The test group showed a significantly higher estimated probability of correct answers to the questions (P = 0.003) when applying the HS model. The HS model may improve educational outcome when using instructional multimedia programs in postgraduate orthodontic training.     

The current state of predoctoral orthodontic education in the United States

The objective of this study was to assess the current state of predoctoral orthodontic education in the United States. We hypothesized that there are significant differences in the teaching methods, course content, and assessment methods in current predoctoral orthodontic curricula in U.S. dental schools. To test this hypothesis, predoctoral orthodontic directors at fifty-five dental schools were invited to complete an anonymous online survey during the months of June and July 2010. Twenty-nine program directors (53 percent) completed the survey. Our data showed that the mean number of full-time and part-time equivalent faculty members teaching predoctoral orthodontics is 2.12 and 2.5, respectively. Students are presented with orthodontic material as early as the first year in some dental schools; however, the majority of schools present the most orthodontic material in the third year. The number of curriculum hours devoted to teaching orthodontics during the predoctoral years varies greatly between schools, and many programs teach students a variety of orthodontic techniques. Less than half (48.15 percent) of the responding programs require students to treat orthodontic patients. The majority of the responding programs require students to observe residents (65.38 percent), while those requiring students to assist in graduate orthodontics clinic are in the minority (34.62 percent). Two-thirds of the responding programs consider the current time allotted for predoctoral orthodontic clinical education at their institutions to be adequate. Our results suggest that there are, indeed, large variations in teaching methods, curriculum content, and methods of assessment in predoctoral orthodontic programs.     

Incidental Findings in Small Field of View Cone-beam Computed Tomography Scans,Part 2: Interpretation with Aid of a Checklist

IntroductionCone-beam computed tomography (CBCT) scans are routinely used by endodontic residents and faculty at Tufts University School of Dental Medicine for diagnostic purposes but are not routinely read for pathologic findings by a radiologist. In a 2017 study by Oser et al (part 1), endodontic residents and a radiologist interpreted CBCT scans taken for endodontic diagnostic purposes, and their findings were compared. The results demonstrated that a radiologist is significantly more likely to report incidental findings in small field of view (FOV) scans. A limitation of this study was that the radiologist used a checklist of common findings to review the scans. The purpose of this study was to examine whether the use of a checklist would improve the sensitivity of the endodontic residents’ reporting of incidental findings in small FOV CBCT scans.MethodsThe 203 small FOV CBCT scans used in part 1 were obtained and reviewed by endodontic residents in a systematic fashion. Radiographic findings were reported using a blank checklist. The results were compared with those previously reported.ResultsThe radiologist reported abnormalities in 176 of the 203 subjects (87%), and the residents reported abnormalities in 184 of the 203 subjects (91%). There was an increase in false positive findings when the residents were using a checklist.ConclusionsThe use of a checklist improved the sensitivity but decreased the specificity of the reporting of incidental findings in small FOV CBCT scans by endodontic residents.     

Evaluation of postgraduate dental specialty residents: a survey of program directors

The professional dental literature is lacking in information concerning the use of technology in evaluation procedures utilized in postgraduate dental education. The purpose of this study was to identify the methods of evaluation of U.S. postgraduate specialty residents currently in place. The study also sought to determine if there were any patterns among programs more likely to utilize electronic submission in the evaluation process. An electronic survey consisting of eighteen questions was sent to the program directors of all accredited U.S. dental specialty programs (n=416). The survey yielded 150 responses, for a 36 percent response rate. The results showed that the majority of responding program directors (68 percent) evaluate their residents using a hardcopy evaluation instrument, while a minority of directors (32 percent) reported using an electronic evaluation instrument. The majority of respondents (58 percent) said they require faculty members to formally evaluate residents semiannually. Fifty percent of responding program directors reported a need for improvement in their current evaluation system. Those reporting a need for improvement were less likely to be using an electronic format. There was no statistical significance between faculty responsiveness and the mode of evaluation used. With many program directors reporting room for improvement in their current evaluation system, innovation in the evaluation systems of postgraduate dental education is needed.     

Value of Two Cone-beam Computed Tomography Systems from an Orthodontic Point of View

AIM: Since its introduction in dental radiology in 1998, cone-beam computed tomography (CBCT) has found increasing acceptance in clinical routine. The aim of this study was thus to evaluate this imaging modality from an orthodontic point of view. MATERIALS AND METHODS: Two systems formed the basis of this investigation: the NewTom 9000 (NewTom Germany AG, Marburg, Germany), in use at the University Medical Center Hamburg-Eppendorf since October 2002, and the mobile Arcadis Orbic 3D system (Siemens Medical Solutions, Erlangen, Germany), which was introduced in February 2005. Two independent examiners evaluated a total of 68 NewTom and 15 Arcadis Orbic 3D images involving orthodontic indications. The images were categorized according to their indications and diagnostic value assessed according to a predefined and quantifiable protocol. Information obtained from the CBCT was also compared to that gleaned from conventional radiographs. RESULTS: The indication for the NewTom images in cleft patients as well as for all Arcadis Orbic 3D images was considered justified. The osseous morphology of the cleft and position of osteosynthetic screws and plates were particularly well visualized. CBCT implementation in cases of tooth impaction or for assessing third molars was considered justified, although its value was judged differently by the two examiners. CBCT did not provide more information than conventional imaging regarding cartilaginous joint structures. CONCLUSIONS: In complex orthodontic cases in which 3D imaging is mandatory, CBCT is the method of choice. Furthermore, in cleft patients and those undergoing combined orthodontic and maxillofacial therapy, CBCT proved advantageous, providing more information than conventional images.     

Prosthodontic Program Directors' Perceptions Regarding Implant Placement by Prosthodontic Residents: A 2004 Survey Conducted by the Educational Policy Subcommittee of the American College of Prosthodontists

Purpose: In 2004, a survey regarding implant placement by prosthodontic residents was conducted by the Educational Policy Subcommittee of the American College of Prosthodontists (ACP). The aim of the survey was to assess the current trends in implant curricula at advanced graduate prosthodontics programs in the United States and Canada and determine the issues surrounding surgical implant training for prosthodontic residents. Materials and Methods: The survey was mailed to the prosthodontic/maxillofacial prosthetic program directors of the 59 prosthodontic graduate programs in the United States and Canada in 2004. Of these, 27 program directors replied, yielding a response rate of 46%. Results: Of the replying programs, 43% either required residents to place or offered the option to have residents place implants. Forty‐four percent reported that residents participate by functioning as first assistants for some of their implant patients, 40% have a specific curriculum to train residents in implant placement, 50% reported not having any institutional barriers that prevent program directors from training prosthodontic residents in implant placement, 51% provide implant training using plastic jaws, and 66% of the programs required residents to observe implant surgery in the clinic before they are permitted to place implants. Of prosthodontic residents who treated implant‐related patients, the majority treated 11 to 20 patients during their residency. In 2004, 40% of program directors were not trained in the placement of dental implants, and if they did have the implant training, the majority (82%) stated that the nature of their training was 1‐ to 3‐day course(s). Conclusions: This survey showed that implant dentistry has become an integral part of the postgraduate prosthodontic curriculum. The trends to incorporate implant placement into the postgraduate prosthodontic curriculum were already evident prior to 2004. To address the demand for implant treatment in patient care and enhance surgical implant knowledge, the ACP in 2005 added placement of implants to its Accreditation Standards for Advanced Specialty Education Programs in Prosthodontics.     

Graduate orthodontic education in Turkey: the residents' perspective

The aim of the present study was to explore residents' perceptions of their educational and clinical treatment experiences including the number of clinical cases undertaken, patient completion rates, techniques utilised and the scientific component of Turkish graduate orthodontic programmes. Residents recorded in the list of Turkish Orthodontic Society were sent an e‐mail to participate in a survey containing 46 multiple‐choice questions and ten one‐line answers. An e‐mail with a personalised online link was sent to a total of 227 residents throughout the Turkey. Data were categorised, and basic statistics including chi‐square comparative analyses were performed. A total of 136 (response rate of 59.91%) residents completed the survey. The majority of residents (58.08%) were either ‘very satisfied’ or ‘satisfied’ with their programme. Respondents said they have just the right amount of formal didactic teaching sessions or dedicated and protected academic time. Most residents (69.11%) indicated their programme offers training in numerous philosophies; whilst 97.79% said they have sufficient clinically based training and 42.64% said they have sufficient research‐based training. Overall, residents in the Turkey are satisfied with their orthodontic programme. They receive comprehensive training with the opportunity to start and complete a significant number of their patients. The survey findings suggest that orthodontic programmes in Turkey are deficient in providing care to underserviced populations and disabled patients. Programmes could improve the opportunity for residents to treat patients requiring interdisciplinary treatment.     

Interactive distance learning in orthodontic residency programs: problems and potential solutions

Sharing resources through distance education has been proposed as one way to deal with a lack of full-time faculty members and maintain high-quality content in orthodontic residency programs. To keep distance education for orthodontic residents cost-effective while retaining interaction, a blended approach was developed that combines observation of web-based seminars with live post-seminar discussions. To evaluate this approach, a grant from the American Association of Orthodontists (AAO) opened free access during the 2009-10 academic year to twenty-five recorded seminars in four instructional sequences to all sixty-three orthodontic programs in the United States and Canada. The only requirement was to also participate in the evaluation. Just over half (52 percent) of the U.S. programs chose to participate; the primary reason for participating was because faculty members wanted their residents to have exposure to other faculty members and ideas. The non-participating programs cited technical and logistical problems and their own ability to teach these subjects satisfactorily as reasons. Although participating distant faculty members and residents were generally pleased with the experience, problems in both educational and technical aspects were observed. Educationally, the biggest problem was lack of distant resident preparation and expectation of a lecture rather than a seminar. Technically, the logistics of scheduling distant seminars and uneven quality of the audio and video recordings were the major concerns of both residents and faculty members. Proposed solutions to these educational and technical problems are discussed.     

Do pediatric dentists practice the orthodontics they are taught?

PURPOSE: The purpose of this study was to determine whether the orthodontic treatment provided by pediatric dentists reflects the orthodontic training received in pediatric dental residency programs. METHODS: Five questions from a survey of the American Academy of Pediatric Dentistry (AAPD) diplomates in August 2002 and a survey of pediatric dental residency program directors in June 2002 were statistically analyzed to compare the orthodontic treatment provided by diplomates to that provided within pediatric dental residency programs. RESULTS: Patient populations differed financially between pediatric dental residencies and diplomates of the AAPD. Residents treated significantly more public assistance patients. The residents were more likely than diplomates to use most orthodontic appliances and treat most stages of dental development and most conditions/malocclusions with orthodontics. Diplomates anticipated a decrease in the amount of orthodontic treatment provided in the next 5 years, while program directors anticipated an increase. CONCLUSIONS: The majority of the orthodontic treatment provided by pediatric dental residents and diplomates was similar, although the residents were exposed to more diverse orthodontic treatment modalities than those used by diplomates. The residencies were also more likely than the diplomates to increase the amount of orthodontic treatment provided in the next 5 years.     

Mid-line clefts of the cervical vertebrae - an incidental finding arising from cone beam computed tomography of the dental patient

Cone beam computed tomography (CBCT) is a rapidly emerging imaging modality in dentistry that offers the advantages of high diagnostic yield with short scanning times and a radiation dose significantly lower than conventional CT. Clinical applications of CBCT are numerous and they are being used both within the hospital and the primary care setting. The need for complete interpretation of CBCT images is essential. This report presents two patients for whom CBCT was carried out for orthodontic related purposes and incidental findings of cervical vertebrae clefts diagnosed. CBCT wherever they are undertaken should be reported by someone who has undergone adequate training in their interpretation particularly when machines using a large field of view are employed.     

Evaluation of the use of digital study models in postgraduate orthodontic programs in the United States and Canada

Objective:To investigate the extent, experience, and trends associated with digital model use, as well as the advantages of using a particular study model type (digital or plaster) in postgraduate orthodontic programs in the United States and Canada.Materials and Methods:An electronic survey consisting of 14 questions was sent to 72 program directors or chairpersons of accredited orthodontic postgraduate programs in the United States and Canada.Results:Fifty-one responded for a 71% response rate. Sixty-five percent of the schools use plaster study models compared with 35% that use digital models. The most common advantages of plaster models were a three-dimensional feel and the ability for them to be mounted on an articulator. The most common advantages of digital models were the ease of storage and retrieval, and the residents'' exposure to new technology. About one third of the plaster model users reported that they wanted to switch to digital models in the future, with 12% planning to do so within 1 year.Conclusions:Based on our study, 35% of accredited orthodontic postgraduate programs in the United States and Canada are using digital study models in most cases treated in their programs, and the trend is for increased digital model use in the future.     

The role of caries prevention protocol in pediatric dentistry specialty programs

Advanced specialty education programs in pediatric dentistry are often overwhelmed with patients who need restorative and surgical care, often on an emergency basis. Still, the Commission on Dental Accreditation Standards for Advanced Specialty Education Programs requires that residents receive didactic and clinical training in the prevention of dental caries. This paper contains several recommendations for strengthening the training of pediatric dental residents in caries risk assessment and prevention, including the suggestion that pediatric dental training programs become "dental homes" for their patients.     

Conscious sedation experiences in graduate pediatric dentistry programs

PURPOSE: Conscious sedation is a behavior modification adjunct taught in all postgraduate pediatric dental residency programs. It has been a decade since the last survey was done specifically related to didactic and clinical aspects of conscious sedation in postgraduate pediatric dental programs. The aim of the study was to determine the clinical and didactic experiences associated with conscious sedation in these programs and to compare some of the findings to those collected a decade ago. METHODS: A 31-item survey similar to that of a decade ago was constructed and sent to all pediatric dentistry program directors of accredited postgraduate and residency programs in the United States. The items covered several didactics including didactic topics, sedative agents, monitoring, and emergency policy among others. A follow-up mailing was done involving those who had not responded 6 weeks following the initial mailing. RESULTS: Fifty-four of 58 (93%) program directors returned the 31-item survey. The following are highlighted findings. Conscious sedation among residency programs was achieved most commonly with a combination of sedative agents used with N2O. Midazolam was more popular than chloral hydrate. The oral route was the predominant route of administration. More lecture hours were spent on conscious sedation than 10 years ago. The pre-cordial stethoscope, pulse oximeter, and blood pressure cuff were the most commonly used monitors. Sedative agent and anticipated depth of sedation were the factors most often considered in choosing monitors used during the sedation of a patient. The capnograph was being used more frequently than it was 10 years ago. Programs did not report an increase in sedation emergencies but practiced emergency drills more often and had increased numbers of individuals certified in Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS). The percent of the total patient population which required sedation is about 1-20%, with most directors reporting an increase in the numbers of sedations done in the past few years. CONCLUSIONS: While many factors remained unchanged or slightly modified when compared to the survey done a decade ago, the results of this study suggest that there has been significant changes in several key factors including the most frequently used sedative (i.e., midazolam) and increased preparation in the area of emergency preparedness.     

Graduate orthodontic education: the residents' perspective.

INTRODUCTION: The purpose of this study was to identify current demographic trends of orthodontic residents, their goals for the future, and their perspectives on orthodontic training. METHODS: A 26-item survey was conducted at the Graduate Orthodontic Residency Program (GORP) at Harvard University in August 2003. Questionnaires were distributed to residents representing 51 orthodontic programs (of 58 in the United States). Surveys were sent to 5 of the 7 programs whose residents did not attend GORP. RESULTS: Of the 380 questionnaires distributed, 295 were completed and returned at the meeting for a 77% response rate. Additionally, 35 of the 50 mailed questionnaires were completed and returned, for a total response rate of 77% (330 completed/430 distributed). Most residents stated that clinical education was the most important factor when choosing a residency. Most residents planned to publish their research, complete American Board of Orthodontics certification requirements, and work 4 days a week after program completion. CONCLUSIONS: Several trends were identified since orthodontic residents were last surveyed in 1992. The most significant change reported was an increase in the number of those who plan to complete American Board of Orthodontics certification requirements.