bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of Student Performance in a Simulation Clinic and a Traditional Laboratory Environment: Three‐Year Results
Authors: Clancy James M.S. , Lindquist Terry J. , Palik Joyce F. , Johnson Lynn A.
Published: June 2020

With simulation clinics, dental schools have improved their preclinical laboratories to provide a more realistic clinical teaching environment. However, there is very little data to support the assumption that these facilities actually improve student performance of technical skills. This study compared the scores of two fixed preparations for full cast crowns by third‐year dental students. One of the preparations was made in the simulation clinic manikin, and the other was prepared on the bench top. Three prosthodontic faculty members scored the preparations in the areas of occlusal reduction, axial reduction, resistance and retention, and margination. The study also compared the performance of three classes of dental students: one class with no experience in the simulation clinic, one with one year of experience, and one with two years of experience. The amount of time since completing the fixed prosthodontics course among the students was also evaluated. This was done because the third‐year students at the University of Iowa rotate through a series of ten‐week clerkships rather than a comprehensive care model. (Therefore, not all students start clinical prosthodontics at the same time.) In addition, all student participants completed a questionnaire that addressed their perception of their clinical readiness prior to treating their first fixed prosthodontic patient. When we compared the classes of years 1, 2, and 3 by average preparation score, we found a significant difference among the scores for teeth prepared on the bench top (p = 0.0001) but not for the teeth prepared in the mannequin (p = 0.1176). For Year 1 (no simulation clinic experience), the amount of elapsed time following completion of the fixed prosthodontic course was not significant for the tooth prepared on the bench top or in the manikin (p = 0.57113 and 0.0661). For Year 2 (one year of simulation clinic experience), the elapsed time following completion of the fixed prosthodontic course was significant for the tooth prepared on the bench top (p = 0.0482), but it was not significant for the tooth prepared in the manikin (p = 0.2968). For Year 3 (two years of simulation clinic experience), the amount of elapsed time following completion of the fixed prosthodontic course was not significant for the tooth prepared on the bench top or in the manikin (p = 0.7275 and 0.6007). The questionnaire revealed that, in general, the majority of the students perceived their clinical readiness as more than adequate. These results are mixed in that students with more bench top experience scored better on the bench top, and students with more manikin experience scored equally in both environments.
Trends in Dental Specialty Education and Practice, 1990‐99
Authors: Neumann Laura M. , Nix Judith A.
Published: June 2020

Policy issues related to dental specialty education and practice have been the responsibility of the American Dental Association's Council on Dental Education and Licensure. In 2001, the council concluded a comprehensive study of the ADA‐recognized dental specialties that included a review of specialty practice and the practice environment, membership in specialty organizations, requirements and trends in board certification, advances in research and technology related to each specialty, and trends in advanced specialty education. This paper provides an overview of the results of this study and the council's analysis of data and information provided by the dental specialty organizations and the ADA Survey Center with an emphasis on dental specialty education. The council concluded that none of the dental specialties should be considered for rerecognition, but identified concerns regarding the shortage of qualified faculty and educational program directors. As a result of the council's study, recommendations have been made to the dental specialty organizations and ADA‐recognized dental specialty certifying boards that they continue to monitor the number of board‐certified specialists and identify ways to increase the number of board‐certified specialists.
Goals, Costs, and Outcomes of a Predoctoral Student Research Program
Authors: Rosenstiel Stephen F. , Johnston William M.
Published: June 2020

The aims of this work were to describe the goals and costs of a predoctoral student research program and compare the career choice and school donations of dental alumni who received student research experience to those without the experience. The identity of participants in the student research program was obtained from college records, and outcomes data on the student researchers from the years 1991 to 1994 were obtained with a telephone survey. Survey responses were compared to recent alumni surveys of the classes of 1992 and 1994, mathematically corrected to provide an estimate for non‐research participants. A student research program that involves about one‐fourth of the class currently costs in excess of $100,000. However, the benefits were found to be considerable. Compared to the class as a whole, after seven to ten years student researchers were 3.5 times more likely to complete specialty training, nearly five times more likely to become full‐time faculty members, and 32 percent more likely to be donors.
Phase 1 of a Comprehensive Course Review Process: Program Innovation
Authors: Skelton Judith , West Karen P. , Zeff Tina
Published: June 2020

A systematic college‐wide course review process can serve as an effective and efficient vehicle for both curricular management and faculty development. The purpose of this paper is to describe Phase 1 of an evolving course review process at the University of Kentucky College of Dentistry (UKCD). Phase 1 was designed to provide the foundation necessary to ultimately achieve an overall program of continuous evaluation that will produce sustainable curricular improvement and faculty renewal. The course review process includes elements of self‐assessment and collaborative peer review. Elements of the current system include emphasis on both the curriculum as a whole and individual course characteristics. It encourages faculty to view their courses as part of the whole and to develop sensitivity to the impact their courses have on other parts of the curriculum. Equally important are the elements that focus on individual course elements and educational methodologies used.
The Relationship of Performance on the Dental Admission Test and Performance on Part I of the National Board Dental Examinations
Authors: De Ball Suzanne , Sullivan Kathleen , Horine Julie , Duncan William K. , Replogle William
Published: June 2020

Although many schools use scores on the Dental Admission Test (DAT) to evaluate applicants, the association of these scores with students' performance on Part I of the National Board Dental Examinations (NBDE) has not been recently evaluated. In this study, the hypothesis that the DAT scores would be a significant predictor of Part I of the NBDE scores was tested. We analyzed by multiple regression the scores on both examinations for the 114 students matriculating in the University of Mississippi School of Dentistry in 1992, 1993, 1994, and 1995. The results indicate that DAT reading comprehension was a statistically significant predictor (p value less than or equal to 0.05) of all four subtests of Part I of the NBDE. The DAT biology and organic chemistry scores were statistically significant predictors of NBDE biochemistry‐physiology, and the DAT quantitative analysis score was a statistically significant predictor of NBDE dental anatomy and occlusion. DAT perceptual ability and general chemistry were not significant predictors.
Perceptions of Canadian Dental Faculty and Students About Appropriate Penalties for Academic Dishonesty
Authors: Teplitsky Paul E.
Published: June 2020

The purpose of this investigation was to a) compare the opinions of Canadian faculty and students as regards to what they felt was an appropriate penalty for particular academic offenses and b) to analyze the results and create a jurisprudence grid to serve as a guideline for appropriate disciplinary action. Two hundred questionnaires were distributed to the ten dental colleges in Canada. Each college was asked to have ten faculty and ten students complete the survey. A response rate of 100 percent was achieved for students and 92 percent for faculty. The questionnaire required respondents to select what they felt were appropriate penalties for a list of fifteen academic offenses and to render judgment on three specific cases. Statistical analysis of survey responses led to the following conclusions: 1) students gave equal or more lenient penalties than faculty for the same offense; 2) extenuating circumstances introduced via case presentations altered penalty choice only slightly; and 3) offenses could be grouped to correspond with appropriate penalties, thereby establishing a jurisprudence grid that may serve as a guideline for adjudication committees.
Case II: Conflict Recognition—The Case of the Misdirected Faculty
Authors: Hoelscher Diane C. , Comer Robert W.
Published: June 2020

Early recognition is fundamental to managing conflict. Successful leaders rely upon their ability to recognize conflict before it escalates into crisis. This article reviews the signs and sources of conflict along with related management theories. Conflict management includes understanding the sources and types of conflict as well as the impact potential; in the case presented, the leaders were unaware of conflict. Dr. Forester, the faculty member “in the middle,” was in a precarious position. Her performance evaluation reflected unacceptable accomplishments. However, her self‐assessment, based on the hiring agreement, was successful. Her requests for guidance and clarification were unproductive. What does she do now? The management theories that apply to the case of “the misdirected faculty” include analysis and discussion of communication, feedback, and expectancy theory. Action alternatives are presented to explore some of the options available to stimulate discussion and to provide readers with an eclectic approach to applying a case analysis.
Characteristics of Civilian Postdoctoral General Dentistry Programs
Authors: Mito Ronald S. , Atchison Kathryn A. , Lefever Karen H. , Lin Sylvia , Engelhardt Rita
Published: June 2020

U.S. civilian (non‐VA/non‐military) Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs were identified (n=208) and surveyed. The assessment evaluated infrastructure support, populations served, services provided, and trainee stipends. One hundred thirty‐one programs responded (thirty‐two AEGD, 64 percent/ninety‐nine GPR, 63 percent). Sixty‐nine programs were HRSA‐funded (53 percent), and sixty‐three (47 percent) were nonfunded. One hundred and five responses identified hospital/medical center resources; fifty‐six indicated dental school support. Mean faculty support was similar regardless of program type or HRSA funding. Mean first‐year positions in AEGDs were greater than GPRs. Mean first‐year GPR positions were greater in funded than in nonfunded programs. A comparison of AEGD and GPR programs showed that residents in GPRs treated more children, medically intensive, economically/socially disadvantaged, and in‐patient/ same‐day surgery patients (p<0.05). Residents in AEGDs treated more healthy adults (p<0.05). GPRs treated more lower fee (no pay, Medicaid, welfare/general relief, Medicare, and capitation/HMO) patients. AEGDs treated more insurance/private pay patients (p=.0001). No differences existed in comprehensive care and emergency visits between AEGDs and GPRs. GPRs treated more hospital‐based patients. The mean stipends for GPRs ($32,055) and AEGDs ($22,403) were different.
Systematic Review of Randomized Trials for the Treatment of Oral Leukoplakia
Authors: Lodi Giovanni , Sardella Andrea , Bez Cristina , Demarosi Federica , Carrassi Antonio
Published: June 2020

Oral leukoplakia is a relatively common oral lesion that, in a varying proportion of cases, undergoes malignant transformation. The aim of this review was to assess the effectiveness of treatments for leukoplakia. Randomized controlled trials (RCTs) enrolling patients with a diagnosis of oral leukoplakia were identified by searching biomedical databases, hand‐searching relevant oral medicine journals, and contacting oral medicine experts through a European mailing list. The methodological quality of included studies was assessed on the basis of the method of allocation concealment, blindness of the study, and loss of participants. Data were analyzed by calculating relative risk. Malignant transformation of leukoplakia, demonstrated by histo‐pathological examination, was the main outcome considered. Secondary outcomes included clinical resolution of the lesion and variation in dysplasia severity. Six RCTs were included in the review. Vitamin A and retinoids were tested in four RCTs; the other agents tested were bleomycin, mixed tea, and beta carotene. Malignant transformation was recorded in just two studies: none of the treatments tested showed a benefit when compared with placebo. Treatment with beta carotene and vitamin A or retinoids was associated with better rates of clinical remission, compared with placebo or absence of treatment. Whenever reported, a high rate of relapse was a common finding. Side effects of variable severity were often described; however, interventions were well accepted by patients since drop‐out rates were similar between treatment and control groups. It is noteworthy that the possible effectiveness of surgical interventions, including laser therapy and cryotherapy, has apparently never been studied by means of an RCT. To date, in conclusion, there is no evidence of effective treatment in preventing malignant transformation of leukoplakia. Treatments may be effective in the resolution of lesion; however, relapses and adverse effects are common.
Prevention of Oral Mucositis and Oral Candidiasis for Patients with Cancer Treated with Chemotherapy: Cochrane Systematic Review
Authors: Worthington H.V. , Clarkson J.E.
Published: June 2020

The objectives of this study were to determine whether oral prophylactic agents are superior to placebo or no treatment on the incidence of oral mucositis and oral candidiasis for patients with cancer. A Cochrane systematic review was conducted of randomized trials of oral (and topical) prophylactic agents for mucositis and oral candidiasis, anywhere in the world, among patients with cancer (excluding head and neck) who were receiving chemotherapy. Eleven studies were included in the meta‐analysis for mucositis. Of the six prophylactic agents used for mucositis, only one—ice chips—was effective (relative risk 0.57, 95% CI 0.43 to 0.77). Fifteen studies were included in the meta‐analysis for oral candidiasis. There is evidence that antifungal agents that are partially or fully absorbed from the gastrointestinal tract prevent oral candidiasis and that the partially absorbed agents may be more effective than the fully absorbed agents. The RR for partially absorbed agents was 0.13 (95% CI 0.06 to 0.27). In conclusion, there is weak and unreliable evidence that ice chips prevent mucositis. There is evidence that prophylactic use of antifungal agents, which are absorbed or partially absorbed from the gastrointestinal tract, reduce the clinical signs of oral candidiasis.
The Role and Importance of Research and Scholarship in Dental Education and Practice
Authors: Bertolami Charles N.
Published: June 2020

Understanding the role and importance of research and scholarship in dental education and practice requires an appreciation of dentistry as a learned profession. A foundational attribute for the members of such a profession has to be sheer intellectual curiosity—a trait as important for the clinician as for the scientist. That improved patient care results from technical advances made possible through research is not seriously disputed by anyone. What is less apparent, however, is the role for research in the education of dentists and in the broader life of dental schools. Accosting this matter requires a distinction to be made between research and scholarship: while all research qualifies as scholarship, not all scholarship qualifies as research. Though the exact role of research in the educational process is open to debate, the importance of scholarship is not. An education colored by research is one way of achieving the intellectual rigor necessary for the professional. The key is cultivating in students a taste for complexity, for problems, and for problem solving. All dental schools without exception need to help students acquire this taste. In doing so, they will generate a few scientists; but, more importantly, they will create out of every graduate a man or woman of science. Only by becoming a person of science is there any hope that the practitioner will be able to acquire and assimilate new knowledge and to adapt to the changes in practice and in the profession that the future requires.
Gender Differences in First‐Year Dental Students' Motivation to Attend Dental School
Authors: Scarbecz Mark , Ross Judith A.
Published: June 2020

Women's role in the field of dentistry has historically been limited to the dental auxiliary fields, rather than that of D.D.S. or D.M.D. Today, women are nearly 38 percent of U.S. dental school students and 14 percent of active practitioners. The slow(er) influx of women into dentistry has been little studied by dental educators. During the 2000‐01 academic year, we conducted a survey of first‐year dental students at a sample of publicly funded U.S. dental schools. The purpose of the survey was to assess gender differences in motives for pursuing a dental career. The data show that male dental students rate self‐employment and business‐related motives as more important, while female dental students rate people‐oriented motives more highly. Factor analysis revealed four distinct clusters of motives for pursuing a dental career: a financial motive, a business‐oriented motive, a people‐oriented or caring motive, and a flexibility motive. Women scored significantly higher than men on the caring factor, whereas the reverse was true on the business factor. Male and female students rated financial and flexibility motives equally. The implications of the results for attracting students to the profession of dentistry are discussed.
Information‐Seeking Patterns of Dentists in Istanbul, Turkey
Authors: Selvi Firat , Ozerkan Altan G.
Published: June 2020

The authors surveyed dentists in Istanbul, Turkey to determine the modes they were using to access current professional information. A questionnaire was sent to 379 privately practicing dentists. The response rate was 35 percent. Privately practicing dentists frequently preferred to use traditional methods, such as discussions with colleagues, textbooks, and the brochures of products, to obtain information. Textbooks were found to be the most helpful information retrieval method. The lack of time after work and the difficulties in traffic in Istanbul were cited as the leading barriers to accessing information. We conclude that Turkish dentists in private practice need to improve their computer literacy skills in order to benefit from the generous opportunities that technology offers them and also to overcome the problem of professional isolation in their lives.
A Measure of Agreement Between Clinicians and a Computer‐Based Decision Support System for Planning Dental Treatment
Authors: Kawahata Naotsugu , MacEntee Michael I.
Published: June 2020

This study was conducted to estimate agreement and explain differences between treatment decisions and associated fees recommended by dentists and by a computer‐based decision‐support program (TxDENT 2.0©). The treatment fees associated with forty‐eight clinical records of patients attending a dental school clinic provided a measure of correlation and agreement between treatments recommended by TxDENT and by clinical instructors with students. The average difference between the two methods of forecasting fees was $466, and a regression line (y=0.43x+407) with an r‐value of 0.54 indicated the strength of the relationship. The differences between methods increased as the cost of treatment increased, due largely to disagreements about the need to restore or replace weak or missing teeth. There is reasonable agreement between TxDENT and the collaborative treatment plans of clinical instructors with their students, which suggests that this computer‐based decision‐support system for screening patients in a standardized way could be a helpful predictor of treatment provided in a dental school clinic.
Impact of a Dental/Dental Hygiene Tobacco‐Use Cessation Curriculum on Practice
Authors: Gelskey Shirley C.
Published: June 2020

Tobacco use is the chief avoidable cause of morbidity and mortality in North America and is associated with increased risk for oral cancer and increased prevalence and severity of periodontitis and other oral conditions. By delivering two‐ to three‐minute tobacco‐use cessation counseling (TUCC), oral health professionals can achieve quit rates substantially higher than the spontaneous quit rate. However, many clinicians report lack of training and knowledge in TUCC as barriers to providing cessation counseling. The purpose of this study was to evaluate whether implementation of a comprehensive, dental school‐based, tobacco‐use cessation program would increase the extent to which tobacco‐using patients received TUCC. The school's program was based on the critical administrative, cultural, structural, and policy components of effective TUCC interventions outlined by Fiore et al. A pre‐ and post‐program telephone interview of tobacco‐using patients assessed TUCC intervention by students. A significantly greater proportion of patients received TUCC post‐program compared to pre‐program in terms of consequences associated with tobacco use as well as advice to quit. A comprehensive TUCC program resulted in an improvement of 11.7 percent for consequences and 23 percent for advice to quit.
Effectiveness of Tobacco Counseling in the Dental Office
Authors: Warnakulasuriya Saman
Published: June 2020

This article describes the results of studies among dental care providers regarding tobacco cessation in the past two decades. In the early period, surveys described what dentists were doing in their own practices. The results suggested that they were not adequately communicating to their patients the importance of quitting. There is good evidence that brief interventions from health professionals can increase rates of smoking cessation. The outcome from a number of trials that examined the feasibility of conducting smoking cessation in dental practices is reviewed here. The pivotal role of a team approach is highlighted in many studies. Dentists who implement an effective smoking cessation program can expect to achieve quit rates up to 10‐15 percent each year among their patients who smoke or use smokeless tobacco. The challenge is implementing effective treatment in one's practice or institution while using available primary care resources to provide additional benefit.
Meeting the Demand for Future Dental School Faculty: Trends, Challenges, and Responses
Authors: Haden N. Karl , Weaver Richard G. , Valachovic Richard W.
Published: June 2020

This report presents data from ADEA's 2001‐02 survey of vacant budgeted faculty positions and examines challenges likely to exacerbate faculty shortages in the immediate future. The fifty‐four dental schools responding to the survey reported 344 vacant budgeted positions, a decrease of 4 percent from 2000 to 2001. Seventy‐nine percent of these vacancies are for full‐time positions. Approximately one out of four dental schools has ten or more vacancies. Of just over 1,000 faculty separations during 2001‐02, 53 percent were reported to be individuals leaving to enter private practice. There is no indication of a near‐term reversal of the decade‐long trend toward increasing budgeted vacancies, and the current economic environment along with other factors delineated in this report makes the challenge to recruit and retain dental faculty more difficult. ADEA and other stakeholders are currently pursuing a number of strategies to meet the demand for future dental school faculty.
Professional Monopoly, Social Covenant, and Access to Oral Health Care in the United States
Authors: Benn Douglas K.
Published: June 2020

Lack of access to oral care is a severe problem in the United States with over one‐third of the population lacking dental insurance. In this group, 32 million people lack dental insurance and access to public dental services (Medicaid or Medicare), and 7 million of them need dental care. In some high‐risk populations, such as Native Americans, two‐thirds have unmet dental needs. Only 1 percent of Medicaid‐eligible babies have a dental examination before twelve months of age. In this paper the social covenant of the dental profession is examined and suggestions made for improving access to care through improved efficiency. It is proposed that 1) private dentists should accept 5 percent per annum of their patients for indigent care funded by improved efficiency from utilizing allied dental providers (ADP) in new roles, and 2) ADP should have their own independent state boards. If dentists refuse to honor their social covenant, then ADP should be allowed to practice independently, breaking the professional monopoly.
A Model for Assessing the Ethical Environment in Academic Dentistry
Authors: Whitehead Albert W. , Novak Karen F.
Published: June 2020

Weber's “Institutional Ethics Audit” model was designed as a tool for assessment of an organization's effort to institutionalize ethics into its operations. In this model, the overall ethical environment of an organization is evaluated through an assessment of its 1) ethical cultures, 2) ethics policy, 3) enforcement mechanisms, and 4) ethical training. Assessment of these components allows the organization to be placed along a continuum that spans aethical firms, compliance firms, emerging firms, and integrity firms. This paper presents the conceptual framework for this model. We propose that application of this model to academic institutions, including dental schools, could provide appropriate information to improve the ethical climate of the institution.
Predictive Validity of Critical Thinking Skills for Initial Clinical Dental Hygiene Performance
Authors: Williams Karen B. , Glasnapp Douglas R. , Tilliss Terri S.I. , Osborn Joy , Wilkins Kris , Mitchell Shannon , Kershbaum Wendy , Schmidt Colleen
Published: June 2020

This study collected validity evidence on the utility of critical thinking skills and critical thinking disposition in predicting initial clinical performance. The predictive value of critical thinking skills scores and disposition scores was examined to determine their unique contribution beyond that provided by traditional predictors: grade point average, age, and number of college hours. The study involved three phases: establishing content validity of three outcome measures; assessing students' baseline critical thinking skills and disposition using the California Critical Thinking Skills Test (CCTST) and the California Critical Thinking Dispositions Inventory (CCTDI); and assessing students' initial clinical competence, clinical reasoning, and clinical knowledge. All baccalaureate‐level dental hygiene programs in the United States affiliated with a dental school (N=22) were invited to participate; of those, seven volunteered. A convenience sample of 207 first‐year dental hygiene students was obtained. A series of hierarchical multiple regression analyses demonstrated that CCTST scores explained a statistically significant (p<.05) proportion of variance in students' initial clinical reasoning scores, acquired knowledge scores, and faculty ratings, above and beyond that explained by other predictor variables. CCTDI scores were not significant predictors of any outcome measure. It was concluded that CCTST is a good predictor of initial student outcomes and may have utility for student selection and retention.
Addressing Health Disparities Through Dental‐Medical Collaborations, Part II. Cross‐Cutting Themes in the Care of Special Populations
Authors: Mouradian Wendy E. , Corbin Stephen B.
Published: June 2020

This article introduces the second group in a series of articles in this journal on dental‐medical collaborations to reduce oral health disparities. This group targets the needs of the elderly and individuals with mental retardation, developmental disabilities, and other special health problems. Five themes are common to these populations: the importance of oral‐systemic interactions and need for interprofessional collaboration in care and training; the possibility of diminished mental and motor capacities and ability to provide self‐care; difficulty accessing appropriate dental care; complex social and cultural factors; and the lack of a sufficient evidence base on basic mechanisms and clinical interventions. Gaps in training of dental, medical, and other health professionals contribute to disparities. Few programs provide integrated, interdisciplinary approaches, despite the growing numbers of elderly and the increasing life span of individuals with developmental disabilities. The inability of many such individuals to advocate for themselves, limitations in financial mechanisms, and societal biases fuel health disparities. These articles propose recommendations for key changes in dental and other health professional training, advocate increased commitment to special populations in research agendas, and encourage collaboration across health professions and with community and advocacy groups. A strong emphasis on prevention must be a part of these changes.
Automated External Defibrillator Use Among the General Population
Authors: Roccia Wayne D. , Modic Paul E. , Cuddy Michael A.
Published: June 2020

Automated External Defibrillators (AED) are becoming more prominent in public locations within the mainstream of our society. They are marketed as providing the ability for a broader range of people, beyond clinicians and community emergency medical services personal, to successfully defibrillate a person in cardiac arrest. The objectives of this study were to determine whether or not a member of the general population, without previous exposure to an AED, could successfully operate an AED, thus delivering the necessary shock in ventricular fibrillation arrest. In addition, we analyzed the relationship between health care training and the time required to defibrillate a patient using an AED and investigated the overall success of operating an AED with respect to health care training. Utilizing an AED trainer, we conducted a timed trial study of five subject categories (general population; first‐year dental students; third‐year dental students; dentists, hygienists, and nurses; and anesthesiologists and surgeons) as each operator attempted to defibrillate a mannequin (n=50). Their times, success in defibrillation, and comments were recorded. The general population group experienced an 80 percent failure rate, while the other groups showed an inverse relationship between failure rates and the amount of health care training. Overall, only 58 percent of the subjects successfully performed the defibrillation with the AED. Operator speed in relation to the amount of health care training showed another inverse relationship as times decreased from group one (general population) to group five (anesthesiologists and surgeons). The findings suggest that prior exposure to an AED leads to a greater number of successful defibrillations. It remains unclear at this time as to whether a member of the general population can successfully operate an AED.
Analysis of Federal Support for Postgraduate General Dentistry
Authors: Atchison Kathryn A. , Mito Ronald S. , Lefever Karen H. , McCauley Kevin R. , Lin Sylvia , Engelhardt Rita , Gutierrez John J.
Published: June 2020

We compared the funding granted by the federal government between 1985 and 1997 to stimulate the growth of AEGD and GPR programs across HRSA regions, states, and populations. Information regarding the number, size, and location of programs available during the time period of 1985 to 1997 was collected. During this period, although the number of programs remained constant, the composition of the programs changed, with AEGD programs increasing by 113 percent and GPR programs decreasing by 13 percent. HRSA Regions 2, 3, and 5 combined offered over 50 percent of all programs. The number of residency positions rose by 28 percent in civilian programs and dropped by 11 percent in Veterans and Military (VA/M) positions. Overall growth in AEGD positions increased 208 percent, while the civilian GPR positions remained constant and the number of VA/M GPR positions dropped by 30 percent. A higher percentage increase in programs occurred in cities of greater than 500,000 population than in less densely populated areas. HRSA spent $41,254,501 in the thirteen‐year time frame, and funding by region varied by over a hundredfold. Programs in the least dense population groups were often the least funded. There was great variability in the amount of HRSA money received by state, with fifteen states receiving no funding during the thirteen years. Without HRSA dollars, it is apparent that the postgraduate general dental training program would not have gained the vitality it currently offers. However, attention must be paid to developing programs among states with a lack of infrastructure in dental education and training.
Distance Education in the U.S. and Canadian Undergraduate Dental Curriculum
Authors: Andrews Kenneth G. , Demps Elaine L.
Published: June 2020

A major trend at all levels of education in recent years has been the advent of distance learning and, more specifically, the use of computers and communications capabilities to provide online learning. The purpose of this study was to determine the extent to which distance learning and online technologies are being employed by dental schools in the United States and Canada. Two groups were surveyed: academic deans and faculty members of U.S. and Canadian dental schools. Thirty‐eight academic deans responded to a paper‐based survey, and more than 400 faculty members responded to a web‐based survey. The results of these surveys indicate that online delivery of content and information has a bright future in the delivery of the dental school curriculum. At the same time, formidable obstacles must be addressed for this approach to be successful.
Systematic Review of Controlled Trials on the Effectiveness of Fluoride Gels for the Prevention of Dental Caries in Children
Authors: Marinho Valeria C.C. , Higgins Julian P.T. , Logan Stuart , Sheiham Aubrey
Published: June 2020

Fluoride gels have been widely used since the 1970s. The aim of this review was to assess the effectiveness and safety of fluoride gels in the prevention of dental caries in children and to examine factors potentially modifying their effectiveness. Relevant randomized or quasi‐randomized trials were identified without language restrictions by searching multiple databases, reference lists of articles, and journals and by contacting selected authors and manufacturers. Trials with blind outcome assessment comparing fluoride gel with placebo or no treatment for at least one year and involving children under seventeen years of age were selected. Inclusion decisions, quality assessment, and data extraction were duplicated in a random sample of one third of studies, and consensus was achieved by discussion or a third party. Random effects meta‐analyses were performed where data could be pooled. Potential sources of heterogeneity were examined in random effects meta‐regression analyses. The main outcome was caries increment measured by the change in decayed, missing, and filled permanent tooth surfaces (D(M)FS). The primary measure of effect was the prevented fraction (PF) that is the difference in mean caries increment between the treatment and control groups expressed as a percentage of the mean increment in the control group. Potential adverse effects and unacceptability of treatment were also recorded. Twenty‐five studies were included, involving 7,747 children. For the twenty‐three that contributed data for meta‐analysis, the D(M)FS pooled prevented fraction estimate was 28 percent (95 percent CI, 19 percent to 37 percent; p<0.0001). There was clear heterogeneity, confirmed statistically (p<0.0001). The effect of fluoride gel varied according to type of control group used, with D(M)FS PF on average being 19 percent (95 percent CI, 5 percent to 33 percent; p<0.009) higher in non‐placebo controlled trials. Only two trials reported on adverse events. There is clear evidence of a caries‐inhibiting effect of fluoride gel. The best estimate of the magnitude of this effect, based on the fourteen placebo‐controlled trials, is a 21 percent reduction (95 percent CI, 14 to 28 percent) in D(M)FS. This corresponds to an NNT of two (95 percent CI, 1 to 3) to avoid one D(M)FS in a population with a caries increment of 2.2 D(M)FS/year, or an NNT of twenty‐four (95 percent CI, 18 to 36) based on an increment of 0.2 D(M)FS/year. However, further work is needed to identify and quantify potential harmful effects of fluoride gels.
Underserved Region Recruitment and Return to Practice: A Thirty‐Year Analysis
Authors: Osborne Paul B. , Haubenreich James E.
Published: June 2020

The purpose of this investigation was a retrospective analysis of a select group of graduates from the University of Kentucky College of Dentistry (UKCD) over a thirty‐year history to determine how many of these individuals came from the Appalachian Region of Eastern Kentucky, which historically has been economically depressed and underserved by health care practitioners including dentists. This same group of dental school graduates was then tracked to see if they established dental practices in the Appalachian region of the state. Recruiting trends were investigated by reviewing student records regarding county of origin from targeted classes at UKCD in 1969, 1979, and 1989 to gain ten‐year incremental, historical perspectives. To identify more recent trends, classes graduating in 1994 through 1999 were reviewed. Once identified, the databank of the Kentucky Board of Dentistry was used to determine if these individuals reported practicing in counties of Kentucky designated by the Appalachian Regional Commission (ARC). The findings of this study indicate an alarming decline both in numbers of students being recruited from this underserved area and a concomitant decline in those recruits returning to ARC‐designated counties in the state. This study establishes the need for persistent diligence in recruitment of students from underserved areas and challenges dental schools to create strategies that will encourage their graduates to establish practices in these regions.
Improving the Oral Health Status of All Americans: Roles and Responsibilities of Academic Dental Institutions
Authors: Haden N. Karl , Catalanotto Frank A. , Alexander Charles J. , Bailit Howard , Battrell Ann , Broussard Jack , Buchanan Judith , Douglass Chester W. , Fox Claude Earl , Glassman Paul , Lugo R. Ivan , George Mary , Meyerowitz Cyril , Scott Edward R. , Yaple Newell , Bresch Jack , Gutman‐Betts Zlata , Luke Gina G. , Moss Myla , Sinkford Jeanne C. , Weaver Richard G. , Valachovic Richard W.
Published: June 2020

Academic dental institutions are the fundamental underpinning of the nation's oral health. Education, research, and patient care are the cornerstones of academic dentistry that form the foundation upon which the dental profession rises to provide care to the public. The oral health status of Americans has improved dramatically over the past twenty‐five to thirty years. In his 2000 report on oral health, the Surgeon General acknowledges the success of the dental profession in improving the oral health status of Americans over the past twenty‐five years, but he also juxtaposes this success to profound and consequential disparities in the oral health of Americans. In 2002, the American Dental Education Association brought together an ADEA President's Commission of national experts to explore the roles and responsibilities of academic dental institutions in improving the oral health status of all Americans. They have issued this report and made a variety of policy recommendations, including a Statement of Position, to the 2003 ADEA House of Delegates. The commission's work will help guide ADEA in such areas as: identifying barriers to oral health care, providing guiding principles for academic dental institutions, anticipating workforce needs, and improving access through a diverse workforce and the types of oral health providers, including full utilization of allied dental professionals and collaborations with colleagues from medicine.
A Multimedia Patient Simulation for Teaching and Assessing Endodontic Diagnosis
Authors: Littlefield John H. , Demps Elaine L. , Keiser Karl , Chatterjee Lipika , Yuan Cheng H. , Hargreaves Kenneth M.
Published: June 2020

Teaching and assessing diagnostic skills are difficult due to relatively small numbers of total clinical experiences and a shortage of clinical faculty. Patient simulations could help teach and assess diagnosis by displaying a well‐defined diagnostic task, then providing informative feedback and opportunities for repetition and correction of errors. This report describes the development and initial evaluation of SimEndo I, a multimedia patient simulation program that could be used for teaching or assessing endodontic diagnosis. Students interact with a graphical interface that has four pull‐down menus and related submenus. In response to student requests, the program presents patient information. Scoring is based on diagnosis of each case by endodontists. Pilot testing with seventy‐four junior dental students identified numerous needed improvements to the user interface program. A multi‐school field test of the interface program using three patient cases addressed three research questions: 1) How did the field test students evaluate SimEndo I? Overall mean evaluation was 8.1 on a 0 to 10 scale; 2) How many cases are needed to generate a reproducible diagnostic proficiency score for an individual student using the Rimoldi scoring procedure? Mean diagnostic proficiency scores by case ranged from .27 to .40 on a 0 to 1 scale; five cases would produce a score with a 0.80 reliability coefficient; and 3) Did students accurately diagnose each case? Mean correct diagnosis scores by case ranged from .54 to .78 on a 0 to 1 scale. We conclude that multimedia patient simulations offer a promising alternative for teaching and assessing student diagnostic skills.
Cultural Competency: Dentistry and Medicine Learning from One Another
Authors: Formicola Allan J. , Stavisky Judith , Lewy Robert
Published: June 2020

The Institute of Medicine (IOM) report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care is serving as a catalyst for the medical profession to re‐examine the manner in which its institutions and training programs relate to cultural competence. This report found that racial and ethnic disparities exist in health care and that a lack of access to care does not fully explain why such disparities exist. The IOM study found bias, stereotyping, prejudice, and clinical uncertainty as possible contributing causes. The U.S. Surgeon General's Report on the Oral Health of the Nation also pointed to oral health disparities related to race, ethnicity, and culture. This paper discusses how medicine is responding to the Unequal Treatment report and the lessons to be considered for dentistry. Recommendations on how dentistry can apply the knowledge from this report to help reduce oral health disparities are suggested.
3000 by 2000 and Beyond: Next Steps for Promoting Diversity in the Health Professions
Authors: Terrell Charles , Beaudreau James
Published: June 2020

In 1991, the Association of American Medical Colleges (AAMC) launched a national campaign to enroll 3,000 underrepresented minority students in medical school by the year 2000. (The AAMC defined underrepresented minorities as blacks, Mexican Americans, mainland Puerto Ricans, and Native Americans, which includes American Indians, Alaska Natives, and Native Hawaiians.*) The initiative, named Project 3000 by 2000, focused on education‐pipeline interventions. Although the project did not meet its numeric goal, in large part because of court decisions in several regions of the country that hampered affirmative action programs, Project 3000 by 2000 did have a number of important successes. At a time when there is a need to develop new and creative ways to promote diversity in health professions education, there are a number of lessons to be learned from this project. Large‐scale national campaigns serve an extremely useful purpose in promoting diversity in the health professions. And for these campaigns to be successful, it is important that the health professions work together to coordinate their activities and share their resources to ensure that health professions close the diversity gap in the twenty‐first century.
The Work Covenant: A Management Strategy for Department Chairs and Program Directors
Authors: Durham Timothy M. , Lange Brian
Published: June 2020

Learning contracts have been used in adult education to ensure a positive and successful learning process. By means of a learning contract, the instructor can support the learner in a manner that best suits the learner's individual requirements. Like the learning environment, the workplace finds individuals with varying skill sets, areas of interest, and degrees of motivation. Understanding and applying the skills of the worker to appropriate tasks and interests have important ramifications for how workers perceive their jobs and the ultimate effectiveness of the organization. Studies show that the quality of the work environment is critical for the job satisfaction and retention of employees in the public and private sector as well as for the dental academician. Recent literature on faculty development has focused on adapting business‐based motivation, mentoring, and performance counseling strategies to the academic setting. By leading and managing faculty development through the use of such strategies, the quality of the work environment can be improved. This article briefly summarizes the commonality between retention strategies and learning contracts within a human resource context and provides a model document that can be used by chairs and program directors to organize and focus their faculty development efforts.
Application of Rapid Prototyping to Operative Dentistry Curriculum
Authors: Chan Daniel C.N. , Frazier Kevin B. , Tse Laam A. , Rosen David W.
Published: June 2020

Computers are becoming an integral part of dental education and dental practice. Rapid prototyping is a technique for the production of solid objects from computer models. The variety of rapid prototyping devices and materials that can be processed is increasing all the time. In this article, the authors present a discriminative learning device and associated exercises for developing visual recognition skills and examine the potential for the application of rapid prototyping to the operative dentistry curriculum. Other rapid prototyping technologies as applied in dentistry are also discussed.