bluuebunny/crossref_metadata_2025 huggingface dataset:
The perception of surrogate teaching patients with HIV disease of dental providers' fear and comfort
Authors: Brimlow DL , Ross MW , Rankin KV
Published: June 2020

We conducted a focus group with eight surrogate teaching patients who participate in an HIV/AIDS training program for dentists and auxiliaries. With one exception, these surrogate patients were HIV‐seropositive, had taken part in eight training sessions over six months, and had been examined by about forty groups of trainees. Researchers inquired about how surrogate patients could tell if the trainees were afraid or comfortable, what negative experiences with trainees occurred or stood out, and what positive experiences were recalled or stood out. Theme analysis was used to interpret the results of the focus group. The main signifiers of clinician discomfort were related to physical distance, avoidance of physical contact, verbal interaction, and what we call “dentist interaction.” The results suggest that training of dentists and other dental personnel to interact with patients with HIV/AIDS should attend to reduction of patients' psychological distress as well as management of any physical discomfort. The feedback from surrogate patients with HIV disease who have experienced a large number of dental examinations is a valuable tool for providing feedback to, and insight into, the factors that cause psychological discomfort to patients with HIV disease.
Emerging Methods of Caries Diagnosis
Authors: Stookey George K. , González‐Cabezas Carlos
Published: June 2020

Current diagnostic tools used in dental caries detection are not sensitive enough to diagnose the disease process in its early stages and, frequently, once a diagnosis is made, restoration is the only effective means of treatment. The purpose of this review was to systematically assess the available literature for evidence to determine if emerging diagnostic methods for dental caries are more efficient than traditional methods for detecting and monitoring the progress of caries in permanent and primary teeth. Inclusion and exclusion criteria were established preceding the literature search. Included articles were grouped by type of emerging technology and study design. The types of emerging technologies included laser fluorescence, light fluorescence, digital imaging fiber optic transillumination, and ultrasound. Primarily on the basis of in vitro and preclinical data, some of the reviewed methodologies showed promising results for the detection and monitoring of early caries lesions. However, very little clinical data are available to validate these emerging technologies. It was concluded that, although significant promise is apparent with these technologies, there is not enough evidence available at this time for any of the reviewed diagnostic techniques to be recommended as a substitute for traditional diagnostic techniques.
Effectiveness of Methods Used by Dental Professionals for the Primary Prevention of Dental Caries
Authors: Rozier R. Gary
Published: June 2020

This paper summarizes and rates the evidence for the effectiveness of methods available to dental professionals for their use in the primary prevention of dental caries. It reviews operator‐applied therapeutic agents or materials and patient counseling. Evidence of effectiveness is extracted from published systematic reviews. A search for articles since publication of these reviews was done to provide updates, and a systematic review of the caries‐inhibiting effects of fluoride varnish in primary teeth is provided. Good evidence is available for the effectiveness of fluoride gel and varnish, chlorhexidine gel, and sealant when used to prevent caries in permanent teeth of children and adolescents. The evidence for effectiveness of fluoride varnish use in primary teeth, chlorhexidine varnish, and patient counseling is judged to be insufficient. Use of fluoride, chlorhexidine and sealant according to tested protocols and for the populations in which evidence of effect is available can be recommended. However, they may need to be used selectively. Estimates for the number of patients or tooth surfaces needed to treat to prevent a carious event suggest that the effects of these professional treatments are low in patients who are at reduced risk for dental caries. The literature on use of these preventive methods in individuals other than school‐aged children needs expansion.
Methods Employed for Other Systematic Reviews
Authors: Horowitz Alice M. , Anderson P.F.
Published: June 2020

Two separate groups of reviewers were involved in the Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life. The training of the independent reviewers and the methodology they used differed from that of the team at the Research Triangle Institute and the University of North Carolina at Chapel Hill (RTI/UNC).
Radiographic Diagnosis of Dental Caries
Authors: Dove S. Brent
Published: June 2020

The purpose of this report was to respond to aspects of the RTI/UNC systematic review relating to the radiographic diagnosis of dental caries. The systematic review was commissioned as part of the NIH Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life. The systematic review evaluated the dental literature from 1966 to 1999. Well‐defined search criteria along with clear inclusion and exclusion criteria were used to perform the review. Some of the inclusion and exclusion criteria used in the systematic review may have limited the evidence supporting the use of radiography, especially for the diagnosis of proximal surface caries. The RTI/UNC review only included studies in which sensitivity and specificity were reported or could be derived from the data presented. Studies that used the receiver operating characteristic as a measure of diagnostic accuracy were not included. Although the strength of evidence is considered poor, this does not mean that the use of radiographic methods is of no diagnostic value. It simply means that, using the criteria established by the systematic review, the evidence is inadequate to validate the method. Guidelines should be developed for assessing diagnostic methods that assist researchers in developing study designs that will hold up to critical review.
University of Kentucky Community‐Based Field Experience: Program Description
Authors: Skelton Judith , Mullins M. Raynor , Kaplan Alan L. , West Karen P. , Smith Timothy A.
Published: June 2020

Community‐based field experiences (CBFE) provide students with exemplary experiential learning opportunities. The purposes of this paper are to describe the University of Kentucky College of Dentistry (UKCD) CBFE and report the results of a two‐year, self‐report survey that assessed the primary course goal, students' perceptions of change in knowledge and skills related to nineteen areas of patient care (n = 90, 100% return rate), and their overall rating of the program. Knowledge and skill data were analyzed using the non‐parametric binomial test for comparing proportions. A significant (.05 level) majority of students reported increases in knowledge in all areas to which they were exposed. Descriptive frequencies summarizing the results of the total CBFE experience indicate that the majority of students felt it was a positive experience. The CBFE continues to be a meaningful element in the UKCD curriculum as it provides students with a relevant, authentic educational experience.
Dental Work Force Strategies During a Period of Change and Uncertainty
Authors: Brown L. Jackson
Published: June 2020

Both supply and demand influence the ability of the dental work force to adequately and efficiently provide dental care to a U.S. population growing in size and diversity. Major changes are occurring on both sides of the dental care market. Among factors shaping the demand for dental care are changing disease patterns, shifting population demographics, the extent and features of third‐party payment, and growth of the economy and the population. The capacity of the dental work force to provide care is influenced by enhancements of productivity and numbers of dental health personnel, as well as their demographic and practice characteristics. The full impact of these changes is difficult to predict. The dentist‐to‐population ratio does not reflect all the factors that must be considered to develop an effective dental work force policy. Nationally, the dental work force is likely to be adequate for the next several years, but regional work force imbalances appear to exist and may get worse. Against this backdrop of change and uncertainty, future dental work force strategies should strive for short‐term responsiveness while avoiding long‐term inflexibility. Trends in the work force must be continually monitored. Thorough analysis is required, and action should be taken when necessary.
Tutor and student perceptions of the tutor's role in problem‐based learning
Authors: Chaves JF , Lantz MS , Lynch MD
Published: June 2020

The role of the tutor in problem‐based learning (PBL) differs dramatically from the traditional teaching role with which dental students and faculty are familiar. In this investigation, the dimensionality and complexity of the tutor role were assessed by first‐ and second‐year dental students and by the tutors themselves using a twenty‐four‐item Likert‐type questionnaire that served as one component of a comprehensive web‐based assessment tool, the PBL‐Evaluator. Evaluations were completed after each PBL case over a period of one and a half years by one class of students and for half a year by a second class. Exploratory principal components analyses of the responses to the questionnaire revealed a more complex factor structure for tutors than for students. While a five‐factor solution was required for the tutors, a simpler two‐factor solution sufficed for both groups of first‐year students, and a three‐factor solution was necessary for the second‐year students. Although tutors displayed a more nuanced perspective on their performance than did students, items related to tutor modeling of professional conduct within tutorials consistently emerged as important for both.
Hypnosis, Behavioral Theory, and Smoking Cessation
Authors: Covino Nicholas A. , Bottari Melissa
Published: June 2020

Although nicotine replacement and other pharmacological treatments head the list of popular interventions for smoking cessation, approaches based on psychology can also assist smokers. Hypnosis, suggestion, and behavior therapies have been offered to patients and studied experimentally for several decades. Although no single psychological approach has been found to be superior to others, psychological interventions contribute significantly to successful treatment outcome in smoking cessation. This article describes common hypnotic and behavioral approaches to smoking cessation and critically reviews some of the findings from clinical and experimental research studies. The authors also offer suggestions regarding treatment and future research.
Tissue Engineering's Impact on Dentistry
Authors: Kaigler Darnell , Mooney David
Published: June 2020

Tissue engineering is a novel and exciting field that aims to re‐create functional, healthy tissues and organs in order to replace diseased, dying, or dead tissues. The field has developed due to the inadequate supply of organs and tissues for patients requiring organ and tissue replacement. The following review first describes three major tissue engineering strategies. Although similar in their objectives, these strategies each maintain a unique component. Next, several examples of preclinical and clinical progress engineering oral‐maxillofacial tissues are presented. Each of these examples highlights specific tissue engineering applications to different tissues of the oral‐maxillofacial apparatus. Finally, practical implications are addressed as well as challenges that must be met in order for tissue engineering to reach its full potential.
Evidence‐Based Dentistry and Health Services Research: Is One Possible Without the Other?
Authors: Coulter Ian D.
Published: June 2020

Barriers have been identified in the literature to the implementation of evidence‐based practice in dentistry. A major concern is the lack of rigorous evidence for clinical practices. Little attention has been given to the lack of rigorous health services research. Evidence‐based practice is more about effectiveness than efficacy and will influence the type of research that characterizes health services research (HSR) because it involves levels of data below that of the random controlled trials, involves questions about the appropriateness of care, and involves examining the structure, process, and outcomes of care. The need for HSR can be seen by examining the appropriateness of dental care and health‐related quality of life outcomes. The conclusion to be drawn is that evidence‐based dentistry needs HSR if it is to fulfill the promise currently held for it in the profession.
Teaching Ethics in Dental Schools: Trends, Techniques, and Targets
Authors: Berk Nancy W.
Published: June 2020

The importance of promoting ethical behavior in dental students is reflected in the emphasis on formal ethics teaching within the curricula of most dental schools. Over the last three decades, dental educators have addressed the need for ethics training and examined varied teaching approaches. Today, state‐of‐the‐art ethics education has moved from purely didactic instruction to more interactional teaching methods that promote student introspection and group problem‐solving. This paper provides an overview of trends in ethics teaching in dental schools and the current teaching approaches advocated in health science schools. In addition, future needs in dental ethics education are explored including the importance of addressing the unique aspects of the dental education environment.
Implications for Dental Education of a Dental School‐Initiated Practice Research Network
Authors: Wotman Stephen , Lalumandier James , Nelson Suchitra , Stange Kurt
Published: June 2020

The Case Western Reserve University (CWRU) School of Dentistry has organized a research network of 210 general dentists in northern Ohio. Seventeen of these dentists have volunteered to serve on a steering committee, for the purpose of generating research questions and helping with network organization. To enable the practitioners to investigate questions of interest in their practices, faculty in the CWRU schools of Dentistry and Medicine provide consultation to network dentists, as needed, with regard to research design, implementation, and analysis. In turn, the network serves as a resource for the dental school, facilitating faculty development, encouraging the development of new research programs, and providing an opportunity for students throughout the university to become involved in dental practice research. To date, faculty members have initiated studies of dental practice that include a survey of dentists' attitudes toward tobacco, a weekly return caries study, and a direct observation study of general dental practice. The network provides a research “laboratory” for the dental school, enabling clinical faculty to participate in research concerning dental practice. It has also stimulated a major re‐examination of several curriculum elements in the school.
Access to Dental Care: A Historical Review of Medicaid Eligibility Growth and Dental Productivity Decline
Authors: Kinlaw Delma H.
Published: June 2020

The present dilemma in providing dental services to the indigent and Medicaid recipients throughout this nation has generated considerable controversy as to the evolution of the problem. Most states recognize that there are deficiencies in the provision of dental services to these populations and are seeking resolutions. While state licensing board practices and dental professional society politics have been the object of criticism as contributing to if not causing of this problem, other rational and statistically valid explanations for the current difficulty exist. As an explanation for access to care issues, this paper explores the decline in the national numbers of dental practitioners and concomitant dental productivity. Furthermore, it relates those parameters to the dramatic rise in the utilization and demand for dental services resulting from a robust economy, population growth trends, and changes in state and federal Medicaid legislation that increase numbers of Medicaid‐eligible recipients. While these general trends are national in scope and application, the state of North Carolina and its experience will be used to fully explore the impact of these trends at the state and local level.
Intentional Use of the Hawthorne Effect to Improve Oral Hygiene Compliance in Orthodontic Patients
Authors: Feil Philip H. , Grauer Jennifer Sherah , Gadbury‐Amyot Cynthia C. , Kula Katherine , McCunniff Michael D.
Published: June 2020

The purpose of this study was to evaluate whether the home care of noncompliant adolescent orthodontic patients with “poor” oral hygiene could be improved through the use of a deception strategy designed to intentionally induce the Hawthorne effect. This effect is often cited as being responsible for oral health improvements of control groups that receive placebo treatments. It is thought that participating in and fulfilling the requirements of a study alters subjects' behavior, thereby contributing to the improvement. Forty patients with histories of poor oral hygiene were assigned, in a quasi‐random fashion, to two groups. Experimental subjects (n = 20) were presented with a situation that simulated participation in an experiment. These included the use of a consent form; distribution of tubes of toothpaste labeled “experimental”; instructions to brush twice a day for two minutes using a timer; and a request to return unused toothpaste. Control subjects (n = 20) had no knowledge of study participation. Tooth surface area covered with plaque was used as a proxy measure of home care behavior. It was measured at baseline, three months, and six months. Mean percentages of tooth surface covered with plaque for the experimental and control groups were 71 (11.52) and 74 (11.46) at baseline; 54 (13.79) and 78 (12.18) at three months; and 52 (13.04) and 79 (10.76) at six months. No statistically significant difference (p > .05) was obtained between groups at baseline. Statistically significant differences (p < .05) were found between groups at three and six months. Significant differences (p < .05) were also found only for the experimental subjects between baseline and each of the two subsequent observation periods. The efficiency and potential effectiveness of this strategy suggest that additional research be conducted to assess oral health improvements and possible applications to the private practice setting.
Learning Disabilities in Dental Education: Trends, Management, and Concerns in U.S. Dental Schools
Authors: Cruikshank Darcy , Howell Thomas H. , Brinckerhoff Loring C. , Badovinac Rachel , Karimbux Nadeem Y.
Published: June 2020

The prevalence of learning disabilities (LD) in higher education has drawn significant attention at the undergraduate level. College freshmen reporting learning disabilities have increased significantly in the past twenty years. Although anecdotal evidence suggests an increase in the number of dental students with learning disabilities, nothing has been published regarding how dental education is affected by this general trend. The purpose of this study was to obtain information from U.S. dental school administrators regarding the incidence and prevalence of learning disabilities in dental education. We hypothesized that there has been an increase in diagnosed cases of learning disabilities in dental education. Following a pilot study to identify individuals responsible for working with students with learning disabilities in U.S. dental schools (response rate 91 percent, n=49), a eighteen‐item survey instrument was distributed to specific contact individuals (response rate 81 percent, n=44). Mean cumulative incidence of diagnosed cases of learning disabilities was 0.3 percent; mean prevalence of identified diagnosed cases of LD 0.7 percent. Pearson analysis revealed a statistically significant weak positive correlation between mean prevalence and year, suggesting an increase in identified diagnosed cases of LD in U.S. dental schools over the past seven years (r=0.24, p=0.002). We conclude that the presence of learning disabilities in dental education is silent, pervasive, and deserves increased attention.
Perspectives on Dental Education in the Nordic Countries
Authors: Fiehn Nils‐Erik
Published: June 2020

Abstact: The object of this review is to discuss the state of dental education and describe current developments at dental schools in the Nordic countries. The main focus is the undergraduate dental education; however, the postgraduate system will also be addressed. The curriculum model for undergraduate dental education in the Nordic countries is based upon the odontological tradition. The influence of biomedicine on dental education is increasing at present due to scientific and medico‐technological developments and the altered disease profiles of oral and systemic diseases. These circumstances create new possibilities for dental education, but at the same time they raise some problems. In the long term, the strong biomedical influence on dental education will be an advantage to future dentists' function and tasks in health care systems in the Nordic countries. In the short term, it may result in an identity crisis for dental schools, students, and our profession, as we experience the evolution from the traditional odontological curriculum model to one significantly influenced by ongoing changes in the biomedical field. Continuing professional education and advanced training in clinical specialties are likely to play important roles in this evolution.
Applicant Analysis: 2000 Entering Class
Authors: Weaver Richard G. , Valachovic Richard W. , Haden N. Karl
Published: June 2020

There were 7,770 applicants to the entering dental school class of 2000. This is almost 14 percent less than the number of applicants to the entering class of 1999. Since the peak of dental school applicants in 1997 (at 9,829), the number has declined 21 percent. (This is most similar to the decline that has occurred in medical school applicants since their peak of applicants in 1996, at 46,968.) Almost 55 percent of the applicants to dental school were enrolled in 2000. Dental schools reported 4,234 first‐time, first‐year enrollees in 2000. This is an increase of 25 enrollees over the number reported in 1999. Since 1989, when dental school enrollment once again began to increase, total first‐year dental school enrollment has increased 8.7 percent. The number of applicants per first‐time, first‐year position was 1.84 in 2000. It was 2.14 in 1999. (The most recent low was 1.34 in 1989.) The GPA and DAT scores of the first‐time, first‐year enrollees in 2000 were all either equal to or slightly higher than they were in 1999. Women were approximately 40 percent of the applicants and first‐time, first‐year enrollees in 2000, up slightly from 1999. Underrepresented minorities comprised slightly over 12 percent of the applicants and 10.6 percent of the first‐time, first‐year enrollees, also up slightly from 1999.
Internal Consistency and Reliability of a Questionnaire Assessing Organizational Innovation in Two Schools of Dentistry
Authors: Ismail Amid I. , Belli Robert F. , Sohn Woosung , Toussaint Loren
Published: June 2020

The objective of this study was to test the internal consistency and test‐retest reliability of a questionnaire designed to assess the status of and factors associated with organizational innovation in schools of dentistry. The questionnaire included thirty‐three questions that assessed the following six domains: innovation/environment, innovation/leadership, innovation/ personal, feedback/environment, feedback/personal, and feedback/interpersonal. A seventh domain, evidence‐based learning, assessed the reaction of dental faculty to a scenario where the scientific evidence found a current treatment to be ineffective in improving the health status of patients. The questionnaire was mailed three times to a systematic sample of fifty‐six dental faculty working at a research‐intensive dental school (RES) and all thirty‐nine dental faculty working at a dental school where the emphasis is on clinical education (CL). The two U.S. dental schools had similar numbers of students; however, they differed significantly in their research portfolios. The response rate was 70.5 percent. The seven domains had alpha coefficients ranging between 0.60 and 0.89. The test‐retest reliability for the seven domains ranged between 0.65 and 0.92. Dental faculty of the RES school had significantly higher average scores than faculty of the CL school on innovation/leadership, innovation/environment, feedback/environment, and feedback/personal domains. Regression analyses found no differences between the two schools in innovation/environment scores. The innovation/environment scores were significantly associated with innovation/leadership, feedback/environment, feedback/interpersonal, and age. The evidence‐based learning domain was negatively associated with the innovation/environment domain, indicating that faculty who were willing to abandon teaching of a treatment found to be ineffective felt that their school environment was not highly innovative. In conclusion, this preliminary study found that the questionnaire reliably assessed six domains representing innovation and feedback. This preliminary study also found that an innovative environment in two schools of dentistry is associated with presence of leaders who promote change and innovation, an environment that encourages feedback, and faculty members who value interpersonal feedback.
Quality Assurance and Risk Management: A Survey of Dental Schools and Recommendations for Integrated Program Management
Authors: Fredekind Richard E. , Cuny Eve J. , Nadershahi Nader A.
Published: June 2020

Quality assurance (QA) and risk management (RM) programs are intended to improve patient care, meet accreditation standards, and ensure compliance with liability insurance policies. The purpose of this project was to obtain and disseminate information on whether dental schools integrate QA and RM and what mechanisms have been most effective in measuring accomplishments in these programs. All sixty‐five U.S. and Canadian dental schools were sent a twenty‐nine‐item survey, and forty‐six (71 percent) schools responded. The main findings are as follows: 66 percent had a written QA program combined with a QA committee; 95 percent received administrative support; there was wide variation in the makeup of the QA committee; many institutions reported significant changes resulting from the QA program; and over half of the respondents merged QA and RM in some fashion. To develop or maintain an effective QA/RM program, the authors propose the following: obtain active support from the dean; develop goals and mission/vision statements; include trained personnel on the committee; establish wide levels of involvement in the QA program; develop QA measurements to ensure compliance with institutionally developed standards of patient care; and establish continuous cycles of improvement.
The Effectiveness of a Mock Board Experience in Coaching Students for the Dental Hygiene National Board Examination
Authors: Dadian Taline , Guerink Kathy , Olney Cynthia , Littlefield John
Published: June 2020

A Mock Board is available through the American Dental Association to any student or dental hygiene program as a study aid for the Dental Hygiene National Board Examination (DHNBE). The purpose of this study was to evaluate the usefulness of this Mock Board as a learning activity to help students gain familiarity with the question formats and the overall board exam experience. A sensitivity‐specificity model was applied to validate the Mock Board's accuracy in identifying students who would pass or fail the DHNBE. A survey was conducted to assess students' opinions of the Mock Board experience. The Mock Board accurately identified success or failure on the DHNBE for 75 percent of the participants. However, the Mock Board's sensitivity was much better than its specificity. A majority of students reported the Mock Board motivated them to study and prepared them well for the national board experience. Comments showed, however, that students did not feel the Mock Board experience was as intense as taking the DHNBE. Findings indicate the Mock Board can be a valid and effective addition to board preparation activities. Dental hygiene faculty members are urged to consider incorporating the Mock Board experience with more traditional methods of coaching in preparing students for the DHNBE.
Military and VA General Dentistry Training: A National Resource
Authors: Atchison Kathryn A. , Bachand William , Buchanan C. Richard , Lefever Karen H. , Lin Sylvia , Engelhardt Rita
Published: June 2020

In 1999, HRSA contracted with the UCLA School of Dentistry to evaluate the postgraduate general dentistry (PDG) training programs. The purpose of this article is to compare the program characteristics of the PGD training programs sponsored by the Armed Services (military) and VA. Surveys mailed to sixty‐six VA and forty‐two military program directors in fall 2000 sought information regarding the infrastructure of the program, the program emphasis, resident preparation prior to entering the program, and a description of patients served and types of services provided. Of the eighty‐one returned surveys (75 percent response rate), thirty were received from military program directors and fifty‐one were received from VA program directors. AEGDs reported treating a higher proportion of children patients and GPRs more medically intensive, disadvantaged and HIV/ AIDS patients. Over half of the directors reported increases in curriculum emphasis in implantology. The program directors reported a high level of inadequate preparation among incoming dental residents. Having a higher ratio of residents to total number of faculty predicted inadequate preparation (p=.022) although the model was weak. Although HRSA doesn't financially support federally sponsored programs, their goal of improved dental training to care for medically compromised individuals is facilitated through these programs, thus making military and VA general dentistry programs a national resource.
Longitudinal Analysis of Student Performance in a Dental Hygiene Distance Education Program
Authors: Olmsted Jodi L.
Published: June 2020

The purpose of the study was to determine if learners who receive face‐to‐face instruction in an educational program performed statistically better on established benchmark assessments (GPA, course averages, and NBDHE) than learners at a distance from the didactic course instructor. A comparative, quasi‐experimental, ex‐post facto study was conducted. The treatment variable was program type: face‐to‐face vs. distance. The performance of five consecutive classes was analyzed, from 1997 to 2001. These five classes consisted of 221 learners, 105 of them at the host site and 115 using distance learning. The experimental groups were divided based upon location—host or cooperating college (distance) site learners. Study results identified no significant difference between host and distance learner performance for the entire educational program. The use of interactive television (ITV) for delivery of an educational program using distance education technology provided acceptable results in learner didactic performance. Learners at both the host and cooperating college (distance) sites performed equally well. The results were used to document program outcomes.
Sources of Stress and Psychological Disturbance Among Dental Students in the West Indies
Authors: Naidu Rahul S. , Adams Jerry S. , Simeon Donald , Persad Suzette
Published: June 2020

The aim of this study was to investigate sources of stress and psychological disturbance in dental students across the five years of undergraduate study at a dental school in Trinidad. Eighty‐three percent of students completed a modified version of the Dental Environment Stress questionnaire (DES) and the Brief Symptom Inventory (BSI). On a scale ranging from 0 (not stressful) to 5 (highly stressful), overall mean DES scores for each of the five years of study were 1.58, 1.83, 2.65, 2.39, and 2.61 respectively, suggesting that levels of stress increase over the five years with a noticeable spike at the transition between the preclinical and clinical phases. Significant differences were found between specific stressors across the five years of study. Seven specific stressors and the stressor domains of Academic work and Clinical factors were more stressful for female students (t‐test p < 0.05). The Global Severity Index of the BSI indicated that 54.8 percent of males and 44.2 percent of females were in the clinical range indicating significant psychological disturbance. Psychological disturbance was significantly associated with stress levels for male students (Spearmans rank correlation r = 0.56; p< 0.001), but not generally for female students. Further development is needed of dental educational programs that enhance students' psychosocial well‐being.
Assessment of Evidence‐Based Dental Prophylaxis Education in Postdoctoral Pediatric Dentistry Programs
Authors: Redford‐Badwal Deborah A. , Nainar S.M. Hashim
Published: June 2020

The objective of the study was to investigate various aspects of evidence‐based dental prophylaxis education in postdoctoral pediatric dentistry training programs in the United States. An anonymous nationwide postal survey of fifty‐two postdoctoral pediatric dentistry program directors was conducted in September 2001. The survey had a response rate of 75 percent with all geographic regions of the nation represented and with a preponderance of university‐based programs (62 percent). Most of the training programs (74 percent) routinely recommended dental prophylaxis for all recall patients. The proportion of programs that recommended dental prophylaxis for the following indications were: plaque, stain and/or calculus removal—97 percent; caries prevention—59 percent; prior to topical fluoride application—67 percent; prior to sealant application—62 percent; and for behavioral modification—77 percent. Most training programs (77 percent) defined dental prophylaxis as both rubber cup pumice prophylaxis and toothbrush prophylaxis. However, only one‐half of the training programs (51 percent) had modified their teaching to substitute toothbrush prophylaxis in lieu of rubber cup pumice prophylaxis. In conclusion, only one half of postdoctoral pediatric dentistry training programs in the United States teach evidence‐based practice of dental prophylaxis for recall patients.
Assessing the Effectiveness of a New Curriculum: Part I
Authors: Dagenais Marie E. , Hawley Dana , Lund James P.
Published: June 2020

Although it is important to assess the effectiveness of programs, courses, and teaching methods to ensure that goals are being achieved, it is very difficult to evaluate the impact of fundamental changes in a whole curriculum. This paper reviews measures that have been used in the past in dentistry and medicine for evaluating academic programs: curriculum guidelines; competency documents; discussion and focus groups; competency examinations; board examinations; oral comprehensive examinations; student, alumni, and patient satisfaction surveys; evaluation by instructors; and clinical productivity. We conclude that, since no standard method exists, several tools should be used to obtain a multidimensional assessment.
Curriculum Evaluation of Ethical Reasoning and Professional Responsibility
Authors: Christie Carole R. , Bowen Denise M. , Paarmann Carlene S.
Published: June 2020

This exploratory study evaluated curricular content and evaluation mechanisms related to ethics and professionalism in the baccalaureate dental hygiene program at Idaho State University. Competency‐based education requires enhanced student preparation in ethical reasoning, critical thinking, and decision‐making. Graduates must integrate concepts, beliefs, principles, and values to fulfill ethical and professional responsibilities. Methods included 1) development of five supporting competencies defining ethics and professionalism to provide a framework for curricular evaluation; 2) assessment of all course content and evaluation methods for each supporting competency; 3) evaluation of students' clinical performance based on professional judgment grades; and 4) survey of junior (n=30) and senior (n=27) students' attitudes about dental hygiene practice related to ethics and professionalism. Results revealed that most courses include content and evaluation related to at least one supporting competency; however, authentic evaluation is weak. Clinical instructors rarely relate evaluations to ethical principles or values. Surveys showed significant differences between junior and senior students' attitudes about ethics and professionalism in six of thirty‐four areas (the six were laws and regulations; communication and interpersonal skills; problem solving; professional activities/programs; integrity; and safe work environment). This article shares one approach for evaluating curricular content and evaluation methods designed to develop student competence in ethical reasoning and professionalism. Based upon the study's findings, recommendations are made for curricular enhancement via authentic evaluation and faculty training.
Salivary Biomarkers Associated with Academic Assessment Stress Among Dental Undergraduates
Authors: Ng Vivian , Koh David , Mok Betty Y.Y. , Chia Sin‐Eng , Lim Lum‐Peng
Published: June 2020

This study aims to assess the difference in self‐perceived stress before and after an academic assessment and its association with the marks scored and to study the association of salivary cortisol, Immunoglobulin A (IgA), and chromogranin A (CgA) with stress levels before and after the assessment. Thirty‐one third‐year dental undergraduates indicated how stressed they felt on a 5‐point rating scale just prior to and immediately after a one‐hour written test. Five‐minute unstimulated whole saliva samples were also collected at those times to measure salivary cortisol, IgA, and CgA. Students rated significantly higher stress scores before (median [inter quartile range]: 3[1]), compared to after the test (2[2]) (p=0.015). Higher cortisol levels (mean: 6.32 nmol/l) were observed before than after the exam (mean: 5.16 nmol/l) (p=0.015). No significant differences were noted between the pre‐ and post‐test saliva samples for salivary IgA and CgA levels. A negative correlation was seen between post‐test stress scores and test marks (Spearman's r = ‐0.325, p=0.07). Dental students perceived a higher level of stress prior to the test, which declined after that. Pre‐test stress scores were associated with raised salivary cortisol, but not IgA or CgA. Students who perceived higher levels of stress after the test generally had poorer results.
Caries Vaccines for the Twenty‐First Century
Authors: Smith Daniel J.
Published: June 2020

Can infection with the dental caries pathogen, Streptococcus mutans, be intercepted or modified immunologically? Resolving this question requires answers to many questions: What are the pathways by which this cariogenic streptococcus enters and accumulates in the dental biofilm? Can bacterial components associated with virulence induce immune responses? What is the level of maturity of immune pathways in the oral cavity of the young child at the time of infection? Can immune strategies deal effectively with chronic S. mutans infections? Are these vaccines safe? Many such questions have been answered. For example, preclinical application of modern methods of mucosal vaccine design and delivery has routinely resulted in protection from dental caries caused by S. mutans infection, using antigens involved in the sucrose‐independent or sucrose‐dependent mechanisms of infection by these cariogenic streptococci. Passive administration of antibody to functional epitopes of S. mutans virulence antigens has also provided a degree of protection in preclinical studies and small‐scale human investigations. The caries‐protective capacity of active immunization with dental caries vaccines now awaits proof of principle in pediatric clinical trials.
A Survey of Deans and ADEA Activities on Dental Licensure Issues
Authors: Ranney Richard R. , Haden N. Karl , Weaver Richard W. , Valachovic Richard W.
Published: June 2020

A written survey on issues in clinical testing for licensure was sent to the deans of all dental schools in the United States. Response rate was 89 percent. Results indicate that administrative leaders of the country's dental schools think that third‐party evaluation of graduates is appropriate, but they do not have confidence in current clinical tests for licensure. More than nine out of ten respondents indicated that change was needed in current testing procedures, and 82 percent thought the tests as currently conducted were not valid for decision purposes. Regional differences existed among the responses, with the least dissatisfaction occurring in the West. The highest‐rated and most frequently mentioned reasons for dissatisfaction with clinical tests were the involvement of patients (human subjects) as currently done. Most respondents favored a national level for licensure tests, although the majority also approved of the recently enacted New York law that permits completion of a postgraduate year in an accredited program to substitute for clinical testing. Respondents indicated a belief that a national database on academic measures as compared to outcomes on clinical licensure tests would be useful, with overall grade point average or class rank as the favored academic measure. Informed by the recommendations of its representatives to the AADE‐ADEA Innovative Testing and Educational Methodologies Committee and results of the survey of deans, ADEA is pursuing steps to foster change in the clinical licensure process.
Reflective Learning in Community‐Based Dental Education
Authors: Strauss Ronald , Mofidi Mahyar , Sandler Eugene S. , Williamson Robert , McMurtry Brian A. , Carl Linda S. , Neal Edward M.
Published: June 2020

Learners gain additional value from community‐based education when they are guided through a reflective process. The purpose of this article is to describe how structured reflection assignments and methods are incorporated in the University of North Carolina School of Dentistry's community‐based DISC (Dentistry in Service to Communities) program. The following strategies are described as ways to enrich community‐based learning experiences for dental students: photographic documentation; written narratives; critical incident reports; and mentored post‐experiential small group discussions. Fieldwork and course‐related examples are drawn from community‐based dental experiences to illustrate how reflective teaching approaches can enhance student learning. A directed process of reflection is suggested as a way to increase the impact of the community learning experience.
The American Academy of Developmental Medicine and Dentistry: Eliminating Health Disparities for Individuals with Mental Retardation and Other Developmental Disabilities
Authors: Fenton Sanford J. , Hood Henry , Holder Matthew , May Philip B. , Mouradian Wendy E.
Published: June 2020

Recent reports by Special Olympics International and the U.S. Surgeon General have revealed significant disparities and unmet health needs encountered by persons with mental retardation and other developmental disabilities (MR/DD). Factors contributing to these disparities include deinstitutionalization, increased survival of individuals with MR/DD, lack of appropriately trained providers, and inadequate financing of dental services. To address these problems, a group of academically oriented dentists and physicians formed the American Academy of Developmental Medicine and Dentistry (AADMD). The mission of the AADMD is to improve the quality of health services provided to persons with MR/DD by improving dental and medical school‐based training of dentists and enhancing clinically relevant research. A central theme of the AADMD is full collaboration between physicians and dentists in meeting its goals. The National Action Strategy developed by the AADMD focuses on creating a series of university‐based Developmental Medicine and Dentistry Programs (UDMDPs) in medical and dental schools, which collaborate in service, teaching, and research with community‐based primary care clinics, community hospitals, intermediate care facilities, and other private service delivery systems such as the Special Olympics Healthy Athletes Program that serve these patients. Oral‐systemic interactions will receive special emphasis by the training and research programs.
CASE STUDIES for Dentistry®: Development of a Tool to Author Interactive, Multimedia, Computer‐Based Patient Simulations
Authors: Abbey Louis M. , Arnold Pamela , Halunko Lucy , Huneke Mary Beth , Lee Stacie
Published: June 2020

Computer‐based patient simulations have been used to enhance the dental curriculum since the 1980s. This article describes the development of CASE STUDIES for Dentistry® (CSD), a patient case simulation building template, developed at Virginia Commonwealth University, with which authors who have no programming expertise can create realistic, effective, interactive multimedia patient simulations by entering their own information and images into a straightforward, fill in the blanks interface. This program was written with Authorware®, by Macromedia® Inc. Design considerations included emphasis on information collection and analysis, synthesis of collected information, hypothesis proposal and testing, diagnosis, and treatment planning. The program consists of easily accessible interfaces for both authors and students. Authors build simulated patients using typed‐in text and their own images. Faculty can build computer‐based simulated patients so that students can immediately practice what they learn in class within a simulated doctor‐patient relationship. CSD allows building simulations ranging from simple to complex patients in multiple disciplines. Robust feedback and other features allow students to learn both process and content in a self‐directed, interactive environment.
The New York State Postgraduate Fifth‐Year Dental Residency as a New Licensure Path: Concerns for Public Protection
Authors: Maitland Ronald I.
Published: June 2020

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