bluuebunny/crossref_metadata_2025 huggingface dataset:
The association of oral status with systemic health, quality of life, and economic productivity
Authors: Hollister MC , Weintraub JA
Published: June 2020

It is well established that many systemic adverse health conditions have manifestations in the oral cavity. The purpose of this paper is to summarize the available scientific evidence that describes the opposite effect, how adverse oral health conditions affect three aspects of daily living: 1) systemic health, 2) quality of life, and 3) economic productivity. Examples of oral health affecting systemic health include rheumatic fever patients who develop infective endocarditis from oral bacteria and organ transplant patients who develop severe complications from oral infections. Both systemic health and quality of life are compromised when edentulousness, xerostomia, soft tissue lesions, or poorly fitting dentures affect eating and food choices. Conditions such as oral clefts, missing teeth, severe malocclusion, or severe caries are associated with feelings of embarrassment, withdrawal, and anxiety. Oral and facial pain from dentures, temporomandibular joint disorders, and oral infections affect social interaction and daily behaviors. The results of oral disorders can be felt not only physically and socially but also economically in our society. Dental disease accounts for many lost work and school days. Lower wage earners and minorities are disproportionately affected. Although there are many studies that evaluate these relationships, most are case reports, cross‐sectional studies, or studies restricted to small or unique population groups. Lack of standardized measurements make comparisons across studies difficult. More population‐based and longitudinal studies are needed to better understand the nature of these relationships.
Behavior management techniques in predoctoral and postdoctoral pediatric dentistry programs
Authors: Tilliss TS
Published: June 2020

This study surveyed predoctoral and postdoctoral pediatric dental programs, to determine what behavior management techniques are being taught. The expected didactic and clinical proficiency levels were determined for behavior management techniques in four categories: sedation, restraint, parental presence, and communicative behavior management. Postdoctoral programs expect clinical proficiency in most of the 20 selected management techniques while predoctoral programs expect clinical basic competency in some techniques and do not teach others. Both program levels emphasize communicative behavior management techniques. A high percentage of both programs anticipate no change in the teaching of most of the 20 selected techniques. For both types of programs, less emphasis or elimination of “hand‐over‐mouth” techniques but more emphasis on parental presence for the introductory visit, using positive reinforcement, and using age‐appropriate language and descriptions is anticipated. The two most influential factors affecting these anticipated changes were parental preference and changing standards in pediatric dentistry.
A preliminary study of the effect of eliminating requirements on clinical performance
Authors: Dodge WW , Dale RA , Hendricson WD
Published: June 2020

This study determined the effect of a clinical program driven by patient needs upon students' productivity, attitudes, and academic performance. A group of eight senior students, whose academic and clinical performance profile replicated that of the rest of the class, were chosen to participate in a year‐long non‐requirement clinic. The students were expected to attend all clinic sessions, and treat their assigned patients. Their performance was compared to that of classmates in the regular requirement‐driven curriculum. The non‐requirement group had significantly higher academic achievement and significantly outproduced their classmates. Non‐requirement students had no state board failures, versus 17 percent in the regular curriculum, and reported significantly lower stress. This study suggests that predoctoral clinical programs can maintain quality and productivity in the absence of unit requirements.
The impact of a dental ethics curriculum on moral reasoning
Authors: Bebeau MJ , Thoma SJ
Published: June 2020

This study explored the effects of problem‐oriented dental ethics curriculum, consisting of 39 contact hours distributed over four years on moral reasoning development and on attitudes about the value of instruction. Students (n = 720) in the classes of 1985 through 1992 participated in the required curriculum and completed, as freshman and seniors, the Defining Issues Test (DIT), a well‐validated test of moral reasoning. In addition, students responded to open‐ended questions about the value of ethics instruction. Cross‐sectional comparison of the eight classes of entering freshman with two classes of third quarter juniors (n = 265) who completed the DIT prior to implementing the ethic curriculum indicated that the dental curriculum offered prior to 1981 had little influence on moral reasoning. Pre‐ to posttest DIT comparisons for seven of the eight classes of instructed students indicated statistically significant improvement. Comparison of the effect sizes (Cohen's d) of our intervention with the average effect size reported in a meta analysis of effective interventions indicates that results cannot be attributed to student maturation alone. Analysis of individual change patterns suggest that the success occurred despite a higher than average (17 percent vs. 6 percent) number of students who showed regression from pre‐ to posttest. Substantive explanations (gender, motivation, regression to the mean) did not appear to account for the change patterns, but theoretical explanations, based on observations in other settings, offer insights for further research and curriculum development. In conclusion, the results indicate that students not only benefit from ethics instruction, but value it.
Issues in dental curriculum development and change
Authors: Tedesco LA
Published: June 2020

Lessons from other places present several diverse suggestions for the dental curriculum's continuing improvement. Models from other professional education venues (medical schools), conceptual frameworks for self‐reflection (ethos), and the scientific bases for learning and teaching (cognitive psychology) demonstrate that an interplay of factors must be addressed to advance the curriculum.
Dental hygienists' information seeking and computer application behavior
Authors: Gravois SL , Bowen DM , Fisher W , Patrick SC
Published: June 2020

A questionnaire requesting information on information seeking, critical analysis, and computer applications was returned in 1992 by 136 of 197 (69 percent) currently licensed dental hygienists residing in Alaska, Delaware, and Idaho. The most common sources used for professional development and information retrieval were continuing education courses, discussions with colleagues, and journals. The respondents' own experience, credibility of the journal, and discussions with colleagues were the most frequent methods used to evaluate professional information. Many hygienists owned or had access to a computer, yet they rarely conducted online database searches to obtain professional information. The computer was primarily used to perform business functions rather than for clinical applications in these dental hygienists' employment settings. The majority of these hygienists were interested in attending related continuing education courses and indicated that computer skills should be part of dental hygiene curricula.
A survey of minority student recruitment and retention efforts in dental schools
Authors: Chalkley Y
Published: June 2020

What I have tried to do is to provide a way that we can look at overall recruitment and retention of our minority students. As you can see from the results of the survey, some of us are doing a lot, some not so much. About 10% of the colleges have many of the components of retention suggested within this schema. Some of us are seeing results of our efforts–with many of us reporting that the attrition of minority students is equal to less than that of majority students–yet many of us feel that much more can be done to improve the total environment for our minority students. You will recall the word used the most in your responses, “more”, more of nearly everything. I am sure you join with me in looking forward to the presentations during our conference so that we may find ways to increase our efforts. We do not want in the future for either us or our students to again sound like Oliver Twist when he pleaded “Please Sir, I want some more”.
Legal issues of the electronic dental record: security and confidentiality
Authors: Szekely DG , Milam S , Khademi JA
Published: June 2020

Computer‐based, electronic dental record keeping involves complex issues of patient privacy and the dental practitioner's ethical duty of confidentiality. Federal and state law is responding to the new legal issues presented by computer technology. Authenticating the electronic record in terms of ensuring its reliability and accuracy is essential in order to protect its admissibility as evidence in legal actions. Security systems must be carefully planned to limit access and provide for back‐up and storage of dental records. Carefully planned security systems protect the patient from disclosure without the patient's consent and also protect the practitioner from the liability that would arise from such disclosure. Human errors account for the majority of data security problems. Personnel security is assured through pre‐employment screening, employment contracts, policies, and staff education. Contracts for health information systems should include provisions for indemnification and ensure the confidentiality of the system by the vendor.
The electronic window to the world
Authors: Zimmerman JL
Published: June 2020

Computer networking is a fundamental change in communication technology that carries with it the same significance as the development of human language. The discovery of new tools adds to the human experience, but the ability to communicate and share that knowledge and wisdom results in a factorial increase in the collective wisdom of a global community. This paper presents a brief history and overview of the Internet and then discusses how network application tools can be used in dentistry. Examples of various implementations will be given and a brief discussion of some constraints to implementation of network technology is also included.
New premises and new tools for medical care and education
Authors: Weed LL
Published: June 2020

New information tools enable us to leave behind a world of medical practice in which providers of all sorts have been allowed to operate in the face of avoidable ignorance‐ignorance of many relevant details from the medical literature as well as ignorance of details about a given patient. Furthermore, the new tools release providers and patients alike from the “predictable and undesirable internal constraints” of the unaided human mind as it tries to process vast amounts of information in the course of everyday medical care.
Perceived environmental stressors for dental hygiene students
Authors: Roberts RA , Ellingson PL
Published: June 2020

This study identifies stressors for dental hygiene students and examined significant differences in stress levels between first‐ and last‐year dental hygiene students and between dental hygiene and dental students. A modified dental environmental stress (DES) questionnaire was utilized to determine the sources of stress. The questionnaire was completed by 153 (93 percent) first‐ and last‐year dental hygiene students from four programs. Seven stressors were among the top ten stress items cited by both classes of dental hygiene students; seven other stressors exhibited significant differences (p = .01). The authors' hypothesis is that some of these stressors may be remediable. Seven of the top ten stressors for first‐year dental hygiene and dental students were shared, while ten exhibited significant differences. Among last‐year students, eighteen items were significant, and seven of the top ten stressors were the same.
The role of health services research in the renaissance of the dental profession
Authors: Grembowski D
Published: June 2020

Health services research may play a critical role in achieving the recommendations of the IOM study. Toward this end, the field of health services research is defined. Applications of health services research to health outcomes, patient care, and other IOM directives are reviewed. Alternative approaches to building the capacities of dental schools to conduct health services research are presented.
Orthodontic residents' indications for use of the lateral TMJ tomogram and the posteroanterior cephalogram
Authors: Luke LS , Lee P , Atchison KA , White SC
Published: June 2020

The purpose of this study was to determine the selection criteria used by orthodontic residents for ordering a corrected lateral tomogram (LT) of the temporomandibular joint (TMJ) and a posteroanterior cephalogram (PAC) for the diagnosis of patients needing orthodontic care. The impact of the radiographs on their treatment plans was also assessed. We conducted a study of the 144 new patients assigned to eight orthodontic residents during a two‐year period. The residents responded through questionnaires describing their rationale for ordering the radiographs. A LT was ordered for twenty‐eight (19 percent) of the patients. The most common reasons cited for requesting the LTs were TMJ clicking (67 percent) and pain (33 percent). The residents also perceived a need to order the LT for medico‐legal protection in 85 percent of these cases. The LT tended not to have an impact on treatment planning. A PAC was ordered thirty‐eight times (26 percent). The most common reasons cited by residents for ordering a PAC included clinical findings of facial asymmetry (41 percent) and maxillary airway anatomy (24 percent). Medico‐legal protection was a perceived need in only 12 percent of the cases. While the PAC had no impact on treatment planning for 56 percent of the cases, they did define the transverse problems as dental or skeletal for 38 percent of the cases. Six patient traits were statistically associated with PAC requests: difficulty chewing, abnormal TMJ, TMJ clicking, facial asymmetry. crossbite, and midline discrepancy. The teaching of appropriate selection criteria for ordering these radiographs needs to be emphasized early in a resident's training.
Teaching physiology to predoctoral dental students
Authors: Robertson LT
Published: June 2020

A survey was sent to the physiology course directors of the fifty‐three dental schools in the continental United States. Information was collected regarding the type of instructional arrangements, course content and emphasis, and amount and type of nondidactic instruction. Responses were obtained for forty‐eight courses, all of which covered the core topics of physiology, although twelve schools taught neurophysiology as part of a neuroscience course. Combined medical and dental student (MS+DS) courses used six to fourteen hours of nondidactic instruction per core topic, whereas the courses taught by dental school‐(DS‐B) or medical school‐based instructors used 0.5 to 2.6 hours per topic. Courses combining dental students with other nonmedical professional students used mainly didactic instruction. While most dental school physiology courses continue to rely on traditional didactic instruction, a few schools integrate physiology with other basic science and clinical courses, include problem‐solving exercises, and offer advanced physiological topics during the clinical years. Consequently, there is considerable potential for change in predoctoral physiology instruction.
General dentistry grant program: 1976–1996
Authors: Duffy R , Weaver RG , Hayes KL
Published: June 2020

The federal general dentistry grant program supports the development of new programs and first‐year positions in postdoctoral general dentistry (PGD) education. One hundred and fifteen institutions have participated in the grant program since awards were first made in 1978. The grant program assisted in establishing 59 new PGD programs and 560 new positions. Eighty‐eight percent of the new programs are still in operation; 69 percent of the positions are still being filled. These retained programs and positions represent 72 percent and 77 percent of the net growth in PGD programs and positions, respectively, that has occurred since 1977.
Patient caries status in the context of practical, evidence‐based management of the initial caries lesion
Authors: Pitts NB
Published: June 2020

This consideration of the determination of patient caries status in the context of practical, evidence‐based management of the initial caries lesion relates to assessments of caries in individuals. It provides the diagnostic basis for the related topics of radiographic monitoring, caries activity testing, and lesion management strategies that follow in subsequent papers. The “totality” of caries experience must be recognized in making individual assessments; this ranges from sub‐clinical, to initial, and then dentinal (including hidden) lesions. The detection of initial and dentine lesions using existing diagnostic tools is imperfect and to an extent unreliable, but, notwithstanding the limitations of existing technology, this step is of pivotal importance. Similarly, the measurement of lesion extent and depth by existing methods is problematic but possible. Having identified different types of caries, categorization of lesions by the appropriate management “option” permits clear statements of intent to be made to both patients and dental funding agencies. The NAC/PCA/PCA + OCA system is suggested as a simple and explicit method of describing caries status for individual lesions and for communicating their current caries status to patients.
Effectiveness of an endodontic diagnosis computer simulation program
Authors: Fouad AF , Burleson JA
Published: June 2020

The effectiveness of a recently developed endodontic diagnosis computer simulation program was examined. Third‐year dental students (n = 90) in three successive academic classes were given a pre‐test in endodontic diagnosis before any endodontic instruction, and then received ten lectures on diagnostic techniques, endodontic pathology, and radiographic interpretation. The students were subsequently divided into three equal groups not differing statistically on their pre‐test results. The first group used an endodontic computer simulation program containing fifteen patient simulations for one hour. The second group had a small‐group seminar aiming to cover the same material as in the computer program in the same time period. The third group (control) had no further instruction. The three groups then took a post‐test to evaluate their diagnostic knowledge in endodontics. The improvement of scores from pre‐ to post‐test in the three groups were statistically different (p = 0.018). The simulation group students improved significantly more than the seminar group (p = 0.05) and the Control Group (p = 0.0024). Difference in improvement between the seminar group and the control group was not statistically significant (p = 0.20). Students were able to cover more cases on average using the simulation program than were covered in the seminar (t‐test, p < 0.0001).
Assessment of preclinical problem‐based learning versus lecture‐based learning
Authors: Login GR , Ransil BJ , Meyer M , Truong NT , Donoff RB , McArdle PJ
Published: June 2020

Academic performance on a standardized oral comprehensive exam (OCE) was compared for students taught basic science in a problem‐based learning (PBL) curriculum and a lecture‐based learning (LBL) curriculum. The OCE was administered to the graduating classes of 1991–1994 (n approximately 20/class) six months after completion of their basic science courses. The OCE contained six components including: Organization and Thoroughness, Diagnosis, Primary Treatment Plan, Alternate Treatment Plan, Science and Medical Knowledge, and Dental Knowledge. Six to eight examiners graded each of the students by using a standardized scoring system and by subjective comments. The class of 1991 was taught by LBL, classes of 1993 and 1994 by PBL, and the class of 1992 by an incomplete PBL teaching method. Mean OCE scores were not significantly different between classes; however, the Science and Medical Knowledge component score was significantly better for the class of 1994 than for 1991 (p < 0.05). There was a non‐significant 40 percent increase (p = 0.07) in honors and a 269 percent (p < 0.001) increase in cumulative positive examiner comments between 1991 and 1994.
Linking postdoctoral general dentistry programs with community‐based clinical care settings
Authors: Weaver RG , Gray CF , Demby NA , Cinotti WR , Clark NP , Hicks JL
Published: June 2020

This article presents the results of a small workgroup convened by the American Association of Dental Schools to examine experiences related to establishing and conducting dental education programs that have significant affiliations with community‐based clinical care settings. The workgroup meeting is a component of the association's effort to identify and promote innovative and non‐traditional methods by which the number of postdoctoral general dentistry (PGD) positions can be increased to meet current demand for PGD education. The participants identified factors and conditions believed to be critical to successful program linkages. The information should be helpful to others as they consider opportunities to establish PGD programs or increase their number of PGD training positions.
The effect of magnification on student performance in pediatric operative dentistry
Authors: Donaldson ME , Knight GW , Guenzel PJ
Published: June 2020

Previous research has shown that accurate student self‐evaluation is related to higher quality dental products. Variance in student performance still remains. Enhancement of visual perception could contribute to product improvement. Only one study has evaluated the effects of magnification on simulated dental patient care. The present study sought to determine if magnification had a positive effect on student‐generated products in pediatric amalgam preparations. Fifty‐two third‐year students were randomly assigned to experimental (magnification) or control (no magnification) groups. Members of the experimental group used magnification in their daily work in the pediatric dentistry clinic. No significant differences between the groups' preparations or evaluations of standard preparations were found. Further study should address these issues: 1) possible effects of specific training in the use of magnification devices; 2) whether the tolerance for error in dental preparations is so great that finer vision contributes little to product improvement; 3) the role of tactile sensation in evaluation and preparation; and 4) the possible benefits of magnification for effect of age. Based on this study, it seems that requiring students to purchase magnification devices may not be justified.
Dental fear among university employees: implications for dental education
Authors: Kaakko T , Milgrom P , Coldwell SE , Getz T , Weinstein P , Ramsay DS
Published: June 2020

We surveyed 350 University of Washington permanent employees chosen randomly from among both faculty and staff. The aim was to determine the extent and nature of dental anxiety in the university population potentially available for teaching clinics. In addition, the relationship of fears to self‐reported dental health, utilization of dental care, and other general and mental health issues was examined. Dental anxiety was prevalent in this population; 13 percent of subjects reported high dental fear. In contrast to respondents with lower dental fear, subjects with clinically significant fear reported poorer perceived dental health, a longer interval since their last dental appointment, a higher frequency of past fear behaviors, more physical symptoms during last dental injection, and higher percentage of symptoms of anxiety and depression. Dental anxiety was not associated with poorer perceived general health or a longer interval since the last dental injection. University employees are a rich source of potential teaching patients for achieving curricular requirements for managing anxious patients. Student clinicians need guidance to be able to recognize fearful patients; they also need instruction about psychiatric conditions like anxiety and depression in order to be able to better manage and prevent dropouts in their patient roster.
Assessment of ergonomic education in dental hygiene curricula
Authors: Beach JC , DeBiase CB
Published: June 2020

An investigation was conducted to determine the existence and extent of ergonomic education in dental hygiene curricula to prevent musculoskeletal disorders (MSDs). A survey was mailed to the 216 accredited dental hygiene programs in the United States with items addressing demographics, existence and extent of basic and additional ergonomic education, continuing education sponsorship, and incidence of musculoskeletal pain in students. The majority of dental hygiene programs provide basic ergonomic education (patient/operator positioning and instrumentation), but additional education (beyond patient/operator positioning and instrumentation; for example, body mechanics or preventive exercises) is generally unavailable or available only on a limited basis to dental hygiene students. The most frequently cited reasons for the lack of additional education were a lack of space in the current curricula and that this type of education was never discussed as a possibility. Integration of ergonomic education in dental hygiene curricula may help prevent MSDs in dental hygienists by enabling them to begin their dental hygiene careers with awareness of MSDs and good ergonomic work habits.
Survey of the information‐seeking patterns of dental hygienists
Authors: Covington P , Craig BJ
Published: June 2020

This descriptive study explored the methods that dental hygienists in northern British Columbia have utilized to access information. A self‐administered questionnaire sent to 130 dental hygienists registered in that geographic experienced a response rate of 81.5 percent. The respondents preferred and utilized traditional information sources such as discussions with colleagues, journal articles, and mailings from professional associations and licensing bodies. The least utilized information sources were the indices to the literature and electronic information sources. Geographic isolation, lack of electronic information sources, and costs were identified as the top three barriers to information access. Dental hygienists may need to acquire or improve computer literacy skills while in school and through continuing education to enable them to use the newer methods of electronic information retrieval and communications because dental hygienists need to access a variety of information sources to provide quality care.
Time management behaviors as potential explanatory factors in dental academic achievement
Authors: Mace JG , Tira DE
Published: June 2020

DAT scores and predental GPAs have made the greatest but an imperfect contribution to the reliable estimation of dental students' academic success. One variable unaddressed yet having potential in accounting for unexplained variability in dental school performance is time management behaviors (TMB), a multidimensional attribute that is critical to success in a dental curriculum. Research has indicated a relationship of TMB dimensions (Setting Goals and Priorities, Mechanics of Time Management, Preference for Organization) with undergraduate academic achievement. The purposes of this study were: 1) to ascertain the levels of TMB dimensions reflected in predental students; 2) to validate in predental students the relationship of TMB dimensions and undergraduate academic achievement; and 3) to explore the relationship of TMB dimensions of predental students as explanatory variables of their early academic achievement in the dental curriculum. All individuals who were applicants interviewed for the 1997 entering D.D.S. class and the majority of members of the 1996 entering D.D.S. class participated in this study (n = 192). Each completed the TMB scale. High levels of TMB across dimensions were observed in predental and dental students. Unlike prior research, results showed virtually no relationship of TMB dimensions with undergraduate GPA of these subjects. Though a small relationship was found between dimensions and first‐year dental GPAs, no dimension explained a significant amount of variance in any of these dental GPAs beyond that of undergraduate science GPA.
The hepatitis B e‐antigen positive dental school applicant
Authors: Fredekind RE , Cuny EJ , Peltier B , Carpenter WM
Published: June 2020

There are few guidelines available for dental school faculty and administrators in the management of hepatitis B e‐antigen positive (HBeAg+) dental school applicants. It is apparent that this serostatus is unique and requires a different approach from that used for applicants with other infectious diseases, such as the human immunodeficiency virus (HIV). The issue is examined from a number of perspectives, including the science, policy, legal, and ethical considerations confronted in establishing a policy for the HBeAg+ dental school applicant.
Developing a competency‐based curriculum for a dental hygiene program
Authors: DeWald JP , McCann AL
Published: June 2020

A three‐step process was used that involved developing a competency document, an evaluation plan, and a curriculum inventory. The competency document, Competencies for the Dental Hygienist, included three domains, nine major competencies, and fifty‐four supporting competencies. These became the department's educational goals. The evaluation plan included multiple methods for assessing each of the nine major competencies. The faculty initially identified evaluation methods that were currently in place and then added strategies for the various gaps in the plan. The curriculum inventory defined the entire curriculum in terms of the competencies. For each supporting competency, there was a list of major and foundation topics, each linked to specific courses. The strategy used to identify both the evaluation methods and curriculum topics was to survey the faculty. Information from assessments and the curriculum inventory directed the modification of the curriculum for alignment with the competencies. This process has resulted in improvements in teaching, evaluation, and student learning. The strengths and weaknesses of this competency‐based curriculum development are presented, with specific recommendations for other‐programs undergoing similar curriculum development.
Influence of practice and personal characteristics on dental job satisfaction
Authors: Wells A , Winter PA
Published: June 2020

Job satisfaction has been called a barometer of the dental profession. The Dentist Satisfaction Survey (DSS), an instrument that measures both specific facets related and overall job satisfaction of dentists, was administered to general dentists in Kentucky (N = 987). Independent variables included eleven job facets, plus practice characteristics and personal characteristics including student loan debt. Results of the stepwise multiple regression showed that 60 percent of the variance of the dependent variable, overall job satisfaction, was attributable to six job facets: respect, perception of income, delivery of care, stress, patient relations, and professional time. The most significant predictors of dental job satisfaction involved the intrinsic rewards of being a dentist and the delivery of dental health services. Less satisfying aspects of dentistry included business operations, including practice management and financial planning. Despite concern among educators about the potential influence of student loan debt, there was no significant correlation between student loan debt and overall job satisfaction. Findings from this study have implications for student recruitment, dental school curriculum design, and dental workforce planning.
Using choice‐based conjoint to determine the relative importance of dental benefit plan attributes
Authors: Cunningham MA , Gaeth GJ , Juang C , Chakraborty G
Published: June 2020

The purpose of this study was to use conjoint analysis to determine the importance of specific dental benefit plan features for University of Iowa (UI) staff and to build a model to predict enrollment. From a random sample of 2000 UI staff, 40 percent responded (N = 773). The survey instrument was developed using seven attributes (five dental benefit plan features and two facility characteristics) each offered at three levels (e.g., premium = $20, $15, $10/month). Pilot testing was used to find a realistic range of plan options. Twenty‐seven hypothetical dental benefit plans were developed using fractional factorial combinations of the three levels for each of the seven attributes. For all of the hypothetical plans, dental care was to be provided in the UI predoctoral dental clinic. Plan profiles were arranged four per page by combining the existing plan with three hypothetical plans, for a total of nine pages. Respondents' task was to select one plan from each set of four. A regression‐like statistical model (Multinomial Logit) was used to estimate importance of each attribute and each attribute level. Relative importance (and coefficients) for each of the seven attributes are as follows: maximum annual benefit (.98), orthodontic coverage (.72), routine restorative (.70), major restorative (.67), time to complete treatment (.61), clinic hours of operation (.47), premium (.18). For each attribute, relative importance of each of three levels will also be presented. These coefficients for each level are used to predict enrollment for plans with specific combinations of the dental benefit plan features.
The effect of an extramural education program on the perceived clinical competence of dental hygiene students
Authors: Butters JM , Vaught RL
Published: June 2020

The purpose of this study is to evaluate the effect of an extramural rotation on dental hygiene student self‐perceptions of competence in specific clinical areas. Dental hygiene students attending one midwestern university from 1992 through 1998 rated their perceived level of competence on nineteen dimensions of dental hygiene practice prior to beginning a four‐week extramural rotation and again at the completion of the rotation. Results indicated that student perceptions of competence improved significantly on six of the nineteen dimensions in each of the study years. Study results suggest that an extramural rotation is a valuable component of a dental hygiene curriculum to enhance student self‐perceptions of clinical competence.
Use of discriminant and regression analyses to modify a clinical certification board examination
Authors: Gerrow JD , Boyd MA , Scott DA , Boulais AP
Published: June 2020

The National Dental Examining Board of Canada (NDEB) conducts mandatory, high stakes, pass/fail, certification examinations for dental licensure. One of these examinations was a seven‐part, simulated clinical examination in which candidates were required to perform procedures on typodonts. These requirements were two intracoronal and two extracoronal preparations, an amalgam restoration, a provisional crown, and a diagnostic wax‐up. Feedback from candidates and examiners indicated that one or more of the requirements may not have been contributing effectively to the overall evaluation of candidates. The NDEB's Clinical Examination Committee therefore requested that an in‐depth statistical analysis be performed to identify potential areas of concern and to provide a basis for modifying the examinations. The results of two examination sessions with a total of 168 candidates were subjected to both a discriminant and a logistic regression analysis. Every candidate had results for each of the seven requirements, and no candidate participated in both sessions of the examination. The discriminant analysis revealed that six of the seven requirements could be used to reliably assign examinees according to their true pass/fail classifications. Stepwise discriminant analysis resulted in a 98.81 percent classification success rate with a corresponding 2.50 percent false‐positive classification error rate. The logistic regression analysis showed that five components correctly predicted 99.40 percent with a 1.25 percent false‐positive rate. The Clinical Examination Committee concluded that one requirement (diagnostic wax‐up) should be eliminated and that a second requirement (PFM preparation) be significantly modified and reevaluated. This study demonstrates the usefulness of statistical methods in the analysis and modification of a clinical certification board examination.
Postdoctoral education in dentistry: preparing dental practitioners to meet the oral health needs of America in the 21st century
Authors: Glassman P , Meyerowitz C
Published: June 2020

There has been increasing interest in the organization and accreditation of Postdoctoral General Dentistry Programs (PGD). In addition, numerous national organizations have called for increases in the number of first postdoctoral year (PGY‐1) positions and programs. At the same time there has been a movement to incorporate concepts of competency‐based education into dental education programs in order to stress the outcomes of education rather then the process. These movements have coincided with an increased recognition that dental education will be affected by the changing demographics of our population, the emerging trends in health care delivery and financing, and the need for an increase in the number of primary care providers in dentistry, trained at an advanced level, who are capable of caring for an increasingly socially diverse and medically complex population in our country in the next century. This paper reviews the history of postdoctoral education programs in dentistry and medicine with a focus on PGD education, describes the changing health care environment in which future dental professionals will practice, and relates the dental postdoctoral experience to that in medicine. A strategy is presented for the dental profession to prepare dental practitioners with the competencies needed for the future and to create enough training opportunities to prepare these practitioners to care for the oral health needs of the nation. This proposal calls for a “National Consensus Development Conference on the Future of Postdoctoral Primary Care Education in Dentistry”. This conference would define the strategies necessary to prepare dental practitioners with the competencies needed for the future and develop approaches to create enough training opportunities to prepare these practitioners to care for the oral health needs of the nation.
Infection and exposure control in North American dental schools
Authors: Sampson E , Dhuru VB
Published: June 2020

The results of a survey sent to all U.S. and Canadian dental schools clearly indicate that several substantial changes have occurred in infection control and exposure control in the past fifteen to twenty years. Predominant among these are that the responsibility for instrument preparation and sterilization in most schools has passed from the student to trained staff, the routine practice of universal precautions has eliminated the need to treat patients known to carry bloodborne diseases in a special area, and pre‐admission and enrollment vaccination and health screening requirements have changed significantly. Other important changes result from the fact that the majority of U.S. schools responding to the survey are now, to a great extent, in compliance with the OSHA Bloodborne Pathogens Standard or equivalent requirements.
An association perspective: responding to the American Dental Association's future of dentistry project
Authors: Hutchinson RA , Haden NK , Valachovic RW
Published: June 2020

In response to the American Dental Association's (ADA) Future of Dentistry Project, the American Dental Education Association (ADEA) provided its perspective on the most critical issues facing the dental profession. ADEA responded in six areas, each corresponding to the areas of focus in the ADA project. The comments in this Association Report reflect those provided to the six panels conducting the project.
Issues of academic integrity in U.S. dental schools
Authors: Beemsterboer PL , Odom JG , Pate TD , Haden NK
Published: June 2020

Evidence of violations of academic integrity can be identified at all levels of education. A survey on academic integrity was mailed in 1998 to the academic deans of all fifty‐five U.S. dental schools, with a response rate of 84 percent. This survey showed that reported incidents of academic dishonesty occur in most dental schools, with the average school dealing with one or two cases a year. The most common incidents of dishonest behavior involved copying or aiding another student during a written examinations; the second most common involved writing an untrue patient record entry or signing a faculty member's name in a patient chart. Respondents indicated the major reason for failure to report academic dishonesty was fear of involvement because of time and procedural hassles and fear of repercussions from students and peers.
An initial evaluation of the Iowa Dental Surgical Simulator
Authors: Johnson L , Thomas G , Dow S , Stanford C
Published: June 2020

The University of Iowa colleges of dentistry and engineering are collaborating to build an effective but low‐cost surgical simulator that uses force feedback to teach and assess the tactile skills of dentistry. A prototype simulator was built, and a formative evaluation examined the realism of the haptics and identified directions for future work. Using a cross‐over design, twelve experienced practitioners probed two virtual teeth using two instruments attached to the force feedback device. The session was videotaped, the forces recorded, and a standardized questionnaire completed. Two analyses were conducted: an ANOVA examined practitioners' questionnaire responses, and a t‐test analyzed the probing forces. Significant tooth order by instrument order interaction and instrument effects were found. Practitioners were generally satisfied. They preferred a standard joystick to an explorer, felt that two‐dimensional graphics were sufficient, and emphasized that the existing vibration be eliminated. Random placement of caries should help teach generalized skills.
U.S. dental school applicants and enrollees: a ten year perspective
Authors: Weaver RG , Haden NK , Valachovic RW
Published: June 2020

Applications to dental schools increased throughout the 1990s until 1997. In 1998 this pattern reversed, and the number of dental school applicants has dropped each year since that time and continues to decline through the application cycle for the 2001–2002 first‐year class. Possible reasons for the decline in applications include an abundance of financially rewarding career opportunities fueled by the robust U.S. economy, a reluctance by college students to assume more educational debt, an unfavorable view of healthcare careers in the light of managed care and declining federal reimbursement, and assumptions about the difficulty of gaining admittance to dental school given the high academic achievement of those who have been admitted in recent years. A national decline in the applicant pool does not necessarily translate into a decline for any given dental school. The quality of applicants, judged by grade point averages and Dental Admissions Test scores, is high. Nevertheless, the recent drop in dental school applicants is a cause for concern. Because recruitment must be approached as a process that takes years to yield results, stakeholders in dental education need to sustain vigorous recruiting efforts even in the best of times.
The influence of a workshop on dental students' perceptions about sexual harassment
Authors: Lillich TT , Webster DB , Marshall EO , Smith TA , Seaver DC , Szeluga MA
Published: June 2020

The objective of this study was to determine the effects of a workshop on the sexual harassment perceptions of students at the University of Kentucky College of Dentistry. Responses to a twenty‐six‐item questionnaire were elicited from 147 first‐through fourth‐year students before and after they attended a two‐hour sexual harassment workshop. Five questions explored students' personal experiences with sexual harassment; twenty‐one questions addressed students' attitudes about sexual harassment. The repeated measures option of the SPSS General Linear Model statistical program was used to individually analyze the Likert‐type scale response to the twenty‐one attitude items for the following variables: gender, year in dental education, and whether respondents had been sexually harassed or had observed harassment of others. Workshop participation significantly changed some student attitudes about sexual harassment regardless of gender, year in dental education, or whether they had been harassed personally or had witnessed harassment of someone else (p < .05). There were also significant gender‐related differences in the direction and magnitude of change in pre‐ versus post‐workshop responses to several attitude items (p < .05). Workshop participants were better informed about and more sensitive to a wide range of sexual harassment issues. The workshop empowered students, especially females, to help create an environment that minimizes the probability of sexual harassment. This may be possible because, after the workshop, participants better understood institutional policies and procedures to handle complaints, including provisions for protection from retaliation if they do file a grievance. This knowledge and sensitivity may result in an environment that facilitates the education of beginning general practitioners who are competent, empathetic, and sensitive.
A survey of neuroscience courses for predoctoral dental students
Authors: Robertson LT
Published: June 2020

Course directors of the seventeen neuroscience courses offered in U.S. dental schools were surveyed. Information was obtained about the course organization, topics covered, and the amount of didactic and nondidactic instruction for sixteen neuroscience courses, which included four courses that combined medical and dental student instruction. The courses averaged 51.4 contact hours with a range of 11 to 110 hours. Approximately 75 percent of time was for didactic instruction. Most courses emphasized neuroanatomy, electrochemical cell signaling, and the somatic sensory system, including specific lectures on pain sensation. The majority of courses also included several lectures on topics dealing with motor control and the limbic and the autonomic systems, whereas limited time was allocated to topics concerned with higher cortical functions. The nondidactic instruction typically included neuroanatomy laboratories and group discussions of the relation between lesions of sensory and motor pathways and neurological signs. The establishment of guidelines for neuroscience could encourage dental schools to provide a strong basic science foundation in neuroscience.