bluuebunny/crossref_metadata_2025 huggingface dataset:
General Dentists and Special Needs Patients: Does Dental Education Matter?
Authors: Dao Loan P. , Zwetchkenbaum Samuel , Inglehart Marita Rohr
Published: June 2020

Special needs patients are one of the underserved dental patient groups in the United States. This study investigates whether undergraduate dental education about special needs patients affects general dentists’ a) professional behavior, b) practice characteristics, and c) attitudes concerning special needs patients. Data were collected from 208 general dentists (178 male/30 female; average age: 49.85 years) who were members of the Michigan Dental Association. The more the respondents agreed that dental education had prepared them well, the more likely they were to treat various types of special needs patients and to set up their practices so they could treat them and the more they liked treating these patients. In conclusion, most general dentists did not think their undergraduate dental education had prepared them well to treat special needs patients. However, the better they reported to have been educated, the more likely they were to treat special needs patients. Given the access to care problems for many special needs patients, it seems crucial to revise dental curricula and provide more didactic and clinical education concerning the treatment of special needs patients.
Use of Computer Technology to Modify Objective Structured Clinical Examinations
Authors: Holyfield Lavern J. , Bolin Kenneth A. , Rankin Kathleen V. , Shulman Jay D. , Jones Daniel L. , Eden Becky DeSpain
Published: June 2020

Objective structured clinical examinations (OSCEs) are multistationed clinical examinations that have been shown to be effective in testing students’ ability to integrate the knowledge, skills, and attitudes acquired during their preclinical and clinical training and experiences. The original OSCE for the third‐year Preventive Dentistry course at Baylor College of Dentistry was based on the traditional format consisting of four sections of twelve stations with a group of twelve students rotating through each of the sections simultaneously. This arrangement allowed for examination of one‐half of the class. The other half of the class took the exam on an alternate date. To reduce the disruption caused by the students’ moving from station to station and to allow for examination of the entire class in one setting, the traditional concept was modified using computer technology, and the twelve stations “moved” via a PowerPoint presentation while students remained stationary. Questions on both exams provided a means for testing data interpretation, diagnostic skills, and, to some extent, interpersonal skills. The overall atmosphere during the computer‐based examination was less chaotic. Each student received identical instructions, explanations, and time allotments to respond to the information presented. The ratio of faculty to students required to monitor the exam was less than required for the traditional format. Additionally, since there was no need to allow time for student transition, the total time required to administer the exam was reduced. Thus, objective assessment of the entire class was accomplished using fewer faculty members and less class time and with less disruption for the students.
Students’ Comfort Level in Treating Vulnerable Populations and Future Willingness to Treat: Results Prior to Extramural Participation
Authors: Kuthy Raymond A. , McQuistan Michelle R. , Riniker Katharine J. , Heller Keith E. , Qian Fang
Published: June 2020

This study analyzed senior dental students’ perceptions prior to extramural rotations for comfort and future willingness to treat patients with special needs and other vulnerable groups. The sample included 690 University of Iowa senior dental students who graduated from 1992 through 2004. These students completed a questionnaire concerning twelve vulnerable population groups. Logistic regression models were performed, using student comfort and future willingness to treat each group as the dependent variable. There was a wide percentage of range of comfort with these groups, yet there was no individual group that more than 60 percent of these students were willing to treat in their future practices. Generally, prior experience with the group had a positive impact on comfort level. When gender was included in the regression models, male students were more likely to express comfort. In all instances except one, experience had a positive influence on perceived future willingness to treat the associated group. However, younger graduates had a greater willingness to treat. When controlling for other variables within the future willingness to treat models, comfort was statistically significant only for HIV+/AIDS and non‐English speaking groups. This study provides insight about comfort with and perceived future willingness to treat special needs and other vulnerable patient groups.
Further Dialogue on Ethics in Dental Education: A Response to the Koerber et al. and Jenson Articles
Authors: Bertolami Charles N.
Published: June 2020

In this article, I respond to the critiques of my article “Why Our Ethics Curricula Don't Work” (J Dent Educ 2004; :–25) by Koerber et al. and by Jenson that are published in this issue. I maintain that there are assertions ascribed to me by Koerber et al. that are not contained in my original work. These include the assertions that “ethics in dental schools should be taught as a precurriculum prior to entering dental school, that the dental school ethics course should be elective,” and that the precurriculum should replace existing ethics courses rather than supplement them. My original article proposed a need to supplement the existing courses (not to replace them or make them electives) and that this supplementary experience should come “very early in the dental educational experience to address the disconnect between knowledge and action.” Further, I qualify Jenson's opinion that we can say our ethics curriculum does work as true only when we ask little of it, and the less we ask, the more successful it will appear to be.
Comparing Standardized Measures of Diligence and Achievement with Dental Student Academic Performance
Authors: Jedrychowski Joseph , Lindemann Robert
Published: June 2020

Utilizing a reliable and valid instrument to measure a student's application of energy and effort towards a goal (diligence) or the ability to reach goals (achievement) would enable dental educators to anticipate academic performance. This knowledge could be used to better distribute faculty and educational resources, as additional tutors could be provided for students who score low on diligence and achievement instruments. In this study, fourth‐year dental students completed the Diligence Inventory and the NachNaff Scale (which measures desire to achieve) immediately prior to graduation. The scores from both inventories were correlated with nine measures of academic performance. For males, the NachNaff Scale positively correlated (p<.05) only with the quantity of exceptional performance reports (EPR) and for females negatively correlated only with science DAT scores. The modest positive correlations, which differ for gender, suggest that the NachNaff may be of limited use to predict dental student performance. For males, the Total Diligence mean positively correlated with EPR and National Board Parts I and II scores. For females, the Total Diligence mean positively correlated with EPR and a predental biology‐chemistry‐physics grade composite. Given the simplicity of the Diligence Inventory and its significant correlations with academic performance demonstrated in this study, it appears to be a useful tool to gain insight into students’ diligence in striving to obtain goals.
Family Medicine Residency Directors’ Knowledge and Attitudes About Pediatric Oral Health Education for Residents
Authors: Gonsalves Wanda C. , Skelton Judith , Heaton Lisa , Smith Timothy , Feretti Gerald , Hardison James D.
Published: June 2020

The Surgeon General's report on oral health called for improved education about oral health, a renewed understanding of relationships between oral and overall health, and an interdisciplinary approach to oral health involving primary care providers. This study examined the following: 1) family medicine residency directors’ knowledge of preventive dental care, 2) status of an oral heath curriculum in family medicine residencies, and 3) the likelihood of initiating an oral health curriculum. We conducted a fifty‐item survey of family medicine program directors emphasizing pediatric oral health assessed demographics, knowledge of preventive procedures, existing oral health curriculum, composition, and time commitment for an oral health curriculum. Directors returned 208 (45 percent) surveys. Approximately 95 percent agreed that oral health knowledge should be a component of residency training. Most programs are teaching anticipatory guidance. The mean time program directors felt should be given to an oral health curriculum was four hours. Program directors lack knowledge of preventive dental procedures and oral health care recommendations. Oral health care knowledge is felt to be an important component of residency training. Program directors need faculty development for a successful delivery of an oral health curriculum.
Use of the Internet Among Dental Students in Turkey
Authors: Komerik Nurgul
Published: June 2020

The extent to which dental students in Suleyman Demirel University (Turkey) use the Internet during their undergraduate dental training and their attitudes towards the Internet in general were assessed in this study. Ninety‐three percent of the students use the Internet in various frequencies. Seven percent stated that they do not know how to use the Internet and, in this regard, the gender proportion was higher in the female students (p=0.026). In general, male students use the Internet more often than their female counterparts (p<0.001). Although a similar proportion of students (approximately 55 percent) use the Internet to retrieve information for general and dental topics, dental topics were searched in the Internet less frequently. To obtain information on dental topics, students generally referred to lecture handouts or textbooks (76 percent) while 32 percent accessed the Internet. Students who use the Internet to obtain information on dental topics most commonly preferred the university sites (71 percent), followed by search engines by performing key word searches (47 percent). The texts are the most commonly accessed materials (83 percent). Clinical photographs were accessed by 53 percent and histopathologic and radiographic materials by 14 percent of the students.
The Oral Health Information Suite (OHIS): Its Use in the Management of Periodontal Disease
Authors: Page Roy C. , Martin John A. , Loeb Carl F.
Published: June 2020

Health care costs continue to increase at a rapid rate. Dental costs alone have risen from $31.5 billion in 1990 to $70.3 billion in 2002, outpacing inflation by 160 percent. Payers for health care services have no means to evaluate the value of these large expenditures. Quantified information is not available regarding a patient's condition prior to and after treatment nor on the probability of future disease. The absence of this information prevents dentists from responding effectively to challenges by payers and patients, and specifically prevents dentists from effectively influencing the quality of periodontal care. We have developed a user‐friendly Internet‐based technology that quantifies risk for periodontitis and periodontal disease severity and extent and generates recommended treatments and interventions. A caries risk assessment tool has also been developed, and an oral cancer assessment tool is being developed. This technology, designated the Oral Health Information Suite (OHIS)™, provides quantitative information to the clinician and patient as an aid to diagnosis and to facilitate individual, needs‐based treatment planning. OHIS enables successful application of the wellness model of oral health care, which may be expected to result in more uniform and accurate clinical decision making, improved oral health, reduction in the need for complex periodontal therapy, reduction in oral health care costs, and improved clinician productivity and income. It also will permit patients to become more involved in their oral health care, payers to quantify and predict their health care expenditures, dentists to experience an increase in trust and respect, and periodontists to be more properly consulted regarding periodontal care.
Dental Biomaterials: Where Are We and Where Are We Going?
Authors: Bayne Stephen C.
Published: June 2020

This article reviews the current state of the art for restorative biomaterials by examining the roles of 1) truly biological biomaterials, with respect to the “near‐future” of five to ten years, 2) traditional synthetic biomaterials, and 3) performance outcomes for biomaterials. Biological biomaterials are discussed in terms of tissue engineering and stem cell research, self‐assembling system opportunities, and nanotechniques or technologies. Future developments for major areas of synthetic biomaterials are considered for bonding systems, composites, VLC curing, ceramics, and cements. Performance outcomes are discussed for all biomaterials in terms of safety, efficacy, and longevity of materials.
The Ethical Climate in Academic Dentistry in India: Faculty and Student Perceptions
Authors: Acharya Shashidhar
Published: June 2020

The aims of this study were to describe both the ethical climate in a private dental institution in India and the possible influence of selected factors in influencing faculty and students’ perception of their institution's ethical environment. The Ethical‐Climate Questionnaire and the General‐Health Questionnaire (GHQ‐12) were completed by twenty‐eight full‐time faculty and forty‐seven final‐year undergraduate students. Results showed that, overall, the study population had a mixed opinion about the ethical climate in their institution. Psychological distress and academic experience played an important role in shaping the perception of institutional ethics among the study population. The results showed that there is a need for better communication of the institution's ethical policies and better ethical training to help the faculty and students recognize their institution's commitment to ethics.
An Evidence‐Based Journal Club for Dental Residents in a GPR Program
Authors: Grant William D.
Published: June 2020

The journal club offers a significant opportunity to serve as both an educational experience but also as a real‐world example of the application of the principles and practices of evidence‐based dentistry (EBD). Designed around the American Dental Association's recommended four steps in the implementation of the EBD process, the journal clubs are held once per month for GPR residents. The structured process allows residents to formulate answerable clinical questions, track down with maximum efficiency the best evidence with which to answer the questions, critically appraise the evidence for its validity and usefulness, and apply the results of this appraisal in clinical practice as appropriate.
Access to Dental Care Among Older Adults in the United States
Authors: Dolan Teresa A. , Atchison Kathryn , Huynh Tri N.
Published: June 2020

Oral health is essential to an older adult's general health and well‐being. Yet, many older adults are not regular users of dental services and may experience significant barriers to receiving necessary dental care. This literature review summarizes national trends in access to dental care and dental service utilization by older adults in the United States. Issues related to geriatric dentistry and concerns about access to dental care include the increasing diversity of the older adult population, concerns about the degree to which the dental workforce is prepared to meet the oral health needs of older patients, and the adequacy of the future workforce, including concern about training opportunities in gerontology and geriatrics for dental and allied dental practitioners.
Dental Care for Aging Populations in Denmark, Sweden, Norway, United Kingdom, and Germany
Authors: Holm‐Pedersen Poul , Vigild Merete , Nitschke Ina , Berkey Douglas B.
Published: June 2020

This article reviews access to and financing of dental care for aging populations in selected nations in Europe. Old age per se does not seem to be a major factor in determining the use of dental services. Dentition status, on the other hand, is a major determinant of dental attendance. In addition to perceived need, a variety of social and behavioral factors as well as general health factors have been identified as determinants of dental service use. Frail and functionally dependent elderly have special difficulties in accessing dental care; private dental practitioners are hesitant to provide dental care to these patients. One reason may be that the fee for treating these patients is too low, considering high dental office expenses. Another reason may be problems related to management of medically compromised patients. This raises an important question: does inadequate training in geriatric dentistry discourage dentists from seeking opportunities to treat geriatric patients? Overall, the availability of dental services, the organization of the dental health care delivery system, and price subsidy for dental treatment are important factors influencing access to dental care among older people in Europe as well as in the United States.
Band‐Aid Solutions to the Dental Access Crisis: Conceptually Flawed—A Response to Dr. David H. Smith
Authors: Mouradian Wendy E.
Published: June 2020

Though laudable, “band‐aid solutions” are inadequate to solve dental access problems. By nature, such efforts are provider‐driven and not designed to match the needs of underserved populations. They do not empower patients, families, or communities or provide for ongoing care. Band‐aid solutions do not ensure a workforce with the capacity or geographic distribution to meet the needs of the underserved. Neither do such solutions address systemic issues such as lack of dental insurance or the need to prioritize prevention. Such solutions do not engage other health professionals in promoting oral health. Furthermore, such solutions maintain the prevailing viewpoint that dental volunteer efforts are all that is required of the dental profession; they fail to acknowledge that a response is mandated by the social contract between dentistry and society. Finally, such an approach fails to recognize the complexity of health disparities and the broad solutions that must be advanced. In the case of children, it is possible to outline an approach to defining a basic standard of oral health care and to argue that all children should receive such care. Band‐aid solutions could never ensure a population‐wide distribution of care and hence are not morally defensible.
Eliminating Oral Health Disparities: Ethics Workshop Reactor Comments
Authors: Evans Caswell A.
Published: June 2020

Oral health encompasses dentistry and is broader in concept. Dentistry alone appears insufficient to ensure oral health for the population at large. Troubling disparities in oral health status and access to care have been documented. The segment of the population that has little or no access to care is growing; aging baby‐boomers are adding to this problem. As suggested in Oral Health in America: A Report of the Surgeon General, partnerships and collaboration are essential to improving oral health. The ethics of dental practice and the profession are being called into question. Who will provide the necessary leadership to address and resolve these issues, so that oral health is attainable by all?
Building Moral Communities? First, Do No Harm
Authors: Dharamsi Shafik
Published: June 2020

As concern for the oral health of vulnerable populations grows, dentistry continues to seek effective ways to respond. In August 2005, Dr. Donald Patthoff and Dr. Frank Catalanotto convened a national workshop at the American Dental Association headquarters on the ethics of access to oral health care. A series of papers were produced for the workshop and subsequently revised for publication. This one responds to the paper by Dr. David Chambers on moral communities and the discursive imperative for building community and consensus around issues affecting equitable access to oral health care. I explore three interrelated issues that ought to be considered when endeavoring to build moral communities: 1) the problem of power relations—a fundamental constituent within discourse that can impede constructive efforts; 2) the discursive disconnect between theoretical ethics and social constructs affecting dentistry; and 3) the bioethical principle of nonmaleficence as a priority in the desire for building moral communities. In essence, this article responds also to the call from ethicists who see a significant need for substantive interdisciplinary contributions to inform how people at different social levels react in ethically problematic situations in its broad social context.
Evolution of Dental School Clinics as Patient Care Delivery Centers
Authors: Formicola Allan J. , Myers Ronnie , Hasler John F. , Peterson Melanie , Dodge William , Bailit Howard L. , Beazoglou Tryfon , Tedesco Lisa A.
Published: June 2020

Dental school clinics, originally envisioned as closely similar to private practice, evolved instead as teaching clinics. In the former, graduate and licensed dentists perform the treatment while undergraduate dental students are assigned treatment within their capabilities. In the latter, dental students provide the treatment under faculty supervision. It is generally recognized that the care provided by the teaching clinics is inefficient. However, in the last quarter of the twentieth century, dental school clinics began to pay much more attention to how treatment is rendered. The comprehensive care movement and quality assurance systems are leading towards more efficient patient‐centered care. Case studies at the University of Maryland, Columbia University, and University of Louisville describe activities to make their clinic programs more efficient and patient‐friendly. This article explores whether the potential exists for faculty to take a direct patient care delivery role in dental clinics in order for those clinics to become efficient patient care delivery systems as originally envisioned in the early part of the twentieth century.
A Twenty‐Year Follow‐Up Survey of Medical Emergency Education in U.S. Dental Schools
Authors: Clark Morris S. , Wall Benjamin E. , Tholström Tad C. , Christensen Edward H. , Payne Brandon C.
Published: June 2020

This article reports the results of a 2003 survey of medical emergency education taught in U.S. dental schools and compares the results to findings from surveys conducted in 1983 and 1992. A questionnaire was sent to the deans of all U.S. dental schools, requesting completion of the survey by the faculty member responsible for medical emergency education. Forty‐three of fifty‐four U.S. dental schools responded, and the data were compared to similar surveys conducted in 1983 and 1992. Special attention was given to changes in technology (pulse oximetry and automated external defibrillators), teaching methods (audiovisual, role‐playing, and simulation), and subject matter (CPR, venipuncture, and endotracheal intubation) that affect medical emergency education. The study found a large disparity in number of hours dedicated to medical emergency training among dental schools. Surprisingly, CPR certification/recertification for both students and faculty was not provided at three of the reporting U.S. dental schools. Most schools included venipuncture and endotracheal intubation in their curriculum. Routine monitoring of vital signs remained fairly consistent over the past twenty years with a slight dip in the 1992 survey. A standardization of medical emergency education needs to take place to ensure an appropriate level of training for all dental students.
Effectiveness of an Electronic Histology Tutorial for First‐Year Dental Students and Improvement in “Normalized” Test Scores
Authors: Rosenberg Harold , Kermalli Jaffer , Freeman Eric , Tenenbaum Howard , Locker David , Cohen Howard
Published: June 2020

The effectiveness of an electronic histology tutorial (EHT) as a mode of learning was assessed by comparing performance on two term tests for an EHT class of sixty‐nine students and five prior classes (n=347) who learned by traditional methods. The aims of this study were to 1) develop and introduce a self‐instructional, computer‐aided approach to guide student learning in the first‐year histology course at the University of Toronto Faculty of Dentistry; 2) evaluate the effectiveness of the self‐study electronic histology tutorial by comparing students’ test scores for the EHT group to students’ scores in previous years; and 3) evaluate students’ acceptance of this novel mode of learning by means of a satisfaction questionnaire. The EHT group performed significantly better on both the general histology and oral histology term tests than the five prior control years (p<0.001), yet there were no significant differences in overall GPA between the groups, suggesting that the improvement was specific to the EHT/histology course grades (p=0.1 to 0.47). A statistically significant improvement in performance per unit overall GPA was noted in the test group, which demonstrated an increase in this test score normalized ratio (TSNR) of 3–18 percent in the general histology term test and 7–21 percent in the oral histology term test over the control groups. In addition to determining the effects of the EHT on grade performance, this study sought to evaluate students’ acceptance of this alternative mode of learning in comparison to the standard teaching model by means of a satisfaction questionnaire. Overall, students’ responses to the questionnaire were positive with an overall mean level of agreement for all ten responses of 4.5 out of 5 (90 percent).
Predoctoral Dental Student Evaluation of American Academy of Pediatric Dentistry's Caries‐Risk Assessment Tool
Authors: Nainar S.M. Hashim , Straffon Lloyd H.
Published: June 2020

The purpose of this study was to determine predoctoral dental student evaluation of the American Academy of Pediatric Dentistry's Caries‐Risk Assessment Tool (CAT) for children. Dental students were introduced to the CAT instrument as part of their didactic pediatric dentistry curriculum. These students were later encouraged to use the CAT instrument for determining caries risk in their pediatric patients. Following a two‐year exposure to the CAT instrument, dental students completed an anonymous seven‐item evaluation of the instrument at the end of their primary clinical experience in pediatric dentistry. The students were asked to score each item on a five‐point scale ranging from strongly agree (#5) to neutral (#3) to strongly disagree (#1). Ninety‐seven percent of eligible students completed the CAT evaluation questionnaire. Most students agreed that the CAT instrument was easy to understand (86 percent), simple to apply (76 percent), useful for prescribing radiographs (76 percent), and useful for determining preventive procedures (84 percent). Eighty percent of them indicated that they were likely to use the CAT instrument in their clinical practice. In conclusion, student acceptance of the CAT instrument indicates that it may educate predoctoral dental students regarding caries risk assessment in children.
Application of an Interactive Computer Program to Manage a Problem‐Based Dental Curriculum
Authors: McGrath Colman , Comfort Margaret B. , Luo Yan , Samaranayake Lakshman P. , Clark Christopher D.
Published: June 2020

Managing the change from traditional to problem‐based learning (PBL) curricula is complex because PBL employs problem cases as the vehicle for learning. Each problem case covers a wide range of different learning issues across many disciplines and is coordinated by different facilitators drawn from the school's multidisciplinary pool. The objective of this project was to adapt an interactive computer program to manage a problem‐based dental curriculum. Through application of a commercial database software—CATs (Curriculum Analysis Tools)—an electronic database for all modules of a five‐year problem‐based program was developed. This involved inputting basic information on each problem case relating to competencies covered, key words (learning objectives), participating faculty, independent study, and homework assignments, as well as inputting information on contact hours. General reports were generated to provide an overview of the curriculum. In addition, competency, key word, manpower, and clock‐hour reports at three levels (individual PBL course component, yearly, and the entire curriculum) were produced. Implications and uses of such reports are discussed. The adaptation of electronic technology for managing dental curricula for use in a PBL curriculum has implications for all those involved in managing new‐style PBL dental curricula and those who have concerns about managing the PBL process.
Promoting Interpersonal Skills and Cultural Sensitivity Among Dental Students
Authors: Broder Hillary L. , Janal Mal
Published: June 2020

This study evaluated interpersonal communication skills among third‐ and fourth‐year dental students during two clinical communications training programs. Students participated in two clinical communications (CC) training sessions, each comprised of four encounters with patient instructors (PIs) who were trained to enact standardized patient scenarios. Scenarios in CC1 addressed straightforward patient care situations in dentistry (e.g., bridge adjustment), while CC2 added cultural sensitivity issues to the dental scenarios. After each encounter, patient instructors used the Arizona Clinical Interviewing Rating Scale (ACIR) to rate the students’ interpersonal skills and gave the students feedback on their performance. The students also received feedback and coaching from dental school faculty in debriefings after encounters with the PIs. Students anonymously rated the program at the end of each session. To evaluate the program, students’ performance was compared within and between the two training sessions. Analysis showed statistically significant increases in interpersonal communication skills within each training session (p<0.05) from unsatisfactory to above satisfactory levels. Performance scores at the start of CC2 were statistically lower than at the end of CC1, suggesting that performance wanes without practice. Student evaluations of the program were very positive. Interpersonal communication skills improved during this patient instructor program.
Grading Dental Students in a “Nongraded” Clinical Assessment Program
Authors: Taleghani Mohsen , Solomon Eric S. , Wathen William F.
Published: June 2020

This article details how Baylor College of Dentistry (BCD) merges graded and nongraded aspects of student assessments into grade point averages (GPAs); explains the use of its assessment tools to evaluate students, faculty, and curriculum simultaneously; and calls for continuous progress and quality improvement toward educational excellence among all levels of the oral health education community. “Nongraded” student assessments at BCD are only applicable to preclinical and chairside activities that involve direct patient care. We further summarize how we have attempted to improve the accuracy of grading while providing objective numeric grades to measure student performance and generate a class rank. We suggest that faculty evaluation and curricular change require appropriate evaluation methods and continuous quality improvement based on the chosen assessment methodologies. We then summarize how we merge graded and nongraded assessments into a final student evaluation that realistically discriminates among students’ performance and present our numeric‐to‐letter grade conversion table. We conclude that 1) multiple strategies are required, available, and adequate to provide graduates with the numerical GPAs demanded by postdoctoral programs and that 2) continuous quality improvement among all levels of the oral health education community should be vigorously pursued by administration and faculty alike.
Child Abuse and Neglect: Dental and Dental Hygiene Students’ Educational Experiences and Knowledge
Authors: Thomas John E. , Straffon Lloyd , Inglehart Marita Rohr
Published: June 2020

The objective of this study was to explore dental and dental hygiene students’ educational experiences and knowledge concerning child abuse/neglect. Questionnaire data were collected from 233 dental (116 male/117 female; response rate=54.82 percent) and seventy‐six dental hygiene students (all female; response rate=76.77 percent). Of those surveyed, 94.7 percent of the dental hygiene and 70.5 percent of the dental students reported having learned about child abuse/neglect in classroom settings, and 15.8 percent of the dental hygiene and 29.3 percent of the dental students reported having learned about it in clinical settings. Dental students reported more minutes of instruction about this topic than dental hygiene students (184.48 vs. 112.90 minutes; p=.006). Only 5.5 percent of the dental and 16.7 percent of the dental hygiene students defined child abuse correctly; 32.2 percent of the dental and 13.2 percent of the dental hygiene students did not know their legal responsibility concerning reporting child abuse; and 82.4 percent of the dental and 78.9 percent of the dental hygiene students did not know where to report child abuse. Dental care providers are likely to encounter child abuse and neglect in their professional lives and are legally required to respond to these matters. Dental and dental hygiene curricula should be revisited to ensure that students are adequately prepared for this professional task.
Critical Appraisal and Positive Outcome Bias in Case Reports Published in Brazilian Dental Journals
Authors: Oliveira Geraldo J. , Leles Cláudio R.
Published: June 2020

The aim of this study was to carry out a critical appraisal to detect the occurrence of publication bias, specifically positive‐outcome bias, in Brazilian dental journals. A convenience sample of twenty‐eight dental journals published in Brazil between 1994 and 2003 was selected (564 issues containing 5,453 articles). Each article was classified according to methodological design; 1,064 were classified as case reports. A simple random sample of 435 articles comprised the final study sample and was submitted to a critical appraisal by previously trained raters. Although a great part of case reports achieve proper structural aspects, most authors did not consider important aspects that could help the decision making process, such as discussion of alternative approaches, limitation of the performed procedures, lack of long‐term clinical follow‐up, possible variations in treatment outcome, and failure to discuss limitations of study design. In addition, unanimous reports of successful outcomes of clinical interventions strongly suggest that publication of case reports was influenced by positive outcome bias, which may influence readers’ clinical decision making process.
Management of Occupational Bloodborne Exposure in a Dental Teaching Environment
Authors: Machado‐Carvalhais Helenaura P. , Martins Túlio César P.M. , Ramos‐Jorge Maria Letícia , Magela‐Machado Daniela , Paiva Saul M. , Pordeus Isabela A.
Published: June 2020

The aims of this cross‐sectional study were to investigate the prevalence of reporting occupational accidents regarding exposure to biological material among undergraduate students of dentistry at an institution of higher education and to estimate risk factors associated with underreporting. Data were collected by means of a questionnaire, which had an 86.4 percent rate of return. The sample was made up of 286 undergraduate dental students enrolled in the clinical component of the curriculum, corresponding to the final six semesters of study. The average age of the subjects was 22.4 years. Descriptive, bivariate, simple logistic regression and multiple logistic regression (Stepwise Forward Procedure) analyses were performed, with the significance level set at p≤0.05. Of the total 167 individuals who had been exposed to biological material, 120 (71.9 percent) failed to report the accidents. The variables that were statistically associated with the nonreporting of occupational accidents were nonexposure to blood (OR=4.0; CI 95%: 1.7–10.0) and the fact that the students considered the exposure to be minor or of low risk (OR=8.8; CI 95%: 3.5–23.0) or considered the protocol adopted by the institution to be inadequate (OR=5.2; CI 95%: 1.2–17.1). The development of a procedure review policy is recommended with the aim of establishing continuous vigilance and encouraging the reporting of bloodborne exposure.
Using Delphi Technique in a Consensual Curriculum for Periodontics
Authors: Fried Hana , Leao Anna Thereza
Published: June 2020

Periodontics has experienced several important conceptual changes in the last few decades. As such, it is important to have a periodontics curriculum built upon the expertise of specialists in that discipline and reflecting those changes. The main goal of this study was to attain a consensus, through the use of the Delphi technique, on the topics that should be included in a periodontics curriculum for undergraduate dental students. A sample of periodontics lecturers from nine dental schools in two Brazilian cities was used, and a Delphi technique approach was followed to investigate sample member perceptions on the subject. Participants received four postal mail questionnaires asking them to rate and rerate eighty‐nine topics for possible inclusion in the curriculum. A descriptive analysis was conducted, and topic frequencies were calculated. Topics rated as highly important for inclusion were the following: health, ailment, prevention, etiology, epidemiology, diagnosis, and treatment. The Delphi technique approach proved successful in involving periodontics lecturers in the design of a periodontics curriculum for undergraduate dental students.
A Patient‐Instructor Program to Promote Dental Students’ Communication Skills with Diverse Patients
Authors: Wagner Julie , Arteaga Sarita , D’Ambrosio Joseph , Hodge Cynthia E. , Ioannidou Efthimia , Pfeiffer Carol A. , Yong Lynne , Reisine Susan
Published: June 2020

This article describes the design and evaluation of a patient‐instructor (PI) program that was developed to teach and assess dental student communication skills with patients, with an emphasis on cross‐cultural patient encounters. The PIs were individuals from the community trained to portray specific simulated patients. One hundred eighteen dental students (three graduating classes) completed two half‐day rotations that occurred in the junior year; seventy‐nine of those students (two graduating classes) also completed a third rotation that occurred in the senior year. On each rotation, students worked with several simulated patients in mock clinic appointments. PIs used a standardized rating scale and case‐specific content checklists to assess students’ ability to elicit and provide essential information. Across counterbalanced cases, students improved as they progressed through encounters. Rate of improvement varied by rotation, but students improved most during their first rotation. Overall performance was best on the final rotation. Qualitative review of content checklist items indicated areas of strengths and weaknesses in communication regarding medical, dental, psychosocial, and cultural content. Results can direct curriculum changes to improve communication skills. Future research should address the effects of the PI program on students’ diversity‐related attitudes and behaviors.
How Dentists Account for Social Responsibility: Economic Imperatives and Professional Obligations
Authors: Dharamsi Shafik , Pratt Daniel D. , MacEntee Michael I.
Published: June 2020

This study explores how dentists explain the concept of social responsibility and its relationship to issues affecting access to oral health care by vulnerable segments of the population. Analysis of open‐ended interviews with thirty‐four dentists, including dental educators, and administrators and officials of dental public health programs in Canada and the United States revealed that four main themes—economics, professionalism, individual choice, and politics—influenced the respondents’ sense of social responsibility in dentistry. There was a belief that social responsibility in dentistry is dominated by economic imperatives that impact negatively on the policies and practices directing access to care. Yet, despite the highly critical stance on dentistry as a business, there was practical recognition of the economic realities of dental practice. Nevertheless, those who focused on social responsibility as a professional obligation highlighted the privileges of self‐governance along with the accompanying duty to serve the welfare of everyone and not just those who are socioeconomically advantaged.
Emotional Intelligence and Perceived Stress in Dental Undergraduates: A Multinational Survey
Authors: Pau Allan , Rowland Michael L. , Naidoo Sudeshni , AbdulKadir Rahimah , Makrynika Elisavet , Moraru Ruxandra , Huang Boyen , Croucher Ray
Published: June 2020

This multinational survey investigated the relationship between emotional intelligence (EI) and perceived stress (PS) in seven countries. First‐year dental undergraduates attending a dental school in England, Greece, Romania, South Africa, Australia, and the United States and three schools in Malaysia were invited to complete a set of questionnaires on age, gender, academic background, satisfaction with career choice, EI, and PS. Of 860 questionnaires distributed, 596 were fully completed—a response rate of 69.3 percent. Mean EI score was 123.8 (95 percent CI 122.7–124.9), and mean PS score was 19.1 (95 percent CI 18.6–19.7). Significant differences in EI and PS scores were detected between different countries. Females (p<0.05), younger students (p<0.001), those without a previous higher education qualification (p<0.001), and those not satisfied with their decision to study dentistry (p<0.001) were more likely to report PS when compared to their counterparts. A significant inverse relationship (coefficient=−0.29, p=0.001) between EI and PS was detected. Independent significant predictors of PS identified were gender (ß=0.22, t=5.71, p=0.001), previous higher education qualification (ß=−0.14, t=−2.42, p=0.010), satisfaction with decision to study dentistry (ß=−0.20, t=−5.11, p=0.001), and EI (ß=−0.24, t=−6.09, p=0.001), with the latter being relatively the most important predictor. In conclusion, the inverse relationship between EI and PS has been confirmed in this heterogeneous sample representing diverse sociocultural and academic contexts of dental undergraduates.
Renewing Professionalism in Dental Education: Overcoming the Market Environment
Authors: Masella Richard S.
Published: June 2020

The most important mission of dental education is development of student professionalism. It is only within the context of professionalism that specialized knowledge and technical expertise find meaning. Altruism, integrity, caring, community focus, and commitment to excellence are attributes of professionalism. Its backbone is the obligation of service to people before service to self—a social contract. Professionalism can and should be acquired by targeted interventions, not as an assumed by‐product of dental education. Top‐down, rule‐based professionalism is contrasted with its experience‐based, mentor‐mediated, socially driven counterpart. Moral principles are inherent in professional development and the professional way of life. Unfortunately, American society, including higher education, glorifies a market mentality centered on expansion and profit. Through formal and hidden curricula, dental schools send mixed messages to students about the importance of professionalism. Institutional consensus on professionalism should be developed among faculty, administration, and students through passionate advocacy and careful analysis of dentistry's moral convictions. The consensus message should communicate to stakeholders that morality and ethics “really count.” Maximum student exposure to faculty exemplars, substantial service‐learning experiences, and portfolio use are likely to enhance professionalism, which should be measured for every student, every semester, along with faculty and institutional assessment. Research reveals a significant relationship between levels of student moral reasoning and measures of clinical performance and shows that moral reasoning ability can be enhanced in dental students. Valid and reliable surveys exist to assess student moral reasoning. Documented student unprofessional behavior is a predictor of future state professional board disciplinary action against practitioners, along with low admissions test scores and course failures in the first two professional school years. ADEA Policy Statements recognize the importance of professionalism in student development. From day 1 of dental school, faculty and students should have no doubt as to what constitutes acceptable and unacceptable behavior in academic and clinical settings. With education and experience, dental students and dentists are likely to elevate their standards of professionalism.
Intra‐ and Inter‐Examiner Variability in Evaluating Preclinical Pediatric Dentistry Operative Procedures
Authors: Sharaf Aly A. , AbdelAziz Amr M. , El Meligy Omar A.S.
Published: June 2020

Many investigators have reported attempts to develop reliable laboratory and clinic evaluation systems. However, few studies, regardless of level of success, have used an analytic procedure to identify those components of the evaluation system that, if refined further, could improve reliability. The purpose of this study was to compare intra‐ and inter‐examiner variability in two evaluation methods: glance and grade (global), and checklist and criteria (analytical). Three faculty staff members with more than ten years of clinical and teaching experience evaluated operative procedures performed on plastic teeth representing the primary teeth by thirty dental students in pediatric dentistry preclinical laboratory sessions. The preparations were graded blindly by each of the three evaluators (A, B, and C) three times without magnification. The values were statistically analyzed using Wilcoxon signed rank test and Friedman test setting value of significance at 5 percent. The study revealed that, among the three examiners, the intra‐examiner variability was nonsignificant in most situations. On the other hand, there was statistically significant variability between evaluators (i.e., inter‐examiner) for almost all preparations. Neither cutting off the scores nor using either evaluation method (glance and grade or criteria and checklist) caused an improvement in variability. The problem of inter‐examiner reliability and variability still existed.