bluuebunny/crossref_metadata_2025 huggingface dataset:
The Antimicrobial Approach to Caries Management
Authors: Caufield Page W. , Dasanayake Ananda P. , Li Yihong
Published: June 2020

Dental caries is an infectious disease of bacterial origin. The use of antimicrobial agents to reduce or eliminate the bacteria associated with caries follows the approach used to combat other infectious diseases of humans. Unfortunately, only a few dozen studies have sufficient resolving power to make inferences as to the anticaries efficacy of the antimicrobial approach to caries management. Here, we comment on the findings of the RTI/UNC review concerning antimicrobials, discuss additional findings not covered in that review, and make recommendations based upon both the available literature and from our own experience. Even though the studies published thus far are inconclusive or lack sufficient demonstration of efficacy to recommend a specific approach involving antimicrobial agents in routine clinical practice, several pieces of information from these studies suggest future avenues of investigation.
Clinical Applications and Outcomes of Using Indicators of Risk in Caries Management
Authors: Zero Domenick , Fontana Margherita , Lennon Áine M.
Published: June 2020

The aim of this review was to systematically assess clinical evidence in the literature to determine the predictive validity of currently available multivariate caries risk‐assessment strategies (including environmental, sociodemographic, behavioral, microbiological, dietary/nutritional, and/or salivary risk factors) in: 1) primary teeth; 2) coronal surfaces of permanent teeth; and 3) root surfaces of permanent teeth. We identified 1,249 articles in the search, and selected 169 for full review. Inclusion and exclusion criteria were established prior to commencement of the literature search. Papers that conformed to these criteria were included (n = 15 for primary teeth; n = 22 for permanent teeth; and n = 6 for root surfaces), and 126 papers were excluded. Included articles were grouped by study design as: longitudinal, retrospective, and cross‐sectional. The predictive validity of the models reviewed depended strongly on the caries prevalence and characteristics of the population for which they were designed. In many instances, the use of a single predictor gave equally good results as the use of a combination of predictors. Previous caries experience was an important predictor for all tooth types.
Dental School Vacant Budgeted Faculty Positions: Academic Year 2000 ‐ 2001
Authors: Weaver Richard G. , Haden N. Karl , Valachovic Richard W.
Published: June 2020

The 1999 Report of the AADS President's Task Force on the Future of Dental School Faculty1 drew attention to the situation dental schools are experiencing in attracting and retaining faculty. A year 2000 ADEA Association Report on faculty shortages indicated the number of vacant budgeted positions was approaching 4002. The year 2000 ‐ 2001 ADEA survey of vacant budgeted positions indicates a further four percent increase in vacant budgeted positions. Over 73 percent of the vacancies were in the clinical sciences. Of identified full time faculty separations in the 2000–2001 ADEA Survey of Dental Educators3, almost 34 percent were due to retirements; 33 percent were faculty moves to other schools; and a little over 18 percent were moves to enter private practice. Almost three percent of identified faculty separations were from deaths. It is anticipated that, with a further “graying” of an already aged dental school faculty, retirements will further exacerbate the problem of faculty vacancies and the ability to attract and retain new faculty. There is needed urgency in implementing strategies and recommendations provided in the 1999 President's Report and the 2000 Association Report.
Chronic Orofacial Pain: Is the Puzzle Unraveling?
Authors: Stohler Christian S.
Published: June 2020

Conditions involving chronic orofacial pain represent a major health problem, and patients with persistent pain are difficult to manage successfully. These conditions are often comorbid with additional health issues such as sleep disturbances, cardiovascular, gastrointestinal and reproductive system complaints, weight loss or weight gain, swelling, numbness, sweating and flushing, and concerns regarding loss of libido, drive, attention, and memory. Neuroendocrine and autonomic pain‐stress responsivity and the consequences of pain for sensory, motor, immune and reproductive functions, and mood seem to account for the broad range of comorbid complaints. Susceptibility to a particular response appears to explain intra‐individual differences in disease expression. Understanding of these regulatory, mostly adaptive processes will support novel treatments to manage many troublesome comorbid complaints for which current approaches are unsatisfactory.
Tobacco Use and Oral Disease
Authors: Winn Deborah M.
Published: June 2020

Tobacco use is a risk factor for oral cancer, oral mucosal lesions, periodontal disease and impaired healing after periodontal treatment, gingival recession, and coronal and root caries. Available evidence suggests that the risks of oral diseases increase with greater use of tobacco and that quitting smoking can result in decreased risk. The magnitude of the effect of tobacco on the occurrence of oral diseases is high, with users having many times the risk of non‐users. There is a clear benefit to quitting tobacco use. The risks of oral cancer and periodontal disease decline as time from cessation increases, and some oral mucosal lesions may resolve with cessation of smokeless tobacco use. Smoking accounts for half of periodontal disease and three‐fourths of oral cancers in the United States. Because tobacco accounts for such a high proportion of these diseases, comprehensive tobacco control policies are required to make progress in reducing the burden of tobacco‐related oral diseases. Effective treatments to prevent tobacco use and increase cessation are available and need greater implementation. Dental practices may provide a uniquely effective setting for tobacco prevention and cessation.
The Feasibility and Efficacy of Tobacco Use Prevention in Orthodontics
Authors: Hovell Melbourne F. , Jones Jennifer A. , Adams Marc A.
Published: June 2020

SMILES PLUS was the first study to extend the clinician‐delivered logic model to prevention of tobacco use among adolescents. This multi‐site trial with 154 participating offices, based on social learning theory and a behavioral ecological model, was designed to test whether orthodontists can prevent preteens from initiating smoking. The study found that orthodontists do not automatically adhere to anti‐tobacco prevention services. Social learning variables can enhance both adherence to counseling guidelines and content of counseling to increase prevention effects. Providing financial incentives, tracking prescriptions, prompting positive feedback from patients, and adopting anti‐tobacco counseling models in the office are likely to enhance anti‐tobacco preventive services. Training orthodontists to be comfortable when advising nonsmoking youth not to start and to use social consequences to justify youth avoidance of tobacco might increase adherence to protocols and make their counseling more powerful. Adolescent smokers prior to intervention were more likely to start other risky behaviors later. Preventing tobacco use may halt additional risk behaviors and thereby reduce morbidity/mortality even more than expected from tobacco control alone. New and refined clinical trials should be conducted to determine the most effective interventions for adolescent tobacco control by clinicians.
The EXCEL Program: Strengthening Diversity
Authors: Friedman Paula K.
Published: June 2020

The Boston University Henry M. Goldman School of Dental Medicine (BUSDM) initiated a program in the summer of 1993 to strengthen diversity in the entering class of first‐year students. The Experiential Center for Excellence in Learning (EXCEL) Program is a voluntary, one‐month‐long prematriculation experience that combines didactic, laboratory, study skills, and social activities to prepare participants to transition into the rigorous first‐year curriculum. From 1996 to 2000, ninety students participated in EXCEL. The two primary reasons cited for participating were to become familiar with the school, faculty, and classmates and to strengthen basic science background. Participants' ages ranged from twenty to over forty. Fifty‐nine percent of participants had been out of college for more than one year; 10 percent had been out of school for three years or more. Thirty percent listed nontraditional predental school majors. Fifty‐six percent listed a country other than the United States as country of birth. Of those completing an exit survey, 96 percent reported that EXCEL strengthened their decision to study dentistry, and 97 percent would recommend that future entering BUSDM students participate in EXCEL. The EXCEL Program may serve as a model for increasing diversity in U.S. dental school enrollment.
Factors Considered by New Faculty in Their Decision to Choose Careers in Academic Dentistry
Authors: Schenkein Harvey A. , Best Al M.
Published: June 2020

To determine the characteristics of new dental faculty and what factors influenced them to choose academic careers, a survey was sent to deans at all U.S. dental schools to be distributed to faculty with length of service of four years or less. Responses were received from 240 individuals. About half of the respondents had been in private practice for an average of eight years, and 20 percent had military experience averaging almost sixteen years. A majority had postgraduate training and 60 percent had specialty training. Nearly 32 percent of new faculty were female and 80 percent were U.S. citizens. Analyses of responses to survey items indicated that correlated factors in the survey fell into the following empirical categories: teaching and scholarship, income and indebtedness, research, work schedule, influence of mentors and role models, and long‐term aspirations. In general, the respondents identified factors relating to teaching and scholarship to be the most important influences on their choice of academic careers, while concerns about income and indebtedness were the most important negative considerations in this regard. Other positive factors identified by the survey related to the influence of mentors and role models, long‐term aspirations, and research. Age, private practice experience, and military experience were found to particularly influence the new faculty members' responses to items concerning income and indebtedness, and citizenship influenced responses to factors relating to research. The data from this select group of dentists support the current view that inequities in income of dental faculty compared to private practitioners and student debt are important concerns in choosing academic careers. Importantly, the desire to teach and participate in scholarly activities are important attractions in academic careers. Mentoring activities and creation of opportunities for career development are crucial factors in developing interest in academics among graduate dentists.
Factors Influencing Pursuit and Satisfaction of Academic Dentistry Careers: Perceptions of New Dental Educators
Authors: Shepherd Kathi R. , Nihill Patricia , Botto Ronald W. , McCarthy Melanie W.
Published: June 2020

New dental educators (n = 280) with zero to five years full‐time teaching experience were surveyed to ascertain their perceptions regarding salary, work environment, and workload to determine the impact of these factors on faculty recruitment and retention. Work environment was the most frequently reported factor for considering and maintaining an academic dentistry position. Educational resources, facilities, salary, and benefits were ranked as moderately important for considering an academic position. Mentoring, startup funds for research, and external private practice opportunities weren also reported as moderately important for maintaining a position. Other factors of concern to new faculty included quality of administration and leadership, reputation of program, professional development opportunities, faculty autonomy, and reasonable criteria for tenure and promotion. These findings suggest that resources, strategies, and formal mentoring programs that provide direction and guidance in the areas of teaching, promotion, and tenure for new educators should be considered for implementation in our dental schools.
Validation of an Instrument to Measure Dental Students' Use of, Knowledge About, and Attitudes Towards Computers
Authors: Schleyer Titus K.L. , Torres‐Urquidy Humberto , Straja Sorin
Published: June 2020

Currently, no validated survey instrument exists to measure dental students' use of, knowledge about, and attitudes towards computers. Several studies have surveyed students about their knowledge and opinions regarding computers, but none of them has established the reliability and validity of the instrument(s) used. A measurement study to validate a preliminary survey for dental students was conducted. The preliminary instrument contained five scales: computer use, information resource use, computer knowledge, capabilities of computer systems, and effects of computers on dental practice. Selected variables were summarized descriptively, and a factor analysis for each scale was performed. In addition, construct validity was assessed through correlational analyses among several variables. Three hundred seventy surveys distributed to students at nine dental schools generated 156 responses (42 percent response rate). Sixty‐four percent of respondents were male, 36 percent female. Respondents used computers an average approximately four hours per week, and most had begun using computers in 1991. All survey scales except computer use were unidimensional. Computer use required a two‐factor solution that distinguished between clinical and nonclinical uses of computers. The instrument can be used for a demonstration study, but should be continuously refined and validated.
Dental Enamel Formation and Its Impact on Clinical Dentistry
Authors: Simmer James P. , Hu Jan C‐C.
Published: June 2020

The nature of tooth enamel is of inherent interest to dental professionals. The current‐day clinical practice of dentistry involves the prevention of enamel demineralization, the promotion of enamel remineralization, the restoration of cavitated enamel where demineralization has become irreversible, the vital bleaching of dental enamel that has become discolored, and the diagnosis and treatment of developmental enamel malformations, which can be caused by environmental or genetic factors. On a daily basis, dental health providers make diagnostic and treatment decisions that are influenced by their understanding of tooth formation. A systemic condition during tooth development, such as high fever, can produce a pattern of enamel defects in the dentition. Knowing the timing of tooth development permits estimates about the timing of the disturbance. The process of enamel maturation continues following tooth eruption, so that erupted teeth can become less susceptible to decay over time. Mutations in the genes encoding enamel proteins lead to amelogenesis imperfecta, a collection of inherited diseases having enamel malformations as the predominant phenotype. Defects in the amelogenin gene cause X‐linked amelogenesis imperfecta, and genes encoding other enamel proteins are candidates for autosomal forms. Here we review our current understanding of dental enamel formation, and relate this information to clinical circumstances where this understanding may be particularly relevant.
Transferring Genes to Salivary Glands
Authors: Simmons Raymond K. , Baum Bruce J.
Published: June 2020

This review provides a brief description of gene transfer studies using salivary glands as the target tissue. The aggregate results demonstrate the potential clinical value of this methodological approach for managing several conditions lacking fully satisfactory conventional treatments. Routine clinical applications are still seven to ten years away, primarily because of the need for improved gene transfer vectors. Overall, this body of work provides the dental educator with a substantive example of how biotechnological progress will significantly affect the treatment of oral problems in the near future.
ADEA Annual Survey of Clinic Fees And Revenue: 1998‐1999 Academic Year
Authors: Weaver Richard G. , Haden N. Karl , Valachovic Richard W.
Published: June 2020

The American Dental Education Association's 1998‐1999 Survey of Clinic Fees and Revenue obtained data by which to report, by school, clinic revenue information per undergraduate student. Fifty of the fifty‐five U.S. dental schools responded to the survey. The median revenue per third‐year student was $6,313. It was $11,680 for fourth‐year students. Clinic revenue data was also obtained by type of postdoctoral program. The postdoctoral general dentistry programs had the highest per student clinic revenues, at over $59,000 per AEGD student and almost $35,000 per student of GPR programs. Other areas of the survey provided information regarding clinic fees by type of program, levels of uncompensated care by type of program, clinic revenue by source of payment, and dental school fees as a percent of usual and customary private practice fees.
Tutoring in a Problem‐Based Curriculum: Expert Versus Nonexpert
Authors: Bochner Daniela , Badovinac Rachel L. , Howell Thomas H. , Karimbux Nadeem Y.
Published: June 2020

Many studies have examined whether being an “expert” influences the success of a tutor in a problem‐based learning curriculum. There are, however, no established standards by which to determine expertise. The purpose of this study was to examine whether students evaluate expert and nonexpert tutors comparably and to determine whether setting different standards to determine expertise influences the outcome of the above findings. Tutor evaluations, consisting of eight Likert‐type questions completed by first‐, second‐, and third‐year dental students, were analyzed. Tutors were ranked by the authors within three different categories of expertise based on the highest educational degree they had attained, familiarity with the specific subject matter, and previous problem‐based learning (PBL) experience. Linear regression analyses were then performed between each category and student evaluation results. A statistically significant difference was found in the way students evaluated experts, but only when expertise was defined by the tutor's previous tutorial experience. The findings of this study underscore the importance of the retention of dental faculty with PBL experience in a PBL‐based curriculum.
Undergraduate Basic Science Preparation for Dental School
Authors: Humphrey Sue P. , Mathews Robert E. , Kaplan Alan L. , Beeman Cynthia S.
Published: June 2020

In the Institute of Medicine's report Dental Education at the Crossroads, it was suggested that dental schools across the country move toward integrated basic science education for dental and medical students in their curricula. To do so, dental school admission requirements and recommendations must be closely reviewed to ensure that students are adequately prepared for this coursework. The purpose of our study was twofold: 1) to identify student dentists' perceptions of their predental preparation as it relates to course content, and 2) to track student dentists' undergraduate basic science course preparation and relate that to DAT performance, basic science course performance in dental school, and Part I and Part II National Board performance. In the first part of the research, a total of ninety student dentists (forty‐five from each class) from the entering classes of 1996 and 1997 were asked to respond to a survey. The survey instrument was distributed to each class of students after each completed the largest basic science class given in their second‐year curriculum. The survey investigated the area of undergraduate major, a checklist of courses completed in their undergraduate preparation, the relevance of the undergraduate classes to the block basic science courses, and the strength of requiring or recommending the listed undergraduate courses as a part of admission to dental school. Results of the survey, using frequency analysis, indicate that students felt that the following classes should be required, not recommended, for admission to dental school: Microbiology 70 percent, Biochemistry 54.4 percent, Immunology 57.78 percent, Anatomy 50 percent, Physiology 58.89 percent, and Cell Biology 50 percent. The second part of the research involved anonymously tracking undergraduate basic science preparation of the same students with DAT scores, the grade received in a representative large basic science course, and Part I and Part II National Board performance. Using T‐test analysis correlations, results indicate that having completed multiple undergraduate basic science courses (as reported by AADSAS BCP hours) did not significantly (p<.05) enhance student performance in any of these parameters. Based on these results, we conclude that student dentists with undergraduate preparation in science and nonscience majors can successfully negotiate the dental school curriculum, even though the students themselves would increase admission requirements to include more basic science courses than commonly required. Basically, the students' recommendations for required undergraduate basic science courses would replicate the standard basic science coursework found in most dental schools: anatomy, histology, biochemistry, microbiology, physiology, and immunology plus the universal foundation course of biology.
An Evaluation of Clinical Mock Boards and Their Influence on the Success Rate on Qualifying Boards
Authors: Jessee Stephen A.
Published: June 2020

An important responsibility of each dental school to its graduating dental students is exposure to and evaluation on a mock board that simulates one or more of the examinations given by its respective regional testing agencies. An introduction to the procedures and environment that will be encountered on a qualifying examination will hopefully increase a student's chance for success on such a test. The purpose of this study was to test the relationship of the various attributes or variables of mock boards given by dental schools in the United States and Puerto Rico with results obtained on the regional or state qualifying board(s) related to timing, structure, method of evaluation, graduation, and remediation. A twenty‐item questionnaire was mailed to key clinical or curricular deans at fifty‐four accredited dental schools. Ninety‐three percent of schools completed and returned the questionnaire. In the sample of respondents, the percentages of schools participating in the various qualifying exams were: CRDTS = 22 percent; NERB = 42 percent; SRTA = 20 percent; WREB = 28 percent; Independents = 24 percent, with a reported overall passing rate (greater than or equal to 70) of 58 percent. The median time between the mock board and the qualifying board was 7.5 weeks. Results indicated that no single aspect of a mock board had a statistically significant effect on the outcome of qualifying examinations, resulting in a failure to reject the null hypothesis. Such findings may indicate that schools should focus their efforts on reassessing the restrictions and requirements imposed upon their students related to their mock board. A future study could include surveying recent graduates for their opinions of the value of their mock board experiences.
How Well Prepared Are Texas Dental Hygienists to Recognize and Report Elderly Abuse?
Authors: Murphree Kellie R. , Campbell Patricia R. , Gutmann Marylou E. , Plichta Stacey B. , Nunn Martha E. , McCann Ann L. , Gibson Gretchen
Published: June 2020

The elderly are the nation's fastest‐growing population, and the number of elder abuse victims has reached epidemic proportions. In Texas, dentists and dental hygienists are mandated by law to report suspected abuse. This study surveyed Texas dental hygienists regarding elder abuse education received in dental hygiene school and post‐graduation. Respondents were also asked to self‐assess their knowledge level in recognizing the six types of elder abuse and to answer questions regarding Texas law and mandatory reporting of abuse. A survey designed for this study was mailed to 780 Texas licensed dental hygienists, representing 10 percent of the Texas dental hygiene population. Respondents were selected using a computer‐generated random sample. A second mailing was sent to nonrespondents to prevent response bias. Results were analyzed using Statistical Programs for Social Scientists (SPSS). Over one‐half of the respondents (56 percent) stated that abuse education was not part of their dental hygiene school curriculum. Only 46 percent of the respondents who replied that abuse education had been included in the curriculum were educated on elder abuse. A majority of respondents stated they lacked knowledge in recognizing the six types of elder abuse, and 81 percent of respondents reported being unknowledgeable about reporting elder abuse. The current status of elder abuse education in dental hygiene programs and post‐graduation is insufficient. Dental hygienists have an obligation to become knowledgeable in recognizing and reporting elder abuse in order to provide complete care for their patients.
How Do U.S. and Canadian Dental Schools Teach Interpersonal Communication Skills?
Authors: Yoshida Toshiko , Milgrom Peter , Coldwell Susan
Published: June 2020

The status of instruction in interpersonal communication was surveyed in forty U.S and Canadian dental schools. Key faculty members were identified, and syllabi and course descriptions were collected and content‐analyzed. The following findings were obtained for responding schools: 1) only one‐third of schools had courses specifically focusing on interpersonal communication; 2) more than half of the schools offered these types of courses only during the first two years; 3) the most common topics were communication skills, patient interviewing, and patient education/consultation; 4) the most frequently used method of teaching was lectures; active practice was used less often; 5) written examination was the primary instructional evaluation tool, whereas more sophisticated performance‐oriented assessments were used less often; and 6) about half of the teachers did not have a D.D.S. degree; those not dentists were primarily psychologists. At least eight of the forty dental schools surveyed do not appear to meet the accreditation guidelines for predoctoral programs in this area of instruction. Some could not identify a faculty member responsible for such instruction. Schools offering more extensive instruction were more likely to offer active rather than passive teaching and use more sophisticated student evaluation strategies. This research suggests a need for reevaluation of teaching in this subject area.
Evaluation of Web‐Based Dental CE Courses
Authors: Spallek Heiko , Pilcher Elizabeth , Lee Ji‐Young , Schleyer Titus
Published: June 2020

Various organizations offer online continuing dental education (CDE) courses. While previous investigations focused on objective measures to determine the quality of the courses, this exploratory study evaluates the participants' experience with them. We surveyed 436 past course participants from nine online CDE courses (courses provided by six organizations) regarding their experience with the courses taken. Our analysis of the 169 responses (38.8 percent response rate) focuses on how the participants of online CDE courses can be characterized; whether the participants' expectations were met by the courses; how the participants evaluated the content of the courses; why they enrolled; and the participants' experience of the online environment. The results suggest that online CDE courses partially meet the needs and expectations of dental professionals. The lack of communication with peers and instructors as well as the fact that courses appeared outdated were main reasons for dissatisfaction. Most of the participants accomplished their goals of gaining new knowledge and deepening their understanding of the subject. Based on this evaluation, future courses can be tailored to meet more closely the expectations and needs of dental professionals.
Survey of Undergraduate Esthetic Courses in U.S. and Canadian Dental Schools
Authors: Osborne Paul B. , Skelton Judith
Published: June 2020

U.S. and Canadian dental schools were surveyed regarding curriculum issues related to undergraduate dental esthetic restorative courses. A one‐page survey instrument was sent to deans of academic affairs (n=59) of dental schools to complete or forward to the most appropriate faculty at their respective schools who would be knowledgeable about the esthetic restorative curriculum. Responses were received from forty‐two dental schools (42/59) for a response rate of 72.9 percent. The first part of the survey asked if a specific esthetic restorative course was offered at their school, if it was mandatory or elective, and details of the course length and content. The second part of the survey asked whether selected esthetic restorative procedures were included in the curriculum. Respondents to this survey indicated that most types of esthetic restorative procedures are taught whether or not an esthetic course is included in the curriculum.
Patterns of Oral Care in Dental School and General Dental Practice
Authors: Leggott Penelope J. , Robertson Paul B. , del Aguila Michael , Swift Jason J. , Porterfield Denise , Phillips Sandra , Anderson Maxwell H.
Published: June 2020

This study compared patterns of oral care provided by predoctoral dental students for patients seeking treatment at the University of Washington (UW) with patterns reported for general dental offices by the Washington Dental Service (WDS). Dental care included about 5 million services provided to 880,317 patients by 2,803 WDS general dentists and about 45,600 dental services provided to 9,488 patients by 155 UW dental students during 1999. There was high fidelity between databases and randomly surveyed patient records for treatment provided in both UW (95 percent) and WDS (97 percent) populations. While patient age patterns were generally similar, UW students completed more procedures for young children and for adults older than seventy‐four years but completed fewer procedures for age groups of from thirteen to eighteen and from forty‐five to fifty‐four than general dental offices. The relative mix of all services completed by UW and WDS providers was similar (ANOVA, P=0.82). Within categories of service, the percentage of total services completed by students compared to those submitted by community dentists to WDS was about the same for examinations, radiographs, fluoride and sealants, amalgams, composites, single crowns, and endodontics. The percentage of total procedures completed showed a greater emphasis by UW students on inlays/onlays, dentures, extractions, and periodontal maintenance, and lesser experience with implants, orthodontics, sedation, and emergency procedures than general dental offices. We conclude that the relative distribution of clinical services provided by UW dental students is comparable to those procedures reported to WDS by dental offices in the adjacent community.
How Does Time‐Dependent Dental Unit Waterline Flushing Affect Planktonic Bacteria Levels?
Authors: Cobb Charles M. , Martel Christopher R. , McKnight Sidney A. , Pasley‐Mowry Cathy , Ferguson Brett L. , Williams Karen
Published: June 2020

The purpose of this study was to evaluate how time‐dependent waterline flushing affects the presence of biofilm in otherwise‐untreated dental unit waterlines (DUWLs). Water samples were obtained from twelve highspeed handpiece DUWLs located in the undergraduate treatment clinic at the University of Missouri‐Kansas City, School of Dentistry. Baseline water samples (50 cc) were collected prior to the start of continuous flushing. Additional 50 cc samples were collected after two‐, three‐, and four‐minute flushing intervals from the baseline. The levels of planktonic bacteria in DUWLs were quantified by counting colony forming units (CFUs). In addition, segments of water tubing from each of the highspeed handpiece waterlines were examined by scanning electron microscopy, which confirmed the presence of a residual biofilm in the lumen of each dental unit waterline. A one‐factor repeated measures ANOVA showed a statistically significant (p< 0.01) reduction in CFUs at all intervals compared to baseline and between each successive time interval. Indeed, after four minutes of continuous flushing, all waterlines still harbored CFU levels that exceed current American Dental Association (ADA) recommendations. It was concluded that water flushing of DUWLs produced a statistically significant reduction in planktonic bacteria at each time interval compared to the baseline and between each successive time interval. However, the level of CFUs after four minutes of continuous water flushing still exceeds the current ADA recommendations for acceptable levels of microorganisms.
Banning Live Patients as Test Subjects on Licensing Examinations
Authors: Formicola Allan J. , Shub Judith L. , Murphy Francis J.
Published: June 2020

The use of live patients on the licensing examinations was a part of dentistry for almost the entire twentieth century and continues up until today. Considerable new debate about the appropriateness of using live patients as test subjects began in the mid‐1990s and culminated in the passage of a resolution in the American Dental Association's year 2000 House of Delegates calling for an end to this practice by the year 2005. The live patient examination tests a narrow range of clinical skills, creates ethical dilemmas for candidates, for the host institution, and for the profession, and is unable to distinguish between those ready to assume independent practice from those who are not yet at that level of competence. There are other ways to test for such readiness including proposals in New York State to substitute a postdoctoral year or mannequins in place of live subjects. The public and the dental profession will be better off by developing alternative licensing tests to the use of live subjects.
The Use of Radiation Dose‐Reduction Techniques in the Practices of Dental Faculty Members
Authors: Geist James R. , Katz Jerald O.
Published: June 2020

X‐ray exposure to dental patients has been significantly reduced by the introduction of speed group E intraoral film, rectangular beam limitation, long position indicating devices (PIDs), and rare‐earth intensifying screens for extraoral radiography. Research indicates that many dentists do not use these techniques. However, schools of dentistry have implemented them to varying degrees for many years, so this investigation was conducted to determine the extent to which dental school faculty members use these materials and techniques in their own practices. Comparisons were made between full‐ and part‐time instructors, those in practice for fifteen years or less and those in practice for more than fifteen years, and those with postgraduate education versus those with no formal education beyond dental school. The significance of differences was measured with chi‐square analysis. The results indicate that dentists with faculty appointments utilize dose‐reducing techniques to degrees that are comparable to or greater than reported usage by nondental faculty practitioners. Faculty dentists in practice fifteen years or less are more likely than their older colleagues to use E‐speed film (p = 0.001), whereas those in practice more than fifteen years are more likely to use longer PIDs (p = 0.049). Greater acceptance of these practices by faculty may lead to reinforcement of their use in the clinical education of dental students.
Mentoring Future Dental Educators Through an Apprentice Teaching Experience
Authors: Bibb Carol A. , Lefever Karen H.
Published: June 2020

To address concerns about the growing shortage of dental educators, the UCLA School of Dentistry initiated an elective course to introduce fourth‐year students to issues in academic dentistry and to provide an apprentice teaching experience. Participants in the elective (referred to as student teachers) developed a microcourse entitled “Welcome to Dental Anatomy,” presented to incoming first‐year students during orientation week. Under the guidance of faculty mentors, the student teachers were responsible for development of course content, teaching aids, and evaluation methodology. Two cycles of the elective have been completed, reaching a total of twenty‐one fourth‐year students to date. The positive impact on student teachers and incoming first‐year students indicates that this approach has great potential for encouraging more graduates to pursue careers in academic dentistry. In addition, the program has the potential to be expanded by adaptation to other foundational courses in the dental and dental hygiene curricula.
Reflections on Clinical Practice by First‐Year Dental Students: A Qualitative Study
Authors: Boyd Linda D.
Published: June 2020

During the first and second year of the dental curriculum, students have little time to process and learn the didactic material in a meaningful way because of the large number of required courses in the curriculum. If an outcome of dental education is to promote critical thinking, however, methods need to be explored to encourage this process in dental students throughout the curriculum. Reflecting on experience is the way learners “make meaning” out of the information they acquire, and “making meaning” is an integral component in the development of critical thinking. The purpose of this pilot study was to explore how reflection on clinical experiences may facilitate the development of critical thinking in first‐year dental students as well as assist them in integrating their didactic coursework with clinical care. I used Luborsky's thematic analysis to analyze semi‐structured interviews, clinical observations, and written reflection papers from dental students. The major themes identified from the data were: 1) connections between didactic material and the clinical experience, 2) the students' vision of their future role as dentists, and 3) the nature of the dentist‐patient interaction. The data further suggest a process of reflective thinking that begins with students' questioning assumptions about their prior experience and knowledge that leads them to look at things in a new way and ultimately to recognize the need to take some action to provide care to the patient. The findings suggest that encouraging students to keep a clinic journal or write reflection papers about their experience may be a way to enhance student learning and is an area that deserves further research.
Angiogenesis in Health and Disease: Insights into Basic Mechanisms and Therapeutic Opportunities
Authors: Polverini Peter J.
Published: June 2020

Angiogenesis, the process that leads to the formation of new blood vessels or neovascularization, continues to be a topic of major scientific and public interest. As knowledge of the molecular mechanisms that regulate neovascularization continues to emerge, there is increasing hope that new discoveries will lead to newer therapies that target angiogenesis as a reliable option for disease therapy. For example, it may be possible to develop strategies that, on the one hand, are designed to limit angiogenesis for the treatment of chronic diseases such as cancer or rheumatoid arthritis and, on the other, to promote angiogenesis in the ischemic heart or diabetic limb. With the emergence of tissue engineering as a discipline, it has become increasingly clear that long‐term success in organ and tissue reconstruction will depend on the ability to develop a stable, renewable supply of blood vessels. In this review, I will provide a brief overview of this remarkably versatile biological response and discuss how recent discoveries in the field of angiogenesis have influenced the development of novel therapies, forced a reconsideration of conventional therapies, and revolutionized approaches to organ and tissue reconstruction.
Faculty Appointment Policies and Tracks in U.S. Dental Schools with Clinical or Research Emphases
Authors: Hunt Ronald J. , Gray Carolyn F.
Published: June 2020

The 1995 Institute of Medicine study of the future of dental education, Dental Education at the Crossroads: Challenges and Change, recommended that dental schools increase the use of nontenure‐track positions in their employment of faculty. As part of a larger investigation of faculty appointment processes in U.S. dental schools, dental deans were queried about institutional policies governing faculty appointments and the use of tenure and nontenure faculty tracks. Response from the fifty‐four U.S. schools exceeded 90 percent for each of two mailed questionnaires. Dental schools were classified according to one of two emphases: clinical or research. Deans classified faculty into one of seven appointment tracks. Nontenure‐track appointments were less common in clinical‐emphasis schools. Research‐emphasis schools had a greater mean proportion of their faculties in both the nontenure research track (7.0 percent vs. 2.7 percent) and the nontenure clinical track (20.8 percent vs. 17.4 percent). Compared to faculty appointment data reported in 1990, there were more nontenure‐track faculty in 81 percent of research‐oriented schools and 55 percent of clinical‐oriented schools. The most frequently cited reasons for more nontenure faculty in these thirty‐three schools were greater administrative flexibility, better fulfillment of mission, and increased difficulty achieving tenure. This study showed the number of faculty holding nontenure‐track appointments had increased since 1990, especially among research‐emphasis dental schools.
Managing Nicotine Addiction
Authors: Kotlyar Michael , Hatsukami Dorothy K.
Published: June 2020

Nicotine addiction has been identified as the primary contributor to continued widespread tobacco use worldwide. Although the health benefits of smoking cessation are well publicized, few smokers successfully quit on a long‐term basis. A number of pharmacological agents have been shown to approximately double long‐term smoking cessation rates and have, therefore, been recommended as first‐line therapy for the treatment of nicotine dependence in the clinical practice guidelines recently released by the Agency for Healthcare Research and Quality (AHRQ). These include the currently available dosage forms of nicotine replacement therapy (gum, patch, nasal spray, and inhaler) and bupropion. Other agents that have exhibited some efficacy in increasing smoking cessation rates are nortriptyline and clonidine. All pharmacological treatments are most effective in conjunction with behavioral therapy. Other approaches to treating tobacco use disorder now being investigated include additional ways to administer nicotine, a vaccine to prevent nicotine from crossing the blood‐brain barrier, and agents that alter the metabolism of nicotine. This review summarizes the characteristics of nicotine addiction, reviews the pharmacological agents currently used to treat tobacco use disorder, and describes possible approaches to treat nicotine dependence in the future.
Evaluation of a Clinical Outcomes Assessment Tool in a U.S. Dental School
Authors: Wood A. Jeffrey , Nadershahi Nader A. , Fredekind Richard E.
Published: June 2020

Quality assurance (QA) programs in dental schools have a component of their program devoted to treatment outcomes. To this end, our institution has implemented TOUCH (Treatment Outcomes Unacceptable for Clinical Health) seminars and Unusual Occurrence Reports (UORs). The seminars allow a faculty member to present a case to faculty and students with feedback from the audience on how the case was managed. The UORs track clinical incidents outside the range of normal. Participation in both of these QA measures has been less than expected. The goal of the current study was to discover the reasons for participation and lack of participation. A twelve‐item survey was completed by seventy‐one clinical faculty members and analyzed for trends. Faculty report only 28.3 percent of the unacceptable outcome cases they know about. The two most common reasons given for reporting an unusual occurrence were that it would help the institution reduce similar incidents and it would provide an opportunity to share learning experiences. The most common reason given for not reporting an unusual occurrence was not remembering to do so. Faculty members were most willing to present a TOUCH seminar if guaranteed that no negative repercussions would result. Suggestions for increasing participation in both programs include emphasizing their value, modifying the seminar format, providing more reminders, and reassuring against repercussions.
Therapeutic Use of Hyperbaric Oxygen for Irradiated Dental Implant Patients: A Systematic Review
Authors: Coulthard Paul , Esposito Marco , Worthington Helen V. , Jokstad Asbjorn
Published: June 2020

The aim of this systematic review was to investigate the effectiveness of hyperbaric oxygen (HBO) therapy for irradiated patients who require dental implants using data from randomized controlled clinical trials (RCTs). The review was prepared according to Cochrane Collaboration guidelines. The Cochrane Oral Health Group Specialist Register and the Cochrane Controlled Trials Register were searched (Cochrane Library 2002, Issue 2), together with Medline from 1966 or Embase from 1974. Several journals were hand‐searched, and fifty‐five implant manufacturers were contacted in an attempt to identify ongoing or unpublished studies. The results were that no RCTs comparing HBO with no HBO for implant treatment in irradiated patients were identified. Our principal conclusions are that clinicians ought to be aware and make patients aware of the lack of reliable clinical evidence for or against the clinical effectiveness of HBO therapy in irradiated patients requiring dental implants. There is a need for RCTs to determine the effectiveness of HBO.
A Survey of Information Technology Management at U.S. Dental Schools
Authors: Wrzosek Mariusz , Warner Gary , Donoff R. Bruce , Howell Thomas H. , Karimbux Nadeem
Published: June 2020

The purpose of this project is to assess how information technology (IT) is being implemented and managed in U.S. dental schools. Recent advances in IT have restructured many of the administrative, curricular, and clinical functions in dental schools. Purchasing hardware and software and hiring personnel to maintain IT present significant financial and administrative commitments for these schools. A nine‐question survey was sent to all U.S. dental schools via email with a follow‐up postal mailing. Forty‐six surveys were returned (83.6 percent response rate). The analysis indicates that dental schools are managing IT in vastly different ways. For example, 71 percent of the schools report a centralized structure, and 61 percent have a line item in the budget to manage IT. On average there are 4.4 full‐time equivalents hired to manage IT, with the majority of these people being trained in IT (eight schools reported dually trained IT/dental personnel). The majority of schools report using software to manage their admissions process (70 percent), curriculum analysis (72 percent), and delivery of curriculum content (72 percent), as well as to manage their student clinics (91 percent, business aspect; 87 percent, patients; 65 percent, grading on clinic floor; 76 percent, managing clinical evaluations) and faculty practices (85 percent, business aspect; 65 percent, patients). The use of multimedia (50 percent) and simulation (52 percent) in the preclinical area is mixed. The purchase of laptops (24 percent) and PCs (11 percent) is required in almost a third of all schools participating in this survey. Dental schools in the United States are managing IT in a variety of different ways, using various internally and commercially available tools. The cost to institutions can be large and is usually handled in centralized structures in the school with fixed budgets. The results of this survey can be used to assist schools in the planning and implementation of IT at their institutions.