bluuebunny/crossref_metadata_2025 huggingface dataset:
Program directors' opinions on the competency of postdoctoral general dentistry program graduates
Authors: Glassman P , Redding S , Filler S , Chambers DW
Published: June 2020

Meeting the demand for postdoctoral general dentistry programs will require new, innovative, and flexible models. Many believe that these new models must be competency‐based and focus on the outcomes of postdoctoral general dentistry training rather than on the structure and process of that training. The Section on Postdoctoral General Dentistry of the American Association of Dental Schools formed a broadly representative working group in the fall of 1994 to develop a set of competency and proficiency statements describing graduates of postdoctoral general dentistry programs. PGD program directors were then surveyed to determine the extent to which they felt these competencies matched their concepts of the PGD graduate. Between 44 and 65 competency statements that were rated highly by program directors could serve as the basis for a “core” set of statements to describe the abilities of graduates of postdoctoral general dentistry programs. These data should stimulate further discussion among educators, program directors, accrediting bodies, and government agencies about the future of postdoctoral general dentistry programs.
Using collaborative learning in dental education
Authors: Kleffner JH , Dadian T
Published: June 2020

Collaborative learning organizes students into small groups in which they assist each other to solve problems and integrate skills and knowledge. Students increase self‐esteem and develop a more positive attitude toward learning. Collaborative learning can be used in classrooms, laboratories, and clinical settings. Learning is accomplished through small‐group discussion, with students being responsible for helping each other achieve the desired learning outcomes. Instructors manage content through the design of the learning activities rather than by presenting the material in lectures.
Oral health component of child health services research
Authors: Crall JJ
Published: June 2020

The June 11 JAMA article outlines a rationale for developing a focus on child health services research and offers several strategies for facilitating the process. Developing a child health research agenda is essential to advancing dental care and professional education and, thus, is relevant to educators as well as researchers and policy makers. Oral health considerations are not likely to have high visibility or priority within that agenda unless dental health services researchers and dental schools become involved. An obvious question that is bound to be raised is “does it make sense to attempt to direct some portion of the already scarce resources available for dental health services research to children's issues?” Many individuals in leadership positions will probably think not; however, with an appropriate strategy, a small number of organized individuals and institutions can make a significant difference. Given the nature of dental diseases and the historical values of the profession, what better place to start?
Results of the National Dental Examining Board of Canada written examination and implications for certification
Authors: Gerrow JD , Boyd MA , Duquette P , Bentley KC
Published: June 2020

In 1994, following a request from the ten Provincial Licensing Authorities, the National Dental Examining Board of Canada (NDEB) implemented significant changes to the certification process for dentists seeking a license to practice in Canada. Prior to 1994, graduates of accredited Canadian dental programs were certified without further examination while graduates of United States and other international programs (non‐Canadian, non‐U.S.) were required to complete successfully a written and three‐phase clinical certification examination. Changes implemented in 1994 required graduates of accredited Canadian programs to take both a Written and Objective Structured Clinical Examination (OSCE) Examination. The analysis of the results of the Written Examination for all candidates over the 1994–1996 period supports the following conclusions. There was no meaningful difference in performance of graduates across the ten Canadian dental programs; there was a small difference between the performance of graduates of Canadian and U.S. programs; and Canadian and U.S. graduates performed significantly better than graduates of other international programs. This level of candidate performance and changes to the respective accreditation processes supported the formal agreement providing reciprocal recognition of dental accreditation in Canada and the United States. As of January 1, 1997, graduates of dental programs in Canada and the United States are required to take the same certification examination while international graduates are required to complete a different certification process. These changes to the certification process were ratified by all ten Provincial Licensing Authorities, therefore maintaining a system of national portability for dental licensure in Canada that does not require preclinical or clinical board examinations for graduates of accredited North American dental programs.
Myers‐Briggs Type Indicator and dental school performance
Authors: Jones AC , Courts FJ , Sandow PL , Watson RE
Published: June 2020

The Myers‐Briggs Type Indicator (MBTI) was administered to 256 dental students, representing four classes, at the University of Florida College of Dentistry. The results of this psychological instrument were then correlated with overall dental school performance based on results from the National Dental Board Examinations Part I and II (NB‐I, NB‐II), yearly class rank, and specific academic difficulties as measured by the Student Performance Evaluation Committee. Introverted students were found to display a significantly increased performance on NB‐I (p = .038) and NB‐II (p = .044). They were also found, however, to demonstrate a progressively lower class rank over the four‐year period than extroverted students and were more likely to experience major academic difficulties as well. Judging and sensing individuals were found to earn a higher class rank over the four‐year period than perceiving and intuitive students, respectively. Perceiving students were found to exhibit major difficulties or were placed on probation more often than judging individuals. These results may prove useful in counseling students to recognize potential problems before they commence their dental education or to anticipate and address specific weaknesses during the course of their education.
The effect of frequent quizzes on short‐ and long‐term academic performance
Authors: Geist  , Soehren SE
Published: June 2020

This investigation examined the effect of frequent quiz administration on the performance of dental students on course examinations, post‐tests, and attitudes toward instruction. Students in an introductory radiology course were randomly divided into two groups. Quiz Group (QG) students were given a quiz at the beginning of each class, while students in the Control Group (CG) did not take the quizzes. All students took a midterm and final examination as well as post‐tests at four months and ten months after the end of the course. Students also completed a questionnaire assessing the course and instructor. The QG scored higher than the CG on all exams, but these differences were significant only for the midterm and final exams (p < 0.05) and not the post‐tests (p > 0.05). Evaluations of course content and instructor performance were significantly higher among QG students regarding appropriateness of examinations and overall evaluation of course (p < 0.05). Frequent quizzes enhance short‐term performance on examinations and lead to more favorable student evaluations, but the effects on long‐term retention of knowledge are not significant.
Analyzing the sources of unreliability in fixed prosthodontics mock board examinations
Authors: Chambers DW , Loos L
Published: June 2020

Mock board examinations in fixed prosthodontics were submitted to generalizability analysis in order to determine which sources of unwanted variance of measurement contribute to grade decisions and whether this lack of reliability is of practical significance. Students completed approximately three fixed prosthodontics test cases during their final year of clinic, and each case was scored by two faculty members. Of the subsamples of students where two test cases (trials) per student were graded by the same two raters, the subsamples with the highest and the lowest inter‐rater reliability coefficients were chosen. Typical generalizability coefficients (reliability considering both raters and trials as sources of error) are much lower than the inter‐rater reliability estimate, and the standard error of measurement is 80 percent of a grade interval on a five‐point scale. In all analyses, the largest source of variance was the student‐by‐trial interaction, accounting for about 80 percent of the standard error of measurement or one‐half a grade on a five‐point scale. Even in the subsample with lowest inter‐rater reliability, rater, rater‐by‐student interaction, and rater‐by‐trial interaction made no contribution to measurement error. Nor did students show evidence of improving over time. There is no possible improvement through the use of rater calibration or additional raters that would equal the improvement made by using two test cases rather than one. The concept of gradient of generalizability is introduced, and implications for initial licensure examinations are discussed.
Making science clinically relevant
Authors: Valachovic RW
Published: June 2020

Clinical practice requires a sound foundation in the basic and clinical sciences. However, the traditional dental curriculum often separates the two in a variety of ways that reduce their integration. The basic sciences are commonly taught in the first two years by a basic science faculty with inconsistent integration with clinical dental practice. The clinical sciences are often taught by faculty who may not be actively involved in research‐related activities. The curriculum is dense and is difficult to modify to adapt to evolving scientific discovery and application. The 1995 IOM report focuses much of its attention on these issues. The Harvard School of Dental Medicine has dramatically modified its curriculum twice in the recent past to more closely integrate the basic and clinical sciences and to promote the clinical relevance of the basic sciences. The class entering in 1980 began a five‐year D.M.D. program that was designed to decompress the curriculum and increase experiences that enhance scientific and clinical integration. The class entering in 1994 initiated a four‐year program that uses a problem‐based learning design throughout the entire curriculum. Strategies for integrating the clinical and the basic sciences along with research training and experience were developed and implemented in both programs.
Construct validity of the restructured National Board Dental Hygiene Examination
Authors: Kramer GA , DeMarais DR
Published: June 2020

The construct validity of the restructured National Board Dental Hygiene Examination, as operationalized in the pilot, was examined. The findings show that the examination assesses a full range of relevant content and cognitive behaviors. The results of the principal component analysis of the examination data indicate that the pilot is a unidimensional test of dental hygiene functions. The performances of students on the restructured examination and on the April 1996 dental hygiene examinations were comparable. These findings suggest that the restructured dental hygiene examination will be a valid measure of dental hygiene students' knowledge and problem‐solving skills.
Academic deans' perceptions of current and ideal curriculum emphases
Authors: Graber DR , O'Neil EH , Bellack JP , Musham C , Javed T
Published: June 2020

This study assessed the current and ideal for dental curriculum emphasis of thirty‐three curriculum topic areas and evaluated barriers to curriculum change. A forty‐six item survey was mailed to the academic deans of all U.S. dental schools with an 86 percent e response rate (n = 57). The means of their responses for current curricular emphasis and ideal emphasis on the thirty‐three topic areas were compared. “Health promotion/disease prevention,” “primary care,” and “effective patient‐provider relationships/communication” were the three topic areas rated most highly (for ideal emphasis) by the academic deans. “Case management,” “outpatient/ambulatory care,” and “continuous quality improvement” also received high mean scores for ideal emphasis. The most significant barrier to curriculum reform was “an already crowded curriculum.” The academic deans reasserted the traditional emphasis in dentistry on primary care. There also appears to be considerable support for educational programs that will foster better patient relationships and greater quality assurance and control.
The effect of clinical targets on productivity and perceptions of clinical competency
Authors: Stacey MA , Morgan MV , Wright C
Published: June 2020

This study investigated the effect of clinical targets on clinical productivity and perceptions of clinical competency of final‐year undergraduate dental students. Students were randomly divided into two equal groups. One group was set annual numerical clinical targets while the other had no targets. All final‐year students and final‐year clinical teachers were asked to complete a questionnaire rating six different aspects of student clinical competency at the end of semester 1 and semester 2. Changes in perception of clinical competency by students and clinical teachers were compared between the target and no‐target groups and between students and clinical teachers. The clinical output of both groups was measured. There was no significant difference in performance between the target and no‐target group as assessed by clinical teacher or by student self‐assessment. However, by the completion of the study the clinical teachers scored the students (irrespective of group) significantly lower for clinical competency than students assessed themselves. There was no significant difference between the productivity of the two groups. The setting of clinical targets had no measurable effect on the perceived clinical competency or productivity of this group of undergraduate dental students.
Acquisition of a touching style
Authors: Schifter CC , Bogert M , Boston D
Published: June 2020

A qualitative study investigated dental student perceptions of learning to use touch in dental treatment. A focus group design was used to allow volunteer participants (students, general dentistry residents, and dental faculty; n = 41) to discuss issues related to this question. Each focus group was audiotaped for accuracy and transcribed by an independent person. Data gathered were textually and thematically analyzed around the specific questions asked. The data indicated that learning to touch dental patients was often trial and error and uncomfortable for these students. Further, the data suggested that a fine line exists preventing students from asking for assistance and faculty in offering assistance.
Sources of stress for Australian dental students
Authors: Sanders AE , Lushington K
Published: June 2020

The Dental Environment Stress questionnaire was used to identify and quantify sources of stress for 205 Australian Bachelor of Dental Surgery students. A factor analysis revealed negative self‐efficacy beliefs accounted for almost one third of the total variance, and despite higher stress levels reported by females, a marked similarity in the dominant patterns emerged for males and females. In testing for differences in residency status, international students expressed significantly more stress from peer pressure, and this is discussed within a socio‐cultural context. Irrespective of gender, residency status, and class year, students ranked examinations and grades as the single most stress‐inducing concern. Overall, stress intensity tended to escalate over time, peaking in the fourth year of training. It is suggested that dental students may be prone to unhealthy perfectionism, placing them at risk for the harmful consequences of chronically elevated stress levels.
Report of the ADEA president's task force on the Surgeon General's report on oral health. American Dental Education Association
Authors: Ferrillo PJ , Chance KB , Garcia RI , Kerschbaum WE , Koelbl JJ , Molinari JA , Niessen LC , Wilson S , Hutchinson RA , Crawford LH , Valachovic RW , Haden NK
Published: June 2020

In response to the first‐ever Surgeon General's report on oral health, released on May 25, 2000, ADEA President Rowland A. Hutchinson, D.D.S., M.S., appointed a task force to study the report from the perspective of dental education. The task force was charged with making recommendations to the ADEA Board of Directors as to the Association's message to members and the general public, the Association's role in addressing oral health disparities, the legislative and policy implications of the report, and areas of collaboration between ADEA and others in the dental and health professions. The task force reviewed the report and made five recommendations, including increasing public awareness of the report's messages, promoting collaborative activities with a goal of improving America's oral health, and providing leadership in the drive to promote the incorporation of new science in dental education. The task force also identified numerous ADEA initiatives that address issues related to the Surgeon General's report.
Reasons that orthodontic faculty teach and consider leaving teaching
Authors: Kula K , Glaros A , Larson B , Tuncay O
Published: June 2020

To assess reasons why orthodontic faculty consider leaving academia, a pretested questionnaire was mailed to 200 full‐time (FT) and 200 part‐time (PT) faculty randomly selected from the United States and Canada. A total of 144 (72 percent) of FT and 120 (60 percent) PT responded. About 38 percent FT and 25 percent PT were currently considering leaving academia. The average age of each group was about fifty years. Although significant differences were found in fifteen factors affecting the decision to leave, three factors ranked as most important (means> or =3.4) for FTs: salary support, financial support of department, and control over work or destiny. The three factors most important (means>3. 1) for PTs were: challenge of private practice, family commitments, and personal. FT and PT were similar in the most important and least important factors influencing their initial reasons to teach and satisfaction in teaching. However, the reasons why FT considered leaving were work related, while the PT's reasons were more personal. With the current shortage of FT orthodontic faculty becoming imminently greater, it appears that work‐related issues could be addressed directly by administration.
Observing the behavior of senior dental students in relation to infection control practices
Authors: Freire DN , Pordeus IA , Paixao HH
Published: June 2020

To achieve adequate infection control in the dental practice, dental students should be fully aware and prepared to adopt necessary procedures. But most studies of students' infection control behaviors rely on self‐reported data. This study verified, through direct observation, how senior dental students performed basic infection control procedures and assessed how close to reality the reported behavior is to the observed behavior. Eight students were observed in three clinics: pediatric dentistry, minor oral surgery, and primary care promotion. The students were not aware of who was being observed or why. Later all twenty students comprising that clinical subgroup answered a questionnaire. Seventy‐two patient‐student contacts were observed. Students considered basic infection control procedures as relevant. The reported intention of adoption of these procedures after graduation dropped in relation to their reported relevance. Although the observed behavior in the three clinics was considered satisfactory, when compared to the reported behavior, it was found that the intention was more positive than the behavior itself. Even though the students were conscious about the importance of cross‐infection control in the dental practice, the reported intention of future use and mainly the observed behavior should be improved.
Dental school faculty shortages increase: an update on future dental school faculty
Authors: Haden NK , Beemsterboer PL , Weaver RG , Valachovic RW
Published: June 2020

The 1999 publication of the American Association of Dental Schools (AADS) President s Task Force on Future Dental School Faculty revealed a crisis in the shortages of dental school faculty. Stakeholders from around the nation have used the AADS Task Force report to address the crisis. In addressing one of the AADS Task Force recommendations, the American Dental Education Association (ADEA), formerly AADS, gathered additional data through a new survey of dental school deans to elucidate the current state of faculty shortages. Based on this research, ADEA projects that the number of unfilled budgeted faculty positions in U.S. dental schools now approaches 400. Survey respondents identified retirement as the leading reason for full‐time faculty separations, while separation to enter private practice was the second most frequent reason for leaving the institution. Offering a salary competitive with that of private practice was identified as the most critical factor in recruiting future faculty. A number of short and long‐range strategies to recruit and retain faculty are presented. Ultimately, the dental school faculty shortage places in jeopardy the general and oral health of the public.
Physical and Chemical Aspects of Saliva as Indicators of Risk for Dental Caries in Humans
Authors: Leone Cataldo W. , Oppenheim Frank G.
Published: June 2020

The etiology and pathogenesis of dental caries are known to be multifactorial, but the interplay between intrinsic and extrinsic factors is still not fully understood. As in other host/parasite interactions, there appear to be marked variations in individual susceptibility to the disease. It therefore is likely that intrinsic host factors play a key role in modulating the initiation and progression of caries. The objective of this systematic review was to evaluate critically the evidence supporting the role and effects of saliva in caries pathogenesis. The full‐length evidence report, including evidence tables, and the structured abstract presented at the NIH/NIDCR Consensus Development Conference on the Diagnosis and Management of Dental Caries Throughout Life, March 26‐28, 2001, can be accessed at the web site http://www.nidcr.nih.gov. The present abridged report is a summary of the main findings from our evidence‐based review.
Emerging Methods Used in the Prevention and Repair of Carious Tissues
Authors: Clarkson Brian H. , Rafter Mary E.
Published: June 2020

A systematic review was undertaken to investigate four emerging methodologies that might be used in the prevention of caries and/or repair of carious tissues. These included a partitioned dentifrice, laser technology, fluoride‐releasing dental materials, and for deep carious lesions, bone morphogenic protein (BMP) therapy. The search strategy was to review articles written in English, indexed in MEDLINE and EMBASE databases and published since 1976. Over two hundred articles were read but because of the inclusion and exclusion criteria, only thirty‐three were included in the evidence tables. The review of partitioned toothpaste showed either a greater remineralizing effect or a greater increase in the resistance to demineralization of both enamel and dentin, with the exception of its lack of effectiveness on coronal caries in the only clinical trial. Five of the six in vitro studies on enamel and the one study on dentin reported that lased tissue was less soluble than nonlased. Six clinical and four in situ studies were reviewed in answering the question as to whether fluoride‐releasing restorative materials increase the remineralization or resistance to demineralization of human enamel and dentin. Eight of these reported positive findings. Six animal studies investigating BMP were reviewed, and all showed the ability of BMP to induce tubular dentin formation. Although the laboratory, animal, and limited clinical trials report encouraging results, independent, randomized, controlled clinical trials need to be carried out before these emerging technologies can be recommended for use in general practice.
Clinical Decision‐Making for Caries Management in Primary Teeth
Authors: Tinanoff Norman , Douglass Joanna M.
Published: June 2020

The aim of this review of clinical decision‐making for caries management in primary teeth is to integrate current knowledge in the field of cariology into clinically usable concepts and procedures to aid in the diagnosis and therapy of dental caries in primary teeth. The evidence for this paper is derived from other manuscripts of this conference; computer and hand searches of scientific articles; and policy statements of councils or commissions of various health organizations. Current evidence regarding the carious process and caries risk assessment allows the practitioner to transcend traditional surgical management of dental caries in primary teeth. Therapy can focus on patient‐specific approaches that include disease monitoring and preventive therapies supplemented by restorative therapies. The type and intensity of these therapies should be determined utilizing data from clinical and radiograph examinations as well as information regarding caries risk status; evidence of therapy outcomes; assessment and reassessment of disease activity; natural history of caries progression in primary teeth; and preferences and expectations of guardians and practitioners. Changes in the management of dental caries will require health organizations and dental schools to educate students, practitioners, and patients in evidence‐ and risk‐based care.
The Diagnosis of Root Caries
Authors: Banting David W.
Published: June 2020

The most commonly used clinical signs of root caries are visual (color, contour, surface cavitation) and tactile (surface texture) descriptions of a lesion. The traditional methods of visual‐tactile diagnosis for root caries can produce a correct diagnosis but usually not until the lesion is at an advanced stage. Despite the subjectivity inherent in interpreting the clinical signs of root caries diagnosis, good to excellent inter‐examiner reliability has been reported in clinical studies; however, the presence of filled surfaces dramatically enhances the agreement. When only untreated root caries is diagnosed, examiner reliability is reduced considerably. Clinicians look to diagnostic tests in the hope that they will perform better (that is, be more reliable) than clinical diagnosis and, therefore, can be used to replace clinical diagnosis. From the limited data available on diagnostic tests for root caries, tests determining the presence or absence of mutans streptococci and Lactobacilli are the most clinically helpful, producing calibrated efficiency scores exceeding 40 percent. The risk assessment approach to root caries diagnosis involves the determination of a patient's risk through the interpretation of clinical signs and the selection and application of an appropriate diagnostic test if the clinician is unsure of the diagnosis.
Diagnosis of Secondary Caries
Authors: Kidd Edwina A. M.
Published: June 2020

A systematic review of the diagnosis of dental caries was produced before the conference. It did not include the diagnosis of secondary or recurrent caries. This was a wise decision because what little literature exists on the subject potentially clouds the issue. Diagnosis is a mental resting place on the way to a treatment decision. A vital part of caries diagnosis is to decide whether a lesion is active and rapidly progressing or already arrested. This information is essential to plan logical management. However, lesion activity should be judged in the patient. Thus, research on the diagnosis of secondary caries must be carried out in vivo and this usually precludes histological validation. Even if such validation is possible, it has its own problems, particularly in distinguishing recurrent from residual caries. The diagnosis of secondary caries is very important since so many restorations are replaced because dentists think there is a new decay. It will be important to establish valid criteria for the diagnosis of active secondary caries, which will be facilitated by the suggestion that secondary caries is no different from primary caries except that it occurs next to a filling. This implies that it can be seen clinically and on a radiograph, next to a restoration.
Impact of Undergraduate Medical Training on Housestaff Problem‐Solving Performance: Implications for Problem‐Based Curricula
Authors: Patel Vimla L. , Arocha José F. , Leccisi Michael S.
Published: June 2020

This article reports a study comparing the problem‐solving performance of housestaff with undergraduate medical training in either conventional or problem‐based schools. After reading two clinical cases, residents were required to write differential diagnoses and pathophysiological explanations. Biomedical and clinical knowledge used and reasoning strategies were identified. The results suggest that housestaff performance is influenced by the nature of instruction. Housestaff trained in a conventional curriculum (CC) focused on patient information, separated biomedical from clinical knowledge, and used data‐driven strategies. Housestaff from problem‐based learning curricula (PBLC) organized their knowledge around generated inferences, integrated biomedical and clinical knowledge, and used hypothesis‐driven strategies. Data‐driven reasoning appears to be impeded in PBLC, suggesting that PBLC students have difficulties in acquiring problem schemata. Previous investigations also found this pattern to be true for medical students trained in two different curriculum formats. Although all housestaff generated equal numbers of diagnostic hypotheses during the reasoning process, housestaff from the conventional curriculum generated a greater number of accurate hypotheses than residents in PBLC. These results are discussed in relation to assumptions in health professional curricula about the adequacy of hypothetico‐deductive methods of reasoning as teaching mechanisms and the need for clinical and biomedical knowledge integration.
Use of Simulation Technology in Dental Education
Authors: Buchanan Judith Ann
Published: June 2020

Simulation is becoming very beneficial in the area of health care education. Dentistry has used various types of simulation in preclinical education for some time. This article discusses the impact of the current simulation laboratories on dental education and reviews advanced technology simulation that has recently become available or is in the developmental stage. The abilities of advanced technology simulation, its advantages and disadvantages, and its potential to affect dental education are addressed.
U.S. and Canadian Dental School Involvement in Extramural Programming
Authors: Ayers Curt S. , Abrams Richard , Robinson Michelle
Published: June 2020

This project was undertaken from July 1999 to August 2000 to identify the status of extramural programming (that is, a program that has undergraduate dental students providing any aspect of dental care to individuals in settings outside the main clinical facility of the school) in North American dental schools. A survey instrument was mailed to all United States and Canadian dental schools concerning student involvement in extramural programming. The response rate was 79.7 percent. Of the schools responding, 3.9 percent did not offer extramural programming. The type of extramural sites, the percentage of schools offering each type of site, and the mean number of weeks students are at each site were as follows: hospital clinics—71 percent, 2.5 weeks; public health clinics—65 percent, 6 weeks; schools and day care centers—49, 1.7 weeks; private dental offices—37 percent, 2 weeks; and “other” —29 percent, 2.5 weeks. The average number of weeks spent at extramural site(s) per class was: freshman 1.9 weeks (SD=4.3); sophomores 2.3 weeks (SD=4.2); juniors 2.6 weeks (SD=1.9); and seniors 5.3 weeks (SD=6.7). Of total student time in extramural programming, 43.3 percent was spent delivering basic clinical services, 24.4 percent comprehensive clinical services, 11.8 percent health education, 11.8 percent preventive dentistry, and 8.7 percent community activities. From the data collected, it is apparent that the majority of North American dental schools are providing a variety of extramural experiences for their dental students. It was found that student involvement in extramural programming increases gradually from the freshman to the senior year.
Disinfection/Sterilization of Extracted Teeth for Dental Student Use
Authors: Dominici J. T. , Eleazer P. D. , Clark S. J. , Staat R. H. , Scheetz J. P.
Published: June 2020

Extracted human teeth are used in many preclinical courses. While there has been no report of disease transmission with extracted teeth, sterilization of teeth used in the teaching laboratory should be a concern. The purpose of this study was to determine the effectiveness of different sterilization/disinfection methods of extracted human teeth using Bacillus stearothermophilus, a bacteria resistant to heat and frequently used to test sterilizers. In this study, 110 extracted molars with no carious lesions were collected and stored in buffered saline. An endodontic occlusal access preparation was cut into the pulp chamber of each tooth. Pulp tissue in the chamber was removed with a broach. Approximately 1 times 105 B. stearothermophilus endospores in culture medium were injected into the pulp chamber, sealed with Cavit G, and then placed in sterile saline for twelve hours. Ten teeth were placed into each of eleven groups. Seven groups were immersed for one week in one of the following solutions: a) sterile saline (control group), b) 5.25% NaOCl, c) 2.6% NaOCl, d) 1% NaOCl, e) 10% buffered formalin, f) 2% gluteraldehyde, g) 0.28% quaternary ammonium. Four additional groups were treated by h) 10% formalin for two days, i) 10% formalin for four days, j) autoclaving at 240°F and 20 psi for twenty minutes, and k) autoclaving at 240°F and twenty psi for forty minutes. Each tooth was then aseptically split and placed in an individual test tube with growth medium. Samples were examined for evidence of growth (turbidity) at forty‐eight hours. Only autoclaving for forty minutes at 240°F and 20 psi or soaking in 10 percent formalin for one week were 100 percent effective in preventing growth. A chi‐square analysis of the data indicates these two methods were significantly better than all other methods (p<0.001).
Replacing and Renewing: Synthetic Materials, Biomimetics, and Tissue Engineering in Implant Dentistry
Authors: Ratner Buddy D.
Published: June 2020

Hundreds of thousands of implantations are performed each year in dental clinical practice. Dental implants are a small fraction of the total number of synthetic materials implanted into the human body in all fields of medicine. Basically, these millions of implants going into humans function adequately. But longevity and complications still are significant issues and provide opportunities for the creation of improved devices. This manuscript briefly reviews the history of dental implant devices and the concepts surrounding the word “biocompatibility.” It then contrasts the foreign body reaction with normal healing. Finally, the article describes how ideas gleaned from the study of normal wound healing can be applied to improved dental implants. In a concluding section, three scenarios for dental implants twenty years from now are envisioned.
Occupational Exposures to Blood in A Dental Teaching Environment: Results of a Ten‐Year Surveillance Study
Authors: Younai Fariba S. , Murphy Denise C. , Kotelchuck David
Published: June 2020

Evaluation of occupational exposures can assist with practice modifications, redesign of equipment, and targeted educational efforts. The data presented in this report has been collected as part of a ten‐year surveillance program of occupational exposures to blood or other potentially infectious materials in a large dental teaching institution. From 1987 to 1997, a total of 504 percutaneous/non‐intact skin and mucous membrane exposures were documented. Of these, 494 (98 percent) were percutaneous, and 10 (2 percent) were mucosal, each involving a splash to the eye of the dental care worker (DCW). Among the 504 exposures, 414 (82.1 percent) occurred among dental students, 60 (11.9 percent) among staff, and 30 (6 percent) among faculty. One hundred ninety‐one (37.9 percent) exposures were superficial (no bleeding), 260 (51.6 percent) were moderate (some bleeding), and 53 (10.5 percent) were deep (heavy bleeding). Regarding the circumstances of exposure, 279 (54.5 percent) of the injuries occurred post‐operatively (after the use of the device), and most were related to instrument clean‐up; 210 (41.0 percent) occurred intra‐operatively (during the use of the device); and 23 (4.5 percent) occurred when a DCW collided with a sharp object in the dental operatory (eight cases involved more than one circumstance). The overall exposure rate for the college was 2.46±0.11 SD per 10,000 patient visits. The average rate for the student population was 4.02±0.20 SD per 100 person‐years, with the highest rates being observed among junior year students. The observed rates of occupational exposures to blood and body fluids in this report are consistent with published reports from several other educational settings. Dental teaching institutions are faced with the unique challenge of protecting the student and patient populations against bloodborne infections. Educational efforts must go beyond mere teaching of universal precautions and should include the introduction of safer products and clinical procedures that can minimize the risks associated with the hands‐on aspects of the students' learning process.
Development of New Pain Management Strategies
Authors: Hargreaves Kenneth M. , Keiser Karl
Published: June 2020

The continued development of more effective and predictable methods for pain control is a process that combines the best efforts of basic and clinical scientists. This review explores the developing themes of clinical pain management strategies that are emerging from molecular, cellular, and physiologic research into pain mechanisms and emphasizes the unique opportunity that several years of well‐controlled clinical trials affords the dental education community to provide evidence‐based learning in pain treatment strategies.
Empathic Communication Between Dental Professionals and Persons Living with HIV and AIDS
Authors: Wiltshire Anne D. , Ross Michael W. , Brimlow Deborah L.
Published: June 2020

We studied changes in the affective and empathic responses of sixty‐three dental school faculty, students, and staff to people with HIV/AIDS following an HIV/AIDS training session. Empathic response was measured using a modification of the Gallop Staff Patient Interaction Scale, with five statements to which the provider responded at baseline and three times during and after the training. Data were subjected to theme analysis and analysis of empathic level of response, where a theme is a central idea that can be identified by expressed language. Results indicated that themes of provider response included the role and importance of maintaining health, reassurance, comfort, and hope. Negative responses were rare, accounting for only 3 percent of responses. Following the training, themes were expressed more fully but usually did not change. Changes in level of empathy usually paralleled changes in themes. These data describe the measurement of empathy in dental providers dealing with people with HIV/AIDS and changes in the themes and levels of empathy following an HIV/AIDS training session.
The Influence of Computer‐Assisted Instruction on Acquiring Early Skills in Intraoral Radiography
Authors: Howerton W. Bruce , Platin Enrique , Ludlow John , Tyndall Donald A.
Published: June 2020

The purpose of this study was to determine if there was a significant difference in the diagnostic quality of the initial full‐mouth series (FMS) exposed by first‐year dental students after viewing a Computer Assisted Instruction (CAI) module on radiographic technique as compared to those who did not and to determine if students who used the CAI module expressed a preference to using it and would recommend its use prior to exposure. Fifty‐nine first‐year dental students were randomly selected and assigned to two groups (students who did not view a CAI CD and students who did) before exposing their initial FMS on a Dental X‐ray Training and Teaching Replica (DXTTR®). For each radiographic series, a radiology faculty member determined the total number of error points based on performance criteria. The Wilcoxon Rank Sum Test was used to determine significance between the two groups, p = .05. After exposing the FMS, students in the second group completed a questionnaire to assess their preference for using the CAI CD. The Sign Rank Test was used to determine preference, p = .05. No significant difference in error points were found to exist between the two groups. Dental students who reviewed the CAI preferred using it and would recommend it to others before exposing their FMS.
Learning Approaches and Learning Difficulties: A Comparison of Indian and Nepali Dental Science Students
Authors: Mayya Shreemathi S. , Rao A. Krishna , Ramnarayan K.
Published: June 2020

This study explored the difference in learning approaches and difficulties of Nepali and Indian undergraduate students of dental science. A locally developed inventory was used to measure learning approach and learning difficulties. Data collected from 166 Indians and 69 Nepalis were compared. The scores on various scales of the inventory indicate that Nepalis are more fearful and less confident regarding examination and course completion and have significantly less positive perception about academic capability. Indian students scored significantly higher on motivation, interest, and deep processing. The language problem was significantly greater for Nepali students. Higher percentages of Nepalis experienced various academic and nonacademic problems. The study highlights the need to consider difference in learning approach among the students of health science courses that admit students from different academic, nonacademic, and cultural backgrounds.
Using OSCE‐Based Evaluation: Curricular Impact over Time
Authors: Zartman Rosemarie R. , McWhorter Alton G. , Seale N. Sue , Boone William John
Published: June 2020

The Objective Structured Clinical Examination (OSCE) is becoming more widely used for performance assessment in dentistry. The department of pediatric dentistry at Baylor College of Dentistry (BCD) began incorporating the OSCE into its curriculum in 1995. This article describes the evolution of the department's use of the OSCE and its impact on teaching and the curriculum. The discussion focuses on logistics and station design, curricular content and order, student anxiety, writing and scoring exams, and curriculum assessment. BCD has found that using an OSCE‐based testing format is time‐consuming and labor‐intensive, but provides unprecedented feedback about students' understanding and pinpoints areas of confusion. The demands of an OSCE‐based testing format reveal that students can master, to the level of competency, only a finite amount of information in a given time period. The timed, interactive aspects of the OSCE create high levels of student anxiety that must be addressed. Writing and scoring OSCE items are different from traditional test items. The OSCE is a valuable mechanism to assess the students' progress toward competency. This review of the process of incorporating OSCEs into a curriculum is the foundation for future assessment of the OSCE and its use for curricular improvement.
PGD Training and Its Impact on General Dentist Practice Patterns
Authors: Atchison Kathryn A. , Mito Ronald S. , Rosenberg Dara Jean , Lefever Karen H. , Lin Sylvia , Engelhardt Rita
Published: June 2020

This study compares the practice patterns of general dentists with and without formal advanced training in AGED or GPR programs. The UCLA School of Dentistry surveyed a random selection of dentists from graduating years 1989, 1993, and 1997 as part of a Health Resources Services Administration (HRSA)‐supported evaluation of the impact of federal funding on postgraduate general dentistry (PGD) programs. Using a sample drawn by the American Dental Association (ADA), 6,725 dentists were surveyed about their practice, advanced training, patients served, and services provided. Of the 2,029 dentists (30 percent) who responded, 49 percent were practicing dentists with no formal advanced training in general dentistry or one of the eight ADA specialties; 7 percent had Advanced Education in General Dentistry (AEGD) experience; 20 percent trained in a General Practice Residency (GPR); and 24 percent were specialists. Additionally, 7 percent of respondents had PGD training and a clinical specialty. GPR‐trained dentists were significantly more likely to be on a hospital staff and to treat medically compromised patients even after ten years of practice. PGD dentists were less likely to seek specialty training. Major reasons for seeking PGD training were increasing treatment speed, learning to treat medically compromised patients, and wanting hospital experience. Primary reasons for not selecting training were starting a practice and having a great practice opportunity. Our conclusion is that PGD training has an enduring impact on practice patterns and improves access to dental care for underserved populations.
Major Long‐Term Factors Influencing Dental Education in the Twenty‐First Century
Authors: Cohen M. Michael
Published: June 2020

With evolutionary advances in oral science over the long term, clinical reliance on chemotherapeutics, bacterial replacement therapy, and immunization will necessitate a broader background in medicine. The dramatic increase in the old age population will also require a much stronger medical background. By 2050, those over fifty‐five years of age will represent 56 percent of the population, and 25 percent of these will be sixty‐five years of age and older. The merging of dental and medical education is predicted to occur within the twenty‐first century. Other topics addressed include research activities, with recommended strategies to enhance the integration of scientific and clinical dental approaches; the problem of dental faculty isolation; and the implications of financial constraint and accountability.