Prevention of dental trauma during childhood: An overview

The aim of the present study was to evaluate the prevention of dental trauma in children aged 0 to 3 years, as it is studied in the literature. Since these traumatic injuries can cause damage and complications to the deciduous teeth, and even to the permanent teeth, the development of actions to reduce their occurrence is necessary because these injuries represent a considerable problem in dentistry. Although prevention is difficult in this age group, efforts should be directed at education, especially the development of educational programs involving qualified professional directly engaged in the routine of traumatic dental injuries. The actions to be adopted should be based on the understanding of etiological factors, on the different patterns of the mechanism of injury, and on the characteristics of each community. © 2009 Bentham Science Publishers Ltd.

Influence of the ICDAS e-learning program for occlusal caries detection on dental students

The aim of this study was to evaluate the influence of ICDAS training in a group of dental students for occlusal caries detection in permanent teeth. Premolars and molars (N=104) with occlusal surfaces varying from ICDAS scores 0 to 6 were cleaned, one occlusal site per tooth was selected, and a photograph taken to identify the site. Eight senior dental students examined the teeth twice with a one-week interval between examinations during each of two phases: before and after the ICDAS e-learning program. Teeth were histologically assessed for caries extension. Intraclass correlation coefficients for intra- and interexaminer repeatability were high, both before (0.75 and 0.72, respectively) and after e-learning (0.82 and 0.78, respectively). The ICDAS scores decreased significantly from before to after e-learning (p=0.0001). Correlation between ICDAS scores and histology scores was moderate (0.57 before e-learning and 0.61 after). Although the ROC curve shows an improvement in the use of the ICDAS scoring after e-learning, the difference was not significant (p=0.10). Specificity of the ICDAS scores significantly improved after e-learning (77 percent vs. 36 percent), and sensitivity was reduced slightly after e-learning (87 percent vs. 92 percent). The ICDAS e-learning program improved the performance of the diagnostic skills of the investigated students for the detection of occlusal caries lesions.

Dental caries experience in children attending an infant oral health program

Aim: To investigate: a) caries experience in 5 year-old children and its relationship to the caries risk evaluation made before 1 year of age; b) compliance of parents to an infant oral health program as well as the abandonment reasons. Methods: Group A (GA) - 242 children (60-71 months old) who stayed in the program and had been enrolled since their first year of life underwent a clinical examination according to the WHO's criteria; their parents/caregivers were interviewed to ascertain their compliance to the program. Group B (GB) - parents of 60 children, who had dropped out of the program, were interviewed to check the reasons of withdrawing. The caries risk classification was based on the file at the first appointment. Chi-square test was used (α=0.05) for statistical analyses. Results: Most of the children were free of caries (71.1%). Caries risk evaluation showed low sensibility (34.3%, 95% CI = 22.4-46.1) and high specificity (74.4%, 95% CI = 67.6-81.2) to caries experience. Sixty-two mothers (25.6%) reported difficulty to follow the guidelines. The main reason for dropping out was changing to similar health services (40.0%). Conclusions: Caries risk in the first year of life was not efficient to predict dental caries experience at 5 years of age. Educational practice should be improved to increase the compliance of the parents to the program.

Brazilian dental students' intentions and motivations towards their professional career

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dental students' familiarity with the medical management of dental patients at Brazilian dental schools

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perception of Risk of Musculoskeletal Disorders Among Brazilian Dental Students

The aim of this study was to compare the mean scores of perceived risk factors for the development of musculoskeletal disorders in dental students presently pursuing work/study, according to gender, course series, and the presence of pain/discomfort. The participants were 348 students from the undergraduate course in dentistry at a Brazilian public university. The instrument on work-related factors that could contribute to osteomuscular symptoms and part of the Nordic questionnaire were used. The psychometric properties of the first instrument were estimated. A multivariate analysis of variance (MANOVA) revealed that the instrument had a tri-factorial structure (s2 retained: 62.72 percent). The retained factors were repetitiveness, work posture, and external factors. The internal consistency and reproducibility were adequate (α=0.746 to 0.873; p=0.729 to 0.940). Lower mean scores of perceived external factors were observed for the male participants, as well as lower scores in the three dimensions of the instrument for first-year students of the course and for those who did not report pain/discomfort in the neck, feet, and ankles. The authors concluded that the perception of risk factors for musculoskeletal disorders reported in the work/study environment of dental students was significantly related to gender, the course series, and the presence of pain/discomfort.

Dental students familiarity with the implications of using local anesthetics and dental materials

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Stress and burnout among Swiss dental residents

Stress and burnout have been well-documented in graduate medical and undergraduate dental education, but studies among dental graduate students and residents are sparse. The purpose of this investigation was to examine perceived stressors and three dimensions of burnout among dental residents enrolled in the University of Bern, Switzerland. Thirty-six residents enrolled in five specialty programmes were administered the Graduate Dental Environment Stress (GDES30) questionnaire and the Maslach Burnout Inventory (MBI). Individual stress items and overall GDES30 scores were used to quantify perceived stress. To measure burnout, proportions of burnout "cases" and MBI subscale scores were computed in the domains of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Analyses relied on descriptive and bi-variate methods. The mean GDES30 score was 2.1 (SD = 0.4). "Lack of leisure time", "meeting the research requirement of the programme" and "completing graduation requirements" emerged as the top three stressors. Thirty-six percent of respondents were burnout "cases" on the PA scale, while this proportion was 17% for EE and 8% for DP. Both stress and burnout levels increased according to year of study, whereas younger residents and females had consistently higher stress and burnout scores compared to older ones and males. Overall, low levels of perceived stress and burnout were found among this group of Swiss dental residents.

An investigation of computer literacy and attitudes amongst Greek post-graduate dental students

An accurate assessment of the computer skills of students is a pre-requisite for the success of any e-learning interventions. The aim of the present study was to assess objectively the computer literacy and attitudes in a group of Greek post-graduate students, using a task-oriented questionnaire developed and validated in the University of Malmö, Sweden. 50 post-graduate students in the Athens University School of Dentistry in April 2005 took part in the study. A total competence score of 0-49 was calculated. Socio-demographic characteristics were recorded. Attitudes towards computer use were assessed. Descriptive statistics and linear regression modeling were employed for data analysis. Total competence score was normally distributed (Shapiro-Wilk test: W = 0.99, V = 0.40, P = 0.97) and ranged from 5 to 42.5, with a mean of 22.6 (+/-8.4). Multivariate analysis revealed 'gender', 'e-mail ownership' and 'enrollment in non-clinical programs' as significant predictors of computer literacy. Conclusively, computer literacy of Greek post-graduate dental students was increased amongst males, students in non-clinical programs and those with more positive attitudes towards the implementation of computer assisted learning.

Teaching and assessment of implant dentistry in undergraduate and postgraduate education: a European consensus

This paper constitutes a summary of the consensus documents agreed at the First European Workshop on Implant Dentistry University Education held in Prague on 19-22 June 2008. Implant dentistry is becoming increasingly important treatment alternative for the restoration of missing teeth, as patients expectations and demands increase. Furthermore, implant related complications such as peri-implantitis are presenting more frequently in the dental surgery. This consensus paper recommends that implant dentistry should be an integral part of the undergraduate curriculum. Whilst few schools will achieve student competence in the surgical placement of implants this should not preclude the inclusion of the fundamental principles of implant dentistry in the undergraduate curriculum such as the evidence base for their use, indications and contraindications and treatment of the complications that may arise. The consensus paper sets out the rationale for the introduction of implant dentistry in the dental curriculum and the knowledge base for an undergraduate programme in the subject. It lists the competencies that might be sought without expectations of surgical placement of implants at this stage and the assessment methods that might be employed. The paper also addresses the competencies and educational pathways for postgraduate education in implant dentistry.

Management of children with autism spectrum disorder in the dental setting: concerns, behavioural approaches and recommendations

OBJECTIVES This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon the existing body of evidence. MATERIAL AND METHODS The MEDLINE database was searched using the terms 'Autistic Disorder', 'Behaviour Control/methods', 'Child', 'Dental care for disabled', 'Education', 'Oral Health', and 'Pediatric Dentistry' to locate related articles published up to January 2013. RESULTS Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals. Undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children and account partly for compromised access to dental care. Dental management of an autistic child requires in-depth understanding of the background of the autism and available behavioural guidance theories. The dental professional should be flexible to modify the treatment approach according to the individual patient needs.

Performance of undergraduate dental students on ICDAS clinical caries detection after different learning strategies

AIM This study aimed to evaluate the effect of a digital learning tool on undergraduate dental students' performance in detecting dental caries using ICDAS. METHODS An experimental digital learning tool (DLT) was created using digital photographs of sound and carious teeth. Thirty-nine students were divided into three groups (n = 13) and each assessed 12 randomly allocated patients before and after learning strategies: G1, ICDAS e-learning program; G2, ICDAS e-learning program plus DLT; G3, no learning strategy. Students (n = 32) reassessed patients 2 weeks after training. RESULTS Comparing before and after the learning strategies, any difference in the values of specificity and area under the ROC curve for all groups was found. Sensitivity was statistically significantly higher for G1 and G2. Comparing the groups, G2 showed a significant increase in sensitivity at the D2 and D3 thresholds. Spearman's correlations with the gold standard before and after the learning strategy were 0.60 and 0.61 for G1, 0.57 and 0.63 for G2, and 0.54 and 0.54 for G3, respectively. The Wilcoxon test showed a statistically significant difference between the values obtained before and after learning strategies for G1 and G2. CONCLUSIONS Use of the DLT after the ICDAS e-learning program tended to increase the sensitivity of ICDAS used by undergraduate dental students. The DLT appeared to improve dental students' ability to use ICDAS.

The Dental School Applicant Pool and the Oral Healthcare Workforce

One of the major challenges faced by the dental profession today is the recruitment of the most qualified dental school applicants who are capable of serving the nation’s future oral healthcare needs. The Association of Schools of Public Health (ASPH) also recognizes this challenge, describing one of the three core functions of public health as “assuring that all populations have access to appropriate and cost effective care, including health promotion and disease prevention services.” To achieve this core function, the ASPH cites “a competent public health and personal healthcare workforce” as one of the ten essential public health services. Unfortunately, the goals of both quality and equality in terms of the dental workforce and access to oral healthcare have yet to be realized. When considering access to oral health services on a national or state level, a thoughtful and thorough consideration of the dental school applicant pool is essential. According to a recent study published in the Journal of the American Dental Association, the annual number of retiring dentists will exceed the number of newly licensed dental practitioners in 2009, a trend which is projected to continue throughout the next decade. The approximately 4,400 dentists produced each year from the nation’s 57 accredited dental education programs are charged with the responsibility of meeting the oral healthcare needs of the population at large.

Influence of experience and training on dental students’ examination performance regarding panoramic images

Physician training has greatly benefitted from insights gained in understanding the manner in which experts search medical images for abnormalities. The aims of this study were to compare the search patterns of 30 fourth-year dental students and 15 certified oral and maxillofacial radiologists (OMRs) over panoramic images and to determine the most robust variables for future studies involving image visualization. Eye tracking was used to capture the eye movement patterns of both subject groups when examining 20 panoramic images classified as normal or abnormal. Abnormal images were further subclassified as having an obvious, intermediate, or subtle abnormality. The images were presented in random order to each participant, and data were collected on duration of the participants’ observations and total distance tracked, time to first eye fixation, and total duration and numbers of fixations on and off the area of interest (AOI). The results showed that the OMRs covered greater distances than the dental students (p<0.001) for normal images. For images of pathosis, the OMRs required less total time (p<0.001), made fewer eye fixations (p<0.01) with fewer saccades (p<0.001) than the students, and required less time before making the first fixation on the AOI (p<0.01). Furthermore, the OMRs covered less distance (p<0.001) than the dental students for obvious pathoses. For investigations of images of pathosis, time to first fixation is a robust parameter in predicting ability. For images with different levels of subtlety of pathoses, the number of fixations, total time spent, and numbers of revisits are important parameters to analyze when comparing observer groups with different levels of experience.