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Background: Dental surgery under general anesthesia (GA) is a common treatment for severe childhood caries and thus may serve as an event to motivate behavior change. The frequency of recurrent caries, however, indicates opportunities within current practice to change a child's oral health behaviors. Aim: To assess caregiver experiences related to their child's dental surgery to inform development of a behavioral intervention. Design: Semi‐structured interviews with caregivers of children receiving GA for dental surgery. Transcripts (n = 19) were analyzed using qualitative thematic methods. Results: Children were 2–5 years of age, mean 3.8 years. Limited access to GA services was a source of caregiver frustration and a barrier to caries treatment. Surgical events elicited emotional reactions including guilt, anxiety, and a sense of caregiver accountability for development of severe caries. There was variation in caregiver awareness and/or motivation to change oral health behaviors. Conclusions: A child's dental surgery under GA is an emotionally challenging event yet may inspire hope and expectations for improvement. Surgery offers an opportunity to implement interventions at a time when caregivers may be open to assistance with behavior change, though stress and anxiety may create barriers. Behavioral interventions should be tailored to individual caregiver needs/barriers and stage of developmental readiness. [ABSTRACT FROM AUTHOR]

The aims of this study were to compare third-year dental students' satisfaction and level of learning in case-based learning (CBL) versus team-based learning (TBL) and the resources required in those two methodologies. Level of learning was assessed for both knowledge and application, and resources were defined as student and faculty time and rooms. In academic year 2018-19, all 68 third-year dental students in one U.S. dental school were enrolled in two sequential semester-long courses; the first used CBL, and the second used TBL. After each course, students and faculty facilitators completed surveys, and data from students' knowledge and application exams were collected. The student surveys asked students to report their satisfaction with the learning methodology (CBL or TBL); the faculty surveys asked the faculty facilitators to report the resources used for each methodology. Forty-five of 68 students (66%) consented to participate; however, a larger number of students completed surveys in the two semesters (69% for CBL and 87% for TBL). Fourteen of 16 (88%) faculty facilitators completed the CBL survey, and five of the six (83%) completed the TBL survey. Overall, the results showed that students' satisfaction was higher with CBL than TBL (Mann-Whitney U = 882.0; p<0.001), and students reported having a better understanding of concepts after CBL than TBL (U = 899.0; p<0.001). The students performed better on knowledge exam items in TBL than CBL (86% vs. 82%) but the same on application items (both 86%). Resource requirements for both methods were extensive, with TBL requiring fewer facilitators and rooms than CBL but requiring more time from both students (2.6 vs. 2.3 hours weekly) and faculty members (2.3 vs. 1.4 hours weekly). In this study, students preferred CBL to TBL but had higher knowledge scores in the TBL course. The resources needed for both CBL and TBL were said to be extensive, with infrastructure use higher for CBL but time for students and faculty higher for TBL. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to examine the perspectives of key personnel at partner sites providing community learning experiences to dental students to gain more understanding of the effects that community‐based programs have on the sites themselves. Fourteen semi‐structured interviews were conducted in 2015 with individuals from nine extramural sites. Interviewees had a range of roles from clinicians to CEOs, with six also reporting they were faculty preceptors. Three of the researchers developed a coding scheme focused on the benefits and challenges that community sites experience from participating in a community‐based dental education (CBDE) program. Each coder then reviewed the interview transcripts independently before final group discussions and recoding to agreement. The main themes related to benefits were recruiting future dentists, staying current with clinical developments, sites' indirectly improving their missions by exposing students to broader roles of oral health providers, raising awareness regarding the need for dentistry in community settings, and nurturing a positive workplace environment. The main themes related to challenges were balancing education and training for students with clinical demands, communication with the university, and managing distinctive clinical and professional characteristics of students. This study's participants reported that the main benefit of CBDE for partner sites was dentist recruitment. The study also provided insights for both partner sites and dental schools to consider when developing and maintaining these partnerships. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine if the timing of a case-based discussion affected dental students' assessment scores. The study specifically investigated whether the timing of a 60-minute case-based discussion before or after a 90-minute lecture affected students' performance on a quiz on topics in pediatric dentistry. In addition, students' preferences for the timing of the case discussion and confidence in the material with different timings were assessed in a survey. In a crossover design, all 52 second-year students in fall 2016 at one U.S. dental school participated in a case-based discussion either before or after lectures on stainless steel crowns and pulp therapy, compared to a control unit on space maintenance with no case-based discussion. The students took quizzes and responded to questionnaires a week after the lectures. A total of 45 (87%) of the 52 students consented to have their scores used. The results showed that the students performed better on the quiz when participating in a case-based discussion after the lecture compared to the discussion before the lecture (after mean=6.1±0.8 vs. before mean=5.5±1.3). The students' control quiz mean following a lecture with no associated case discussion was 6.3±0.8. Students also expressed more confidence when the case was held after the lecture (12.7 vs. 11.6, p=0.02) and preferred the case after (p=0.01). This study found that higher quiz and confidence scores resulted when a case discussion was held after (vs. before) a lecture. When dental educators consider adding a case discussion to a lecture format as a method of increasing students' active learning, these results suggest that having the case discussion after the lecture may be more effective for learners new to the material. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test whether an interactive, web-based training program is more effective than an existing, flat-text, e-learning program at improving oral health students' knowledge, motivation, and self-efficacy to address signs of disordered eating behaviors with patients. Eighteen oral health classes of dental and dental hygiene students were randomized to either the Intervention (interactive program; n=259) or Alternative (existing program; n=58) conditions. Hierarchical linear modeling assessed for posttest differences between groups while controlling for baseline measures. Improvement among Intervention participants was superior to those who completed the Alternative program for three of the six outcomes: benefits/bar-riers, self-efficacy, and skills-based knowledge (effect sizes ranging from 0.43 to 0.87). This study thus suggests that interactive training programs may be better than flat-text e-leaming programs for improving the skills-based knowledge and self-efficacy necessary for behavior change. [ABSTRACT FROM AUTHOR]

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1 ) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1 : eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula. [ABSTRACT FROM AUTHOR]

The incorporation of web-based learning into the dental curriculum has been consistently recommended in the literature on reform in dental education. There has been growing support for web-based learning in dental and dental hygiene education as demonstrated by deans' identifying this as a planned curricular innovation. The purpose of our study was to explore characteristics of e-courses that may serve to increase adoption among dental and dental hygiene faculty members. Eight ninety-minute focus groups (three dental; five dental hygiene) were conducted with dental (n=27) and dental hygiene (n=23) faculty members from six academic institutions. The resulting data were analyzed to identify two overarching themes and associated subthemes with regard to benefits and barriers influencing adoption of e-courses. A working conceptual framework, based on the Diffusion of Innovations, was developed from these themes to understand the characteristics that may influence the rate of adoption of e-courses among dental and dental hygiene faculty members. Analysis of the data revealed four main adoption barriers: 1) low perceived relative advantage to faculty members; 2) low compatibility with current curriculum; 3) high perceived time commitment; and 4) complexity of e-course development. This exploratory assessment identifies leverage points for facilitating the adoption and sustainability of e-courses in dental and dental hygiene education. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a major public health concern for the U.S. population because of its high prevalence and longterm health implications. The purpose of this study was to apply the Theory of Planned Behavior (TPB) to assess dental faculty member and student willingness to provide diabetes education and counseling to patients in a dental school. A survey was administered to dental students (n= 101 respondents) and faculty members (n=39 respondents), and summary scores for seven diabetic educational activities and TPB constructs were calculated and analyzed. Participants were most willing to refer a patient to a physician for treatment and provide basic information about diabetes and oral health, and they were least willing to provide basic information about diabetic medications. Importance, self-efficacy, and barriers constructs predicted willingness to perform diabetic educational or counseling activities. Our findings suggest that, when developing innovative approaches to expand diabetic education and counseling in our dental education environment, programs should demonstrate how diabetic counseling can improve patients' health and should include diabetic management skills-building in the curriculum. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine gender disparities in dental leadership and academics in the United States. Nine journals that represent the dental specialties and high published impact factors were selected to analyze the percentage of female dentists' first and senior authorship for the years 1986, 1990, 1995, 2000, 2005, and 2008. Data on appointment status and female deanship were collected from the American Dental Association (ADA) survey, and the trends were studied. The proportion of female presidents in ADA-recognized specialty organizations was also calculated. Overall, the increase in first female authorship was not statistically significant, but the increase of last female authorship was statistically significant in a linear trend over the years. The percentage of tenured female faculty members and female deans in U.S. dental schools increased by factors of 1 .7 and 9, respectively, during the study period. However, female involvement in professional organizations was limited. Findings from this study indicate that female participation in authorship and leadership has increased over time. Nevertheless, females are still a minority in dental academics and leadership. [ABSTRACT FROM AUTHOR]

Although oral health care providers (OHP) are key in the secondary prevention of eating disorders (ED), the majority are not engaged in assessment, referral, and case management. This innovative pilot project developed and evaluated a web-based training program for dental and dental hygiene students and providers on the secondary prevention of ED. The intervention combined didactic and skill-based objectives to train OHP on ED and its oral health effects, OHP roles, skills in identifying the oral signs of ED, communication, treatment, and referral. Using a convenience sample of OHP (n=66), a pre-/post-test evaluated short-term outcomes and user satisfaction. Results revealed statistically significant improvements in self-efficacy (p<.001); knowledge of oral manifestations from restrictive behaviors (p<.001) and purging behaviors (p<.001); knowledge of oral treatment options (p<.001); and attitudes towards the secondary prevention of ED (p<.001). Most participants strongly agreed or agreed that the program provided more information (89 percent) and resources (89 percent) about the secondary prevention of ED than were currently available; 91 percent strongly agreed or agreed that they would access this program for information regarding the secondary prevention of ED. This pilot project provides unique training in the clinical evaluation, patient approach, referral, and oral treatment that takes a multidisciplinary approach to address ED. [ABSTRACT FROM AUTHOR]

Objective: To interview health professionals in a Latino community about the association between diabetes and periodontitis, and provide a basis to develop interventions for them to promote oral health and good glycemic control among patients with diabetes. Methods: Five dentists, seven nurses and two nutritionists were interviewed about their practices relevant to oral health and diabetes, knowledge about the association, beliefs about Latinos, recommendations on reaching others in their fields, and barriers. The interviews were audiotaped, transcribed, and analyzed qualitatively. Results: Professionals identified policy, community and practice barriers for promoting diabetic control and oral health. Conclusions: Producing a resource list, cross-educating professionals about diabetes and oral health, training professionals to better serve Latino patients, developing appropriate protocols for each profession regarding the association between diabetes and periodontitis, and educating the community about diabetic control, oral health and disease prevention were identified as potential strategies to improve oral health among Latino persons with diabetes. [ABSTRACT FROM AUTHOR]

Primary care providers' involvement with and perceptions of the epidemic of early childhood caries could be related to attitudes and knowledge of the disease as well as to differences in discipline-based recommendations. A cross-sectional survey of demographics, opinions on infant oral health care visits and importance of infant oral health care, knowledge of tooth eruption, and knowledge of health care guidelines of the American Academy of Pediatrics (AAP) and American Academy of Pediatric Dentistry (AAPD) was administered by several methods to first- and fourth-year dental and medical students at two University of Illinois campuses. Some expected variations were found among dental and medical students pertaining to perceptions and knowledge of infant oral health. Higher proportions of dental students responded correctly or considered the issues very important. However, Rockford medicine students were more likely to know when children should be weaned, yet less likely to agree with recommendations for time of first dental visit. Furthermore, fourth year dental students were less likely than first-year dental students to give the recommended answer for age of first dental visit. Variances of opinions and basic knowledge of infant oral health of dental and medical students showed inconsistencies with desired outcomes of educational and clinical experiences. Further research is needed to understand the role of experience and other factors to effectively educate primary care providers in this area. [ABSTRACT FROM AUTHOR]

The concept of shared decision making (SDM) is an important emerging trend in clinical medicine but has received little or no attention in the dental literature. Decision aids can play a useful role in SDM by helping patients and clinicians choose among reasonable alternative treatment options. The purpose of this study was to develop and test an Endodontic Decision Board (EndoDB) for chairside use to help clarify treatment alternatives, benefits, risks, prognosis, and costs when root canal therapy or extraction of a tooth was indicated. The hypothesis was that the use of the EndoDB would lead to improved patient knowledge, greater satisfaction with the decision-making process, and no difference in anxiety when compared to the standard discussion and informed consent process (usual care). The EndoDB was tested in a randomized controlled trial in a postgraduate endodontics clinic. After treatment discussion, a brief questionnaire was completed by the patient to measure knowledge, satisfaction, and anxiety. Patients in the EndoDB group (n=32) demonstrated a small, but statistically significant, increase in knowledge (t-test; difference=+0.37; p=0.03) compared to the usual care group (n=35). There was no difference between groups in the measures of satisfaction or anxiety (Mann-Whitney U-test: p>0.05). Decision aids may emerge as a useful tool to facilitate SDM and evidence-based clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: A large study of risky pre-teen behavior provided an opportunity to examine self-reported toothbrushing frequency for stability over time and adequacy.Methods: 1115 metropolitan African-American children at risk for violence and drug use self-reported toothbrushing frequency in at least one of five measurement points from 5th to 8th grade as part of a larger study. Longitudinal data were available for 815 students.Results: 81% reported mainly twice daily, 8% reported mainly once daily, 10% changed over time, and 1% were consistently less than once daily.Conclusions: Overall, the children reported once or twice daily toothbrushing frequency, stable between 5th and 8th grades. A minority of children showed low or inconsistent frequencies and these results may indicate an opportunity for intervention to improve habits. [ABSTRACT FROM AUTHOR]

In an article published in the April 2004 issue of the Journal of Dental Education, Dr. Charles Bertolami proposed that our ethics curricula don't work due to the limitations of didactic education. He suggested that ethics should be taught as a "precurriculum" course prior to entering dental school and that the dental school ethics course should be elective and consist of small groups of students who are guided to introspection to understand their true self-interest. He argued that "enlightened" self-interest is the best means to motivate students to behave ethically. Our article was stimulated by Bertolami's contentions. Six essays are presented that offer perspectives on the issue of professional ethics and ethics instruction from the viewpoints of students, administrators, and faculty at one dental school. The student essays support the difference between teaching about ethics and changing behavior and discuss the pressures to cheat in dental school. Bertolami's proposition regarding the role of self-interest in ethical decision making is examined. The final essays discuss the ways that ethics curricula and dental schools can encourage students to internalize the values of dentistry. They conclude that while some of Bertolami's propositions may have merit, many do not seem to accomplish the desired goals of inculcating ethics or enhancing ethical behavior in dental students, and they encourage further discussion of ethical instruction. [ABSTRACT FROM AUTHOR]

Race has been shown to affect the quality of physician-patient relations. In view of this, dentistry must consider whether race also affects dentist-patient relations. The purpose of this study was to explore whether orthodontic residents showed more social connection and concern for European ancestry patients, were more negative to minority patients, and appropriately used interventions designed to overcome cultural differences. Communications in sixty-eight dentist-patient encounters were analyzed using the Roter Interaction Analysis System (RIAS). The frequencies of each type of utterance were examined according to the patient's race/ethnicity. The race/ethnic groups were European (nineteen), African American (eleven), Latino (thirty-four), and Asian (four). In 90 percent of the sessions, the resident and the patient were of different ethnicity. Residents used social connection utterances more with European ancestry patients, but used personal utterances more with Latino patients. Residents did not use open-ended questions or probes for patient understanding more with minority patients. The communication patterns observed in this study were similar to those reported in the literature. This study has limitations, but additional research may confirm that residents communicate differently with patients by race and could use more appropriate methods of dealing with cross-cultural situations. More research on cross-cultural communication is needed. [ABSTRACT FROM AUTHOR]

The purpose of this research was to explore the changes that occurred in dental students' counseling techniques as a result of training in Brief Motivational Interviewing (BMI). A randomized pretest, posttest design was used with eleven students in each group. Baseline and posttraining measures of students' counseling techniques and the characteristics of the counseling session with standardized patients were made. The measures were: student behavior from videotapes, patient involvement in the treatment, establishment of good doctor-patient rapport, perceived efficacy in promoting patient change, and student confidence and interest in the task. MANOVA found significant differences between the trained and the untrained groups (F = 4.019, p = 0.018). Training resulted in sessions in which students used more BMI techniques and patients were more actively involved. No changes were seen in the other variables. Future studies must examine whether more experience will improve the students' ability to use BMI to enhance patient rapport, to increase their sense of competence and interest in doing counseling, and to determine the effectiveness of the counseling to encourage patient smoking cessation. [ABSTRACT FROM AUTHOR]

Tobacco dependence education (TDE) continues to be a vital component of dental hygiene curricula-made even more important by the fact that tobacco cessation in adults in the United States has stagnated over the past ten years. This study was undertaken to assess the salient characteristics of TDE in U.S. dental hygiene programs. A fifty-one question survey was mailed to the program directors of all 283 accredited dental hygiene programs during the 2007-08 school year (this number does not include the programs in Illinois, which were excluded since they had participated in a previous study). A total of 187 schools returned the survey for a return rate of 66 percent. Curricular content, minutes spent on each topic, existing level of clinical competence measured, expected level of clinical competence, and resources used were assessed. Respondents reported an average of 6.7 hours spent on all identified components of tobacco education. While 77 percent of respondents reported formally assessing whether a student asked if a patient used tobacco, only 26 percent indicated having a formal competency utilizing all of the U.S. Public Health Service's Clinical Practice Guideline 5 As and 5 Rs. In contrast, 72 percent of program directors reported expecting their graduates to be competent in a moderate intervention that included all 5 As. Though there is a clear commitment to TDE among dental hygiene programs in the United States, we recommend training to a more intensive level of TDE in order to facilitate broader adoption of comprehensive, evidence-based guidelines.