Does the teaching of caries risk assessment foster preventive-minded dental students?

Bisphenol A (BPA) may be released in the oral cavity after sealant placement: A critical summary of Kloukos D, Pandis N, Eliades T. In vivo bisphenol-a release from dental pit and fissure sealants: a systematic review. J Dent 2013;41(8):659-667.

Summary. Dental caries is one of the most common dental diseases among children. High rates of dental caries occur even in early childhood, which determines the relevance of the development of prevention programs and evaluation of their effectiveness in dental offices.
 The aim of the study – to evaluate the effectiveness of comprehensive prevention of early childhood dental caries among children living in Bukovyna region.
 Materials and Methods. We examined 80 children aged 2–3 years and formed 2 observation groups: main and comparison (42 and 38 children, respectively). Clinical effectiveness of dental caries prevention was determined using the prevalence, intensity of dental caries (dmft), simplified index of oral hygiene (OHI-S). The content of phosphate ions, alkaline phosphatase, total and ionized calcium in the oral fluid was determined by a unified method using reagents from “Philisit-Diagnostics” (Ukraine). Oral hygiene tools were selected for children in both groups and they were trained in oral hygiene. Vitamin-mineral drug "Supervit" and probiotic pills "BioGaia ProDentis" were orally prescribed for 20 days for the prevention of early childhood dental caries among children of the main group. The course of prevention was repeated 2 times a year. The degree of probability of the obtained results was statistically assessed.
 Results and Discussion. The obtained data after the first course of prevention reflected the positive dynamics of changes in laboratory parameters. In particular, the increase in calcium content, mainly due to its free fraction, and phosphate ions, normalization of alkaline phosphatase activity and increase the pH in the oral fluid.
 Conclusions. We found a significant improvement in the state of the mineralizing potential of oral fluid among children, which confirms the effectiveness of the prevention complex.

Dental caries remains the single most common chronic childhood disease; without intervention, the prevalence and severity of caries increase into adulthood. Dental schools have begun to integrate caries risk assessment (CRA) and prevention counseling into the curriculum. We sought to assess the knowledge, attitudes, and intended behaviors of dental students regarding CRA and prevention counseling with children and adults. We also examined the extent to which these findings were influenced by the years of instruction that students received on these topics. We conducted a cross-sectional survey of dental students at the University of California, San Francisco. All first-year (D1) through fourth-year (D4) students were eligible to participate. Of the 322 eligible students, 290 (90 percent) participated. D4 students correctly answered a mean of 70.4 percent of the knowledge-based questions on CRA; the mean score among D1 students was 50.4 percent. Whereas 95 percent of D4 students identified themselves as confident in their ability to assess adult patients for caries risk, only 68 percent had such confidence with patients less than five years. To effectively prevent early childhood caries, dental schools should provide students with the skills necessary to be confident and willing to perform CRA and prevention counseling for all age groups.

Objectives: to study the effectiveness of dental caries prevention of children with Down syndrome. Sixteen children with Down syndrome (DS) aged 7 to 16 years were included in the case-control study. Indices of dental caries prevalence (DMFT) and caries experience were studied, caries risk assessment was performed by applying Cariogram software. Dental caries (DC) prevention measures included: health education, guided oral cavity hygiene and topical applications of fluoride preparations. To the subjects of the research group (L₁, nr=8) topically was applied solution Gluftored, Vladmiva, that containing nanofluorides, and to the children of the control group (L₀, nr=8) was applied the fluoride varnish Belak-F, Vladmiva. The study was approved by the Research Ethics Committee and was conducted after obtaining written consent from the children’s parents or their legal representatives. Implementation of complex preventive measures over 2 years to children with DS in L₁ provided statistically significant reduction of dental caries and caries risk indicators in comparison with the L₀ group. Conclusions: The superior efficacy of complex preventive measures including topical applications of nanofluoride was demonstrated.

The aim was to study perceptions of professional role, education and the status of the profession among clinical physiotherapy supervisors. Five focus group discussions were conducted with 15 super ...

Introduction: To prevent caries with targeted strategies and to act conservatively, it is essential oral healthcare providers perform an individual caries risk assessment (CRA). This study aimed to explore knowledge and application regarding CRA by Dutch fifth-year dental students (D5DSs) and practitioners (DDPs). Methods: A survey was conducted through a questionnaire sent at random to a group of 1,500 members of the Royal Dutch Dental Association (KNMT) and to 213 D5DSs from all three dental schools in the Netherlands. Results: Of the 374 DDP respondents (25%), 79% reported to perform CRA in routine practice. Female dentists reported using CRA in their daily practice more often than males (p = 0.008). The questionnaire was completed by 118 D5DSs (55%). All D5DS respondents reported using CRA and most students were familiar with Dutch prevention-oriented methods. Eighteen percent of them did not make an individual treatment plan based on caries risk. The familiarity of DDPs regarding Dutch prevention-oriented methods was lower than that of students (p < 0.001). In both groups of respondents, oral hygiene and diet were the two most important factors considered when assessing caries risk in patients, whatever their age. Conclusion: CRA is applied less frequently in the general practice compared to student clinics at university. Our results suggest that dentists in the Netherlands could improve their knowledge about cariology by continuing education. Dental schools should emphasize implementation of the knowledge in clinical practice. In addition, a uniform and evidence-based method to perform CRA in the dental practice is needed.

Background: Lack of faculty training is often cited as the main obstacle to post-graduate teaching in communication skills.Aims: To explore clinical supervisors’ needs and perceptions regarding their role as communication skills trainers.Methods: Four focus group discussions were conducted with clinical supervisors from two in-patient and one out-patient medical services from the Geneva University Hospitals. Focus groups were audio taped, transcribed verbatim and analyzed in a thematic way using Maxqda© software for qualitative data analysis.Results: Clinical supervisors said that they frequently addressed communication issues with residents but tended to intervene as rescuers, clinicians or coaches rather than as formal instructors. They felt their own training did not prepare them to teach communication skills. Other barriers to teach communication skills include lack of time, competing demands, lack of interest and experience on the part of residents, and lack of institutional priority given to communication issues. Respondents expressed a desire for experiential and reflective training in a work-based setting and emphasised the need for a non-judgmental learning atmosphere.Conclusions: Results suggest that organisational priorities, culture and climate strongly influence the degree to which clinical supervisors may feel comfortable to teach communication skills to residents. Attention must be given to these contextual factors in the development of an effective communication skills teaching program for clinical supervisors.

This study explored clinical supervisor's (CS) views and experiences of dental students' cultural competence (CC) at the Melbourne Dental School, The University of Melbourne, Australia. Additionally, this study explored CS insights into how CC could be taught. Semi-structured one-to-one interviews were organised with consenting CS. Interview topics included the following: the importance of CC, communication and rapport, the role of culture in oral health and the need for curriculum enhancement. Interviews were recorded, transcribed and thematically analysed to identify key areas using NVivo software. A total of 12 CS participated in this study. CS acknowledged the importance of CC and felt that it was important for good patient management. CS's definition of CC focused primarily on language and communication skills. CS felt that dental students were generally able to manage culturally diverse patients. However, CS indicated that additional training in this area would be beneficial. Concerns were raised about the students' ability to establish good rapport and communication, with CS highlighting areas such as misuse of interpreters and use of jargon. CS felt that clinical experience, confidence and a positive attitude are effective tools for overcoming cultural barriers. Furthermore, some CS also felt that cultural competency was a skill that is learnt through experience. For most CS, cultural competence was an important part of the clinician-patient exchange which would benefit from enhanced curriculum. They also highlighted areas where transcultural education could be improved. The majority of CS believed dental students managed culturally diverse patients well.

Dental hygienists play a key role in dental caries prevention and management. As the evidence of dental caries risk, prevention, and management becomes more complex, it is essential that dental hygiene (DH) programs have a strong cariology curriculum. This project aimed to assess current cariology content in U.S. DH programs, how content is taught, and interest in development/implementation of a common/core cariology curriculum framework. Directors of 336 U.S. DH programs were invited to participate in a voluntary online survey using Qualtrics. The survey consisted of 41 items including demographics, details about the program's cariology content, and how it was delivered, and items related to a core cariology curriculum. The overall response rate used for analyses was 27.3%. Some findings include: 61.6% stated their program had a defined cariology curriculum, 35.2% did not have an individual cariology course, 61.5% had preclinical hands-on experiences in cariology, 79.7% are teaching management strategies related to salivary gland hypofunction, 68.3% are teaching use of silver diamine fluoride (SDF), and 64.2% felt cariology was adequately being taught. Only 17.7% are teaching the International Caries Detection and Assessment System (ICDAS) system. 87.3% indicated support for developing a core curriculum framework for teaching cariology in DH programs. This study indicated that, although DH programs reported that cariology concepts are being taught both didactically and clinically, discrepancies between concepts taught and the literature exist. Therefore, there is a need to create a more standardized curriculum framework for all U.S. DH programs.

Objectives: The integration of knowledge from basic sciences to clinical dentistry is an important learning process experienced by dentistry students. The entire process is facilitated by the faculty, officially recognized as the clinical supervisor. This research described student perceptions regarding clinical supervision in a Philippine dental school. Materials and Methods: This study used the qualitative method through focused group discussions (FGDs). For each FGD, the target sample size is six to ten participants. Guide questions were prepared. A facilitator who has a background in Master of Health Professions Education and prior experience in facilitating was requested to conduct the FGD proceedings. Audio recording was used and the minutes were transcribed to facilitate analysis and sent to the facilitator and participants after 1 week for validation. Results: Five FGDs consisting of six students each were conducted to probe on students’ perception of clinical supervision. In total, 30 students participated. Most were female junior students. The first theme which arose from the student perceptions was the lack of time due to the high faculty-student ratio. A second theme which arose was that certain faculty traits affect students’ perceptions of clinical supervision. Faculty characteristics which affected them positively were patience, approachability, and fairness. Faculty characteristic which affected them negatively was preferential treatment or favoritism that they see in the clinics. Conclusion: Students mentioned faculty traits of patience, approachability, and fairness as positive traits in a clinical supervisor. On the other hand, students agreed that the general lack of time due to the faculty-student ratio made it difficult for the faculty to allot sufficient attention to each student.

Using research to find the effects of process-oriented educational assessment in critical care nursing practice.

The objective of this study was to determine the knowledge, attitude, and practices regarding caries risk assessment (CRA) and management among dental practitioners in Kampala Metropolitan, Uganda. This cross-sectional study was conducted among 270 dental practitioners in Kampala Metropolitan, Uganda, in May 2021. The participants were dental surgeons and public health dental officers. A self-administered structured questionnaire was used to collect data. The questionnaire included items about participants' sociodemographic characteristics, knowledge, attitude, and practices in CRA and management. Attitude and practices were rated using different Likert scales. Descriptive statistics, Chi-square/Fisher's exact and one-way analysis of variance (ANOVA) with post-hoc Bonferroni tests were used to analyze the data. The significance level was set at p <0.05. About 60.7% of the participants were public health dental officers with a median age of 30 years (interquartile range [IQR], 27-60). Overall, the participants were familiar with the current concepts regarding CRA and management. More than 70% of the participants correctly identified risk factors and indicators of dental caries. Most participants (98.5%) had a positive attitude toward performing CRA. However, their practices regarding caries management were inadequate as majority (>75%) of participants reported that they never or occasionally recommended evidence-based products like topical fluoride, probiotics, or xylitol products in the prevention and management of dental caries. Dental surgeons had significantly better knowledge and practices than public health dental officers (p <0.05). In the present study, the participants were familiar with the current concepts about CRA and had a positive attitude toward CRA. However, their practices regarding caries prevention and management were inadequate. The study provided baseline data about knowledge, attitude, and practices regarding CRA and caries management among dental practitioners in Uganda. It is recommended to design training courses in evidence-based protocols in the prevention and management of dental caries for dental practitioners in Uganda.

Background: Caries risk assessment (CRA) plays a major role in formulating and implementing preventive rather than corrective measures for dental caries, thus reducing the overall cost of management. Dental students’ familiarity with CRA is uncertain and, therefore, it is required to develop and implement regular awareness programs for upcoming dentists in dental schools on the importance of CRA. Aim: The aim of this study was to assess the knowledge, attitude, and practice (KAP) of dental students in three different institutions. Materials and Methods: A validated semi-structured 14-item questionnaire was administered through Google Form to third and final-year undergraduate dental students (n = 540) of three dental centers. The questionnaire consists of three domains: KAP. Students who volunteered to participate and completed the Google Forms were included in the study. The replies that were received after 21 days were not evaluated for this study. Results: The overall knowledge score ranged from 35.2% for “poor socioeconomic level reduces the risk of dental caries” to 88.8% for “diet adjustment will minimize the incidence of dental caries.” There was no statistical significance detected in the responses for the attitude and practice categories. Most participants in the attitude and practice categories strongly agreed that treatment of the dental abnormality minimizes future risk (52.2%) and were confident in applying CRA in practice (73.9%). Conclusion: The results of this study reveal that KAP is adequate among undergraduate dental students (UG) in all the three institutions. However, the usage on the CRA tool is limited in dental practice.

The object of this conference paper was to review and discuss caries risk assessment in general practice from the questions i) 'Why', ii) 'When', and iii) 'How'. Narrative review. i) Patient caries risk assessment is the basic component in the decision-making process for adequate prevention and management of dental caries and for determination of individual recall intervals. ii) Caries risk assessment should always be performed at a child's first dental visit and then regularly throughout life, and especially when social or medical life events are occurring. iii) There are several risk assessment methods and models available for but the evidence for their validity is limited. Although there is no clearly superior method for predicting future caries, the use of structured protocols combining socioeconomy, behavior, general health, diet, oral hygiene routines, clinical data, and salivary tests or computer-based systems are considered best clinical practice. The accuracy ranges between 60% and 90%, depending on age. Caries risk assessment is more effective in the selection of patients at low risk than those with high caries risk. As evidence suggests that past caries experience is far from ideal but the most important single risk component for more caries at all ages, any clinical sign of likely active demineralization on smooth, occlusal, and proximal tooth surfaces should be taken as a signal for the implementation of individually designed preventive and disease management measures.

Evidence-Based Clinical Recommendations for the Use of Pit-and-Fissure Sealants: A Report of the American Dental Association Council on Scientific Affairs