Dental Training Institutions Research Articles

Prevalence of Sharps Injuries at a Tertiary Teaching Oral Health Centre, Gauteng, South Africa

Needle-stick and sharps injuries are an occupational hazard in dental training institutions. The study aimed to quantify and describe the nature of Needle-stick and sharp injuries (NSI) at a Tertiary Teaching Oral Health Centre (TTOHC) in South Africa. An analytic, cross-sectional study was conducted among students engaged in clinical service and oral health staff supervising them at the Oral Health Centre, Gauteng, South Africa. An adapted 18-item self-administered questionnaire was provided to all students and staff. Standard ethical guidelines were followed according to institutional ethics committee approval (M171131). A response rate of 88% (n=73) was obtained from students, with the majority of participants being female(67%), dentistry students (88 %), aged between 18-25 years, in their fourth year of study (45%) while only 3.7% were final year oral hygiene students. The staff participants were dentists (80.6%) while most staff participants (88.3%) were employed for 3 years or less. The NSI prevalence at the TTOHC was 41.3% (n=45). The number of staff reporting the injury for both staff and students was recorded to be 80% (n = 36 of 45 injuries), with 77.3% of injured individuals receiving post-exposure prophylaxis (PEP) against possible HIV-infection, however, more than a third (39%) reported not to have completed the PEP. The department in which the most NSIs occurred was Maxillofacial and Oral Surgery. Sharp injuries were mostly due to needle sticks. Most NSIs occurred among senior students with more clinical experiences and particularly during the early and late periods in a year. The prevalence of needle and sharp injuries was high and of concern. The sharps injury reporting rate was good, however, less than half of injured individuals completed the PEP treatment. The findings highlighted which students were most at risk to encounter NSI, including the period during their training when it was most likely to occur, thus enabling directed re-emphasis and training in Infection Control and Prevention.

Influence of social media platforms in dental education and clinical practice: A cross-sectional survey among dental trainees and professionals.

Social media platforms (SMPs) have become a popular portal for the acquisition and dissemination of dentistry-related information. The study aims to identify the pattern and influence SMPs for education and practice among dental trainees and professionals. A cross-sectional study involving dental trainees and clinical professionals was conducted based on a structured 20-item survey instrument among dental trainees and professionals. The validated questionnaire was circulated among six dental training institutions in India through the internet-based application Google form and achieved a response rate of 60%. The questionnaire focused on identifying the usage of social media in disseminating dentistry-related content. The data from responders were extracted, sorted, and analyzed for descriptive analysis of various factors. The survey revealed the most common SMP used for dentistry-related content as YouTube. The second most commonly used SMP was Facebook for professionals whereas it was Instagram for younger trainees. There was a highly significant difference between professionals and trainees concerning their sources of new information and the most commonly used SMP for dental education (p<0.001). There is a growing consensus among young dental trainees and professionals on SMPs being an effective open access knowledge center. The survey results call for the need for a scientific journal and dental schools to have verified pages in social media to act as flagbearers of evidence-based dental practices. The potentials of SMPs in providing open access information collection to wider viewership across the globe and being a digital archive in attractive audio-visual forms can be used to strengthen the conventional educational model and improvise clinical practice.

A review of the 2030 Human Resources for Health Strategy: Implications for dentistry in South Africa

The South African National Department of Health (NDoH) released a report in March 2020: “2030 Human Resources for Health (HRH) Strategy: Investing in the Health Workforce for Universal Health Coverage”. This report, has implications for the training of dental personnel and the planning of dental services in South Africa(SA). The aim was to summarise and critique the HRH strategic document with reference to dentistry. This was an independent review of the report and included recommendations and implications for the training of dental personnel in SA. The report employed two models to predict the number of dental personnel that will be required; one on achieving provincial equity and the other on improving access to Primary Heath Care (PHC) facilities. The calculations were based on dental personnel employed in the public sector and the number of uninsured people in SA. The first model predicted a shortfall of 486 dentists, 60 specialists, 13 Dental Technicians (Dent Tech), 162 Dental Therapists (DTs) and 104 Oral Hygienists (OHs). The second model, based on PHC utilization, predicted a surplus of 341 dentists and a shortage of 1128 OHs and 1164 DTs. In order to meet these shortages, NDoH would have to allocate R840 million or 2.3 Billion rands respectively, depending on which model is chosen. Irrespective of the model utilised, the NDoH needs to create and fill more dental posts, especially in provinces with low dental practitioner to population ratios. Dental training institutions need to align the training of dental graduates to meet the demands as set out in the report.

Regional distributions of overall dentists and institutional dentists in Taiwan in 2019

Background/purposeTaiwan is facing a huge urban-rural gap in the human resources of dentists between cities and counties. Although the postgraduate year training program for dentists (PGYD) was implemented in Taiwan in 2010, the uneven distribution of dentists is still a serious problem. The purpose of this study was to evaluate the distributions of overall dentists and dental training institutions and their dentists (so-called institutional dentists) in each city and county in 2019 to further analyze the regional distributions of overall dentists and institutional dentists in Taiwan. Materials and methodsThis study collected the numbers of dentists, dental training institutions, and institutional dentists in each city and county in 2019 for evaluating the regional distributions of dentists and institutional dentists in Taiwan. ResultsThe numbers of dentists and institutional dentists in municipalities were significantly higher than those in non-municipalities in Taiwan, respectively. The coefficient of variation was greatest for dentists in the single-system institutions (1.72) and program-management institutions (1.87). The coefficients of correlation between the dentist index and institutional dentist index were R2 = 0.9805 (P < 0.001) for municipalities, R2 = 0.4523 (P < 0.01) for non-municipalities, and R2 = 0.7691 (P < 0.001) for nationwide. ConclusionThe dentist manpower and dental training institutions are concentrated in municipalities of Taiwan. The quantitative and qualitative improvement of collaborating institutions in the PGYD system may have an influence on the distribution of new-entry dentists and contribute to establishment of an effective regional dental health care service.

Imbalance in the geographical distribution of practicing dentists in postgraduate dental training institutions in Taiwan

Background/purposePostgraduate year training program for dentists (PGYD) in Taiwan started since 2010. This study tried to assess the geographical distribution of practicing dentists in postgraduate dental training institutions in Taiwan. Materials and methodsThis study utilized the secondary data analysis to measure and compare the numbers of practicing dentists in each type of dental training institution and the numbers of overall practicing dentists among different cities and counties in Taiwan. ResultsOur results found that the practicing dentists in each type of dental training institution showed a significantly greater imbalance in geographical distribution than the overall practicing dentists. It meant that the practicing dentists in postgraduate dental training institutions were more concentrated in northern part of Taiwan than in other parts of Taiwan, compared to the number of overall practicing dentists in different cities or counties in Taiwan. However, the disparities in the number of practicing dentists in dental training institutions could be compensated by cross-regional collaborating institutions under the joint training group system. ConclusionBecause continuation of the current PGYD system may accelerate the imbalance in geographical distribution of practicing dentists in dental training institutions in Taiwan. To prevent this, further studies on yearly changes in the geographical distribution of dentists in postgraduate dental training institutions by city or county should be taken to monitor whether we should further modify the currently used PGYD system toward a better one to solve the problem of imbalance in the geographical distribution of dentists in postgraduate dental training institutions in Taiwan.

Trends of participation of post-graduate year training program for dentists in Taiwan dental training institutions from 2010 to 2018

Background/purposeThe licensed dentists in Taiwan should join the post-graduate year training program for dentists (PGYD) since 2010. This study aimed to analyze the project types and the geographical distribution of the PGYD training institutions in Taiwan from 2010 to 2018. Materials and methodsFrom 2010 to 2018, 735 hospitals and clinics participated in four types of PGYD project including hospital as the single training institution (project A), clinic as the single training institution (project B), hospital as the main training institution in the joint training group (project C), and clinic as the main training institution in the joint training group (project D). The project types and the geographical distribution of the training institutions were analyzed. ResultsThe 735 PGYD training projects were proposed by the 735 dental institutions. The project number grew from 119 in 2010 to 195 in 2018. The most common project type was project B (307, 41.8%), followed by the project A (249, 33.9%), the project D (101, 13.7%), and the project C (78, 10.6%). Geographically, these 735 main training institutions were located most commonly in northern region of Taiwan (379, 51.6%), followed by the central region of Taiwan (171, 23.3%), southern region of Taiwan (156, 21.2%), and eastern region of Taiwan (29, 3.9%). ConclusionHospital or clinic as the single training institution is the two most common PGYD project types in Taiwan from 2010 to 2018. These single or main dental training institutions are mainly located in the northern, central, and southern regions of Taiwan.

Atraumatic restorative treatment and minimal intervention dentistry.

Too many people worldwide suffer from the consequences of untreated dentine carious lesions. This finding reflects the inability of the currently used traditional mode of treatments to manage such lesions. A change is needed. Dental training institutions should depart from the traditional 'drill and fill' treatments and embrace the holistic oral healthcare approach that is minimal intervention dentistry (MID) and includes within it minimally invasive operative skills. Dental caries is, after all, a preventable disease. The atraumatic restorative treatment (ART) concept is an example of MID. ART consists of a preventive (ART sealant) and a restorative (ART restoration) component. ART sealants using high-viscosity glass-ionomer (HVGIC) have a very high dentine carious lesion preventive effect. The survival rate of these sealants is not significantly different from that of sealants produced with resin. The survival rate of ART/HVGIC restorations matches those of amalgam and resin composite in single- and multiple-surface cavities in primary teeth and in single-surface cavities in permanent teeth. The principles of carious tissue removal within a cavity recommended by the International Caries Consensus Collaboration are in line with those of treating a cavity using ART. Owing to its good performance and the low levels of discomfort/pain and dental anxiety associated with it, ART and/or other evidence-based atraumatic care procedures should be the first treatment for a primary dentine carious lesion. Only if the use of ART is not indicated should other more invasive and less-atraumatic care procedures be used in both primary and permanent dentitions.

RISK FACTORS AFFECTING OCCUPATIONAL EXPOSURE TO BLOOD AND BODY FLUIDS AMONG DENTAL STUDENTS: A CROSS-SECTIONAL STUDY IN A BRAZILIAN FEDERAL UNIVERSITY

Introduction: Dental students are often exposed to bloodborne pathogens during dental training. Several factors are involved in increased risk of human deficiency, hepatitis B and hepatitis C virus (HIV, HBV, and HCV) infection. However, there are few studies that address the risks and forms of prevention among dental students in Brazil. Methods: A cross-sectional study of occupational exposure to blood or body fluids among dental students of Universidade Federal do Rio Grande do Sul, Brazil, was performed. These students were referred to the Occupational Medicine Department of Hospital de Clinicas de Porto Alegre from January 2007 to April 2015. Analyzed data included type of exposure (needlestick injury, mucosal exposure, and exposure to non-intact skin); source patient status for HBV, HIV and HCV infection, accident during dental training, procedure performed, biological material involved, type of accident, and hepatitis B vaccination and serological protection status. The objective was to know the incidence rate and others characteristics of accidents in order to prevent them. Results: There were 312 accidents during the study period of 8 years and 4 months, an estimated incidence rate of Incidence rate was 87,42 exposures per 1000 students-year. Source patient was known in 297 of the cases (95.2%), of which 3 were HBsAg reagent, 12 were HIV reagent, and 17 were HCV reagent. The majority of accidents occurred during procedure, but nearly as high as 40% occurred after procedure, of which 63% occurred during instrument cleaning, disinfecting or sterilizing. Most involved sharp instruments were anesthetic syringe needle and curette. Only 48% of dental students knew their anti-HBs was > 10 mIU/mL. Conclusions: Dental students should be tested for hepatitis B immune status at the beginning of training, and vaccination should be available to all dental students before they start clinical practice. Work practice controls on sharp devices should be addressed at the beginning and strengthened during dental training. Dental training institutions should review instrumental cleaning process to minimize handling of loose contaminated instruments. Keywords: Dental students; occupational exposure; bloodborne pathogens; sharp injury; needlestick injury.

Role of Dental Institutions in Tobacco Cessation in India: Current Status and Future Prospects

Tobacco abuse is a major preventable cause of premature death and disease, including various cancers. The Global Adult Tobacco Survey India (GATS) 2009-10 revealed that more than one-third of adults use tobacco in one form or the other. Nearly two in five smokers and smokeless tobacco users made attempts to quit the habit in the past 12 months. Tobacco dependence is a chronic condition characterized by susceptibility of relapse over years. It can be well handled by sustained professional support from health care providers mainly through behavioral counseling and pharmacotherapy. Dental professionals can play a pivotal role in diagnosing and effectively managing tobacco dependence. Dental Institutions have rapidly grown in last two decades across the country and so has the curriculum been adapted to improve student competencies to accommodate changing disease patterns and technological advances, but not in regard to tobacco cessation. Untapped dental manpower like undergraduates, dental hygienists and other paramedical staff need effective training to be more penetrative. The present review paper explores the potential role of dental training institutions and recommends various approaches to counter public health jeopardy of tobacco related diseases.

Conhecimento e Prática de Cirurgiões-Dentistas Nigerianos Sobre a Terapia do Arco Dental Reduzido (TADR)

Objective: To determine the knowledge and practice of a cross-section of Nigerian dentists about shortened dental arch therapy (SDAT). Method: A cross-sectional study was conducted using a self-administered structured questionnaire. The questionnaire requested for information on knowledge and practice of the respondents as regards to the SDAT. The questionnaires were randomly distributed among general dental practitioners and residents (postgraduate doctors) in dental training institutions in Nigeria. Results: Only 47 (43.5%) respondents were aware of the concept of shortened dental arch therapy (SDAT). Most of the respondents were not aware of the age group indication and the suggested criteria for active shortening of the dental arches. The percentage of patients with shortened dental arch was put at ≤ 5% by most of the respondents. About half of the respondents list the SDAT as a treatment option in ≤5% of cases. Most of the respondents have never applied active and or passive shortening in their practice. Conclusion: The knowledge of the respondents about SDAT is generally less than satisfactory. The application of the concept in a developing country like Nigeria also appeared grossly inadequate at the moment.

The Impact of Title VII on General and Pediatric Dental Education and Training

The authors describe the impact of the Title VII, Section 747 Training in Primary Care Medicine and Dentistry (Title VII) grant program on the development, growth, and expansion of general and pediatric dentistry residency programs in the United States. They first briefly review the legislative history of the Title VII program as it pertains to dental education, followed by a historical overview of dental education in the United States, including a description of the differences between dental and medical education and the routes to professional practice. The authors then present an extensive assessment of the role of the Title VII grant program in building general and pediatric dental training capacity, diversifying the dental workforce, providing outreach and service to underserved and vulnerable populations, stimulating innovations in dental education, and engaging collaborative and interdisciplinary training with medicine. Finally, the authors call for broadening the scope of the Title VII program to allow for predoctoral training (dental student education) and faculty development in general and pediatric dentistry. In doing so, the Title VII program can more effectively address current and future challenges in dental education, dentist workforce, and disparities in oral health and access to care.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

Use of sealants: societal and professional factors

At present, sealant use continues at a low level in private practice by dentists and hygienists, and is moderate in community programs although there is high interest in their use in public health settings. Widespread delegation of sealant application to hygienists has not occurred even though the majority of state dental practice acts allow it, and even though practicing hygienists are highly interested in applying sealants. Use in federally sponsored programs is minimal or nonexistent. Information about sealants and adequate clinical experience in their application appear minimal in dental training institutions, and few opportunities have existed for continuing education. Generally, knowledge about sealants among dentists is low; many hold doubtful opinions. Insurance carriers, including commercial, provider, and governmental programs, appear reluctant to reimburse for sealants without purchaser demand and organized dentistry's blessings. Although society emphasizes patient rights to informed consent, few opportunities exist for the public, including group insurance purchasers and union negotiators, to learn about sealant use in conjunction with appropriate fluoride use. Public educational materials are sparse. Manufacturer marketing efforts at present, aimed at providers alone, are at best minimal, with a few exceptions; those targeting the public are nonexistent. Organized dentistry's Council statements may have contributed to a constriction, to date, in the flow of public information about sealants from industry. Lack of communication, or miscommunication, between practitioners and dental scientists has resulted in much misinformation and confusion about the value of sealants and their use. And, the contemporary status of dental manpower and the economy of dental practice in the private sector appear to have provided an infertile environment for acceptance of sealants as a primary preventive technology. In the public sector, interest in sealants is high but two primary constraints are inadequate manpower and lack of financial resources. Clearly there has been a time-lag in the adoption of new sealant products, and it is apparent that no one factor can explain this lag; rather, many complex factors must be taken into account simultaneously. Extent of need does not appear to have influenced use, to date. Often, social change is slow, and all things considered, the lag observed for sealants may not be totally unreasonable.(ABSTRACT TRUNCATED AT 250 WORDS)