Predoctoral Dental Education Research Articles

An environmental scan of pharmacists supporting pre-doctoral dental education institutions.

Reports have described pharmacists providing services within academic dental settings. The full scope of these activities and where they exist is unreported. This environmental scan was performed to identify and summarize the levels in which pharmacists provide support to predoctoral dental education programs. A survey was circulated in summer 2019 to all CODA accredited dental schools through the American Dental Education Association (ADEA) clinical dean listserv. The IRB approved survey consisted of 23 questions pertaining to the pharmacist's role in predoctoral dental education programs. Institutions were asked whether pharmacists were used and what kinds of services pharmacists provided. Pharmacist roles were classified into standard pharmacy services, clinical pharmacy services, medication inventory, education, and administration/research. Univariate analysis was performed on responses and reported using descriptive statistics. A response rate of 59.1% from 66 institutions was achieved. Of those responding, 28.21% reported utilizing a pharmacist at their institution. Of the institutions responding positively to utilizing a pharmacist, the most common standard pharmacy services used were patient counseling regarding a disease state (50%), and medication errors/adverse event reporting (60%). Some clinical pharmacy services provided were medication history collection (70%), advising antimicrobial selection (50%), and treatment plan consultation (60%). Pharmacists were also found to be active in education, school administration, and research. Pharmacists are utilized at just over a quarter of responding CODA accredited predoctoral dental education institutions in the United States. Where deployed, pharmacists provide a wide array of services.

Assessment of a Pediatric Population Using Telehealth Training in Predoctoral Dental Education

This article aims to increase dental workforce and quantify outcomes of telehealth curriculum by integrating predoctoral dental students in the delivery of asynchronous teledentistry. Preliminary data from the quality improvement process suggests that over 90% of recommended treatment plans coincided between onpremise and off-premise, second-year predoctoral dental students. This initial data establishes a quantitative measurement for telehealth and supports the incorporation of teledentistry into predoctoral dental curriculum for its use in clinical practice.

"I don't think the problem's the student…I think it's us": Engaging faculty in curriculum innovation.

The need to innovate predoctoral dental education is well established; however, there are few recent reports to guide substantial curriculum transformation. The purpose of this study was to describe faculty perspectives on their vision of future graduates, curriculum needs, and potential barriers to a successful redesign. This information would be used to inform strategic planning for the predoctoral curriculum transformation. Eighty full-time faculty from the University of North Carolina Adams School of Dentistry participated in 60-minute focus groups in March 2018. Focus group questions were developed to elicit perceptions about the current curriculum, what the dental graduate should know in 2040, and what is needed to engage faculty in curriculum change. Transcripts of the focus group sessions were analyzed by a third-party research group using qualitative thematic analysis to identify pertinent themes shared by participants. Faculty identified that developing clinical skill that engages multiple specialties, student time to engage in advocacy activities, and opportunities to integrate biomedical, clinical, and behavioral sciences as critical features of the curriculum. They believed the 2040 graduate should be able to critically evaluate literature, exhibit strong leadership skills, and adapt to the changing healthcare environment. To better engage faculty in curriculum change, there needs to be dedicated time, sufficient resources, a clear plan, and greater collaboration across the school. When embarking on curriculum transformation, engagement with faculty is a critical component of the change process. Focus groups can be used as a technique to better understand faculty perspectives about curricular needs and the overall vision.

Can an interactive case‐based activity help bridge the theory‐practice gap in operative dentistry?

A theory-practice gap in pre-doctoral dental education is a common source of stress for dental students. An interactive, small-group, case-based activity was designed to bridge the gap between pre-clinical and clinical experiences. The aim of our study was to assess the effectiveness of the case-based activity by evaluating students' comfort level in operative procedures. Over 5years, a total of 172second-year students from the classes of 2017 through 2021 participated in the case-based activity delivered after the completion of the core operative dentistry course. The exercise included a pre-activity online quiz, an in-class case-based session and a laboratory exercise. Students' self-reported comfort levels in performing operative procedures were collected by surveys at three different times. They included the post-course survey distributed after the completion of the core operative dentistry course, the post-activity survey distributed after the completion of the case-based activity, and the follow-up survey distributed after students completed their first operative procedures in clinic. There was a 93% response rate. The average rating of all eight statements revealed statistically significant increase in students' comfort level after completing the case-based activity and after performing their first operative procedures in the teaching practice. This observation suggests that the case-based activity was effective in raising students' comfort levels. The activity may serve as an important tool in bridging the theory-practice gap between pre-clinical and clinical operative experiences.

Faculty perspectives of an entrustable professional activity (EPA) framework in predoctoral dental education.

The entrustable professional activity (EPA) framework is an assessment approach used to define the educational outcomes of a program by outlining discrete work tasks learners are expected to perform independently upon graduation. This study outlines the development and evaluation of an EPA framework for predoctoral dental education at the University of North Carolina Adams School of Dentistry. The draft EPA framework was created in collaboration with a group of faculty members and included 15 statements that were mapped to relevant Commission on Dental Accreditation standards. The draft EPA framework was distributed to faculty via an electronic survey, requesting participants to evaluate whether the EPAs were well-defined; observable; measurable; expected of a general dentist; transferable to other practice settings; and required application of relevant knowledge, skills, and attitudes. In addition, participants were asked to identify the percentage of graduates who could perform these tasks independently and whether learners must be able to perform the list of EPAs upon graduation. Sixty-eight faculty members completed the survey (72% response rate); participants represented all divisions across the school and had extensive dental practice experiences. Overall, participants agreed the EPAs met the defined criteria and were considered important for graduates to be able to demonstrate. Feedback from faculty voiced support for the EPA framework and identified concerns regarding the implementation due to potential faculty calibration and time constraints. Evidence from this study supports additional research to explore how the EPA framework can be further developed in predoctoral and postgraduate dental education programs.

Exploring research opportunities and challenges facing dental students in Khartoum state

Context: Research is an essential component of many predoctoral medical and dental education programs focused on training students as clinicians, educators, and researchers in evidence-based practices. Despite the importance of clinical research, a variety of factors discourage young candidates from entering clinical research careers. As the rate of conduction of clinical researches in the dental field is increasing nowadays, it is important to define the impediments that face undergraduate and postgraduate dental students and hence formulate solutions. Aim: The aim of this study was to explore the research opportunities and challenges facing undergraduate and postgraduate dental students among different universities in Khartoum state. Settings and Design: Four hundred and twenty-six questionnaires were distributed in this descriptive cross-sectional study, among both undergraduate and postgraduate dental students in five universities in the Khartoum state. Materials and Methods: The questionnaire was modified from the dental students' research inventory questionnaire which was well validated. Statistical Analysis Used: The analysis was done using SPSS Version 22 (SPSS Inc., Chicago, IL, USA). Results: Most of the participants included in this study were undergraduates (89%). The study showed that only 4.4% were found to face high challenges concerning data analysis, 46.7% have had a high challenge in writing a report and publishing their research data, and 60.4% encountered curriculum problems while conducting their research. Generally, most of the participants were unsatisfied about the different facilities and opportunities that were available to them. In addition, 84.8% of them were moderately satisfied from the knowledge and skills they gained from their research experience. Conclusion: Dental students among different universities in Khartoum state are facing challenges in several aspects while conducting a research project. Research committees should develop and enhance the needed facilities that would encourage young candidates to conduct research.

Incorporating Humanities in Dental Education is Essential, but Seldom Routine

Humanities in Predoctoral Dental Education: A Scoping Review. Marti KC, Mylonas AI, MacEachern M, Gruppen L. J Dent Educ 2019;83(10):1174-1198. None declared. A scoping review.

Dentoalveolar Surgery Articles

Resnick CM, Calabrese CE, Afshar S, Padwa BL: Do oral and maxillofacial surgeons over-prescribe opioids after extraction of asymptomatic third molars? J Oral Maxillofac Surg 77:1332, 2019 Nicolatou-Galitis O, Schiødt M, Mendes RA, et al: Medication-related osteonecrosis of the jaw: Definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 127:117, 2019 Otto S, Pautke C, Van den Wyngaert T, et al: Medication-related osteonecrosis of the jaw: Prevention, diagnosis and management in patients with cancer and bone metastases. Cancer Treat Rev 69:177, 2018 Schmitt CM, Buchbender M, Musazada S, et al: Evaluation of staff satisfaction after implementation of a surgical safety checklist in the ambulatory of an oral and maxillofacial surgery department and its impact on patient safety. J Oral Maxillofac Surg 76:1616, 2018 Pippi R, Spota A, Santoro M: Medicolegal considerations involving iatrogenic lingual nerve damage. J Oral Maxillofac Surg 76:1651.e1, 2018 Geisler BP, Ji YD, Peacock ZS: Value in oral and maxillofacial surgery: A systematic review of economic analyses. J Oral Maxillofac Surg 75:2287, 2017 Ferneini EM, Goldberg MH: Management of oral and maxillofacial infections. J Oral Maxillofac Surg 76:469, 2017 Cheng KL, Dodson TB, Egbert MA, Susarla SM: Which factors affect citation rates in the oral and maxillofacial surgery literature? J Oral Maxillofac Surg 75:1313, 2017 Dennis MJ, Bennett JD, DeLuke DM, et al: Improving the medical curriculum in predoctoral dental education: Recommendations from the American Association of Oral and Maxillofacial Surgeons committee on predoctoral education and training. J Oral Maxillofac Surg 75:240, 2017 Reiland MD, Ettinger KS, Lohse CM, Viozzi CF: Does administration of oral versus intravenous antibiotics for third molar removal have an effect on the incidence of alveolar osteitis or postoperative surgical site infections? J Oral Maxillofac Surg 75:1801, 2017 Bouloux GF, Busaidy KF, Beirne OR, et al: What is the risk of future extraction of asymptomatic third molars? A systematic review. J Oral Maxillofac Surg 73:806, 2015

Humanities in Predoctoral Dental Education: A Scoping Review.

Health humanities usually includes such disciplines as philosophy, ethics, history, literature, performing arts, and cultural anthropology. The aims of this scoping review were, first, to search the published literature for references to the humanities in predoctoral dental education and, second, to determine if any research studies found that introducing humanities in dental education improved the overall profile of dental graduates. Literature searches were run in Ovid MEDLINE, Embase, ERIC, CINAHL, and Dentistry and Oral Sciences Source. A total of 248 articles were included in the review, with inclusion criteria comprising the areas of the curriculum, the scope of humanities, and predoctoral dental education. Of those articles, 101 referred in a targeted way to ethics in predoctoral dental education, while others mainly referred to the humanities in general or pointed out the role and place of humanities topics in predoctoral dental curricula. Topics covered included professional ethics, music, narrative learning, theater, art, communication skills, empathy, emotional intelligence, and cultural competence in the context of general humanistic education. The review found limited evidence of a clear impact, either short-term or long-term, of humanities education in predoctoral dental education. Reflections on humanistic education in the practice of clinical dentistry were sparse, as mainly documented by development of the ideal dentist-patient relationship, enhancement of empathy for patients, and most importantly, construction of professional moral values.

Predoctoral Dental Education in Tooth Prognosis and Treatment Complexity: A Survey of U.S. Dental Schools.

The aim of this study was to determine the educational methods and tools used to teach tooth prognosis and treatment complexity determination in U.S. predoctoral dental programs. In 2018, an online survey was emailed to the academic deans of all 66 accredited U.S. dental schools. Of these, 42 schools responded (63.6%), and 36 schools completed the entire survey (54.5%). The methods reported for teaching tooth prognosis and case complexity determination varied widely among the participating schools. Among the respondents, 25% reported using the American Association of Endodontists' Endodontic Case Difficulty Assessment, while 10% reported having no specific method for teaching prognosis. The most common method for teaching overall treatment complexity was the Prosthodontic Diagnostic Index, which was used by 24% of the respondents. However, another 24% reported that their school did not have a specific method for teaching treatment complexity. Large percentages of the respondents reported that students sometimes or often made wrong tooth prognosis and case complexity determination (90% and 92%, respectively). The most prominent feedback provided by the respondents based on their experience was the importance of faculty standardization, the understanding of students' inexperience, and the need for an interdisciplinary approach. The majority of these respondents reported that their schools had specific methods of teaching prognosis and case complexity determination. However, there was a wide range of teaching practices related to the contents and levels of evidence.

Pediatric dentists who accept new Medicaid-enrolled children report higher willingness to advocate for community water Fluoridation

BackgroundDentists, who advocate for Community Water Fluoridation (CWF), can help decrease the dental caries disparity gap between low and high socioeconomic groups. Advocating for CWF, a cause that promotes oral health at the population level is an altruistic behavior. Dentists who accept and provide services to Medicaid-insured children, who are from low socioeconomic backgrounds, are also considered altruistic. We tested the association between accepting new Medicaid-insured children every month, and willingness to advocate for CWF programs in pediatric dentists (PDs).MethodsIn 2016, a 22-item pilot tested online survey was sent to 5394 PD members of the American Academy of Pediatric Dentistry. Descriptive analysis and a multiple adjusted logistic regression model was conducted.ResultsDentists who accept new Medicaid-insured children every month (OR: 1.62; 95% CI: 1.06–2.47; p = 0.02) were more willing to advocate for CWF compared to their counterparts. Those practicing primarily in rural (OR = 4.67; 95% CI: 1.82–11.9; p = 0.001), and urban areas (OR = 2.27; 95%CI: 1.05–4.89; p = 0.04), and those willing to promote fluoridated water consumption to parents in the clinic (OR = 3.40; 95% CI: 1.87–6.21; p = < 0.0001) were significantly more likely to be willing to advocate for CWF. PDs trained in public health advocacy during pediatric residency alone (OR = 2.37; 95% CI: 1.24–4.51; p = 0.009), or during both pre-doctoral dental education and pediatric residency (OR = 3.51; 95% CI: 1.87–5.6; p = < 0.0001) were more willing to advocate for CWF compared to their counterparts.ConclusionsPDs who accepted new Medicaid-insured children every month were more willing to advocate for CWF programs compared to those who did not.

Effect of Collaborative Group Testing on Dental Students' Performance and Perceived Learning in an Introductory Comprehensive Care Course.

The use of collaboration while in dental school can help prepare dental students for the team-oriented nature of the workforce. One way to do this is via collaborative group testing (CGT), a method of assessment allowing students to learn from one another. The aim of this study was to examine the CGT method in a predoctoral dental education setting to determine if student examination performance improved with the addition of collaboration and if collaborative testing was beneficial to students' learning process. In 2016, all first-year dental students (n=76) at one U.S. dental school were assessed in an introductory comprehensive care course using a two-stage CGT in which students were assessed individually, prior to taking the same test in collaboration with an assigned partner. Three quizzes and a final examination were given in which student participants served as both control (individual assessments) and treatment (collaborative assessment). At the conclusion of the course, a questionnaire was administered to ascertain student perspectives. All assessments yielded favorable results with an overall score improvement from a mean of 81.1% on individual assessments to 91% on collaborative assessments (p=0.001), indicating that collaboration improved assessment outcomes. Additionally, retention of material was suggested with individual scores on the cumulative final surpassing average individual scores of the preceding quizzes (p<0.001). Students' responses on the questionnaire indicated that they perceived implementation of CGT was beneficial to their learning process. With these results, this testing methodology shows promise to enhance dental student learning, material retention, and teamwork.

Teaching Silver Diamine Fluoride in U.S. Dental Schools' Predoctoral Curricula.

Silver diamine fluoride (SDF), a low-cost topical agent used in many countries to arrest dental caries, was cleared as a desensitizing agent by the Food & Drug Administration for the U.S. market in 2014. The aim of this study was to survey U.S. dental schools regarding their teaching of SDF. Email invitations were sent to all accredited U.S. predoctoral dental education programs (n=66) in September 2016. Deans, chairs, and selected faculty members were asked to respond or forward the survey-link provided to the appropriate person in their school. Under the assumption that some respondents from the same school were unaware of SDF implementation across departments, multiple responses from the same school were collapsed for analysis. A total of 62 schools (94% response rate) responded to the survey, and 67.7% of them reported that SDF was part of their curricula. There was a wide variation across dental schools' teaching about SDF indications and protocols of application. All but one school consistently agreed on using SDF for arresting caries on primary teeth. Only 18 respondents were able to confirm if there was an existing protocol at their school for the use of SDF. When re-application after initially arresting caries with SDF was taught, 50% of respondents advocated 2×/year re-application. Schools not teaching SDF (n=20) planned on including it in their curricula in the future. These findings suggest that, with the use of SDF increasing rapidly in the U.S. and its adoption in most dental schools, there is a need for the development of standardized evidence-based protocols.

Evidence-based dentistry skill acquisition by second-year dental students.

Identification and assessment of Evidence-based dentistry (EBD) outcomes have been elusive. Our objective was to describe EBD skill acquisition during the second (D2) year of pre-doctoral dental education and student competency at the end of the year. The first and fourth (final) curricular-required EBD Exercises (ie, application of the first 4 steps of the 5-Step evidence-based practice process applied to a real or hypothetical situation) completed by D2 students (n=151) during 2014-2015 and 2015-2016 were evaluated to measure skill acquisition through use of a novel rubric with measures of performance from novice to expert. Exercises were evaluated on the performance for each step, identification of manuscript details and reflective commentary on manuscript components. Changes in performance were evaluated using the chi-square test for trend and the Wilcoxon signed-rank test. Seventy-eight per cent of students scored competent or higher on the Ask step at the beginning of the D2year; scores improved with 58% scoring proficient or expert on the fourth Exercise (P<.001). Most students were advanced beginners or higher in the Acquire, Appraise and Apply steps at the beginning of the D2year, with minimal growth observed during the year. Identification of manuscript details improved between the first and fourth Exercises (P=.015); however, depth of commentary skills did not change. Unlike previous investigations evaluating EBD knowledge or behaviour in a testing situation, we evaluated skill acquisition using applied Exercises. Consistent with their clinical and scientific maturity, D2 students minimally performed as advanced beginners at the end of their D2year.

The Dental School Interview As a Predictor of Dental Students' OSCE Performance.

The aim of this study was to evaluate the use of the dental school admissions interview score as a noncognitive indicator of performance in predoctoral dental education, with specific attention to whether a correlation existed between the admissions interview scores and performance on the objective structured clinical examination (OSCE). The study population consisted of all 175 students in the Harvard School of Dental Medicine (HSDM) DMD Classes of 2012 through 2016. Data on students' gender and age on entering dental school were self-reported using their applications for admission to the HSDM DMD program. Data on students' OSCE scores for three examination sessions were collected from the Office of Dental Education. The results showed that the students' interview scores did not significantly correlate with OSCE performance on any of the three exams. Performance on the first and second OSCEs did, however, correlate with performance on the third OSCE (p<0.05). Age on entering dental school was not significantly associated with performance on any of the three OSCEs; however, among male students, there was a significant negative correlation (p<0.05) between entering age and performance on the second and third OSCEs. There was no significant association between gender and OSCE or interview score. These results suggest that although the admissions interview scores can serve as an important resource in student selection, with the lack of association between interview and OSCE scores, it is possible that the communication skills required for the interview do not directly overlap with those required for OSCE success.

Effect of Advocacy Training During Dental Education on Pediatric Dentists' Interest in Advocating for Community Water Fluoridation.

Dentists, like other health professionals, are uniquely positioned to be public health advocates. One venue where dental students can become skilled public health advocates is in dental education programs. However, debates about the need and importance of integrating advocacy training into dental curricula exist. Therefore, the aim of this study was to assess the association between pediatric dentists' interest in and willingness to participate in an advocacy-related activity and their prior training in advocacy during dental education. The advocacy activity used in the study related to community water fluoridation (CWF). A 22-item pilot-tested online survey was sent in February-May 2016 to 5,394 pediatric dentists who were members of the American Academy of Pediatric Dentistry. The final response rate was 16% (n=830). Most (77%) of the respondents were willing to advocate for CWF initiatives at the community and/or state levels. Only 44% of the respondents reported receiving training in advocacy during their predoctoral dental and/or pediatric dental residency education. The pediatric dentists who were willing to advocate for CWF initiatives had 2.7 times (95% CI: 1.63-4.39, p<0.0001) the odds of having received advocacy training during their dental education compared to those who were unwilling. These results suggest a positive association between the pediatric dentists' willingness to advocate for CWF and their prior advocacy training during dental education. This finding provides support for the Commission on Dental Accreditation's requirement for pediatric dental residency programs to train residents in advocacy. Because dentists are respected leaders in their community, the study results also support the integration of advocacy training into predoctoral dental curricula.

Looking Back to Move Ahead: Interprofessional Education in Dental Education.

Interprofessional education (IPE) is a widely recognized and critical component of dental and health professions education and is included in two of the predoctoral education standards required by the Commission on Dental Accreditation (CODA). Following a review of the literature on the state of IPE education in U.S. dental education programs, this article revisits six institutions identified in previous research as exemplars successfully implementing IPE on their campuses. Interviews were conducted with leaders at the following programs: Columbia University, Medical University of South Carolina, University of Colorado Anschutz Medical Campus, University of Florida, University of Minnesota, and Western University of Health Sciences. Strengths and weakness of IPE in dental education are discussed, along with opportunities for the future including reducing barriers to scheduling, increasing intraprofessional education, and consistent outcomes assessment. The article concludes with lessons learned by administrators and suggestions for improving incorporation of these requirements into predoctoral dental education programs by emphasizing the importance of IPE and dentistry's role in overall health. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Integration of Digital Dentistry into a Predoctoral Implant Program: Program Description, Rationale, and Utilization Trends.

A recently revised predoctoral implant curriculum at the University of Illinois at Chicago College of Dentistry integrated digital dentistry into both the preclinical dental implant course and clinical activities. Traditionally, competence in the didactic and clinical parts of predoctoral education in single tooth implant restorations has emphasized the analog impression technique and subsequent mounting of soft tissue working casts. However, computer-aided design/computer-aided manufacturing (CAD/CAM) implant restorations can play a significant role in predoctoral dental education utilizing digital technologies. The goal of the curriculum expansion is to transition from analog to partially digital and, finally, complete digital workflow. The aim of this article is to describe the specific components, implementation, and rationale for the new digitally integrated implant curriculum and present short-term clinical utilization trends.

Improving the Medical Curriculum in Predoctoral Dental Education: Recommendations From the American Association of Oral and Maxillofacial Surgeons Committee on Predoctoral Education and Training

Dental procedures are often performed on patients who present with some level of medical fragility. In many dental schools, the exercise of taking a medical history is all too often a transcription of information to the dental chart, with little emphasis on the presurgical risk assessment and the development of a treatment plan appropriate to the medical status of the dental patient. Changes in dentistry, driven by an increasingly medically complex population of dental patients, combined with treatment advances rooted in the biomedical sciences necessitate the adaptation of our dental education to include a stronger background in systemic health. Many predoctoral educators in the American Association of Oral and Maxillofacial Surgeons (AAOMS) have expressed concern about the medical preparedness of our dental students; therefore, the AAOMS and its Committee on Predoctoral Education and Training have provided recommendations for improving the medical curriculum in predoctoral dental education, including a strengthening of training in clinical medicine and biomedical sciences, with specific recommendations for improved training of our dental students and dental faculty.

Updated competencies for the dental public health specialist: using the past and present to frame the future.

A new set of competencies for entry-level specialists in dental public health (DPH) developed in 2016 updates the 1998 version. Our objective is to provide some context and perspective on this update. We discuss the evolution of this dental specialty, how it differs from other dental specialties, and its importance for the public's oral health. Some societal trends that provide the rationale for this update are summarized. The ways in which this set of competencies differs from the last version are described. The first set of behavioral objectives was established in 1974 and updated at workshops in 1988 and 1997. Advanced population-based knowledge and public health perspectives beyond that obtained in predoctoral dental education continue to be essential for the nation's oral health. Since 1998, the impact of the digital age, advances in science and technology, changes in population demographics, health status and increasing inequalities, treatment needs, prevention and treatment modalities, healthcare delivery systems, financing, personnel, legislation, and regulations have all influenced DPH practice. The updated competencies include guiding principles for the specialty, a new focus on social determinants of health, and more flexibility to address the increasing complexity and interdisciplinary nature of public health problems and the expanding knowledge and skills needed to address them. The rapid expansion of public health education might serve as an important pipeline for future DPH specialists. The updated competencies can guide the educational preparation of DPH specialists and are aligned with the rapidly changing environment.