Dental School Research Articles

Stress, psychosocial resources and possible interventions: a qualitative study among dental students

BackgroundPrior studies found that dental students are affected by various stressors during their studies. Those stressors can exert adverse effects on their (mental) health. Our study addresses the lack of qualitative data on students’ perspectives by exploring perceived stressors and resources among dental students and interventions suggested by them. The results of our study can contribute to the development of better preventive measures and interventions.MethodsIn total, 57 dental students enrolled at a dental school in Germany participated in seven focus groups in the summer semester 2019 (May to July). Discussions were facilitated using a topic guide, and data collection was conducted until thematic saturation. All discussions were audio-recorded, transcribed and content-analyzed using MAXQDA.ResultsKey emerging stressors were related to the organization of the study program, a lack of digitalization, practical tasks, the examination system, the work/study environment and social interactions. Resources encompassed, e.g., good organization, practical courses, patient work and valued feedback. Interventions suggested by students included regular meetings to enhance collaboration, improved communication between staff and students, a central coordination unit, fixed evaluation criteria and the integration of physical exercises and physiotherapy in the study program to prevent neck and back pain.ConclusionsKnown stressors for dental students and new aspects (e.g., concurring exams or obligatory brands) emerged from our data. Interventions suggested by the students included the use of digital learning platforms, communication training or the improvement of evaluation processes. Additional research, e.g., to explore perspectives of teaching staff and other stakeholders is necessary to gain more insights into study conditions and ways to reduce stress among dental students.

Comparison of clinical independence level scores among predoctoral dental students between dental school clinic and community clinic rotation.

The aim of this study was to compare the difference in the level of clinical independence among predoctoral dental students during their community clinic rotation with their dental school clinic rotations. Descriptive statistics, assessment of sample normality, and T-tests were performed to present the difference in average independence scale scores for the participants in each of the clinical disciplines at dental school clinical rotations and community rotations. The relative impact of each community clinical site was assessed to compare scores assigned at varying locations by different faculty. This study analyzed 222 dental students, including 29 from International Dental Program (IDP) and 193 traditional Doctor of Dental Surgery (DDS) students. Community clinic scores showed greater variability, with significantly higher scores in diagnostics and operative dentistry compared to school clinics, where higher scores were noted in endodontics and oral surgery. IDP students scored lower than traditional DDS students in school clinics but outperformed them in community settings. Community clinic scores showed greater variation between 2023 and 2024 compared to the smaller changes observed in dental school clinic scores. This study highlights the impact of clinical setting, and duration on student procedural experience and performance, suggesting that varied clinical settings can enhance students' skills and readiness for practice. It reveals differences in DDS and IDP students' experiences due to prior training and potential evaluation biases. Study findings suggested lack of significant variance in the overall scores across different evaluators in community rotations. Future research should focus on refining evaluation metrics and better prepare students for practice.

Assessment of glove integrity across various dental specialties in a dental school setting

ObjectivesThis study aimed to evaluate the integrity of non-sterile, powder-free latex gloves used by dental students in various dental specialties.Materials and methodsThis cross-sectional study involved dental students from Ajman University who provided gloves during various dental specialty procedures. A total of 177 pairs of latex examination powder-free gloves were included and categorized as follows: 43 pairs (24.3%) were used in operative dentistry, 30 pairs (16.9%) in oral surgery, 28 pairs (15.8%) in endodontics, 24 pairs (13.6%) in periodontics, 21 pairs (11.9%) in pedodontics, 13 pairs (7.3%) in prosthodontics, and 18 pairs (10.2%) as control gloves. After use, glove integrity was assessed with a modified water leak test.ResultsPerforations were identified in 72 cases (40.7%) of gloves, distributed as follows: 22 cases (51.2%) in operative dentistry, 12 cases (40.0%) in oral surgery, 11 cases (39.3%) in endodontics, 11 cases (45.8%) in periodontics, 10 cases (47.6%) in pedodontics, 5 cases (38.5%) in prosthodontics, and 1 case (5.5%) in the control group. There were no statistically significant differences in the loss of glove integrity among different dental specialty procedures (χ2 = 11.899, p = 0.064) or among different glove usage durations (χ2 = 1.732, p = 0.785). However, the location of perforations in the experimental groups was statistically significant (χ2 = 34.427, p < 0.001). The most common locations were the right thumb (n = 18; 13.7%) and the right index finger (n = 17; 13%), with no perforations in the left ring finger and only one perforation in the left little finger (n = 1, 0.08%). There was a statistically significant correlation between the anticipated and actual presence of defects (χ2 = 32.875, p < 0.001).ConclusionsThe study found a high rate of glove perforations during dental procedures by undergraduate students, especially in the right thumb and index finger. To reduce cross-infection risks, strict protocols like double gloving, frequent glove changes, and covering wounds with plaster are recommended.

Developing institution-specific admission competency criteria for prospective health sciences students

BackgroundGiven the critical role of health professionals in societal health, the development of robust and effective selection methods is of fundamental concern for educational institutions within the field of health sciences education. Conventionally, admission competencies have been determined by institutional authorities. Developing institution-specific competency criteria enables an admission process that is mission- and value-aware, evidence-based, and strategically adaptable. However, few schools have established their admission competency criteria, although the majority possess their own models of graduation competencies. This study reports the process of developing and validating an institution-specific admission competency model that addresses the need for evidence-based and mission-aligned selection processes that are distinct from standardized models.MethodsThis study was conducted in two phases, using both qualitative and quantitative analyses. Phase I involved constructing an admission competency model through a qualitative approach facilitated by workshops with 17 faculty members and 92 first-year pre-doctoral students of a dental school. Through constant comparative analysis, this phase focused on the extraction and refinement of competencies for entering dental students. In Phase II, a questionnaire developed from the workshops asked respondents to rate the importance of 47 attributes across 10 constructs on a 5-point Likert scale. A total of 301 individuals participated in the survey. Exploratory Factor Analysis (EFA) identified the factor structure, and Confirmatory Factor Analysis (CFA) examined construct validity and assessed the model fit with the data.ResultsThe EFA of the 47 attributes identified 10 factors, and the CFA results indicated a good-to-acceptable level of fit for the ten-factor model. Aligned with the American Association of Medical Colleges Premed competencies, this study identified unique attributes specific to the institution, such as confidence, leadership, and entrepreneurship. These findings highlight the importance of developing tailored competencies reflecting the unique needs of institutions and their fields.ConclusionsThis study demonstrates the feasibility and value of creating institution-specific admission competency models, offering a methodology that aligns with evidence-based mission-driven selection processes. The distinct competencies identified emphasize the need for educational institutions to consider unique institutional and field-specific requirements and move beyond standardized models to enhance the selection of medical students.

Evaluation of teaching cognitive bias to dental students during the transition to independent dental practice.

Cognitive bias is an increasingly important topic in healthcare education, though its significance in dental education remains underexplored. Ensuring that dental students learn more about cognitive bias to enhance dental care is challenging. This study aimed to evaluate dental students' perceptions of the value of teaching cognitive bias awareness in independent practice. The content of cognitive biases, along with related theories and debiasing strategies, was delivered through interactive lectures in April 2022 and May 2024 to final-year dental students transitioning to independent dental practice at Mahidol Dental School. At the end of the session, students' perceptions of the benefits of cognitive bias awareness in dental practice were assessed using an online questionnaire via Google Form. Students also provided feedback on the lecture through the same questionnaire. Seventy-six dental students completed the questionnaire (55.47% response rate). Students reported gaining greater knowledge and understanding of cognitive biases, with most expressing satisfaction with the teaching format (interactive lecture with case discussions). They noted that they could apply debiasing strategies in their future practice to minimize clinical errors, enhance clinical reasoning and decision-making skills, and provide better patient care. Students also recommended incorporating cognitive bias awareness into both undergraduate and postgraduate dental curricula. Cognitive bias awareness is an important topic that should be integrated into dental education before students begin independent dental practice. Debiasing strategies can help dental students and practitioners reduce clinical errors and improve the quality of dental care.

Determination of cervical vertebral maturation using machine learning in lateral cephalograms

Background. The accurate timing of growth modification treatments is crucial for optimal results in orthodontics. However, traditional methods for assessing growth status, such as hand-wrist radiographs and subjective interpretation of lateral cephalograms, have limitations. This study aimed to develop a semi-automated approach using machine learning based on cervical vertebral dimensions (CVD) for determining skeletal maturation status. Methods. A dataset comprising 980 lateral cephalograms was collected from the Department of Orthodontics, Shahid Beheshti Dental School in Tehran, Iran. Eight landmarks representing the corners of the third and fourth cervical vertebrae were selected. A ratio-based approach was employed to compute the values of C3 and C4, accompanied by the implementation of an auto_error_reduction (AER) function to enhance the accuracy of landmark selection. Linear distances and ratios were measured using the dedicated software. A novel data augmentation technique was applied to expand the dataset. Subsequently, a stacking model was developed, trained on the augmented dataset, and evaluated using a separate test set of 196 cephalograms. Results. The proposed model achieved an accuracy of 99.49% and demonstrated a loss of 0.003 on the test set. Conclusion. By employing feature engineering, simplified landmark selection, AER function, data augmentation, and eliminating gender and age features, a model was developed for accurate assessment of skeletal maturation for clinical applications.

Effect of the COVID-19 Pandemic on the Educational Indicators in the Dentistry Career of the University of Costa Rica

This study aimed to determine the effect of the COVID-19 pandemic on the educational indicators of students who enrolled in the dentistry program at the University of Costa Rica between 2015 and 2021. Records of 522 students were analyzed, considering variables such as gender, age at entry, nationality, marital status, children, place and type of high school attended, and course performance. Information was extracted from the Student Applications System, physical records, and the Civil Registry of Costa Rica. Descriptive and bivariate analyses were performed to identify patterns and correlations between variables, and approval rates before and during the pandemic were evaluated. Seventy percent of the students were women, predominantly Costa Rican, aged between 19 and 23, from public high schools, and originating from the Greater Metropolitan Area. Terminal efficiency was zero due to the closure of clinical courses in 2020, which prevented the 2015 to 2017 cohorts from graduating within 12 semesters. The dropout rate was highest in the first and second semesters, with a progressive decrease in subsequent semesters. Most cohorts experienced delays, particularly in semesters 7-8 and 9-10. First-attempt approval rates increased in some service courses with virtualization during the pandemic, such as Intensive General Chemistry and Elementary Mathematics, but no difference was observed in the courses specific to the School of Dentistry. The COVID-19 pandemic had varying impacts on educational indicators, with virtualization improving performance in some theoretical courses while posing challenges in those with practical and clinical components.

Survival Rate of Direct Posterior Composite Resin Restorations at a Southern California Dental School

Survival Rate of Direct Posterior Composite Resin Restorations at a Southern California Dental School

Enhancing, Targeting, and Improving Dental Trauma Education: Engaging Generations Y and Z.

Dental trauma is highly prevalent, involving 25% of school-age children and about 12.5% of the general population of the world. Due to the young age of the patients that are usually involved in dental trauma, there are tooth-related complicating factors, such as open apices, thin dentinal walls, and unfavorable crown-to-root ratio, as well as patient-related factors, such as anxiety and cooperation, and other challenges related to the complex diagnosis and treatment. Therefore, it is not surprising that the global status of knowledge for the prevention and emergency management of traumatic dental injuries among dental professionals was often reported as insufficient. Aiming to improve dental trauma education, one should consider that the contemporary educational settings have transitioned to a digital learning ecosystem and that the current students belong to a unique generational cohort. Therefore, this paper examines the challenges educators encounter in contemporary dental school classrooms and the defining characteristics of current generation Y and Z dental student cohorts. Finally, it outlines strategies to optimize dental trauma learning, considering the unique generational characteristics of the current dental students.

Optimizing dental students' use of feedback: Validation of a theoretical model.

A model describing the factors that influence the use of feedback by dental students from three UK dental schools has been proposed. Seven factors that influence feedback utilization were identified. This project aims to test the validity of this model in a larger student population from two UK dental schools in Newcastle upon Tyne and Cardiff. An electronic questionnaire was created and circulated to two dental schools. Data from schools were combined and analyzed using SPSS software. A total of 304 responses were analyzed using principal component analysis resulting in the extraction of nine components which were identified as "most important." The Kruskal-Wallis test was used to analyze the correlations of these components with the demographic characteristics of participants. The nine components were feedback utility, feedback value, credibility, learning approach, the learner's understanding of the feedback's purpose, and its processes, accessibility, future applicability, and institutional processes. According to the Kruskal-Wallis analysis, seven of the components (but not credibility or institutional processes) were found to be influenced by differences in the gender, nationality, and ethnicity of students as well as their previous educational experience. However, no evidence was found that variables such as age, student year group, or religious beliefs affected any of these components. Some demographic characteristics are more engaged with one or more components than others. Understanding that will help optimizing this model and ultimately benefits students and institutions. The main project's goal was met by the research in validating the previously developed model.

Investigating the relationship between the type of occlusion and mandibular radiomorphometric indices in patients with normal facial height.

The ability to predict the extent and direction of horizontal growth of the patient's face at an early age allows clinicians to timely identify cases that require treatment during the growth period and to ensure that appropriate treatment can be administered. The aim of this study was to investigate the role of the antegonial angle, gonial angle, antegonial notch depth, and the type of the antegonial notch on predicting horizontal facial growth in individuals with normal facial height. In this descriptive analytic study, lateral and panoramic radiographs of 180 patients aged 17-30 years with normal facial height who were referred to the School of Dentistry of Qazvin University of Medical Sciences and private dental clinics were investigated. The indices of the gonial angle, antegonial angle, type of antegonial notch, and antegonial notch depth were plotted bilaterally on tracing paper and subsequently measured using panoramic radiographs. Additionally, the relationship between the desired radiomorphometric indices and the occlusion class in the samples was investigated. There was a statistically significant relationship between the occlusion class and the antegonial notch depth (analysis of variance (ANOVA), p = 0.048), as well as the antegonial angle (Kruskal-Wallis test, p = 0.002). The results of this study indicate that the antegonial notch depth and angle indices can be clinically valuable in predicting the process of mandibular growth and developing appropriate treatment plans.

Training future dentists: Acquisition of "soft skills" during oral medicine clinical chairside teaching in an undergraduate dental school.

Training future dentists: Acquisition of "soft skills" during oral medicine clinical chairside teaching in an undergraduate dental school.

Dental Student Engagement in Research: A Survey of California Dental Schools

Dental Student Engagement in Research: A Survey of California Dental Schools

Finances and employment domains are strong determinants when screening for unmet social needs in a predoctoral dental clinic: A preliminary assessment.

Recent efforts by advocates and policy makers have articulated the importance of gaining a deeper understanding of determinants of health to improve health outcomes and reduce health disparities. Social determinants of health (SDOH) are routinely taught in oral health professions curriculum; however, there are limited studies assessing clinical implications. The purpose of this study was to assess the prevalence of SDOH in dental school clinics and associations with socioeconomic and demographic data and health literacy (HL). Predoctoral clinical patients were surveyed using a 28-item, using Likert scale, multiple choice, open text, and binary yes/no items. Associations between unmet social needs (USNs) and gender, age, race/ethnicity, annual household income, zip code, and HL were evaluated. The data were descriptively and statistically analyzed (p-values<0.05). There were 204 respondents, males (48%) and females (50%), with 2% non-binary reporting 331 USN cumulatively and 76% reporting one or more USN. The greatest domains were employment (27.5%), finance (23.0%), food (27.5%), and transportation (18.6%), with significant associations for employment (p<0.0001), finance (p<0.0001), food (p<0.0001), and transportation (p<0.0001). A total of 80.79% of the respondents had adequate HL, and individuals with zero and one USN had higher mean HL score versus three USNs (p=0.0014 and 0.041, respectively). Screening for USNs in dental clinics is an excellent method to gather non-medical information that can be used to improve health outcomes. Within the limits of this study dental clinic patients have unmet need across the SDOH domains, with the highest in finance, employment, transportation, and food insecurities.

Ageism combating strategies in oral healthcare: A systematic review

AbstractPurposeThe aim of this study is to investigate the existing evidence regarding the effectiveness of strategies aimed at combating ageism against older adults among dental students.MethodsA systematic review was performed following preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines to identify articles from seven electronic databases: MEDLINE via the PubMed interface, Embase, Age‐Line, Scopus, Web of Science, CINAHL, and Cochrane.ResultsAmong twenty‐four references reporting on ageism among oral health care providers and/or students, only two reported on the outcomes of strategies for combating ageism at dental schools, with a 12‐year gap between them. Both studies showed that non‐geriatric‐specific clinical activities during dental school might reduce ageism among students. Notably, each article used a different tool to assess ageism.ConclusionAlthough the dental literature calls for action to reduce ageism in many published articles, there is a need for more studies evaluating the outcomes of strategies to combat ageism in oral healthcare.

Comparison of perceptions of the dental education environment among students from national dental schools in South Korea, Laos, and Vietnam

Purpose: This study seeks to analyze the educational environments of the national dental schools in South Korea, Laos, and Vietnam to develop targeted educational support strategies for Laos and Vietnam.Materials and methods: The survey, using the DREEM specific to the healthcare field, was conducted online, with 97, 109, 215 dental students from a single national university in South Korea (SKU), Laos (LU), and Vietnam (VU), respectively. The data allowed us to compare students’ perceptions of the educational environment across the three institutions and analyze differences by gender, academic achievement, and year of study.Results: VU, LU, and SKU reported scores of 133.47, 129.66, and 104.23, respectively, all within the "more positive than negative" range (101–150 points). SKU scored lowest in the category of "students’ perception of learning" (mean score of 1.82), while VU and LU had the lowest scores in category of "students’ perceptions of atmosphere" (mean scores of 2.49 and 2.57, respectively) and "students’ social self-perceptions" (mean scores of 2.49 and 2.52, respectively). In contrast to SKU, VU and LU showed no differences between achievement groups, with male students scoring lower than female students in some DREEM categories.Conclusion: We expect that analyzing the educational environment from the beneficiaries’ perspective and developing strategies based on this analysis will provide practical support to dental schools in Laos and Vietnam.

Radiographic characteristics and chronological patterns of transient apical breakdown (TAB) in luxated permanent teeth: A retrospective observational study.

To describe radiographic features, clinical signs and symptoms, and chronological patterns of post-traumatic transient apical breakdown (TAB) in luxated permanent teeth. Records from 56 patients treated at the Dental Trauma Clinic of the School of Dentistry of the Federal University of Minas Gerais from 1993 to 2024 were accessed to collect demographic, clinical, and imaging features of 89 teeth that presented with radiographic signs of TAB after traumatic dental injury (TDI). Kaplan-Meier curves were built to illustrate the time elapsed between trauma until TAB onset and resolution for the whole sample and for each one of the TAB patterns. A Cox regression was used to explore the effect of clinical covariates in both events. Patients' mean age at the time of trauma was 17.7 ± 6.6years (range 9.1 to 39.7years), with most being male (59.6%). All included teeth were mature at the time of trauma (Moorrees stage 6). Upper central incisors (66.3%) were predominant and mostly suffered extrusions (40.4%) or lateral luxations (32.6%). TAB was observed as an expansion of the periodontal ligament associated with a "V-shaped" widening of the apical foramen together with apical root resorption in 45 teeth (50.6%). Expansion of the periodontal ligament associated with "V-shaped widening of the apical foramen only was observed in 32 teeth (36%), and 12 teeth (13.5%) showed expansion of the periodontal ligament associated with apical root resorption only. The overall median time for TAB onset was 3.2months (range, 26days to 8months), being significantly lower for pattern 2 (1.8months) when compared to TAB pattern 1 and 3 (3.4, and 3.9months) respectively (Logrank test p values < 0.001 for both comparisons). The overall median time for TAB regression was 9.1months (range, 4.8 to 34.8months) after trauma. Again, TAB pattern 2 presented lower periods when compared to TAB pattern 1 and 3 (Logrank test p values < 0.001 and 0.013, respectively). Color changes were not frequent neither at the time of TAB onset nor at the time of TAB resolution. However, while most teeth (53.3%) did not respond to pulp sensibility tests at the time of TAB onset, this proportion decreased to 17.6% by the time of TAB resolution. TAB was mainly diagnosed within four months after luxation of mature teeth, most of them being resolved within the 1-year of follow-up. The most frequent TAB pattern was an expansion of the PDL associated with a "V-shaped" widening of the apical foramen together with external apical root resorption. These findings represent an important contribution for treatment decision-making during the follow-up of luxated permanent teeth.

The challenging reality of the clinical learning environment at Damascus University Faculty of Dental Medicine in Syria: A qualitative study

Introduction In Syria, specialist dentists undergo five years of undergraduate education and four years of postgraduate education. In the latter, students engage in treating complex cases as part of their professional training. This study aimed to obtain in-depth qualitative understanding of the clinical learning environment at Damascus University Faculty of Dental Medicine, Syria. Methods Semi-structured interviews were held with eight postgraduate dental students at Damascus University Faculty of Dental Medicine. The faculty has eight clinical departments; therefore, a single participant was purposively sampled from each department. The male-female ratio of the eight interviewed participants was 1:1. All interviews were conducted between 26th April 2020 and 8th January 2021. Data were analyzed inductively using reflective thematic analysis. Pragmatic saturation was discussed during the analysis and the authors made an interpretative judgement to stop data collection at the eighth interview. Results Major themes which emerged covered different aspects of the clinical learning environment such as clinical training, social interaction and assessment procedures. Faculty’s negligence of their teaching duties was one of the most recurrent themes. In clinical training and due to faculty inaccessibility, students had to rely on themselves or their senior peers in training. The social climate was perceived negatively and assessment was described as unfair and biased. Discussion This study employed Gruppen’s conceptual framework to conduct a theory informed analysis of the clinical learning environment in a dental school with limited resources. The findings highlight important areas of improvement that needs addressing, including the unavailability of teaching staff, neglect of student needs, a competitive social atmosphere, and inconsistent assessment practices. Future research ought to focus on understanding the perspectives of teaching faculty and decision makers regarding the obstacles to implementing substantial reforms aimed at enhancing the clinical learning experience.

Novel topical dressing for dry socket and comparison of its efficacy with that of Alvogyl®: A randomized controlled clinical trial.

To evaluate the efficacy of a novel topical dressing (composed of triamcinolone, ground Dianthus caryophyllus, eugenol, honey, and Iris germanica) for alveolar osteitis (dry socket) against Alvogyl® (composed of eugenol, butamben, and iodoform). In a randomized parallel-armed clinical trial at Mashhad Dental School's Department of Oral and Maxillofacial Surgery, 36 patients with alveolar osteitis were randomly allocated into two groups according to the inclusion criteria (n=18), using sealed envelopes: one receiving a novel topical dressing and the other receiving Alvogyl®. Post-treatment pain was assessed using a visual analog scale immediately after the procedure and at 30 and 60 minutes, 24, 48, 72, and 96 hours, and one week later, as well as the frequency of dressing applications and analgesic usage. Data analysis was performed using SPSS version 26. Analyses were completed on all 36 participants without dropouts. No significant age or gender differences were found between the groups at baseline (p=0.370 and p=0.502, respectively). The novel dressing group experienced significantly lower pain scores at 30 and 60 minutes post-treatment (p<0.001), but higher scores at 24 (p=0.029), 48 (p=0.001), and 72 (p=0.017) hours, and similar pain scores immediately after the procedure and at 96 hours and 1 week (p>0.05), compared to the Alvogyl® group. The mean number of analgesics taken (p=0.097) and the mean frequency of dressing application (p=0.839) were not significantly different between the two groups. The novel topical dressing demonstrated efficacy comparable to Alvogyl®, with the added benefits of cost-effectiveness and the absence of side effects, suggesting its potential as an alternative treatment for dry socket.

Development of a dynamic clinical assessment for finals

Different dental schools assess ‘finals' in different ways. Assessment of applied clinical knowledge and skills are commonly based on either objective structured clinical examinations or multiple ‘long cases'. While iterative changes naturally occur throughout education and assessment, it is important to step back and question what skills should be assessed and either identify or develop new assessment methods. At the point of graduation, these should capture the professional attributes expected of a ‘qualified dentist'. New graduate attributes we consider valuable, which can often be challenging to assess summatively in a high-stakes examination, include effective communication skills in a variety of contexts, the ability to be reactive and responsive, and to manage case complexity appropriately for the graduate level.Here, we report a dynamic assessment incorporating candidate interaction with a range of stakeholders. To reflect progression of changing clinical situations, we move away from solely traditional case-based discussions, which principally assess interaction with an examiner, and have introduced multiple scenarios with rapid situation changes, long-term follow-up, treatment complications and challenging communications. A cross-cutting assessment rubric was developed to assess candidates' information gathering/giving, communication, clinical and diagnostic reasoning, applied knowledge, management and professionalism.