Emotional intelligence and clinical interview performance of dental students.

One hundred and sixteen third-year dental students participating in a consultation skills course in Dunedin, New Zealand, completed a standardized psychometric Social Skills Inventory (SSI) and were assessed by tutors, simulated patients, and themselves. Students with higher social skills abilities obtained higher performance scores and demonstrated better interview structure. Patients reported being more likely to return to students for a dental consultation following the second interview, and students' consultation skills were rated (by tutors, patients, and students) higher at the end of the course than the beginning. Female students had higher global social skills abilities and were more emotionally expressive and sensitive than male students, while the latter had better emotional control. Female students performed better in the first interview than male students, but there was no significant gender difference in the second interview. Tutor and simulated patient ratings suggested that a consultation skills course can increase the ability of students in general, and English as a second language students in particular, to relate to their patients, manage anxiety, identify ethical issues, and recognize significant psychosocial issues that lead to more accurate diagnosis and treatment processes, ensuring the effective delivery of patient-centered dental education.

Axon sprouting in adult mouse spinal cord after motor cortex stroke.

Functional reorganization of brain cortical areas occurs following stroke in humans, and many instances of this plasticity are associated with recovery of function. Rodent studies have shown that following a cortical stroke, neurons in uninjured areas of the brain are capable of sprouting new axons into areas previously innervated by injured cortex. The pattern and extent of structural plasticity depend on the species, experimental model, and lesion localization. In this study, we examined the pattern of axon sprouting in spinal cord after a localized lesion which selectively targeted the primary motor cortex in adult mice. We subjected mice to a stereotaxic-guided photothrombotic stroke of the left motor cortex, followed 2 weeks later by an injection of the neuronal tracer biotinylated dextran amine (BDA) into the uninjured right motor cortex. BDA-positive axons originating from the uninjured motor cortex were increased in the gray matter of the right cervical spinal cord in stroke mice, compared to sham control mice. These results show that axon sprouting can occur in the spinal cord of adult wild-type mice after a localized stroke in motor cortex.

A qualitative investigation of the experiences of immigrant dentists working in New Zealand.

OBJECTIVES: To determine the nature of problems experienced by overseas-trained dentists settling in New Zealand (NZ), and to ascertain what can be done to improve their experiences. DESIGN: Qualitative study using semi-structured interviews. SUBJECTS AND METHODS: A convenience sample of fourteen overseas-qualified dentists was selected and individuals invited to participate in a semi-structured interview. Each interview was audiotaped, transcribed and analysed in order to identify key patterns and themes. RESULTS: Those who were required to sit the New Zealand Dental Registration Examination (NZDREX) found it very challenging, with the majority requiring more than one attempt. Most interviewees had moved to NZ for an improved quality of life and had settled well into dental practice. However, some reported that they had experienced significant difficulties. These primarily related to financial issues, employment issues, being accepted into the profession, and establishing suitable peer contact. The dentists considered that the Dental Council and the NZDA were very helpful, but that there was a need for clearer information about the content of the NZDREX examinations, and a peer support network for immigrant dentists. CONCLUSIONS: Improved support for immigrant dentists would aid their transition into general practice in this country.

Changes in the New Zealand dentist workforce over a nine-year period.

OBJECTIVE: To identify and describe trends in the NZ dentist workforce over a nine-year period. METHODS: Data from the 1997, 2001 and 2005 DCNZ workforce questionnaires were collated and analysed using both cross-sectional and longitudinal methods. RESULTS: 2088 dentists completed the workforce questionnaire in at least one of these years, and 1026 (49.1%) did so in all three of them. Substantial changes occurred in the NZ dentist workforce over the observation period. The proportion of women and overseas-trained dentists in the workforce continued to increase, along with the mean age of dentists. There was a large decrease in the number of hours worked per week by specialist dentists (who still worked more hours than dentists), but there was no clear trend for general dentists. Increasing numbers of dentists appear to be opting for part-time work; the main reasons for doing so included personal choice, parental responsibilities, and semi-retirement. There was a trend for fewer dentists to be working in small towns, mainly through dentists leaving (or retiring) and not being replaced, rather than dentists moving from towns to the cities. Rural dentists and female practitioners were less likely to achieve the continuing professional development (CPD) target than their colleagues. In 1997, fewer overseas-qualified dentists (than NZ graduates) were self-employed and had undertaken 20 hours CPD, and a larger proportion worked in small towns. However, these differences were not evident in the later years. CONCLUSION: The New Zealand dental workforce continues to change, particularly with respect to gender mix, age, work circumstances and CPD activities.

Gender differences in dentists' working practices and job satisfaction.

OBJECTIVES: To describe the working practices and level of job satisfaction of male and female dentists. METHODS: A nationwide postal survey of all dentists holding an annual practising certificate in New Zealand (response rate 78.1%). RESULTS: The mean number of hours worked per week was 29.1 for female and 36.0 for male dentists. The main reason for part-time practice given by women was caring for children (cited by 67.2%) and for men was personal choice (cited by 63.6%). A greater proportion of females than males were employed on a salary or as an associate in practice rather than owning their own practice. Male dentists were more active in continuing education than females. The mean career satisfaction score for male respondents was 7.6 and for females 7.1 (P<0.001). Relatively more women than men had taken a career break, usually for child rearing. Two-thirds of women and one-third of men planned to retire from dentistry before 60 years of age. CONCLUSIONS: Male and female dentists differ in their working patterns and career satisfaction. There is a need for ongoing monitoring of the workforce, particularly as the gender distribution (and societal trends and expectations) continues to change.

The working practices and job satisfaction of dental hygienists in New Zealand.

OBJECTIVES: To describe the current working practices and level of job satisfaction of dental hygienists in New Zealand. METHODS: Postal survey of all dental hygienists on the New Zealand Dental Council's database. An initial mailing was followed by a 3-week follow-up. Information was sought on respondents' demographic characteristics, current occupation and working practice, history of career breaks, continuing education and career satisfaction. RESULTS: 213 responses were received (73.2%); 90.6% were currently working as hygienists, mostly in private practice. Many worked part time, particularly those with children. Almost 50% of respondents had taken at least one career break, most frequently for childrearing. The mean time taken in career breaks was 3.6 years. Overall, dental hygienists reported high levels of satisfaction with their careers and their income. Older hygienists had higher career satisfaction scores. Most respondents were actively involved in continuing education. Almost half were interested in expanding the range of procedures they perform. Over one-third plan to retire within the next 10 years. CONCLUSIONS: While many hygienists take career breaks and work part time, most have a high level of career satisfaction, actively participate in continuing education, and are satisfied with their remuneration.

A communication skills course for undergraduate dental students.

Sixty-seven third-year dental students in Dunedin, New Zealand, participated in a communication skills course, using simulated patients, case-based scenarios, videotaped interviews, and class roleplays. The course introduced active listening techniques, taking a medical history, and emotion-handling skills. This course was adapted from an existing course for medical students run by the Department of Psychological Medicine, Dunedin School of Medicine. The results of the student evaluation questionnaire (n = 59) indicated that students rated the course very highly. Retrospective ratings indicated that the students considered communication skills to be significantly more important as a component of their undergraduate training after completion of the course than prior to it. As might be expected, students whose ratings were higher after the course also reported that the course helped them to develop new communication skills and techniques; increased their interest in the subject and their self-confidence; rated the tutor as more effective and the course materials as more helpful; and considered the course to be significantly more stimulating than those students whose ratings of the importance of communication skills remained the same or decreased.

Outcomes two, three and four years after comprehensive care under general anaesthesia.

OBJECTIVES: The objective was to review the outcomes for three groups of children after two, three and four years following comprehensive dental treatment under general anaesthesia (GA) for 292 children aged 1.8 to 5.9 years of age. DESIGN: The study was a retrospective review of ongoing dental treatment needs following treatment under GA. METHODS: Information including the individual tooth treatments carried out, ongoing care, fluoride status, socioeconomic status and ethnicity was obtained from dental records from the School of Dentistry and the Otago District Health Board School Dental Service. The accuracy of the records was evaluated by clinically examining 10 percent of the children. RESULTS: Ninety-five percent of the treated children were followed up. Fifty-five percent had new caries recorded. For the treatments provided, amalgam had a mean success of 57.1 percent, composite 73.4 percent, compomer 85.2 percent, stainless steel crowns 92.8 percent and pulpotomies 84.6 percent. The majority of replaced restorations were because of new carious lesions. CONCLUSIONS: This study indicated that most of the restorative procedures and materials used have very successful outcomes in these high-risk children. Ongoing risk of dental caries is high despite current preventive approaches. Other preventive approaches should be investigated.

Using significant event analysis in dental and medical education.

As part of a new professional development teaching strand at the University of Otago's School of Dentistry, final-year dental students were each asked to write a "thought-provoking episode report" (TPER). These TPERs formed the basis for group discussion in a professional development course. This article outlines the main content themes of the reports, comparing them with similar reports written by medical students from the same university. While both sets of reports demonstrate students' commitment to high standards of care, there were significant differences in the overall themes. Of the fifty-one dental TPERs, the main themes were "difficult" patients, receiving conflicting advice from different clinical tutors, friends as patients, belittlement, and maintenance of professional standards. Key themes from medical students' TPERs included responding to patient suffering, observing or experiencing belittlement, uncertainty, error and complaints, the role of the undergraduate student, treating family and friends, causing distress in order to learn, and issues with mentoring. Possible interpretations of the similarities and differences in this data include confirmation of the value of personal experience as a basis for student discussion, the necessity for formal programs in professional development, and the presence of a hidden curriculum in dental and medical education.

Amelogenesis imperfecta--multidisciplinary management from eruption to adulthood. Review and case report.

Amelogenesis imperfecta (AI) is a group of hereditary conditions that affect enamel formation. It is associated with a high morbidity for the patients and may present major restorative and sometimes orthodontic challenges for the dental team. Early recognition followed by appropriate preventive and restorative care is essential in the successful management of AI. A multidisciplinary approach with careful planning from early childhood will maximise the treatment options available for the permanent dentition and optimise the final outcome. In this case, a team consisting of two paediatric dentists, an orthodontist, a restorative dentist, and an oral and maxillofacial surgeon were involved in the management of the patient over a 12-year period. Treatment included preventive advice, interim composite restorations, two phases of orthodontic treatment, orthognathic surgery and placement of cast crowns. The patient is extremely happy with the result.

Novel dental anomalies associated with congenital contractural arachnodactyly: a case report.

Congenital contractural arachnodactyly (CCA) is an inherited disorder of connective tissue similar to Marfan's syndrome. The craniofacial and oral features of a young girl with CCA are described. The patient has the typical features of CCA as well as some additional dental anomalies which have not previously been reported with this syndrome. These include banded pitted enamel hypoplasia and hypomineralization, long, spindly tapered roots, and pulp canal obliteration with multiple pulp stones. Dentists must be aware of the clinical features of a patient's syndrome to determine whether there are implications for dental treatment such as a need for antibiotic prophylaxis. It is important to exclude Marfan's syndrome as a differential diagnosis for CCA because the former has more associated complications and a less favorable prognosis.

A qualitative study of oral health knowledge and attitudes among staff caring for older people in Dunedin long-term care facilities.

Over the next few decades, the number and proportion of older New Zealanders will increase, and many will retain their natural teeth. Many older people in care will be dependent on caregivers for their oral health care. The purpose of this qualitative study was to investigate the dental knowledge and attitudes of staff caring for older people in Dunedin long-term care facilities. In-depth, semi-structured interviews with 20 participants from three facilities were recorded on audiotape and subsequently transcribed. The transcripts were analysed to identify themes expressed by the participants. Some of the staff reported poor oral health, and many were irregular dental attenders. Interviewees had a reasonable basic knowledge of dental caries, but were uninformed on many other dental issues, such as the benefits of fluoride and the effects of medication on oral health. All understood that oral health could influence general health. The staff had received very little education about oral health and related issues in their training. There is a need to improve the oral health care knowledge of long-term care facility staff. Incorporation of oral health care into in-service and formal training programmes would be valuable.