A profile of dental school deans, 2021.

OBJECTIVE: In 2021, US dental school deans were surveyed to update and expand ADEA deans' profiles developed in 2002 and 2014. METHODS: The American Dental Education Association (ADEA) and the Academy for Advancing Leadership (AAL) collaborated on an updated version of the 2014 dental deans' profile survey. On July 1, 2021, the research project was approved as exempt from IRB oversight. The survey was distributed in electronic format on July 31, 2021, to the deans of the 70 US dental schools, including 3 schools that had not yet held their first year of classes. A total of 60 responses were considered. RESULTS: Administration/management activities continue to consume deans' time the most, followed by fundraising. Managing personnel issues and financial/budget issues, including fundraising, represent the top aspects of the position deans must master and the greatest challenges they face and expect to face for the next 5 years. Deans found these same issues the most surprising aspects of their position, reporting a low level of preparedness to meet those challenges. Most deans advocated for additional leadership programs to supplement the current training received through ADEA and AAL. CONCLUSION: In recent years, gradual changes have occurred in the dental deans' profile, with more women and underrepresented groups assuming this leadership role and the average and median ages of deans increasing. Substantial turnover occurred among deans in recent years; when the 2014 survey was conducted, one respondent was an interim/acting dean. By comparison, seven reported their deanship status as interim/acting in 2021.

Which Way to Lean? A National Study of Women Dental Faculty Members' Career Aspirations and Choices.

The aim of this first national study of women in academic dentistry was to explore factors and perceived barriers for why administrative/leadership positions were or were not sought via data collected from full-time women dental faculty members in the U.S. In fall 2015, the researchers conducted a survey that employed a combination of response formats: forced choice from a menu, multiple allowable answers, and open-ended written comments. The overall response rate for the survey was 35.6% (537/1504). Respondents were from 48 of the 65 U.S. dental schools. Half of the respondents indicated their primary appointment was in clinical sciences, 22.9% were in administration, 7.3% in research, 7.1% in basic science, and 2.5% in behavioral science. While a quarter of the respondents indicated administration as their primary appointment, over half reported holding administrative positions, and nearly all (92.4%) reported currently holding leadership roles at their institutions. For those not currently in administrative/leadership roles, 52.6% indicated a desire for an administrative role and 70.7% a leadership role. Of those in administrative/leadership roles, 62.1% indicated not receiving extra remuneration for those responsibilities. Half of the respondents perceived that they were paid less in their current position than men doing the same work. The most dominant theme emerging from qualitative analysis of barriers the respondents experienced was the difficulty women in dental education have in a traditionally male-dominated profession. The results confirmed that women faculty members are "leaning in" to seek administrative/leadership roles in academic dentistry. However, pay equity remains an issue, and faculty development and mentoring are needed for the advancement of academic dentistry and ultimately the dental profession.

Feasibility Study for a Satellite Program of an Established School of Dentistry.

UNLABELLED: Creative thinking is required to solve the many challenges the oral health care delivery system faces in meeting the needs of the U.S. POPULATION: Access to oral health care services varies widely across the country based on a host of factors including individual patient characteristics, demographic variables, and distribution of professionals by locale. There is also significant variability of need, so that many new solutions have been proposed to meet the needs of specific areas. In late 2012, the University of Missouri-Kansas City School of Dentistry embarked on a feasibility study to determine whether its existing DDS program could be extended closer to underserved areas of Missouri and surrounding regions by utilizing distance education and a clinical training facility in conjunction with another public university. This article describes the study and its outcomes. Other institutions may find this process useful as they assess factors that could impact the success of future programming and seek new solutions to long-standing problems.

Interprofessional education in U.S. and Canadian dental schools: an ADEA Team Study Group report.

The state of interprofessional education (IPE) in U.S. and Canadian dental schools was studied by the American Dental Education Association (ADEA) Team Study Group on Interprofessional Education. The study group reviewed the pertinent IPE literature, examined IPE competencies for dental students, surveyed U.S. and Canadian dental schools to determine the current and planned status of IPE activities, and identified best practices. Members of the study group prepared case studies of the exemplary IPE programs of six dental schools, based on information provided by those schools; representatives from each school then reviewed and approved its case study. Six reviewers critiqued a draft of the study group's report, and study group members and reviewers met together to prepare recommendations for schools. This report identifies four domains of competence for student achievement in IPE and summarizes responses to the survey (which had an 86 percent response rate). It also includes the case descriptions of six schools' IPE programs and the study group's recommendations for dental schools. The report concludes that there is general recognition of the goals of IPE across U.S. and Canadian dental schools, but a wide range of progress in IPE on the various campuses. Challenges to the further development of IPE are discussed.

New models of dental education and curricular change: their potential impact on dental education.

The collective body of work over the last seventy-five years in the Journal of Dental Education has chronicled the ongoing critical issues and trends in dental education. The evolution of the curriculum has run in fits and starts across the twentieth century and into the twenty-first. Today, there has been a resurgence in the introspective work of the profession to examine what is taught, how it is taught, in what sequence it is taught, and the context relating dental education to other health professions and the global reach of the educational and professional environment. In the context of contemporary times, individual as well as organizational leadership has refocused the educational environment from teaching to learning. This article discusses the types of curricular changes documented in the Journal of Dental Education.

Fast forward five years: has dental education changed?

Five years ago, the American Dental Education Association created the Commission on Change and Innovation in Dental Education (ADEA CCI). Much positive movement in dental education has occurred since the CCI's inception. This paper reviews some of the initial change motivation and assesses the progress to date, taking note of unresolved issues that remain.

Prophylactic third molar extractions: US dental school departments' recommendations from 1998/99 to 2004/05.

OBJECTIVE: To review the recommendations by dental faculties regarding prophylactic removal of third molars (PR-3M) and to determine if the recommendations at institutions differed and whether there have been changes since 1998/99. METHOD AND MATERIALS: In 1998/99 and 2004/05, a questionnaire was sent to department chairpersons of oral surgery, orthodontics, and restorative dentistry/prosthodontics of US dental schools. They were asked to characterize their department's PR-3M recommendations for adolescents (< 21 years of age), young adults (21 to 35 years), and adults (> 35 years). Third molars were categorized as fully erupted, semierupted, and unerupted. Participants also were to indicate their rationale for PR-3M. Nonparametric and independent t tests were applied to the data (P

Engineering curriculum change at a private Midwest school of dental medicine: a faculty innovation.

The national dental educational environment has been sensitized to the changing needs of the profession and students, resulting in an agenda for curriculum change in a number of dental schools. This report discusses the impetus for change at a private Midwestern school that has begun a multiyear implementation of an innovative curriculum. The process by which the innovations have been instituted, while unique to this school, may provide insights for change at other dental schools.

Prevalence and etiology of erythema migrans among children in northeast Ohio.

OBJECTIVE: To determine the prevalence of erythema migrans (EM) in northeast Ohio; to identify demographic, health, and dental characteristics associated with this condition in patients aged 1 to 15 years; and to investigate the possibility that EM is a marker for children with multiple medications and certain systemic conditions. METHOD AND MATERIALS: In this retrospective chart review study, 1,900 charts were reviewed at 2 separate offices. One thousand were analyzed at a hospital dental clinic in Cleveland, Ohio, and 900 at a private pediatric dental office in a Cleveland suburb. Data were collected from each chart by 1 investigator and recorded in a database to be statistically analyzed. Nonparametric measures of association and logistic regression were used to determine differences between the presence of EM and the study variables and odds for EM. Significance level was set at P = .05. RESULTS: Seventy-two subjects (3.8%) were found to have EM. The more medications patients were taking, either prescription or over-the-counter, the greater the likelihood of EM (P <.001). Similarly, there was increased likelihood of EM with increasing numbers of medical diagnoses. Gender, oral hygiene, and behavioral status were not found to be statistically significant in the presence of EM. CONCLUSION: Erythema migrans was found in the records of 3.8% of children in 2 clinical facilities in the Midwest. Also, increased prevalence was found among patients with multiple health conditions in conjunction with multiple medication use.

The angle of the articular eminence in modern dentate African-Americans and European-Americans.

The purpose of this study was to determine if there were differences in the angle of eminentia of two 20th century populations based on race, age, gender, and number of teeth and whether there was asymmetry of the angles of eminentia. The sample included dry skulls from the Hamann-Todd Osteological collection as follows: 80 African-Americans (AA, 53 males and 27 females) and 62 European-Americans (EA, 49 males and 13 females), ranging in age from 16-77 years. The lateral, central, and medial aspects of the right and left slopes of the articular eminence were measured in a parasagittal plane. Independent t-tests, paired t-tests, and Pearson correlation coefficients were computed. For the AA population, the right central, lateral, and medial angles of eminentia were steeper than the corresponding left angles (paired t-test, p<0.05); for the AE males only the right lateral and medial angles were significantly steeper than the corresponding left angles (paired t-test, p<0.05). There were no significant relationships between age or number of teeth and the angle of eminentia measurements, nor were there differences in angle of eminentia by gender. There were two differences by race: the EA males had steeper left central and left medial angles than the AA males (independent t-test, p<0.05). The central angle of eminentia was consistently steeper than the medial angle (paired t-test, p<0.01), and the lateral was generally steeper than the medial.

Nursing home executive directors' perception of oral care in long-term care facilities.

Oral health in long-term care (LTC) facilities has been repeatedly documented as less than ideal. The complex nature of this environment has made it difficult to understand and improve the oral health status of residents through education and training. The purpose of the study was to investigate how the executive directors (EDs) of LTC facilities value oral health and to determine facility variables, which may influence how oral care is delivered. A mail survey of the EDs of all LTC facilities in Ohio (n = 1018) was conducted with 338 responses received after secondary follow-up (33.2% response rate). The 30-item survey included information concerning the nursing facility, the EDs, the EDs' perception of the level of oral health care, and value statements rated on a Likert-like scale. The results of the survey showed that more than two-thirds of the EDs were female and that most facilities were proprietary (70.3%). ED gender was not statistically associated with any of the oral health variables. Fifty-three percent of the EDs rated their residents' oral health as fair or poor but were still satisfied with the oral care provided at their facilities. The apparent discontinuity between perceived levels of oral health and satisfaction with oral care suggests that EDs are distanced from the oral care of their residents or they do not acknowledge oral health care needs. While the survey results revealed important facility characteristics and administrators' perceptions about oral health, the most important aspect of this project was the low response rate despite secondary follow-up. That, coupled with the negativity expressed upon follow-up, suggests a larger issue that may affect oral health in nursing facilities: oral health continues to have a low priority in this setting. Continuing efforts to improve oral health and educate LTC professionals about oral health's influence on general health is critical for managing the oral health of future generations of aging adults.

Priorities for oral health goals in a sample of older adults.

This study was conducted to identify oral health factors that are important to people who are elderly. By identifying factors valued by patients who are older, dental professionals can gain better insights into the preferences and priorities that patients use in making dental treatment decisions. To determine which factors are important to this population, we compiled a list of oral health goals identified through a literature review. To supplement this initial list, we undertook line-by-line (open) coding of transcripts of two sets of semi-structured interviews. The first set of interviews explored the decision of older adults to seek treatment in response tooth pain. The second set of interviews elicited anticipated responses to three scenarios involving extensive restoration and one scenario involving extraction and prosthetic replacement among older patients at a dental school.

Oral health disparities among the elderly: interdisciplinary challenges for the future.

The elderly, like other population groups, have experienced varying levels of oral health among their diverse demographic subgroups. For those in poverty, experiencing social isolation, residing in long-term care institutions, and with complex medical illness, oral health care may be unreachable. Various models of training, education, and community, public, and professional collaboration have been proposed, yet few strategies have been implemented. Interdisciplinary approaches that bring interested partners together as equal stakeholders may create faster tracks in improving access to health care for those geriatric patients who lack it. This article explores past and present recommendations for interdisciplinary collaborations, reviews the current and future needs of the geriatric population, discusses educational models and content, and expresses the need for leadership to address oral health disparities in the elderly. Finally, strategies for making improvements in the existing oral health disparities are discussed.

Changing perceptions of oral health and its importance to general health: provider perceptions, public perceptions, policymaker perceptions.

The first ever Surgeon General's Report on Oral Health emphasizes that oral health is essential to the general health and well-being of all Americans, and that oral health can be achieved. But it will require that we think about and approach oral health activities in a different manner. If we desire to influence the mind-set of health care providers, the public, policymakers, and institutions, how do we get from what we know about the relationship of oral health and general health to integrating the notion into everyday actions? The Surgeon General's Report on Oral Health has elevated this issue to the forefront of health care and provided us with an extraordinary opportunity. The challenge: Lead with action and catalyze integration into multiple forums-public, private, and professional-and engage in activities that will change how oral health is perceived broadly. Ultimately, geriatric oral health and the health of all access-limited populations should benefit. To continue preserving the oral health of the millions of older individuals who now enjoy it and to ensure it for those who lack it will require change on multiple societal levels: the health care providers, the neighborhood, the community; Federal, state, and local governments; and the nation as a whole. It means addressing and overcoming multiple barriers to oral health care, which may include problems or disparities in: education, economics, the environment, cultural and social issues, and the health care system itself. To change perceptions, we must remove the barriers to care, educate the stakeholders who can influence or benefit from training programs, conduct broader, population-based research, build public and private partnerships, develop a stronger health care infrastructure, and expand initiatives that target specific risks for declining oral health. In addition to seeking new answers to these problems, it is imperative that we apply what we already know.