Benefits of virtual externships with a pediatric dentistry program for potential residents.

PURPOSE: To determine if a virtual externship (VE) is beneficial to potential applicants regarding their perceived knowledge of a pediatric dentistry residency program. Secondarily, this study identified general program characteristics that influence resident ranking decisions. METHODS: All applicants who applied to a pediatric dentistry residency program in the Southeast were invited to participate in a VE. Those who participated in the externship (n = 65) were asked to voluntarily complete Pre- and Post-VE surveys. Participants were asked 22 questions about their level of knowledge of both tangible and intangible aspects of the program such as stipend, patient volume, faculty-resident interaction, and resident comradery. Participants were also asked to rank 9 general characteristics that influence ranking decisions such as geography, cost to attend, and reputation of the program and were asked to rate their satisfaction with the VE. Post-VE data were compared to pre-VE data to determine level of knowledge gained via Wilcoxin matched pairs signed rank test (significance set at p < 0.05). RESULTS: When comparing Pre- and Post-VE ratings of level of knowledge about each category, all 22 categories assessed showed statistically significant mean differences indicating perceived knowledge gain with the most knowledge gained for "resident satisfaction in the program." Of the nine program characteristics, clinical experience was the most important factor to participants. Participants (100%) were satisfied with the VE experience and indicated the VE gave them the opportunity to get to know the program. CONCLUSIONS: A virtual externship is a satisfactory option for increasing applicant knowledge of the tangible and intangible aspects of a residency program.

Dental students and recent dental graduates' perceptions of preparedness in treating pediatric patients.

PURPOSE/OBJECTIVES: To survey potential applicants applying to advanced education in pediatric dental programs and evaluate their preparedness upon graduating from an accredited dental school. METHODS: Attendees of a virtual externship of a University program were recruited to participate in a web-based survey. The survey collected demographic data, current levels of confidence with various pediatric clinical procedures, predicted confidence with those procedures, and number of procedures completed. Chi-Square and analysis of variance statistics were performed on resulting data to determine statistical significance. RESULTS: Fifty-three participants completed the survey in its entirety (n = 53). Most respondents reported adequate didactic training, mean score of 3.6 (range 0-5) and a moderate to high impact of coronavirus disease 2019 on their overall training with a mean score of 4.9 (range 0-10). Current dental students reported that they are "not confident at all" (<2.0) for 15/24 (63%) of the procedures. Graduates reported "somewhat confident" (<3.0) for 13/24 (54%) of the categories. Both students and graduates report the lowest levels of confidence for managing dental trauma, invasive treatment of young patients (<4 years of age), and patients with special healthcare needs. Dental students self-reported the expectation to feel more confident throughout their matriculation; however, their clinical experience was still reported to be limited. Students did not report reaching the level of "confident" for 75% of the procedures. CONCLUSION: Dental students and recent dental graduates alike perceive themselves to be under prepared for practice and do not feel confident in performing pediatric dental procedures. This study can provide dental schools, program directors, recent graduates, and dental students with an understanding of areas where they are under prepared and could offer areas where curricula and clinical experiences could be updated or modified.

Alcohol use among US dental students: Results of a nationwide survey.

PURPOSE/OBJECTIVES: Substance use may be a consequence of dental student stress. Studies have examined the alcohol use among medical students, but there are fewer studies among dental students. The purpose of this study was to examine alcohol use in a large geographically diverse sample of US Dental Students. METHODS: An anonymous web-based survey instrument was modeled after well-known surveys of college student substance use. Survey data collection used best practices for web-based surveys when possible. RESULTS: 2019 responses were collected with the cooperation of fifteen US dental schools (potential sample size: 6029; RR: 7.6%, n = 463). 2021 responses were collected using the American Student Dental Association email list (potential sample size: 18,722; RR: 2.2%, n = 424). Respondents came from all regions of the US. Thirty-day alcohol usage and binge drinking rates were somewhat higher among dental students than college-age students from other surveys. Women's 30-day prevalence of alcohol use was slightly higher than men, but binge drinking prevalence was greater among men. Prevalence of binge drinking was higher among white students, as was mean drinks per drinking occasion. Students who self-reported below average academic performance were more likely to report drinking to get away from problems and had a higher prevalence of some alcohol-related problems (ARPs). CONCLUSIONS: Despite the limitations of this study, the results are consistent with that of other studies. This study has provided some valuable insight into the prevalence of alcohol usage and ARPs among US dental students. Of special concern are the reasons for drinking as mechanisms for relieving tension and stress, which may continue into dental practice.

A Randomized Controlled Pilot Study Examining Effects of Animal Assisted Therapy in Children Undergoing Sealant Placement.

Purpose: The purpose of this study was to examine the effects of a companion canine on physiologic responses, discomfort level, and behavior in children undergoing sealant placement using a dental isolation system (Isodry®). Methods: Forty-seven healthy six- to 10-year-olds who needed sealants were randomly assigned to a control group (N =23) or experimental group (N =24) that utilized an emotional support canine in the child's lap. Preoperative baseline anxiety was obtained. Pulse, pulse oximetry, and behavior (measured by Frankl and Houpt scales) were recorded at various time points (beginning, at first sealant placement, switching the isolation system to the other side, second side sealant placement, and end) throughout the procedure. Participants reported a comfort level utilizing the FACES scale. Participants in the intervention group were asked, "Did you like having the dog in your lap?" The dentist rated the difficulty of and time required for the procedure. Results: Baseline anxiety was similar; no significant differences in physiologic measurements or FACES ratings were found between groups. The intervention group had significantly lower Houpt ratings for all three variables when the isolation system was repositioned (P=0.002, P=0.03, and P=0.05) and had higher Frankl scores at isolation repositioning and when completing sealants on the second side (P=0.02 and P=0.03, respectively). Both groups had similar ratings from the dentist. Conclusions: Animal-assisted therapy (AAT) should be studied more rigorously to substantiate its effectiveness in enhancing cooperative behavior in children for dental procedures. High levels of satisfaction were observed among pediatric users of AAT.

Parents' Preferences and Perceptions of Their Children's Consumption of Sugar and Non-nutritive Sugar Substitutes.

Purpose: The purpose of this study was to investigate opinions and preferences of parents from various sociodemographics regarding sugar and both natural and artificial non-nutritive sugar substitutes (NNS). Methods: Oral interview surveys were conducted in dental practice settings. Parents were asked about demographics, their consumption of and feelings about sugar and NNS for themselves and their children, and their concerns regarding NNS. Parents were asked about natural and artificial labels and were asked to select snacks/beverages they would purchase for their children. Results: Parents (N equals 100) preferred sugar-sweetened drinks for their children (76 percent), and 78 percent expressed concern about the potential health effects of NNS, especially cancer. Parents felt sugar was safer than NNS and were more positive about natural NNS than artificial ones. More highly educated parents (P = 0.02) were more likely to avoid NNS for their children, and parents of the lowest income level were likely to express ambivalence regarding naturally labeled NNS. Conclusions: Parents are concerned about giving their children NNS and cite cancer as the primary reason. Parents from higher sociodemographic backgrounds are more likely to limit their children's consumption of NNS and have negative feelings about them. Most parents, especially those of higher sociodemographics, are more accepting of natural NNS.

Trends in First-Year Dental Students' Information Technology Knowledge and Use: Results from a U.S. Dental School in 2009, 2012, and 2017.

Dental students must be skilled in the use and application of information technology (IT), but there are few studies of IT use and knowledge among U.S. dental students. The aim of this study was to retrospectively analyze survey data regarding IT use and knowledge collected from first-year dental students at one U.S. dental school in 2009, 2012, and 2017. Data were collected from an anonymous survey of these students as part of a D1 course called Informatics and Evaluation of Dental Literature. All students participated in the survey each year, for a response rate of 100%. Annual numbers of participants were 80 (2009), 90 (2012), and 97 (2017), for a total 267 respondents. The students reported that they frequently accessed Internet resources multiple times per day and that frequency of use had increased over time, principally from access via smartphones. These students reported feeling comfortable with higher education IT applications such as learning management systems and computerized testing. However, despite their frequent IT use, the students reported low levels of knowledge about IT security, and the three years of survey data showed that IT security knowledge had declined over time. These findings have implications for dental educators, including the need for methods for training students to protect their personal data and that of their patients.

An International Survey of Female Dental Students' Perceptions About Gender Bias and Sexual Misconduct at Four Dental Schools.

As women enter the dental profession in increasing numbers in North America and around the world, the questions of how they perceive their environment and what kind of barriers they face are important subjects to be addressed. The aim of this study was to assess and compare women dental students' perceptions of bias in their environment and experiences of sexual misconduct at one dental school in each of four countries. In spring 2017, 1,293 female students at four dental schools in the U.S., Bulgaria, Brazil, and India were invited to participate in a 24-item survey developed by researchers from the four countries; 990 students responded (response rate 76.6%). The overall majority of the respondents reported thinking the admissions process at their school was fair (79.7%); but a fifth of U.S. and Brazilian students perceived their school was not fully embracing of females, with most Bulgarian students agreeing (87.2%) and all Indian students disagreeing. Most respondents overall perceived that male faculty members did not favor male students (79.5%) and did not think there was discrimination against female students by faculty (87.1%), but half of the U.S. respondents reported feeling discriminated against by both male faculty and male students. When the responses "I've been verbally harassed" and "I've been somewhat verbally harassed" were combined, 10.1% of the U.S. respondents reported verbal harassment, compared to 20% of Brazilian, 15% of Bulgarian, and 2% of Indian respondents. When the responses "I've been sexually assaulted" and "I've been somewhat sexually assaulted" were combined, 6% of U.S. respondents reported being sexually assaulted, compared to 6.2% of Brazilian, 2.5% of Bulgarian, and none of the Indian respondents. Almost half (46.9%) of these students overall perceived their school was not or only somewhat vigilant about issues of sexual misconduct, and only 54% said they would feel comfortable or very comfortable reporting misconduct. These results suggest that academic dental institutions in all four countries need improvements to make their environments more equitable and free of bias and sexual misconduct.

Effect of dental restorative materials on total antioxidant capacity and calcium concentration of unstimulated saliva.

BACKGROUND: To evaluate the effect of dental amalgam and composite restorations on total antioxidant capacity (TAC) and calcium (Ca) ion concentration of unstimulated saliva. MATERIAL AND METHODS: Forty-eight children aged 6-10 years selected and divided into three groups of sixteen (8 males, 8 females). In group A and B, samples consisted of two class II dental composite or amalgam restorations, while in group C samples were caries-free (control group). Unstimulated saliva from all samples was collected and TAC was measured by spectrophotometry using an adaptation of 2, 2'-azino-di-(3-ethylbenzthiazoline-6-sulphonate) (ABTS) assay. The Ca ion level was estimated by an auto- analyzer. Data were analyzed with one- and two-way ANOVA test, at a p<.05 level of significance. RESULTS: Composite samples showed significantly higher TAC and lower Ca ion levels compared to amalgam and caries-free samples (p<.05). The TAC values showed only significant difference between groups (p<.05), while the Ca ion results showed significant differences within and between groups (p<.05). CONCLUSIONS: Dental composite restorations increased TAC and decreased Ca ion levels more than amalgam restorations in saliva. Gender is an effective factor in changes induced in oral cavity as females showed more emphatic reaction to dental filling materials than males. STATEMENT OF CLINICAL RELEVANCE: Patients who have dental restorations, especially dental composites, should pay more attention to their dental hygiene, because dental restorations can increase oxidative stress and decrease Ca ion level in saliva, which might jeopardize remineralization process of tooth structures after demineralization. Key words:Amalgam, caries, composite, saliva, total antioxidant capacity.

Clinical Evaluation and Parental Satisfaction with Pediatric Zirconia Anterior Crowns.

PURPOSE: The purpose of this study was to evaluate the clinical success of and parental satisfaction with anterior pediatric zirconia crowns. METHODS: A retrospective analysis of maxillary anterior pediatric zirconia crowns was performed. Crowns were evaluated for retention, gingival health, color match, contour, marginal integrity, and opposing tooth wear. Parental satisfaction regarding the esthetics of the crowns and parental perception of the impact of treatment on the child's appearance and oral health were evaluated by questionnaire. RESULTS: Fifty-seven crowns were evaluated in 18 children. Eight teeth were lost to exfoliation, three were extracted due to pathology, and two crowns debonded, leaving 44 available for examination. The average crown age at time of examination was 20.8 months. Sixteen crowns (36 percent) displayed gingival inflammation and color mismatch. No recurrent caries or opposing tooth wear was noted. Parents reported high satisfaction with the color, size, and shape of the crowns. The majority of parents reported that crowns improved the appearance and oral health of their child (78 percent and 83 percent, respectively). Eight-nine percent of parents reported that they would highly recommend these crowns. CONCLUSIONS: Zirconia crowns are clinically acceptable restorations in the primary maxillary anterior dentition. Parental satisfaction with zirconia crowns is high.

A poster and a mobile healthcare application as information tools for dental trauma management.

BACKGROUND/AIMS: Prompt management of dental trauma in children affects outcomes, and multiple educational resources are available. The aim of this study was to compare subjects' accuracy in answering a survey about dental trauma management utilizing a poster and a mobile healthcare application and to determine user preference for mode of delivery of information. MATERIALS AND METHODS: A survey was administered to parents of patients in two pediatric dental practices. Questions collected demographic information, frequency of internet use, and responses to questions regarding dental trauma management for two separate scenarios. Participants used both a poster and a mobile application, but were randomly assigned as to which tool was utilized first. RESULTS: Eighty-nine surveys were usable. The majority of respondents were aged 36-45 years (50.6%), had education beyond high school (64%), and had private insurance (52.8%). Less-educated individuals were more likely to report searching the Internet (74%) compared to individuals with a graduate degree (57%) (P = 0.017). The majority of subjects answered trauma management questions correctly with both tools. However, for an avulsed permanent tooth, individuals receiving the mobile application were more likely to select: 'put the tooth back in place' (71.1%) compared to those utilizing the poster, who chose 'put the tooth in milk' (56.8%) (P = 0.004). Less-educated individuals were willing to pay more for the application (P = 0.015) and were more likely to report being interested in receiving dental information through mobile technology in the future (P = 0.006). CONCLUSIONS: Both a poster and a mobile healthcare application are effective in delivering dental trauma information.

Seeking to Understand the Reader of Interest-Your Patient-Health Literacy and Adherence Concerns for the Dentist and the Dental/Medical Team.

The overall health of the United States' (U.S.) population has been surveyed and reported for several decades in a quest by healthcare professionals to understand the etiology for healthcare disparities and seek to lessen its effects on individuals and, ultimately, eliminate them. Many of these surveys and reports have illuminated disparities, of access to healthcare by focusing on measures to address health literacy deficiencies. A plethora of information concerning patients' health literacy skills and printed information has been made available for dentists and their staff. The printed information is in the format of published patient- centered educational guidelines and readable dental and medical limited reach media (LRM), such as information sheets and prescription drug leaflets. LRM has great potential to enhance access to healthcare information for the reader of interest--your patient--at a readable and comprehensible level. Printed materials are an effective means to enhance health promotion and education for the lay populace. Tailored LRM protocol and the Patient Introduction Form (PIF) are excellent educational instruments for dentists and the dental/medical team (The Team). These instruments are valuable assets for The Team to assist its patients in monitoring and maintaining dental and medical adherence protocols in their daily lives.

Comparing comprehensive care and departmental clinical education models: students' perceptions at the University of Tennessee College of Dentistry.

In summer 2012, the University of Tennessee Health Science Center College of Dentistry transitioned from a departmental clinical education model to a comprehensive care/group leader model. The aim of this study was to investigate the perspectives of the fourth-year class of dental students who, because the transition took place during their training, had experienced treating patients under both educational models. To achieve this objective, a questionnaire was designed to assess the students' opinions on the efficiency of their effort, availability of specialty faculty, stress, collaboration with classmates, and availability of exposure to different practice styles and techniques under the two systems. The students were also given an opportunity to provide open-ended feedback on the shortcomings and advantages of the systems. The Class of 2013 had 81 students, 55 of whom participated in the survey for a response rate of 67.9%. The majority (86%) of the respondents preferred the comprehensive care model and reported feeling that, in it, they were able to accomplish more comprehensive dentistry with greater consistency of supervision from faculty in a more patient-centered environment than in the departmental model. However, 56 percent considered having the same group leader for two years a disadvantage and recommended rotation of at least one group leader every six months. The results of this survey can help this college and other dental schools that are seeking to optimize their educational model to best serve students' educational experience and the dental needs of their patient population.

The incidence and pattern of maxillofacial injuries in helmeted versus non-helmeted motorcycle accident patients.

PURPOSE: The aim of this study was to investigate the difference in incidence and pattern of bony and soft tissue injuries sustained by helmeted versus non-helmeted motorcycle accident patients. MATERIALS AND METHODS: The medical records of motorcycle accident patients over a 10-year period were reviewed. Basic demographic data including age, gender, and Injury Severity Score (ISS) were collected. The patients were separated into 2 groups based on helmet use. For each group, the incidence of specific maxillofacial injuries (based on the International Classification of Diseases, Ninth Revision) was tallied. Statistical analysis was performed with the Fisher exact test. RESULTS: A total of 717 patients were included in the study: 598 patients (mean age, 41.6 years; male gender, 90.8%; ISS, 18.2) were in the helmeted group and 119 patients (mean age, 40.8 years; male gender, 90.8%; ISS, 19.5) were in the non-helmeted group. Among the helmeted riders, 26.1% (n=156) sustained a maxillofacial injury, and among the non-helmeted riders, 45.4% (n=54) sustained a maxillofacial injury (P=.0001). The non-helmeted riders also had a significantly higher incidence of malar and maxillary fractures (P=.040), orbital fractures (P=.044), and soft tissue contusions and abrasions (P=.031). CONCLUSIONS: The results of this study suggest that not only do helmets protect against facial injuries in totality, they appear to be more effective at preventing midfacial fractures when compared with mandible fractures.

The influence of endodontic broken stainless steel instruments on the urinary levels of iron.

Previous studies on the endodontic broken stainless steel instruments have mainly focused on retrieval of specimens. However, the systemic consequences of the retained separated instruments need an investigation. The current study aimed to evaluate the correlation between broken stainless steel instruments inside the root canal space and the urinary level of iron (Fe) in patients. Sixty near-aged and same-gender patients were selected. Thirty patients in the control group had no endodontic treatment in their history, while the other 30 patients in the endodontic group had broken stainless steel instrument. The urine samples were collected in iron-free containers. All specimens were refrigerated for 1 day and then subjected to Fe level measurement by electrothermal atomic absorption spectrometry. Data were analyzed by Kolmogorov-Smirnov and t tests at P < 0.05. The correlation coefficients of age and sex were also evaluated in relation with Fe levels in the urine. The level of Fe did not show any significant increase in the experimental group (P > 0.05). There was a positive correlation between age and Fe levels of endodontic and control groups. However, the joint effects of age and sex on Fe levels were different for the two groups. The presence of broken stainless steel instruments inside the root canal space did not elevate the level of Fe in the urine of patients. However, this value was positively correlated with the patient age.

Parents' understanding of and accuracy in using measuring devices to administer liquid oral pain medication.

BACKGROUND: Dentists recommend over-the-counter medications for postoperative pain in children, and parents often make dosing errors when administering these medications. The authors compared the dosing accuracy when parents used various measuring devices and aimed to identify risk factors associated with dosing errors. METHODS: The authors recruited parent-child pairs visiting the Pediatric Clinic at the College of Dentistry at The University of Tennessee Health Science Center, Memphis, and three private dental offices. The parents completed a survey and a liquid measuring exercise. The authors instructed parents to measure 5 milliliters of liquid by using a medicine cup with clear markings, a medicine cup with printed markings, a cylindrical measuring spoon and an oral syringe. For the medicine cup with printed markings, the authors placed the parents randomly into one of two groups: those receiving text-only instructions or those receiving text-pictogram instructions. The authors weighed each device before and after the measuring exercise and compared the difference in weight with a reference weight of 5 mL. RESULTS: A total of 120 parent-child pairs participated. The results of a McNemar test revealed a significant difference in parents' ability to measure accurate doses with the various devices. The results of a Pearson χ(2) test showed no statistically significant difference between the control and study groups for dosing accuracy. The χ(2) analysis results showed no significant differences in risk factors that could be associated with dosing errors. CONCLUSIONS: Medicine cups were the devices parents reported using most frequently. Medicine cups had a higher occurrence of dosing errors when compared with the other devices. No sociodemographic factors were associated with dosing errors. Practical Implications. Dentists can improve pain management in pediatric patients by educating parents about accurate measuring devices, weight-based dosing and correct interpretation of medication dosing charts.

The effect of long-term aspirin intake on the outcome of non-surgical periodontal therapy in smokers: a double-blind, randomized pilot study.

OBJECTIVE: The objective of this parallel, double-blind, randomized pilot study was to determine the effect of a daily dose of 325 mg of aspirin (ASA) on the clinical outcomes of scaling and root planing in a selected group of adult smokers. BACKGROUND: The response to periodontal therapy is inferior among smokers compared to non-smokers. Long-term intake of ASA has been shown to exert a positive impact on reducing both the prevalence and severity of periodontitis, among high-risk groups of subjects such as heavy smokers and diabetics. It is reasonable to assume that systemic administration of ASA in conjunction with reduction of the bacterial load by scaling and root planing may improve and prolong the benefits of periodontal therapy. To date, only few prospective interventional clinical studies have specifically addressed the periodontal needs of smokers. METHODS: The study includes 24 smokers. The following clinical parameters were measured preoperatively and at 3, 6, 9 and 12 mo postoperatively: (i) gingival index; (ii) plaque index; (iii) probing depth; (iii) probing attachment level; (iv) gingival recession; and (v) bleeding scores. Study subjects received scaling and root planing over several visits and were randomly assigned into two equal groups; a control group (C), which received a placebo and a test group (T), which took a daily dose of 325 mg ASA. No additional therapy was provided over the 1 year observation period. RESULTS: There were more statistically significant differences (p < 0.05; one- tailed) between pretest and posttest scores in the T group than in the C group. Mean percent increase in sites with probing depth 1-3 mm (T: 8.78; C: 7.21); mean percent reduction in sites with probing depth 4-6 mm (T: -7.25; C: -5.09 not statistically significant, NS); mean percent reduction in sites with probing depth ≥ 7 mm (T: -1.42; C: -02.09); mean percent reduction in sites with probing attachment level 3-4 mm (T: -3.63; C: 0.48 NS); mean percent reduction in sites with bleeding on probing (T: -12.37; C: -2.59 NS) (p < 0.05, NS). CONCLUSIONS: Daily intake of 325 mg of ASA following scaling and root planing improved treatment outcomes in smokers, without an increase in gingival bleeding tendency. ASA promoted a higher incidence of shallow pockets and more gain in attachment level.

The role of occlusal loading in the pathogenesis of non-carious cervical lesions.

PURPOSE: To evaluate the putative role of occlusal loading in the pathogenesis of non-carious cervical lesions (NCCLs) in subjects who exhibited mixed excursive guidance [i.e., immediate canine guidance on one side and group function (GF) on the other]. METHODS: 20 subjects with Angle Class 1 occlusion and having from 1 to 5 NCCLs on separate teeth were selected. Only subjects who displayed mixed excursive guidance were recruited so that they could serve as their own controls. Non-carious cervical lesions were recorded on casts mounted in semi-adjustable articulators. RESULTS: On the GF sides, 22.5% of all teeth that contacted in working excursions exhibited NCCLs; only 2.1% of the teeth on the canine guided sides exhibited NCCLs, which were found exclusively in canines. Although a case for the multifactorial etiology of NCCLs remains strong, our data, albeit limited, seems to support the dominant role of occlusion in lesion formation.

An innovative behavioral science curriculum at the University of Tennessee College of Dentistry.

Communication skills have long been associated with practice success in dentistry. The Commission on Dental Accreditation's standards state that "Graduates must be competent in the application of the fundamental principles of behavioral sciences" and that "Graduates must be competent in managing a diverse patient population and have...interpersonal and communications skills." A recent survey of U.S. dentists found an underutilization of communication skills by general dentists. The University of Tennessee College of Dentistry strives for continuous improvement and has implemented an innovative behavioral science curriculum to improve students' communication skills, consistent with the College's "patient-centered, comprehensive care" philosophy. We describe the design and implementation of our "Patient-Centered Dentistry" course, in which third-year dental students practice communication skills with simulated patients in the Kaplan Clinical Skills Center on the UTHSC campus. The clinical simulations involve the following scenarios: The Initial Interview with a Patient, Presenting a Treatment Plan, Treating Patients with Fear and Anxiety, Interviewing Considerations for Difficult Patients, Delivering Distressing News to Patients, and Coping with a Drug-Seeking Patient. Student simulations were videotaped and assessed by course instructors as well as clinical faculty, and students received immediate feedback by instructors and clinical faculty after their simulations. Students were provided with the opportunity to view their simulation performance and to reflect on their performance in order to recognize their communication strengths as well as areas for improvement. The use of simulation experiences is becoming a widespread and expected practice in health care education. The Patient-Centered Dentistry course provides students with the opportunity to experience the kinds of real-life situations that they would experience in dental practice, without risks to patients. It provides students with the opportunity to assess their communication skills, make mistakes and improve.