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.

Operational and financial impact of the COVID-19 pandemic on U.S. dental school clinics.

PURPOSE: This study assessed the impact of the COVID-19 pandemic on U.S. dental schools and their school-based clinic operations and finances during the first eight months (April to December 2020) of the outbreak. School-based clinics are critical to training and educating future dentists and delivering oral health care services to underserved communities. METHODS: The American Dental Education Association (ADEA) conducted a structured survey with the 67 accredited U.S. dental schools between November 2020 and January 2021 to assess the impact of the COVID-19 pandemic on their operations, especially on their school-based clinics. The response rate was 67%. The authors employed descriptive statistics and text analysis to examine the survey results. RESULTS: This study revealed that from April to December 2020, dental schools experienced a 50% reduction in patient visits at dental school clinics, a 7% median decrease in budget, a 42% decline in revenue, changes in clinical and nonclinical faculty and staff, and investments related to infection control measures to remain operational. Ninety-two percent of dental school clinics suspended community-based patient care experiences outside the dental school in the first eight months of the pandemic compared to the same time period the year prior. CONCLUSIONS: This research shows the extent of the operational and financial challenges dental school clinics faced in the pandemic's first eight months, April to December 2020. In these unique times, dental school clinics continued to train and educate the dentists of tomorrow and deliver oral health care services to vulnerable communities while implementing safeguards and infection control measures to combat the propagation of the COVID-19 virus in their institutions.

Dentists of tomorrow 2020: An analysis of the results of the 2020 ADEA Survey of U.S. Dental School Seniors.

PURPOSE/OBJECTIVES: This study examines the journey of U.S. dental schools' predoctoral senior class of 2020, from the influences on and their motivations to pursue careers in dentistry, aspects of their dental school experiences, to plans upon graduation and the investment in their careers. METHODS: The study is an analysis of the results of the ADEA Survey of Dental School Seniors, 2020 Graduating Class. Each year, ADEA surveys senior predoctoral students from the accredited U.S. dental schools. Whenever feasible, the answers of the survey respondents from the 2020 class were compared with their 2015 counterparts. RESULTS: The analysis revealed that 46% of the 2020 respondents decided to become a dentist before going to undergraduate college, more than the proportion of those deciding while in college (42%). When it comes to preparedness to practice dentistry, the responses indicated a high level of readiness to go into the profession. Seventy-seven percent of survey participants reported the COVID-19 pandemic did not affect their plans after graduation. Between 2015 and 2020, the share of survey respondents who planned to go into advanced dental education immediately after graduation increased from 35% to 40%. Almost a third of the 2020 respondents who planned to go into private practice immediately upon graduation intended to join a Dental Service Organization (DSO). Grants and scholarships represented a higher share of the average funding for dental education for the 2020 respondents than five years ago. The share of respondents expecting to graduate without any loans to finance their dental degrees and predental education (educational debt) increased significantly, from 12% in 2015 to 17% in 2020. CONCLUSION(S): This research shows that during these uncertain times, U.S. dental schools continued their mission to train and graduate oral health professionals fully prepared to go into the profession.

Curricular and clinical approaches to addressing the opioid epidemic: Results from the 2019 ADEA opioid dental school survey.

PURPOSE/OBJECTIVES: Dental educators have played a critical role in addressing the opioid public health crisis. METHODS: The American Dental Education Association (ADEA) conducted a semi-structured survey with all 66 accredited U.S. dental schools in 2019. The survey was organized into four modules to facilitate response and descriptive statistics and qualitative thematic analyses were performed. RESULTS: Seventy percent of the dental schools consented to participate. Each module varied in response rate: curricular (Module 1, 48%), clinical (Module 2, 47%), implemented curricular/clinical changes (Module 3, 56%), and willingness to participate in future studies (Module 4, 47%). The survey revealed that 87% of respondent dental schools have implemented curricular changes or curricular changes were in process in response to the opioid epidemic. Ninety-three percent of responding schools reported making clinical changes or that clinical changes were in process. Schools reported two factors that most frequently influence changes made: the adoption of state-specific regulations/mandates and the Commission on Dental Accreditation (CODA) Standard 2-24e, which requires competency in prescription practices on substance use disorders. An analysis of the open-ended questions found four overarching themes to curricular changes, in order of frequency: didactic curriculum; integration of opioid epidemic subject matter experts in curricula; Screening, Brief, Intervention, and Referral to Treatment (SBIRT) training; and prescription guidelines. Similarly, four overarching themes were identified for clinical changes: protocol and policy development, Prescription Drug Monitoring Programs (PDMP), faculty and provider education, and prescription guidelines. CONCLUSIONS: This research shows that dental educators are working to ensure that new dental professionals gain the necessary competencies in substance abuse, specifically related to opioids, to prevent and minimize prescription drug misuse.

The dangers of dental devices as reported in the Food and Drug Administration Manufacturer and User Facility Device Experience Database.

BACKGROUND: The authors conducted a study to determine the frequency and type of adverse events (AEs) associated with dental devices reported to the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. METHODS: The authors downloaded and reviewed the dental device-related AEs reported to MAUDE from January 1, 1996, through December 31,2011. RESULTS: MAUDE received a total of 1,978,056 reports between January 1, 1996, and December 31, 2011. Among these reports, 28,046 (1.4%) AE reports were associated with dental devices. Within the dental AE reports that had event type information, 17,261 reported injuries, 7,777 reported device malfunctions, and 66 reported deaths. Among the 66 entries classified as death reports, 52 reported a death in the description; the remaining were either misclassified or lacked sufficient information in the report to determine whether a death had occurred. Of the dental device-associated AEs, 53.5% pertained to endosseous implants. CONCLUSIONS: A plethora of devices are used in dental care. To achieve Element 1 of Agency for Healthcare Research and Quality's Patient Safety Initiative, clinicians and researchers must be able to monitor the safety of dental devices. Although MAUDE was identified by the authors as essentially the sole source of this valuable information on adverse events, their investigations led them to conclude that MAUDE had substantial limitations that prevent it from being the broad-based patient safety sentinel the profession requires. PRACTICAL IMPLICATIONS: As potential contributors to MAUDE, dental care teams play a key role in improving the profession's access to information about the safety of dental devices.

Consortium for oral health-related informatics: improving dental research, education, and treatment.

Advances in informatics, particularly the implementation of electronic health records (EHR), in dentistry have facilitated the exchange of information. The majority of dental schools in North America use the same EHR system, providing an unprecedented opportunity to integrate these data into a repository that can be used for oral health education and research. In 2007, fourteen dental schools formed the Consortium for Oral Health-Related Informatics (COHRI). Since its inception, COHRI has established structural and operational processes, governance and bylaws, and a number of work groups organized in two divisions: one focused on research (data standardization, integration, and analysis), and one focused on education (performance evaluations, virtual standardized patients, and objective structured clinical examinations). To date, COHRI (which now includes twenty dental schools) has been successful in developing a data repository, pilot-testing data integration, and sharing EHR enhancements among the group. This consortium has collaborated on standardizing medical and dental histories, developing diagnostic terminology, and promoting the utilization of informatics in dental education. The consortium is in the process of assembling the largest oral health database ever created. This will be an invaluable resource for research and provide a foundation for evidence-based dentistry for years to come.

Health Information Technology Systems profoundly impact users: a case study in a dental school.

The purpose of this study was to increase our understanding of the impact of Health Information Technology Systems (HITS) on dental school users when the systems are integrated into chair-side patient care. We used qualitative research methods, including interviews, focus groups, and observations, to capture the experiences of HITS users at a single institution. Users included administrators, clinical faculty members, predoctoral students, support staff, and residents. The data were analyzed using a grounded theory approach, and nine themes emerged: 1) HITS benefits were disproportionate among users; 2) communicating about the HITS was challenging; 3) users experienced a range of strong emotions; 4) the instructor persona diminished; 5) there were shifts in the school's power structure; 6) allocation of end-users' time shifted; 7) the training and support needs of end-users were significant; 8) perceived lack of HITS usability made documentation cumbersome for clinicians; and 9) clinicians' workflow was disrupted. HITS integration into patient care impacts the work of all system users, especially end-users. The themes highlight areas of potential concern for implementers and users in integrating a HITS into patient care.

The training and support needs of faculty and students using a health information technology system were significant: a case study in a dental school.

Health Information Technology Systems (HITS) are becoming more widely integrated into patient care in the dental school setting. The purpose of this study was to evaluate the impact of a chairside HITS on users in the dental school setting. Qualitative techniques, including interviews, focus groups and observations, were used. Using grounded theory, we saw 9 themes emerge. One theme of particular interest was that "training and support needs of end-users were significant." This paper explores this theme in detail and discusses the implications.

Serving the public good: challenges of dental education in the twenty-first century.

The purpose of this study was to explore perceptions of the roles and responsibilities of dental education in serving the public good, and the extent to which they are being met, from the vantage point of leaders at the university and state level. Five questions were developed to gather views on dental education's success in meeting the expectations and needs of the public. Fifty-one interviews were conducted with leaders at seven institutions and with public officials in six states. Overall, dental education was perceived as fulfilling its public purpose in promoting oral health, providing access to care, and conducting relevant research. However, significant areas for improvement were noted including better communication of accomplishments to key stakeholders, graduating a more socially aware, culturally sensitive, and community-oriented dental practitioner, and being a committed partner with other community leaders in improving access to care for all citizens. Current programs aimed at addressing these gaps (e.g., Pipeline, Profession, and Practice program) are discussed. Dental education can address these perceptions only by producing graduates who desire to fulfill their obligations to society and serve the public good.

Oral health and use of dental services among Hispanics.

OBJECTIVES: This study examined factors related to oral health and dental service use among Mexican-Americans, Cuban-Americans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982-84 (HHANES). METHODS: Categorical measures of oral health were created: (1) perceived oral health status, (2) evaluated oral health status, (3) decayed permanent teeth, (4) teeth missing due to caries, (5) total permanent teeth present, and (6) periodontal classification. The effects of acculturation, education, dental insurance, and perceived condition of teeth and gums on dental service use in the past two and five years were examined using logistic regression. All analyses were performed separately for each of the three samples using SAS-callable SUDDAN. RESULTS: Dental insurance and education were the most important factors in determining use of dental cleanings and use of dental care. For Mexican-Americans, Cuban-Americans, and Puerto Ricans, acculturation was a factor in determining use of dental care in the past five years. CONCLUSIONS: While dental insurance and education appear to be the most important factors for determining both use of dental cleaning services and use of dental care in all three samples, acculturation also had some impact for determining use of dental care.