Similarities and differences in specialty training of conservative dentistry and endodontics (India), operative dentistry (Pakistan) and restorative dentistry-endodontics (United Kingdom).

Dental education and training in Pakistan and India are largely influenced by the British system of education. However, there are some differences in the mode of postgraduate training in these countries. In Pakistan, hospital-based residency training is the mainstay, culminating in a fellowship diploma awarded by the College of Physicians and Surgeons of Pakistan. Whereas, in Indian students of dentistry pursue university-based MDS programme as the primary pathway to specialist training. From the beginning the Indian dental academia has remained vigilant in adopting a correct nomenclature for the specialty concerned with the dental conservation. They named it Conservative Dentistry & Endodontics while in Pakistan the same specialty termed Operative Dentistry has become an obsolete term and does not represent the scope of work practiced by specialists in this discipline. A simple addition of the term "Endodontics" to the present nomenclature of "Operative Dentistry" will resolve the matter of a missing identity in a clinical specialty in Pakistan. The present paper suggests the need for advocacy to change the term used for this particular dental specialty.

Dentists' responses about the effectiveness of continuing education activities.

OBJECTIVE: To report the responses of dentists about the effectiveness of continuing education (CE) activities. METHODS: This cross-sectional study involved the administration of a pilot-tested questionnaire amongst dentists from different cities of the eastern province of Saudi Arabia. A calculated sample of dentists (n = 323) was approached in person to collect their responses about CE activities they attended during the last one year. Descriptive statistics and multivariate logistic regression analyses were performed. RESULTS: The response rate was 79.5% as 257 dentists returned completed questionnaires. There were 54.9% male and 45.1% female participants (mean age 31.18 ± 12.4 years). The majority of participants reported an improvement in knowledge (79.8%), a motivation for learning (79.8%), and quality of dental care (73.9%) as a result of CE activities. More than two-thirds recognised the importance of CE courses for maintaining licensure in dentistry, and 91.1% felt the need to increase CE activities. Logistic regression models showed that male participants were less likely (OR = 0.48, P = 0.05) than female counterparts to report an improvement in clinical skills. Having a private job (OR = 2.38 P = 0.005) and >10 years since graduation (OR = 1.84, P = 0.05) were associated with an improvement in clinical skills. Believing in the importance of CE activities for maintaining licensure was significantly associated with the effectiveness of CE activities in improving knowledge (OR = 2.76, P = 0.01), clinical skills (OR = 2.02, P = 0.04) and patient satisfaction (OR = 2.22, P = 0.01). CONCLUSION: The majority of dentists recognised that CE activities were effective in improving their knowledge, clinical practice, quality of patient care and motivation for learning.

[Reform efforts in dentistry - national and international approaches]. / Reformbemühungen in der Zahnmedizin ­ nationale und internationale Ansätze.

The Study of dentistry in Germany is in need of reform. The actual regulation on licensing dentists in Germany is from 1955, with the last changes made in 1993. Recently there have been different initiatives related to reform: a national catalogue of competency-based learning objectives in dental education (NKLZ), changes and stipulations in the respective rules relating to undergraduate curriculum in dental medicine, and an initiative of the Germany Ministry of Health to tackle and reorganize dental education in Germany.This article presents and reflects on these reform efforts in the context of actual teaching in Germany, Europe, and the United States.The reform process is an opportunity for dental education in German faculties of medicine. New dentistry programs are allowed at all faculties with model educational programs in medicine. Therefore, an example of actual reform efforts are presented based on the experiences of Hamburg. Research on dental educational programs revealed interesting approaches in dental education in other European faculties of medicine. Selected faculties were visited. These experiences led to the formulation of five main goals of reform: interdisciplinary study, problem- and symptom-based learning, early patient contact, science-based education, and communication training. The main goal is a dental education program designed along science-based, prevention-oriented, multidisciplinary, and individualized dental care that contributes to the life-long oral health of patients.

Perspectives of New York State Dental Residency Directors on Licensure by Residency.

In 2003, New York State enacted legislation that allowed graduating dentists to undertake a one-year postgraduate residency in place of a licensure exam. In 2007, it became mandated throughout the state. This was a paradigm shift for the dental community, and overall opinions varied widely on the topic. On one side, proponents of a board exam claim that the point of dental school is to produce competent practitioners and weed out those who would be dangerous to the practice of dentistry. Contrarily, proponents of residency see the need for further evaluation and assessment of practitioners in order to even understand their levels of competence. In the current residency model of licensure, it is up to attending dentists and residency directors to deem the dentists ready to practice. At this point, there is no standard way of assessing residents, nor are there any guidelines as to what should be used to assess prospective dentists. This puts a lot of responsibility on specific directors to decide what is appropriate in their own situation. The purpose of this survey was to collect and assess residency directors' perspectives on the current licensure model of a residency. The survey response rate was 57% of all residency directors in New York State. The results show how the biggest stakeholders view their role in licensure, what levels of assessment they use and what improvements they would choose to utilize if available.

Regulators and regulations: who will guard the guards? (or 'Quis custodiet ipsos custodes' as old Juvenal used to say).

Overbearing regulators with their various labyrinthine regulations have had adverse impacts on dentists and their teams' behaviours. This has produced the perverse outcomes of demoralizing dental teams as well as reducing their capacity and/or desire to deliver compassionate oral healthcare. These adverse outcomes do not seem to have benefited patients, or dentists, or their teams, in any sensible or measurable way. CPD/CLINICAL RELEVANCE: The vastly increased burdens on the UK dental profession of intrusive, bullying regulations, emanating from the various UK agencies, such as the supposedly fair and independent GDC, but including the increasingly politically controlled NHS and the CQC, have had unfortunate, perverse, effects on many dentists' clinical practices and affected dental teams' desires, or willingness, to be as compassionate as they used to be about helping to solve some patients' dental or oral problems.

The Implications of the New GDC Standards for Dental Professionals.

This article is about the publication by the General Dental Council in 2013 of the Standards expected of those members of the dental team who are registered with the Council, on each of their Registers, and discusses the implications of the new Standards for dental professionals.

What it means to be a doctor. Sensitizing the dentist and the student to professionalism.

Professional demeanor and the inter-personal behavior of the dentist play a large part in building the trust patients measure as they gain confidence in their choice of practitioner. Most of the time, patients experience comfort through the competent, compassionate care of a genuinely respected provider. That important im- age is determined by the ethical and proper relationships every patient encounters. The following discussion brings to the forefront image-damaging episodes that have occurred as a result of unwise or unthinking circumstances playing out not only in the office, but in the community and in private life as well. Can a professional shield the public from disappointing legal, unprofessional entanglements that could cast doubt on the good judgment and safety expected of the doctor? What effects on a practice may be seen?

State Dental Boards and Public Protection: Fulfilling the Contract.

Dental boards are agents of the state, sworn to protect the public. They combine the skills of professional training with responsibility to ensure that patients receive safe and effective care. They can play a vital role in ensuring that the profession does not invite more regulation by working to maintain the public's trust. Two cases are presented illustrating that one's perspective can cloud the sense of what is right and that it is wrong to pass ethical responsibilities on to others.

What Contract? With Whom? For What Purpose?

The central point in the U.S. Supreme Court upholding the Federal Trade Commission's action against the North Carolina State Board of Dental Examiners was that they acted without proper supervision from the State of North Carolina in curbing commercial activity: issuing cease and desist orders to teeth-whitening businesses, for example. It appears unlikely that the law of the land will allow professions to enforce and may substantially limit a profession's voice in defining nearby commercial activity. The line between professional services and commercial ones is not clear. Vending whitening agents, as drug stores do, is commercial but may not be professional. Providing such services in the dental office certainly should be professional, but is also certainly commercial. As dentistry becomes more overtly commercial in nature, it is likely that the profession will have less say over defining and enforcing oral healthcare practices.

How Will the U.S. Supreme Court's Decision in North Carolina Dental Affect the Regulation of the Professions?

The contract between the public and the professions is between two parties; so it is reasonable to expect that there might be at least two perspectives when a ruling is given regarding the interpretation of the contract. The Citizen Advocacy Center recently convened a conference to look at the U.S. Supreme Court decision in the functioning of the North Carolina Dental Board in balancing protection of the public with availability of oral health services. New questions are being asked.

A Closer Look at the North Carolina Board of Dental Examiners and Who Can Practice Dentistry.

On February 25, 2015, the U.S. Supreme Court rendered a six-to-three opinion in favor of the Federal Trade Commission in their dispute with the North Carolina State Board of Dental Examiners concerning teeth-whitening services provided by nondentists. That decision was the culmination of almost nine years of arguments and allegations that began with a disagreement regarding the definition of the practice of dentistry. The ethical aspect of this dispute resides in the one's perspective regarding the motivation behind the actions taken in the North Carolina State Board of Dental Examiners.

An international survey of speciality training in oral and maxillofacial pathology.

BACKGROUND: Speciality training in oral and maxillofacial pathology (OMFP) across the world would be aided by guidance on a generic curriculum and training programme that all countries could use as a template. In order to facilitate this, we require an understanding of the various forms which OMFP training takes across the world. METHODS: We sent a questionnaire to OMF pathologists in the 42 countries represented in the IAOP membership, via their Regional Councillor. The questionnaire included detailed demographics, entry requirements, specialty training program and facilities/resources. RESULTS: Replies were received from 22/42 countries (52%). OMFP is a dental/dental and medical speciality in 72%, and in 92% of those, this is recognised by a licensing board. Training was undertaken in an academic environment in 85% (with many offering a further academic qualification) and the median length of training was 4 years. General/anatomical pathology training is mandated in 85% of programs and a common core of general sub-specialities was identified. An end of training assessment was conducted in 80% of programs with most including written, practical and oral elements. Training program directors and educational supervisors were in place in 12/16 programs and, in most, Quality Assurance of training was externally monitored. In only one country was the number of trainees linked to workforce planning. CONCLUSIONS: Training in OMFP varies across the world. However, we feel there is sufficient commonality for the development of an agreed indicative framework on education and training in Oral and Maxillofacial Pathology, perhaps under the auspices of the IAOP.

Career choice and future design of dental students in China and Japan.

The purpose of this study was to compare career choice and future plans of dental students in China and Japan. Information was derived from a self-answered questionnaire. Significant differences were detected for eight items between the two countries. Regarding motivation towards career choice, 41% of Japanese students indicated positive motives related to helping others, achieving self-worth and health-care related interests, whereas Chinese students indicated that their choice was mainly for financial and prestige reasons, and for 32% of them, dentistry was a passive choice. More Chinese dental students (74%) wanted further education compared with Japanese students (22%). The majority of Japanese students (56.9%) planned to work as general dentists. Conversely, Chinese students were more likely to specialise (50%). More than 50% of Japanese students wanted to work in dental offices, but the majority of Chinese students (65%) preferred university hospital. We found it is strange that nearly one-fourth of the Chinese students did not want to be a clinical dentist mainly because of the poor health-care environment. This study provides a description of the perspectives of Japanese and Chinese dental students and enables a better understanding of career choices and future course design issues.

Increased number of dental professionals in New York State counties.

Despite decreases in the population for 49 of the 62 counties in New York State between 2006 and 2013, the number of dentists increased in 52 counties. In addition, in 2013, there were more dental hygienists than dental establishments in 54 of the state counties. This change in landscape from 2000 to 2006, when the number of dentists decreased in 27 counties and a sizeable proportion of the state had little or no coverage, is reviewed using federal and state government reports.

Practice transition with intelligence and grace.

Viable practices change with the professional and personal needs of dentists and with trends in society. There is no single way for transitioning out of practice--concluding a direct sale, remaining as an associate, and even purchasing a new practice to better match one's more mature lifestyle and practiced preferences. Changing ratios of dentists to patients currently favor a seller's market and emergence of corporate models provide new options. An analysis is given of the Canadian practice market. Planning advice is also offered.

Sesquicentennial review: the making of a profession.

I shook my head on many occasions as I contemplated the changes in dentistry that have occurred over the past 150 years that I would discuss in this article, often thinking to myself, "How could the early dentists have possibly practiced dentistry every day under those circumstances and with those tools?" It made my own clinical career seem pretty easy but engendered in me great admiration for my predecessors and our profession.

Supreme Court ruling may determine the future of state-based professionai licensing.

The U.S. Supreme Court heard oral arguments this fall in a case involving the North Carolina State Board of Dental Examiners that could have a dramatic impact on how states license and regulate professionals in America. This paper briefly describes the facts of the case and the history of professional licensing in America and then discuses and evaluates the potential impact of the various legal arguments presented by the parties in the case.

Performance of Generative Artificial Intelligence in Dental Licensing Examinations.

OBJECTIVES: Generative artificial intelligence (GenAI), including large language models (LLMs), has vast potential applications in health care and education. However, it is unclear how proficient LLMs are in interpreting written input and providing accurate answers in dentistry. This study aims to investigate the accuracy of GenAI in answering questions from dental licensing examinations. METHODS: A total of 1461 multiple-choice questions from question books for the US and the UK dental licensing examinations were input into 2 versions of ChatGPT 3.5 and 4.0. The passing rates of the US and UK dental examinations were 75.0% and 50.0%, respectively. The performance of the 2 versions of GenAI in individual examinations and dental subjects was analysed and compared. RESULTS: ChatGPT 3.5 correctly answered 68.3% (n = 509) and 43.3% (n = 296) of questions from the US and UK dental licensing examinations, respectively. The scores for ChatGPT 4.0 were 80.7% (n = 601) and 62.7% (n = 429), respectively. ChatGPT 4.0 passed both written dental licensing examinations, whilst ChatGPT 3.5 failed. ChatGPT 4.0 answered 327 more questions correctly and 102 incorrectly compared to ChatGPT 3.5 when comparing the 2 versions. CONCLUSIONS: The newer version of GenAI has shown good proficiency in answering multiple-choice questions from dental licensing examinations. Whilst the more recent version of GenAI generally performed better, this observation may not hold true in all scenarios, and further improvements are necessary. The use of GenAI in dentistry will have significant implications for dentist-patient communication and the training of dental professionals.

Continuing professional development systems and requirements for graduate dentists in the EU: survey results from the DentCPD project.

INTRODUCTION: By maintaining skills and keeping dentists up-to-date, continuing professional development (CPD) supports safe clinical practice. However, CPD for dentists across Europe is not harmonised. AIM: One aim of the 'DentCPD' project (www.dentcpd.org) was to identify and agree essential CPD requirements for EU dentists. As part of the process, data were collected on existing approaches to CPD for EU dentists. This paper reports those findings. METHODS: Informed by a review of the literature and internet search, the CPD for Graduate Dentists questionnaire gathered data from dental educators on CPD systems, requirements, provision and accreditation in Europe. It sought opinion on mandatory CPD and e-learning. RESULTS: Responses were received from 143 individuals from 30 EU countries. About half the countries had a compulsory CPD system which typically included mandatory core topics. Elsewhere CPD was optional or based on recommended hours. University dental schools and professional dental associations were the most common CPD providers. National regulatory bodies were the most common accrediting body. Only 41% of respondents thought they knew the criteria for successful accreditation of CPD. Eighty-one percent agreed that 'CPD should be obligatory for all dentists'. CONCLUSION: These results present an overview of the status of CPD for EU dentists. Despite a notable trend towards regulated CPD systems, current requirements for dentists to engage in CPD show variation. The harmonisation of requirements would enhance both dentist mobility and safe clinical practice.

Core continuing professional development (CPD) topics for the European dentist.

INTRODUCTION: In the context of free movement, EU-citizens need assurance that dental practitioners providing their care have a degree/license to practice that meets EU-standards and that they maintain their knowledge and skills through ongoing education. AIM: One aim of the 'DentCPD' project (HYPERLINK 'http://www.dentcpd.org' www.dentcpd.org) was to identify and agree essential CPD requirements for EU dentists. This paper reports the consensus process and outcomes. METHODS: Agreement on core components of CPD was achieved through a three stage process: an online survey of dental educators' (n = 143) views on compulsory topics; a paper-based questionnaire to practitioners (n = 411); leading to a proposal discussed at the Association for Dental Education (ADEE) 2011 Lifelong Learning special interest group (SIG). RESULTS: From the online survey and practitioner questionnaire, high levels of agreement were achieved for medical emergencies (89%), infection control (79%) and the medically compromised patient (71%). The SIG (34 attendees from 16 countries) concluded that these three CPD topics plus radiation protection should be core-compulsory and three CPD topics should be core-recommended (health and safety, pain management, and safeguarding children & vulnerable adults). They also agreed that the teaching of all topics should be underpinned by evidence-based dentistry. CONCLUSION: Building four core topics into CPD requirements and making quality-approved education and training available will ensure that all dentists have up-to-date knowledge and skills in topic areas of direct relevance to patient safety. In turn, this will contribute to patients having access to comparably high standards of oral health care across Europe.