Antibiotics and antimicrobial resistance: Evaluation of the knowledge, attitude, and perception among students and faculty within US dental schools.

PURPOSE: This study examined knowledge, attitudes, perceptions, and awareness regarding antibiotic use among students and academic faculty in US dental schools. METHODS: Two questionnaires, 1 for third-year/fourth-year dental students and the other for academic deans/department chairs were administered electronically. Questions on demographics, antibiotic knowledge, educational formats, and the role of dentistry in antibiotic stewardship were included. Knowledge about antibiotics and antibiotics stewardship was compared between third-year and fourth-year students and between students and academic faculty using t-test and chi-squared test at 0.05 significance level. RESULTS: A total of 18 responses on the academic dean and department chair survey and 172 responses on the dental student survey were collected. Overall, 71% of students reported that they could benefit from more education regarding antibiotics. Both faculty and students agreed that dentistry should play an important role in reducing antimicrobial resistance, but most dental students were "not at all familiar" with the term antimicrobial stewardship and several (32%) were unsure if clinical guidelines were present at their schools. CONCLUSION: Improvements to the dental educational curriculum regarding the responsible use of antibiotics, along with the implementation of stewardship programs within dentistry are strongly encouraged.

Is Maximal Dosage for Local Anesthetics Taught Consistently Across U.S. Dental Schools? A National Survey.

Administration of safe and effective local anesthesia is a cornerstone of dental practice, but there is some discrepancy in recommendations for maximum doses, with the Council on Dental Therapeutics and American Academy of Pediatric Dentistry's guidelines differing from the guidelines of manufacturers and contemporary textbooks. The aim of this study was to determine the level of uniformity across U.S. dental schools in teaching maximal safe doses for commonly used local anesthetics. Faculty members primarily responsible for teaching local anesthesia to dental students at all 62 U.S. dental schools that had graduated classes were invited to participate in a survey in March 2017. The survey included questions about maximum doses taught, awareness of the existence of two differing guidelines, and whether one or both guidelines were commonly taught to students. A total of 37 responses were received, for a response rate of 60%. The respondents included oral and maxillofacial surgeons, general dentists, dental anesthesiologists, and periodontists. Of the respondents, 22% reported being unaware of the existence of more than one standard, and there was inconsistency in teaching practices. A majority (73%) reported teaching the higher maximum dose (7 mg/kg) for lidocaine, while a similar but smaller majority (60%) reported teaching the lower dose threshold (4.4 mg/kg) for mepivacaine. This study found no standard recommended maximum dose of lidocaine or mepivacaine being taught in U.S dental schools. Students should be made aware that there is more than one standard, and teaching should emphasize sound medical and pharmacologic principles. There is also a need to ensure that questions on dental licensing examinations are consistent regarding maximum safe doses for local anesthesia.

Three Modeling Applications to Promote Automatic Item Generation for Examinations in Dentistry.

Test items created for dentistry examinations are often individually written by content experts. This approach to item development is expensive because it requires the time and effort of many content experts but yields relatively few items. The aim of this study was to describe and illustrate how items can be generated using a systematic approach. Automatic item generation (AIG) is an alternative method that allows a small number of content experts to produce large numbers of items by integrating their domain expertise with computer technology. This article describes and illustrates how three modeling approaches to item content-item cloning, cognitive modeling, and image-anchored modeling-can be used to generate large numbers of multiple-choice test items for examinations in dentistry. Test items can be generated by combining the expertise of two content specialists with technology supported by AIG. A total of 5,467 new items were created during this study. From substitution of item content, to modeling appropriate responses based upon a cognitive model of correct responses, to generating items linked to specific graphical findings, AIG has the potential for meeting increasing demands for test items. Further, the methods described in this study can be generalized and applied to many other item types. Future research applications for AIG in dental education are discussed.

Drug interactions: a review and update.

Dealing with drug interactions can be challenging. New medications are continually being introduced to the market, and dentists should have a fundamental knowledge of drug interactions. Medication regimens must be routinely screened for potential drug interactions. When assessing potential drug interactions, it is necessary to consider the result of such interference, whether this outcome can be adjusted for and whether the benefit of therapy overrides the risk of such an interaction. In many situations, drug interactions are not seen clinically because the course of therapy of the potential offending agent is short (i.e., antibiotics), because of patient characteristics or because there is a failure to identify them.

Antibiotic use by members of the American Association of Endodontists in the year 2000: report of a national survey.

The purpose of this study was to determine the prescribing habits of active members of the American Association of Endodontists (AAE) with regard to antibiotics. A one-page, double-sided questionnaire was sent to the active members of the AAE living in the United States. The 1999 mailing list of 3203 members was obtained from the AAE, and the return rate was 50.1% (1606 surveys). With a sample size over 1000, the study was able to distinguish differences to within 0.5% with power = 80% (at alpha = 5%). The data were analyzed using descriptive statistics and chi-square tests of independence. Penicillin VK, 500 mg, 4 times a day, was the first choice antibiotic prescribed by 61.48% of respondents. Clindamycin (Cleocin), 150 mg, 4 times a day, was selected by 29.59%. For those patients with a penicillin allergy, 57.03% prescribed clindamycin and various erythromycin preparations were prescribed by 26.65%. A loading dose was used by 85.14%. The average duration of antibiotic therapy was 7.58 days. Those respondents involved in academics, either part-time or full-time, were significantly more likely to prescribe penicillin VK, 500 mg, 4 times a day at a rate of 85% versus those in part-time or full-time private practice at a rate of 67%. For cases of irreversible pulpitis, 16.76% of responding endodontists prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis, and no swelling, 53.93% prescribed antibiotics. Almost 12% prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract. For the most part, the majority of the members of the AAE were selecting the appropriate antibiotic for use in orofacial infections, but there are still many who are prescribing antibiotics inappropriately. Although there were trends of improvement in some areas with regards to prescribing antibiotics, there were other areas where there had been no improvement in 25 years. Unless these trends change, our generation and those to come may not have effective antibiotics for use in the management of true orofacial infections.