Pediatric dentistry, prosthodontics, and oral and maxillofacial surgery residents' stress, career satisfaction, and gender-based discrimination/harassment.

OBJECTIVES: Dental residents experience high stress in their demanding programs and gender-based harassment/discrimination can contribute to their stress. The objectives were to compare stress, satisfaction, experienced sexual harassment and observed discrimination of women in dental graduate programs with high, medium, and low percentages of women and to explore relationships between these constructs of interest. METHODS: Note that, 112 pediatric dentistry (PD), 44 prosthodontics, and 56 oral and maxillofacial surgery (OMS) residents responded to a survey. RESULTS: PD residents had the lowest personal life-related stress (4-point scale with 4 = very stressful: PD = 2.99/P = 3.67/OMS = 3.56; p < 0.001), faculty-related stress (2.68/3.66/3.03; p < 0.001), lack of confidence-related stress (2.79/3.31/2.96; p < 0.01) and academic stress (2.65/3.24/3.02; p < 0.001), while prosthodontics residents had the highest stress levels. The average frequency of experiencing sexual harassment was highest for OMS residents and lowest for PD residents (5-point scale with 1 = never: 1.15/2.62/2.74; p < 0.001). PD residents observed least and OMS residents most frequently that female residents were treated less positively by other residents because of their gender (1.59/2.57/3.00; p < 0.001). Prosthodontics residents had the lowest job satisfaction score (5-point scale with 1 = lowest satisfaction: 4.12/3.14/4.20; p < 0.001). The more frequently male and female residents experienced sexual harassment, the higher their personal life-related stress, faculty-related stress, lack of confidence-related stress, and academic stress, and the lower their career satisfaction, specialty content satisfaction, and stress-related satisfaction. Women's frequencies of observed gender-based discrimination were associated with higher stress and lower satisfaction, while men's frequencies of these observations were not associated with stress, but associated with increased satisfaction. CONCLUSIONS: Dental residents' stress, career satisfaction, experienced sexual harassment, and observed discrimination of women residents differ depending on the dental specialty program. Both male and female residents report more stress and less satisfaction the more they experience sexual harassment. The more women observe discrimination of women, the more stressed and the less satisfied they are. For men, the frequencies of these observations are not associated with stress, but positively associated with increased satisfaction.

Periodontists and oral surgeons' peri-implantitis-related education, knowledge, attitudes, and professional behavior: A national survey.

OBJECTIVES: Each year, approximately 5 million dental implants are placed in the United States and one out of three patients is likely to experience peri-implantitis (PI). The objectives were to compare the PI-related education, knowledge, attitudes, and professional behavior of periodontists and oral maxillofacial surgeons (OMS), and to explore relationships between these constructs of interest. METHODS: A total of 389 periodontists and 161 OMS responded to a web-based survey. Descriptive and inferential statistical analyses (independent sample t-tests, chi-square tests, and correlational analyses) were conducted. RESULTS: On average, periodontists reported a higher percentage of time spent in residency on implant surgery (21.02% vs. 7.27%; p < 0.001), better education about PI (5-point scale with 1 = not at all well: means: 2.86 vs. 2.59; p < 0.001), and better knowledge of risk factors (4.07 vs. 3.86; p < 0.001) than OMS. Periodontists argued that oral hygiene-related treatment (4.45 vs. 4.22; p = 0.001) and regeneration-focused treatments such as guided tissue regeneration (3.62 vs. 3.20; p < 0.001) contributed more to successfully treating PI and used these treatments more in their practices (4.86 vs. 4.56; p < 0.001/3.06 vs. 2.68; p < 0.001) than OMS. They also considered PI as a more serious problem than OMS (4.55 vs. 3.80; p < 0.001). The better the respondents' PI-related knowledge was, the more they considered PI as a serious problem (r = 0.19; p < 0.001). The more cases they treated per month, the more they considered PI as a serious problem (r = 0.19; p < 0.001). CONCLUSIONS: The results of the present study highlight the lack of standardization in the specialty training of periodontists and OMS. Best practice guidelines for the diagnosis and treatment of PI are needed to optimize graduate education about this important topic.

Parents of Children With Versus Without Special Health Care Needs and Oral Health Promotion: Challenges and Best Practices.

Purpose: Oral health care is a leading unmet health care need of children with special health care needs (CSHCNs). The purposes of this study were to: (1) compare the responses of parents (parents, caregivers) of children with versus without special health care needs (SHCNs) concerning their child's functioning, oral health-related knowledge, attitudes, and behavior; and (2) assess which information parents received/wanted to receive from dentists. Methods: A total of 122 parents of CSHCNs and 115 parents of children without SHCNs responded to the surveys. Results: Parents of CSHCNs reported that their children had lower functioning (per a four-point scale, with zero indicating worst functioning; means without SHCNs/CSHCNs equal 1.98/2.70; P<0.001) and nonverbal interactions (2.24/2.77; P<0.001), flossed and used mouth rinse less frequently (per a fivepoint scale, with one indicating never: 2.23/2.70; P=0.002; 1.82/2.27; P=0.004) than parents of children without SHCNs. They reported more oral care-related challenges (43.4 percent versus 21.7 percent; P<0.001), were less comfortable helping with oral care (per a five-point answer scale, with five indicating very comfortable: 3.92/4.48; P<0.001) and less interested in receiving information (3.13/3.71; P<0.001) than parents of children without SHCNs. Conclusions: Parents of children with or without special health care needs do not differ in their knowledge and attitudes. However, parents of CSHCNs are less comfortable in helping with oral care and less interested in receiving information than parents of children without SHCNs. Understanding the obstacles parents of CSHCNs face when providing oral care for their children can help dentists better support their oral health-related efforts.

Periodontists and stem cell-based therapy for alveolar bone regeneration: A national survey.

BACKGROUND: Stem cell-based therapy for bone regeneration has received attention in medical settings but has not yet been used in clinical practice for treating alveolar bone defects. The objectives of this study were to explore whether periodontists had heard about this approach, and if so how, how interested they were to learn about it, which attitudes and behavioral intentions they had related to using stem cell-based grafting, and what they would like to know before using this approach. METHODS: Anonymous survey data were collected from 481 members of the American Academy of Periodontology (response rate: 19.41%). RESULTS: Responses showed 35.3% had heard about stem cell-based therapy, mostly from publications (9.6%) and meetings (8.3%); 76.1% wanted to learn about it through in-person continuing education (CE) courses, 68.6% in online CE courses, and 57.1% from manuals; 73% considered this approach promising; and 54.9% preferred it to traditional approaches. It was important to them that it would result in more bone volume (93%), better bone quality (90.4%), and accelerated healing (83.2%). Also, 60.1% considered it likely/very likely that they would adopt this approach, 54% that patients would prefer it, and 62.1% that it would benefit their practice. When asked what they would like to know about this approach, information about short- and long-term outcomes, cost, and logistical considerations were most frequently named. CONCLUSIONS: These findings provide the basis to develop educational interventions for periodontists about this novel approach and inform future research activities aimed to translate this approach to clinical practice.

Dentists' considerations concerning treating patients from the Deaf and Hard of Hearing community: A national survey.

OBJECTIVES: Research shows that adults who were Deaf or Hard of Hearing (HoH) had poorer oral health than adults who did not belong to this community. The objectives were to assess dentists' education, knowledge, attitudes, and professional behavior related to treating patients from the Deaf or HoH community and the relationships between these constructs. METHODS: A total of 207 members of the American Dental Association and the Michigan Dental Association responded to a mailed or web-based survey concerning their education, knowledge, attitudes, and professional behavior related to treating patients from the Deaf or HoH community. RESULTS: On average, the respondents disagreed that they were well educated in classroom-based, clinical, or community-based dental school settings (five-point answer scale with 1 = disagree strongly; mean = 2.29/2.27/2.35) or by their professional organization (mean = 2.00) about treating Deaf or HoH patients. However, the more recently the respondents had graduated from dental school, the better they described their education about this topic (r = 0.29; p < 0.001). Additionally, 45.9% agreed/strongly agreed that they would like to attend a continuing education course about this topic; 68.9% agreed/agreed strongly that negative consequences for patients' general health can occur; and 61.1% that patients cannot be well educated about oral hygiene if Deaf or HoH patients do not have appropriate interpretive support in dental offices. The better dentists were educated about this topic, the more knowledge they had (r = 0.50; p < 0.001). On average, the respondents agreed more strongly that they were comfortable treating adult patients who communicated orally than patients using American Sign Language (4.02 vs. 3.25; p < 0.001). CONCLUSIONS: These findings show that efforts are needed to improve dental school and continuing education curricula about dental treatment for Deaf and HoH patients. The more recently the respondents had graduated, the more positively they described their education. Increased dental school and continuing education efforts are still urgently needed.

Dentists' education, knowledge, and professional behavior concerning the diagnosis and treatment of dentin hypersensitivity: An exploration.

OBJECTIVES: Dentin hypersensitivity (DH) affects patients' oral health-related quality of life, but is not always optimally treated in dental offices. The objectives were to assess dentists' DH-related education, knowledge, and professional behavior and explore relationships between education, knowledge, and behavior. METHODS: Survey data were collected from 220 ADA members in the United States. Descriptive and correlational analyses were performed. RESULTS: About half of the respondents agreed/strongly agreed that their dental school had educated them well about diagnosing DH in classroom-based (53.6%) and clinical settings (48.9%). Lower percentages agreed being well educated about treating DH (40.9%/37.3%). The majority self-educated themselves about DH after dental school by attending continuing education courses in person or online (60.6%/36.8%), reading articles (64.1%), or consulting with colleagues (59.6%). The majority knew that patients with DH describe their pain as stimulated (91.4%) and that recessed gingiva (89.6%), abrasion lesions (72.3%), tooth whitening (63.1%), erosion lesions (58.6%), and abfraction lesions (51.4%) are risk factors for DH. The majority diagnosed DH with patient self-reporting, confirmed by exams (81.8%), applying air blasts (53.7%), or cold-water (52.3%). They treated patients with DH often/very often with over-the-counter desensitizing agents (90%), and prescribing fluoride formulations toothpaste (82.8%) and/or potassium nitrate toothpastes (60.9%). In their offices, the majority (73.2%) educated their patients often/very often about DH and used fluoride dental varnish for treating DH (71.8%). The more recently respondents had graduated from dental school, the more positively they described their dental school education (r = 0.14; p < 0.05), the more ways to diagnose DH they used (r = 0.16; p < 0.05) and the more often they used fluoride dental varnish in their offices (r = 0.23; p < 0.001). The more dentists had educated themselves, the more methods for diagnosing DH they used (r = 0.23; p < 0.001) and the more often they used potassium oxalate products (r = 0.19; p < 0.01), Arginine/calcium products (r = 0.19; p < 0.01) and dentin bonding (r = 0.22; p < 0.001). CONCLUSIONS: More recently graduating from dental school correlates with more positive evaluations of DH-related dental school education. The finding that most dentists engage in self-education about DH after dental school should motivate dental educators to increase education about this topic not only in dental school, but also in continuing education courses.

Oral maxillofacial surgery resident, faculty and practitioner role models and dental students' interest in oral maxillofacial surgery careers: Does gender matter?

PURPOSE: Residency programs in oral maxillofacial surgery (OMS) have the lowest percentage (2020: 18.4%) of female graduates among all dental specialty programs. When considering this underrepresentation of female OMS residents, prior studies have not examined how OMS role models might shape dental students' interest in OMS careers. The objectives were to assess female versus male students' OMS-related career motivation, their experiences/attitudes toward three groups of OMS role models (i.e., OMS residents, faculty, and practitioners), and relationships between role model-related experiences/attitudes and career motivation. METHODS: 363 female and 335 male students from 14 United States and two Canadian dental schools participated in this cross-sectional study by responding to an online survey. RESULTS: 13.8% of female and 26% of male respondents (p < 0.001) were much/very much interested in OMS careers. More male than female students had shadowed an OMS in an office setting (43.4% vs. 35.1%; p < 0.05). The groups did not differ in their motivation to learn more and earlier about OMS nor in the quantity of OMS-related experiences prior to and during dental school. However, male students were more satisfied with the quality of these experiences (5-point scale with 5 = most positive: Means: 3.76 vs. 3.53; p < 0.05), were more comfortable approaching/working with OMS instructors (3.51 vs. 3.19; p < 0.01) and reported to have learned more from residents (3.52 vs. 3.31; p < 0.05) and faculty (3.75 vs. 3.45; p < 0.01) than female students. Female students agreed less that OMS residents, faculty, and practitioners encouraged students to pursue OMS (3.27 vs. 3.44; p < 0.01 / 3.46 vs. 3.63; p < 0.01 / 3.45 vs. 3.61; p < 0.01). Role model-related experiences and attitudes correlated with an interest in an OMS career. CONCLUSIONS: The two groups do not differ in the quantity of most OMS experiences before and during dental school and their motivation to learn more and earlier about OMS. However, female students' less positive OMS-related educational experiences and less positive attitudes toward role models correlate with a lower interest in OMS careers.

Introducing dental students to complete denture treatment in times of COVID-19: Students' responses.

OBJECTIVES: The COVID-19 pandemic required changes in the complete denture courses to comply with lock-in and social distancing requirements. The objectives were to assess (a) dental students' interest in a required complete denture course and the prosthodontics specialty, (b) how much time students spent on studying background, lab, and clinical content, and (c) how difficult and helpful course components were. Additionally, open-ended responses concerning what the students liked and what they wanted to have changed were analyzed as well. METHODS: After this "complete denture" course, 81 of 109 students responded to a web-based survey with questions about course content and design. This hybrid course consisted of weekly asynchronous virtual lectures, in-person simulated laboratory (sim lab) exercises, and synchronous virtual workshops. RESULTS: Exactly 53.7% were much/very much interested in this course, with nobody considering prosthodontics as their specialty. The students studied on average of 79.61 minutes for 1 hour (of background-related lecture, 69.92 minutes for a lab-based lecture, and 77.00 minutes for a clinical-content lecture (p < 0.001). They evaluated clinical content as most difficult, lab content as less difficult, and background material as least difficult (3-point scale with 1 = not at all difficult: means = 1.90/1.85/1.80; p < 0.001). They rated background lectures as least helpful, clinical material as more helpful, and lab content as most helpful (5-point scale with 1 = most helpful: means = 2.33/2.67/2.96; p < 0.001). Open-ended answers showed exceptionally positive responses for content and pedagogy of sim lab and clinical content. CONCLUSIONS: Gaining a better understanding of students' responses to hybrid "complete denture" courses is critical for optimally teaching this material in times of COVID-19.

OMS residents' obstructive sleep apnea-related education, knowledge, and professional behavior: A national survey.

OBJECTIVES: Oral and maxillofacial surgeons (OMS) treat adult and pediatric patients with obstructive sleep apnea (OSA). Objective 1 assessed sleep apnea-related education, knowledge, and professional behavior of OMS residents in the United States. Objective 2 was to compare the responses of junior versus senior residents and residents in single- versus dual-degree programs. METHODS: OMS residents in the United States received a recruitment email with a link to an anonymous online survey; 81 residents responded. The survey included 20 questions to assess respondents' OSA-related education, knowledge, attitudes, and professional behavior. RESULTS: Respondents generally agreed that they had received OSA-related didactic-based education (5-point scale with "5" = agree strongly: mean = 3.62) and clinical training (mean = 3.75). Clinical and classroom educational gaps were identified in relation to treatment with oral appliances and hypoglossal nerve stimulation. The residents scored on average 10.38 out of 18 (58%) possible correct answer points for the knowledge questions. Findings about pediatric OSA suggest that only 43.8% of residents understand diagnostic criteria for pediatric OSA, with only 26.6% screening pediatric patients for OSA. A case analysis showed that only 1.5% of residents correctly identified an apnea-hypopnea index of 17 as moderate sleep apnea. CONCLUSION(S): This survey found knowledge gaps in several areas that can be improved upon. It identifies deficiency in objective knowledge about OSA among OMS residents and a specific lack of clinical training and confidence with hypoglossal nerve stimulation and management of pediatric patients with OSA. Junior and senior residents and single- and dual-degree residents showed no statistically significant differences in any category except senior residents in regard to surgical management of OSA, particularly with maxillomandibular advancement.

Pre-doctoral dental students' computer-aided design/computer-aided manufacturing-related education, knowledge, attitudes and behavior: A national survey.

OBJECTIVES: Computer-aided design/computer-aided manufacturing (CAD/CAM) technology transformed the world of restorative dentistry. The objectives were to assess pre-doctoral dental students' CAD/CAM-related education, knowledge, attitudes, and professional behavior, and to explore the relationships between the year in dental school and these constructs. METHODS: A total of 358 pre-doctoral dental students from 17 of the 68 US dental schools responded to a web-based anonymous survey. RESULTS: CAD/CAM-related classroom-based education was likely to happen in lectures (87.2%) and simulated exercises as part of a class (86.9%). Faculty were most likely to provide CAD/CAM instruction (87.9%), with staff (44.8%) and dental technicians (20.2%) being engaged as well. Preclinical education included video demonstrations (81.8%), demonstrations during a lecture (76.4%) or for smaller groups of students (69.2%), hands-on workshops (65.6%), and individual instruction (50.4%). Considering the digital workflow in clinics, 45.2% reported using intraoral scans. The more advanced the students were in their program, the more CAD/CAM knowledge (r = 0.27; p < 0.001) and knowledge about what can be fabricated with CAD/CAM technology they had (r = 0.25; p < 0.001). However, the student's satisfaction with the education about CAD/CAM did not increase over the years (r = -0.04; n.s.) and remained neutral, while their attitudes became more positive the longer they were in dental school (r = 0.13; p < 0.05). Their attitudes were quite positive, with most students considering that CAD/CAM is the future of dentistry (5 = most positive: Mean = 4.34), agreeing that they enjoyed working with CAD/CAM (Mean = 4.11) and that CAD/CAM has the potential of making them a better dentist (Mean = 4.07). CONCLUSIONS: The majority of students in the US dental schools appreciate CAD/CAM technology, consider it to be the future of dentistry, and believe it makes them better dentists. The fact that the majority is not satisfied with their classroom-based, preclinical and clinical CAD/CAM-related education should therefore be a call to action to rethink dental school curricula in this content area.

Faculty diversity, equity, and inclusion in academic dentistry: Revisiting the past and analyzing the present to create the future.

AIM: In 2021, NIDCR published the landmark report "Oral Health in America." It described that while oral health-related research and care has seen amazing progress, oral health inequities and lack of oral care for large segments of the US population have not improved. This situation plus the predicted increase of the diversification of the US population requires decisive actions to ensure that future dentists will be optimally prepared to provide the best possible care for all patients. A diverse dental educator workforce plays a crucial role in obtaining this goal. The objectives of this document were threefold. Aim 1 was to analyze past and current trends in the diversity and inclusion of historically underrepresented ethnic/racial (HURE) and marginalized (HURM) dental faculty members. Aim 2 focused on reviewing best practices and challenges related to achieving dental faculty and leadership diversity and inclusion. Aim 3 was to develop recommendations for increasing the diversity and inclusion of dental faculty in the present and future. METHODS: An analysis of ethnicity/race and gender faculty data collected by the American Dental Education Association (ADEA) in 2011-2012 and 2018-2019 showed that achieving faculty diversity and inclusion has been an ongoing challenge, with limited success for faculty from HURE backgrounds. In order to create this much-needed change, best practices to increase the applicant pool, change recruitment strategies, and develop solid retention and promotion efforts were described. Research discussing the challenges to creating such changes was analyzed, and strategies for interventions were discussed. CONCLUSION: In conclusion, evaluations of efforts designed to create a more diverse and inclusive work force is crucial. Institutions must evaluate their diversity data, practices utilized, and the policies implemented to determine whether the desired outcomes are achieved. Only then will the future dental workforce be optimally prepared to provide the best possible care for all patients in the United States.

Dental students' interest in orthodontic careers: do orthodontic-related experiences and faculty and practitioner role models matter?

OBJECTIVES: To assess the percentage of dental students interested in orthodontics and likely to apply to orthodontic residency programs, the role of orthodontic-related experiences, and of orthodontic faculty and practitioner role models for student career decision-making. MATERIALS AND METHODS: This study had a cross-sectional design. A total of 335 students from seven U.S. dental schools responded to an anonymous web-based survey. RESULTS: 35% were much/very much interested in becoming orthodontists and 26% were likely to apply for this specialty training. A total of 80.1% had orthodontic treatment, 58.7% knew an orthodontist in their community, 44% had shadowed an orthodontist, and 10.8% had worked in an orthodontic practice before dental school. Respondents evaluated orthodontic practitioners more positively than orthodontic faculty. They considered practitioners as more compassionate providers than faculty members (5-point scale with 5 = agree strongly: mean = 4.25 vs 3.83; P < .001), making more of a difference in their patients' lives (4.44 vs 4.05; P < .001), and as better role models (4.21 vs 3.94; P < .001) who encouraged students more to pursue orthodontics (4.03 vs 3.65; P < .001). Their interest in becoming an orthodontist and in applying for an orthodontic residency program correlated with educational experiences (r = 0.35; P < .001 / r = 0.34; P < .001) and positive impressions of orthodontic faculty (r = 0.23; P < .001 / r = 0.22; P < .001) and practicing orthodontists (r = 0.29; P < .001 / r = 0.27; P < .001). CONCLUSIONS: Better understanding of factors motivating dental students to pursue orthodontics is crucial. Orthodontic practitioners and faculty play an important role in this context.

Agreement in measurements of ultrasonography-derived periodontal diagnostic parameters among multiple raters: A diagnostic accuracy study.

OBJECTIVE: The aim of this study was to investigate the reproducibility of measurements of ultrasound-derived periodontal diagnostic parameters (PDPs) among raters. STUDY DESIGN: Periodontists with various degrees of ultrasound experience were invited to measure 3 PDPs: soft tissue height (STH), soft tissue thickness (STT), and crestal bone thickness (CBT) on 37 human periodontal ultrasound scans acquired at the midfacial site of non-molar maxillary teeth. After an online training session and a 2-week calibration exercise, intraclass correlation coefficients (ICCs) were estimated with mixed linear regression models. The interrater mean absolute differences (MADs) were calculated among the raters and between the raters and a reference standard examiner. RESULTS: Thirteen raters participated in the study. MADs among the 13 raters were 0.18 mm (STH), 0.16 mm (STT), and 0.12 mm (CBT). ICC values for STH, STT, and CBT were 0.83, 0.77, and 0.76, respectively. The MADs between the raters and the reference standard were 0.23 mm (STH), 0.19 mm (STT), and 0.14 mm (CBT). Survey results showed that ultrasound has diagnostic value and is generally easy to learn. CONCLUSIONS: Within the limitations of this study, good agreement was observed among ultrasound learners with various degrees of experience when measuring ultrasound-derived PDPs.

Impact of Parents' Oral Health Literacy on Their Own and Their Children's Oral Health in Chinese Population.

Background: Oral health literacy (OHL) has been recognized as a component of oral health disparities; however, the precise relationship between literacy and oral health outcomes has not been established. To explore the role of parents' OHL for their own subjective oral health, related behavior, and for the proxy assessment of their child's oral health, oral health-related behavior. Methods: Survey data were collected from 406 parents of 4- to 7-year-old children in Beijing, China. The background characteristics, oral health assessment, oral health-related behavior, knowledge and attitudes, and diet-related questions of parents and their children were surveyed by a questionnaire. OHL was assessed with the Hong Kong Rapid Estimate of Adult Literacy in Dentistry (HKREAL-30) Scale and a revised version that asked the respondents to indicate if they understood the words (HKREALD-30-Understand). Results: The HKREALD-30 responses correlated with the HKREALD-30-Understand responses. The higher the parents' HKREALD-30-Understand scores, the better they described the health of their own teeth and gums, the greater their child's diet was influenced by the protein, sugar and calories of the food, and the more positive their oral health-related attitudes were. The higher the parent's HKREALD-30 scores, the healthier they described their child's teeth and gums. Conclusions: Both the HKREALD-30 and HKREALD-30-Understand Scores correlate with parents' self and proxy oral health-related responses. Chinese parents could understand that the word would add predictive value to the prediction of how parents' oral health literacy affects their own oral health care, children's oral health and other related aspects.

Career motivation and satisfaction of dental hygiene students in associate versus bachelor degree programs: A national survey.

OBJECTIVES: Entry-level dental hygiene programs give associate (AD) and bachelor degrees (BD). The objectives were to compare how AD versus BD students differ in career-related role models and information sources, career motivations, and satisfaction and to explore the relationships between career motivations and satisfaction. METHODS: Two hundred seventy-one students in AD and 269 students in BD programs responded to a survey. RESULTS: AD students were older than BD students (26.71/23.6; p < 0.001). Both groups were most likely to name a nurse/dental hygienist (37.6%/37.3%) as role models in their families, were likely to have shadowed a dental hygienist (77.6%/75.0%), and had talked to a health professional (27.7%/23.7%) prior to program application. BD students decided earlier to become dental hygienists (17.20/19.97 years; p < 0.001) and were less likely to have been dental assistants before than AD students (28.3%/36.9%; p = 0.034). Both groups agreed strongly that they wanted to become dental hygienists to help patients (5-point scale with 5 = agree strongly: 4.88/4.86), make a difference in the life of patients (4.88/4.86) and because it is a flexible career (4.83/4.80). Open-ended responses showed that 62.4% of AD students compared to 35.3% of BD students choose their career because of lifestyle considerations (p < 0.001), while 47.2% of BD students versus 38.0% of AD students wanted to work in the healthcare field (p < 0.001). Both groups had high job satisfaction (3-point scale: 2.94/2.97). For AD students, job satisfaction correlated with wanting to help patients (r = 0.49; p < 0.01) and with making a difference in the life of patients (r = 0.52; p < 0.001). For BD students, wanting to work in a team (r = 0.34; p < 0.001) and having a dentist in the family (r = 0.32; p < 0.001) correlated with job satisfaction. CONCLUSIONS: Dental hygiene students in AD versus BD programs differ in the factors that are associated with job satisfaction. Dental hygiene educators can utilize these findings when recruiting future students. The findings related to motivational determinants of job satisfaction can guide educational efforts.

Risk factors, diagnosis, and treatment of peri-implantitis: A cross-cultural comparison of U.S. and European periodontists' considerations.

BACKGROUND: Peri-implantitis (PI) is a growing concern in the dental community worldwide. The study aimed to compare U.S. versus European periodontists' considerations of risk factors, diagnostic criteria, and management of PI. METHODS: A total of 393 periodontists from the United States and 100 periodontists from Europe (Germany, Greece, Netherlands) responded to anonymous surveys electronically or by mail. RESULTS: Compared to U.S. periodontists, European respondents were younger, more likely to be female and placed fewer implants per month (9.12 vs 13.90; P = 0.003). Poor oral hygiene, history of periodontitis, and smoking were considered as very important risk factors by both groups (rated > 4 on 5-point scale). European periodontists rated poor oral hygiene (4.64 vs 4.45; P = 0.005) and history of periodontitis (4.36 vs 4.10; P = 0.006) as more important and implant surface (2.91 vs 3.18; P = 0.023), occlusion (2.80 vs 3.75; P < 0.001) and presence of keratinized tissue (3.27 vs 3.77; P < 0.001) as less important than did U.S. periodontists. Both groups rated clinical probing, radiographic bone loss, and presence of bleeding and suppuration as rather important diagnostic criteria. They rated implant exposure/mucosal recession as relatively less important with U.S. periodontists giving higher importance ratings than European periodontists (3.99 vs 3.54; P = 0.001). Both groups nearly always used patient education, plaque control and mechanical debridement when treating PI. U.S. periodontists were more likely to use antibiotics (3.88 vs 3.07; P < 0.001), lasers (2.11 vs 1.68; P = 0.005), allograft (3.39 vs 2.14; P < 0.001) and regenerative approaches (3.57 vs 2.56; P < 0.001), but less likely to use resective surgery (3.09 vs 3.53; P < 0.001) than European periodontists. CONCLUSIONS: U.S. and European periodontists' considerations concerning risk factors, diagnosis and management of PI were evidence-based. Identified differences between the two groups can inform future educational efforts.

The status of climate studies in the United States and Canadian dental schools: Deans' perspectives.

OBJECTIVES: Institutions with a positive cultural climate make community members from all backgrounds valued and included, and treated equitably. Such an environment is optimally suited to prepare future dentists well for leading a diverse team of staff members and addressing the oral health care needs of increasingly more diverse patient populations. The objectives were to assess how many United States and Canadian dental schools had participated in a climate study at their parent institution and/or had conducted their own climate study, which topics these studies had addressed, how they collected their data, from whom they collected data, and how the findings affected these academic units. METHODS: In January 2020, 54 of the 78 dental school deans in the United States and Canada responded to a web-based survey (response rate: 69%). RESULTS: Forty-six parent institutions (85%) and 27 dental schools (50%) had conducted climate studies. Eighty-seven percent of parent institutions assessed the climate overall and the climate for specific groups (70%), such as for persons from underrepresented minority backgrounds (67%) or different religious backgrounds (59%). Most parent institution and dental school studies utilized surveys to collect data from faculty (parent institutions: 76%/dental schools: 96%), staff (74%/93%), administrators (72%/93%), and students (72%/89%). Overall, climate study results positively affected parent institutions' and dental schools' humanistic environment (61%/63%) and the recruitment of faculty (46%/50%), students (46%/46%), and staff (41%/43%). CONCLUSIONS: Climate studies are a widely accepted practice at dental schools and their parent institutions. Their results can play a vital role in shaping the climate of these academic units by fostering efforts to increase diversity, equity, and inclusion.

Comparisons of orthodontic residents' performance and attitudes using 2D, 3D, and virtual reality surgical simulation methods.

PURPOSE: Advances in virtual reality technology for surgical simulation methods may improve diagnosis and treatment planning of complex orthognathic surgery cases. The objectives were to assess orthodontic residents' performance and attitudes when treatment planning orthognathic surgery cases using two-dimensional (2D) digital, three-dimensional (3D) digital, and virtual reality (VR) surgical simulations. METHODS: The study had a mixed methods study design involving 20 graduate orthodontic residents. Their previous experiences, confidence, and competence with orthodontic diagnosis and surgical treatment planning were assessed with a baseline survey. Each resident completed 2D, 3D, and VR treatment planning and simulation tasks in a randomized order and recorded their diagnosis, objectives, treatment plan, and special surgical concerns for each case using a treatment planning worksheet. The worksheets were scored and quantitative data were analyzed. Attitudinal responses to the simulation experience were captured with a post-survey and interview. RESULTS: The number of total prescribed surgical movements was greater for 3D and VR simulation methods (p = 0.001). There were no differences in the overall total written treatment plan analysis score among the three surgical simulation tasks. Participants took longer to complete the VR and 3D tasks (p < 0.001) and asked more questions regarding manipulation (p < 0.001) and software features (p < 0.002) for higher fidelity tools. Analysis of qualitative feedback showed positive attitudes toward higher fidelity tools with regard to visualization, manipulation, and enjoyment of the task. CONCLUSIONS: The results demonstrate that simulation methods of increased fidelity (3D and VR) are appropriate alternatives to 2D conventional orthognathic surgical simulation methods when combined with traditional records. Qualitative feedback confirms residents' readiness to adopt VR simulation. However, comprehensive training is needed to increase familiarity and comfort with using the new technology.

Dental students' OMFS-related experiences and interest in OMFS careers: An exploration.

PURPOSE: While the numbers of oral maxillofacial surgery (OMFS) residents increased over time, women and residents from underrepresented minority backgrounds are still underrepresented. The objectives were to assess dental students' OMFS-related personal and educational experiences and attitudes and explore which factors correlate with their interest in future OMFS careers. METHODS: Data were collected from 493 dental students in 1 dental school and 206 students from 15 other US and Canadian dental schools. RESULTS: The students in the national sample were more likely to have experienced an OMFS procedure themselves (64.6% vs. 50.7%; P = 0.001), have shadowed an OMFS in an operating room (23.2% vs. 14.9%; P = 0.009) prior to coming to dental school and to be much/very much interested in an OMFS career (36.4% vs. 12%; P < 0.001) than the students at the home school. While the majority of both groups rated their experiences with rotations in the OMFS department in the dental school (68% vs. 62.5%) and in the hospital (80.3% vs. 85.7%) as very interesting, the students in the national sample were more likely to agree/strongly agree that they were satisfied with their OMFS experiences (68.1% vs. 36.3%; P < 0.001) and had learned a lot from the OMFS faculty (57.9% vs. 30.8%) than the students in the home school. For both groups, the degree of interest in an OMFS career correlated with having had more personal OMFS experiences (home: r = 0.28; P < 0.001/other: r = 0.39; P < 0.001), more interesting OMFS experiences in the dental school (r = 0.23; P < 0.05/r = 0.40; P < 0.001) and the hospital (0.33; P < 0.05/r = 0.50; P < 0.001) and more positive attitudes toward OMFS faculty (r = 0.26; P < 0.001/r = 0.37; P < 0.001). CONCLUSIONS: Positive personal and educational OMFS experiences and positive attitudes toward OMFS faculty were associated with an interest in OMFS careers. These findings provide a basis for developing educational interventions aimed at increasing the percentage of women and residents from URM backgrounds in OMFS programs.

Pediatric Dentists' Educational Experiences, Attitudes, and Professional Behavior Concerning Resin Infiltration: Implications for Dental Education.

Minimally invasive dentistry (MID) is receiving increased attention. Resin infiltration (RI) is one micro-invasive technique for treating initial caries by sealing white spot lesions on tooth surfaces. The aims of this study were to assess pediatric dentists' RI-related educational experiences, attitudes, and professional behavior and to determine if their educational experiences were significantly related to their professional attitudes and behavior regarding RI. This cross-sectional study used an online survey to collect data from members of the American Academy of Pediatric Dentistry (AAPD) in March-April 2017. Of the 2,367 AAPD members invited to participate, 43 emails could not be delivered, and 273 surveys were completed, for a response rate of 11.8%. While only 9% of the 273 respondents reported that their classroom-based dental education had informed them about RI and only 1% that it had prepared them well to use RI with pediatric patients, higher percentages said they had been informed/prepared well by their classroom-based (24%) and clinical residency education (12%). The majority wanted to learn more about RI (71%) and would like to take a related CE course (59%). The respondents' average RI-related attitudes were positive (on five-point scale with 1=worst attitude: Mean=3.84). Regarding use of RI, 28% of respondents said they used RI sometimes and 4% often/very often, with 64% considering implementing RI in their clinics. Graduation year did not correlate with RI attitudes and use. However, the more education about RI the respondents had received during their residency (r=0.20; p<0.01) and in professional development after graduation (r=0.34; p<0.001), the more they used RI in their own work. This study found that the pediatric dentists' RI-related education was positively correlated with their professional behavior. Increasing predoctoral, resident, and continuing professional education about RI should therefore be considered.