Can Critical Thinking Skills Be Transferred from the Accomplished Scientist to the Beginning Scientist?

We seldom apply rigorous methods to how scientists think as they make new discoveries and open new avenues of inquiry. The progress of science relies on one generation of scientists transferring their thought processes and methods to the next. In a culture of inquiry, respect, rigor, and role modeling, critical thinking can thrive as novices become accomplished scientists. Although scientists are typically judged on the basis of results (publication, symposium, etc.) rather than the thought process used to get that result, the thought process is of paramount importance for training the next generation of scientists. As a profession pays closer attention to the educational process whereby novices become accomplished scientists, a wider discussion of how accomplished scientists think is vital to help novice scientists positively advance through the early vulnerable years. Thinking critically about our goals and values-including the value of emulation, experience, biases, and doubt-is a necessary part of that process.

Caries levels and patterns in the primary dentition of preschool children in Taiwan.

BACKGROUND: The specific caries experience and caries patterns have not been systematically studied in Taiwan. The purpose of this study was to determine the prevalence of caries patterns and caries levels for children aged 3 through 6 years in the northern Taiwan area. METHODS: Eight hundred fifty-one children were examined and their dentition classified according to five etiology-oriented caries patterns. RESULTS: The deft was 2.8 for 3-year-olds, 3.2 for 4-year-olds, 3.8 for 5-year-olds, and 3.7 for 6-year-olds. Nearly half the children (44.4%) had the "facial lingual/molar proximal" pattern; this pattern is consistent with bottle caries continuing to the smooth surfaces of molars. Only 15.4% were caries-free. CONCLUSION: We interpret the disease to be well established by age 3; prevention programs should thus begin before that age. The influence of bottle caries is interpreted from the high percentage of children with facial-lingual caries by age 3.

Response to Horowitz: research issues in early childhood caries.

Interest in early childhood caries (ECC) remains strong internationally, yet a name remains elusive. Baby bottle tooth decay (BBTD) was widely recognized by non-dental health professionals--a factor to consider in choosing a more appropriate name. Due to limits in historic data, progress against the disease remains difficult to determine. As reflected by Dr Horowitz's list of recommendations, a focused agenda is not at hand on research leading to specific interventions. We also struggle to develop a specific set of interventions suitable for public health settings. In the absence of research-based effective interventions, I hope we do not withdraw from efforts to reduce ECC.

The preschool "passage". An overview of dental health.

Children undergo major transformations between birth and approximately 5 years of age. The most common examples are personality development and the potential explosiveness of the course of the disease caries. Each demands recognition, assessment of degree of difficulty, and an adaptation by the dentist. Starting dental care for children early is based on the anticipated time children can develop disease, the fact that most dental disease is preventable, and the desire to gain the trust of the child by first, minimizing the need for invasive procedures. Dental trends set in the preschool period tend to carry for many years. The dentist's assessment of the degree of difficulty is the first key in successful care for each child. The general dentist and pediatric dentist both play important and complementary roles in the care of children. There are differences in the practice habits between the two. Self assessment of skills for common situations leads to improved care. Because children don't vote, a responsibility falls on the health care provider to advocate for children in the political and professional arenas.

Malocclusion in Labrador Inuit youth: a psychosocial, dental and cephalometric evaluation.

Epidemiological studies of malocclusion of world populations have been previously limited to dental parameters. This cross-sectional study examined the prevalence of malocclusion in the dentitions of Inuit (Eskimo) youth aged between 5-22 years from Labrador, Canada, using psychosocial, dental and skeletal (radiographic) parameters. Data were obtained from two communities, Nain (population 1079) and Hopedale (population 534). About 82% (n = 363) of the Inuit youth and 50% (n = 222) of their parents responded to the psychosocial questionnaires. In total, 78% (n = 348) of the Inuit youth were examined intraorally to determine the prevalence of malocclusion using the Treatment Priority Index (TPI), and 23% (n = 100) had cephalometric radiographs taken using a portable cephalometer. The results indicated that 95% of the Labrador Inuit youth examined had some degree of malocclusion, 10-16% were aware of their occlusal disharmonies, 55-65% wanted to have their teeth straightened, and 5% were teased by others because of their malocclusions. In addition, 63% of the parents seemed to be aware of their child's occlusal problems and 70% wished their children to wear orthodontic appliances if they were needed. Prevalence and awareness to malocclusion were positively correlated. According to the TPI, 18% had "severely handicapping" and 20% had "very severely handicapping" malocclusions. The TPI score increased with age from 5.25 in the young group to 8.05 in the older age group (mean 6.7). There were high prevalences of crowded anterior teeth, upper lingual posterior crossbites, and open or edge to edge bites. A prevalence of 35% Angle Class I, 49% Angle Class II and 16% Angle Class III molar relationships were observed. Cephalometric analysis demonstrated a mean wits measurement of -2.0 mm, a mean ANB angle of 4.7, a mean lower face height of 68.3 mm, a mean interincisal angle of 125 degrees and a mean frankfort mandibular plane angle of 31.3 degrees. A need for orthodontic care and further education were clearly indicated and highly recommended.

The prevalence and patterns of dental caries in Labrador Inuit youth.

OBJECTIVES: This study was undertaken to examine the prevalence of dental caries in Inuit (Eskimo) youth aged 5-22 years. METHODS: Both tooth-oriented indices and child-oriented caries patterns were recorded in a field study conducted in 1991 in Nain and Hopedale, Northern Labrador. Seventy-eight percent (N = 347) of all school-children in these two locations were examined by a single examiner. RESULTS: Three percent of the population were caries free and 88 percent of those with caries experience had untreated dental decay. The mean combined dmft and DMFT per child for all ages was 6.85, while the mean combined dmfs and DMFS was 15.72. About 38 percent of subjects had pit and fissure caries; 2 percent had hypoplastic lesions; 4 percent had faciolingual caries; 31 percent had molar-approximal caries and 22 percent had faciolingual and molar-approximal caries, the most destructive caries pattern. About 68 percent of the 5-6-year-olds and 26 percent of the 15-22-year-olds experienced the most destructive pattern of decay in their primary and permanent dentitions, respectively. CONCLUSIONS: Preventive measures should start well before the age of 5 years. Describing caries patterns according to the dentition type complemented the traditional indices.

Caries pattern identification in primary dentition: a comparison of clinician assignment and clinical analysis groupings.

The purpose of this study was to compare the assessment of caries patterns by clinical definition and by cluster analysis. One of five etiology-oriented caries patterns was assigned to Head Start children in primary dentition. Cluster analysis grouped children based on carious tooth surfaces for each child. One hundred twenty-seven of the 155 children with at least one carious lesion fell into clusters of at least four children. At least two-thirds of the subjects in each cluster were assigned to a single caries pattern. The largest cluster of 70 children had 66 of its subjects assigned to the pit and fissure pattern. The second largest cluster of 26 children had 20 of its subjects assigned to the faciolingual pattern (intended to identify bottle caries). This study is interpreted to reinforce the notion that caries in the primary dentition occurs in fairly distinct patterns.

The role of the pediatrician in identifying and treating dental caries.

Although dental caries has been reduced greatly in the last two generations, this infectious disease persists. The pediatrician can play a direct and indirect role in preventing dental caries. The pediatrician can provide counseling on feeding practices to prevent baby bottle tooth decay as well as identify children at risk. Dental caries of the grooves of molar teeth now accounts for dental caries in more children than any other form of caries. Dental sealants are recommended to coat the grooves and prevent dental caries. Restoration of decayed teeth is the most direct means of treating dental caries.

Prevention of intraoral trauma in sports.

Dental, oral, facial, and cranial injuries can be reduced by the use of mouthguards and faceguards. Disadvantages of mouthguard use are based mostly on lack of information. There is a growing endorsement for the use of mouthguards and faceguards, presenting the dental profession with a major opportunity to improve the oral health of athletes.

Enamel defects: a developmental marker for hemifacial microsomia.

We have observed primary tooth enamel defects in 4 children with hemifacial microsomia. The distribution of enamel defects was concordant with the laterality of craniofacial anomalies in these patients and was most pronounced on the maxillary incisors. Since the location of enamel defects serves as a chronicle for the events of tooth formation, we propose that enamel defects may serve as a developmental marker for the events leading to hemifacial microsomia.

Genioglossus response to airway occlusion in apneic versus nonapneic infants.

The ability to maintain pharyngeal patency is compromised in infants who have apneic episodes associated with airway obstruction. Since the genioglossus (GG) muscle is thought to be important in maintaining pharyngeal patency, we measured the GG EMG with sublingual surface electrodes during unobstructed breathing and in response to end-expiratory airway occlusion. Studies were performed in nine premature infants with mixed and obstructive apnea and in eight nonapneic control infants. Phasic GG EMG was usually absent during normal tidal breathing in both groups of infants, however, GG activity typically appeared during airway occlusion. The response of the GG muscle during airway occlusion differed between control and apneic infants. During the first three occluded inspiratory efforts, control infants had 42 +/- 5, 74 +/- 5, and 80 +/- 5% (mean +/- SEM) of their occlusions associated with a GG EMG response, respectively. In contrast, apneic infants had significantly fewer (13 +/- 4, 38 +/- 9, and 52 +/- 9%) occlusions associated with a GG EMG response. There was a delay in onset of the GG EMG when compared to the onset of the diaphragm EMG and initial negative esophageal pressure swing, but this delay decreased with each subsequent appearance of the GG EMG in both infant groups. Infants with mixed and obstructive apnea thus have decreased activation of their GG in response to occlusion which may reflect their inability to recruit dilating muscles of the upper airway during spontaneous airway obstruction.

Hearing and neurologic impairment: insult timing indicated by primary tooth enamel defects.

The association between hearing loss, neurologic impairment, and primary tooth enamel defects was examined in a group of 88 children presenting for hearing evaluation at a tertiary care children's hospital. Forty-one had classifiable enamel defects, reflecting the time and duration of prenatal or perinatal insult. Hearing loss was more prevalent and severe in 19 children with enamel defects of the incisal tooth edge (mean = 61 dB) reflecting a systemic insult at 14 to 16 weeks gestation, than in 7 children with cervical third tooth defects (mean = 23 dB) reflecting insult near term (X2 = 4.08; p less than 0.05). Audiometric findings among the 15 children with incisor defects of the middle third varied; 7 had significant hearing loss and 8 were normal. A correlation was observed between severity of hearing loss (in dB) and estimated time of systemic insult (in weeks gestational age) determined by tooth defect site (r = -0.48; p less than 0.01). The neurologic data revealed similar trends. The group with early systemic insults more frequently had moderate or severe neurologic deficits known to originate early in fetal development. The two groups with third trimester or term insults tended to have mild or no neurologic impairment. A differential susceptibility for developing auditory and neurologic structures based on insult timing is supported.

Proportional changes in caries patterns from early to late primary dentition.

A tooth-oriented caries measure has limitations in depicting the caries experience in the primary dentition for a population. Caries patterns based on the child have been presented previously and quantified. The purpose of this study was to explore proportional changes in caries patterns of the primary dentition in two populations. Graphic representation is suggested in developing a model. Children two to five years of age were examined in a city pediatric dental clinic and in a suburban private practice and were categorized as caries-free or as having one of the following etiology-oriented caries experiences associated with lesion sites: Fissures, Hypoplasia, Facial-Lingual, Molar-Approximal, or Facial Lingual/Molar-Approximal. Over 85 percent of children aged 2.5 years or younger were either caries-free or fit the Facial-Lingual category consistent with descriptions of "nursing caries." Trends explored in this study would not be evident using an average for a tooth-oriented caries measure.