Antibiotic prophylaxis prescribing practices of dentists in Singapore.

BACKGROUND: Infective endocarditis is a serious complication that results in significant morbidity and mortality in susceptible patients. The guidelines for antibiotic prophylaxis have been updated by the American Heart Association and National Institute for Health and Clinical Excellence. The antibiotic prophylaxis prescribing practices among dentists in Singapore are unknown. AIM: To determine the specific infective endocarditis antibiotic prophylaxis prescribing practices of dentists in Singapore. METHODS: A questionnaire survey was sent through an email link and by postal mail. Statistical analysis was carried out using SPSS 19.0. RESULTS: Responses were received from 458 dentists (34.3% response rate), of which 278 (65.9%) were general practitioners. The majority of respondents (39.8%) followed the American Heart Association 2007 guidelines and 30.2% followed cardiologists' recommendations. The accuracy of prescriptions for 13 cardiac conditions and 12 dental procedures were evaluated. The median number of accurate answers for cardiac conditions was eight for the American Heart Association 1999 guidelines, and four for the American Heart Association 2007 and National Institute for Health and Clinical Excellence guidelines, respectively. The median number of accurate answers for dental procedures was generally high, both for dentists who followed the American Heart Association 1999 guidelines (median = 10) and American Heart Association 2007 (median = 9) guidelines. Majority of respondents (82.8%) felt that developing a local guideline would be beneficial to the local dental community. CONCLUSION: Dentists were accurate in their prescriptions of antibiotic prophylaxis for dental procedures, but not for cardiac conditions. It may be helpful to attain a consensus among local cardiologists and dentists to unify the antibiotic prophylaxis prescription practices in Singapore.

Teaching pediatric behavior management in student dentists with constructive video feedback from faculty.

PURPOSE: The range of child behaviors encountered in real-life situations far exceeds that of any classroom-based simulated scenarios. For such reasons, clinical training with real-time clinical supervisor's feedback is optimal for learner-centricity. This study aimed to objectively evaluate the effect of video feedback on the student dentist's ability to manage behaviors in children. METHODS: Third-year dental student volunteers were randomly allocated to two groups: control and intervention. They were video recorded for three pediatric dental treatment sessions and received standard feedback for all sessions. Additionally, the intervention group received two constructive 1-on-1 feedback sessions after the first and second video sessions. Students' application of behavior management techniques for all recorded treatment sessions was scored with a study-specific objective scale (maximum score: 20; larger score indicating better performance) by two independent and blinded evaluators. A self-administered student questionnaire elicited subjective feedback on the intervention. RESULTS: There was a significant difference (p = 0.008) between behavior management scores when comparing all pre-intervention sessions (10.74 ± 3.55) and all post-intervention sessions (13.57 ± 2.96). The intervention significantly improved these techniques: 1. Providing specific feedback - positive reinforcement and descriptive praise (p = 0.006) and 2. Distraction - Using imagination with stories and singing (p = 0.035). The feedback sessions (4.29 ± 0.54) were perceived to be significantly (p = 0.032) more effective than having the students view the videos on their own (3.76 ± 0.87). CONCLUSION: Video feedback improved the behavior management scores of student dentists. The faculty feedback sessions were found by student dentists to improve confidence and the techniques for managing children.