Dentists' Experiences and Dental Care in the COVID-19 Pandemic: Insights from Nova Scotia, Canada.

BACKGROUND: This study aimed to describe dental care provision and the perceptions of dentists in Nova Scotia, Canada, during 1 week of the COVID-19 pandemic, shortly after the closing down of non-emergency, in-person care. METHODS: A survey was distributed to all 542 registered dentists in Nova Scotia, asking about dental care provision during 19-25 April 2020. Most answers were categorical, and descriptive analyses of these were performed. Data from the 1 open-ended question were analyzed using an inductive approach to identify themes. RESULTS: The response rate was 43% (n = 235). Most dentists (181) provided care but only 13 provided in-person care. From the open-ended question, 4 concerns emerged: communication from the regulatory authority; respondents' health and that of their staff; the health of and access to care for patients; and the future of their business. CONCLUSION: Most respondents remained engaged in non-in-person dental care using various modes. They expressed concerns about their health and that of their staff and patients as well as about the future of their practice. PRACTICAL IMPLICATIONS: Dentists and dental regulatory authorities should engage in discussions to promote the health of dental staff and patients and quality of care during the chronic phase of the pandemic.

Developing Person-Centred Dental Care: The Perspectives of People Living in Poverty.

Dentistry has seen a slow trend toward person-centred care (PCC), with most approaches developed by scholars who have tried to progress away from disease-centred care. Unfortunately, the perspectives and experiences of underprivileged people have not been considered in the development of these approaches. Our objective was thus to understand underprivileged people's experiences and expectations about dental care and contribute to the development of person-centred dentistry. We conducted a qualitative descriptive study with a sample of 13 people living in poverty. We used a maximum variation sampling strategy and selected them among the users of a free dental clinic in Montreal, Canada. We conducted semi-structured interviews that we audio recorded, transcribed verbatim, and thematically analysed. Our main finding is that participants wanted to feel human and respected by dentists. More specifically, they wanted to be more involved in the dental care process through quality time and empathetic conversations with the dentist. They also wished for an exchange of information free of technical terms and built on mutual trust. In conclusion, person-centred dental care models should emphasize empathy, trust, and quality care beyond technical skills. Clinicians should provide comprehensive information in dental encounters and treat their patients as whole persons.

A scoping review on social justice education in current undergraduate dental curricula.

BACKGROUND: A recent shift in educational components within healthcare has pushed dentistry toward a greater understanding of the role of social components on oral health. There has also been an increased awareness of inappropriate conduct among dental students. STUDY DESIGN AND METHODS: A scoping review was conducted to determine if, how, and when social-justice-oriented education has been incorporated into dental curricula worldwide. A systematic and reiterative search of articles was performed on February 22, 2018, and combined quantitative and qualitative synthesis of data. An updated search was done on September 26, 2019. PRIMARY RESULTS: Seventy-three studies were evaluated: 46 quantitative (63%), 24 qualitative (33%), 3 multimethods (4%). The majority used self-reported surveys and questionnaires (66%), while the remaining used interviews (9.5%), student reflections (16%) and focus groups (5.5%). Studies included dental students only (78%); dental students with dental hygiene students (5.5%) or faculty/staff (4.1%); dental students in year 1 (17%), year 2 (1.6%), year 3 (1.6%), year 4 (14.2%); first- and second-year students (3%); third- and fourth-year students (1.6%); all years of study (20%); and academic year not specified (41%). The study areas included "learning in dental school," "experiencing dental school," "focusing on cultural competency," and "addressing dental ethics and social responsibility." PRINCIPAL CONCLUSIONS: Three major research gaps were identified: no discussion of a social contract between dentists and society, no explicit social justice-oriented topics within undergraduate dental curricula, and no standardized tool to measure these topics. Further research is necessary to understand how such topics can be included in dental curricula to form socially competent dentists.

Assessing Dental Students' Readiness to Treat Populations That Are Underserved: A Scoping Review.

In North America, all dental schools have adopted some form of community-based dental education (CBDE) or service-learning, but little is known about the areas being researched and reported in published studies. The aim of this study was to conduct a scoping review to determine what areas of research had been conducted to determine the effects of CBDE on dental students' readiness to treat populations that are underserved. A systematic search of articles published in English or French since 2000 was performed on July 29, 2015, and combined quantitative and qualitative synthesis of data was conducted. Of the 32 studies evaluated, 23 (72%) were quantitative, seven (22%) were qualitative, and two were multi-method. The majority (66%) used self-report methods, most frequently surveys. Participants in 50% of the studies were fourth-year dental students; the others assessed third- and fourth-year (13%), first- and second-year (6%), and first-year (13%) students. Dentists were the participants in three studies (9%), with dentists and students in one study (3%). Either the types of populations receiving care were unspecified or four or more groups were pooled together in 25 studies (78%), while two focused on children, one on rural populations, one on elderly populations, two on persons with special health care needs, and one on low-income populations. The study areas were wide-ranging, but generally fell into three categories: student performance (37.5%), teaching approaches and evaluation methods (37.5%), and perceptions of CBDE (25%). This review identified many research gaps for determining whether students are prepared to treat populations that are underserved. The disparate nature of CBDE research demonstrates a compelling argument for determining elements that define student readiness to care for patients who are underserved and for research that includes the voices of patients, curriculum development, and more comprehensive and rigorous evaluation methodologies.

The Canadian minimum dataset for chronic low back pain research: a cross-cultural adaptation of the National Institutes of Health Task Force Research Standards.

BACKGROUND: To better standardize clinical and epidemiological studies about the prevalence, risk factors, prognosis, impact and treatment of chronic low back pain, a minimum data set was developed by the National Institutes of Health (NIH) Task Force on Research Standards for Chronic Low Back Pain. The aim of the present study was to develop a culturally adapted questionnaire that could be used for chronic low back pain research among French-speaking populations in Canada. METHODS: The adaptation of the French Canadian version of the minimum data set was achieved according to guidelines for the cross-cultural adaptation of self-reported measures (double forward-backward translation, expert committee, pretest among 35 patients with pain in the low back region). Minor cultural adaptations were also incorporated into the English version by the expert committee (e.g., items about race/ethnicity, education level). RESULTS: This cross-cultural adaptation provides an equivalent French-Canadian version of the minimal data set questionnaire and a culturally adapted English-Canadian version. Modifications made to the original NIH minimum data set were minimized to facilitate comparison between the Canadian and American versions. INTERPRETATION: The present study is a first step toward the use of a culturally adapted instrument for phenotyping French- and English-speaking low back pain patients in Canada. Clinicians and researchers will recognize the importance of this standardized tool and are encouraged to incorporate it into future research studies on chronic low back pain.