European Federation of Periodontology Survey of Postgraduate and Specialist Training in Europe in 2020.

AIMS: The survey's aim was to establish which universities and other educational organisations deliver postgraduate and specialist training in Periodontology in the 31 countries who are members of the European Federation of Periodontology (EFP) and to obtain details of how these programmes are organised, funded, regulated and evaluated. METHODS: A questionnaire and covering letter were emailed to all national periodontal societies. The questions were on the name of country, official recognition, training programmes, entry to specialist training, specialist training assessment and recognition after completion of training. RESULTS: Twenty-nine (93%) of national periodontal societies responded. Key findings included the following: Periodontology was reported as being recognised at a national level in 17 countries, there was a three-year full-time programme in 12 countries, no fees were charged for specialist training in 10 countries, in 14 countries trainees received annual salaries, end of training (summative) assessments varied from country to country, 12 countries reported that they had a requirement for specialists in Periodontology to complete continuing education to maintain registration as specialists. CONCLUSIONS: This survey has established which universities and other educational organisations deliver postgraduate and specialist training in Periodontology and how these programmes are organised, funded, regulated and evaluated. To provide uniformly high-quality periodontal care for patients in all European countries, further harmonisation of postgraduate and specialty training in Periodontology would be advantageous.

Performance of zirconia implants.

Design A prospective, controlled clinical study, conducted at least in part in practice, to compare approximal plaque index (API), sulcus bleeding index (SBI), periodontal probing depth (PPD), probing attachment level (PAL), creeping or recession of the mucosa/gingiva (CR/REC) and pink esthetic (PE) scores between Z-look 3 Implant System dental implants (Z-Systems, Oensingen, Switzerland) and adjacent natural teeth as controls over a mean follow-up period of 7.8 years (range: 6.1-9.7 years). The peri-implant marginal bone levels (MBL) at implant placement and follow-up visits were determined by panoramic radiography and recorded for comparison.Microbial contamination of the implants and control teeth was investigated using Paro Check 20 (Greiner Bio-one, Frickenhausen, Germany; Institute for Mikro-ecology, Herborn-Horbach, Germany). A validated questionnaire to assess patient satisfaction provided data to complement the clinical findings. The study, which lacks a clearly stated hypothesis, was approved by the ethics committee of the University Hospital in Frankfurt, Germany (No. 118/08).Sample selection Thirty-eight 'healthy' adult, partially edentulous patients (15 females, 13 males) with a mean age of 63.5 years (range: 39-80 years of age) were included in the study. A total of 106 zirconia implants were placed in these patients. No details of power calculations or inclusion/exclusion criteria are provided other than 'healthy' and partially edentulous.Data analysis SPSS for Windows statistical software was used for data analysis. The Gaussian distribution was analysed using the Kolmogorov-Smirnov test. As most of the data was 'non-normally' distributed, non-parametric tests were applied. The level of significance was set at 0.05. The Wilcoxon signed-ranks test was used for comparison of the API, SBI, PPD, PAL, CR/REC and microbial data. The analyses could be considered appropriate for the intended purpose.Results The findings presented pertain to 83 implants (38 maxillary and 45 mandibular) and 570 control teeth in 28 patients who remained in the study. The 26% attrition in patients and 22% attrition in implants available for investigation was attributed to 'decease and relocation'. Such attrition was presumably anticipated and factored into power calculations given the mean age of the patients being 63.5 years at the beginning of the study. A survival rate of 100% is reported with 'no major complications' despite 'biological impairment' having been observed in one patient, resulting in increased bone resorption, PPDs and recession/attachment loss affecting both implants and control teeth. The zirconia implants had a statistically significant lower plaque accumulation (P <0.01) compared to control teeth, whereas peri-implant PPDs were significantly higher around the implants (P <0.01). It is reported that the data presented 'underlines the tissue-friendly properties of zirconia implants'. The mean peri-implant bone resorption (1.2 mm) associated with the implants was interpreted as moderate 'without indication for a growing peri-implantitis'. The microbial analysis 'revealed no statistically significance difference in the total number of bacteria within the peri-implant sulcus when compared to corresponding regions of the CT' (control teeth)'. Several bacteria in the 'red complex', considered to play a vital role in the development of periodontitis, were detected in significantly higher numbers around zirconia implants when compared to control teeth. The results presented are difficult to put into context not knowing how the zirconia implants were restored and loaded in function, and in the absence of information on the maintenance regimes followed by the patients. It would certainly appear that the patients had good oral health both at the outset and throughout the duration of the study.Conclusion Given the limitations of the study and its reporting, it is suggested in the conclusion that 'the superiority of zirconia implants regarding plaque affinity and soft-tissue compatibility could be proven' is not fully supported. Similarly, the conclusion that 'the findings of the present prospective study could prove the ability of zirconia implants to replace missing teeth with maintenance of peri-implant hard- and soft-tissue health' is not considered to be fully supported. That said, the study does demonstrate that in selected patients, assumed to have and to maintain good oral health, zirconia implants of the type investigated may be found to have good clinical performance, assuming the implants investigated were all restored at an appropriate time following placement and were in function throughout the duration of the study.

European Federation of Periodontology-the first twenty-five years: periodontal health for a better life.

The European Federation of Periodontology (EFP), founded in 1991, has become one of Europe's foremost dental organisations and a global force in the field of Periodontology, including implant dentistry. This paper records the many, different achievements of the EFP in its short but selfless and highly successful contributions to the Federation.

Sultanate of Oman: building a dental workforce.

BACKGROUND: A medium- and long-term perspective is required in human resource development to ensure that future needs and demands for oral healthcare are met by the most appropriate health professionals. This paper presents a case study of the Sultanate of Oman, one of the Gulf States with a current population of 3.8 million, which has initiated dental training through the creation of a dental college. OBJECTIVES: The objectives of this paper are first to describe trends in the dental workforce in Oman from 1990 to date and compare the dental workforce with its medical counterparts in Oman and with other countries, and second, to consider future dental workforce in the Sultanate. METHODS: Data were collected from published sources, including the Ministry of Health (MoH), Ministry of Manpower (MoM), and Ministry of National Economy (MoNE)-Sultanate of Oman; the World Health Organization (WHO); World Bank; and the Central Intelligence Agency (CIA). Dentist-to-population ratios were compared nationally, regionally and globally for medicine and dentistry. Dental graduate outputs were mapped onto the local supply. Future trends were examined using population growth predictions, exploring the expected impact in relation to global, regional and European workforce densities. RESULTS: Population growth in Oman is increasing at a rate of over 2% per year. Oman has historically been dependent upon an expatriate dental workforce with only 24% of the dentist workforce Omani in 2010 (n = 160). Subsequent to Oman Dental College (ODC) starting to qualify dental (BDS) graduates in 2012, there is an increase in the annual growth of the dentist workforce. On the assumption that all future dental graduates from ODC have an opportunity to practise in Oman, ODC graduates will boost the annual Omani dentist growth rate starting at 28% per annum from 2012 onwards, building capacity towards global (n = 1711) and regional levels (Gulf State: n = 2167) in the medium term. CONCLUSION: The output of dental graduates from Oman Dental College is improving the dentist-to-population ratio and helping the Sultanate to realize its aim of developing an Omani-majority dental workforce. The implications for retention of dentists and team training are discussed.

Dental workforce development as part of the oral health agenda for Brunei Darussalam.

BACKGROUND: Brunei Darussalam is a Sultanate with a Malay Islamic monarchy. There are high levels of dental disease among its 406,200 population. The population's oral health needs require an integrated blend of primary and specialist care, together with oral health promotion. PROCESS AND OUTCOMES: This paper describes the planning and measures taken to address these needs. In accordance with an oral health agenda published and launched in 2008, focusing on access, health promotion and prevention, and the education and training of the dental workforce, the Brunei Darussalam Ministry of Health is seeking to improve oral health status and reduce the burden of oral disease. It also seeks to transform the country's oral health services into a preventatively orientated, high-quality, seamless service underpinned by the concept of 'teeth for life'. In the process of effecting this transition, the Brunei Darussalam Ministry of Health is developing a dental workforce fit for future purpose, with an emphasis on a modern approach to skill mix. An important element of this programme has been the development of a highly successful Brunei Darussalam Diploma in Dental Therapy and Dental Hygiene. CONCLUSION: It is concluded that the Brunei Darussalam oral health agenda and, in particular, the forward-looking programme of dental workforce development is a model for other countries facing similar oral health challenges.

Teaching of posterior composites for the restoration of permanent teeth in undergraduate dental training programmes: Systematic review and meta-analysis.

OBJECTIVES: To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools. STUDY SELECTION: Quantitative studies reporting on dental schools' teaching regarding the placement of PCRs in permanent teeth. Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed based on the Medical Education Research Study Quality Instrument (MERSQI). SOURCES: Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in January 2023. DATA: Forty sources reporting on 34 studies having surveyed 1,286 dental schools were included. Overall, 92.7% (95%-CI: 88.2-95.5) of dental schools reported to teach PCRs. PCRs in three-surface Class II cavities are taught by 82.0% (95%-CI: 70.4-89.7). The mandatory use of liners in deep cavities is taught by 78.3% (95%-CI: 68.9-85.5), and 44.0% (95%-CI: 34.3-54.2) reported to teach bulk-fill composites. While most posterior restorations placed by students were composites (56.1%; 95%-CI: 46.0-65.8), 94.7% (95%-CI: 86.6-98.0) of dental schools (still) teach posterior amalgam restorations. The proportion of dental schools teaching PCRs in three-surface Class II cavities increased and the mean proportion of PCRs among all posterior restorations increased over time (padj.≤0.003). CONCLUSIONS: The teaching of PCRs in dental schools around the world reflects the increased use of resin composite in clinical practice, with students in countries where dental amalgam continues to be used, placing more posterior composites than restorations of dental amalgam. The teaching of PCRs, which is anticipated to increase, will continue to be refined with further developments in adhesive materials, devices, instrumentation, and techniques. CLINICAL SIGNIFICANCE: Graduating dentists can be expected to be familiar with the use of resin composites for the restoration of posterior teeth.

Current and future trends in the teaching of removable partial dentures in dental schools in Malaysia: A cross sectional study.

AIMS: To investigate, using a validated questionnaire, the teaching of removable partial dentures (RPDs) in dental schools of Malaysia. MATERIALS AND METHODS: A validated questionnaire to investigating trends in the teaching of RPDs in dental schools in Oceania was emailed (in English version form) to Heads of Restorative/Prosthodontics/course coordinators in the 13 dental schools in Malaysia. Follow-up reminders were sent and participants were given six weeks to complete and return the questionnaire. Data was entered into an Excel spreadsheet and results compiled and analyzed. RESULTS: Completed questionnaires were received from 13 dental school - a 100% response rate. All schools (n = 13) provided a preclinical technical course in RPD design. In most schools (n = 9, 69.2%), course work was supervised by senior lecturers while rest of the institutions made use of associate professor/professors. There were significant differences (p<0.05) between dental schools in terms of the contact hours dedicated to preclinical teaching. Students received an average of 62 h of instruction. Didactic instruction was the primary focus with practical (78 h) and didactic teaching (32 h). All dental schools (n = 13) provided practical surveyor design teaching (8 h). The staff student ratio for formal lectures (1:61), tutorials (1:29) and lab demonstrations (1:12) were recorded. Majority of the schools (n = 11, 84.6%) employed paired teaching in clinical sessions. All schools (n = 13, 100%) emphasized on increased teaching of RPD design and prescription writing in future clinical RPD courses. CONCLUSION: Teaching of RPDs in Malaysia may be considered sufficient and comparable to the teaching in other parts of the world. CLINICAL SIGNIFICANCE: Whilst the teaching of partial dentures at Dental Schools in Malaysia provides the core competencies involved in partial denture design and construction based on sound fundamental, scientific principles they should address the challenges of teaching partial dentures and other areas of dental education including improving working conditions for dental professionals.

The graduate entry generation: a qualitative study exploring the factors influencing the career expectations and aspirations of a graduating cohort of graduate entry dental students in one London institution.

BACKGROUND: Dentistry in the UK has a number of new graduate-entry programmes. The aim of the study was to explore the motivation, career expectations and experiences of final year students who chose to pursue a dental career through the graduate entry programme route in one institution; and to explore if, and how, their intended career expectations and aspirations were informed by this choice. METHOD: In-depth interviews of 14 graduate entry students in their final year of study. Data were transcribed verbatim and analysed using framework analysis. RESULTS: There were three categories of factors influencing students' choice to study dentistry through graduate entry: 'push', 'pull' and 'mediating'. Mediating factors related to students' personal concerns and circumstances, whereas push and pull factors related to features of their previous and future careers and wider social factors. Routes to Graduate Entry study comprised: 'early career changers', 'established career changers' and those pursuing 'routes to specialisation'. These routes also influenced the students' practice of dentistry, as students integrated skills in their dental studies, and encountered new challenges.Factors which students believed would influence their future careers included: vocational training; opportunities for specialisation or developing special interests and policy-related issues, together with wider professional and social concerns.The graduate entry programme was considered 'hard work' but a quick route to a professional career which had much to offer. Students' felt more could have been made of their pre-dental studies and/or experience during the programme. Factors perceived as influencing students' future contribution to dentistry included personal and social influences. Overall there was strong support for the values of the NHS and 'giving back' to the system in their future career. CONCLUSION: Graduate entry students appear to be motivated to enter dentistry by a range of factors which suit their preferences and circumstances. They generally embrace the programme enthusiastically and seek to serve within healthcare, largely in the public sector. These students, who carry wider responsibilities, bring knowledge, skills and experience to dentistry which could be harnessed further during the programme. The findings suggest that graduate entry students, facilitated by varied career options, will contribute to an engaged workforce.

Repair versus replacement of defective composite restorations in dental schools in Germany.

The aim of this paper was to review the current teaching of repairs to direct composite restorations in dental schools in Germany, last surveyed ten years ago. Based on an 83% response rate, the findings indicate that most, but not all, dental schools included teaching of repair techniques; however marked variations were found to exist regarding clinical indications and repair techniques of the teaching. It is suggested that certain aspects of the existing teaching in some schools should be reviewed, specifically the lack of use of a bonding agent and the issue of flowable composites to complete repairs.

Defective dental restorations: to repair or not to repair? Part 2: All-ceramics and porcelain fused to metal systems.

UNLABELLED: With the increasing use of ceramics in restorative dentistry, and trends to extend restoration longevity through the use of minimal interventive techniques, dental practitioners should be familiar with the factors that may influence the decision either to repair or replace fractured metal-ceramic and all-ceramic restorations and, also, the materials and techniques available to repair these restorations. This second of two papers addresses the possible modes of failure of ceramic restorations and outlines indications and techniques in this developing aspect of restoration repair in clinical practice. CLINICAL RELEVANCE: The repair of metal-ceramic and all-ceramic restorations is a reliable low-cost, low-risk technique that may be of value for the management of loss or fracture of porcelain from a crown or bridge in clinical practice.

Defective dental restorations: to repair or not to repair? Part 1: direct composite restorations.

UNLABELLED: The presentation of patients with failing dental restorations that exhibit minor defects is a common clinical situation in everyday dental practice. The repair of such restorations, rather than replacement, is increasingly considered to be a viable alternative to the replacement of the defective restoration. This first of two papers considers indications and techniques for the repair of defective direct composite restorations. It is possible that some dental practitioners are unaware of the option of repair rather than replacement of composite restorations. This article provides an overview of contemporary knowledge and understanding of restoration repair in the clinical management of defective composite restorations. CLINICAL RELEVANCE: A sound understanding of the indications, benefits and techniques of direct composite restoration repair could allow the longevity of the existing restoration to be extended without unnecessarily sacrificing healthy tooth structure.

Influence of dental college funding and time established on the satisfaction of dental graduates with their undergraduate experience in Saudi Arabia.

OBJECTIVE: With the emergence of graduates from all government and private-funded dental colleges in Saudi Arabia (SA), it is pressing to explore the graduates' satisfaction with the dental undergraduate education and training they received. The aim of the present study was to investigate the graduates' satisfaction with their education and training according to college funding arrangements (government vs private-funded) and time since establishment (established- >15 years vs new-<15 years). METHODS: A piloted, electronic questionnaire was emailed to all the members of the Saudi Dental Society who had graduated from government and and private dental colleges in SA (2,185 registrants). RESULTS: The response rate was 36.4%, with 580 government-funded college graduates (72.9%) and 216 private college graduates (27.1%) having completed and returned the questionnaire. The distribution of participants between established and new colleges was 'established' 396 (49.8%) and 'new' 400 (50.2%). Levels of dissatisfaction were recorded for graduates from established and new, government-funded and private colleges. The levels of dissatisfaction were greater amongst the graduates of established and government-funded colleges. CONCLUSION: The findings of the present study indicate concerning levels of dissatisfaction with important aspects of dental education in SA. It is suggested that there is a pressing need for more integration of basic and clinical sciences and an emphasis on hands-on training. National coordination of arrangements for dental curricula could make a major contribution to addressing the problems identified.

A nationwide survey assessing the satisfaction of dental colleges graduates with their undergraduate experience in Saudi Arabia.

OBJECTIVE: To date, there are no publications on the Saudi graduates' perceived value of their dental curriculum. The aim of this nation-wide survey was to investigate graduates' satisfaction with specific disciplines of their dental education and training. The first part of this study addressed findings according to the respondents' gender and the number of years of postgraduate experience (Graduate-related factors). METHODS: An electronic questionnaire was emailed to registrants of the Saudi Dental Society, specifically dental interns, general dentists, and specialized dentists who graduated from private and governmental dental colleges in Saudi Arabia (n = 2185). RESULTS: The response rate was 36.4 %. The number of male respondents was (n = 352, 44.2 %), the remainder being female (n = 444, 55.8 %). The number of recent dentists (≤ 5 years since graduation) was (n = 428, 53.8 %) and experienced dentists (n = 368, 46.2 %). There were statistically significant gender variations in satisfaction levels, and among dentists with different post-graduation experiences. Although male and female dental students are taught similar curriculums and have similar graduation requirements, there were statistically significant differences in various subjects covered. Similarly, recent and experienced dentists reported statistically significant differences in satisfaction in various subjects. CONCLUSION: This study provides graduates' perspectives on the strengths and weaknesses of their dental education in Saudi Arabia. The findings help in curriculum reform and collaborations between the dental colleges nationally. Ultimately this can lead to formulating a national dental accreditation and assessment body. CLINICAL SIGNIFICANCE: The findings of this study provide graduates' perspective on the dental education received in Saudi Arabia. This will help stimulate discussion and collaboration within and amongst the colleges on improving their curriculum in this fast-paced, evolving field of dentistry.

Current and future trends in the teaching of direct posterior resin composites in Malaysian dental schools: a cross-sectional study.

OBJECTIVE: To investigate the current and future teaching of posterior composite restorations in undergraduate curricula in Malaysian dental schools. METHODS: A 24-item validated questionnaire including closed and open questions on the teaching of posterior composites was emailed to faculty members in all 13 Dental Schools in Malaysia. Responses were compiled on Excel and analysed. RESULTS: All 13 dental schools responded to the survey yielding a 100 % response. All schools indicated the use of posterior composites for 2- and 3-surface cavities in premolars and molars. The didactic teaching time devoted to composites was greater than for amalgam (38 h vs 29 h). Clinically, most posterior restorations placed by students were composites (average 74.1 %, range 10 %-100 %); the remaining 25.9 % were amalgams (range, 0 %-50 %). Slot-type cavities were the preparation techniques most commonly taught (n = 11,84.6 %). The use of rubber dam for moisture control was mandatory in most schools (n = 11, 84.6 %). History of adverse reaction to composites was found to be the most common contraindication to composite placement. The phase down of teaching and use of amalgam in Malaysia is expected to occur within the next six years. CONCLUSION: The trend to increase the teaching of posterior composites reported for other countries is confirmed by the findings from Malaysian dental schools. Notwithstanding this trend, the use of amalgam is still taught, and future studies are required to investigate the implications of the phase down of amalgam in favour of posterior composites. CLINICAL SIGNIFICANCE: Notwithstanding the increase in the teaching of posterior composites there is a pressing need to update and refine clinical guidelines for the teaching of posterior composites globally.

Contemporary teaching of posterior composites at dental schools in Austria, Germany, and Switzerland.

OBJECTIVE: To investigate current teaching and operative techniques for posterior composite resin restorations in dental schools in Austria, Germany, and Switzerland. METHODS: Data on teaching, including operative techniques applied in the placement of posterior composites, were collected by means of a 25-item validated questionnaire sent to the Heads of Department of Operative/Restorative Dentistry at all 38 dental schools in Austria, Germany, and Switzerland. Responses were compiled in Excel and analysed. RESULTS: Thirty-three schools responded to the survey, resulting in a response rate of 87 %. All dental schools indicated teaching of 2- and 3-surface posterior composite restorations. About one third only of the preclinical teaching is assigned to teaching posterior composite restorations, while the vast majority of posterior restorations placed by students in their clinical instruction are composite (89.6 ±â€¯9.3 %). Most dental schools teach few contraindications to posterior composites, except for adverse reactions such as allergies. All dental schools consider moisture control to be important, while approaches to the management of exposed dentine differ. CONCLUSIONS: The teaching of the placement of posterior composite restorations is common to all the dental schools in Austria, Germany, and Switzerland which participated in the present study. Most aspects of the teaching were found to be consistent amongst the schools. However, marked variations were observed in respect of operative techniques for the placement of posterior composites. CLINICAL SIGNIFICANCE: Graduates from dental schools in Austria, Germany, and Switzerland may be found to have received theoretical, preclinical, and clinical instruction in posterior composites, but do show some variation in approach to the management of exposed dentine.

Effects of toothbrushing on surface characteristics of microhybrid and nanofilled resin composites following different finishing and polishing procedures.

OBJECTIVES: To evaluate the effects of simulated tooth brushing (STB) on the surface roughness of microhybrid and nanofilled resin composites following different finishing and polishing procedures. MATERIALS AND METHODS: Ninety cylindrical-shaped specimens of Filtek Supreme XT (a universal nano resin composite) and Filtek Z250 (a universal microhybrid resin composite) were prepared. The specimens were allocated at random into 9 paired groups each of 10 specimens. The finishing and polishing systems included were Tungsten Carbide bur (TC); Diamond bur (Db); Sof-Lex discs (S); PoGo discs (PG); TC + S; Db + S; TC + PG; Db + PG. Polymerisation against a Mylar strip without finishing and polishing acted as the control. Surface roughness was measured using a 3D non-contact optical profilometer and surface morphology was examined by scanning electron microscopy. Specimens were subjected to the equivalent of four years STB and surface roughness was measured again. RESULTS: Mylar formed surfaces were the smoothest for both composites before and after STB. Finishing with the diamond finishing bur caused significantly greater surface irregularity (p < 0.0001) before and after STB compared to the tungsten carbide bur. The surface treatment with Db + PG resulted in significantly greater surface roughness following STB than all other regimes of finishing and polishing (p < 0.01). CONCLUSION: Where indicated clinically, finishing is better conducted using a tungsten carbide bur rather than a diamond finishing bur. The combination of tungsten carbide bur/Enhance PoGo and tungsten carbide bur/Sof-Lex surface protocols produced a similarly smooth finish for both composites. The composite surfaces in all groups increased in surface irregularity following STB. CLINICAL SIGNIfiCANCE: Whilst finishing using a tungsten carbide finishing bur followed by either the Sof-Lex or PoGo polishing system may be found to result in a smooth surface finish, all the surfaces investigated increased in surface roughness following toothbrushing.

The emerging dental workforce: long-term career expectations and influences. A quantitative study of final year dental students' views on their long-term career from one London Dental School.

BACKGROUND: Research into the motivation and expectations of the emerging workforce and their short-term expectations has already been reported with a view to informing professional and policy decisions. The objective of this component of the research programme was to examine the long-term goals and perceived influences on final year dental students' professional careers. METHODS: Univariate analysis of a self completed questionnaire survey of all final year dental students from King's College London, comprising questions on demography, long-term career goals and influences, proposed commitment to dentistry, commitment to healthcare systems and the influences thereon. Statistical analysis included Chi Squared tests for linear association. RESULTS: Ninety per cent of students responded to this survey (n = 126), the majority of whom were aged 23 years (59%), female (58%) and Asian (70%). Long-term career goals were fairly evenly split between 'dentist with a special interest' (27%), 'primary dental care practitioner' (26%) and 'specialist' (25%), with 19% not certain. Only 60% of total respondents anticipated working full-time in the long-term (79% males cf 52% females; p = 0.00). The vast majority of respondents (> or =80%) identified 'work-life balance', 'financial stability' and 'professional development' as 'important' or 'very important' influences on the number of future sessions. Females were significantly more likely to rate childcare commitments as an important influence on their future working capacity compared with males (p = 0.00). A wide range of factors were considered important or very important in making the NHS attractive, led by support for professional development (88%) and feeling valued by patients (88%), as well as funding, time with patients, rewards for prevention and practical issues such as dental materials and premises. Females were significantly more likely than males to be attracted to work within the NHS by 'childcare support' (p = 0.02), 'retraining facilities after career break' (p = 0.01), 'assistance with student debt' (p = 0.01) and 'incentives to work in deprived areas'. CONCLUSION: Long-term career plans of new graduates from this London Dental School commonly embrace opportunities for professional development as well as personal issues such as work/life balance and financial income. Significant differences were identified between male and females long-term plans and influences. The implications of these findings are discussed.

A question of value: a qualitative study of vocational dental practitioners' views on oral healthcare systems and their future careers.

BACKGROUND: New dental graduates in England and Wales spend one year as vocational dental practitioners (VDPs) preparing for independent clinical practice. In recent years, they have entered a state-funded healthcare system undergoing the greatest period of change since the inception of the National Health Service (NHS) and a profession in which there has been a significant shift of care to the private sector. Against this background, the objectives of this study were to investigate VDPs' vision of their future professional career and the influences that will impact on their choice of state-funded (NHS) and/or private dentistry, and to identify what factors may attract graduates to work for the NHS. METHODS: In 2004/2005, purposive sampling of a range of VDP training schemes across England and Wales was used to select the VDPs from ten schemes to take part in focus groups. To standardise data collection, a topic guide was used. Respondents' views were recorded on tape and field notes. The data were transcribed and analysed using framework methodology. RESULTS: Ninety-nine VDPs from all parts of England and Wales participated in ten focus groups. They identified three main categories of future practice: private, state-funded (NHS), and mixed. Private practice was perceived as providing 'professional independence', 'financial reward', 'time with patients' and 'clinical freedom'. NHS practice was associated with 'providing access to specialist training' and 'gaining clinical experience', often as preparation for private practice. Providing NHS care was attractive for VDPs who valued the ethos of public service. The VDPs considered that NHS practice could be made more attractive to young dentists by a range of factors, involving the funding, culture and philosophy of the system and the degree of fit with their personal and professional vision. They reported that they would welcome 'incentives to work in areas of high need', 'assistance with debt' and a 'culture of valuing NHS dentists'. CONCLUSIONS: The findings suggest that the commitment to healthcare systems of the VDPs who took part in this study was associated with being true to their values and being valued within the system. They perceived a tension between state-funded and private practice, considering the latter more likely to meet personal and professional expectations. However, they remained open to working in an enhanced and supportive state-funded system, should it correspond with their values, and demonstrate that they were valued healthcare professionals.

Trends in dental education in the Persian Gulf--an example from Iran: contemporary placement of posterior composites.

In recent years, there has been expansion of dental education programmes from established European and North American schools into regions in the Middle East, the Persian Gulf States, and Asia. Accompanying this, there has been migration of dentists from these regions of the world to Europe and North America in the hope of finding employment or to pursue postgraduate education. Little awareness exists, however in western countries on the amount and level of clinical training provided in dental schools in which these dentists have trained. The aim of this paper is to investigate the teaching to undergraduate students in Iran of an important aspect of clinical dentistry which is showing continual development in western schools, namely the use of resin-based composites in the restoration of posterior teeth. In 2008, a questionnaire seeking information on the teaching of posterior resin-based composites was distributed by email to the person responsible for delivering teaching of operative dentistry in each of the 18 dental schools with undergraduate dental degree programmes in Iran. All 18 schools teach the placement of occlusal and occlusoproximal resin-based composite restorations in premolar and permanent molar teeth. Resin-based composites currently account for 42% of posterior direct restorations placed by undergraduates in Iran. Despite variations between dental schools being noted in the teaching of certain techniques for posterior resin-based composites, the overall extent and content of teaching of posterior resin-based composites in Iran could be described as comparable to that observed in western countries.

Dentists of the Future.

Changes in social structure and advances in technology will influence oral healthcare and the dental workforce. The Council of European Dentists (CED) acknowledges distinct differences between existing dentists and dentists of the future, identifying skills and competencies necessary to make the dentist of the future fit for purpose. These skills and competences are discussed in the context of the profile of the dentist of the future, highlighting the need to review arrangements for the recruitment and retention of future dental workforce.