Training healthcare providers to respond to intimate partner violence against women.

BACKGROUND: Intimate partner violence (IPV) includes any violence (physical, sexual or psychological/emotional) by a current or former partner. This review reflects the current understanding of IPV as a profoundly gendered issue, perpetrated most often by men against women. IPV may result in substantial physical and mental health impacts for survivors. Women affected by IPV are more likely to have contact with healthcare providers (HCPs) (e.g. nurses, doctors, midwives), even though women often do not disclose the violence. Training HCPs on IPV, including how to respond to survivors of IPV, is an important intervention to improve HCPs' knowledge, attitudes and practice, and subsequently the care and health outcomes for IPV survivors. OBJECTIVES: To assess the effectiveness of training programmes that seek to improve HCPs' identification of and response to IPV against women, compared to no intervention, wait-list, placebo or training as usual. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and seven other databases up to June 2020. We also searched two clinical trials registries and relevant websites. In addition, we contacted primary authors of included studies to ask if they knew of any relevant studies not identified in the search. We evaluated the reference lists of all included studies and systematic reviews for inclusion. We applied no restrictions by search dates or language. SELECTION CRITERIA: All randomised and quasi-randomised controlled trials comparing IPV training or educational programmes for HCPs compared with no training, wait-list, training as usual, placebo, or a sub-component of the intervention. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures outlined by Cochrane. Two review authors independently assessed studies for eligibility, undertook data extraction and assessed risks of bias. Where possible, we synthesised the effects of IPV training in a meta-analysis. Other analyses were synthesised in a narrative manner. We assessed evidence certainty using the GRADE approach. MAIN RESULTS: We included 19 trials involving 1662 participants. Three-quarters of all studies were conducted in the USA, with single studies from Australia, Iran, Mexico, Turkey and the Netherlands. Twelve trials compared IPV training versus no training, and seven trials compared the effects of IPV training to training as usual or a sub-component of the intervention in the comparison group, or both. Study participants included 618 medical staff/students, 460 nurses/students, 348 dentists/students, 161 counsellors or psychologists/students, 70 midwives and 5 social workers. Studies were heterogeneous and varied across training content delivered, pedagogy and time to follow-up (immediately post training to 24 months). The risk of bias assessment highlighted unclear reporting across many areas of bias. The GRADE assessment of the studies found that the certainty of the evidence for the primary outcomes was low to very low, with studies often reporting on perceived or self-reported outcomes rather than actual HCPs' practices or outcomes for women. Eleven of the 19 included studies received some form of research grant funding to complete the research. Within 12 months post-intervention, the evidence suggests that compared to no intervention, wait-list or placebo, IPV training: · may improve HCPs' attitudes towards IPV survivors (standardised mean difference (SMD) 0.71, 95% CI 0.39 to 1.03; 8 studies, 641 participants; low-certainty evidence); · may have a large effect on HCPs' self-perceived readiness to respond to IPV survivors, although the evidence was uncertain (SMD 2.44, 95% CI 1.51 to 3.37; 6 studies, 487 participants; very low-certainty evidence); · may have a large effect on HCPs' knowledge of IPV, although the evidence was uncertain (SMD 6.56, 95% CI 2.49 to 10.63; 3 studies, 239 participants; very low-certainty evidence); · may make little to no difference to HCPs' referral practices of women to support agencies, although this is based on only one study (with 49 clinics) assessed to be very low certainty; · has an uncertain effect on HCPs' response behaviours (based on two studies of very low certainty), with one trial (with 27 participants) reporting that trained HCPs were more likely to successfully provide advice on safety planning during their interactions with standardised patients, and the other study (with 49 clinics) reporting no clear impact on safety planning practices; · may improve identification of IPV at six months post-training (RR 4.54, 95% CI 2.5 to 8.09) as in one study (with 54 participants), although three studies (with 48 participants) reported little to no effects of training on identification or documentation of IPV, or both. No studies assessed the impact of training HCPs on the mental health of women survivors of IPV compared to no intervention, wait-list or placebo. When IPV training was compared to training as usual or a sub-component of the intervention, or both, no clear effects were seen on HCPs' attitudes/beliefs, safety planning, and referral to services or mental health outcomes for women. Inconsistent results were seen for HCPs' readiness to respond (improvements in two out of three studies) and HCPs' IPV knowledge (improved in two out of four studies). One study found that IPV training improved HCPs' validation responses. No adverse IPV-related events were reported in any of the studies identified in this review. AUTHORS' CONCLUSIONS: Overall, IPV training for HCPs may be effective for outcomes that are precursors to behaviour change. There is some, albeit weak evidence that IPV training may improve HCPs' attitudes towards IPV. Training may also improve IPV knowledge and HCPs' self-perceived readiness to respond to those affected by IPV, although we are not certain about this evidence. Although supportive evidence is weak and inconsistent, training may improve HCPs' actual responses, including the use of safety planning, identification and documentation of IPV in women's case histories. The sustained effect of training on these outcomes beyond 12 months is undetermined. Our confidence in these findings is reduced by the substantial level of heterogeneity across studies and the unclear risk of bias around randomisation and blinding of participants, as well as high risk of bias from attrition in many studies. Further research is needed that overcomes these limitations, as well as assesses the impacts of IPV training on HCPs' behavioral outcomes and the well-being of women survivors of IPV.

Dentists' performance in dentin-composite resin bonding before and after hands-on course learning.

BACKGROUND/PURPOSE: The restoration longevity depends on a high dentin-composite bond quality. This study investigated learning outcomes when using etch-and-rinse and self-etch adhesives among general practitioners in a hands-on bonding test course. METHODS: We recruited 30 general practitioners to perform shear bond strength (SBS) tests using five adhesives: one Peak® Universal Bond (PUB) etch-and-rinse and four Futurabond DC, Single Bond universal (SBU), Versa Optibond (VOB), and Tetric-N Bond Self-Etch (TNS) self-etch adhesives. SBS tests were conducted at pre-demonstration (pre-demo), post-demonstration (post-demo), and 24-h storage (delayed bonding) stages. SBS data were analyzed with paired Student's t-tests. We defined 17 MPa as "qualified bond strength (QBS)". The percentages of samples with SBS achieving QBS were analyzed using Mantel-Haenszel chi-square tests. The fracture surfaces of the samples were examined by scanning electron microscopy (SEM). RESULTS: Using PUB caused no significant differences in SBS between pre- and post-demo samples, whereas the SBS of the two self-etch adhesives (SBU and VOB) improved in post-demo samples (p < 0.05). SBU showed the highest percentage of samples with SBS achieving QBS in all three groups (pre-demo = 70%, post-demo = 83%, and delayed bonding = 76.5%). The QBS percentages of VOB and TNS notably improved from 0% (pre-demo) to 71.4% and 23.5% (post-demo), respectively. SEM indicated bubble-like defects at the dentin-resin interfaces in cases of low SBS. CONCLUSION: Bonding performance is both operator- and product-dependent. The continuing education hands-on course does help dentists to improve the bond strength especially when the self-etch system is used.

Evaluating the Effectiveness of Human Papillomavirus Educational Intervention among Oral Health Professionals.

This study aims to evaluate the effectiveness of an educational intervention that was designed to increase human papillomavirus (HPV) awareness and knowledge among oral health providers (OHPs). HPV educational lectures and a dental information toolkit on HPV were offered to OHPs in New England in 2016-2017. OHPs included dentists and dental hygienists. Post intervention surveys were distributed 1 month later. A total of 230 participants attended the educational lectures and received the toolkit. Descriptive statistics were used to compare the difference in knowledge and preparedness about HPV before and after the intervention. Eighty-nine OHPs completed the surveys. The response rate was 38.7%; however, for each question, the number of responses varied. Fifty-four (54%) (n = 26) of survey respondents were between 55 and 75 years of age with 73.5% (n = 36) being female and 55% (n = 45) working in private practice. Post intervention, 67.5% (n = 27) of the respondents felt more prepared, 82.6% (n = 38) reported clarity of their roles in educating their patients about HPV, and 91.6% (n = 44) reported an increase in knowledge about HPV. The HPV educational intervention was well received and successful at improving self-reported knowledge, comfort level, and preparedness of OHPs in discussing HPV with their patients. OHPs have the great opportunity to educate their patients about HPV and HPV vaccination. Further continuing education efforts may improve OHPs' participation in HPV prevention.

Referral patterns of pediatric dentists and general practitioners to orthodontists based on case complexity.

OBJECTIVE: The objectives of this research were to investigate and compare general and pediatric dentists' subjective judgments of orthodontic case complexity and to determine how their perceptions of case complexity influence their decisions to refer the patient to an orthodontist. METHODS: Twenty pediatric dentists and 21 general dentists participated in the study. Pretreatment orthodontic records of 20 patients with a variety of malocclusions and a range of American Board of Orthodontics Discrepancy Index (DI) scores were used. Respondents were asked about their background and training in orthodontics. They were also asked to identify the subjective complexity of each case with the use of a 100-point visual analog scale (VAS) and whether they would refer the patient to an orthodontic specialist. A mixed-model multivariate data analysis was used to evaluate the subjective case complexity with the use of fixed factors such as DI score, type of panel member, experience, annual continuing education rate, and gender. Generalized linear mixed models were used to investigate the referral patterns of the general dentists and pediatric dentists. Level of significance was set at P < 0.05 for all statistical analyses. RESULTS: General dentists appeared to provide more overall orthodontic treatment than pediatric dentists; many general dentists provide limited orthodontic treatment and clear aligner therapy (P < 0.05). The perceived complexity score for cases was not significantly different between the 2 groups (P = 0.82). The association between DI score and perceived complexity was similar in both groups (P = 0.183) and there was a high correlation between DI and VAS score in the sample (r = 0.71; 95% Cl 0.38-0.87). Pediatric dentists had higher referral rates for cases with DI scores both below and above 20. Significant differences were noted between the pediatric and general dentists in the individual case referral decision as evaluated by the DI (P < 0.037) and VAS (P < 0.042) scores. CONCLUSIONS: General dentists provided more orthodontic care than the pediatric dentists. Both groups identified case complexity similarly, with only minor differences, but pediatric dentists had higher referral rates to orthodontic specialists regardless of the initial case complexity.

Attitudes and knowledge of paediatric dentists' on digital radiography and cone beam computed tomography.

OBJECTIVE: To determine the frequency and reasons of digital radiography and cone-beam computed tomography usage among paediatric dental practitioners, and to assess their knowledge and need for specific education.. METHODS: The cross-sectional study was conducted from January to July 2017 and comprised paediatric dentists present at the European Academy of Paediatric Dentistry Interim Seminar in Turin, Italy, and members of the Turkish Society of Paediatric Dentistry who did not attend the event. Data about sociodemographics and their attitude towards, use of, and knowledge of digital radiography and cone beam computed tomography was collected by means of a 20-item questionnaire that was mailed to all the subjects. SPSS 22 was used to evaluate data. RESULTS: Of the 435 questionnaires distributed, 245(56%) were returned, while 194 (45%) were deemed usable. The mean age of the responding paediatric dentists was 35.84±9.10 (range: 24-67 years) and 126(64.9%) were female. Users of digital radiography identified its advantages, such as lower radiation dose 166(85.7%), ease of image storage 150(77.3%), and the possibility to change image settings and to carry out measurements 106(54.5%). Overall, 70(36%) paediatric dentists had no knowledge of cone beam computed tomography. Dental trauma was cited as the reason for using cone beam computed tomography by 70(61.3%) subjects, dental development issues by 138(71%) and pathology in the jaws by 147(75.8%). CONCLUSIONS: Digital radiography and cone beam computed tomography users are increasing in the world.

Preparation content updating of future dentists to professional interaction.

OBJECTIVE: Introduction: One of the most important indicators of the professional training of future dentists, their competitiveness is the development of professional interaction. The aim of the article is to update the content of the training of future dentists to engage in professional interaction. PATIENTS AND METHODS: Materials and methods: The study, completed during 2015-2018, was attended by 292 students of the specialty "Stomatology". The research uses the following methods: theoretical - analysis, synthesis, systematization and synthesis of scientific literature; empirical - testing, survey, monitoring, pedagogical experiment to find out the effectiveness of the developed content of training future dentists; methods of mathematical statistics. RESULTS: Results and conclusions: For realization of the research purpose it was specially developed a discipline "Professional interaction of dentists" which is aimed at the realization of the tasks: the acquisition of future dentists theoretical knowledge on problems of communication and interaction; increasing the need for communication, implementing a variety of interactions; the formation of future dentists readiness for the implementation of professional interaction, positive communicative attitude to team interaction and receiving satisfaction from it. The program results of the study of the indicated discipline are presented, content of its modules is disclosed. Interactive forms which are used in the process of training future dentists (trainings, business games, problem situations, etc.) and teaching methods (dialogue-discussion, polygon, brainstorming, method of ideas generation, situational dialogues, etc.) are described. The components of future dentist's readiness for professional interaction are developed: motivational, cognitive, operational and personal. The results of the pedagogical experiment, which proved the effectiveness of the implementation of the special course "Professional Interaction of Dentists¼, are presented. Statistical analysis of the results of the study made it possible to establish that after studying the special course in the experimental group there was a noticeable significant increase in the number of students assigned to the high level, in addition, the number of future dentists with a low level was significantly reduced.

Assessment of a training programme on detection of temporomandibular joint osseous changes applying pre-defined 2D multiplane cone beam computed tomography reconstructions.

OBJECTIVES: Osseous changes in temporomandibular joint disorders (TMD) are common indications for cone beam computed tomography (CBCT). The number of such cases is increasing while a number of qualified oral radiologists is limited. This study investigated the usefulness of a training programme for general dental practitioners (GDPs) regarding temporomandibular joint (TMJ) osseous changes detection in CBCT images. METHODS: We selected CBCT images of 35 TMD cases and chose 5 of them to use in training 7 GDPs on detecting osseous changes in the TMJ. In evaluation directly following training, GDPs assessed the 30 remaining cases. Three qualified radiologists served as reference standard. A 2-month follow-up of training comprising evaluation of the same cases. The cases are assessed according to Ahmad et al (Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 107, 2009, 844) protocol of TMJ osseous changes in CBCT images. RESULTS: Sensitivity and specificity of the CBCT protocol were high, except for some criteria that did not appear in the cases. Average observer sensitivity was 65% while specificity was 87%. Average correct individual response rate was 84%. Mean agreement among the GDPs was 73%. Observer performance had improved at the 2-month follow-up. CONCLUSION: The present educational programme could be a helpful material on recognising possible osseous changes of TMJ and it can be used as a part of a training programme for GDP and for specialist candidates.

Pilot Test of Survey to Assess Dental and Dental Hygiene Student Human Papillomavirus-Related Oropharyngeal Cancer Knowledge, Perceptions, and Clinical Practices.

This was the first study to develop and pilot test an assessment tool for the examination of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) knowledge, perceptions, and clinical practices of oral health students. An interdisciplinary team developed the tool using surveys that examined this topic in other populations. The tool was then pilot tested at two different dental programs. Results from the pilot informed revisions to the final version of the tool. Of the 46 student participants, 18 were first-year dental hygiene and 28 were first-year dental students. The majority of participants were female (N = 29, 63%) and ages 18 to 29 years old (N = 41, 89%). Four scales used in the questionnaire were analyzed for reliability. Of these, the HPV and HPV-OPC knowledge and the HPV vaccination knowledge scales had Cronbach alphas of 0.71 and 0.79, respectively. Questions assessing HPV and the role of dental professionals had a correlation coefficient of 0.71. Questions assessing willingness to administer vaccines in the dental office had a correlation coefficient of 0.85. Assessing oral health students' HPV-OPC knowledge, perceptions, and clinical practices are important for future assessment of possible HPV-OPC cases. Dental professionals may be optimally positioned to provide HPV patient education. The tool developed and pilot tested in this study can help schools assess their students' knowledge and guide their dental curriculum to address deficiencies. Since this topic has not been effectively examined with dental health students, the results could help improve dental education and dental care.

HPV-Related Knowledge Among Dentists and Dental Hygienists.

Dental providers, such as dentists and dental hygienists, play an important role in HPV-related oropharyngeal cancer prevention. Dental professional organizations recommend dental providers educate patients about HPV and oral cancers. The objective of this study was to assess HPV knowledge among dental providers. Dentists (n = 36) and dental hygienists (n = 146) attending a professional conference completed a continuing education post-test survey, which included socio-demographics, an HPV knowledge scale, and measure of HPV discussion with patients ("no," "yes," and "yes, but only with some patients"). Chi-square tests, t tests, and ANOVA tests were used for this analysis. Although dental hygienists (35.4%) reported less discussion with patients about HPV than dentists (52.8%), these differences were not significant. The mean knowledge score was 24.7 (SD = 3.8) with no significant differences by profession. Among dentists, knowledge did not significantly differ by discussion category (p = 0.28). In contrast, dental hygienists who did not discuss HPV with patients had significantly lower mean knowledge scores (mean = 23.4) than those who discussed with patients (mean = 26.5, p < 0.01) or discussed only with some patients (mean = 26.0, p = 0.01). Knowledge deficits included outcomes associated with HPV, HPV in men, and curability. Specifically, participants incorrectly answered that HPV can affect a women's ability to get pregnant (81.9%), that one can never get rid of HPV once they have it (69.2%), and that HPV can cause herpes (43.4%). This study identified HPV knowledge deficits among dental providers. Given the recommendation for dental providers to discuss HPV prevention with their patients, additional education and training on this emerging topic may benefit these professionals.

Prevention of HPV-Related Oral Cancer by Dentists: Assessing the Opinion of Dutch Dental Students.

The aim of this study is to assess dental students' opinions of the dentists' role in primary prevention of human papillomavirus (HPV)-related oral cancer using a cross-sectional web-based survey. A questionnaire, containing questions about knowledge of HPV and oral cancer, confidence in head and neck examination and role of the dentist in preventing HPV-related oral cancer, was sent to all students of the Academic Centre of Dentistry Amsterdam (n = 912). One hundred and twenty-six (n = 126) students completed the questionnaire. Significantly, more master students (75%) than bachelor students (54.3%) were aware that HPV is a causative factor for oral cancer. Master students had more knowledge of HPV than bachelor students, but knowledge about HPV vaccination was irrespective of the study phase. The majority of dental students agreed that it is important to discuss HPV vaccination with patients. Eighty-nine percent of the students think that more education about symptoms of oral cancer will increase screening for oral cancer. Development of a protocol for screening in dental practices was considered even more important. According to dental students, dentists should discuss HPV as a risk factor for oral cancer with patients. Future dentists are willing to be involved in both primary and secondary prevention of HPV-related oral cancer. Therefore, screening for oral cancer and education about HPV vaccination should be integral elements of the dental curriculum.

Survey results of currently used techniques and materials by dentists for fabrication of complete removable dental prostheses.

The present study was based on the screening of procedures and materials used by dentists in constructing complete removable dental prostheses, considering their professional background and years of experience. Questions arose regarding differences and similarities within the local dental society, of which approximately 75% were trained in Europeans countries with differences in academic background, and compared to international dentistry. A questionnaire web site was used in order to anonymously collect answers to the survey by general practicing and specialist dentists. The survey contained 28 multiple choice questions that were based on 5 parameters: years of experience, location of dental studies, specialization, location and field of specialization. One hundred one survey sheets were collected. The results show statistical significance (p less than 0.05) for the following comparisons: practicing time had an impact on practitioner-technician interaction, while the level of qualification had an effect on articulator and face-bow usage. Location of dental studies, specialization and residency had impact on final impression materials, teeth set-up as well as tooth shape and color selection. The differences found between dentists’ working techniques set the ground for future research that should focus on rating the success of the different methods towards a goal of creating recommendations for an ideal set of working techniques.

Teledentistry: A Tool to Promote Continuing Education Actions on Oral Medicine for Primary Healthcare Professionals.

BACKGROUND: Difficulties in diagnosis of oral mucosal lesions are a significant cause of delayed oral cancer diagnosis, and this difficulty may be due to gaps in knowledge. This study evaluated the diagnostic skills of primary healthcare professionals regarding oral cancer and presented them with an e-learning course. MATERIALS AND METHODS: Forty-seven primary healthcare professionals (32 dentists and 15 nondentists) enrolled in a 24-h course on oral medicine delivered through an e-learning platform. A test, based on 33 clinical images of oral lesions, was used to evaluate the diagnostic skills of participants. The participants were requested to classify each lesion as benign, potentially malignant, or malignant as well as to inform their clinical impression. Three specialists also took the test as the gold standard. RESULTS: Twenty-seven participants completed the test. Nondentists and dentists showed a comparable sensitivity of 68.8 ± 11.1 and 63.7 ± 15.8, respectively. Specialists performed somewhat better; however, the difference was not statistically significant (81.0% ± 4.1%, p = 0.16). Dentists and specialists (70.0% ± 16.6% and 95.5% ± 3.1%, respectively) showed higher specificity than nondentists (39.3 ± 20.6, p < 0.01). Nondentists had a higher number of unanswered questions (p < 0.01) for classification and clinical impression (50.0% ±45.1% and 72.0% ± 25.0%, respectively) than dentists (5.7% ±11.9% and 19.8% ± 20%, respectively). Both dentists and nondentists had low attendance in the course (44.57% ± 37.38% and 26.53% ± 26.53%, respectively, p = 0.26). To the best of our knowledge, this is the first study to assess the diagnostic skills of public health workers belonging to different professional categories. CONCLUSION: Both dentists and nondentists have a fairly good capacity for discriminating the nature of oral lesions. Early squamous cell carcinoma is the most challenging situation and remains an issue to be addressed.

Understanding continuous professional development participation and choice of mid-career general dental practitioners.

OBJECTIVE: Participating in continuing professional development (CPD) activities is a requirement for dental practitioners to keep their skills and knowledge up to date. Understanding the ways dental practitioners engage with professional development and the impact on practice is not fully known (Eaton et al. 2011, http://www.gdc-uk.org/Aboutus/policy/Documents/Impact%20Of%20CPD%20In%20Dentistry.pdf). The aim of this study was to gain insights into the ways that dentists reflect on their professional development and what may be influencing their choices. METHOD: Empirical qualitative data were collected by semi-structured interviewing of five mid-career dentists. Using grounded theory, the data were analysed for themes about CPD choice and participation. RESULTS: Three themes were identified as influences to dentists' choices of CPD with pragmatic considerations of how new learning could benefit their patients and their practices. Dental practitioners were influenced by the requirements of external regulatory bodies which they did not consider to necessarily improve practice. CONCLUSION: Dentists working in primary care in the UK are undertaking CPD which is influenced by the pragmatic requirements of running a small business and to meet regulatory requirements. In this sample, dentists are not critically reflecting on their education needs when choosing their CPD activity. Protected learning time and organisational feedback and support are recommended as a way to promote more meaningful reflection on learning and to improve professional development.

Child Abuse and Neglect: Do We know enough? A Cross-sectional Study of Knowledge, Attitude, and Behavior of Dentists regarding Child Abuse and Neglect in Pune, India.

INTRODUCTION: Child abuse and neglect (CAN) is a significant global problem with a serious impact on the victims throughout their lives. Dentists have the unique opportunity to address this problem. However, reporting such cases has become a sensitive issue due to the uncertainty of the diagnosis. The authors are testing the knowledge of the dentists toward CAN and also trying to question the efforts of the educational institutions to improve this knowledge for the better future of the younger generation. MATERIALS AND METHODS: Questionnaire data were distributed to 1,106 members regarding their knowledge, professional responsibilities, and behavior concerning child abuse. RESULTS: There were 762 responses to the questionnaire, yielding a response rate of 68.9%. Although dentists consider themselves able to identify suspicious cases, only a small percentage of the participants correctly identified all signs of abuse and 76.8% knew the indicators of child abuse. Most of them were willing to get involved in detecting a case and about 90% believed that it is their ethical duty to report child abuse. Only 7.2% suspected an abuse case in the past. The numbers indicate a lack of awareness about CAN in these participants. No differences were observed between sexes, year of graduation, types of license, frequency at which children were treated, and formal training already received. CONCLUSION: A large proportion of child physical abuse cases go undocumented and unreported. The data showed that not all dental care providers and students were prepared to fulfill their legal and professional responsibilities in these situations. CLINICAL SIGNIFICANCE: There should be modifications in the dental school curriculum focusing on educational experiences regarding child abuse to strengthen their capability to care and protect children.

[Improvement of training quality in continuous medial education of dentists and maxillofacial surgeons]. / Povyshenie kachestva podgotovki spetsialistov-stomatologov i cheliustno-litsevykh khirurgov v sisteme nepreryvnogo meditsinskogo obrazovaniia.

The new concept of continuous medical education is based on individual learning paths of each specialist in conjunction with the use of modern educational technologies, including IT. The aim of this study was to undertake a review of modern methods of health care professionals training in the framework of continuous medical education profile introduced by the Ministry of Health. The paper presents the best IT practices of Central Research Institute of Dentistry and Maxillofacial Surgery in the training of dentists and maxillofacial surgeons aimed for the modernization of medical education.

[Essential questions of training of dentists for accreditation]. / Aktual'nye voprosy podgotovki vrachei-stomatologov k akkreditatsii spetsialistov.

The paper presents sociological study aimed to analyze the conditions and methodological rationale for the basic directions of optimization of accreditation procedure for dentists. The study included 129 graduates of dental faculties of educational institutions of Sechenov First Moscow State Medical University. The material was collected by questionnaire survey and interviewing. The obtained results show that the introduced system of professionals' accreditation is an innovative educational technology allowing objectively assess the level of theoretical and practical training of dentists. Much of its effectiveness depends on the quality of produced and updated on a timely basis uniform base of assessment tools, the selection of the most prepared members for the accreditation commissions and creation of adequate conditions for its implementation in educational and scientific organizations.

Dental opioid prescribing practices and risk mitigation strategy implementation: Identification of potential targets for provider-level intervention.

BACKGROUND: Given the regular use of immediate-release opioids for dental pain management, as well as documented opioid misuse among dental patients, the dental visit may provide a viable point of intervention to screen, identify, and educate patients regarding the risks associated with prescription opioid misuse and diversion. The aims of this statewide survey of dental practitioners were to assess (a) awareness of the scope of prescription opioid misuse and diversion; (b) current opioid prescribing practices; (c) use of and opinions regarding risk mitigation strategies; and (d) use and perceived utility of drug monitoring programs. METHODS: This cross-sectional study surveyed dentists (N = 87) participating in statewide professional and alumni organizations. Dentists were invited via e-mail and listserv announcement to participate in a one-time, online, 59-item, self-administered survey. RESULTS: A majority of respondents reported prescribing opioids (n = 66; 75.8%). A minority of respondents (n = 38; 44%) reported regularly screening for current prescription drug abuse. Dentists reported low rates of requesting prior medical records (n = 5; 5.8%). Only 38% (n = 33) of respondents had ever accessed a prescription drug monitoring program (PDMP), and only 4 (4.7%) consistently used a PDMP. Dentists reporting prior training in drug diversion were significantly more likely to have accessed their PDMP, P < .01. Interest in continuing education regarding assessment of prescription drug abuse/diversion and use of drug monitoring programs was high. CONCLUSIONS: Although most dentists received training related to prescribing opioids, findings identified a gap in existing dental training in the assessment/identification of prescription opioid misuse and diversion. Findings also identified gaps in the implementation of recommended risk mitigation strategies, including screening for prescription drug abuse, consistent provision of patient education, and use of a PDMP prior to prescribing opioids.

A pilot study of dentists' assessment of caries detection and staging systems applied to early caries: PEARL Network findings.

The International Caries Detection and Assessment System (ICDAS II) and the Caries Classification System (CCS) are caries stage description systems proposed for adoption into clinical practice. This pilot study investigated clinicians' training in and use of these systems for detection of early caries and recommendations for individual tooth treatment. Patient participants (N = 8) with a range of noncavitated lesions (CCS ranks 2 and 4 and ICDAS II ranks 2-4) identified by a team of calibrated examiners were recruited from the New York University College of Dentistry clinic. Eighteen dentists-8 from the Practitioners Engaged in Applied Research and Learning (PEARL) Network and 10 recruited from the Academy of General Dentistry-were randomly assigned to 1 of 3 groups: 5 dentists used only visual-tactile (VT) examination, 7 were trained in the ICDAS II, and 6 were trained in the CCS. Lesion stage for each tooth was determined by the ICDAS II and CCS groups, and recommended treatment was decided by all groups. Teeth were assessed both with and without radiographs. Caries was detected in 92.7% (95% CI, 88%-96%) of the teeth by dentists with CCS training, 88.8% (95% CI, 84%-92%) of the teeth by those with ICDAS II training, and 62.3% (95% CI, 55%-69%) of teeth by the VT group. Web-based training was acceptable to all dentists in the CCS group (6 of 6) but fewer of the dentists in the ICDAS II group (5 of 7). The modified CCS translated clinically to more accurate caries detection, particularly compared to detection by untrained dentists (VT group). Moreover, the CCS was more accepted than was the ICDAS II, but dentists in both groups were open to the application of these systems. Agreement on caries staging requires additional training prior to a larger validation study.

Practical Implementation of Evidence-Based Dentistry Into Daily Dental Practice Through a Short Time Dependent Searching Method.

INTRODUCTION: Despite the fact that the benefits of implementation of Evidence-Based Dentistry (EBD) into clinical practice is increasingly being highlighted, there are still clear limitations in its implementation into daily dental practice. One potentially important barrier to effective implementation into practice is the perception of EBD as a time-consuming process. The aim of the present study is to increase the familiarity of dental practitioners with the benefits of different time-dependent 'practical' search strategies important to EBD using a clinical question from the field of dental implantology as an example. MATERIALS AND METHODS: The PICO (population, intervention, comparison, outcome) question used in this study was: "In young adults with anterior single-tooth implant what is the effect of immediate or delayed loading on success?" A bibliographic search according to the Haynes 5S pyramid, together with 3 different time-dependent strategies (5-min, 30-min and more than 60-min), were applied. RESULTS: Both the Haynes 5S Pyramid and time-dependent search strategies revealed promising results for enhancing decision-making for determining the feasibility of immediate or conventional loading of anterior single dental implants. Results clearly showed that selection of the loading protocol would be case (patient)-specific and also indicated high primary implant stability and bone quality as the most important prerequisites for a successful immediate/early loading. From among the 3 different time-dependent strategies (5 min, 30 min and more than 60 min), the 60+ min search results were quite comparable with the Haynes pyramid search results. CONCLUSION: It is likely that the different time-dependent search strategies may have the potential to support the clinical decision making process and may improve the implementation of EBD into daily dental practice. Increased time spent searching naturally seems to increase the extent of this support. However, even with short time-dependent searches, busy dental clinicians may get an improved idea/opinion regarding a clinical question.

[Practical approach to the problem of additional vocational training of dentists]. / Poluchenie novoi (dopolnitel'noi) vrachebnoi spetsial'nosti rabotayushchimi vrachami-stomatologami: prakticheskaya realizatsiya poslediplomnogo obrazovaniya v svete sovremennykh pravovykh realii.

We consider the political and legal features and the possibility of operating a new medical specialty in the light of current legal requirements. The paper presents the review of the most pressing issues of modern law enforcement practices and features of the implementation of the rights and interests of the physician and the employer in terms of the search for a balance of interests and reasonable approach not contradicting to legal norms.