Perception of Special Needs Dentistry education and practice amongst Australian dental auxiliary students.

INTRODUCTION: The role of dental auxiliaries in collaborative care of patients with special needs is compelling. This study was undertaken to investigate the perceptions of Special Needs Dentistry (SND) education and practice amongst students enrolled in Australian programmes in dental auxiliary, namely dental hygiene, dental therapy and oral health therapy (DH/DT/OHT). MATERIALS AND METHODS: All Australian institutions offering DH/DT/OHT programmes (n = 14) were invited to participate in a self-administered questionnaire survey, conducted online, involving students across all academic years. Twelve institutions agreed to participate, but only five institutions were included in the final analysis, with a student response rate of 31.1%. Answers to open-ended questions were coded and grouped for measurement of frequencies. Quantitative data were analysed via chi-squared and Fisher's exact tests (significance taken as P < .05). RESULTS: The majority of students could not define SND (87.0%) were not aware of the existence of this specialty (53.5%) and did not have clinical experience treating patients with special needs (68.9%). Nevertheless, they felt comfortable and positive about treating these patients independently. Most agreed that they should receive clinical and didactic education in SND, with many of them expressing interest in pursuing a specialty training in this field. CONCLUSION: DH/DT/OHT students' comfort levels, positive attitudes and supportiveness for SND suggested positive implications for these practitioners to partake in multidisciplinary management of patients with special needs, thus indicating the need for standardised training requirements and practice guidelines in this area of care.

How do educators in one New Zealand undergraduate Bachelor of Oral Health course teach and nurture professionalism?

INTRODUCTION: Research on integrated dental hygiene and dental therapy courses is scarce; studies reporting on how staff in these combined scope courses teach professionalism are even more scarce. This study aimed to partially fill these research gaps. METHOD AND MATERIALS: In 2016, online surveys were sent to 34 staff members who taught into the integrated Bachelor of Oral Health (BOH) course at the University of Otago's Faculty of Dentistry; 13 were returned. Two focus groups were conducted with six BOH educators. RESULTS: Aspects of professionalism were taught and nurtured in the formal curriculum, the clinic and the informal curriculum. In the formal curriculum, policies outlining the professional standards of behaviour expected of oral health practitioners and students in New Zealand and the Faculty were discussed. In the clinic, educators taught professionalism through modelling clinical skills, assessing students' performance and commenting on their reflective logbooks. In the informal curriculum, BOH teachers nurtured professionalism through discussions about standards of behaviour outside of the university. Role modelling was the most common method that participants reported they taught or nurtured professionalism in their students. DISCUSSION: Professionalism is a complex concept that is taught and nurtured in a number of ways over all aspects of the course. CONCLUSION: Oral Health educators need to maintain a high standard of professionalism when interacting with students and patients, as well as in public spaces, in order to model professionalism to their students.

Formative evaluation of a teledentistry training programme for oral health professionals.

INTRODUCTION: The objective of this study was to conduct a formative evaluation of a teledentistry (TD) programme that was developed for a predominantly rural state in the Midwestern United States. MATERIALS AND METHODS: Formative evaluation data were collected on programme activities from the TD programme records. In addition, the effectiveness of the TD training programme was evaluated using a self-administered paper-based survey administered to the participants, immediately following completion of the training activity. Ninety-three dental students, oral health and other health professionals participated in the TD training programme. RESULTS: Overall, the trainees rated the TD training programme highly, with regard to the content, format and skills improvement. The evaluation also demonstrated a positive change in all trainees' attitudes following the training sessions, with most trainees acknowledging a positive impact of the training on their knowledge and competency. DISCUSSION AND CONCLUSIONS: We identified challenges in the development of the TD programme and in expanding access to oral health care for rural communities. Challenges included reimbursement and a limited interest amongst established dental offices. Dental schools can play an important role in preparing both dental health professionals and other health professionals in the use of TD by providing training and oral health expertise. The use of TD by non-dental providers for consultation, referral and disease management has the potential to improve oral health outcomes, particularly for rural and underserved populations. Evaluation data provide critical feedback to programme planners and administrators.

Predictors of academic performance in the discipline specific bioscience paper: A retrospective quantitative study [corrected].

INTRODUCTION: The cohort of students enrolled in the discipline-specific bioscience paper reflects a structural diversity in that it includes students of multiple ethnicities, varied age groups, differing scholastic and life experiences. These divergent identities of students are known to influence academic performance. The purpose of this retrospective quantitative study was to determine the ability of a set of variables such as age, gender, ethnicity, level of prior education, the place from which prior education was obtained, work experience and prior academic achievement to predict academic performance in the discipline-specific bioscience paper. METHOD: The sample for this study was a purposive sample of all oral health students who had enrolled in the paper at the Auckland University of Technology from 2011 to 2014. The desensitised empirical data of 116 students from the University's database were subject to multivariable regression analysis. Pearson's correlation coefficients were calculated. RESULTS: Prior academic achievement was a statistically significant predictor variable (P < 0.001) for the academic performance in the discipline-specific bioscience paper and was also positively correlated (r = 0.641, P < 0.001) to the grades in the discipline-specific bioscience paper. CONCLUSION: Prior academic achievement was the only variable that was demonstrated to be correlated to and predictive of the academic performance in the discipline-specific bioscience paper.

A Workforce Strategy for Reducing Oral Health Disparities: Dental Therapists.

This article seeks to chronicle how dental therapists are being used to bolster the supply of providers for the underserved and explore their potential to diversify the field of dentistry and improve public health. Of the factors that contribute to persistent oral health disparities in the United States, an insufficient oral health workforce figures prominently. A growing number of states are authorizing a midlevel dental provider (often called a dental therapist) to address this problem. Dental therapists work under the supervision of dentists to deliver routine preventive and restorative care, including preparing and filling cavities and performing extractions. They can serve all populations in 3 states, are caring for Native Americans in an additional 3 states under federal or state authority, and are being considered in about a dozen state houses.

Indian Country Leads National Movement to Knock Down Barriers to Oral Health Equity.

Tribal and other underserved communities are struggling under the weight of devastating oral health disparities. Tribes as sovereign nations are searching for innovative solutions to address their unique barriers to oral health care. Dental therapists are primary oral health providers who work as part of the dental team to provide a limited scope of services to patients. They were first brought to tribal communities by the Alaska Native Tribal Health Consortium. Despite strong opposition from the American Dental Association aimed at protecting its monopoly on oral health care, dental therapists are sweeping the nation. Evidence shows that they are effective and provide high-quality care, particularly in underserved communities. A community's ability to develop public health policy solutions tailored to its needs and priorities is essential in eliminating health disparities and achieving health equity. The Swinomish Indian Tribal Community is leading the way to more effective and efficient dental teams and working hard to lay the groundwork for the elimination of oral health disparities.

The Francis Report--Implications for the Education and Training of Dental Professionals.

This paper explores the implications of the Francis Report for education of the dental team. It considers selection of candidates for training, issues relating to the curriculum itself, including assessment and the importance of listening to trainees. The overriding importance of the 'informal' or 'hidden' curriculum, through which students and trainees observe their teachers and develop a sense of the professional and ethical culture within an educational institution, is stressed. Clinical relevance: Sound education, rooted in the recognized ethical principles highlighted in the Francis Report, is essential to the delivery of a dental work force that will deliver care according to the fundamental standards laid down by the GDC.

Oral mucosal screening and referral attitudes of Australian oral health therapists and dental hygienists in Queensland.

OBJECTIVES: The aim of this study was to describe oral mucosal screening and referral attitudes of Australian oral health therapists (OHTs) and dental hygienists (DHs). METHODS: Questionnaires were distributed to participants who attended dental hygiene courses run in both regional and metropolitan Queensland. RESULTS: One hundred and two participants comprised 58 OHTs and 44 DHs, with a mean of 8.9 years since graduation. Thirty-four participants worked in regional locations, while 68 were from metropolitan areas. 97% of participants agreed that mucosal screening should be performed for all new and recall patients, while a minority (5%) agreed that patients will detect an oral mucosal change themselves. The majority (77%) agreed that oral cancer would be encountered in their practising career. Most participants (81%) felt comfortable discussing the presence of a suspicious lesion with patients and 88% agreed that it was their role to screen. In terms of barriers to oral cancer screening, lack of training was seen as the most prevalent barrier (56%) followed by lack of confidence (51%). Lack of time was seen as the third most prevalent barrier (40%), and lack of financial incentives was the least prevalent barrier (16%). CONCLUSIONS: Oral health therapists and DHs understand the importance of oral mucosal screening and are likely to be alert to oral mucosal changes. While lack of time and financial incentives was perceived to be impediments to mucosal screening, lack of confidence and training was the most prevalent barriers. This issue should be addressed through implementation of effective continuing education courses targeting oral cancer screening and referral practices.

Analysis of Nigerian dentists' opinion and consequences on expanded function dental auxiliaries.

OBJECTIVE: To examine Nigerian dentists' opinion on expanded function dental auxiliaries. METHODS: This cross-sectional study of Nigerian dentists attending a dental conference was conducting in 2012 using self-administered questionnaire. The data were analyzed using Statistical Package for the Social Sciences version 16.0. P < 0.05 was considered statistically significant. RESULTS: The majority of the 82 dentists that participated in this study were male, aged 31-40 years, either specialist or specializing (residents), practiced for < 10 years, teaching hospital and urban practitioners. Of the participants, 22 (26.8%) reported favorable opinion towards expanded duty dental auxiliaries. The mean scores on consequences, of expanded function dental auxiliaries ranked redundancy of dentist as highest. Males and non-specialist significantly reported expanded function dental auxiliaries would lead to redundancy of dentists. Practitioners working in other hospitals other than teaching hospital significantly reported that appropriate legislation are necessary before expansion of duties of the dental auxiliaries can be done. The dentists with favorable opinion significantly reported that expanded duty dental auxiliaries would not cause redundancy of dentist and the task are not too difficult for dental auxiliaries with necessary training but will increase service delivery and efficiency, increase job satisfaction, lead to dental auxiliary specialization with legislation. CONCLUSION: Data from this study revealed overall unfavorable opinion of Nigerian dentists on the expanded duty dental auxiliaries. However, those with favorable opinion were significantly supportive of expanded function dental auxiliaries. This information would serve as a useful tool for Nigerian oral healthcare policy formulators.

Dental skill mix: a cross-sectional analysis of delegation practices between dental and dental hygiene-therapy students involved in team training in the South of England.

BACKGROUND: Research suggests that health professionals who have trained together have a better understanding of one another's scope of practice and are thus equipped for teamwork during their professional careers. Dental hygiene-therapists (DHTs) are mid-level providers that can deliver routine care working alongside dentists. This study examines patterns of delegation (selected tasks and patients) by dental students to DHT students training together in an integrated team. METHODS: A retrospective sample of patient data (n = 2,063) was extracted from a patient management system showing the treatment activities of two student cohorts (dental and DHT) involved in team training in a primary care setting in the South of England over two academic years. The data extracted included key procedures delegated by dental students to DHT students coded by skill-mix of operator (e.g., fissure sealants, restorations, paediatric extractions) and patient demography. χ2 tests were conducted to investigate the relationship between delegation and patient age group, gender, smoking status, payment-exemption status, and social deprivation. RESULTS: A total of 2,063 patients managed during this period received treatments that could be undertaken by either student type; in total, they received 14,996 treatment procedures. The treatments most commonly delegated were fissure sealants (90%) and restorations (51%); whilst the least delegated were paediatric extractions (2%). Over half of these patients (55%) had at least one instance of delegation from a dental to a DHT student. Associations were found between delegation and patient age group and smoking status (P <0.001). Children under 18 years old had a higher level of delegation (86%) compared with adults of working age (50%) and patients aged 65 years and over (56%). A higher proportion of smokers had been delegated compared with non-smokers (45% cf. 26%; P <0.001). CONCLUSIONS: The findings suggest that delegation of care to DHT students training as a team with dental students, involved significantly greater experience in treating children and adult smokers, and providing preventive rather than invasive care in this integrated educational and primary care setting. The implications for their contribution to dentistry and the dental team are discussed, along with recommendations for primary care data recording.

Evaluation of a capacity building clinical educational model for oral health clinicians treating very young children.

OBJECTIVE: There are significant levels of dental caries in Australian school-aged children, with children aged five years having a mean dmft of 1.3. It has also been identified that, in general, oral health clinicians lack confidence to treat very young children and this study aimed to increase capacity of public sector oral health clinicians to treat preschool children. BASIC RESEARCH DESIGN: An educational program was developed, implemented and evaluated for its capability to increase the confidence and knowledge of oral health clinicians and dental assistants in providing oral care for children aged 12 months to 5 years. RESULTS: In 2011 and 2012, the course was delivered to 36 clinicians (22 dentists, 12 dental therapists, and two oral health therapists) and showed increases in their confidence and knowledge for participants when providing dental procedures to preschool children. CONCLUSIONS: The educational program that was developed and implemented has met its objective of increasing the knowledge and confidence of practicing oral health clinicians and dental assistants in the management of preschool children. Strategies to further enhance the outcomes of this educational program have been proposed.

Dental manpower in India: changing trends since 1920.

AIM: To analyse the changing trends in dental manpower production of India since 1920 and its development to date. METHODS AND MATERIAL: The databases consulted were those provided by the Central Bureau of Health Intelligence, Dental Council of India, and Ministry of Health and Family Welfare. STATISTICAL ANALYSIS USED: Descriptive statistics. RESULTS: In India, dental education was formally established in 1920 when the first dental college was started. Current data revealed that there are 301 colleges nationwide granting degrees in dentistry, with a total of 25,270 student positions offering annually. Both the distribution of dental colleges and of dentists varies among the regions of the country with the greatest concentration in major urban areas, resulting in limited coverage in rural regions. CONCLUSIONS: The current scenario indicates that there is lack of systematic planning in the allocation and development of dental colleges in India.

Motivation to study dental professions in one London Dental Institute.

INTRODUCTION: While past research has explored dental students' motivation to study, there is limited understanding in the reasons behind career choice for hygienists/therapists and dental nurses. The aim of this study was to investigate simultaneously the views of students of dentistry, hygiene/therapy and dental nursing in King's College London and explore similarities or differences in career choice. METHODS: All first-year students were invited to the questionnaire survey, exploring motivation to study using a 23-item instrument. Data were analysed using SPSS v18; statistical analysis included one-way analyses of variance and factor analysis. RESULTS: The overall response rate to the study was 75% (n = 209). Ten out of 23 factors were considered important by more than 80% of respondents, with 'job security' (93.8%), 'desire to work with people' (88%) and 'degree leading to recognised job' (87.5%) being top three. Analysis suggested that 52% of the total variation in motivating influences was explained by four factors: 'features of the job' (26%), 'education/skills' (11%), 'public service' (8%) and 'careers-advising' (7%); at group level 'features of the job' were significantly more important for the direct entrants to dentistry (P = 0.001). DISCUSSION: The findings suggest that across groups students were motivated to study by common influences reflecting altruistic, but also pragmatic and realistic motives, while 'features of the job' were more important for the direct entrants to dentistry.

Knowledge, attitudes and practices of oral health care workers in Lesotho regarding the management of patients with oral manifestations of HIV/AIDS.

Lesotho has the third highest prevalence of HIV in the world with an estimated 23% of the adult population infected. At least 70% of people living with HIV/AIDS (PLWHA) have presented with oral manifestation of HIV as the first sign of the disease. Oral health workers regularly encounter patients presenting with oral lesions associated with HIV disease and therefore need to have adequate knowledge of these conditions for diagnosis and management. The aim of the present study was to determine the knowledge, attitudes and practices of oral health care workers (OHCW) of Lesotho regarding the management of oral manifestations of HIV/AIDS. A descriptive cross-sectional survey was conducted on all 46 OHCW in 26 public and private care facilities in all ten districts of Lesotho. A self-administered questionnaire was used to gather information. The response rate was 100%. Nearly all (94.7%) agreed that oral lesions are common in people living with HIV and/or AIDS. The majority (91.3%) named oral candidiasis (OC) as the most common lesion found in PLWHA while Kaposi's Sarcoma (KS) (34.7%) and Oral Hairy Leukoplakia (OHL) (32.6%) were mentioned as the least common oral lesions of HIV. Most correctly identified the images of oral candidiasis (97.8%), angular cheilitis (86.9%) and herpes zoster (80.4%). Only 16.7% felt they had comprehensive knowledge of oral HIV lesions, although 84.8% reported having previously received training. Almost three quarters (71%) reported that there was no need to treat HIV positive patients differently from HIV negative patients. OHCW in Lesotho demonstrated high confidence levels in their competence in managing dental patients with oral lesions associated with HIV, however, they lacked an in-depth knowledge in this regard. Amongst this group there is a need for comprehensive training with regards to diagnosis and management of oral lesions of HIV including the training of other cadres of health care workers together with nurses and community health workers.

Advancing the voice of women through doctoral education: Proposed models for dental hygienists and dental therapists.

The increase in scientific knowledge, oral healthcare, new dental hygiene workforce models, and the latest clinical skills, have elevated the need for doctoral prepared dental hygienists and dental therapists. These oral care providers need to be empowered with advanced preparation in education, research, and leadership. Therefore, the purpose of this paper is to present two curricular models for a doctorate of philosophy and a doctorate of oral health practice recognizing that students may have different goals and interests in educational pursuits. The doctoral program models support the conduct of research and scholarship, which supports the research infrastructure of the profession and emphasizes the dissemination of scholarly works. Creation of doctoral programs for dental hygienists and dental therapists provides opportunities to broaden choices and strive for autonomy throughout their careers. These programs may support the development of additional scholars and advanced practitioners who can contribute to the scientific body of knowledge and create policies and pathways to improve population oral health.

An integrated curriculum for dentists and dental therapists in Liverpool.

The role of the dental therapist has evolved over the course of the past 70 years, both in the UK and across the globe. The General Dental Council's Scope of practice guidance sets out the skills and abilities of each of the professional roles within the dental team, including the dental therapist. Scope of practice of the multidisciplinary team remains poorly understood, to the detriment of teamworking. The dental profession is under pressure and the development of a flexible and appropriately trained skill mix might help us adapt to meet the oral health needs of the population, while leveraging a sustainable workforce. In 2019, the School of Dentistry at the University of Liverpool introduced a novel 'centennial curriculum', designed to fully integrate the interprofessional training requirements of dentists and dental therapists, following application via two distinct routes of entry. Challenges have arisen and addressing these has required a culture of openness and honesty regarding the complexities of shared care and scope of practice.

Changes in Bachelor of Oral Health students' perceptions of their dental education environment.

This study used the Dundee Ready Educational Environment Measure (DREEM) to examine how a cohort of Bachelor of Oral Health (BOH) students at the University of Otago's Faculty of Dentistry perceived their educational environment. Four DREEM questionnaires were administered over the three-year programme; a modified version at the beginning of the first year asked students what they expected their year would be like, while questionnaires at the end of each subsequent year surveyed students on their actual experiences within the BOH programme. All four questionnaires were completed by 78% of students (N=31). Overall, the students' perceptions of their educational environment were more positive than negative, and they identified both strengths and weaknesses in the BOH programme. Both positive and negative shifts occurred between the 'Expected' and 'Actual' individual DREEM outcomes. The difference between students' 'Expected' and 'Actual' DREEM responses indicates, in some areas, that BOH students expected more from their educational environment than what they actually experienced. The changes in BOH students' perception of their educational environment over the three years can be explained, in part, by changes in the curriculum from year to year.

Evidence-based prevention: a comparison of oral hygiene advice given by dental and dental care professional students.

AIM: This study aimed to examine the oral hygiene advice given by student dentists and dental care professionals (DCPs), focussing on adherence to evidence-based recommendations provided by the Department of Health and the Scottish Intercollegiate Guidelines Network. METHOD: A self-administered questionnaire was distributed to 121 fourth- and fifth-year dental undergraduates and 38 hygiene/combined dental hygiene and dental therapy students at a UK dental school. RESULTS: Completed questionnaires were returned by 39/64 fourth-year and 36/57 fifth-year dental students and 23/38 student DCPs, an overall response rate of 61.6%. Only 48% (36) of dental undergraduates in comparison with 95.7% (22) of DCP students stated that they would give oral hygiene advice to every adult patient (P<0.001). In addition, only 24 (32%) responding dental students were able to accurately state the recommended fluoride toothpaste concentration for adult use; this contrasts with 18 (78.3%) student DCPs. Dental undergraduates tended to accord less importance to oral hygiene advice when compared with student DCPs, only providing it when they felt it was clinically necessary. CONCLUSIONS: The role of the dental practitioner in providing oral health education requires greater emphasis in the undergraduate curriculum. Given the unfavourable comparison between the attitude and knowledge of dental students and that of DCPs, prequalification training for the dental team should be integrated wherever possible. The apparent lack of awareness of current guidelines is of concern.

Senior dentists' perceptions of dental therapists' roles and education needs in Malaysia.

UNLABELLED: To describe the perceptions of senior dental officers (SDOs) on the roles of dental therapists (DTs) and their education needs in Malaysia. METHODS: A cross-sectional survey was conducted using a self-administered postal questionnaire targeting all 112 SDOs in the Malaysian Ministry of Health. The SDOs were asked about their perceptions of DT's roles in relation to clinical tasks, oral health promotion, administration and the dental team and their perceptions of DT's future education needs. Data were analysed using spss software, version 17 (SPSS Inc., Chicago, IL, USA). RESULTS: The response rate was 60%. A majority of SDOs were women (68%) with a mean age of 44.9 (SD: 8.04). Generally, the majority of SDOs perceived the current roles of DT in non-complex clinical tasks such as examination and diagnosis, preventive treatment, extraction of deciduous teeth and oral health promotion as very important. Fewer than half of SDOs perceived DT's role in the extraction of permanent teeth as important. Most SDOs perceived the need to train DT in 'scaling and polishing for adults' (80.5%), 'delivering inferior alveolar nerve block' (57.3%) and 'pulp therapy' (59.2%). They also had positive perceptions of providing education for DT up to degree level (70.8%). CONCLUSION: This study suggests that Malaysian SDOs have positive perceptions of the current roles of DT and of the expansion of some of their clinical tasks to include broader client groups through further training and education. These findings indicate a need to revise the current curriculum and legislation pertaining to DT's education and scope of practice in Malaysia.