Flowcharts improve periodontal diagnosis by dental and dental hygiene students.

Background: In 2017, the American Academy of Periodontology and the European Federation of Periodontology updated the classification of periodontal and peri-implant diseases and conditions. The goal of the present crossover study was to develop straightforward, illustrative flowcharts and determine their impact on the accuracy and speed of diagnosing periodontal conditions by predoctoral dental students (DS) and dental hygiene students (DHS). Methods: Two flowcharts (a decision-tree flowchart and one based on the periodontal disease/condition entity) were developed using updated diagnostic determinants proposed by the 2017 classification. A total of 26 second-, third-, and fourth-year DS (DS2, DS3, and DS4, respectively) and second-year DHS (DHS2) took a mock examination consisting of 10 periodontal clinical cases. The participants first diagnosed periodontal conditions using only their curricula-based knowledge (control) and then using the flowcharts (test). They also completed an optional post-examination questionnaire to provide feedback on the flowcharts. Statistical significance was detected at p ≤ 0.05. Results: Combined test groups had significantly higher accuracy in diagnosing periodontal conditions compared to controls (73.5% vs 50.0%, respectively), with the most substantial improvement in DS2 (66.3% vs 30%, respectively) and DHS2 (70.0% vs 41.4%, respectively). Combined test groups also completed the examination more quickly compared to controls (14.92 vs 20.85 minutes, respectively). The participants provided positive feedback and constructive criticism on the flowcharts, and also suggested converting them into application software. Conclusion: The flowcharts significantly improved the accuracy of diagnosing periodontal conditions in academic settings, especially among junior, less experienced participants.

Contexte: En 2017, l'Académie américaine de parodontologie et la Fédération européenne de parodontologie ont mis à jour leur classification des maladies et des affections parodontales et péri-implantaires. L'objectif de la présente étude croisée était de créer des organigrammes simples et représentatifs et de déterminer leur effet sur l'exactitude et la vitesse de diagnostic des affections parodontales par les étudiants en médecine dentaire, prédoctorat(ÉD) et les étudiants en hygiène dentaire (ÉHD). Méthodes: Deux organigrammes (un organigramme d'arbre décisionnel et un graphique basé sur l'entité de la maladie ou de l'affection parodontale) ont été élaborés à l'aide des déterminants diagnostiques actualisés, comme proposés dans la classification de 2017. Un total de 26 étudiants de deuxième, troisième et quatrième année (ÉD2, ÉD3 et ÉD4, respectivement) en médecine dentaire et des étudiants de deuxième année en hygiène dentaire (ÉHD2) ont passé un examen fictif portant sur 10 cas cliniques parodontaux. Les participants ont d'abord diagnostiqué les affections parodontales en utilisant seulement leurs connaissances fondées sur leur programme d'études (témoins) et en utilisant ensuite les organigrammes (tests). Ils ont aussi rempli un questionnaire optionnel après avoir passé l'examen afin de fournir des commentaires sur les organigrammes. La signification statistique a été décelée à p ≤ 0,05. Résultats: Les groupes de tests combinés avaient une exactitude considérablement plus élevée dans le diagnostic des affections parodontales par rapport aux groupes témoins (73,5 % contre 50,0 %, respectivement), et l'amélioration la plus importante était chez les ÉD2 (66,3 % contre 30 %, respectivement) et les ÉHD2 (70,0 % contre 41,4 %, respectivement). Les groupes de tests combinés ont aussi terminé l'examen plus rapidement par rapport aux groupes témoins (14,92 contre 20,85 minutes, respectivement). Les participants ont fourni des commentaires positifs et des critiques constructives sur les organigrammes et ont aussi suggéré de les convertir en logiciels d'application. Conclusion: Les organigrammes ont considérablement amélioré l'exactitude du diagnostic des affections parodontales dans les milieux d'enseignement, surtout chez les participants débutants et moins expérimentés.

Diversity, cultural sensitivity, unequal treatment, and sexual harassment in a school of dental hygiene.

PURPOSE: The purpose of this study was to assess the cultural environment in the School of Dental Hygiene at the University of Texas Dental Branch (UTDB) at Houston. METHODS: A 36-item questionnaire was developed and administered to first- (DH1; n=34) and second-year (DH2, n=33) dental hygiene students. Questions explored satisfaction with diversity and interactions with faculty, staff, patients, and other students relative to gender, ethnicity/race, age, and sexual orientation. Data were analyzed using 2x3 and 2x5 contingency tables to calculate the chi square test statistic. RESULTS: Ninety-one percent of the 67 DH students responded. While the majority of students reported satisfaction with the cultural diversity and their interactions at UTDB at Houston, 76% of the DH2 students and 62% of the DH1 students reported that the curriculum did not prepare them to work with patients whose primary language is not English. Eighty-two percent of DH1 students and 59% of DH2 students reported that the curriculum did not prepare them to work with patients with different sexual orientations and religious backgrounds. The DH2 students reported unequal treatment by faculty of another gender (24%) and ethnicity (21%), and sexual harassment by other students (6%). DH1 reported 6%, 12%, and 0%, respectively. CONCLUSION: Data indicate that dental hygiene students in the UTDB at Houston dental hygiene program experienced unequal treatment and sexual harassment by either faculty, staff, patients, or other students. To create a more culturally sensitive environment, the students, faculty, and staff could benefit from training on diversity, cross-cultural competence and awareness, and sexual harassment prevention and management. The dental hygiene curriculum should be reviewed for the inclusion of topics related to diversity, cultural competence, and sexual harassment.

Effects of four prophylaxis pastes on surface roughness of a composite, a hybrid ionomer, and a compomer restorative material.

PURPOSE: This study was undertaken to compare the effects of three prophylaxis pastes (Nupro with coarse, medium, or fine pumice) with a new paste (Clinpro with perlite) on the surface roughness of a resin composite (Dyract AP), a hybrid ionomer (Fuji II LC), and a compomer (TPH Spectrum). MATERIALS AND METHODS: Twenty disks (2 mm thick x 10 mm in diameter) of each material were prepared in split molds and stored for 24 hours at 37 degrees C in a 100% relative humidity humidistat. Baseline Mylar surface roughness values were determined. A single operator polished each specimen for 10 seconds with each paste. Five tracings of each specimen of surface roughness (Ra, microm) were made using a surface profilometer. Means and standard deviations were calculated, and analyzed by two-way analysis of variance (three restorative materials and four prophylaxis pastes as factors) and compared using Tukey-Kramer intervals calculated at the 0.05 level of significance. RESULTS: Analysis of variance showed significant differences among restorative materials (after polishing) and prophylaxis polishing agents. Tukey-Kramer intervals for comparisons were 0.04 and 0.05 microm, respectively. All polishing agents produced significant increased roughness compared with baseline, yielding the following results (X + SD, microm) for the three restorative materials (Fuji II LC, TPH Spectrum, Dyract AP): perlite, 0.16 +/- 0.07, 0.28 +/- 0.26, 0.79 +/- 0.64; course pumice, 0.36 +/- 0.17, 0.48 +/- 0.25, 0.88 +/- 0.46; medium pumice, 0.26 +/- 0.10, 0.35 +/- 0.30, 0.46 +/- 0.21; and fine pumice, 0.16 +/- 0.06, 0.34 +/- 0.30, 0.42 +/- 0.24). Fine pumice and perlite produced the least roughness on the hybrid ionomer, medium and fine pumice on the resin composite, and perlite on the compomer. CLINICAL SIGNIFICANCE: Since prophylaxis pastes have the potential to increase the surface roughness of resin composite, hybrid ionomer, and compomer restorative materials, routine polishing during prophylaxis should be avoided.