Oral health status of older adults in Kentucky: results from the Kentucky Elder Oral Health Survey.

The purpose of the Kentucky Elder Oral Health Survey (KEOHS) was to assess the oral health status of Kentuckians 65 and older. The KEOHS consisted of a self-administered questionnaire and a clinical examination. Recruitment occurred from May 2002 through March 2005 of persons aged 65 and older (n = 1,386) whose functional ability was classified by residential setting. Independent elders living in their own homes were designated as "well-elders," those who lived in skilled nursing facilities and who were functionally dependent were designated as "nursing home elders," and those older adults who were considered frail were designated as "homebound elders." Significant associations were found between the functional ability of the elders and demographic characteristics. While elders who were homebound reported the highest rate of barriers to care, dental insurance, affordability, and transportation were consistently reported as barriers for all groups of elders. This study has established the baseline oral health status of older adults in Kentucky and the data show differences that exist for various community living situations.

Advanced general dentistry program directors' attitudes on physician involvement in pediatric oral health care.

Childhood oral disease is a significant health problem, particularly for vulnerable populations. Since a major focus of General Dentistry Program directors is the management of vulnerable populations, we wanted to assess their attitudes regarding the inclusion of physicians in the prevention, assessment, and treatment of childhood oral disease. A survey was mailed to all General Practice Residency and Advanced Education in General Dentistry program directors (accessed through the ADA website) to gather data. Spearman's rho was used to determine correlation among variables due to nonnormal distributions. Overall, Advanced General Dentistry directors were supportive of physicians' involvement in basic aspects of oral health care for children, with the exception of applying fluoride varnish. The large majority of directors agreed with physicians' assessing children's oral health and counseling patients on the prevention of dental problems. Directors who treated larger numbers of children from vulnerable populations tended to strongly support physician assistance with early assessment and preventive counseling.

CenteringPregnancySmiles: implementation of a small group prenatal care model with oral health.

Preterm/low birth weights are the leading perinatal problem in the U.S., and an association between preterm/low birth weight outcomes and oral health has been identified. In response to this, a group prenatal care program--CenteringPregnancySmiles--was implemented in rural Kentucky in 2006. This report describes the model and preliminary outcomes of the CenteringPregnancySmiles program.

Discovering expectant mothers' beliefs about oral health: an application of the Centering Pregnancy Smiles program.

Research shows expectant mothers with oral infections may have an increased risk for delivering preterm, low birth weight babies. Difficulty accessing dental services, limited resources, and beliefs about dental care put expectant mothers from rural communities at a greater risk for oral health problems, which can have adverse health consequences for themselves and their unborn children. There is a need to better educate these women on proper oral health practices to decrease oral infections and increase the likelihood of delivering healthy babies. Using the Extended Parallel Process Model (EPPM) [1], this study examines the impact of a prenatal program, Centering Pregnancy Smiles (CPS), on changing rural expectant mothers' attitudes and beliefs about maintaining good oral health during pregnancy. Results showed the CPS program had a primarily positive impact on changing expectant mothers' attitudes and beliefs regarding oral health. Implications for educational prenatal programs on oral health in rural areas are discussed.

Advanced general dentistry program directors' attitudes and behaviors regarding pediatric dental training for residents.

The oral health of children became a more prominent concern with the U.S. surgeon general's report on oral health in America in 2000. The purpose of our study was 1) to assess General Practice Residency (GPR) and Advanced Education in General Dentistry (AEGD) (here jointly referred to as advanced general dentistry [AGD] programs) directors' current behaviors with regard to pediatric training of residents and 2) to assess their attitudes about which components of pediatric oral health training should be included in AGD programs. A twenty-one item survey was mailed to all GPR and AEGD programs accessed through the American Dental Association website. Seventy percent of directors (N=187) completed and returned the survey. Responses indicated that AGD residents receive adequate clinical exposure to pediatric patients and provide much-needed services to uninsured, underinsured, and underserved people. Although clinical training in pediatric treatment was high, didactic hours focused on pediatric treatment did not seem commensurate with clinical activity. Program directors indicated strong attitudinal support for teaching residents many components of pediatric oral health care, although most directors have concerns over increasing didactic hours spent on pediatric oral health due to already crowded curricula. Approximately 88 percent of directors said that they would implement a pediatric oral health module in their curricula if they had access to one.

Family medicine residency directors' knowledge and attitudes about pediatric oral health education for residents.

The Surgeon General's report on oral health called for improved education about oral health, a renewed understanding of relationships between oral and overall health, and an interdisciplinary approach to oral health involving primary care providers. This study examined the following: 1) family medicine residency directors' knowledge of preventive dental care, 2) status of an oral heath curriculum in family medicine residencies, and 3) the likelihood of initiating an oral health curriculum. We conducted a fifty-item survey of family medicine program directors emphasizing pediatric oral health assessed demographics, knowledge of preventive procedures, existing oral health curriculum, composition, and time commitment for an oral health curriculum. Directors returned 208 (45 percent) surveys. Approximately 95 percent agreed that oral health knowledge should be a component of residency training. Most programs are teaching anticipatory guidance. The mean time program directors felt should be given to an oral health curriculum was four hours. Program directors lack knowledge of preventive dental procedures and oral health care recommendations. Oral health care knowledge is felt to be an important component of residency training. Program directors need faculty development for a successful delivery of an oral health curriculum.

Physicians' oral health education in Kentucky.

OBJECTIVES: The Physicians' Oral Health Education in Kentucky (POHEK) curriculum was developed to teach family medicine residents to (1) perform oral health screening and risk assessment and (2) recognize and manage common oral conditions for children ages 5 years and under. METHODS: Family medicine residents in urban and rural settings received didactics and hands-on experience providing oral screening, risk assessments, and counseling for their pediatric patients. EVALUATION: Residents were evaluated by comparing pretest and posttest means of surveys that assessed attitudes and knowledge. Chart audits were also performed. CONCLUSIONS: Residents' knowledge and attitudes improved in the oral health care of their pediatric patients.

Service learning in the medical curriculum: developing and evaluating an elective experience.

BACKGROUND: Medical educators are seeking ways to nurture the service commitments of their medical students while promoting interactions with the communities they serve. Service learning is a pedagogy that links community service with academic experience. DESCRIPTION: The University of Kentucky College of Medicine has developed and implemented an experiential service learning elective. The elective is based in local community agencies where small groups of students perform an asset-needs assessment and design a service project based on their findings. The elective is linked to a behavioral science course that provides accompanying biopsychosocial instruction. EVALUATION: Over the 2-year project period, we used multiple methods (i.e., surveys, interviews, reflection questionnaires, evaluations of student performance, and course evaluations) to gather information on the motivations, observations, and assessments of students, faculty preceptors, and community agency partners. CONCLUSION: Linking a service learning elective to a pre-existing course worked well, achieved its objectives, and will be continued

Improving the oral health knowledge of osteopathic medical students.

Due to a complex set of circumstances including culture, poverty, low educational achievement, and limited access to dental care, the oral health of rural Appalachians is poorer than that of people in other parts of Kentucky. Limited health care dollars go to primary medical care which may be the only contact these individuals have with the health care system. Consequently, primary care physicians can help improve oral health. The University of Kentucky College of Dentistry (UKCD) and the Pikeville College School of Osteopathic Medicine (PCSOM) developed an oral health education block for third-year PCSOM students. Eleven UKCD faculty and one PCSOM faculty participated in the two-day, sixteen-hour oral health curriculum. Knowledge retention data from the post-tests was collected four months after the educational program. Students significantly improved their performance in six of the topic areas, with performance staying the same in one area and dropping significantly in one area. Focus groups were conducted with sixteen (two groups of eight) randomly selected students one year after the educational program. Students reported using the knowledge and oral exam techniques included in the course and felt that it was a valuable addition to their curriculum.

How we implemented a service-learning elective.

This paper describes the process used to introduce a service-learning course into the medical curriculum at the University of Kentucky College of Medicine. The rationale for taking the initiative to begin such a project is outlined and curriculum planning considerations are reviewed, including how to identify project team members, choose community agency partners, develop the instructional plan, and define roles and responsibilities of the participants. The importance of understanding the philosophy of service learning and taking time for reflection are underscored. Also discussed are program evaluation issues and strategies are suggested for evaluating service learning, obtaining information relevant to the continuation of the project, and disseminating information about the service learning outcomes.

Phase 1 of a comprehensive course review process: program innovation.

A systematic college-wide course review process can serve as an effective and efficient vehicle for both curricular management and faculty development. The purpose of this paper is to describe Phase I of an evolving course review process at the University of Kentucky College of Dentistry (UKCD). Phase 1 was designed to provide the foundation necessary to ultimately achieve an overall program of continuous evaluation that will produce sustainable curricular improvement and faculty renewal. The course review process includes elements of self-assessment and collaborative peer review. Elements of the current system include emphasis on both the curriculum as a whole and individual course characteristics. It encourages faculty to view their courses as part of the whole and to develop sensitivity to the impact their courses have on other parts of the curriculum. Equally important are the elements that focus on individual course elements and educational methodologies used.

Survey of undergraduate esthetic courses in U.S. and Canadian dental schools.

U.S. and Canadian dental schools were surveyed regarding curriculum issues related to undergraduate dental esthetic restorative courses. A one-page survey instrument was sent to deans of academic affairs (n=59) of dental schools to complete or forward to the most appropriate faculty at their respective schools who would be knowledgeable about the esthetic restorative curriculum. Responses were received from forty-two dental schools (42/59) for a response rate of 72.9 percent. The first part of the survey asked if a specific esthetic restorative course was offered at their school, if it was mandatory or elective, and details of the course length and content. The second part of the survey asked whether selected esthetic restorative procedures were included in the curriculum. Respondents to this survey indicated that most types of esthetic restorative procedures are taught whether or not an esthetic course is included in the curriculum.