Methods and timing of curricular integration in U.S. dental education in preparation for the Integrated National Board Dental Examination.

PURPOSE: To characterize methods, timing, faculty training, and barriers pertaining to curricular integration in preparation for the Integrated National Board Dental Examination (INBDE) at U.S. dental schools METHODS: Academic deans at 67 U.S. dental schools were emailed an online survey consisting of questions on the time frame and methods of curricular integration, faculty training, and barriers to curricular integration RESULTS: Approximately 86% of schools have implemented (∼39%) or will implement (∼61%) changes in curriculum in preparation for the INBDE. Curricular integration was completed in 3-4 years in most schools, with those schools with larger class sizes taking longer. While 56% of respondents reported avoiding a complete curricular overhaul, 79% reported course sequencing changes, adding, subtracting, or combining courses, and making some changes in existing courses. Curriculum committees had the most input in curricular changes, while individual instructors had the least influence. Sixty seven percent of respondents reported faculty being trained to teach in an integrated curriculum. Problem/case-based learning and clinical case presentations are being used more for incorporation of biomedical sciences in clinical curriculum; use of clinical examples was the most used mechanism to integrate clinical information in biomedical sciences curriculum. Eighty two percent of respondents indicated that lack of faculty time to prepare courses as the primary barrier for implementing an integrated curriculum. CONCLUSIONS: Our results show that most U.S. dental schools are implementing integrated teaching models to prepare their students for the INBDE. However, lack of faculty time and training need to be addressed for more successful curricular integration.

Mutans streptococci genetic strains in children with severe early childhood caries: follow-up study at one-year post-dental rehabilitation therapy.

BACKGROUND: Genotypic strains of cariogenic mutans streptococci (MS) may vary in important virulence properties. In previous published studies, we identified 39 MS strains from pediatric patients undergoing full-mouth dental rehabilitation, including the removal and/or repair of carious lesions and application of antimicrobial rinse and fluoride varnish. OBJECTIVES: The objectives of this current 1-year follow-up study are to assess the variability of MS strains that occur at 1-year post-rehabilitation and characterize the xylitol-resistance properties of MS strains that predominate. METHODS: Plaque from five children with severe early childhood caries was collected 1-year post-rehabilitation. MS isolates were subjected to arbitrarily primed-polymerase chain reaction (AP-PCR) for identification of genetic strains and in vitro xylitol-inhibition experiments. To more precisely define strain distributions within each patient, we isolated large numbers of isolates per patient. RESULTS: MS strains diminished from several strains pre-rehabilitation, to one dominant strain at 1-year post-rehabilitation, with several new emergent strains. The majority of the clinical MS strains, as well as the Streptococcus mutans laboratory strains ATCC 25175 and 35668, were predicted to undergo 50% inhibition with 2.48-5.58% xylitol, with some clinical MS strains being significantly more resistant in vitro. CONCLUSIONS: Our follow-up study using patients from the original cohort demonstrates that specific MS strains are dominant at 1-year post-dental rehabilitation. Most of the clinical MS strains are similar in xylitol resistance to the attenuated S. mutans ATCC control strains, with some strains being more resistant to xylitol in vitro.