Women in leadership positions in dentistry: A scoping review.

BACKGROUND: The objectives of this scoping review were to calculate the prevalence of women in leadership positions in dentistry, present existing research on gender (male, female) disparities affecting dentistry globally, identify gaps in the literature that can drive future research, and provide recommendations for achieving gender parity in leadership positions. TYPES OF STUDIES REVIEWED: A search of PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Google Scholar, and Cochrane Central Register of Controlled Trials databases was performed using search terms. The search strategies were developed to cover English-language articles from January 2016 through April 2022 that examined the prevalence of women in leadership positions in dentistry. Abstracts, newsletters, qualitative reports, and letters to the editors were excluded. RESULTS: Eighteen studies met all inclusion criteria and were included in the final analysis. Low prevalence was noted of women in leadership positions in dentistry globally. Multiple reasons that have led to gender disparities were identified and recommendations for decreasing gender disparities and achieving gender equity in dentistry were provided. PRACTICAL IMPLICATIONS: Over the years, several factors have contributed to gender inequalities in dentistry. However, during the past decade, gender equity, inclusion, and diversity have been recognized increasingly as core values of the dental profession. Presenting and analyzing all available data surrounding this topic are of paramount importance to start formulating appropriate strategies to achieve gender parity in all areas of dental leadership.

A narrative review of imaging tools for imaging subgingival calculus.

Background and Objective: The conventional method of detecting subgingival calculus involves using a periodontal probe to sense tactile differences on the dental root surface. Although efficient, this method can result in false positives and false negatives. This literature review explores alternative detection techniques that can detect subgingival calculus with improved accuracy and consistency. The accumulation of dental calculus below the gingival margin can foster periodontitis-inducing bacterial growth. Conventional methods of locating subgingival calculus are often inaccurate and highly dependent on clinician skill. This literature review evaluates techniques used to improve the accuracy of imaging and detecting subgingival calculus. Methods: Google Scholar, PubMed and PubMed Central databases were searched for peer-reviewed original articles evaluating subgingival calculus imaging and detection techniques. A total of 46 relevant articles ranging from 1981 to 2021 were included. Key Content and Findings: This narrative review discusses the subgingival calculus detection and imaging capabilities of periodontal endoscopy in an in vivo study and of optical coherence tomography (OCT), fluorescence spectroscopy, and differential reflectometry in in vitro settings. Each technique has unique benefits and limitations that distinguishes it from the others. Conclusions: In vitro studies have revealed that techniques including periodontal endoscopy, OCT, fluorescence spectroscopy, or differential reflectometry allow for a more accurate diagnosis of subgingival calculus deposits in comparison to detection via periodontal probing. Despite the improved results, the common limitations of these techniques include longer operation times and expensive equipment. Further studies are needed to transition these imaging and detection methods to clinical environments.

Role of gender and age in influencing dentist perceptions of effective leadership capabilities.

STATEMENT OF THE PROBLEM: The characteristics of effective leaders in dentistry are unknown, especially as they relate to the perceptions of attributes associated with emotional intelligence. PURPOSE: The purpose of this study was to survey dentists about their perceptions of the relative importance of emotional intelligence domains in effective leadership and in effective leaders with whom they have worked and to determine whether the differences were based on gender and age. MATERIAL AND METHODS: A survey was sent to a list of over 50 000 dentists. The survey asked respondents to rate important qualities found in effective leaders in general and to identify important qualities found in the most effective leaders with whom they had worked or by whom they had been mentored. Additionally, demographic information such as the age and gender of the participants was captured in the survey. Descriptive statistics were created and statistical differences (α=.05) between genders were determined. RESULTS: A total of 256 respondents completed the survey. Self-management and relationship management were perceived to be more important than social awareness or self-awareness. Adaptability was the highest ranked personal competence skill, while conflict management was perceived as the least important personal competence skill. The social competence skills of empathy, organizational awareness, influence, and inspirational leadership were similarly ranked as highly important. When asked to identify the most important leadership skill of previous leaders, respondents noted that conflict management was most important and emotional self-awareness was least important. Women viewed the attributes of adaptability, organizational awareness, and conflict management as more important. Men viewed achievement orientation and coaching or mentoring as more important attributes of leaders. When answers were stratified for age group responses, younger respondents valued relationship management and adaptability, and whether their leader valued and exhibited conflict management more than older respondents. Older respondents were more likely to respond "yes" to valuing self-management and to whether their leader valued and exhibited inspirational leadership. CONCLUSIONS: Different genders and different age groups view leadership skills in effective leaders differently. The results of this study indicate that women may need different leadership skills to lead colleagues of different ages.

Effect of self-reported clinician experience level on perceptions of the relative rankings of risk factors for biological complications with dental implant therapy.

STATEMENT OF PROBLEM: The effect of clinician experience on the perception of risks for biological complications associated with dental implant therapy is unknown. PURPOSE: The purpose of this study was to determine whether clinician experience levels, as assessed by the number of implants placed and/or restored, as well as by type of clinical experience (restorative/prosthodontic and/or surgical), influence the perception of risk for biological complications with dental implant therapy. MATERIAL AND METHODS: A 10-item survey instrument was developed that asked participants from a convenience sample to rank different risk factors for peri-implant complications in the areas of patient history, clinical findings, and clinician choices and postimplant placement findings. Information about participant experience (number of implants placed and restored and type of experience) was also captured. The Kruskal-Wallis and Mann-Whitney U test statistical analyses were performed to determine the degree, if any, to which the level of clinician experience influenced risk factor rankings (α=.05). RESULTS: Clinicians with more experience viewed the use of selective serotonin reuptake inhibitor (SSRI) medications and clinician inexperience as more important risk factors than did less experienced clinicians. Clinicians with less experience viewed treated moderate or severe chronic periodontitis and thin tissue biotype as more important risk factors than did more experienced clinicians. Clinicians with predominantly surgical experience viewed a heavy plaque index as a more important risk factor than clinicians with predominantly restorative experience. CONCLUSIONS: The data indicate that the level of clinical experience influences how risk factors associated with biological complications of dental implant therapy are viewed by clinicians.

Influence of clinician gender, age, and geographic work location on the relative rankings of risk factors for biological complications with dental implant therapy.

STATEMENT OF PROBLEM: Clinician perceptions of risk factors influencing biologic complications with dental implants are poorly understood but are relevant to how clinicians manage conversations with patients seeking dental implant therapy. PURPOSE: The purpose of this clinician survey was to assess the relative ranking of biologic risk factors with dental implants identified via the history, clinical examination, and clinical decisions and postimplant placement findings. MATERIALS AND METHODS: A 10-item survey instrument was tested, refined, and distributed to past participants of the Future Leaders in Prosthodontics (FLIP) workshop series asking for their opinion on the relative ranking of commonly identified risk factors in the areas of patient history, clinical examination, and clinical decisions and postimplant placement findings. Descriptive statistics and frequency tables were developed to identify age groupings, geographic work location, and gender. Group differences with respect to risk factor rankings were identified by using Kruskal-Wallis H tests, and, if significant, paired comparisons were conducted using the Mann-Whitney U test with adjustments for Type I error (α=.05). RESULTS: Significant differences were found by gender, age, and geographic work location. Women viewed "implant placement in site of previous implant loss" (P=.013) and "treated moderate or severe chronic periodontitis" (P=.021) as having significantly greater relative importance than did men, yet men ranked "implant position closer than 1.5 mm from adjacent tooth" (P=.023), "currently using selective serotonin reuptake inhibitor drugs (SSRI)" (P=.001), and "heavy plaque index (PI>50%)" (P=.023) as having significantly greater relative importance than did women. Significant differences were found by geographic work location of practice with respondents from Australasia viewing "treatment plan includes prostheses that limit access for cleaning resulting in an increase in bacterial load" as having greater relative importance than did respondents from Africa (P<.001) and from South America (P<.001). Respondents from South America viewed "implant lacks 2.0 mm of attached tissue around implants" as having greater relative importance than did respondents from Australasia (P<.002) or Asia (P<.001). CONCLUSIONS: Clinicians viewed the relative importance of risk factors for biologic complications with dental implants differently, and those differences varied by clinicians' age, gender, and geographic location of practice.

Designing the careful and kind clinic: an evidence-based approach.

BACKGROUND: There is evidence that creating a 'healthy workplace' can be of profound importance for clinicians, team members and patients. Yet there have been few papers that have proposed mechanisms to take decades of research and translate this into a practical list of options for leaders and managers to take into account when structuring a clinic based on care and kindness to achieve optimal health. EVIDENCE: We bring together 20 years of scholarship linking care of the caregivers with outcomes for caregivers and patients. The data are used to support both structures and cultures that will result in satisfied and thriving healthcare team members, as well as satisfied and healthy patients. RESULTS: The clinic based on care of the caregivers will be structured to address key aspects of worklife that are known to cause either satisfaction or burnout. Aspects of care, such as time pressure, chaotic environments and worker control of their workplace, will be taken into account in clinical design; organisational culture will be supportive and cohesive, emphasising quality, values and communication. Experiences based on gender and race will be measured and continuously improved; and performance will be evaluated in a new, human-centred manner. OUTCOMES: The careful and kind clinic will be a remarkable place to work; in contrast to industrialised healthcare, this will be an environment where health can indeed be optimised, for both workers and patients.

Leadership diversity in prosthodontics: Number and percentage of women chief editors of journals publishing prosthodontic science.

STATEMENT OF PROBLEM: The number and percentage of women chief editors of journals publishing prosthodontic science is unknown. PURPOSE: The purpose of this observational study was to calculate and compare the number and percentage of women and men chief editors of journals publishing prosthodontic science. MATERIAL AND METHODS: A list of the dental journals, as ranked by impact factor, was obtained through the Web of Science Journal Citation Reports 2020 using the category "Dentistry, Oral Surgery, and Medicine." Of the 91 journals listed in the Journal Citation Report, 28 published scientific findings related to prosthodontics. The chief editors of these 28 journals were identified, and their gender was recorded. The percentage of women and men chief editors was compared with the percentage of women and men members of the International Association of Dental Research (IADR) and the International College of Prosthodontists (ICP) by using the binomial test (α=.05). RESULTS: Of the 28 included journals, a total of 32 chief editors were identified; of whom, 4 (12.5%) were women and 28 (87.5%) were men. There were 7886 members of the IADR who reported their gender; of whom, 3448 (43.7%) were women. There were 906 members of the ICP; of whom, 248 (27.5%) were women. Compared with the percentage of women and men members of the IADR and ICP, women chief editors were significantly underrepresented (P<.001 and P=.039, respectively). CONCLUSIONS: The number and percentage of women chief editors of journals publishing prosthodontic science is of concern.

Gender diversity and senior leadership in academic dentistry: Female representation at the dean position in the United States.

PURPOSE/OBJECTIVES: The purpose of this study was to calculate the male to female dean ratio in the US dental schools, assess whether the dean's gender is affected by specific school characteristics (such as geographic location or class size), and determine whether the dean's gender affects the percent of women in the school leadership team. METHODS: Each US school's website was reviewed to capture the name and gender of each dean and others holding assistant, associate or vice dean positions. All data were entered in an Excel database (Microsoft Excel 2016) and analyzed using a statistical analysis software program (IBM SPSS Statistics, v26; IBM Corp). The level of significance was set to α = 0.05. RESULTS: The male to female dean ratio (approximately 5:1) differed significantly from the hypothesized ratio 1:1 (z = 5.22, p < 0.001). Mean class size (χ2  = 0.869, p = 0.351) and school funding source (χ2  = 0.430, p = 0.512) did not differ between schools with a male versus female dean. The percentage of women in the school's leadership team was higher in schools with a female dean (U = 151, p = 0.004). CONCLUSIONS: In the US dental schools, there is one female dean for every five deans who are male, indicating underrepresentation of women at the highest role in academic leadership. Schools with female deans tend to have more women in other administrative roles as well. Change is needed in order to promote equity, diversity, and inclusion in academic dentistry.

Leadership diversity in science: Women editors of dental journals are underrepresented compared to women editors of medical journals.

OBJECTIVES: Increasing numbers of women are entering dentistry and medicine and it is anticipated that global leadership positions represent this demographic. In this study, the proportion of women editors of prominent medical and dental journals was compared. METHODS: A list of dental and medical journals, ranked by impact factor, were obtained through Web of Science Journal Citation Reports 2020. Chief and associate editors of these journals were identified as either a woman or a man. RESULTS: Ninety one dental journals had 100 editors, 15 of whom were women. There were significantly less women chief editors than men (p < 0.0001) compared to the percentage expected (global proportion of women and men dental scientists [IADR] membership: 43.72% women). Of ninety one comparable medical journals ranked by impact factor, there were 103 chief editors, 41 of whom were women. There was no significant difference in the number of men and women chief editors for medical journals (p = 0.242). There were significantly fewer women chief editors for dental journals compared to medical journals (p < 0.0001). There was no significant difference between the mean impact factor for journals with women and men editors for dental (p = 0.556) or medical (p = 0.492) journals. For the 91 dental journals, there were a total of 828 associate editors, of whom 638 were men and 190 were women and this difference was significant (p < 0.0001). CONCLUSIONS: The results demonstrate that women in dental research have attained editor positions with less frequency than men indicating the presence of barriers to progress in scientific dental publishing.

Leadership diversity in prosthodontics: Number of women and nonwhite individuals serving as President of selected prosthodontic organizations in the last 20 years.

STATEMENT OF PROBLEM: As a measure of the leadership diversity in prosthodontics, the number and percentage of women and nonwhite Presidents of prosthodontics organizations is unknown. PURPOSE: The purpose of this observational study was to calculate and compare the number and percentage of women and nonwhite Presidents of 10 selected prosthodontic organizations over the past 20 years and to determine whether the number of women and nonwhite Presidents has changed over the time frame of 2000-2019 in comparison to male and white Presidents. MATERIAL AND METHODS: The number of women and nonwhite Presidents of the Academy of Prosthodontics (AP), American Academy of Fixed Prosthodontics (AAFP), American Academy of Maxillofacial Prosthetics (AAMP), American College of Prosthodontists (ACP), American Prosthodontic Society (APS), European Prosthodontic Association (EPA), International Association of Dental Research - Prosthodontics group (IADR-P), International College of Prosthodontists (ICP), Greater New York Academy of Prosthodontics (GNYAP), and Pacific Coast Society for Prosthodontics (PCSP) was recorded. The chi-square test was used to determine differences in the percentage of women and nonwhite Presidents over time and between organizations. RESULTS: The range of women Presidents in the selected years was 20% (EPA) to 0% (APS) with a mean of 10%. No statistically significant differences over time and between organizations were observed. The range of nonwhite Presidents in the selected years was 25% (ICP) to 0% (AAFP, AAMP, ACP, and GNYAP) with a mean of 7.5%. No statistically significant difference over time was observed while a statistically significant difference between organizations was observed (P=.015). Multiple comparisons revealed the ICP had significantly more nonwhite Presidents in the selected years. CONCLUSIONS: The relatively low numbers of women and nonwhite Presidents in the organizations studied is compelling evidence that there are an insufficient number of women and nonwhite role models in prosthodontics and that important voices representing the diversity of members of the prosthodontic community remain unheard.

Single versus splinted short implants at sinus augmented sites: A systematic review and meta-analysis.

OBJECTIVE: This review primarily evaluated the success, survival and failure rates of implants shorter than 10 mm restored with single-unit or splinted fixed dental prostheses in maxillary sinus augmented sites. MATERIAL AND METHODS: Two reviewers independently performed the systematic search of electronic databases, including MEDLINE, EMBASE and CENTRAL, up to September 2019 with no language restriction. A supplemental hand search consisted of screening 13 journals. The inclusion criteria were: primary studies reporting implant, prosthetic and patient-reported outcome measures (PROMs) of extra-short and short implants placed in conjunction with sinus floor elevation in partially dentate patients, restored with single- and splinted-crowns for direct comparison, with a minimal 1-year follow-up. Weighted arithmetic mean (WAM) of the implant survival was performed according to the type of prosthesis. This was confirmed by using Review Manager software to perform meta-analysis. RESULTS: Two observational studies reporting on 106 tapered, press-fit, sintered porous-surfaced implants with a length ranging from 5 mm to 9 mm were included in this systematic review. Of these, 20 and 86 implants were restored with single and splinted prostheses, respectively. The risk ratio (RR) was 1.16 (95% CI: .31-4.30, p = .58, I² = 0%) for individually restored implants failure when compared to splinted implants, indicating that short dental implants restored with single crowns could have a 16% higher possibility of failure if compared to implants with splinted crowns. The heterogeneity value was not statistically significative (p = .58). No statistical difference in the implant survival rate of the two types of analysed prostheses was observed after WAM (p= .923). The level of evidence for the included studies ranged from low (4) to fair (2B). CONCLUSION: Similar clinical outcomes up to a 9-year follow-up were observed in single and splinted porous-surfaced implants shorter than 10 mm located in sites with sinus lift. However, the conclusion shall be interpreted with caution due to the level of evidence and limited number of included studies included in this systematic review.

Leadership diversity in prosthodontics: Recommendations for the representation of women speakers at scientific prosthodontic meetings.

STATEMENT OF PROBLEM: Leadership platforms in the professions include invitations to speak at the meetings of major organizations. However, the percentage of women speakers at prosthodontic meetings is lower than that of women prosthodontists overall. Recommendations or reporting requirements to address this deficiency are lacking. PURPOSE: The purpose of this observational study was to determine the probability of the number of women speakers at any scientific meetings of 6 different prosthodontic organizations over the past decade occurring by chance alone and to make recommendations for scientific program committees and organizations regarding the number of women speakers at future meetings. MATERIAL AND METHODS: The number of men and women speakers at the 2009-2018 annual meetings of the Academy of Prosthodontics (AP), American Academy of Fixed Prosthodontics (AAFP), American College of Prosthodontics (ACP), American Prosthodontic Society (APS), Greater New York Academy of Prosthodontics (GNYAP), and Pacific Coast Society for Prosthodontics (PCSP) was recorded. The chi-square test was used to determine differences in the percentage of women speakers over time and between organizations. The BINOM.DIST function was used to calculate the probability of selecting the exact number of women speakers at each meeting (α=.05). RESULTS: The mean percentage of women speakers across all organizations and all years was 10.80%. The percentage ranged from 0.00% (AAFP 2013; ACP 2013; APS 2012, 2015; GNYAP 2009, 2014; and PCSP 2009, 2010, 2011) to 42.86% (AP 2013). No change in women speaker presence was observed over the time frame investigated. The AP had significantly more women speakers than the other organizations. Of the 60 meetings included, 25 meetings had a statistically significantly low number of women speakers, and 1 meeting had a statistically significantly high number of women speakers. CONCLUSIONS: The number of women speakers at the scientific meetings of the organizations analyzed was significantly low and has not changed significantly over the years from 2009 to 2018. There were significantly more women speakers at the scientific meetings of the Academy of Prosthodontics than in the 5 other major prosthodontic organizations over the years 2009 to 2018. A recommendation is made that prosthodontic organizations include more women speakers on scientific programs. Specifically, a minimum of 25% of speakers should be women (rolling 3-year average) or 25% of podium time should be for women speakers (rolling 3-year average).

Leadership diversity in prosthodontics: The number and percentage of women speakers at recent annual scientific meetings of prosthodontic organizations.

STATEMENT OF PROBLEM: Leadership platforms in the professions include invitations to speak at major organization meetings. However, speaker profiles from underrepresented groups at annual scientific meetings of prosthodontic organizations have not been reported. PURPOSE: The purpose of this observational study was to determine the percentage of women invited to speak at selected prosthodontic organization meetings. MATERIAL AND METHODS: The number of men and women speakers at the 2009, 2014, 2015, 2016, 2017, and 2018 annual meetings of the Academy of Prosthodontics, American Academy of Fixed Prosthodontics, American College of Prosthodontics, American Prosthodontic Society, Greater New York Academy of Prosthodontics, and Pacific Coast Society for Prosthodontics were recorded. The chi-square test was used to determine differences in the percentage of women speakers over time and between organizations. RESULTS: A total of 781 speakers in the years 2009 and 2014 to 2018 from the scientific meetings of the 6 prosthodontic organizations reviewed met the inclusion criteria. Of the 781 speakers, 693 (88.7%) were men and 88 (11.3%) were women. No significant differences were noted between organizations nor did the number of women speakers change significantly over time. CONCLUSIONS: The number of women speakers at scientific meetings is lower than that of women prosthodontists and has not changed significantly over the past decade.

Innovative Trends in Implant Dentistry Training and Education: A Narrative Review.

BACKGROUND: The field of implant dentistry education is rapidly evolving as new technologies permit innovative methods to teach the fundamentals of implant dentistry. METHODS: Literature from the fields of active learning, blended learning, augmented reality, artificial intelligence, haptics, and mixed reality were reviewed and combined with the experience and opinions of expert authors. Both positive and negative aspects of the learning methods are presented. RESULTS AND CONCLUSION: The fundamental objectives of teaching and learning remain unchanged, yet the opportunities to reach larger audiences and integrate their learning into active experiences are evolving due to the introduction of new teaching and learning methodologies. The ability to reach a global audience has never been more apparent. Nevertheless, as much as new technology can be alluring, each new method comes with unique limitations.

Leadership education in prosthodontics: Development and impact of the Future Leaders in Prosthodontics (FLIP) workshops.

STATEMENT OF PROBLEM: The effectiveness of leadership education for prosthodontists is unknown. PURPOSE: The purpose of this survey study was to evaluate the self-perceived impact a 2- to 2.5-day leadership education workshop in prosthodontics had on participants' professional, leadership, and management development. MATERIAL AND METHODS: Participants who attended a leadership workshop for future leaders in prosthodontics (FLIP) were surveyed to assess their self-reported improvements in different leadership domains. The survey was administered to 89 participants using an online survey tool, and demographic data about participants were also collected. Results were tabulated for descriptive presentation. Where applicable, the Spearman correlation coefficients were calculated. RESULTS: Seventy-two individuals responded to the invitation for a response rate of 80.9%. Improvement in all 11 leadership capabilities assessed in the survey was noted by over 75% of respondents. Over 90% of respondents reported improvement in overall leadership, career management, team management, self-awareness, problem-solving, and conflict resolution. No significant (P>.13) relationships were found among demographic data such as age, sex, home continent, or primary career focus (academics or private practice). CONCLUSIONS: Within the limitations of this survey study, participants in a leadership workshop noted improvement in a variety of leadership capabilities.