Expanding the functions of dental assistants in Bulgaria and perceptions about their role in the Bulgarian healhcare workforce.

AIM: The study queries a sample of dentists and dental assistants in Bulgaria about their understanding and perceptions of Expanded Function Dental Auxiliaries (EFDA). The study considers whether expanding the skillset of dental assistants to function in specific scenarios without personal supervision by the dentist may be a viable strategy to address various oral health inequities in the country. MATERIALS AND METHODS: An anonymous survey was conducted among 103 practicing dentists and 100 dental assistants throughout the country. The questionnaire consisted of 20 questions that probed respondents' understanding about the duties performed by EFDAs and their potential to increase productivity and efficiency of the dental workforce. Sociological (poll) and statistical (alternative analysis) methods were used in the survey. RESULTS: The majority of respondents were female. Most worked in the larger cities. One worked in a village. Most were ethnic Bulgarians and none were Roma, reflecting the racial imbalance in the national workforce. Two-thirds (67%) believed that dental assistants with appropriate training are capable of doing expanded dental procedures without personal supervision by a dentist. The majority (83.7%) believed that EFDAs could improve efficiency of a dental practice, while 58.1% indicated that with appropriate training, they could perform expanded duties as well as the dentist. However, only one third believed that EFDAs could increase practice output (38.9%); enhance the quality of the dentist's work (37.4%); or decrease patient anxiety (31.5%). Though most respondents (78.3%) believed that a patient would not be receptive to an EFDA placing a restoration without personal supervision by the dentist, two thirds of respondents (66.5%) would like to see dental assistants trained to perform expanded duties otherwise reserved for dentists. Most respondents felt that EFDAs could help to build a well-functioning dental team. CONCLUSIONS: Most respondents believed that EFDAs can benefit the efficiency of a practice, suggesting that Bulgarian dental professionals would respond favorably to enhancing the skillset of assistants with expanded functions. The study suggests they are skeptical about "general" versus "personal" supervision. EFDAs may potentially provide improved access by underserved communities, while building a more inclusive oral healthcare workforce reflective of the population.

Dental students' knowledge and reporting of child maltreatment: Where are we at today both here and abroad?

INTRODUCTION: The study investigates whether suspected child abuse/neglect (SCAN) training in dental school has increased dental student SCAN knowledge and, consequently, reporting. MATERIALS AND METHODS: A 25-question survey used to assess for SCAN knowledge in 2006 was readministered to a group of dental students at one US dental school in St. Louis, MO, which has integrated SCAN training into its curriculum for at least 3 years, and one dental school in Plovdiv, Bulgaria, which has not integrated SCAN training as a control. RESULTS: Of 16 questions assessing for SCAN knowledge, group US students answered 14 questions correctly and performed better than US students surveyed in 2006. By comparison, group Bulgaria students with no SCAN training answered 15 questions correctly. When asked what their legal responsibilities were concerning SCAN, 96.4% of group US students knew they were required to report, whilst only half of group Bulgaria (48.9%) responded correctly. The results suggest that integrating SCAN training into the curriculum is effective in conveying this important message. However, in a question asking students whether they encountered a child at dental school who they suspected was the victim of child maltreatment and if so, how did they act, there were no indications that students at either school made any reports as the question was either answered "no" or left blank. The number of SCAN cases reported by campus authorities was also zero. CONCLUSION: The results suggest that classroom training in SCAN is not motivating students to report SCAN at their dental school, despite increased knowledge.

SEM analysis of the endodontic cavity wall after removal of restorative materials used as temporary restoration.

AIM: The aim of the present in vitro study was to analyze the endodontic cavity walls for presence of remnants of conventional glass ionomer cement and flowable light cure composite used as temporary restorative materials of endodontically treated teeth. The dentine surface of the access cavity was observed with scanning electron microscopy after the final removal of the temporary restoration using high-speed turbine and diamond bur or ultrasonic device and diamond tip.

An International Survey of Female Dental Students' Perceptions About Gender Bias and Sexual Misconduct at Four Dental Schools.

As women enter the dental profession in increasing numbers in North America and around the world, the questions of how they perceive their environment and what kind of barriers they face are important subjects to be addressed. The aim of this study was to assess and compare women dental students' perceptions of bias in their environment and experiences of sexual misconduct at one dental school in each of four countries. In spring 2017, 1,293 female students at four dental schools in the U.S., Bulgaria, Brazil, and India were invited to participate in a 24-item survey developed by researchers from the four countries; 990 students responded (response rate 76.6%). The overall majority of the respondents reported thinking the admissions process at their school was fair (79.7%); but a fifth of U.S. and Brazilian students perceived their school was not fully embracing of females, with most Bulgarian students agreeing (87.2%) and all Indian students disagreeing. Most respondents overall perceived that male faculty members did not favor male students (79.5%) and did not think there was discrimination against female students by faculty (87.1%), but half of the U.S. respondents reported feeling discriminated against by both male faculty and male students. When the responses "I've been verbally harassed" and "I've been somewhat verbally harassed" were combined, 10.1% of the U.S. respondents reported verbal harassment, compared to 20% of Brazilian, 15% of Bulgarian, and 2% of Indian respondents. When the responses "I've been sexually assaulted" and "I've been somewhat sexually assaulted" were combined, 6% of U.S. respondents reported being sexually assaulted, compared to 6.2% of Brazilian, 2.5% of Bulgarian, and none of the Indian respondents. Almost half (46.9%) of these students overall perceived their school was not or only somewhat vigilant about issues of sexual misconduct, and only 54% said they would feel comfortable or very comfortable reporting misconduct. These results suggest that academic dental institutions in all four countries need improvements to make their environments more equitable and free of bias and sexual misconduct.

A global probe into dental student perceptions about philanthropy, global dentistry and international student exchanges.

BACKGROUND: Training culturally competent graduates who can practice effectively in a multicultural environment is a goal of contemporary dental education. The Global Oral Health Initiative is a network of dental schools seeking to promote global dentistry as a component of cultural competency training. OBJECTIVE: Before initiating international student exchanges, a survey was conducted to assess students' awareness of global dentistry and interest in cross-national clerkships. METHODS: A 22-question, YES/NO survey was distributed to 3,487 dental students at eight schools in seven countries. The questions probed students about their school's commitment to enhance their education by promoting global dentistry, volunteerism and philanthropy. The data were analysed using Vassarstats statistical software. RESULTS: In total, 2,371 students (67.9%) completed the survey. Cultural diversity was seen as an important component of dental education by 72.8% of the students, with two-thirds (66.9%) acknowledging that their training provided preparation for understanding the oral health care needs of disparate peoples. A high proportion (87.9%) agreed that volunteerism and philanthropy are important qualities of a well-rounded dentist, but only about one-third felt that their school supported these behaviours (36.2%) or demonstrated a commitment to promote global dentistry (35.5%). In addition, 87.4% felt that dental schools are morally bound to improve oral health care in marginalised global communities and should provide students with international exchange missions (91%), which would enhance their cultural competency (88.9%) and encourage their participation in charitable missions after graduation (67.6%). CONCLUSION: The study suggests that dental students would value international exchanges, which may enhance students' knowledge and self-awareness related to cultural competence.