Trends in Generalist and Specialty Advanced Dental Education and Practice, 2005-06 to 2015-16 and Beyond.

This article reviews the data on advanced dental education for the past decade and explores what advanced dental education might look like in the years leading up to 2040, including how its graduates will address the oral health needs of the population. The authors based these projections on published data about advanced dental education collected by the American Dental Association and other organizations. Nevertheless, a certain degree of speculation was involved. The article presents current data and trends in advanced dental education, environmental factors impacting advanced dental education, and lessons drawn from other areas of health care that support the potential scenarios that are described. This article was written as part of the project "Advancing Dental Education in the 21st Century."

SPECIAL FEATURE. PEDIATRIC DENTISTRY.

There are approximately 2 million children living in the state of Michigan who will receive dental care with one of more than 5,500 MDA member dentists. Of these 5,500 MDA members, only approximately 100 are pediatric dentists.(1-3) Thus, it's safe to say that most children will find their dental homes in general dental offices. These general dentists will be providing preventive, diagnostic, and restorative care to most children under most circumstances. And with that in mind, it's of great importance that all dentists be comfortable providing high quality care to the majority of children, referring only a select group for care by a pediatric dentist.

[The rise and development of general dentistry in China].

General dentistry is an important part of the dental medicine and general dentists and general dentistry form the basis of clinical dental medicine. China's general dentistry has a long history, which started as an independent specialist in the 1990s. At present, the Chinese general dental medicine has received more and more attention as an independent profession. General dental medical model has been rapidly developed in the general hospital department of dentistry, private practice and community dentistry institutions, dental specialist hospitals and so on. In this paper, we will review the rise and development of China's general dentistry, and report its theoretical characteristics, institutional framework, academic progress, member development report, and look forward to its development in the future.

Nivel de aplicación del Consentimiento Informado en residentes de la especialidad Estomatología General Integral / Level of application of the Informed Consent in residents of Integrated General Stomatology

Introducción: los avances tecnológicos en el campo de la estomatología han provocado que aspectos de la ética y bioética que regulan la profesión revelen su importancia. Objetivo: determinar el nivel de aplicación del consentimiento informado en la práctica clínica. Método: se realizó un estudio descriptivo y transversal en estomatólogos recién graduados que se encontraban realizando la especialidad en Estomatología General Integral de la clínica estomatológica del policlínico comunitario René Vallejo Ortiz y Hospital Celia Sánchez Manduley de Manzanillo, en el período comprendido de Octubre del 2013 a Abril del 2014. El universo estuvo constituido por 76 residentes y la muestra fue de 70. Resultados: el consentimiento informado no se elabora cumpliendo con los requisitos necesarios, lo realizan de forma verbal, la información brindada a los pacientes no es suficiente porque no ofrecen alternativas de tratamiento con sus ventajas y desventajas, no describe detalladamente los procedimientos a realizar y no advierte de incomodidades previstas. Conclusiones: los residentes de la carrera de estomatología presentan conocimientos sobre el consentimiento informado pero su nivel de aplicación es bajo. Desconocen los beneficios que ofrece el CI, no lo confeccionan con los requisitos indispensables, no brinda información suficiente aunque influye positivamente en las decisiones de los pacientes(AU)

Introduction: the technological advances in the dentistry field have provoked that ethics and bioethics aspects that regulate the profession reveal their importance. Objective: to determine the level of application of informed consent in clinical practice.Method: it was performed a descriptive and transversal study on newly graduated dentists who were carrying out the Integrated General Dentistry Specialty in the Dental Clinic of the Community Polyclinic René Vallejo Ortiz and Celia Sanchez Hospital in Manzanillo, in the period of October 2013 to April 2014. The universe consisted of 76 residents and the sample was about 70. Results: informed consent was not made according to the necessary requirements, it was made verbally, and the information provided to patients was not enough because it did not offer treatment alternatives with their advantages and disadvantages, it did not thoroughly describe the procedures to be performed and it did not prevent the predicted discomfort. Conclusions: residents of the stomatology career do have knowledge about the informed consent but their level of implementation is low. They ignore the benefits offered by IC, because it is not elaborated with the necessary requirements, and it does not provide sufficient information although it influences positively in the decisions of the patients(EU)

Is general dentistry dead? How mid-level dental providers will affect the profession.

The rhetoric concerning mid-level providers and their impact on general dental practice is building in intensity. This is a complex issue and there is no clear picture of either the benefits or dangers to the public of such a delivery model, whether such plans are economically sustainable, or the role of general dentists in the configuration of future practices. The opinions of a representative sample of thinkers from various perspectives are sampled.

A model for dental practice in the 21st century.

The dental profession is responsible for the prevention, diagnosis, and treatment of diseases and disorders of the oral cavity and related structures. Although the majority of the US population receives excellent oral health care, a significant portion is unable to access regular care. Along with proposals to develop midlevel providers, the scope of practice for dentists needs to be reconceptualized and expanded. A broad number of primary health care activities may be conducted in the dental office, such as screening for hypertension, diabetes mellitus, and dermatopathology; smoking prevention and cessation activities; and obesity interventions. More than 70% of adults saw a dentist in the past year, which represents an unrealized opportunity to improve both oral health and general health.

Trends in extraction of permanent teeth in private dental practices in Kerala state, India.

AIM: The aim of the present study was to identify the trends in tooth loss among patients attending four general dental practices in the south Indian State of Kerala. METHODS AND MATERIALS: The reasons for extraction of permanent teeth among patients who had attended the four clinics during a one-month period were categorized as follows: (1) dental caries and their sequelae, (2) periodontal disease, (3) orthodontic, (4) impactions, (5) prosthodontic, and (6) other reasons. RESULTS: A total of 997 permanent teeth were extracted, of which 445 (44.6 percent) teeth were extracted due to dental caries and their sequelae, 331 (33.2 percent) teeth due to periodontal disease, 111 (11.1 percent) teeth for orthodontic purposes, 25 (2.5 percent) teeth due to impactions, 25 (2.5 percent) teeth for prosthodontic purposes, and 60 (6 percent) teeth for other reasons. CONCLUSION: The results of the present study suggest that dental caries and periodontal disease were the two major causes of tooth mortality in this particular patient population. CLINICAL SIGNIFICANCE: This is probably the first study to report on the trends in tooth loss in general practice in India. Similar studies should be conducted in other regions of the country to generate valuable data regarding the oral health patterns of the nation's population.

Treatment planning for replacing missing teeth in UK general dental practice: current trends.

The aim of this study was to examine the confidence, barriers and attitudes towards the replacement of missing teeth by general dental practitioners (GDPs). The perceived impact of the recently introduced National Health Service (NHS) contract on the provision of prosthodontic treatments was also considered. Pre-piloted postal questionnaires were mailed to 500 GDPs in Wales. Open- and closed-ended questions were utilised to establish confidence, adequacy of training and attitudes towards treatments for replacing missing teeth. Two hundred and seventeen completed questionnaires were received (response rate = 43.4%). Many respondents described themselves as 'confident' or 'very confident' in the provision of removable partial dentures (RPDs) (acrylic = 100%, metal based = 99.5%), cantilever resin-bonded bridges (94.4%) and conventional bridgework (98.6%). GDPs were 'not confident' providing fixed-fixed resin-bonded bridges (21.1%) or implants (81.4%). Financial barriers were identified to the provision of prosthodontic treatments, including comments such as "the new [National Health Service] contract does limit the treatments available". Privately funded patients were more likely to be offered a fixed bridge or implant replacement of a missing upper first molar, whereas non-privately funded patients were more likely to be offered no treatment (P < 0.01). Most respondents reported confidence at providing more routine forms of prosthodontic care such as RPDs and bridges. It appears that funding arrangements may have an impact on treatments offered to replace missing teeth, particularly under the current NHS contract.

Addressing children's oral health in the new millennium: trends in the dental workforce.

Oral Health in America: A Report of the Surgeon General (SGROH) and National Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity, and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist-to-population ratio is declining while shortages of dentists continue in rural and underserved communities. The diversity of the dental workforce has only improved slightly, and the the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include enhanced training in children's oral health for general dentists, expanded scope of practice for allied dental health professionals, new dental practitioners including the dental health aid therapist, and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts, and strong partnerships with communities will be needed to effect substantive changes in children's oral health.

Stability of practice beliefs and preferences for patients among private general dentists: a comparison of 1997 and 2007.

BACKGROUND: Practice beliefs and dentist preferences for patients have been related to service rates and appropriateness of care. If practice beliefs and preferences for patients are stable then they could restrain long-term changes in practice styles and service rates. The aim of this paper was to assess the stability of practice beliefs and preferences for patients between 1997 and 2007. METHODS: Practice beliefs and dentist preferences for patients were recorded on a five-point Likert scale using mailed questionnaires from a random sample of dentists in 1997 (response rate = 60 per cent) and 2007 (response rate = 77 per cent). RESULTS: In both 1997 and 2007, n = 215 dentists provided data. For practice beliefs, 1 out of 8 items were significantly different (p < 0.05; McNemar's test) between the two observations (12.5 per cent of practice belief items) while 5 out of 37 dentist preferences for patient characteristics items were significantly different (13.5 per cent of items). CONCLUSIONS: The majority of items were not significantly different over time. This demonstrates a generally high degree of stability over time in the level of agreement with dentist practice beliefs and preferences for patients. Given that it may be difficult for clinicians to change practice beliefs and behaviours that have become established, it is important for policy makers to understand the relationship between provider characteristics and service patterns and for educators to positively shape beliefs and behaviours through undergraduate and continuing education.