Dental school faculty shortages increase: an update on future dental school faculty.

The 1999 publication of the American Association of Dental Schools (AADS) President s Task Force on Future Dental School Faculty revealed a crisis in the shortages of dental school faculty. Stakeholders from around the nation have used the AADS Task Force report to address the crisis. In addressing one of the AADS Task Force recommendations, the American Dental Education Association (ADEA), formerly AADS, gathered additional data through a new survey of dental school deans to elucidate the current state of faculty shortages. Based on this research, ADEA projects that the number of unfilled budgeted faculty positions in U.S. dental schools now approaches 400. Survey respondents identified retirement as the leading reason for full-time faculty separations, while separation to enter private practice was the second most frequent reason for leaving the institution. Offering a salary competitive with that of private practice was identified as the most critical factor in recruiting future faculty. A number of short and long-range strategies to recruit and retain faculty are presented. Ultimately, the dental school faculty shortage places in jeopardy the general and oral health of the public.

A cognitive task analysis for dental hygiene.

To be an effective assessment tool, a simulation-based examination must be able to evoke and interpret observable evidence about targeted knowledge, strategies, and skills in a manner that is logical and defensible. Dental Interactive Simulations Corporation's first assessment effort is the development of a scoring algorithm for a simulation-based dental hygiene initial licensure examination. The first phase in developing a scoring system is the completion of a cognitive task analysis (CTA) of the dental hygiene domain. In the first step of the CTA, a specifications map was generated to provide a framework of the tasks and knowledge that are important to the practice of dental hygiene. Using this framework, broad classes of behaviors that would tend to distinguish along the dental hygiene expert-novice continuum were identified. Nine paper-based cases were then designed with the expectation that the solutions of expert, competent, and novice dental hygienists would differ. Interviews were conducted with thirty-one dental hygiene students/practitioners to capture solutions to the paper-based cases. Transcripts of the interviews were analyzed to identify performance features that distinguish among the interviewees on the basis of their expertise. These features were more detailed and empirically grounded than the originating broad classes and better serve to ground the design of a scoring system. The resulting performance features were collapsed into nine major categories: 1) gathering and using information, 2) formulating problems and investigating hypotheses, 3) communication and language, 4) scripting behavior, 5) ethics, 6) patient assessment, 7) treatment planning, 8) treatment, and 9) evaluation. The results of the CTA provide critical information for defining the necessary elements of a simulation-based dental hygiene examination.

Issues of academic integrity in U.S. dental schools.

Evidence of violations of academic integrity can be identified at all levels of education. A survey on academic integrity was mailed in 1998 to the academic deans of all fifty-five U.S. dental schools, with a response rate of 84 percent. This survey showed that reported incidents of academic dishonesty occur in most dental schools, with the average school dealing with one or two cases a year. The most common incidents of dishonest behavior involved copying or aiding another student during a written examinations; the second most common involved writing an untrue patient record entry or signing a faculty member's name in a patient chart. Respondents indicated the major reason for failure to report academic dishonesty was fear of involvement because of time and procedural hassles and fear of repercussions from students and peers.

Analysis of electromyographic signals in human jaw closing muscles at various isometric force levels.

The effect of sustained isometric contraction on surface electromyograph (EMG) and force signals derived from these muscles was examined. Premolar-molar region force was measured with a small unilaterally positioned force transducer. Subjects produced and sustained 25, 50, 75 and 100 per cent isometric force levels, and measurements were made at the beginning and end of these efforts. There was no significant change in the resulting EMG/force ratio at any of the force levels. The EMG signal did exhibit a significant shift in its frequency both as the force level increased and during the sustained effort. Neuromuscular fatigue, when defined as a change in the EMG/force ratio, was not demonstrated even though there was a consistent change in the frequency of the EMG signal.

Interdental thickness discrimination in myofascial pain dysfunction subjects.

Interdental thickness discrimination (ITD) was evaluated on twenty-eight normal subjects and twenty subjects with myofascial pain dysfunction (MPD). This evaluation was performed before and after a submaximal isometric clenching task sustained to pain tolerance. The results of the study demonstrate a significant difference in ITD ability at several test points between the normal and MPD subjects. The experimental variable of sustained submaximal clenching did not significantly alter the ITD ability of either subject group.

The effect of sustained submaximal clenching on maximum bite force in myofascial pain dysfunction patients.

The effect of a sustained (30% maximum) isometric clenching task on the maximum voluntary bite force level was evaluated on normal jaw function subjects as well as on abnormal jaw function subjects (MPD patients). The results indicate that the MPD subjects had a lower maximum voluntary bite force level and a shorter endurance time when compared to normal subjects. Neither the control subjects nor the MPD subjects demonstrated a change in their brief MVBF after a 'fatigue inducing' task. These results suggest a lack of contractile element failure in the jaw closing muscles following sustained submaximal isometric clenching on a force transducer.

Nocturnal electromyographic evaluation of myofascial pain dysfunction in patients undergoing occlusal splint therapy.

Twenty-five patients with symptoms of myofascial pain and abnormal jaw function were treated with use of a full arch maxillary occlusal splint. The level of nocturnal activity of the masseter muscle was monitored as were symptoms before, during, and after occlusal splint therapy. A decreased nocturnal EMG level during treatment was noted for 52% of the patients. A return to pretreatment EMG levels after removal of the splint was noticed in 92% of the patients; in 28% no change was shown and in 20%, an increase was shown in nocturnal EMG levels. The splint was most likely to reduce nocturnal EMG levels in patients with least severe symptoms.

The effect of the bite plane splint on the electromyographic silent period duration.

An electromyographic study of the masseter and anterior part of the temporalis muscles was performed on ten patients presenting temporomandibular joint dysfunction symptoms. The EMG silent periods (SP) produced in the open-close-clench cycle and jaw-jerk reflex were compared for duration before and after treatment with an occlusal bite splint. Following use of the splint, there was a shortening of SP indicating the possible use of the duration of SP as a diagnostic measurement, and also as an indication of treatment effectiveness.