The status of the scholarship of teaching and learning in dental education.

The purpose of this study was to determine the current status of the Scholarship of Teaching and Learning (SoTL) within academic dentistry. A twenty-two-item survey was distributed to faculty members of American Dental Education Association (ADEA) member schools asking about their awareness of SoTL practices, perceived barriers to SoTL application, and ways to enhance SoTL activity. Four hundred thirty surveys with equal distribution of assistant, associate, and full professors were received (this may be considered a response rate of 5.4 percent out of roughly 8,000 ADEA faculty members). Almost 70 percent of the respondents indicated that they highly valued SoTL; only 2.1 percent indicated they did not. The extent to which the respondents valued SoTL was positively correlated with their perception of SoTL's value among other faculty members in their program (r(322)=0.374, p<0.001), school (r(299)=0.204, p<0.001), and institution (r(233)=0.296, p<0.002). However, the respondents were generally unsure how SoTL was applied at their institutions. Respondents from private institutions reported making more SoTL presentations at conferences than did those from public institutions (t(303)=-2.761, p=0.006) and stronger promotion of SoTL in their institutional policies (t(330)= -3.004, p=0.003). Barriers to changing the perception and application of SoTL appeared to exist at both organizational and individual levels, and ADEA was perceived to be well positioned to assist with both.

Preventive services program: a model engaging volunteers to expand community-based oral health services for children.

PURPOSE: This paper describes the Preventive Services Program (PSP), a community based oral health program model which engages volunteers to provide preventive services and education for underserved children in Missouri. In 2006, the Missouri Department of Health and Senior Services created a program for children designed to use a systems approach for population-based prevention of oral disease. Currently, 5 part-time dental hygienists serve as Oral Health Program Consultants to work with the citizens of a community to engage dentists, dental hygienists, parents and other interested stakeholders in the activities of the program. Dental volunteers evaluate oral health and disease in the community's children and facilitate referrals for dental care. Other volunteers apply fluoride varnish and provide educational services to the children. PROGRAM OUTCOMES: In 2006, 273 volunteer dentists and dental hygienists and 415 community volunteers provided oral screenings, oral health education, 2 fluoride varnish applications and referral for unmet dental care for 8,529 children. In 2011, 775 volunteer dentists and dental hygienists and 1,837 other community volunteers provided by PSP services to nearly 65,000 children. CONCLUSION: It has been demonstrated that when the local citizens take responsibility for their own needs that a sustainable and evidence-based program like PSP is possible. Guidelines which provide criteria for matching models with the specific community characteristics need to be generated. Furthermore, a national review of successful program models would be helpful to those endeavoring to implement community oral health program.

Extending oral health care services to underserved children through a school-based collaboration: part 1: a descriptive overview.

PURPOSE: The purpose of this report is to describe the process and outcomes of a collaborative, comprehensive preventive oral health program between the University of Missouri-Kansas City School of Dentistry, the Olathe School District and an Extended Care Permit I dental hygienist. The report describes the programs collectively working to provide school-based services to disadvantaged children in 4 Title I schools using the community collaborative practice oral health model and tele-dentistry. METHODS: The "Miles of Smiles" clinic was assembled in 4 elementary schools using portable dental equipment. Dental hygiene students, supervised by a dental hygiene faculty member with an extended care permit, provided comprehensive preventive oral health care to unserved and underserved children. RESULTS: Twenty-eight dental hygiene students provided prophylaxis, radiographs, sealants, fluoride varnish, oral health education and nutritional counseling to 339 children in the Miles of Smiles clinic during the 2008 to 2009 academic year. Sixty-three percent of children had decay and were referred to a dentist. Upon re-evaluating at the end of the school year, 11% had begun the transition process of seeking restorative care at a safety net clinic or from a local dentist. CONCLUSION: School based oral health models, using dental hygienists with expanded scopes of practice to provide preventive oral health services and referrals, can serve as one approach to overcoming barriers and reaching vulnerable children that desperately need oral health care. However, transitioning children outside of their school to a safety net clinic or local dentist to receive restorative care was found to be problematic.

Extending oral health care services to underserved children through a school-based collaboration: part 2: the student experience.

PURPOSE: The purpose of this study was to examine the experiences of dental hygiene students providing services to unserved and underserved children in a school-based collaboration between a dental school, school district and Extended Care Permit I (ECP-I) dental hygienist in Kansas. METHODS: Following comprehensive preventive oral health care services to children in 4 schools supervised by an ECP-I dental hygienist, 26 senior dental hygiene students enrolled in the dental hygiene program at the University of Missouri-Kansas City submitted rotation data records and self-reflection journals describing the experience. Using the constant comparative method, 3 faculty researchers unitized the data by identifying key themes. RESULTS: Data from student reflections was aggregated into 5 categories: skill development (46%), awareness (19%), type of experience (15%), description of environment/setting (13%) and role model (7%). CONCLUSION: Participation in well-designed service learning programs is rewarding for students providing the services and works toward developing the skills needed to competently care for the changing needs of society. New models of oral health care and expanded roles for dental hygienists are providing greater access to preventive oral health care in Kansas.

Evaluation of social interaction, task management, and trust among dental hygiene students in a collaborative learning environment.

The purpose of this study was to evaluate the impact of collaborative learning on the development of social interaction, task management, and trust in dental hygiene students. These three traits were assessed with the Teamwork Assessment Scale in two different learning environments (traditional lecture/lab and collaborative learning environment). A convenience sample of fifty-six entry-level dental hygiene students taking an introductory/preclinic course at two metropolitan area dental hygiene programs provided comparable experimental and control groups. Factor scores were computed for the three traits, and comparisons were conducted using the Ryan-Einot-Gabriel-Welsh multiple comparison procedure among specific cell comparisons generated from a two-factor repeated measures ANOVA. The results indicate that the collaborative learning environment influenced dental hygiene students positively regarding the traits of social interaction, task management, and trust. However, comparing dental hygiene students to undergraduate students overall indicates that dental hygiene students already possess somewhat higher levels of these traits. Future studies on active learning strategies should examine factors such as student achievement and explore other possible active learning methodologies.

Examining the role of collaborative assessment in a didactic dental hygiene course.

The purpose of this study was to evaluate a technique known as collaborative assessment considering students' and faculty members' perceptions of the value and utility of this approach. Twenty-eight dental hygiene students took eight individual assessments (quizzes) immediately followed by completion of the same assessment in a five-member peer group as part of a didactic dental hygiene course. At the end of the semester, student perceptions and course performance were examined. Faculty perceptions were also collected. A paired samples t-test was conducted to compare student performance on individual and group assessments. Students reported that this collaborative assessment approach enhanced their learning, provided them with experience in defending their answers, and decreased stress. Concerns for fairness and individual accountability were noted by both students and faculty. The mean group score for all quizzes combined (M=91 percent, SD=2 percent) was significantly higher by 16 percentage points (91 percent versus 75 percent) than the mean individual score for all quizzes combined (M=75 percent, SD=8 percent), t(27)=11.61, alpha =.05, p<.0005. This study suggests that additional measures are needed to ensure individual preparation and accountability when using the collaborative assessment process as a learning strategy with dental hygiene students.

Evaluation of an academic service-learning course on special needs patients for dental hygiene students: a qualitative study.

The purpose of this study was to evaluate the outcomes of a service-learning course on special needs patients for dental hygiene students by considering student reflections, community site coordinators' feedback, and faculty reflections in a qualitative analysis. Twenty-three female dental hygiene students beginning their fourth semester in the program provided preventive oral health services at eight community sites serving six diverse groups of people having special health care needs. Students reflected on the experience via commentaries written in self-reflection journals. The investigators applied the constant comparative method to analyze and unitize the data, ultimately reaching consensus on three category topics: awareness, higher order thinking, and professionalism. End of course project assessments provided additional data that was used to triangulate with data from the reflective journals. Telephone interviews with the site coordinators and personal interviews with the course faculty provided data from multiple perspectives. The outcomes of this study suggest that service-learning pedagogy can facilitate a deeper understanding of the subject matter and provide an opportunity for students to use critical thinking strategies in addition to becoming aware of complex social and professional issues related to the oral health care of individuals with special needs.

Comparison of probes for microbial contamination following use in periodontal pockets of various depths.

BACKGROUND: It has been speculated that periodontal probes can transmit periodontal pathogens from site to site. The purpose of this study was to evaluate the potential for bacterial transmission as a function of periodontal probe design. METHODS: Four different periodontal probes were used to measure probing depths ranging from 0 to 3 mm and > or = 4 mm. Following measurement of each pocket, probes were transported to a laboratory and cultured on blood agar, and colony forming units (CFUs) were determined for total aerobic, anaerobic, and dark-pigmented colonies (DPCs). Eight randomly selected probe tips, representing each probe type and probing depth category, were selected for examination by scanning electron microscopy (SEM) to determine distribution and morphotypes of adhering microbes. RESULTS: Results showed no statistically significant main effect for probes with respect to CFUs. However, there was a statistically significant increase in CFUs for deeper pockets when compared to pockets 0 to 3 mm. SEM observations were consistent among groups, regardless of probe design or probing depth. All probes exhibited a rough surface texture. Microbes were observed as single organisms or in aggregates and were adherent along the entire length of the probe up to the maximum probing depth. CONCLUSIONS: There was no difference in CFUs obtained as a function of periodontal probes. The rough surfaces of the probes used in this study likely promoted bacterial adherence through two different mechanisms: through scraping of the pocket walls by the roughened surfaces of the probe and by the high surface-free energy of the metal probes, facilitating bacterial adherence.

A TEM/SEM study of the microbial plaque overlying the necrotic gingival papillae of HIV-seropositive, necrotizing ulcerative periodontitis.

The purpose of this study was to examine by transmission (TEM) and scanning electron microscopy (SEM) the supragingival microbial plaque overlying the ulcerated gingival papillae of necrotizing ulcerative periodontitis (NUP) lesions in HIV-seropositive patients. The microbiota of NUP and HIV-seropositive patients with periodontitis has been reported to be similar to that of conventional periodontitis in non-infected subjects, although several investigators have also reported high recovery rates of microbes not generally associated with the indigenous oral microbial flora. Light and electron microscopic observations and microbial culture studies indicate a similar high prevalence of spirochetes in both necrotizing ulcerative gingivitis (NUG) and NUP. In addition, several studies have reported more frequent isolation of Candida albicans from diseased periodontal sites in HIV-seropositive patients than from non-diseased sites. Ten male and six female patients, each HIV-seropositive and exhibiting NUP, constituted the study population. Two biopsies of involved gingival papillae from between posterior teeth were obtained from each patient and processed for examination by both TEM and SEM. Microscopic examination revealed a surface biofilm comprised of a mixed microbial flora of various morphotypes in 81.3% of biopsy specimens. The subsurface flora featured dense aggregations of spirochetes in 87.5% of specimens. Zones of aggregated polymorphonuclear leukocytes and necrotic cells were also noted. Yeasts were observed in 65.6% of specimens and herpes-like viruses in 56.5% of the specimens. Collectively, except for the presence of yeast and viruses, the results suggest that the microbial flora and possibly the soft tissue lesions of NUP and necrotizing ulcerative gingivitis are very similar.