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.

Dental utilization by low-income mothers.

OBJECTIVE: This study examines the influence of predisposing, enabling, and need variables on whether low-income mothers sought dental care during the past year. This report is a substudy of mothers and children on their self-reported health status, utilization, access, and satisfaction with health care in general. METHODS: A convenience sample of 502 mothers and youngest child younger than 6 years old was administered a face-to-face questionnaire in four Ohio counties. Information was collected at county human services offices and WIC clinics between November 1995 and July 1996. Using whether or not the mother sought dental care as the dependent variable, logistic regression models were created for the variables within the predisposing, enabling, and need characteristics separately and together. RESULTS: Fewer than one-half of the mothers sought dental care during the past year. Variables associated with the predisposing characteristic explained little about who sought care. Those mothers who have Medicaid coverage are 2.7 times more likely to have a dental visit than those without insurance. Moreover, those mothers who perceive any dental need are several times less likely to have received dental care than those who have no perceived need. CONCLUSIONS: Even among a somewhat homogeneous population of low-income women, source of payment for dental services and perceived need for dental care are discriminating variables in determining who seeks dental care.

Informed consent and the geriatric dental patient.

Dental professionals are increasingly aware of their ethical responsibility to permit patients to participate in treatment decisions through the informed consent process. At the same time, growing numbers of geriatric patients present special challenges that can jeopardize the use of informed consent. Consequently, the use of informed consent with geriatric patients warrants special analysis due to complicating factors such as patient passivity and questionable competency. This article establishes the relationship between the ethical principle of autonomy and informed consent while examining factors that must be present in order for a valid informed consent to be obtained. Additionally, the article addresses informed consent issues regarding competent patients, geriatric patients with fluctuating or uncertain competency, and patients who are clearly incompetent.

Ethics and dental amalgam removal.

Recent media attention regarding dental amalgam restorations has generated needless fears among millions of dental patients. This article examines the issue of dental amalgam removal from an ethical perspective and offers some practical advice on how to address this problem in the dental office.

Parental attitudes toward behavior management techniques used in pediatric dentistry.

Previous studies evaluating parents' attitudes toward behavior management techniques used in pediatric dentistry suggest that parental attitudes are generally negative. The purpose of this study was to reexamine this issue by comparing the effect of prior explanation on parental acceptance of eight behavior management techniques. Videotaped segments were made of children's dental appointments containing examples of eight behavior management techniques. One group of 40 parents viewed a videotape which provided no explanation for each technique before it was shown. Another group of 40 parents viewed a videotape which provided no explanation of the techniques. The parents then were asked to rate the acceptability of each technique using a visual analogue scale. Results indicated that the informed parents were significantly more accepting of behavior management techniques than the uninformed parents but both groups were generally positive about the techniques studied. Further, parents reporting greater stress were less accepting of the techniques studied.

Treatment decision-making: student choices of autonomy versus paternalism.

The purpose of this study was to evaluate dental students' use of the Hippocratic Principle versus a patient-autonomy approach to ethical decision-making. A questionnaire composed of three independent case situations was distributed to 113 junior dental students. The survey instrument allowed subjects to prioritize their choices of action from a series of alternative responses and to identify factors that influence their choice of action. A majority of responses appear to reflect a decision-making process based on patient-autonomy principles. Patient rights are important for this population, and their choice of action and the factors influencing these choices consistently emphasized autonomy.

Local dental programs: a descriptive assessment of funding and activities.

In 1986, 201 local dental programs received a dental survey requesting information on their programmatic activities. Survey categories included general agency information, dental coordinator characteristics, program budget, staffing and salaries, clinical services, health education and other programs, and miscellaneous questions. A total of 156 programs returned the survey, for a 77.6 percent response rate. This article provides descriptive data on various selected activities within local dental health organizations. Highlights include: (1) 12 agencies have terminated their dental program since 1982; (2) 88 percent of existing dental programs have a clinical component; and (3) the budgets of viable programs have increased over the past three years. These data will assist local health agencies and national organizations in program planning and serve as a resource for program directors, as well as those who are developing new programs.