Proposing a communication module to enhance dental students' attitudes towards people with dementia: Phase 1 of a curriculum revision study.

INTRODUCTION: The number of mentally altered patients a dentist meets in practice is increasing and interaction with them can be very challenging. As a baseline for an interventional study, we want to assess the attitude of dental students and identify areas of improvement in patient communication. This work compares the attitude of dental students towards people suffering from dementia to the attitudes of trained medical caregivers and the general population. Our aim is to use the results to assess the need for training in communicating with mentally altered patients. MATERIALS AND METHODS: Fourth-year dental students attended two lectures on dementia given by a psychiatrist as part of the geriatric dentistry lecture and were questioned afterwards using the Dementia Attitude Scale. In 2016 and 2017, 73 students at the University of Greifswald were interviewed. The response rate was 84%. Using a factor analysis, the Dementia Attitude Scale's validated questions were interpreted and compared with data from nursing staff from Switzerland and the USA. RESULTS: The factor analysis of the data showed the same two-factor loadings as the comparative groups, and that dental students' attitude is more comparable to the general population than to medically trained nursing staff. CONCLUSION: Given the results, we conclude that the implementation of a communication module can serve in improving the attitude of dental students towards patients with dementia.

[NKLZ 2.0: the further development of the National Competence-Based Learning Objectives Catalogue for Dentistry as a basis for the design of the new licensing regulations]. / NKLZ 2.0: Die Weiterentwicklung des Nationalen Kompetenzbasierten Lernzielkatalogs Zahnmedizin als Basis für die Ausgestaltung der neuen Approbationsordnung.

The National Competence-Based Catalogue of Learning Objectives in Dentistry (NKLZ) was adopted in 2015 and defines the learning objectives for dental training in Germany. It specifies which competences students should acquire and serves as a basis for the curricular design of the study programme, examinations and teaching materials. The NKLZ promotes a comprehensive education that includes clinical skills and abilities, professional behaviour and communication skills in addition to specialist knowledge. It contributes to the preparation of future dentists for their profession and standardizes training to ensure quality and comparability.This article describes the background, history, structure and further development of the NKLZ. Currently, the NKLZ is being further developed to version 2.0 in a multi-stage process. Its structure is based on the NKLM 2.0, the National Competence-Based Learning Objectives Catalogue for Medicine. The aim is to comprehensively map the requirements for the dental licensing regulations.An important prerequisite for the official recognition of the NKLZ as a basic guideline for the training of dentists is that it be anchored in a dental licensing regulation that is to be reformed soon. This creates clarity and liability for teachers and students. Such an anchoring also enables better coordination between training objectives and the requirements of professional practice. Since the licensing regulations are modified less frequently, the integration of the NKLZ offers the possibility of updating and adapting the catalogue of learning objectives in a structured and regulated manner. This ensures that training is in line with current standards and developments.

Prevalence of SARS-CoV-2 IgG antibodies among dental teams in Germany.

OBJECTIVES: During the corona pandemic, dental practices temporarily closed their doors to patients except for emergency treatments. Due to the daily occupational exposure, the risk of SARS-CoV-2 transmission among dentists and their team is presumed to be higher than that in the general population. This study examined this issue among dental teams across Germany. MATERIALS AND METHODS: In total, 2784 participants provided usable questionnaires and dry blood samples. Dry blood samples were used to detect IgG antibodies against SARS-CoV-2. The questionnaires were analyzed to investigate demographic data and working conditions during the pandemic. Multivariable logistic mixed-effects models were applied. RESULTS: We observed 146 participants with positive SARS-CoV-2 IgG antibodies (5.2%) and 30 subjects with a borderline finding (1.1%). Seventy-four out of the 146 participants with SARS-CoV-2 IgG antibodies did not report a positive SARS-CoV-2 PCR test (50.7%), while 27 participants without SARS-CoV-2 IgG antibodies reported a positive SARS-CoV-2 PCR test (1.1%). Combining the laboratory and self-reported information, the number of participants with a SARS-CoV-2 infection was 179 (6.5%). Though after adjustment for region, mixed-effects models indicated associations of use of rubber dams (OR 1.65; 95% CI: 1.01-2.72) and the number of protective measures (OR 1.16; 95% CI: 1.01-1.34) with increased risk for positive SARS-CoV-2 status, none of those variables was significantly associated with a SARS-CoV-2 status in fully adjusted models. CONCLUSIONS: The risk of SARS-CoV-2 transmission was not higher among the dental team compared to the general population. CLINICAL RELEVANCE: Following hygienic regulations and infection control measures ensures the safety of the dental team and their patients.

RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment.

OBJECTIVE: To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. MATERIALS AND METHODS: In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. RESULTS: Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. CONCLUSION: This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. CLINICAL RELEVANCE: ILA could be considered as an effective alternative for routine dental treatment. TRIAL REGISTRATION: NCT04563351.

What German dentists choose for their teeth: A Web-based survey of molar restorations and their longevity.

STATEMENT OF PROBLEM: Which restorative material is best suited for treating the posterior molar region is unclear. As dentists presumably choose the most appropriate restoration, German dentists were asked how their own molars were treated. PURPOSE: The purpose of this survey study was to examine molar restorations and their durability in German dentists. MATERIAL AND METHODS: In the official journal of the Federal Dental Association, German dentists were asked to participate in an online survey that gathered demographic data and information on the type and durability of their molar restorations. To reduce selection bias, the data were weighted for region, sex, and age of the dentist. RESULTS: The data set consisted of 1719 molars from 288 dentists. Restorations included gold inlays (25%), composite resin (24.3%), amalgam (11.8%), ceramic inlays (5.4%), glass ionomer cement or compomer (0.8%), gold crowns (21.8%), ceramic crowns (6.6%), and metal-ceramic crowns (4.3%). Notable differences were identified based on the sex, age, and region of the dentist. Women selected increased esthetic options, as did young dentists. Restorations made of gold, amalgam, and base metal had the highest longevity, at more than 20 years CONCLUSIONS: Among German dentists, restorations with metallic materials dominated in molars, with gold accounting for the largest share. In recent years, the proportion of tooth-colored restorations has increased, and in particular, young dentists use composite resin and ceramics.

Association Between Symptoms of Posttraumatic Stress Disorder and Signs of Temporomandibular Disorders in the General Population.

AIMS: To estimate the association between signs of temporomandibular disorders (TMD) and symptoms of posttraumatic stress disorder (PTSD) in a representative sample from the general population of northeastern Germany. METHODS: Signs of TMD were assessed with a clinical functional analysis that included palpation of the temporomandibular joints (TMJs) and masticatory muscles. PTSD was assessed with the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, ed 4. The change-in-estimate method for binary logistic regression models was used to determine the final model and control for confounders. RESULTS: After the exclusion of subjects without prior traumatic events, the sample for joint pain consisted of 1,673 participants with a median age of 58.9 years (interquartile range 24.8), and the sample for muscle pain consisted of 1,689 participants with a median age of 59.1 years (interquartile range 24.8). Of these samples, 84 participants had pain on palpation of the TMJ, and 42 participants had pain on palpation of the masticatory muscles. Subjects having clinical PTSD (n = 62) had a 2.56-fold increase in joint pain (odds ratio [OR] = 2.56; 95% confidence interval [CI]: 1.14 to 5.71, P = .022) and a 3.86-fold increase (OR = 3.86; 95% CI: 1.51 to 9.85, P = .005) in muscle pain compared to subjects having no clinical PTSD. CONCLUSION: These results should encourage general practitioners and dentists to acknowledge the role of PTSD and traumatic events in the diagnosis and therapy of TMD, especially in a period of international migration and military foreign assignments.

Assessment formats in dental medicine: An overview.

AIM: At the annual meeting of German dentists in Frankfurt am Main in 2013, the Working Group for the Advancement of Dental Education (AKWLZ) initiated an interdisciplinary working group to address assessments in dental education. This paper presents an overview of the current work being done by this working group, some of whose members are also actively involved in the German Association for Medical Education's (GMA) working group for dental education. The aim is to present a summary of the current state of research on this topic for all those who participate in the design, administration and evaluation of university-specific assessments in dentistry. METHOD: Based on systematic literature research, the testing scenarios listed in the National Competency-based Catalogue of Learning Objectives (NKLZ) have been compiled and presented in tables according to assessment value. RESULTS: Different assessment scenarios are described briefly in table form addressing validity (V), reliability (R), acceptance (A), cost (C), feasibility (F), and the influence on teaching and learning (EI) as presented in the current literature. Infoboxes were deliberately chosen to allow readers quick access to the information and to facilitate comparisons between the various assessment formats. Following each description is a list summarizing the uses in dental and medical education. CONCLUSION: This overview provides a summary of competency-based testing formats. It is meant to have a formative effect on dental and medical schools and provide support for developing workplace-based strategies in dental education for learning, teaching and testing in the future.

Outcome-Based Quality Control by a Dental Reference Profile of a Population-Based Study (SHIP-0).

Objectives. The aim was to develop an instrument for quality control in dental practices. We compared the number of teeth of subjects of the Study of Health in Pomerania (SHIP-0) with those from patients of dental practices. Methods. Patients from seven dental practices (n = 1,497) were randomly sampled by age strata and gender for a period of two years. Dental status derived from patient files was transformed into practice profiles using age-specific number of teeth as a parameter. Practice profiles were compared with a nomogram, which was based on the age-specific number of teeth of 3,990 SHIP-0 participants regularly visiting the dentist. Further, negative binomial regression models were evaluated to model associations between the number of teeth with age and dental practices, including interactions. Results. The practice profiles ranged between the 45th and 95th quantile curves of the reference population SHIP-0. The rate ratios (RR) for the number of missing teeth ranged from 0.37 to 0.67 (p < 0.001) between the different dental practices, indicating lower risk for higher numbers of missing teeth in comparison to SHIP-0. Conclusions. This study showed considerable differences between dental practices and the reference population of SHIP-0 regarding the pattern of tooth loss and confirms the value of nomograms to compare age-specific numbers of teeth between patients of dental practices and a population-based-study as a tool for quality control. For further analyses, the socioeconomic status of patients and relevant risk factors will be used to adjust for structural differences in order to improve the validity of the comparisons.

The virtual articulator in dentistry: concept and development.

Virtual Reality (VR) technology is one of the most important innovations for research, development, and industrial production. In dentistry, VR technology will be useful in providing better education through simulation and in enhancing working procedures that are conventionally limited, e.g., the mechanical articulator. It is the purpose of this article to present concepts and strategies for a future replacement of the mechanical articulator by a virtual one.