Validation of ageism scale for dental students in India: (Ageism Scale for Dental Students- India) - a cross sectional study.

Background: Ageism persists in many different societies as it is innate and subconscious in nature. Negative effects such as loneliness, mistreatment, and occupational discrimination are frequently present due to ageism. The dental students in our study were wary of the possible benefits of expensive dental care because ageism is rife in their field. There is no validated and reliable ageism scale to assess how dental students perceive ageism in India. The current study was carried out to validate the ageism scale for dental students in the Indian context. METHODS: This was a cross sectional analytical study carried out among both males and females in Manipal College of Dental Sciences, Mangalore in which the instrument was 27-item Ageism scale for dental students. Content validity was done by six subject experts. The final version was administered to 213 students/Residents of dental school. The factorability of data was confirmed with KMO = 0.61 and Bartlett's Test of Sphericity resulting in p < 0.001. RESULTS: Final PCA model resulted in 15 items and six components that together accounted for 70.37% of overall variance. The six components had reliability ranging from marginal 0.51 (Component 6) to a high of 0.81 (Component 3). As per the gender differences by component females showed less ageism than men in "non-compliance" (-0.9(-1.66-0.14), p<0.05) and "practitioner perspective" (1.43 (0.84, 2.03), p<0.01). Statistical significance was seen in Barriers/concerns in dental treatment of elderly where residents showed reversed (1.4 (0.41, 2.38), p<0.01). Urban group showed more ageism for component 'time restraint' (-0.79 (-1.57, -0.02), p<0.05. CONCLUSION: Preliminary validation resulted in 15 item scale with six components with acceptable validity of the ageism scale and could be further tested in large samples. This scale will help recognize ageism in Indian context and provide necessary information to make changes in the curriculum as required.

Inclusion of gerodontology in dental curriculum: An urgent case for India.

The proportion of older adults is on the rise. Management of dental problems in this group is different from the general population, and hence requires special training. Gerodontology is yet to find its place in the Indian dental curriculum. A lack of training would result in inadequate care delivery. In this article, we share our views on the need for inclusion of the subject, potential challenges, and a guide for incorporation of gerodontology in undergraduate and postgraduate curriculum in the Indian dental institutes. We propose a framework based on the salient features of Kern's 6-step approach for curriculum development and Kotter's 8-step change management model. Some features are common to both the models. A combination of these models includes the following salient features: Problem identification and general needs assessment, beginning with a sense of urgency and targeted needs assessment, communication of the vision for change, working in guided coalitions and defining clear goals and objectives, adopting the relevant educational strategies, implementation strategies to enable change and generating short-term wins, evaluating the effectiveness of the curricular reform and sustaining and anchoring the change. The proposed framework may also be useful for countries where gerodontology is yet to be implemented.

COVID-19 pandemic and its impact on dental students: A multi-institutional survey.

PURPOSE/OBJECTIVES: To investigate dental students' perceptions and concerns regarding the COVID-19 pandemic, their coping strategies and support resources, and their perceived stress levels. METHODS: A customized 19-item survey and the perceived stress scale (PSS) were applied to undergraduate dental students from the US, Spain, Ireland, Chile, India, and Brazil between April 10 and July 5, 2020. Linear modeling and mediation analysis were used to explore the relationships among demographics, stressors, coping mechanisms, social support, and stress RESULTS: A total of 4475 students responded to the survey. The majority (72.4%) were women, and 52.3% had no COVID-19 training at the time of the survey. The students reported that they had to accommodate to changes in patient care (96.6%) and didactic learning (95.2%) activities, while 88.5% of the respondents indicated at least one of their courses moved online. Transition to online courses went "smoothly with some troubles" for 51.8% of the respondents, and 48.3% perceived the faculty as prepared for the online transition; however, 45.9% reported feeling extremely concerned about the impact of COVID-19 on their education. The average PSS score was 21.9 of 40 (moderate stress). Multivariate models were built for participants with full data (n = 3899). Being male, having completed more dental coursework, and perceiving a smoother transition were associated with lower PSS scores; more concern about academic progress was associated with higher PSS. Faculty support mediated the relationship between a smoothness of transition and concern about academic progress and PSS scores CONCLUSION: Stress caused by the pandemic may be alleviated by smoother transition and good faculty support.

Interprofessional education - a case for Gerodontology training.

Increasing life expectancy, concepts of patient well-being, and the multiplicity of needs of the geriatric population, demand contribution, and collaboration of physicians, dentists, psychologists, pharmacists, and other allied health disciplines, to provide quality care to patients. Interprofessional education (IPE) is an approach to education that improves collaboration among health professionals and it can aid in better management of geriatric patients. Communication and cooperation affect health care performance and hence, influence patient outcomes. Currently, each of the disciplines mentioned has customized undergraduate and/or postgraduate training in geriatric care. Though a uni-disciplinary educational approach increases knowledge and skills of individual professions separately, IPE offers significant advantages. IPE seeks to have students learning together, as well as from each other to develop exemplary collaborative practice. The World Health Organization (WHO) has proposed that IPE will ensure optimum health care. However, IPE is yet to find its proper place in dental education. It would help dental students to develop a positive attitude toward geriatric patients and increase their empathy and efficiency in the management of these patients. This manuscript seeks to highlight the concept of interprofessional education (IPE) in gerodontology and develop recommendations for implementation of IPE in India.

Current status of gerodontology curriculum in India and other parts of the world: A narrative review.

BACKGROUND: The current rise in the world's geriatric population has placed additional demands on dental professionals, as the management of geriatric patients requires distinct competencies. AIM: To review and perform a content analysis of the gerodontology undergraduate curriculum worldwide. DATA SOURCES: A search was carried out in PubMed, Web of Science, ERIC and EMBASE databases for the period-July 2008 till May 2019, using MeSH terms. A search for websites of Indian universities was also done, and undergraduate curricula were screened. STUDY ELIGIBILITY CRITERIA: The study included articles related to the undergraduate curriculum, which contained training in geriatric dentistry. Articles in foreign languages and those related to dental hygienists were excluded. RESULTS: A total of 218 articles were obtained, of which 19 met the inclusion criteria. A total of 301 colleges taught gerodontology. Amongst them, 50 colleges had a gerodontology department. Clinical training and outreach experience were provided in 175 and 73 colleges, respectively. There are no reports on the status of gerodontology in Asian countries (excluding Japan). In India, gerodontology is not taught as a separate subject. However, few gerodontology-related topics are covered in clinical subjects. CONCLUSIONS: There seems to be a wide variation in the content of gerodontology curriculum taught worldwide. Other than the European and American regions, gerodontology is yet to develop in other parts of the world. In India, a robust training programme is required to address the lack of dental care providers for the geriatric population using guidelines established by ECG and ADEA.

An anthropometric study to evaluate the correlation of vertical dimension at rest and length of thumb: A multi-national, multi-centre pilot study.

AIM: A variety of anthropometric techniques have been proposed to determine the correct vertical dimension of occlusion. However, none have reported correlating thumb length (TL) with vertical dimension at rest (VDR). This study aimed to correlate the VDR to measurements of the thumb in a multi-national, multi-centric trial in participants with and without orthodontic treatment and establish a regression equation for each region. SETTINGS AND DESIGN: A cross-sectional multi-national, multi-centric correlation trial. MATERIALS AND METHODS: A cross-sectional study was conducted in India and Malaysia with a total of 688 participants. Measurements of thumb and VDR were obtained using a modified Willi's gauge using a standard operating procedure. STATISTICAL ANALYSIS USED: Pearson's correlation coefficient was calculated to determine the correlation between TL and VDR. A multiple linear regression was done to correlate VDR from gender, orthodontic treatment, and length of thumb. RESULTS: Correlation coefficient between TL and VDR in patients with orthodontic treatment was 0.829 and 0.774 in patients without orthodontic treatment. The correlation between TL and VDR in patients with orthodontic treatment in North India was 0.484, P = 0.010 and Malaysia was 0.946, P < 0.001. There were significant correlations between TL and VDR in patients without orthodontic treatment in all regions (P < 0.001). Regression equations were obtained for different ethnic groups for calculating the VDR. CONCLUSION: There was an overall positive correlation between TL and VDR in patients with and without orthodontic treatment. The regression equations presented in this article could help clinicians in their clinical practice and researchers to conduct future trials.

Are Multiple Choice Questions for Post Graduate Dental Entrance Examinations Spot On?-Item Analysis of MCQs in Prosthodontics in India.

BACKGROUND: Construction of appropriate test items is a challenge in preparing quality multiple choice questions. Item analysis provides valuable feedback data on validity of multiple choice questions. The present study was conducted to evaluate the difficulty index, discrimination index and distracter efficiency of the items present in the multiple choice questions of post graduate dental entrance examinations. METHODS: A list consisting of 20 MCQs was taken from the entrance exam books of MCQs on an introductory topic and administered to 104 undergraduate students. RESULTS: In the present study 15% of the MCQs related to impression making procedure were difficult with difficulty index (p) less than 30%, 15% were poor discriminators and 55% had at least one non-functional distracter. CONCLUSION: Item analysis of MCQs in post graduate entrance examinations demonstrated low difficulty index, discrimination index and distracter efficiency. Hence, we propose a strong need for faculty training in test constructors and their post validation.

Challenges in Learning Preclinical Prosthodontics: A Survey of Perceptions of Dental Undergraduates and Teaching Faculty at an Indian Dental School.

INTRODUCTION: Preclinical dental education promotes development of competency and expertise before students work on patients, but this phase is devoid of exposure to real patients leading to challenges in teaching-learning. AIM: The aim of this study was to explore the challenges faced by students during the process of learning preclinical prosthodontics. MATERIALS AND METHODS: Two Focus Group Discussions (FGDs) were conducted with two different groups of students and one FGD was held with prosthodontics faculty. The FGDs explored the student's and faculty perceptions on the topics which were difficult for the students to understand and their suggestions on how these topics can be made easier to understand. The discussions were audio taped with prior consent and transcribed. RESULTS: The students and the faculty felt that the subject of prosthodontics is vast, difficult to visualize and also difficult to correlate theory with practical aspects. Lack of clinical exposure coupled with use of conventional methods of teaching were identified as reasons for difficulty in understanding the subject. Both students and faculty members suggested that use of simulation, demonstrations, and videos could augment the learning process for the students. Early clinical exposure will help solve many problems encountered during learning and contribute to a better understanding. CONCLUSION: The students and faculty expressed a "need" for early clinical exposure to enhance the learner's understanding of the preclinical aspects of the subject. The present study highlights the need for change in instruction methods to enhance the learning experiences in preclinical prosthodontics of dental undergraduate students in India.

Prosthetic rehabilitation of a geriatric patient with squamous cell carcinoma of the buccal mucosa: A report of clinical challenges.

OBJECTIVE: This article aims to highlight the rehabilitation of a geriatric patient with an orofacial cheek defect by an extraoral silicone prosthesis. METHODOLOGY: Structured extra- and intra-oral examination of tissues coupled with a justified choice of impression materials, techniques, and prosthetic rehabilitation with a high-temperature vulcanizing silicone was done. RESULTS: The presence of compressible tissues, static appearance of the prosthesis during patient's facial movements, variability in complexion of the skin around the defect, and manipulating heat-vulcanized silicone were the challenges faced during clinical procedures. Rehabilitation of orofacial defects is a challenge to the maxillofacial prosthodontist due to limited material properties, soft-tissue mobility, compromised retention of prostheses, and poor patient acceptance. The fabrication of a facial prosthesis is as much an art as it is science. Prosthetic form, coloration, and texture of the prosthesis must be indiscernible from the surrounding tissues. Prosthetic reconstruction helps in restoring functional disability and aids in raising the morale of the patient. Prosthetic options of rehabilitation include interim and definitive conventional adhesive-retained or implant-retained prostheses. Initially, vulcanite rubber and acrylic resins were used for reconstruction. CONCLUSION: We report clinical challenges during extraoral rehabilitation of orofacial tissues with a silicone cheek prosthesis such as impression making and shade matching during restoration in a geriatric patient. The use of silicone maxillofacial elastomers allowed intrinsic, extrinsic coloring and ease of construction.

Case-based learning: A study to ascertain the effectiveness in enhancing the knowledge among interns of an Indian dental institute.

OBJECTIVE: Time and again, it has been shown that active learning promotes critical thinking, and this environment has to be fostered in dental education too. Therefore, the present study was carried out with an aim to know the effectiveness of case-based learning (CBL) in enhancing the knowledge of dental interns of a dental institute in India. MATERIALS AND METHODS: This pre-post single-blinded, experimental study was conducted in two sessions on a purposive sample of 45 dental interns who gave informed consent. The interns answered a pretest questionnaire comprising questions related to their knowledge of hyperplastic tissue in complete denture patients. The interns were randomly allocated into three subgroups for thorough discussion. Each group viewed all three parts of a case related to hyperplastic tissue and presented the case in the presence of a facilitator. The facilitator discussed the subject with the three subgroups. A post-test was conducted immediately, and the results were compared with the pretest. The facilitator explained about hyperplastic tissue with an audio-visual aid after the post-test was administered. The perception of interns toward CBL was assessed by a standard questionnaire. RESULTS: On analysis, the comparison of the overall knowledge scores pre- and post-CBL showed a statistically significant increase from 9.8 ± 2.14 to 12.6 ± 1.37 (P < 0.001). CONCLUSION: CBL proved to be effective in enhancing the knowledge of dental interns.

Evaluating the efficacy of denture cleansing materials in removal of tea and turmeric stains: An in vitro study.

CONTEXT: Extrinsic staining of acrylic resin dentures could be a major esthetic problem for denture wearers. Tea, coffee, cola, turmeric, and tobacco often cause extrinsic staining of dentures. AIM: To evaluate the efficacy of various denture cleansing materials in the removal of tea and turmeric stains and to compare the efficacy of those denture cleansers with each other in the removal of tea and turmeric stains. MATERIALS AND METHODS: Heat-cured acrylic resin specimens were stained using tea and turmeric solutions. The spectrophotometer was used to determine the reflectance values of the samples and to evaluate the efficacy of various denture cleansing materials in removal of tea and turmeric stains. Three denture cleansers, namely, sodium hypochlorite, Safe plus, and Clinsodent were used in the study. Water was used as a control. STATISTICAL ANALYSIS USED: ANOVA test and post hoc Tukey's test were used to determine the statistical difference between the groups. RESULT: A statistically significant difference was found (p ≤ 0.05) between the different denture cleansing materials used. Products containing sodium perborate along with trisodium phosphate had the highest stain removing capability. CONCLUSION: It was found that all the denture cleansing materials used in the study were effective in removing tea and turmeric stains. Products containing sodium perborate along with trisodium phosphate had a comparatively greater stain removal capability than products containing sodium perborate along with sodium bicarbonate followed by products containing sodium hypochlorite followed by water (control).

Use of PowerPoint presentation as a teaching tool for undergraduate students in the subject of gerodontology.

AIM: Though different teaching learning media have been employed in the instruction of geriatric dentistry, their efficacy has not been adequately evaluated. This study was conducted with the aim to determine the efficacy of a PowerPoint presentation in teaching gerodontology. MATERIALS AND METHODS: This is a prospective follow-up study using a pre- and post-intervention assessment. A pilot study was conducted on the final year students to check the feasibility of the study. A convenience sampling procedure was used. All interns (n = 80) of the Modern Dental College and Research Centre, Indore, India were invited to participate. Interns completed a 24-item questionnaire documenting their current knowledge on gerodontology. One week after a 30 min PowerPoint presentation on gerodontology, the same interns completed the same questionnaire again, providing an indication of the efficacy of the learning tool. Paired t-test and McNemar test were employed for statistical analysis. RESULTS: A statistically significant difference was observed in pre- and post-intervention scores (P < 0.05). CONCLUSION: The results of this study indicated that PowerPoint presentation can be used as an effective tool for improving the knowledge regarding gerodontology.

A novel speech prosthesis for mandibular guidance therapy in hemimandibulectomy patient: A clinical report.

Treating diverse maxillofacial patients poses a challenge to the maxillofacial prosthodontist. Rehabilitation of hemimandibulectomy patients must aim at restoring mastication and other functions such as intelligible speech, swallowing, and esthetics. Prosthetic methods such as palatal ramp and mandibular guiding flange reposition the deviated mandible. Such prosthesis can also be used to restore speech in case of patients with debilitating speech following surgical resection. This clinical report gives detail of a hemimandibulectomy patient provided with an interim removable dental speech prosthesis with composite resin flange for mandibular guidance therapy.

An in vivo study to correlate the relationship of the extraoral and intraoral anatomical landmarks with the occlusal plane in dentulous subjects.

BACKGROUND: The occlusal plane position is considered to be the primary link between esthetic and function. AIM: To evaluate the relationship between extraoral and intraoral soft tissue landmarks with the occlusal plane in dentulous subjects on both sides and to check for any variations. STUDY AND DESIGN: An in vivo study and 100 subjects with all healthy permanent teeth in normal arch and alignment were selected from Modern Dental College and Research Centre, Indore. MATERIALS AND METHODS: Three custom made instruments (occlusal plane analyzer, buccinator groove relator, and level analyzer) were indigenously designed to check parallelism of the interpupillary line, ala-tragus line, buccinator groove with the occlusal plane. Relation of retromolar pad with the occlusal plane was checked with the metallic scale. STATISTICAL ANALYSIS: Chi-square test. RESULTS: In 20.0% subjects, the occlusal plane was parallel to the interpupillary line. The posterior reference point for ala-tragus line was middle point on right side in 56% and left side in 58% subjects. Intraorally, right side 59% and left side 62% subjects had the occlusal plane at the same level as that of buccinator groove. Right side 48% and left side 45% subjects showed occlusal plane at the middle one-third of retromolar pad. CONCLUSION: The occlusal plane is not generally parallel to interpupillary line. The occlusal plane is parallel to the ala-tragus line with middle point of tragus as posterior reference point on right and left sides. Both sides, the buccinator groove and the middle one-third retromolar pad are coinciding with occlusal plane level.

Perception and knowledge of dental interns toward interdepartmental coordination for successful prosthodontic treatment: A pilot study.

BACKGROUND: The graduating dentist should be trained in providing treatment utilizing the interdisciplinary approach because of the rapid advancements and increase in patient expectations, which demands for collaboration between the different specialists. PURPOSE: A pilot study was undertaken with an aim to assess the perception and knowledge of dental interns toward interdepartmental coordination for successful prosthodontic treatment. SUBJECTS AND METHODS: Dental interns from two dental colleges in Sangli (India) participated in the study. A 24-item self-administered, structured closed-ended questionnaire was used to collect the data. Four questions assessed the perception and 20 questions assessed the knowledge, which were based on the four domains viz.: General, Endodontics, Orthodontics, and Prosthodontics. They were framed from case scenarios reporting to the Department of Prosthodontics, which required interdepartmental consultation. The questionnaire was validated before its application and reliability were also assessed. The final score for each question was calculated based on the correct responses. Descriptive analysis was calculated using the frequencies, percentages, and mean values by using SPSS 16 software. RESULTS: Among 117 interns who participated in the study, 79.5% reported that they lacked training in an interdisciplinary approach. Approximately, 96% reported that the curriculum should be designed to include interdisciplinary training. Nearly, 88% reported that specialist from different specialty should be posted in one interdisciplinary department. Around 60% reported that they did not have the confidence of treating the patient as a whole. When the overall mean scores were considered, the highest scores were obtained for the general domain (95.3) and the lowest for the prosthodontic domain (83.6). CONCLUSION: The dental interns perceived that they lacked training in interdisciplinary approach, and the curriculum should include interdisciplinary training.

Assessment of the learning environment in prosthodontic department based on Dental College Learning Environment Survey by the graduates of a dental institute in India / 보건의료교육평가

The purpose of this study was to determine dental graduates' perceptions of learning environment in a prosthodontic department in a dental institute in India. The 60-item closed-ended, cross-sectional questionnaire with five options was completed by the dental graduates and the dentists. The data obtained was analyzed using statistical software. The mean, SD, frequency and percentages were calculated wherever appropriate. The questionnaire was answered by 242 dentists and dental graduates. Of the seven Dental College Learning Environment Survey scales, the highest mean scores were for student to student interaction (2.76+/-0.53) followed by meaningful learning experience (2.67+/-0.39). The lowest scores were for flexibility (2.26+/-0.51) followed by supportiveness (2.40+/-0.59). The lowest mean scores obtained for the 'flexibility scale' conveys that the opportunity for the faculty and students to modify the learning environment are less than for the other categories, and there is thus a need to modify the learning environment. Faculty should also increase their support to the students by contributing to an effective and meaningful interaction by creating a congenial environment.

Tooth loss, prosthetic status and treatment needs among industrial workers in Belgaum, Karnataka, India.

The health of industrial workers often goes uncared for due to their stressful working conditions, busy schedules and poor economic conditions. A cross-sectional survey was conducted to determine the prevalence of tooth loss, prosthetic status and treatment needs among industrial workers in Belgaum, Karnataka, India according to the criteria described in the World Health Organization (WHO) Oral Health Assessment form (1997). A total of 614 workers participated in the study. Information was obtained regarding their oral hygiene practice. The presence or absence of habits, and the frequency and duration since the last visit to a dentist were recorded followed by clinical examination. Chi-square test was used to determine the association between the variables and tooth loss. There was a statistically significant difference between the number of missing teeth in different age groups, methods of cleaning, smoking habits and visits to the dentist. Regarding prosthetic status, only one worker had a fixed prosthesis in the mandibular arch. The study revealed that tooth loss was associated with oral hygiene practices, habits and visits to the dentist. Poor prosthetic status and high treatment needs were observed. This study emphasized the need for improved dental health awareness and availability of dental facilities to industrial workers.

Assessment of dental anxiety and its correlation with denture satisfaction in edentulous patients.

OBJECTIVE: The objectives of this study were to measure the level of dental anxiety and its correlation with dental history, denture satisfaction and other variables. MATERIALS AND METHODS: A cross-sectional study was conducted on 150 completely edentulous patients reporting to the Department of Prosthodontics, KLES's Institute of Dental Sciences, Belgaum, over a period of 17 months (August 2005 to March 2007). The anxiety level of the patients was assessed with the help of a questionnaire, after obtaining an informed consent. Reliability of the dental anxiety scale was assessed by means of coefficient alpha. RESULTS: The results of this study concluded that dental anxiety scale for edentulous patients was a reliable scale for measuring dental anxiety. The anxiety score was higher for female than male patients. A significant correlation was found between denture satisfaction score and anxiety. DISCUSSION: Anxiety plays a major role in denture satisfaction. The variables included: Previous denture experience, occupation, medical history, age, gender, dental anxiety scale, period of edentulousness, age of previous dentures, number of complete dentures, denture satisfaction score, and the score on the Hamilton anxiety scale. CONCLUSION: The study indicated that gender correlates significantly with dental anxiety. Patients with medical history were found to be more anxious than normal patients. Patients with higher anxiety values were less satisfied with the treatment. Lastly, subjects with higher general anxiety showed greater values on the dental anxiety scale. CLINICAL SIGNIFICANCE: The assessment of dental anxiety will help the prosthodontist in the management of anxious patients and secondly to provide evidence-based research into this psychological construct which has been shown to predict dental avoidance.