Remineralization potential of dentifrices with calcium sodium phosphosilicate and functionalized tri-calcium phosphate in the deeper incipient carious lesions: An in vitro study.

OBJECTIVES: This study evaluated the remineralization potential of calcium sodium phosphosilicate and functionalized tri-calcium phosphate (f-TCP) dentifrices in deeper incipient carious lesions (ICLs). MATERIALS AND METHODS: Artificial ICLs were created by placing premolars into demineralizing solutions. Teeth were randomly assigned into four groups: calcium sodium phosphosilicate (Group 1), f-TCP (Group 2), 1450 ppm fluoride (Group 3), and distilled water (Group 4), which were subjected to 10-day pH cycling. Mineral density (MD) was assessed using microcomputed tomography (Micro-CT), while hardness (H) and elastic modulus (EM) were assessed using nanomechanical testing. RESULTS: MD % gain was higher in Groups 1-3 than in Group 4. In addition, Groups 1 and 2 exhibited significantly higher MD % gain than Group 3. Also, Groups 1-3 showed significantly higher EM and H values than Group 4 in the outer enamel area; yet, Groups 1 and 2 displayed significantly higher EM and H values than Groups 3 and 4 in the inner enamel. CONCLUSIONS: The MD, EM, and H of ICLs significantly increased with the addition of calcium sodium phosphosilicate or f-TCP to fluoridated dentifrices compared to standard fluoride dentifrices. The added active ingredients remineralized the deeper parts of the ICLs, while remineralization at the lesion surface was similar between tested dentifrices.

Dental and oro-facial features of Foetal Anticonvulsant Syndrome.

AIM: Emerging evidence suggests dental/oro-facial anomalies are features of Foetal Anticonvulsant Syndrome (FACS) and have an impact on quality of life. Currently there is limited research on these, and no Aotearoa New Zealand data on FACS overall. This study aimed to collect national data on the dental and oro-facial features of FACS. METHODS: A participatory model was utilised; a questionnaire was developed and distributed to FACS-affected families via the Foetal Anticonvulsant Syndrome New Zealand (FACS NZ) organisation. Open-ended questions were asked about: socio-demographics, anticonvulsant drug regime at the time of pregnancy, characteristic features of the affected child, including oro-facial function, dental/oro-facial anomalies, and dental history. RESULTS: Valproate was the most prescribed anticonvulsant during pregnancy. Oro-facial functional abnormalities in speech, swallowing, and eating were identified in 70.4% of the FACS population. Dental anomalies were reported by 81%, the most common being dental crowding, followed by tooth discolouration and microdontia. CONCLUSION: Dental and oro-facial anomalies were reported commonly in the Aotearoa New Zealand FACS population, laying foundation for further research. Recognition of these features assists in FACS diagnosis, early referral, and improved management of FACS patients. The need for FACS education for women of reproductive age requiring anticonvulsant therapy, in Aotearoa New Zealand, was identified.

Comparison of self-perceived competence of recent dental graduates from the Universities of Otago and Dalhousie.

INTRODUCTION: This study investigates and compares the self-perceived competencies of recent dental graduates from the University of Otago (UoO) (Dunedin, New Zealand) and Dalhousie University (DU) (Nova Scotia, Canada). MATERIALS AND METHODS: A validated survey was emailed to recent graduates from the UoO (December 2019) and DU (May 2020). Chi-squared statistical analysis examined the differences between groups. RESULTS: The response rate was 73% from the UoO class and 75% from the DU class. Out of 59 competencies, 11 items showed a significant difference. Orthodontics and the surgical aspects of dentistry were the main areas where significant differences have been observed between the two cohorts. Out of the four items in orthodontics, a significantly higher proportion of DU graduates felt more competent than graduates from UoO in three items ("performing orthodontic treatment planning," "performing space maintenance/regaining" and "performing orthodontic full-arch alignment"; p < .001). Similarly, graduates from DU felt significantly more competent in three of the eight items in the oral and maxillofacial surgery domain ("managing complications of oral surgery," "performing soft-tissue biopsies" and "managing trauma to the dentofacial complex"; p < .001), all requiring surgical training and skills. CONCLUSION: Of the differences identified, graduates from DU reported higher levels of self-perceived competence compared with their UoO counterparts, especially in the orthodontics and oral and maxillofacial surgery domains. This could be because DU students have more practice in these specialties during their training. The results suggest that increased exposure for UoO students in these areas may be beneficial to their self-perceived competence.

Working characteristics for practising dental hygienists in two countries in different hemispheres.

OBJECTIVES: The study aimed to collect and compare practising characteristics for dental hygienists (DHs) in New Zealand (NZ) and Sweden. METHODS: Dental hygienists from NZ and Sweden were invited to participate in an anonymous online survey focussing on their working practices. An email, with a link to the online survey and a participant information sheet, was sent to DHs registered with their professional association in their respective country. Frequency analyses and cross-tabulations were conducted using chi-square and Fisher's exact tests to investigate possible statistical associations to allow for comparisons between the countries. RESULTS: DH is a female-dominated workforce with equal distribution of gender in both countries. The majority of DHs in NZ worked in private practice while Swedish DHs mostly worked in the public sector. NZ participants were younger and with a more recent qualification than their Swedish counterparts. The highest degree of education was a PhD for DHs working in Sweden, compared with a master's degree for NZ participants. The majority of participants from both countries treated patients 65 years of age or older, with the most common medical conditions being cardiovascular disease and diabetes mellitus. The most common dental condition observed/treated was periodontal disease. Over 60% agreed to have an understanding of information technology (IT). The most used technical equipment was digital radiology, followed by other diagnostic tools. CONCLUSION: Findings confirm previous international data on demographical uptake for the DH workforce in NZ and Sweden. A coherence was seen in patient characteristics, DHs' attitudes towards information technology and use of technical equipment.

Identifying perceptions and themed learning outcomes between pharmacy and dentistry students through interprofessional education and collaboration in the dental clinic.

BACKGROUND: The educational value of interprofessional education (IPE) experiences inside a dental clinic are largely unexplored. Increasing research suggests that pharmacists, as medication experts, may positively impact dental care in collaborative settings and dentists, as oral health experts, may provide insightful knowledge and understanding to pharmacists. The purpose of this project was therefore to investigate perceptions and associated learning outcomes of a dental clinic-based IPE experience between pharmacy and dentistry students. EDUCATIONAL ACTIVITY AND SETTING: A total of eight pharmacy students and eight dentistry students were paired for this activity. Students were oriented to project procedures and then arranged to meet for one patient visit to the dental clinic. Paired students collaboratively conducted a patient assessment inside the dental clinic with a real patient and discussed any follow-up required. Following this activity, student perceptions were measured using a cross-sectional survey. FINDINGS: Overall, student perceptions were greatly positive, but students suggested more than one clinic encounter would be ideal for increasing the impact of learning. The primary collaborative learning outcome identified as part of this activity was role clarification. SUMMARY: Findings support further development of IPE between pharmacy and dentistry students within a dental clinic but call for the redesign of the activity using a longitudinal approach.

Nutritional Implications of Baby-Led Weaning and Baby Food Pouches as Novel Methods of Infant Feeding: Protocol for an Observational Study.

BACKGROUND: The complementary feeding period is a time of unparalleled dietary change for every human, during which the diet changes from one that is 100% milk to one that resembles the usual diet of the wider family in less than a year. Despite this major dietary shift, we know relatively little about food and nutrient intake in infants worldwide and virtually nothing about the impact of baby food "pouches" and "baby-led weaning" (BLW), which are infant feeding approaches that are becoming increasingly popular. Pouches are squeezable containers with a plastic spout that have great appeal for parents, as evidenced by their extraordinary market share worldwide. BLW is an alternative approach to introducing solids that promotes infant self-feeding of whole foods rather than being fed purées, and is popular and widely advocated on social media. The nutritional and health impacts of these novel methods of infant feeding have not yet been determined. OBJECTIVE: The aim of the First Foods New Zealand study is to determine the iron status, growth, food and nutrient intakes, breast milk intake, eating and feeding behaviors, dental health, oral motor skills, and choking risk of New Zealand infants in general and those who are using pouches or BLW compared with those who are not. METHODS: Dietary intake (two 24-hour recalls supplemented with food photographs), iron status (hemoglobin, plasma ferritin, and soluble transferrin receptor), weight status (BMI), food pouch use and extent of BLW (questionnaire), breast milk intake (deuterium oxide "dose-to-mother" technique), eating and feeding behaviors (questionnaires and video recording of an evening meal), dental health (photographs of upper and lower teeth for counting of caries and developmental defects of enamel), oral motor skills (questionnaires), and choking risk (questionnaire) will be assessed in 625 infants aged 7.0 to 9.9 months. Propensity score matching will be used to address bias caused by differences in demographics between groups so that the results more closely represent a potential causal effect. RESULTS: This observational study has full ethical approval from the Health and Disability Ethics Committees New Zealand (19/STH/151) and was funded in May 2019 by the Health Research Council (HRC) of New Zealand (grant 19/172). Data collection commenced in July 2020, and the first results are expected to be submitted for publication in 2022. CONCLUSIONS: This large study will provide much needed data on the implications for nutritional intake and health with the use of baby food pouches and BLW in infancy. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12620000459921; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379436. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/29048.

The relative frequency of paediatric oral and maxillofacial pathology in New Zealand: A 10-year review of a national specialist centre.

BACKGROUND: There has been no previous report of the prevalence of paediatric oral and maxillofacial pathology in a New Zealand oral pathology diagnostic service. AIM: The aim of this study was to review cases of paediatric oral pathology to determine relative frequencies of oral lesions in this age group. DESIGN: Paediatric oral pathology cases (≤15 years of age) received between 2007 and 2016 were retrieved from the electronic database of the Oral Pathology Centre, University of Otago. Data collected included diagnoses (categorised into 12 groups), age at diagnosis, and gender. The prevalence of each diagnosis was calculated in terms of percentage of all diagnoses made. Male-to-female ratio and mean age at diagnosis were also determined. RESULTS: A total of 1139 paediatric cases were identified representing 5.2% of all cases. The most common diagnostic group was salivary gland pathology (25.4%), followed by dental (24.8%) pathology. The most prevalent lesion was mucocoele (23%), followed by dental follicle (14.1%). Malignancies were rare with only two cases identified. CONCLUSION: The findings provide an insight into the prevalence of paediatric oral pathology for clinicians. Mucocoele was the most common diagnosis made, suggesting a high prevalence of soft tissue injury as a main presenting concern warranting diagnosis and management through biopsy.

Working together in clinical pathology: An interprofessional education initiative for dentistry, oral health, and medical laboratory science teachers and students.

This article was migrated. The article was marked as recommended. Introduction. In the health professional education literature, there is a need for information about the teaching and learning of medical laboratory sciences for clinical practice. The goal of this reflection-on-practice is to describe how an orofacial pathology interprofessional education (IPE) initiative was designed and implemented. Innovation. The designers of this initiative were teachers from dentistry, oral health, and medical laboratory science. The designers used six interprofessional competencies (patient-centred care, role clarification, team functioning, collaborative leadership, communication, and cultural practice) to guide their construction of teaching and learning resources. The initiative required students to work collaboratively with a given patient case to develop a differential diagnosis, prepare a treatment plan, present their case to classmates and staff members, and describe how they worked together to address the orofacial pathology in their case. Evaluation. The designers collected and considered evaluation information including the learning resources used, logistical arrangements for the initiative, and evaluation data from students via an anonymous 10-item questionnaire. Students rated statements that addressed the six interprofessional competencies and provided written comments about the initiative. Outcomes. In general, the 18 students agreed strongly with all statements except for cultural practice. Written comments about the initiative were positive and indicated that students appreciated learning about their own discipline and that of other professionals in the context of providing oral healthcare involving orofacial pathology. What next? Given the acceptability of this initiative to the designers, facilitators, and students, the next step is to consider the feasibility of scaling-up this small voluntary IPE initiative into a permanent component of the dentistry, oral health, and medical laboratory science programmes. Aspects to consider include staffing, scheduling, assessment, and cultural perspectives.

Curriculum development in final year dentistry to enhance competency and professionalism for contemporary general dental practice.

INTRODUCTION: General dentistry is the most common area of practice, and new dentists must have the competency and skills to safely deliver patient care. In New Zealand (NZ), completion of a 5-year Bachelor of Dental Surgery (BDS) degree enables graduates to register with the Dental Council in NZ. This necessitates that the clinical component of the curriculum in final year dentistry (BDS5) transparently delivers learning opportunities and evaluates competency for independent practice. A review of the BDS5 Clinical Practice course was undertaken in 2015 and a revised curriculum introduced in 2016. CURRICULUM: We present a BDS5 curriculum for a Clinical Practice course that is learner focused with emphasis on comprehensive patient-centred care, competency and professional practice. Learning opportunities and assessment processes are described alongside teacher training. These changes have provided students scaffolding to support clinical and professional development, and accommodate different learning preferences. The outcomes align with the competency requirements of the NZ regulatory body for registration as a general dental practitioner. Since its introduction 3 years ago, ongoing feedback from students and staff has been positive and indicates the curriculum is effective in achieving its objectives. CONCLUSIONS: This curriculum provides a firm foundation for students transitioning to independent clinical practice in the community and supports the professional development of clinical teachers. It may also be translated to other areas of health education to ensure the delivery of quality holistic patient care.

Oral Health and Dental Students' Perceptions of Their Clinical Learning Environment: A Focus Group Study.

Creating an optimal clinical learning environment poses a challenge to health professions educators. To evaluate and improve the clinical learning environment, it is necessary to understand students' experiences of their environment and the factors they perceive as having an impact on their learning. The aim of this explorative qualitative study was to examine University of Otago Faculty of Dentistry students' perceptions of their clinical learning environment to gain insights into how learning outcomes could be enhanced. In 2015, all approximately 600 students at all levels of the Bachelor of Oral Health and Bachelor of Dental Surgery degrees at the University of Otago, Dunedin, New Zealand, were invited to participate in focus groups. Focus groups facilitated by the faculty education research fellow and another researcher employed for the project were conducted during the second half of the academic year. Transcribed data were analyzed using a general inductive approach. Twenty-one students from all levels of the two programs attended one of six confidential focus groups. Three broad themes were evident in the results from all groups: feedback processes, assessments and grading, and tutor interactions. In the focus groups, students expressed dissatisfaction regarding current feedback practices, types of feedback to benefit learning, consistency in the grading system, and impact of different educators' teaching styles on learning. These results indicated a need for further research and curricular efforts to promote good student-teacher relationships in the clinical learning environment, which are paramount for creating an optimal teaching and learning environment and enhancing student outcomes.

An exploratory study of the acceptability of delivering oral health information in community pharmacies.

OBJECTIVE: The community pharmacy is an accessible service which, with further training and support, could be used to deliver oral health messages. This is important especially for those with systemic diseases such as diabetes mellitus and cardiovascular disease, where the oral environment may have a negative impact. This qualitative study assessed the feasibility of pharmacists delivering oral health messages in community pharmacies. DESIGN AND METHODS: Semi-structured interviews were conducted with 49 pharmacists in Dunedin and Auckland, New Zealand, with a focus on the pharmacists' current knowledge, attitudes and possibilities for providing oral health information to patients with diabetes and cardiovascular disease. FINDINGS: There is potential for community pharmacists to provide oral health information to patients, dependent on the approach of the pharmacist and the patient response. The majority of pharmacists agreed that providing oral health advice was within their role; however, few did so proactively. They highlighted a lack of available resources relating to oral health and systemic disease. Further training relating to oral health and systemic disease would be necessary to provide the knowledge to support any resources. The preferred option by pharmacists for such training was an evening course or workshop.

Professional storytelling in clinical dental anatomy teaching.

The aim of the present work was to see if storytelling in a clinical dental anatomy course would increase student satisfaction. We enhanced teaching by spontaneous storytelling in problem-based learning, in half of the third-year dentistry class. At the end of the course, we administered an anonymous questionnaire to the students in the class, consisting of 12 questions that students had to answer on a Likert scale of 1-5. An overall satisfaction score was obtained and we used a linear mixed model to compare differences in satisfaction between the two groups, with "group" as the fixed effect. We also conducted an exploratory factor analysis of the responses to investigate whether there were distinct constructs within the data. Overall satisfaction is high, with students "with stories" having higher satisfaction than those "without stories." The former group consistently gives higher satisfaction scores, regardless of which question is being asked. Factor analysis provides evidence that storytelling nurtures reflective learning, while students work on their clinical anatomy problems.

The working practices and job satisfaction of dental hygienists in New Zealand.

OBJECTIVES: To describe the current working practices and level of job satisfaction of dental hygienists in New Zealand. METHODS: Postal survey of all dental hygienists on the New Zealand Dental Council's database. An initial mailing was followed by a 3-week follow-up. Information was sought on respondents' demographic characteristics, current occupation and working practice, history of career breaks, continuing education and career satisfaction. RESULTS: 213 responses were received (73.2%); 90.6% were currently working as hygienists, mostly in private practice. Many worked part time, particularly those with children. Almost 50% of respondents had taken at least one career break, most frequently for childrearing. The mean time taken in career breaks was 3.6 years. Overall, dental hygienists reported high levels of satisfaction with their careers and their income. Older hygienists had higher career satisfaction scores. Most respondents were actively involved in continuing education. Almost half were interested in expanding the range of procedures they perform. Over one-third plan to retire within the next 10 years. CONCLUSIONS: While many hygienists take career breaks and work part time, most have a high level of career satisfaction, actively participate in continuing education, and are satisfied with their remuneration.