Pediatric dental residents' on-call experience.

PURPOSE/OBJECTIVES: The Commission on Dental (CODA) requires that pediatric dentistry training programs provide residents with clinical experiences in oral-facial injury and emergency care, as well as interprofessional patient care through hospital dentistry. These standards are often met through pediatric dental residents being on-call for children's hospitals. The aim of this study was to describe the on-call experience of pediatric dental residents at two urban children's hospitals. METHODS: This cross-sectional descriptive study collected and analyzed data on the number, type, and time and date distributions of on-call pages received by pediatric dental residents over a 36-month study period. RESULTS: A total of 737 on-call pages were received. Each pediatric dental resident responded to 70 pages on average during their training. The most common reason for pages being received was inpatient consultation and oral-facial trauma. The mean number of pages received did not vary by year, month, or day of the week. There was a statically significant difference in the mean number of pages received by the hour of the day. CONCLUSION: Having an on-call pediatric dental service in pediatric dentistry training programs is a meaningful way of exposing pediatric dental residents to oral-facial trauma, hospital dentistry, and interprofessional care.

Burnout and Work Engagement Among US Dentists.

BACKGROUND: Burnout is a threat to patient safety. It relates to emotional exhaustion, depersonalization, and lack of personal accomplishment. Work engagement conversely composed of levels of vigor, dedication, and absorption in one's profession. The aim of this study was to examine burnout and work engagement among US dentists. METHODS: This study used the extensively validated Maslach Burnout Inventory-Human Services Survey and Utrecht Work Engagement Scale to measure burnout in a self-administered survey of 167 US dentists who attended continuing education courses held in Boston, Pittsburg, Iowa City, and Las Vegas. The mean scores on the 3 subscales of Maslach Burnout Inventory-Human Services Survey and Utrecht Work Engagement Scale were computed. The interscale correlations between the components of burnout and work engagement were assessed using Pearson correlations. We used 1-way analysis of variance and independent 2 sample t tests to examine the relationship between burnout and work engagement across sex and various age categories. Prevalence of burnout in our study population was also computed. RESULTS: We observed that 13.2% of our study population experienced burnout and 16.2% of our study population was highly work engaged. There was a statistically significant, unadjusted association between burnout risk and work engagement (χ2 = 22.51, P < 0.0001). Furthermore, the scores in the subscales of burnout were significantly correlated with scores in the subscales of work engagement. CONCLUSIONS: In this preliminary study, we observed some evidence of burnout among practicing US dentists. It is imperative that the dental profession understands this and works to promote professional practices that increase work engagement and decrease burnout.

Adverse Events in Pediatric Dentistry: An Exploratory Study.

Purpose: Existing studies on adverse events (AEs) in pediatric dentistry have been limited in scope. The purpose of this study was to develop a comprehensive list of pediatric dental adverse events and assess their occurrences among pediatric dentists. This study developed the first inventory of pediatric dental adverse events. Methods: Over a three-month period, semistructured interviews were conducted with domain expert pediatric dentists to develop a comprehensive list of AEs occurring in pediatric dentistry. American Academy of Pediatric Dentistry (AAPD) members were invited to complete a validated 15-item survey about their experience with pediatric dental AEs. Data analysis was performed to determine the percentage of pediatric dentists experiencing AEs. Results: A total of 193 pediatric dental AEs were identified through interviews and surveys; 1,042 AAPD members completed the survey (response rate equals 16.3 percent). The most common AEs experienced were post-treatment soft tissue trauma (86.1 percent), nicking/damaging of adjacent teeth (52.0 percent), and intraoperative soft tissue damage (47.1 percent). The least commonly experienced AEs were patients requiring CPR (0.5 percent) and patients aspirating materials (0.4 percent). Conclusions: A significant proportion of pediatric dentists experienced adverse events, and a small but poignant number indicated that their patients faced moderate to severe AEs.

Focal Epithelial Hyperplasia in a Child with Hereditary Sensory and Autonomic Neuropathy type IV: A Rare Co-Occurrence.

Hereditary sensory and autonomic neuropathies (HSAN) are a set of rare neurological conditions with five differing phenotypes. Type IV HSAN is notable for congenital insensitivity to pain. Focal epithelial hyperplasia (Heck's disease), a variant of human papillomavirus (HPV), presents as intraoral papules. The purpose of this report is to present the case of a five-year-old patient with HSAN type IV who was referred by her pediatric dentist to evaluate a tongue mass. Her medical history included recurrent urinary tract infections and verrucae on her hands and self-mutilation of the tongue and hands. Her dental history revealed that she had self-extracted 14 primary teeth. A soft tissue exam revealed flat surface papules on the tongue and a raised yellow, white and pink lesion on the right lateral tongue, which was diagnosed as focal epithelial hyperplasia. The co-occurrence of HSAN type IV and focal epithelial hyperplasia is a rare case that demonstrates the need for coordination among medical and dental professionals to achieve the optimal outcome. (J Dent Child 2019;86(3):154-7).

Underrepresented Minority Dentists: Quantifying Their Numbers And Characterizing The Communities They Serve.

The underrepresentation of Blacks, Hispanics or Latinos, and American Indians or Alaska Natives among dentists raises concerns about the diversity of the dental workforce, disparities in access to dental care and in oral health status, and social justice. We quantified the shortage of underrepresented minority dentists and examined these dentists' practice patterns in relation to the characteristics of the communities they serve. The underrepresented minority dentist workforce is disproportionately smaller than, and unevenly distributed in relation to, minority populations in the United States. Members of minority groups represent larger shares of these dentists' patient panels than of the populations in the communities where the dentists are located. Compared to counties with no underrepresented minority dentists, counties with one or more such dentists are more racially diverse and affluent but also have greater economic and social inequality. Current policy approaches to improve the diversity of the dental workforce are a critical first step, but more must be done to improve equity in dental health.