American Board of Dental Public Health diplomate survey, 2021: Competency domains and practice.

OBJECTIVE: To describe current Dental Public Health diplomates and list the competency domains that diplomates considered either essential or optional elements of their practice. METHODS: The American Board of Dental Public Health administered an electronic survey to active and life member diplomates during September 2021. The survey included 101 items in three sections: (1) Education and Work Experience; (2) Dental Public Health Tasks; and (3) Demographics. The Dental Public Health Tasks section asked individuals how essential work-related tasks were to their current practice. Descriptive analyses were conducted using SAS. RESULTS: The overall response rate was 82.6% (157 eligible of 190 returned). Most respondents were women, 35 to 54 years of age, and either non-Hispanic white or non-Hispanic Asian. Twice as many had DDS or DMD degrees than BDS degrees. The vast majority completed a Dental Public Health residency and received masters level training from an accredited program. About three-fourths worked in the United States and held a U.S. license. More than 37% reported a second doctoral degree and 70% worked in academia. Responses to questions about tasks closely aligned with working in academia and less so with positions related to advocacy, regulation, and program evaluation. CONCLUSIONS: Current diplomates are concentrated in academia. If this trend continues, it may be necessary to restructure the competencies, so training and skills acquisition remain timely and relevant. The specialty may also need to encourage future generations to consider non-academic positions so Dental Public Health remains an impactful component of the public health care system.

Improving Dental Service Utilization Rate Using a Proactive Telephone-Based Scheduling Strategy in Primary Healthcare

Abstract Objective: To determine the effect of a proactive telephone-based scheduling strategy to improve dental service utilization rate in primary healthcare. Material and Methods: A retrospective study was carried out based on the dental appointments' records of a primary healthcare center before-strategy and after-strategy periods. The variables studied for both periods were the number of dental appointments requested, dental appointments undergone, no-shows, and available quotas. Data collection was performed by two researchers between May and June 2018. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: A total of 10,193 records of dental appointments were registered within the two periods. After-strategy period, dental appointments undergone increased by 16,7%, no-shows decreased by 3%, and available quotas decreased by 21.3%. Conclusion: A proactive telephone-based scheduling strategy increased the dental service utilization rate in primary healthcare.

Faculty Development for Metro New York City Postdoctoral Dental Program Directors: Delphi Assessment and Program Response.

Faculty development for dental academicians is essential to cultivate a continuous faculty workforce, retain existing faculty members, enhance their teaching skill sets, and remain responsive to changing program requirements and curricular reforms. To maximize the utility of dental faculty development, it is important to systematically assess and address faculty members' perceived training needs. The aims of this study were to determine priority topics among one group of postdoctoral program directors and to translate those topics into faculty development programs as part of Columbia University's Health Resources and Services Administration (HRSA)-sponsored faculty training program for primary care educators. The study was conducted in 2013-16. A Delphi consensus technique was implemented with three sequential surveys of 26 New York City metropolitan area general, pediatric, and public health dentistry residency program directors. On the first survey, the five respondents (19% response rate) identified 31 topics. On the second survey, 17 respondents (response rate 65%) rated the 15 most important topics. In the third and final round, 19 respondents (73% response rate) ranked teaching research methods and teaching literature reviews as the topics of greatest interest. Overall, the responses highlighted needs for faculty development on teaching research methods, motivating trainees, trainee evaluation, and clinical care assessment. Based on these results, a series of six Faculty Forums was developed and implemented for dental educators in the metropolitan area, starting with the topic of teaching research methods. The process flow used for assessing training needs and developing and evaluating training can be applied to a variety of populations of educators.

Updated competencies for the dental public health specialist: using the past and present to frame the future.

OBJECTIVE: A new set of competencies for entry-level specialists in dental public health (DPH) developed in 2016 updates the 1998 version. Our objective is to provide some context and perspective on this update. METHODS: We discuss the evolution of this dental specialty, how it differs from other dental specialties, and its importance for the public's oral health. Some societal trends that provide the rationale for this update are summarized. The ways in which this set of competencies differs from the last version are described. RESULTS: The first set of behavioral objectives was established in 1974 and updated at workshops in 1988 and 1997. Advanced population-based knowledge and public health perspectives beyond that obtained in predoctoral dental education continue to be essential for the nation's oral health. Since 1998, the impact of the digital age, advances in science and technology, changes in population demographics, health status and increasing inequalities, treatment needs, prevention and treatment modalities, healthcare delivery systems, financing, personnel, legislation, and regulations have all influenced DPH practice. The updated competencies include guiding principles for the specialty, a new focus on social determinants of health, and more flexibility to address the increasing complexity and interdisciplinary nature of public health problems and the expanding knowledge and skills needed to address them. The rapid expansion of public health education might serve as an important pipeline for future DPH specialists. CONCLUSION: The updated competencies can guide the educational preparation of DPH specialists and are aligned with the rapidly changing environment.

Dental public health capacity worldwide: Results of a global survey.

The World Federation of Public Health Associations' Oral Health Working Group (WFPHA OHWG) carried out a survey to establish the extent of global dental public health (DPH) capacity. Senior stakeholders in DPH completed 124 surveys, covering 73 countries and all WHO regions. The survey evaluated DPH workforce within the country, funding, education, current services, and integration between public health and DPH in countries across the world. In 62 per cent of countries, DPH is only partially integrated in the public health system, while in 25 per cent of countries it has not yet been formally integrated. DPH programs at Masters level are available in 44 per cent of countries. Over half of countries have 0 to 10 trained DPH professionals. Because both poor oral and general health share several common risk factors, DPH must be integrated into national health systems and budgets, with an emphasis on having trained DPH specialists available in every country to collaborate in healthcare policy and provision.

The teaching of Dental Public Health - 50 years on.

In 1966, James published an article in the British Dental Journal (and reprinted here) which made recommendations on the teaching of dental public health. The following commentary reviews the ideas put forward by James and how these relate to concepts of dental public health in the undergraduate dental curricula of 2016 .

Community-based learning in a challenging context: the development and evaluation of an outreach dental public health programme in Damascus University, Syria.

INTRODUCTION: This study aimed to describe the development and evaluation of an outreach dental public health (DPH) programme in Damascus University, in terms of developing undergraduates' required knowledge, skills and attitudes (KSA), improving the quality aspects of training and assessment (T&A), and achieving the satisfaction of served children and their social network. METHODS: The outreach DPH programme offered opportunities to undergraduates to carry out outreach health-promotion activities, conduct and communicate the results of applied DPH research, and build partnership with students in other higher education sectors. A cross-sectional evaluation collected mixed qualitative and quantitative data, by a means of a short-essay and a self-completed questionnaire, from 400 third-year dental undergraduates, on KSA gained from outreach activities and quality aspects of T&A. The latter were compared with corresponding figures of other traditional dental programmes (TDP). Satisfaction with the outreach activities were collected from 215 children with special needs and 130 parents and school staff, by questionnaires. RESULTS: The response rates were 74.8%, 100% and 100% for undergraduates, children and parents/school staff, respectively. The derived categories of students' gained KSA included the following: unique clinical skills, social responsibility, voluntarism, communication, team working, personal growth, reflection on career aspirations and self-satisfaction with the contribution to needy groups. Their satisfaction with quality aspects of T&A was significantly higher than TDP (P < 0.001). Children's and parents/school staff's satisfaction was high. CONCLUSION: The outreach DPH programme in Damascus University is a successful example of developing undergraduates' required KSA, improving the quality aspects of T&A, and achieving the satisfaction of served community.

Pilot testing a predoctoral dental public health curriculum: reporting process and outcomes.

OBJECTIVES: The purpose of this study was to pilot test the predoctoral dental public health (DPH) curriculum developed by the American Association of Public Health Dentistry (AAPHD) in various US dental schools and dental hygiene programs. METHODS: Following the Lewy's theoretical framework, we used all three curriculum tryout methods (laboratory tryout, pilot tryout, and field tryout) for the pilot testing process. Open-ended questions on the structure, presentation, and content of the curriculum were sent to faculty pilot testing the DPH curriculum to obtain critical feedback and comments. RESULTS: Between Summer 2013 and Spring 2015, the curriculum was pilot tested in nine dental schools and seven dental hygiene programs with over 1,300 students. The majority of the comments from the faculty were favorable. Positive comments about the structure of the curriculum focused on the well-organized nature of the curriculum, the value of the instructor guide and speaker notes, rubrics, and the flow of the presentations. In terms of the content, faculty commented on the wide range of public health issues covered and the clarity of course and lecture objectives. Negative comments dealt with the level of detail, some confusing assignments, and outdated data. Problems identified in pilot testing were corrected in the final DPH curriculum. CONCLUSIONS: The curriculum was successfully utilized in varied formats and well received. Through AAPHD, this standardized DPH core curriculum is now available for widespread use at dental schools and dental hygiene programs.

Establishing a speaker's bureau to teach dental public health curriculum in predoctoral dental and dental hygiene programs.

The opening of new dental schools and dental hygiene programs in the past decade has further exacerbated the shortage of faculty, including those with dental public health (DPH) expertise to teach. Therefore, one of the aims for the American Association of Public Health Dentistry's (AAPHD) Predoctoral Dental Public Health Competencies and Curriculum Project (Project), to develop DPH competencies and curriculum, was to establish a speakers bureau of interested dental professionals to teach the curriculum in dental schools and dental hygiene programs at the predoctoral level. This paper describes the process for establishing a speakers bureau including identifying and training individuals to teach the developed DPH curriculum. The speakers bureau and its availability were promoted through the AAPHD website and through letters to deans of dental schools and directors of dental hygiene programs.

e-Assessment in a Limited-Resources Dental School Using an Open-Source Learning Management System.

e-Assessment provides solutions to some problems encountered in dental students' evaluation. The aim of this study was to evaluate the experience of a limited-resources dental school with e-assessment provided through an open-source learning management system (LMS). Data about users' access and types of e-assessment activities at the Faculty of Dentistry, Alexandria University, Egypt, were obtained from the web-based LMS Moodle. A questionnaire developed to assess students' perceptions of the e-assessment was also sent to students registered in two courses (undergraduate and postgraduate) with the same instructor. The results showed that most e-courses at the school had one form of e-assessment (82%) and, of these, 16.7% had summative assessment activities. There were significant differences among departments in the number of e-courses with e-assessment. One-quarter of e-courses with e-assessment used Moodle quizzes. Of 285 students registered in the two courses that included the questionnaire, 170 responded (response rate=59.6%). The responding students positively perceived the impact of e-assessment on learning and its reliability and security, whereas technical issues and related stresses were negatively perceived. This study suggests that e-assessment can be used at minimal cost in dental schools with limited resources and large class sizes with the least demands on faculty members and teaching staff time. For these schools, an open-source LMS such as Moodle provides formative e-assessment not available otherwise and accommodates various question formats and varying levels of instructors' technical skills. These students seemed to have a positive impression of the e-assessment although technical problems and related stresses are issues that need to be addressed.

The impact of a continuing education programme on the adoption of nickel-titanium rotary instrumentation and root-filling quality amongst a group of Swedish general dental practitioners.

INTRODUCTION: The aim of the study was to test the hypothesis that a further education programme relating to nickel-titanium rotary instrumentation (NTRI), with the concurrent activation of social/professional networks amongst all general dental practitioners (GDPs) in a public dental service in Sweden, would increase the adoption rate and improve root-filling quality. MATERIAL AND METHOD: To activate the networks, the GDPs at the 25 clinics elected training coaches from amongst themselves. The coaches were educated by a specialist and were then free to organise and conduct the training of the local GDPs. However, collective hands-on training and discussions were mandatory. Lectures were held by an endodontist. The rate of adoption and root-filling quality was evaluated just before and 6 months after the education. Statistical tests were performed with chi-square using a 95% confidence interval. RESULTS: Nickel-titanium rotary instrumentation was adopted by 88%. Excellent root fillings (score 1) increased from 45% to 59% (P = 0.003). The rate of poor-quality root fillings (score 4 and score 5) was not affected. The quality ratio (score 1/score 5) increased from 5.36 (118/22) to 9.5 (133/14). Eleven dentists (17%) at nine different clinics produced 49% of the poor-quality root fillings (score 4 and score 5). Seventy-three per cent of these dentists stated that they had adopted NTRI. CONCLUSIONS: The introduction of NTRI will increase the adoption rate and the frequency of good-quality root fillings. However, it will not overcome the problems associated with dentists producing a low-quality level, even if a local professional network is activated.

How can dental public health competencies be addressed at the undergraduate level?

OBJECTIVES: To discuss the extent to which an undergraduate dental module addresses dental public health competencies via its different learning pedagogies and to explore the relevance of students' written reflections on these dental public health competencies. METHODS: This article uses a literature review to situate the extent to which dental public health competencies are addressed by the University of British Columbia undergraduate dental module entitled "Professionalism and Community Services" (PACS). It also uses students' written individual self-reflections (between 100 and 500 words) on community service learning activities to critically illustrate how dental public health competencies support their learning. RESULTS: The PACS dental module is delivered to undergraduate students in all 4 years, more than 190 in total, and addresses six dental public health competencies, including oral health promotion, ethics, and evidence-based practice. The multifaceted pedagogical approach employed to discuss aspects of dentistry related to dental public health includes guest lectures, community activities, small group activities, self-reflection, and reports. CONCLUSIONS: Given the falling number of dental public health professionals in North America, the discussed undergraduate pedagogy aims to sensitize future dentists to a career focused on dental public health. Through reflections, students pondered ideas related to dental public health; they also engaged in developing meaningful activities in various underserved communities. Further studies are needed to evaluate the influence of this community-based curriculum upon students' practice choice.

Advances and challenges in oral health after a decade of the "Smiling Brazil" Program.

OBJECTIVE: To analyze oral health work changes in primary health care after Brazil's National Oral Health Policy Guidelines were released. METHODS: A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. RESULTS: Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people's participation and social control; and intersectorial actions. CONCLUSIONS: Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities.

Evolução da cobertura das equipes de saúde bucal nas macrorregiões brasileiras / Expansion of the oral health family teams among the Brazilian regions

A saúde bucal no Brasil impulsionou-se com a implantação das Equipes de Saúde Bucal (ESB), Estratégia Saúde da Família (ESF). Este artigo propôs-se analisar a evolução da cobertura das ESB, nas macrorregiões brasileiras. Os dados foram obtidos do consolidado histórico de cobertura da saúde da família, Departamento da Atenção Básica/Ministério da Saúde (2001- 2013) e analisados no programa STATA®10.0. Observou-se que a 59,2% da quantidade de ESB I em relação ao total de equipes brasileiras implantadas no ano de 2001 estava na região Nordeste e 4,9% no Norte, em 2013: 48,5% e 7,8%, respectivamente. Quanto à proporção populacional coberta por algum tipo de ESB o Nordeste apresentou maior proporção de ESB I: 69,1% e Sudeste, menor proporção 25,6%. Ao relacionar-se a proporção ESB I/ESB II o Nordeste apresentou a pior relação 1:33,4 e o Sul melhor 1:5,6. Na análise de regressão de efeitos mistos houve associação significante entre número ESB e teto de implantação de equipes. Concluiu-se então que o número de ESB é insatisfatório, cobrindo apenas 42,1% da população brasileira, bem aquém do teto de 100%. Desde sua implantação, as ESB I apresentaram crescimento exponencial, enquanto as ESB II apresentaram um crescimento discreto.

Oral health care in Brazil boosted with the implementation of oral health teams (ESB), the Family Health Strategy (FHS). This paper set out to analyze the evolution of the coverage of ESBs in the Brazilian regions. Data were obtained from the historical consolidated coverage family health, Department of Primary Care / Ministry of Health (2001- 2013) and analyzed in STATA®10.0 program. Through them we observed, distribution of ESB I in 2001: 59.2% - 4.9% -North and Northeast in 2013: 48.5% and 7.8%, respectively. As for the population proportion covered by any kind of ESB, northwest showed a higher proportion of ESB I: 69,1% and Southeast smaller proportion 25,6%. In relating the proportion ESB I / II ESB: 1: 33,4 Northwest- wost and better South: 1: 5,6. In the analysis of mixed effects regression was no significant association between the average number ESB and cover needs. It was concluded that the number of ESB is unsatisfactory, covering only 42,1% of the population, totally apart from the ceiling of 100%. Since its implementation, the ESB I showed exponential growth, while the ESB II showed a slight growth.

Advances and challenges in oral health after a decade of the "Smiling Brazil" Program / Avanços e desafios da saúde bucal após uma década de Programa Brasil Sorridente

ABSTRACT OBJECTIVE To analyze oral health work changes in primary health care after Brazil's National Oral Health Policy Guidelines were released. METHODS A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. RESULTS Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people's participation and social control; and intersectorial actions. CONCLUSIONS Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities.

RESUMO OBJETIVO Analisar as mudanças no trabalho em saúde bucal na atenção primária à saúde após o lançamento das Diretrizes da Política Nacional de Saúde Bucal. MÉTODOS Foi realizada revisão da literatura nas bases de dados Medline, Lilacs, Embase, SciELO, Biblioteca Virtual em Saúde e The Cochrane Library, de 2000 a 2013, sobre elementos analisadores das mudanças no trabalho. Os descritores utilizados foram: atenção primária à saúde, saúde da família, trabalho, política de saúde, serviços de saúde bucal, odontologia, saúde bucal e Brasil. Foram selecionados e analisados 32 estudos, com predomínio de estudos qualitativos, da região Nordeste, com trabalhadores, sobretudo dentistas, e com foco na integralidade e qualificação da assistência. RESULTADOS Os avanços observados concentraram-se nas ações educativas e de educação permanente; no acolhimento, vínculo e responsabilização. Os principais desafios estiveram relacionados à: integralidade; ampliação e qualificação da assistência; trabalho integrado em equipe; condições de trabalho; planejamento, monitoramento e avaliação das ações; estímulo à participação popular e ao controle social; e ações intersetoriais. CONCLUSÕES Apesar do novo cenário normativo, as mudanças são incipientes no trabalho em saúde bucal. Os profissionais tendem a reproduzir o modelo biomédico dominante. Serão necessários esforços continuados no campo da gestão do trabalho, da formação e da educação permanente. Dentre as possibilidades, está a ampliação do engajamento dos gestores e dos profissionais num processo de compreensão da dinâmica do trabalho e da formação na perspectiva de construir mudanças significativas para as realidades locais.

Percepção dos usuários da unidade de saúde da família do distrito sanitário III e conhecimento dos profissionais sobre lesões de boca em tecido mole / Perception of users of the family health unit of sanitary district III and knowledge of professionals on soft tissue mouth lesions

A legislação do SUS garante a saúde para todos e de maneira integral, do homem como um ser holístico, desde problemas básicos e simples até cirurgias avançadas de nível terciário. A saúde bucal faz parte dessa garantia de atendimento e um dos problemas mais graves enfrentados é câncer de boca, que tem na educação e no conhecimento dois pilares para sua prevenção e diagnóstico precoce, sendo eles: a percepção dos usuários que é apurada pelo conhecimento dos profissionais que capacitam a população referenciada a ele e o encaminhamento correto dos casos. É exatamente esse o objetivo do nosso estudo realizado nas Unidades de Saúde da Família do Distrito Sanitário III, Recife - Pernambuco com os usuários que estiveram em atendimento. De acordo com a pesquisa, 13,63% dos dentistas não têm segurança para diagnosticar, referenciam o paciente para o serviço correto, porém não notificam a lesão, e a população precisa ser melhor instruída em relação às lesões de boca.

The legislation ensures health care to all and in a general way through a holistic approach, including basic and simple procedures as well as advanced third level surgeries. Oral health is part of this service and one of the most serious problems faced is oral cancer, which has on the education and knowledge two pillars for its prevention and early diagnosis: the perception of users is determined by the knowledge of professionals who enable the enrolled population, as well as the proper routing of cases. That was precisely the aim of our study with the users of the Family Health Unit of Sanitary District III (Recife-PE). According to the survey, 13.63% of dentists do not have security to diagnose, refer the patient to the correct service, but do not report the injury, and the population needs to be better educated about the mouth lesions.

Student-led oral health education for the homeless community of East London.

Within the BDS curriculum, dental public health and the importance of social responsibility is clearly emphasised though often in a didactic manner, without practical application. Preventative concepts are taught and relayed to individual patients being treated within a dental school. The impact of oral disease on general health within disadvantaged communities is a problem commonly addressed by healthcare professionals. Part of this responsibility should be shared with and experienced by the next generation of dental practitioners through health education outreach programmes within the undergraduate curriculum. Not only will this benefit recipients within disadvantaged populations such as the homeless, but it will also develop and encourage a philosophy of social responsibility throughout the future careers of undergraduate dental and hygiene/therapy students. To explore the feasibility of achieving this objective, we devised an oral health awareness programme to address the needs of 'hard to reach' homeless people within the communities served by the Community Dental Service of Tower Hamlets, City and Hackney, London.