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1.
Ned Tijdschr Tandheelkd ; 126(11): 571-578, 2019 Nov.
Artigo em Holandês | MEDLINE | ID: mdl-31730134

RESUMO

Dentists frequently have to deal with anxious children and adults. Whether these patients can be treated successfully in a regular dental office depends on the type of fear and its severity. Proper diagnostic procedures are therefore paramount. This article gives an overview of how dental fear develops, is sustained, and can be treated. It elaborates on the communication skills important in reducing anxiety and preventing children from developing dental fear.


Assuntos
Ansiedade ao Tratamento Odontológico , Relações Dentista-Paciente , Adulto , Criança , Comunicação , Assistência Odontológica , Consultórios Odontológicos , Humanos
2.
BMC Oral Health ; 19(1): 162, 2019 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340799

RESUMO

BACKGROUND: There is a paucity of research concerning paediatric dental consultations in primary care. This is potentially due to the difficulty of measuring the communication behaviours in the complex triadic consultations. The present study aims to describe the development and refinement of a coding scheme to record the triadic communication between dental professionals, child patients and parents. METHODS: The PaeD-TrICS was developed from video observation of triadic communications and refined through an iterative process. Its practical applicability was assessed via implementation of the scheme on specialised behavioural coding software. Reliability was calculated using Cohen's Kappa. RESULTS: The PaeD-TrICS contains 45 codes. Forty-four dental professional-child-parent communications were successfully coded through administering the scheme on The Observer XT 10.5 system. Cohen's Kappa was 0.83 (inter-coder) and 0.90 (intra-coder). "Parental verbal facilitation" (mean = 1.68/min) was the most frequent behaviour. Dental professionals' "dentally engaging talk" (mean = 1.24/min), "praise" (mean = 1.10/min) and "instruction" (mean = 0.62/min) were frequently seen. Children's common behaviours included "speech other" (mean = 0.66/min) and non-verbal behaviour i.e. "non-verbal agreement" and verbal behaviour "speech yes" (mean = 0.26/min). CONCLUSIONS: The PaeD-TrICS is developed to capture the communication behaviour of the triadic consultations in a preventive dental setting. It demonstrates satisfactory intra- and inter-coder reliability and has been successfully used in paediatric dental consultations.


Assuntos
Codificação Clínica , Comunicação , Relações Dentista-Paciente , Odontólogos/psicologia , Pais/psicologia , Encaminhamento e Consulta , Criança , Comportamento Infantil , Pré-Escolar , Codificação Clínica/métodos , Humanos , Pacientes , Serviços Preventivos de Saúde/organização & administração , Psicometria , Reprodutibilidade dos Testes , Gravação em Vídeo
3.
Br Dent J ; 227(2): 69, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31350470
4.
Ned Tijdschr Tandheelkd ; 126(7-8): 377-383, 2019 Jul.
Artigo em Holandês | MEDLINE | ID: mdl-31309936

RESUMO

Dentists will increasingly have to treat patients with a variety of cultural backgrounds. They will consequently have to deal with various preconceptions about health and how people ought to behave with each other. In order to develop a good dentist-patient relationship and provide appropriate care, the dentist will have to learn to communicate in a culturally competent manner. That requires an open, empathetic attitude and an awareness of one's own norms, values and views. The dentist will have to consider how they differ from those of people from another (sub) culture. With the help of a number of examples, this article will provide an impulse to do that.


Assuntos
Comunicação , Competência Cultural , Relações Dentista-Paciente , Odontólogos , Humanos
5.
J Dent Educ ; 83(10): 1174-1198, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31285365

RESUMO

Health humanities usually includes such disciplines as philosophy, ethics, history, literature, performing arts, and cultural anthropology. The aims of this scoping review were, first, to search the published literature for references to the humanities in predoctoral dental education and, second, to determine if any research studies found that introducing humanities in dental education improved the overall profile of dental graduates. Literature searches were run in Ovid MEDLINE, Embase, ERIC, CINAHL, and Dentistry and Oral Sciences Source. A total of 248 articles were included in the review, with inclusion criteria comprising the areas of the curriculum, the scope of humanities, and predoctoral dental education. Of those articles, 101 referred in a targeted way to ethics in predoctoral dental education, while others mainly referred to the humanities in general or pointed out the role and place of humanities topics in predoctoral dental curricula. Topics covered included professional ethics, music, narrative learning, theater, art, communication skills, empathy, emotional intelligence, and cultural competence in the context of general humanistic education. The review found limited evidence of a clear impact, either short-term or long-term, of humanities education in predoctoral dental education. Reflections on humanistic education in the practice of clinical dentistry were sparse, as mainly documented by development of the ideal dentist-patient relationship, enhancement of empathy for patients, and most importantly, construction of professional moral values.


Assuntos
Currículo , Educação em Odontologia , Ética Odontológica , Ciências Humanas , Arte , Comunicação , Competência Cultural , Relações Dentista-Paciente , Inteligência Emocional , Empatia , Humanos , Aprendizagem , Música
7.
J Dent Educ ; 83(10): 1134-1141, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31235504

RESUMO

A successful health care provider may be described as a clinician capable of establishing a comprehensive diagnosis including identifying related risk factors. However, an equally important quality a clinician should possess is the ability to understand the experiences and feelings of others to allow better communication for better outcomes. It is likely that faculty empathy levels influence students' ability to demonstrate this attribute. The aim of this study was to assess the levels of empathy of dental faculty members relative to dental students at the Universidad San Sebastian in Chile. Using a cross-sectional design of survey-collected data collected with the Jefferson Scale of Empathy, the authors compared the perceptions of the dental faculty involved in teaching fourth- and fifth-year dental students (n=116) to the perceptions of basic and preclinical students (n=346) and clinical students (n=189). The data were collected in 2016-17. The results showed that the mean faculty scores were higher than that of the students in compassionate care (90.1%) and perspective adoption (89.7%); however, for putting oneself in the other's shoes, the faculty had a lower score (57.8%) than the clinical students (58.2%). Future investigations are needed to understand the impact of faculty empathy scores on students and whether pedagogical interventions can increase empathy scores.


Assuntos
Relações Dentista-Paciente , Empatia , Docentes de Odontologia/psicologia , Estudantes de Odontologia/psicologia , Atitude do Pessoal de Saúde , Chile , Comunicação , Estudos Transversais , Humanos , Faculdades de Odontologia , Inquéritos e Questionários
8.
J Dent Educ ; 83(10): 1142-1150, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31235505

RESUMO

Simulation may help translate didactic learning to patient care in areas such as communication skills and medical emergency management. The aims of this study were to investigate how multiple cohorts of dental students evaluated simulations utilizing standardized patients and manikins and to explore evaluations of a simulation that combined social determinants of health with oral health education. All approximately 600 second- and fourth-year dental students at one U.S. dental school participated in simulation activities for five years (2014-18). The activities involved clinical communication skills with an urgent care patient, medical emergency management, and communication skills with a parent with low income. After the simulations, students were invited to complete an evaluation of the experience. Questionnaire items addressed perceived applicability to patient care, value of the experience, and fulfillment of objectives; and open-ended questions asked for comments specific to the parent with low income simulation. A total of 497 responses from D2 and D4 students were collected over the five-year period, as well as from all 12 periodontics residents in 2017, for an overall 91.7% response rate. The vast majority (>90.6%) positively evaluated all items for each simulation. The positive ratings ranged from a mean of 99.3% for the urgent care simulation to 93.8% for the parent with low income simulation. Positive student comments often related to learning from/with others and effective practice of teach back and patient education tactics. Students' most frequent suggestions for improvement called for better preparation. In this study, simulations with both standardized patients and manikins led to positive evaluations as well as anticipated improvement of clinical performance. These results suggest that incorporating simulation into an already-crowded curriculum is worth it from the student perspective, especially for reinforcement of clinical skills not easily amenable to classroom instruction.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Comunicação , Relações Dentista-Paciente , Educação em Odontologia/métodos , Simulação de Paciente , Estudantes de Odontologia/psicologia , Assistência Ambulatorial , Estudos de Coortes , Currículo , Serviços Médicos de Emergência , Humanos , Manequins , Pobreza , Faculdades de Odontologia , Inquéritos e Questionários , Estados Unidos
9.
J Public Health Dent ; 79(3): 246-252, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31063236

RESUMO

OBJECTIVES: Integrating smoking cessation interventions into dental care is an efficient way to intervene with smokers. This study of dentists and dental hygienists who provide dental care to Medicaid-insured patients explores awareness of Medicaid smoking cessation benefits, awareness of Quitline resources, beliefs about perceived role in providing tobacco interventions, and behaviors around clinical intervention. METHODS: In 2015, we conducted a survey of dentists and hygienists who serve Medicaid patients in New York State. RESULTS: A total of 182 dentists and 92 hygienists completed the survey. Ninety percent reported that helping patients quit smoking is part of their role, while 51.0 percent reported feeling confident in their ability to counsel a patient about quitting. Most respondents (73.4 percent) asked patients about tobacco use, 83.7 percent advised smokers to quit, and 49.1 percent assisted with quit attempts. We found that 26.7 percent were aware that dentist smoking cessation counseling is covered by Medicaid, and 15.5 percent were aware that hygienist smoking cessation counseling is covered. A total of 38.9 percent were aware of any Medicaid coverage for smoking cessation. Awareness of the Medicaid smoking cessation benefit was associated with intervention behaviors of asking and assisting. CONCLUSIONS: Most dental care providers see smoking cessation as part of their role, but few are aware of the Medicaid benefits available to help patients. Expanding coverage of and promoting Medicaid benefits for smoking cessation have the potential to increase the reach and quality of smoking cessation interventions for Medicaid-insured smokers, a population disproportionately affected by tobacco use.


Assuntos
Abandono do Hábito de Fumar , Aconselhamento , Higienistas Dentários , Relações Dentista-Paciente , Odontólogos , Humanos , Medicaid , Estados Unidos
10.
J Dent Educ ; 83(9): 1039-1046, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31133617

RESUMO

The aim of this study was to assess older adults' experience of care in an academic dental practice to identify opportunities to improve the patient experience for older adults. A cross-sectional descriptive survey design with a sample of adults aged 65 and older was conducted using the Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) 12-month survey 2.0, with supplemental survey item sets addressing cultural competence and health literacy. A total of 850 older adults were invited to participate in the survey in fall 2016, and a 43% response rate was achieved. Overall, participants reported a positive experience of care and high ratings for their dental providers. Significant differences were found based on age, education level, race, and health status. A significantly more favorable experience of care was reported by patients aged 75 and older, as well as adults without any college education. Non-white patients were less likely to highly rate their dental providers and gave lower ratings for experiencing trust with their dental providers than white patients. Patients reporting good/fair/poor health were also less likely than those reporting very good/excellent health to highly rate their dental providers, and they gave lower ratings for patient-provider communication. This study demonstrated the feasibility of using the CG-CAHPS survey to assess the patient experience for older adults in an academic dental practice. Results identified opportunities for improving the dental practice and underscored the importance of enhancing dental curricula in areas of cultural competence, health literacy, and diversity.


Assuntos
Competência Cultural , Assistência Odontológica para Idosos , Clínicas Odontológicas , Pacientes/psicologia , Qualidade da Assistência à Saúde , Faculdades de Odontologia , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Estudos Transversais , Relações Dentista-Paciente , Feminino , Pesquisas sobre Serviços de Saúde , Nível de Saúde , Humanos , Masculino , Satisfação do Paciente , Assistência Centrada no Paciente , Inquéritos e Questionários , Confiança , Estados Unidos
12.
Oral Health Prev Dent ; 17(1): 35-41, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30793120

RESUMO

PURPOSE: To evaluate dental anxiety from the dentist's perspective. MATERIALS AND METHODS: A cross-sectional study was performed on a convenience sample. Data were gathered using questionnaires that included general information and specific questions concerning dentally anxious patients. RESULTS: Three hundred ten practicing dentists completed the survey. Participants estimated that 27% of their adolescent/adult patients and 35% of their child patients suffer from dental anxiety. Dentists reported devoting about a quarter of their weekly work hours to treating such patients. The most common anxiety management techniques used for adults and children alike were nitrous oxide and/or behavioural techniques (such as distraction, reinforcement, gradual exposure, and relaxation). Dentists generally agreed that it is their responsibility to help dentally anxious patients. Eighty-one percent expressed interest in taking part in dental anxiety management courses. The consensus was that treating dentally anxious patients involves long treatment times, insufficient payment, and frequent appointment cancellations. CONCLUSIONS: According to practicing dentists, over one-quarter of their patients suffer from dental anxiety. Most dentists perceive themselves as responsible for treating these patients and are willing to receive appropriate training. Incorporating behavioural and pharmacological management techniques in the undergraduate dental curriculum and expanding postgraduate training programmes in this field are important issues that can improve the well-being of both dentally anxious patients and their dentists.


Assuntos
Relações Dentista-Paciente , Odontólogos , Adolescente , Adulto , Criança , Estudos Transversais , Ansiedade ao Tratamento Odontológico , Humanos , Inquéritos e Questionários
13.
Clin Oral Investig ; 23(12): 4189-4194, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30790085

RESUMO

OBJECTIVES: The aim of this study was to investigate the attitude, observations, and knowledge of German dentists regarding the management of dry mouth. MATERIALS AND METHODS: A questionnaire including queries about attitudes, observations, and treatment options in patients with dry mouth was developed and sent to all 1251 dentist members of a regional German dental association. RESULTS: An overall total of 284 returned questionnaires were included in the analyses, which relates to a response rate of 22.7%. Dentists infrequently encountered dry mouth in their clinical routine, yet were well aware that patients suffer from the symptoms of dry mouth; for affected patients, the majority of participating dentists provided specific dental prophylaxis measures. Drug side effects, neoplasia, and psychological disorders were regarded as the primary etiological factors for dry mouth, and caries, increased plaque formation, and rhagades as the most frequently observed clinical symptoms. While the majority of participating dentists was of the opinion that saliva substitutes are useful treatment options in patients with dry mouth, only few frequently recommended their use. Mechanical and gustatory stimulation of salivary flow as well as the advice to rinse with water were the most frequently pursued treatment options. CONCLUSIONS: Despite the high prevalence of dry mouth identified in epidemiological studies, it appears to be an infrequent observation in clinical routine. CLINICAL RELEVANCE: Pre- and postgraduate education should sensitize dentists for dry mouth and its treatment options.


Assuntos
Odontólogos/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Xerostomia/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Relações Dentista-Paciente , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Xerostomia/etiologia , Adulto Jovem
15.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4427, 01 Fevereiro 2019. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-998241

RESUMO

Objective: To identify the social representations of children in relation to the image of the dentist. Material and Methods: This is a descriptive cross-sectional study with quantitativequalitative approach. The sample consisted of 80 children of both sexes aged 7-10 years attended at a clinic-school of a university in eastern Minas Gerais, Brazil. For data collection, the Test of Free Words Association (TALP) was used, with the word "dentist" as its inducing theme. The four items included in the research instrument were: 1) evoke up to five words or expressions related to the dentist; 2) to order each of them numerically, with number one being the most important and number five being the least important; 3) to conceptualize the one elected as number one; and 4) to justify the reason for that choice. The EVOC software was used to carry out quantitative analyses and the Analysis of Content of Bardin for qualitative analyses. Results: The words that composed the central nucleus of social representations were "tooth", "pain", "brushing" and "treats". This grouping of ideas points to the following conceptual formulation: "The dentist is someone who 'brushes' and 'treats' teeth, but sometimes performs procedures that cause 'pain'. The categories abstracted from participants' discourse were "oral health", "personal characteristics of the dentist" and "child-dentist interaction". Conclusion: Children presented predominantly positive image regarding the dentist.


Assuntos
Humanos , Masculino , Feminino , Criança , Criança , Comportamento Infantil/psicologia , Psicologia da Criança , Relações Dentista-Paciente , Odontólogos , Brasil , Análise Qualitativa , Estudos Transversais/métodos
16.
J Dent Educ ; 83(3): 296-302, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30692192

RESUMO

The aim of this replication study was to determine if prior findings at one U.S. dental school about dental students' comfort discussing and perceptions of the relevance of 15 risk behaviors to adolescent patient oral health care would be observed at other institutions. All first- and fourth-year dental students (n=414) at three U.S. dental schools in fall 2017 were invited to participate, and 218 completed the survey (52.7% response rate). These students reported feeling comfortable to uncomfortable discussing risk behaviors with adolescent patients, yet perceived those risk behaviors as relevant to their oral health. There were significant differences in student comfort discussing risk behaviors with adolescents and their perceptions of relevance by gender, age, class status, and school location. Males were more comfortable than females discussing oral health risk behaviors. There were no significant differences by race/ethnicity. Fourth-year students had higher levels of comfort discussing risk behaviors than first-year students. Compared to students in the South and Midwest schools, students at the West school were more comfortable discussing selected topics and had higher perceptions of their relevance to adolescent oral health care. These results suggest there is room for improvement in this area of dental education. Dental schools should aim to strengthen students' knowledge of and comfort in discussing oral health risk behaviors with adolescent patients with the use of educational activities and clinical experiences.


Assuntos
Competência Clínica , Psicologia do Adolescente/educação , Assunção de Riscos , Estudantes de Odontologia , Adolescente , Adulto , Competência Clínica/estatística & dados numéricos , Comunicação , Relações Dentista-Paciente , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
17.
Eur J Dent Educ ; 23(2): 220-229, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30659766

RESUMO

A consultation model for dentistry is presented, with communication skills in a didactic and structural format, applicable for most types of visits, patients and problems. A characteristic of the dental visit is its division into dialogue phases and clinical phases, which makes verbal exchange especially challenging. The original Four Habits Model (4H) has been adapted from medicine to the specific structure and content of a dental visit, and a modified model is proposed. The dental model consists of a structural core framework relevant for all dental consultations, and additional extensions applicable to commonly occurring issues. Facilitate Perceived Control has been added to the model, due to its crucial importance in dental visits, and we suggest naming the model "The Four + One Habits Model for Dental Visits (4 + 1HD)." The proposed model should have clinical relevance for improving patient care and patient experience, as well as easing the busy everyday life for dentists in a variety of clinical settings. It is also likely to be a flexible framework for communication skills training at all levels of dental education. More research is needed to validate and test the model in various clinical and educational settings.


Assuntos
Competência Clínica , Comunicação , Assistência Odontológica , Relações Dentista-Paciente , Odontólogos , Educação em Odontologia , Visita a Consultório Médico , Assistência Centrada no Paciente , Encaminhamento e Consulta , Estudantes de Odontologia , Humanos , Modelos Teóricos , Qualidade da Assistência à Saúde
18.
Ned Tijdschr Tandheelkd ; 126(1): 37-44, 2019 01.
Artigo em Holandês | MEDLINE | ID: mdl-30636264

RESUMO

A good dentist-patient relationship promotes better oral health of the patient. In order to build and maintain such a relationship a dentist should possess good communication skills. First of all, an open, empathic attitude is important, in which the dentist is aware that he can make mistakes interpreting patient behaviour. Good observational skills are necessary to detect (non-)verbal signals indicating how to interpret the patient's story. By demonstrating non-verbal, paralingual and verbal listening behaviour,he can show patients that he is paying attention to them. When discussing findings, it is important for patients to receive a clear explanation and be given the opportunity to ask questions. It is also wise to pay attention to the patient's expectations of the treatment outcome, elaborate on the advantages and disadvantages of the treatment alternatives and to be transparent in case of complications.


Assuntos
Comunicação , Relações Dentista-Paciente , Saúde Bucal , Humanos
19.
J Dent Educ ; 83(1): 16-31, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30600246

RESUMO

Dentist-patient communication skills are important aspects of contemporary oral health care, as shared decision making with patients becomes more common. The aim of this systematic review of the literature on teaching and assessment methodologies for communication skills in dental practice was to categorize those skills most relevant to dental practice and determine the best-evidence teaching and assessment methods. The systematic review was conducted using MEDLINE, EBM-Cochrane Libraries, Embase, ERIC, BIOSIS, CAB Abstracts, and PsycINFO using the OVID search engine, together with manually searching relevant journal articles. Relevant data were extracted from all included articles, and thematic analysis, categorization, and quality review of the articles was performed. Fifty articles published between 2000 and 2016 were identified as relevant to this study. Most were comparative design studies. The largest numbers were single group studies with before and after tests and cross-sectional studies. A total of 26 communication skills were identified and grouped into four major categories: generic skills, case-specific skills, time-specific skills, and emerging skills. Review of the teaching methods described in those articles showed that educators used a combination of passive and active strategies. All the assessment measures were considered to be valid and reliable. This categorization of essential dentist-patient communication skills reported in the literature may be used to assist in curriculum design along with use of tested teaching methods and validated assessment measures. The review highlights the need for more robust study designs for research in this important aspect of dental education.


Assuntos
Relações Dentista-Paciente , Educação em Odontologia/métodos , Comunicação , Odontologia Baseada em Evidências , Humanos
20.
J Dent Educ ; 83(1): 94-102, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30600255

RESUMO

The Ten Item Personality Inventory (TIPI) is a widely used instrument based on a personality framework measuring five dimensions: Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Openness to Experiences. The aim of this study was to establish a scale to assess dental students' professionalism by adding to the TIPI's five dimensions a set of descriptors that define professional behavior in dental students. The resulting Patient Management and Professionalism Scale (PMPS) was then tested with a cohort of graduating students at the University of Michigan School of Dentistry. To develop the scale, one clinic director and a patient care coordinator from four clinics wrote descriptive statements for each of the five dimensions based on their observations of dental students in the context of their clinical experiences. These descriptors were compiled into a single scale. The PMPS demonstrated good scale reliability and interrater agreement and correlated significantly with students' patient management grade scores and cumulative GPA at the end of their fourth year. Exploratory factor analysis showed the presence of a single factor (professionalism) with all five dimensions loading highly on this factor, accounting for 66% of variance in scores. While a useful standardized measure to assess professionalism in dental students, the PMPS also has a flexible format that makes it easy for other schools to use.


Assuntos
Relações Dentista-Paciente , Avaliação Educacional/métodos , Profissionalismo , Estudantes de Odontologia , Competência Clínica/normas , Feminino , Humanos , Masculino , Inventário de Personalidade , Profissionalismo/normas , Estudantes de Odontologia/psicologia
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