Oral and Maxillofacial Surgery Foundation Research and Fellowship Awards: A 26-Year Review at Massachusetts General Hospital and Harvard School of Dental Medicine.

PURPOSE: The purpose of this study was to review outcomes of the Oral and Maxillofacial Surgery (OMS) Foundation's funding awards to members of the OMS department at Massachusetts General Hospital (MGH) in terms of projects completed, abstracts presented, peer-reviewed publications, and career trajectories of recipients. MATERIALS AND METHODS: Data were collected from MGH and OMS Foundation records and interviews with award recipients. Primary outcome variables included 1) number of awards and award types, 2) funding amount, 3) project completion, 4) number of presented abstracts, 5) conversion from abstracts to publications, 6) number of peer-reviewed publications, 7) career trajectories of awardees, and 8) additional extramural funding. RESULTS: Eleven Student Research Training Awards provided $135,000 for 39 projects conducted by 37 students. Of these, 34 (87.2%) were completed. There were 30 student abstracts presented, 21 peer-reviewed publications, and a publication conversion rate of 58.8%. Faculty research awards comprised $1,510,970 for 22 research projects by 12 faculty members and two research fellows. Of the 22 funded projects, 21 (95.5%) were completed. There were 110 faculty and research fellow abstracts presented and 113 peer-reviewed publications, for a publication conversion rate of 93.8%. In the student group, 17 of 37 (45.9%) are enrolled in or are applying for OMS residencies. Of the 10 students who have completed OMS training, 3 (30%) are in full-time academic positions. Of the 12 faculty recipients, 9 (75%) remain in OMS academic practice. During this time period, the department received $9.9 million of extramural foundation or National Institutes of Health funding directly or indirectly related to the OMS Foundation grants. CONCLUSIONS: The results of this study indicate that 90.2% of projects funded by the OMS Foundation have been completed. Most projects resulted in abstracts and publications in peer-reviewed journals. These grants encouraged students to pursue OMS careers and aided OMS faculty in developing their research programs.

Lessons learned from the disruption of dental training of Malaysian students studying in Egypt during the Arab spring.

BACKGROUND: Political crisis and worsening security situation in Egypt in late 2013 resulted in Malaysian students who were pursuing their dental education in Egypt being recalled home to Malaysia. The Ministry of Higher Education in Malaysia took steps to integrate these students into public and private universities in Malaysia. METHODS: We used a questionnaire and informal interviews to learn from students returning from Egypt about their experiences transitioning from dental schools in Egypt to Malaysia. RESULTS: We discuss the challenges students faced with regards to credit transfer, pastoral care, the differences in the curriculum between the dental faculties of the two nations, and the financial implications of this disruption of their training. DISCUSSION: We live in a fragile world where similar political situations will surely arise again. The approaches used by the Malaysian government and the lessons learned from these students may help others. The perspectives of these students may help educators reintegrate expatriate students who are displaced by political instability back into the education system of their own countries.

Simple cost analysis of a rural dental training facility in Australia.

INTRODUCTION: Student clinical placements away from the university dental school clinics are an integral component of dental training programs. In 2009, the School of Dentistry and Oral Health, Griffith University, commenced a clinical placement in a remote rural community in Australia. This paper presents a simple cost analysis of the project from mid-2008 to mid-2011. METHODS: All expenditures of the project are audited by the Financial and Planning Services unit of the university. The budget was divided into capital and operational costs, and the latter were further subdivided into salary and non-salary costs, and these were further analysed for the various types of expenditures incurred. The value of the treatments provided and income generated is also presented. RESULTS: Remote rural placements have additional (to the usual university dental clinic) costs in terms of salary incentives, travel, accommodation and subsistence support. However, the benefits of the placement to both the students and the local community might outweigh the additional costs of the placement. CONCLUSIONS AND IMPLICATIONS: Because of high costs of rural student clinical placements, the financial support of partners, including the local Shire Council, state/territory and Commonwealth governments, is crucial in the establishment and ongoing sustainability of rural dental student clinical placements.

Effects of a proposed rural dental school on regional dental workforce and access to care.

INTRODUCTION: Southwest Virginia is a rural, low-income region with a relatively small dentist workforce and poor oral health outcomes. The opening of a dental school in the region has been proposed by policy-makers as one approach to improving the size of the dentist workforce and oral health outcomes. METHODS: A policy simulation was conducted to assess how a hypothetical dental school in rural Southwest Virginia would affect the availability of dentists and utilization levels of dental services. The simulation focuses on two channels through which the dental school would most likely affect the region. First, the number of graduates who are expected to remain in the region was varied, based on the extensiveness of the education pipeline used to attract local students. Second, the number of patients treated in the dental school clinic under different dental school clinical models, including the traditional model, a patient-centered clinic model and a community-based clinic model, was varied in the simulation to obtain a range of additional dentists and utilization rates under differing dental school models. RESULTS: Under a set of plausible assumptions, the low yield scenario (ie private school with a traditional clinic) would result in three additional dentists residing in the region and a total of 8090 additional underserved patients receiving care. Under the high yield scenario (ie dental pipeline program with community based clinics) nine new dentists would reside in the region and as many as 18 054 underserved patients would receive care. Even with the high yield scenario and the strong assumption that these patients would not otherwise access care, the utilization rate increases to 68.9% from its current 60.1%. CONCLUSIONS: While the new dental school in Southwest Virginia would increase the dentist workforce and utilization rates, the high cost combined with the continued low rate of dental utilization suggests that there may be more effective alternatives to improving oral health in rural areas. Alternative policies that have shown considerable promise in expanding access to disadvantaged populations include virtual dental homes, enhanced Medicaid reimbursement programs, and school-based dental care systems.

Dental student indebtedness: Where did it come from and where will it lead?

Today's dental school graduates are burdened by an ever-increasing amount of student loan debt from both their undergraduate and predoctoral educations. Although considered to be multifactorial in origin, this article explores the microeconomic theory of supply and demand as a source for rising tuition costs and subsequent educational debt. The historical context for the cost of a dental education is provided, and serious questions are posed about how this indebtedness might impact the future of the profession.

Advanced dental education programs: status and implications for access to care in California.

Primary care residencies in dentistry include general practice residency and advanced education in general dentistry--collectively known as postdoctoral general--dentistry and pediatric dentistry. These primary care programs are the most likely to serve underserved populations during the training experience. An expansion of primary care dental residency positions in California has the potential to positively impact access to care in California. However, there are significant political and financial barriers to realizing this potential.

A national and Indiana perspective: the rising cost of dental education.

Indiana University School of Dentistry remains committed to graduate competent general dentists. In the face of the cost of dental education, we are open to explore alternative educational and clinical models to enhance the educational experience for all students, while reducing the cost to provide that education. As dean, I welcome your thoughts and ideas to further reduce educational costs.

National and Indiana dental workforce trends: IUSD DDS enrollment shaping.

The IU School of Dentistry remains committed to serving its statewide mission to educate highly qualified individuals in preparation for the independent practice of dentistry. National dental workforce analyses indicate a stable number or slight decline in the number of dentists to 2025. Previous Indiana data indicate that 29 percent of nonresidents remain in the state following graduation. We believe our analysis strongly supports a need for DDS enrollment expansion consistent with the IUPUI Enrollment Shaping strategy if we are to achieve our goal of garnering new financial resources to construct a new dental building.

To teach or not to teach: making the transition from dental practice to dental faculty.

The authors, with more than forty years of combined private practice experience, discuss professional satisfaction in the private practice setting. A change to an academic career may provide job satisfaction and revitalize a dental career, while simultaneously satisfying the need for faculty in our dental schools.

Mobile dental operations: capital budgeting and long-term viability.

OBJECTIVE: The University of Kentucky College of Dentistry (UKCD) runs a large mobile dental operation. Economic conditions dictate that as the mobile units age it will be harder to find donors willing or able to provide the financial resources for asset replacement. In order to maintain current levels of access for the underserved, consideration of replacement is paramount. A financial analysis for a new mobile unit was conducted to determine self-sustainability, return on investment (ROI), and feasibility of generating a cash reserve for its replacement in 12 years. METHODS: Information on clinical income, operational and replacement costs, and capital costs was collected. A capital budgeting analysis (CBA) was conducted using the Net Present Value (NPV) methodology in four different scenarios. Depreciation funding was calculated by transferring funds from cash inflows and reinvested to offset depreciation at fixed compound interest. RESULTS: A positive ROI was obtained for two scenarios. He depreciation fund did not generate a cash reserve sufficient to replace the mobile unit. CONCLUSIONS: Mobile dental programs can play a vital role in providing access to care to underserved populations and ensuring their mission requires long-term planning. Careful financial viability and CBA based on sound assumptions are excellent decision-making tools.

Comparison of dental education and professional development between mainland China and North America.

Different educational and professional developments within the dental field create different sets of missions, norms, and practices regarding dental diseases and their appropriate treatment. This review has addressed differences in dental education and professional development between mainland China and North America. Many factors influence the choice of model and it is very difficult to predict which model will become predominant. However, there is growing sentiment that the independent faculty model in North America is logical and superior to the model, which 'integrates' dental and medical education in mainland China. Many North America dental schools place a high priority on preclinical and clinical training in the curriculum in order to expose students to patient oral health needs and systemic dental problems much earlier than in mainland China. North America dental schools promote and embrace students self-learning skills by the use of PBL, CRL, and TRAD education methodologies and new e-based technologies and approaches whereby students learn rather than are taught. In mainland China, the traditional lecture-based format is still employed in the majority of dental schools; however, strategies to enhance students self-learning skills is increasingly utilised in most well-known Chinese dental schools. The Chinese dental education model, which treats dentistry as a sub-specialty of medicine, has brought about fundamental differences, with the dentist functioning essentially as a stomatologist. For example, China has built up a large oral and maxillofacial surgery society, and craniofacial surgery is performed to a much broader extent by Chinese dentists than by most North American counterparts. In North America, dentists engage in full-time work, attend continuing training/education programmes, belong to an association, gain legal status, and construct a code of ethics emphasising the quality of care delivered to the public. Currently, continuing dental education in North America is available through a variety of venues involving licensing authorities, universities and private programmes. The concept of professional development in mainland China is relatively new and is still considered primarily in the context of promotion or achieving a higher professional title. Mandatory continuing dental professional education requirements do not guarantee the competence of members of the profession. Today, the Chinese government and society place increasing emphasis upon the accountability of self-regulating professions. Rather than attempting to summarise the current scope of dental education and professional development between mainland China and North America, this paper hopes to enhance mutual understanding, and promote greater academic exchanges in dental education.

Dental students--dental advocates.

Student advocacy and involvement in the political process is built into the structure of the American Student Dental Association (ASDA), especially in its Legislative Grassroots Network and an internal communication network among students to ensure political awareness. Students are concerned with such issues as a universally accepted, non-patient-based licensure process, mid-level providers, loan availability and tax deductibility, financial support for schools, and service early in one's professional career (giving forward rather than giving back). Through collaboration with the American Dental Education Association and with many state associations, students participate in lobbying, awareness campaigns, and behind the scenes as legislative aids. Although students share the same love for the profession that animates established practitioners, they are perceived by legislators as being different. Students are involved in the legislative process because it represents their future.

U.S. state-supported dental schools: financial projections and implications.

This article examines the impact of financial trends in state-supported dental schools on full-time clinical faculty; the diversity of dental students and their career choices; investments in physical facilities; and the place of dentistry in research universities. The findings of our study are the following: the number of students per full-time clinical faculty member increased; the three schools with the lowest revenue increases lost a third of their full-time clinical faculty; more students are from wealthier families; most schools are not able to adequately invest in their physical plant; and more than half of schools have substantial NIH-funded research programs. If current trends continue, the term "crisis" will describe the situation faced by most dental schools. Now is the time to build the political consensus needed to develop new and more effective strategies to educate the next generation of American dentists and to keep dental education primarily based in research universities. The future of the dental profession and the oral health of the American people depend on it.

Dental school vacant budgeted faculty positions, academic years 2005-06 and 2006-07.

The annual turnover of dental school faculty creates a varying number of vacant budgeted positions at any given time. The American Dental Education Association (ADEA) conducts an annual survey to determine the status and characteristics of these vacant faculty positions. In addition, ADEA conducts an annual survey of dental educators to maintain a database on the size and characteristics of dental school faculty, including data on the distribution of full-time, part-time, and volunteer faculty, reasons for faculty separations, and sources of new faculty. The number of vacant budgeted faculty positions within U.S. dental schools increased throughout the 1990s, with a peak of 358 positions in 2000. Following this peak, the number of vacancies declined, falling to 275 in 2004-05. Since that time, there has been a rapid increase in the number of estimated vacancies, reaching 417 in 2005-06, then falling slightly to 406 in 2006-07. The 2005-06 and 2006-07 faculty vacancies surveys explore these increases, along with information relevant to trends in the faculty workforce, factors influencing faculty vacancies, and the impact of vacant positions on dental schools.