Preparedness of Dentists to Manage Anxiety in Developmentally Disabled Patients.

Background: Recently, the National Council on Disability urged the Commission on Dental Accreditation to require more thorough training in the care of developmentally disabled patients. Curricula is early in its development and its' effectiveness is unknown. Objectives: The aim of this study was to determine if special needs dental education has had an impact on providers' professional behavior, practice characteristics, attitudes, and confidence when treating these patients and managing their dental anxiety. Methods: A nonrandomized, noninterventional, and anonymous, Qualtrics survey was administered prospectively to members of one local and one national organization. Results: Of the 107 respondents (response rate of 81.06%), 89% treat special needs patients. Positive reinforcement (88.64%), distraction (85.23%), and enhancing control (85.23%) were the modalities most used by these participants. Regarding treating this population, the average response regarding both confidence and wanting to learn more fell between disagree and agree at 2.92, while the average response regarding concern about safety fell between agree and strongly agree at 3.22. Level of specific expertize had the strongest influence on a provider's decision to treat, while reimbursement level had the least influence. Among participants who completed postdoctoral education, the average response for how well their education prepared them to manage patients with special needs was higher for their postdoctoral training compared to their dental school training, with pediatric dentists reporting the highest rate of preparation. No correlation was found between year of dental school graduation and how well they felt their education prepared them for treating this population. Significance level was set at 5%. Conclusion: Dental education can have a significant impact on dentists' knowledge, attitudes, beliefs, and confidence about treating those with developmental disabilities and managing their dental anxiety. Acknowledging that this relationship exists should encourage educational improvements in this area.

Prevention of oral disease for long-term care and homebound elderly.

Despite the fact that many oral diseases afflicting the long-term care or homebound elderly are preventable or treatable, many older people do not seek available treatment, or their oral health care needs are not being met. The dental profession must, therefore, increase the preventative dental awareness of elders and make preventative and treatment services more accessible to this population. Interdisciplinary training and collaborative efforts among the dental profession, medical profession and caregivers are necessary in preventing oral disease for this geriatric population, which would improve not just oral health, but overall systemic health as well, thereby improving their quality of life.

Serving underserved and hard-core smokers in a dental school setting.

The dental profession has recognized tobacco cessation as an important part of comprehensive dental care, yet implementation of the Public Health Service clinical practice guideline on "Treating Tobacco Use and Dependence" remains a challenge. This is especially the case for patients presenting in dental clinics for whom smoking represents a large financial burden. Many of these smoking-addicted patients also present with multiple risk factors: dental, medical, and psychiatric. Innovative approaches are necessary to reduce barriers to providing smoking cessation services to underserved and high-risk smokers. A tobacco cessation clinic in a dental school setting provides an opportunity for dental students to learn about the management of difficult-to-treat cases and to bring their enhanced intervention skills back into the primary care dental setting. This paper describes a multidisciplinary approach to tobacco cessation in a dental school clinic within an academic medical center.