Differences in the perception of seven behaviour-modifying techniques in paediatric dentistry by undergraduate students using lecturing and video sequences for teaching.

Whilst preparing undergraduate students for a clinical course in paediatric dentistry, four consecutive classes (n = 107) were divided into two groups. Seven behaviour-modifying techniques were introduced: systematic desensitization, operant conditioning, modelling, Tell, Show, Do-principle, substitution, change of roles and the active involvement of the patient. The behaviour-modifying techniques that had been taught to group one (n = 57) through lecturing were taught to group two (n = 50) through video sequences and vice versa in the following semester. Immediately after the presentations, students were asked by means of a questionnaire about their perceptions of ease of using the different techniques and their intention for clinical application of each technique. After completion of the clinical course, they were asked about which behaviour-modifying techniques they had actually used when dealing with patients. Concerning the perception of ease of using the different techniques, there were considerable differences for six of the seven techniques (P < 0.05). Whilst some techniques seemed more difficult to apply clinically after lecturing, others seemed more difficult after video-based teaching. Concerning the intention for clinical application and the actual clinical application, there were higher percentages for all techniques taught after video-based teaching. However, the differences were significant only for two techniques in each case (P < 0.05). It is concluded that the use of video based teaching enhances the intention for application and the actual clinical application only for a limited number of behaviour-modifying techniques.

An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students.

OBJECTIVE: To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students. DESIGN: Cross-cultural survey of dental students. SETTING: 18 cultural areas. PARTICIPANTS AND METHODS: 904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions. RESULTS: The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001). CONCLUSIONS: Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.

Self-reported changes in clinical behaviour by undergraduate dental students after video-based teaching in paediatric dentistry.

Four cohorts of undergraduate students (n = 113) were filmed on video tapes whilst performing paediatric treatments. Selected parts of these tapes were shown the day after. Thus, within one term each student was able to view his performance on a videotape as well as those of fellow students. After completion of the clinical course in paediatric dentistry students were asked by means of a questionnaire about behavioural changes in their clinical work regarding different topics. Considerable changes in behaviour were reported for various topics. Most of the students emphasised the viable role of the video for changing their behaviour. This was especially true for aspects of verbal and non-verbal communication where mainly female students benefited. Moreover, video was thought to have been useful for improving capacities to deal with patients in fear or pain and for ergonomics. About two-thirds of the students (64.6%) thought that watching the video had made it easier for them to put theoretical knowledge into action. Video does not seem to play an important role for confirmation and maintenance of behaviour patterns. In conclusion however, it can be stated that video has a high impact on the modification of behaviour patterns of undergraduate students for many aspects of clinical work. The use of video can thus attribute to dental education in an effective way.

Acceptance of psychology teaching in paediatric dentistry by undergraduate dental students.

By means of a questionnaire, 4 cohorts of undergraduate students (n = 144) were asked before and after the clinical course in paediatric dentistry about their acceptance of the teaching of psychological aspects in dentistry. A generally very high interest was found for psychology as well as for child-related psychology. The teaching of this topic by means of lectures was thought to be useful, but other didactic means were demanded to supplement teaching. For many of the aspects taught, more information was requested. Moreover, teaching of aspects not taught in the lectures was also requested. The more obvious the practical relevance of each topic appeared, the greater was the students' interest. Psychology was thought to be useful as an aid to paediatric treatment. However, interest dropped after the completion of the paediatric dentistry course. It is concluded that undergraduate dental students have no particular inclination towards the treatment of children but rather a need for guidelines to avoid potential problems in dealing with this demanding group of patients.

Caries risk analysis: considering caries as an individual time-dependent process.

AIM: To estimate the probability that a tooth does not develop a cavitated lesion (= end-stage caries) within time periods of interest. Additionally it was of interest to assess the heterogeneity between patients, in relation to the time periods required for their teeth to develop a cavitated lesion. DESIGN: A prospective study using patient data of a clinical pedodontic course. SAMPLE AND METHODS: Forty-one patients who had been followed for at least 3 years were selected. Before initiation of therapy, affiliation to a specific risk group was checked. Nine individuals who had belonged to a high-risk group on test were excluded. Of 1968 teeth, 1378 were eligible for data evaluation. The statistical techniques applied originate from time-to-event analysis methods, including a parametric frailty approach providing estimates of the relative caries risk for each individual to develop a cavitated lesion. RESULTS: In the selected group of patients the probability that a tooth remained free of a cavitated lesion within five years ranged from 0.89 to 0.95 applying a 95% confidence interval. In the present sample the true caries risk of the patients to develop a cavitated lesion varied considerably although such variation was not expected from the individual examinations at baseline. CONCLUSION: The frailty model accounts sufficiently for the heterogeneity of each patient. The applied time-to-event methods facilitated reliable estimation of both the probability that a tooth remains free of a cavitated lesion within a certain time and the relative caries risk of an individual to develop a cavitated lesion.