Evaluation of an individual anamnesis tool for teaching risk-oriented prevention - a pilot study in undergraduate dental students

BACKGROUND

A comprehensive medical history is needed to establish and ensure a high standard in dental care; however, it is challenging to draw clinical consequences on the variety of potential diseases and medications, especially for dental students. Aim of this observational study was to investigate, whether undergraduate dental students using an analog anamnesis tool for risk classification would be more confident and have more knowledge in risk classification than other students in the same year of study.

METHODS

A cohort of 48 fifth year dental students was included and allocated into two groups based on their curriculum-related division (group A: n = 25, group B: n = 23). Group A received a teaching event and provision of an analog anamnesis tool for risk classification; group B received neither a teaching event nor the anamnesis tool. At baseline and after two weeks (follow-up), questionnaires regarding self-perceived confidence with risk classification, questions on different disease, medications and lifestyle factors and a task with 15 medical histories of prepared patient cases were applied. The data was statistically analyzed using Mann-Whitney or Wilcoxon test.

RESULTS

In group comparison of the differences between baseline and follow-up regarding self-perceived confidence, significantly higher improvement was noted in group A compared to group B for all questions (p < 0.05). With regard to knowledge, the group comparison revealed that the differences in all of the four tasks were significantly higher in group A compared to group B (pi ≤ 0.01). Thereby, the different tasks in group A differed between baseline and follow-up as follows: Risk of complications: 49.04 ± 13.59 vs. 67.96 ± 17.22, p < 0.01, Risk of oral diseases: 48.77 ± 13.57 vs. 63.44 ± 16.78, p = 0.01, Indication of antibiotic prophylaxis: 75.70 ± 13.45 vs. 87.97 ± 10.37, p < 0.01 and the Medical history task on 15 patient cases: 58.45 ± 4.74 vs. 71.47 ± 9.54, p < 0.01.

CONCLUSION

The applied analog anamnesis tool supported an increase in students´ confidence with issues related to at-risk patients alongside with their knowledge in risk classification. The applied anamnesis tool can be recommended for improving teaching of risk management for undergraduate dental students.

Dental Students’ Knowledge, Confidence, Ability, and Self-Reported Difficulties in Periodontal Education: A Mixed Method Pilot Study

Evidence on periodontal education areas in which students have difficulties and their factors are limited. In this study, third- and fourth-year dental students’ knowledge was assessed as well as their confidence and ability in five periodontal educational areas using a mixed-method approach. A survey was used to collect data related to history-taking, medical examination, diagnosis, treatment planning, and follow-up. Student answers were compared to the consensual answers of an expert panel using the cosine-similarity index (CSI). Descriptive statistics assessed confidence and ability for diagnosis. Semi-structured individual interviews were used to collect data on reported reasons for difficulties in periodontal education. A content analysis was employed to analyze the interview data. Eighteen third- and fourth-year dental students completed the survey and eleven were interviewed. Students’ knowledge was adequate regarding diagnosis and treatment planning. Third-year students’ median CSI were 0.93 and 0.89, respectively. Fourth-year students’ median CSI were 0.9 and 0.93, respectively. Students felt confident in history-taking and examination but lacked confidence and ability in diagnosis and treatment planning. Reported reasons for difficulties in periodontal education were linked to both preclinical and clinical pedagogical issues. Further improvements in preclinical and clinical periodontal education are needed to address students’ lack of knowledge, confidence, and skills in key periodontal areas.

Evaluation of an educational concept for risk-oriented prevention in undergraduate dental education

BACKGROUND

Aim of this observational study with a three-month follow-up was to evaluate an educational concept for risk-oriented prevention applied by fifth-year undergraduate dental students.

METHODS

Dental students from two clinical treatment courses of the last undergraduate year were included. The subjects were divided into two groups according to their assignment to the two clinical classes. Group A received a sequence of seminars, including the basics of a risk classification system (RCS) with the theoretical background and case studies in the context of preventive dentistry. Thereby, 1) a theoretical seminar (background, RCS, cases) and 2) the transfer of the RCS on a clinical patient case chosen by the student, and its presentation within a discussion round was applied. Group B served as a comparison group with students who did not receive any of teaching events in terms of RCS. The self-perceived knowledge and importance of RCS, as well as objective knowledge (qualitative questions), were assessed with a standardized questionnaire at baseline and after 3 months.

RESULTS

Out of 90 students at baseline, 79 (group A: 39, group B: 40) were re-evaluated after 3 months. At this follow-up, Group A estimated their confidence in handling the medication (p = 0.02), the RCS (p < 0.01), and in identifying the risk of oral diseases (p = 0.02) higher than group B. Furthermore, group A felt it was more important to identify patients at risk (p = 0.02), the risk of complications (p = 0.02) and to apply an RCS (p = 0.03). At follow-up, group A exhibited more correct answers of qualitative questions than group B regarding risk of complications (p < 0.01) and bacteremia (p < 0.01). Group A felt more confident with at-risk patients and more competent concerning RCS than group B (p < 0.01).

CONCLUSION

The concept for educating risk-oriented prevention increased the self-perceived skills and the knowledge of undergraduate dental students after 3 months within a clinical treatment course.

Awareness of oral complications and oral hygiene habits of subjects with diagnosed Diabetes Mellitus

Background/Aim: The aim was to evaluate Diabetes Mellitus (DM) patients' awareness of their risk for oral and dental complications, to evaluate their oral health behaviors, assess their sources of related information, and to detect the influence of their awareness on oral health and dental management. Material and Methods: Total of 240 DM patients presenting to a university outpatient dental facility for routine care completed a self-administered questionnaire about demographic socioeconomic characteristics, oral health care and awareness on oral complications of DM. Dental status of each patient was recorded. Data were analyzed with Chi- square test; p was set as 0.05. Results: The patients' mean age was 52.85 years; the majority had Type 2 DM (72.1%) and 61.7% were females. Two thirds of the patients had tooth loss; 65% brushed daily and used toothpick for interproximal cleaning (35%). Only 12.9% had regular dental visits and 37.5% reported their oral health as 'poor'. DM patients rarely received guidance from their health care professionals regarding their oral health (28.3%). Even though 62.5% were aware of oral complications of DM, only 46.3% knew that oral health may affect DM. The patients with Type 1 and Type 2 DM had similar perceptions about their oral health status (p=0.15>0.05). However, insulin users were more aware of the interaction between oral health and DM (p>0.05), and were more likely to consider their oral health as 'poor' (p>0.05). Conclusions: DM patients' awareness of the effect of DM on oral health was higher than that of the effect of oral health on DM management. Medical health care providers were failing to provide the necessary information regarding these issues when compared to dentists.

Periodontal Inflammatory Conditions Among Smokers and Never-Smokers With and Without Type 2 Diabetes Mellitus

BACKGROUND

There is a dearth of studies regarding the influence of cigarette smoking on periodontal inflammatory conditions among patients with type 2 diabetes mellitus (T2DM). The aim of the present study is to assess periodontal inflammatory conditions among smokers and never-smokers with and without T2DM.

METHODS

One hundred individuals (50 patients with T2DM [25 smokers and 25 never-smokers] and 50 controls [25 smokers and 25 never-smokers]) were included. Information regarding age, sex, duration and daily frequency of smoking, duration and treatment of diabetes, and oral hygiene was recorded using a questionnaire. Periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], clinical attachment loss [AL], and marginal bone loss [MBL]) were measured. Hemoglobin A1c (HbA1c) levels were also recorded.

RESULTS

Mean age, monthly income status, and education levels were comparable among smokers and never-smokers with and without T2DM. Mean HbA1c levels were significantly higher among patients with T2DM (8.2% ± 0.1%) compared with controls (4.4% ± 0.3%) (P <0.05). Smokers in the control group were smoking significantly greater numbers of cigarettes (15.5 ± 2.5 cigarettes daily) compared with smokers with T2DM (6.2 ± 2.1 cigarettes daily) (P <0.05). Periodontal parameters were comparable among smokers and never-smokers with T2DM. Among controls, periodontal parameters (PI [P <0.05], AL [P <0.05], PD ≥4 mm [P <0.05], and MBL [P <0.05]) were significantly higher in smokers than never-smokers. Never-smokers with T2DM had worse periodontal status than smokers and never-smokers in the control group (P <0.05).

CONCLUSIONS

Periodontal inflammatory conditions are comparable among smokers and never-smokers with T2DM. Among controls, periodontal inflammation is worse among smokers than never-smokers.