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Sharka R. Factors associated with predoctoral and graduate dental students' intention to care for elderly patients: A cross-sectional study. J Dent Educ 2024. [PMID: 38783410 DOI: 10.1002/jdd.13594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/29/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES Ageism among pre-doctoral and graduate dental students may reduce their propensity to provide dental treatment to elderly patients leading to substandard healthcare for this population. This study evaluated the impact of perceived ageism constructs and geriatric dentistry education on the intention of pre-doctoral and graduate students to provide dental care for elderly patients. METHODS A questionnaire was applied to collect the data for this cross-sectional study from pre-doctoral students in their clinical years and graduate students in their internship year (N = 201). A total of 183 completed responses were received, and the response rate was 91%. Hierarchical regression analysis was performed to determine the incremental effects of perceived ageism constructs and geriatric dentistry education on the intention to provide dental care for elderly patients. RESULTS Geriatric dental education (B = 0.328, t = 3.826, p < 0.001) and patients' low compliance (B = 0.503, t = 4.658, p < 0.001) were significantly positive predictors of pre-doctoral and graduate students' intentions to care for elderly patients. Also, negative attitudes toward the lives of elderly people have a substantial adverse effect on the intention of care for this population (B = -0.225, t = -2.206, p = 0.029). Cronbach's alpha for the scale constructs ranged from 0.738 to 0.886. CONCLUSIONS Advanced geriatric training may cultivate pre-doctoral and graduate students' deeper understanding and recognition of the intellectual and practical benefits that might arise from offering dental care to elderly people.
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Affiliation(s)
- Rayan Sharka
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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Miyagami T, Teranaka S, Mine Y, Matsumoto T, Yoshimatsu Y, Matsumoto S, Yamaguchi K, Morikawa T. Lack of Physician-Dentist Collaboration in Aspiration Pneumonia Prevention. Int J Gen Med 2024; 17:1293-1295. [PMID: 38591000 PMCID: PMC10999501 DOI: 10.2147/ijgm.s405712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/01/2024] [Indexed: 04/10/2024] Open
Abstract
This opinion paper addresses the challenges and future directions for preventing aspiration pneumonia in Japan's rapidly aging population. It highlights the increasing proportion of elderly individuals and the associated rise in health issues like decreased swallowing function, a risk factor for aspiration pneumonia. The paper emphasizes the effectiveness of dentist-provided oral care in preventing this condition but notes the lack of collaboration between dentists and physicians in Japan's clinical practice. Key challenges identified include the scarcity of full-time hospital dentists, insufficient communication between physicians and dentists, limited patient understanding and motivation regarding oral care, and a lack of training in geriatric dentistry. The paper advocates for enhanced awareness among healthcare professionals and patients, increased hospital dentists, and improved collaboration mechanisms, particularly in light of recent positive changes in insurance reimbursement policies for elderly oral care.
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Affiliation(s)
- Taiju Miyagami
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Teranaka
- Department of Physical Medicine and Rehabilitation, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
| | - Yuichiro Mine
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | | | - Yuki Yoshimatsu
- Elderly Care, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
- Centre for Exercise Activity and Rehabilitation, School of Human Sciences, University of Greenwich, London, UK
| | | | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toru Morikawa
- Department of General Medicine, Nara City Hospital, Nara, Japan
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan
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Elliott K, Dukes KC, Barlow PB, Kossioni A, Marchini L. Ageism scale for dental students (ASDS): A focus group review of content validity. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38217073 DOI: 10.1111/scd.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE/AIM Improve content validity of the Ageism Scale for Dental Students (ASDS) and identify barriers to using the scale. METHODS Thematic analysis of transcripts of three purposively sampled focus groups of 1) geriatric dentistry specialists, 2) older adult dental patients, and 3) dental students. RESULTS Twenty-five participants engaged in focus groups. No new concepts to define ageism were identified. Experts found the scale acceptable and appropriate, yet they raised specific potential revisions to scale questions. Commonly reported themes already addressed by ASDS included the importance of tailoring decision-making to patient preference and not making assumptions about older adults' capacity or preferences for dental care. Barriers to identifying ageism or using the scale included experiential differences in interpreting scale items, cultural differences in attitudes towards older adults, and potential overlap with social determinants of health. Secondary findings include recommendations for older-adult focused training for dental students to provide positive, concrete guidance on caring for older adults. CONCLUSION There are opportunities to refine the Ageism Scale for Dental Students and to allow tailoring of the scale for specific national or cultural contexts.
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Affiliation(s)
| | - Kimberly C Dukes
- University of Wisconsin-Madison Law School, Iowa City, USA
- Iowa City Veterans Affairs Health Care System (ICVAHCS), Iowa City, USA
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Patrick B Barlow
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Anastassia Kossioni
- School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonardo Marchini
- College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa, USA
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Arany S, Eliav E, Medina-Walpole A, Caprio TV. Postgraduate dental resident education: A pilot in age-friendly "mentation" training. SPECIAL CARE IN DENTISTRY 2023; 43:765-771. [PMID: 37147183 DOI: 10.1111/scd.12871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/12/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Postdoctoral dental education in caring for older adults lacks didactic and clinical training in mentation topics, one of the core elements of the Age-Friendly Health Systems (AFHS) framework. Our primary goal was to launch a pilot project in clinical geriatrics focusing on older adults' mentation concerns, with a secondary goal to improve dental residents' confidence and competence in dental care and oral health. BACKGROUND Age-friendly care elements are not routinely incorporated into the dental education of residents caring for older adults with cognitive impairment or dementia. Therefore, we implemented a pilot educational project, providing the missing educational opportunity for residents in geriatric training covering cognitive impairment and focusing on Alzheimer's disease and related dementias. MATERIALS AND METHODS We designed educational sessions through a needs assessment, focus group discussions, and expert validation. We developed three e-Learning modules covering mentation concerns and dementia screening. We tested the modules in a pilot study of 15 dental postdoctoral residents as an essential part of their clinical practice. RESULTS The dementia dental learning module increased the residents' satisfaction with didactic preparedness (4.45 ± $ \pm \ $ 0.97) and knowledge acquisition (4.36 ± $ \pm \ $ 0.84). Residents strongly believed that learning about the AFHS-mentation topic would improve patient care. CONCLUSION Our pilot study is a pioneer project in support of a new AFHS-themed dental curriculum for clinical education. Further expansion of the age-friendly principles to include mobility, medications, and what matters to older adults will establish a model framework of redesigned geriatric dental education for academic centers.
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Affiliation(s)
- Szilvia Arany
- Department of Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Eli Eliav
- Department of Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Annette Medina-Walpole
- Division of Geriatrics and Aging, Department of Medicine, University of Rochester, Rochester, New York, USA
| | - Thomas V Caprio
- Division of Geriatrics and Aging, Department of Medicine, University of Rochester, Rochester, New York, USA
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Tabrizi M, Lee WC. Linking current dental education to gerontological education to meet the oral health needs of growing aging populations. FRONTIERS IN ORAL HEALTH 2023; 4:1232489. [PMID: 37876529 PMCID: PMC10591445 DOI: 10.3389/froh.2023.1232489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
Objective This study aimed to recognize the gaps in dental education by studying the current level of geriatric oral health training of recent graduated dentists who have been admitted into an Advanced Education in General Dentistry (AEGD) program. Methods The AEGD program was developed along with the Age-Friendly 4Ms model to enhance current dental education. We adopted the Rapid Cycle Quality Improvement model to test the effectiveness of the training for AEGD residents from 2019 to 2022. A total of 18 residents participated (6 residents each year). A 5-question survey was administered before and after the rotation and Wilcoxon signed-rank with Fisher Exact tests were conducted to compare pre- and post- rotation results. Results All 18 residents have completed pre- and post-program surveys. They self-reported minimal to no training in preparation to provide care to older adults with multiple chronic conditions. After the rotation, residents' confidence in treating older adults was significantly increased (p = 0.011). Meanwhile, residents gained knowledge to apply the 4Ms framework (what matters, medication, mentation, and mobility) to their practices (p = 0.015) and provide age-friendly care for older adults. Conclusion The study identified and addressed the missing link in dental education to gerontological and geriatrics education. More clinical rotations and didactic training to equip residents with competences of providing geriatric oral health are strongly recommended.
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Affiliation(s)
- Maryam Tabrizi
- School of Dental Medicine, University of Nevada, Las Vegas, NV, United States
| | - Wei-Chen Lee
- Department of Family Medicine, John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, United States
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Schmalz G, Brauer L, Haak R, Ziebolz D. Evaluation of a concept to classify anamnesis-related risk of complications and oral diseases in patients attending the clinical course in dental education. BMC Oral Health 2023; 23:609. [PMID: 37644402 PMCID: PMC10466859 DOI: 10.1186/s12903-023-03343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Aim of the current study was the assessment of risk classes according to a previously established system to classify the anamnesis-related risk of complications and of oral diseases in a cohort of patients attending the dental student course for dental preventive measures. METHODS Patients attending the student course between April 2020 and December 2021 were included. To assess the medical history, a specific anamnesis tool was used, which included the classification of different potential anamneis-related risks originating from general diseases, medications or lifestyle factors into a low, moderate or high risk of complications and/or risk of oral diseases. Thereby, the risk of complications was defined as the increaeed probability of harm during dental measures (professional tooth cleaning, invasive dental treatment or any kind of manipulation, which may cause a bacteremia), e.g. infectious endocarditis. On the other hand, the risk of oral diseases was an increaeed probability of development and/or progression of oral diseases like caries, periodontitis or mucosal diseases. Those risk classes were subsequently analyzed under consideration of age and gender. RESULTS 858 patients, with a mean age of 50.48 ± 20.72 [median: 52.0] years, and a nearly balanced gender distribution (50.8% female and 49.2% male) were included. In the overall cohort, the risk of complications related with dental measures was low in 38.3%, moderate in 42.4% and high in 19.3% of participants. The risk of oral diseases was low in 33.1%, moderate in 37.2% and high in 29.7% of participants. Both, the risk of complications and the risk of oral diseases increased with patients' age (p < 0.01). Thereby, the risk of complications as well as the risk of oral diseases related to general diseases and medication significantly increased with age (p < 0.01). CONCLUSION Nearly one fifth of patients in dental student couse show a high risk of complications related with dental measures. Morever, nearly one third of those individuals have a high anamnesis-related risk of oral diseases. With increasing age, the amount of patients in high risk classes becomes higher. Future dental education and research should address the high relevance of anamnesis-related risk factors.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Lena Brauer
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
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Marchini L. Educating dental students to provide compassionate age friendly care for older adults. J Dent Educ 2023. [PMID: 37082979 DOI: 10.1002/jdd.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/31/2023] [Accepted: 04/08/2023] [Indexed: 04/22/2023]
Abstract
As the world population ages, the need for age friendly care increases. In dentistry, age friendly care requires an appropriate comprehension of multiple factors that can be categorized in socio-economic circumstances, systemic health problems, and oral health conditions. In addition to the understanding of these factors and its relationships among each other, the future dental workforce should also be aware of unconscious and pervasive societal stereotypical perception of older persons, aging, and being old, which results in ageism and ageist attitudes. Dental schools can play an important role on raising ageism awareness and combating ageism in healthcare, thus preparing the future of the dental workforce to provide compassionate age friendly care. This paper will discuss ageism in dental schools and learning strategies used to combat it and increase compassionate care delivery for older adults.
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Affiliation(s)
- Leonardo Marchini
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
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Corrigendum for
J Dent Educ
. 2022;86:1233‐1241. J Dent Educ 2022; 86:1552. [DOI: 10.1002/jdd.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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