Do undergraduate dental students perform well detecting and staging caries and assessing activity by visual examination? A systematic review and meta-analysis

Global overview on current paediatric dentistry teaching: A survey of National Member Societies of the IAPD

BACKGROUND

Published information on the teaching and recognition of paediatric dentistry (PD) is limited worldwide.

AIM

The aim of this study was to investigate the status of current teaching of undergraduate and postgraduate training in PD and identify differences by country-level economic development.

DESIGN

Representatives from 80 national member societies of the International Association of Paediatric Dentistry (IAPD) were invited to complete a questionnaire on undergraduate and postgraduate PD curricula, types of postgraduate education offered, and recognition of the specialty. Country economic development level was classified according to the World Bank criteria. The chi-squared test and the Spearman correlation coefficient were used for data analysis (α = 0.005).

RESULTS

Response rate was 63%. Teaching of PD at the undergraduate level was present in all countries, but PD specialization, master's, and Doctor of Philosophy (PhD) coursework were offered in 75%, 64%, and 53% of surveyed countries, respectively. Postgraduate specialization courses were offered in a significantly larger proportion of high-income countries than in upper-middle- or lower-middle-income countries (p < .01). In 20% of participating countries, PD was not an officially recognized specialty with no difference in recognition of the specialty by country's economic development level (p = .62).

CONCLUSION

Paediatric dentistry is taught at the undergraduate level universally, but at the postgraduate level, significantly fewer courses are available, especially in lower-income countries.

Diffuse Reflectance Spectroscopy as a Novel Method of Caries Detection-An In Vitro Comparative Study in Permanent Teeth

This in vitro study aimed to compare outcomes of dental caries detection using visual inspection classified according to the International Caries Detection and Assessment System (ICDAS) with objective assessments using a well-established laser fluorescence system (Diagnodent pen) and a novel diffuse reflectance spectroscopy (DRS) device. One hundred extracted permanent premolars and molars were utilized, including sound teeth, teeth with non-cavitated caries, or teeth with small cavitated lesions. A total of 300 regions of interest (ROIs) were assessed using each detection method. Visual inspection, being a subjective method, was performed by two independent examiners. The presence and extent of caries were histologically verified according to Downer's criteria, serving as a reference for other detection methods. Histological results revealed 180 sound ROIs and 120 carious ROIs, categorized into three different extents of caries. Overall, there was no significant difference between the detection methods in sensitivity (0.90-0.93) and false negative rate (0.05-0.07). However, DRS exhibited superior performance in specificity (0.98), accuracy (0.95), and false positive rate (0.04) compared to other detection methods. Although the tested DRS prototype device exhibited limited penetration depth, it shows promise as a method, particularly for the detection of incipient caries.

Knowledge of undergraduate dental students regarding management of caries lesions

Objectives

Understanding of lifelong control of disease processes associated with caries and its management is an essential part of dental education. This study evaluated the dental students’ knowledge of caries diagnosis and management using the International Caries Classification and Management System (ICCMS).

Methods

A survey was conducted among undergraduate dental students at two dental schools, attending the sixth (centre 1) and seventh semester (centre 2), respectively. Medical histories, clinical images and radiographs of 12 patients were compiled as anonymous cases. For each case, a specific lesion was to be assessed. In addition, the students should determine the patient’s caries risk and select a treatment option. An expert report (consensus decision) was used as the reference standard. For statistical analysis, kappa statistics and binomial tests were used.

Results

A total of 46 students participated in this study. The percentage of agreement of responses to the reference was: centre 1: 40.7–51.3%, centre 2: 57.9–67.9%. The corresponding Kappa values were: centre 1: 0.073–0.175, centre 2: 0.315–0.432. Overall, students tended to underestimate the codes compared to the reference standard (p < 0.001).

Conclusion

Introducing systematic content about caries diagnosis and management such as ICDAS and ICCMS in the learning objectives of undergraduate dental students can be proposed. However, in order to improve diagnosis and enable a more reliable choice of treatment options, attention should also be given to the way they are didactically taught.