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Nanji N, Nanji A, Chamut S, Chandel T. Advancing dental care access for patients with disabilities: A global scoping review of predoctoral training. J Dent Educ 2024; 88:957-973. [PMID: 38597196 DOI: 10.1002/jdd.13508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/08/2024] [Accepted: 02/23/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE To examine predoctoral training programs that address the unique needs of patients with special healthcare needs (SHCN) and provide an overview of current global training initiatives, while exploring innovative approaches to enhance dental students' preparation in managing SHCN patients. METHODS A scoping review (SR) was conducted focusing on three key concepts: dental education, pre-doctoral training, and intellectual disability/developmental disability. The search encompassed five databases including Medline, Embase, Dentistry and Oral Sciences Source (EBSCO), Global Health (EBSCO), and WHO Global Index Medicus, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. EndNote and Covidence were utilized to prevent duplication and facilitate title/abstract screening. RESULTS After screening abstracts, a total of 2309 articles were initially identified with 28 articles meeting eligibility criteria for data extraction relevant to the research question. Two major categories characterized the key findings included in the review: 12 interventional studies and 16 perception-based studies. CONCLUSION This SR revealed that dental students are not adequately trained to treat special needs populations; consequentially, dental students lack confidence in providing high-quality care to this demographic. The absence of standardized training poses a global challenge, exacerbating care disparities. Addressing this issue is crucial to better prepare dental students and advance equitable access and quality care for underserved populations.
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Affiliation(s)
- Natasha Nanji
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Alisha Nanji
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Steffany Chamut
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Tejasvita Chandel
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Ramadhani A, Izzati FR, Maharani DA, Malik NA, Setiawati F. Perception of Special-Care Dentistry among Dental Students at Universitas Indonesia: A Cross-Sectional Study. Dent J (Basel) 2024; 12:19. [PMID: 38275680 PMCID: PMC10814598 DOI: 10.3390/dj12010019] [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: 11/22/2023] [Revised: 12/30/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVE To assess the perceptions of special-care dentistry (SCD) among dental students in the Faculty of Dentistry, Universitas Indonesia, Indonesia. METHODS This cross-sectional study used a self-administered online questionnaire, and all preclinical and clinical students were invited to participate. The survey items comprised four domains related to participants' characteristics, perceptions of SCD, perceptions of managing patients with special needs, and perceptions of SCD education. The chi-square test and Mann-Whitney test were used in the analysis. RESULTS A total of 572 students participated in this study. The findings showed that the clinical students were more familiar with SCD than the preclinical students were (p = 0.008). A statistically significant relationship was found between the study program and the ability to work independently with special-needs patients after graduation (p < 0.001), the ability to refer special-needs patients to specialists (p = 0.042), the perception of postgraduate training-program needs (p < 0.001), and the opportunity to consider postgraduate training (p = 0.004). CONCLUSION Most of the respondents had a favorable perception of SCD. Thus, an improved SCD curriculum and SCD training for undergraduate and postgraduate students should be provided to develop the knowledge and skills needed to provide care to special-needs patients.
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Affiliation(s)
- Atik Ramadhani
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok 16424, Indonesia; (A.R.); (F.R.I.); (D.A.M.)
| | - Fiki Rizqa Izzati
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok 16424, Indonesia; (A.R.); (F.R.I.); (D.A.M.)
| | - Diah Ayu Maharani
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok 16424, Indonesia; (A.R.); (F.R.I.); (D.A.M.)
| | - Normaliza Ab Malik
- Department of Conservative Dentistry and Prosthodontic, Faculty of Dentistry, Universiti Sains Islam Malaysia, Bandar Baru Nilai, Nilai 71800, Malaysia;
| | - Febriana Setiawati
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok 16424, Indonesia; (A.R.); (F.R.I.); (D.A.M.)
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Spolarich AE, Gohlke E, Fallone K, Bay RC. Training dental hygiene students to care for patients with disabilities. Int J Dent Hyg 2023; 21:699-709. [PMID: 37602535 DOI: 10.1111/idh.12722] [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: 04/27/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the impact of a novel training programme on dental hygiene students' knowledge, attitudes, and beliefs about caring for individuals with disabilities. METHODS A mixed methods approach was used. Students from five dental hygiene programmes based at community colleges completed a two-hour didactic training session to supplement their existing special care dentistry coursework. Students completed an original 14-item pretest and posttest before and after the training that assessed attitudes and beliefs, and two validated posttests that assessed knowledge. Afterwards, students completed a clinical rotation in an advanced care dental clinic at a local academic institution, gaining hands-on experience with equipment and patient treatment. Descriptive statistics were used to report training scores, types of services rendered, and modifications to treatment. Student comments about their experiences were assessed using thematic analysis. RESULTS Two hundred and ninety-four students completed didactic training, and 261 completed clinical rotations. Posttest scores indicated positive improvements in knowledge, attitudes, and beliefs. All students provided direct patient care. Sixty-nine percent treated patients with intellectual and developmental disabilities; 75% placed silver diamine fluoride or fluoride varnish. Altered patient positioning was used by 70.5%. Most students (95.4%) reported that their experience positively changed their attitudes towards caring for patients with disabilities in the future. Eight themes emerged, notably increased comfort and confidence, a willingness and desire to treat patients, the acquisition of new skills, and clinician behaviours of empathy and compassion towards others. CONCLUSION Training can help prepare dental hygiene students with the confidence and skills to address the oral health needs of individuals with disabilities.
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Affiliation(s)
| | - Ellen Gohlke
- Advanced Care Clinic, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona, USA
| | - Karen Fallone
- Advanced Care Clinic, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona, USA
| | - R Curtis Bay
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
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Hugar SM, Soneta SP, Gokhale N, Badakar C, Joshi RS, Davalbhakta R. Assessment of Dentist's Perception of the Oral Health Care toward Child with Special Healthcare Needs: A Cross-sectional Study. Int J Clin Pediatr Dent 2020; 13:240-245. [PMID: 32903974 PMCID: PMC7450186 DOI: 10.5005/jp-journals-10005-1777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim The study aimed to explore dentist's perception of the oral health care toward child with special healthcare needs (CSHCN). Materials and methods A total sample size of 250 was calculated. A 13-item validated questionnaire containing four domains were distributed among the participants. Descriptive analysis was used followed by one-way analysis of variance for comparison. Results The results showed 51.54% confidence, 71.33% knowledge, and 66.90% perception among the participants. A statistically significant results were found between three domains (p value < 0.0001). Conclusion The study concludes that there is a need to raise the level of knowledge and awareness about the oral health care of CSHCN among the dental students and professionals. How to cite this article Hugar SM, Soneta SP, Gokhale N, et al. Assessment of Dentist's Perception of the Oral Health Care toward Child with Special Healthcare Needs: A Cross-sectional Study. Int J Clin Pediatr Dent 2020;13(3):240–245.
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Affiliation(s)
- Shivayogi M Hugar
- Department of Pediatrics and Preventive Dentistry, KAHER's KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Sanjana P Soneta
- Department of Pediatrics and Preventive Dentistry, KAHER's KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Niraj Gokhale
- Department of Pediatrics and Preventive Dentistry, KAHER's KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Chandrashekhar Badakar
- Department of Pediatrics and Preventive Dentistry, KAHER's KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Riddhi S Joshi
- Department of Pediatrics and Preventive Dentistry, KAHER's KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Rucha Davalbhakta
- Department of Pediatrics and Preventive Dentistry, KAHER's KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
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Holzinger A, Lettner S, Franz A. Attitudes of dental students towards patients with special healthcare needs: Can they be improved? EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:243-251. [PMID: 31845452 PMCID: PMC7328724 DOI: 10.1111/eje.12490] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/06/2019] [Accepted: 12/12/2019] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Lack of knowledge and skills as well as negative attitudes towards patients with special healthcare needs may adversely affect the services available to this group. In 2010, a line on the treatment of patients with special healthcare needs has been implemented in the dental curriculum at the Medical University of Vienna, including five seminars and a practical course. In this study, we examine to what extent the programme helps improve attitudes towards persons with special healthcare needs and positively impacts the readiness to engage in treating this clientele. MATERIALS AND METHODS In 2017 and 2018, all students who were in their fourth study year participated in the study. Students' attitudes were assessed before the first seminar, after the last seminar and after the practical course. At all three time points, the same fully structured questionnaire was used, including established instruments for the assessment of emotional reactions and the desire for social distance plus ad hoc questions for assessing students' future intention to treat patients with special healthcare needs. The data were analysed by means of linear fixed models. RESULTS At the end of the line devoted to patients with special healthcare needs, students tended less to express negative emotions and showed more positive emotional reactions than before the start of the programme. However, students' social acceptance of such patients and their readiness to engage in treating them did not change significantly. DISCUSSION While our programme was able to improve students' emotional reactions to people with special healthcare needs, it proved unable to reduce the desire for social distance and to lower the barrier when it comes to treatment. It is planned to further develop our programme which, hopefully, will then succeed in increasing students' readiness to treat this clientele. CONCLUSION Improving dental students' emotional reactions to patients with special healthcare needs does not necessarily translate into greater readiness to treat this clientele.
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Affiliation(s)
| | - Stefan Lettner
- University Clinic of DentistryMedical University of ViennaViennaAustria
| | - Alexander Franz
- University Clinic of DentistryMedical University of ViennaViennaAustria
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LeClaire JP, Stille SO, Foster KD, Berg RG. Analyzing essays about treating adults with special health care needs and intellectual and developmental disabilities. J Dent Educ 2020; 84:543-551. [PMID: 31985057 DOI: 10.1002/jdd.12040] [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: 07/25/2019] [Revised: 12/13/2019] [Accepted: 12/17/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Analyze reflection essays written by one graduating class of students after an initial experience in a clinic for adults with special health care needs (SHCN) and intellectual and developmental disabilities, to draw insights from the patterns of observations expressed. METHODS Essays were written by students from the University of Colorado School of Dental Medicine during the 2016-2017 academic year after completing a 1-day clinical experience treating this patient population. Readers identified 18 primary themes (PTs) previously identified in essays written during 2012-2013. RESULTS The PT Complex communicating through third party was identified in 79.4% of essays. Least common were Frustrated patient could not understand (1.9%) and Frustrated patient could not talk (1.9%). Nine PTs were grouped to represent 3 component themes (CTs): CT1 Communication challenges, CT2 Behavioral challenge, and CT3 Altruistic responses. This grouping showed moderate internal reliability. A fourth, CT4 Emotional challenges, was rejected due to low internal reliability. CT1 was most frequently identified, followed by CT3 then CT2. Three PTs were chosen as indicative of desirable outcomes and were labeled outcome themes (OTs): OT1 Willing to see patients with SHCNs after graduation, OT2 Would like more Special Care Clinic (SCC) experiences in the future, and OT3 Looking forward to next SCC experience. Associations between CTs and OTs were not statistically significant, but provided useful insights. CONCLUSION Reflection essays indicate discussion of strategies to manage behavioral challenges and encouragement of altruistic feelings are both vital in orientation sessions. These topics may be critical to positive student perceptions of the experience.
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Affiliation(s)
- JoAnn P LeClaire
- Department of Community Dentistry and Population Health, University of Colorado School of Dental Medicine, Aurora, Colorado, USA.,Special Care Clinic Program, Aurora, Colorado, USA
| | - Sheila O Stille
- Special Care Clinic Program, Aurora, Colorado, USA.,Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, Colorado, USA.,General Practice Residency Program, Aurora, Colorado, USA
| | - Karen D Foster
- Department of Community Dentistry and Population Health, University of Colorado School of Dental Medicine, Aurora, Colorado, USA.,Special Care Clinic Program, Aurora, Colorado, USA
| | - Rob G Berg
- Department of Community Dentistry and Population Health, University of Colorado School of Dental Medicine, Aurora, Colorado, USA
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