The future of pediatric dentistry education and curricula: a Chilean perspective

Are we practising what we preach and are we all singing from the same hymn sheet? An exploration of teaching in paediatric caries management across UK dental schools

BACKGROUND

The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching provided to undergraduate dental students, with the ongoing teaching of outdated methods within some dental schools.

AIM

To capture the current undergraduate teaching provision and clinical treatment experience requirement relative to caries management in paediatric dentistry in UK dental schools.

DESIGN

Cross-sectional analysis of current teaching methods on paediatric caries management was obtained using a piloted online data collection form. Question content included current caries teaching methods, assessment of student exposure and competence. The results were analysed descriptively.

RESULTS

Of the 16 UK dental schools, 14 participated. Discrepancy in teaching content was apparent. Many schools (n = 9) taught biological caries management through therapeutic fissure sealants, yet this was not reflected in assessment and clinical requirements. Some schools (n = 4) taught amalgam placement in children, and most (n = 12) operatively taught treatments that would no longer be routinely provided in general dental practice in the UK, including primary tooth pulpotomy.

CONCLUSION

There is substantial variation in the paediatric caries management techniques that are taught across UK dental schools, demonstrating a need for a national consensus to address these disparities.

Expert consensus on relevant topics for undergraduate paediatric dental curriculum using the fuzzy Delphi method: a new direction for Malaysian dental education

BACKGROUND

Paediatric dentistry is a branch of dental specialty that focuses on dental care for children from infancy through adolescence. However, there is no standardised national undergraduate paediatric dental curriculum in Malaysia. The present study aimed to identify relevant topics for undergraduate paediatric dental curricula and to determine the appropriate cognitive and psychomotor levels for each topic based on the consensus among paediatric dental experts.

METHODS

Potential relevant undergraduate paediatric dentistry topics were initially drafted and revised according to the revised national competency statement. The final draft included 65 topics clustered under 18 domains. A fuzzy Delphi method was used and experts who fulfilled the inclusion criteria were invited to anonymously ranked the importance of relevant topics using a five-point Likert scale and proposed suitable cognitive and psychomotor levels for each topic. Fuzzy evaluation was then performed, and experts were considered to have reached a consensus if the following three conditions were achieved: (a). the difference between the average and expert rating data was ≤ 0.2; (b). the average expert consensus was ˃70%; and (c). the average fuzzy number was ≥ 0.5. Subsequently, the mean ratings were used to determine the cognitive and psychomotor levels.

RESULTS

20 experts participated in the survey. 64 out of 65 paediatric dentistry topics were deemed acceptable. The average fuzzy number ranged from 0.36 to 0.85, while the average Likert score ranged from 3.05 to 5.00. The topic "Dental amalgam" was rejected based on expert consensus since the average fuzzy number was 0.36. The most significant topic was "Pit and fissure sealant", followed by "Preventive advice", "Early childhood caries", "Dental caries in children & adolescent", "Management of dental caries in paediatric patients", and "Consent" which were equally ranked as the second most important topics. According to Bloom's and Simpson's taxonomies, most of the paediatric dentistry topics were rated adequate for undergraduate students at the cognitive level of "Apply" (C3) and a psychomotor level of "Guided response" (P3).

CONCLUSION

The current study successfully identified relevant undergraduate paediatric dentistry topics using the fuzzy Delphi method, which can facilitate future educators to improve existing Malaysian undergraduate paediatric dental curricula.

Undergraduate dental students' perception of paediatric dental teaching in an urban and rural Australian dental school

BACKGROUND

Confidence in performing paediatric dental treatment is important as it ensures better oral health outcomes in the patient's adulthood.

AIM

To investigate the confidence and attitudes of final year dentistry students, attending an urban and rural dental programme, towards their paediatric dentistry training.

DESIGN

A questionnaire was distributed to final year dentistry students at the urban-based university, The University of Queensland, and at the rural-based university, La Trobe University. The questionnaire collected information using 5-point Likert scale and short-answer questions, which explored the theoretical, observational, preclinical and clinical aspects of students' paediatric dentistry training. Jamovi and GraphPad Prism were used for data analysis and the creation of graphs.

RESULTS

The questionnaire was completed by 32 rural students and 47 urban students, with a response rate of 79%. Rural students were found to be less confident with the theory on restorative procedures than urban students. Observations of a dentist performing treatment on child were completed by a significantly larger proportion of urban students (70.2%) than rural students (46.9%). Students from both universities reported to have developed the least confidence in the preclinical training of pulp therapies and expressed the need for additional preclinical sessions for more training. At both universities, students indicated they were the least confident in the clinical practice of pulp therapies and management of traumatic dental injuries. Urban students were found to be more confident than their rural counterparts in the clinical practice of examination, treatment planning and preventative procedures, as well as in restorative procedures.

CONCLUSIONS

Both urban and rural students were found to have the least confidence in preclinical and clinical skills related to pulp therapies. Restorative dentistry was an area in which urban students were significantly more confident than rural students in both the theoretical and the clinical aspects.

Dental students and recent dental graduates' perceptions of preparedness in treating pediatric patients

PURPOSE/OBJECTIVES

To survey potential applicants applying to advanced education in pediatric dental programs and evaluate their preparedness upon graduating from an accredited dental school.

METHODS

Attendees of a virtual externship of a University program were recruited to participate in a web-based survey. The survey collected demographic data, current levels of confidence with various pediatric clinical procedures, predicted confidence with those procedures, and number of procedures completed. Chi-Square and analysis of variance statistics were performed on resulting data to determine statistical significance.

RESULTS

Fifty-three participants completed the survey in its entirety (n = 53). Most respondents reported adequate didactic training, mean score of 3.6 (range 0-5) and a moderate to high impact of coronavirus disease 2019 on their overall training with a mean score of 4.9 (range 0-10). Current dental students reported that they are "not confident at all" (<2.0) for 15/24 (63%) of the procedures. Graduates reported "somewhat confident" (<3.0) for 13/24 (54%) of the categories. Both students and graduates report the lowest levels of confidence for managing dental trauma, invasive treatment of young patients (<4 years of age), and patients with special healthcare needs. Dental students self-reported the expectation to feel more confident throughout their matriculation; however, their clinical experience was still reported to be limited. Students did not report reaching the level of "confident" for 75% of the procedures.

CONCLUSION

Dental students and recent dental graduates alike perceive themselves to be under prepared for practice and do not feel confident in performing pediatric dental procedures. This study can provide dental schools, program directors, recent graduates, and dental students with an understanding of areas where they are under prepared and could offer areas where curricula and clinical experiences could be updated or modified.

How is paediatric dentistry taught? A survey to evaluate undergraduate dental teaching in dental schools in the United Kingdom

INTRODUCTION

The quality assurance of undergraduate dental education in the UK is regulated by the General Dental Council who describe the competencies expected of the newly qualified dentist or "safe beginner." Whilst the literature has explored the level of undergraduate training in a number of dental specialties within the UK, there is a paucity of information on the UK curriculum for undergraduate paediatric dental teaching.

AIMS

This study aimed to assess the undergraduate teaching of paediatric dentistry within dental schools in the UK.

METHODS

An anonymous questionnaire was distributed to all 16 UK dental schools via email.

RESULTS

Twelve questionnaires were completed, giving a response rate of 75%. First exposure to both academic teaching and clinical teaching in paediatric dentistry ranged from years 1-4. Whilst there were broad similarities between units with regard to core components of the curricula, there were notable differences including the teaching of regenerative endodontics (75%) and the use of the titanium trauma splint (58%). Silver diamine fluoride was only used clinically in one unit (8%), and non-vital pulpotomy was taught by two units (16%). There was also considerable heterogeneity in assessment methods between universities.

CONCLUSION

The undergraduate paediatric dental curriculum is broadly similar between UK dental schools. However, there are discrepancies in assessment methods and the teaching of new advances.

A curriculum for behaviour and oral healthcare management for dentally anxious children-Recommendations from the Children Experiencing Dental Anxiety: Collaboration on Research and Education (CEDACORE)

BACKGROUND

Dentists need training in the management of children's anxiety (DA), fear (DF) and behaviour management problems (DBMP) but little is known of their competence on this topic.

AIM

To report dentists' opinions and attitudes about protective stabilisation and pharmacological techniques for the management of children with DA/DF/DBMP; to propose a postgraduate curriculum focussing on DA/DF/DBMP.

DESIGN

A survey of 301 Brazilian dentists and later a modified Delphi process to outline the curriculum in two phases: (a) face-to-face discussions with 33 early career researchers mentored by six researchers, both from UK and Brazil; (b) online discussions by eight early and senior researchers on the knowledge, experience, and competencies necessary for a specialist in paediatric dentistry in Brazil that should be included in the core curriculum of postgraduate courses.

RESULTS

Almost all (99.0%) of the survey respondents provide treatment to children with DA/DF/DBMP, and 91.2% do not systematically diagnose these conditions; 94.3% use protective stabilisation, and 20.0%-30.0% have training in pharmacological techniques. The four-domain framework supporting the proposed curriculum is as follows: DA/DF/DBMP assessment, non-pharmacological and pharmacological approaches, and decision-making.

CONCLUSION

Dental curricula should be customised to solve the misconceptions and promote a comprehensive and positive attitude to DA/DF/DBMP by paediatric oral healthcare practitioners.

Review and analysis of Chilean dental undergraduate education: curriculum composition and profiles of first year dental students

BACKGROUND

In Chile, dentistry has become a very popular career choice for students, which has resulted in a substantial increase in both, the number of dental graduates and dental schools. Nonetheless, there is a need for change in the way dental schools select and educate their students to keep pace with the rapidly changing nature of societal needs and to tackle the marked health inequalities that exist in the country. The aim of this study was to review and critique dental undergraduate education in Chile, with a particular focus on the curriculum composition and profiles of students admitted to dental schools from 2010 to 2014.

METHODS

A descriptive and retrospective design was utilised. Two different methods were undertaken: primary data collection regarding curriculum and secondary data analysis in relation to students' profiles. Descriptive statistics were used to assess the relative proportions of subject modules within the undergraduate dental curriculum and in particular the public health components. The analysis of the student profiles described specific background factors, namely, gender, age, secondary school type, location, rural-urban status and student's year of admission. Also, trends of dental students' intake between 2010 and 2014 were investigated. Logistic regression analysis was undertaken to assess potential associations between the aforementioned background factors and students' choice of dental school.

RESULTS

Regarding the curriculum review, a 67% response rate was obtained. The most dominant component of Chilean dental curriculum was the clinical subjects (33%), followed by the basic and biological sciences (16%) and then medical and dental sciences (13%). In relation to the admission of students, the majority attended private schools (72%); most were females (62%); aged 19 years or less (74%); had an urban origin (99%); and came from subsidised private secondary schools (48%). Significant differences were found between students admitted to traditional and private dental schools.

CONCLUSIONS

Clinical sciences are the most dominant subjects in the Chilean dental curriculum. Overall, traditional and private institutions had a broadly similar composition in their curriculum with the exception of the public health component. Students from disadvantaged backgrounds were the minority in dental schools across Chile.