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Brandt AC, Lingard L, Dong CS. A multi-faceted construct to guide geriatric dental education: Findings from a scoping review with consultation. Gerodontology 2024. [PMID: 38874011 DOI: 10.1111/ger.12769] [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] [Accepted: 05/28/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND AND OBJECTIVES Older adults report unmet oral health care needs and barriers in access to care, due in part to provider attitudes and discomfort towards treating older patients. Our study asked: What is known from the literature about the use of undergraduate dentistry programmes to influence dental students' attitudes, perceptions and comfort towards treating geriatric patients? And how can interdisciplinary care facilitate the ability of dentists to work with geriatric patients? MATERIALS AND METHODS A scoping review and stakeholder consultation followed established methodological guidelines. Four databases and two grey literature sources were searched. Two researchers independently selected articles using predefined inclusion criteria. Pertinent information was inputted into an iteratively developed extraction table. NVivo 12 was used to organise the extracted data into themes. Key findings were confirmed through stakeholder consultation. RESULTS Sixty-eight articles were included in the scoping review. Five key themes emerged: (1) Curricular targets; (2) Intervention components; (3) Dentist and patient factors; (4) The role of interdisciplinary care; and (5) Post-graduation insights on knowledge-seeking patterns. Stakeholder consultations involved 19 participants from Southwestern Ontario and generally confirmed our findings. CONCLUSIONS Inconsistent reporting of multiple intervention dimensions constrains our ability to strengthen this knowledge. Future interventions and their reporting could be improved by adopting "willingness to treat" as an overarching, multi-faceted concept which encompasses knowledge on ageing, attitudes towards older patients, perceived competence and empathy. Stakeholder interviews complemented these findings.
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Affiliation(s)
- Alicia C Brandt
- Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Lorelei Lingard
- Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
- Centre for Education Research & Innovation, University of Western Ontario, London, Ontario, Canada
| | - Cecilia S Dong
- Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
- Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
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Brandt AC, Abbas A, Dong CS. Exploring the acceptance of geriatric dentistry programming for undergraduate dental students through stakeholder interviews. J Dent Educ 2024; 88:573-586. [PMID: 38321860 DOI: 10.1002/jdd.13461] [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: 03/04/2023] [Revised: 11/28/2023] [Accepted: 01/06/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE/OBJECTIVES Older adults frequently report unmet oral healthcare needs. Current research suggests a lack of provider willingness to perform geriatric dental care plays a role in limiting older adults' access to dental services. To better understand the acceptance of geriatric dentistry programming in Ontario, and to explore considerations for successful implementation, we completed consultations with dental students and dental education stakeholders. Findings from a scoping review we conducted previously (Alicia C. Brandt and Cecilia S. Dong) were used to guide this research. METHODS Consultations involved a questionnaire and semi-structured individual interviews. Descriptive and parametric statistics such as Pearson's bivariate correlation and One-way analysis of variance were completed on questionnaire data using SPSS V.28. Interview data were transcribed verbatim, and the content was analyzed using emergent coding and thematic analysis in NVivo. Student and faculty data were analyzed separately and then consolidated. RESULTS Ten students and 12 dental faculty members completed the questionnaire of which ten students and nine faculty members also participated in interviews. Themes were organized into barriers and facilitators, with a subsection on interprofessional collaboration. Barriers included: 1. Student anxiety and skill level; 2. Constraints of the learning environment; 3. Patient factors; and 4. Knowledge gaps. Facilitators included: 1. Learning environment and culture; 2. Volume of exposure; 3. Soft skills; and 4. Desired interventions. CONCLUSIONS Both students and faculty stakeholders demonstrated acceptance of geriatric dentistry programming at the undergraduate dentistry level that supports improved access to care for this population. Pilot programs integrating different intervention elements which were viewed as most promising would be beneficial.
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Affiliation(s)
- Alicia C Brandt
- Department of Dentistry, Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada
| | - Ahmed Abbas
- Department of Dentistry, Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada
| | - Cecilia S Dong
- Department of Dentistry, Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada
- Department of Pathology and Laboratory Medicine, University of Western Ontario, Ontario, Canada
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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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Perception of Old Age in German Undergraduate Dental Students-A Comparison of Two Cohorts 10 Years Apart. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063279. [PMID: 33810017 PMCID: PMC8004841 DOI: 10.3390/ijerph18063279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/09/2021] [Accepted: 03/18/2021] [Indexed: 11/24/2022]
Abstract
Previous studies revealed that students’ willingness to provide dental services for older patients is mainly influenced by their individual perception of elders rather than their knowledge about old age. The aim of this study was to estimate students’ perception of old and young age as well as their hopes and fears associated with old age and to compare two cohorts that participated in the study 10 years apart. Data were obtained from a questionnaire completed by two cohorts of undergraduate dental students from 2006 to 2008 (T1, n = 207) and 2016 to 2018 (T2, n = 135). Participants were asked to define the ages that they consider a man or woman to be old and young. Moreover, they had to specify their fears and hopes associated with old age. Reported thresholds for old age differed significantly between T1 and T2. In contrast to T1 students, T2 students defined a person to be old at a higher age and barely differentiated between the old ages of men and women. Furthermore, T2 students presented more fears related to aging than T1 students, e.g., psychological problems or loss of independence. The perception of age appears to be a multifactorial process and significantly changed between students of T1 and T2. Fears of dental students regarding old age should be addressed in, e.g., gerodontological curricula, to foster positive experiences in interaction with older people and highlight the important and rewarding aspects of gerodontology.
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Diet and Oral Health Coaching Methods and Models for the Independent Elderly. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10114021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Health-related behavior based on diet is an important determinant of oral health in independent elderly. Aging impairs senses, mastication, oral status, and function, causing nutritional needs and diet insufficiencies that contribute to a vicious circle of impairment. But the present needs of independent older adults suggest that health research and oral health care should shift from disease management and therapy to integral customized and personal treatment plans, including lifestyle, psychological, nutritional, and oral health coaching approaches. In this paper health coaching approaches in medical and dental settings are valued as to their effectiveness for older adults. Furthermore, coaching approaches for seniors are discussed and coaching models for better senior patient-dentist cooperation on the diet issue are suggested. Diet and oral health coaching is proven to be a modern senior patient-centered approach that needs to be incorporated at all relevant settings. It should aim to empower older adults in co-management of their oral diseases or bad diet habits affecting their oral health. This can be carried out through an incorporated educational plan for dentists either at the postgraduate or professional level since advantages seem to enhance the quality of life of the independent elderly.
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Nilsson A, Young L, Croker F. A call to greater inclusion of gerodontology in the dental curriculum: A narrative review. Aust Dent J 2018; 64:82-89. [PMID: 30388299 DOI: 10.1111/adj.12663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2018] [Indexed: 11/29/2022]
Abstract
AIM This literature review explores the need for greater prominence of gerodontology in the undergraduate dental curriculum, focusing on the significance of gerodontology for dental students on clinical placements. BACKGROUND As Australia's population ages the number of dentate older people is increasing. An assessment of the dental profession's preparedness, including that of future providers, is needed to ensure that this public health issue is addressed. METHODS A database search was performed in MEDLINE (Ovid), CINAHL and JCU OneSearch. Of the 41 articles identified, 31 were selected for review using a narrative approach. DISCUSSION Of the 31 articles reviewed, 12 were Australian, 9 North American and 5 European. Five overarching themes were identified, including preparedness for residential aged care facilities; barriers to oral health services provision; attitudes to aged care; gerodontology as part of a dental school curriculum and service-based learning. CONCLUSION There are differences in the gerodontology curricula of dental schools, with a wide variation of clinical exposure to older patients. There is evidence that exposure to gerodontology curriculum prior to treating older people may help dental students feel more prepared for managing patients in aged care. The current marginal status of gerodontology in dental school curricula is in need of review.
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Affiliation(s)
- A Nilsson
- James Cook University, Townsville, Queensland, Australia
| | - L Young
- James Cook University, Townsville, Queensland, Australia
| | - F Croker
- James Cook University, Townsville, Queensland, Australia
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Waldrop D, Nochajski T, Davis EL, Fabiano J, Goldberg L. Empathy in Dentistry: How Attitudes and Interaction With Older Adults Make a Difference. GERONTOLOGY & GERIATRICS EDUCATION 2016; 37:359-380. [PMID: 25495912 DOI: 10.1080/02701960.2014.993065] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The development of empathy and positive attitudes are essential elements of professional education. This study explored the nature of empathy and its association with attitudes about, and exposure to older patients in a sample of dental students. Students completed an adapted version of the Jefferson Scale of Physician Empathy (JSPE), the Aging Semantic Differential (ASD) and answered questions about their exposure to older people. Factor analysis was used to identify four factors: (1) Empathy is Valuable, (2) Empathy is Demonstrated, (3) Empathy is not Influential, and (4) Empathy is Difficult to Accomplish. Higher empathy scores were related to the ASD subscale attitude of acceptability of aging and to greater exposure to older adults outside of clinical practice. There were no demographic predictors of higher empathy scores.
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Affiliation(s)
- Deborah Waldrop
- a School of Social Work , University at Buffalo , Buffalo , New York , USA
| | - Thomas Nochajski
- a School of Social Work , University at Buffalo , Buffalo , New York , USA
| | - Elaine L Davis
- b School of Dental Medicine , University at Buffalo , Buffalo , New York , USA
| | | | - Louis Goldberg
- b School of Dental Medicine , University at Buffalo , Buffalo , New York , USA
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Wolff MS, Schenkel AB, Allen KL. Delivering the evidence--skill mix and education for elder care. Gerodontology 2015; 31 Suppl 1:60-6. [PMID: 24446981 DOI: 10.1111/ger.12088] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To review the current status of dental curricula on elder care, and the current curricula regarding elder care, and it's effect on altering practitioner behaviors while addressing the needs of a growing North American elder population. BACKGROUND An impending crisis is looming over the oral healthcare of our aging population. At the same moment that life expectancy is being extended through increasingly complex healthcare improvements, the numbers of trained dental providers capable and interested in delivering the needed care is failing to grow at an adequate rate. DISCUSSION The skills necessary to manage these increasingly complex patients require an interprofessional approach capable of delivering care to sicker patients, in a variety of living accommodations, while managing a variety of care givers. The dental skills necessary to treat these elderly are modifications of skills students routinely learn in dental school. As a matter of fact, the skills students acquire to treat an adult patient population may be contrary to the basic skills necessary to manage the elderly dependent adult patient. Teaching students the nuance differences needed to properly diagnose and care for this population is a difficult task that must be taught in a contextual environment. CONCLUSION Significant changes in the teaching of dental management of the elderly are critical within much of the education community. Just as teaching students to care for the pediatric population as general dentists, the clinical education must involve a sufficient number of quality experiences to address issues of both competency, that of the graduate to perform care independently, and attitudes, the actually willingness to treat the elderly.
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Affiliation(s)
- Mark S Wolff
- Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, NY, USA
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Bonwell PB, Parsons PL, Best AM, Hise S. An interprofessional educational approach to oral health care in the geriatric population. GERONTOLOGY & GERIATRICS EDUCATION 2013; 35:182-199. [PMID: 24131421 DOI: 10.1080/02701960.2013.827572] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
An interprofessional educational approach was used to provide five in-service training sessions for all direct health care providers in a long-term care facility, and one half-day seminar/live webinar for community-licensed health care professionals. Content included presentations by five disciplines: (a) periodontist: oral-systemic relationship, (b) oral pathologist: oral pathology, (c) pharmacist: oral health-pharmacological link, (d) dietitian: oral health-dietary link, and (e) occupational therapist: providing and practicing proper oral hygiene. Significant improvement in posttest scores for the five in-service training sessions and the half-day seminar/live webinar was revealed in t-test results, representing an increase in knowledge gained. Approximately 80% of the 145 participants indicated that they would make a change in patient care. Findings indicate that the in-service training sessions and half-day seminar/live webinar supported development of the geriatric work force by utilizing an interprofessional educational approach which will assist in meeting the oral health care needs of the geriatric population.
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Affiliation(s)
- Patricia Brown Bonwell
- a Dental Hygiene Program, Department of Oral Health Promotion and Community Outreach, School of Dentistry , Virginia Commonwealth University , Richmond , Virginia , USA
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Doris JM, Davis E, Du Pont C, Holdaway B. Social work in dentistry: the CARES model for improving patient retention and access to care. Dent Clin North Am 2009; 53:549-559. [PMID: 19482129 DOI: 10.1016/j.cden.2009.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Social work programs in dental schools and dental clinics have been operated successfully since the 1940s, and have been documented as contributing to patients' access to care and to dental education. However, unlike medical social work, with which it has much in common, social work in dentistry has failed to become a standard feature of dental schools and clinics. Few of the social work initiatives that have been implemented in dental schools have survived after initial grant funding ran out, or the institutional supporters of the program moved on. The authors hope that the CARES program serves as a model for the successful development of other programs at the intersection of social work and dentistry to the benefit of both dental patients and providers.
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Affiliation(s)
- Joan M Doris
- Department of Pediatric and Community Dentistry, School of Dental Medicine, University at Buffalo, Buffalo, NY 14214, USA.
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Nochajski TH, Waldrop DP, Davis EL, Fabiano JA, Goldberg LJ. Factors That Influence Dental Students’ Attitudes About Older Adults. J Dent Educ 2009. [DOI: 10.1002/j.0022-0337.2009.73.1.tb04642.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | - Elaine L. Davis
- Department of Oral Diagnostic Sciences; School of Dental Medicine; University at Buffalo
| | - Jude A. Fabiano
- Department of Restorative Dentistry; School of Dental Medicine; University at Buffalo
| | - Louis J. Goldberg
- Department of Oral Diagnostic Sciences; School of Dental Medicine; University at Buffalo
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