Oral medicine: defining an emerging specialty in the United States

Oral medicine is a specialized area of study within the scope of dental medicine. This discipline is often viewed as the crossroads between medicine and dentistry and has become integral in both pre-and postdoctoral dental education. Oral medicine is recognized as a dental specialty throughout most of the world and currently represents an emerging specialty in the United States. Historically, oral medicine has been loosely defined in the United States without a clear consensus definition. Recent published studies regarding international oral medicine postdoctoral programs and clinical practice have helped to provide more specific information regarding oral medicine from many perspectives. This article will review the literature relevant to defining oral medicine in the United States and present a new definition of this important discipline based on recent studies.

The emerging dental workforce: long-term career expectations and influences. A quantitative study of final year dental students' views on their long-term career from one London Dental School

BACKGROUND

Research into the motivation and expectations of the emerging workforce and their short-term expectations has already been reported with a view to informing professional and policy decisions. The objective of this component of the research programme was to examine the long-term goals and perceived influences on final year dental students' professional careers.

METHODS

Univariate analysis of a self completed questionnaire survey of all final year dental students from King's College London, comprising questions on demography, long-term career goals and influences, proposed commitment to dentistry, commitment to healthcare systems and the influences thereon. Statistical analysis included Chi Squared tests for linear association.

RESULTS

Ninety per cent of students responded to this survey (n = 126), the majority of whom were aged 23 years (59%), female (58%) and Asian (70%). Long-term career goals were fairly evenly split between 'dentist with a special interest' (27%), 'primary dental care practitioner' (26%) and 'specialist' (25%), with 19% not certain. Only 60% of total respondents anticipated working full-time in the long-term (79% males cf 52% females; p = 0.00). The vast majority of respondents (> or =80%) identified 'work-life balance', 'financial stability' and 'professional development' as 'important' or 'very important' influences on the number of future sessions. Females were significantly more likely to rate childcare commitments as an important influence on their future working capacity compared with males (p = 0.00). A wide range of factors were considered important or very important in making the NHS attractive, led by support for professional development (88%) and feeling valued by patients (88%), as well as funding, time with patients, rewards for prevention and practical issues such as dental materials and premises. Females were significantly more likely than males to be attracted to work within the NHS by 'childcare support' (p = 0.02), 'retraining facilities after career break' (p = 0.01), 'assistance with student debt' (p = 0.01) and 'incentives to work in deprived areas'.

CONCLUSION

Long-term career plans of new graduates from this London Dental School commonly embrace opportunities for professional development as well as personal issues such as work/life balance and financial income. Significant differences were identified between male and females long-term plans and influences. The implications of these findings are discussed.

Is there a need for a common framework of dental specialties in Europe?

This paper aims to promote discussion about dental specialties and post-graduate dental education in the European Union (EU). Previously, dental educators have concentrated their efforts of seeking Pan-EU convergence in undergraduate dental education. However, the impact of the enlargement of the EU, the new European Commission (EC) Directive of professional training and the Bologna Process all impact on post-graduate (specialist) just as much as on undergraduate dental education. The provisions of the new EC directive mean that, unlike new medical specialties, new Pan-EU dental specialties cannot be created purely because they exist in two-fifths of EU Member States. At present, some EU Member States recognise eight or more dental specialties, whereas others recognise none. It is suggested that changing needs and demands of patients, which reflect a general improvement in oral health, increased wealth and an aging population will place increasing demands on dentistry to provide more complex care and treatment and that the current undergraduate curriculum cannot be expanded to provide suitable training to meet these needs and demands. There is thus a need to expand dental specialist training in all EU Member States, to agree common standards for specialist education and to officially recognise a wider range of Pan-EU dental specialties. The paper concludes that in order to achieve these goals, there is a need of a better collaboration between competent authorities, including governments, universities, dental associations and the various Pan-European Scientific Specialist Organizations.

Antibiotic prescription and dental practice within Saudi Arabia; the need to reinforce guidelines and implement specialty needs

The aim of the present survey was to analyse the frequency and type of antibiotic prescriptions used in dental practice in Saudi Arabia, to assess the awareness of periodontal treatment need among dentists and specialists and to evaluate the distribution of dental specialties in Saudi Arabia. We distributed a questionnaire to 378 dentists including different specialists working in various major hospitals and dental departments. This same questionnaire was then redistributed, 3 years later, to 211 participants. Results from both surveys indicated that antibiotics were not always prescribed on a scientific basis. Cost was the most significant factor (p < 0.05). Interestingly, and although periodontal disease was included as one of the possible causes of infections, the penicillin group was shown to be the group of choice (p < 0.007) and was prescribed by 45% of all participants, metronidazole and tetracyclines followed and were the second most commonly prescribed antibiotics in both surveys (p < 0.05). It was further demonstrated that although the need for periodontics is present among patients and specialists, it is one of the least practised specialties (p < or = 0.008) along with oral surgery (p < or = 0.36).

What is the role of specialties in dentistry?

Dental specialties have an important, positive role in improving education and practice, stimulating research and defining quality expectations in their areas of expertise. However, it is well-known that general dental practitioners accomplish a significant portion of the dental therapy that commonly is classified as being within the scope of the respective recognized specialty areas. In this column, I have made suggestions about methods for improving the interaction between specialists and generalists and a call for better acceptance by each group of the capabilities of the other.

Specialized dentistry

Knowledge of the disciplines of dentistry is needed for the dental assistant to properly communicate with the patient, insurance companies, labs and medical offices. It also helps the dental assistant identify workplace settings. It is the responsibility of the dental assistant to become familiar with these subject areas in order to better communicate with patients about their treatment. While it is nearly impossible to know the details of all of the thousands of dental procedures performed on patients, knowledge of the common topic areas helps the dental assistant to provide additional information to the patient.