American Academy of Gold Foil Operators. Clinician of the year award. Dr. William T. Pike.
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It is now widely recognised that dentistry based mainly on the restoration of teeth has failed to deliver dental health to our patients. There is an urgent need for GDPs to face up to the full implications of this failure and implement a truly preventive practice philosophy. We must also recognise the particular plight of our patients with very heavily restored dentitions who are the real victims of the drill and fill culture of the last 40 years. There must be no more additions to their ranks.
Current and projected approaches to dental education have created a wide interest in clinical simulation, and recently there has been a considerable expansion in the availability of experiential learning tools which imitate "real life" clinical conditions in dentistry. These include patient simulation devices such as heads, jaws, teeth and clinical environments, standardized patients, interactive video-discs and computer-based instruction. This paper reviews some of the equipment currently available for simulation of clinical procedures, and assesses the initial experiences and responses of 2nd, 3rd and 4th year undergraduate dental students at The University of Melbourne to case-based simulations in a patient simulator in comparison with preclinical exercises in a traditional bench and manikin laboratory. Student response to teaching and learning in the simulator over a 3-year evaluation period, collected via a student questionnaire was uniformly positive. Students were very enthusiastic about the learning environment and educational approach, preferring it to traditional preclinical laboratory instruction.
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Dr Marshall Webb (1844-1883), author, lecturer, debater, clinician, inventor, and dentist extraordinaire, was a decade ahead of others in putting forth a concept of "extension for prevention." One hundred twenty years ago, he was one of the best known, most advanced, and highly regarded dentists in the world. His pioneering work in cardiology, preventive dentistry, ethics, and prevention of recurrent decay raised the standards of what we call operative or conservative dentistry, but he is almost unknown now. However, his concept of conservative tooth preparation could be applied today.
Preclinical technique curricula seldom provide training in those prerequisite skills that may facilitate performance in a large class of procedures. Instead, students typically progress from simple to increasingly difficult preparations and it is assumed that positive transfer occurs between them. Another strategy that may provide greater benefits is the leadup activity, which closely simulates the criterion tasks, but eliminates one or more complexities thought to interfere with prerequisite skill acquisition. This investigation evaluated the effectiveness of such a training program on performance in all projects of a freshman operative laboratory course. Twenty-six student volunteers participated in an eight-hour program that was largely self-instructional. Their performance was compared to that of a randomly selected control group with replacement at each observation. Raters were calibrated and blind to group affiliation of completed preparations. Analyses of covariance with PAT as the covariate indicated that the experimental group statistically significantly outperformed the control group on all but one preparation. It is concluded that the implementation of leadup activities at least for a freshman operative technique laboratory may be warranted.
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PURPOSE: The purpose of this study was to report the results of a survey of pediatric dentistry post-doctoral program directors regarding education of post-doctoral students about management of caries in children 3 years-of-age or younger. METHODS: Fifty-two pediatric dentistry advanced education program directors were sent questionnaires inquiring about payer sources in their programs, distribution of caries in children 3 years of age or younger within the payer sources, the methods they teach and use to treat the caries, and the effectiveness of treatment and outcome data about the success of their treatment. RESULTS: Twenty-nine programs responded (56%). On average, two-thirds (66%) of the patients in post-doctoral pediatric dentistry programs are Medicaid patients. Program directors are fairly uniform in how they define methods of caries management, and they rate definitive therapy as the most effective method to manage all types of caries. Literature/textbooks were most frequently cited as the major source of scientific evidence to support treatment decisions. Fewer than 20% of program directors have outcome data on the effectiveness of their methods of treatment. CONCLUSIONS: Medicaid is the major payer source for patients in post-doctoral programs and definitive therapy is considered by program directors to be the most effective approach to managing caries in this patient population. Program directors rely on the literature and textbooks and few have outcome data.