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PubMed1997

Clinical guidelines and self-assessment in dental education.

This paper describes an educational programme where clinical guidelines are used in dental education and assesses the value of these guidelines as perceived by undergraduate students. It presents a comparison of students' own assessments of their performance with those of their instructors, according to such guidelines. The educational programme at the Faculty of Odontology, Lund University, is described through 3 main principles: problem-based learning, adoption of a holistic attitude to patient care and the promotion of oral health. The dental curriculum occupies 5 years comprising 10 semesters. 41, 5th semester students (16 male and 25 female) participated in the study. Students were introduced to guidelines in group discussions at the beginning of the semester. At the completion of a patient's planned course of treatment, the outcome was formally assessed both by students and clinical instructors. Performance was scored in various categories as "excellent", "acceptable" or "unacceptable" according to the standards defined. A total of 1373 scores were made by both students and instructors. 88% cent of students used the guidelines often or almost always and found them useful. Overall, no students received an "unacceptable" score and 40% of students achieved a score of "excellent". Female students tended towards a higher score, but this was not significant. Instructors' and students' scores agreed in almost 90% of instances. Students under-scored their performance more frequently than they over-scored it. It appears that the use of clinical guidelines may encourage an increased awareness of the decision-making processes involved in clinical practice, but it must be acknowledged that these guidelines are complex both in derivation and application.

Curriculum↗
PubMed2004

Reflective practice in the teaching of conservative dentistry to undergraduate dental students - perceptions derived from a pilot study using personal development diaries.

The aim of this study was to explore final-year student perceptions to the use of personal development diaries (PDDs) and to compare the findings with an established system of competitive continuous assessment, using open display of score ratings displayed on a clinic notice board. Focus groups in conjunction with personal development diaries (PDDs) were used to investigate the teaching of conservative dentistry to senior dental undergraduates. Thirty per cent of the statements made reference to the positive aspects of PDDs, while a small percentage (6%) was negative. Nineteen per cent of the comments derived from the focus groups showed that the undergraduates disliked the open display of their marks on the conservation clinic notice board. This compared with only 2% who claimed that they enjoyed the competitive method. A further 22% of the comments related to the fact that open display of marks was stressful, whereas 3% were unaffected. Eighteen per cent of the responses indicated that clinical conservative dentistry was a stressful experience.

Competitive Behavior↗
PubMed2005

Effect of augmented visual feedback from a virtual reality simulation system on manual dexterity training.

Little research has been published about the impact of simulation technology on the learning process of novel motor skills. Especially the role of augmented feedback (FB) on the quality of performance and the transfer of the acquired behaviour to a no-augmented FB condition require further investigation. Therefore, novice dental students were randomly assigned to one of three groups and given the task of drilling a geometrical class 1 cavity. The FB group trained under augmented visual FB conditions, provided by the virtual reality (VR) system (DentSim). The no-FB group practised under normal vision conditions, in the absence of augmented FB. A control group performed the test sessions without participating in any training programme. All preparations were evaluated by the VR grading system according to four traditional (outline shape, floor depth, floor smoothness and wall inclination), and two critical, criteria (pulp exposure and damage to adjacent teeth). Performance analyses revealed an overall trend towards significant improvement with training for the experimental groups. The FB group obtained the highest scores. It scored better for floor depth (P < 0.001), whilst the no-FB group was best for floor smoothness (P < 0.005). However, at the retention tests, the FB group demonstrated inferior performance in comparison with the no-FB group. The transfer test on a traditional unit revealed no significant differences between the training groups. Consequently, drilling experience on a VR system under the condition of frequently provided FB and lack of any tutorial input was considered to be not beneficial to learning. The present data are discussed in view of the guidance hypothesis of FB, which refers to the apprentice's dependence on FB.

Adolescent↗
PubMed2005

Patients treated by dental students in outreach: the first year of a pilot project.

This paper describes the patients treated by 4th year undergraduate students during the first year of a pilot outreach course to teach Restorative Dentistry in community clinics in 2001-02. Data were collected from 908 summaries of patient treatment completed by the students, and from 139 patient questionnaires. Some 75% of patients were aged between 16 and 64, 58% were female, and 16% had dental phobia or anxiety. Most lived locally to the clinic and 41% made their initial contact as an emergency or drop-in. Some 37% made only a single visit (including children treated as emergencies) but 22% made six or more visits. Did not attend (DNA) was a problem and 18% of patients DNA to complete their treatment. Students undertook the full range of restorative procedures, with the emphasis on direct restorations, preventive treatment and advice, scaling, extractions and emergency treatment. Patients' main reasons for attending the clinic were lay recommendation, the need for treatment, convenience, free treatment, or the lack of access to a dentist. Some 30% said they did not have or did not know of an alternative source of dental care, and half had not seen a dentist for at least 2 years. The study demonstrates that despite difficulties related to attendance, a suitable patient base can be established offering students the opportunity to provide comprehensive care for adults in a primary care setting.

Adolescent↗
PubMed2007

The introduction of a new assessment system in restorative dentistry: the undergraduate and patient experience.

In 2000, the University of Bristol Dental School Division of Restorative Dentistry carried out a review of the assessment methods used within the undergraduate programme. Following this review, a number of key recommendations were made and the system of formative assessment within the division was changed. Audits were conducted immediately prior to the introduction of the new system and 2 years after it had been introduced, the results of these audits are presented. There was no change in the number of failed appointments between the initial audit and the second audit. There was a reduction in the number of patients treated by more than one student from 25% to 14% (approximating to 3% if student withdrawal from the course is taken into account). The length of time taken to complete treatment reduced between the two audits with more than half of all patients having their treatment completed within 3 months of their initial examination in the second audit. Ninety-five percent of treatment plans were completed in the second audit compared with only 62% in the first audit. In the second audit, the outstanding 5% of cases were signed off as incomplete for satisfactory reasons by the member of supervisory staff (e.g. patients who had moved away or were discharged due to poor attendance). Student comments were mostly positive, the small number of negative comments related to some students being confused by the paperwork in the new system. The overall process has been an extremely positive experience which has resulted in an assessment system with increased clarity which appears to have reduced the stress levels reported by the undergraduate students on the programme and improved the quality of patient care within restorative dentistry.

Dental Audit↗
PubMed1987

Intra-vascular thrombosis associated with dental ultrasound.

Ultrasonic instruments used in dentistry generally operate at frequencies of 25 to 42 kHz. A wire oscillating at these ultrasonic frequencies immersed in a liquid produces local flow patterns termed acoustic microstreaming. Large shear forces are produced which are able to rupture erythrocytes and platelets both in vitro and in vivo. This results in activation of the blood coagulation system with subsequent thrombus formation. The probe tip of an ultrasonic scaler was positioned to touch a mammalian mesenteric artery. The probe was operated for 10 to 20 s at a displacement amplitude of 15 micron. Acoustic microstreaming occurred which disturbed blood flow and this microstreaming ceased when the power was switched off. After continued operation of the probe, thrombi were formed against the vessel wall with fragments embolising downstream. These thrombi eventually grew to occlude the vessel. Furthermore, an in situ model demonstrated that acoustic energy was transmitted through the tooth during typical ultrasonic scaling procedures. As a consequence of these observations, it is possible that acoustic microstreaming fields may be generated within the blood vessels entering the tooth apex which are large enough to induce platelet damage. Therefore there is a potential hazard from the use of the ultrasonic scaler which may induce similar thrombi formation within the pulpal or perapical tissues of the teeth. If this were to occur it could result in tooth death which might not become evident until a long time after the ultrasonic exposure.

Acoustics↗
PubMed2003

Esthetic techniques and restorative systems used in the second-year undergraduate dental curriculum.

Metal-free tooth-colored restorative systems for fabricating indirect intracoronal and extracoronal restorations have been developed because of patients' demand for superior esthetics. During the past decade, long-term clinical studies have demonstrated the success of many of these types of restorations in terms of function and esthetics. Ceramic veneers, all-ceramic crowns, ceramic onlays, and composite-resin inlays are becoming an integral part of contemporary clinical practice. The constant evolution in bonding techniques, adhesive systems, and cements plays a major role in the success of these metal-free restorations. In addition, home-bleaching procedures have become an integral part of the esthetically oriented dental practice. This article discusses the rationale, scientific basis, and implementation of a new undergraduate preclinical esthetics course for second-year dental students at the Louisiana State University Health Sciences Center School of Dentistry.

Crowns↗
PubMed2006

Victorian era esthetic and restorative dentistry: an advertising trade card gallery.

A chief means of print advertising in the Victorian era was the "trade card." Innumerable products, companies, and services were highlighted on colorful chromolithographic trade cards, and these became desirable collectible objects which were pasted into scrapbooks and enjoyed by many families. Dentistry- and oral health-related subjects were often depicted on Victorian trade cards, and esthetic and restorative dentistry themes were featured. This review describes the history of advertising trade cards and offers a photographic gallery of dentistry-related cards of the era.

Advertising↗