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It's time to revive dental study clubs.

Dental study clubs provide a major opportunity for dentists to meet with other dentists and dental team members and to learn in a friendly, nonthreatening environment. They afford members the opportunity to increase their knowledge of and clinical skills in using new concepts, materials, techniques and devices by hearing about them from fellow members or by working with and evaluating innovations themselves for the benefit of other members. I strongly support the study club concept, and I feel that it should be encouraged in all clinical disciplines in all parts of the country.

Clinical Competence↗

Teaching students the repair of resin-based composite restorations: a survey of North American dental schools.

BACKGROUND: The purpose of this study was to evaluate whether North American dental schools teach students to repair resin-based composite, or RBC, restorations and to compare the findings with those from similar European surveys. MATERIALS AND METHODS: The authors mailed a 15-item questionnaire to 64 dental schools in the United States, Canada and Puerto Rico. The survey asked whether the school taught repair of RBC restorations and inquired about the respondent's experience with such procedures. Questions also elicited reasons why schools taught or did not teach repair, information in regard to relevant decision-making processes, criteria for deciding whether to perform repairs and the nature of the instruction (theoretical, practical, preclinical or clinical). RESULTS: Fifty-two (81 percent) of 64 schools participated in the survey. Thirty-seven (71 percent) of the respondents reported that they taught undergraduate students repair techniques as an alternative to replacing failing RBC restorations. Twenty-seven (73 percent) of these 37 schools reported that such teaching was at the clinical level, while only three schools (8 percent) reported that it was included in formal lectures as part of preclinical courses. The major reasons given for teaching students how to repair RBC restorations were tooth structure preservation and reduction of potentially harmful effects on the pulp. Indications included the correction of marginal defect and marginal discoloration. CONCLUSIONS: More than one-half of the respondents reported that they taught repair of RBC restorations and that patients were willing to accept such treatment. Most schools considered the repair of RBC restorations to be a definitive measure and reported that, on average, expected a repaired RBC restoration to have a longevity of four years.

Canada↗

'Patch-and-mend'.

Explore the source record for details and available documents.

Composite Resins↗

Should a dental explorer be used to probe suspected carious lesions? Yes--an explorer is a time-tested tool for caries detection.

The caries rate is dropping worldwide, a fact that appears to have no relationship to whether dentists in the affected countries use an explorer to probe suspected carious lesions. Questions have been raised about this procedure on the basis of the purported inaccuracy of its contribution to caries diagnosis, its possible spread of infective plaque from other teeth in the mouth or the damage it can cause to pits and fissures. Longterm randomized clinical trials are necessary in these areas of question, trials that use endpoints that are clear and meaningful to clinical dentists. Until the time comes that facts emerge from acceptable long-term clinical trials, dentists should feel comfortable using the dental explorer to probe suspected carious lesions.

Dental Caries↗

The advantages of minimally invasive dentistry.

Minimally invasive dentistry, in cases in which it is appropriate, is a concept that preserves dentitions and supporting structures. In this column, I have discussed several examples of minimally invasive dental techniques. This type of dentistry is gratifying for dentists and appreciated by patients. If more dentists would practice it, the dental profession could enhance the public's perception of its honesty and increase its professionalism as well.

Air Abrasion, Dental↗

The challenge of esthetic dentistry and elective services.

Many dentists would like to increase the number of esthetic and elective procedures they perform. What may be holding them back is the ability to communicate with, educate and motivate patients in the area of esthetic and elective dentistry. While implants, esthetic dentistry or elective dentistry is not for every patient, each of these areas has improved the quality of many people's lives, allowing the dental profession to continue to serve the public in the broadest possible way.

Communication↗

Teaching the placement of posterior resin-based composite restorations in U.S. dental schools.

BACKGROUND: In light of the increased use of and demand for posterior resin-based composite restorations in dental practice, the authors investigated U.S. dental schools' current teaching with regard to placement of posterior composite restorations. METHODS: In early 2005, the authors invited 52 schools to participate in an e-mailed survey. RESULTS: The authors received 47 completed responses, for a 90 percent response rate. Although all schools provided didactic and clinical teaching in the placement of occlusal resin-based composites in posterior teeth, the survey results showed variation in teaching the use of two- and three-surface occlusoproximal composites. CONCLUSIONS: The survey findings demonstrate a marked change in instruction in placement of posterior resin-based composite restorations in U.S. dental schools during the last five to 10 years. However, the authors found much variation in the nature and extent of the instruction and techniques taught. CLINICAL IMPLICATIONS: Dental schools need to ensure that their graduating students are well-prepared for independent clinical practice.

Bicuspid↗

Cutting characteristics of dental diamond burs made with CVD technology.

The aim of this study was to determine the cutting ability of chemical vapor deposition (CVD) diamond burs coupled to an ultrasonic dental unit handpiece for minimally invasive cavity preparation. One standard cavity was prepared on the mesial and distal surfaces of 40 extracted human third molars either with cylindrical or with spherical CVD burs. The cutting ability was compared regarding type of substrate (enamel and dentin) and direction of handpiece motion. The morphological characteristics, width and depth of the cavities were analyzed and measured using scanning electron micrographs. Statistical analysis using the Kruskal-Wallis test (p < 0.05) revealed that the width and depth of the cavities were significantly greater when they were prepared on dentin. Wider cavities were prepared when the cylindrical CVD bur was used, and deeper cavities resulted from preparation with the spherical CVD bur. The direction of handpiece motion did not influence the size of the cavities, and the CVD burs produced precise and conservative cutting.

Adolescent↗

Pathogenesis and prevention of native valve infective endocarditis in elderly dental patients.

Elderly dental patients are at risk of developing infective endocarditis. Increased longevity is associated with an increased prevalence of cardiac valvular disease and impairment of the immune system. Aortic stenosis commonly occurs in persons between 60 and 75 years of age. Degenerative calcification of the mitral valve ring leading to valve incompetency often develops in those over age 70 years. Men over the age of 60 years with mitral valve prolapse and systolic hypertension are at risk of infective endocarditis because the excessive haemodynamic load placed upon the abnormal valve causes extensive stretching of cusps and loss of valve surface endothelium. Dental procedures, that result in mucosal or gingival bleeding (most notably dental extractions, periodontal probing, scaling and surgery, endodontics and restorative procedures which extend below the gingival line), frequently produce a bacteraemia. Anaerobic strains of bacteria are isolated twice as frequently as aerobic strains. Antibiotic prophylaxis decreases the level of bacteraemia, prevents adherence of bacteria to the damaged valvular epithelium and suppresses the growth of those microbes that manage to adhere to the valve. The standard prophylactic regimen consists of amoxicillin 3g 1 hour before the dental procedure, then 1.5g 6 hours after the initial dose. Erythromycin is a good alternative for penicillin-allergic patients. Topical chlorhexidine 5 minutes before initiating dental therapy reduces the bacterial inoculum and the likelihood of endocarditis.

Aged↗