Community Dentistry

The limited access to oral health care in developing countries can be greatly improved by integrating oral health into the Primary Health Care (PHC) system. This study was designed to assess the views of PHC workers on integrating oral health care into the PHC system. A self-administered questionnaire survey was conducted in two selected local government areas of Lagos State. The instrument contained three sections assessing sociodemographic features, knowledge of common oral diseases and views on integration of oral health into PHC respectively. The mean knowledge score was 7.75 (SD=±1.81), while 60.4% of the respondents had average knowledge scores. Educational status (P=0.018) and designation (P=0.033) were significantly related to the mean knowledge scores. There was no significant difference in the oral health knowledge of the various cadres (P=0.393). Majority (85.4%) of the respondents were willing to include oral health education in their job schedule and 82% believed they n...

This qualitative study sought to identify cultural beliefs, practices and experiences that influence access to preventive oral health care for young children from different racial and ethnic groups. Four to six focus groups in each of the African-American, Chinese, Latino and Filipino communities in San Francisco, California were included in the study. Participants were carers of children aged 1-5 years. The 22 groups (n = 177 participants) were stratified by carer's age and, except in the African-American community, by whether US or non-US born. Sessions were conducted in different languages as needed. Lack of knowledge and beliefs about primary teeth created barriers to early preventive care in all groups. In Chinese groups more than others, health beliefs regarding disease causation and prevention influenced access to preventive dental care. In all groups, multiple family carers, especially elders, influenced access to preventive care. Dental fear, whether derived from prevailing community beliefs or personal negative dental experiences, greatly influenced attitudes regarding accessing preventive care. There are both similarities and differences between racial/ethnic groups in how cultural beliefs and experiences influence young children's access to dental care and how it might be improved.

Abstract – This paper reports the results of a study of the reliability of a modified version of the Index of Orthodontic Treatment Need (IOTN) for use in oral health surveys. Twelve non-specialist dental examiners were trained in the use of the Modified IOTN using a standardised teaching protocol lasting approximately 1.5 hours. Following a school-based calibration exercise it was found that nearly all the examiners achieved either good or excellent agreement (mean Kappa=0.74). The average sensitivity and specificity scores were 0.90 and 0.84, respectively. The Modified IOTN appears to overcome the training and reliability problems that often accompany the use of orthodontic indices by non-specialists in oral health surveys.

Objectives: The purpose of this paper is to provide a useful critical review relating to the effects of malocclusion on the physical, social, and psychological aspects of the Quality of Life (QoL) of patients. Methods: The information presented in previous articles was reviewed. They include reviews, meta-analyses, cross-sectional studies, retrospective and prospective longitudinal studies, and randomized controlled trials. These full-text English-language papers were studied to determine the effects of malocclusion on QoL. Results: Recent studies have found that malocclusion is associated with higher levels of dissatisfaction with appearance, and have the potential to negatively impact Oral Health Related Quality of Life (OHRQoL). However, due to the differences in study designs, population demographics studied, and methods of assessment of physical, social, and psychological health, the evidence needs more analysis. Conclusion: In recent years, attention to patient-centered assess...

The Dental Hygiene Program is a fairly recent addition in the field of the health professions in Portugal. In the past 19 years, the programme has developed community activities alongside with clinical work. This programme provides an education that is responsive, scientific and professional, in a learning environment that is dynamic, student-centred and that encourages collaboration between students and faculty. The community activities play a major role in the curricula of the programme and allow the students to develop skills in working with a wide range of population groups and to attend to their specific needs. Dental hygienists are integrated in health teams and work under the supervision of a physician or a dentist. Among other responsibilities, the following functions are part of the scope of the profession: to participate in health education programmes and sensitise the population to the prevention of dental diseases, to participate in the planning, implementation, and eval...

The traditional method for the delivery of didactic instruction and patient care in dental schools has come under fire from a number of sources over the past several years. The American Dental Education Association and others have outlined numerous issues impeding the swift progression of student learning through the dental curriculum. Declining state revenues allotted to dental education, the increasing shortage of dental faculty, and the management of student learning in an already overcrowded dental school curriculum have led to the investigation of strategies that address solutions to these and other shortcomings in the current milieu of dental education. To address these deficiencies, strategies for change have been suggested. This article describes the development, implementation, and assessment of a new dental school that addresses these and other challenges to the education of today's dental student, thus creating the Arizona Model. Following seven years of operation, ou...

Community-based dental education (CBDE) shifts a substantial portion of dental clinical education from dental school clinics to mainly public health settings. For dental students to learn effectively in community settings they need preparatory education in cultural awareness, communication skills, and the social and behavioral sciences. The effective integration of CBDE into a dental curriculum requires reflective components, evaluation, and highly organized community-based experiences. This chapter reviews organizational principles and specific strategies to ensure that CBDE is conducted in a fashion that enables student learning and community oral health service. CBDE has substantial potential for affecting the values and behaviors of dental students relative to health care access for underserved populations and for attracting diverse students to dental education. CBDE also provides dentistry with an opportunity to guide dental faculty and student values and orientation towards pu...

Dentists' self-reported attitudes towards patients with HIV/AIDS might not reflect their actual behaviour. In this study 2 observers posed as HIV-positive patients and directly evaluated the behaviour of 300 dentists in Tehran, Islamic Republic of Iran. Two months later another observer interviewed the same dentists at their offices regarding AIDS-related knowledge and self-reported attitudes. Only 14.9% of dentists agreed to treat the simulated HIV-positive patients, 78.5% referred and 6.6% rejected them. Older age, longer work experience, graduation from a non-Iranian university and not having additional degrees were significantly related to adverse behaviours. Mean scores were 8.3 (SD 9.7) (out of 18) for knowledge and 17.5 (SD 7.1) (out of 39) for attitude. There were no significant correlations between dentists' knowledge and attitude or between knowledge and behaviour, but there was a weak positive correlation between self-reported attitude and observed behaviour.

Abstract– The purpose of this comparative study of caries and dental fluorosis experience in Chilean children was to estimate the optimal range of fluoride concentration in tap water under conditions currently prevailing in Chile. The sample included 2431 schoolchildren 7, 12 and 15 years old, life-long residents of five communities with fluoride concentrations in their tap water in the range 0.07–1.1 mg/L. The study population received an oral clinical examination including caries experience and an enamel fluorosis evaluation of the permanent dentition (Dean's scoring system). For 15-year-old children, the DMFT index changed from 5.06 to 2.60, and for 12-year-olds it changed from 3.10 to 1.36 when fluoride water concentration changed from 0.07 to 1.10 mg/L. For 7-year-old children the dmft index correspondingly changed from 3.67 to 1.59. The relationship between DMFT for 12-year-olds and water fluoride concentration was best fitted by a logarithmic function (r2=0.98). The Community Fluorosis Index (CFI) was used to assess enamel fluorosis in the study population, and it showed a linear relationship (r2=0.983) with increasing fluoride concentration of water for the 12-year-old group. Results obtained suggest that under current Chilean conditions, the optimal range of fluoride concentration in potable water should lie in the 0.5–0.6 mg/L range.

The objectives of this study were to explore how dentists with well-structured vs. not well-structured community-based dental education (CBDE) experiences differ in perceptions of their CBDE and its impact on their professional lives and in their professional attitudes and behavior related to treating patients from underserved populations. The relationships between CBDE evaluations and impact on the dentists' professional lives and professional attitudes and behavior were explored as well. Data were collected from 254 dentists who participated in CBDE before graduating from the University of Michigan School of Dentistry between 1970 and 2011. The results showed that the alumni with well-structured experiences rated the quality of their CBDE more positively and its impact on their professional lives as stronger than those with less well-structured experiences. They also had more positive attitudes concerning treating underserved patients and were more likely to treat underserved ...

Service-learning has become an important component of higher education. Integrating service-learning into dental and dental hygiene curricula will foster graduates who are better prepared to work effectively among diverse populations and to function dynamically in the health policy arena. Although the phrase is familiar to dental educators, there is not a consistent understanding of what comprises this pedagogy. This article offers a framework for service-learning in dental education and describes ten components that characterize true service-learning. This framework can provide a common understanding of this form of experiential education that brings community engagement and educational objectives together. More effective programs can be built around a shared understanding of the characteristics and goals of service-learning in dental education.

Over the past few years, community-based clinical teaching/outreach teaching programs have been established in many dental schools in the United Kingdom. One such program was developed by Cardiff University at the local St. David's Hospital in 2002. Students visit this unit throughout their dental school program--as an assistant/observer initially, but gaining a significant amount of clinical operating experience within the unit during their final year of studies. While contemporaneous feedback from current dental students at this and other programs has been positive, very little information exists on the impact of this form of training on the subsequent clinical careers and working practices of qualified dentists. In autumn 2009, a postal questionnaire was distributed to dentists who graduated from the School of Dentistry at Cardiff in 2004 (n=41) and 2007 (n=51). Fifty-eight responses were returned, for a response rate of 63 percent: 2004 (66 percent), 2007 (61 percent). Forty...

Service-learning has become an important component of higher education. Integrating service-learning into dental and dental hygiene curricula will foster graduates who are better prepared to work effectively among diverse populations and to function dynamically in the health policy arena. Although the phrase is familiar to dental educators, there is not a consistent understanding of what comprises this pedagogy. This article offers a framework for service-learning in dental education and describes ten components that characterize true service-learning. This framework can provide a common understanding of this form of experiential education that brings community engagement and educational objectives together. More effective programs can be built around a shared understanding of the characteristics and goals of service-learning in dental education.

Background: Dental anxiety is a common worldwide problem; it may cause treatment difficulties for the dentist, as well as severe consequences for the patient. Pain is the main reason foe seeking dental care. Expressing patient's anxiety appears when the stimulus triggers the reaction of anxiety.
Objective: The aim of this study is to determine the prevalence and causes of dental anxiety in patient attending teaching hospital at Umm Al-Qura University.
Methods: A questionnaire was designed to collect the data from adult dental patient regarding to dental anxiety. We used Modified Dental Anxiety Scale (MDAS) to determine the level of anxiety.
Result: The results showed that 90% of patients were anxious. Anesthesia and drilling were the most common causes for dental anxiety. According to Dental Anxiety Scale we found that 50 % of patients were slightly anxious, 25 % fairly anxious, 14% very anxious, 1% extremely anxious and 10% non-anxious.
Conclusion: The majority of patients were anxious and anesthesia was the major cause of anxiety. Necessary measures are needed to reduce dental anxiety.

As community-based dental education programs proliferate, so do concerns about the quality of education at extramural sites. While there have been some comparisons of the effects of community-based programs on attitudes and perceptions of competency, there is virtually no information about whether such programs can train students to carry out standard dental procedures as well as if they were prepared in the dental school proper. To address this gap in our knowledge about the educational outcomes of community-based programs, the following performance measures were retrospectively compared for 457 students in traditional senior year curricula and fifty seniors in a community-based program: scores and pass/fail rates on the Northeastern Regional Boards (NERB), clinical production, passage of competencies, and on-time graduation rates. Students in the CODE (Community-Oriented Dental Education) program at the University of Medicine and Dentistry of New Jersey (UMDNJ)-New Jersey Dental S...

In 2007, the Faculty of Dentistry at the University of British Columbia formally introduced the course Professionalism and Community Service (PACS) in year one of its dental curriculum. PACS features community-based dental education as an experiential learning pedagogy, as well as additional themes that support the community experience. PACS will be incorporated into all four years of the curriculum, with health promotion activities in community sites as the focus in years one and two and the provision of patient care in community clinics in years three and four. Students are encouraged to provide feedback on this newly implemented course. The objective of this article is to provide an overview of the themes and modules of PACS, in the context of its being an evolving course for implementing community-based health promotion activities as experiential education for dental students. The current PACS modules are designed to expose students to a variety of experiences-from assessing com...

Abstract The aim of this study was to analyze oral hygiene habits among Finnish adolescents with regard to age, sex, residence, socioeconomic factors, school career and success. A representative sample of 3209 Finnish adolescents, 13–19 years of age, was drawn. The data were collected by mail surveys in February and September 1977. Participation percentages were 88 and 79. The proportions of daily brushers were 89 % in girls and 57 % in boys. Toothpicks were used sporadically by every second adolescent but daily by 3% only. Dental floss was used sporadically by 10% of the adolescents but daily by 1 %only. In this respect girls were more assiduous than boys. Frequency of toothbrushing clearly increased with age. Girls brushed their teeth significantly more often than boys. The influence of socioeconomic factors was consistent in boys but almost nonexistent in girls. Children of white-collar workers reported better oral hygiene habits than children of blue-collar workers and farmers. Urban adolescents reported better habits than rural adolescents. School success correlated positively with toothbrushing frequency in the younger age groups. Dental health education given by a dentist, a teacher, a hygienist or a nurse had poor correlation with the oral hygiene habits of Finnish adolescents. It was concluded that dental health education should be more directed towards boys, especially at ages 13–15. The education should be planned so that the dental health education better reaches youth of rural areas and lower social classes.

Compulsory community service (CCS) was introduced into the health service by the South African government to address the shortage and maldistribution of health professionals within the public sector. The aim of this study was to determine the attitudes of dental therapy students regarding CCS. A self-administered questionnaire was delivered to the two dental schools that train dental therapists in South Africa. There was a 64 percent response rate; 56 percent of the respondents were female. The average age was 20.3 years. There was no difference in the variables between the two dental schools, so the results were combined. The majority (81 percent) supported the introduction of CCS and preferred to carry it out in Kwa-Zulu Natal. Most students opted to perform oral health promotional (64 percent) and clinical (15 percent) activities. By aligning these requirements with the current dental needs and priority strategies of the South African Department of Health, this support would add ...

Columbia University College of Dental Medicine, in partnership with the Harlem United Community AIDS Center, has developed a service-learning (SL) program for use in the training of Advanced Education in General Dentistry (AEGD) residents. This article presents basic tenets of SL, their applicability for dentistry, and our experience implementing SL in care of people living with HIV/AIDS. It proposes that social-behavioral theory, when incorporated into the basic components of SL, can play a useful role in resolving a number of challenges inherent in competency-based training programs. Although the article provides examples of how a particular theory, the Theory of Planned Behavior, might be applied in the SL context, opportunities for the application of other social-behavioral theories potentially exist.