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Sharka R. Factors associated with predoctoral and graduate dental students' intention to care for elderly patients: A cross-sectional study. J Dent Educ 2024. [PMID: 38783410 DOI: 10.1002/jdd.13594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/29/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES Ageism among pre-doctoral and graduate dental students may reduce their propensity to provide dental treatment to elderly patients leading to substandard healthcare for this population. This study evaluated the impact of perceived ageism constructs and geriatric dentistry education on the intention of pre-doctoral and graduate students to provide dental care for elderly patients. METHODS A questionnaire was applied to collect the data for this cross-sectional study from pre-doctoral students in their clinical years and graduate students in their internship year (N = 201). A total of 183 completed responses were received, and the response rate was 91%. Hierarchical regression analysis was performed to determine the incremental effects of perceived ageism constructs and geriatric dentistry education on the intention to provide dental care for elderly patients. RESULTS Geriatric dental education (B = 0.328, t = 3.826, p < 0.001) and patients' low compliance (B = 0.503, t = 4.658, p < 0.001) were significantly positive predictors of pre-doctoral and graduate students' intentions to care for elderly patients. Also, negative attitudes toward the lives of elderly people have a substantial adverse effect on the intention of care for this population (B = -0.225, t = -2.206, p = 0.029). Cronbach's alpha for the scale constructs ranged from 0.738 to 0.886. CONCLUSIONS Advanced geriatric training may cultivate pre-doctoral and graduate students' deeper understanding and recognition of the intellectual and practical benefits that might arise from offering dental care to elderly people.
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Affiliation(s)
- Rayan Sharka
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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2
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Tabrizi M, Lee WC. Linking current dental education to gerontological education to meet the oral health needs of growing aging populations. FRONTIERS IN ORAL HEALTH 2023; 4:1232489. [PMID: 37876529 PMCID: PMC10591445 DOI: 10.3389/froh.2023.1232489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
Objective This study aimed to recognize the gaps in dental education by studying the current level of geriatric oral health training of recent graduated dentists who have been admitted into an Advanced Education in General Dentistry (AEGD) program. Methods The AEGD program was developed along with the Age-Friendly 4Ms model to enhance current dental education. We adopted the Rapid Cycle Quality Improvement model to test the effectiveness of the training for AEGD residents from 2019 to 2022. A total of 18 residents participated (6 residents each year). A 5-question survey was administered before and after the rotation and Wilcoxon signed-rank with Fisher Exact tests were conducted to compare pre- and post- rotation results. Results All 18 residents have completed pre- and post-program surveys. They self-reported minimal to no training in preparation to provide care to older adults with multiple chronic conditions. After the rotation, residents' confidence in treating older adults was significantly increased (p = 0.011). Meanwhile, residents gained knowledge to apply the 4Ms framework (what matters, medication, mentation, and mobility) to their practices (p = 0.015) and provide age-friendly care for older adults. Conclusion The study identified and addressed the missing link in dental education to gerontological and geriatrics education. More clinical rotations and didactic training to equip residents with competences of providing geriatric oral health are strongly recommended.
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Affiliation(s)
- Maryam Tabrizi
- School of Dental Medicine, University of Nevada, Las Vegas, NV, United States
| | - Wei-Chen Lee
- Department of Family Medicine, John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, United States
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3
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León S, Giacaman RA, Araya-Bustos F, Venegas S, Saavedra N, Hugo FN, De Marchi RJ, Muñoz MF, Salazar C, Castrejón-Pérez RC, Bustillos L, Fortanete A, de López AC, Aredes JE, Marín-Zuluaga D, Elias-Boneta A. Current status of geriatric dentistry education in selected dental schools in Latin America and the Caribbean. Gerodontology 2023. [PMID: 37792411 DOI: 10.1111/ger.12714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Latin American and Carribean (LAC) are currently experiencing a rapid aging of their population, coupled with a significant burden of oral diseases. Despites this, there is a scarcity of evidence regarding the manner in wich geriatric dentistry is being taught in dental schools across LAC. So, the objective of this study is to investigate the current status of geriatric dentistry education at undergraduate and postgraduate levels in selected LAC dental schools. METHODS An electronic questionnaire was developed and emailed to all 539 dental schools in 19 LAC countries. The questionnaire recorded activity levels, contents and methodology of geriatric dentistry education as part of dental degree programmes. Reminders by email and telephone calls were used to encourage non-responders to complete the questionnaire. RESULTS In total, 317 schools from 17 countries responded to the questionnaire (response rate: 58.8%). Geriatric dentistry was taught in 54.6% of the schools at the undergraduate level and in 6.9% at the postgraduate level. Thirty two percent of the schools had a programme director trained in geriatric dentistry. Geriatric dentistry was taught as an independent course in 14.5% of the schools. Dry mouth, periodontal disease, denture-related conditions and prosthodontic management, oral mucosal disease and age-related changes of the orofacial complex were the most frequently covered topics. Clinical teaching of geriatric dentistry was reported by 26.5% of the schools, with 38.0% providing clinical training in outreach facilities. CONCLUSIONS Geriatric dentistry education remains incipient in LAC, with only one in every four dental school offering it as a standalone course. There is an urgent need to further develop geriatric dentistry education in the continent, including further research to develop a minimum geriatric dentistry curriculum.
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Affiliation(s)
- Soraya León
- Gerodontology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca and Interuniversity Center for Healthy Aging, Talca, Chile
| | - Rodrigo A Giacaman
- Gerodontology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca and Interuniversity Center for Healthy Aging, Talca, Chile
| | - Francisca Araya-Bustos
- Gerodontology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca and Interuniversity Center for Healthy Aging, Talca, Chile
| | - Sardi Venegas
- Gerodontology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca and Interuniversity Center for Healthy Aging, Talca, Chile
| | - Nicole Saavedra
- Gerodontology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca and Interuniversity Center for Healthy Aging, Talca, Chile
| | - Fernando Neves Hugo
- Departamento de Odontologia Preventiva e Social, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Renato J De Marchi
- Departamento de Odontologia Preventiva e Social, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | | | | | | | | | | | | | | | | - Augusto Elias-Boneta
- Recinto de Ciencias Médicas, Escuela de Medicina Dental, Universidad de Puerto Rico, San Juan, Puerto Rico
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Thompson LA, Kaplish S, Park SE, Chamut S. Is dental education meeting the oral health needs of older adults? J Dent Educ 2022; 86:1233-1241. [PMID: 36165248 DOI: 10.1002/jdd.13026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 11/07/2022]
Abstract
The aim of this article is to highlight the importance of promoting oral health for the geriatric population and implementing change to address their complex oral and systemic health needs. Oral healthcare providers are unequipped to meet the demanding oral health needs of the aging population, resulting in a geriatric oral health crisis that needs immediate attention and action. Despite the advancements in geriatric education over the last two decades, the geriatric curriculum in 2022 is still inadequate, and varies greatly among different US dental schools for both pre- and postdoctoral programs. Predoctoral students are graduating without being sufficiently trained to identify and treat the dental issues of older adults due to lack of a purposely planned curriculum with balanced didactic and clinical exposure. It is critical to have a trained and competent workforce that meets the oral health needs of current and future older adults. To change the present environment, there is a need for curriculum redesign, faculty development, and training. In addition, more research to evaluate pre- and postdoctoral geriatric dentistry curricula, their impact on increasing access to care, and the likelihood of graduating dentists competent to treat functionally dependent and frail older adults is needed. Furthermore, decision-makers in dental education, national dental organizations, and government institutions must support policies that integrate oral health into overall health through robust reimbursement mechanisms, including a dental benefit in Medicare, and recognition of geriatric dentistry as a specialty.
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Affiliation(s)
- Lisa A Thompson
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shivangi Kaplish
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Sang E Park
- Office of Dental Education, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Steffany Chamut
- Department of Oral Health Policy and Epidemiology and the Office of Global and Community Health, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,New York State Psychiatric Institute, Columbia University, New York City, New York, USA
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5
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Kang KL, Kang MS, So JS, Ko SM, Ha SR, Hwang JY, Lee SG, Lee SG, Kho HS. The teaching of geriatric dentistry in South Korean dental schools. Gerodontology 2022; 40:238-243. [PMID: 35876153 DOI: 10.1111/ger.12647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the curriculum of geriatric dentistry for undergraduates in Korean dental schools. BACKGROUND For development purposes, it was necessary to compare geriatric dentistry education programmes in South Korea to programmes in the United States and Europe. METHODS The most recent curriculum and related information on geriatric dentistry at the undergraduate level in all 11 dental schools in South Korea were collected by both official letter and e-mail. A symposium for gathering expert opinions to improve geriatric dentistry education in South Korea was also held. The collected data were analysed, and the expert opinions at the symposium were summarised. RESULTS Six of 11 schools had a didactic course as compulsory and three schools as elective. The course was usually conducted as a form of integrated lectures, and the level of standardisation of lecture content was very low. There were no topics for older people who cannot access dental clinics due to functional frailty or disability. No dental school-affiliated hospitals had an independent department for geriatric dentistry. No schools provided clinical teaching for geriatric dentistry. There were no outreach programmes for geriatric dentistry. CONCLUSIONS The educational curriculum for geriatric dentistry in South Korea was insufficient to cope with social and demographic changes. Curriculum content should include clinical practice education and needs to be focused on frail and dependent older adult patients. An essential educational curriculum and core competency for geriatric dentistry should be prepared.
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Affiliation(s)
- Kyung Lhi Kang
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Myoung Sheen Kang
- Department of Humanities in Dentistry & Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, South Korea
| | | | | | - Seung-Ryong Ha
- Department of Prosthodontics, School of Dentistry, Dankook University, Cheonan, South Korea
| | - Ji-Young Hwang
- Public Health Department, Seoul Dental Hospital for the Disabled, Seoul, South Korea
| | | | | | - Hong-Seop Kho
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea.,Institute of Aging, Seoul National University, Seoul, South Korea.,The Korean Academy of Geriatric Dentistry (KAGD), Uiwang-si, South Korea
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6
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Teaching of gerodontology to dental and dental hygiene therapy students in the UK. Br Dent J 2022; 232:813-818. [PMID: 35689065 DOI: 10.1038/s41415-022-4301-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/20/2022] [Indexed: 11/08/2022]
Abstract
Introduction The demographic shift in the age profile of the UK is now well established. Older people have more complex requirements to maintain their oral health and appropriate training is required to provide good-quality oral and dental care. This research aimed to review the training in gerodontology currently being provided to undergraduate dental and dental hygiene therapy (DHT) students in the UK.Methods Quantitative data were generated through completion of an online questionnaire, emailed to the directors of dental education in each of the UK dental (n = 16) and DHT schools (n = 21). Data were analysed using IBM SPSS Statistics V26.Results There was a response rate of 37.5% from dental schools and 61.9% from DHT schools. Although gerodontology was being taught in every school that responded, it was only a standalone course in 16.7% of dental schools and 7.7% of DHT schools that responded. While all respondents reported a theoretical component, only 50% of dental schools and 53.8% of DHT schools reported providing clinical experience. Moreover, 33.3% of dental schools and 15.4% of DHT schools reported closely following the European curriculum guidelines in gerodontology.Conclusions The current training in gerodontology is not standardised across either dental or DHT schools in the UK and there seems to be a lack of awareness of the recommended European guidelines. The findings from this research demonstrate that future improvements in gerodontology training are still required for this to be achieved.
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Stuck AK, Schimmel M. A model for a geriatric teaching programme and its impact on self-rated and tested competencies of undergraduate dental students. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:21-27. [PMID: 33512016 PMCID: PMC9290808 DOI: 10.1111/eje.12668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/11/2021] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION In the light of the growing ageing population, it is important that future dentists be taught geriatric competencies to assure good dental care and treatment addressing the special needs of older patients. MATERIALS AND METHODS We developed and evaluated a geriatric teaching programme amongst final year undergraduate dental students (n = 30) at the University of Bern, Switzerland. The geriatric teaching programme was based on the European undergraduate curriculum in geriatric medicine for medical students covering the following eight geriatric domains that were considered relevant to dental care: Analgesics, cognitive impairment, decision-making capacity, gait and balance disorder, hearing impairment, malnutrition, polypharmacy and vision impairment. Using a pre/post-design, we administered a structured questionnaire including standardised questions on self-rated and tested competencies. Both assessments scores were standardised to a maximum score of 100 points. Data were evaluated by comparison of pre-test and post-test mean scores. RESULTS The geriatric teaching programme proved to be feasible covering eight geriatric domains based on a case-based didactic approach in totally eight 45-minute lessons. Both self-rated and tested competencies of dental students increased in all eight domains in the course of the geriatric teaching programme. After the geriatric teaching programme, both mean self-rated competency scores (67.9 vs. 49.6, p < .001) and mean tested competency scores (78.7 vs. 56.7 points, p < .001) significantly improved compared to baseline. CONCLUSIONS Integrating a consolidated refined geriatric teaching programme is a potentially feasible and effective method for dental undergraduate students and is expected to have an impact on better dental care of older patients.
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Affiliation(s)
- Anna K. Stuck
- Department of Geriatrics, InselspitalBern University Hospital, and University of BernBernSwitzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and GerodontologySchool of Dental MedicineUniversity of BernBernSwitzerland
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Chandel T, Alulaiyan M, Farraj M, Riedy CA, Barrow JR, Brennan L, Thompson L, Bass MB, Chamut S. Training and educational programs that support geriatric dental care in rural settings: A scoping review. J Dent Educ 2022; 86:792-803. [DOI: 10.1002/jdd.12885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/08/2022] [Indexed: 12/18/2022]
Affiliation(s)
- Tejasvita Chandel
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Mohammed Alulaiyan
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Malik Farraj
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Christine A. Riedy
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Jane R. Barrow
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Leonard Brennan
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Lisa Thompson
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Michelle B. Bass
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Steffany Chamut
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
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9
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Tabrizi M, Lee WC. Geriatric oral health competency among dental providers. AIMS Public Health 2021; 8:682-690. [PMID: 34786428 PMCID: PMC8568591 DOI: 10.3934/publichealth.2021054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/27/2021] [Indexed: 11/20/2022] Open
Abstract
Background Geriatrics as an educational topic has been a high priority in current health care. The innovative Age-Friendly health system with the 4Ms structure (what Matters most, Medication, Mentation, Mobility) needs to be integrated into oral health and dental services training. The purpose of this study is to respond to one question: are the graduating general dentists trained and prepared to treat medically vulnerable elderly in communities? Methods All pre-doctorate dental students from first year to fourth year were invited to voluntarily respond to an online survey provided on Qualtrics. The survey provided examples of two broken molar teeth that need extraction. First, students were asked how comfortable they felt extracting the two molars based on the x-rays. Then, the question was repeated to evaluate if they felt comfortable with extracting the teeth in a patient with one chronic condition and related medication(s). Finally, the students were again questioned whether they feel comfortable to provide the same service to medically vulnerable patients with multiple health conditions and polypharmacy. Results The majority of students who participated in this study said they were comfortable with extracting the teeth of patients without any chronic condition. However, many more chose to refer medically vulnerable patients with multiple chronic conditions and polypharmacy to a specialist. Conclusions Dental education in many U.S. dental schools may provide adequate education and create competent general dentists. Yet, the competency and confidence required for dentists to be able to treat older adults with multiple health conditions and using prescribed or over-the-counter medication is insufficient.
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Affiliation(s)
- Maryam Tabrizi
- Department of General Practice and Dental Public Health, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Wei-Chen Lee
- Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, United States
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10
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Nilsson A, Young L, Glass B, Lee A. Gerodontology in the dental school curriculum: A scoping review. Gerodontology 2021; 38:325-337. [PMID: 33977554 DOI: 10.1111/ger.12555] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/26/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the current status of gerodontology in the undergraduate dental curriculum. BACKGROUND Internationally, there is recognition for the need to include gerodontology in dental education due to accelerating numbers of older dentate people. There is wide variation in the content and method of delivery of gerodontology in undergraduate curricula of dental schools. METHODS A scoping review framework was chosen to identify existing gaps and key concepts in the research on current undergraduate gerodontology education. Arksey and O'Malley's framework was used with the qualitative data analysis software NVivo to identify comparable information on geriatric dental education. RESULTS Five themes were highlighted in the studies including (1) gerodontology curriculum content, (2) attitudes, skills and knowledge of undergraduate dental students, (3) didactic teaching, (4) elective and compulsory teaching, and (5) extra-mural learning. The review found large variations in methodologies, presentation of data and findings. All studies emphasised a need for greater inclusion of gerodontology content in the undergraduate dental curriculum. CONCLUSION The review found limited research reporting on the educational outcomes of gerodontology in dental curricula with a lack of comprehensive information to inform gerodontology content in dental schools. This review has highlighted the need for national and international guidelines to ensure mandatory inclusion of sufficient and specific gerodontology training to prepare graduates for a growing dentate frail and care-dependent population.
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Affiliation(s)
| | - Louise Young
- James Cook University, Townsville, QLD, Australia
| | | | - Andrew Lee
- James Cook University, Townsville, QLD, Australia
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Mueldener EJ, McQuistan MR, Qian F, Hartshorn JE, Oishi MM. An evaluation of the geriatric dental curricula within Advanced Education in General Dentistry and General Practice Residency programs in the United States. SPECIAL CARE IN DENTISTRY 2020; 41:210-217. [PMID: 33382104 DOI: 10.1111/scd.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To compare the geriatric dentistry curricula between Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs. METHODS A 108-item survey was developed to assess residents' didactic and clinical experiences pertaining to geriatric patients. Surveys were mailed in 2018 to all AEGD (N = 89) and GPR (N = 180) program directors. Statistical analysis consisted of descriptive and bivariate analyses with the chi-square test, Fisher's exact test, and the Wilcoxon rank sum test (alpha = .05). RESULTS Twenty-four AEGD and fifty-eight GPR directors completed surveys (response rate = 30%). Seventy-one percent of responding programs reported mandatory didactic training pertaining to frail and functionally dependent geriatric adults. Ninety-nine percent of respondents reported that residents provided treatment to geriatric patients; however, they were less likely to perform procedures on frail and functionally dependent patients. Only 15% of respondents provided nursing home care. Considering all patient encounters, responding GPR programs were more likely than AEGD programs to treat patients using IV bisphosphonates (63% vs 25%; P < .01), undergoing chemotherapy (48% vs 16%; P = .02), and undergoing head and neck radiation therapy (55% vs 25%; P = .02). CONCLUSION A majority of responding AEGD and GPR programs reported providing educational experiences pertaining to geriatric patients; however, GPR programs reported treating more medically complex patients than AEGD programs.
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Affiliation(s)
- Emma J Mueldener
- Hospital Dentistry Institute, University of Iowa, Iowa City, Iowa
| | - Michelle R McQuistan
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Fang Qian
- Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Jennifer E Hartshorn
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Matthew M Oishi
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
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12
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Xavier I, Ettinger RL, Proença L, Botelho J, Machado V, Rua J, Delgado AS, Mendes JJ. Geriatric Dentistry Curriculum in Six Continents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134682. [PMID: 32610664 PMCID: PMC7370086 DOI: 10.3390/ijerph17134682] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/21/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine the presence of geriatric dentistry (GD) in the curricula of worldwide dental schools, and to identify and compare their curriculum content. Eighty-three dental schools (16.4% response rate), from 24 countries, in six continents, completed a 25-item online questionnaire, to assess their GD curriculum, and were included in the study. GD was a mandatory course in 56 dental schools (67.5%), an independent subject in 14 schools (16.9%), and was taught as a series of lectures in 31 schools (37.4%). Clinically, 56 dental schools (67.5%) had some form of mandatory education in GD. The type of school, location and method of presentation were not associated with greater interest in expanding their curriculum in GD (p = 0.256, p = 0.276, and p = 0.919, respectively, using the Chi-square test). We found GD is a curriculum requirement in most of the surveyed dental schools and is becoming more common among dental school curricula. This survey is the first study to present data from dental schools from all continents, using a web-based survey which is a resourceful, less-expensive tool to gather data.
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Affiliation(s)
- Irina Xavier
- Clinical Research Unit (CRU)-Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (J.B.); (V.M.); (J.R.); (A.S.D.); (J.J.M.)
- Correspondence: ; Tel.: +351-916-727-803
| | - Ronald L. Ettinger
- Department of Prosthodontics and Dows Institute for Dental Research, University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA 52242, USA;
| | - Luís Proença
- Quantitative Methods for Health Research Unit (MQIS), CiiEM, IUEM, 2829-511 Monte de Caparica, Portugal;
| | - João Botelho
- Clinical Research Unit (CRU)-Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (J.B.); (V.M.); (J.R.); (A.S.D.); (J.J.M.)
| | - Vanessa Machado
- Clinical Research Unit (CRU)-Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (J.B.); (V.M.); (J.R.); (A.S.D.); (J.J.M.)
| | - João Rua
- Clinical Research Unit (CRU)-Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (J.B.); (V.M.); (J.R.); (A.S.D.); (J.J.M.)
| | - Ana S. Delgado
- Clinical Research Unit (CRU)-Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (J.B.); (V.M.); (J.R.); (A.S.D.); (J.J.M.)
| | - José J. Mendes
- Clinical Research Unit (CRU)-Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (J.B.); (V.M.); (J.R.); (A.S.D.); (J.J.M.)
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Shigli K, Nayak SS, Jirge V, Srinagesh J, Murthy V, Gali S. Current status of gerodontology curriculum in India and other parts of the world: A narrative review. Gerodontology 2020; 37:110-131. [DOI: 10.1111/ger.12461] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/23/2019] [Accepted: 01/05/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Kamal Shigli
- Department of Prosthodontics D.Y. Patil Dental School Lohegaon Pune Maharashtra India
| | | | - Vasanti Jirge
- Department of Oral Medicine and Radiology KLE VK Institute of Dental Sciences Belgavi Karnataka India
| | | | - Varsha Murthy
- Department of Prosthodontics Sri Venkateshwaraa Dental College Pondicherry India
| | - Sivaranjani Gali
- Department of Prosthodontics Faculty of Dental Sciences M.S. Ramaiah University of Applied Sciences Bangalore India
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Del Rosario Ruiz Núñez M, Finkler M, Castro RG, Carcereri DL, Ferreira de Mello ALS. Teaching undergraduate geriatric dentistry in five South America countries. Gerodontology 2019; 36:180-187. [PMID: 30821854 DOI: 10.1111/ger.12400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/13/2019] [Accepted: 02/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to qualitatively analyse undergraduate geriatric dentistry (GD) teaching characteristics identified by geriatric dentistry teachers and senior students in five South American countries. BACKGROUND GD involves the knowledge and skills required to provide oral health care for older people. METHODS Exploratory-descriptive research with a qualitative approach developed in the undergraduate context of public universities in Chile, Argentina, Brazil, Colombia and Peru. Nine dental schools were intentionally selected. The participants were GD module teachers (20) and their senior students (30). Data were collected through open interviews via Skype® conducted between May and August 2015 and were analysed using a content analysis technique with ATLAS.ti® software, resulting in four categories. RESULTS GD modules are theoretical or a theoretical-practical mix. Most teachers are prosthodontists without specific training in GD. Their motivations to teach GD are related to personal, family, professional and social reasons. Humanity, sensitivity and knowledge of older people are considered fundamental characteristics of a GD teacher. CONCLUSIONS Students' first contact with an older person usually occurs during clinical activities. The participants mentioned insufficient hours for GD modules in the curricula and exclusively theoretical modules that do not allow students to learn typical specificities of older people. In the context of this study, the undergraduate GD teaching-learning process presented some weaknesses regarding educational methods, professor training and the interaction between older people and students. Diversification of learning scenarios and GD professor training are highly recommended.
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Nilsson A, Young L, Croker F. A call to greater inclusion of gerodontology in the dental curriculum: A narrative review. Aust Dent J 2018; 64:82-89. [PMID: 30388299 DOI: 10.1111/adj.12663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2018] [Indexed: 11/29/2022]
Abstract
AIM This literature review explores the need for greater prominence of gerodontology in the undergraduate dental curriculum, focusing on the significance of gerodontology for dental students on clinical placements. BACKGROUND As Australia's population ages the number of dentate older people is increasing. An assessment of the dental profession's preparedness, including that of future providers, is needed to ensure that this public health issue is addressed. METHODS A database search was performed in MEDLINE (Ovid), CINAHL and JCU OneSearch. Of the 41 articles identified, 31 were selected for review using a narrative approach. DISCUSSION Of the 31 articles reviewed, 12 were Australian, 9 North American and 5 European. Five overarching themes were identified, including preparedness for residential aged care facilities; barriers to oral health services provision; attitudes to aged care; gerodontology as part of a dental school curriculum and service-based learning. CONCLUSION There are differences in the gerodontology curricula of dental schools, with a wide variation of clinical exposure to older patients. There is evidence that exposure to gerodontology curriculum prior to treating older people may help dental students feel more prepared for managing patients in aged care. The current marginal status of gerodontology in dental school curricula is in need of review.
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Affiliation(s)
- A Nilsson
- James Cook University, Townsville, Queensland, Australia
| | - L Young
- James Cook University, Townsville, Queensland, Australia
| | - F Croker
- James Cook University, Townsville, Queensland, Australia
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Venturelli Garay RE, Watt RG. Review and analysis of Chilean dental undergraduate education: curriculum composition and profiles of first year dental students. HUMAN RESOURCES FOR HEALTH 2018; 16:48. [PMID: 30223851 PMCID: PMC6142632 DOI: 10.1186/s12960-018-0314-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND In Chile, dentistry has become a very popular career choice for students, which has resulted in a substantial increase in both, the number of dental graduates and dental schools. Nonetheless, there is a need for change in the way dental schools select and educate their students to keep pace with the rapidly changing nature of societal needs and to tackle the marked health inequalities that exist in the country. The aim of this study was to review and critique dental undergraduate education in Chile, with a particular focus on the curriculum composition and profiles of students admitted to dental schools from 2010 to 2014. METHODS A descriptive and retrospective design was utilised. Two different methods were undertaken: primary data collection regarding curriculum and secondary data analysis in relation to students' profiles. Descriptive statistics were used to assess the relative proportions of subject modules within the undergraduate dental curriculum and in particular the public health components. The analysis of the student profiles described specific background factors, namely, gender, age, secondary school type, location, rural-urban status and student's year of admission. Also, trends of dental students' intake between 2010 and 2014 were investigated. Logistic regression analysis was undertaken to assess potential associations between the aforementioned background factors and students' choice of dental school. RESULTS Regarding the curriculum review, a 67% response rate was obtained. The most dominant component of Chilean dental curriculum was the clinical subjects (33%), followed by the basic and biological sciences (16%) and then medical and dental sciences (13%). In relation to the admission of students, the majority attended private schools (72%); most were females (62%); aged 19 years or less (74%); had an urban origin (99%); and came from subsidised private secondary schools (48%). Significant differences were found between students admitted to traditional and private dental schools. CONCLUSIONS Clinical sciences are the most dominant subjects in the Chilean dental curriculum. Overall, traditional and private institutions had a broadly similar composition in their curriculum with the exception of the public health component. Students from disadvantaged backgrounds were the minority in dental schools across Chile.
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Affiliation(s)
- Renato E Venturelli Garay
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom.
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom
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Marchini L, Ettinger R, Chen X, Kossioni A, Tan H, Tada S, Ikebe K, Dosumu EB, Oginni FO, Akeredolu PA, Butali A, Donnelly L, Brondani M, Fritzsch B, Adeola HA. Geriatric dentistry education and context in a selection of countries in 5 continents. SPECIAL CARE IN DENTISTRY 2018; 38:123-132. [DOI: 10.1111/scd.12281] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Leonardo Marchini
- Department of Preventive and Community Dentistry; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Ronald Ettinger
- Department of Prosthodontics; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Xi Chen
- Department of Preventive and Community Dentistry; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Anastassia Kossioni
- Division of Gerodontology; Faculty of Dentistry; National and Kapodistrian University of Athens; Greece
| | - Haiping Tan
- Australian Research Centre for Population Oral Health; Adelaide Dental School; The University of Adelaide; Adelaide Australia
| | - Sayaka Tada
- Division of Preventive Dentistry; Department of Oral Health Dentistry; Niigata University Graduate School of Medical and Dental Science; Niigata Japan
| | - Kazunori Ikebe
- Department of Prosthodontics; Gerodontology and Oral Rehabilitation Osaka University Graduate School of Dentistry; Osaka Japan
| | - Elizabeth Bosede Dosumu
- Department of Periodontology & Community Dentistry; Faculty of Dentistry; University of Ibadan; Ibadan Nigeria
| | - Fadekemi O. Oginni
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Obafemi Awolowo University; Ile-Ife Nigeria
| | | | - Azeez Butali
- Department of Oral Pathology; Radiology and Medicine College of Dentistry, University of Iowa,; USA
| | - Leeann Donnelly
- Department of Oral Biological & Medical Sciences; University of British Columbia; Vancouver Canada
| | - Mario Brondani
- Department of Oral Health Sciences; University of British Columbia; Vancouver Canada
| | - Bernd Fritzsch
- Director, Center of Aging & Aging Mind and Brain Initiative, Department of Biology, College of Liberal Arts and Science; University of Iowa
| | - Henry A. Adeola
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
- Department of Oral and Maxillofacial Pathology; Faculty of Dentistry; University of the Western Cape at Tygerberg Hospital; Cape Town South Africa
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18
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Geriatric patients’ psychological status relative to the removable prosthodontic treatment. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ettinger RL, Goettsche ZS, Qian F. Curriculum content in geriatric dentistry in USA dental schools. Gerodontology 2017; 35:11-17. [PMID: 29063645 DOI: 10.1111/ger.12305] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to re-examine the teaching of geriatric dentistry in the USA dental schools, to identify curriculum content and compare the findings to previous reports. METHODS All dental schools in the United States were contacted via email with a questionnaire to assess the teaching of geriatric dentistry. Non-responding schools were sent a minimum of three reminder emails to complete the survey. A statistical analysis was performed. Descriptive statistics were conducted to profile the variables of interest. Bivariate analysis was performed to explore if any of the variables were related using Fisher's exact test, non-parametric Wilcoxon rank-sum test and the Kruskal-Wallis test. RESULTS Fifty-six of the 67 dental schools completed the questionnaire. Geriatric dentistry was taught in all dental schools; for 92.8%, the course was compulsory. We found that 62.5% were teaching it as an independent course, 25% as an organised series of lectures and 8.9% as occasional lectures in parts of other courses. Clinically, 84.2% have some form of compulsory education in geriatric dentistry. Public schools were marginally associated with an increased interest in expanding the geriatric dentistry curriculum (P = .078). No differences were found between these variables and school location. CONCLUSIONS Geriatric dentistry is now required in 92.8% of dental schools. The teaching of traditional topics has not changed much; however, the number of gerontological topics has increased. Clinical teaching needs to be expanded, as in only 57.1% of schools was it a requirement. The ageing imperative will require research to determine the impact of teaching on services to the geriatric community.
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Affiliation(s)
- Ronald L Ettinger
- Department of Prosthodontics and Dows Institute for Dental Research, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA
| | - Zachary S Goettsche
- Department of Endodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA
| | - Fang Qian
- Department of Preventive and Community Dentistry, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA
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Ettinger RL, Goettsche ZS, Qian F. Postdoctoral Teaching of Geriatric Dentistry in U.S. Dental Schools. J Dent Educ 2017; 81:1220-1226. [DOI: 10.21815/jde.017.079] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/08/2017] [Indexed: 11/20/2022]
Affiliation(s)
- Ronald L. Ettinger
- Department of Prosthodontics; Dows Institute for Dental Research; University of Iowa College of Dentistry and Dental Clinics
| | - Zachary S. Goettsche
- Department of Endodontics; University of Iowa College of Dentistry and Dental Clinics
| | - Fang Qian
- Department of Preventive and Community Dentistry; University of Iowa College of Dentistry and Dental Clinics
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21
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Ettinger RL, Goettsche ZS, Qian F. Predoctoral Teaching of Geriatric Dentistry in U.S. Dental Schools. J Dent Educ 2017; 81:921-928. [PMID: 28765436 DOI: 10.21815/jde.017.043] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/07/2017] [Indexed: 11/20/2022]
Abstract
The aim of this study was to assess the current teaching of geriatric dentistry in U.S. dental schools and compare the findings to previous reports. Academic deans at all 67 U.S. dental schools were contacted in November 2015 via email, asking them to complete a questionnaire about the teaching of geriatric dentistry or gerodontology at their institution. Questionnaires were received from 56 of the 67 schools (84% response rate). The results showed that geriatric dentistry was taught in all responding schools; for 92.8% of the respondents, the instruction was compulsory. Among the responding schools, 62.5% were teaching it as an independent course, 25% as an organized series of lectures, and 8.9% as occasional lectures in parts of other courses. In addition, 57.1% had some form of compulsory clinical education in geriatric dentistry. Public schools, as opposed to private schools, were marginally associated with an increased interest in expanding geriatric dentistry teaching (p=0.078). No differences were found between any teaching variables and school location. This study found that the form of education in geriatric dentistry in U.S. dental schools differed in many ways, but the teaching of geriatric dentistry had increased among all respondents and had been increasing for over 30 years. Future research is needed to determine the impact of this teaching on services to the geriatric community.
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Affiliation(s)
- Ronald L Ettinger
- Dr. Ettinger is Professor Emeritus, Department of Prosthodontics and Dows Institute for Dental Research, University of Iowa College of Dentistry & Dental Clinics; Dr. Goettsche is a graduate student, Department of Endodontics, University of Iowa College of Dentistry & Dental Clinics; and Dr. Qian is Senior Research Associate, Department of Preventive and Community Dentistry, University of Iowa College of Dentistry & Dental Clinics.
| | - Zachary S Goettsche
- Dr. Ettinger is Professor Emeritus, Department of Prosthodontics and Dows Institute for Dental Research, University of Iowa College of Dentistry & Dental Clinics; Dr. Goettsche is a graduate student, Department of Endodontics, University of Iowa College of Dentistry & Dental Clinics; and Dr. Qian is Senior Research Associate, Department of Preventive and Community Dentistry, University of Iowa College of Dentistry & Dental Clinics
| | - Fang Qian
- Dr. Ettinger is Professor Emeritus, Department of Prosthodontics and Dows Institute for Dental Research, University of Iowa College of Dentistry & Dental Clinics; Dr. Goettsche is a graduate student, Department of Endodontics, University of Iowa College of Dentistry & Dental Clinics; and Dr. Qian is Senior Research Associate, Department of Preventive and Community Dentistry, University of Iowa College of Dentistry & Dental Clinics
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Kossioni A, McKenna G, Müller F, Schimmel M, Vanobbergen J. Higher education in Gerodontology in European Universities. BMC Oral Health 2017; 17:71. [PMID: 28351394 PMCID: PMC5371193 DOI: 10.1186/s12903-017-0362-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/11/2017] [Indexed: 11/27/2022] Open
Abstract
Background The rapid aging of the European population and the subsequent increase in the oral care needs in older adults necessitates adequate training of dental professionals in Gerodontology (Geriatric Dentistry). This study was designed to investigate the current status of Gerodontology teaching amongst European dental schools at the undergraduate, postgraduate and continuing education levels. Methods An electronic questionnaire was developed by a panel of experts and emailed to the Deans or other contact persons of 216 dental schools across 39 European countries. The questionnaire recorded activity levels, contents and methodology of Gerodontology teaching as part of dental education programs. Repeated e-mail reminders and telephone calls were used to encourage non-responders to complete the questionnaire. Results A total of 123 responses from 29 countries were received (response rate: 56.9%). Gerodontology was taught in 86.2% of schools at the undergraduate level, in 30.9% at the postgraduate level and in 30.1% at the continuing education level. A total of 43.9% of the responding schools had a dedicated Gerodontology program director. Gerodontology was taught as an independent subject in 37.4% of the respondent schools. Medical problems in old age, salivary impairment and prosthodontic management were the most commonly covered topics in Gerodontology teaching. Clinical teaching took place in 64.2% of the respondent schools, with 26.8% offering clinical training in outreach facilities. Conclusions The vast majority of European dental schools currently teach Gerodontology at the undergraduate level. More training opportunities in oral care of frail elders should be offered, and more emphasis should be placed on interdisciplinary and interprofessional training, educational collaborations, and the use of modern technologies. Dedicated postgraduate Gerodontology courses need to be developed to create a significant number of specialized dentists and trained academics. Electronic supplementary material The online version of this article (doi:10.1186/s12903-017-0362-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anastassia Kossioni
- Division of Gerodontology, Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Thivon 2 Goudi, Athens, 11527, Greece.
| | - Gerry McKenna
- Centre for Public Health, Royal Victoria Hospital, Queens University Belfast, Belfast, Northern Ireland
| | - Frauke Müller
- Department of Gerodontology & Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Thomson WM, Ma S. An ageing population poses dental challenges. ACTA ACUST UNITED AC 2014; 35C:3-8. [DOI: 10.1016/j.sdj.2014.10.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
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Affiliation(s)
- Ronald L. Ettinger
- Department of Prosthodontics and Dows Institute Of Dental Research; College of Dentistry University of Iowa; Iowa City
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