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Martignon S, Cortes A, Avila V, Velasco K, Abreu-Placeres N, Aranguiz V, Bullen M, Giacaman R, Malheiros Z, Pozos-Guillén A, Sampaio F, Fernández CE, García M, González-Montero M, Gudiño-Fernandez S, Hugo FN, Pardo-Silva MI, Salazar L, Squassi A, Zarta OL, Stewart B, Jácome-Liévano S. Core Cariology Curriculum Framework in Spanish for Latin American dental schools: development and consensus. Braz Oral Res 2023; 37:e119. [PMID: 38055570 DOI: 10.1590/1807-3107bor-2023.vol37.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 12/08/2023] Open
Abstract
The aim of this study was to develop and achieve consensus on a cariology teaching framework for dental schools in Latin American Spanish-speaking countries. The Delphi process, with a ≥8 0% pre-defined participants' agreement, included three phases and a Coordinating Group. During the Preparation phase three panels of experts were selected and invited to participate: a) Regional academic/professional Dental Associations (Associations-Panel): n = 12; b) Regional Dental Schools (Dental-Schools-Panel): existing dental schools (n = 263) from the 19 Spanish-speaking regional countries; c) International academic/professional associations Peer Experts (Peer-Panel): n = 4. Based on consensus documents from Europe, Colombia, the Caribbean, USA, Chile and Spain, and updated scientific evidence, the Coordinating Group developed a baseline framework proposal of domains, main competencies (MC) and specific competencies (SC). The Consultation-Agreement and Consensus phases included three rounds of questionnaires with a step-wise sharing of the MC updated version of the consensus framework with the Dental-Schools-Panel and including SC with the Associations-Panel. Diverse communication strategies were used ( e.g ., independent google-form questionnaires and workshops). Consensus was reached after an on-site Associations-Panel workshop and secret voting, followed by an online meeting with the Peers-Panel. A total of 127 academic/professional institutions participated (Associations-Panel: 11, 91.6%; Dental-Schools-Panel: 112, 42.6%, all countries; Peers-Panel: 4, 100%). The baseline Cariology teaching framework of 5 domains, 10 MC and 92 SC underwent modifications after agreements for a final consensus framework consisting of 5 domains, 10 MC and 85 SC. A Core Cariology curriculum framework in Spanish for Latin American Dental Schools was successfully developed and agreed upon with regional dental academic and professional institutions.
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Affiliation(s)
- Stefania Martignon
- Universidad El Bosque , UNICA - Caries Research Unit, Research Department , Bogotá , Colombia
| | - Andrea Cortes
- Universidad El Bosque , UNICA - Caries Research Unit, Research Department , Bogotá , Colombia
| | - Viviana Avila
- Universidad El Bosque , UNICA - Caries Research Unit, Research Department , Bogotá , Colombia
| | - Karina Velasco
- Universidad El Bosque , UNICA - Caries Research Unit, Research Department , Bogotá , Colombia
| | - Ninoska Abreu-Placeres
- Universidad Iberoamericana , Biomaterials and Dentistry Research Center , Research and Innovation Department , Santo Domingo , Dominican Republic
| | - Vicente Aranguiz
- Universidad de los Andes , Faculty of Dentistry , Cariology Unit, Santiago , Chile
| | - Miriam Bullen
- Panama University , Restorative Dentistry Department , Panama City , Panama
| | - Rodrigo Giacaman
- University of Talca , Faculty of Dentistry , Cariology Unit, Talca , Chile
| | - Zilson Malheiros
- Latin American Oral Health Association - LAOHA, São Paulo , SP , Brazil
| | - Amaury Pozos-Guillén
- Universidad Autónoma de San Luis Potosí , Faculty of Dentistry , Basic Sciences Laboratory , San Luis Potosí , México
| | - Fabio Sampaio
- Universidade Federal da Paraíba - UFPB , Health Science Center , Department of Clinical and Community Dentistry , João Pessoa , PB , Brazil
| | | | | | | | - Sylvia Gudiño-Fernandez
- Universidad de Costa Rica , Pediatric Dentistry Master Degree Program, San José , Costa Rica
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRGS, Departamento de Odontologia Preventiva e Social , Porto Alegre , Brasil
| | | | - Lupe Salazar
- Universidad de Panamá , Facultad de Odontología , Departamento de Clínica Integrada , Panama City , Panamá
| | - Aldo Squassi
- Universidad de Buenos Aires , Facultad de Odontología , Instituto de Investigaciones en Salud Pública , Buenos Aires , Argentina
| | - Olga Lucía Zarta
- Universidad El Bosque , Dental School ,Posgrado de Operatoria Estética y Materiales Dentales, Bogotá , Colombia
| | - Bernal Stewart
- Colgate-Palmolive Technology Center , Clinical Research, Piscataway , NJ , United States
| | - Sofía Jácome-Liévano
- Universidad El Bosque , UNICA - Caries Research Unit, Research Department , Bogotá , Colombia
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Zafar M, Levy SM, Warren JJ, Xie XJ, Kolker J, Pendleton C. Prevalence of non-cavitated lesions and progression, regression, and no change from age 9 to 23 years. J Public Health Dent 2022; 82:313-320. [PMID: 35781658 PMCID: PMC9544189 DOI: 10.1111/jphd.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 04/01/2022] [Accepted: 06/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Some non-cavitated caries lesions (D1 ), the initial stage of caries, progress to cavitation. This article reports participant-level and surface-level D1 prevalence and changes in status of D1 lesions through different periods from age 9 to 23. METHODS The Iowa Fluoride Study (IFS) participants were followed longitudinally; all permanent tooth surfaces were examined clinically for caries at ages 9, 13, 17, and 23 using standardized criteria for sound (S), questionable (D0 ), non-cavitated (D1 ), cavitated (D2+ ), filled (F), or missing due to decay (M). D1 lesions at the beginning of each interval were reassessed at each follow-up age to determine transitions (to the 5 categories or no transition). RESULTS The sample had relatively high socioeconomic status (SES), with about 52%-55% high SES, 32-35% middle SES, and 12-13% low SES. Person-level prevalences of D1 lesions were 23%, 38%, 60%, and 45% at ages 9, 13, 17, and 23, respectively. Surface-level prevalences were less than 1% at ages 9 and 13, 3% at 17, and 2% at 23. Thirteen percent of D1 s at age 9 progressed at 13, 18% progressed from 13 to 17, and 11% progressed from 17 to 23. The percentages regressing (to sound or D0 ) were 72%, 54%, and 72%, respectively. CONCLUSION Non-cavitated lesions were more prevalent at age 17 than at ages 9, 13, and 23. The high rates of regression compared to progression or no change suggest that many non-cavitated lesions do not progress to cavitated lesions and could be reversed; therefore, surgical intervention should not be the treatment of choice for incipient lesions.
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Affiliation(s)
- Mahrukh Zafar
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.,Department of Community Dentistry, Rawal Institute of Health Sciences, Islamabad, Pakistan
| | - Steven M Levy
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - John J Warren
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Xian Jin Xie
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.,Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa, Iowa City, Iowa, USA.,Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Justine Kolker
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Chandler Pendleton
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
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Cortés-Martinicorena FJ, Ceballos L, Martínez-Pérez E, Hernández-Juyol M, Schulte AG, Almerich-Silla JM. Spanish Curriculum in Cariology for undergraduate dental students: Proceedings and consensus. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:317-328. [PMID: 34143927 DOI: 10.1111/eje.12706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/14/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Cariology is today a broad-based discipline and in the Spanish university teaching field, all this knowledge is not unified in a curriculum. Therefore, the aim was to develop a consensus text based on the European Core Curriculum, updated, and adapted to the characteristics of the Spanish university environment. MATERIALS AND METHODS A Spanish Cariology Curriculum Group (SCCG) was set up with members of the Spanish Society of Epidemiology and Oral Public Health (SESPO), Spanish Society of Conservative and Aesthetic Dentistry (SEOC) and Spanish Society of Paediatric Dentistry (SEOP) and university experts to adapt the European Core Curriculum in Cariology for undergraduate dental students (ECCC) for Spain. The work was carried out online during 2018 and 2019, and also face-to-face meetings took place to obtain a draft curriculum open for discussion that was presented to all the Spanish universities. The final modifications to the document were specified in a Consensus Conference of Spanish universities offering a Degree in Dentistry that took place in Madrid on 19 November 2019. RESULTS Thirty-eight university experts, under SCCG supervision, participated in the elaboration of the new framework document. A total of 16 universities, from 23 invited, reached a consensus as to the contents of the Spanish Curriculum in Cariology for undergraduate dental students. This new Curriculum emphasises learning outcomes, uses a consensus-based terminology pertaining to caries and other hard-tissue conditions, and introduces a new domain of competence in Domain III of ECCC. CONCLUSION This new Cariology Curriculum is the result of a very broad-based consensus of university experts in Spain and lays the foundation for the implementation of an integrated teaching of Cariology in Spain in adherence to Alliance for a Caries Free Future (ACFF) objectives.
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Splieth CH, Abudrya MH, Anandakrishna L, Cheng L, Al-Khalifa KS, Kim BI, Kuzmina I, Tarabaih A, Salami A, Elhamouly Y, Schmoeckel J. Teaching Cariology in Asia and Arabia. Caries Res 2022; 56:109-115. [PMID: 35313313 PMCID: PMC9254296 DOI: 10.1159/000524168] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/13/2022] [Indexed: 11/19/2022] Open
Abstract
The European Organisation for Caries Research education platform 2020 had the aim to assess the undergraduate curriculum in cariology in Asian and Arabian countries in order to support structured teaching of cariology in these countries with about almost half of the global population. Representatives of 4 Asian and 4 Arabian countries completed a comprehensive questionnaire on structure of dental education in their country in general and the extent, the content, the responsibilities, structure and standardization regarding cariology in particular. In spite of a wide range from very few universities (Lebanon 3) to larger numbers of dental schools (India 313, China 121, Russia 52) there were similar statements on the list of content for cariology teaching. Often the catalogue was close to the Undergraduate Core Curriculum in Cariology (UCCC) covering most of the 5 domains from basic science to dental public health, but a national curriculum for cariology or dentistry was mostly missing. With various departments being involved, a need of coordination is obvious. Most representatives thought it possible and feasible to teach a standardized curriculum in cariology on the basis of the UCCC. In conclusion, many Arabian and Asian countries have implemented modern, evidence-based curricula in their universities, but an obligatory national curriculum in cariology would be advisable to standardize the quality in teaching.
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Affiliation(s)
- Christian H. Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
- *Christian H. Splieth,
| | - Mohamed Hassan Abudrya
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Latha Anandakrishna
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M S Ramaiah University of Applied Sciences, Bengaluru, India
| | - Lei Cheng
- Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Chengdu, China
| | - Khalifa S. Al-Khalifa
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Baek-Il Kim
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 FOUR Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Irina Kuzmina
- Department of Preventive Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
| | - Ahmad Tarabaih
- Division of Pediatric Dentistry, Department of Developmental Sciences, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Anas Salami
- Pediatric Dentistry Department, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Yasmine Elhamouly
- Department of Pediatric Dentistry and Community, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - Julian Schmoeckel
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
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Abreu-Placeres N, Grau-Grullón P, Naidu R, García-Godoy F, Newton JT, Ekstrand KR, Pitts N, Lopez Del Valle LM, Féliz-Matos L, Rivera Y, González RF, Rajendra Santosh AB, Morou-Bermudez E, Jácome-Liévano S, Martignon S. Cariology consensus for undergraduates at dental schools in the Caribbean region. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:717-732. [PMID: 33369839 DOI: 10.1111/eje.12651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/22/2020] [Accepted: 12/12/2020] [Indexed: 06/12/2023]
Abstract
AIM To obtain a consensus on the domains of cariology for undergraduates in dental schools in the Caribbean. MATERIALS AND METHODS Dental school deans from the Dominican Republic (DR) and Puerto Rico (PR) were invited to participate. Afterwards, 24 cariology faculty members from the dental schools in the DR received a 40-h workshop on the current understanding of dental caries. Then, representatives from participating dental schools in the DR and PR were divided into six groups and tasked with exploring the cariology domains described in the European and Colombian consensus. For each domain, the competencies in what the dental student, upon graduation, would have to (1) be proficient in, (2) have knowledge of, (3) and be familiar with were described. Two cariology consensus meetings to work on the domains and suggest changes for the Caribbean region were done, and representatives from the DR and PR agreed on a cariology consensus. For the second stage, Caribbean English-speaking countries were invited to participate in the consensus. Meetings were held with representatives from dental schools in Trinidad and Tobago (TT) and Jamaica (J) to include their suggestions on each consensus domain. RESULTS A total of 15 dental schools (DR = 12; PR = 1; TT = 1; and J = 1) participated; they agreed on a new consensus considering the realities of the Caribbean participating countries. CONCLUSION A cariology consensus for undergraduates was achieved for 15 dental schools in the Caribbean region. This accomplishment will promote a shift for the Caribbean dental schools' graduates towards a current understanding of dental caries.
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Affiliation(s)
- Ninoska Abreu-Placeres
- Biomaterials and Dentistry Research Center (CIBO-UNIBE), Research and Innovation Department, Universidad Iberoamericana, Santo Domingo, Dominican Republic
| | - Patricia Grau-Grullón
- Biomaterials and Dentistry Research Center (CIBO-UNIBE), Research and Innovation Department, Universidad Iberoamericana, Santo Domingo, Dominican Republic
| | - Rahul Naidu
- School of Dentistry, The University of the West Indies, Saint Augustine, Trinidad and Tobago
| | - Franklin García-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Forsyth Research Institute, Cambridge, Massachusetts, USA
| | - Jonathon Timothy Newton
- Psychology as Applied to Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London, UK
| | - Kim R Ekstrand
- Section of Cariology and Endodontics, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nigel Pitts
- Dental Innovation and Translation Hub, Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London, UK
| | - Lydia M Lopez Del Valle
- Office of Assistant Dean of Research and Surgical Sciences Department, University of Puerto Rico School of Dental Medicine, San Juan, Puerto Rico
| | - Leandro Féliz-Matos
- Biomaterials and Dentistry Research Center (CIBO-UNIBE), Research and Innovation Department, Universidad Iberoamericana, Santo Domingo, Dominican Republic
| | - Yilda Rivera
- Department of Ecological Sciences, University of Puerto Rico School of Dental Medicine, San Juan, Puerto Rico
| | - Ramón F González
- Department of Restorative Sciences, University of Puerto Rico School of Dental Medicine, San Juan, Puerto Rico
| | | | | | - Sofía Jácome-Liévano
- UNICA - Caries Research Unit, Research Vice-rectory, Universidad El Bosque, Bogotá, Colombia
| | - Stefania Martignon
- UNICA - Caries Research Unit, Research Vice-rectory, Universidad El Bosque, Bogotá, Colombia
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Current Novel Caries Diagnostic Technologies: Restorative Dentists' Attitude and Use Preferences. Healthcare (Basel) 2021; 9:healthcare9101387. [PMID: 34683068 PMCID: PMC8535563 DOI: 10.3390/healthcare9101387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/02/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
Early detection of caries lesions is key to a successful restorative dental treatment plan. The aim of this study was to investigate the preferences and attitude of graduate restorative dentistry residents (RDRs) regarding novel caries diagnostic technologies (NCDT) and to provide a brief overview of available technologies for both specialized and general dental practice. This cross-sectional study used an online questionnaire (17 questions) concerning RDRs’ attitude, preferences, and insights regarding five available NCDTs. It was distributed among twenty RDRs at a local government dental school following a review session about NCDTs. Collected responses were analyzed statistically using one-way analysis of variance (ANOVA), chi-squared with Bonferroni correction, and Kruskal-Wallis tests at a 0.05 significance level. Sixty-five percent of RDRs reported an interest in NCDTs as a discussion topic and almost half of them were positive towards their use, however, sixty percent of respondents were hesitant to diagnose caries solely using NCDTs. Fiber-optic-transillumination (FOTI) systems were ranked the best overall and with regard to all the investigated criteria (p < 0.05). Chosen reasons for FOTI included price followed by ease of use. In general, high price rated as the most perceived reason for not choosing a given NCDT followed by low practical applicability. Meanwhile, ease of use followed by relevant application ranked as the main reported reasons to choose an NCDTs.
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Sampaio FC, Bönecker M, Paiva SM, Martignon S, Ricomini Filho AP, Pozos-Guillen A, Oliveira BH, Bullen M, Naidu R, Guarnizo-Herreño C, Gomez J, Malheiros Z, Stewart B, Ryan M, Pitts N. Dental caries prevalence, prospects, and challenges for Latin America and Caribbean countries: a summary and final recommendations from a Regional Consensus. Braz Oral Res 2021; 35:e056. [PMID: 34076080 DOI: 10.1590/1807-3107bor-2021.vol35.0056] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 11/21/2022] Open
Abstract
Dental caries can be effectively managed and prevented from developing into cavitated lesions while preserving tooth structure at all levels. However, the strong correlation between caries and socioeconomic factors may compromise the efficacy of preventive strategies. The high prevalence of persistent inequalities in dental caries in Latin American and Caribbean countries (LACC) is a matter of concern. The estimates of the burden of disease in some countries in this region are outdated or absent. This paper aims to summarize and present the final recommendations of a regional Consensus for Dental Caries Prevalence, Prospects, and Challenges for LACC. This consensus is based on four articles that were written by a team of Latin American experts, reviewed by dental associations, and presented and discussed in two consensus events. The following domains were explored: epidemiology, risk factors, prevention strategies, and management of dental caries with a focus on restorative procedures. Dental caries can manifest throughout the lifespan of an individual, making it a matter of concern for infants, children, adults, and older people alike. The prevalence rates of untreated caries in deciduous and permanent teeth are high in many parts of the world, including LACCs. Previous evidence suggests that the prevalence of dental caries in 12-year-olds is moderate to high in most Latin American countries. Moreover, the prevalence of treatment needs and dental caries in the adult and elderly population can also be regarded as high in this region. The risk/protective factors (e.g., sugar consumption, exposure to fluoride, and oral hygiene) probably operate similarly in all LACCs, although variations in the interplay of these factors in some countries and within the same country cannot be ruled out. Although salt and water fluoridation programs are implemented in many countries, there is a need for implementation of a surveillance policy. There is also room for improvement with regard to the introduction of minimal intervention techniques in practice and public health programs. Dental caries is a marker of social disadvantage, and oral health promotion programs and interventions aimed at reducing the burden of dental caries in LACCs must consider the complexity of the socioeconomic dynamics in this region. There is an urgent need to promote engagement of stakeholders, policymakers, medical personnel, universities, dental associations, community members, and industries to develop regional plans that enhance the oral health agenda for LACCs. A list of recommendations has been presented to underpin strategies aimed at reducing the prevalence and severity of dental caries and improving the quality of life of the impacted LACC population in the near future.
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Affiliation(s)
- Fabio Correia Sampaio
- Universidade Federal da Paraíba - UFPB, Health Science Center, Department of Clinical and Community Dentistry, João Pessoa, PB, Brazil
| | - Marcelo Bönecker
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry, São Paulo, SP, Brazil.,Latin American Oral Health Association, LAOHA, São Paulo, SP, Brazil
| | - Saul Martins Paiva
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Stefania Martignon
- Universidad El Bosque - Unica, Caries Research Unit, Research Department, Bogotá, Colombia
| | - Antonio Pedro Ricomini Filho
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Biosciences, Piracicaba, SP, Brazil
| | - Amaury Pozos-Guillen
- Universidad Autónoma de San Luis Potosí, Facultad de Estomatología, San Luis Potosí, México
| | - Branca Heloisa Oliveira
- Universidade do Estado do Rio de Janeiro - UERJ, Department of Community and Preventive Dentistry, Rio de Janeiro, RJ, Brasil.,Latin American Oral Health Association, LAOHA, São Paulo, SP, Brazil
| | - Miriam Bullen
- University of Panama, School of Dentistry, Panama City, Panama.,Federación Odontológica Latinoamericana - FOLA, Panama City, Panama
| | - Rahul Naidu
- The University of the West Indies, Faculty of Medical Sciences, School of Dentistry, Saint Augustine, Trinidad and Tobago.,Caribbean Oral Health Initiative - COHI, San Juan, Puerto Rico
| | | | - Juliana Gomez
- Colgate Palmolive Company, Colgate Technology Center, Piscataway, NJ, USA
| | - Zilson Malheiros
- Colgate Palmolive Company, Colgate Technology Center, Piscataway, NJ, USA.,Latin American Oral Health Association, LAOHA, São Paulo, SP, Brazil
| | - Bernal Stewart
- Colgate Palmolive Company, Colgate Technology Center, Piscataway, NJ, USA.,Latin American Oral Health Association, LAOHA, São Paulo, SP, Brazil
| | - Maria Ryan
- Colgate Palmolive Company, Colgate Technology Center, Piscataway, NJ, USA
| | - Nigel Pitts
- King's College London, Faculty of Dentistry, Oral & Craniofacial Sciences, Dental Innovation and Translation hub, London, UK
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Martignon S, Roncalli AG, Alvarez E, Aránguiz V, Feldens CA, Buzalaf MAR. Risk factors for dental caries in Latin American and Caribbean countries. Braz Oral Res 2021; 35:e053. [PMID: 34076077 DOI: 10.1590/1807-3107bor-2021.vol35.0053] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022] Open
Abstract
Identifying the risk factors for dental caries is vital in epidemiology and clinical practices for developing effective preventive strategies, both, at the individual and collective levels. Different causality/determination models have been proposed to understand the development process of dental caries. In the present review, we designed a model inspired by the world-known social determinants models proposed in the 90s and more recently in the 10s, wherein the contextual factors are placed more externally and encompass the individual factors. The contextual factors included those related to the cultural and societal values, as well as the social and health government policies. The individual factors were classified into the following categories: socioeconomic (social class, occupation, income, and education level), demographic characteristics (age, sex, and ethnicity), behavioral factors (non-use of fluoride dentifrice, sugar consumption, poor oral hygiene, and lack of preventive dental care), and biological factors (recent caries experience/active caries lesions, biofilm retentive factors, developmental defects of the enamel, disabilities, saliva amount and quality, cariogenic biofilm). Each of these variables was addressed, while focusing on the current evidence from studies conducted in Latin American and Caribbean countries (LACC). Based on the proposed model, educational aspects were addressed, and individual caries risk assessment and management decisions were proposed; further, implications for public health policies and clinical practice were described. The identification of modifiable risk factors for dental caries should be the basis for multi-strategy actions that consider the diversity of Latin American communities.
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Affiliation(s)
- Stefania Martignon
- Universidad El Bosque, Caries Research Unit, Research Department, Bogotá, Colombia
| | | | - Evelyn Alvarez
- Universidad Científica del Sur, School of Dentistry, Department of Pediatric Dentistry, Lima, Perú
| | - Vicente Aránguiz
- Universidad de los Andes, Faculty of Dentistry, Cariology Unit, Santiago, Chile
| | - Carlos Alberto Feldens
- Universidade Luterana do Brasil, School of Dentistry, Department of Pediatric Dentistry, Canoas, RS, Brazil
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9
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A survey of cariology education in U.S. dental hygiene programs: The need for a core curriculum framework. J Dent Educ 2020; 84:1348-1358. [DOI: 10.1002/jdd.12348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/29/2020] [Accepted: 07/21/2020] [Indexed: 11/07/2022]
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10
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Abstract
Despite evidence strongly supporting use of non-invasive or minimally invasive procedures in caries management, there is still a large gap between evidence-based recommendations and application of these concepts in practice, with the practice of dentistry still largely dominated by invasive procedures in the US. This paper describes efforts in education and clinical practice in the US in the last decade to promote evidence-based cariology strategies, which support a minimum intervention dentistry (MID) philosophy. These include, for example: a competency-based core cariology curriculum framework which has been developed and disseminated. National education accreditation standards supporting caries management are likely to soon be changed to support assessment of best evidence in cariology. There are several ongoing efforts by organised dentistry and other groups involving dental educators, researchers and clinical practitioners to promote cariology concepts in practice, such as the development of evidence-based clinical practice guidelines for caries management by the American Dental Association. Within each of these strategies there are challenges, but also opportunities to expand the implementation of MID in the US, which create optimism for future improvements over time.
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Escobar E, Piedrahita M, Gregory RL. Growth and viability of Streptococcus mutans in sucrose with different concentrations of Stevia rebaudiana Bertoni. Clin Oral Investig 2020; 24:3237-3242. [DOI: 10.1007/s00784-020-03197-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 01/03/2020] [Indexed: 10/24/2022]
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Fernández CE, Chanin M, Appice GM, Culver AM, Stein A. Conceptualization of dental caries by dental students is related to their preventive oral care routine. J Dent Educ 2020; 84:1426-1437. [PMID: 32805773 DOI: 10.1002/jdd.12357] [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] [Received: 11/08/2019] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Whether the understanding of dental caries influences how future dentists manage the disease themselves has not been previously studied. Thus, this study evaluated whether the conceptualization (understanding) of dental caries by dental students is related to their own preventive oral care routine. METHODS Dental students at a U.S. dental school (n = 517) were invited to voluntarily respond to an anonymous electronic survey in spring 2018. Demographic characteristics, caries conceptualization (CC), dental care habits, and self-caries risk determination were asked. Discursive responses to CC were analyzed by content analysis technique, and categories [c] were created. Chi-square and Fisher's exact tests were used for analysis. RESULTS Overall response rate was 54.5% (n = 282, 48.2% female). Three researchers independently analyzed discursive answers and classified them into 1 of 6 caries concept categories [c]: [c1] only signs of the disease (10.3%), [c2] bacterial disease-not specifying bacterial metabolism (38.3%), [c3] bacterial byproducts-not specifying substrate (13.8%), [c4] biological or multifactorial concept (24.8%), [c5] comprehensive multifactorial disease (8.2%), or [c6] other (4.6%). Only 33% completely defined dental caries according to the modern understanding of the disease (c4-c5). Statistical differences were found between: CC and diet modification, CC and rinsing after brushing, year of school (YS) and self-determined caries-risk, YS and brushing at school, and YS and rinsing after brushing (P < 0.05). CONCLUSION Our data suggest that the students' understanding of the disease can influence how they will manage the disease in terms of diet modification and behavior after brushing. Moreover, self-caries risk determination influenced students' brushing behavior.
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Affiliation(s)
- Constanza E Fernández
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Marisa Chanin
- College of Dental Medicine-Illinois (CDMI), Midwestern University, Illinois, USA
| | - Gabriella M Appice
- College of Dental Medicine-Illinois (CDMI), Midwestern University, Illinois, USA
| | - Ashley M Culver
- College of Dental Medicine-Illinois (CDMI), Midwestern University, Illinois, USA
| | - Amy Stein
- Office of Research and Sponsored Programs, Midwestern University, Arizona, USA
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Lara JS, Braga MM, Zagatto CG, Wen CL, Mendes FM, Murisi PU, Haddad AE. A Virtual 3D Dynamic Model of Caries Lesion Progression as a Learning Object for Caries Detection Training and Teaching: Video Development Study. JMIR MEDICAL EDUCATION 2020; 6:e14140. [PMID: 32441661 PMCID: PMC7275258 DOI: 10.2196/14140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 03/06/2020] [Accepted: 03/23/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND In the last decade, 3D virtual models have been used for educational purposes in the health sciences, specifically for teaching human anatomy and pathology. These models provide an opportunity to didactically visualize key spatial relations that can be poorly understood when taught by traditional educational approaches. Caries lesion detection is a crucial process in dentistry that has been reported to be difficult to learn. One especially difficult aspect is linking clinical characteristics of the different severity stages with their histological features, which is fundamental for treatment decision-making. OBJECTIVE This project was designed to develop a virtual 3D digital model of caries lesion formation and progression to aid the detection of lesions at different severity stages as a potential complement to traditional lectures. METHODS Pedagogical planning, including identification of objectives, exploration of the degree of difficulty of caries diagnosis-associated topics perceived by dental students and lecturers, review of the literature regarding key concepts, and consultation of experts, was performed prior to constructing the model. An educational script strategy was created based on the topics to be addressed (dental tissues, biofilm stagnation areas, the demineralization process, caries lesion progression on occlusal surfaces, clinical characteristics related to different stages of caries progression, and histological correlations). Virtual 3D models were developed using the Virtual Man Project and refined using multiple 3D software applications. In the next phase, computer graphic modelling and previsualization were executed. After that, the video was revised and edited based on suggestions. Finally, explanatory subtitles were generated, the models were textured and rendered, and voiceovers in 3 languages were implemented. RESULTS We developed a 6-minute virtual 3D dynamic video in 3 languages (English, Spanish, and Brazilian Portuguese) intended for dentists and dental students to support teaching and learning of caries lesion detection. The videos were made available on YouTube; to date, they have received more than 100,000 views. CONCLUSIONS Complementary pedagogical tools are valuable to support cariology education. This tool will be further tested in terms of utility and usability as well as user satisfaction in achieving the proposed objectives in specific contexts.
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Affiliation(s)
- Juan Sebastian Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, United States
| | - Mariana Minatel Braga
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Carlos Gustavo Zagatto
- Discipline of Telemedicine, Department of Pathology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Chao Lung Wen
- Discipline of Telemedicine, Department of Pathology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Pedroza Uribe Murisi
- Department of Pediatric Dentistry, Dental School, University of Guadalajara, Guadalajara, Mexico
| | - Ana Estela Haddad
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
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Dental Caries Preventive Considerations: Awareness of Undergraduate Dental Students. Dent J (Basel) 2020; 8:dj8020031. [PMID: 32244840 PMCID: PMC7345073 DOI: 10.3390/dj8020031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/24/2020] [Accepted: 03/30/2020] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess awareness and knowledge of undergraduate dental students of common caries-related preventive considerations and to highlight these factors in a concise manner to act as a guide for dental practitioners. A sample of 118 undergraduate students at a local government dental school was included. An interactive survey that contains questions related to common preventive strategies against dental caries was presented to the students. The survey contained 22 questions concerning dietary and therapeutic strategies. Students casted their votes using their mobile cellphones. The correct answer for each question was shown to the students, and further discussion was held. Data was collected, and the statistical analysis was conducted using one-sample z- and chi-squared tests at 0.05 significance level. The students answered the questions related to oral hygiene practices, xylitol, and the common knowledge regarding fluoride. The questions related to the use of chlorhexidine, dietary factors, and fluoride formulations were answered mostly incorrectly. The students seemed to grasp details of important concepts of flossing, brushing, reducing frequency of sugar exposure, and the use of fluoride products. Still, more emphasis should be given to increase students’ awareness of dietary guidelines for caries prevention, since adequate knowledge of these modalities is paramount for graduating dentists.
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Turchiello RZ, Pedrotti D, Braga MM, Rocha RO, Rodrigues JA, Lenzi TL. Do undergraduate dental students perform well detecting and staging caries and assessing activity by visual examination? A systematic review and meta-analysis. Int J Paediatr Dent 2019; 29:281-293. [PMID: 30620110 DOI: 10.1111/ipd.12463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 11/26/2022]
Abstract
AIM To assess the undergraduate students' performance in detecting and staging caries and assessing activity using visual inspection. DESIGN Two independent reviewers searched the literature through PubMed/MEDLINE, Scopus, Lilacs databases, and OpenSINGLE. Meta-analyses summarized the results concerning reproducibility and accuracy at D1 (considering all lesions) and D3 (including only cavitated lesions or lesions into dentin) levels. For activity, we considered sound surfaces plus inactive caries lesions vs active lesions. Meta-regression assessed the effect of methodological variables on the outcomes. RESULTS Fourteen studies were included. The mean reproducibility values were ≥0.52, except for interexaminer agreement when assessing caries activity (0.39; 95% CI 0.10-0.67). The intra-examiner reproducibility tended to be higher than the interexaminer reproducibility. Overall, undergraduate students' performance in staging caries lesions using visual examination was good (AUC>0.85 and DOR>25). The sensitivity values were moderate; however, these were associated with excellent specificity values. Despite few pooled studies, caries activity assessment revealed moderate overall performance, with lower pooled sensitivity than pooled specificity. Students' education level and background clinical experience had no influence on the accuracy and reproducibility of the visual inspection. CONCLUSION Undergraduate students' performance in detecting and staging caries using visual inspection was good, although caries activity assessment still requires improvement.
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Affiliation(s)
- Ronairo Z Turchiello
- Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Djessica Pedrotti
- Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Mariana M Braga
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - Rachel O Rocha
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Jonas A Rodrigues
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tathiane L Lenzi
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Ngoc CN, Donovan TE. Education About Dental Erosion in U.S. and Canadian Dental Schools. J Dent Educ 2018; 82:1296-1304. [DOI: 10.21815/jde.018.140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/16/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Caroline Nguyen Ngoc
- Department of Restorative Dentistry, Faculté de Médecine Dentaire; Université de Montréal
| | - Terry E. Donovan
- Department of Operative Dentistry; University of North Carolina at Chapel Hill School of Dentistry
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GOUVEA DB, GROISMAN S, BÖNECKER MJS, SAMPAIO F, PAIVA SM, KRIGER L, SCHULTE A, RODRIGUES JA. Cariology education for undergraduate Brazilian dental students. ACTA ACUST UNITED AC 2018. [DOI: 10.1590/1981-863720180003000073428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT This study sought to provide an overview of current cariology education for undergraduate Brazilian dental students. Data collection was via a Portuguese version of a 12-item questionnaire (Schulte et al., 2011) that was sent to all Brazilian dental schools (n = 219). The response rate was 57.0% (n = 125). Of the schools that returned the questionnaire, 84.8% supported the development of a Brazilian cariology curriculum. The units responsible for teaching cariology were predominantly operative dentistry (49.6%), pediatric dentistry (49.6%), dental public health (44.8%), and cariology (32%). Theoretical teaching of cariology (74.4%) and pre-clinical exercises (63.2%) were cited to occur mainly during the second year of the course, while clinical activities were placed in the third (71.2%) and fourth (64.8%) years. Among respondents, 76.8% of the schools included dental erosion and 86.4% included defects of dental hard tissues, such as abrasion, in teaching cariology. This survey was able to determine the panorama of cariology education in Brazil and to detect some differences among Brazilian geographic areas. The promotion of a workshop to discuss the topics that should be taught to undergraduate dental students and the development of a Brazilian core curriculum in cariology would be likely to reduce the differences in teaching cariology in Brazil.
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Affiliation(s)
| | | | | | | | | | - Léo KRIGER
- Pontifícia Universidade Católica do Paraná, Brazil
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18
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Abreu-Placeres N, Newton JT, Pitts N, Garrido LE, Ekstrand KR, Avila V, Martignon S. Understanding dentists' caries management: The COM-B ICCMS™ questionnaire. Community Dent Oral Epidemiol 2018; 46:545-554. [PMID: 29869802 DOI: 10.1111/cdoe.12388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 04/30/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To design and validate a questionnaire to measure caries management based on the Capability, Opportunity, and Motivation Behavior model (COM-B) and the International Caries Classification and Management System (ICCMS™). METHODS A combination of Cariology and Psychology experts developed a 79-item pool that measured the COM-B components according to the ICCMS™ caries management recommended behaviours. After face and content validation and a pilot study, two samples of Colombian dentists participated: clinicians (n = 277) and clinical-practice educators (n = 212). RESULTS Using parallel analysis and exploratory structural equation modelling (ESEM), the questionnaire was reduced to a 47-item 5-factor instrument that demonstrated good internal consistency and validity properties, including a robust factor structure, measurement invariance across samples and high predictive validity of ICCMS™ recommended behaviours. Scales' mean scores showed that dentists were conducting recommended behaviours "most-of-the-time" (Behavior), showed high confidence in their ability to conduct these behaviours (Capability) and considered recommendations as highly relevant (Opportunity-Relevance), while their appraisals of the available resources (Opportunity-Resources) and remuneration (Motivation) were notably lower. CONCLUSION Overall, the findings highlight the practical utility of the COM-B ICCMS™ Questionnaire in understanding the potential antecedent variables that may explain dentists' behaviours related to caries diagnosis and management and in suggesting avenues for achieving a positive change in their behaviour.
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Affiliation(s)
- Ninoska Abreu-Placeres
- UNICA - Caries Research Unit, Research Vice-rectory, Universidad El Bosque, Bogotá, Colombia.,Biomaterials and Dentistry Research Center (CIBO-UNIBE), Academic Research Department, Universidad Iberoamericana, Santo Domingo, Dominican Republic
| | | | - Nigel Pitts
- Dental Innovation and Translation Centre, King's College London Dental Institute, London, UK
| | - Luis Eduardo Garrido
- Vicerrectoría de Investigación e Innovación, Pontificia Universidad Católica Madre y Maestra, Santo Domingo, República Dominicana.,Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Kim R Ekstrand
- Section of Cariology and Endodontics, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Viviana Avila
- UNICA - Caries Research Unit, Research Vice-rectory, Universidad El Bosque, Bogotá, Colombia
| | - Stefania Martignon
- UNICA - Caries Research Unit, Research Vice-rectory, Universidad El Bosque, Bogotá, Colombia.,Dental Innovation and Translation Centre, King's College London Dental Institute, London, UK
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Raphael SL, Foster Page LA, Hopcraft MS, Dennison PJ, Widmer RP, Evans RW. A survey of cariology teaching in Australia and New Zealand. BMC MEDICAL EDUCATION 2018; 18:75. [PMID: 29631580 PMCID: PMC5892021 DOI: 10.1186/s12909-018-1176-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The Australian and New Zealand chapter of the Alliance for a Cavity Free Future was launched in 2013 and one of its primary aims was to conduct a survey of the local learning and teaching of cariology in dentistry and oral health therapy programs. METHODS A questionnaire was developed using the framework of the European Organisation for Caries Research (ORCA)/Association of Dental Education in Europe (ADEE) cariology survey conducted in Europe in 2009. The questionnaire was comprised of multiple choice and open-ended questions exploring many aspects of the cariology teaching. The survey was distributed to the cariology curriculum coordinator of each of the 21 programs across Australia and New Zealand via Survey Monkey in January 2015. Simple analysis of results was carried out with frequencies and average numbers of hours collated and open-ended responses collected and compiled into tables. RESULTS Seventeen responses from a total of 21 programs had been received including 7 Dentistry and 10 Oral Health programs. Key findings from the survey were - one quarter of respondents indicated that cariology was identified as a specific discipline with their course and 41% had a cariology curriculum in written format. With regard to lesion detection and caries diagnosis, all of the program coordinators who responded indicated that visual/tactile methods and radiographic interpretation were recommended with ICDAS also being used by over half them. Despite all respondents teaching early caries lesion management centred on prevention and remineralisation, many taught operative intervention at an earlier stage of lesion depth than current evidence supports. Findings showed over 40% of respondents still teach operative intervention for lesions confined to enamel. CONCLUSION Despite modern theoretical concepts of cariology being taught in Australia and New Zealand, they do not appear to be fully translated into clinical teaching at the present time.
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Affiliation(s)
- Sarah L. Raphael
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
| | | | | | | | - Richard P. Widmer
- Department of Dentistry, Children’s Hospital at Westmead, Westmead, Australia
| | - R. Wendell Evans
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
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Tikhonova S, Girard F, Fontana M. Cariology Education in Canadian Dental Schools: Where Are We? Where Do We Need to Go? J Dent Educ 2018; 82:39-46. [PMID: 29292324 DOI: 10.21815/jde.018.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/07/2017] [Indexed: 11/20/2022]
Abstract
The aim of this study was to document cariology education across Canadian dental schools. Ten faculty members who supervise cariology education at each of the ten Canadian dental schools were invited to participate in the study in 2016. An adapted version of the European Organization for Caries Research-Association for Dental Education in Europe cariology curriculum group questionnaire was used. Representatives of all ten dental schools completed the questionnaire, for a 100% response rate. In four schools, cariology and restorative dentistry were taught by the same department. Five schools had didactic/laboratory courses focusing primarily on cariology as well as a specific written curriculum. Six schools provided cariology-related hands-on workshops/laboratories before students started working with patients. In teaching cariology, seven institutions included dental hard tissues defects. The following caries detection methods were addressed didactically in cariology education: visual (10/10 total schools), tactile (9/10), International Caries Detection and Assessment System criteria (6/10), caries activity assessment (9/10), radiographic (10/10), and other detection tools (8/10). Seven schools charted activity of carious lesions in clinic. Only one school used the concept of caries risk assessment regularly in clinic. Clinical cariology teaching was carried out mostly by private dentists hired as clinical instructors (7/10) and faculty members involved in didactic cariology education (9/10). Calibration of faculty members for caries detection criteria was reported by only one school. The main concern reported by all institutions was the difficulty of implementing didactic instruction on cariology into clinical training. This study found that contemporary cariology concepts are in the process of being implemented in didactic education across Canadian dental schools, but all schools lacked appropriate integration of cariology education into clinical training. These findings suggest a need for harmonization of evidence-based cariology education in Canada.
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Affiliation(s)
- Svetlana Tikhonova
- Dr. Tikhonova is Faculty Lecturer, Faculty of Dentistry, McGill University; Dr. Girard is Assistant Professor, Department of Oral Health, Faculty of Dentistry, Université de Montréal; Dr. Fontana is Professor of Cariology, School of Dentistry, University of Michigan.
| | - Félix Girard
- Dr. Tikhonova is Faculty Lecturer, Faculty of Dentistry, McGill University; Dr. Girard is Assistant Professor, Department of Oral Health, Faculty of Dentistry, Université de Montréal; Dr. Fontana is Professor of Cariology, School of Dentistry, University of Michigan
| | - Margherita Fontana
- Dr. Tikhonova is Faculty Lecturer, Faculty of Dentistry, McGill University; Dr. Girard is Assistant Professor, Department of Oral Health, Faculty of Dentistry, Université de Montréal; Dr. Fontana is Professor of Cariology, School of Dentistry, University of Michigan
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21
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Makhija SK, Robinson ME, Bader JD, Shugars DA, Litaker MS, Im HR, Rindal DB, Pihlstrom DJ, Meyerowitz C, Gordan VV, Buchberg MK, Gilbert GH. Dentists' decision strategies for suspicious occlusal caries lesions in a National Dental PBRN study. J Dent 2017; 69:83-87. [PMID: 29138112 DOI: 10.1016/j.jdent.2017.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/25/2017] [Accepted: 11/08/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Case presentations (vignettes) were completed by dentists in the National Dental Practice-Based Research Network study "Decision Aids for the Management of Suspicious Occlusal Caries Lesions (SOCLs)". The objective was to determine dentists' decision strategies for SOCLs. METHODS 107 dentists viewed a series of 16 vignettes that represented all combinations of 4 clinical cues: color, luster, lesion roughness, and patient-level caries risk. Each vignette included a patient description and a photograph of a tooth presenting the 4 cues. Dentists were asked to decide the likelihood that a suspected lesion extended into dentin. A lens model analysis was used to examine how dentists use these cues in making their decisions. RESULTS 86% of dentists had a consistent pattern of cue use that defined their decision strategy. On average, 70% of the variance in their decisions was accounted for by their use of the 4 cues. However, there was considerable variability in the individual cues used by each dentist. The percentages of dentists who used the different cues consistently were: luster (58%), color (48%), roughness (36%), and risk (35%). 14% of dentists reliably used only color, 7% used only luster, 4% used only roughness, and 1% used only risk when making SOCL decisions. CONCLUSIONS The online vignette system suggests that clinical SOCL decision strategies are highly individualized and dentists do not use all cues available to them to make these decisions. CLINICAL SIGNIFICANCE Prior to this study, there has been little evidence about how dentists use these cues (either individually or in combination) when judging the extent of caries progression. Such knowledge would be valuable when designing interventions to help dentists maximize the likelihood of appropriate treatment decisions.
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Affiliation(s)
- Sonia K Makhija
- University of Alabama at Birmingham, Birmingham, AL, United States.
| | | | - James D Bader
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Daniel A Shugars
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Mark S Litaker
- University of Alabama at Birmingham, Birmingham, AL, United States
| | - Hong R Im
- Private Practice, Austin, TX, United States
| | - D Brad Rindal
- HealthPartners Institute, Minneapolis, MN, United States
| | | | - Cyril Meyerowitz
- University of Rochester, Eastman Institute for Oral Health, Rochester, NY, United States
| | | | - Meredith K Buchberg
- University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Gregg H Gilbert
- University of Alabama at Birmingham, Birmingham, AL, United States
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Managing caries: the need to close the gap between the evidence base and current practice. Br Dent J 2017; 219:433-8. [PMID: 26564354 DOI: 10.1038/sj.bdj.2015.842] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 11/08/2022]
Abstract
Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.
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Fontana M, Guzmán-Armstrong S, Schenkel AB, Allen KL, Featherstone J, Goolsby S, Kanjirath P, Kolker J, Martignon S, Pitts N, Schulte A, Slayton RL, Young D, Wolff M. Development of a Core Curriculum Framework in Cariology for U.S. Dental Schools. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.6.tb06133.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | | | | | | | - Susie Goolsby
- School of Dentistry; Virginia Commonwealth University
| | | | - Justine Kolker
- College of Dentistry and Dental Clinics; University of Iowa
| | | | | | - Andreas Schulte
- Department for Special Care Dentistry; Dental School; University of Witten/Herdecke; Witten Germany
| | | | - Douglas Young
- Arthur A. Dugoni School of Dentistry; University of the Pacific
| | - Mark Wolff
- College of Dentistry; New York University
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Martignon S, Marín LM, Pitts N, Jácome-Liévano S. Consensus on domains, formation objectives and contents in cariology for undergraduate dental students in Colombia. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2014; 18:222-233. [PMID: 24612126 DOI: 10.1111/eje.12091] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To achieve a consensus for an undergraduate cariology teaching curriculum between Colombian dental schools in line with the 2015 Global Alliance for a Cavity-Free Future goal: '90% of dental schools adopting the current caries paradigm'. MATERIALS AND METHODS First phase: Four-regional 2-day workshops were conducted with 4 representative teachers (cariology, clinics, basic-science, public health and specialisations) from each of the 24-ACFO schools (Colombian Dental Schools Association) as follows: Presentations: -Main Colombian cariology teaching barriers, -Caries and public health current paradigms; -Schools' cariology teaching descriptions; -European Cariology Curriculum. Five main-domain subgroup discussions: (i) the knowledge base; (ii) risk assessment, diagnosis and synthesis; (iii) decision-making, preventive non-surgical therapy; (iv) decision-making, surgical therapy; and (v) evidence-based cariology in clinical and public health practice, to adapt domains, objectives and contents to Colombian curriculum, public health and national health system needs. These 4-regional plus 24-school consensuses sent 1 month afterwards were adapted into a preliminary document. 2nd-phase: 10 peer review by national faculty in cariology, and 10 curriculum, basic sciences, research, clinical management and public health experts. School participants and deans reviewed the draft document and suggestions were discussed and adapted into a final consensus document officially presented to the academic community at the ACFO National-Research-Meeting (September, 2012). RESULTS 24 schools and 92 teachers participated. The Colombian Cariology Curriculum was agreed by 23 schools. It positioned public health into one domain. A general focus on social determination was included, and more relevance was given to fluorosis than erosion. CONCLUSIONS A consensus on cariology teaching for undergraduate dental students was achieved in Colombia and work to promote its adoption has commenced.
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Affiliation(s)
- S Martignon
- UNICA - Caries Research Unit, Dental Faculty, Universidad El Bosque, Bogotá, Colombia
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Ferreira-Nóbilo NDP, Sousa MDLRD, Cury JA. Cariology in Curriculum of Brazilian Dental Schools. Braz Dent J 2014; 25:265-70. [DOI: 10.1590/0103-6440201300149] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/03/2014] [Indexed: 11/22/2022] Open
Abstract
Reasons for the iniquities of caries, globally recognized, may be related to how Cariology has been taught in dental schools. In Brazil, the most important universities, when considering healthcare teaching, are the public ones. The objective of this study was to identify the insertion of the contents of Cariology in the course flowcharts of public dental schools in the country. The survey was conducted in 2013 seeking to identify the realities of different geographical regions, aimed to the census of public dental schools. It was performed a documentary analysis of the menus of disciplines, identifying the following issues: number of dental schools that include content related to Cariology in their curricula; average total workload undergraduate courses and disciplines that contemplate the theme; distribution of disciplines in professional training cycles (basic, clinical and public health); existence of discipline and/or a specific department; verification of bibliographic indication directly related to Cariology. The response rate was 93.6%. All dental schools recommended specific books, and none of them had a Department of Cariology. All dental schools in the country contemplated content related to Cariology in their disciplines, distributed in specific disciplines (except for the Northern region) and disciplines in the three cycles of learning (basic, clinical and public health), with larger workload in the clinical cycle. Although public dental schools in Brazil demonstrated commitment to contemplating the content related to Cariology in their disciplines, the emphasis on the clinical cycle may not be promoting the integrated formation of students, which could be contributing to reflect the inequalities of the disease in the country.
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