Special needs dentistry: perception, attitudes and educational experience of Malaysian dental students

Exploring the acceptance of geriatric dentistry programming for undergraduate dental students through stakeholder interviews

PURPOSE/OBJECTIVES

Older adults frequently report unmet oral healthcare needs. Current research suggests a lack of provider willingness to perform geriatric dental care plays a role in limiting older adults' access to dental services. To better understand the acceptance of geriatric dentistry programming in Ontario, and to explore considerations for successful implementation, we completed consultations with dental students and dental education stakeholders. Findings from a scoping review we conducted previously (Alicia C. Brandt and Cecilia S. Dong) were used to guide this research.

METHODS

Consultations involved a questionnaire and semi-structured individual interviews. Descriptive and parametric statistics such as Pearson's bivariate correlation and One-way analysis of variance were completed on questionnaire data using SPSS V.28. Interview data were transcribed verbatim, and the content was analyzed using emergent coding and thematic analysis in NVivo. Student and faculty data were analyzed separately and then consolidated.

RESULTS

Ten students and 12 dental faculty members completed the questionnaire of which ten students and nine faculty members also participated in interviews. Themes were organized into barriers and facilitators, with a subsection on interprofessional collaboration. Barriers included: 1. Student anxiety and skill level; 2. Constraints of the learning environment; 3. Patient factors; and 4. Knowledge gaps. Facilitators included: 1. Learning environment and culture; 2. Volume of exposure; 3. Soft skills; and 4. Desired interventions.

CONCLUSIONS

Both students and faculty stakeholders demonstrated acceptance of geriatric dentistry programming at the undergraduate dentistry level that supports improved access to care for this population. Pilot programs integrating different intervention elements which were viewed as most promising would be beneficial.

Advancing dental care access for patients with disabilities: A global scoping review of predoctoral training

OBJECTIVE

To examine predoctoral training programs that address the unique needs of patients with special healthcare needs (SHCN) and provide an overview of current global training initiatives, while exploring innovative approaches to enhance dental students' preparation in managing SHCN patients.

METHODS

A scoping review (SR) was conducted focusing on three key concepts: dental education, pre-doctoral training, and intellectual disability/developmental disability. The search encompassed five databases including Medline, Embase, Dentistry and Oral Sciences Source (EBSCO), Global Health (EBSCO), and WHO Global Index Medicus, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. EndNote and Covidence were utilized to prevent duplication and facilitate title/abstract screening.

RESULTS

After screening abstracts, a total of 2309 articles were initially identified with 28 articles meeting eligibility criteria for data extraction relevant to the research question. Two major categories characterized the key findings included in the review: 12 interventional studies and 16 perception-based studies.

CONCLUSION

This SR revealed that dental students are not adequately trained to treat special needs populations; consequentially, dental students lack confidence in providing high-quality care to this demographic. The absence of standardized training poses a global challenge, exacerbating care disparities. Addressing this issue is crucial to better prepare dental students and advance equitable access and quality care for underserved populations.

Singapore dentists' attitudes toward dental care provision for older adults with disabilities

OBJECTIVES

This study aimed to assess dentists' attitudes toward providing dental care for older adults with disabilities in Singapore and the factors influencing their willingness to provide care.

BACKGROUND

Dentists face a rapidly ageing patient demographic. Practitioner unwillingness to circumvent the attending challenges of care provision prevents older adults from accessing the dental care necessary for better oral and systemic health. Previous studies have reported on dentists' attitudes toward caring for older adults with disabilities; however, these are mostly limited to dependent older adults and exclude frail, community-dwelling older persons.

METHODS

A cross-sectional study was conducted in 2020 using a self-administered questionnaire. Quantitative data analysis was presented in the form of descriptive statistics, followed by bivariate analyses.

RESULTS

There were 193 respondents, a response rate of under 9%. Dentists were less willing, confident and involved in the care of older adults with disabilities as the individual's severity of impairments increased. Less than half of respondents were willing to treat individuals with severe disabilities in cooperation (23.3%), swallowing (30.6%), mobility (33.7%) and communication (45.1%). Dentists with training in geriatric dentistry were more willing to provide care. However, younger dentists, general dental practitioners, private practitioners and public sector dentists had specific restraining and driving forces, which further modulated their willingness to provide care.

CONCLUSIONS

The current areas of training needs among Singapore dentists are in severe impairments of swallowing, communication, cooperation and mobility. Further geriatric dentistry training may effectively increase dentists' willingness to provide care; however, additional specific targeted interventions are also needed.

Factors associated with dental interns and professors perception of the management of disabled patients: A cross-sectional study under multivariable analysis

Background

Patients with disabilities experience oral health inequalities, including increased disease prevalence and unmet healthcare needs. The aim of this study was to assess factors associated to the perceived management of patients with physical disabilities among dental interns and professors at a university located in the capital city and a branch in a province in Peru.

Methods

This cross-sectional, observational, and analytical study included 100 dental interns and 75 Peruvian dental professors and was conducted from January to April 2022. A validated perception scale was used to evaluate the management of disabled patients. For the statistical analysis, the study employed Pearson's chi-square test and Fisher's exact test, along with a Poisson regression model that used robust variance. The adjusted prevalence ratio (APR) was utilized to evaluate perception while taking into account factors such as gender, age, marital status, origin, professional experience, previous treatment of a patient with physical disability, and previous cohabitation with a disabled patient. The significance level was set at p < 0.05.

Results

The 86 % of dental interns and 88 % of dental professors had a poor perception of managing disabled patients, with no significant association between them (p = 0.698). Male and female dental interns displayed significant differences in perception (p = 0.004), while no other variables showed significant differences (p < 0.05). Conversely, dental professors displayed significant differences in all variables analyzed (p < 0.05). In dental interns, gender was found to be the only influential variable, with females having a 41 % higher likelihood of perceiving disabled patient management poorly compared to males (APR = 1.41; 95 % CI: 1.04-1.91) (p = 0.028). However, gender was not found to be a significant factor for dental professors (p = 0.449).

Conclusion

The majority of dental interns and professors had a poor perception of managing disabled patients, with no significant differences observed between them. Moreover, gender significantly influenced the perception of managing patients with physical disabilities among dental interns specifically. On the other hand, neither age, marital status, origin, professional experience, previous treatment of a patient with physical disability, nor previous cohabitation with a disabled patient were found to be associated factors among dental interns and professors.

Perception of Special-Care Dentistry among Dental Students at Universitas Indonesia: A Cross-Sectional Study

OBJECTIVE

To assess the perceptions of special-care dentistry (SCD) among dental students in the Faculty of Dentistry, Universitas Indonesia, Indonesia.

METHODS

This cross-sectional study used a self-administered online questionnaire, and all preclinical and clinical students were invited to participate. The survey items comprised four domains related to participants' characteristics, perceptions of SCD, perceptions of managing patients with special needs, and perceptions of SCD education. The chi-square test and Mann-Whitney test were used in the analysis.

RESULTS

A total of 572 students participated in this study. The findings showed that the clinical students were more familiar with SCD than the preclinical students were (p = 0.008). A statistically significant relationship was found between the study program and the ability to work independently with special-needs patients after graduation (p < 0.001), the ability to refer special-needs patients to specialists (p = 0.042), the perception of postgraduate training-program needs (p < 0.001), and the opportunity to consider postgraduate training (p = 0.004).

CONCLUSION

Most of the respondents had a favorable perception of SCD. Thus, an improved SCD curriculum and SCD training for undergraduate and postgraduate students should be provided to develop the knowledge and skills needed to provide care to special-needs patients.

Training dental hygiene students to care for patients with disabilities

OBJECTIVE

The purpose of this study was to evaluate the impact of a novel training programme on dental hygiene students' knowledge, attitudes, and beliefs about caring for individuals with disabilities.

METHODS

A mixed methods approach was used. Students from five dental hygiene programmes based at community colleges completed a two-hour didactic training session to supplement their existing special care dentistry coursework. Students completed an original 14-item pretest and posttest before and after the training that assessed attitudes and beliefs, and two validated posttests that assessed knowledge. Afterwards, students completed a clinical rotation in an advanced care dental clinic at a local academic institution, gaining hands-on experience with equipment and patient treatment. Descriptive statistics were used to report training scores, types of services rendered, and modifications to treatment. Student comments about their experiences were assessed using thematic analysis.

RESULTS

Two hundred and ninety-four students completed didactic training, and 261 completed clinical rotations. Posttest scores indicated positive improvements in knowledge, attitudes, and beliefs. All students provided direct patient care. Sixty-nine percent treated patients with intellectual and developmental disabilities; 75% placed silver diamine fluoride or fluoride varnish. Altered patient positioning was used by 70.5%. Most students (95.4%) reported that their experience positively changed their attitudes towards caring for patients with disabilities in the future. Eight themes emerged, notably increased comfort and confidence, a willingness and desire to treat patients, the acquisition of new skills, and clinician behaviours of empathy and compassion towards others.

CONCLUSION

Training can help prepare dental hygiene students with the confidence and skills to address the oral health needs of individuals with disabilities.

Special care dentistry education during the COVID-19 pandemic: The impact of online peer-assisted learning

OBJECTIVES

This study aims to analyze the impact and students' perceptions of online peer-assisted learning (OPL), developed as an alternative and innovative approach to Special Care Dentistry (SCD) training during the COVID-19 pandemic. Online peer-assisted learning (OPL) is an alternative pedagogical approach that combines online education and peer-assisted teaching.

METHODS

The OPL session was conducted by two postgraduate students in SCD (as teachers), to final year undergraduate dental students (as learners) (n = 90), supervised by two specialists in SCD-related areas (as supervisors). Vetted online pre- and post-intervention quizzes were conducted before and after the session, respectively, followed by an online validated feedback survey of the students' learning experiences. Meanwhile, a reflective session was conducted between the postgraduate students and supervisors to explore their perceptions of OPL. Quantitative data was analyzed via paired t-test (significance level, P < .05). Qualitative data was analyzed via thematic analysis.

RESULTS

Overall, 68 (response rate = 75.6%) and 81 (response rate = 90.0%) undergraduate students completed the quiz and feedback survey, respectively. There was a significant difference in total mean scores, and mean scores of 7 (out of 10) individual items on the quizzes. Most students offered positive reviews of multiple aspects of OPL. They acknowledged the benefit of OPL for its content and preparation process, technology utilized, and experts' roles. Postgraduate students perceived that OPL encourages knowledge-recall and utilization of technology-based educational tools, while improving their teaching skills.

CONCLUSION

Students provided positive responses toward the implementation of OPL as an innovative approach to the teaching and learning of SCD during the COVID-19 pandemic.

Special care in dental curriculum: A transversal axis for integrating oral health with systemic health

AIMS

Distance between dentistry and medicine is a traditional and historical obstacle that affects multiple levels of the health system, especially the health policies to improve health service quality. Changes in dental education, especially involving the adoption of integrative health models in professional development, are considered essential for reducing this gap. We aimed to show a dental curriculum focused on special care as a tool for medicine-dentistry integration.

METHODS

In this study, we present a new proposal for an undergraduate dental curriculum in which topics related to special care are addressed transversally and are the core for interdisciplinary integration of oral health with systemic health. We also describe how themes related to dental home care and hospital dentistry were included in this course as basic professional competencies.

RESULTS AND CONCLUSION

This initiative is aligned with the global trend to adopt educational systems that contribute to the reduction of health care inequalities and improve health service quality.

Intersection of the iADH undergraduate curriculum in special care dentistry and the association of Canadian faculties of dentistry competencies framework

AIMS

To map the International Association of Disability and Oral Health (iADH) curriculum to the Association of Canadian Faculties of Dentistry (ACFD) competencies framework to develop a strategy for teaching special care dentistry (SCD) using the International Classification of Functioning, Disability, and Health (ICF). To review the literature to identify educational methodologies that support teaching SCD competencies.

METHODS

The 20 subdomains of the ACFD competencies framework were mapped to the 18 subdomains of the iADH competency matrix. A literature review of methods, techniques, or innovations used to teach SCD was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and the Sample, Phenomenon of Interest, Design, Evaluation, and Research Type (SPIDER) tool.

RESULTS

The iADH curriculum was mapped to the ACFD competencies in the areas of patient care, professionalism, communication and collaboration, practice information management, and health promotion. A total of 176 articles from PubMed and 10 resources from MedEdPortal were identified in the literature search. Eleven articles met the inclusion and exclusion criteria. The overall quantity and quality of studies was low. Experiential learning in either a dental school or hospital-based program seemed to improve knowledge of SCD and to incite greater willingness to treat patients requiring SCD.

CONCLUSIONS

Case-based learning, computer-based modules, standardized patients, and clinical practice are educational strategies for teaching SCD competencies. The integration of SCD into the undergraduate dental curriculum seems feasible, as most required competencies are transferable to all dental disciplines. Furthermore, the ICF provides a functional model that is a patient-centered approach and is applicable to dentistry beyond SCD.

Education's impact on primary care dentists' confidence in treating patients with special health care needs

INTRODUCTION

Special care dentistry (SCD) is still developing in XX. This study aimed to clarify whether primary care dentists are treating patients with special health care needs (SHCN), to know if they have had previous education on SCD (on an undergraduate or postgraduate level), whether their training level impacts their confidence when treating patients with SHCN, and to assess their opinion on SCD as a relevant topic in undergraduate education.

METHODS

A survey was answered by 149 primary care dentists working for the National Health Service of the XX region in XX, including information on their daily clinical practice, undergraduate, and postgraduate training in SCD, and their opinions on them.

RESULTS

Most interviewees would like to complement their training and believed that SCD should be formally incorporated into undergraduate programs. There was a significant association between confidence in treating patients with SHCN and the rating of their undergraduate training, and between confidence and the number of hours of continuous development courses.

CONCLUSION

Most primary care dentists treat patients with SHCN regularly. Therefore, including training in the undergraduate curriculum and afterward becomes necessary to increase their confidence when facing this challenging group of patients.

Dental student readiness to treat special care patients upon graduation

INTRODUCTION

There has been a global increase in patients with special needs. Undergraduate dental curricula need to adjust to meet the needs of these patients. This study aimed to identify how confident final year dental students felt about treating patients with special needs upon graduation and evaluate the influence that the curriculum had on their preparedness based on competencies outlined by the International Association for Disability and Oral Health (iADH).

METHODS

A questionnaire was administered to final year dental students at two different Universities in Scotland and in Spain to: (1) evaluate how prepared students felt when treating patients with special needs and (2) assess the competencies outlined by iADH.

RESULTS

The response rate was 18.4% (30/163 students). Overall, 83.3% of the students (n = 25) perceived they would benefit from more practical sessions with patients with learning and physical disabilities to improve their clinical management of these patients. 53.3% (n = 16) didn't feel that had the knowledge to properly treat all special care dentistry (SCD) patients upon graduation (scored 5 or 6 on the IADH competency framework). 83.3% of the students (n = 25) felt that the mode of teaching should be problem-based complemented with small group seminars.

CONCLUSION

Students from both Universities agreed that more clinical practice might be required for them to further their skills to treat special needs patients upon graduation, which correlates with the need to have more practical sessions to consolidate competency 4 (communication skills with SCD) and competency 6 (clinical management of patients requiring SCD).

Analysis of Health Profile and Treatment Needs of Patients with Special Health Care Needs at a Malaysian Teaching Hospital: A 6-Year Observation

Aims and Objectives

Special care dentistry (SCD) provides oral health care to disabled individuals in an environmental, cultural or social setting that supports their oral health. This study aimed to analyze the profiles of patients managed at an SCD clinic in a teaching hospital based on their sociodemographic background, medical condition or disability, dental diagnosis and treatment provided.

Materials and Methods

This retrospective audit study included patients seen from the clinic's inception in January 2017 until June 2022, retrieved from the faculty's record management system. The pattern of patients seen was arranged on an Excel sheet and analyzed using SPSS. Quantitative data were analyzed via descriptive analysis (frequency) and chi-square test (P < 0.05).

Results

A 220% surge in the number of patients treated between January 2017 and June 2022, from two to 91 years old, with more male patients seen. Most patients had an intellectual disability (49.7%), followed by medical compromised (16.4%) and genetic conditions or syndromes (12.0%). 43% of had caries, which is more prevalent in women, and 31.6% had periodontal disease, with the majority being between the ages of 21 and 40. Periodontal treatment accounted for most of the dental treatment (76.1%). Even though only a small percentage of endodontic therapy was performed (2.4%), a significant association was found between the treatment, gender and age group of patients seen in the clinic.

Conclusion

Considering their health profile, oral diagnosis and therapy, this study demonstrated the varied sorts of patients encountered in an SCD specialist clinic. This useful information will be beneficial in the development of a comprehensive care dentistry center for this community.

Cross sectional study on the competence and confidence of dental students and graduates in the management of medically compromised patients and acute medical emergencies

A rapidly aging population means many people have multiple health issues leading to an increased risk of acute medical emergencies. The objective of this study was to evaluate how essential experiential learning is in developing dental graduates' ability to manage medically compromised patients. Three hundred and twenty-seven students and graduates were invited to participate in an online survey to rate their confidence in managing medically compromised patients and acute medical emergencies using a 5-point Likert scale. Competence of knowledge was evaluated using 30 multiple choice questions (MCQs) across six domains. The respondents were also asked whether a theory-only training adequately prepared them to manage medically compromised patients, or whether it must be supplemented with clinical training. Two-hundred and sixty-four responses were collected from 75 undergraduates (UG), 96 junior dental officers (JDO) and 93 senior dental officers (SDO). The UG reported that they infrequently managed medically compromised patients, whereas both the JDO and SDO reported having frequent encounters with these patients. The mean confidence scale in the management of medically compromised patients were 2.62, 3.50 and 3.69 (out of 5), respectively. In contrast, their confidence scale in the management of acute medical emergencies was 2.05, 2.33 and 2.50 (out of 5), respectively. The MCQ scores were 25.51, 26.44 and 26.86 out of 30, respectively. The outcomes of the JDO and SDO were significantly better than the UG (t-tests, p<0.05). All three groups responded that a theory-only training in dental school did not adequately prepare them to manage medically compromised patients. Both the JDO and SDO felt that their clinical work experience better prepared them to manage these patients. Experiential learning from "real-life" clinical experience is an essential component in developing graduates' confidence and competence in the management of medically compromised patients. A dental curriculum with theory-only training in this aspect is inadequate.

Evaluation of a special needs dental workshop for health professionals and students in Trinidad and Tobago

Aims

This study aimed to evaluate a special needs dental workshop for dentists, allied dental health professionals and students in Trinidad and Tobago.

Methods

This feedback study conducted in 2019-2020, included two surveys, one at the time of the workshop and a second survey one year after it. The first survey utilized an anonymous self-administered questionnaire enquiring about the reason for attendance, profession/education, demographics, and difficulties faced in treating patients with special needs. The follow-up study used an online survey tool assessing the workshop and queried comments/suggestions. The Chi-square test served for statistical analysis.

Results

Of the 176 attendees 131 participated (response: 74.4%). The majority (81.5%) were females. Most attendees were dental students (50.3%) or dentists (38.9%). Knowledge acquisition (73.1%) and professional development (14.2%) were the main motives for attendance while communication (31.8%) and non-compliance (34.5%) were the main problems faced in treating patients with special needs. The follow-up evaluation (post-workshop) (response: 72.5%) showed that most participants (90.5%) assessed the workshop as positive; 80% reported an increase in their knowledge and 64.2% perceived a need for further education.

Conclusion

These findings suggest a considerable demand for special needs dental services and continuing education and show that workshops can actively affect patient care.

Impact of the special care dentistry education on Malaysian students' attitudes, self-efficacy and intention to treat people with learning disability

INTRODUCTION

Special Care Dentistry (SCD) education has been introduced in Malaysia, but there are limited number of studies about its impact to students. Thus, this study aimed to explore the level of students' readiness to treat people with learning disability (PWLD) based on their attitudes, self-efficacy and intention to treat.

METHODS

A questionnaire was developed based on the Dental Student Attitude to the Handicapped Scale, Scale of Attitudes to the Disabled Persons and Health Action Process Approach. The self-administered, validated questionnaire was tested for reliability (Cronbach's alpha = .71-.81), before being distributed to clinical dental students of both genders from two universities (University A, n = 176 and University B, n = 175). Quantitative data were analysed via t test and ANOVA (p < .05) using the SPSS software.

RESULTS

There was no significant difference in mean total attitude score between the universities, although dental students from University A, who mostly reported having received hands-on clinical experience in SCD and exposure to Disability Equality Training (DET), showed significantly higher individual mean attitude score for 5 (out of 24) attitudinal items. The mean total self-efficacy score and individual mean self-efficacy score for 1 (out of 5) self-efficacy items were also significantly higher amongst University A dental students. The intention to treat PWLD was not significantly influenced by university, gender or year of study.

CONCLUSION

Incorporation of SCD education in the undergraduate curriculum, with hands-on clinical experience and exposure to DET, is recommended to equip students to be efficient oral healthcare providers for PWLD.

A Systematic Review and Meta-Analysis of the Association Between Periodontal Disease and Severe Mental Illness

BACKGROUND

Periodontal disease represents a global public health concern, with a disproportionate burden being borne by vulnerable populations. One such group is people with severe mental illness (SMI), and this study examined whether periodontal health is poorer in people with SMI than the general population.

METHODS

We conducted a systematic search for studies published before March 2021 on the periodontal health of people with SMI using the following databases: PubMed, PsycINFO, EMBASE, China National Knowledge Infrastructure, and Chongqing VIP. Outcomes were periodontitis, periodontal disease, and shallow and deep periodontal pockets. Results were compared with the general population.

RESULTS

Seventeen studies had sufficient data for a random-effects meta-analysis, consisting of 4404 psychiatric patients and 95,411 controls. SMI was associated with an increased prevalence of periodontitis (odds ratio = 1.97, 95% confidence interval [CI] = 1.15-3.35) compared with the general population. People with SMI had 4.28 the odds of having periodontal disease compared with controls (95% CI = 2.54-7.21). They also had 3.65 the odds of shallow pockets (95% CI = 1.80-7.42) and 2.76 the odds of deep pockets (95% CI = 1.10-6.93).

CONCLUSIONS

Our findings highlight the increased prevalence and severity of periodontal disease in people with SMI. Oral health is often considered the gateway to overall health and should be a public health priority for this population.

Dental health care for children with Down syndrome: Parents' description of their children's needs in dental health care settings

A visit to the dental clinic may be challenging for a child with Down syndrome due to medical and oral health problems as well as communication problems. The aim of the present study was to explore how parents of children with Down syndrome describe their child's needs in the dental health care setting. In a survey concerning parental experiences with dental health care in Sweden, free comments were analysed with content analysis and resulted in five categories: “Need for continuity of care in dental health care”; “Need for dental health care professionals to have knowledge and expertise in caring for children with Down syndrome and other disabilities”; “Need for dental health care professionals to use a caring approach with children with Down syndrome”; “Need for the child with Down syndrome to be prepared to participate in their dental health care visit” and “Need for the child with Down syndrome to be given the same rights as typically developing children”. To support children with Down syndrome in an optimal way, dental health care needs to be tailored to meet the child's unique needs. In addition, dental health care professionals need knowledge of and expertise in the care of children with Down syndrome.

Factors associated with dental hospitalisations in children with intellectual disability or autism spectrum disorder: a Western Australian population-based retrospective cohort study

PURPOSE

This study investigated dental hospitalisations in Western Australian (WA) children with intellectual disability (ID) and/or autism spectrum disorder (ASD) aged up to 18 years.

METHODS

Data on WA live births from 1983 to 2004 from the WA Midwives Notification System were linked to the Intellectual Disability Exploring Answers database, the WA Hospital Morbidity Data System, and the Western Australian Birth Defects Registry databases. Children were followed from birth to 2010 and the data grouped into three age-groups. Primary and secondary admissions for relevant dental diagnoses were identified and factors associated with having a dental hospitalisation investigated.

RESULTS

There were 1366, 1596, and 780 dental hospitalisations amongst 1122, 1154, and 609 children with ID and/or ASD in the 0-6, >6-12, and >12-18 year age groups, respectively. Children with severe ID were much more likely to be hospitalised than those with mild/moderate ID. More socioeconomically disadvantaged children were less likely to be hospitalised than children whose parents were socially advantaged.

CONCLUSIONS

There is concern that more vulnerable children in the WA community with ID or ASD are receiving an inadequate level of dental services compared with other groups resulting in potentially preventable hospitalisations, a situation in need of urgent remediation.Implications for rehabilitationLittle is known about why some children with intellectual disability (ID) or autism are being hospitalised for their dental care and others are not.Children with disability whose families are socioeconomically disadvantaged should have equivalent opportunity to receive optimal dental care.Dental practitioners at all levels need training and confidence in treating children with ID.

Special care dentistry perception among dentists in Jakarta: An online survey study

Special Care Dentistry (SCD) or Special Needs Dentistry is a branch of dentistry concerned with the oral health of people with a variety of medical conditions or limitations that require more than routine delivery of care. There were reports on oral status of special care patients and special interest group for SCD dentists in Indonesia has existed. However, there was not perception report on SCD amongst dentists in Jakarta. This paper will describe the perception of dentists in Jakarta towards SCD. A cross-sectional questionnaire, translated and cross adapted to Indonesian, was distributed online through Whatsapp to dentists registered in Jakarta late 2019. Quantitative data was analyzed using statistical software for proportion and correlation using Chi-Square test. The questionnaire explored dentists’ perception towards SCD. A total of 250 dentists participated in this study, of them 173 general practitioners and 77 specialist dentists. Most respondents reported that they did not have SCD component during undergraduate dental school and did not provide treatment to patients with special needs in their clinical practice. Most respondents have poor perception of SCD, however, most of the respondents showed motivation and interest towards SCD training. Dentists in Jakarta involved in this study had poor perception of SCD. More efforts should be performed to improve SCD education and awareness.

Photodentistry - an innovative approach to improving students' empathy and learning experiences in comprehensive patient care

OBJECTIVES

Preparing future dental school graduates to provide comprehensive patient care with empathy requires the completion of adequate training in such practice. This study was undertaken to investigate the effectiveness of the Photodentistry learning activity, which uses visual arts, in improving dental students' empathy and learning experience in comprehensive patient care.

METHODS

All fourth-year undergraduate dental students (n = 69, response rate = 100%) participated in the Photodentistry learning activity developed by specialists from the areas of dentistry, arts, education, and psychology. A survey using the Toronto Empathy Questionnaire (TEQ) was conducted both pretest and posttest, followed by an open-ended written survey of their reflection towards the learning activity. Quantitative data were analyzed via paired t-test (P < 0.05), while qualitative data were analyzed using thematic analysis.

RESULTS

There was a significant increase in both students' total mean empathy score and the individual scores for 8 (out of 16) items of the TEQ after the learning activity. Students stated that they had an improved understanding of managing patients in a comprehensive manner (e.g., managing medically compromised patients, performing treatment planning, communication with patients who have special health care needs). Students also reported the development of skills (e.g., observation, critical thinking) and positive attitudes (e.g., empathy, responsibility) towards patients.

CONCLUSION

Photodentistry is an effective learning approach for improving dental students' empathy and learning experience in comprehensive patient care.

Extramural Oral Health Educational Program Involving Individuals With Disabilities: Impact on Dental Students' Professionalism

Context

Oral health inequalities experienced by patients, including people with disabilities (PWD), have been related to dentists' lack of professionalism and inadequate experience in managing patients with special needs.

Aims

This study investigated the impact of an extramural program involving PWD on dental students' professionalism and students' perception of training in managing patients with special needs.

Materials and Methods

A group of 165 undergraduate dental students (year 1 to year 5) participated in a voluntary program, involving 124 visually impaired children, at a special education school in Kuala Lumpur, Malaysia. A dedicated module in oral health was developed by specialists in special care dentistry, pedodontics, and medical sciences. Dental students then participated in a semi-structured focus group interview survey to discuss perceptions of their learning experiences. Qualitative data were analyzed via thematic analysis.

Results

The program had positive impact on various aspects categorized into four major domains: professional knowledge (e.g., understanding of oral-systemic-social-environmental health interaction and understanding of disability), professional skills (e.g., communication and organizational skills), professional behavior (e.g., empathy and teamwork), and value-added learning (e.g., photography and information technology skills). Students showed improved willingness to manage, and comfort in managing PWD, and expressed support for future educational programs involving this patient cohort.

Conclusion

Improved knowledge, skills, attitudes, and personal values, as well as support for future programs, indicate the positive impact of extramural educational activities involving PWD in developing professionalism in patient care, while providing an opportunity for students to be exposed to managing patients with special needs.

Meeting the needs of patients with disabilities: how can we better prepare the new dental graduate?

Background Over the last two decades, the introduction of equality legislation has resulted in disabled people having improved opportunities and better access to services. Within the field of oral health care, the specialty of special care dentistry exists to act as an advocate for those with disabilities and it is recognised that there is a need to reduce health inequalities. To ensure the future dental workforce is able to respond to the needs of those with disabilities, education is key. This raises the question: 'are we adequately preparing future dental professionals to fulfil their obligations?'.Aim To explore final year dental students' insight into issues of disability in order to inform the undergraduate special care dentistry programme.Method Qualitative methods using focus groups were employed to address the research issue. The data were analysed using thematic analysis.Results Four main themes were identified: 'perceptions of disability', 'experience of disability', 'patient management' and 'teaching and learning'. The level of preparedness varied among students and could be attributed to: knowledge of disability issues; previous experience of people with disabilities; how education in the field of special care dentistry was delivered. Students identified the need for more structure to their teaching and increased exposure to the disabled community.Conclusion The issues identified reflect current literature and highlight the importance of addressing disability within the wider undergraduate curriculum. Responding to the 'student voice' has the potential to tailor elements of the special care dentistry programme, in order to address their educational needs.

Knowledge, Attitude, and Practices of Dental Practitioners in Thiruvananthapuram on Oral Health Care for Children with Special Needs

The objective of this study was to investigate knowledge, attitude, and practices of dental practitioners in Thiruvananthapuram, India regarding dental management of children with special healthcare needs (CSHCN).

MATERIALS AND METHODS

A structured questionnaire was given to 400 dental practitioners. The data were analyzed using SPSS software (version 23.0) and Chi-square test was used.

RESULTS

The response rate was 94%. An estimated 73.8% treated children, 66.5% showed willingness to treat CSHCN, and 70.8% had attended CSHCN in their practice. A partial knowledge in dental management of CSHCN was reported by 67.5%. An estimated 36% had undergone training in special care dentistry (SCD) but 45% were not sure whether they can provide dental care with the graduate-level training. Knowledge regarding guidelines for CSHCN was known to 19.5% and that regarding timing of the first dental visit was known to 69% of participants. Tooth extraction (43.1%) and a subsequent caries treatment (39.1%) were the most frequently done procedures, and nonpharmacological management (46.5%) was the mostly used behavior management technique. Among the barriers faced by dentists in treating CSHCN, time consumption (55.6%) and lack of training (55.1%) were commonly enlisted. Further training and improved facilities would motivate the respondents in providing better care to CSHCN.

CONCLUSION

This study suggests that majority of the dentists participated had a partial knowledge on SCD and were willing to treat CSHCN. Insufficient training in the field of SCD was a major drawback, which prevented most general dentists from effectively managing CSHCN. Additional training and improving facilities can improve dental care to CSHCN.

HOW TO CITE THIS ARTICLE

Rajan S, Kuriakose S, et al. Knowledge, Attitude, and Practices of Dental Practitioners in Thiruvananthapuram on Oral Health Care for Children with Special Needs. Int J Clin Pediatr Dent 2019;12(4):251-254.

Assessment of oral hygiene trends among dental patients in relation to chronic medical conditions by dental students. A cross-sectional study

INTRODUCTION

There is a lack of information about knowledge, attitude and behavior regarding oral hygiene and dietary habits of adult patients attending dental clinical settings. Hypertension, diabetes, obesity and caries are increasing among different populations, resulting in the deterioration of the quality of life related to oral and general health.

OBJECTIVES

To involve second year dental students in assessing oral health knowledge, attitude, behavior, dietary habits and general health of dental patients, and screening for blood pressure, blood glucose level and obesity.

PARTICIPANTS AND METHODS

A convenient sample of 652 adult subjects participated in the study. They were screened, and involved in an interviewer - led questionnaire, led by the students over the period of two successive academic years (2013-2014 and 2014-2015).

RESULTS

Subjects with high blood pressure and /or blood glucose levels were more likely to disagree regarding the presence of a relation between general health and dental health [(correlation coefficient (r) = - 0.159, probability value P < 0.001) (correlation coefficient (r) = - 0.257, probability value P < 0.001) respectively]. Subjects with high BMI were less aware of the importance of using the tooth brush in prevention of gingival inflammation. The overall students' satisfaction score was 71.5%. The practical part of the research had the highest satisfaction score (83.7%).

CONCLUSIONS

There is scarcity of data regarding dental healthcare knowledge and attitudes in dental clinical settings. Additional clinical training for dental students would increase their willingness to play a preventive and educational role in the oral care of patients.

Perception of Special Needs Dentistry education and practice amongst Australian dental auxiliary students

INTRODUCTION

The role of dental auxiliaries in collaborative care of patients with special needs is compelling. This study was undertaken to investigate the perceptions of Special Needs Dentistry (SND) education and practice amongst students enrolled in Australian programmes in dental auxiliary, namely dental hygiene, dental therapy and oral health therapy (DH/DT/OHT).

MATERIALS AND METHODS

All Australian institutions offering DH/DT/OHT programmes (n = 14) were invited to participate in a self-administered questionnaire survey, conducted online, involving students across all academic years. Twelve institutions agreed to participate, but only five institutions were included in the final analysis, with a student response rate of 31.1%. Answers to open-ended questions were coded and grouped for measurement of frequencies. Quantitative data were analysed via chi-squared and Fisher's exact tests (significance taken as P < .05).

RESULTS

The majority of students could not define SND (87.0%) were not aware of the existence of this specialty (53.5%) and did not have clinical experience treating patients with special needs (68.9%). Nevertheless, they felt comfortable and positive about treating these patients independently. Most agreed that they should receive clinical and didactic education in SND, with many of them expressing interest in pursuing a specialty training in this field.

CONCLUSION

DH/DT/OHT students' comfort levels, positive attitudes and supportiveness for SND suggested positive implications for these practitioners to partake in multidisciplinary management of patients with special needs, thus indicating the need for standardised training requirements and practice guidelines in this area of care.

Access to dental services for children with intellectual and developmental disabilities - A scoping review

BACKGROUND

Children with Intellectual and Developmental Disabilities (IDD) face considerable challenges in participating in dental services. These challenges include resource constraints and inadequate skills of health service providers to work with this population.

AIM

The aim was to scope published studies that addressed access to dental services for children with IDD in order to determine the extent to which various barriers have been researched, using an access framework derived from the literature. Access was defined to include the six dimensions of accessibility, availability, affordability, accommodation, acceptability, and appropriateness.

METHOD

Arksey and O'Malley's scoping review framework was used. Relevant databases (e.g., Medline) were searched for all empirical studies conducted from January 2000 to February 2017 that met inclusion criteria. Data were extracted along the six dimensions of the access framework.

RESULTS

Sixteen international studies were identified which indicated common key barriers to dental service use: the difficulties of physical inaccessibility, lack of access to information among carers, lack of knowledge of disability issues, and low experience and skills in caring for children with IDD among dental practitioners.

CONCLUSIONS

Key recommendations made were exploring dental practitioners' understanding of disability legislation and developing training for practitioners to expand on issues specific to IDD.