Journal of dental education
-
Conscious sedation administered in the office setting is one important method for helping people obtain necessary dental care. Patients who may benefit from sedation include the dentally fearful, young children, the behaviorally or medically challenged, and individuals who are undergoing invasive procedures or have problems with gagging or local anesthesia. In-office sedation is effective in reducing apprehension and can improve patient behavior without adversely affecting the patient's physiological status. ⋯ Future advances in conscious sedation may include agents and techniques currently thought to be dangerous for nongeneral anesthesia-trained dentists because of their ability to produce rapid changes in anesthetic depth. However, delivery devices such as infusion pumps for drugs like propofol, when coupled with computers to help regulate the infusion rate and monitor the sedative effect, may provide the necessary control for safe administration of propofol and similar drugs by these individuals. A final approach to drug delivery may involve patient-controlled sedation in which the patient self-infuses small boluses incrementally until the desired effect is achieved.
-
The 1999 Report of the AADS President's Task Force on the Future of Dental School Faculty (1) drew attention to the situation dental schools are experiencing in attracting and retaining faculty. A year 2000 ADEA Association Report on faculty shortages indicated the number of vacant budgeted positions was approaching 400 (2). The year 2000 - 2001 ADEA survey of vacant budgeted positions indicates a further four percent increase in vacant budgeted positions. ⋯ Almost three percent of identified faculty separations were from deaths. It is anticipated that, with a further "graying" of an already aged dental school faculty, retirements will further exacerbate the problem of faculty vacancies and the ability to attract and retain new faculty. There is needed urgency in implementing strategies and recommendations provided in the 1999 President's Report and the 2000 Association Report.
-
This project was undertaken from July 1999 to August 2000 to identify the status of extramural programming (that is, a program that has undergraduate dental students providing any aspect of dental care to individuals in settings outside the main clinical facility of the school) in North American dental schools. A survey instrument was mailed to all United States and Canadian dental schools concerning student involvement in extramural programming. The response rate was 79.7 percent. ⋯ Of total student time in extramural programming, 43.3 percent was spent delivering basic clinical services, 24.4 percent comprehensive clinical services, 11.8 percent health education, 11.8 percent preventive dentistry, and 8.7 percent community activities. From the data collected it is apparent that the majority of North American dental schools are providing a variety of extramural experiences for their dental students. It was found that student involvement in extramural programming increases gradually from the freshman to the senior year.
-
The aim of this review of clinical decision-making for caries management in primary teeth is to integrate current knowledge in the field of cariology into clinically usable concepts and procedures to aid in the diagnosis and therapy of dental caries in primary teeth. The evidence for this paper is derived from other manuscripts of this conference, computer and hand searches of scientific articles; and policy statements of councils or commissions of various health organizations. ⋯ The type and intensity of these therapies should be determined utilizing data from clinical and radiograph examinations as well as information regarding caries risk status; evidence of therapy outcomes; assessment and reassessment of disease activity; natural history of caries progression in primary teeth; and preferences and expectations of guardians and practitioners. Changes in the management of dental caries will require health organizations and dental schools to educate students, practitioners, and patients in evidence- and risk-based care.
-
Optimal conservative treatment decisions to prevent, arrest, and reverse tooth demineralization caused by caries require probability estimates on caries risk and treatment outcomes. This review is focused on the use of the best scientific evidence to recommend treatment strategies for management of coronal caries in permanent teeth as a function of caries risk. Evidence suggests that assigning therapeutic regimens to individuals according to their risk levels should yield a significantly greater probability of success and better cost effectiveness than applying identical treatments to all patients independent of risk. Depending on caries risk levels, treatment decisions based on risk can minimize unnecessary surgical intervention by incorporating the best evidence to prescribe treatment regimens for the use of fluoride-releasing agents, sealants, chlorhexidine, or combinations of these products.