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Biomedical subjects

Allan J Formicola

Publications and source records attributed to Allan J Formicola.

13 recordsLinked to original sources
PubMed2006

U.S. State-supported dental schools: financial projections and implications.

This article examines the impact of financial trends in state-supported dental schools on full-time clinical faculty; the diversity of dental students and their career choices; investments in physical facilities; and the place of dentistry in research universities. The findings of our study are the following: the number of students per full-time clinical faculty member increased; the three schools with the lowest revenue increases lost a third of their full-time clinical faculty; more students are from wealthier families; most schools are not able to adequately invest in their physical plant; and more than half of schools have substantial NIH-funded research programs. If current trends continue, the term "crisis" will describe the situation faced by most dental schools. Now is the time to build the political consensus needed to develop new and more effective strategies to educate the next generation of American dentists and to keep dental education primarily based in research universities. The future of the dental profession and the oral health of the American people depend on it.

Capital Financing↗
PubMed2006

Evolution of dental school clinics as patient care delivery centers.

Dental school clinics, originally envisioned as closely similar to private practice, evolved instead as teaching clinics. In the former, graduate and licensed dentists perform the treatment while undergraduate dental students are assigned treatment within their capabilities. In the latter, dental students provide the treatment under faculty supervision. It is generally recognized that the care provided by the teaching clinics is inefficient. However, in the last quarter of the twentieth century, dental school clinics began to pay much more attention to how treatment is rendered. The comprehensive care movement and quality assurance systems are leading towards more efficient patient-centered care. Case studies at the University of Maryland, Columbia University, and University of Louisville describe activities to make their clinic programs more efficient and patient-friendly. This article explores whether the potential exists for faculty to take a direct patient care delivery role in dental clinics in order for those clinics to become efficient patient care delivery systems as originally envisioned in the early part of the twentieth century.

Comprehensive Dental Care↗
PubMed2005

The origins and design of the Dental Pipeline program.

Funded by The Robert Wood Johnson Foundation and the California Endowment and with student financial aid from the W.K. Kellogg Foundation, the primary goal of the Pipeline, Profession, and Practice: Community-Based Dental Education program is to reduce disparities in access to dental care. In a national competition, fifteen dental schools were selected to participate. By the final year (2007) of the five-year project, the schools are expected to achieve three objectives: 1) increase the time (sixty days/year) that senior students and residents spend in patient-centered community clinics and practices treating underserved populations; 2) provide didactic and clinical courses for students and residents that prepare them for their community experiences; and 3) recruit more underrepresented minority and low-income students. The national program office that directs the project is located at Columbia University, and a national advisory committee oversees the program for the sponsoring organizations. The challenge is to demonstrate that the Pipeline objectives are achievable and that the program is sustainable without external support.

Community Dentistry↗
PubMed2003

Dental caries experience in northern Manhattan adolescents.

OBJECTIVE: The study sought to document dental caries among adolescents residing in northern Manhattan, New York, by race, sex, and community. METHODS: Clinical and demographic data were collected from children aged 12-17 years at five school-based dental clinics in northern Manhattan. Data on dental caries were collected by calibrated examiners using the National Institute of Dental and Craniofacial Research criteria for oral examinations. RESULTS: A total of 566 children participated in the study. They were predominantly Hispanic (64%) or African American (28%). Compared to data from the National Health and Nutrition Examination Survey III, mean DMFT (3.36 vs 2.53; P<.01) and the prevalence of untreated disease (36% vs 16%; P<.01) were significantly higher for northern Manhattan adolescents. Of the adolescents evaluated, 13 percent had at least one severely carious tooth with pulpal involvement that required either extraction or endodontic therapy. CONCLUSIONS: Adolescents in northern Manhattan have higher caries prevalence and higher levels of untreated caries than their national counterparts. Carious lesions progress to pulpal involvement in a high percentage of northern Manhattan children and require extraction or root canal therapy as treatment. There is an urgent need for affordable and available dental primary care services targeted to economically disadvantaged communities.

Adolescent↗
PubMed2003

Creating an environment for diversity in dental schools: one school's approach.

Recent reports have indicated the need to improve the diversity in the dental profession's workforce. The enrollment of underrepresented minority students in the nation's dental schools must increase to accomplish this goal. A complex change process within the dental schools is required to prepare schools to enroll a more diverse student body. While each dental school in the United States is unique, a product of its history and institutional culture, and will, therefore, create an environment for diversity in different ways, it is appropriate to describe lessons learned in individual schools as they strive for diversity. The purpose of this paper is to describe how one dental school, the Columbia University School of Dental and Oral Surgery, approached diversity, so that appropriate strategies can be shared among schools.

Cultural Diversity↗
PubMed2003

Cultural competency: dentistry and medicine learning from one another.

The Institute of Medicine (IOM) report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care is serving as a catalyst for the medical profession to re-examine the manner in which its institutions and training programs relate to cultural competence. This report found that racial and ethnic disparities exist in health care and that a lack of access to care does not fully explain why such disparities exist. The IOM study found bias, stereotyping, prejudice, and clinical uncertainty as possible contributing causes. The U.S. Surgeon General's Report on the Oral Health of the Nation also pointed to oral health disparities related to race, ethnicity, and culture. This paper discusses how medicine is responding to the Unequal Treatment report and the lessons to be considered for dentistry. Recommendations on how dentistry can apply the knowledge from this report to help reduce oral health disparities are suggested.

Attitude of Health Personnel↗
PubMed2002

Banning live patients as test subjects on licensing examinations.

The use of live patients on the licensing examinations was a part of dentistry for almost the entire twentieth century and continues up until today. Considerable new debate about the appropriateness of using live patients as test subjects began in the mid-1990s and culminated in the passage of a resolution in the American Dental Association's year 2000 House of Delegates calling for an end to this practice by the year 2005. The live patient examination tests a narrow range of clinical skills, creates ethical dilemmas for candidates, for the host institution, and for the profession, and is unable to distinguish between those ready to assume independent practice from those who are not yet at that level of competence. There are other ways to test for such readiness including proposals in New York State to substitute a postdoctoral year or mannequins in place of live subjects. The public and the dental profession will be better off by developing alternative licensing tests to the use of live subjects.

Clinical Competence↗
PubMed2002

Dentistry and medicine, then and now.

Two factors have, at times, pushed dentistry and medicine together and pulled them apart. The factor acting to create a symbiosis is the common biomedical or scientific foundation for these fields. The factor causing independence deals with socio-cultural matters impacting on the professions and the public. These two factors will be examined at three points in time when the relationship between the two professions was significantly important for the welfare of the public: the 1920s and '30s, the 1960s and '70s, and our own time. Contemporary major discussion about the alignment of dental education, scientific advances, and societal needs point to a need for a new look at how dentistry and medicine relate to one another.

Culture↗
PubMed2002

A new format for dental education.

Three trends that have been with dental education for a number of years are identified: a crowded curriculum, promising growth in the biological understudying of oral conditions, and disparities in access to oral health care among Americans. To address these influences, a restructuring of dental education in the U. S. is proposed. Among the changes called for are bringing biomedical science education in the first two years of dental school to parity with medical school education, increasing the time and quality of extramural clinical education, and adding a mandatory year of postdoctoral education.

Biology↗