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Decisions in postgraduate education: community dental practice.

Since its inception, the Community Dental Service has evolved from a child-centred organization to its much wider remit of current times. This article reviews the present role of the CDS, examines the type of people who make up the workforce and considers what a career in community dental practice can offer to new or recent graduates. Specialization in community or special needs dentistry is not an option at the moment. However, a number of appropriate training opportunities leading to further qualifications are highlighted and are becoming more readily accessible.

Career Choice↗

What are Section 63 and 'approved' courses and how are they organised?

Although Section 63 courses for general dental practitioners in the NHS have been running for many years, there seems to be poor understanding of what 'Section 63' means and how it operates. To some extent this is because of the changes which have taken place since it was introduced and the tremendous expansion in postgraduate dental education (and its objectives) in recent years. The introduction of other 'approved' courses and postgraduate education allowances have created further uncertainties. This paper gives an overview of Section 63, the source of the funds, how they are allocated, how they may be used and who is eligible, and outlines details of other 'approved' courses and the various allowances which GDPs can claim in relation to these different categories of courses.

Education, Dental, Continuing↗

Introducing problem-based learning to special needs dentistry--a case study.

INTRODUCTION: In order to promote training and education in special-needs dentistry an attempt was made to introduce problem-based learning (PBL) as a method of postgraduate dental education. The aim of this paper was to review the principles of PBL and report on a case study using this methodology. METHOD: The case study was of a PBL session, on the subject of 'problems of obtaining appropriate dental care for people with epilepsy', undertaken at a national conference. Delegates were asked to complete a pre- and post-session questionnaire on PBL and their attitudes to the session. RESULTS: The session received a mixed response. Only 33 (35%) thought the session was valuable and only 20 (31%) thought it was better than conventional teaching methods and yet over half (55%) said they would like to attend more PBL in special-needs dentistry. Professionals complementary to dentistry were more likely to find the PBL session of value and to prefer the method to a more conventional format than dentists were (chi-square = 5.5, df = 1, p < 0.05 and chi-square = 5.9, df = 1, p < 0.05 respectively). CONCLUSION: Valuable feedback was received from delegates. This will enable improvements to be made in future courses so that the effectiveness of PBL can be optimised.

Dental Care for Chronically Ill↗

The dental role in smoking cessation advice for patients with mental and behavioural disorders--time for improvement?

The past few years have seen an increasing emphasis upon the role of the dental team in smoking cessation. The recent advances in knowledge of the level and role of tobacco use in patients with mental and behavioural disorders, the biological factors involved and the influences of tobacco on psychiatric medication metabolism and side effects has not been reflected in dental postgraduate education. Perhaps it is time for an evidence based improvement in care standards by referring these patients for specialist cessation advice?

Counseling↗

New directions for dental education in Japan.

To meet recent changes in the oral health sciences, general science, and social needs, the guidelines for the dental curriculum were revised by the Japanese Deans Meeting in 1994. This new program addresses the need to modify both undergraduate and postgraduate dental education in Japan. Lifelong education for dentists has been also modified recently. Reforming of dental education is pushed forward with the concept of continuity and flexibility. In this report, an overview of dental education and the most recent dental curriculum in Japan is briefly discussed.

Clinical Competence↗

The development of an assessment system for dental vocational training and general professional training: a Scottish approach.

The role of competencies in postgraduate dental education and training has been a major topic of interest in recent years. Concerns have been voiced from all sides of the profession about how the competence of trainees and the quality of training can be assured so that high standards of patient care can be maintained. A three year project which seeks to develop a competency-based assessment system for general professional training is underway which hopes to answer some of the concerns and provide an evidence-based system of assessment for the early postgraduate years. This paper looks at the reasoning behind the project, its aims, and the progress made to date.

Clinical Competence↗

The orthodontic skill mix in Sweden.

During 1989 I visited the Institute of Postgraduate Dental Education, Jonkoping, Sweden. The trip was funded by a T.C. White Travel Grant from the Royal College of Physicians & Surgeons of Glasgow and the Cordent Dental Trust. The aim of the visit was to observe the methods of teaching orthodontics to general dental practitioners, in Jonkoping, and to discover the role of dental nurses in providing orthodontic treatment in Sweden.

Dental Auxiliaries↗

Postgraduate training for specialisation.

With the prospect of changes brought about through the Mouatt Report and the European Union, calls for a more flexible approach to teaching dentistry are being made. This article describes a postgraduate dental education system that involves modules and credits set up at the University of Leeds. The new system moves away from the more traditional methods of educating post-graduate students.

Credentialing↗

Effects of dental probing on occlusal surfaces--a scanning electron microscopy evaluation.

The aim of this clinical-morphological study was to investigate the effects of dental probing on occlusal surfaces by scanning electron microscopy (SEM). Twenty sound occlusal surfaces of third molars and 20 teeth with initial carious lesions of 17- to 26-year-old patients (n = 18) were involved. Ten molars of each group were probed with a sharp dental probe (No. 23) before extraction; the other molars served as negative controls. After extraction of the teeth, the crowns were separated and prepared for the SEM study. Probing-related surface defects, enlargements and break-offs of occlusal pits and fissures were observed on all occlusal surfaces with initial carious lesions and on 2 sound surfaces, respectively. No traumatic defects whatsoever were visible on unprobed occlusal surfaces. This investigation confirms findings of light-microscopic studies that using a sharp dental probe for occlusal caries detection causes enamel defects. Therefore, dental probing should be considered as an inappropriate procedure and should be replaced by a meticulous visual inspection. Critical views of tactile caries detection methods with a sharp dental probe as a diagnostic tool seem to be inevitable in undergraduate and postgraduate dental education programmes.

Adolescent↗

The interface between United Kingdom, Irish and Australasian college qualifications.

Colleges in different parts of the world fulfil an important role in setting standards and ensuring a high calibre of postgraduate dental education and training. They have evolved to fulfil the requirements of the particular circumstances prevailing in each country. With the changes that are taking place throughout the world and the increasing demands for high quality general and specialist dental care, all of the colleges are modifying their structures and examination formats. In many ways these changes are bringing the colleges more in line with each other. In view of this, there is a need for better communication and closer collaboration between the colleges. In the United Kingdom and Ireland proposals for shorter, more structured training programmes and for more specialist dental care to be provided outside hospitals, together with the influence of European Community law, have resulted in major changes. Among the effects of these changes are a restructuring of training programmes, the development and recognition of new specialties and the reconfiguration of college qualifications.

Australia↗

Indirect pulp capping: a survey.

This study addresses the acceptance of the clinical practice of indirect pulp capping. State and regional dental boards and postgraduate dental education programs throughout the United States were surveyed. Results indicate that no clear consensus exists for the acceptance of this clinical procedure.

Dental Pulp Capping↗

Complications, supplementary treatment, and maintenance in edentulous arches with implant-supported fixed prostheses.

The first 50 edentulous arches treated with osseointegrated fixed partial dentures at the Postgraduate Dental Education Center, Orebro, Sweden, were studied retrospectively with concern for complications and time used for supplementary treatment and maintenance. The longest observation period was 9 years, the shortest 3 years, and the mean 5.2 years. Twenty-two percent of the patients experienced fractures of artificial teeth and/or the acrylic resin superstructure. The most severe technical complications were fractured or bent abutment screws (three) and fracture of the framework (one). The average time for supplementary treatment and maintenance was as follows: for surgery, 0.16 hours per prosthesis and year; for prosthodontics, 0.64 hours per prosthesis and year; and for dental laboratory procedures, 1.0 hour per prosthesis and year.

Dental Implants↗

Implant-supported maxillary overdentures: outcome in planned and emergency cases.

At the Postgraduate Dental Education Center, Orebro, Sweden, maxillary implant-supported overdentures have mainly been used in either planned cases (where implants sufficient for a fixed prosthesis could not be placed) or emergency cases (originally planned for a fixed restoration but where implants lost during the healing period made such treatment impossible). Twenty-five cases were studied retrospectively. In the planned group, only two of 19 patients had lost an implant during the follow-up period with overdentures; in the emergency group, four subjects of six lost implant(s) during the same period. The total loss of implants during healing and overdenture function was 7% in the planned group and 72% in the emergency group. The curves for survival of overdentures without loss of supporting implants were significantly different (P = .00) for the planned group and the emergency group.

Adult↗