[Social dentistry--community dentistry].
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Community Dentistry has developed as the dental profession's response to a social conscience, recognising the individual social and health needs and personal rights of each member of the community. In this context, forensic odontology is seen as providing that body of dental expertise necessary for the fulfillment of a number of social functions required by law, in both the civil and criminal arenas, with particular reference to the scientific identification of the dead, the investigation of bitemarks, the estimation of age and dental traumatology. The important role of dental records in these matters emphasises the social responsibility of each dentist to exercise great care in the documentation of his treatment procedures. This obligation also extends to the identification marking of dentures. The need for legislation in this area is discussed and the social responsibility of dental educators to include forensic odontology in the curricula of all dental schools, particularly in developing countries, is stressed. Research in forensic odontology should take into account the particular needs of each community in the light of their geographical, social and cultural backgrounds.
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A national survey of predoctoral community dentistry faculty members provided "ratings of importance" for each of 32 community dentistry topics. Departmental chairpersons, identified by respondents, were sent a second questionnaire to determine clock hours of didactic instruction for each topic. A response rate of 79 percent (N = 121) was achieved for the faculty survey with a 91 percent response rate (N = 53) for the chairperson survey. Mean clock hours of didactic instruction in community dentistry ranged from .5 to 3.1 hours per topic with a cumulative mean total of 51.3 hours. Mean ratings of importance for each of the 32 community dentistry topics ranged from 4.3 to 2.7 (on a five-point scale). The results of this survey provide information on the current status of predoctoral community dentistry curricula in U.S. dental schools.
Approximately a decade after the first plans for the teaching of community dentistry were made in the Nordic countries, a questionnaire survey of Nordic dental schools was conducted to find out to what extent community dentistry subjects had been introduced in undergraduate curricula. Replies were received from the 12 dental schools in Denmark, Finland, Norway and Sweden. These schools admitted 915 students in 1982-83. Seven had a department of community dentistry, and at least two others had plans to start one. About 100 h of teaching were given on community dentistry subjects during the 5-yr course of study, mostly on the traditional subjects of epidemiology, statistics, law and ethics. In some schools health education and other behavioral sciences subjects received a large amount of curriculum time. Decisionmaking theory and political science were not reported taught at any school. Three departments had attached clinics, with widely differing functions. The Nordic textbook in community dentistry was widely used, and separate examinations were held in community dentistry at most schools. Full-time postgraduate courses were offered at three schools. Although schools in all four countries expected the number of dental students to decrease in coming years, several schools expected community dentistry to expand with regard to curriculum time and staff, in keeping with trends in other countries.
In 1960, Blackerby asked the question "Why not a department of social dentistry?". Since that time most of the dental schools in the United States have made some attempt at establishing such a department. Various names were given to these departments, but the one that appears to be in the forefront is the Department of Community Dentistry. Since that time each school with such a department has strived to develop various innovative methods of teaching community dentistry to its students. When the amount of time is taken into consideration, unlike the biological and clinical sciences, time allotted to community dentistry is minimal. However, at The University of Michigan students spend 232 hours in community dentistry, which necessitates development of creative teaching techniques to maintain their interest. This paper discusses one such technique which has proven to be successful over the past 3 years. Emphasis is placed on utilizing a modified method of the developmental discussion approach in teaching a course in community dentistry to 3rd-year dental students.
The authorization of departments of community dentistry and public health in the nation's dental schools is a relatively recent innovation in dental education. Such a department was established at the University of Southern California School of Dentistry in 1966, as part of the School of Medicine's effort to share responsibility in providing both access and availability of health services in inner-city Los Angeles, California. Dentistry was included in the protocol submitted to the US Office of Economic Opportunity to build a neighborhood health center in Watts, operated under the joint jurisdiction of the medical and dental schools. The dental division of the health center was designated a satellite of the community dentistry department. The department envisioned future changes during the revolutionary 1960s when all aspects of the nation were experiencing upheaval as traditional concepts were challenged by new attitudes. The nation's leaders in government and education as well as in the health professions were stimulated by scientific and technologic discoveries. Dentistry had come of age, having gained the respect of other health-care disciplines. It was a time of expanded exploration of means toward a healthier populace and a more sensitive ethical provider of health care. In one decade, the USC community dentistry department accomplished a major shift in attitude about the specialty from one of pervasive opposition and antipathy to that of acceptance and even enthusiasm. The department became competitive with similar units nationwide in educating dental students and practitioners to fulfill their responsibilities at the highest level of proficiency and to be true to the trust bestowed on them by the public. In pursuit of these goals, the department reflected credit on dentistry and the University of Southern California.
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The British Association for the Study of Community Dentistry (BASCD) has coordinated National Health Service surveys of the dental health of school children since 1985, when Wales and parts of England were included. Scotland joined in 1987 and Northern Ireland in 1994. This series spans an interesting time in the growth of accessible technology in both statistics and medical research. The purpose of this paper is to chart the development of this data base from pen and paper via microcomputers to the Internet. The annual work now involves calibration of examiners, data collection with portable computers or by manual transcription and subsequent 'punching', paper reports passed to regional coordinators who fill in spread sheets that are passed by e-mail or through posted discs to the data coordinating centre at the Dental Health Services Research Unit at the University of Dundee. The data is checked; statistical analyses are undertaken; a paper is prepared for print and the data is deposited on the BASCD Web Site. Four operating systems and at least eight software packages are used to produce and distribute the survey results.
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The author discusses the need for clearly stated goals in community dentistry, the choice of goals, and the chances to achieve them. Goals in community health planning should be based on the values, needs and resources of the community in question. When analyzing goals a distinction should be made between dental health and dental care. Some goals for dental care, e.g. equity of access, may concern social justice but do not necessarily lead to better dental health. It is generally agreed that good dental health for a whole community cannot be achieved by restorative treatment alone; good dental health habits are considered to be a better way to promote dental health. Existing research indicates that there are chances to attain an acceptable level of dental health if the community effort is systematically planned and executed. There are indications that a reduction in the prevalence of dental disease can be brought about by new and effective means in the future. Long-term planning should be flexible enough to respond to new opportunities.