Assessment of implementation of the caries management by risk assessment philosophy in a dental school.
assessment
caries risk assessment
caries risk management
dental caries
dental sealants
evidence-based dentistry
preventive dentistry
undergraduate dental education
Journal
Journal of dental education
ISSN: 1930-7837
Titre abrégé: J Dent Educ
Pays: United States
ID NLM: 8000150
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
revised:
27
04
2023
received:
15
12
2022
accepted:
11
06
2023
medline:
23
10
2023
pubmed:
5
7
2023
entrez:
4
7
2023
Statut:
ppublish
Résumé
This cross-sectional study assessed the implementation of documenting a baseline caries risk assessment (CRA) of patients seen by predoctoral dental students and its association with the presence of caries risk management (CRM) treatment. A convenience sample of 10,000 electronic axiUm patient records at Tufts University School of Dental Medicine was retrospectively assessed for the presence or absence of a completed CRA and CRM after IRB approval following predetermined inclusion and exclusion criteria. The CRM variables (nutrition counseling, sealant, fluoride) were identified by procedure codes that were completed by the student. Associations were assessed via the chi-square test, Kruskal-Wallis test (with Dunn's test and the Bonferroni correction used in post-hoc tests) and Mann-Whitney U test. Most patients (70.5%) had a CRA completed. However, only 24.9% (out of the 7045 patients with a completed CRA) received CRM, while 22.9% of the 2,955 patients without a CRA received CRM. The difference between the groups with and without a completed CRA in terms of the percentage receiving CRM was not clinically significant. Significant associations were found between a completed CRA and in-house fluoride treatment (p = .034) and between a completed CRA and sealant treatment (p = .001). Patients with higher baseline CRA levels (i.e., greater risk) were more likely to have CRM (16.9% of the 785 patients at low risk, 21.1% of the 1282 patients at moderate risk, 26.3% of the 4347 patients at high risk, and 32.6% of the 631 patients at extreme risk). The association between these two variables was significant (p < .001). There is evidence that students were mostly compliant with completing a CRA for most patients; however, there is a deficiency in implementation of CRM approach to help support dental caries management, and there is still much room for improvement.
Substances chimiques
Fluorides
Q80VPU408O
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1410-1418Informations de copyright
© 2023 American Dental Education Association.
Références
Yorty JS, Walls AT, Wearden S. Caries risk assessment/treatment programs in U.S. dental schools: an eleven-year follow-up. J Dent Educ. 2011;75(1):62-67.
Spallek H, O'Donnell JA, Yoo YIJ. Preparing faculty members for significant curricular revisions in a school of dental medicine. J Dent Educ. 2010;74(3):275-288.
Fontana M, Zero D. Bridging the gap in caries management between research and practice through education: the Indiana University experience. J Dent Educ. 2007;71(5):579-591.
Teich ST, Demko C, Al-Rawi W, Gutberg T. Assessment of implementation of a CAMBRA-based program in a dental school environment. J Dent Educ. 2013;77(4):438-447.
Scruggs RR, George MC. Faculty calibration in clinical education: a review of the literature. Educ Dir Dent Hyg. 1985;10(4):15-21.
Holmes DC, Boston DW, Budenz AW, Licari FW. Predoctoral clinical curriculum models at U.S. and Canadian dental schools. J Dent Educ. 2003;67(12):1302-1311.
Chaffee BW, Featherstone JDB. Long-term adoption of caries management by risk assessment among dental students in a university clinic. J Dent Educ. 2015;79(5):539-547.
Commission on Dental Accreditation. Accreditation standards for dental education programs. 2022. Accessed December 8, 2022. https://coda.ada.org/standards
Tellez M, Gomez J, Pretty I, Ellwood R, Ismail AI. Evidence on existing caries risk assessment systems: are they predictive of future caries? Community Dent Oral Epidemiol. 2013;41(1):67-78.
American Dental Association - ADA. Achieving Common Ground on Caries Risk Assessment in Children - Interim Report on Expert Panel Processes and Findings. American Dental Association; 2018.
Maupome G, Isyutina O. Dental students' and faculty members' concepts and emotions associated with a caries risk assessment program. J Dent Educ. 2013;77(11):1477-1487.
Hagel N, DiLuigi M, Jain S. Caries risk assessment after graduation: Tufts alumni use, attitudes and beliefs. Paper presented at: The annual meeting of the American Dental Education Association; March 11-14, 2023; Portland, OR.
Righolt AJ, Sidorenkov G, Faggion CM Jr, Listl S, Duijster D. Quality measures for dental care: a systematic review. Community Dent Oral Epidemiol. 2019;47(1):12-23.
Anderson KM, Marsh CA, Flemming AC, Isenstein H, Reynolds J. Measurement Enabled by Health IT: Overview, Possibilities, and Challenges. Agency for Healthcare Research and Quality; 2012. https://healthit.ahrq.gov/sites/default/files/docs/page/final-hit-enabled-quality-measurement-snapshot.pdf
Huh AJH, Chen JW, Bakland L, Goodacre C. Comparison of different clinical decision support tools in aiding dental and medical professionals in managing primary dentition traumatic injuries. Pediatr Emerg Care. 2022;38(2):e534-e539.
Mertz E, Bolarinwa O, Wides C, et al. Provider attitudes toward the implementation of clinical decision support tools in dental practice. J Evid Based Dent Pract. 2015;15(4):152-163.
Jiang X, Jiang X, Wang Y, Huang R. Correlation between tobacco smoking and dental caries: a systematic review and meta-analysis. Tob Induc Dis. 2019;17:34.
Schulz-Katterbach M, Imfeld T, Imfeld C. Cannabis and caries-does regular cannabis use increase the risk of caries in cigarette smokers? Schweiz Monatsschr Zahnmed. 2009;119(6):576-583.
Latti BR, Kalburge JV, Birajdar SB, Latti RG. Evaluation of relationship between dental caries, diabetes mellitus and oral microbiota in diabetics. J Oral Maxillofac Pathol. 2018;22(2):282.
Coll PP, Lindsay A, Meng J, et al. The prevention of infections in older adults: oral health. J Am Geriatr Soc. 2020;68(2):411-416.
Reddy LS, Lakshmi SV, Lakshmi YV, Lakshmi KPD, Sravanthi Y, Kaur M. Root caries experience and its association with risk indicators among middle-aged adults. J Pharm Bioallied Sci. 2021;13(Suppl 2):S1523-S1529.
Zhang J, Sardana D, Wong MCM, Leung KCM, Lo ECM. Factors associated with dental root caries: a systematic review. JDR Clin Trans Res. 2020;5(1):13-15.
Chung J, Monroe GS. Exploring social desirability bias. J Bus Ethics. 2003;44:291-302.
Martinez-Mier EA, Zandona AF. The impact of gender on caries prevalence and risk assessment. Dent Clin North Am. 2013;57(2):301-315. https://doi.org/10.1016/j.cden.2013.01.001. PMID: 23570807.
Krustrup U, Petersen PE. Dental caries prevalence among adults in Denmark-the impact of socio-demographic factors and use of oral health services. Community Dent Health. 2007;24(4):225-232. PMID: 18246840.
Lukacs JR. Gender differences in oral health in South Asia: metadata imply multifactorial biological and cultural causes. Am J Hum Biol. 2011;23(3):398-411. https://doi.org/10.1002/ajhb.21164. PMID: 21448908.
Krumpal I. Determinants of social desirability bias in sensitive surveys: a literature review. Qual Quant. 2013;47:2025-2047.
Larson RB. Controlling social desirability bias. Int J Market Res. 2019;61(5):534-547.
Nederhof AJ. Methods of coping with social desirability bias: a review. Eur J Soc Psychol. 1985;15(3):263-280.
Chan D. So why ask me? Are self-report data really that bad? In: Lance CE, Vandenberg RJ, eds. Statistical and Methodological Myths and Urban Legends: Doctrine, Verity and Fable in the Organizational and Social Sciences. Routledge; 2009.
Ranganathan P, Pramesh CS, Buyse M. Common pitfalls in statistical analysis: clinical versus statistical significance. Perspect Clin Res. 2015;6:169-170.