Dental Auxiliaries

Background. The aviation industry uses crew resource management (CRM) to address the human aspect of error. Dentistry can incorporate these concepts to reduce dental error. The authors provide a checklist to help clinicians mitigate error. Methods. Health care systems have begun to focus on medical error. During the past 30 years, the airline industry has developed mitigation strategies that are being adapted for medicine. CRM involves the use of information, equipment and people to increase safety by targeting early identification of errors. Results. To enhance safety, practitioners must implement forwardthinking strategies. Because human error is inevitable, threat and error management (TEM) techniques are needed to help identify and trap error before it develops into unexpected outcomes. Risk analysis increases situational awareness (SA) of potential dental error. Efficiency increases with early error detection. Conclusions. The authors provide a dental checklist that is divided into "appointment review," "before procedure," "procedure," "before dismissal" and "after dismissal" to organize dental activities in a manner that enhances error detection. Practice Implications. The dental checklist is a tool to incorporate CRM and TEM techniques into the dental care environment to increase SA, safety and efficiency.

The University of Minnesota School of Dentistry launched its new dental therapy program in September 2009 after the Minnesota state legislature had authorized the training and practice of a dental therapist in May of the same year. The creation of this mid-level dental provider is seen as a workforce solution to help address the problem of access to dental care experienced by some members of our society. However, there is a lack of consensus and even controversy in organized dentistry about dental therapy, one of the mid-level provider models. This study explored the attitudes and perceptions of dental school faculty members who have been tasked to prepare these new dental therapists to do their work. Focus groups were conducted with a randomly selected group of faculty members, the results of which were used to develop a survey of faculty members in all departments of the school. A total of 151 faculty members responded to the survey: 68 percent of these respondents were fifty-one ...

Objective To describe the establishment of an outreach centre for the training of all members of the orthodontic team. The development of the orthodontic team The remit of orthodontic nurses and orthodontic therapists is described and how their training may be delivered and integrated within a primary care training centre. Outreach training The reasons for the development of outreach training are discussed and how these are particularly relevant for the development of orthodontic training in the UK. The University of Warwick orthodontic outreach centre This has been established in Leamington Spa in comprehensively equipped premises providing seven surgeries, a lecture theatre, clinical skills laboratory, and technical support. It currently provides an MSc course in orthodontics for general dental practitioners (GDPs) and training for qualifi ed dental nurses leading to the award of an Orthodontic Nurse's Certifi cate. It has also recently been approved by the General Dental Council (GDC) for the delivery of a course leading to the Diploma in Orthodontic Therapy commencing in July 2008.

Introduction: A survey of the members of the Angle Society of Europe showed that 60% of orthodontists took their own clinical photographs, 35% assigned the task to an auxiliary, and 5% hired professional clinical photographers. It is always useful to ensure that orthodontists' time is used to maximum effect. Clinical photography could be delegated to auxiliary staff. In this study, we assessed the quality of photographs taken by orthodontists to see whether those taken by orthodontic auxiliaries and clinical photographers are of comparable quality. Methods: Fifty sets of orthodontic photographs were collected from each of 3 types of photographers: orthodontists, orthodontic auxiliaries, and professional clinical photographers. Four assessors scored each set for quality and detailed errors. The results were compared to determine whether there were differences between the quality of the photographs taken by the different groups. Results and Conclusions: Most of the photos taken by the 3 groups of photographers were judged to be good or acceptable. The results for extraoral photographs showed no statistically significant differences between the 3 groups for good (P 5 0.398) and acceptable (P 5 0.398) images. The results for intraoral photographs did not differ significantly for acceptable and unacceptable photographs, but orthodontists produced significantly more good-quality intraoral photographs (P 5 0.046). (Am J Orthod Dentofacial Orthop 2009;135:657-62)

The scientific literature contains very little about the role of the dental hygienist/therapist in the specific areas of forensic investigations and collection of evidence. The authors examine how the contribution of a highly qualified dental hygienist can be particularly helpful during human forensic identification operations and non-accidental traumas like domestic violence, child abuse, neglect and bitemarks. Forensic dental identification of human remains is a highly complex multidisciplinary challenge. It requires the involvement of several professionals who are expert in forensic science. Among these, one or more adequately trained dental hygienists could be involved. Dental hygienists/therapists may also be asked to record cutaneous lesions in two different situations. The first may be the dental office where she/he may detect oval, elliptic, or semicircular lesions on the skin of the uncovered neck, shoulder and arms of a patient. The second is the crime scene or the morgue (if one is involved), which may require a visit by the forensic odontologist called by the medical examiner or the coroner to perform an odontological autopsy. The purpose of our study is to highlight procedures that should be followed by the dental hygienist/therapist in collecting forensic information in the above-mentioned scenarios. As a valuable resource, the authors recommend training of dental hygienists in the area of forensic sciences, with particular attention to information technology and photography.

Abstract:  Health, education and social services are placing increasing emphasis on preventing abuse and neglect by early intervention to support families where children and young people may be at risk. Dental hygienist and dental assistants, like all other health professionals, can have a part in recognizing and preventing children from those who would cause them harm. They should be aware of the warning signs, recognizing what to consider as abuse or dental neglect and know how to deal with these young patients, and to fulfil their legal and ethical obligation to report suspected cases.The purpose of this report is to review the oral and dental aspects of child abuse and dental neglect thus helping the dental team in detecting such conditions. In particular, this report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, early childhood caries and diseases that may be indicative of child abuse or neglect.Emphasis is placed on an appropriate protocol to follow in the dental practice to best treat and protect children who may have suffered abuse, helping the team in the diagnosis and documentation.

In the practice of dentistry, stress, tension, and postural practices can contribute to back and neck problems. Two hundred and four dentists and dental auxiliary (87 males and 117 females) in Riyadh city, Saudi Arabia were surveyed to determine the prevalence of postural problems. The candidates were interviewed and observed during practice. The data obtained showed that 111 (54.4%) of the subjects complained of neck pain and 150 (73.5%) complained of back pain. Only 37% of those complaining of back pain sought medical help. Within the limitations of this study, it might be concluded that neck and back pain among dental personnel are not of a severe nature.

treatments, 1 there are considerable barriers to developing and maintaining the skills of dental therapists. 3,4 Brocklehurst and Tickle 5 identified four factors affecting skill mix in dentistry: regulation, professional culture, societal (patient acceptability) and structural influences (including remuneration, infrastructure and training). Bullock and Firmstone 6 organised such factors into three operational levels: macro (including regulation, workforce profile, commissioning frameworks and demand for services), meso (payment systems in practices and premises capacity) and micro (lead dentist's knowledge, therapist motivations, patient attitudes). They argued that education and training plays a central role in realising skill-mix change. The TFT scheme Introduced in 2008, the Oxford and Wessex Postgraduate Dental Deanery's dental therapists' foundation training (TFT) scheme was the first in England. In its first year of operation the scheme was evaluated. 7 TFT runs for 12 months. The main features of

The study aimed to determine the following among the workforce of the Jaipur Dental College, India: their awareness regarding biomedical (BM) waste management policy and practices, their attitude towards biomedical waste management, and their awareness regarding needle-stick injury and its prevalence among different categories of health care providers. A cross-sectional study was conducted using a questionnaire with closed-ended questions. It was distributed to 144 dentists, nurses, laboratory technicians and Class IV employees (cleaners and maintenance personnel) at Jaipur Dental College. The questionnaire was used to assess their knowledge of biomedical medical waste disposal. The resulting answers were graded and the percentage of correct and incorrect answers for each question from all the participants was obtained. Of the 144 questionnaires, 140 were returned and the answers graded. The results showed that there was a poor level of knowledge and awareness of biomedical waste ge...

Thailand is geographically located in southeast Asia and its population is 63 million. Little has been published on dental education in Thailand. This paper provides information about Thailand regarding its dental history, dental school system including curriculum and dental licensure. There are eight public and one private dental school in Thailand. A six-year dental education leads to the DDS degree. On graduation from the public dental schools, dentists are required to work in the public system for three years. Currently, there are approximately 8000 active dentists, with a dentist: population ratio of approximately 1:7000.

All those involved in education have a strong motivation to ensure that all its aspects, including content and teaching practice, are of the highest standard. This paper describes how agencies such as the Quality Assurance Agency for Higher Education (QAA) and the General Dental Council (GDC) have established frameworks and specifications to monitor the quality of education provided in dental schools and other institutes that provide education and training for dentists and dental care professionals (DCPs). It then considers quality issues in programme and course development, techniques for assessing the quality of education, including content and presentation, and the role of students. It goes on to review the work that has been done in developing quality assessment for distance learning in dentistry. It concludes that, to date, much of the work on quality applies to education as a whole and that the assessment of the quality of e-learning in dentistry is in its infancy. Section A: Teaching and technology 1. A description of the new technologies used in transforming dental education 2. Seeing is believing: dental education benefi ts from developments in videoconferencing 3. Webcasting: casting the web more widely 4. Top of the pops-CD-ROM and DVDs in dental education Section B: Informatics: better informed by systems and services 5. Better informed: an overview of health informatics 6. Better informed in clinical practice a brief overview of dental informatics 7. Digital clinical records and practice administration in primary dental care Section C: Impact of e-learning in dental education 8. Remember the days in the old school yard: from lectures to online learning 9. An intricate web-designing and authoring a web-based course 10. The many faces of interaction 11. Supporting the learner and teacher online 12. Making a mark-taking assessment to technology 13. Continuing professional development and ICT: target practice 14. Assuring quality Section D: A connected future

Although dentists perform highly technical procedures in complex environments, patient safety has not received the same focus in dentistry as in medicine. Cultivating a robust patient safety culture is foundational to minimizing patient harm, but little is known about how dental teams view patient safety or the patient safety culture within their practice. As a step toward rectifying that omission, the goals of this study were to benchmark the patient safety culture in three U.S. dental schools, identifying areas for improvement. The extensively validated Medical Office Survey on Patient Safety Culture (MOSOPS), developed by the Agency for Healthcare Research and Quality, was administered to dental faculty, dental hygienists, dental students, and staff at the three schools. Forty-seven percent of the 328 invited individuals completed the survey. The "Teamwork" category received the highest marks and "Patient Care Tracking and Follow-Up" and "Leadership Suppo...

PURPOSE Using John Kingdon's agenda-setting model, this paper explores how Minnesota came to legislate a mid-level dental practitioner to its oral health workforce. Using a pluralist framework embracing the existence of various interests and convictions, this analysis highlights the roles of issue formation, agenda setting and politics in policymaking. METHODS Using Kingdon's agenda-setting model as a theoretical lens, and applying case study methodology, this paper analyzes how Minnesota came to legislate a mid-level dental practitione to its oral health workforce. Data have come from scholarly research, governmental and foundation agency reports, interviews with leaders involved in the mid-level dental practitioner initiative, news articles, and Minnesota statute. RESULTS After 2 years of contentious and challenging legislative initiatives, the problem, policy and political streams converged and aligned with the compromise passage of a bill legalizing mid-level dental prac...

Academic dental institutions are the fundamental underpinning of the nation's oral health. Education, research, and patient care are the cornerstones of academic dentistry that form the foundation upon which the dental profession rises to provide care to the public. The oral health status of Americans has improved dramatically over the past twenty-five to thirty years. In his 2000 report on oral health, the Surgeon General acknowledges the success of the dental profession in improving the oral health status of Americans over the past twenty-five years, but he also juxtaposes this success to profound and consequential disparities in the oral health of Americans. In 2002, the American Dental Education Association brought together an ADEA President's Commission of national experts to explore the roles and responsibilities of academic dental institutions in improving the oral health status of all Americans. They have issued this report and made a variety of policy recommendations, including a Statement of Position, to the 2003 ADEA House of Delegates. The commission's work will help guide ADEA in such areas as: identifying barriers to oral health care, providing guiding principles for academic dental institutions, anticipating workforce needs, and improving access through a diverse workforce and the types of oral health providers, including full utilization of allied dental professionals and collaborations with colleagues from medicine.

This report provides general guidelines for the structure of a curriculum, followed by specific advice on the principles of learning and teaching, the process of restructuring and change leadership and management. It provides examples of several educational philosophies, including vertical and horizontal integration. It discusses the use of competence, learning outcomes, level of degree and assessment and provides a number of recommendations. It does not seek to be prescriptive of time allocation to disciplines within a curriculum. Although this report has been written primarily for those who will develop an undergraduate curriculum, the information may be sufficiently generic to apply to the recent development in graduate entry ('shortened dental' or 'accelerated') courses and to postgraduate degree planning and higher education certificate or diploma courses for other dental care professionals (auxiliaries). The report was developed by a working group of ADEE and inevitably has a European bias as progress is made to converge and enhance educational standards in 29 countries with different educational approaches-a microcosm of global collaboration. A balance is necessary between the prescriptive elements of a curriculum and the desire to produce self-directed learners. These tensions have been represented diagrammatically by ten Cate:

Although dentists perform highly technical procedures in complex environments, patient safety has not received the same focus in dentistry as in medicine. Cultivating a robust patient safety culture is foundational to minimizing patient harm, but little is known about how dental teams view patient safety or the patient safety culture within their practice. As a step toward rectifying that omission, the goals of this study were to benchmark the patient safety culture in three U.S. dental schools, identifying areas for improvement. The extensively validated Medical Office Survey on Patient Safety Culture (MOSOPS), developed by the Agency for Healthcare Research and Quality, was administered to dental faculty, dental hygienists, dental students, and staff at the three schools. Forty-seven percent of the 328 invited individuals completed the survey. The "Teamwork" category received the highest marks and "Patient Care Tracking and Follow-Up" and "Leadership Support for Patient Safety" the lowest. Only 48 percent of the respondents rated systems and processes in place to prevent/catch patient problems as good/excellent. All patient safety dimensions received lower marks than in medical practices. These findings and the inherent risk associated with dental procedures lead to the conclusion that dentistry in general, and academic dental clinics in particular, stands to benefit from an increased focus on patient safety. This first published use of the MOSOPS in a dental clinic setting highlights both clinical and educational priorities for improving the safety of care in dental school clinics.

Health care reform often involves a search for interventions that have the greatest value, both in terms of outcome and cost. Preventive dental care for children is simple, low risk, affordable, and has benefits that exceed its cost, making it a sensible type of care for all children to receive. However, there is a literal epidemic of preventable tooth decay amongst children in this country, an epidemic that has proven resistant to many attempts to ameliorate it. This epidemic leads to pain, poor school performance, poor nutrition, infection, and increased risk of heart problems in adulthood. It also, at times, leads to children’s deaths. This Article argues that this pervasive, stubborn problem of preventable dental decay is structural, and requires legal reforms to create a system whereby all, or at least most, children receive the necessary preventive care in a timely manner. This epidemic has highest rates of prevalence in children who have other significant stressors in their l...

access and the efficiency of dental services. 4-6 In addition, changes in population treatment need mean that therapists could provide treatment at 70% of all visits; representing 60% of all clinical time in UK primary dental care. 7 A commonly reported concern is the impact of skill-mix on the quality of dental care. 8 Quality in healthcare is a multidimensional concept, with the efficiency, effectiveness and acceptability of services being key factors. 9,10 Existing data on efficiency and effectiveness in dentistry suggest that concerns about skill-mix may be unfounded. However, less is known about its acceptability. 11,12 Assessments of the acceptability of services should consider professional, social acceptability (or legitimacy) and the experiential views of service users. 10 Our study on the legitimacy and social acceptability

This paper describes the health care system in Cyprus and the funding arrangements for oral health care. Some epidemiological data and costs are also presented. Although almost 83% of the population is entitled to free of charge oral health care within the public sector, only 10% make use of it. Most patients prefer to use the private sector, where they pay out of pocket on a fee-for-service basis. Additionally, issues regarding the dental workforce in Cyprus are discussed, including the fact that there is no dental school in Cyprus.

Introduction: A survey of the members of the Angle Society of Europe showed that 60% of orthodontists took their own clinical photographs, 35% assigned the task to an auxiliary, and 5% hired professional clinical photographers. It is always useful to ensure that orthodontists' time is used to maximum effect. Clinical photography could be delegated to auxiliary staff. In this study, we assessed the quality of photographs taken by orthodontists to see whether those taken by orthodontic auxiliaries and clinical photographers are of comparable quality. Methods: Fifty sets of orthodontic photographs were collected from each of 3 types of photographers: orthodontists, orthodontic auxiliaries, and professional clinical photographers. Four assessors scored each set for quality and detailed errors. The results were compared to determine whether there were differences between the quality of the photographs taken by the different groups. Results and Conclusions: Most of the photos taken by the 3 groups of photographers were judged to be good or acceptable. The results for extraoral photographs showed no statistically significant differences between the 3 groups for good (P 5 0.398) and acceptable (P 5 0.398) images. The results for intraoral photographs did not differ significantly for acceptable and unacceptable photographs, but orthodontists produced significantly more good-quality intraoral photographs (P 5 0.046). (Am J Orthod Dentofacial Orthop 2009;135:657-62)

Objective: This study was conducted to determine the prevalence and severity of dental caries, missing and restored teeth (DMFT) and the efficiency of oral health programs for patients with intellectual disabilities, from age 11 to 38, who attended at the Association of Exceptional Children’s Parents and Friends (APAE) in Passo Fundo, southern Brazil. Methods: The prevalence of dental caries was assessed by DMFT in 109 patients. The mean and standard deviation were evaluated by One-way ANOVA with 5% significance level. Results: 47 of the evaluated students were female and 62 male, with moderate mental disability, Down syndrome, cerebral paralysis and epilepsy. The DMFT average was 3.93 for 11-14 years, 3.47 for 15-19 years, 4.74 for 20-30 years and 5.68 for the group 31-40 years. There were no significant differences among the DMFT index, gender and intellectual disability for the groups. Conclusion: Patients had acceptable oral hygiene within their limitations, suggesting that prev...

Compulsory community service (CCS) was introduced into the health service by the South African government to address the shortage and maldistribution of health professionals within the public sector. The aim of this study was to determine the attitudes of dental therapy students regarding CCS. A self-administered questionnaire was delivered to the two dental schools that train dental therapists in South Africa. There was a 64 percent response rate; 56 percent of the respondents were female. The average age was 20.3 years. There was no difference in the variables between the two dental schools, so the results were combined. The majority (81 percent) supported the introduction of CCS and preferred to carry it out in Kwa-Zulu Natal. Most students opted to perform oral health promotional (64 percent) and clinical (15 percent) activities. By aligning these requirements with the current dental needs and priority strategies of the South African Department of Health, this support would add ...

Although dentists perform highly technical procedures in complex environments, patient safety has not received the same focus in dentistry as in medicine. Cultivating a robust patient safety culture is foundational to minimizing patient harm, but little is known about how dental teams view patient safety or the patient safety culture within their practice. As a step toward rectifying that omission, the goals of this study were to benchmark the patient safety culture in three U.S. dental schools, identifying areas for improvement. The extensively validated Medical Office Survey on Patient Safety Culture (MOSOPS), developed by the Agency for Healthcare Research and Quality, was administered to dental faculty, dental hygienists, dental students, and staff at the three schools. Forty-seven percent of the 328 invited individuals completed the survey. The "Teamwork" category received the highest marks and "Patient Care Tracking and Follow-Up" and "Leadership Suppo...

Thailand is geographically located in southeast Asia and its population is 63 million. Little has been published on dental education in Thailand. This paper provides information about Thailand regarding its dental history, dental school system including curriculum and dental licensure. There are eight public and one private dental school in Thailand. A six-year dental education leads to the DDS degree.

This paper outlines the Bulgarian health insurance system in 2007 and how it funds some aspects of oral health care for the population. It explains which oral health care treatments are funded partly or completely by the National Health Insurance Fund and that most payments for oral health care are made privately by patients themselves. It then describes the Bulgarian oral health care workforce, which includes dentists, dental technicians, and some dental nurses (chair-side assistants), and notes that eight dental specialties are recognised in Bulgaria. Details of the education of dentists, dental specialists, and dental technicians follow. All dental education takes place in public dental schools (Faculties of Dental Medicine). At present, there is no overproduction of new dentists and very few (fewer than 90) dentists who graduated in other countries work in Bulgaria. The paper goes on to give estimates of the national mean DMFT for 12-year-olds and the percentage of 12-year-olds ...

Health is a critical dimension of human well-being and flourishing; oral health is an integral component of health. One is not healthy without oral health. Significant barriers exist to ensuring the world's people receive basic health care, including oral health care. Among the barriers are poverty, ignorance, inadequate financial resources, and lack of adequate numbers of educated and trained (oral) health care workers. Emerging economies are encouraged to develop a national strategic plan for oral health. International organizations have developed goals for oral health that can be referenced and adapted by emerging economies as they seek to formulate specific objectives for their countries. Demographic data that assess the nature and extent of oral diseases in a country are essential to sound planning and the development of an oral health care system that is relevant, effective, and economically viable. Prevention should be emphasised and priority consideration be given to oral health care for children. The types and numbers of members of the oral health care team (workforce) will vary from country to country depending on the oral Chapter 2.5 Global Congress on Dental Education September 2007 2-17 health care system developed. Potential members of the workforce include: generalist dentists, specialist dentists, dental therapists, dental hygienists, denturists, expanded function dental assistants (dental nurses), and community oral health workers/aides. Competences for dentists, and other members of the team, should be developed to ensure quality care. Developed economies should cooperate with emerging economies. The development, by more advanced economies, of digital, virtual curricula, which could be used by emerging economies for educating and training members of the oral health care team, should be an important initiative. The International Federation of Dental Educators and Associations (IFDEA) should lead in such an effort.