Purpose/Objectives Retention and recruitment of part time clinical adjunct faculty members in dental education is becoming increasingly difficult as dental schools come to rely on this workforce for their increased involvement in clinical education. Contributing factors include full time faculty shortage, aging workforce, practice and student debt, practice and family commitments, and financial compensation. This study attempts to ascertain barriers to teaching so appropriate strategies can be formulated to address this issue. Methods In the spring of 2016 an email survey was sent to current and former adjunct faculty members to ascertain demographics and retention and recruitment strategies. Descriptive analyses were completed for all variables in the sample. Results Twenty nine of forty six subjects responded to the survey with a response rate of 63%. Subjects over the age of sixty comprised 55% with only 17% being under the age of forty five. Overall family and practice commitments along with compensation were the primary barriers to teaching part time. For new dentists, student loan debt was the primary barrier to teaching. Travel to teach was also a barrier as 70% of respondents drove 200 miles or less to the dental school. Conclusion The study demonstrated that the aging part time work force is a great concern and new part time clinical adjunct faculty members must be recruited. Barriers to recruitment and retention of faculty must be considered and addressed to sustain this teaching model.

OBJECTIVES:Complementary and alternative medicine (CAM) is a diverse collection of approaches used to prevent or treat diseases. The goal of this study was to examine relationships between dental patient characteristics and current usage of CAM therapies.METHODS:The CAM definition encompassed 24 therapies excluding prayer. Associations and trends in usage were assessed for gender, income, education, and age. Multivariable logistic and negative binomial models were used to identify factors impacting the use and number of CAM therapies used.RESULTS:In dental patients (n = 402), nearly 67 percent of subjects reported at least one CAM treatment. Gender was significantly associated with recent utilization of CAM, biological, manipulative (all P < 0.01), and mind-body (P = 0.04) therapies, as well as the number (P < 0.01) of therapies used. Higher education levels were significant in usage of any CAM, biological, and mind-body therapies (P < 0.01).CONCLUSION:A large proportion of dental patients reported use of CAM therapies. While CAM therapies and those who use them are diverse, given their widespread use, they clearly have potential impacts on the oral health of the public. Knowledge of the characteristics of dental patients who use CAM therapies is a first step in developing a broader understanding how CAM therapies and associated beliefs may affect oral health and public health programs.

The purpose of this study was to identify the prevalence of complementary and alternative medicine (CAM) education in U.S. dental schools. A survey was administered via e-mail to each U.S. dental school's academic dean, and data were collected from respondents in a fillable PDF form submitted electronically to the study investigators. The survey asked respondents whether CAM was taught at the institution; if the response was yes, information was requested regarding the CAM therapies included, credentials of the instructor, number of hours taught, reason for teaching CAM, and format in which CAM was taught. Of the sixty dental schools contacted, twenty-two responded to the survey (37 percent response rate). Of these respondents, ten (45.5 percent) reported offering instruction in CAM as part of their predoctoral curricula. Herb/drug interactions were found to be taught with more frequency than any other CAM topic (in six out of the ten institutions). Limitations of the study are discussed, and suggestions for future studies are made.

Abstract This resource was created to support faculty assessment of dental student performance in the predoctoral comprehensive care clinic. This resource consists of an instructor's guide, the quarterly student evaluation by faculty form, the quarterly student self-evaluation form, and the criteria for the final course grade. At approximately 10 week intervals, each faculty member that has worked with the student in clinical patient contact completes the quarterly evaluation form, noting a subjective assessment of each student's current status with regard to each of the six domains and adding written comments regarding the student's strengths and weaknesses, as well as suggestions for professional growth. At the same point in time, the student will complete the quarterly student self-evaluation form and submit it to the group leader. The group leader compiles all the evaluations of the faculty; student progress is discussed together amongst faculty in faculty conferences each 10 weeks throughout the course. After each faculty conference, the group leader provides students with formal face-to-face individual feedback regarding current grade status, perceived strengths, shortcomings, and suggestions for professional growth. At these meetings, the group leader and the student also review the student's self-evaluation form, with particular focus on how this self-evaluation compares with the faculty assessments. The forms and protocols included here were developed and refined specifically for use in the Family Dentistry program at the University of Iowa College of Dentistry. These assessment tools were created to guide learning, reinforce learning, and to support dental student evaluation in the predoctoral comprehensive care clinic. The forms and protocols presented here have been in use in our clinical program since 2007. They are reviewed and refined annually, and have proven to be effective in achieving our objectives.

Academic dental institutions today seek to provide curricular content and learning opportunities for students to develop an essential skill set for evidence-based practice. To support that effort, studies that explore current practice patterns are valuable in identifying factors that influence the evidence-based habits and behaviors of dental school graduates. The purpose of this study was to explore the knowledge, perceptions, and behavior of private practice dentists in the state of Iowa with respect to evidence-based dentistry and to determine the influence of the dentist's education and the scope of his or her practice on those opinions and habits. A questionnaire addressing practitioners' familiarity with, understanding of, and adoption of an evidence-based philosophy of practice was mailed in September 2009 to all dentists licensed and practicing in Iowa. Questionnaires were returned by 518 practitioners, for an overall response rate of 38.4 percent. The majority of respondents reported awareness, understanding, and adoption of an evidence-based approach to their practice of dentistry. Recent graduates were more likely to report insufficient time as the primary obstacle to practicing evidence-based dentistry. Dental specialists indicated a higher level of comfort in assessing scientific information, as well as implementing current reliable, valid published research in practice, than did general practitioners.

This pilot study investigated the prevalence and specific reasons for usage of complementary and alternative medicine (CAM) among patients of a dental school clinic. Four hundred and two patients completed a 30-page survey on CAM usage. A higher rate of CAM usage was found in this dental school clinic population than rates previously reported in a general population. More than three-quarters (76.1%) of the respondents reported using at least one CAM treatment in the past 12 months; 93.3% reported using at least one CAM treatment at some time in their lives. High rates of chiropractic use were found in this population. Tooth pain was the most frequently reported dental condition motivating CAM use. About 10% of dental school clinic patients use topical oral herbal and/or natural products to treat dental conditions, most frequently for preventive/oral health reasons or for tooth pain.

This study investigated current trends of Iowa dental practitioners with regard to acquisition and utilization of scientific information resources to support decision making in the clinical practice of dentistry. A survey questionnaire regarding the utilization of various sources of information to support clinical decisions was mailed in September 2009 to all dentists licensed and practicing in the state of Iowa. Dentists appointed full-time within the University of Iowa College of Dentistry were excluded from this study. Continuing education courses were the most frequently utilized and preferred information source by respondents, followed by print journals and consultation with other health care professionals. Practice patterns according to decade of dental school graduation as well as scope of practice were noted. The results of this study demonstrate that dental practitioners utilize a variety of evidence-based and non-evidence-based information resources to support decisions in clinical practice. The habits of newer graduates vary somewhat from those of earlier graduates; the habits of specialists vary from those of general practitioners.

A concise overview of an institution's aspirations for its students becomes increasingly elusive because dental education has evolving emphases on priorities like critical thinking and adapting to new technology. The purpose of this article is to offer a learner-oriented matrix that gives a focus for discussion and an overview of an institution's educational outcomes. On one axis of the matrix, common educational outcomes are listed: knowledge, technical skills, critical thinking, ethical and professional values, patient and practice management, and social responsibility awareness. On the other axis, methodologies are listed: definition, cultivation strategies, measures (summative/formative, objective/subjective), institutional coordination, and competency determination. By completing the matrix, an overview of the process by which students reach these outcomes emerges. Each institution would likely complete the matrix differently and, ideally, with active discussion. While the matrix can first be used to establish "Where are we now?" for an institution, it can also be a starting point for more extensive matrices and further discussion. Vertical and horizontal analyses of the matrix provide a unique lens for viewing the institution's learning environment.

Anxiety experienced by individuals visiting the dental office to receive treatment is common. Evidence has shown biofeedback to be a useful modality of treatment for numerous maladies associated with anxiety. The purpose of the current pilot study was to investigate the use of a novel biofeedback device (RESPeRATE™) to reduce patients' pre-operative general anxiety levels and consequently reduce the pain associated with dental injections. Eighty-one subjects participated in this study, forty in the experimental group and forty-one in the control group. Subjects in the experimental group used the biofeedback technique, while those in the control group were not exposed to any biofeedback. All subjects filled out a pre-injection anxiety survey, then received an inferior alveolar injection of local anesthetic. Post-injection, both groups were given an anxiety survey and asked to respond to four questions regarding the injection experience using a Visual Analog Scale (VAS). With the use of the respiratory rate biofeedback device, there was a significant reduction of negative feelings regarding the overall injection experience, as measured by a VAS. Our findings demonstrate that this novel biofeedback technique may be helpful in the amelioration of dental anxiety, and may help produce a more pleasant overall experience for the patient.

BACKGROUND:A problem faced by health professions education throughout the world is a lack of full-time clinical teachers. This is particularly serious in dentistry and nursing, but is increasingly also true in medicine. To make up for this shortfall there is a growing reliance on part-time clinical teachers. CONTEXT:Part-time clinical teachers are essential for the education of students. However, compared with their full-time counterparts, the part-time teachers are often not adequately prepared for their roles as educators within the context of the clinical curriculum. They might not be trained in the latest educational practices, and may be unprepared for the time needed to excel as teachers and mentors. IMPLICATIONS:As part-time teachers take on more responsibility, it is important that they take part in orientation and training sessions to assist them in developing the skills they need to succeed. This will require a significant commitment from the institution as well as the part-time teacher, but is critical for maintaining the academic quality of the clinical training programmes. This also represents an untapped area for research into how to ensure the success of part-time clinical teachers.

Although four-handed dentistry is routine in most dental practices in the United States, solo unassisted clinical practice is the norm for students at many North American dental schools. The objective of this study was to compare the clinical productivity of fourth-year dental students practicing in a four-handed model to the clinical productivity of those same fourth-year dental students practicing in a solo, unassisted mode at the University of Iowa College of Dentistry for the three academic years 2005-08. Students averaged 2.62 patient visits per day in the four-handed Dental Auxiliary Utilization (DAU) Clinic and 1.74 visits per day in the regular Family Dentistry Clinic. Charging fees that are approximately 50 percent of prevailing local private practice fees, the mean daily charges for services provided by individual students averaged $329 in the DAU Clinic and $190 in the Family Dentistry Clinic. The mean daily productivity differentials were 0.88 patient visits and $139. While students averaged 51 percent more patient visits and 75 percent higher charges daily in the DAU Clinic as compared to the regular Family Dentistry Clinic, the increased revenues might not be sufficient to offset increased expenses incurred in the four-handed clinical operation.

The purpose of this study was to investigate the associations among several dental school admission criteria and several measures of dental school achievement. Data were collected for 2000-07 University of Iowa dentistry graduates, including five specific preadmission credentials and five specific measures of dental school achievement for each student. Pearson product moment correlations or Mann-Whitney U statistics were computed for the association of each of the ten variables with the nine others. The strongest correlation observed was between predental science grade point average (GPA) and overall predental GPA. Dental Admission Test (DAT) Academic Average was very strongly correlated with DAT Total Science, and both of these were each moderately correlated with DAT Perceptual Ability, predental science GPA, and overall predental GPA. Among the measures of dental school achievement, the strongest association was observed between National Board Dental Examination (NBDE) scores and dental school GPA. These were also moderately correlated with final clinical grade. All of the measures of dental school achievement were slightly stronger for candidates who passed the Central Regional Dental Testing Service (CRDTS) examination than for those who failed that exam. Of the predental credentials considered, predental science GPA and overall predental GPA were the best predictors of dental school GPA. DAT Academic Average was the best predictor of NBDE scores. Although DAT Perceptual Ability was the best predictor of clinical competency at the time of graduation, these two variables were only weakly correlated. DAT Perceptual Ability scores and overall predental GPA were slightly higher for candidates who passed the CRDTS examination than for those who failed that exam.

PURPOSE:To determine if there was a significant difference between the vertical marginal openings of cast restorations, computer-aided design, and computer-aided machining restorations.MATERIALS AND METHODS:Ten working dies were created from a single master die and used to fabricate ten restorations in each of the following groups: computer-aided design/computer-assisted machining (CAD/CAM), WAX/CAM, and WAX/CAST. The CAD/CAM titanium restorations were fabricated using the scanning and crown design modules of the KaVo Everest system. The WAX/CAM titanium restorations were fabricated using the double scan technique with the KaVo Everest system. The WAX/CAST high noble copings were fabricated using the conventional lost wax casting technique. The restorations were seated on the master die, and high-resolution digital photographs were made of the marginal area on all four sides. The vertical marginal opening was then measured using a calibrated digital software program. One-way ANOVA and Tukey's post hoc tests were used to determine the presence of statistically significant differences.RESULTS:The vertical margin openings were CAD/CAM: 79.43 +/- 25.46 microm; WAX/CAM: 73.12 +/- 24.15 microm; WAX/CAST: 23.91 +/- 9.80 microm. There was a statistically significant difference between the WAX/CAST group and the remaining groups.CONCLUSIONS:There was no difference between the vertical marginal gaps of the CAD/CAM and WAX/CAM. The WAX/CAST technique resulted in smaller vertical marginal gaps than either CAD/CAM or WAX/CAM.

The purpose of this study was to investigate the correlation between the quantity of a student's clinical experiences in the final year of dental school and the student's overall clinical competence at graduation, as evaluated by faculty at the University of Iowa College of Dentistry. Further, the authors sought to determine whether this correlation changed over time, as new generations of students come to dental school. Information including year of graduation, age at graduation, final grade in the course Clinical Competencies in Comprehensive Care, and final total Clinical Experience Units (CEUs) earned by each student in the D4 Family Dentistry Clinic was collected for 1987–2008 graduates of the University of Iowa College of Dentistry. Spearman's rank correlation coefficient ( r s ) was computed for the association of final clinical course grade and final CEU total for each graduation year. The correlation between final course grade and final CEU total was variable, ranging from moderately strong ( r s =0.614, Class of 1991) to negligible ( r s =−0.013, Class of 2008). This correlation generally tended to become weaker over time. The results of this study suggest that the terminal quality of a dental student's work is not solely a function of repetitions of prescribed procedures and that repetition of procedures may have even less influence on the quality of clinical performance for the new generation of dental students.

The purpose of this study was to investigate the correlation between the quantity of a student's clinical experiences in the final year of dental school and the student's overall clinical competence at graduation, as evaluated by faculty at the University of Iowa College of Dentistry. Further, the authors sought to determine whether this correlation changed over time, as new generations Of students come to dental School. Information including year of graduation, age at graduation, final grade in the course Clinical Competencies in Comprehensive Care, and final total Clinical Experience Units (CEUs) earned by each student in the D4 Family Dentistry Clinic was collected for 1987-2008 graduates of the University of Iowa College of Dentistry. Spearman's rank correlation Coefficient (r) was computed for the association of Clinical course grade and final CEU total for each graduation year. The correlation between final course grade and final CEU total was variable, ranging from moderately strong (r, =0.614, Class of 1991) to negligible (r =-0.013 Class of 2008). This correlation generally tended to become weaker over time. The results Of this Study suggest that the terminal quality of a dental student's work is not solely a function of repetitions of prescribed procedures and that repetition of procedures may have even less influence on the quality of clinical performance for the new generation of dental students.

Journal of Dental EducationVolume 67, Issue 12 p. 1299-1301 Article Clinical Curriculum for the Twenty-First Century David C. Holmes D.D.S., M.S., Corresponding Author David C. Holmes D.D.S., M.S. David.Holmes@uchsc.edu Direct correspondence and requests for reprints to Dr. David C. Holmes, University of Colorado School of Dentistry, Campus Box C284, 4200 E. Ninth Avenue, Denver, CO 80262; 303-315-6371 phone; 303-315-0346 fax; David.Holmes@uchsc.edu.Search for more papers by this authorDaniel W. Boston D.M.D., Daniel W. Boston D.M.D.Search for more papers by this authorAlan W. Budenz M.S., D.D.S., M.B.A., Alan W. Budenz M.S., D.D.S., M.B.A.Search for more papers by this authorFrank W. Licari D.D.S., M.P.H., M.B.A., Frank W. Licari D.D.S., M.P.H., M.B.A.Search for more papers by this author David C. Holmes D.D.S., M.S., Corresponding Author David C. Holmes D.D.S., M.S. David.Holmes@uchsc.edu Direct correspondence and requests for reprints to Dr. David C. Holmes, University of Colorado School of Dentistry, Campus Box C284, 4200 E. Ninth Avenue, Denver, CO 80262; 303-315-6371 phone; 303-315-0346 fax; David.Holmes@uchsc.edu.Search for more papers by this authorDaniel W. Boston D.M.D., Daniel W. Boston D.M.D.Search for more papers by this authorAlan W. Budenz M.S., D.D.S., M.B.A., Alan W. Budenz M.S., D.D.S., M.B.A.Search for more papers by this authorFrank W. Licari D.D.S., M.P.H., M.B.A., Frank W. Licari D.D.S., M.P.H., M.B.A.Search for more papers by this author First published: 01 December 2003 https://doi.org/10.1002/j.0022-0337.2003.67.12.tb03721.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume67, Issue12December 2003Pages 1299-1301 RelatedInformation

Using complete denture treatment as an introduction to clinical patient care for dental students, the purposes of the Complete Denture Prosthodontics Transition Clinic at the University of Colorado School of Dentistry are to reduce the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience, and to encourage development of student self-confidence and skills. In the 2002 spring semester, faculty at the University of Colorado School of Dentistry initiated the Complete Denture Prosthodontics Transition Clinic for DS-II (second-year) dental students, as an introduction to clinical patient care. Each patient was assigned to a team of two dental students. Three Division of Prosthodontics faculty members staffed each clinic session, providing a student-to-faculty ratio of approximately 6.6:1 and a patient-to-faculty ratio of approximately 3.3:1. All DS-II students in the Class of 2004 delivered their first complete dentures no later than 8 months (average, 184 days) after the last day of the preclinical complete denture prosthodontics course. The time from the diagnostic appointment through the denture placement appointment averaged 39 days for patients treated in this program, compared with an average of 98 days or more for previous classes. The program was successful in achieving the goal of reducing the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience.

In fall 2002, the ADEA Section on Comprehensive Care and General Dentistry conducted a survey of the predoctoral clinical curriculum models at sixty-four North American dental schools. Fifty-eight percent of the schools reported that most patient care is provided in a comprehensive care clinic setting, 22 percent reported that most patient care is provided in discipline-specific settings, and 20 percent reported a hybrid of comprehensive care and discipline-specific settings. While ten Primarily Discipline-Based (PD) schools have instituted new Primarily Comprehensive Care (PCC) or Hybrid clinical curricula since 1997, one PCC school has converted to a Hybrid model, and one PCC school has converted to a PD model. PCC curriculum models were frequently associated with the following institutional factors: more densely populated metropolitan areas; private institutional sponsorship; location within a university medical center; larger class size; and more students enrolled in advanced training at the school. Curriculum factors frequently associated with PCC models included the following: increased use of simulation technology: higher proportion of clinical/teaching track faculty; higher proportion of part-time faculty; higher proportion of generalist faculty; same faculty supervising both treatment planning and patient treatment; and use of competency exams as the main requirement for completion of the curriculum.

As the dental students of the Class of 2000 entered the Comprehensive Care Clinic at the University of Colorado School of Dentistry in the spring of their second year (spring of 1998), a different, competency-based set of clinical expectations was communicated to them. These students were presented a list of "Recommended Core Experiences" and told that the "requirements" for completion of the Comprehensive Care Program were 1) successful performance on all departmental competency examinations, and 2) timely completion of the comprehensive dental treatment appropriate to each assigned patient. This study examined the number of procedures completed during the six semesters in the Comprehensive Care Clinic for the Class of 2000, as compared to the clinical activity for the Class of 1999 during the same stage of their career. The overall mean number of clinical procedures performed per student was 7 percent greater for the students in the Class of 2000 than for those in the Class of 1999. These results suggest that numerical requirements are not necessary to ensure dental student productivity and that, in fact, students can complete more clinical procedures in a comprehensive care clinical environment without numerical requirements.

Purpose The purpose of this study was to compare the stress distribution in the resin element and the retaining screw for three different IMZ prosthetic systems: 1) original threaded Intra‐Mobile Element (IME); 2) Abutment Complete (ABC); and 3) Intra‐Mobile Connector (IMC). This stress distribution comparison was then related to variations in deflection of the prosthetic superstructure.Materials and Methods Employing the finite element method, a three‐dimensional model simulating a cast gold restoration attached to an osseointegrated IMZ implant fixture was generated for each system. The representation of the implant fixture, the supporting structures, and the external contours of the crown were identical in the three models, while the configuration of the abutment varied to characterize the individual systems. Each model was discretized into axisymmetric finite elements representing the crown, the various implant system components, and supporting structures. A series of harmonic functions was written to define non‐axisymmetric loads of 100 N and 500 N evenly distributed over the entire occlusal surface of the crown. Each load was applied individually to the models, first in a vertical direction, and then at a 45° angle to the median plane. Predicted deflection and stress distributions were computed and plotted for each loading condition of each model.Results Deflections measured at the buccal cusp tip ranged from 0.002 mm (100‐N load applied vertically to the ABC model) to 0.802 mm (500‐N load applied at 45° to the IME model). Maximum effective stresses in the retaining screw ranged from 129 MPa (100‐N load applied vertically to the ABC model) to 1,315 MPa (500‐N load applied at 45°C to the IMC model). A correlation was observed between the peak stresses in the screw and the deflection of the superstructure.Conclusions Deflections and stress concentrations with the IMC were predicted to be in the same range as with the IME, but much greater than with the ABC.