Ethical dilemmas and financial burdens faced by clinical dental students in a ‘quota-driven’ curriculum

Unprofessional behaviour, cheating or falsifying of information by undergraduate dental students is a serious problem, and may be a predictor of future professional board disciplinary actions against practitioners. In quota-driven curricula students have to complete a minimum number of procedures, many of which require laboratory services. In order to achieve this some students at the University of Limpopo had begun bribing technicians to complete their work preferentially, or to do part of it for them. A final-year dental student carried out an independent investigation to establish the extent of the problem so that school authorities could be alerted and requested to curb this practice. Anonymous questionnaires were given to all the clinical-year dental students, who were asked to answer as honestly as possible. Results showed that almost half of the 4th-year students (47%) and double that of 5th-years (86%) had paid technicians for special favours and services. Payment methods and amounts ranged from gifts to actual monetary reimbursement. Ninety-three per cent of students reported additional financial burdens owing to their having paid for patient treatment, transport costs, telephone calls or food, or for the actual prosthesis.Ethics courses are part of most dental curricula, but have no standard, universally accepted outline or structure. Bribery was investigated by a student who had experienced it as a problem himself, highlighting the point that students will be more engaged in ethics education when it addresses issues directly relevant to them. Faculties should therefore design dental ethics curricula that are practical and relevant to students’ experiences, and ensure these courses begin early in the dental education and span its entire duration. Faculties should also support and encourage consistent professional conduct in undergraduate students which they will hopefully continue to practise in their future professional lives as dentists.

Utilization of the ART approach in a group of public oral health operators in South Africa: a 5-year longitudinal study

Contains fulltext : 80990.pdf (publisher's version ) (Open Access)BACKGROUND: A significant increase in the proportion of restorations to the number of tooth extractions was reported after the introduction of ART in an academic mobile dental service in South Africa. The changes were ascribed to its less threatening procedure. Based on these findings, ART was subsequently introduced into the public oral health service of Ekurhuleni district in the South African province of Gauteng. This article reports on the 5-year restorative treatment pattern of operators in the Ekurhuleni district, who adopted the ART approach into their daily dental practice. METHODS: Of the 21 trained operators, 11 had placed more than 10% of restorations using ART at year 1 and were evaluated after 5 years. Data, including number of restored and extracted teeth and type of restoration, were drawn from clinical records 4 months before, and up to 5 years after training. The restoration/extraction ratio (REX score) and the proportion of ART restorations to the total number of restorations were calculated. The paired sample t-test and linear regression analysis were applied. RESULTS: The mean percentage of ART restorations after 1 year was 24.0% (SE 7.2) and significantly increased annually to 42.7% (SE 9.2) after 5 years in permanent dentitions. In primary dentitions the mean percentage of ART restorations after 1 year was 80.6% (SE 4.9) and 72.6% (SE 8.8) after 5 years. The mean REX score before ART training was 0.08 (SE 0.03) and 0.07 (SE 0.04) for permanent and primary teeth, respectively and 0.11 (SE 0.03) and 0.17 (SE 0.05) after 5 years. CONCLUSION: Five years after training, ART had been used consistently in this selected group of operators as the predominant restorative treatment used for primary teeth and showed a significant annual increase in permanent teeth. However, this change had not resulted in an increase in the REX score in both dentitions

Factors inhibiting the implementation of the atraumatic restorative treatment approach in public oral health services in Gauteng province, South Africa.

Contains fulltext : 51790.pdf (publisher's version ) (Open Access

Atraumatic restorative treatment and dental anxiety in outpatients attending public oral health clinics in South Africa.

Contains fulltext : 53216.pdf (publisher's version ) (Closed access)OBJECTIVES: This study was undertaken to test the hypotheses that using the atraumatic restorative treatment (ART) approach results in lower patient anxiety and that lower anxiety leads to higher restoration/extraction ratios. METHODS: The test group of dental operators (n = 9) was trained in ART The control group (n = 11) was not, and did not apply ART The Short Form of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-SF) and Corah's Dental Anxiety Scale (DAS) were used to assess patient anxiety after ART (test group) and after traditional restorations (control group). The restoration/extraction ratio calculated for primary (children) and permanent dentitions (adults) per operator was based on 12-month treatment statistics. Dental anxiety assessments were analysed using ANOVA. Differences were compared using the t-test and corrected for confounding factors (ANCOVA). The Pearson correlation coefficient was used to measure the correlation between dental anxiety levels and restoration/extraction ratios. RESULTS: The mean CFSS-SF score for test-group children was statistically significantly lower than for the control-group children. The mean DAS score for test-group adults was statistically significant lower than the control. No significant correlation was observed between dental anxiety level and restoration/extraction ratio per operator for both dentitions in both groups. Conclusion: The first hypothesis was accepted; the second, rejected. Although dental anxiety scores were lower both in child and in adult patients treated by ART than in those who received traditional restorative treatments, this positive effect had not resulted in higher restoration/extraction ratios

South African Teachers' Voices on Support in Inclusive Education

This article reports on the state of inclusive education in South Africa saying that with the history of school segregation there, inclusive education has not fully been achieved. Studies show that only 64 thousand children with disabilities have been accommodated out of the estimated 400,000 with special needs. The biggest barriers towards implementation are class size that can reach 80 students, and the lack of funds to add services and support staff

Barriers to the treatment of childhood caries perceived by dentists working in different countries

Community Dental Health211 SUPPL.112-12

Curriculum structure: Principles and strategy

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 may have 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. © 2008 Blackwell Munksgaard and The American Dental Education Association