An Interdisciplinary Approach to Case‐Based Teaching: Does It Create Patient‐Centered and Culturally Sensitive Providers?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153681/1/jddj002203372006703tb04084x.pd

Periodontal Health, Quality of Life, and Smiling Patterns – An Exploration

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142236/1/jper0224.pd

Surgical or Nonâ Surgical Periodontal Treatment: Factors Affecting Patient Decision Making

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141226/1/jper0678.pd

Periodontal Referral Patterns of General Dentists: Lessons for Dental Education

The objectives of this study were to investigate periodontal treatment and referral patterns and the considerations used in the process of dentists who make no periodontal referrals, relatively few referrals, or more referrals. Specifically, the role of disease characteristics, patient‐ and provider‐related factors, attitudes towards periodontal referrals, and perceptions of dental education were explored. The relationships between the perceived quality of dental education concerning periodontal diagnosis and treatment and the considerations used in this process were evaluated as well. Data were collected from 160 members of the Michigan Dental Association using a mailed questionnaire. The respondents were predominantly male (77 percent) and white (96 percent) and had practiced for an average of twenty‐three years (SD=10.7). While 13 percent of the respondents had not made any periodontal referrals during the past month, 69 percent had referred between one and five patients, and 18 percent more than five patients. Dentists who referred more than three patients per month considered the patients’ oral hygiene as more important, had fewer patients from lower socioeconomic backgrounds and more patients with private insurance, and felt less well prepared by their dental education compared to general dentists who referred fewer than three patients per month to a periodontist. The more positively dentists evaluated their dental education in periodontics, the more conservative they were when considering percentage of bone loss as a basis for referral (r=.228; p=.014), the more frequently they used systemic antibiotics in their treatment of periodontal disease (r=.180; p=.036), and the more they considered whether their patients would return after the periodontal treatment (r=.185; p=.028) as a factor in their referral decisions. General dentists’ perceptions of the quality of their dental school education in periodontics decreased their willingness to refer patients and increased their desire to treat these patients in their own practices. Future research should analyze the ways in which dental school curricula could prepare students to make timely and necessary periodontal referrals.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153664/1/jddj002203372009732tb04655x.pd

Accuracy and Consistency of Radiographic Interpretation Among Clinical Instructors in Conjunction with a Training Program

There are inaccuracies and inconsistencies of radiographic interpretation among clinical instructors. The purpose of this investigation was to determine if a training program could improve the accuracy and consistency of instructors’ ratings of bone loss. A total of thirty-five clinical instructors consisting of periodontal faculty (periodontists and general dentists), dental hygiene faculty, and periodontal graduate students viewed projected digitized radiographic images and quantified bone loss for twenty-five teeth into four descriptive categories. Ratings of bone loss were made immediately before (pretest) and after (post-test 1) initiation of the training program and then again three months later (post-test 2). Ratings were compared to the correct choice categories as determined by direct measurement using the Schei ruler. Overall agreement with the correct choice improved over time (from 64.5 percent to 85.2 percent) with the greatest change from pretest (64.5 percent) to post-test 1 (76.5 percent). Mean and absolute differences improved in three of the four categories, but worsened in one from pretest to post-test 1. This category returned to its original high value at post-test 2. The greatest improvement in consistency among instructors’ ratings was seen in one of the four categories, which was “none” (no bone loss). Extension of the training program may further enhance the accuracy and consistency of instructors’ radiographic interpretation

Accuracy and Consistency of Radiographic Interpretation Among Clinical Instructors Using Two Viewing Systems

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153540/1/jddj002203372006702tb04071x.pd

Variation in Periodontal Diagnosis and Treatment Planning Among Clinical Instructors

Consistency in clinical decision making may be necessary for reliable assessment of student performance and teaching effectiveness, yet little has been done to examine variation in periodontal diagnosis and treatment planning among dental school faculty. The purpose of this investigation was to examine variation among faculty in diagnosis and management of common periodontal diseases. Twenty-seven clinical instructors (periodontists, general dentists, dental hygienists, and first- and second-year periodontal graduate students) reviewed three web-based cases and answered a brief questionnaire focusing on radiographic interpretation, periodontal diagnosis, and treatment planning. Response rates for the three cases ranged from 62 percent to 70 percent. Clinical instructors’ rating of percent bone loss in the majority of cases varied between three descriptive categories for the same tooth. Greater consistency in periodontal diagnosis was noted within the graduate student group as compared to periodontal and dental hygiene faculty groups. Diagnoses offered for one of the three patients varied between gingivitis and chronic and aggressive periodontitis. Six to nineteen different treatment plans (many with subtle differences) were submitted for each of the three cases. Inter-rater variation was qualitatively more prevalent than intra-rater variation. To our knowledge, this is the first study to document substantial variation among instructors in radiographic interpretation, diagnosis, and treatment planning for common periodontal diseases. Qualitative judgments speculating on the impact of variability among dental school faculty on student performance and patient care can be made but as yet remain unknown. Consistent use of accepted practice guidelines and greater consensus-building opportunities may decrease variation among faculty and enhance dental education