The graduate entry generation: a qualitative study exploring the factors influencing the career expectations and aspirations of a graduating cohort of graduate entry dental students in one London institution

Background: Dentistry in the UK has a number of new graduate-entry programmes. The aim of the study was to explore the motivation, career expectations and experiences of final year students who chose to pursue a dental career through the graduate entry programme route in one institution; and to explore if, and how, their intended career expectations and aspirations were informed by this choice. Method: In-depth interviews of 14 graduate entry students in their final year of study. Data were transcribed verbatim and analysed using framework analysis. Results: There were three categories of factors influencing students' choice to study dentistry through graduate entry: 'push', 'pull' and 'mediating'. Mediating factors related to students' personal concerns and circumstances, whereas push and pull factors related to features of their previous and future careers and wider social factors. Routes to Graduate Entry study comprised: 'early career changers', 'established career changers' and those pursuing 'routes to specialisation'. These routes also influenced the students' practice of dentistry, as students integrated skills in their dental studies, and encountered new challenges. Factors which students believed would influence their future careers included: vocational training; opportunities for specialisation or developing special interests and policy-related issues, together with wider professional and social concerns. The graduate entry programme was considered 'hard work' but a quick route to a professional career which had much to offer. Students' felt more could have been made of their pre-dental studies and/or experience during the programme. Factors perceived as influencing students' future contribution to dentistry included personal and social influences. Overall there was strong support for the values of the NHS and 'giving back' to the system in their future career. Conclusion: Graduate entry students appear to be motivated to enter dentistry by a range of factors which suit their preferences and circumstances. They generally embrace the programme enthusiastically and seek to serve within healthcare, largely in the public sector. These students, who carry wider responsibilities, bring knowledge, skills and experience to dentistry which could be harnessed further during the programme. The findings suggest that graduate entry students, facilitated by varied career options, will contribute to an engaged workforce

A randomised controlled study on the use of finishing and polishing systems on different resin composites using 3D contact optical profilometry and scanning electron microscopy

Objectives: The aim of this study was to evaluate theeffects of different finishing and polishing techniques on the surface roughness of microhybrid and nanofilled resin composites. Methods: The resin composites included were Filtek Z250 (a universal microhybrid resin composite) and Filtek Supreme XTE (a universal nanofill resin composite). Ninety cylindrical-shaped specimens were prepared for each composite resin material. The polishing methods used included tungsten carbide bur (TC); diamond bur (Db); Sof-Lex discs (S); Enhance PoGo discs (PG); TC + S; Db + S; TC + PG; Db + PG. Polymerisation against a Mylar strip without finishing and polishing acted as the control group. Surface roughness was measured using a 3D contact optical profilometer and surface morphology was examined by scanning electron microscope examination. Results: The results showed that the Mylar-formed surfaces were smoothest for both composites. Finishing with the 20 μm diamond finishing bur caused significantly greater surface irregularity (P < 0.0001) and damage than finishing with the tungsten carbide finishing bur. The Enhance PoGo polishing system produced smoother surfaces than the Sof-Lex disc polishing system; this difference was statistically highly significant (P < 0.0001). Conclusion: For both composites, the Mylar-formed surfaces were smoothest. Where indicated clinically, finishing is better conducted using a tungsten carbide bur- rather than a diamond finishing bur. The Enhance PoGo system was found to produce a smoother surface finish than the Sof-Lex system. Clinical Significance: If finishing and polishing is required the use a tungsten carbide finishing bur followed by Enhance PoGo polishing may be found to result in the smoothest surface finish

The teaching of posterior resin composites: planning for the future based on 25 years of research

Objectives: The restoration of posterior teeth affected by caries, trauma or wear remains one of the commonest procedures in the practice of dentistry. Over the past 20 years the first author and latterly the second author have led a series of surveys around the world to capture information on the teaching of posterior resin composites. The aim of this paper is to identify trends, reflect on the findings and make recommendations for the further development of this important aspect of the curriculum for primary dental qualifications. Methods: Surveys on the teaching of posterior resin composites were completed in 1986, 1997–99, 2004–05 and 2007–2009. The findings from these surveys were reviewed and drawn together to allow historical and contemporary international trends to be identified. Recommendations for further developments in the teaching of posterior resin composites were formulated from the cumulated data and trends identified. Results: Information was available from a total of 679 survey returns. Increased teaching of posterior resin composites has been observed over the period of the surveys: while 90% of dental school curricula did not include any didactic teaching of posterior resin composites in the mid-1980s, this dropped to 4% or less in the late 1990s, and to 0% in the early 2000s. In the late 2000s, however, 21% of dental schools still did not teach the placement of resin composites in three-surface cavities in permanent molar teeth. Areas of confusion were reported in the teaching of certain aspects of cavity design, notably the use of bevels, and in the protection of operatively exposed dentine. Conclusions: While there has been steady growth in, and trends towards evidence-based teaching of posterior resin composites in dental schools around the world over the last 20–25 years, there is a need for further developments and harmonisation in this important aspect of curricula for primary dental qualifications. This need is now pressing, subsequent to the signing of the Minamata Convention. It is recommended that all new graduates, from no later than 2020, should have the knowledge, skills, competences and confidence to effectively restore damaged and diseased posterior teeth with state-of-the-art resin composite systems

Effects of toothbrushing on surface characteristics of microhybrid and nanofilled resin composites following different finishing and polishing procedures

ObjectivesTo evaluate the effects of simulated tooth brushing (STB) on the surface roughness of microhybrid and nanofilled resin composites following different finishing and polishing procedures. Materials and methodsNinety cylindrical-shaped specimens of Filtek Supreme XT (a universal nano resin composite) and Filtek Z250 (a universal microhybrid resin composite) were prepared. The specimens were allocated at random into 9 paired groups each of 10 specimens. The finishing and polishing systems included were Tungsten Carbide bur (TC); Diamond bur (Db); Sof-Lex discs (S); PoGo discs (PG); TC + S; Db + S; TC + PG; Db + PG. Polymerisation against a Mylar strip without finishing and polishing acted as the control. Surface roughness was measured using a 3D non-contact optical profilometer and surface morphology was examined by scanning electron microscopy. Specimens were subjected to the equivalent of four years STB and surface roughness was measured again. ResultsMylar formed surfaces were the smoothest for both composites before and after STB. Finishing with the diamond finishing bur caused significantly greater surface irregularity (p < 0.0001) before and after STB compared to the tungsten carbide bur. The surface treatment with Db + PG resulted in significantly greater surface roughness following STB than all other regimes of finishing and polishing (p < 0.01). ConclusionWhere indicated clinically, finishing is better conducted using a tungsten carbide bur rather than a diamond finishing bur. The combination of tungsten carbide bur/Enhance PoGo and tungsten carbide bur/Sof-Lex surface protocols produced a similarly smooth finish for both composites. The composite surfaces in all groups increased in surface irregularity following STB. Clinical significanceWhilst finishing using a tungsten carbide finishing bur followed by either the Sof-Lex or PoGo polishing system may be found to result in a smooth surface finish, all the surfaces investigated increased in surface roughness following toothbrushing

Monitoring erosive toothwear:BEWE, a simple tool to protect patients and the profession

Erosive tooth wear is the third most commonly observed oral condition after caries and periodontal disease, with a prevalence similar to that of dentine hypersensitivity. However, it is not a condition that is routinely screened, or monitored, as part of the standard dental examination. Following a meeting held in 2018, this paper considers the outlook for erosive tooth wear and the need for dental professionals to monitor for signs of the condition as part of an oral health assessment, to provide protection for patients and the profession. The use of the basic erosive wear examination (BEWE) is proposed as a simple screening tool designed to detect erosive tooth wear in clinical practice