Patient satisfaction with intraoral examination in a Nigerian tertiary hospital

Objectives: While studies on satisfaction following medical procedures are well documented, but this is not so with dental procedures. Therefore, this study aims to determine the level of satisfaction in patient undergoing intraoral examination (IOE). Material and Methods: Consecutive patients attending the oral diagnosis clinic of University of Benin Teaching Hospital from April 2020 to September 2020 were interviewed using a questionnaire modified from the modified Group Health Association of America-9 questionnaire. Results: A total number of 103 consecutive dental patients were recruited as they all agreed to participate in the study. The age range was 18­77 years with a mean age of 35.8 ± 14.3 years. There were more males (51.5%). The overall satisfaction was 82.5%. The maximum satisfactory response was on doctor's manner (93.2%), followed by staff 's manner (89.3%), comfort during IOE (80.6%), adequate explanation (78.6%), and finally by waiting time (60.2%). There was association between occupation (P = 0.04) of the patients, type of dental condition (P = 0.03), waiting time (P = 0.01), doctor's manner (P = 0.00), staff manner (P = 0.00), adequate explanation (P = 0.00), comfort during IOE (P = 0.00), and level of satisfaction. The problem rate was 16%. Conclusion: Although waiting time and adequate explanation ranked the highest in terms of unfavorable responses, the overall satisfaction of patients following IOE was generally good. The factors that influence satisfaction were occupation of the patients, type of dental condition, waiting time, doctor's manner, staff manner, adequate explanation, and comfort during IOE.

Introduction of structured oral examination in formative assessment of pharmacology for 2nd professional MBBS students

Background: Conventional Oral Examination (COE) is criticized for being too subjective and being influenced by academic and non-academic factors. Another pitfall of COE is unequal distribution of time. Different examiners use a different set of questions with varying difficulty levels. Student related factors include gender, accent, vocabulary used and ability to pick nonverbal cues. These factors make COE less reliable and valid assessment tool. To overcome the limitations of this useful tool, SOE can be implement instead of COE.Methods: It is a prospective and non-randomized study comprising 79 students of pharmacology appeared for two forms of viva i.e. COE and SOE. Three sets of questionnaires - Must know, should know and nice to know were prepared, each having 15 items with increasing difficulty levels and were validated by subject experts and pretested. Ten minutes were allotted for each student for each form of viva. Feedback of students about the novel method was obtained by using semi-structured questionnaire comprising of 19 closed ended questions and one open-ended question.Results: Structured oral examination (SOE) yielded significantly higher marks as compared to COE. There were significant inter-examiner variations in marks awarded in SOE and COE. Other factors influencing implementation were difficulty in structuring viva, rigid time limits, lack of flexibility in knowledge content, monotony and fatigue. The students perceived this format not different from COE but felt that it required in depth preparation of topic.Conclusions: Conducting SOE is a resource-intensive exercise. Despite structuring, inter-examiner variability was not completely eliminated. The student’s performance was depended on factors related to examiners such as teaching experience, vernacular language used, and lack of training. Orientation and training of examiners in assessment strategies is necessary. Standardization of questionnaire is necessary before the implementation of SOE for summative assessment.

Oral health management for children / 华西口腔医学杂志

Pediatric dentistry should focus not only on the treatment of various oral diseases during the entire growth and development of children but also on the early prevention, diagnosis, and intervention of various oral diseases in this process. Early identification and removal of risk factors or early intervention for common oral diseases is necessary to the implementation of oral health management for pregnant women, infants, preschool and school-age children, and adolescents with different general and oral physiological characteristics and common oral diseases. The treatment enables the growth and development of the teeth, as well as occlusion and facials along the normal trajectory, ultimately achieving the functional perfection and aesthetic coordination of the cranio-maxillary and occlusion.

Sialolitíase em glândula salivar menor: relato de caso e revisão de literatura / Sialolithiasis in minor salivary gland: case report and literature review

A sialolitíase é uma afecção que se caracteriza pela obstrução da glândula salivar ou de seu ducto devido à formação de estruturas calcificadas acometendo predominantemente as glândulas submandibulares e muito raramente as glândulas salivares menores. O objetivo deste trabalho é realizar um relato de caso sobre sialolitíase em glândula salivar menor. Paciente do sexo masculino, leucoderma, 54 anos, se apresentou com queixa principal de "tumor na boca". O exame físico intrabucal revelou um nódulo localizado na mucosa labial do lado superior direito, próximo a comissura, único, medindo aproximadamente 2 centímetros no seu maior diâmetro. A ultrassonografia da região do lábio superior evidenciou a hipótese diagnóstica de corpo estranho. O diagnóstico diferencial e o clínico incluíram reação a corpo estranho. Foi realizada a biópsia excisional e durante o ato cirúrgico, foi encontrado um material endurecido, de aproximadamente 3 mm, de cor amarelada, que foi enviado para análise histopatológica, a qual revelou fragmento mineralizado compatível com sialolito. Com base nos achados clínicos e imaginológicos o diagnóstico foi de sialolitíase. Após três meses de acompanhamento, o paciente se apresentou sem evidência da doença. Esta revisão de literatura e o presente relato permitiram concluir que um exame clínico criterioso associado a exames imaginológicos adequados são essenciais para a obtenção de um diagnóstico clínico correto(AU)

Sialolithiasis is a condition characterized by obstruction of salivary gland or its duct due to formation of calcified structure, predominantly affecting the submandibular glands or, rarely, the minor salivary glands. The main objective is to report a case of sialolithiasis in the minor salivary gland on a male patient, leucoderma,54, and his main complaint was a "tumor in the mouth". Intraoral physical examination revealed a nodule located on labial mucosa of the upper right side of the mouth, near the commissure, single, and its diameter measuring approximately 2 cm. The ultrasound examination on the upper lip region resulted in a strange body. The differencial and clinical diagnosis was included strange body. During the excision biopsy surgery, a hardened material, measuring about 3 mm and yellowish was removed and sent for histopathologic exams and the diagnosis was sialolithiasis. After three mouths' follow-up, the patient was free of the disease. This literature review and the present case concluded that a careful clinical examination associated with imaging and histopathology examinations are essential for obtaining a correct clinical diagnosis(AU)

In-Depth Interview of Parents Experienced First Infant Oral Examination / 치위생과학회지

The purpose of this study is to analyze the experience of the parents who examined the first infant oral examination and to understand how to improve the practical oral examination business. In-depth interviews were held with 10 parents who did the first infant oral examination, and their children's age was less than 18 to 29 months. The following conclusions were obtained by deriving the concepts and categories of the recorded contents. First, the main reason for the unsatisfactory examination of this study was that it was formal. Parents were disappointed in the fact that they did not look at the mouth of the child at the same time as it was fast and they said because it is carried out free of charge, it is more formal than the examination for general dental treatment. Second, most of the participants questioned whether they should resume infant oral examination. Third, it appears that the tooth number or dental terminology in the result notice is difficult to understand. Fourth, the opinion on the improvement of the infant oral examinations was should provided that the oral health management information after examination and the direct oral health management method education at the examination. In addition, we identified the need for parents' oral health care education for infants. Therefore, it has been confirmed that in order for the infant oral examination and young children to be practically carried out, the problems should be improved by collecting opinions of the parents. Also it is necessary to search for efficient business management method through repeated research related to infant oral examination.

Medical Education in Hungarian Medical Schools / 医学教育

Recently, there has been an increase in the number of Japanese students who want to practice medicine in Japan after receiving their education in a Hungarian medical school and passing the Japanese national examination for medical practitioners. It is of great concern whether they received a sufficient amount of medical education to meet the public trust. Researchers from Japan visited Hungary and observed their medical education system. There are 4 national medical schools that have international courses for educating students from abroad in English. Three of those schools also offer education in German. The Japanese researchers observed international courses being taught in English at Semmerwise University in Budapest and Debrechen University in Debrechen, the 2nd biggest city in Hungary. Although the international education system is not much different from other European countries, some systems such as small group tutorial education, assessment via oral examination, and the requirement of a graduation thesis stood out as key strengths of the Hungarian education system.

Small group structured oral examination: An innovation in oral examination.

Assessment drives learning, For the past years, we have been using an Traditional oral exam i.e. one examiner or tow examiner taking oral examination of one student, as a part of the examination process for the First MBBS formative and summative assessment. There appears to be tremendous variation on what constitutes the "traditional" oral examination. Studies analyzing characteristics of oral examinations vary most often by format and number of examiners. Considering above pros and cons of traditional oral examination and on the basis of examiners’ feedback, the new format of viva voce examination is started in the form of “Small Group Structured Oral Examination”(SGSOE). In SGSOE Students will be divided in the small group of 10 to 12 students in each group. They have to sit in chronological order in group. Two examiners will be assigned to group . For examination, according to roll no, they have to randomly select a chit from box. Than student has to give answer of main question mention in structured viva card of the topic Than rest of the students one by one, has to give answer of leading question related to that topic. after completion of Group Viva (GV) group of two examiner present at group viva will decides Marks, depending number of topic attend by all the students. Thus, It is one of the new exam systems designed to make an objective, valid and reliable assessment of different components of subject.

Prevalence of oral lesions in elderly patients on oral cancer prevention campaigns in Paraná state Brazil 1989-2013 / Prevalência de lesões orais em pacientes idosos atendidos em campanhas de prevenção de câncer bucal no estado do Paraná, Brasil entre 1989 - 2013

Objective: recently, there has been a rapid aging process of the world population. Despite of a longer permanence of natural teeth and a reduction of oral diseases caused by the improvement of life conditions and the provision of health care, the prevalence of oral diseases in the elderly is still considered significant. Therefore, the aim of this study is to evaluate the epidemiological profile of elderly patients (above 60 years old) attended in 25 years of campaigns oral cancer prevention in the Paraná state, Brazil, between 1989 and 2013. Material and Methods: Patients, volunteers, were evaluated during 25 years of oral cancer prevention by the campaign team and all patients were evaluated in a methodical way with inspection of all intra-oral areas. Results: a total of 22,909 patients were attended during the 25 years of projects. Of these, 6,134 were older than 60 years old, with appearance of 1,523 oral lesions during the examination and 4,611 patients had no oral alterations during the dentist evaluation, among those were found injuries by traumatic origin, inflammatory lesions and others types of injury. Conclusion: it is clear the necessity for specialized care and active surveillance of these patients, since it is a consensus in the literature that the best treatment is early diagnosis. It is also necessary the development of epidemiological studies of the elderly population, which are scarce and difficult to elaboration of plans for effective action to meet the specific demands of this age group.

Objetivo: a população mundial atualmente sofre com um rápido processo de envelhecimento. Apesar de uma maior permanência dos dentes naturais e da redução de doenças bucais causadas pela melhoria das condições de vida e da prestação de cuidados de saúde, a prevalência de doenças bucais em idosos ainda é considerado significativa. Portanto, o objetivo deste estudo é avaliar o perfil epidemiológico dos pacientes idosos (acima de 60 anos) que foram atendidos em 25 anos de campanhas de prevenção do câncer de boca no estado do Paraná, Brasil, entre 1989 e 2013. Material e Métodos: Os pacientes foram selecionados voluntariamente e avaliados durante 25 anos de prevenção de câncer bucal pela equipe participante, os quais foram avaliados de forma metódica com a inspeção de todas as áreas intra-orais. Resultados: um total de 22.909 pacientes foram atendidos durante os 25 anos de projetos. Destes, 6.134 tinham mais de 60 anos, com presença de 1.523 pacientes com lesões orais durante o exame e 4.611 pacientes sem alterações orais durante a avaliação do dentista. As lesões encontradas tinham origem traumática, inflamatórias e outras. Conclusão: é evidente a necessidade de atendimento especializado e da busca ativa desses pacientes, uma vez que é um consenso na literatura de que o melhor tratamento de lesões orais é o diagnóstico precoce. Também é necessário o desenvolvimento de estudos epidemiológicos da população idosa, que são escassos e difíceis de elaboração assim como a realização de planos de ação eficazes para atender às demandas específicas desta faixa etária.

Assessment in Undergraduate Medical Education: Bangladesh Perspectives.

Background: Medical education in Bangladesh is totally controlled by the Government and run a unique undergraduate curriculum throughout the country in both public and private sectors. This paper is aimed to briefly describe the medical education reform in Bangladesh and suggests further assessment changes. The present official form of undergraduate medical curriculum has first evolved in 1988 followed by revision in 2002 and 2012. Assessment and teaching are the two sides of the same coin. Assessment drives learning and learning drives practices. Following the curriculum reform since 2002, the assessment in undergraduate medical education has been greatly changed. There are a lot of in-course formative assessments which include item examination, card final and term final, designed to improve the quality of education. Ten percent marks of summative written examinations derive from formative assessment. Traditional oral examination has been changed to structured form to ensure greater reliability. Even then, teachers are not yet building up to conduct oral examination in such a structured way. Examiners differ in their personality, style and level of experience with variation of questioning and scoring from student to students. Weakness of reliability on oral examination still exists. Students also feel very stressful during the oral examinations. Moreover, to conduct such oral examination, three to four months times per year are lost by the faculties which can be efficiently utilised for teaching and research purposes. Worlds' leading medical schools now-a-days used oral examination only for borderline and distinction students. Bangladesh also must consider oral examination only for borderline and distinction students.

Development of a smart oral examination system for tablet personal computers / 대한구강보건학회지

OBJECTIVES: In the present study, we aimed to develop an oral examination smart chart application for tablet personal computers (PC). We evaluated the time required to perform an oral examination and assessed the degree of user's convenience by using this application. We determined to make our application cost and human resource effective by automatically computerizing the statistics to facilitate its application in oral health services such as national oral health research. The development of this application for tablet PCs was aimed at recording the results of oral examinations. METHODS: We produced flow charts and designed the program screen, which would replace the existing paper chart. To evaluate the efficiency of the application, 1 preventive dentistry professor and 6 dentistry students performed an oral examination on 41 subjects. We performed the oral examination in duplicate using a tablet PC and a paper chart. The data collected were analyzed using the SPSS 18.0 program. P-values less than 0.05 were considered statistically significant. RESULTS: The time required for oral examination by the study group (the group using the application) and the control group (the group using paper) were 131.93+/-10.14 and 151.85+/-7.77, respectively; the difference between these values was statistically significant (P-value=0.002). The oral examination could be performed faster in the study group (the group using the application) than in the control group; therefore, we noted that the time taken for oral examination was reduced by using the application. CONCLUSIONS: The tablet-based system has been shown to save time by omitting the step of entering the paper chart data into a computer. Further, the findings of this study can be used to establish an oral health index database with the help of additional resources. Moreover, it would facilitate creating awareness among the patients with regard to their oral health indices through the use of visual aids.

Usefullness of panoramic radiograph for the improvement of periodic oral examination / 대한구강악안면방사선학회지

PURPOSE: This study was designed to evaluate the efficacy and utility of panoramic radiograph for the improvement of the periodic oral examinations. MATERIALS AND METHODS: Clinical examinations and panoramic examinations were done for the 242 subjects of oral examinations. The results of panoramic radiograph interpretation were compared with the clinical findings. Two questionnaires were created. One was carried out before the panoramic examination and the other done afterwards, to find out the subjects' cognition and satisfaction for the clinical and panoramic examinations. RESULTS: 1. Panoramic findings showed a higher detection rate of 31.9% for periodontal diseases, and 23.1% for dental caries than clinical findings. CONCLUSION: The panoramic examination was revealed to improve the effectiveness of the periodic oral examination and to increase the satisfaction of the subjects of examination.

The Use of Oral Test on Pathology Course / 한국의학교육

Gachon Medical School used an oral examination in the pathology course taught during the 2nd semester of the 2000 school year as a performance assessment of students abilities in three areas: comprehension, logic and problem solving. The evaluation instrument was designed in four stages: assessment objectives were determined, abilities to be measured were selected, the assessment instrument was designed, and the examiners' checklist was drafted. The assessment instrument included two gross and two microscopic cases and the checklist was developed using 5 Likert type scales. The students were divided into three groups of 12 to 13 students and two examiners were allocated to each group. The mean score on the oral examination was 3.56(the highest possible score is 5.00). The correlation between examiners was 0.952 while the correlation of gross and microscopic cases was 0.979. Obviously, these data are statistically significant. The correlation between the written examination pathologic-laboratory examination was the highest, that between the oral examination and pathologic-laboratory examination was in the middle, and that between the oral examination and the written examination was the lowest. Students expressed doubts about the objectivity of individual examiners. The high correlation between the examiners' scores and how students scored on other tasks shows that students fears can be assuaged. It is concluded that the oral examination is a powerful tool in measuring students ability, and can be used in a basic medical science course. As an assessment instrument, it is both valid and reliable.