Dental curriculum revision in Iran: dentists' perspective on achievement of essential competencies through national curriculum

Based on the current emphasis on competency-based education, as a part of need assessment phase of dental curriculum revision in Iran, in the present study the dental graduates' perspective concerning the minimum competency requirements for an Iranian general dentist has been investigated. Based on the three available major competency documents in the literature a questionnaire was developed in which the participants were asked to indicate their opinion about the necessity of each of the 142 stated competencies for an Iranian general dentist [Yes/No], and to state the degree to which they believed the current curriculum covers each competency [Completely, Partially, Not at all]. In an annual meeting in June 2008, the provincial chief dental managers were asked to distribute the questionnaires among general dentists in their province [10 questionnaires in each province]. The managers posted back the completed questionnaires to the researchers. Of 300 questionnaires distributed in the 30 provinces of the country, 250 questionnaires [83%] were returned. While most of the participants considered the competencies as necessary for an Iranian dentist, less than 40% of the respondents believed that the graduates acquire the most required competencies of the profession during the current educational program. A necessity exists for curriculum revision. In addition to clinical skills, in this revision more emphasis also should be placed on the non-clinical part of the curriculum

[Clinical comparison of dental caries by DMFT and ICDAS systems]

The common method of caries status evaluation is the number of decayed, missed and filled teeth [DMFT] index. Recently the International Caries Diagnosis and Assessment System [ICDAS] has been introduced for a detailed evaluation of the dental caries. The aim of this study was to evaluate the caries status with this new system while comparing it with the DMF index as a common method. A total of 110 dental students were selected randomly and examined. Examination was done in the dental unit under good light circumstances. First, all surfaces of the teeth were cleaned with a brush, rubber cup and prophylaxis paste and then rinsed. Subsequently, examination was performed in each person by two calibrated examiners according to DMFT system and ICDAS [evaluation of teeth status in occlusal and smooth surfaces in dry and wet situations according to codes of this system] and the information forms were completed. Chi square statistical test was used for data analysis. The mean DMFT was 7.16. According to ICDAS system nobody had 00 code meaning that at least one surface of 182 dental surfaces had a lesion. Only seven cases had codes 00-02. The results for codes 03 through 06 were as follow, respectively: 51, 49, 34, 2. Ninety nine cases had extracted or non-examinable teeth. The interexaminer kappa coefficient was 0.916. The new system, ICDASl, provides more accurate information than DMF for the investigators and epidemiologists. The DMFT number does not show any details about the dental status of the cases

[Comparison of cytological findings of the buccal mucosa between smokers and non smokers]

In the past few years an alarming rise in the occurence of oral and oropharyngeal squamous cell carcinoma which now comprises 3% of all cancers in men and 2% of all cancers in women has been seen. Tobacco smoking is a single most well-known and important risk factor for squamous cell carcinoma in oral cavity. However, the pathogenesis, especially the initial changes brought about by smoking is not fully understood. The aim of this study is to compare cytological findings of apparently normal buccal mucosa among smokers and nonsmokers based on samples obtained by brush biopsy. Thirty-eight smokers and 42 nonsmokers, who did not show any conspicuous oral lesions were evaluated in a cross-sectional study. The specimens were taken from healthy and apparently normal buccal mucosa by a commercial cytobrush. Cytologic evaluation of biopsy specimens in terms of frequency of dysplasia/neoplasia, granular cells, binuclear cells, coarse chromatin, clear nucleus, apoptotic cells, pleomorphism in nuclear and cytoplasmic morphology was performed. Chi square test was used for comparison and analysis. Studied samples included 80 men [mean age, 40 years] in both groups. There was no dysplastic or neoplastic changes in any of the groups. Cytologic studies demonstrated that clear nucleus, coarse chromatin and the frequency of nuclear pleomorphism showed statistically significant differences between the two groups [P<01, P<001 and P<01 respectively]. Buccal mucosa of smokers showed some differences compared to samples from nonsmokers. However, the clinical significance of these changes is uncertain

[Assessment of periodontal condition among Iranian HIV+ patients during 2005]

There is no precise information of periodontal status in HIV-infected Iranian patients, so this descriptive study was performed to assess periodontal condition among HIV-infected patients referred to the three HIV patients medical centers in Tehran during 2005. One hundred and eighteen known HIV+ patients, confirmed by ELISA, Western blot and clinical examination, participated in this study. Data on age, gender, level of education, smoking, marital status, type of addiction, type of antiretroviral medicine, their dose and duration of consumption, etiology of their disease, and level of CD4 were recorded. None had surgery on neck and mouth. MGI, PI [Shick and Ash], PD, and CAL were measured on 6 surfaces of each of the Ramjord's teeth. Data analysis was done by SPSS, SAS, generalized estimated equation, Hotte Ling's multivariate model, Pearson and Spearman correlation tests. One hundred and fourteen men [96.6%] and 4 women [3.4%] with mean age of 33.6 +/- 6.49 participated in the study. 14 persons [27%] had CD4<200, 29 patients [55.7%] had 200500. Mean MGI, PI, and PD were 1.33 +/- 0.41, 2.8 +/- 0.18, and 1.66 +/- 0.98 respectively. There was no difference between CD4 and MGI and PI [P=0.1 and P=0.2], but in patients with CD4<200, CAL was significantly higher than the other two CD4 groups [P=0.02]. PD in this group was significantly higher than the other CD4 groups [P=0.01]. MGI and PI level in the study group were high which indicates poor oral hygiene. CAL was increased with immune system deficiency which indicates the influence of HIV-infection as a risk factor on the periodontal disease severity