Medical history complexity of patients attending dental student restorative treatment clinics compared with dental emergency clinics.

INTRODUCTION: Dental students should graduate from undergraduate programmes with the knowledge and skills to safely manage patients. This requires exposure to patients with a range of medical needs, which may impact the planning and delivery of care. AIMS AND OBJECTIVES: We wished to establish the medical history complexity of patients presenting to student restorative clinics and compare them to patients attending a dental emergency clinic. MATERIALS AND METHODS: We recorded the medical history data of 200 anonymised patients attending student restorative clinics and compared them to previously collected data from 200 dental emergency clinic patients. We collected basic demographic data (age/gender) and noted the number of medical disorders, amount of comorbidity and the number and types of medications for each patient. RESULTS: The age and medical complexity of patients were different, with fewer young patients seen in the dental restorative clinics. Patients attending restorative clinics were more likely to have multiple comorbidities and took greater numbers and types of medications than those seen in dental emergency clinics. CONCLUSIONS: For patients seen in student restorative clinics, medical histories are taken once at the beginning of care and the subsequent treatment plan is delivered over many appointments accounting for that medical history. Emergency clinic patients attend for single treatment episodes and their medical complexity is immediately relevant to the treatment offered. Students have multiple, single encounters with patients in emergency clinics. In both clinics, dental treatment plans need to be adjusted to account for patients' drugs and diseases, providing opportunities to consolidate human disease learning.

Consolidating human disease learning in the Dental Emergency Clinic.

INTRODUCTION: Dental undergraduates typically learn and are assessed on aspects of human disease (HD) in the early part of their programme, but it is not until later in the programme that their HD knowledge is put into practice when they provide courses of treatment for numerous patients over multiple visits. The teaching of HD provides core knowledge on medical conditions and medications and is therefore essential in allowing newly graduated dentists to provide safe treatment for medically compromised patients or those taking medications. We wanted to examine the medical complexity of patients attending a university hospital dental emergency clinic to determine whether this was a suitable group that would help students to consolidate their HD learning in the context of a single visit where treatment was also provided. MATERIALS AND METHODS: We examined the medical history of 200 patients attending the dental emergency clinic in the University Dental Hospital, Cardiff, using a previous study as a benchmark. Anonymous data were collected using the medical history proforma, and included age, gender, medications, types and number of medical conditions/disorders. RESULTS: Patients attending the clinic were more medically complex than those in the comparator study and the demographics reflect wider population data showing increasing numbers of older patients with greater medical morbidity. DISCUSSION/CONCLUSIONS: The emergency dental clinic is the place where most patients are new to the hospital, have a dental history, medical history, investigations, diagnosis and treatment in a single visit, and offers excellent opportunities for consolidating HD learning in a one-stop clinical treatment episode, guided by suitable instructors.

Paediatric dentistry trainee views on training relating to the medically compromised child and oral medicine elements of specialty training curricula.

INTRODUCTION: Paediatric dentists care for children who are medically compromised and with an orofacial disease; therefore, trainees need appropriate training in these areas. The prevalence of congenital and chronic diseases in children is increasing, and future specialists need an understanding of human health and disease and oral medicine. This study aimed to determine if current teaching and assessments were fulfilling these requirements. MATERIALS AND METHODS: A survey distributed to the UK and Ireland specialty trainees asked their opinions on whether knowledge gained prior to entering training, and teaching and learning during training equipped them for future management of medically compromised children and those with oral medicine diagnoses. RESULTS: The response rate was 51% (26 trainees). Most were aware of curriculum elements for medically compromised children and oral medicine. The majority felt that knowledge and experience gained as undergraduates and early graduates was insufficient and recognised the need for these topics in speciality training. For medically compromised children, this learning was considered a good use of time by 96% of trainees, and 88% felt that this topic should be given more attention. For oral medicine, this learning was considered a good use of time by 96% of trainees, and 69% felt that this topic should have more attention. CONCLUSION: Paediatric dentistry specialty trainees recognise that knowledge and experience of managing patients considered medically compromised and those with oral medicine conditions are an important part of training and need greater emphasis, especially in light of changing demographics with congenital and acquired chronic disease, and children with oral medicine disorders.