Curriculum content and assessment of pre-clinical dental skills: A survey of undergraduate dental education in Europe.

INTRODUCTION: Since 1981, the qualifications for various healthcare professionals across the European Union have enjoyed mutual recognition in accordance with the EU Directive 81/1057/EEC. Whilst the directive includes dental practitioners, it is recognised that significant variation exists in curriculum structure, content and scope of practice across institutions. This article aimed to explore pan-European practice in relation to curriculum content, teaching and learning strategies and assessment of pre-clinical dental skills. METHOD: A request to complete an online questionnaire, in English, was sent electronically to skills leads at all Association of Dental Education in Europe member schools. The questionnaire collected information in relation to institution and country, regulatory requirements to demonstrate safety, details of specific pre-clinical skills courses, learning materials and teaching staff. RESULTS: Forty-eight institutions, from 25 European countries responded. Seven countries (n=7, 28%) reported no requirement to demonstrate student operative safety prior to patient treatment. Several core and operative clinical skills are common to the majority of institutions. The most commonly taught core skills related directly to the clinical environment such as cross-infection control and hand washing. The least common were skills that indirectly related to patient care, such as communication skills and working as a team. CONCLUSION: There are clear differences within European pre-clinical dental education, and greater efforts are needed to demonstrate that all European students are fit to practice before they start treating patients. Learning outcomes, teaching activities and assessment activities of pre-clinical skills should be shared collaboratively to further standardise curricula.

The Flipped Classroom for pre-clinical dental skills teaching - a reflective commentary.

A Flipped Classroom method for teaching of adult practical pre-clinical dental skills was introduced to the BDS curriculum in Glasgow during the 2015/2016 academic session. This report provides a commentary of the first year of employing this method - from the identification of the need to optimise teaching resources, through the planning, implementation and development of the method, with an early indication of performance.

Sedation in dentistry. Part 2: Management of the gagging patient.

Sedation should be considered as a useful part of the general dental practitioner's armamentarium and as an important alternative to general anaesthesia in selected cases. In this, one of a series of articles on the uses of sedation in various circumstances, the management of the gagging patient is discussed. The many factors involved in the aetiology of the hyperactive gag response are reviewed and measures for dealing with it suggested.

Rebuilding the face of George Buchanan (1506-1582).

For many years, controversy has existed as to which of several portraits bore the closest resemblance to George Buchanan, Scottish humanist, historian, churchman, statesman and tutor to James VI of Scotland (later James I of England). It was considered that a formal facial reconstruction from his skull, which is housed in Edinburgh University Anatomy Museum, would help clarify this long standing dilemma. The reconstruction process and its results are described and illustrated.

The use of cantilever bridges.

Replacement of missing teeth with fixed bridgework often involves producing full crown retainers on teeth on both sides of an edentulous space. Unfortunately, this approach can result in the destruction of much healthy tooth tissue, and the clinician must balance the benefits of replacing missing teeth with the amount of tooth preparation required. Current thinking in restorative dentistry places the preservation of tooth tissue at a premium, and most practitioners are happy to use techniques that embrace this philosophy. Because of this, cantilever bridges have an increasing role in dental practice, where the replacement for a missing tooth or teeth has one or more abutments on only one side of the edentulous space, being unsupported at the other. Cantilever bridges fall into several types, depending on the number of abutments and types of retainers. This article describes the various cantilever bridge designs, considers the biomechanics of these restorations, and provides guidelines for their clinical use.

Vertical height differences in subjects with severe dental wear.

The present study aims to determine differences in vertical facial dimensions as a result of severe dental wear. The sample consisted of 35 subjects (mean age 48.4 years) who had advanced dental wear recognized by loss of more than one-third of the estimated original incisor crown length. The control group comprised 40 subjects (mean age 26.1 years) with acceptable occlusions and no signs of severe generalized tooth wear. Lateral skull radiographs were taken for both the study sample and the control group with the mandible in the maximum retruded position, from which measurements were made using a digitizer. The results showed no significant differences for total face height (n-gn) between the groups (P > 0.05) although for the study sample, upper face height was greater (P < 0.05) and lower face height was smaller (P < 0.05). Smaller values for tooth length were found in the wear sample, with the mean differences in tooth length being 5.0 mm for upper incisors and 3.3 mm for lower incisors. The overbite was smaller in the wear sample and the lower incisor position differed from controls in this group. It is concluded that the differences in face height together with differences in lower incisor position through dento-alveolar development contribute to maintenance of total facial height, so compensating for loss of vertical height through severe dental wear.

Tooth wear and facial morphology.

This review sets out to explore the relationship between tooth wear and facial morphology, with particular reference to the occlusal vertical dimension. Evidence from anthropological and archaeological investigations suggests that severe tooth wear may not only affect the teeth and occlusion, but may also have more wide ranging effects on overall dentofacial morphology. Studies on contemporary subjects confirm this finding, and the literature on the nature of these effects is reviewed. It is concluded that the adult dentofacial complex is not a static entity, but can compensate for the dental effects of wear. The consequences of this with respect to reconstruction of the worn dentition are discussed, and it is proposed that the dynamic nature of this complex may be employed to help simplify the treatment of severe tooth wear.

Teaching integrated treatment at Newcastle upon Tyne Dental School.

This article explains the educational policy decisions that lay behind the development of a teaching and training programme of integrated dentistry at the Dental School at Newcastle upon Tyne. The development and organisation of a specially designed clinic is described. The pattern of work undertaken during the first 2 years of operation is analysed and the means of clinical assessment of this work discussed.