Balancing the role of the dental school in teaching, research and patient care; including care for underserved areas.

Inequalities within dentistry are common and are reflected in wide differences in the levels of oral health and the standard of care available both within and between countries and communities. Furthermore there are patients, particularly those with special treatment needs, who do not have the same access to dental services as the general public. The dental school should aim to recruit students from varied backgrounds into all areas covered by the oral healthcare team and to train students to treat the full spectrum of patients including those with special needs. It is essential, however, that the dental student achieves a high standard of clinical competence and this cannot be gained by treating only those patients with low expectations for care. Balancing these aspects of clinical education is difficult. Research is an important stimulus to better teaching and better clinical care. It is recognized that dental school staff should be active in research, teaching, clinical work and frequently administration. Maintaining a balance between the commitments to clinical care, teaching and research while also taking account of underserved areas in each of these categories is a difficult challenge but one that has to be met to a high degree in a successful, modern dental school.

Transforming public health through distance learning.

Public health agencies face old and new problems in the next century: emerging infectious and chronic diseases, health problems related to personal behaviors, a changing demography, and a deteriorating physical and social environment. To meet these challenges, public health agencies should consider the following: the advent of new communications technologies, the need for a strong workforce, and the need for new partnerships. Distance learning can serve as a means to facilitate a strong workforce and new partnerships.

Dental public health strategies and health care reform.

There are significant challenges that need to be met to improve oral health in this country. Even if access to clinical preventive dental services is increased through a national health care plan, substantial improvement in the country's oral health cannot be achieved without support and assistance of public health initiatives. In January 1993, the steering committee for the Core Functions Project, U.S. Public Health Service, issued a report, Health Care Reform and Public Health: Population-Based Core Functions, to address the health care needs and conditions of populations as opposed to the individual health care needs under consideration by the national health care reform initiative. By adapting the report's core functions to the public's oral health, this article lays a foundation for the prevention, protection, and promotion of America's oral health.

Arizona providers' use and knowledge of fluoride supplements.

Dietary fluoride supplements are recommended for dental caries prevention in children without access to optimally fluoridated water. Previous studies have shown deficiencies in dentists' and physicians' knowledge about dietary fluoride supplementation. Data were collected from dentists, physicians and other healthcare provider groups to assess dietary fluoride supplement knowledge and practices. Pediatricians and dentists were found to be the most knowledgeable concerning the recommended prescribing protocols. Substantial proportions of all practitioner groups had insufficient knowledge about the recommended dosages of dietary fluoride supplements by age, fluoride levels in local water supplies, and the effectiveness of fluoride delivery methods. Baseline knowledge and practices were determined for healthcare provider groups within Arizona.

Economic impact of dental service utilization by older adults.

A total of 747 general dental practitioners--in Arizona, Colorado, Connecticut, Florida, and Minnesota--responded to a questionnaire in 1988 by completing a detailed productivity report of patient services performed during a specified period. The results, based on 11,909 patient visits and 22,712 dental procedures, indicated that stereotypes of older adults as underutilizers of dental care are incorrect. This finding and others, detailed within this article, indicate that older adults make up a substantial portion of regular patients and that their utilization of dental services should increase throughout 1990.

Self-care motivation: a model for primary preventive oral health behavior change.

Attempts to promote compliance of children with preventive health practices are most successful when strategies for motivating self-care behavior change address the physical, cognitive, and affective components of individuals. This study evaluated the effectiveness of using a Self-Care Motivation Model and curriculum to promote oral health and hygiene behavior change among 92 third grade students randomly selected according to homeroom assignments in five Gloucester, Mass., public schools. Student gingival health and oral hygiene measures were obtained two weeks prior to, and two weeks, three months, and one year after educational sessions. Group one, comprised of mid-high socioeconomic status family students, served as an oral examination control. Groups two-five received educational sessions designed to teach students various aspects of oral health. Significant improvements (p less than .001) in gingival health and dental plaque scores were observed in all experimental groups for up to three months. During a period of three months to one year, mean group scores returned to baseline and worsened for all groups except group five, the lowest socioeconomic family status group and the only group receiving the full series of self-care motivation curriculum sessions. Experimental group teachers reported that most children responded favorably to the program, and specific attitude and behavior changes were observed in many children. Further research evaluating the efficacy of using this self-care motivation model in primary preventive health education programs is indicated.