A survey of dental school applicants' career intentions and the balance with family life.

PURPOSE: To investigate the career plans of prospective dental students and how they foresee their work life balance. METHOD: Applicants to Dundee and Manchester dental schools completed anonymous questionnaires when they attended for interview. RESULTS: The useable response rate was 94% (n=436). The majority of the respondents (91.3%) intended working full time when they enter the workforce, with no significant variation detected between males and females. The cohort anticipated their mean salary to be just over 28,000 UK pounds, five years into their career, although the males felt they would be earning 5,000 UK pounds more than the females. Individuals of Pakistani and Indian origin thought they would earn most, and Asians least. Sixty-five per cent would enter general dental practice and, of these, only 2.8% expected to work exclusively within the NHS. Fifteen per cent intended to go into the hospital dental service, with orthodontics the most popular choice of subspecialty (43.7%), followed by oral surgery (31.1%). Significant variation was seen between ethnic groups, with the hospital and community dental services being more popular with those who identified themselves as of non-white ethnic origin, although the majority would still plan on entering general dental practice. Almost half (44.5%) would take time out of their career to concentrate on childcare when children were of pre-school age, with a further 11% taking longer. Ninety per cent of females and 70% of males anticipated taking time out, of a varying duration. Half of the respondents indicated that they felt a child would affect their career to a moderate extent. CONCLUSIONS: The dental profession will be severely affected if both males and females take time out of their careers in the future. As well as a work force shortage, the problems of accessibility to NHS dental services will be exacerbated if fewer dentists choose to provide NHS care.

The future of the profession--a survey of dental school applicants.

PURPOSE: To gather background information about applicants to the dental undergraduate course, and ascertain the factors involved in their decision to study dentistry. METHOD: Applicants attending for interview at Dundee and Manchester Dental Schools completed anonymous questionnaires. The useable response rate was 94% (n = 436). RESULTS: There were equal numbers of male and female applicants to the two schools as a whole. Although there was a much broader ethnic mix in the applicants to Manchester, the overall proportion of minority ethnic groups was considerably greater than in the UK population as a whole. Seventy-five per cent came from professional backgrounds, although marked differences were apparent between ethnic groups. A quarter had family relations who were dentists, and 30% were related to doctors. Over half (53%) decided to apply within the last year, with popular motivating factors including a general interest in dentistry, a desire to help people and to work with their hands. Dentistry was the first choice of career of 89%, with medicine the most popular alternative. CONCLUSION: Valuable information was gathered from these prospective dental students regarding their backgrounds and the decision process involved in their career selection. This will prove beneficial when developing the recruitment process and allow appropriate tailoring to the target audience.

How relevant is counselling in relation to dentistry?

This article attempts to explain reasons behind the general public's fear of dentistry by examining the historical perspective and, using case scenarios, demonstrates areas where patients' dental treatment might have been helped by the use of counselling. Distinguishing between the use of counselling skills vis-à-vis professional counselling, the wider issues for the dental profession - education, boundaries and the need for referrals - are explored. It is suggested that if a counsellor were included as part of the dental team, patients and professionals would benefit. The counsellor could act as an advisor and educator for the team in addition to undertaking professional counselling on referral. Patients with anxiety or phobias could be recognised and helped appropriately and occupational stress experienced by practitioners would be reduced.

Biological guides to the positioning of the artificial teeth in complete dentures.

Setting teeth for complete dentures is traditionally done away from the clinic in the dental laboratory. This has unwittingly given the impression that arranging tooth position is a mechanical process in which the clinician has little say. Many technicians are given few instructions, but a detailed prescription is crucial to the success of the denture. This article describes those considerations the dentist should address in communicating with the laboratory technician. A 'denture space' impression technique is described to assist the dentist in the correct prescription for posterior teeth placement.

Students' perceptions of seminar and lecture-based teaching in restorative dentistry.

In an era of self-directed learning, it is important to seek the views of dental students regarding their learning experience. Using an anonymous questionnaire, clinical dental students' perceptions of seminar and lecture-based teaching in restorative dentistry were sought. 116 of 136 questionnaires circulated were returned for analysis giving a response rate of 85%. Clinical seminars as opposed to lectures were, in the opinion of the students, a more effective way of learning, more relevant to self-development and more interactive. Seminar-based learning was considered to be more amenable to self-direction than formal didactic lectures. It is concluded that the students included in this study were found to prefer seminar-based learning opportunities as opposed to more traditional styles of learning, specifically, didactic lectures.

Relating personality to interview results and performance in the first year of the dental course.

The aim of this paper is to relate personality measures of Year 1 undergraduate dental students to their performance at admissions interview and during the first year of their course. The personality profiles of 58 first year dental students, were statistically related to results of the first year examinations and to the results of 54 of the students' structured admissions interviews. A relationship was found to exist which related personality to interview results and performance in the first year of their dental course.

An analysis of an admissions system: can performance in the first year of the dental course be predicted?

The admissions process must be scrupulously fair and select the most suitable students. Data on applicants to the Manchester Dental School for the 1996/97 academic year were analysed. The aims of this project were to: describe the applicants using information from the UCAS (university entrance) form; to relate information from the UCAS form to interview performance and A-level results; and to evaluate whether these factors can predict performance during the first year of the course.

Organising the introduction of, and evaluating interviewing in, an admissions system.

This paper describes the admissions process, especially the organisation of an interviewing system. The method of application to Dental School is discussed and basic selection processes outlined. The introduction of a new interviewing system is explained and criteria for interview selection and marking defined. All interviewers received regular training; the content of training days is described together with the experience of those involved. Changes made to the interview marking system after 1 year are discussed. Criteria marked at interview were monitored against students' success in year 1 and 2 examinations. Results show that students who performed highly at interview for leadership were more likely to succeed in semester 2 of the course and in year 1 examinations overall.

Measurement of changes in dimensions of resorbing alveolar bone: description of a method.

This study evaluated a cast-measuring device used to investigate effects of augmenting fresh extraction sockets with dense hydroxyapatite granules. Following reproducible location of the casts, alterations in ridge tracings were related to radiographically determined ridge height alterations. A randomised controlled study compared two groups of immediate complete denture wearers. One group received conventional immediate dentures, the other received immediate complete dentures after dense hydroxyapatite implantation into canine sockets. Ridge height alterations with time were recorded from radiographs. Alterations in ridge form were recorded from several models transferred reproducibly to a mounting jig attached to a profiling apparatus. Further, the osteo-retentive ability of the hydroxyapatite in the sockets was seen to be close to significance (after six months width differences, in the canine region: P = 0.059, LHS, and P = 0.065, RHS).

Geroprosthodontics: The Nijmegen and Manchester Dental Schools approach.

If quality of care for elderly patients is to be achieved, thorough and realistic geroprosthodontic treatment planning is essential. This requires mature consideration, incorporating comprehensive patient assessment and selection of the most appropriate treatment option for each patient. The latter should be based on criteria which meet the demands of a healthy dentition and which enable a patient to achieve satisfactory oral function. The Nijmegen and Manchester Dental Schools have evolved simple patient-related treatment guidelines. These start with a problem-oriented approach which leads to a provisional treatment. The provisional treatment is intended to result in a healthy dentition that is monitored over an appropriate period. Evaluation of the provisional treatment leads to three options: extension of the monitoring time, preservation of the natural occlusion or loss of the natural occlusion. Definitive prosthodontic treatment plans are based on the second or third option. In the maintenance of good oral health after prosthodontic treatments, plaque and diet control are essential elements. Recall or maintenance programmes must be carried out if successful treatment is to be achieved and maintained.

Student debt: an inevitable problem?

Since the government introduced the loan scheme for university students in 1990, it has become abundantly apparent that students are falling increasingly into debt. This paper describes the results of two studies undertaken by Manchester undergraduate dental students into the level and consequences of debt on dental students.

Organization, appointment planning, and surgery design in the treatment of the older patient.

As the proportion of the elderly in society increases and as more people retain teeth into old age, the type of dental treatment needed for this group will increase in both complexity and quantity. This article describes problems faced by the elderly such as mobility, fear, and medical conditions that may affect dental treatment either by increasing anxiety levels or by affecting duration or timing of appointments. The effects of visual impairment, hearing loss, and common medical conditions on elderly people are considered.

Identification of elderly in particular need: results of a survey undertaken in residential homes in the Manchester area.

OBJECTIVES: This paper aims to identify which groups of elderly people living in residential institutions are in particular need of dental care and advice. Comparison of different types of residential institution allows identification of elderly in greatest need of dental assistance. METHODS: A postal survey of carers in 250 residential homes for elderly people in Manchester, UK, was undertaken to determine the frequency of dental visits, arrangements for dental care of the residents' teeth and denture cleansing and appliance-wearing patterns and, also, the carers' knowledge and practice of simple dental and oral maintenance procedures for residents. Comparisons were undertaken using the SPSS software package of: social service and private homes, large and small homes, homes where regular visits were undertaken and those not regularly visited, and also homes which maintained records of their clients' dental state with those which did not. RESULTS: Residents' oral health tended to be more at risk in smaller or privately managed homes, in those where no dentist visited regularly and where no records of dental care were kept. CONCLUSION: The dental profession needs to especially target homes where care is less well organized, not only to examine and treat residents, but also to instruct carers in simple mouth care techniques, in order that dental disability in an increasingly dentate population can be minimized.

Provision of domiciliary care in a UK urban area: results of a survey.

A proportion of the population is unable to attend a dentist for treatment and it is therefore essential that an adequate domiciliary service is available. The availability of such a service was evaluated by means of a postal questionnaire distributed to 180 dentists practising in Manchester. The response rate was 57.8%. The results indicated that domiciliary care was provided by 84.6% of respondents, with the mean number of domiciliary patients treated per month being 2.9. Appointments for domiciliary care were arranged outside normal working hours by 65.9% of respondents and by arranging specific time periods by 43.2% of respondents. In general, domiciliary care was limited to prosthetic treatment, extractions, scaling and polishing, and simple restorations. A statistical association was found between number of years since graduation and the provision of domiciliary care.

Osseoretention? Comparative assessment of particulate hydroxyapatite inserted beneath immediate dentures.

This paper presents the results of a study to observe the effect on bone resorption and residual alveolar ridge form, of placement of dense non-resorbable hydroxyapatite granules into fresh canine sockets, at the time of immediate denture provision. Thirty five subjects were randomly divided into two groups cross matched for age and sex. All subjects required bilateral extraction of at least a lower canine and an adjacent tooth. Results demonstrate that six months post-extraction the control group had lost four times more bone than the implant group. These results were highly significant (P=0.000, LHS and P=0.001, RHS).

The carer's perspective: results of a survey of attitudes to dental care in 250 residential homes in Manchester.

A postal survey of 250 residential homes in the Manchester area was undertaken in late spring 1991. The 152 questionnaires returned gave information about 3757 residents. In spite of an apparently adequate understanding of the importance of dental care, carers did not appear to provide as effective a service as they thought necessary. Ninety-one percent of carers realised dentures do not last indefinitely and 77.4% thought dentures should be checked every 2 years. Yet, in over 50% of homes, there was no provision for regular dental checks and in only 42.8% were residents seen every 2 years. It was pleasing to note that 70.7% of respondents welcomed the suggestion of a half-day educational workshop. Suggestions are made for assisting homes with areas of particular concern. The importance of good rapport with local dental surgeons is stressed.

Attitudes to identification of dentures: the patients' perspective.

The importance of placing identification marks on dentures has long been acknowledged by the dental profession. More recently, following the fatalities at the Bradford City, England, football club fire, the need for marking dentures has been made more public. This paper outlines the different types of marking systems available and describes a survey on denture wearers to investigate their attitude toward the placement of identification marks on dentures. Results show that few dentures are marked at manufacture but that wearers are in favor of having their name on their denture. Of the 63 subjects sampled, 93.5% did not know that identification marks could be placed on dentures. The profession must be encouraged to routinely label all dentures at manufacture.

Assessment of elderly people on entry to residential homes and continuing care arrangements.

Increasing numbers of elderly people are entering private residential homes in the UK. Results of surveys show poor oral health in this group. A survey was therefore conducted of 50 residential homes (housing 1337 residents) to determine assessment on entry and continuing care provision. In 38 per cent of homes no written notes were made of the initial assessment. Topics of dental interests were infrequently assessed on entry (only 16 per cent of carers examined the oral cavity, 52 per cent assessed the subject's ability to care for their dentures). Medical topics (mobility, incontinence, eyesight, etc) were all assessed in more than 80 per cent of subjects. Suggestions are made for utilization of an easy assessment questionnaire and improved denture naming arrangements. The importance of regular check-ups, education and publicity for this group is stressed.