Patient education in dental medicine: A review of the literature.

INTRODUCTION: In dental medicine, chronic diseases and chronic conditions (such as chronic periodontitis, temporomandibular disorders, chronic orofacial pain) justify patient education to self-care. This strategy of secondary or tertiary prevention, even if officially recognised, is still less known compared to health education, a form of primary prevention. The aim of the study was to make the point of recent studies devoted to patient education. Thus, the purpose of the study was to give an updated picture of patient education in odontology, describing, through an analysis of the international literature from 2006 to 2016, its characteristics and development. METHODS: The main databases selected were: PubMed, EMBASE, CINAHL, Web of Sciences, DOSS, 302 articles published between 2006 and 2016 on patient education among which four RCTs and a case study were analysed because of their rigorous scientific quality. RESULTS: Patient education concerns chronic diseases and conditions also in the field of orthodontics. This limited number of studies, showed that patient education in odontology can bring real bio-clinic, cognitive, psychological and economic benefits to patients. Overall, it allows patients to better understand their illness and treatment and, thus, to improve their health behaviours and self-care techniques, which would reduce the treatment costs. Educational interventions in odontology should constitute a component of patient education in several chronic systemic diseases such as diabetes. It would be necessary to train future practitioners in this field and to develop a scientific research on this practice.

The hierarchical cluster analysis of oral health attitudes and behaviour using the Hiroshima University--Dental Behavioural Inventory (HU-DBI) among final year dental students in 17 countries.

OBJECTIVE: To explore and describe international oral health attitudes/ behaviours among final year dental students. METHODS: Validated translated versions of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) questionnaire were administered to 1,096 final-year dental students in 17 countries. Hierarchical cluster analysis was conducted within the data to detect patterns and groupings. RESULTS: The overall response rate was 72%. The cluster analysis identified two main groups among the countries. Group 1 consisted of twelve countries: one Oceanic (Australia), one Middle-Eastern (Israel), seven European (Northern Ireland, England, Finland, Greece, Germany, Italy, and France) and three Asian (Korea, Thailand and Malaysia) countries. Group 2 consisted of five countries: one South American (Brazil), one European (Belgium) and three Asian (China, Indonesia and Japan) countries. The percentages of 'agree' responses in three HU-DBI questionnaire items were significantly higher in Group 2 than in Group 1. They include: "I worry about the colour of my teeth."; "I have noticed some white sticky deposits on my teeth."; and "I am bothered by the colour of my gums." CONCLUSION: Grouping the countries into international clusters yielded useful information for dentistry and dental education.

Undergraduate education in endodontology at two European dental schools. A comparison between the Faculty of Odontology, Malmö University, Malmö, Sweden and Faculty of Odontology, Paris 5 University (René Descartes), France.

The aim of this study was to compare the courses in endodontics and to assess the treatment quality in the student clinics in two dental schools, in Malmö, Sweden and Paris, France. A further aim was to improve the curriculum development in Paris 5 and Malmö by testing student exchange programmes. The comparison was based on the guidelines for undergraduate education set up by the European Society of Endodontology (ESE) [Int. Endod. J. 25 (1992) 169] and on the criteria formulated by Qualtrough and Dummer [Int. Endod. J. 30 (1997) 234]. The latter criteria covered the following aspects: educational methods, the timing of endodontic teaching, pre-clinical practical exercises, student assessment, recommended literature, clinical/practical procedures, the education of the staff and number of students per teacher. The quality guidelines for endodontic treatment set up by the ESE [Int. Endod. J. 27 (1994) 115] were used for the assessment of the quality of the treatment. The following aspects were covered: history, diagnosis and treatment planning, records, infection control, root-canal treatment, assessment of endodontic treatment. The undergraduate education in endodontics was fundamentally similar in Paris 5 and Malmö. The main differences observed were related to: Educational methods: In Malmö, problem-based learning and in Paris 5, traditional. Assessment of student performance. In Malmö, self-assessment and in Paris 5, credits for clinical/practical procedures. Clinical/practical procedures relating to infection control. Aseptic treatment regimens were more meticulously performed in Malmö than in Paris 5. Assessment (follow-up) of all endodontic treatments was a routine only in Malmö.

2.2 Continuous quality improvement.

Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, followed by external and internal evaluations resulting in improvements that can serve as goals for a next cycle. The need for CQI is apparent, because of public accountability, maintaining European standards and the improvement of dental education. Many examples are known where recommendations from both external and internal evaluation are used for the improvement of dental education. Unfortunately, the implementation of the recommendations is inconsistent, rarely systematic and usually not transparent. This section agreed that it is essential to apply CQI in a structured, systematic and transparent way if we are to improve and maintain the quality of dental education. A model is proposed which includes three aspects: a) the process of CQI; b) the subjects to which CQI should be applied; and c) the management tools to govern CQI. It is stressed, that CQI is a process that can be applied in any dental school irrespective of curriculum or educational approach within the relevant context of the country or the region. The approach needs to recognize the complexity and the need to balance a quality improvement with accountability. A CQI system is also constrained in any organization by the attitudes and values of the staff. Inevitably there has to be a wide range in the application of CQI. Nevertheless, an agreed model on CQI might enhance convergence towards higher standards of dental education. The process of CQI can be supported by developments in information and communication technology (ICT): collection of data, identifying the steps in CQI, formats of reports, etc. The section was set, as one of its tasks, to advise on the development of a network based on a number of case studies on the application of CQI in dental education.