Investigating the technical quality of undergraduate endodontic treatment in a primary care-based dental school.

Introduction The success of root canal treatment (RCTx) relies on the technical quality of the root canal filling, often assessed through radiographic evaluation.Aims This audit aims to evaluate the technical proficiency of Peninsula Dental School (PDS) undergraduate dental students in RCTx, comparing it with established European standards.Design Conducted as a retrospective study, this evaluation focuses on assessing the technical quality of RCTx performed by undergraduate dental students at PDS across various academic years.Setting PDS, a primary care-based dental school in the UK, serves as the focal point for this evaluation.Materials and methods Reviewed 2021-2022 endodontic cases by supervised undergraduates. Analysed radiographs for obturation, voids and errors based on established benchmarks. Randomly selected unbiased cases, assessing voids, filling proximity, missed canals and canal anatomy preservation.Interventions Comparative analysis of RCTx quality between PDS students and counterparts from other dental schools, exemplified by Dublin Dental University Hospital (DDUH).Results Findings revealed that 62.07% of single-rooted and 60% of multi-rooted teeth treated by PDS students met European standards.Discussion The implications highlight the proficiency of PDS students in RCTx, comparing favourably to DDUH.Conclusion Recommendations emphasise conducting regular educational audits in dental schools to continually enhance RCTx techniques and ensure high-quality clinical teaching.

Blended learning in undergraduate dental education: a global pilot study.

AIMS: To explore the global trends in blended learning in undergraduate dental education during the COVID pandemic and during the recovery phase by engaging with the students and faculty and evaluate the implications for dental education in the post-COVID era. METHODS: It was a pilot cross-sectional study which employed a convenience sampling technique to recruit representatives of dental faculty and undergraduate students in 80 dental institutions globally. A previously validated questionnaire consisting of a combination of closed and open-ended items was used for data collection. Responses to these online questionnaires were processed and analysed using the R statistical computing environment. RESULTS: A total of 320 dental students and 169 faculty members from 47 different dental institutions participated in the study. Video and Live Online Tutorials were considered to be the most effective method of online learning followed by online question banks by both groups. Significant differences were noted between faculty and students regarding time spent and effectiveness of online teaching and learning, respectively, both before and after the start of COVID. The results highlight the faculty need to engage more closely with the students to address their learning needs. Finally, the participants provided several recommendations regarding the future development of teaching and learning strategies as well as assessments in the post-pandemic era. CONCLUSIONS: This is the first study which explores blended learning in dental education with participants from multiple institutions in different regions of the globe. Compared to the faculty, students considered online learning to be less interactive and preferred learning activities and all assessments to be delivered face-to-face. The results underscore the need to adapt teaching practices to suit the learning needs of the students.

Oral microbes and the formation of cerebral abscesses: A single-centre retrospective study.

OBJECTIVE: Intracranial abscesses are relatively uncommon, but can result in significant mortality and morbidity. Whilst many potential causes of brain abscesses are recognised, in many cases the origin of infection remains clinically unidentified. Our objective was to investigate the role of bacteria found in the oral cavity in the development of brain abscesses. METHODS: A retrospective analysis was performed using data from 87 patients admitted to a single UK neurosurgical unit with brain abscesses over a 16-year period. Using microbiological data obtained from abscess sampling and peripheral cultures, species of bacteria were categorised in patients where no primary source of infection was identified (NSI) for their brain abscess (n = 52), or where an infective source (ISI) was identified. The microbiological data was then screened to identify common oral bacteria in each group. RESULTS: Brain abscesses from the ISI group (n = 35) demonstrated a significantly lower preponderance of oral bacteria (n = 8), than the NSI group (n = 29) (p < 0.05). Brain abscesses from the NSI group also had significantly higher counts of Streptococcus anginosus compared to ISI (p < 0.05), with brain abscesses being most common in the frontal and parietal lobes for both ISI and NSI. CONCLUSIONS: These findings suggest that the oral cavity could be considered as a source of occult infection in cases of brain abscess where no clear cause has been identified. Future studies should include oral screening and microbiome analysis to better understand the mechanisms involved and develop approaches for prevention. CLINICAL SIGNIFICANCE STATEMENT: Oral bacteria may be an under-recognised cause of brain abscesses. Careful review of oral health in brain abscess patients may help establish causation, particularly in patients with no cause for their abscess identified. Good levels of oral health may help prevent the development of brain abscesses in some individuals.

Does prophylactic application of doxycycline at the implant-abutment interface improve clinical outcomes of dental implants?

Design Randomised controlled clinical trial.Data sources Not applicable.Study aims This split-mouth randomised controlled clinical trial assessed the effects of placing doxycycline hyclate (Atridox) at the implant-abutment interface on the short-term clinical outcomes of dental implants.Methods The study sample included 20 patients; each patient had two mandibular implants placed, one on either side of the mandible, resulting in a total of 40 implants placed in the study sample. At the time of final prosthesis delivery, doxycycline hyclate (Atridox 10% doxycycline hyclate) was injected at the implant-abutment interface of 20 randomly selected implants on the test side (N = 20) while no intervention was done on the control side (N = 20). The primary outcome measure was changes in pocket probing depth while secondary outcome measures included the incidence of peri-implant mucositis, bleeding on probing, and changes in marginal bone levels on mesial and distal bone aspects of the implant. The outcome measures were assessed at baseline, 3 months, 6 months and 12 months.Results The results showed favourable effects of prophylactic doxycycline application. Marginal bone levels and pocket probing depths after 6 and 12 months on the test side were less compared to the control side and these differences were statistically significant. The test side also showed fewer implants with bleeding on probing and lower risk of peri-implant mucositis after 3, 6 and 12 months.Conclusion Prophylactic placement of doxycycline hyclate may reduce peri-implant bone loss and pocket probing depths, and may also reduce the risk of peri-implant mucositis.

Necrotising periodontal diseases: an update on classification and management.

Necrotising periodontal diseases can present with significant morbidity and, whilst unusual, they are not entirely uncommon in primary care. With this in mind, members of the dental team should be aware of relatively recent changes to the classification and management of these diseases to optimise patient outcomes. Similarly, understanding the bacteriology, patterns of tissue breakdown, and management and maintenance of these conditions will allow clinicians to manage these diseases should they present. The progression of necrotising diseases in Sub-Saharan Africa to present as noma is also discussed. The objective is to help the reader understand the classification and management of necrotising periodontal diseases.

Dental Pain in Care Homes: Is It a Phenomenon? A Systematic Review of the Literature.

BACKGROUND: Evidence suggests that 80% of residents living in nursing homes have moderate to severe pain, could dental causes be an under reported contributory factor. The evidence suggests that this is an under-researched area. Our project aims were to explore and consolidate the current literature and conduct some stakeholder groups with care home managers and dentists. Our stakeholder group will be reported elsewhere. METHODS: We used the SPIDER framework to set out key search terms. Which included "dementia" OR "cognitively-impaired" OR "carehome residents" AND "dental pain" OR "oralfacial pain" OR "mouth pain" AND "pain assessment" OR "pain identification". A literature search was carried out on 8 and 9 March 2022 in the electronic databases: Cochrane, PubMed, Medline, Dental & Oral Sciences Source, CINAHL, Global Health, SocINDEX, Ovid (Medline) and Scopus. Restrictions were placed on dates and language (2012-2022 and English only). RESULTS: The search yielded 775 papers up to the year 2020. After screening and exclusion, we were left with five papers: four quantitative and one qualitative. CONCLUSIONS: This review demonstrates that there has been very little research into oral health and/or dental pain in adults with dementia. Furthermore, the recommendations have yet to be taken forward. Identifying pain in older adults with dementia remains challenging. There is a need to develop an algorithm in conjunction with care home staff and dental practitioners in order to identify and address the pain associated with dental disease in adults with dementia.

Dental education in primary care: 14 years of Peninsula Dental School.

Peninsula Dental School, established in 2006, was the UK's first new dental school in 40 years. It had the freedom to develop a completely new dental education curriculum planned on pedagogic thinking, designed to equip the dental care professionals of the twenty-first century. This was based on three distinct pillars: professionalism (developing a student's trust in their own autonomy); dental skills of the highest order (not just technical skills but also communication skills); and social engagement. As such, a truly innovative approach to dental education was created that has strong roots in evidence.This paper describes the University of Plymouth Peninsula Dental School's achievements against these initial objectives under the following areas: training in primary care; a novel spiralling integrated curriculum and assessments; facilities reaching out to deliver patient care; bringing meaningful patient contact to students from the earliest months of their course; embedding community engagement within the curriculum; development of Peninsula Dental Social Enterprise; and team working, training a variety of dental care profession students side by side.The University of Plymouth Peninsula Dental School, working with all its partners, has successfully pioneered and delivered significant changes in the field of education and continues to strive to further develop these and more for the future.

Dentistry where there is no Dentist: A retrospective analysis of urgent dental care reported through the British Antarctic Survey Medical Unit (BASMU), 2015 - 2020.

AIM: To evaluate the nature of dental related morbidity in British Antarctic Survey (BAS) deployed personnel, and to compare the findings to those in other deployed population groups. Additional aims include outlining the evidence-based approach to further developing a training programme for non-dentists, to manage dental emergencies. METHODS: A retrospective analysis of dental morbidity between 2015 - 2020 reported through the British Antarctic Survey Medical Unit (BASMU) database of dental reported morbidity recorded by deployed medical officers. RESULTS: Analysis and comparison of dental morbidity in deployed personnel to austere environments revealed similarity, in that relatively minor conditions led to the most significant number of presentations for personnel seeking dental advice when deployed. CONCLUSIONS: Dental morbidity for deployed personnel in austere conditions can present with a range of symptoms from relatively minor to severe. Use of best evidence to configure training packages to likely presentations, may limit likelihood of necessitating evacuation from remote locations, or limit morbidity when evacuation is not feasible.

The dental therapist's role in a 'shared care' approach to optimise clinical outcomes.

Introduction Dental therapists have a key role to play in the provision of dentistry in the UK. The Dental Workforce Advisory Group has reported this is relevant in multiple areas, including prevention and care in young children, and to support dentists in providing advanced and routine treatment for complex adult patients within the wider collaborative dental team. There remain diverse and multiple barriers and challenges to utilising the optimal scope of the dental therapist in general practice. In 2013, the General Dental Council introduced direct access (DA) legislation in the UK. By utilising the potential of dental therapists, some of the above challenges could be overcome and the DA approach optimised.Aims The purpose of this article through presenting clinical cases is to demonstrate the full scope of practice of the dental therapist and highlight how clinical outcomes can be optimised for patients when a 'shared care' approach is followed.Conclusions Notwithstanding the complexities of the financial implications practice owners face, through knowledge and understanding of the role and scope of the dental therapist within the wider dental team, optimal treatment of dental patients in the UK can be encouraged.

Addressing racial inequalities in dental education: decolonising the dental curricula.

The aim of this paper is to highlight the impact of racial disparities on the educational experiences of Black and minority ethnic students in healthcare education. Attainment gaps and barriers to career progression for minority ethnic home students in the United Kingdom have been recognised for decades, but little progress has been made to address these issues. Students and staff in higher education have been campaigning for 'decolonisation of the curriculum' to improve inclusivity and representation. These trends are being mirrored in medical education and there is growing recognition to decolonise the medical curricula. This would improve the educational experience and attainment of minority ethnic students and doctors, and would also help to address disparities in healthcare provision for minority ethnic patients. The context for decolonisation of the dental curricula is provided, followed by a discussion on the benefits, challenges and strategies for such decolonisation.