Training status and interest in certification of nondiplomate faculty teaching predoctoral dental public health.

OBJECTIVES: A survey was conducted to better understand the training needs of faculty members without dental public health (DPH) specialty board certification who teach DPH to dental students. METHODS: An 11-item questionnaire was sent to 193 non-DPH diplomate faculty members at US dental schools who were dentists and at least one of the following: a member of the American Association of Dental Schools Community and Preventive Dentistry Section, a referral from an academic American Board of Dental Public Health diplomate, a DPH faculty listed on the school's Web pages, a DPH contact from the AADS Institutional Directory, or the school's dean if no other contact. RESULTS: A 70 percent response rate was obtained. Seventy-nine percent of the respondents taught at least one national board-related DPH topic. Among these faculty members, 67 percent have or are in training for the master of public health, 26 percent have completed or are in a DPH residency, and 63 percent desire training in one or more of the DPH topics. The majority (64%) does not plan to take the specialty exam, while 28 percent plan to take the exam within five years. About half reported no personal incentives to take the exam and 39 percent perceived no institutional incentives. CONCLUSIONS: These nondiplomate teachers of predoctoral DPH desire training, but appear to have barriers and perceive few benefits to achieving DPH board certification.

Geriatric dentistry in the next millennium: opportunities for leadership in oral health.

"The twentieth century will be remembered chiefly, not as an age of political conflicts and technical inventions, but as an age in which human society dared to think of the health of the whole human race as a practical objective." Arnold Toynbee, British historian. Individuals throughout the world often view the passage of a new year as a time for re-evaluation of personal and/or professionals goals. The new millennium offers the dental profession a chance to view the future and observe the challenges and opportunities facing it. Professor Toynbee's observation is particularly poignant when one considers the improvements in oral health made in the last 100 years. Caries, once considered a ubiquitous oral disease, has been prevented in some children in developed countries. Research on periodontal disease continues to identify risk factors and the pathobiological mechanisms underlying the disease. Concurrently the population of the world is aging presenting new opportunities for improving oral health. In this paper the data on aging, chronic diseases and oral health is largely from the US but reflects to varying degrees other industrial countries. By integrating these demographic, epidemiologic and biologic data, one can paint a portrait of the future dental patient and their oral health needs. From this portrait, dental professionals can identify leadership opportunities to improve the oral health of an aging world population.

Aging and oral health for the 21st century.

Americans' oral health, along with their life expectancy, has improved dramatically during the 20th century. The 21st century offers dental professionals the opportunity to help patients maintain their oral health for a lifetime. This article describes trends in health and wellness among older adults that will affect use of dental services; reviews risk factors such as chronic diseases, medications, and nursing home placement that will increase oral diseases in older adults; and concludes with opportunities for dental leadership to improve the oral health of aging Americans.

Report of the ADEA president's task force on the Surgeon General's report on oral health. American Dental Education Association.

In response to the first-ever Surgeon General's report on oral health, released on May 25, 2000, ADEA President Rowland A. Hutchinson, D.D.S., M.S., appointed a task force to study the report from the perspective of dental education. The task force was charged with making recommendations to the ADEA Board of Directors as to the Association's message to members and the general public, the Association's role in addressing oral health disparities, the legislative and policy implications of the report, and areas of collaboration between ADEA and others in the dental and health professions. The task force reviewed the report and made five recommendations, including increasing public awareness of the report's messages, promoting collaborative activities with a goal of improving America's oral health, and providing leadership in the drive to promote the incorporation of new science in dental education. The task force also identified numerous ADEA initiatives that address issues related to the Surgeon General's report.

Customer for life: marketing oral health care to older adults.

Respect for and awareness of the needs of older patients from dental office staff will help such patients feel welcome in a practice. Marketing to older patients is built upon this foundation. In addition, there are other strategies for internal and external marketing aimed at older people. This article addresses the concept of turning aging patients into "customers for life."

Customers for life: marketing oral health care to older adults.

Respect for and awareness of the needs of older patients from dental office staff will help such patients feel welcome in a practice. Marketing to older patients is built upon this foundation. In addition, there are other strategies for internal and external marketing aimed at older people. This article addresses the concept of turning aging patients into "customers for life."

Dental public health for the 21st century: implications for specialty education and practice.

A panel of public health practitioners sponsored by the Health Resources and Services Administration met December 6-8, 1994, to examine current roles and responsibilities for dental public health workers and to recommend changes in education and training to meet challenges posed by an evolving health care system. Overall, at least the same number, if not more, dental public health personnel will be needed in the future. While some new roles were identified, the panel felt that only small numbers of personnel will be needed to fill these new roles. Not all of these roles necessarily require a dental degree. The panel felt that a need exists for more academicians for dental schools, schools of public health, dental public health residencies, and dental hygiene programs; oral epidemiologists and health services researchers; health educators; and specialists in utilization review/outcomes assessment, dental informatics, nutrition, program evaluation, and prevention. To meet these personnel needs: (1) dental public health residency programs should be structured to meet the educational needs of working public health dentists with MPH degrees through on-the-job residency programs; (2) the standards for advanced specialty education programs in dental public health should be made sufficiently flexible to include dentists who have advanced education and the requisite core public health courses; (3) flexible MPH degree programs must be available because of the rising debt of dental students and the decreased numbers of graduating dentists; (4) loan repayment should be available for dentists who have pursued public health training and are working in state or local health departments; and (5) standards for advanced education in dental public health should be developed for dental hygienists.

Dental public health postdoctoral education: a survey on the status of funding and career opportunities.

OBJECTIVES: This paper reports the results of a survey to determine the consequences of budget reductions on the status of dental public health postdoctoral training in the United States, and opinions of experts in education and practice regarding career opportunities in dental public health. METHODS: A survey was mailed to 154 dental and public health education and service institutions. RESULTS: Most respondents (74 of 103; 72%) agreed that training opportunities depend on funding, and 73 percent (n = 75) expressed the view that more dental public health specialists are needed. Respondents reported that funding for current dental public health master's degree and residency programs is less than satisfactory. Respondents involved in training of dental public health professionals held marginally statistically significant different opinions regarding career opportunities than those who were not involved. No significant differences in opinions of respondents existed by type of institution. CONCLUSION: With decreased numbers of dental graduates, improved funding for dental public health programs will be critical, particularly at the specialty entry level, to ensure that adequate numbers of specialists are trained and available to meet the oral health needs of all the US population.

Academic dental public health diplomates: their distribution and recommendations concerning the predoctoral dental public health faculty.

OBJECTIVE: The purpose of this study was to assess the representation of academically based diplomates of the American Board of Dental Public Health (ABDPH) and to identify their perceptions on the training of dental public health predoctoral faculty. METHODS: Data were collected by a mailed, self-administered, 13-item questionnaire. The population was the 48 diplomates of the ABDPH as of March 1997 associated with academic institutions. RESULTS: Twenty of the 55 US dental schools had a diplomate of the ABDPH with a mean of 1.8 diplomates per school with a diplomate. An average of 4.5 full-time faculty members per school were associated with teaching dental public health. A master's degree in public health (MPH) was the most frequently suggested educational requirement for dental public health faculty. Continuing education courses were training needs perceived for dental public health faculty. The lack of time, money, and incentives, along with perceived rigidity of requirements for board certification, were reported as major barriers for faculty becoming dental public health board certified. CONCLUSIONS: Numerous challenges confront the development of a strong dental public health presence in US dental schools. These challenges include, among others, insufficient numbers of academic dental public health specialists and insufficient motivations to encourage promising candidates to pursue specialty status.

Oral/pharyngeal, laryngeal, and lung cancer discharge trends in Department of Veterans Affairs hospitals.

OBJECTIVE: This paper describes trends in oral and pharyngeal (O/P) cancer diagnoses in Department of Veterans Affairs (VA) hospitals from 1983 to 1993 and compares these trends to those of laryngeal and lung cancers. METHODS: The VA patient treatment file was used to identify unique hospital discharges from 1983 to 1993 having ICD-9-CM codes for O/P, laryngeal, and lung cancers. Descriptive statistics were tabulated to determine prevalence and distribution. Trends of change over time were analyzed using regression analyses of the percent rate on year. RESULTS: Between 1983 and 1993 the annual number of O/P cases among users of VA hospitals decreased from 4,983 to 3,298. Despite overall declines in O/P cancer discharges in VA, cancer of the pharynx, tongue, and salivary gland continues to increase. O/P cancer in younger persons also continues to increase in VA. Overall, laryngeal cancers significantly increased, while no significant change was associated with lung cancer. CONCLUSIONS: VA needs to evaluate the changes in the patterns of O/P cancer to ascertain whether this represents a shift in care from inpatient to outpatient care. VA should seek further information regarding these trends to better plan, implement, and evaluate programs to provide early diagnosis and treatment targeted to veterans.

Issues in esthetic dentistry for older adults.

Esthetic dentistry offers a myriad of opportunities for older adults wishing to improve their smile, oral function, and self-esteem. The challenge for dental professionals is to maintain oral health throughout the patient's lifetime, even through periods of dependence that may include residence in a nursing home. Dental professionals will have increasing opportunities to share their knowledge and expertise about the relation between oral health and overall health, with a variety of health professionals who care for the aging population.

Research issues related to the oral health status of aging veterans.

This article reviews the research on the oral health status of aging veterans and offers recommendations for a research agenda that will improve their oral health and quality of life. Uniform definitions, or a "composite" measure, of overall oral health status would facilitate oral health status measurement. Because such a measure is not available, traditional oral epidemiologic indexes or treatment-needs data have been used to identify oral health status in aging veterans. Few studies of national scope have been conducted on veterans. A cost-effective alternative may be cooperative studies within the Department of Veterans Affairs (VA) and other organizations. The Department of Veterans Affairs Dental Longitudinal Study (DLS), begun in 1968, provides the richest data on an aging veteran population. More frequently, VA investigators have examined local or regional veteran populations. These studies have examined oral health status and risk factors associated with oral diseases. Unlike the DLS, most studies have been cross-sectional, and a few studies have examined the effect of systemic disease on oral health and vice versa. Key research agenda items and recommendations include: Development and validation of functional measures of oral health status; Implementation of multicenter, cooperative, descriptive, and analytic epidemiologic studies; Implementation of focused cross-sectional and longitudinal studies on oral health status, treatment needs, and patient outcomes; Enumeration of data sets in the VA system that can be shared with non-VA investigators; Implementation of targeted studies of aging populations who have specific comorbidities prevalent in VA; and Use of VA continuum of care to study the relation between oral and systemic diseases.

Oral cavity and pharyngeal cancer among Department of Veterans Affairs hospital discharges.

OBJECTIVES: The purpose of this study is to determine the number of oral cavity and pharyngeal cancers among hospital discharges at Department of Veterans Affairs (VA) medical centers in one 12-month period. METHODS: A SAS file was created from the patient treatment file (PTF) with all discharges during fiscal 1990 having ICD-9-CM codes for oral cavity and pharyngeal cancer. Up to 10 discharge diagnoses from the most recent discharge summary were included in the data set. ICD-9-CM codes for alcohol dependence syndrome, drug dependence, and nondependent abuse of drugs also were included. ICD-9-CM codes for salivary and nasopharyngeal cancers were excluded. RESULTS: There were 3,733 unique individuals discharged with a diagnosis of oral cavity and pharyngeal cancer. The majority of cases (62%) were found in the oral cavity. The age distribution of oral cavity and pharyngeal cancer did not parallel the age distribution of veterans discharged during this year. Race and ethnicity of those discharged with the disease does not differ from that of all VA hospital discharges for 1990. CONCLUSIONS: VA data provide descriptive statistics of oral cavity and pharyngeal cancer among VA hospital discharges. VA data sets such as the PTF may offer the opportunity to examine hospital management issues, length of stay, and co-morbid diagnoses associated with oral cavity and pharyngeal cancer.