Can the results of the OSCE predict the results of clinical assessment in dental education?

INTRODUCTION: The aims of this study were to evaluate the correlation between the results of the objective structured clinical examination (OSCE) and clinical assessment and to test the reliability of OSCE test stations. MATERIAL AND METHODS: All 4th year undergraduate dental students (n = 47, 100%) attended the OSCE in April 2010. The students were divided into two groups (morning group, group 1; afternoon group, group 2). Groups 1 and 2 were also divided into two subgroups that attended the stations in two concurrent sessions (A and B). The OSCE included 12 10-min test stations. Clinical assessment was based on long-term observation during the semesters. The disciplines assessed were cross-infection control, endodontics, paediatric dentistry, periodontology, prosthodontics and restorative dentistry. RESULTS: Statistical analysis using Cronbach's alpha indicated good reliability of the OSCE. The correlation between the results of the OSCE and clinical assessment in the 4th year was statistically significant in cross-infection control (ρ = 0.340, P = 0.022), endodontics (ρ = 0.298, P = 0.047), prosthodontics (ρ = 0.296, P = 0.048) and restorative dentistry (ρ = 0.376, P = 0.011). Clinical assessment in the 5th year correlated with the OSCE results statistically significant in restorative dentistry (ρ = 0.522, P = 0.001). CONCLUSION: Both the OSCE and constant longitudinal assessment are needed in clinical assessment, as they both play an important role in the overall assessment.

Long-term predictive value of salivary microbial diagnostic tests in children.

AIM: To investigate in a group of children (n=183) the predictive value of early colonization of salivary lactobacilli and candida on caries development in primary molars and permanent first molars in 7 years of follow-up time by applying a longitudinal survival analysis method. STUDY DESIGN: Longitudinal cohort study of clinical outcomes based on dental records. METHODS: The Kaplan-Meier survival analysis method was used to compare survival times to caries onset in primary molars and permanent first molars for children colonized by salivary lactobacilli and candida and children who were not colonized by those microbes at baseline when children's mean age was 2.5 years. The survival time was the time elapsing between the birth of a child and the first restoration as a result of dental caries, that is the time when caries has progressed to a stage when a dentist has made a decision to restore the affected tooth. RESULTS: The survival curves for primary and permanent molars were consistently lower for those children whose mouths were colonized by salivary lactobacilli at baseline. A statistically significant relationship was found with onset of caries in both primary and permanent molars and colonization by salivary lactobacilli. The survival of primary second molars was 60% at the age of 9 years in the group colonized by lactobacilli and 80% in those children whose mouths were not colonized. Colonization by candida was also a significant risk factor for caries onset in primary molars but not in permanent first molars. CONCLUSION: Children whose mouths were colonized by salivary lactobacilli at baseline were more susceptible to caries onset in both primary and permanent molars at any given time during follow- up of seven years than children who were not colonized by those caries associated microorganisms.

Prolonged pacifier-sucking and use of a nursing bottle at night: possible risk factors for dental caries in children.

At the baseline of this cohort study we determined risk factors for colonization of oral lactobacilli and candida in a group of children (n = 166) whose mean age was 2.5 years. The results showed that pacifier-sucking and the use of a nursing bottle at night increase the occurrence of both salivary lactobacilli and candida. In the present study these children were followed for 2 years, and the progression of caries was recorded with particular reference to the etiologic factors measured before. The results of the logistic regression analysis showed prolonged pacifier-sucking (> or = 24 months) to be a significant risk factor for caries development in children, with a rather high relative risk (RR) of 3.5 (95% confidence interval (CI), 1.5-8.2; P= 0.003). Prolonged use of a nursing bottle at night (> or = 24 months) was also a risk factor, but less significant than pacifier-sucking (RR, 2.6; CI, 1.1-6.4; P= 0.03). On the grounds of this study we conclude that prolonged pacifier-sucking (> or = 2 years) and use of a nursing bottle at night are risk factors for dental caries in children.

Risk factors for colonization of salivary lactobacilli and Candida in children.

We analyzed the occurrence of salivary lactobacilli and Candida in a sample of 166 children aged 1-4 years (mean, 2.5 years) in relation to possible risk factors for colonization of the microbes. The risk factors examined were sucking habits, feeding habits, symptoms of respiratory infections, and antibiotic therapy at the time of sampling. Lactobacilli occurred in 18% of the children's saliva, and Candida in 24%. In the logistic modeling the variables most strongly associated with the occurrence of lactobacilli were pacifier-sucking (relative risk (RR), 2.9; 95% confidence interval (CI), 1.1-7.0; P = 0.01) and antibiotic therapy (RR, 4.6; CI, 1.2-16.9; P = 0.01). The association between positive Candida test and use of a pacifier was also significant (RR, 4.8; CI, 2.1-10.7; P = 0.0001). The results of the study suggest that the use of a pacifier increases the occurrence of both salivary lactobacilli and Candida. It could therefore be a factor influencing caries susceptibility and activity in children.

Incidence of dental caries in children with acute lymphoblastic leukemia is related to the therapy used.

Dental caries is an infectious disease and it may be harmful for children suffering from leukemia. DMFS, DMFT scores of forty-five children with acute lymphoblastic leukemia (ALL) were significantly higher than in healthy age-and-sex-matched controls after cessation of therapy. The children with CNS irradiation had higher DMFT (7.13 than children with only chemotherapy (3.4) and the controls (1.8). Lifelong caries incidence showed that children with ALL had 2.7 new caries lesions per year during the therapy compared to the 1.1 (p < 0.05) new lesions in controls. More detailed analysis of permanent anterior teeth at the age of twelve years showed that all patient groups had more filled anterior teeth than controls (p < 0.001); and children with bone marrow transplantation had significantly more fillings than the other two groups.