Preparing the Next Generation of Clinicians for Practice Using Augmented and Artificial Intelligence.

Artificial intelligence (AI) and Augmented Intelligence (AuI) have existed for decades but have only recently been applied to dentistry and incorporated into higher education for dental professionals. Early examples of the incorporation of AI into dental education suggest it can enhance students' learning and can be applied in pre-clinical and clinical instruction. AI can be used to support clinical decision-making for dental professionals, making radiographic interpretation more precise and consistent. This paper provides a brief overview of AI, highlights opportunities to improve higher education and provides brief case studies of individuals and organizations working to advance the quality of dental education using AI. Opportunities for the application of AI in dental education include the adoption of clinical decision support that can improve patient outcomes and overall quality of patient care; development of courses that assist students in learning enhanced radiographic interpretation, diagnosis and treatment planning; research collaborations with industry for product evaluation and future product developments; and practice administration in understanding the quality of the care being delivered at the school.

The oral health quality of life for seniors in residential facilities who have direct access to care as compared to those without access.

INTRODUCTION: This pilot study tests whether there is a perceived difference in oral health when residents in long-term care facilities receive direct access to the scaling of teeth/debridement using dental hygiene instruments compared to facilities who provide only minimal oral hygiene care. METHODS: The study was a quasi-experimental pretest/post-test control group design and took place at two long-term care senior residential facilities in Sheridan, Wyoming. Fifteen residents from each facility comprised the study sample (n = 30). The treatment group received a debridement and oral hygiene education and the control group received brushing, flossing, and oral hygiene education. RESULTS: Results revealed a significant difference in pre/post OHIP-5 scores in the treatment group (p = 0.0222). The control group had improved scores, but it was not significant. CONCLUSIONS: This study demonstrated a significant difference in the perception of oral health quality of life when seniors received a dental cleaning where they reside.

Dental Students' Intent to Practice in Rural Communities Before and After Community-Based Rotations in a Rural Area.

Community-based dental education (CBDE) has the potential to positively impact the educational process in a manner that both contributes to educational outcomes and shapes the learner's behavior. The aim of this study was to determine the correlation between dental students' intended practice location and the size of their hometown and to assess any impact their CBDE rotation in a rural location had on practice location intention. From March 7, 2016, to August 12, 2018, fourth-year students at one U.S. dental school were invited to complete a ten-item questionnaire prior to and after their four-week clinical rotations at a rural clinic. Of the 123 dental students on rotation at the clinic during this time, 106 completed the pre-rotation survey and 112 the post-rotation survey, for response rates of 86% and 91%, respectively. Prior to the rotation, 58.6% selected one of the rural locations as an ideal practice location, and that percentage increased slightly to 61.4% after the rotation; the difference was not statistically significant (p=0.984). The results did show a significant increase from pre to post rotation for women intending to practice in rural communities (p=0.0413). This study found that students' intent to practice in a rural location was not significantly affected by a clinical rotation in a rural clinic; however, there was strong evidence that students from rural communities intended to practice in rural communities after graduation.

Oral Health Care Delivery Within the Accountable Care Organization.

UNLABELLED: The accountable care organization (ACO) provides an opportunity to strategically design a comprehensive health system in which oral health works within primary care. A dental hygienist/therapist within the ACO represents value-based health care in action. BACKGROUND: Inspired by health care reform efforts in Minnesota, a vision of an accountable care organization that integrates oral health into primary health care was developed. Dental hygienists and dental therapists can help accelerate the integration of oral health into primary care, particularly in light of the compelling evidence confirming the cost-effectiveness of care delivered by an allied workforce. METHODS: A dental insurance Chief Operating Officer and a dental hygiene educator used their unique perspectives and experience to describe the potential of an interdisciplinary team-based approach to individual and population health, including oral health, via an accountable care community. CONCLUSIONS: The principles of the patient-centered medical home and the vision for accountable care communities present a paradigm shift from a curative system of care to a prevention-based system that encompasses the behavioral, social, nutritional, economic, and environmental factors that impact health and well-being. Oral health measures embedded in the spectrum of general health care have the potential to ensure a truly comprehensive healthcare system.

Minnesota dentists׳ attitudes toward the dental therapist workforce model.

The purpose of this study was to evaluate dentists' attitudes and perceptions toward dental therapists, a new licensed dental provider in Minnesota. This study employed mixed modes to administer a survey using a stratified random sample of 1000 dentists in Minnesota. The response rate was 55% (AAPOR RR1: n=551/999). Results showed a majority of dentists were opposed to dental therapists performing irreversible procedures. In addition, results identified perceived barriers to hiring a dental therapist and found dentists do not believe dental therapists will alleviate oral health disparity in the State.

Utilization of nondentist providers and attitudes toward new provider models: findings from the National Dental Practice-Based Research Network.

OBJECTIVES: The purpose of this study was to quantify, within the National Dental Practice-Based Research Network, current utilization of dental hygienists and assistants with expanded functions and quantify network dentists' attitudes toward a new nondentist provider model - the dental therapist. METHODS: National Dental Practice-Based Research Network practitioner-investigators participated in a single, cross-sectional administration of a questionnaire. RESULTS: Current nondentist providers are not being utilized by network practitioner-investigators to the fullest extent allowed by law. Minnesota practitioners, practitioners in large group practices, and those with prior experience with expanded-function nondentist providers delegate at a higher rate and had more-positive perceptions of the new dental therapist model. CONCLUSIONS: Expanding scopes of practice for dental hygienists and assistants has not translated to the maximal delegation allowed by law among network practices. This finding may provide insight into dentists' acceptance of newer nondentist provider models.

A comparison of dental service use among commercially insured women in Minnesota before, during and after pregnancy.

BACKGROUND: The authors examined and compared dental services used by women before, during and after pregnancy. METHODS: In their study, the authors combined medical and dental claims data for 3,462 pregnant women in Minnesota with commercial dental insurance who had been pregnant between Jan. 1, 2004, and Dec. 31, 2005. The authors used McNemar pairwise comparisons, with each subject serving as her own control and her use of various dental services before pregnancy as her own baseline, to evaluate and compare the dental services used during and after pregnancy. RESULTS: During pregnancy, subjects' use of several dental services-radiographs, restorative services, third-molar extractions and anesthesia-decreased significantly (P < .001) in comparison with their prepregnancy use. After pregnancy, subjects' use of checkups, radiographs and restorative services showed significant increases (P < .001). CONCLUSIONS: The significant decreases in use of these services during pregnancy and significant increases after pregnancy may suggest that these women and their dentists were using these services only conservatively during pregnancy or postponing their use altogether until after delivery. CLINICAL IMPLICATIONS: This study's findings may provide useful background information to medical and dental providers, health care plan administrators and policymakers as they consider recommendations regarding oral health care for women during pregnancy.