Dental students' reflective learning from a geriatric interview assignment.

OBJECTIVES: As part of geriatric education at the University of British Columbia's Faculty of Dentistry, undergraduate students are required to interview an older adult over 65 years old and critically reflect in writing on the meaning of this interview to themselves and their professional lives in not more than 2000 words. They are also encouraged to use a life grid. This study explored the impact of this assignment on the students as learners and on their views about their profession. METHODS: Interview assignments were collected from the entire cohort of 54 third-year students in 2021 and analyzed in 5 stages, using an exploratory thematic analysis, including an interactive coding process to identify patterns (themes) within the assignments using NVivo R1 software. Two researchers coded assignments individually and met to reach a consensus about the codes, to mitigate potential biases. RESULTS: Five main themes were identified, including communication, life course journey, person-centered care, social determinants of health, and access to care. A wide range of ideas emerged under each theme, including several practical suggestions to improve future practice as an oral health professional. A little over 40% of the students used the life grid in their interviews. Modifications on the interview assignment are suggested. CONCLUSION: Students' reflections highlighted their observations on a wide range of ideas within each theme, many pertaining to their future profession. They also discussed how this knowledge would inform their future practice in terms of their interactions with, and providing care to, patients with similar situations.

Teledentistry content in Canadian dental and dental hygiene curricula.

OBJECTIVES: To explore the extent to which teledentistry (TD) content is incorporated into Canadian dental and dental hygiene curricula. METHODS: An anonymous survey was distributed among all 10 dental and 35 dental hygiene programs across Canada in June and July 2022. The survey focused on TD teaching (methods employed, content taught, and barriers to TD education), with descriptive (frequency, maximum, minimum, mean) and inferential (Pearson chi-square for odds ratio test) data analyses using SPSS. A ρ - value < 0.05 was considered statistically significant. RESULTS: Thirty-four programs responsed to the survey, including all dental (n = 10) and 68% (n = 24) of dental hygiene programs; eighteen reported having TD content, including three dental programs. An average of 9.22 ± 4.86 h was reported for teaching TD, with lecture format as the most employed approach and using TD in dental practice as the most covered topic. While 53% of the dental hygiene programs employed formative and summative assessments, only one dental program reported having assessment for this content. Moreover, programs that dedicated less than 9 h to teaching this content were less likely to address more than seven topics (Odds ratio (OR) = 0.14). CONCLUSION: The dental and dental hygiene programs in Canada differ in their offering TD education, and 30% of the dental and 62.5% of the surveyed dental hygiene programs addressed TD content. This scarcity emphasizes the necessity for incorporating such content in future curriculum planning to consequently decrease the lack of knowledge, an identified barrier to TD implementation in education and practice, as today's students will be future educators.

The fear of letting go and the Ivory Tower of dental educational training.

ISSUE: Clinical training in dental education is complex and happens mostly within a well-controlled environment such as a university dental clinic where oral health care services are delivered; it is mostly student-centered. While such training is important, it is also possible to augment and enhance it by training predoctoral dental students outside such a clinic within off-site community-based placements using a more person-centered approach. However, there seems to exist a reluctance in recognizing and utilizing the work produced in these off-site placements holistically as an integral part of students' clinical assessment. APPROACH: Community-based clinical experience adds value to the training of our predoctoral dental students. This perspective describes the benefits of community placements and recognizes their importance in the clinical and professional development of a future graduate. It also presents a way to assess students' performance that by-and-large mirrors that of the university dental clinic while striking a balance between student-centered education and person-centered care. IMPACT: In this perspective, we argue that the clinical work delivered at a community placement ought to be weighted equitably with the clinical work delivered at a university clinic when assessing students' competency as a whole. Our message is to keep a balance of student-centered education and person-centered care to the benefit of all those involved.

Students' resilience and mental health in the dental curriculum.

OBJECTIVES: Dental education is perceived as a source of students' psychological and occupational stress. Resilience has been proposed as a protective factor that may support students' in managing that stress. The objectives of this study were twofold: to map the mental health and well-being content in the curriculum of the Faculty of Dentistry (FoD) at the University of British Columbia (UBC) and to investigate factors influencing resilience levels amongst dental students at UBC. METHODS: The curricular database and website of UBC's FoD were used to gather information on mental health content. A survey with the Connor-Davidson 10-Item Resilience Scale was distributed to dental students at UBC (N = 289). Students' de-identified demographic data were also collected. RESULTS: Two main mental health and well-being curricular components were identified: one didactic session on stress management and one interactive workshop on resilience. The response rate for the survey was 68.2%. Students who did not receive any mental health content (2020/21 year 1 students) had higher resilience scores (p = .043) when compared to students who received both components (2019/20 year 1 students and 2018/19 year 2 students). The multiple regression analysis highlighted North American/European ethnic origins as a predictor for higher resilience levels (p = .008). CONCLUSIONS: The results of this study showed that ethnic origins and major life events, such as the pandemic, influenced resilience. Curricular activities promoting resilience seemed to not necessarily impact students' resilience. Further longitudinal studies are needed to assess the curricular and non-curricular activities influence over dental students' well-being.

Developing a land-based oral health promotion project with an Indigenous community in northern British Columbia, Canada.

In British Columbia, Canada, First Nations children and youth consistently present with a higher incidence of dental disease. Efforts to improve the oral health status of Indigenous populations have had mixed success, and programs have typically been offered through a Western lens. Recent years have brought calls for oral health professionals to embrace a more holistic approach to health promotion, representative of Indigenous cultures. Colonization has been considered a negative health determinant as it led to the destruction of culture, language, and the removal of Indigenous peoples from their traditional lands. Self-determination and cultural connection are critical to mitigating cultural genocide. Health promotion projects have the potential to support these goals. Fundamental to decolonizing oral health promotion is the development of a sustainable program founded in the traditional ways of Indigenous health and healing. The purpose of this short communication is to report on a collaborative oral health project that used cultural connection as the framework for oral health promotion in a remote Indigenous community.

En Colombie-Britannique, au Canada, les enfants et les jeunes des Premières Nations présentent systématiquement une incidence plus élevée de maladies dentaires. Les efforts visant à améliorer l'état de santé buccodentaire des populations autochtones ont connu un succès mitigé, bien que les programmes aient généralement été offerts dans une optique occidentale. Ces dernières années, les professionnels de la santé buccodentaire ont été appelés à adopter une approche plus globale de la promotion de la santé, représentative des cultures autochtones. La colonisation a été considérée comme un déterminant négatif de la santé, car elle a mené à la destruction de la culture et de la langue, ainsi que l'expulsion des Autochtones de leurs terres traditionnelles. L'autodétermination et le lien culturel sont essentiels pour atténuer le génocide culturel. Les projets de promotion de la santé ont le potentiel de soutenir ces objectifs. L'élaboration d'un programme durable fondé sur les méthodes traditionnelles de santé et de guérison autochtones est essentielle à la décolonisation de la promotion de la santé buccodentaire. L'objectif de cette brève communication est de faire le point sur un projet de santé buccodentaire collaboratif qui a utilisé le lien culturel à titre de cadre pour la promotion de la santé buccodentaire dans une communauté autochtone éloignée.

Data set and methodology involving pedagogical approaches to teach mental health and substance use in dental education.

OBJECTIVE: In this Data note, we provide a raw data set in the form of brief self-guided reflections. We also present the methodological approach to generate these reflections including an educational vignette so that other dental schools can plan for their teaching activities involving mental health and substance use topics. DATA DESCRIPTION: Between 2015/16 and 2018/19, the University of British Columbia's (UBC) undergraduate dental and dental hygiene students submitted optional written guided reflections to address 'how can an educational vignette, depicting a patient with a history of substance use and mental health disorders accessing dental care, promote an open dialogue about stigma?' From a total of 323 undergraduate students, 148 anonymous reflections between 200 and 400 characters each were received. The main ideas that may emerge from the reflections include 'exploring power relations' and 'patient-centered care approach to counteract stigma'.

Mental health and wellness in Canadian dental schools: Findings from a national study.

OBJECTIVES: To survey the mental health and wellbeing content in the curricula, services, and activities of the 10 Canadian dental schools, and to explore the specifics of this area in the Faculty of Dentistry (FoD) at The University of British Columbia (UBC). METHODS: An electronic survey consisted of four major categories: curricular activities and services, structural approaches, infrastructural approaches, and evaluation methods, was distributed to all Canadian dental schools. A situational analysis was conducted at UBC's FoD via document appraisal and key informants' exploratory interviews. RESULTS: Eight dental schools responded to the survey showing that didactic sessions being the pedagogical method to deliver resilience content. None of the responding schools reported formally evaluating their mental health content. Through situational analysis, a relational map that identified four major areas contributing to students' mental health at UBC's FoD was generated which includes four major aspects: (1) curricular content on mental health, (2) informal wellbeing and mental health networks, (3) protective, and (4) risk factors influencing students' mental health. CONCLUSIONS: As this study described the mental health and wellbeing activities, services, and curricular content across multiple Canadian dental schools, the diverse approaches each school adopted and how personal and professional aspects of students' lives being attempted to be addressed are a critical starting point to engage educators in dentistry. The situational analysis outcome, where a detailed description of the mental health situation at UBC's FoD, can be used to guide in-depth studies of the area of wellbeing at other dental schools.

An Overview of Pedagogical Approaches to Caries-Control Medications in Canadian Dental and Dental Hygiene Programs.

OBJECTIVE: To investigate pedagogical approaches and perceived barriers to teaching about caries-control medications, particularly silver diamine fluoride (SDF), in Canadian undergraduate dental and dental hygiene programs. METHODS: In summer 2018, a 9-item questionnaire was distributed to all 10 dental schools and 32 dental hygiene programs in Canada. It enquired about the types of caries-control medications used, teaching methods and perceived barriers to instruction on managing active caries with SDF. METHODS: In summer 2018, a 9-item questionnaire was distributed to all 10 dental schools and 32 dental hygiene programs in Canada. It enquired about the types of caries-control medications used, teaching methods and perceived barriers to instruction on managing active caries with SDF. RESULTS: The response rate was 80% (n = 8) from dental schools and 72% (n = 23) from dental hygiene programs. All curricula included information about conventional caries-control medications: fluoride, silver nitrate and povidone iodine. In all programs, instruction regarding SDF was predominantly didactic: 93% of programs presented lectures on SDF and 30% of programs included clinical teaching and use of SDF in primary dentition only. The lack of consensus on clinical protocols outlining the number and frequency of SDF applications to arrest caries was cited by 43% of the programs as a barrier to clinical teaching. CONCLUSION: There is some variation across Canada in pedagogical approaches to caries-control medications and the inclusion of SDF in curricula. Poorly defined clinical protocols were reported as the main barrier to didactic and clinical use of SDF in undergraduate dental education programs.

The role of an educational vignette to teach dental students on issues of substance use and mental health disorders in patients at the University of British Columbia: an exploratory qualitative study.

BACKGROUND: Inverted classroom approaches and the use of vignettes have been suggested in health care education. The objective of this study was to use an educational vignette to discuss issues of stigma around substance use and mental disorders within undergraduate Doctor of Medicine in Dentistry (DMD) and Bachelor of Dental Science in Dental Hygiene (BDSc-DH) students at the University of British Columbia, Canada. Our research question was "how can an educational vignette, depicting a fictitious patient with a history of substance use and mental health disorders accessing dental care, promote an open dialogue about stigma?" METHODS: An educational vignette was developed based on individuals' lived-experiences with a variety of substance use and/or mental health disorders. This vignette was used to generate in-class discussion involving all the DMD and BDSc-DH undergraduate students enrolled between 2015/16 and 2018/19 who attended a mandatory 2.5 h didactic session using an inverted classroom approach. Students were also encouraged to provide a post-class voluntary written reflection, between 200 and 300 words, around stigma. The authors took written field notes on students' response to the vignette and used excerpts from students' de-identified reflections to illustrate the impact of such an educational tool. RESULTS: A total of 323 DMD and BDSc-DH students attended the didactic sessions between 2015/16 and 2018/19, and 148 reflections were submitted over the same time period. The inverted classroom approached showed to be engaging and collaborative. The vignette promoted open dialogue and was determined to be a conducive tool to generate in-class discussion and reflection. Major themes from the textual data included 'exploring power relations' and 'patient-centered care approach to counteract stigma'. The vignette also enabled the discussion of positive experiences characterized by empathy, reassurance and communication, although it might not have prompted all students to participate in class or in writing the reflections. CONCLUSION: The inverted classroom approach and the vignette seemed to be an effective way to facilitate dialogue and reflection for most students. This study highlighted the need to explore innovative ways in which to continuously prepare current and future oral health care providers to professionally address the needs of patients with a history of substance use and/or mental health disorders.

A preparedness model for the provision of oral health care during unfolding threats: the case of the covid-19 pandemic.

BACKGROUND: The aim of this study was to appraise a recently developed preparedness model for the provision of oral health care during a threat such as the COVID-19 pandemic from the perspectives of oral health care providers, administrators/staff, and patients. METHODS: An exploratory qualitative inquiry via at-a-distance semi-structured interviews and group discussions engaged a purposefully selected sample of oral health care workers and patients in British Columbia (BC), Canada. Participants were asked to appraise a preparedness model by considering how to prepare for oral care during a pandemic, while answering open-ended questions about the model content and visual presentation. Interviews and group discussions occurred between April 2020 and January 2021, were audio recorded, and transcribed verbatim. An inductive coding process was used to identify themes, subthemes, and categories of information until saturation was achieved. RESULTS: Seventy-four participants, including 19 dentists, 15 dental hygienists, 10 certified dental assistants, 9 administrators, and 21 patients, suggested modifications to the recently developed preparedness model. Individual interviews (41 participants) and group discussions (33 participants in groups ranging from 2 to 9 attendees each) lasted for an average of 53 min. Eighty-four hours of audio recordings led to more than 1110 single-spaced pages of transcripts. The thematic analysis identified 82 codes, 12 categories, and four main themes: life-long learning, critical thinking, personal and professional risk, and patient-centred care. These themes were understood within provider characteristics and social and environmental contexts. Participants highlighted the need for the model to focus on information and communication, developing awareness and understanding, inferring risks, and performing oral health care during a threat such as a pandemic or disease outbreak. A modified portrayal of the model was suggested to better represent participants' perspectives. CONCLUSION: A recently developed preparedness model for the provision of dental care during an unfolding threat like the COVID-19 pandemic was appraised and modified by oral health care workers. Future studies are warranted to evaluate the modified model for use in the event of another unfolding threat collaboratively with providers, patients and stakeholders.

Uncertainties around COVID-19 from the perspectives of oral health care workers during the first wave of SARS-CoV-2 infections in British Columbia, Canada.

BACKGROUND: The first wave of COVID-19 infections caused disturbances in all aspects of personal and professional lives. The aim of this study was to explore the ways in which that first wave of novel coronavirus infections resulted in uncertainties, as experienced by members of the oral health care workforce in British Columbia, Canada. METHODS: This qualitative inquiry purposefully recruited frontline oral health care workers, including dentists, dental hygienists, certified dental assistants, and administrative staff, via remote semi-structured interviews between April 20 and May 4, 2020. Coding, categories, and themes were inductively assigned. RESULTS: A total of 45 interviews, lasting between 39 and 74 minutes each, were conducted involving 18 dentists (6 females), 12 dental hygienists (11 females), 6 certified dental assistants (all females), and 9 administrators/front-desk staff (7 females). Fifty-one hours of audio recordings and more than 650 single-spaced pages of transcripts were produced. Five main themes emerged pertaining to uncertainties surrounding COVID-19, patient care, personal lives and infectiousness, concern for the future, and variations among different pandemics. Certitudes were less evident, but surfaced mostly when considering a potential new normal resulting from the pandemic. CONCLUSION: Participants indicated that the uncertainties they felt were dependent upon what is known, and unknown, about the pandemic and the provision of oral health care during the first wave of infections. Future studies are needed to include the viewpoints of oral health care workers from other provinces, as well the perceptions of patients who received oral health care during the height of the first wave of the pandemic.

Clinical Oral Disorders in Adults Screening Protocol (CODA-SP) from the 2019 Vancouver IADR Consensus Symposium.

BACKGROUND: The Clinical Oral Disorder in Elders (CODE) index was proposed in 1999 to assess the oral health status and treatment needs of older people who typically were edentate or had few natural teeth. Since then, more people are retaining natural teeth into old age and have oral disorders similar to younger adults. In addition, there has been further guidance on screening for disease that includes changes to the clinical indicators of several oral disorders and greater sensitivity to people's concerns about their oral health and care needs. METHODS: Experts in dental geriatrics assembled at a satellite symposium of the International Association of Dental Research in June 2019 to revise the objectives and content of the CODE index. Before the symposium, 139 registrants were asked for comments on the CODE index, and 11 content experts summarised current evidence and assembled reference lists of relevant information on each indicator. The reference lists provided the base for a narrative review of relevant evidence supplemented by reference tracking and direct searches of selected literature for additional evidence. RESULTS: Analysis of the evidence by consensus of the experts produced the Clinical Oral Disorders in Adults Screening Protocol (CODA-SP). CONCLUSIONS: The CODA-SP encompasses multiple domains of physical and subjective indicators with weighted severity scores. Field tests are required now to validate its effectiveness and utility in oral healthcare services, outcomes and infrastructure.

A Pan-Canadian narrative review on the protocols for reopening dental services during the COVID-19 pandemic.

The current coronavirus disease 2019 (COVID-19) pandemic is impacting the way in which dental services are provided. The aim of this narrative review was twofold: to summarize key areas from the Canadian protocols available for the reopening and restructuring of dental services across the country and to critically review these protocols based on existing evidence. A narrative review of the existing Canadian protocols, written in English and French, was undertaken between April 15 and July 13, 2020. The protocols were obtained by searching through regulatory bodies and websites from professional organizations, and from personal contacts through academic institutions and policy leaders. The data extraction form focused only on protocols related to dentistry, and the information was compiled by a hired assistant. Content was categorized via group discussions with the research team on eight areas: office management and procedures, patient and staff screening, treatment procedures, office layout, risk reduction, personal protective equipment, supporting information, and length and readability. Thirteen protocols were identified and offered substantial variation in the level of details provided. All but two protocols specified proper donning/doffing of personal protective equipment, while all protocols recommended daily monitoring of COVID-19 related signs and symptoms in staff and patients. They varied in terms of recommended mask types, eye and face shield protection, and head coverings. While all protocols aimed at restructuring emergency dental services, their recommendations were often not based on the published evidence. This narrative review summarized key areas from 13 provincial and territorial protocols in Canada to help oral health care providers plan the reopening of their services. The information conveyed across all documents was clear, but variance highlights the need for a coordinated effort to develop an evidence-based document for dental practitioners.

Access to oral health care for people living with HIV/AIDS attending a community-based program.

Objective: People living with HIV/AIDS (PLWHA) have difficulty accessing oral health services primarily due to HIV-related stigma and discrimination. In 2011, the University of British Columbia (UBC) Dental Hygiene Degree Program implemented a preventive oral health services program at the Positive Living Society of British Columbia (PLSBC), a non-profit organization supporting PLWHA. This study aims to assess the perception of how this type of service delivery influenced access to oral health care for members of PLSBC. Methods: Personal interviews with 10 members and one focus group comprising 12 staff were conducted. Audiorecordings were transcribed verbatim and coded thematically. Emerging themes were identified using the interpretative phenomenology approach following Penchansky and Thomas' theory of access. Results: The program helped members maximize their dental coverage to receive other types of dental services. Members who were influenced by past traumatic experiences appreciated that services were delivered in a safe manner and in a stigma-free setting. Members valued the opportunity to educate future dental professionals to reduce HIV-related stigma. However, dental needs that could not be addressed by the program remained untreated for some members who continued to face barriers to care at referral clinics. Conclusion: This community-based preventive dental program provided affordable dental care, a stigma-free setting, care delivered in a safe manner, an educational opportunity, and accessible location, which all seemed to have a positive influence on access to oral health care for members of PLSBC. However, the limited availability of the program prevented many members from accessing comprehensive oral health care and is a factor that should be addressed.

Objectif: Les gens qui vivent avec le VIH/SIDA (GVAVS) ont de la difficulté à accéder à des services de santé buccodentaire, principalement en raison de la stigmatisation et de la discrimination associées au VIH. En 2011, le Programme de baccalauréat en hygiène dentaire de l'Université de la Colombie-Britannique (UBC) a mis en place un programme de services de santé buccodentaire préventifs à la Positive Living Society of British Columbia (PLSBC), un organisme sans but lucratif soutenant les GVAVS. La présente étude vise à évaluer la perception de la façon dont ce type de prestation de service a influencé l'accès aux soins de santé buccodentaire pour les membres de la PLSBC. Méthodologie: Des entrevues personnelles ont été menées avec 10 membres et un groupe de discussion comprenant 12 membres du personnel. Les enregistrements sonores ont été transcrits mot à mot et codés par thème. Des thèmes émergents ont été ciblés au moyen de l'approche phénoménologique et interprétative, fondée sur la théorie sur l'accès de Penchansky et Thomas. Résultats: Le programme a aidé les membres à maximiser leur couverture dentaire afin de pouvoir recevoir d'autres types de services dentaires. Les membres qui ont été influencés par des expériences traumatiques précédentes ont été reconnaissants que les services aient été fournis de façon sécuritaire et dans un milieu exempt de stigmatisation. Les membres ont aimé avoir l'occasion d'éduquer les futurs professionnels dentaires en vue de réduire la stigmatisation liée au VIH. Cependant, les besoins dentaires qui ne pouvaient pas être satisfaits par le programme sont demeurés non traités pour certains membres qui ont continué à faire face à des obstacles en matière de soins aux cliniques de renvois. Conclusion: Ce programme dentaire préventif offert en milieu communautaire fournit des soins dentaires à prix abordables, un milieu libre de stigmatisation, des soins offerts de manière sécuritaire, une occasion de formation et un emplacement accessible, qui semblent tous avoir une influence positive sur l'accès aux soins de santé buccodentaire des membres de la PLSBC. Cependant, l'accessibilité limitée du programme a empêché plusieurs membres d'avoir accès à des soins de santé buccodentaire complets et cela est un élément qui doit être abordé.

Perceptions of access to oral care at a community dental hygiene clinic for women involved with the criminal justice system.

Background: Women involved with the criminal justice system are often marginalized or vulnerable and may face oral health inequities. Through a community-engaged program at a Canadian university, dental hygiene students provided preventive care at an organization supporting this population. This study explored the impact of these oral care services from client and organization staff perspectives. Methods: One focus group with 6 clients, 2-person interviews with 4 clients, individual interviews with 3 clients, and one focus group with 4 organization staff members were conducted. Discussions were audio recorded, transcribed verbatim, and analysed thematically. The concept of access, proposed by Penchansky and Thomas (1981) and Saurman (2015), was used as the conceptual framework to organize the themes. Results: Nine themes were identified from the focus group and interview discussions: limited options, convenience, realistic expectations, respect and attention, no judgement, physical environment, communication, clients' unique needs, and appropriate messaging. Discussion: The clinic's close proximity and services, for which women did not need to pay out-of-pocket, facilitated access to preventive care. The person-centred and trauma-informed care further facilitated access. However, access to comprehensive care through referrals was limited by cost and likely issues of stigmatization from other dental care providers. Clinic aesthetics, advertising, and communication between the students and women receiving care also hindered access. Conclusion: Preventive oral care services provided at this clinic for marginalized and vulnerable women who have been involved with the criminal justice system were valued by clients and staff. Findings will help inform future community-based dental hygiene clinics for this population.

Contexte: Les femmes qui font face au système de justice pénale sont souvent marginalisées ou vulnérables et peuvent être confrontées à des inégalités en matière de santé buccodentaire. Dans le cadre d'un programme engagé sur le plan communautaire, mis en place dans une université canadienne, des étudiants en hygiène dentaire ont prodigué des soins préventifs dans une organisation qui soutient cette population. La présente étude a exploré les répercussions de ces services de soins buccodentaires du point de vue des clients et du personnel de l'organisation. Méthodologie: Un groupe de discussion comprenant 6 clients, des entrevues à 2 personnes avec 4 clients, des entrevues individuelles avec 3 clients et un groupe de discussion avec 4 membres du personnel de l'organisation ont été menées. Les discussions ont fait l'objet d'un enregistrement sonore, puis ont été transcrites textuellement et analysées par thèmes. Le concept d'accès, proposé par Penchansky et Thomas (1981) et Saurman (2015), a été utilisé à titre de cadre conceptuel pour organiser les thèmes. Résultats: Le groupe de discussion et les entrevues ont permis de définir 9 thèmes : choix limités, commodité, attentes réalistes, respect et attention, absence de jugement, environnement physique, communication, besoins uniques des clients, et messages appropriés. Discussion: La proximité et les services de la clinique, pour lesquels les femmes n'avaient pas à payer de leur poche, ont facilité l'accès aux soins préventifs. Les soins axés sur la personne et les soins adaptés au traumatisme ont davantage facilité l'accès. Cependant, l'accès à des soins complets par l'intermédiaire de renvois a été limité par le coût et les enjeux de stigmatisation probables de la part d'autres fournisseurs de soins dentaires. L'esthétique de la clinique, la publicité et la communication entre les étudiants et les femmes recevant les soins ont également entravé l'accès. Conclusion: Les clients et le personnel ont attribué une valeur aux soins buccodentaires préventifs fournis à cette clinique réservée aux femmes marginalisées et vulnérables qui ont été impliquées dans le système de justice pénale. Les résultats permettront d'orienter les cliniques communautaires futures d'hygiène dentaire destinées à cette population.

Community as the teacher on issues of social responsibility, substance use, and queer health in dental education.

INTRODUCTION: In order to foster dental and dental hygiene practices that are inclusive, sensitive to diversity, equitable, and without prejudice, a call to broadly teach cultural diversity within dental and dental hygiene education has been made. The research question of this study was "to what extent can an interactive and open dialogue about substance use, queer health, and social responsibility foster transformative learning?" METHODS: A collaborative and interdisciplinary project engaged the community as a teacher over the Summer and Fall of 2019 to address issues of substance use, queer health, and social responsibility and was delivered to 55 first-year undergraduate dental and 23 third-year dental hygiene students over three educational sessions. Dental and dental hygiene students were asked to reflect, in writing, on each session using between 200 and 400 words. Textual information from students' self-reflections and from the community's feedback were analyzed thematically for content (e.g., codes and themes). RESULTS: In total, 128 written reflections-for an average of 42 reflections per session-were gathered and analyzed interactively by the authors. Three major themes emerged: feeling privileged, breaking stereotypes, and coalescing learning. Feedback from the participating community members highlighted changes to be implemented in these sessions in the future, including more opportunities for small group activities in class. CONCLUSIONS: The three major themes that emerged from the thematic analysis of the self-reflections and community member feedback (feeling privileged, breaking stereotypes, and coalescing leaning) further highlighted the impact of community-driven curricula on students' learning in regard to substance use, queer health, and social responsibility. Further work is critical to understand the impact of such a pedagogy on students' practices once they leave their undergraduate programs.

COVID-19 pandemic: Students' perspectives on dental geriatric care and education.

OBJECTIVES: With the emergence of the COVID-19 pandemic in Canada and the curtailment of clinical and face-to-face university instruction in British Columbia on March 16, 2020, the opportunity arose to explore how third- and fourth-year undergraduate dental students critically considered the impact of the pandemic on education and the practice of dental geriatrics. METHODS: All third- and fourth-year undergraduate dental students within a dental geriatric module were asked to provide a written guided reflection on the question: "In your opinion, what factors make outbreaks (or pandemics) like COVID-19 relevant to the practice of dental geriatrics?" Reflections were gathered from March 12 to May 8, 2020. Thematic analysis was conducted to identify and interpret patterns of meaning within the reflections by means of an interactive coding process. RESULTS: A total of 115 reflections, between 291 and 710 words each, were received from 56 third-year (62.5% male) and 59 fourth-year (42.6% male) students. Five main themes emerged: experiencing uncertainties, frailty as a moderator, constraints in accessing care, preparedness protocol, and redefining care. The frequency in which the same codes, categories, and themes were assigned varied from 16 to 140 times. CONCLUSIONS: Students' reflections highlighted the effects of the pandemic, not only on their education but also on frail older adults themselves and the profession of dentistry in general. Further studies are warranted to explore how this curtailment might impact educators' approaches to geriatric education, as well as the way graduating students will set up their practices and approach geriatric care in the future.

Exploring residential care aide experiences with oral malodour in long-term care.

Aim: To determine what experiences do residential care aides (RCAs) have with individuals living with oral malodour in a long-term care (LTC) facility? Design: Study investigation was done using an interpretive qualitative approach paired with a social constructivism interpretive framework. Methods: The study was conducted in May of 2015 through face-to-face interviews with RCAs, which were recorded and transcribed verbatim, observations of RCAs in their work environment, as well as RCA personal logs of their daily experiences with odour during caregiving. Thereafter, data were analysed and coded for emerging themes. Results: Five major themes were identified after grouping the codes: 1) attitudes and behaviours when caring for residents with malodour; 2)RCA knowledge of oral malodour; 3) level of job satisfaction among RCAs that care for residents with malodour; 4) culture and malodour; and 5) challenges of care giving compounded by malodour. These themes depict the overall experiences of study participants.

What are the self-reported unmet dental treatment needs of people living with HIV in British Columbia? A case of minority subpopulation in Canada.

OBJECTIVES: To identify associations of Andersen and Newman's (A&N) predisposing, enabling, and need factors with self-reported oral health status and self-reported unmet dental treatment needs in a sample of people living with HIV (PLHIV) in British Columbia (BC), Canada. METHODS: Participants responded anonymously to a 41-item online questionnaire with the following inclusion criteria: a) be at least 19 years old; b) self-identify as HIV-positive; c) be able to provide consent and be willing to voluntarily participate in the study; d) be residing in British Columbia; and e) be able to proficiently respond to the questions in English. Following the descriptive statistics, associations between A&N model factors and the main outcome variables (self-reported oral health status and self-reported dental treatment needs) were evaluated using bivariate inferential analyses. RESULTS: A total of 186 participants met the inclusion criteria. Approximately 40% (n = 74) of participants rated the health of their mouth as fair/poor and more than half (n = 112; 60.2%) reported having bleeding gums, tooth decay or tooth sensitivity. The bivariate analysis for the self-reported oral status as the outcome variable showed "having fair/poor general health" (P = 0.001), "unemployment" (P = 0.019), "avoiding dental treatment due to cost" (P = 0.005), and "not visiting a dental professional within the last year" (P < 0.001) as the strongest predictors. For the second outcome variable unmet dental treatment needs, the strongest predictors were "experience of being discriminated by dental professionals" (P = 0.001), "having fair/poor general health" (P = 0.006), and "suffering from past and current medical conditions due to HIV" (P < 0.001). CONCLUSIONS: Several predisposing, enabling and need factors from the A&N model were associated with self-reported oral health status and unmet dental treatment needs of PLHIV. Results from this study highlight the needs of improving access to affordable dental care to address the unmet oral health needs of PLHIV.

Dental care utilization: patterns and predictors in persons living with HIV in British Columbia, Canada.

OBJECTIVES: To identify the predisposing, enabling, and need factors of the Andersen and Newman (A&N) model and their associations with the pattern of dental service utilization in a sample of people living with HIV (PLHIV) in British Columbia. METHODS: Participants responded anonymously to a 40-item online questionnaire to explore the patterns of dental service utilization. Following the descriptive statistics, the associations between A&N model factors and main outcome variables (having a dental visit in the last year and reasons for the dental visit) were evaluated using simple and multiple logistic regression analyses. RESULTS: Out of 600 potential PLHIV participants, 210 responded to the survey and 186 met the inclusion criteria. The experience of being discriminated against by dental professionals (P = 0.005), having dental anxiety (P < 0.001), not having dental insurance (P = 0.001), and having living condition difficulties (P = 0.004) were significantly associated with nonemergency dental visits. In multiple logistic regression analysis, dental anxiety (OR = 0.1; 95 percent CI 0.0; 0.4), having a regular dentist (OR = 3.7; 95 percent CI 1.1; 12.6), and visiting a dental office in the last year (OR = 21.6; 95 percent CI 6.1; 76.5) were the strongest predictors of dental service utilization in this study. CONCLUSIONS: Several predisposing, enabling, and need factors from the A&N model were associated with dental service utilization by PLHIV. In addition to various psychosocial barriers, a significant number of respondents reported experiencing stigma and discrimination from their oral care providers.