Readiness for Teledentistry: Validation of a Tool for Oral Health Professionals.

We validated a survey tool to test the readiness of oral health professionals for teledentistry (TD). The survey tool, the University of Calgary Health Telematics Unit's Practitioner Readiness Assessment Tool (PRAT) gathered information about the participants' beliefs, attitudes and readiness for TD before and after a teledentistry training program developed for a rural state in the Mid-Western United States. Ninety-three dental students, oral health and other health professionals participated in the TD training program and responded to the survey. Wilcoxon signed rank test was used to assess statistical differences in the change in the readiness rating before and after the training. Principal Components Analysis identified a three factor structure for the PRAT tool: Attitudes/ Attributes of Personnel; Motivation to Change and Institutional Resources. Overall, the evaluation demonstrated a positive change in all trainees' attitudes following the training sessions, with the majority of trainees acknowledging a positive impact of the training on their readiness for teledentistry.

Impact of Community-Based Dental Education on Attainment of ADEA Competencies: Students' Self-Ratings.

Fourth-year dental students at the College of Dentistry, University of Nebraska Medical Center participate in a community-based dental education (CBDE) program that includes a four-week rotation in rural dental practices and community health clinics across Nebraska and nearby states. The aim of this study was to assess the impact of participation in the CBDE program on the self-rated competencies of these students. A retrospective survey was administered to students who participated in extramural rotations in two academic years. The survey collected demographic data and asked students to rate themselves on a scale from 1=not competent at all to 5=very competent on attainment of the American Dental Education Association (ADEA) Competencies for the New General Dentist for before and after the rotations. A total of 92 responses were obtained: 43 students for 2011-12 and 49 students for 2012-13 (95% response rate for each cohort). The results showed that the students' mean pre-program self-ratings ranged from 3.28 for the competency domain of Practice Management and Informatics to 3.93 for Professionalism. Their mean post-program self-ratings ranged from 3.76 for Practice Management and Informatics to 4.31 for Professionalism. The students showed a statistically significant increase in self-ratings for all six competency domains. The increase was greatest in the domain of Critical Thinking and least in Communication and Interpersonal Skills. Overall, these results suggest that the CBDE program was effective in improving the students' self-perceptions of competence in all six domains and support the idea that a competency-based evaluation of CBDE programs can provide valuable information to dental educators about program effectiveness.

Use of dental services by immigration status in the United States.

BACKGROUND: There is limited research with mixed findings comparing differences in oral health outcomes and the use of dental services by immigration status. The authors conducted a study by reviewing nationally representative data to describe differences in dental care among noncitizens, naturalized citizens, and US-born citizens in the United States. METHODS: The authors used nationally representative data from the 2008-2012 Medical Expenditure Panel Survey to examine dental care for US-born citizens, naturalized citizens, and noncitizens 18 years and older. Total analytical sample size was 98,107 adults. They used multivariate logistic regression to model dental service use adjusting for confounding factors. RESULTS: Naturalized citizens and noncitizens were significantly less likely to have at least 1 dental visit within 12 months (39.5% and 23.1%, respectively) compared with US-born citizens (43.6%; P < .001). Among users, a smaller proportion of comprehensive examination visits were for naturalized citizens and noncitizens (75.9% and 71.4%, respectively) compared with US-born citizens (82.8%; P < .01). Noncitizen visits to dentists were also more likely to involve tooth extraction compared with those of US-born citizens (11.3% versus 8.8%; P < .01). Multivariate logistic regression suggests both non- and naturalized citizens had lower adjusted odds of having a comprehensive examination compared with US-born citizens during a visit (P < .01). CONCLUSIONS: Noncitizens and naturalized citizens had a lower rate of dental service use, and noncitizens were more likely to have had tooth extraction compared with US-born citizens. PRACTICAL IMPLICATIONS: Increased outreach efforts tailored to noncitizens and naturalized citizens who are at high risk of experiencing dental problems are needed, particularly to address misperceptions on the necessity of preventive dental visits.

Rural dentists: does growing up in a small community matter?

BACKGROUND: The aging of the dental work-force has implications for both patients and dentists, especially those in rural and underserved areas. Anecdotal information regarding dental workforce trends indicates that students from rural communities are more likely to practice in rural communities than are students from urban areas. Although the medical literature supports this premise relative to physicians, there are no data to verify this statement relative to dentistry. Therefore, the authors decided to study whether this premise applies to dentistry. METHODS: The authors conducted a retrospective analysis of dental student records from a Midwestern dental school for the years 1980 through 2010 to determine if there was a statistical correlation between the size of a dental student's town of origin and the size of the community where he or she practiced after graduation. They also examined what role, if any, the student's sex played. RESULTS: Dentists from rural areas were approximately six times more likely to practice in a rural area than were dentists from urban areas. Female dentists were only slightly less likely to practice in a rural community than were male dentists. CONCLUSION: Dentists from rural communities were more likely to practice in rural communities than were dental students from urban areas. PRACTICE IMPLICATIONS: To ensure future access to care in rural communities, rural dentists may want to recruit actively or work closely with dental students from rural areas when hiring associates or seeking purchasers for their dental practices.

Access to dental care for rural children: a survey of Nebraska general dentists.

BACKGROUND: Pediatric dentists are too few in number to care for all children. Therefore, the level of pediatric dental services provided by general dentists, especially in rural areas, is crucial to improving the dental health of children. PURPOSE: The objectives of the study were to establish a baseline in regard to the quantity of pediatric dental care provided by general dentists in rural Nebraska as well as to measure their interest, if any, in receiving additional pediatric training. METHODS: All rural general dentists (n = 350) in the state of Nebraska received an Institutional Review Board (IRB) approved 12-item questionnaire. The response rate was 71% (n = 248). Both descriptive and bivariate analyses were conducted, including chi-square and the analysis of variance (ANOVA). FINDINGS: Forty-five percent of rural Nebraska dentists devote more than 20% of their practice to serving the dental needs of children. One-third of all rural Nebraska dentists indicated they would like additional training in pediatric dentistry. CONCLUSIONS: A significant opportunity exists to provide additional pediatric training for general dentists in rural Nebraska to further increase access to care for children.

Rural dentists of the future: dental school enrollment strategies.

The purpose of this study was to determine the relationship, if any, of a dental student's 1) state of residency and 2) gender to his or her practice location in a rural Nebraska community after graduation. Previous research has demonstrated that dental students generally locate their practices near their place of rearing and that male graduates are more likely than female graduates to locate in rural areas. Dental student data for all University of Nebraska Medical Center College of Dentistry graduates from 1989 to 2008 (n=879) were analyzed. Descriptive and quantitative analyses were performed utilizing SPSS software (version 17.0). Chi-square and odds ratio analyses were also conducted. In contrast to previous research, women dentists who remained in the state after graduation were more likely to locate their practice in a rural community than were male dentists: 59 percent and 48.5 percent, respectively. Nonresidents who remained in the state after graduation were also more likely to locate in a rural community than were residents: 69 percent and 51 percent, respectively. Dental schools may find this information useful as state officials and policymakers look to dental schools for leadership in addressing dental workforce needs, especially in rural/underserved areas.