Evaluating the patient sociodemographic factors affecting dental students' clinical communication skills using a three-perspective approach.

OBJECTIVE: This study aimed to assess undergraduate dental students' communication skills in relation to patient sociodemographic factors using a three-perspective approach; the student, the patient, and the clinical instructor perspective. MATERIALS AND METHODS: A cross-sectional study was conducted using validated modified-communication tools; Patient Communication Assessment Instruments (PCAI), Student Communication Assessment Instruments (SCAI), and Clinical Communication Assessment Instruments (CCAI). Moreover, 176 undergraduate clinical year students were recruited in this study whereby each student was assessed by a clinical instructor, a patient, and self-evaluation. RESULTS: The clinical communication skills domains were not significantly influenced by patient sociodemographic factors, including sex, educational background, and the number of visits (p > .05). However, this study revealed a statistically significant difference in the domain of "caring and respectful" of the SCAI between the low- and middle-income groups. CONCLUSIONS: Overall, most of the patient sociodemographic factors did not affect clinical communication skills. However, patient income groups played a significant role in one of the communication domains.

Determinants of Dentist-Patient Relationships: A Scoping Review.

OBJECTIVES: The dentist-patient relationship (DPR) is considered to be a key element in dental clinical settings. This scoping review aimed to examine the extent of previous research on DPR, focussing on its determinants for the reification of the construct. METHODS: This research was directed by the guidance for systematic scoping reviews from the Joanna Briggs Institute. The inclusion/exclusion criteria were based on participants of general adults and dentists, the concept of determinants of DPR, and the context of dental health care encounters. A literature search was performed in 6 major electronic databases in July 2023. Key information from included articles was extracted to chart the results, mainly to identify the determinants of DPR. Each determinant of DPR was classified according to the conceptual model of DPR. RESULTS: A total of 1727 records were initially identified, and 16 articles were included in the review. Nine studies used a quantitative method and 7 were nonempirical articles. All but 2 articles were from the perspective of patients. Factors were grouped into 6 main domains: dentist, patient, society/environment, clinical structure, clinical process, and outcome. Amongst the 6 domains of DPR, most determining factors were related to the clinical process. "Communication" was most frequently counted, at 8 times, followed by "trust" (frequency, 6). At the patient level, "dental fear/anxiety" was frequently used to measure DPR. CONCLUSIONS: Previous literature about DPR indicated a few common and dentistry-specific determinants from the patient perspective. Further studies are encouraged to develop a more comprehensive framework and evaluation scale of DPR.

Psychosocial factors, dentist-patient relationships, and oral health-related quality of life: a structural equation modelling.

BACKGROUND: Psychosocial factors and dentist-patient relationships (DPR) have been suggested to be associated with oral health outcomes. This study aimed to test a conceptual model which hypothesised relationships among psychosocial factors, DPR variables, and oral health-related quality of life (OHRQoL) in the 'distal-to-proximal' framework. METHODS: A total of 12,245 adults aged 18 years or over living in South Australia were randomly sampled for the study. Data were collected from self-complete questionnaires in 2015-2016. The outcome variable of Oral Health Impact Profile was used to measure OHRQoL. Psychosocial domain consisted of psychological well-being, social support, and health self-efficacy. DPR domain included trust in dentists, satisfaction with dental care, and dental fear. The hypothesised model was tested using the two-step approach in structural equation modelling. RESULTS: Data were analysed from 3767 respondents after the screening/preparing process (adjusted valid response rate 37.4%). In the first step of the analysis, confirmatory factor analyses produced acceptable measurement models for each of the six latent variables (GFI = 0.95, CFI = 0.98, RMSEA = 0.04). The final structural model indicated that better well-being, higher self-efficacy, and more satisfaction were associated with lower oral health impact (ß = - 0.12, - 0.07, - 0.14, respectively) whereas fear was positively associated (ß = 0.19). Among intermediates, support was positively associated with satisfaction within a small effect size (ß = 0.06) as compared to self-efficacy with trust (ß = 0.22). The invariance of the final model was also confirmed on participants' SES and dental service characteristics except the variable of 'last dental visit'. CONCLUSIONS: Psychosocial factors and DPR variables were associated with oral health impact in both direct and indirect paths. The framework of 'distal-to-proximal' actions is empirically supported from psychosocial factors via DPR variables to OHRQoL.

Oral health behind the bars: oral health seeking behavior among jail prisoners at central jail of Peshawar, Pakistan: a cross-sectional study.

BACKGROUND: The oral health care-seeking behavior among prison inmates is an overlooked area, often leading to deteriorating general health due to the prisoners' limited awareness of oral hygiene practices. It is crucial to address this issue and understand the factors associated with oral healthcare-seeking behavior in prisons. OBJECTIVE: To assess the oral healthcare-seeking behavior of prison inmates at Central Prisoner Jail, Peshawar Pakistan and to look the factors associated with their dental care utilization. MATERIAL AND METHODS: This cross-sectional study was conducted at Central Prisoner Jail, Peshawar Khyber Pakhtunkhwa, Pakistan from November 2021 to April 2022. A consecutive sampling technique was used to collect data from both convicted and under-trial prisoners by using a pre-tested WHO Basic Oral Health Survey 2013 tool. Our outcome variable was "Visit to a dentist in the last 12 months (Never/Once or more than one visit). Chi-square test was used to determine univariate association with other explanatory variables while multivariable logistic regression was performed to adjust for potential confounders. RESULT: A total of 225 participants were recruited to the study with a mean (SD) age of 32.9(11.4). More than two-thirds of 200(88.9%) of the participants were males. One-third of the sample never visited the dentist75(33.3). Participants who completed college/university education and never visited the dentist in the last 12 months constituted a smaller proportion (17.6%) compared to those who visited the dentist once or more than once n = 28(82.4%, p-value = 0.003). Individuals who were using toothbrushes were most frequently visiting the dentist n = 130(72.6%=p value = 0.001) as compared to never visitors. Multivariate logistic regression analysis revealed that Participants who experienced teeth pain or discomfort had 0.42 times lower odds of visiting the dentist compared to those who did not experience any pain or discomfort [AOR 0.42 (95% CI 0.17-0.80), p = 0.04]. Similarly, Participants who do not use any denture have 4.06 times higher odds[AOR 4.06(95% CI 1.76-9.36), p = 0.001] of visiting the dentist compared to those who use a denture. CONCLUSION: Our result demonstrates that those prisoners who were experiencing tooth pain or discomfort and not using dentures were the strong predictors with lower dental visit frequency to seek oral health care.

Role-playing para la mejora de las habilidades comunicativas en estudiantes de grado de Odontología. Un ensayo clínico no aleatorizado / Role-playing for the improvement of communication skills in Dentistry undergraduate students. A non-randomized clinical trial

Introducción: Se trata de analizar el impacto de una secuencia formativa en la autopercepción del alumnado sobre las habilidades comunicativas. Secundariamente, se pretende conocer el grado de satisfacción del alumnado en relación con las actividades propuestas. Mètodos: Es un estudio cuasi experimental realizado sobre cuatro de los subgrupos de prácticas de la asignatura obligatoria de cuarto curso Cirugía Bucal Clínica e Implantología. Dos de los subgrupos recibieron una secuencia formativa específica para la mejora de sus habilidades comunicativas (n = 40) y los otros dos actuaron como controles (n = 47). Al inicio y al final del estudio, los participantes respondieron el cuestionario validado SE-12 de autopercepción sobre comunicación odontólogo-paciente. La estrategia evaluativa fue continua y formativa. Se analizaron y compararon las puntuaciones de los distintos indicadores e instrumentos de evaluación empleados.Resultados: A excepción de un alumno del grupo de control, todos los estudiantes participaron de forma activa en el proyecto. En ambos grupos se observó una mejora estadísticamente significativa en la percepción de las habilidades comunicativas (p < 0,001). No obstante, los alumnos asignados al grupo experimental percibieron una mejora significativamente mayor (diferencia de medias = 0,96 puntos; intervalo de confianza al 95% = 0,66-1,27; p < 0,001). Los alumnos valoraron la secuencia con un 8,56 (desviación estándar = 1,14).Conclusiones: La implementación de la secuencia formativa produjo una mejora en la percepción que tienen los estudiantes sobre sus habilidades comunicativas. Es necesaria la inclusión de programas longitudinales de formación en comunicación en los planes de estudio para acreditar la consecución de las competencias comunicativas.(AU)

Introduction: To analyze the impact of a training-learning sequence on students' self-perception of communication skills. Secondarily, to know the degree of student satisfaction in relation to the proposed activities.Methods: A quasi-experimental study was carried out on four of the clinical practice subgroups of Clinical Oral Surgery and Implantology (fourth year of study). Two of the subgroups received a specific training-learning sequence to improve their communication skills (n = 40) and the other two served as controls (n = 47). At the beginning and end of the study, the participants answered the validated SE-12 self-perception questionnaire on dentist-patient communication. The evaluation strategy was continuous and formative. The scores of the different indicators and evaluation instruments used were analyzed and compared.Results: Except for one student in the control group, all students participated actively in the project. In both groups, a statistically significant improvement was observed in the perception of communication skills (p < 0.001). However, the students assigned to the experimental group perceived a significantly greater improvement (difference in means = 0.96 points; 95% confidence interval = 0.66-1.27; p < 0.001). The students valued the training-learning sequence with an 8.56 (standard deviation = 1.14).Conclusions: The implementation of the training-learning sequence produced an improvement in the perception that students have about their communication skills. It is necessary to include longitudinal training programs in communication in the curricula to prove the achievement of communication skills competences.(AU)

Use of Social Media to View and Post Dentistry-related Information in Bahrain: A Cross-Sectional Study.

OBJECTIVES: Healthcare-related information sharing via social media is on the rise following the coronavirus disease 2019 (COVID-19) pandemic. Dental practices primarily use social media to search, share, and communicate health-related information. Considering the increasing trend of using social media, the primary aim of the present study was to identify the use of social media by dentists and laypeople to post and view dentistry-related content in Bahrain. METHODS: This questionnaire-based cross-sectional study included adult participants and dentists. A pretested validated questionnaire was administered. The chi-square test for association was used to assess the association between categorical outcomes. A p-value of ≤ 0.05 was considered statistically significant. RESULTS: In total, 249 adult participants and 53 dentists were included. A substantial majority (83.5%) of the participants reported that they always used social media to view dentistry-related content, and 69.8% of the dentists felt that patients who use social media have better oral health awareness. A longer duration of social media usage showed significant associations with particularly viewing dentistry-related content (p = 0.008) and contacting dentists directly through social media for consultation (p = 0.055). CONCLUSIONS: An extremely high percentage of the younger population in Bahrain is using various social media to discuss dentistry. This engagement should be wisely managed to promote dentistry-related information sharing, which can lead to increased awareness related to overall dental health. There is a definite need to enforce certain standard operating procedures in every country that will prevent the misuse of this technological advancement.

Evaluation of a digital game for teaching behavioral aspects of clinical communication in dentistry.

INTRODUCTION: Traditionally, dental students learn the skills for dentist-patient interaction and communication via on-site contact with patients, when they start clinical training. However, preclinical students (who have not started clinical practice) have fewer chances to realize the context of dentist-patient interaction. It has remained unclear if a gamification approach via digital media, i.e., a computer role-playing game, can help to learn clinical communication skills. The intervention-based study investigates the effectiveness of the clinical dentist-patient communication (CDPC) game on students' motivation, beliefs, and self-efficacy to learn behavioral issues of clinical communication. METHODS: Fifty-two dental students (Preclinical group) and 18 dental interns and dentists (Clinical group) played the CDPC game, which consists of 16 scenes of clinical context about dentist-patient communication (less than 40 min for playing), via web browsers. Pre-test and post-test questionnaires were used to assess their motivation, beliefs, and self-efficacy to learn behavioral issues of clinical communication. The effectiveness was examined by comparing pre-test and post-test scores within-subject and between-group difference was compared between Preclinical and Clinical groups, via non-parametric statistical tests. RESULTS: (A) In the Preclinical group, participants showed a significant increase in motivation and self-efficacy in learning after playing the CDPC game (p < 0.05, adjusted of multiple comparison). (B) In contrast, the Clinical group did not show a significant difference before vs. after playing the game. (C) After playing the game, the Preclinical group showed a significant association between motivation and beliefs (p = 0.024) and between motivation and self-efficacy (p = 0.001); the Clinical group showed a significant association between motivation and beliefs (p = 0.033). CONCLUSIONS: The current evidence suggests that gamification of learning helps preclinical students to understand the context of clinical dentist-patient interaction and increase their motivation and self-efficacy to learn behavioral issues of clinical communication.

Effects of a dental Spanish educational intervention among predoctoral students at a US dental school.

PURPOSE/OBJECTIVES: This study investigated the effects of an online module intended to educate dental students about Spanish terms and phrases relevant to a patient appointment. Effects investigated included perceived value of dental Spanish, confidence utilizing Spanish terms in a patient appointment, and degree of knowledge retention. METHODS: This study utilized pre- and postsurvey data collected from three classes at one US dental institution (D2-D4) via an online measure accompanying the virtual educational module. Questions assessed degree of accurate knowledge retained, level of confidence, perceived value of dental Spanish, language proficiency, and year in school. RESULTS: Predoctoral dental students in three cohorts participated in the study (97% and 87% pre/post-test response rate, respectively). Most students reported dental Spanish to be beneficial and necessary. However, the intervention did not influence students' perceived value of dental Spanish. Students who disagreed that dental Spanish was valuable performed significantly worse on the postintervention knowledge assessment when compared to those students who positively reported value of dental Spanish. The intervention significantly increased confidence levels overall regarding use of dental Spanish in a patient appointment. Significant knowledge acquisition occurred for each of the components assessed. CONCLUSION(S): A brief online educational intervention can effectively increase dental students' knowledge of and confidence utilizing Spanish terms commonly employed during a patient appointment. Perceived value of dental Spanish is high and impacts students' knowledge retention but is not affected by education alone.

A medicalização na prática de dentistas no SUS: um olhar qualitativo para os sentidos da prática / Dentistry medicalization at SUS: a qualitative practice-based perspective

Resumo Este artigo explora sentidos e significados do trabalho odontológico no SUS, no contexto da relação profissional-paciente. Pesquisa qualitativa com 20 cirurgiões-dentistas que atuavam em um município paulista de médio porte, abordada por meio de três grupos focais, com a pergunta disparadora "Qual é o sentido ou significado do seu trabalho, aqui na prefeitura, para você?". O material foi áudio-gravado, transcrito na íntegra e analisado pelo método de análise de conteúdo temática. Procedemos a realização de leitura flutuante, categorização e discussão dos achados junto aos pares de pesquisadores para validação final. Como resultados, aponta-se a construção das categorias 1) Estranheza às necessidades percebidas pelos pacientes e a consequente medicalização da vida, e 2) Poder e consumo como significados da prática. O trabalho do cirurgião dentista, nesse contexto, evidenciou as diferenças entre as necessidades percebidas pelo paciente e aquelas que o dentista considera. Além disso, revelou o poder que emana da assimetria entre paciente e profissional como dificultador da produção de autonomia do paciente. Tais significações parecem trazer sofrimento para esses profissionais no seu trabalho. Concluiu-se que há necessidade de reflexão sobre o trabalho em saúde como forma de se evitar sofrimento, e que a prática desses dentistas é carregada de sentidos e significados.

Abstract This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in São Paulo, divided into three focus groups and asked the guiding question "What sense or meaning do you attribute to your work here in the city?" Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients' needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients' needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients' autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.

Contribución de la ética convergente en la enseñanza de la odontología / Contribution of convergent ethics in the teaching of dentistry

Objetivo: refexionar sobre la aplicación de la ética convergente en la práctica odontológica de pregrado para comprender las tensiones entre los principios cardinales que pueden suscitarse en la relación estudiante-paciente. Métodos: se exponen los fundamentos teóricos de la ética convergente y se relacionan las tensiones bio(éticas) que propone con un ejemplo en la práctica formativa estudiante-paciente de odontología. Resultados: se desarrolló una articulación de la ética convergente con un caso práctico en odontología. Conclusión: la ética convergente puede brindar un punto de partida para aplicar el análisis bioético en la práctica clínica odontológica, por parte del estudiante.

Objective: To refect on the application of convergent ethics in undergraduate dental practice to understand the tensions between the cardinal principles that can arise in the student-patient relationship. Methods: The theoretical foundations of convergent ethics are exposed and the bio(ethical) tensions proposed in convergent ethics are related to an example of their application in the dental student-patient training practice. Results: An articulation of convergent ethics was developed with a practical case in dentistry. Conclusion: Convergent ethics can provide a starting point to apply bioethical analysis in the clinical practice of dental students.

Power in Dentistry: A Foucauldian Shift in South Korea.

The established method of understanding power in dentistry is based on the early Foucauldian discourse that dentistry enforces oral health discipline to the people on behalf of state power. This exhibits the hierarchy between dentists and patients, which clearly appears in clinical dentistry and effectively explains the responsibility of oral care assigned to patients. However, there presents no way to becoming free from the framework in the discourse as a resistance. Beyond the political aspect of the medico-sociological framework, this paper seeks a different way to understand power in dentistry through 'care of the self', a late Foucauldian concept. First, based on the current discussion of the dentist-patient relationship (DPR), the paper examines two trends of clinical dental treatments in South Korea. The high prevalence of dental implant and orthognathic surgery indicates that traditional prejudices including ableism and pursuit of Western beauty still remain in South Korea albeit with the society overcoming paternalism in DPRs. These dental phenomena, however, contain excesses that cannot be explained only by traditional prejudice, and this paper attempts to interpret them as the pursuit of care of the self that appears in the dentist's professionalism and the patient's self-determination. In dentistry, care of the self can be introduced in the form of empowerment, which is implemented through the improvement of oral health literacy and shared decision-making. This paper argues that this interpretation helps surmount the traditional dyadic model of the DPR and revise the understanding of power in dentistry.

Integralidade do atendimento odontológico à mulher em situação de violência: revisão narrativa da conduta profissional / Dental care integrality for women in violent situations: a narrative review of professional conduct

O desempenho de atributos profissionais de integralidade do atendimento de mulheres em situação de violência depende de como os cirurgiões-dentistas (CDs)estruturam suas práticas de cuidado e como compreendem a violência. Por isso, o objetivo desta revisão foi acumular evidências da responsabilidade profissional e obrigações sociais do CDe sua imprescindibilidade no enfrentamento da violência contra a mulher. Foram selecionados artigos nas bases de dados PubMed, SciELOe LILACS, a partir de Descritores emCiências da Saúde, para fundamentar e aprofundar as perspectivas sobre a integralidade do atendimento odontológico, considerando os conflitos sociais subentendidos na queixa principal. Constatou-se que a violência contra a mulher é resultante de processoshistóricos-sociais de desigualdade entre os gêneros; a agressão física sobressai-se entre as principais queixas e mulheres agredidas por seu parceiro têm alta prevalência de sofrer injúrias na cabeça e na face. As sequelas da violência vão além dos vestígios físicos e difundem-se a inúmeros problemas orais. Verificou-se pouca aptidão dos cirurgiões-dentistas para identificar, conduzir e propor alternativas de tratamento global à paciente, mesmo com protocolos para naturalização da investigação por meio da anamnese. A ampliação do conhecimento e discussão das políticas de ensino são oportunidades para consolidar a humanização e a integralidade de saúde, evitando exames e tratamentos mecânicos, sem afeto ou respeito. Essa estratégia faz parte da construção coletiva para o estabelecimento e manutenção do compromisso ético e social do Ensino em Odontologia, em que o CD compreende a magnitude de sua profissão e presta seus serviços articulado com a realidade social (AU).

Improving integrality on dental care for women in a violent situation depends on how the dentist conducts the care practices and how to comprehend the violence. For that reason, the goal of this review was to gather evidence and concerns about the role of dentists in addressing violence against women, professional responsibilities, and social obligation. At PubMed, SciELO, and LILACS were selected research and studies to substantiate and deepen perspectives about integrality on dental care attendance considering the social conflicts implied in the main complaint. Violence against women is produced in gender inequality arising from historical and social processes. Physical aggression is the main complaint. Women assaulted by their partners have a high prevalence of suffering head and face injuries. The violence's sequelae spread to countless problems beyond the physical traces. Dentists do not be able to identify, conduct, and purpose alternatives of global treatment even though with protocols of investigationthrough the anamnesis. Multiprofessional discussion expands the knowledge and it is an opportunity to reinforce oral health inclusive criteria avoiding mechanicaltreatment with no respect or affect. Thus, this is a collective construction strategy to establish and maintenance of the ethical and social commitment of Dentistry, on what dentists improve the dental care screening, intervening, and changing behavior according to the real demand of our society (AU).

Design of a communication skills course in dentistry: Applying active-learning strategies to improve educational outcomes.

PURPOSE/OBJECTIVE: Effective communication, between patient and dentist, is a core clinical skill that commands dedicated pedagogy similar to that of developing scientific knowledge and psychomotor skills. This study aimed to describe active-learning strategies in a dental communication skills course, which sits within a broader foundation dental course and evaluate students' educational outcomes. METHODS: This is a two-phase retrospective, mono-centred study, completed in 2019 at an Australian dental school. Phase I, a case report, describes the Communication Skills for Oral Health (CSOH) course design and its active-learning strategies. Phase II analysed data from the course using Kirkpatrick's evaluation model to objectively measure the impact of the course and provide feedback to education designer. Students' perception (Level 1) was evaluated with an institutional, validated online survey. Descriptive and statistical analysis, included paired tests and Spearman's correlation analyses, used to investigate learning effect (Level 2) and student behaviour change (Level 3). To assess the impact of the CSOH course design (Level 4) the student grades from the course were analysed. RESULTS: The CSOH course encompasses three major topics: Essentials of Communication Skills, Professional-Patient Relationship and Managing Difficult Situations. Each topic included didactic content complimented with a variety of active-learning strategies to teach and assess students. Positive outcomes were recorded across all Kirkpatrick levels. CONCLUSIONS: This study suggests an efficient communication skills course design, which may assist in the development of communication skills courses in other dental education institutions.

Opposition to Early Dental Visit by Dentists: A Qualitative Study on Mothers' Social Networks.

OBJECTIVES: To examine whether information that mothers received from dentists in their social network was consistent with professional recommendations for the first dental visit at age 1 y. METHODS: We performed a cross-sectional qualitative study on mothers in Pennsylvania and West Virginia from 2018 to 2020 to explore how their social networks influence their children's dental service utilization. In-person, semistructured interviews were conducted with 126 mothers of children ages 3 to 5 y. Qualitative data were transcribed, coded, and analyzed using NVivo 12. Two investigators analyzed data using grounded theory and the constant comparative method. RESULTS: Over half of mothers reported a professional relationship with a dentist as part of their social network on children's oral health. Mothers described the following themes: 1) mothers contacted dentists in their social network for child dental information and to schedule their child's first dental visit, 2) mothers described dentists' justifications for the timing of the first dental visit older than age 1 y, 3) mothers described the impact of the dentist declining to see her child, and 4) after the dentist declined to see her child, some mothers did not comply with the dentist's recommendation of delayed child dental visits because they were given alternative information that encouraged early dental visits. CONCLUSIONS: Our findings indicate a need for dentists to reinforce mothers' dental-seeking behavior for young children and adhere to recommendations on the age 1 dental visit. KNOWLEDGE TRANSFER STATEMENT: Qualitative data on mothers' social networks show that dentists play a key role in access to early dental visits, particularly when dentists decline to see the mother's child for visits.

Comparing pre- and post-treatment patients' perceptions on dental implant therapy.

BACKGROUND: Appropriate patients' perceptions as one of Patient Reported Outcome Measures (PROMs), are shown to be critical for the sustainable success of implant therapy, little is known however of how they prospectively evolve throughout the treatment process. OBJECTIVE: This study aimed to prospectively assess patients' perceptions before and after treatment with dental implants and to identify the impact of patients' characteristics on their perceptions. MATERIALS AND METHODS: Patients' perceptions on implant therapy were prospectively assessed by means of purpose-made questionnaire, rating the extent of agreement/disagreement with a set of statements on a visual analog scale. The questionnaire was collected before initial consultation with the implant dentist and post-treatment at least 1 month after prosthetic loading of the implant. Changes in patients' perceptions were analyzed with the Wilcoxon signed-rank test. RESULTS: Pretreatment questionnaire was collected from 359 patients. While 245 of them proceeded with implant therapy, 145 received final restoration within the timeframe of the study and completed the post-treatment questionnaires between 1 and 6 months after prosthesis delivery. The most common source of information was dental professions (72.4%). Although patients' perceptions were more realistic at post-treatment, few improper perceptions persisted as only 51% of patients agreed with the statement "There is a chance of dental implant failure," 28% agreed with the statement "Dental implants last longer than natural teeth," and higher percentage of patients agreed with "Dental implant therapy is appropriate for all patients." CONCLUSIONS: Although patients appear to harbor more realistic perceptions of implant therapy, certain improper perceptions still persist at post-treatment. The design of appropriate patient educational program might be essential to correct misperceptions that might affect long term success of implant therapy. This study had been registered on Thai Clinical Trials Registry (TCTR) with the TCTR identification number: TCTR20181101001.

Translation, Cross-cultural Adaptation and Reliability Analysis of the Survey of Anxiety and Information for Dentists (SAID) among Brazilian Adolescents

ABSTRACT Objective: To translate, perform a cross-cultural adaptation and reliability analysis of the Survey of Anxiety and Information for Dentists (SAID) for use with Brazilian adolescents. Material and Methods: The SAID was translated into Brazilian Portuguese and back-translated to English. An expert committee compared both versions and examined their equivalence. Then, a face validation was performed with 10 adolescents. The SAID was applied in printed format with 25 questions. Participants answered and commented on the questions with a researcher to confirm the understanding and provide suggestions. The suggestions were implemented, and the expert committee approved the final version of the SAID in Brazilian Portuguese. The psychometric properties were tested with 60 adolescents aged 10 to 19 years. Participants answered the Brazilian version of the SAID before their first dental appointment and two weeks later to determine test-retest reliability. Reliability was analyzed by internal consistency analysis (Cronbach's alpha) and test-retest (ICC). Results: The instrument presented excellent reliability according to internal consistency (Cronbach's alpha = 0.77) and test-retest coefficients (ICC = 0.88; 95% CI: 0.81-0.93). The Kappa coefficients and the degree of agreement of the dichotomous questions indicated good reproducibility of the new version. Conclusion: The SAID translation, cross-cultural adaptation and reliability analysis were completed successfully. Thus, the Brazilian version of the SAID can be a useful survey tool for dental care of adolescent patients.

Are trust and satisfaction similar in dental care settings?

OBJECTIVES: Trust and satisfaction in dental care settings are salient constructs to operationalize the concept of dentist-patient relationships (DPR). This study aimed to compare the similarity of both constructs with regard to factor structure and revise the scales for better psychometric properties. METHODS: Data analysed in the study were collected in self-complete questionnaires from a random sample of 4011 adults living in South Australia. Trust and satisfaction were assessed using the Dentist Trust Scale and the Dental Care Satisfaction scale. Items in the scales were initially examined with a split-half sample in exploratory factor analysis and cluster analysis. Factor structures of different model designs were tested on the other half sample in confirmatory factor analysis. The final model was cross-validated on the first half sample for structural invariance. RESULTS: Exploratory factor analysis revealed a three-factor structure consisting of 'trust', 'satisfaction' and 'distrust/dissatisfaction' (60.2% of the variance explained; Cronbach's α = 0.94, 0.81, 0.73, respectively). Cluster analysis supported the factor solution with the same three major clusters except for a single-item independent branch of the 'cost' domain from the satisfaction scale. The final model was designed with two correlated but distinct factors, 'trust' and 'satisfaction', with the modification of one inter-item covariance and deleting the least associated item (GFI = 0.96, CFI = 0.98, RMSEA = 0.06). The stability of the final model was achieved through cross-validation (P = .143, ∆CFI < 0.001). CONCLUSIONS: Trust and satisfaction in dental care settings are unidimensionally different yet highly correlated factors concurrently. Demonstrating the discriminant and complementary functions of both constructs can justify the rationale to apply them together in further studies for DPR.

Dentist-patient relationships and oral health impact in Australian adults.

OBJECTIVES: Dentist-patient relationships (DPRs) are a key component in clinical encounters with potential benefits for oral health outcomes. This study aimed to investigate whether better DPR variables are associated with higher oral health-related quality of life (OHRQoL). METHODS: A total of 12 245 adults aged 18 years or over were randomly sampled from South Australia in 2015-2016. Data were collected from self-complete questionnaires and analysed as a cross-sectional design. The outcome variable was the Oral Health Impact Profile (OHIP-14). Explanatory DPR variables included trust in dentists, satisfaction with dental care, and dental fear. Covariates comprising oral health behaviours, dental services, demographics, and socioeconomic status were included as potential confounding variables. Bivariate correlation analyses and multivariable linear regression were performed for the associations among explanatory, outcome variables and other covariates. RESULTS: Response data were analysed from 4220 participants (response rate = 41.9%). Unadjusted mean total scores of DPR variables and OHIP-14 were associated with most of the study participants' characteristics (P < .05). Bivariate correlations among DPR variables and OHIP-14 showed a diverse range of coefficients (|r| or |ρ|=0.22-0.67). Multivariable regression analyses in both individual/clustered block entry and full model indicated that higher satisfaction and less dental fear (B = -0.039 and 0.316, respectively in the full model) were associated with lower OHIP-14 after adjusting for possible confounders (P < .01). CONCLUSIONS: This study found that favourable DPR variables, mainly greater satisfaction and less dental fear are positively associated with better OHRQoL. Further studies are warranted to investigate the causality and mediation/moderation of DPR variables on oral health outcomes.

The Multiple Mini Interview as a Dental School Admission Tool: Can It Predict Noncognitive Traits Associated with Professional Behaviors?

The aim of this study was to investigate the reliability and validity of the Multiple Mini Interview (MMI) process and to assess its use as an admission tool to predict noncognitive traits associated with professional behavior during patient care in one cohort of dental students at a single U.S. dental school. Data were analyzed for the 95 candidates who matriculated and graduated as part of the 2017 graduating cohort at the University of Michigan School of Dentistry. All MMI interviewees for one cycle of admissions rotated through ten stations: two traditional interview question stations and eight scenario stations measuring domains that included four questions scored on a five-point Likert scale. Generalizability theory analysis showed the MMI to have good reliability (G Coefficient of 0.74). Station reliabilities (Cronbach's alpha) ranged from 0.88 to 0.92. MMI scores showed a positive significant correlation with students' scores on the Dental Admission Test and Perceptual Ability Test, D1 cumulative GPA, and D4 Patient Management grade. MMI scores positively correlated with professional behaviors relating to three domains-openness, conscientiousness, and emotional stability-thus demonstrating good predictive validity for measuring noncognitive traits associated with professionalism. This study found that the MMI was a reliable and valid tool that predicted key behavioral traits associated with professionalism in dental students.

Trust in dentist-patient relationships: mapping the relevant concepts.

Trust has a central role in healthcare encounters. This review explored concepts relevant to trust in dentist-patient relationships. The findings were demonstrated by drawing visual system maps for better understanding of the inherent complexity. A pragmatic approach was employed to search for evidence. The approach was initiated with a systematised searching protocol and followed by an iterative process of drawing maps and complementing references. The analysis-synthesis process found relevant key concepts and sub-concepts presented within three frameworks: the continuum of studying trust (utilisation, measurement, and establishment); beneficiaries of trust utilisation (patients, dentists, and oral health system); and a transformational model of trust development (identification-based, knowledge-based, and deterrence/calculus-based trust). Trust in dentist-patient relationships needs to be assessed in a multidisciplinary approach for interconnectedness among relevant concepts. The findings are represented in patient-centred care and quality of care with common underlying values. Despite the centrality of trust in medical/dental contexts, empirical evidence is insufficient beyond normative suggestions from previous studies. Based on the implications of thematic analysis and interpretation of the system maps, this paper can serve as a guide and source of information for further research of trust in dentist-patient relationships.