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This pilot study examines the similarities and differences between treatment recommendations offered by a decision system and trained tobacco treatment specialists. Using a sample of ten de-identified patient cases who used tobacco, we compared recommendations from the manual and preliminary review of cases by four tobacco specialists with the automated analysis of patient cases using both the first version of the rule-based system and the second version with improved and additional rules.
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Sistemas de Computación , Nicotiana , Computadores , Humanos , Proyectos Piloto , Uso de TabacoRESUMEN
With appropriate interprofessional collaboration, dental schools have the capacity to facilitate the dental management of patients with head and neck cancer who are facing multiple barriers to care.
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AIM AND OBJECTIVE: The aim of this pilot study is to explore the possible correlation between radiographic bone density and clinical bone quality in edentulous implant sites with and without a history of bone grafting. MATERIALS AND METHODS: A retrospective evaluation of 273 surgically placed dental implants with adequate preoperative cone-beam computed tomography (CBCT) between 2017 and 2019. Misch classification was used to assess the bone quality, and CBCT grayscale values, utilizing Hounsfield units (HU), were used for radiographic bone density assessment. RESULTS: Sixty-six patients (mean age, 58 years; 43 [65%] female and 23 [35%] male) with 118 implant sites were included. A total of 38 sites with bone grafts were evaluated. Controlling for location, sites with previous bone graft had softer bone quality (p = 0.003) and greater bone density (p <0.001) compared to sites without previous bone grafts. A significant correlation existed between radiographic bone density and clinical bone quality (p ≤0.01). The magnitude of the relationship increased in the absence of bone graft (p <0.001) and became nonsignificant in sites with previous grafting. In sites with allograft, the relationship was not statistically different than those without bone graft (both p ≥0.07), while it was statistically different in sites with xenograft when sites assumed independent (p = 0.02). CONCLUSION: CBCT-determined radiographic bone density was correlated to clinical bone quality in the absence of previous bone grafting, while in the presence of previous bone graft, the radiographic bone density of the edentulous sites seemed to be not associated with the clinical bone density, especially in sites with history of xenograft bone grafting. CLINICAL SIGNIFICANCE: CBCT could be utilized to predict preoperative clinical bone quality in sites without previous bone grafting. When assessing sites with history of bone grafting, the CBCT should be interpreted with caution, especially if xenografts were used.
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Densidad Ósea , Tomografía Computarizada de Haz Cónico Espiral , Trasplante Óseo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios RetrospectivosRESUMEN
The purpose of the current study was to assess knowledge and attitudes about human papillomavirus (HPV) and HPV vaccination for oropharyngeal cancer (OPC) prevention in first-year through fourth-year dental students. METHODS: In this cross-sectional quantitative study, surveys assessed knowledge and attitudes about HPV, HPV-related OPC, and HPV vaccination of incoming first-year dental students (D1), outgoing first- and second-year dental students (D1-D2), and outgoing third- and fourth-year dental students (D3-D4). After completing a 40-item pre-training knowledge and attitude assessment survey, a one-time, one-hour national HPV training session was conducted. An 8-item attitudinal post-survey was completed after training. RESULTS: Of 173 participants (75.9% response rate), over 85% did not know that the rate of HPV is not highest among women in their 30s, and only 11% to 28% knew that smoking-associated OPC is more deadly than HPV-associated OPC. While participants overall expressed willingness to administer the HPV vaccine, the willingness of dental students to do so in their future practice tapered off progressively through dental school year categories (p < 0.001). Among outgoing D1-D4 students, the one-hour HPV training increased participants' self-perceived ability to describe the burden of HPV disease, discuss the importance of HPV vaccination for cancer prevention, and provide needed HPV vaccination information to parents (all p ≤ 0.004). CONCLUSIONS: Understanding deficits in dental student knowledge and attitudes across the 4 years of dental school may help dental educators better understand the timing and content needed for effective HPV training in the dental school curriculum to reduce HPV-associated OPC prevalence.
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PURPOSE/OBJECTIVES: Oral health inequities and limited access to care cause patients to seek dental treatment in hospital emergency departments. In addition, conventional clinic models and curricular limitations may result in inadequate experiences for students learning urgent dental care. The aim of the current study was to investigate student perceptions of a novel dental school urgent care clinic model. METHODS: A mixed-methods, cross-sectional study design was used to survey third-year and fourth-year students at a Midwest dental school in spring 2020 about their experiences providing patient care in the school's internal urgent care center. Along with a structured curriculum, the urgent care clinic model incorporates an on-site partnership with a community health center and a hospital emergency department affiliation that serves as a referral base to provide students with their learning experiences. RESULTS: Of 81 students, 78 completed the survey (96% response rate). The majority of students treated 50 or more patients. From their urgent care experiences, a majority of students felt prepared to manage patients with acute dental pain and swelling (72/77, 94%), and reported a better understanding of interprofessional collaborations in dentistry (42/77, 55%) and the importance of providing urgent dental care to underserved patients (72/77, 94%). Most students (64/75, 85%) were more likely to offer urgent dental care services to underserved populations in future practice. CONCLUSION: This collaborative school-based urgent care clinic model incorporating community partnerships provided transformative learning experiences, positively impacted student perceptions of their learning, and influenced future practice behaviors related to urgent dental care.
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Facultades de Odontología , Estudiantes de Odontología , Instituciones de Atención Ambulatoria , Estudios Transversales , Curriculum , Atención Odontológica , Humanos , PercepciónRESUMEN
PURPOSE/OBJECTIVES: Competence in nitrous oxide/oxygen (N2 O/O2 ) inhalation sedation is expected of dental graduates, but applying what is learned through didactic instruction to patient care can be challenging without firsthand experience. Therefore, the purpose of the current study was to evaluate the impact of experiential learning on dental students' confidence and sense of preparedness for administration of N2 O/O2 . METHODS: A biphasic, mixed methods study was conducted at a Midwestern dental school and included 2 cohorts of dental students. In Phase 1 (spring 2019), a cross-sectional study design was used to survey outgoing third-year and fourth-year students who received didactic N2 O/O2 instruction alone. In Phase 2 (summer 2019), a nonrandomized, preintervention-postintervention study design was used to survey incoming third-year students before and after a hands-on N2 O/O2 laboratory exercise. RESULTS: Of the 79 Phase 1 students (99% response rate), all believed a firsthand learning experience with N2 O/O2 during didactic learning would increase their confidence and preparedness when administering to a patient (both P < .001). Of the 41 Phase 2 students (100% response rate), after the lab exercise, all felt that firsthand experience enhanced classroom instruction and increased confidence and preparedness when administering N2 O to a patient (all P < .001). Fifty-six (71%) Phase 1 and 39 (80%) Phase 2 students believed classroom instruction alone was inadequate to prepare them to administer N2 O/O2 (both P < .001). CONCLUSIONS: Our results strongly suggest that experiential learning of N2 O/O2 inhalation sedation through a hands-on laboratory exercise should be incorporated into the predoctoral curricula of dental schools.
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Óxido Nitroso , Aprendizaje Basado en Problemas , Competencia Clínica , Estudios Transversales , Curriculum , Educación en Odontología , Humanos , Estudiantes de OdontologíaRESUMEN
BACKGROUND: In the last three decades there is a growing recognition in the dental profession that dental education must go beyond teaching the technicalities of dentistry and include professionalism and communication skills that the future dentist may need. Such skills are best taught in a student-centered way. Literature suggests that student-centered elements are difficult to introduce in traditional, teacher-centered curricula. This is especially true in post-communist countries where higher education was under strict state control for decades. The aim of the piece of research presented here was to investigate how difficult it is to introduce a student-centered career skills course in a traditionally teacher-centered dental curriculum. METHODS: Considering the needs of our final-year dental students and Super's model of career development, we created an undergraduate curricular career skills course running for two semesters in two languages (Hungarian and English). The primary aim of the course is to help students with their career expectations and develop their identity as a professional workforce. The secondary aim is to teach skills that students can use when applying for a job. At the end of the semesters, we assessed our students' satisfaction with various aspects of the course by using a questionnaire. Results were analyzed item-wise and according to the main aspects of the course (i.e., groups of items organized around a particular aspect). RESULTS: General satisfaction with the course was high, and practical skills training (such as CV and motivation letter writing) got the highest scores. From the answers it appears that the students were the least comfortable with having to deal with their personal values and preferences. CONCLUSIONS: While it is common for universities to offer various forms of career intervention, to our knowledge, no other university offers a curricular career skills course specifically for dental students. Our student-centered course designed in a problem-based learning framework worked even in a traditionally teacher-centered educational environment, where university students are rarely encouraged to be active participants in courses. By sharing our experience, we would like to encourage our fellow dental educators working in similar environments to devise and offer such courses.
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Educación en Odontología , Educación de Pregrado en Medicina , Estudiantes de Odontología , Orientación Vocacional , Adulto , Curriculum , Femenino , Humanos , Hungría , Masculino , Aprendizaje Basado en Problemas , Investigación Cualitativa , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Assessment in competency-based dental education continues to be a recognized area for growth and development within dental programs around the world. At the joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, the workshop on assessment was designed to continue the discussion started in 2017 at the ADEA-ADEE Shaping the Future of Dental Education II.1 The focus of the 2019 conference involved examining the potential of entrustable professional activities (EPAs) and current thinking about workplace-based assessment (WBA) within competency-based education in the 21st century. Approximately 30 years ago, George Miller wrote about the assessment of competence in medical education and challenged faculty to reach for higher levels of assessment than knowledge or skill.2 Acknowledging that no one assessment method can result in a valid assessment of competence, Miller proposed a four-level framework for assessment. The lowest level involves measuring what students know ("knows"), followed by assessment of the skill with which knowledge is applied in relevant tasks or problems ("knows how"). Next is an assessment of task performance in standardized settings ("shows how"), and finally, the highest level assesses the student's performance in the unstandardized clinical workplace ("does"). The 2019 assessment workshop focused on advances in the assessment of learners in the unstandardized workplace-the highest level of Miller's assessment pyramid ("does"). Research has shown that dental education has struggled to implement assessment strategies that meet this level.3 The workshop brought together individuals from around the world, with an interest in assessment in dental education, to consider how assessment in the "does" level, specifically EPAs and WBA, factors into competence assessment in dentistry/dental education.
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Educación Basada en Competencias , Educación en Odontología , Competencia Clínica , Europa (Continente) , Predicción , Humanos , Lugar de TrabajoRESUMEN
The World Health Organization has indicated that Interprofessional Education (IPE) occurs when "students from two or more professions learn about, from, and with each other".1 These IPE experiences are widely thought to provide students with the opportunity to learn and practice the knowledge, skills, behaviors and attitudes that will ultimately translate into the provision of safer, higher quality, team-based patient care when they become health care practitioners in collaborative care environments. At the joint American Dental Education Association (ADEA) and Association for Dental Education in Europe (ADEE) 2019 Shaping the Future of Dental Education III conference in Brescia, Italy, delegates explored the concept of transprofessional learning, where students learn skills across a wider range of professions than health professions alone. The workshop continued the dialogue that began during the 2017 ADEA-ADEE Shaping the Future of Dental Education II conference in London, England as previously reported by Davis et al.,2 and explored the use of transprofessional learning through the lenses of dental education, applied linguistics education and law education focusing on the use of reflective practices. The workshop brought together educators from around the globe in a highly interactive setting where they had the opportunity to discuss and develop tools and practices for teaching reflective practice by using a transprofessional learning approach.
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Educación en Odontología , Relaciones Interprofesionales , Odontología , Inglaterra , Europa (Continente) , Humanos , Lingüística , LondresRESUMEN
The central purpose of scientific research and emerging dental health technologies is to improve care for patients and achieve health equity. The Impact of Scientific Technologies and Discoveries on Oral Health Globally workshop conducted joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, highlighted innovative technologies and scientific discoveries to support personalized dental care in an academic and clinical setting. The 2019 workshop built upon the new ideas and way forward identified in the 2017 ADEE-ADEA joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education II held in London. During the most recent workshop the approach was to explore the "Teaching Clinic of the Future". Participants applied ideas proposed by keynote speakers, Dr. Walji and Dr. Vervoorn to educational models (Logic Model) in an ideal dental education setting. It is only through this continuous improvement of our use of scientific and technological advances that dental education will be able to convey to students the cognitive skills required to continually adapt to the changes that will affect them and consequently their patients throughout their career. This workshop was a valuable experience for highlighting opportunities and challenges for all stakeholders when aiming to incorporate new technologies to facilitate patient care and students' education.
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Curriculum , Salud Bucal , Educación en Odontología , Europa (Continente) , Humanos , Londres , Estados UnidosRESUMEN
Global networking has been identified as an important method of enhancing health care education and services in the field of dentistry.1 The ability to share expertise, resources, knowledge, and experience to benefit all is highly desired among students, educators, health care professionals, and communities globally. Both our student and patient populations are dynamic societies that are becoming increasingly complex and facing growing needs and expectations, which is a constant challenge for educators and health care professionals to satisfy.2 The key question, stemming from the Global Networking (GN) workshop of the 2017 ADEE-ADEA Shaping the Future of Dental Education II meeting, was identified as, "How can dental educators around the world network to share ideas, experience, expertise, and resources to improve our curricula and teaching and learning environments for our educators, students, and communities that they serve?" The action plan devised by the GN workshop from the 2017meeting indicated two key steps in these early stages of setting up a global network: 1) " grassroots participation for input and consumption of meaningful and needed content," and 2) " advisors/consultants for organizational top-down guidance to define and maintain the global networking philosophy and platform ".1 The GN workshop of 2019 SFDE meeting aimed to deliver guidance and discussion with those experienced in engaging local communities from both a grassroots and an organizational approach.
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Educación en Odontología , Salud Bucal , Curriculum , Odontología , Predicción , HumanosRESUMEN
OBJECTIVES: The purpose of the present study was to examine differences in oral human papillomavirus (HPV) prevalence among adults based on HPV vaccination status and periodontitis status. METHODS: Data from 2011 to 2012 and 2013 to2014 National Health and Nutrition Examination Surveys (n = 822) were retrieved in order to predict the prevalence of oral HPV in 24 separate demographic groups (age by sex by race) based on the following characteristics: HPV vaccination status and periodontitis status. A multiple logistic regression model, controlling for gender, age, race, smoking behavior, alcohol consumption, and sexual partners, was calculated in order to generate prevalence estimates. RESULTS: Median predicted oral HPV prevalence rates per 1,000 in 2011-2012 were highest among nonvaccinated individuals with periodontitis [median ( xË ) = 31.62, interquartile range (IQR) = 102.97], followed by nonvaccinated individuals without periodontitis ( xË = 24.63, IQR = 81.84), vaccinated individuals with periodontitis ( xË = 18.40, IQR = 62.27), and vaccinated individuals without periodontitis ( xË = 14.29, IQR = 48.96). Median predicted oral HPV prevalence rates per 1,000 in 2013-2014 were highest among nonvaccinated individuals with periodontitis ( xË = 9.50, IQR = 33.02), followed by nonvaccinated individuals without periodontitis ( xË = 7.37, IQR = 25.76), vaccinated individuals with periodontitis ( xË = 5.48, IQR = 19.27), and vaccinated individuals without periodontitis ( xË = 4.25, IQR = 14.98). CONCLUSIONS: Interventions that integrate primary care and dental care are needed, given increased risk for oral HPV among unvaccinated individuals with periodontitis.
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Alphapapillomavirus , Infecciones por Papillomavirus , Periodontitis , Adulto , Humanos , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , Periodontitis/epidemiología , Prevalencia , VacunaciónRESUMEN
BACKGROUND: Tobacco use is the leading preventable cause of morbidity and premature mortality and is a significant factor in the development of oral disease. Tobacco dependence education (TDE) has not, however, been consistently integrated into predoctoral education. The authors conducted a study assessing the content and extent of TDE and intervention skills in US and Canadian dental schools. METHODS: In 2013, the authors contacted the academic deans of the 74 accredited US and Canadian dental schools to identify the educator who would be most appropriately described as the tobacco-use cessation "champion" at their institution. The authors e-mailed an introductory letter to each school's champion with a hyperlink to a 45-item survey; 2 follow-up emails were sent with links to the survey. RESULTS: The response rate was 66% (N = 49). TDE was taught at 92% of dental schools; 90% of respondents indicated that faculty members were confident to extremely confident in teaching tobacco-related pathology. Only 49% reported this level of confidence in teaching students how to help patients quit tobacco. TDE is taught in periodontics (82%), oral pathology (77%), clinic (66%), oral diagnosis (59%), public health dentistry (55%), pharmacology (55%), oral medicine (52%), and other disciplines (less than 50%). CONCLUSIONS: The survey responses revealed that TDE is not a curricular component in all US and Canadian dental schools. Faculty members were most confident in teaching tobacco-related pathology but may lack the interest and skills needed to integrate TDE as part of patient care. PRACTICE IMPLICATIONS: Patients who use tobacco in any form are at an increased risk of developing periodontitis, developing oral cancer, and having poorer surgical outcomes, emphasizing the need for the dental team to be well-prepared through predoctoral dental education.
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Educación en Odontología , Facultades de Odontología , Tabaquismo , Canadá , Curriculum , Humanos , Encuestas y CuestionariosRESUMEN
The aim of this study was to assess the level of tobacco dependence education (TDE) in the curricula of U.S. dental assisting programs and to compare the findings to those from a similar assessment of dental hygiene curricula. In the 2012-13 academic year, a 51-item survey was sent to directors of all 298 accredited dental assisting programs. Assessed were curricular TDE content, time spent on each topic, expected levels of clinical competence, and resources used. Of the 298 potential participants, 89 programs returned completed surveys, for a response rate of 30%. Of the 13 TDE-related content areas, those most often covered were oral disease related to tobacco use (100%) and general diseases related to tobacco use (93%); those least often covered were stages of (behavior) change (29%), how to develop a comprehensive tobacco intervention program in a private office setting (23%), and strategies for community-based tobacco control (22%). Responding program directors indicated the following levels of tobacco cessation intervention at which students should demonstrate competence: brief, 44%; moderate, 55%; intensive, 8%. Less than half of the reporting programs conducted a formal assessment of clinical competence in any TDE-related skills; however, skills in assessing patient tobacco use and associating head and neck findings to tobacco use were formally or informally assessed by 74% and 61%, respectively. Compared to dental hygiene programs, TDE appeared to play a smaller role in the curricula of dental assisting programs, and dental assisting programs were less likely to formally assess clinical competence in TDE.
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Curriculum , Asistentes Dentales/educación , Tabaquismo , Competencia Clínica , Estudios de Cohortes , Consejo , Estudios Transversales , Higienistas Dentales/educación , Consultorios Odontológicos , Conductas Relacionadas con la Salud , Humanos , Entrevista Motivacional , Enfermedades de la Boca/etiología , Relaciones Profesional-Paciente , Desarrollo de Programa , Derivación y Consulta , Cese del Uso de Tabaco/métodos , Dispositivos para Dejar de Fumar Tabaco/clasificación , Tabaquismo/complicaciones , Estados UnidosRESUMEN
The aim of this study was to assess the level of tobacco dependence education offered by Italian dental hygiene programs. A fifty-question survey was mailed to the thirty-one active public and private dental hygiene programs in Italy during the 2008-09 academic year. The survey assessed faculty confidence in teaching tobacco treatment, which courses contained tobacco dependence content, the number of minutes spent on specific content areas, and the level of clinical competence that dental hygiene graduates should be able to demonstrate. Surveys were returned by sixteen programs for a response rate of 52 percent. Respondents indicated tobacco dependence education was included in clinic or clinic seminar (56 percent), periodontics (44 percent), oral pathology (31 percent), and prevention (19 percent). All programs reported including the effects of tobacco on general and oral diseases in courses. However, more in-depth topics received less curriculum time; these included tobacco treatment strategies (63 percent) and discussion of cessation medications (31 percent). Interestingly, 62 percent of the respondents indicated they expected dental hygiene graduates to demonstrate a tobacco treatment competency level of a moderate intervention or higher (counseling, discussion of medications, follow-up) rather than a brief intervention in which patients are advised to quit then referred to a quitline. The results of this study indicated that Italian dental hygiene students are not currently receiving adequate instruction in tobacco treatment techniques nor are they being adequately assessed. This unique overview of Italian dental hygiene tobacco dependence education provides a basis for further discussion towards a national competency-based curriculum.
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Curriculum , Higienistas Dentales/educación , Tabaquismo , Actitud del Personal de Salud , Competencia Clínica , Consejo , Evaluación Educacional , Docentes , Humanos , Italia , Motivación , Patología Bucal/educación , Periodoncia/educación , Odontología Preventiva/educación , Autoeficacia , Enseñanza/métodos , Factores de Tiempo , Cese del Uso de Tabaco , Dispositivos para Dejar de Fumar Tabaco , Tabaquismo/prevención & control , Tabaquismo/terapiaRESUMEN
INTRODUCTION: The US Public Health Service calls for health professionals to provide tobacco dependence counseling for patients. The purpose of this study was to understand how dental hygiene programs make decisions about and provide training for tobacco dependence counseling to help them graduate more fully competent hygienists. METHODS: We conducted interviews (N = 32) with mainly program and clinic directors from 19 US dental hygiene education programs for this qualitative case study. We explored fluoride therapy training and tooth whitening training for comparison. Two analysts summarized the transcripts into a case study for each program. RESULTS: All programs reported a similar process of learning about and choosing a method for teaching the topics explored. The programs used a common process, ADPIE (assess, diagnose, plan, implement, evaluate), to structure students'clinical encounters. Almost all programs train students to ask about tobacco use and to advise quitting, but few programs train students to effectively help patients to quit and only 2 programs evaluated the competence of all students to provide such training. ADPIE shows promise for integrating tobacco dependence treatment more fully into the clinical training of dental hygiene students. Comparison to tooth whitening and fluoride therapy training indicated that complexity of the treatment and alignment with dental hygiene's mission were themes related to training decisions. CONCLUSION: Full implementation of tobacco dependence counseling into dental hygiene education requires a commitment by dental hygiene educators to train students and faculty in counseling techniques and their evaluation. We identified an existing clinical structure as showing promise for facilitating improvement.
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Consejo/educación , Toma de Decisiones , Higienistas Dentales/educación , Educación en Odontología/organización & administración , Fluoruro de Sodio/uso terapéutico , Tabaquismo/prevención & control , Blanqueadores Dentales/uso terapéutico , Personal Administrativo/psicología , Competencia Clínica/normas , Consejo/métodos , Curriculum/normas , Higienistas Dentales/normas , Relaciones Dentista-Paciente , Educación en Odontología/métodos , Educación en Odontología/normas , Evaluación Educacional , Implementación de Plan de Salud , Humanos , Estudios de Casos Organizacionales , Innovación Organizacional , Relaciones Profesional-Paciente , Desarrollo de Programa , Investigación Cualitativa , Estudiantes de Odontología/psicología , Estudiantes de Odontología/estadística & datos numéricos , Cese del Uso de Tabaco/métodos , Tabaquismo/terapia , Estados Unidos/epidemiologíaRESUMEN
A nurse working at a remote island resort meets the diverse health and safety needs of employees and guests and combines her love of nursing with her love of scuba diving.
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Buceo , Colonias de Salud , Satisfacción en el Trabajo , Actividades Recreativas , Enfermería del Trabajo/organización & administración , HumanosRESUMEN
PURPOSE: Tobacco use continues to be the single most preventable cause of death and disease in the United States. A paradigm shift is needed in physician assistant (PA) education to address tobacco dependence as a chronic, relapsing disease requiring patient education, counseling, treatment, and follow-up. METHODS: A national study was conducted to assess the existing tobacco dependence education currently offered in U.S. PA programs. An established tobacco dependence curriculum survey was revised and mailed to the 141 accredited PA programs in the United States during the 2008-2009 academic year. The survey asked respondents to report the following with regard to tobacco dependence education content in their PA program; (1) Perceived self-efficacy and barriers; (2) Medical topics covered and minutes spent; (3) Evaluation of students' competency level; (4) Tobacco courses, topics, and resources used; and (5) Level of tobacco-cessation competency expected upon graduation. RESULTS: A total of 79 surveys were returned (56% response rate). Though, on average, over 827 minutes (14 hours) were devoted to tobacco dependence education curriculum, most minutes (223 minutes) were spent on the health effects of tobacco use, with only 42 minutes spent on cessation counseling, 55 minutes on medications, and 13 minutes on integrating tobacco-cessation into clinical practice. CONCLUSIONS: PA educators have the unique opportunity to affect tobacco-related morbidity and mortality. The present study demonstrates that PA instructors are more than adequately teaching students about tobacco use. However, it is not clear if students are being adequately taught how to assist patients to quit using tobacco.
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Educación en Salud/métodos , Asistentes Médicos/educación , Cese del Hábito de Fumar , Fumar , Tabaquismo , Curriculum , Guías como Asunto , Encuestas Epidemiológicas , Humanos , Autoeficacia , Fumar/efectos adversos , Prevención del Hábito de Fumar , Nicotiana/efectos adversos , Tabaquismo/prevención & control , Estados UnidosRESUMEN
BACKGROUND: The risks/benefits balance of hormone replacement therapy (HRT) is controversial. The aim of this study was to assess the periodontal status of a postmenopausal women group receiving HRT and to determine the effects of HRT on clinical measures of periodontal disease. MATERIAL/METHODS: Ninety-one postmenopausal women, 52 taking HRT (HRT+) and 39 not taking HRT (HRT-), completed the study. Clinical parameters measured included visible supragingival plaque, probing pocket depth (PD) and clinical attachment level (CAL). Gingival status was recorded as gingival bleeding on probing (BOP). Previous oral contraceptive use and current and past smoking status were also assessed. RESULTS: Data indicated that PD and CAL were not significantly different between HRT+ patients and HRT- patients (P=0.8067 and P=0.1627, respectively). The HRT+ group exhibited significantly lower visible plaque levels compared to the control group (P<0.0001). The percentage of gingival sites with positive BOP was significantly lower in the HRT+ group compared to the HRT- group (34.85% vs. 65.15%; P=0.0007). Plaque accumulation was also tested in ANCOVA as a possible explanatory variable for the differences observed in gingival bleeding. The ANCOVA showed no significant differences in gingival bleeding between HRT+ and HRT- women (P=0.4677). No significant differences in past smoking status and oral contraceptive use were detected between HRT+ and HRT- women (P=0.9999 and P=0.0845, respectively). CONCLUSIONS: These findings indicated that long-term HRT was not associated with relevant effects on periodontal status and clinical measures of periodontal disease, thus suggesting that HRT may not confer protection against periodontitis in postmenopausal women.