RESUMEN

OBJECTIVE: To summarise evidence regarding the effectiveness of various implementation strategies to stimulate the delivery of smoking cessation advice and support during daily dental care. BASIC RESEARCH DESIGN: Search of online medical and psychological databases, correspondence with authors and checking of reference lists. Only studies were selected which examined a support strategy to promote tobacco use cessation having a component to be delivered by a dentist, dental hygienist or dental assistant in the daily practice setting. Furthermore only controlled studies and systematic reviews were included. Methodological quality and outcomes were independently summarised and checked by two reviewers. RESULTS: Eight studies met the inclusion criteria: 4 addressed strategies aimed at the dental professional and 4 addressed strategies aimed at both professional and patient. Only 4 of the studies were of a good quality. The 8 studies used combinations of implementation strategies, which made it difficult to evaluate the effectiveness of distinct components. Professional education appeared to enhance motivation for smoking cessation activities and advice giving. Organisational interventions (e.g., protocols, involvement of the whole team, referral possibilities) and incorporation of patient-oriented tools also contributed to the delivery of smoking cessation interventions. CONCLUSIONS: Multifaceted support strategies positively influence dental professionals' knowledge of smoking and smoking cessation, their motivation to give advice and their performance. As only 4 studies were of good methodological quality, it was not possible to draw firm conclusions about specific components. Additional research is needed to unravel which strategies best stimulate the provision of smoking cessation advice and support during daily dental practice.

Asunto(s)

Actitud del Personal de Salud , Atención Odontológica , Relaciones Dentista-Paciente , Odontólogos , Cese del Hábito de Fumar/métodos , Consejo , Auxiliares Dentales , Humanos , Atención Primaria de Salud , Relaciones Profesional-Paciente , Cese del Hábito de Fumar/psicología

RESUMEN

This paper presents an updated statement on behalf of the Association for Dental Education in Europe (ADEE) in relation to proposals for undergraduate Curriculum Structure, Content, Learning, Assessment and Student / Staff Exchange for dental education in Europe. A task force was constituted to consider these issues and the two previous, related publications produced by the Association (Plasschaert et al 2006 and 2007) were revised. The broad European dental community was circulated and contributed to the revisions. The paper was approved at the General Assembly of ADEE, held in Amsterdam in August 2010 and will be updated again in 2015.

Asunto(s)

Educación en Odontología/normas , Educación Basada en Competencias , Curriculum , Educación en Odontología/métodos , Educación en Odontología/organización & administración , Educación a Distancia , Evaluación Educacional , Europa (Continente) , Unión Europea , Humanos , Intercambio Educacional Internacional , Aprendizaje , Modelos Educacionales , Rol Profesional , Evaluación de Programas y Proyectos de Salud , Estudiantes de Odontología , Enseñanza/métodos

RESUMEN

In a controlled study, primary care dental professionals in the intervention group were encouraged to provide smoking cessation advice and support for all smoking patients with the help of a stage-based motivational protocol. The barriers and facilitators reported by the dental professionals on two occasions for their efforts to incorporate smoking cessation advice and counselling into daily patient care are summarised here. Lack of practice time and anticipated resistance on the part of the patient were cited as barriers by over 50% of the dental professionals in the first interviews. Periodontal treatment and the presence of smoking-related diseases were mentioned as the most important stimuli. The experience-based interviews revealed key points for the implementation of smoking cessation advice and support in daily dental care. Education on the associations between smoking and oral health, vocational training on motivational interviewing and the offering of structured advice protocols were identified as promising components for an implementation strategy to promote the involvement of dental professionals in the primary and secondary prevention of tobacco addiction.

Asunto(s)

Atención Odontológica , Odontólogos , Cese del Hábito de Fumar/métodos , Adulto , Actitud Frente a la Salud , Protocolos Clínicos , Consejo , Higienistas Dentales , Relaciones Dentista-Paciente , Educación Continua en Odontología , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Motivación , Enfermedades de la Boca/terapia , Educación del Paciente como Asunto , Pacientes/psicología , Enfermedades Periodontales/terapia , Atención Primaria de Salud , Prevención Primaria , Relaciones Profesional-Paciente , Prevención Secundaria , Fumar/efectos adversos , Prevención del Hábito de Fumar , Factores de Tiempo , Tabaquismo/prevención & control

RESUMEN

This paper presents the profile and competences for the European Dentist as approved by the General Assembly of the Association for Dental Education in Europe at its annual meeting held in Helsinki in August 2009. A new taskforce was convened to update the previous document published in 2005. The updated document was then sent to all European Dental Schools, ministries of health, national dental associations and dental specialty associations or societies in Europe. The feedback received was used to improve the document. European dental schools are expected to adhere to the profile and the 17 major competences but the supporting competences may vary in detail between schools. The document will be reviewed once again in 5 years time. Feedback to the newly published document is welcomed and all dental educators are encouraged to draw upon the content of the paper to assist them in harmonising the curriculum throughout Europe with the aim of improving the quality of the dental curriculum.

Asunto(s)

Competencia Clínica/normas , Odontólogos/normas , Educación en Odontología/normas , Guías como Asunto , Actitud del Personal de Salud , Comunicación , Curriculum/normas , Atención Odontológica , Relaciones Dentista-Paciente , Odontólogos/ética , Odontólogos/legislación & jurisprudencia , Educación Continua en Odontología , Ética Odontológica/educación , Europa (Continente) , Unión Europea , Odontología Basada en la Evidencia , Conductas Relacionadas con la Salud , Promoción de la Salud , Humanos , Control de Infección Dental , Alfabetización Informacional , Relaciones Interprofesionales , Legislación en Odontología , Anamnesis , Planificación de Atención al Paciente , Grupo de Atención al Paciente , Odontología Preventiva , Competencia Profesional , Facultades de Odontología , Tecnología Radiológica

RESUMEN

OBJECTIVE: Smoking influences oral health in several ways (such as the occurrence of periodontitis, teeth discolouration and oral cancer); therefore, smoking behaviour should be addressed in dental care. Dentists can play a role in primary and secondary prevention of tobacco dependence. They see their patients repeatedly over time. This study investigates whether oral health complaints can be seized as an opportunity to start smoking cessation counselling. METHODS: A structured patient questionnaire in a sample of 1101 smokers (52.1% women, mean age 40.4 years) in a convenience sample of 87 primary care dental practices. The I-change model was used to describe factors influencing behavioural change. Dependent factors such as intention to quit smoking and related factors (attitude, social support and self-efficacy) were analysed in relation to independent factors such as oral health complaints (gingiva problems, gingiva inflammation, oral cancer and discoloured teeth) using a general linear model (univariate analysis), multinomial logistic regression analysis and multiple linear regression analysis. RESULTS: A total of 56.3% had discoloured teeth, 27% of the smokers had a problem with their gums and 15.7% had gingiva inflammation. We found no direct relation between oral health complaints and the intention to quit smoking. However, teeth discolouration was positively related to attitudes towards smoking cessation [ß, Confidential interval (95%); 1.92 (1.45-2.40 for advantages and -0.86(-1.18 to -0.53) for disadvantages] and negatively to self-efficacy regarding quitting [-2.69 (-3.49 to 1.88)]. CONCLUSIONS: We found no direct relation between oral health complaints and the intention to quit smoking, but oral health complaints and especially teeth discolouration were related to factors influencing the quit intention. Patients with discoloured teeth are more likely to have a positive attitude towards smoking cessation but are uncertain to persist smoking cessation. It is suggested that teeth discolouration can be a good entrance for addressing smoking cessation in daily dental practice.

Asunto(s)

Salud Bucal , Cese del Hábito de Fumar/psicología , Adulto , Actitud Frente a la Salud , Atención Odontológica/psicología , Femenino , Gingivitis/psicología , Humanos , Intención , Modelos Lineales , Modelos Logísticos , Masculino , Enfermedades Periodontales/psicología , Autoeficacia , Cese del Hábito de Fumar/estadística & datos numéricos , Apoyo Social , Decoloración de Dientes/psicología

RESUMEN

In Western European countries, dentists use standardized procedures, rather than individualized risk assessment, for routine oral examinations. The predictive hypothesis was that guideline implementation strategies based on multifaceted interventions would be more effective in patient care than the dissemination of guidelines only. A cluster-randomized trial was conducted, with groups of general dental practitioners (GDPs) as the unit of randomization. Patients were clustered within practices and prospectively enrolled in the trial. Patient data were collected from registration forms. The primary outcome measure was guideline-adherent recall assignment, and a secondary outcome measure was guideline-adherent bitewing frequency. The interventions consisted of online training, guideline dissemination, and educational sessions. For low-risk patients, guideline-adherent recall increased in the intervention group (+8%), which differed from the control group (-6.1%) (p = 0.01). Guideline-adherent bitewings showed mixed results. We conclude that multifaceted intervention had a moderate but relevant effect on the performance of GDPs, which is consistent with other findings in primary care.

Asunto(s)

Atención Odontológica/normas , Odontología General/normas , Adhesión a Directriz , Guías de Práctica Clínica como Asunto , Diente Impactado/terapia , Adolescente , Citas y Horarios , Niño , Análisis por Conglomerados , Árboles de Decisión , Humanos , Mandíbula , Persona de Mediana Edad , Revisión por Pares , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Radiografía de Mordida Lateral/normas , Gestión de Riesgos , Diente Impactado/diagnóstico , Resultado del Tratamiento

RESUMEN

In an editorial in the British Dental Journal (2007) E.J. Kay raised the question whether dentist-general practitioners have to be educated in dental schools affiliated with (academic) hospitals. Her hypothesis is that some 95% of graduating dentists enter in general practice and that the educational environment therefore should be there as well. In the present reaction it is argued that this is a bad idea because the complete separation of dental education from the academic medical environment would mean a drastic and undesirable limitation and impoverishment of the curriculum. At the same time it is not denied that outreach programmes in a dental school curriculum can be very meaningful.

Asunto(s)

Curriculum , Odontología/normas , Educación en Odontología/normas , Facultades de Odontología/normas , Educación Basada en Competencias , Humanos , Países Bajos , Práctica Profesional

RESUMEN

OBJECTIVE: To investigate determinants of the provision of smoking cessation advice and counselling by various dental professionals in the dental team (dentists, dental hygienists and prevention auxiliaries). DESIGN: Cross-sectional design. SETTING: Sixty-two general dental practices in the Netherlands. METHODS: Multivariate logistic analyses of self-reported counselling behaviour collected from questionnaires for dentists (n = 72), dental hygienists (n = 31) and prevention auxiliaries (n = 50) in general dental practices. MAIN OUTCOME MEASURES: Stimuli and barriers for smoking cessation counselling and advice behaviour to patients with or without oral health problems. RESULTS: Dental hygienists provided more general cessation advice and counselling than dentists. However, when patients had oral complaints, dentists counselled more often compared to prevention auxiliaries. The support from experienced colleagues positively influenced the provision of advice and counselling as well as the perceived self-efficacy for all kinds of dental professionals. CONCLUSIONS: The provision of general smoking cessation advice to patients with no acute oral complaints can be improved by more involvement of the dentist and/or task delegation to prevention auxiliaries and dental hygienists. Social support is important in encouraging more smoking cessation advice and counselling. Implementation strategies for support of smoking cessation in dental care should focus on creating a positive advice culture among colleagues.

Asunto(s)

Actitud del Personal de Salud , Consejo , Personal de Odontología , Relaciones Dentista-Paciente , Cese del Hábito de Fumar/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Motivación , Países Bajos , Autoeficacia , Apoyo Social , Encuestas y Cuestionarios

RESUMEN

AIM: To investigate ex vivo, the root canal morphology of the MB root of maxillary first molar teeth by means of micro-computed tomography. METHODOLOGY: Thirty extracted intact human maxillary first molar teeth were selected for micro-tomographic analysis (SkyScan 1072, Aartselaar, Belgium) with a slice thickness of 38.0 mum. The following data regarding the MB root were analysed and recorded: number and type of root canals, prevalence of isthmuses, prevalence of intercanal connections, presence of accessory canals, presence of loops and number of apical foramina. RESULTS: The MB2 canal was present in 80% of specimens and was independent in 42% of these cases. When present, the MB2 canal merged with the MB1 canal in 58% of cases. Communications between the two canals were found in all specimens, with isthmuses in 71% of the cases. These communications and isthmuses were respectively in 42% and 54% of the cases in the coronal third, in 59% and 79% of the cases in the middle third and in 24% and 50% of the cases in the apical third. A single apical foramen was found in 37% of specimens, two apical foramina were present in 23% of the cases, with three or more separate apical foramina occurring in 40% of the specimens. CONCLUSIONS: The MB root canal anatomy was complex: a high incidence of MB2 root canals, isthmuses, accessory canals, apical delta and loops was found.

Asunto(s)

Cavidad Pulpar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen , Microtomografía por Rayos X/métodos , Adulto , Anatomía Transversal , Cavidad Pulpar/patología , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Maxilar , Persona de Mediana Edad , Diente Molar/patología , Ápice del Diente/diagnóstico por imagen , Ápice del Diente/patología , Raíz del Diente/patología

RESUMEN

Smoking may cause periodontal diseases and raises the chance of getting oral cancer. The Dutch Guideline for the Treatment of Tobacco Addiction recommends that dental professionals explicitly advise all patients who smoke to stop smoking. In 12 dental practices a study was made of how the guidelines could be implemented. The strategy consisted of a patient protocol for minimal, one-time cessation advice or for more intensive supervision, a patient leaflet, centralized training for the dental team, and repeated monitoring with feedback on the patients' experience of the behaviour that they have been advised to follow. Before the training and again 3 months after, professionals (n = 38) and an a-select sample of smoking patients (n = 197) completed questionnaires. A majority of patients was receptive to cessation advice of a dentist (95%) or counseling (68%). After 3 months it appeared that patient behaviour as reported by patients with respect to all points of the patient protocol had significantly improved.

Asunto(s)

Relaciones Dentista-Paciente , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Cese del Hábito de Fumar/métodos , Fumar , Adulto , Consejo , Femenino , Humanos , Masculino , Países Bajos , Derivación y Consulta , Refuerzo en Psicología , Fumar/efectos adversos , Fumar/psicología , Prevención del Hábito de Fumar , Encuestas y Cuestionarios , Resultado del Tratamiento

RESUMEN

This paper presents a brief context of dental undergraduate curricular structure and content and lays out the Association for Dental Education in Europe's views on requirements and recommendations for learning, teaching and assessment procedures/performance.

Asunto(s)

Curriculum , Educación en Odontología , Evaluación Educacional , Aprendizaje , Facultades de Odontología , Enseñanza/métodos , Competencia Clínica/normas , Curriculum/normas , Educación en Odontología/métodos , Educación en Odontología/normas , Educación a Distancia , Evaluación Educacional/métodos , Evaluación Educacional/normas , Europa (Continente) , Docentes de Odontología , Guías como Asunto , Humanos , Intercambio Educacional Internacional , Internet , Modelos Educacionales , Aprendizaje Basado en Problemas , Facultades de Odontología/organización & administración , Facultades de Odontología/normas , Desarrollo de Personal , Estudiantes de Odontología , Enseñanza/normas

RESUMEN

This document was written by Task Force 3 of DentEd III, which is a European Union funded Thematic Network working under the auspices of the Association for Dental Education in Europe (ADEE). It provides a guide to assist in the harmonisation of Dental Education Quality Assurance (QA) systems across the European Higher Education Area (EHEA). There is reference to the work, thus far, of DentEd, DentEd Evolves, DentEd III and the ADEE as they strive to assist the convergence of standards in dental education; obviously QA and benchmarking has an important part to play in the European HE response to the Bologna Process. Definitions of Quality, Quality Assurance, Quality Management and Quality Improvement are given and put into the context of dental education. The possible process and framework for Quality Assurance are outlined and some basic guidelines/recommendations suggested. It is recognised that Quality Assurance in Dental Schools has to co-exist as part of established Quality Assurance systems within faculties and universities, and that Schools also may have to comply with existing local or national systems. Perhaps of greatest importance are the 14 'requirements' for the Quality Assurance of Dental Education in Europe. These, together with the document and its appendices, were unanimously supported by the ADEE at its General Assembly in 2006. As there must be more than one road to achieve a convergence or harmonisation standard, a number of appendices are made available on the ADEE website. These provide a series of 'toolkits' from which schools can 'pick and choose' to assist them in developing QA systems appropriate to their own environment. Validated contributions and examples continue to be most welcome from all members of the European dental community for inclusion at this website. It is realised that not all schools will be able to achieve all of these requirements immediately, by definition, successful harmonisation is a process that will take time. At the end of the DentEd III project, ADEE will continue to support the progress of all schools in Europe towards these aims.

Asunto(s)

Benchmarking , Educación en Odontología/normas , Facultades de Odontología/organización & administración , Gestión de la Calidad Total , Acreditación , Benchmarking/métodos , Benchmarking/organización & administración , Benchmarking/normas , Curriculum/normas , Europa (Continente) , Unión Europea , Docentes de Odontología/normas , Retroalimentación , Guías como Asunto , Humanos , Revisión por Pares , Evaluación de Programas y Proyectos de Salud , Facultades de Odontología/normas , Estudiantes de Odontología , Gestión de la Calidad Total/métodos , Gestión de la Calidad Total/organización & administración , Gestión de la Calidad Total/normas

RESUMEN

BACKGROUND: There is a range of treatment options for the management of the pulp in extensively decayed teeth. These include direct and indirect pulp capping, pulpotomy or pulpectomy. If the tooth is symptomatic or if there are periapical bone changes, then endodontic treatment is required. However, if the tooth is asymptomatic but the caries is extensive, there is no consensus as to the best method of management. In addition, there has been a recent move towards using alternative materials and methods such as the direct or indirect placement of bonding agents and mineral trioxide aggregate. Most studies have investigated the management of asymptomatic carious teeth with or without an exposed dental pulp using various capping materials (e.g. calcium hydroxide, Ledermix, Triodent, Biorex, etc.). However, there is no long term data regarding the outcome of management of asymptomatic, carious teeth according to different regimens. OBJECTIVES: This study aims to assess the effectiveness of techniques used to treat asymptomatic carious teeth and maintain pulp vitality. SEARCH STRATEGY: Electronic searches of the following databases were undertaken: The Cochrane Oral Health Group's Trials Register (March 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 1), MEDLINE (1966 to week 4, February 2006), EMBASE (1974 to 13 March 2006), National Research Register (March 2006), Science Citation Index - SCISEARCH (1981 to March 2006). Detailed search strategies were developed for each database. Handsearching and screening of reference lists were undertaken. There was no restriction with regard to language of publication. SELECTION CRITERIA: Studies included were randomised controlled trials (RCTs). Asymptomatic vital permanent teeth with extensive caries were included. Studies were those which compared techniques to maintain pulp vitality. Outcome measures included clinical success and adverse events. DATA COLLECTION AND ANALYSIS: Data were independently extracted by three review authors. Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed. MAIN RESULTS: Only four RCTs were identified. Interventions examined included: Ledermix, glycerrhetinic acid/antibiotic mix, zinc oxide eugenol, calcium hydroxide, Cavitec, Life, Dycal, potassium nitrate, dimethyl isosorbide, and polycarboxylate cement. Only one study showed a statistically significant finding; potassium nitrate/dimethyl isosorbide/polycarboxylate cement resulted in fewer clinical symptoms than potassium nitrate/polycarboxylate cement or polycarboxylate cement alone when used as a capping material for carious pulps. AUTHORS' CONCLUSIONS: It was disappointing that there were so few studies which could be considered as being suitable for inclusion in this review. The findings from this review do not suggest that there should be any significant change from accepted conventional practice procedures when the pulp of the carious tooth is considered. Further well designed RCTs are needed to investigate the potential of contemporary materials which may be suitable when used in the management of carious teeth. It is recognised that it is difficult to establish the 'ideal' clinical study when ethical approval for new materials must be sought and strict attention to case selection, study protocol and interpretation of data is considered. It is also not easy to recruit sufficient numbers of patients meeting the necessary criteria.

Asunto(s)

Caries Dental/terapia , Enfermedades de la Pulpa Dental/terapia , Pulpa Dental , Adulto , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto

Asunto(s)

Caries Dental/prevención & control , Restauración Dental Permanente/tendencias , Educación en Odontología/tendencias , Endodoncia/tendencias , Tratamiento del Conducto Radicular/tendencias , Restauración Dental Permanente/métodos , Educación en Odontología/normas , Endodoncia/métodos , Fluoruros , Humanos , Países Bajos , Higiene Bucal , Estudios Retrospectivos , Tratamiento del Conducto Radicular/métodos , Pastas de Dientes

RESUMEN

OBJECTIVE: The aim of this study was to investigate changes in proximal contact tightness up to 6 months after the restorative treatment. MATERIALS AND METHODS: In a randomised clinical trial Class II composite resin restorations were placed in 52 patients. Proximal contact tightness was measured before, directly after, and 6 months after treatment. These data were analysed statistically using linear regression and t-tests. RESULTS: Proximal contacts, that increased in tightness as result of the treatment tend to loose tightness after a 6-months period but remain tighter than before treatment. Proximal contacts, that decreased after treatment hardly change after 6 months. CONCLUSIONS: A change in contact tightness after restorative treatment will not always remain stable over time.

Asunto(s)

Resinas Compuestas/química , Restauración Dental Permanente/clasificación , Adulto , Anciano , Restauración Dental Permanente/instrumentación , Femenino , Estudios de Seguimiento , Fricción , Humanos , Masculino , Bandas de Matriz , Metacrilatos/química , Persona de Mediana Edad , Cementos de Resina/química , Propiedades de Superficie , Factores de Tiempo

RESUMEN

This paper presents a proposed curriculum structure and system of European Credit Transfer (ECTS) for undergraduate dental schools throughout Europe. It is the result of the work of a Taskforce ('Taskforce II'), appointed by DentEd, a thematic network of European dental schools and the Association for Dental Education in Europe (ADEE). There has been pan-European discussion of the document in draft stages (it was distributed to 200 dental schools) and following amendment, it was agreed formally at the National Assembly of ADEE in Athens, Greece, in September 2005. The main elements of the paper relate to: (i) a description of the framework proposed with relevance to the Bologna recommendations and common directive on recognition for professional qualifications as they apply to Dentistry; (ii) the structure of an undergraduate dental curriculum; (iii) student exchange and ECTS. In addition, the paper presents a series of requirements, guidelines and recommendations for action. ADEE expects that the 'requirements' proposed will be followed by dental schools in Europe, whilst the 'guidelines' and 'recommendations' also provided are open to local interpretation. The paper is also published on the ADEE website.

Asunto(s)

Curriculum/normas , Educación en Odontología/métodos , Guías como Asunto , Intercambio Educacional Internacional , Comités Consultivos , Europa (Continente) , Humanos , Modelos Educacionales , Sociedades Odontológicas

RESUMEN

As part of a revised dental curriculum, a 3(rd) year module on medical subjects was developed based on a mixture of self-study and problem-oriented approach using cases. Pairs of students had to select a specific medical problem and solve a paper patient case using a problem-solving cycle. Results were presented in working groups and by writing an essay. The quality of the presentations was assessed by colleague students and by the teacher supervisor; the expert teacher in the field graded the essay. The results contributed for 40% to the overall grade of the module. A questionnaire filled out by 94% of the participating students showed that 85% of the students agreed in preferring this way of handling medical problems as compared with conventional, lecture-based education. Almost all of them enjoyed the provided opportunity to give a case presentation. The problem-oriented model was assessed as useful by 73% of the students. Knowledge concerning the topic chosen turned out to be higher than knowledge of other topics. Although this study cannot prove that this mode of education actually results in a better ability to cope with medical problems, it may contribute in several ways to the final competences in the area of general medicine in the undergraduate dental curriculum.

Asunto(s)

Medicina Clínica/educación , Curriculum , Educación en Odontología/métodos , Aprendizaje Basado en Problemas , Actitud del Personal de Salud , Evaluación Educacional , Humanos , Evaluación de Programas y Proyectos de Salud , Estudiantes de Odontología/psicología , Encuestas y Cuestionarios

RESUMEN

This paper presents the profile and competences for the European Dentist as approved by the General Assembly of the Association for Dental Education in Europe at its annual meeting held in Cardiff in September 2004. A task-force drafted the document, which was then sent to all European Dental Schools. Reactions received were used to amend the document. European dental schools are expected to adhere to the profile and the 17 major competences but the supporting competences may vary in detail between schools. The document will be reviewed in 5 years time. This paper will be disseminated to ministries of health, national dental associations and dental specialty associations or societies in Europe and these organisations will be asked to offer their comments. This information will be used in the reviewing process to be started in 2007. It is hoped that the availability of this document will assist dental schools in Europe to further harmonize and improve the quality of their curricula.

Asunto(s)

Odontología/normas , Educación en Odontología/normas , Competencia Profesional/normas , Odontólogos/normas , Europa (Continente) , Humanos

RESUMEN

BACKGROUND: The prophylactic removal of asymptomatic impacted wisdom teeth is defined as the (surgical) removal of wisdom teeth in the absence of local disease. Impacted wisdom teeth have been associated with pathological changes, such as inflammation of the gums around the tooth, root resorption, gums- and alveolar bone disease, damage of the adjacent teeth, the development of cysts and tumours. Several other reasons to justify prophylactic removal have also been given. Wisdom teeth do not always fulfil a functional role in the mouth. When surgical removal is carried out in older patients the risk of more postoperative complications, pain and discomfort increases. Nevertheless, in most developed countries the prophylactic removal of trouble-free wisdom teeth, either impacted or fully erupted, has long been considered as 'appropriate care'. Prudent decision-making, with adherence to specified indicators for removal, may reduce the number of surgical procedures by 60% or more. It has been suggested that watchful monitoring of asymptomatic wisdom teeth may be an appropriate strategy. OBJECTIVES: To evaluate the effect of prophylactic removal of asymptomatic impacted wisdom teeth in adolescents and adults compared with the retention of these wisdom teeth. SEARCH STRATEGY: The following electronic databases were searched:The Cochrane Oral Health Group Trials Register (4 August 2004), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to 4 August 2004), PubMed (1966 to 4 August 2004), EMBASE (1974 to 4 August 2004). There was no restriction on language. Key journals were handsearched. An attempt was made to identify ongoing and unpublished trials. SELECTION CRITERIA: All randomised or controlled clinical trials (RCTs/CCTs) comparing the effect of prophylactic removal of asymptomatic impacted wisdom teeth with no-treatment (retention). DATA COLLECTION AND ANALYSIS: Assessment of relevance, validity and data extraction were conducted in duplicate and independently by three reviewers. Where uncertainty existed, authors were contacted for additional information about randomisation and withdrawals. A quality assessment of the trials was carried out. MAIN RESULTS: Only three trials were identified that satisfied the review selection criteria. Two were completed RCTs and both assessed the influence of prophylactic removal on late incisor crowding in adolescents. One ongoing RCT was identified, but the researchers were unable to provide any data. They intend to publish in the near future and information received will be included in updates. Although both completed trials met the inclusion criteria of the review, regarding participants characteristics, interventions and outcomes assessed, different outcomes measures were assessed which prevented pooling of data. AUTHORS' CONCLUSIONS: No evidence was found to support or refute routine prophylactic removal of asymptomatic impacted wisdom teeth in adults. There is some reliable evidence that suggests that the prophylactic removal of asymptomatic impacted wisdom teeth in adolescents neither reduces nor prevents late incisor crowding.

Asunto(s)

Tercer Molar/cirugía , Extracción Dental/métodos , Diente Impactado/cirugía , Adolescente , Adulto , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto

RESUMEN

There appears to have been little previous research interest in continuing professional development (CPD) of dentists and the oral health team. This paper presents data and information on the following aspects of CPD in 17 countries in Asia, Australasia, Europe and North America: availability of different types of CPD, its providers, data on uptake of CPD courses and activities, and funding of CPD. The results indicate that lectures and hands-on skills courses were held in all 17 countries but the use of the Internet to deliver CPD was by no means universal. CPD was funded from a variety of sources including universities, governments and commercial companies. However, the only universal source of funding for CPD was dentists themselves. Data on participation were available from only three countries. Research issues based on these results will be listed in a second paper.

Asunto(s)

Educación Continua en Odontología/organización & administración , Asia , Australasia , Curriculum , Educación Continua en Odontología/economía , Educación Continua en Odontología/métodos , Europa (Continente) , Humanos , Internacionalidad , Internet , América del Norte , Encuestas y Cuestionarios , Apoyo a la Formación Profesional