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Changing Dental Profession – Modern Forms and Challenges in Dental Practice

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Oral Health".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 26590

Special Issue Editors

Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
Interests: restorative dentistry; endodontics; hypnosis; oral epidemiology; health services research

Special Issue Information

Dear Colleagues,

In the last two decades, an increasing trend toward new forms of dental practice has been observed. Although the classic model of a dental practice with only one dentist is still the most common form of practice internationally, requirements and political conditions have changed enormously. The choice of the practice model and the form of professional practice offer young dentists several options, e.g., being a self-employed intrapreneur or being an employee in one of the practice forms or working in the public health sector or in industry. Expectations for the future career of students and young dentists are diverse, with the oral health care sector shifting due to factors such as financial investors opening many large dental centers, increasing numbers of employed dentists, a possible oversupply in urban and undersupply in rural areas, and a shortage or emigration of skilled personnel. Furthermore, technical and professional challenges associated with progress through research, new fields such as artificial intelligence and big data, sustainability and green dentistry, teledentistry, the cross-border use of services, and digital transformation in health care contribute to change. These factors can influence dentists, people working in the oral health care sector, and even patients. A reorganization of public and private dental care providers’ activities might be required.

Papers addressing these topics are invited to this Special Issue, including protocol papers on dental personnel modification strategies, and surveys on awareness and modification of behaviors by patients and dentists. These influences should be analyzed, and approaches to solutions and support for the next generation of dentists should be developed.

Dr. Thomas Wolf
Prof. Dr. Guglielmo Campus
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • changing dental profession
  • digitalization
  • artificial intelligence
  • future career prospects
  • green dentistry
  • modern forms of practice
  • sustainability
  • oral health policy
  • e-health
  • young dentists

Published Papers (10 papers)

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Editorial

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2 pages, 246 KiB  
Editorial
Changing Dental Profession—Modern Forms and Challenges in Dental Practice
Int. J. Environ. Res. Public Health 2021, 18(4), 1945; https://doi.org/10.3390/ijerph18041945 - 17 Feb 2021
Cited by 6 | Viewed by 4345
Abstract
In the last two decades, an increasing trend towards new forms of dental practice was observed [...] Full article

Research

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8 pages, 629 KiB  
Article
Effect of a One-Time Communication Training Session on Dental Students’ Self-Efficacy Expectancy
Int. J. Environ. Res. Public Health 2023, 20(4), 3323; https://doi.org/10.3390/ijerph20043323 - 14 Feb 2023
Viewed by 856
Abstract
An implementation of training units that provide evidence for improving students’ communication skills in the dental curriculum is now more than ever of utmost importance. This study aimed to investigate how students assess their skills after communication training and whether this training also [...] Read more.
An implementation of training units that provide evidence for improving students’ communication skills in the dental curriculum is now more than ever of utmost importance. This study aimed to investigate how students assess their skills after communication training and whether this training also increased students’ self-efficacy expectancy. A total of 32 male and 71 female students with a mean age of 25.6 ± 3.9 years participated in the study. Self-assessment of communication skills and self-efficacy expectancies were collected at two time points using Likert scales. Our study shows that the communication training, consisting of a practical exercise with actors and an online theory module, significantly improved the students’ self-assessment of their communication skills and also improved some aspects of self-efficacy expectancy. These results indicate that, in addition to the practical and technical-theoretical training of students, communication training is essential in the dental curriculum. In summary, this study showed that a one-time practical exercise with actors together with an online theory module could improve both the self-assessment of communication competence and some aspects of self-efficacy expectancy, which demonstrates the importance of training communication skills alongside practical and technical-theoretical training. Full article
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12 pages, 1574 KiB  
Article
Medical and Dental Students’ Perception of Interdisciplinary Knowledge, Teaching Content, and Interprofessional Status at a German University: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2023, 20(1), 428; https://doi.org/10.3390/ijerph20010428 - 27 Dec 2022
Cited by 1 | Viewed by 1258
Abstract
Although oral health is considered a key indicator of overall health, dentistry is still neglected in medical education at the university level. Interprofessional education (IPE) is an important tool to promote collaboration among health care providers and to reduce barriers to access in [...] Read more.
Although oral health is considered a key indicator of overall health, dentistry is still neglected in medical education at the university level. Interprofessional education (IPE) is an important tool to promote collaboration among health care providers and to reduce barriers to access in health care. In this cross-sectional study, medical and dental students at Mainz University, Germany, were surveyed regarding their perception of interdisciplinary knowledge, teaching content, interprofessional standing, and attitudes toward IPE. Spearman’s rank correlation was used to identify associated statements. Structural equation modeling (SEM) was performed to understand how sex, study progress, and prior education might influence student attitudes. In total, 426 medical students and 211 dental students were included in the study. Dental students rated their interdisciplinary knowledge higher than medical students. The relevance of IPE as assessed by the students correlated significantly with their motivation to continue IPE after graduation. Both groups of students valued the other discipline but rejected a combined graduate program. Students with prior professional training valued the synergy of medicine and dentistry more the students without prior training. Interprofessional knowledge and interest in IPE was higher among dental students. Understanding students’ attitudes toward IPE is an important prerequisite for adapting university curricula to strengthen students’ attitudes and motivation. Full article
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14 pages, 1740 KiB  
Article
Age Estimation Using Maxillary Central Incisor Analysis on Cone Beam Computed Tomography Human Images
Int. J. Environ. Res. Public Health 2022, 19(20), 13370; https://doi.org/10.3390/ijerph192013370 - 16 Oct 2022
Viewed by 1416
Abstract
Forensic dentistry plays an important role in human identification, and dental age estimation is an important part of the process. Secondary dentin deposition throughout an individual’s lifetime and consequent modification in teeth anatomy is an important parameter for age estimation procedures. The aim [...] Read more.
Forensic dentistry plays an important role in human identification, and dental age estimation is an important part of the process. Secondary dentin deposition throughout an individual’s lifetime and consequent modification in teeth anatomy is an important parameter for age estimation procedures. The aim of the present study was to develop regression equations to determine age in adults by means of linear measurements and ratios on sagittal, coronal and axial slices of maxillary central incisors using cone bean computed tomography (CBCT). Multiplanar measurements of upper central incisors were taken for a sample of 373 CBCTs. Subsequently, one-way analysis of variance (ANOVA) and multivariate linear regressions were performed for age estimation. The equations obtained from axial linear measurements and ratios presented a standard error of the estimate (SEE) of ±10.9 years (R2 = 0.49), and a SEE of ±10.8 years (R2 = 0.50), respectively. The equation obtained for multiplanar linear measurements presented a SEE of ±10.9 years (R2 = 0.52), while the equation for multiplanar ratios presented a SEE of ±10.7 years (R2 = 0.51). Thus, CBCT measurements on upper central incisors were found to be an acceptable method for age estimation. Horizontal measurements, especially pulp measurements, improve the accuracy of age estimate equations. Full article
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13 pages, 1050 KiB  
Article
E-Professionalism among Dental Students from Malaysia and Finland
Int. J. Environ. Res. Public Health 2022, 19(6), 3234; https://doi.org/10.3390/ijerph19063234 - 09 Mar 2022
Cited by 5 | Viewed by 2714
Abstract
The increased use of social media in dentistry is associated with both advantages and disadvantages. A new form of professionalism, “e-professionalism,” has emerged. It includes an online persona and online information in any format that displays cues to professional identity, attitudes, and behaviors. [...] Read more.
The increased use of social media in dentistry is associated with both advantages and disadvantages. A new form of professionalism, “e-professionalism,” has emerged. It includes an online persona and online information in any format that displays cues to professional identity, attitudes, and behaviors. The objective was to explore the perceptions of Malaysian and Finnish dental students on e-professionalism. A survey of 613 Malaysian and Finnish students was performed. The main variables assessed were posting of objectionable or inappropriate content among students, attitudes towards unprofessional online content, perceived online presence, contacts with patients and faculty members on social media, and concerns about social media use. The prevalence of posting clearly unprofessional content was not high among dental students. Revealing information of patients was most common content of clear unprofessionalism. Students from Malaysia contacted patients and faculty members more actively in social media than students in Finland (73.6% of students in Malaysia and 11.8% in Finland had invited faculty members to be “friends”). Malaysian students were more concerned and more likely to react to inappropriate content on social media. Attitude of dental students towards social media use in dentistry were very positive in both countries. Students agreed that guiding patients online is a new responsibility for dentists in the digital age (86.4% of students in Malaysia and 73.4% in Finland). The findings indicate the existence of both benefits and dangers of social media on e-professionalism among students. There is a need to include robust digital professionalism awareness training for students. Full article
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10 pages, 1067 KiB  
Article
Influence of Oral Health Care Systems on Future Career Environment of Dental Students in Europe
Int. J. Environ. Res. Public Health 2021, 18(16), 8292; https://doi.org/10.3390/ijerph18168292 - 05 Aug 2021
Cited by 2 | Viewed by 1778
Abstract
Oral healthcare is organized subsidiarily and independently by nation states in Europe and also within the EU and consequently, major differences between the nation states and the various oral healthcare systems in Europe are present. The socialization in the respective catchment area can [...] Read more.
Oral healthcare is organized subsidiarily and independently by nation states in Europe and also within the EU and consequently, major differences between the nation states and the various oral healthcare systems in Europe are present. The socialization in the respective catchment area can have an impact on the job choice and the perception of employment opportunities of different professional groups. Therefore, the purpose of this survey was to elucidate the influence of different oral healthcare systems on students living or studying in the respective catchment area. A questionnaire (in English, French, German, Italian, and Spanish) with 18 different components was administered. Data on gender, age, country of origin, university, semester, nationality, expected time of graduation, and forecast for future professional practices were gathered. In addition, 3851 students participated (2863 f/988 m). The sample distribution was uneven with predominantly Bismarckian and Southern European System participants. The National oral health care system was statistically significantly linked (p < 0.01) to the ownership period of a dental practice. Students in Bismarckian and Nordic systems tended to find their own practice earlier than in the Beverdigian system or Southern European and Transitional—East European systems. An association between the oral health care system and vocational training was inhomogeneous, but also significantly different (p < 0.01). The majority (47.51%, n = 1555) would like to work in their own practice, 18.95% (n = 621) want to establish a practice with two or more owners. It was striking that no student would like to work in the investor practice/practice chain of both Nordic, Beveridgian and Transitional—East European countries systems (p < 0.01). The oral health care system in which a dental student grows up/resides/studies influences the career choice/perception of future professional practice. Full article
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22 pages, 1783 KiB  
Article
Implementation of COVID-19 Infection Control Measures by German Dentists: A Qualitative Study to Identify Enablers and Barriers
Int. J. Environ. Res. Public Health 2021, 18(11), 5710; https://doi.org/10.3390/ijerph18115710 - 26 May 2021
Cited by 7 | Viewed by 2448
Abstract
Objectives: COVID-19 infection control measures have been recommended for dental practices worldwide. This qualitative study explored barriers and enablers for the implementation of these measures in German dental practices. Methods: Semi-structured phone interviews were conducted in November/December 2020 (purposive/snowball sampling). The Theoretical Domains [...] Read more.
Objectives: COVID-19 infection control measures have been recommended for dental practices worldwide. This qualitative study explored barriers and enablers for the implementation of these measures in German dental practices. Methods: Semi-structured phone interviews were conducted in November/December 2020 (purposive/snowball sampling). The Theoretical Domains Framework (TDF) and the Capabilities, Opportunities and Motivations influencing Behaviors model (COM-B) were used to guide interviews. Mayring’s content analysis was employed to analyze interviews. Results: All dentists (28–71 years, 4/8 female/male) had implemented infection control measures. Measures most frequently not adopted were FFP2 masks, face shields (impractical), the rotation of teams (insufficient staffing) and the avoidance of aerosol-generating treatments. Dentists with personal COVID-19 experience or those seeing themselves as a role model were more eager to adopt measures. We identified 34 enablers and 20 barriers. Major barriers were the lack of knowledge, guidelines and recommendations as well as limited availability and high costs of equipment. Pressure by staff and patients to ensure infection control was an enabler. Conclusions: Dentists are motivated to implement infection control measures, but lacking opportunities limited the adoption of certain measures. Policy makers and equipment manufacturers should address these points to increase the implementation of infection control measures against COVID-19 and potential future pandemics. Full article
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9 pages, 691 KiB  
Article
Early Tooth Loss after Periodontal Diagnosis: Development and Validation of a Clinical Decision Model
Int. J. Environ. Res. Public Health 2021, 18(3), 1363; https://doi.org/10.3390/ijerph18031363 - 02 Feb 2021
Cited by 1 | Viewed by 2749
Abstract
The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at the university dental hospital were enrolled in the study. Teeth extracted [...] Read more.
The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at the university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% confidence interval (95% CI): 0.629–0.989) for the validation sample and 0.920 (95% CI: 0.891–0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden. Full article
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Review

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11 pages, 723 KiB  
Review
Effectiveness of Telemedicine and Teledentistry after the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2022, 19(21), 13857; https://doi.org/10.3390/ijerph192113857 - 25 Oct 2022
Cited by 11 | Viewed by 2649
Abstract
Telemedicine has become increasingly important worldwide over the last two decades. As a new field, it became known especially during the COVID-19 pandemic; this review presents fields of activity with special attention to opportunities and risks. Numerous areas of application offer the possibility [...] Read more.
Telemedicine has become increasingly important worldwide over the last two decades. As a new field, it became known especially during the COVID-19 pandemic; this review presents fields of activity with special attention to opportunities and risks. Numerous areas of application offer the possibility for broad use in the medical and dental care landscape in diagnostics, therapy, rehabilitation, and decision advice across a spatial distance. Technical and semantic standards are required, and profiles and guidelines are increasingly defined and organized. Medical/dental consultations have been established in various regions around the world as a response to pandemic challenges and have made video and online emergency consultations possible. Telemedicine applications are already regularly used in medical/dental emergencies, regardless of the pandemic situation, both for transport by train and by plane, from which patients benefit. However, legal hurdles are often still unresolved, but infrastructure challenges both for provider, user hard- and software also complicate deployment. Problems are particularly prevalent in the absence of necessary internet coverage or among socially disadvantaged and vulnerable groups who cannot afford expensive equipment or do not know how to use the technology. Broad access must be enabled, and hardware and software interfaces and updates must be regularly checked and updated. Telemedicine might also improve access to and delivery of oral and general health care support both for rural and urban areas with low costs. Even though dentistry and many medical specialties are still performed clinically by means of practical/manual examination, there are areas of diagnostics where telemedicine applications can provide good support. Therefore, as conclusions, access, and delivery of telemedicine applications in dentistry and medicine should be expanded and improved to provide access to all population groups. Full article
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24 pages, 5598 KiB  
Review
Is Visual Pedagogy Effective in Improving Cooperation towards Oral Hygiene and Dental Care in Children with Autism Spectrum Disorder? A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2021, 18(2), 789; https://doi.org/10.3390/ijerph18020789 - 18 Jan 2021
Cited by 13 | Viewed by 4823
Abstract
Visual pedagogy has emerged as a new approach in improving dental care in children with autism spectrum disorders (ASDs). This paper aimed to evaluate and assess the scientific evidence on the use of visual pedagogy in improving oral hygiene skills and cooperation during [...] Read more.
Visual pedagogy has emerged as a new approach in improving dental care in children with autism spectrum disorders (ASDs). This paper aimed to evaluate and assess the scientific evidence on the use of visual pedagogy in improving oral hygiene skills and cooperation during dental care in children with ASDs. The review protocol was registered on the PROSPERO Register (CRD42020183030). Prospective clinical studies, randomized trials, interruptive case series, before and after comparison studies, and cross-sectional studies following the PRISMA guideline were searched in PubMed, Embase, Scopus, and Google Scholar using ad hoc prepared search strings. The search identified 379 papers, of which 342 were excluded after title and abstract evaluation, and 37 full-text papers were analyzed. An additional four papers were added after consulting reference lists. Eighteen papers were disregarded; 23 were finally included, and their potential bias was assessed using ROB-2 and ROBINS-I tools. The wide heterogenicity of the studies included does not allow for conclusive evidence on the effectiveness of visual pedagogy in oral hygiene skills and dental care. Nevertheless, a significant and unilateral tendency of the overall outcomes was found, suggesting that visual pedagogy supports ASD children in improving both oral hygiene skills and cooperation during dental care. Full article
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