Dental fear among university students: implications for pharmacological research.
University students are often subjects in randomized clinical trials involving anxiolytic and analgesic medications used during clinical dental and medical procedures. The purpose of this study was to describe a typical university student population available for research by using data from a mail survey. Subjects were 350 students chosen randomly from all enrolled, full-time, traditional students on the main campus at the University of Washington in Seattle, WA. The aim was to determine the extent and nature of dental anxiety in this population. In addition, the relationships between subject willingness to receive dental injections and general and mental health and medical avoidance and medical fears were examined. The Dental Anxiety Scale (DAS) was used to measure dental anxiety. Dental anxiety was prevalent in this population; 19% of students reported high rates of dental fear. Thirteen percent of students had never had a dental injection. Students with no experience with dental injections were more reluctant than those with experience to receive an injection if one were needed. DAS scores were correlated with injection reluctance. Students who were reluctant to go ahead with a dental injection also reported poorer general and mental health than those who were less reluctant. These students also reported higher medical avoidance and medical anxiety scores. University students provide a rich source of potential subjects for clinical research. The student population, like the community at large, contains people with high levels of dental and medical fear. (+info)
The inappropriateness of conventional orthodontic bond strength assessment protocols.
The purpose of this article is to examine the soundness of conventional orthodontic bonding assessment methods. A classification of bond strength studies is proposed with the testing environment (in vivo, in vitro, and ex vivo), loading mode (shear, tensile, and torsion), and bonding substrate (enamel, restorative, and prosthetic materials) serving as discriminating variables. Inconsistencies throughout the various stages of research protocols are analysed. These include the following: tooth selection, storage, and preparation; bonding; testing; and data analysis with regard to the clinical applicability of the reported information, as well as the scientific integrity of the testing procedure. Contradictory models may partially account for the considerable variability noted for reported bond strength values of different orthodontic bonding systems. Such discrepancies may also explain the conflicting evidence reported on the failure characteristics of the components of the bonding system in different trials examining the efficacy of nominally identical materials. A novel approach to study the fatigue life of materials is proposed to understand the processes occurring prior to bond failure. Mock research data manipulation is also utilized to illustrate the correct statistical treatment of findings, and recommendations for future research are made to ensure scientific soundness and clinical applicability of data. (+info)
Orthodontics around the world: orthodontics in Brazil: excellence for a minority.
Brazil is the largest country of South America, with an area of 8.511.965 km(2) and 150 million people. It has 113 dental schools and several orthodontic postgraduate courses variously at Certificate, Master, and Doctoral levels. The current article gives an overview of the speciality in Brazil. The discussion puts the delivery of orthodontic care within the context of social conditions in Brazil. Included is a description of two full-time orthodontic courses located in the city of Rio de Janeiro. (+info)
Unconventional dentistry: Part I. Introduction.
This is the first in a series of five articles providing a contemporary overview and introduction to unconventional (alternative) dentistry (UD) and correlation with unconventional (alternative) medicine (UM). UD is analogous to and conceptually inseparable from UM. Dentists should learn about UD and UM and be aware of evidence on the safety and effectiveness of treatments and procedures. While being skeptical of promotions, dentists should be able to accept and encompass science-based advances and reject unproven and disproven methods. Incorporating selected unconventional methods with conventional dentistry in selected patients for specific purposes may be useful to both patients and dentists. Improved education in critical thinking, research, science, medicine, behaviour, communication and patient management is needed. (+info)
Evidence-based dentistry: Part IV. Research design and levels of evidence.
Previous papers in this series on evidence-based dentistry have discussed the first 2 steps in seeking answers to clinical problems formulating a clear question and strategically searching for evidence. The next step, critical appraisal of the evidence, is made easier if one understands the basic concepts of clinical research design. The strongest design, especially for questions related to therapeutic or preventive interventions, is the randomized, controlled trial. Questions relating to diagnosis, prognosis and causation are often studied with observational, rather than experimental, research designs. The strongest study design should be used whenever possible. Rules have been established to grade research evidence. This paper, the fourth in the series, presents an overview of research methodology most commonly used in the dental literature. (+info)
Modern methods for assessing the cariogenic and erosive potential of foods.
Assessment of the acidogenic and cariogenic erosive potential of foods requires the use of reproducible and standardised methods. The methodology laid down at the San Antonio conference in 1985 remain today the basis for research on and the testing of foods. The 1999 workshop has updated the appropriate methodology and introduced guidelines on the testing of erosive potential of foods. It is to be hoped that researchers wishing to evaluate foods and their effect on the teeth will continue to use these methods. (+info)
Evidence-based dentistry and health services research: is one possible without the other?
Barriers have been identified in the literature to the implementation of evidence-based practice in dentistry. A major concern is the lack of rigorous evidence for clinical practices. Little attention has been given to the lack of rigorous health services research. Evidence-based practice is more about effectiveness than efficacy and will influence the type of research that characterizes health services research (HSR) because it involves levels of data below that of the random controlled trials, involves questions about the appropriateness of care, and involves examining the structure, process, and outcomes of care. The need for HSR can be seen by examining the appropriateness of dental care and health-related quality of life outcomes. The conclusion to be drawn is that evidence-based dentistry needs HSR if it is to fulfill the promise currently held for it in the profession. (+info)
Implications for dental education of a dental school-initiated practice research network.
The Case Western Reserve University (CWRU) School of Dentistry has organized a research network of 210 general dentists in northern Ohio. Seventeen of these dentists have volunteered to serve on a steering committee, for the purpose of generating research questions and helping with network organization. To enable the practitioners to investigate questions of interest in their practices, faculty in the CWRU schools of Dentistry and Medicine provide consultation to network dentists, as needed, with regard to research design, implementation, and analysis. In turn, the network serves as a resource for the dental school, facilitating faculty development, encouraging the development of new research programs, and providing an opportunity for students throughout the university to become involved in dental practice research. To date, faculty members have initiated studies of dental practice that include a survey of dentists' attitudes toward tobacco, a weekly return caries study, and a direct observation study of general dental practice. The network provides a research "laboratory" for the dental school, enabling clinical faculty to participate in research concerning dental practice. It has also stimulated a major re-examination of several curriculum elements in the school. (+info)