Long-Term Adoption of Caries Management by Risk Assessment Among Dental Students in a University Clinic
Identifieur interne : 002696 ( Pmc/Corpus ); précédent : 002695; suivant : 002697Long-Term Adoption of Caries Management by Risk Assessment Among Dental Students in a University Clinic
Auteurs : Benjamin W. Chaffee ; John D. B. FeatherstoneSource :
- Journal of dental education [ 0022-0337 ] ; 2015.
Abstract
Evaluate the long-term adoption of a risk-based caries management program at a university dental clinic.
We extracted data from electronic records of adult non-edentulous patients who underwent a comprehensive oral evaluation in the university predoctoral clinic, from July 2007 through June 2014 (N=21,984). Consistency with caries management guidelines was measured as the percentage of patients with caries risk designation (low, moderate, high, or extreme) and by the percentage of patients provided non-operative anti-caries agents within each designated caries-risk category. Additionally, we identified patient and provider characteristics associated with risk assessment completion and with provision of anti-caries therapy.
The percentage of patients with documented caries risk grew steadily from 62.3% in 2007-2008 to 92.8% in 2013-2014. Overall, receipt of non-operative anti-caries agents increased with rising caries risk, from low (6.9%), moderate (14.1%), high (36.4%), to extreme (51.4%), but percentages were stable over the study period. Younger patients were more likely to have a completed risk assessment, and among high- and extreme-risk patients, delivery of anti-caries therapy was more common among patients who were younger, identified as Asian or Caucasian, received public dental benefits, or were seen by a student in the four-year doctoral program or in the final year of training.
Extensive compliance in documenting caries risk was achieved within a decade of implementing risk-based clinical guidelines. Caries risk was the most strongly associated of several factors related to delivery of non-operative therapy. In dental education, transition to a risk-based, prevention-focused curriculum may require a long-term commitment.
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PubMed: 25941147
PubMed Central: 4441821
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PMC:4441821Le document en format XML
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<author><name sortKey="Chaffee, Benjamin W" sort="Chaffee, Benjamin W" uniqKey="Chaffee B" first="Benjamin W." last="Chaffee">Benjamin W. Chaffee</name>
</author>
<author><name sortKey="Featherstone, John D B" sort="Featherstone, John D B" uniqKey="Featherstone J" first="John D. B." last="Featherstone">John D. B. Featherstone</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Long-Term Adoption of Caries Management by Risk Assessment Among Dental Students in a University Clinic</title>
<author><name sortKey="Chaffee, Benjamin W" sort="Chaffee, Benjamin W" uniqKey="Chaffee B" first="Benjamin W." last="Chaffee">Benjamin W. Chaffee</name>
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<author><name sortKey="Featherstone, John D B" sort="Featherstone, John D B" uniqKey="Featherstone J" first="John D. B." last="Featherstone">John D. B. Featherstone</name>
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<series><title level="j">Journal of dental education</title>
<idno type="ISSN">0022-0337</idno>
<idno type="eISSN">1930-7837</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">Evaluate the long-term adoption of a risk-based caries management program at a university dental clinic.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We extracted data from electronic records of adult non-edentulous patients who underwent a comprehensive oral evaluation in the university predoctoral clinic, from July 2007 through June 2014 (N=21,984). Consistency with caries management guidelines was measured as the percentage of patients with caries risk designation (low, moderate, high, or extreme) and by the percentage of patients provided non-operative anti-caries agents within each designated caries-risk category. Additionally, we identified patient and provider characteristics associated with risk assessment completion and with provision of anti-caries therapy.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">The percentage of patients with documented caries risk grew steadily from 62.3% in 2007-2008 to 92.8% in 2013-2014. Overall, receipt of non-operative anti-caries agents increased with rising caries risk, from low (6.9%), moderate (14.1%), high (36.4%), to extreme (51.4%), but percentages were stable over the study period. Younger patients were more likely to have a completed risk assessment, and among high- and extreme-risk patients, delivery of anti-caries therapy was more common among patients who were younger, identified as Asian or Caucasian, received public dental benefits, or were seen by a student in the four-year doctoral program or in the final year of training.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Extensive compliance in documenting caries risk was achieved within a decade of implementing risk-based clinical guidelines. Caries risk was the most strongly associated of several factors related to delivery of non-operative therapy. In dental education, transition to a risk-based, prevention-focused curriculum may require a long-term commitment.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8000150</journal-id>
<journal-id journal-id-type="pubmed-jr-id">4694</journal-id>
<journal-id journal-id-type="nlm-ta">J Dent Educ</journal-id>
<journal-id journal-id-type="iso-abbrev">J Dent Educ</journal-id>
<journal-title-group><journal-title>Journal of dental education</journal-title>
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<issn pub-type="ppub">0022-0337</issn>
<issn pub-type="epub">1930-7837</issn>
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<article-meta><article-id pub-id-type="pmid">25941147</article-id>
<article-id pub-id-type="pmc">4441821</article-id>
<article-id pub-id-type="manuscript">NIHMS690004</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Long-Term Adoption of Caries Management by Risk Assessment Among Dental Students in a University Clinic</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Chaffee</surname>
<given-names>Benjamin W.</given-names>
<prefix>Dr.</prefix>
</name>
<degrees>DDS MPH PhD</degrees>
<role>Assistant Professor</role>
<aff id="A1">Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Featherstone</surname>
<given-names>John D. B.</given-names>
<prefix>Dr.</prefix>
</name>
<degrees>MSc PhD</degrees>
<role>Professor and Dean</role>
<aff id="A2">School of Dentistry, University of California San Francisco</aff>
</contrib>
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<author-notes><corresp id="FN1">Direct correspondence and request for reprints to Dr. Benjamin Chaffee, University of California San Francisco, 3333 California Street, Suite 495, San Francisco, CA 94143-1361; 415-476-9226; <email>benjamin.chaffee@ucsf.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>16</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>5</month>
<year>2016</year>
</pub-date>
<volume>79</volume>
<issue>5</issue>
<fpage>539</fpage>
<lpage>547</lpage>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">Evaluate the long-term adoption of a risk-based caries management program at a university dental clinic.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We extracted data from electronic records of adult non-edentulous patients who underwent a comprehensive oral evaluation in the university predoctoral clinic, from July 2007 through June 2014 (N=21,984). Consistency with caries management guidelines was measured as the percentage of patients with caries risk designation (low, moderate, high, or extreme) and by the percentage of patients provided non-operative anti-caries agents within each designated caries-risk category. Additionally, we identified patient and provider characteristics associated with risk assessment completion and with provision of anti-caries therapy.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">The percentage of patients with documented caries risk grew steadily from 62.3% in 2007-2008 to 92.8% in 2013-2014. Overall, receipt of non-operative anti-caries agents increased with rising caries risk, from low (6.9%), moderate (14.1%), high (36.4%), to extreme (51.4%), but percentages were stable over the study period. Younger patients were more likely to have a completed risk assessment, and among high- and extreme-risk patients, delivery of anti-caries therapy was more common among patients who were younger, identified as Asian or Caucasian, received public dental benefits, or were seen by a student in the four-year doctoral program or in the final year of training.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Extensive compliance in documenting caries risk was achieved within a decade of implementing risk-based clinical guidelines. Caries risk was the most strongly associated of several factors related to delivery of non-operative therapy. In dental education, transition to a risk-based, prevention-focused curriculum may require a long-term commitment.</p>
</sec>
</abstract>
<kwd-group><kwd>caries management</kwd>
<kwd>caries risk assessment</kwd>
<kwd>clinical education</kwd>
<kwd>predoctoral dental education</kwd>
<kwd>CAMBRA</kwd>
<kwd>implementation and evaluation</kwd>
<kwd>professional education</kwd>
</kwd-group>
</article-meta>
</front>
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