Because empathic patient interactions by dentists are associated with improved patient outcomes, self-reported declines in empathy during dental student training are a concern. This study examined differences in empathy in 178 dental students at the University of Toronto and the University of Western Ontario from years one through four using an anonymous self-report webbased survey in a cross-sectional design. To localize the effects of training on empathy, an instrument that separately evaluated emotive (Emo) and cognitive (Cog) types of empathy in both personal (Per) and professional (Pro) contexts was developed, using items modified from previously validated scales and resulting in an empathy scale with four thirteen-item subscales (Per-Emo, Per-Cog, Pro-Emo, Pro-Cog). The response rate was 36.5 percent, and all subscales showed good reliability and validity. A 2x2x4 mixed design ANOVA tested differences in mean scores among the four subscales across the four years of training. Following a significant three-way interaction, subanalyses demonstrated no significant effects in the Per-context, but a significant year by empathy-type interaction in the Pro-context. Post hoc analyses of Pro measures indicated year three emotive empathy scores were significantly lower than earlier years, whereas years three and four cognitive empathy scores were significantly higher. This isolated decrease in Pro-Emo empathy with an increase in Pro-Cog empathy is consistent with the development of "professional empathy," described elsewhere as detached concern.Dr. Yarascavitch is a graduate student at

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Our objective was to estimate the prevalence of mortality and serious morbidity for office-based deep sedation and general anesthesia (DS/GA) for dentistry in Ontario from 1996 to 2015. Data were collected retrospectively in 2 phases. Phase I involved the review of incidents, and phase II involved a survey of DS/GA providers. In phase I, cases involving serious injury or death for dentistry under DS/GA, sourced from the Office of the Chief Coroner of Ontario and from the Royal College of Dental Surgeons of Ontario (RCDSO), were reviewed. Phase II involved a survey of all RCDSO-registered providers of DS/GA in which they were asked to estimate the number of DS/GAs administered in 2015 and the number of years in practice since 1996. Clinician data were pooled to establish an overall number of DS/GAs administered in dental offices in Ontario from 1996 to 2015. Prevalence was calculated using phase I (numerator) and phase II (denominator) findings. The estimated prevalence of mortality in the 20-year period from 1996 to 2015 was 3 deaths in 3,742,068 cases, with an adjusted mortality rate of 0.8 deaths per 1 million cases. The estimated prevalence of serious morbidity was 1 injury in 3,742,068 cases, which adjusts to a serious morbidity rate of 0.25 per 1 million cases. The mortality rate found in this study was slightly lower than those published by earlier studies conducted in Ontario. The risk of serious morbidity was found to be low and similar to other studies investigating morbidity in office-based dental anesthesia.

To share the need for agreement in terminology around how people are supported to receive dental care. Method: In this position paper, we make the case for a shift in behavior support in dentistry from an art to a science. Results: We outline why we need agreement on the definition of behavior support across dentistry, agreement on underlying theory, aims and values, and why we need agreement on terms for specific techniques. Conclusions: We share how patients and dental teams can benefit through better science, education and practice of dental behaviour support.

BackgroundPatients with special care needs (developmental disabilities) have unique and complex needs regarding their oral health and care. This qualitative study aimed to identify the experiences, preferences and challenges of dentists and caregivers regarding behavior guidance techniques for dental care in persons with special care needs.MethodsRelying on qualitative description as articulated by Sandelowski, we conducted telephone interviews with a purposeful sample of five special care dentists and seven caregivers. We analyzed the data using thematic analysis.ResultsFour themes were highlighted: (1) Neither pharmacological or non‐pharmacological behavior guidance techniques was universally suitable, (2) A patient‐centered approach was critical, (3) The dental environment triggered patients’ behaviors and anxiety levels, (4) There was more demand for, than supply of, qualified dentists to treat patients with special care needs.ConclusionsPersons with special care needs are heterogeneous and respond to various behavioral techniques required to deliver their treatment. Behavior guidance planning should be negotiated carefully with patients and caregivers and then individualized based on patients’ capabilities and needs for treatment. The necessity to manage complex behaviors has contributed to the limitation of access to dental care for persons with special care needs. Dentistry as a profession has the obligation to uphold the social contract and meet its responsibility to the dental care needs of this population.

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Background: Empathy is an essential part of patient-centred health care, which positively benefits both patients and clinicians. There is little agreement regarding how best to design and deliver training for healthcare trainees to impart the skills and behaviours of clinical empathy. The study aimed to inform the field by sharing an educational intervention where we aimed to improve empathy amongst dental undergraduate students in Trinity College Dublin using a virtual learning module. Methods: Adopting pre-post-repeat pre-experimental design, dental professional students completed the Jefferson Scale of Empathy (JSE) for Health Professional Students immediately prior to and after a three-week virtual programme designed to increase clinical empathy. Using a three-factor model described for the JSE in the literature, scores were evaluated for internal consistency and paired tests were performed on scores appropriate to their distributions. Seven-point Likert scales were scored to record student experience of training and technology, which are reported descriptively.Results: Most of the 37 participants were female (76%) and represented dental science (N = 27) and dental hygiene roles (N = 7). Results revealed a mean JSE-HPS scale score rise from 110.0 (SD = 10.4) to 116.4 (SD = 11.1), which represented a rise of 5.8% (t (36) = 3.6, p = 0.001). The three factors associated with cognitive empathy, namely perspective-taking (T(36) = 3.931, p < 0.001; walking in the patient's shoes T(36) = 2.093, p = 0.043); and compassionate care (Z = 2.469, p = 0.014) were all found to have increased after the intervention. Students reported a positive experience of discipline-specific and generic videos as part of the module. Conclusion:The study demonstrated that a virtual educational module was associated with an increase in empathy amongst dental undergraduate students. The design of a blended module incorporating the Massive Open Online Course (MOOC) and virtual learning are beneficial and have a promising future.