Background: A national survey was undertaken to establish a baseline of our final year students' perception of how their undergraduate oral surgery education has equipped them for key areas of general dental practice.

The aim of this work was to determine the structure, mode of delivery, mode of assessment and staffing of the oral surgery undergraduate curriculum within UK dental schools. A questionnaire was distributed by e-mail in January 2006 to each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. Those providing feedback then met to clarify any areas as required. Thirteen completed questionnaires were returned. There were a total of 55 academics involved in the teaching of oral surgery at these 13 institutions. Over the three clinical years the mean number of clinical sessions was 51. The mean staff student ratio for supervision of forceps exodontia was 1:5. On average 51 teeth were extracted by each student in the clinical years. The mean staff student ratio for surgical extractions was 1:2. The mean number of surgical extractions for each student was 6. All schools formatively assessed competency in forceps exodontia and 9 of 13 assessed surgical extractions. Summative assessment of exodontia was done in six schools and surgical extractions in 4 of 13 schools. All 13 schools deliver teaching programmes designed to meet the requirements of the frameworks governing the central curriculum. There were, however, variations between individual schools in the content and delivery of the oral surgery clinical teaching programmes. There were dramatic variations in the numbers of academic staff involved and some institutions relied on their NHS colleagues to deliver the clinical teaching.

This study demonstrates that a well-designed virtual course can help to vertically integrate, and make clinically relevant, one of the basic sciences underpinning dental surgery. It has shown that formative assessment acts as a powerful tool to focus student attention and direct student learning. This leads to the conclusion that formative assessments have to be designed with as much care and attention as summative assessments.

Introduction:  Competence based education is becoming more important in dentistry and medicine. In dentistry clinical skills are assessed using longitudinal assessments or structured objective clinical tests. We have previously presented the assessment of competence in surgical extractions however the success rate for this was poor. The opportunity to alter staffing levels and timetabling arose and we present the influence of this on the achievement of competence. Methods:  The competence assessments and portfolios of two consecutive years of dental undergraduates were examined after completing their surgical extraction course. The first cohort received 9 sessions of teaching spread over 2 years with one staff supervisor per session. The second cohort received 10 sessions with varying numbers of staff supervisors. Results:  The first cohort required 210 staff sessions and performed 275 surgical extractions (mean 4), and 23% achieved competence. The second cohort required 240 staff sessions and performed 403 surgical extractions (mean 6), and 66% achieved competence. Thirty six extra sessions were provided for students in the second cohort who failed to complete their competence during the allocated blocks and following this 99% of the second cohort achieved competence. These differences are significant (P < 0.01). Conclusion:  It is possible to demonstrate competence in large numbers of undergraduates in surgical extraction. The process can be influenced by staffing and timetabling changes which focus student experience and learning.

This preliminary study confirms the new screening instrument for AO/PDAP merits progression to field testing.

Persistent orofacial pain (POFP) affects patients’ daily lives and can lead to significant costs for them and/or the health service provider. This partial economic evaluation examined costs and utilities experienced by individuals with POFP over a 24-mo period and used these data to populate the life course Markov model used to estimate costs and quality-adjusted life years (QALYs) from pain onset over an individual’s life course while receiving usual health care. A total of 202 people receiving care for POFP were followed for 24 mo. Data were collected every 6 mo on pain-related disability (Graded Chronic Pain Scale dichotomized to low [0–IIa] or high [IIb–IV] pain-related disability states), health service utilization, and health-related quality of life measured by QALYs derived from the EQ-5D-5L. Unbalanced regressions were used to demonstrate how costs and QALYs varied according to participant characteristics with the results used to parameterize a Markov model. This probabilistic Markov model was used to estimate the outcomes for a cohort of POFP patients from age 25 y until death as determined by age- and sex-specific mortality rates. Across all time points, complete data were available from 129 participants. A high pain-related disability state led to significantly increased health care cost (£221; 95% confidence interval [CI], 87–355; P < 0.01) and a significant decrease in quality of life (mean difference, –0.08; 95% CI, –0.11 to −0.05; P < 0.0001) over a 24-mo period. The Markov model estimated that the average cost was £27,317 (95% CI, 26,558–28,046) and the average lifetime QALYs were 17.54 (95% CI, 17.38–17.71). The modeling suggests that a cohort of POFP patients from age 25 y would only accrue 18 QALYs per person before death. POFP therefore exerts a considerable impact on health, and it is likely more effective care (pathways) could realize substantial gains in terms of both treatment outcomes and health care utilization. Knowledge of Transfer Statement: Despite a substantial number of consultations, individuals experiencing the care pathways in this study continued to have far from perfect health over their life course. The modeling suggests they would only experience 18 y in “perfect health.” There is considerable scope to improve current care/outcomes and patient experience.

Managing orofacial pain can be a daunting prospect for the dentally qualified clinician. This article aims to alleviate some of these concerns by providing guidance when pharmacological intervention may be recommended, alongside their dosing regimens and contraindications. The medications discussed include amitriptyline, nortriptyline, gabapentin, pregabalin, duloxetine, carbamazepine, oxcarbazepine, clonazepam, capsaicin, baclofen, lamotrigine, alpha-lipoic acid, lidocaine hydrochloride and benzydamine hydrochloride. Management of orofacial pain is complex and, hence, often requires the input of specialists in secondary care. While the scope of this guide is aimed chiefly at pharmacological management by secondary care dental prescribers, a holistic approach encompassing all biopsychosocial factors is encouraged. The main take home points have been summarised in a table, aimed for use as a 'quick reference guide' during clinic sessions. Other contemporaneous prescribing guides and guidelines should always be used in conjunction with this article as licensing and dosing regimens of medications can be different around the world.

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