This article reviews current dental education economic challenges such as increasing student tuition and debt, decreasing funds for faculty salaries and the associated faculty shortage, and the high cost of clinic operations and their effect on the future of dentistry. Management tactics to address these issues are also reviewed. Despite recent efforts to change the clinical education model, implementation of proposed faculty recruitment and compensation programs, and creation of educationcorporate partnerships, the authors argue that the current economics of public dental education is not sustainable. To remain viable, the dental education system must adopt transformational actions to re-engineer the program for long-term stability. The proposed re-engineering includes strategies in the following three areas: 1) educational process redesign, 2) reduction and redistribution of time in dental school, and 3) development of a regional curriculum.
This article reports the findings of a survey-based study conducted in 2006 to determine graduating dental hygiene students' attitudes toward ethical dilemmas in eight areas of practice: substandard care, overtreatment of patients, scope of practice, fraud, confidentiality, impaired professionals, sexual harassment, abuse, and health status. The findings, based on responses from 1,165 students at 141 U.S. dental hygiene programs, indicate that many dental hygiene students do not understand what behaviors in the patient care environment are consistent with ethical practice and which are not. Responding students believed that hygienists have a strong duty to report, intercede, or educate in areas of abuse, sexual harassment, detection of cancer, and smoking cessation. However, they were less likely to report concerns about ethical transgressions such as fraud, inadequate infection control, exceeding practice scope, and failure to diagnose disease when such disclosures could potentially threaten their employment status. Based on the results, we recommend that dental hygiene programs explore curriculum enhancements to improve students' comprehension of what constitutes fraud and other ethical transgressions and the proper reporting mechanisms.
One of the consequences of morbid obesity that has been overlooked is oral health. This paper discusses the oral consequences associated with drugs used to control weight, as well as the oral side effects produced by medications used to treat comorbidities of obesity. We also address how dietary behaviors, and the ergonomic inability to obtain dental care, affect oral health. The relationship between poor oral health and behavior in the bariatric patient are also discussed. Finally, an assessment tool is presented that can assist bariatric nurses evaluate the oral health of bariatric patients.
The healthcare delivery of the United States is confronted with many issues and problems. In an attempt to deal with them, the country has been engaged in a process of healthcare reform. Unfortunately, this reform has largely focused on who is going to pay, what is going to be covered, and how all of the constituencies are hopefully going to be satisfied. What have been largely unaddressed are new delivery paradigms or how the care will be distributed to the underserved. The authors attempt to seek solutions to these last two areas of concern. They spell out how the expansion of the scope of practice for dental hygienists will allow them to bridge the gaps in service and to help deliver dental coverage and elements of systemic healthcare to underserved populations. Finally, the authors provide the steps and mechanisms of how the scope of practice can be expanded. Policy and educational requirements are considered.
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