Three cases are presented in which patients presented with either cutaneous swelling or cutaneous sinus tracts of odontogenic origin. A cutaneous sinus tract of odontogenic origin is a pathway through the alveolar bone that typically begins at the apex of an infected tooth or of an infected portion of the dental alveolus and empties infected material (pus) through the skin. Where as the more common finding of an oral fistula is a pathway from the apical periodontal area of a tooth to the surface of the oral mucous membrane, permitting the discharge of suppurative material. Diagnosis, etiology and treatment are discussed with reference to patient history, clinical examinations, imaging, and treatment perspectives.
The purpose of this study was to adapt the twenty-six-item Communication Skills Attitude Scale (CSAS) developed for medical students for use among dental students and to test the psychometric properties of the modiied instrument. The sample consisted of 250 students (an 80.1 percent response rate) in years D1 to D4 at a dental school in Washington, DC. The mean age of participants was 26.6 years with a range from twenty-one to forty-two years. Slightly more than half of the participants were female (52.4 percent) and were African American or of African descent (51.7 percent). Principal components analysis was used to test the psychometric properties of the instrument. The index that resulted measured both positive and negative attitudes toward learning communications skills. The inal twenty-four-item scale had good internal consistency (Cronbach's alpha=0.87), and the study obtained four important factors-Learning, Importance, Quality, and Success-that explained a signiicant portion of the variance (49.1 percent). Stratiied analysis by demographic variables suggested that there may be gender and ethnic differences in the students' attitudes towards learning communication skills. The authors conclude that the CSAS modiied for dental students, or DCSAS, is a useful tool to assess attitudes towards learning communication skills among dental students. G ood communication skills are essential for effective clinical practice in dentistry. As Hannah et al. noted, "An ability to communicate effectively with patients-in particular, to use active listening skills, to gather and impart information effectively, to handle patient emotions sensitively, and to demonstrate empathy, rapport, ethical awareness, and professionalism-is crucial." 1 In addition, research has found that good communication skills can increase the health care providers' diagnostic eficiency and decision making ability, as well as lead to improved patient satisfaction, greater adherence to provider recommendations, decreased anxiety, and lower rates of complaints and malpractice claims. [2][3][4][5][6][7] Professional associations and governmental organizations, acknowledging the central role of communication in attaining improved quality dental health care for an increasingly diverse population, have established objectives for the profession and the nation. In 2008, the American Dental Education Association (ADEA) House of Delegates approved communication and interpersonal skills as one of the domains of competencies for new general dentists. 8
There are several excellent indices available to quantify diversity within a student body. Richness and evenness can be studied using Simpson’s Index with its associated Reciprocal Index, and with Shannon-Weiner’s Index “H” and Index “E”. Lieberson provides the means to measure isolation and interaction, and Dissimilarity works well to identify segregated communities. Results using these indices show that the Historically Black College of Dentistry is a culturally vibrant and diverse academic and social environment. White students at the Historically Black College of Dentistry are more likely to enjoy interaction with other Whites than will Historically Black and Hispanic students at all other dental schools, except at the other Medical College, the only other HBCU with a dental school. Overall, there was no statistical diversity difference between the Historically Black College of Dentistry and all other dental schools over the 10 year study period. Statistically significant correlations between each index provided a framework for using each index in prediction modeling. Recent methods to manage multi-collinearity, such as extracting unstandardized residuals to use as adjusted coefficients add promise that all indices can be used in future diversity studies.
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