Assessment of the Calibration of Periodontal Diagnosis and Treatment Planning Among Dental Students at Three Dental Schools

Abstract

Calibration in diagnosis and treatment planning is dificult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third-and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chisquare tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically signiicant difference in responses between third-and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning.Dr. Lane is in private practice in Indianapolis, IN; this study was conducted while she was a resident,

Discrepancies in Periodontal Diagnosis and Classification Among Dental Practitioners with Different Educational Backgrounds

“…Dental practitioners have noticed that there are obvious differences in the presentation of periodontal diseases among patients and have attempted to classify periodontal diseases (4). Classification systems have been developed to aid diagnosis and treatment decisions (5), yet even with these systems in place, considerable disagreements in diagnosis and classification have been reported among dental practitioners when using the 1999 classification of periodontal disease (6,7). These inconsistencies could cause over-or underestimation of the severity and extent of periodontal disease and may lead to inappropriate treatment selection for patients.…”

Ergonomics Calibration Training Utilizing Photography for Dental Hygiene Faculty Members

“…Dental and dental hygiene clinical faculty members often do not provide consistent instruction, especially since most procedures involve clinical judgment 1 – 15 . These variations of instruction frequently translate into variations of student performance in, for example, the diagnosis and treatment of periodontal conditions 10 . Although the effect of inconsistent instruction is yet unknown, students may experience detrimental effects from the delivery of inconsistent faculty instruction 2 , 7 , 16 – 18 .…”

Periodontal treatment strategies in general dentistry

“…On the other hand, studies exploring both diagnostic judgements and treatment decision, although separately, have been conducted on dental students from different dental schools. These studies showed that the diagnostic and treatment agreement between students, both within and between the dental schools, were low (John et al, 2013, Lane et al, 2015. Moreover, 31 clinical instructors also vary in their interpretation of clinical findings, periodontal diagnosis, and treatment planning (Lanning et al, 2005) but on the other hand a substantial agreement could be seen between periodontists when discriminating between patient cases with chronic and aggressive periodontitis (Oshman et al, 2016).…”

“…Interestingly a substantial number of DSPs stated that they have received insufficient teaching in periodontology. On the other hand, diagnostic variations are common both within and between dental schools (Lane et al, 2015, John et al, 2013. Several factors could be held accountable for this variation.…”

“…DSPs and DSMs varied significantly in their proposed treatment, regarding both treatment measures and treatment time. Variations in treatment decisions between students from different educational environments are common, both in the field of periodontology (Lane et al, 2015) and in other fields of dentistry, such as cariology (Bervian et al, 2009). Despite the common occurrence of these findings, it is still important to apprise these differences if one aims to strive for better coherence between DSs.…”