Input From Practice: Reshaping Dental Education for Integrated Patient Care

Among the primary challenges in advancing the practice of integrated primary dental and medical health care is the appropriate educational and clinical preparation of a dental workforce that can function and flourish within integrated care environments. Most dental schools teach to traditional concepts and standards of dental care delivery which may be inconsistent with those of integrated care and could deter the entry and retention of graduates in contemporary, non-traditional practice models. To better understand how the dental school curriculum should be modified to accommodate integrative care models, a number of patient care organizations actively engaged in dental-medical integration were site visited to gain insight into the readiness of newer graduates, with emphasis on the US DMD/DDS graduate, to function in integrated practice. Leaders, practicing clinicians and staff were interviewed and common observations and themes were documented. This manuscript will focus on those educational components that integrated care organizations identify as absent or inadequate in current dentist education which must be addressed to meet the unique expectations and requirements of integrated patient care. These changes appear pivotal in the preparation of a dental clinician workforce that is respectful and receptive to new practice concepts, adaptative to new practice models, and competent in new care delivery systems.

Teledentistry: A Novel Tool in our Arsenal to Combat COVID-19

The prevailing havoc due to rapid spread of COVID-19 has led to an unprecedented impact on dental care delivery. With the postponement or cancellation of all routine dental work, other than emergency care, the dental economy has come to a grinding halt. Aerosols and droplets are generated in many dental procedures, so dental professionals are under an enormous risk of occupational exposure to COVID-19. With no clear forays for the restoration of normalcy, the current crisis poses unique challenges to commence and sustain dental practice. Teledentistry has emerged as a panacea to the delivery of health care, with modified approaches promoting a virtual method of consultations, avoiding direct physical contact. Teledentistry can aid in prescreening patients for COVID symptoms, inquiring about travel history or a recent COVID-19 test result, that helps in risk stratification and deferring dental care to protect vulnerable and high-risk groups. But, it is improvident to restrict the utility of teledentistry to this time of pandemic only. Proactive integration of teledentistry in dental practice will enhance the virtual care which will change the way in which dental care services are rendered in the future.

Mobile Dental Delivery System: An Effective Protocol for Hygiene and Disinfection

Mobile dental delivery systems (MDDSs) are receiving growing interest for reaching isolated patients, as well as in dental care for fragile and hospitalized patients, with the advantage of being able to be used from room to room or during general anesthesia (GA) in an operating room. Therefore, ensuring the care safety is crucial. The aim of this study was to elaborate and assess an MDDS maintenance protocol, containing the management of dental unit waterlines and adapted to specific conditions such as dental care under GA. A step-by-step protocol was established and implemented for an MDDS used during dental care under GA in children. Samples of the output water were collected at J0, J+1, 3, 6, 12, and 24 months, and cultured to observe the microbiological quality of the water. All the results (heterotrophic plate count at 22 °C, at 37 °C, and specific pathogenic germs sought) showed an absence of contamination. The protocol presented was effective over time and allowed ensuring the safety of care to be ensured when using MDDS, even during dental procedures under GA. As a result, it could be implemented by any dental care delivery structure wanting to reinforce the safety of its practice.