Wolf, Thomas

Objectives: The study examines the impact of changes on dental education and practice in Europe, including the development of new practice models such as investor-owned dental centers and practice chains. Method and materials: This study aimed to collect and critically examine data regarding the care environment, education, and organizational structures of the dental profession across European Regional Organization of the FDI World Dental Federation (ERO) member states and other countries in the World Health Organization European region. A questionnaire from the ERO was used. Results: National dental associations across 45 countries participated. An average of 1,459.79 (SD ± 800.80) inhabitants per dental practitioner was found, with independent practices being the most prevalent form of dental practice (48.65% ± 28.28%) followed by employment in private practice (24.32% ± 20.33%), and joint practices (15.27% ± 20.39%). There are statistically significantly more state universities than private universities (P .01); the percentage of females attending dental schools was statistically significantly higher than males (P .01). Two-thirds of the participating countries (n = 30, 66.67%) have legal frameworks allowing various stakeholders, including investors, and local communities, to establish dental health care centers. Conclusions: The findings highlight the evolving landscape of the dental profession in Europe and its regulatory context. There is a clear need for ongoing evaluations and adjustments in educational and practice frameworks to ensure and maintain high-quality oral health care. Future research should delve into the various professional dental practice forms and incorporate qualitative, care-related, and patient-centered considerations for a more thorough understanding of Europe’s oral health care dynamics. (Quintessence Int 2024;55:744–755; doi: 10.3290/j.qi.b5714883) Keywords: dental health care center, dental service, Europe, form of dental practice, independent, liberal, questionnaire, young dental practitioners

Purpose: Dental students learn knowledge and practical skills to provide oral health care to the population. Practical skills must be maintained or continuously developed throughout a professional career. This cross-sectional survey aimed to evaluate the perception of practical skills of dental students and dental-school graduates by national dental associations (NDAs) in international comparison in the European Regional Organization of the FDI World Dental Federation (ERO-FDI) zone. Materials and Methods: A questionnaire of 14 items collected information on pre-/postgraduate areas. Results: A total of 25 countries participated (response rate: 69.4%), with 80.0% having minimum requirements for practical skills acquisition and 64.0% starting practical training in the 3rd year of study. In countries where clinical practical work on patients begins in the 2nd year of study, practical skills of graduates are perceived as average, starting in the 3rd year of study as mainly good, starting in the 4th as varying widely from poor to very good. In total, 76.0% of respondents feel that improvements are needed before entering dental practice. Improvements could be reached by treating more patients in dental school (32.0%), increasing the quantity of clinical training (20.0%), or having more clinical instructors (12.0%). In 56.0% of the countries, it is possible to open one’s own dental practice immediately after graduation, and in 16.0%, prior vocational training is mandatory. Conclusions: All participating countries in the ERO-FDI zone reported practical training in dental school, most starting in the 3rd year of study. The perception of practical skills of dental students and dental-school graduates among NDAs is very heterogeneous. Reasons for the perceived deficiencies should be further explored. Keywords: dental association, graduate, international, practical skills, student

Objective: A trend towards increasingly new forms of dental practice has been observed in the FDI World Dental Federation. Elementary foundations such as the free dentist and therapy choice, and independent, free, self-responsible professional practice may be undermined. The current study is aimed at analyzing the general training framework, organization, and professional types of dental practice in the European Regional Organization (ERO) zone and at critically discussing selected aspects of changes in the dental profession. Method and Materials: A questionnaire was developed by the ERO Working-Group "Liberal Dental Practice." Information about dental schools, professional organizations, dental practice regulations, and ambulatory healthcare centers was analyzed. Results: Self-employed dental practice is the most common type of practice (51.7%). Dentists are allowed to work independently immediately after graduation (72.7%). Approximately one-third are organized as compulsory members in chambers/corporations. The density of dentists has a mean of 1,570 inhabitants per dentist. In most countries, there are no special rules for founding dental ambulatory healthcare centers. In a total of 353 universities of the ERO countries surveyed, 16,619 dentists per year were trained, with a trend toward a higher percentage of female students (63%). Conclusions: Despite modern forms of dental practice, the charter of the individual liberal dental profession (CED et al, 2013) should be respected and taken into account on the basis of ethical principles. The commercialization of the dental profession can be neutralized only by establishing and following well-defined ethical principles; oral healthcare quality can thus be ensured without the influence of third parties. Keywords: Europe, liberal dental practice, modern forms of occupation, oral health policy, trends in dental occupation

Aim: An increasing number of physicians and researchers take advantage of smartphones or other mobile devices during their daily professional routine in order to facilitate the retrieval of medical information and to improve their patients' treatment. Mobile health apps have gained tremendous popularity; however, most of them are devoted to easing medical processes or to simplifying the patients' understanding of their diseases rather than providing a tool to actively screen patients with regard to the prevalence of a certain disease. The aim of the present study was to develop an iPad app intended for the screening of adult outpatients with regard to their oral health status and their dental treatment needs as well as their health-related quality of life and their depressive predisposition. The iPad app is also designed to facilitate data acquisition. It includes a dental examination sheet (WHO oral health questionnaire) and two patient-based questionnaires. The objective of this study was to facilitate a screening of outpatients with regard to dental treatment, oral health-related quality life (OHIP-G14), and Beck Depression Inventory (BDI-II) as well as to test our iPad app with regard to its practicability in a clinical setting. Materials and methods: A total of 196 healthy adult outpatients, reporting to the Department of Operative Dentistry, University Medical Center, Mainz, Germany, for check-up visits, were enrolled in the study. For this investigation, an iPad app was developed with the goal of facilitating dental screenings of outpatients (Fig.1). We also wanted to facilitate the evaluation of the questionnaires by directly digitally implementing the data into an Excel sheet. We used the highly standardised WHO oral health assessment questionnaires for the acquisition of the dental parameters. All the patients were also asked to document their answers for the OHIP-G14 (scale: 0-37) and BDI-II (scale: 0-63) questionnaires directly into the iPad App. Results: This study included 94 male and 102 female patients (mean age 39.8±16.9, 18-83 years). The mean number of teeth was 26.5 (SD± 3.8). A high number of teeth showed restorations or crowns (11.1±5) (Fig.2), and there were also a high number of teeth free of caries (16 ± 7.1). Less than one tooth (0.7±0.9) showed primary or secondary caries. Most of the teeth (mean: 22.6± 7) showed a pocket depth of 4mm, and a marginal number (mean 3±4) showed a pocket depth between 4-5 mm (Fig.5). 17.3% of the subjects were smokers, and 82.7% non-smokers. No enamel fluorosis was detected in 47.3%, 14.5% had mild fluorosis, and 38.2% were classified as questionable (Fig.3 and 6). Enamel or dentinal erosions were observed in 39.1% (Fig.4 and 7). The BDI-II score was 4.4±5 (1-44), and the OHIP-G14 score was 3.9±5.8 (0-24). Mucosal lesions were detected in 10%; 87.3% were lesion-free. Treatment need was urgent in 11.8%, 49.1% required preventive or routine treatment, and no treatment was needed in 39.1% (Fig 8). Conclusions: The investigated outpatients represent a cross-section of the oral health care situation of the German population. The data resemble the results of the DMS V recently published in Germany. The use of the novel app is well-suited for the detection of cohorts; however, some older subjects had difficulties using a tablet computer, which required extra time. Keywords: Oral health, quality-of-life assessment, iPad app

An increasing number of physicians and researchers take advantage of smartphones or other mobile devices in their daily professional routine in order to facilitate the retrieval of medical information and to improve their patients' treatment. Mobile health apps have gained tremendous popularity; however most of them are devoted to easing medical processes or to simplifying the patients' understanding of their diseases rather than providing a tool to actively screen patients with regard to the prevalence of a certain disease. The aim of the present study was to develop an iPad app intended for the screening of hospitalised patients with regard to their oral health status, their dental treatment needs, and their health-related quality of life and their depressive predisposition. The iPad app is also designed to facilitate data acquisition. It includes a dental examination sheet (WHO oral health questionnaire) and two patient-based questionnaires (Fig. 1). The objective of this study was to facilitate a screening of hospitalised patients with regard to dental treatment (Fig. 2 and 3), oral-health-related quality life (OHIP-G14), and Beck Depression Inventory (BDI-II) as well as to test the app with regard to its practicability in a clinical setting. Materials and methods: In this clinical study, a total of 145 hospitalised patients, admitted to the Departments of Orthopedics and Traumatology (UC) and the Department of General Surgery (AC) at the University Medical Center of Mainz, Germany, were enrolled. For this investigation, an iPad app was developed with the goal of facilitating dental screenings of hospitalised patients (Fig.1). We also wanted to facilitate the evaluation of the questionnaires by directly digitally implementing the data into an Excel sheet. We used the highly standardised WHO oral health assessment questionnaires for the acquisition of the dental parameters. The patients were asked to document their answers to the OHIP-G14 (scale: 0-37) and BDI-II (Scale 0-63) questionnaires directly into the iPad app. Results: A total of 91 male und 54 female patients with a mean age of 55.6 (SD±17) years were enrolled. The average number of teeth was 23.7 (SD±6) for the UC patients and 21.6 (SD±7) for the AC patients (Fig.4). The patients in the Traumatology Department (UC) generally showed a better oral health status with fewer signs of gingival bleeding (p=0.13; Fig.4), fewer pocket depths over 4mm (UC: 1.2; AC: 2.8) and fewer oral mucosa lesions (UC: 0.5; AC:1) than the General Surgery patients (AC). However, mucosal lesions were only found in 11.4% of all patients. The Beck Depression score (BDI-II) showed significantly better values for the UC patients (2.9; SD±5) than for the AC patients (5.1 SD±6) (p=0.26; Fig.6). Similar observations were found for the OHIP-G14 score (UC patients 3.2±6; AC patients 5.8±8) (Fig. 7). The need for immediate dental treatment was observed in 18%; urgent problems were recorded in 14% of all cases, preventive measures were to be conducted for 31% of all patients, and no dental treatment needs were recorded for 36% of all patients. Conclusions: Using the app is suitable for detecting cohorts in hospitalised patients. However, handling tablets proved to be difficult especially for older patients, so that additional time was necessary. A few patients refused to use the app. Keywords: iPad, oral health, quality of life

Das vorliegende Werk beschreibt detailliert und in einzelnen Handlungsschritten die Verwendung und Handhabung des fließfähigen Komposites und seinen einfachen aber wirkungsvollen Einsatz in der täglichen Arbeit der Zahnerhaltung. Es werden wissenschaftliche Grundlagen und die Entwicklung des fließfähigen Kunststoffs erklärt und Falldarstellungen mit zahlreichen Behandlungsoptionen erläutert. Diese bieten in umfassend aufbereitetem protokolliertem Vorgehen dem Behandler eine optimale Lerngrundlage.

Das Werk greift auf 214 Seiten die Notwendigkeit des zahnärztlichen Englisch im Praxisalltag auf. In diesem sind häufig Patienten mit manchmal nur bruchstückhaften deutschen Sprachkenntnissen anzutreffen. Jedoch bitten diese dann meist in englischer Sprache um Behandlung. Der behandelnde Zahnarzt, wie auch die Praxismitarbeiter/-innen verfügen oft schon seit der Schulzeit über mehrjährige Sprachkenntnisse, manchmal durch Auslandsaufenthalte vertieft, die zwar zum Dialog ausreichen, aber die genaue Terminologie zum Fachgespräch oder zur Patientenaufklärung im Englischen vermissen lassen. Keywords: Bürstenzytologie, Diagnostik, Leitlinien