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  • 1. Course: New Concepts in Education and Public Oral Health 7 weeks full time postgraduate course course period: 11 May - 29 June 2011 Course Description The course covers two main topics. One is on oral health education methods: concepts of learning, problem based learning and problem based treatment planning as practised at the College of Dental Science, Radboud University Nijmegen Medical Centre (RUNMC). Alongside from this, application of evidence based dentistry, appraisal techniques for critical appraisal of scientific literature and research methodology will be taught. The other main topic is public oral health care methods, strategies and clinical procedures, as presented by the Department of Global Oral Health, RUNMC, Nijmegen. Senior dental scientists and professional tutors will present the course subjects in blocks of one or two weeks. Tutors will lead an introduction seminar, an evaluation seminar and instructive lectures in between. The purpose of the seminars is to enable you to assimilate and argue the scientific evidence of the presented subject and to discuss results of your assignments. Between seminars, you are expected to consult the presented study material and to select the information needed for self study assignments. During the clinical blocks you will also participate in skills labs. Objectives The course objective is to acquaint with: - Problem Based Learning and designing problem-oriented treatment plans - Designing student centred educational modules aimed at active participation and using self-study assignments - Evidence Based Dentistry and how to find evidence on the internet, critically appraise the information and apply evidence in dental treatment - Research methodology and the basics of research design and article writing - Public oral health care approaches including BPOC, fluoride advocacy, school (oral) health programs, and the concept of shortened dental arch - Atraumatic Restorative Treatment theory and practice - Use of direct adhesive dentistry procedures and materials in emergency oral care - Developmental periodontal dentistry in a nutshell Subjects Week 1-3 Problem-based learning (PBL); Problem based treatment planning, Evidence Based Dentistry (EBD), Research methodology, Critical appraisal techniques; Week 3-4 Basic Package of Oral Care (BPOC); Shortened Dental Arch (SDA), Public oral health care strategies, planning and programs; 1
  • 2. Week 4-7: Atraumatic Restorative Treatment (ART), Direct adhesive procedures; Basic periodontal care. Subjects in dental education Problem based learning You will study learning concepts and educational principles, in particular problem based learning. A part of the course will focus on planning a dental curriculum or training, taking into account local circumstances such as culture, human and financial resources. In addition, you will learn about the new problem based learning system for students at the College of Dental Science at Nijmegen University. The educational program with pre-set learning goals for every course will be explained. You will be trained to define goals in terms of skills rather than in terms of knowledge. You will study problem oriented and problem solving strategies enhancing independent learning and long term learning results. Problem-oriented Treatment Planning If there is no problem in oral function then why start treatment? Preservation of complete dental arches is neither attainable nor affordable for the majority of patients even in countries with sophisticated dental care systems. Teeth should only be replaced if a problem can be solved. But how many teeth are at least needed to guarantee a functional and healthy occlusion and what does that mean for dental treatment? This approach is called problem-oriented treatment planning. Problem solving treatment is a way to organize a patient’s treatment in a predictive and systematical order. A treatment planning should contain all relevant information about the occlusion and complaints, causes and possible solutions, and the final result. It is a well-structured report for both dentist and patient. You will learn to make choices in treatment planning, following the problem solving approach in seven steps: 1. gathering information; 2. recognition; 3. problem listing; 4. treatment strategy; 5. preliminary treatment planning; 6. therapy; 7. evaluation and prognosis. In addition, you will learn about the shortened dental arch (SDA) and the preservation of strategic teeth, a concept that can be of great help to simplify a treatment plan. Evidence based dentistry The Evidence-based approach is essentially a structured stepwise process for dealing with clinical problems. This approach encourages the use of the latest information rather that a reliance on techniques, materials and treatments learned years earlier. There are five elements to the approach: 1. Question - Developing a clear question based on the patients clinical problem. 2. Find - Finding the latest evidence through efficient searching for information. 3. Appraise - Critically appraising the evidence to assess its value. 4. Act - Acting on the evidence you find, if appropriate and relevant to the clinical situation to provide treatment for the patients. 5. Evaluation - Each aspect of your performance in this process can, and should be evaluated and this is increasingly relevant with the development of continuing professional development. Seminar leaders: Prof Dr. Nico Creugers DDS PhD, chair in Oral Function, curriculum coordinator; Drs. Anneloes Gerritsen DDS, Ass Professor in Oral Function and Prosthetic Dentistry 2
  • 3. Research methodology and critical appraisal techniques In order to understand and appraise evidence, but also if you wish to further your career in an academic environment, rudimentary knowledge of research design, methods and procedures is essential. During this course, you will learn the basics of how to translate a research idea into an appropriate research design. You will also receive a short training on scientific writing. Critical appraisal is the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context. It is an essential skill for evidence-based medicine because it allows clinicians to find and use research evidence reliably and efficiently . Seminar leaders: Dr. Wil van der Sanden DDS PhD, senior researcher DGOH; Ir. Dominique Niesten MSc, DGOH project manager and researcher Subjects in oral health strategies and methods Public Oral Health The difference between the traditional definition of health and modern concepts of health has major implications for oral health care in your home country. You will discuss determinants for (oral) health and the environmental determinants that should be taken into account in strategies to reduce (oral) health inequities. You will learn to explain the difference in perception of oral health by the community and oral health professionals (perceived need versus professional need). Likewise, you will be trained to define conditions needed for improvement of a future oral health care system in your country. The gap between Primary Health Care (PHC) theory and the current situation of oral health care in your country will be addressed. You will study the book Basic Package of Oral Care (BPOC), which includes three components: Oral Urgent Treatment (OUT), Affordable Fluoride Toothpaste (AFT) and Atraumatic Restorative Treatment (ART). You will study and discuss these components in seminars. You will also learn about the approach of policy makers and NGO’s when developing demonstration projects. Additionally, the concept of shortened dental arch (SDA) and its suitability for application in your home country will be discussed. Seminar leaders: Ass Professor Dr Jo Frencken DDS PhD, Head of DGOH; Prof. Dr Nico Creugers DDS PhD Atraumatic Restorative Treatment The Atraumatic Restorative Treatment (ART) approach consists of manually cleaning of cavities using hand instruments. You will study the filling of cavities and adhesive, fluoride-releasing restorative materials in theory and practise in the skills lab. You will practise the application of ART sealants in pits and fissures and discuss the evidence of enamel caries prevention. The treatment of dental caries by ART is shown to not be limited to the dental clinic. You will study the effectiveness in rural areas without electricity through literature investigation. You will be taught to use and to transfer the acquired ART principles and skills as a teacher in ART for local ancillary dental personnel. Seminar leader: Ass. Professor Jo Frencken DDS PhD, Head of DGOH and coordinator of the World Health Organization's " Global initiative on ART" program. 3
  • 4. Basic Periodontal Care The module Basic Periodontal Care covers the etiology of periodontal disease and patient’s self care. Symptoms of gingivitis and periodontitis will be demonstrated in the skills lab and you will practise the proper recording of the different variables on periodontal charts. The prevention and treatment sessions deal with personal home care and professional debridement. You will discuss the instruments needed for an adequate sub gingival scaling and practice in the skills lab. Seminar leader: Dr Ruud Karsten DDS periodontologist Use of direct adhesive procedures and materials in emergency oral care Research in adhesive dentistry and consequent rapid improvements of materials and techniques force dentists to revise their materials and procedures almost continuously. You will learn about the advantages and disadvantages of adhesive procedures. You will study the different adhesive materials in relation to bonding to tooth tissues, reduction of micro leakage, internal coherence of the tooth and repair. In particular, you will learn about treatments that are carried out to repair tooth fractures and those for aesthetic reasons. This will be demonstrated by a so-called veneer restoration used to mask teeth with a discoloration or a deviating shape or position. You will get the opportunity to treat various types of tooth fractures and obvious discoloured teeth placed in a phantom head in a skills laboratory. Seminar leaders: Dr Wil van der Sanden DDS PhD, Dr Jo Frencken DDS PhD Participant Requirements Minimum of five years university training in dentistry that has resulted in a BDS or DDS diploma and a minimum of 3 years work experience in public oral health and / or oral health training. Dental therapists, dental nurses and dental technicians need not apply. Textbooks and Reading The students will be provided with relevant study material concerning: public oral health, BPOC, ART, Functional masticatory system, Basic periodontal care, Direct adhesive procedures, problem based learning, research methodology, critical appraisal techniques, and evidence based dentistry. Information: Ms Janny Wijmenga j.wijmenga@dent.umcn.nl +31 24 361 69 95 Ms Dominique Niesten d.niesten@dent.umcn.nl +31 24 361 64 11 Address: P.O. Box 9101; 6500 HB Department of Global Oral Health College of Dental Science, Radboud University Nijmegen Medical Centre, The Netherlands Phone: + 31 (0)24 3616995 Fax : + 31 (0)24 3541971 4
  • 5. Web: www.globaloralhealth-nijmegen.nl A detailed course schedule will be available in March/ April 2011. 5