I. Section/SIG Name: Community and Preventive Dentistry
II. Councilor/Chair (SIG only) Contact Information
Dr. Vladimir Spolsky, DMD, MPH
Public Health and Community Dentistry
UCLA School of Dentistry
III. 2007-2008 Section/SIG Activities
Describe section/SIG activities and projects during the past year. Take this opportunity
to highlight innovative activities and projects. Note projects with a national scope and/or
collaborative work with other sections, organizations, and institutions.
A. List the Section/SIG activities:
• Newsletter (either electronic or print): yes/no
• Community of Interest: established or on-going
• Project Pool Submission: yes/no
• Project Pool Submission funded: yes/no
o If yes: Title:
o Regional: yes/no
o National: yes/no
o ADEA Annual Session
Co-sponsored by Section on Pediatric Dentistry.
B. What reflects the best example of your Section/SIG activities?
During the last few years, the Section on Community and Preventive Dentistry has had an
outstanding success at the association and national levels through: 1) successful annual
programs, 2) corporate sponsorship of annual programs, 3) success with Pool Project funding,
and 4) Inter-disciplinary collaboration with other health professions through the Taskforce or
the Association of Teachers of Preventive Medicine (ATPM).
A summary of Section’s impact and achievements:
Until now, the section has sponsored/co-sponsored three projects that received funding from
Project Pool Funds
• Current Status of Dental Public Health Faculty in the U.S. Dental Schools
• Soft Drinks and Dental health: Development of an Educational Material
• Development of a Smoking Cessation Training Program in a Dental School Settings
(A summary of this project can be found at the end of this report)
The first project resulted in two peer-reviewed publications in the Journal of Public Health
Dentistry and about 5 poster presentations at the meetings of the American Dental Education
Association and National Oral health Conference.
The second project resulted in an outstanding DVD which was shown to the Council of Sections
during 2006 annual meeting in Orlando
The section’s collaborative work with the other health professions through the Association of
Teachers of Preventive Medicine (ATPM), continue to bring national visibility to the section as
well as the ADEA. The collaborative work has so far resulted in a symposium at the
AADR/ADEA meeting in Baltimore (2005) and Round Table Luncheon Discussions at the
National Oral Health Conference (2004, 2005 and 2006). Additional information about this
collaborative work is available from the following published articles and the ADEA website:
• Allan J, et al. Clinical Prevention and Population Health: Curriculum Framework for
Health Professions. American Journal of Preventive Medicine 2004; 27(5): 471-6.
• Riegelman RK, et al. Why a clinical Prevention and Population Health Curriculum
Framework? American Journal of Preventive Medicine 2004; 27(5): 477.
• Carmona RH. Healthy People Curriculum Taskforce: A Commentary by the Surgeon
general. American Journal of Preventive Medicine 2004; 27(5): 478-9.
• Carey TS, Roper WL. Clinical Prevention and Population Health: Getting There from
Here American Journal of Preventive Medicine 2004; 27(5): 480-1.
The 2007 ADEA House of Delegates endorsed this project.
IV. Membership and Attendance
Access the section membership list and reference the “Members’ Forum Attendance
Roster” provided in the section/SIG information packet to report the following:
A. Total membership for the section as of March 2008:
B. Total attendance at the section’s 2008 Members’ Forum: 33
V. Section Structure (submitted separately)
A. List current contact information for the Section/SIG officer.
B. Describe section structure—other than the four officers—if one exists. Provide
information about regional, national, and international networks. If deemed
appropriate: list additional contact information for reference.
The immediate past chair will serve as a mentor to the newly elected
VI. Financial Status
Each year prior to the Annual Session, ADEA compiles a list of all corporations,
organizations, and foundations that support ADEA activities and programs for publication
in the House of Delegates Manual. This compilation is the basis for honoring these
sponsors at the Annual Session. This information related to section activities is gathered
from your section annual report. If the section receives no external financial support,
note “N/A.” Include the following information:
A. Current Section Balance:
B. Organizations (and contact persons) providing financial support for section activities:
Kerry Maguire, DDS, MSPH
Director, Professional Advocacy
Tom’s of Maine
302 Lafayette Center
Kennebunk, ME 04043
C. Purpose of the support (program, reception, newsletter, etc.), number of participants
and recipients, and other details:
Refreshments and snacks during Members’ Forum.
D. The type of funding: donation or gifts-in-kind, and amount of funding.
The section received a donation of Eight Hundred Dollars.
VII. Meeting Minutes (copy/paste Word document into the field)
American Dental Education Association Annual Meeting
Community and Preventive Dentistry Section
Dallas, Texas 75207
Business Meeting Minutes
March 31, 2008
Call to Order
The annual meeting of the Community and Preventive Dentistry section was called to
order the section chair, Christine Miller. The chair asked the section officers to introduce
themselves. Likewise, she asked the members to introduce themselves and give a brief
description of the activities in which they are involved.
Douglas M. Simmons
Douglas S. Ramsay
Jane M Steffensen
Approval of Minutes
The minutes from last year’s section meeting was read by the secretary and approved.
Vladimir Spolsky presented the councilor’s report and stated that the Section on
Community and Preventive Dentistry had another successful year.
The members engaged in a discussion about a new ADEA initiative, which will allow its
members to publish through AAMC’s med portal. Several members presented ideas
about how the section can use this resource.
The chair conducted an election for the position of section secretary. Jane Steffensen
was unanimously elected as the next secretary. In keeping with section policy, the
current chair-elect ascended to the position of chair and the secretary ascended to the
position of chair-elect. As a result, Sena Narendran became section chair and Douglas
Simmons became section chair-elect. Dr. Vladmir Spolsky will continue as councilor
since his term is not completed.
Sena Narendran gave a report about previous awards to section from the Project Pool
funds. We are currently waiting for a final report from the “Smoking Cessation Training
Programs in Dental Schools” project.
Prof. Christine Miller recommended that the immediate past chair serve as a mentor for
the incoming secretary. Toward that end, she volunteered to mentor Jane Steffensen
about the duties of the section secretary. Christine Miller also volunteered to restart the
Sena Narendran recalled a time when the section officers would meet for breakfast
after our annual meeting to begin planning for the next year’s meeting. As a follow-up
to his musing, the section officers agreed to meet for breakfast Wednesday, May 2,
2008 at 8:45 am.
The section adopted a policy that the chair-elect will be responsible for organizing the
section program and the chair will be responsible for conducting the business meeting.
In addition, the chair will be responsible for submitting the section’s reports.
The meeting was adjourned until the next annual meeting of ADEA.
Minutes submitted by: Douglas M. Simmons
VIII. Additional Comments or Suggestions to the Administrative Board
Provide feedback to the COS Admin Board about section concerns, comments, or
- We would like to thank the Council of Section liaison (Dr. Michael Landers) for
attending the section business meeting in Dallas. It was refreshing to have the liaison at
the meeting after a gap of 2-3 years.
- The previous version of the annual report template was user-friendlier than the
current one; perhaps it’s better to eliminate the lines in the template.
- It’s not appropriate to compute the mean/average for the first item on the evaluation
form, as the item is not on a Likert scale.
- It may be redundant to have the officers’ list in the annual report as it is already
available on the section website; having said that the officers’ list has not yet been
updated on the ADEA website.
- The section should be free to decide as to who is responsible for the annual report and
as a matter of fact the officer update form has a question to that effect.
- The evaluation of the 2008 Members’ Forum by the participants was in general
better than that of the overall meeting.
- We would appreciate to have the deadline for the annual report to be on a
working day and not during the weekend, as it used to be in the past.
- Final report of the recently completed Project Pool Project sponsored by the
Community and Preventive Dentistry:
Submitted by the Principal Investigator, Brenda Heaton
The need for dental professionals to take a more active role in translating the relationship
between oral diseases and systemic conditions into clinical practice was identified through
survey results published in the Journal of the American Dental Association . In particular,
the study identified the role of dentists in promoting smoking cessation among their patients
thereby promoting not only the overall health of their patients but also improving the health of
the general public. However, according to the survey, more than half of the general dentists
viewed smoking-cessation activities as peripheral to dentistry—a view likely barring them from
performing such activities. It is likely that this peripheral view is associated with the lack of
smoking cessation curriculum that dentists experience during their formal education despite the
fact that smokers are at higher risk for a number of oral problems including oral cancer,
periodontal diseases, halitosis, tooth discoloration, and oral mucosal lesions not to mention the
significant tolls on overall health and decrease in the quality and duration of life.
The goal of this project was to assess what smoking cessation curriculum and training, if any,
existed here at Boston University Goldman School of Dental Medicine and what students’
knowledge, attitudes and practices were with respect to their role in providing smoking
cessation counseling. As a result, we were hoping to develop and test a curriculum plan infused
with smoking cessation education. After a year since funding, the student surveys and
curriculum evaluation have been completed and analyzed while curriculum development and
testing is still forthcoming.
The short term outcomes include a report of the knowledge, attitudes, and behaviors of dental
students and faculty members and a unified and improved mechanism for providing smoking
cessation training in dental schools.
II. Project Implementation
a. Student Survey
The survey used for the Prevention and Cessation Education [PACE] program was modified to
address the experiences and role of dental health professionals in fall of 2006. The modified
survey was reviewed by Dr. Michelle Henshaw and Dr. Judith Jones, to ensure its
appropriateness and completeness before being administered to the dental student body. The
survey was administered to the entire dental student body, years 1 though 4, as opposed to
what was outlined in the original proposal which identified only 2nd and 4th year students. This
was done in order to provide an internal comparison group and also provided us with a
“baseline” measure through the inclusion of first year students in their first semester of the
dental school curriculum. Surveys were administered in courses which encouraged attendance
or where attendance was mandatory. In all, 362 students completed the survey which was
comprised of 109 first years, 61 second years, 88 third years and 104 fourth years. Survey
administration was completed between October of 2006 and March of 2007 with an overall
response rate of 79%. Data entry and cleaning was completed by a dental assistant and
conducted over several months.
b. Curriculum Evaluation
In order to promote cooperation among the faculty, an email was sent out by the Associate
Dean of Academic Affairs, Dr. Jeffrey Hutter, which identified the project director (Brenda
Heaton), the purpose of the project and provided encouragement for completing the curriculum
evaluation. Course directors were asked to provide the amount of time (in minutes) that is spent
on tobacco related content within each of the different teaching categories such as didactic,
skills training, applied skills, etc. They were further asked to identify the tobacco content, what
materials and handouts, if any, were used and lastly whether or not the tobacco content
delivered in their course was evaluated via a test, exam or observation. Course directors were
contacted via email from Dean Hutter three different times and also received follow-up
telephone calls conducted by the Project Director as well as an Administrative Assistant.
Recruitment of faculty participants occurred over a matter of about three months. In the end,
only 29 of 44 or 66% of course directors participated. Given the nature of the courses directed
by the non-responding faculty, it can be assumed that little, if any, tobacco content is included in
c. Faculty survey
The purpose of the faculty survey was to identify areas in which the institution may or may not
be poised for curricular change. The faculty survey was completed by Dr. Judith Jones,
Professor and Chair of General Dentistry and by the Associate Dean of Academic Affairs at the
time, Dr. Jeffrey Hutter.
III. Project Findings
a. Student Survey
In all, 362 students across all four dental school years completed surveys. The overall response
rate, based on an expected class size of 115, was 79%. The mean age of all respondent was
25.65 years. Approximately half of the students in all classes were female. Among all
respondents, 53% intended to enter into General Practice, 16% intended to go on to do a
specialty and 29% indicated that they were not sure. Those intending to enter General Practice
increased from 38% among the first year students to 69% among the fourth years, from 15% to
22% for Specialty and 32% to 8% for those that were not sure. On average, males were twice
as likely to intend on entering a specialty. Thirty percent of students reported having a smoking
habit at some time in their lives while 70% reported having never smoked a cigarette.
The overwhelming majority of students reported having never been taught to do tobacco
counseling in case-based discussion, simulated patient encounters, clinical skills course, nor
web-based education exercises. Fourth year students reported more experience in general, but
over half of the students still reported having never been taught in all of the above settings. The
large majority (81%) also report that faculty has not instructed them on how to make a referral
for smoking. However, the large majority of students report that they are interested in learning
more about the health effects of tobacco, receiving tobacco cessation training and information
on nicotine replacement therapy.
Overall, there was a minimal to moderate level of knowledge among students and this did not
generally differ significantly across class year. Only 36% of students across all classes knew
that smoking rates had decreased slightly since the 1990’s and 41% knew what percentage of
smokers were seen by a dentist annually. Approximately one-third of students knew the health
benefits of smoking cessation but 1st years were 30-68% more likely to identify the health
benefits compared to other classes. Half of the students knew that Nicotine Replacement
Therapy was twice as effective as cold turkey in terms of strategies for smoking cessation. Only
9% of students overall were able to identify the 5 A’s (ask, advise, assess, assist and arrange)
from a group of choices but this differed significantly across grades; 9%, 2%, 26% and 8% for
1st through 4th years, respectively. Very few students were able to identify FDA and Public
Health Service-recommended treatments for smoking cessation from a group of choices. Of six
appropriate choices, only 6% could identify all six, 6%, 12%, 23%, 39% and 14% for five, four,
three, two and one of six, respectively.
In general, attitudes toward tobacco counseling did not differ significantly across class years.
The large majority agreed that they were able to prevent some young patients from smoking,
convince some patients to quit as well as to have an impact on smoking behaviors.
Interestingly, however, 4th year students were the least likely to strongly agree with these
statements. In contrast, fourth year students were twice as likely to agree or strongly agree that
they could advise patients about the use of NRT compared to both 1st and 2nd years and 30%
more likely than 3rd years. While they felt confident in their ability, they did not display the
knowledge necessary to do so. There were negligible differences by student year in confidence
levels for discussing smoking with children, adolescents, and their parents and in general and
about half of the students tended to agree that they were capable and confident in doing so.
With regard to implementing the 5 A’s into practice, the majority of students reported poor skill
levels as indicated in Table 1 (attached). Interesting to note is that 4th years reported
significantly lower skill for ‘Advising’ and ‘Assessing’ than any other class year.
Rates for observation of smoking cessation activities conducted by a dentist were relatively low
(see Table 2, attached). Large percentages of students have never seen a dentist take a
smoking history or discuss smoking with his/her patient. Even more surprising is that there was
still approximately half of the fourth years who reported never having seen a dentist counsel a
child about smoking prevention, give tobacco counseling to a pregnant woman nor talk with a
parent about environmental tobacco smoke. A remaining third of the fourth year class also
reported having never seen a dentist take a smoking history and a quarter of them never
observing a dentist counsel patients to quit smoking.
Students were asked to recall if they had been taught a variety of tobacco counseling skills at
least 4 times during their dental school experience. Fourth year students were three times as
likely to have been instructed to take a patient’s smoking history than any other class year.
However, 23% of them still reported having never been instructed to do so. Approximately half
of the students reported having never been instructed to counsel a patient to quit smoking.
Experience with this, however, did increase according to class year and 57% of fourth years
reported having at least some instruction in regards to cessation counseling. The majority of
students also reported having no instruction related to counseling children about smoking
prevention, talking with patients about smoking in pregnancy and talking with a parent about
environmental tobacco smoke.
The overwhelming majority of students reported that they had not been taught to counsel a
smoking parent at a pediatric appointment, how to use the 5A’s, how to appropriately prescribe
nicotine replacement therapy, how to assess nicotine dependence in children, how to employ
culturally competent strategies and how to include family members when they are talking about
smoking and this did not deviate significantly across class years.
b. Curriculum Evaluation
From participating course directors, a total of 495 minutes, 8.25 hours of tobacco related
content was reported to be included across the four year curriculum. Courses which included
tobacco related content included Molecular Genetics, Pathology, Professional Ethics, Oral
Diagnosis and Radiology, Preventive Dentistry, Behavioral Sciences, Preclinical Occlusion, and
Pharmacology. Preventive Dentistry and Oral Pathology logged the most minutes of time
dedicated to tobacco, but only Preventive Dentistry covered topics related to smoking
cessation. All but Pharmacology and Oral Pathology, which are taught in the third year, are
taught in the first two years of the dental school curriculum, prior to a student engaging in any
patient clinical activities. No tobacco content was reported in the fourth year. Most all tobacco
content was delivered via power point slides and on occasion evaluated through exams. In the
120 minutes spent in Oral Pathology, the course director reported that during clinical
consultations with students, they may require a tobacco consult, but the majority of students will
not experience this.
c. Faculty Survey
The faculty survey revealed that topics related to smoking cessation have not yet been included
in competencies nor expected skills to be learned during clinical rotations. However, faculty
responses indicate favorable attitudes towards implementing change into the curriculum.
Additional work on identifying barriers to implementing change is forthcoming with other school
Project implementation encountered several challenges in each of the phases outlined below.
a. Student Survey
For both second and fourth year students, because of the nature of their curriculum schedule, it
was difficult to identify an ideal opportunity for surveying the entire class. Therefore,
participation suffered in both of these class years. Additionally, in both second and fourth year
groups, “Advanced Standing” students were present in the classroom being surveyed and their
responses were therefore included with no way to separate them out. This was not originally
anticipated and therefore, responses from both advanced standing students and traditional pre-
doctoral students are included in the findings.
b. Curriculum Evaluation
A detailed explanation of the expectations of the course director when completing the
evaluation was included in the emailed letter from the Associate Dean of Academic Affairs.
However, course directors rarely adhered to the items requested of them and thus resulted in a
lot of missing information in terms of the details of tobacco related content. Additionally, as
mentioned before, it was very difficult to get the faculty participation despite the Dean’s
overwhelming support of the project. Data collection for this portion of the project also therefore
took much longer and required more man power then originally anticipated.
c. Curriculum Development
It was anticipated that upon preliminary findings, which were just completed in Fall of 2007, that
a meeting would be held with the curriculum committee and other key stake holders to discuss
opportunity for improvement and to begin to discuss approaches to curriculum development and
implementation. Despite the fact the BUGSDM does have a curriculum committee, it has not
held a meeting in the last year and one half and therefore a venue for this discussion has not
been available. As a result, the additional phases outlined in the original proposal have been
V. Next steps
Data analysis exploring predictors of student attitudes, knowledge and other correlations will
continue to be conducted. Data from the Boston University School of Medicine will be used to
provide a comparison and included in the final report of the student survey results which will be
presented to the Dean. It is my understanding that the curriculum committee will be meeting
before the end of the next quarter and I hope to have a presence at that meeting to begin the
next phase of this project.
In recent years, there has been a growing awareness that healthcare professionals, particularly
dental care providers, have the unique ability and responsibility to reach out to the American
public in an attempt to curb smoking and its devastating effects. In order for dentists to provide
optimal smoking cessation counseling to patients, it is crucial to develop an appropriate
curricular approach during pre-doctoral training.”
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