A Survey of Senior Dental Students ’ Experiences with Young Dental Patients in Pennsylvania
dental students ’ comfort with performing on oral exam in young individuals . The rationale for this finding may lie in the structure of the question in the survey that addressed students ’ comfort level with clinical exam of young children , without mentioning age , versus the specific question regarding willingness to see children younger than 2 years old . Responders may have been comfortable with the exam but not interested in performing continuing care to very young patients . Interestingly , willingness to take continuing education in pediatric dentistry did not affect the desire to see children younger than 2 years of age after graduation .
Our findings are consistent with those of other authors 13 , 14 , 15 , 17 , 18 who reported significant associations between attitudes and hands-on educational experiences with very young children . With the shortage of pediatric faculty and subsequent decreases in faculty-student ratios , patients demonstrating behavior management challenges or complex restorative care requiring close faculty supervision will probably not be accepted in pre-doctoral clinics . 11 Pediatric dental clinics increasingly rely on general dentists to teach pediatric dentistry , who may themselves feel less competent in dealing with the very young child . Young children are therefore often sent immediately to the graduate clinics for examination and treatment regardless of their dental needs . Pre-doctoral pediatric dentistry programs teach students to treat children four years of age and older , who are generally well-behaved . 11
This study was limited by the response rate as there is potential bias in that those students responding were those who enjoyed pediatric dentistry . In addition , this study did not attempt to distinguish those who were planning to enter an advanced program in pediatric dentistry . Students who did not enjoy pediatric didactic or clinical experience in dental school may have been oriented towards other specialties , introducing sampling bias .
The majority of graduating dental students from Pennsylvania dental schools have not performed or seen an infant exam performed while in dental school , and they do not plan to see children younger than two years of age in their own offices upon graduation . This continues to create a barrier to access to care for young children in the state . With general dentists staffing most of the federally qualified health centers in the state of Pennsylvania , it is critical to expose pre-doctoral dental students to clinical contact with very young patients . If general dentists provided screenings and anticipatory guidance for young healthy children , while referring children with more extensive needs to pediatric dentists , it is possible that more parents would access dental care for children at an earlier age . Given the survey design , it was not possible to separate responders by academic institution or geographic area , which could affect the generalizability of our findings . The results reported in this study must be interpreted with caution . This study was not designed with a priori sample size calculation , and several groups of responders had lower number of responses per cell , which could have influenced the statistical analysis .
Table 2 . Comparison between classroom instruction , clinical observation of a clinical exam of a child younger than 2 years old , and subject ’ s perceived comfort to do an exam on a young child .
Taught to do an oral exam in children < 2 yrs old in the classroom p = 0.002
YES NO
Observed an oral exam on a child < 2 yrs old ( clinical setting ) p = 0.01
YES NO
Subject ’ s perceived comfort to do an exam on a young child
Yes
No n = 53 n = 10 n = 57 n = 37
n = 34 n = 6 n = 75 n = 41
Total
63 94
40 116
30 September / October 2010 • Pennsylvania Dental Journal