TY - JOUR AU - Alreshaid, Lulwah AU - Alkattan, Rana PY - 2025/3/18 TI - Feedback From Dental Students Using Two Alternate Coaching Methods: Qualitative Focus Group Study JO - JMIR Med Educ SP - e68309 VL - 11 KW - student feedback KW - coaching KW - dental education KW - student evaluation KW - teaching methods KW - educational intervention N2 - Background: Student feedback is crucial for evaluating the effectiveness of institutions. However, implementing feedback can be challenging due to practical difficulties. While student feedback on courses can improve teaching, there is a debate about its effectiveness if not well-written to provide helpful information to the receiver. Objective: This study aimed to evaluate the impact of coaching on proper feedback given by dental students in Saudi Arabia. Methods: A total of 47 first-year dental students from a public dental school in Riyadh, Saudi Arabia, completed 3 surveys throughout the academic year. The surveys assessed their feedback on a Dental Anatomy and Operative Dentistry course, including their feedback on the lectures, practical sessions, examinations, and overall experience. The surveys focused on assessing student feedback on the knowledge, understanding, and practical skills achieved during the course, as aligned with the defined course learning outcomes. The surveys were distributed without coaching, after handout coaching and after workshop coaching on how to provide feedback, designated as survey #1, survey #2, and survey #3, respectively. The same group of students received all 3 surveys consecutively (repeated measures design). The responses were then rated as neutral, positive, negative, or constructive by 2 raters. The feedback was analyzed using McNemar test to compare the effectiveness of the different coaching approaches. Results: While no significant changes were found between the first 2 surveys, a significant increase in constructive feedback was observed in survey #3 after workshop coaching compared with both other surveys (P<.001). The results also showed a higher proportion of desired changes in feedback, defined as any change from positive, negative, or neutral to constructive, after survey #3 (P<.001). Overall, 20.2% reported desired changes at survey #2% and 41.5% at survey #3 compared with survey #1. Conclusions: This study suggests that workshops on feedback coaching can effectively improve the quality of feedback provided by dental students. Incorporating feedback coaching into dental school curricula could help students communicate their concerns more effectively, ultimately enhancing the learning experience. UR - https://mededu.jmir.org/2025/1/e68309 UR - http://dx.doi.org/10.2196/68309 ID - info:doi/10.2196/68309 ER - TY - JOUR AU - Mun, Michelle AU - Byrne, Samantha AU - Shaw, Louise AU - Lyons, Kayley PY - 2025/1/8 TI - Digital Dentists: A Curriculum for the 21st Century JO - JMIR Med Educ SP - e54153 VL - 11 KW - digital health KW - digital transformation KW - informatics KW - ehealth KW - dentistry KW - dental informatics KW - curriculum KW - competence KW - capability KW - dental education UR - https://mededu.jmir.org/2025/1/e54153 UR - http://dx.doi.org/10.2196/54153 ID - info:doi/10.2196/54153 ER - TY - JOUR AU - Nascimento da Silva Mulder, Júlia AU - Ramos Pinto, Marcelo AU - Aníbal, Isabelle AU - Dornellas, Paula Ana AU - Garrido, Deise AU - Huanca, Camila AU - Haddad, Estela Ana AU - Mendes Abdala, Verônica Carmen PY - 2024/11/27 TI - Teledentistry Applied to Health and Education Outcomes: Evidence Gap Map JO - J Med Internet Res SP - e60590 VL - 26 KW - teledentistry KW - systematic review KW - dental education KW - dentistry KW - telemedicine KW - research design KW - health information technologies KW - mobile phone N2 - Background: Teledentistry is a field of activities that comprises information and communication technologies (ICTs) applied to dentistry, including the exchange of clinical information, patient care, and the use of educational strategies across remote distances. Its use has grown progressively over the past decades?intensified by the COVID-19 pandemic?and has been improving the provision of dental services and educational strategies ever since. Objective: This evidence gap map (EGM) study aims to present a collection of systematic reviews (SRs) with meta-analyses to answer the question ?What are the applications of teledentistry in dental services and dental education?? by identifying gaps and current evidence on the improvement of health care and education. Methods: The EGM methodology has been developed by the Latin American and Caribbean Center on Health Sciences Information and is based on the concept created by the International Initiative for Impact Evaluation. Embase, PubMed, and Virtual Health Library databases were used for the literature research, using terms for teledentistry associated with eHealth, dental education, and oral health care. The data obtained from the included studies were then characterized in a Microsoft Excel spreadsheet, with a matrix containing 8 intervention groups (combined interventions, e-learning and tele-education, teleconsultation and teleservice, telemonitoring, telediagnosis, telescreening, ICTs, and artificial intelligence) and 8 outcome groups (diagnosis accuracy, education and professional training, user behavior, clinical practice, patient-centered outcomes, clinical outcomes, health services management, and access to health services). The quality of the studies was assessed using AMSTAR2 (A Measurement Tool to Assess Systematic Reviews). The visual analytics platform Tableau (Salesforce) was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects. Results: The confidence level obtained by the criteria applied was high for 28% (19/68) of the studies, moderate for 6% (4/68), low for 15% (10/68), and critically low for 51% (35/68). Among the interventions, the ICT group stood out with 182 (36.8%) out of 494 associations, followed by interventions with e-learning and tele-education (n=96, 19.4% of associations), telediagnosis (n=67, 13.6%), and combined interventions (n=53, 10.7%). Most of the outcomes were aimed at education and professional training (97/494, 19.6% of associations), patient-centered outcomes (74/494, 15%), and health services management (60/494, 12.1%). Conclusions: This EGM presents an overview of the contributions of teledentistry in patient care, health services, clinical practice, and education. The study results may help guide future research and policy decisions and serve as a convenient virtual tool for accessing valuable evidence-based information on teledentistry. UR - https://www.jmir.org/2024/1/e60590 UR - http://dx.doi.org/10.2196/60590 UR - http://www.ncbi.nlm.nih.gov/pubmed/39602783 ID - info:doi/10.2196/60590 ER - TY - JOUR AU - Pang, MengWei AU - Lu, WeiYu AU - Huang, Chuling AU - Lin, Meixiu AU - Ran, Jiangsheng AU - Tang, Xiaomei AU - Huang, YuanDing AU - Yang, Sheng AU - Song, Jinlin PY - 2024/11/11 TI - Development of an Interprofessional Education Project in Dentistry Based on the Positive Behavior Support Theory: Pilot Curriculum Development and Validation Study JO - JMIR Form Res SP - e50389 VL - 8 KW - innovative interprofessional education KW - dentistry KW - dental technology KW - positive behavior support KW - IPE KW - positive behavior KW - training system KW - dental education KW - N2 - Background: Effective interprofessional education (IPE) can facilitate teamwork between dentists and dental technicians, thereby enabling the efficient provision of high-quality dental care. Objective: This study aimed to design and assess an IPE module named Project 35, which was offered to dental and dental technology students early in their undergraduate training as a precursor to a more comprehensive IPE curriculum in dentistry and dental technology. Methods: Leveraging positive behavior support (PBS) theory, Project 35 was devised as an innovation and entrepreneurship educational training framework. It used project-based learning to cultivate teamwork skills and to promote the professional development of dental and dental technology students. The pilot study was designed to present the IPE module and preliminarily assess its validity. In survey 1, which was conducted immediately after the course, the dental and dental technology students? self-reported skill acquisition and attitudes were assessed and compared. Survey 2, conducted 1 year after the course, focused on the comparative benefits of Project 35 training for dental technology students versus an untrained group. Results: A total of 66 students, including 36 dental students and 30 dental technology students who had undertaken the training, were recruited. Project 35 training improved teamwork skills for students in both disciplines comparably, and the students recognized the training as highly valuable and effective. The mean values for all items indicating skills improvement of students ranged from 4.13 (SD 0.797) to 4.63 (SD 0.495) for dental students and from 4.13 (SD 0.869) to 4.74 (SD 0.619) for dental technology students. Among the dental technology students, the trained group showed greater independent and innovative approaches and was more optimistic about the future of the profession than the nontrained group (P<.05). Conclusions: Despite the small sample size, the validity of the Project 35 training system was evident, and the success of our pilot study provides a sound basis for the future development of IPE in clinical dental and dental technology education programs. UR - https://formative.jmir.org/2024/1/e50389 UR - http://dx.doi.org/10.2196/50389 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/50389 ER - TY - JOUR AU - Claman, Daniel AU - Sezgin, Emre PY - 2024/9/27 TI - Artificial Intelligence in Dental Education: Opportunities and Challenges of Large Language Models and Multimodal Foundation Models JO - JMIR Med Educ SP - e52346 VL - 10 KW - artificial intelligence KW - large language models KW - dental education KW - GPT KW - ChatGPT KW - periodontal health KW - AI KW - LLM KW - LLMs KW - chatbot KW - natural language KW - generative pretrained transformer KW - innovation KW - technology KW - large language model UR - https://mededu.jmir.org/2024/1/e52346 UR - http://dx.doi.org/10.2196/52346 ID - info:doi/10.2196/52346 ER - TY - JOUR AU - Clouet, Roselyne AU - Gaudin, Alexis AU - Tourtelier, Jeanne AU - Gogendeau, Claire AU - Serisier, Samuel AU - Prud'homme, Tony PY - 2024/9/13 TI - Analyzing the Influence of Video Game and Music Engagement on Technical Skills Acquisition in Dental Students in Preclinical Phase: Protocol for a Prospective, Controlled, Longitudinal Study JO - JMIR Res Protoc SP - e55738 VL - 13 KW - video game KW - music practice KW - dental education KW - technical skills KW - simulation KW - video games KW - music KW - preclinical skills KW - dental students KW - dental student KW - pre-clinical phases KW - longitudinal investigation KW - dentistry KW - gestures KW - gesture KW - preclinical training KW - training KW - protocol KW - tool KW - tools KW - cognitive skills, mobile phones N2 - Background: The practice of dental surgery requires a few different skills, including mental rotation of an object, precision of movement with good hand-eye coordination, and speed of technical movement. Learning these different skills begins during the preclinical phase of dental student training. Moreover, playing a musical instrument or video game seems to promote the early development of these skills. However, we found that studies specifically addressing this issue in the field of dental education are lacking. Objective: The main aims of this study are to evaluate whether the ability to mentally represent a volume in 3D, the precision of gestures with their right and left hand, or the speed of gesture execution is better at baseline or progresses faster for players (video games or music or both). Methods: A prospective monocentric controlled and longitudinal study will be conducted from September 2023 and will last until April 2025 in the Faculty of Dental Surgery of Nantes. Participants were students before starting their preclinical training. Different tests will be used such as Vandenberg and Kuse?s mental rotation test, the modified Precision Manual Dexterity (PMD), and performing a pulpotomy on a permanent tooth. This protocol was approved by the Ethics, Deontology, and Scientific Integrity Committee of Nantes University (institutional review board approval number IORG0011023). Results: A total of 86 second-year dental surgery students were enrolled to participate in the study in September 2023. They will take part in 4 iterations of the study, the last of which will take place in April 2025. Conclusions: Playing video games or a musical instrument or both could be a potential tool for initiating or facilitating the learning of certain technical skills in dental surgery. International Registered Report Identifier (IRRID): DERR1-10.2196/55738 UR - https://www.researchprotocols.org/2024/1/e55738 UR - http://dx.doi.org/10.2196/55738 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/55738 ER - TY - JOUR AU - Liu, KeXin AU - Xu, YaQian AU - Ma, ChaoYi AU - Yu, Na AU - Tan, FaBing AU - Li, Yi AU - Bai, YaXin AU - Fu, XiaoMing AU - Wan, JiaWu AU - Fan, DongQi AU - Yin, HuBin AU - Chen, MeiXi AU - Chen, HongJi AU - Jiang, Lin AU - Song, JinLin AU - Ji, Ping AU - Zhao, XiaoHan AU - Pang, MengWei PY - 2024/4/5 TI - Efficacy of a Virtual 3D Simulation?Based Digital Training Module for Building Dental Technology Students? Long-Term Competency in Removable Partial Denture Design: Prospective Cohort Study JO - JMIR Serious Games SP - e46789 VL - 12 KW - removable partial denture KW - RPD KW - virtual simulation KW - dental technology KW - computer-aided design KW - CAD KW - clinical practice KW - efficacy KW - cohort study KW - digital training KW - training KW - dentistry KW - treatment KW - design KW - virtual KW - assessment N2 - Background: Removable partial denture (RPD) design is crucial to long-term success in dental treatment, but shortcomings in RPD design training and competency acquisition among dental students have persisted for decades. Digital production is increasing in prevalence in stomatology, and a digital RPD (D-RPD) module, under the framework of the certified Objective Manipulative Skill Examination of Dental Technicians (OMEDT) system reported in our previous work, may improve on existing RPD training models for students. Objective: We aimed to determine the efficacy of a virtual 3D simulation?based progressive digital training module for RPD design compared to traditional training. Methods: We developed a prospective cohort study including dental technology students at the Stomatology College of Chongqing Medical University. Cohort 1 received traditional RPD design training (7 wk). Cohort 2 received D-RPD module training based on text and 2D sketches (7 wk). Cohort 3 received D-RPD module pilot training based on text and 2D sketches (4 wk) and continued to receive training based on 3D virtual casts of real patients (3 wk). RPD design tests based on virtual casts were conducted at 1 month and 1 year after training. We collected RPD design scores and the time spent to perform each assessment. Results: We collected the RPD design scores and the time spent to perform each assessment at 1 month and 1 year after training. The study recruited 109 students, including 58 (53.2%) female and 51 male (56.8%) students. Cohort 1 scored the lowest and cohort 3 scored the highest in both tests (cohorts 1-3 at 1 mo: mean score 65.8, SD 21.5; mean score 81.9, SD 6.88; and mean score 85.3, SD 8.55, respectively; P<.001; cohorts 1-3 at 1 y: mean score 60.3, SD 16.7; mean score 75.5, SD 3.90; and mean score 90.9, SD 4.3, respectively; P<.001). The difference between cohorts in the time spent was not statistically significant at 1 month (cohorts 1-3: mean 2407.8, SD 1370.3 s; mean 1835.0, SD 1329.2 s; and mean 1790.3, SD 1195.5 s, respectively; P=.06) but was statistically significant at 1 year (cohorts 1-3: mean 2049.16, SD 1099.0 s; mean 1857.33, SD 587.39 s; and mean 2524.3, SD 566.37 s, respectively; P<.001). Intracohort comparisons indicated that the differences in scores at 1 month and 1 year were not statistically significant for cohort 1 (95% CI ?2.1 to 13.0; P=.16), while cohort 3 obtained significantly higher scores 1 year later (95% CI 2.5-8.7; P=.001), and cohort 2 obtained significantly lower scores 1 year later (95% CI ?8.8 to ?3.9; P<.001). Conclusions: Cohort 3 obtained the highest score at both time points with retention of competency at 1 year, indicating that progressive D-RPD training including virtual 3D simulation facilitated improved competency in RPD design. The adoption of D-RPD training may benefit learning outcomes. UR - https://games.jmir.org/2024/1/e46789 UR - http://dx.doi.org/10.2196/46789 ID - info:doi/10.2196/46789 ER - TY - JOUR AU - Lee, Minjung AU - An, Youn So AU - Ihm, Jungjoon PY - 2024/3/8 TI - Dental Students? Satisfaction With Web-Based Learning During the Initial Phase of the COVID-19 Pandemic: Mixed Methods Study JO - J Med Internet Res SP - e50278 VL - 26 KW - web-based learning KW - student satisfaction KW - transactional distance theory KW - health profession education KW - COVID-19 N2 - Background: The COVID-19 pandemic has precipitated an accelerated shift in education, moving from traditional learning to web-based learning. This transition introduced a notable transactional distance (TD) between the instructors and learners. Although disease control and staff and students? safety are the top priorities during a pandemic, the successful delivery of education is equally crucial. However, the ramifications of this swift transition are particularly critical in the context of dental education. Dental education is inherently practice oriented, necessitating hands-on training and manual skills development, which poses unique challenges to distance learning approaches. Objective: This study aims to examine dental students? web-based learning satisfaction and experience of TD, investigate the predictors of web-based learning satisfaction, and explore the perceptions of students about the advantages and disadvantages of web-based learning. Methods: This study explored the factors associated with web-based learning satisfaction using TD theory during the transition to web-based education. Psychological factors that could influence satisfaction were adapted from the health belief model. We conducted a cross-sectional web-based survey of 345 dental students from 2 institutions in South Korea who were enrolled in the spring semester of 2020. Data were collected between July 8 and September 14, 2020. Qualitative analysis was used to examine responses to open-ended questions concerning perceptions of web-based learning. Results: A multivariate hierarchical linear regression model was used to analyze the effects of student characteristics, TD, and psychological factors (ie, perceived risk of infection and efficacy belief of web-based learning) on web-based learning satisfaction. The average score for web-based learning satisfaction was 3.62 (SD 0.84), just above the midpoint of the possible range (1-5). Self-regulated learning (?=0.08; P=.046), learner-instructor interaction (?=0.08; P=.03), and learner-content interaction (?=0.64; P<.001) were associated with higher levels of satisfaction. Moreover, a significant association was revealed between high efficacy beliefs in web-based learning (?=0.20; P<.001) and satisfaction. Although the learning structure (synchronous vs asynchronous) did not exhibit a significant association with satisfaction, the qualitative analysis results revealed that each structure possesses distinct strengths and weaknesses. The students in synchronous learning (79/345, 22.9%) recognized heightened autonomy in the ?learning environment? (19/79, 24%); however, technical issues (28/79, 35%) and reduced concentration (15/79, 19%) were identified as downsides. Conversely, the students in asynchronous settings (266/345, 77.1%) emphasized unlimited access to learning content (74/266, 27.8%) and the flexibility of ?learning in preferred time? (69/266, 25.9%). Nevertheless, challenges, such as self-management difficulties (66/266, 24.8%) and limited interactions (55/266, 20.7%), were evident. Conclusions: The findings suggest that efforts to minimize TD, facilitating self-regulated learning and interaction among students and instructors, are critical for achieving web-based learning satisfaction. Moreover, establishing a common understanding among students regarding the necessity and efficacy of web-based learning during epidemics could enhance their satisfaction. UR - https://www.jmir.org/2024/1/e50278 UR - http://dx.doi.org/10.2196/50278 UR - http://www.ncbi.nlm.nih.gov/pubmed/38457808 ID - info:doi/10.2196/50278 ER - TY - JOUR AU - Al-Sbei, Rasha AU - Ataya, Jawdat AU - Jamous, Issam AU - Dashash, Mayssoon PY - 2024/3/5 TI - The Impact of a Web-Based Restorative Dentistry Course on the Learning Outcomes of Dental Graduates: Pre-Experimental Study JO - JMIR Form Res SP - e51141 VL - 8 KW - restorative dentistry KW - online learning KW - dental education KW - dental graduates KW - Syria KW - education KW - dental KW - dentistry KW - dental practice KW - effectiveness KW - educational program KW - survey N2 - Background: Restorative dentistry plays a crucial role in dental practice, necessitating professionals to stay abreast with the latest advancements in the field. The advancement of technology has made web-based learning a widely used method of education delivery in dentistry, providing learners with extensive information and flexibility. Objective: This study aims to evaluate how effective an online educational course in restorative dentistry is for dental graduates in Syria. Methods: This study used a pre-experimental study design, with pretest and posttest assessments to measure changes in participants? knowledge and skills. A total of 21 dental graduates completed the online course in restorative dentistry, which was hosted on Moodle, using the learning management system of the Syrian Virtual University. Participants were provided with a suggested learning sequence and had the flexibility to navigate the course on their own and at their own pace. The course was developed based on the principles of web course design and web-based course development using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) general instructional design model. The pretest and posttest assessments consisted of 50 multiple-choice questions with a single correct answer, aligning with the course content. Furthermore, participants were asked to complete a course acceptance survey upon finishing the course. Results: The results showed a significant improvement in the participants? knowledge of restorative dentistry, supported by a statistically significant P value of less than .05. The effect size of the difference between the pre and posttest indicated that the effect size, as indicated by ?2, demonstrated a significant 62.1% difference between the pre and posttest, indicating a high and statistically significant effect. Furthermore, the value derived from the Haridy obtained work ratio formula indicated that the educational program was effective, with an effectiveness amount of 3.36%. Additionally, 93% (n=19) of respondents expressed confidence in having gained the expected benefits from the educational course upon its completion. Conclusions: The findings indicated a notable enhancement in the participants? understanding of restorative dentistry. The participants? high satisfaction rate and positive feedback from the course acceptance survey further emphasize the favorable reception of the web-based learning approach. This study highlights the potential of web-based learning in dental education, opening the door for future research in this area. The findings of this study carry important implications for the design and implementation of web-based educational programs in dentistry, suggesting that such programs can serve as an effective tool for continuous professional development in the field. UR - https://formative.jmir.org/2024/1/e51141 UR - http://dx.doi.org/10.2196/51141 UR - http://www.ncbi.nlm.nih.gov/pubmed/38441921 ID - info:doi/10.2196/51141 ER - TY - JOUR AU - Mareli?, Marko AU - Klasni?, Ksenija AU - Vuku?i? Rukavina, Tea PY - 2024/2/27 TI - Measuring e-Professional Behavior of Doctors of Medicine and Dental Medicine on Social Networking Sites: Indexes Construction With Formative Indicators JO - JMIR Med Educ SP - e50156 VL - 10 KW - e-professionalism KW - social media KW - formative index KW - social networking KW - doctors KW - medical KW - dental medicine N2 - Background: Previous studies have predominantly measured e-professionalism through perceptions or attitudes, yet there exists no validated measure specifically targeting the actual behaviors of health care professionals (HCPs) in this realm. This study addresses this gap by constructing a normative framework, drawing from 3 primary sources to define e-professional behavior across 6 domains. Four domains pertain to the dangers of social networking sites (SNSs), encompassing confidentiality, privacy, patient interaction, and equitable resource allocation. Meanwhile, 2 domains focus on the opportunities of SNSs, namely, the proactive dissemination of public health information and maintaining scientific integrity. Objective: This study aims to develop and validate 2 new measures assessing the e-professional behavior of doctors of medicine (MDs) and doctors of dental medicine (DMDs), focusing on both the dangers and opportunities associated with SNSs. Methods: The study used a purposive sample of MDs and DMDs in Croatia who were users of at least one SNS. Data collection took place in 2021 through an online survey. Validation of both indexes used a formative approach, which involved a 5-step methodology: content specification, indicators definition with instructions for item coding and index construction, indicators collinearity check using the variance inflation factor (VIF), external validity test using multiple indicators multiple causes (MIMIC) model, and external validity test by checking the relationships of the indexes with the scale of attitude toward SNSs using Pearson correlation coefficients. Results: A total of 753 responses were included in the analysis. The first e-professionalism index, assessing the dangers associated with SNSs, comprises 14 items. During the indicators collinearity check, all indicators displayed acceptable VIF values below 2.5. The MIMIC model showed good fit (?213=9.4, P=.742; ?2/df=0.723; root-mean-square error of approximation<.001; goodness-of-fit index=0.998; comparative fit index=1.000). The external validity of the index is supported by a statistically significant negative correlation with the scale measuring attitudes toward SNSs (r=?0.225, P<.001). Following the removal of 1 item, the second e-professionalism index, focusing on the opportunities associated with SNSs, comprises 5 items. During the indicators collinearity check, all indicators exhibited acceptable VIF values below 2.5. Additionally, the MIMIC model demonstrated a good fit (?24=2.5, P=.718; ?2/df=0.637; root-mean-square error of approximation<0.001; goodness-of-fit index=0.999; comparative fit index=1.000). The external validity of the index is supported by a statistically significant positive correlation with the scale of attitude toward SNSs (r=0.338; P<.001). Conclusions: Following the validation process, the instrument designed for gauging the e-professional behavior of MDs and DMDs consists of 19 items, which contribute to the formation of 2 distinct indexes: the e-professionalism index, focusing on the dangers associated with SNSs, comprising 14 items, and the e-professionalism index, highlighting the opportunities offered by SNSs, consisting of 5 items. These indexes serve as valid measures of the e-professional behavior of MDs and DMDs, with the potential for further refinement to encompass emerging forms of unprofessional behavior that may arise over time. UR - https://mededu.jmir.org/2024/1/e50156 UR - http://dx.doi.org/10.2196/50156 UR - http://www.ncbi.nlm.nih.gov/pubmed/38412021 ID - info:doi/10.2196/50156 ER - TY - JOUR AU - Holland, Lena AU - Kanzow, Friederike Amelie AU - Wiegand, Annette AU - Kanzow, Philipp PY - 2024/1/31 TI - Quality of Patient-Centered eHealth Information on Erosive Tooth Wear: Systematic Search and Evaluation of Websites and YouTube Videos JO - J Med Internet Res SP - e49514 VL - 26 KW - consumer health information KW - dental erosion KW - dental sciences KW - digital media KW - erosive tooth wear KW - evidence-based dentistry KW - health education KW - information quality KW - internet KW - shared decision making N2 - Background: Due to the declining prevalence of dental caries, noncarious tooth defects such as erosive tooth wear have gained increased attention over the past decades. While patients more frequently search the internet for health-related information, the quality of patient-centered, web-based health information on erosive tooth wear is currently unknown. Objective: This study aimed to assess the quality of patient-centered, web-based health information (websites and YouTube videos) on erosive tooth wear. Methods: German-language websites were systematically identified through 3 electronic search engines (google.de, bing.de or yahoo.de, and duckduckgo.com) in September 2021. Eligible websites were independently assessed for (1) technical and functional aspects via the LIDA instrument, (2) readability via the Flesch reading-ease score, (3) comprehensiveness of information via a structured checklist, and (4) generic quality and risk of bias via the DISCERN instrument by 2 different reviewers. An overall quality score (ie, higher scores being favored) generated from all 4 domains was used as the primary outcome. Quality scores from each domain were separately analyzed as secondary outcomes and compared by the Friedman test. The effect of practice-specific variables on quality scores of websites from private dental offices was assessed using generalized linear modeling. Eligible YouTube videos were judged based on (1) the comprehensiveness of information, (2) viewers? interaction, and (3) viewing rate. The comprehensiveness of information was compared between websites and YouTube videos using the Wilcoxon rank-sum test. Results: Overall, 231 eligible websites and 7 YouTube videos were identified and assessed. The median overall quality of the websites was 33.6% (IQR 29.8%-39.2%). Secondary outcome scores amounted to 64.3% (IQR 59.8%-69.0%) for technical and functional aspects, 40.0% (IQR 34.0%-49.0%) for readability, 11.5% (IQR 3.9%-26.9%) for comprehensiveness of information, and 16.7% (IQR 8.3%-23.3%) for generic quality. While the comprehensiveness of information and generic quality received low scores, technical and functional aspects as well as readability resulted in higher scores (both Padjusted<.001). Regarding practice-specific variables, websites from private dental offices outside Germany (P=.04; B=?6.64, 95% CI ?12.85 to ?0.42) or from dentists who are a dental society member (P=.049; B=?3.55, 95% CI ?7.09 to ?0.01) resulted in lower readability scores (ie, were more difficult to read), while a shorter time since dentists? examination resulted in higher readability scores (P=.01; B=0.24 per year, 95% CI 0.05-0.43). The comprehensiveness of information from YouTube videos was 34.6% (IQR 13.5%-38.5%). However, the comprehensiveness of information did not vary between websites and YouTube videos (P=.09). Additionally, viewers? interaction (1.7%, IQR 0.7%-3.4%) and viewing rates (101%, IQR 54.6%-112.6%) were low. Conclusions: The quality of German-language, patient-centered, web-based information on erosive tooth wear was limited. Especially, the comprehensiveness and trustworthiness of the available information were insufficient. Web-based information on erosive tooth wear requires improvement to inform patients comprehensively and reliably. UR - https://www.jmir.org/2024/1/e49514 UR - http://dx.doi.org/10.2196/49514 UR - http://www.ncbi.nlm.nih.gov/pubmed/38167299 ID - info:doi/10.2196/49514 ER - TY - JOUR AU - Kavadella, Argyro AU - Dias da Silva, Antonio Marco AU - Kaklamanos, G. Eleftherios AU - Stamatopoulos, Vasileios AU - Giannakopoulos, Kostis PY - 2024/1/31 TI - Evaluation of ChatGPT?s Real-Life Implementation in Undergraduate Dental Education: Mixed Methods Study JO - JMIR Med Educ SP - e51344 VL - 10 KW - ChatGPT KW - large language models KW - LLM KW - natural language processing KW - artificial Intelligence KW - dental education KW - higher education KW - learning assignments KW - dental students KW - AI pedagogy KW - dentistry KW - university N2 - Background: The recent artificial intelligence tool ChatGPT seems to offer a range of benefits in academic education while also raising concerns. Relevant literature encompasses issues of plagiarism and academic dishonesty, as well as pedagogy and educational affordances; yet, no real-life implementation of ChatGPT in the educational process has been reported to our knowledge so far. Objective: This mixed methods study aimed to evaluate the implementation of ChatGPT in the educational process, both quantitatively and qualitatively. Methods: In March 2023, a total of 77 second-year dental students of the European University Cyprus were divided into 2 groups and asked to compose a learning assignment on ?Radiation Biology and Radiation Protection in the Dental Office,? working collaboratively in small subgroups, as part of the educational semester program of the Dentomaxillofacial Radiology module. Careful planning ensured a seamless integration of ChatGPT, addressing potential challenges. One group searched the internet for scientific resources to perform the task and the other group used ChatGPT for this purpose. Both groups developed a PowerPoint (Microsoft Corp) presentation based on their research and presented it in class. The ChatGPT group students additionally registered all interactions with the language model during the prompting process and evaluated the final outcome; they also answered an open-ended evaluation questionnaire, including questions on their learning experience. Finally, all students undertook a knowledge examination on the topic, and the grades between the 2 groups were compared statistically, whereas the free-text comments of the questionnaires were thematically analyzed. Results: Out of the 77 students, 39 were assigned to the ChatGPT group and 38 to the literature research group. Seventy students undertook the multiple choice question knowledge examination, and examination grades ranged from 5 to 10 on the 0-10 grading scale. The Mann-Whitney U test showed that students of the ChatGPT group performed significantly better (P=.045) than students of the literature research group. The evaluation questionnaires revealed the benefits (human-like interface, immediate response, and wide knowledge base), the limitations (need for rephrasing the prompts to get a relevant answer, general content, false citations, and incapability to provide images or videos), and the prospects (in education, clinical practice, continuing education, and research) of ChatGPT. Conclusions: Students using ChatGPT for their learning assignments performed significantly better in the knowledge examination than their fellow students who used the literature research methodology. Students adapted quickly to the technological environment of the language model, recognized its opportunities and limitations, and used it creatively and efficiently. Implications for practice: the study underscores the adaptability of students to technological innovations including ChatGPT and its potential to enhance educational outcomes. Educators should consider integrating ChatGPT into curriculum design; awareness programs are warranted to educate both students and educators about the limitations of ChatGPT, encouraging critical engagement and responsible use. UR - https://mededu.jmir.org/2024/1/e51344 UR - http://dx.doi.org/10.2196/51344 UR - http://www.ncbi.nlm.nih.gov/pubmed/38111256 ID - info:doi/10.2196/51344 ER - TY - JOUR AU - Wu, Wenjia AU - Le May, Sylvie AU - Hung, Nicole AU - Fortin, Olivier AU - Genest, Christine AU - Francoeur, Maxime AU - Guingo, Estelle AU - St-Arneault, Kate AU - Sylfra, Annie AU - Vu, Kateri An AU - Carmel, Janick AU - Lessard, Laurence AU - Cara-Slavich, Stephany AU - De Koven, Katheryn AU - Paquette, Julie AU - Hoffman, Hunter AU - Asselin, Marie-Eve PY - 2023/11/10 TI - Effects of a Virtual Reality Game on Children?s Anxiety During Dental Procedures (VR-TOOTH): Protocol for a Pilot Randomized Controlled Trial JO - JMIR Res Protoc SP - e49956 VL - 12 KW - virtual reality KW - pediatrics KW - children KW - dentistry KW - procedures KW - fear KW - anxiety KW - child KW - pediatric KW - dentist KW - dental KW - tooth KW - teeth KW - oral KW - anxious KW - immersion KW - immersive KW - RCT KW - randomized KW - controlled trial N2 - Background: Dental fear and anxiety (DFA) is a condition that affects approximately one-quarter of children and adolescents. It is a significant cause for pediatric patients to avoid dental care later in adulthood. Lack of patient cooperation due to DFA can create an environment of stress, often obligating dentists to end appointments prematurely and consider alternative pharmacological treatment options. Virtual reality (VR) use during dental care, providing an immersive experience through sensory stimuli, is potentially an additional nonpharmacologic tool to better manage DFA in children with special health care needs (SHCN) undergoing dental procedures. Objective: This pilot study aims to assess the feasibility and acceptability of VR immersion as a tool to reduce DFA in pediatric special needs patients undergoing dental procedures. The study also aims to gain insight on parent and health care provider perspectives on the use of VR during dental appointments. Methods: This pilot randomized controlled trial study will follow a parallel design including 2 groups: a control group (clinic?s standard care using a wall TV) and an experimental group (using a VR game). We will randomize 20 participants to either group. Recruitment will be carried out at the dental clinic of the Centre Hospitalier Universitaire Sainte-Justine, a tertiary-quaternary care center that mostly serves pediatric patients with SHCN. The primary outcome will be patient recruitment rates and completion rates of planned procedures. DFA in children will be assessed using both an observation-based proxy assessment with the Venham Anxiety and Behavior Rating Scale and physiological assessments using parameters such as change in heart rate and levels of salivary alpha-amylase as a stress biomarker before and 10 minutes after the procedure. Sociodemographic characteristics, measures of the levels of parent and health care professional satisfaction, occurrence of side effects, and any deviation from normal procedure length will also be collected. Descriptive statistics, nonparametric tests, and effect sizes will be used for demographic and clinical variables and to present parent and health care professional satisfaction levels as well as procedural time. Results: This study will be conducted from May 2023 to May 2024, with results expected to be available in December 2024. Conclusions: The pilot study will provide insight on the feasibility and acceptability of VR use in clinical dentistry to reduce DFA for pediatric patients with SHCN. This study will guide future research on VR use in pediatric dentistry and can serve as a framework for a larger randomized clinical trial. Trial Registration: ClinicalTrials.gov NCT05898100; https://classic.clinicaltrials.gov/ct2/show/NCT05898100 International Registered Report Identifier (IRRID): DERR1-10.2196/49956 UR - https://www.researchprotocols.org/2023/1/e49956/ UR - http://dx.doi.org/10.2196/49956 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/49956 ER - TY - JOUR AU - Zhang, Yue Xi AU - Arata Found, Anelyse AU - Butler, Sheila PY - 2023/11/8 TI - Effects of Distance-Learning Strategies in Dental Fixed Prosthodontics Amidst the COVID-19 Pandemic: Cross-Sectional Questionnaire Study on Preclinical Dental Students? Perspective JO - JMIR Form Res SP - e45311 VL - 7 KW - dental education KW - dental KW - dentist KW - dentistry KW - technology-based learning KW - online learning KW - pre-clinical training KW - distance learning KW - transmissibility KW - dental school KW - mental health KW - COVID-19 KW - student perception KW - online teaching KW - survey KW - teaching methods KW - training KW - isolation KW - teaching KW - module KW - education N2 - Background: COVID-19?s high transmissibility led to gathering restrictions where dental schools experienced disruptions due to restrictions on attending in-person lectures and limitations placed on applied preclinical and clinical activities. Students not only had to rapidly switch to digital technology-based learning (TB-learning) modules but also experienced high levels of social isolation and anxiety around virus transmission. Objective: This study aims to evaluate the preclinical students? perception of switching TB-learning modules amidst the COVID-19 pandemic, identifying which module parameters were associated with strong student outcomes. Methods: A web-based survey of 39 Likert scale questions was delivered to preclinical dental students (Western University) to evaluate students? perceptions concerning TB-learning, fear amidst the COVID-19 pandemic, and the impact on their preclinical training. A Spearman rank correlation coefficient was determined to estimate the relationship between 2 variables in isolation (P=.01). An ordinal regression analysis was performed on variables of interest to determine how module variables (typically within the instructor?s control) influenced the student outcomes (P=.05). Results: The response rate was 30% (n=39). TB-learning was considered vital (34/39, 87.2%) as the students? education improved (18/39, 46.2%). However, 53.8% (n=21) of students showed increased difficulties in retaining, visualizing, or understanding the materials using TB-learning, and 64.1% (n=25) found it more difficult to concentrate than in in-person classes. In total, 79.5% (n=31) of students showed different levels of agreement about feeling fatigued from TB-learning. Through Spearman ? correlation analysis, the quality of questions in quizzes (?=0.514; P<.001), relevant handouts (?=0.729; P<.001), and high-quality audiovisuals (?=0.585; P<.001) were positively correlated with students responding that the modules were useful to preclinical training. Similarly, good organization (?=0.512; P<.001), high-quality questions in quizzes (?=0.431; P=.01), and relevant handouts (?=0.551; P<.001) were positively correlated with web-based classes as an effective way to learn. In total, 91.6% (n=36) of the students agreed that COVID-19 was a dangerous disease, whereas 53.8% (n=21) showed different levels of agreement that they were afraid to be infected personally, and 69.2% (n=27) feared passing COVID-19 along to family and friends. A total of 82.1% (n=32) of the students showed that COVID-19 impacted their overall learning process and had a negative impact on their practical preclinical training (31/39, 79.5%). Conclusions: The students found a difference between TB-learning and face-to-face learning methods, where the students perceived fatigue toward the web-based method with difficulty concentrating and visualizing the subject. Moreover, there was a consensus that COVID-19 itself affected the students? overall learning process and preclinical training. As dental schools continue implementing TB-learning into their curriculum, this investigation identifies the students? struggles with the paradigm shift. In an effort to improve TB-learning, this work highlights 4 variables (organization, quizzes, quality handouts, and quality audiovisuals) within the control of instructors that can help improve content deliverance, improving the students? experience. UR - https://formative.jmir.org/2023/1/e45311 UR - http://dx.doi.org/10.2196/45311 UR - http://www.ncbi.nlm.nih.gov/pubmed/37938882 ID - info:doi/10.2196/45311 ER - TY - JOUR AU - Frank, Charis Ariadne AU - Jennrich, Linda AU - Kanzow, Philipp AU - Wiegand, Annette AU - Krantz-Schäfers, Christiane PY - 2023/4/28 TI - A Sex-Specific Evaluation of Dental Students? Ability to Perform Subgingival Debridement: Randomized Trial JO - JMIR Med Educ SP - e44989 VL - 9 KW - dental KW - dental education KW - dentist KW - education KW - gender KW - periodontics KW - preclinical education KW - root debridement KW - sex KW - student N2 - Background: A successful periodontitis treatment demands good manual skills. A correlation between biological sex and dental students? manual dexterity is currently unknown. Objective: This study examines performance differences between male and female students within subgingival debridement. Methods: A total of 75 third-year dental students were divided by biological sex (male/female) and randomly assigned to one of two work methods (manual curettes n=38; power-driven instruments n=37). Students were trained on periodontitis models for 25 minutes daily over 10 days using the assigned manual or power-driven instrument. Practical training included subgingival debridement of all tooth types on phantom heads. Practical exams were performed after the training session (T1) and after 6 months (T2), and comprised subgingival debridement of four teeth within 20 minutes. The percentage of debrided root surface was assessed and statistically analyzed using a linear mixed-effects regression model (P<.05). Results: The analysis is based on 68 students (both groups n=34). The percentage of cleaned surfaces was not significantly different (P=.40) between male (mean 81.6%, SD 18.2%) and female (mean 76.3%, SD 21.1%) students, irrespective of the instrument used. The use of power-driven instruments (mean 81.3%, SD 20.5%) led to significantly better results than the use of manual curettes (mean 75.4%, SD 19.4%; P=.02), and the overall performance decreased over time (T1: mean 84.5%, SD 17.5%; T2: mean 72.3%, SD 20.8%; P<.001). Conclusions: Female and male students performed equally well in subgingival debridement. Therefore, sex-differentiated teaching methods are not necessary. UR - https://mededu.jmir.org/2023/1/e44989 UR - http://dx.doi.org/10.2196/44989 UR - http://www.ncbi.nlm.nih.gov/pubmed/37002956 ID - info:doi/10.2196/44989 ER - TY - JOUR AU - Haupt, Franziska AU - Kanzow, Philipp PY - 2023/4/18 TI - The Relation Between Students? Theoretical Knowledge and Practical Skills in Endodontics: Retrospective Analysis JO - Interact J Med Res SP - e46305 VL - 12 KW - curricula KW - curriculum KW - dental KW - dental education KW - dentist KW - dentistry KW - endodontics KW - endodontology KW - educational assessment KW - educational measurement KW - examination KW - knowledge assessment KW - practical skills KW - skill assessment KW - theoretical knowledge KW - undergraduate KW - undergraduate curriculum KW - undergraduate education N2 - Background: Dental undergraduate students are required to show sufficient practical skills prior to treating patients. Practical skills and the underlying theoretical knowledge are taught in preclinical courses. Usually, the learning outcome is assessed in written multiple-choice examinations (theoretical knowledge) and practical skills tests. However, students? assessment of practical skills is more time consuming and prone to bias than objective multiple-choice examinations. Objective: This study aims to analyze the relation between students? theoretical knowledge and practical skills in endodontics. Furthermore, the predictive validity of a theoretical knowledge assessment on students? practical skills was assessed. Methods: Examination results from all students who participated in the preclinical phantom course in Operative Dentistry (sixth semester of the undergraduate dental curriculum in Germany) between the 2015 summer term and the 2022 summer term were retrospectively evaluated (N=447). The effects of age, sex, previous course participation, and theoretical knowledge on students? practical skills were assessed, using Pearson correlations, Wilcoxon rank sum tests, and a linear regression analysis. Subsequently, students? theoretical knowledge and practical skills were compared via a Fisher exact test to identify a suitable pass mark for students? theoretical knowledge that was associated with sufficient practical skills (?60%). Results: Students? theoretical knowledge was significantly associated with practical skills (Padjusted=.02; r=0.13). By using the current pass mark for theoretical knowledge (ie, 60%), a significant differentiation between insufficient practical skills (<60%) and sufficient practical skills (?60%) was achieved (P=.02). However, for the discrimination between students with sufficient practical skills and students with insufficient practical skills, an adapted pass mark for theoretical knowledge would be more appropriate. The ideal pass mark amounted to 58% (P=.02). Conclusions: Students? practical skills and theoretical knowledge are significantly correlated. By objectively measuring students? theoretical knowledge, a rough estimation of students? practical skills (ie, a differentiation between sufficient and insufficient practical skills) is possible. UR - https://www.i-jmr.org/2023/1/e46305 UR - http://dx.doi.org/10.2196/46305 UR - http://www.ncbi.nlm.nih.gov/pubmed/36994987 ID - info:doi/10.2196/46305 ER - TY - JOUR AU - Kim, Changgyun AU - Jeong, Hogul AU - Park, Wonse AU - Kim, Donghyun PY - 2022/10/31 TI - Tooth-Related Disease Detection System Based on Panoramic Images and Optimization Through Automation: Development Study JO - JMIR Med Inform SP - e38640 VL - 10 IS - 10 KW - object detection KW - tooth KW - diagnosis KW - panorama KW - dentistry KW - dental health KW - oral health KW - dental caries KW - image analysis KW - artificial intelligence KW - detection model KW - machine learning KW - automation KW - diagnosis system N2 - Background: Early detection of tooth-related diseases in patients plays a key role in maintaining their dental health and preventing future complications. Since dentists are not overly attentive to tooth-related diseases that may be difficult to judge visually, many patients miss timely treatment. The 5 representative tooth-related diseases, that is, coronal caries or defect, proximal caries, cervical caries or abrasion, periapical radiolucency, and residual root can be detected on panoramic images. In this study, a web service was constructed for the detection of these diseases on panoramic images in real time, which helped shorten the treatment planning time and reduce the probability of misdiagnosis. Objective: This study designed a model to assess tooth-related diseases in panoramic images by using artificial intelligence in real time. This model can perform an auxiliary role in the diagnosis of tooth-related diseases by dentists and reduce the treatment planning time spent through telemedicine. Methods: For learning the 5 tooth-related diseases, 10,000 panoramic images were modeled: 4206 coronal caries or defects, 4478 proximal caries, 6920 cervical caries or abrasion, 8290 periapical radiolucencies, and 1446 residual roots. To learn the model, the fast region-based convolutional network (Fast R-CNN), residual neural network (ResNet), and inception models were used. Learning about the 5 tooth-related diseases completely did not provide accurate information on the diseases because of indistinct features present in the panoramic pictures. Therefore, 1 detection model was applied to each tooth-related disease, and the models for each of the diseases were integrated to increase accuracy. Results: The Fast R-CNN model showed the highest accuracy, with an accuracy of over 90%, in diagnosing the 5 tooth-related diseases. Thus, Fast R-CNN was selected as the final judgment model as it facilitated the real-time diagnosis of dental diseases that are difficult to judge visually from radiographs and images, thereby assisting the dentists in their treatment plans. Conclusions: The Fast R-CNN model showed the highest accuracy in the real-time diagnosis of dental diseases and can therefore play an auxiliary role in shortening the treatment planning time after the dentists diagnose the tooth-related disease. In addition, by updating the captured panoramic images of patients on the web service developed in this study, we are looking forward to increasing the accuracy of diagnosing these 5 tooth-related diseases. The dental diagnosis system in this study takes 2 minutes for diagnosing 5 diseases in 1 panoramic image. Therefore, this system plays an effective role in setting a dental treatment schedule. UR - https://medinform.jmir.org/2022/10/e38640 UR - http://dx.doi.org/10.2196/38640 UR - http://www.ncbi.nlm.nih.gov/pubmed/36315222 ID - info:doi/10.2196/38640 ER - TY - JOUR AU - Pithpornchaiyakul, Samerchit AU - Naorungroj, Supawadee AU - Pupong, Kittiwara AU - Hunsrisakhun, Jaranya PY - 2022/10/21 TI - Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study JO - J Med Internet Res SP - e39218 VL - 24 IS - 10 KW - mHealth KW - tele-dentistry KW - digital health KW - chatbot KW - conversional agents KW - oral hygiene KW - oral health behaviors KW - protection motivation theory KW - young children KW - caregiver KW - in-person toothbrushing training KW - COVID-19 N2 - Background: It is recommended that caregivers receive oral health education and in-person training to improve toothbrushing for young children. To strengthen oral health education before COVID-19, the 21-Day FunDee chatbot with in-person toothbrushing training for caregivers was used. During the pandemic, practical experience was difficult to implement. Therefore, the 30-Day FunDee chatbot was created to extend the coverage of chatbots from 21 days to 30 days by incorporating more videos on toothbrushing demonstrations and dialogue. This was a secondary data comparison of 2 chatbots in similar rural areas of Pattani province: Maikan district (Study I) and Maelan district (Study II). Objective: This study aimed to evaluate the effectiveness and usability of 2 chatbots, 21-Day FunDee (Study I) and 30-Day FunDee (Study II), based on the protection motivation theory (PMT). This study explored the feasibility of using the 30-Day FunDee chatbot to increase toothbrushing behaviors for caregivers in oral hygiene care for children aged 6 months to 36 months without in-person training during the COVID-19 pandemic. Methods: A pre-post design was used in both studies. The effectiveness was evaluated among caregivers in terms of oral hygiene practices, knowledge, and oral health care perceptions based on PMT. In Study I, participants received in-person training and a 21-day chatbot course during October 2018 to February 2019. In Study II, participants received only daily chatbot programming for 30 days during December 2021 to February 2022. Data were gathered at baseline of each study and at 30 days and 60 days after the start of Study I and Study II, respectively. After completing their interventions, the chatbot's usability was assessed using open-ended questions. Study I evaluated the plaque score, whereas Study II included an in-depth interview. The 2 studies were compared to determine the feasibility of using the 30-Day FunDee chatbot as an alternative to in-person training. Results: There were 71 pairs of participants: 37 in Study I and 34 in Study II. Both chatbots significantly improved overall knowledge (Study I: P<.001; Study II: P=.001), overall oral health care perceptions based on PMT (Study I: P<.001; Study II: P<.001), and toothbrushing for children by caregivers (Study I: P=.02; Study II: P=.04). Only Study I had statistically significant differences in toothbrushing at least twice a day (P=.002) and perceived vulnerability (P=.003). The highest overall chatbot satisfaction was 9.2 (SD 0.9) in Study I and 8.6 (SD 1.2) in Study II. In Study I, plaque levels differed significantly (P<.001). Conclusions: This was the first study using a chatbot in oral health education. We established the effectiveness and usability of 2 chatbot programs for promoting oral hygiene care of young children by caregivers. The 30-Day FunDee chatbot showed the possibility of improving toothbrushing skills without requiring in-person training. Trial Registration: Thai Clinical Trials Registry TCTR20191223005; http://www.thaiclinicaltrials.org/show/TCTR20191223005 and TCTR20210927004; https://www.thaiclinicaltrials.org/show/TCTR20210927004 UR - https://www.jmir.org/2022/10/e39218 UR - http://dx.doi.org/10.2196/39218 UR - http://www.ncbi.nlm.nih.gov/pubmed/36179147 ID - info:doi/10.2196/39218 ER - TY - JOUR AU - Pang, Mengwei AU - Zhao, Xiaohan AU - Lu, Daiyu AU - Dong, Yihan AU - Jiang, Lin AU - Li, Jie AU - Ji, Ping PY - 2022/9/12 TI - Preliminary User Evaluation of a New Dental Technology Virtual Simulation System: Development and Validation Study JO - JMIR Serious Games SP - e36079 VL - 10 IS - 3 KW - virtual simulation KW - dental technology KW - OSCE KW - virtual reality KW - dentistry KW - dental technician KW - framework KW - certified dental technician KW - development KW - validation KW - serious game KW - dental KW - technology N2 - Background: With the advancements in the dental health care industry, the demand for dental technicians has increased. Dental technicians should be thoroughly assessed and trained in practical skills and pass professional certification examinations to ensure that they are competent to work closely with dentists. Unfortunately, such training courses and tests are in short supply worldwide. The use of virtual simulation technology can help solve these problems. Objective: This study presents a new strategic framework design for a certified dental technician practical examination called as the certified Objective Manipulative Skill Examination of Dental Technicians (OMEDT), which is based on the Objective Structured Clinical Examination (OSCE). We present the development and validation of the OMEDT system, a new virtual simulated training system, to meet the demands of the OMEDT framework. The combination of OMEDT and the OMEDT system can solve the complex problems encountered in the certified dental technician practical examination with excellent efficiency, high quality, and low cost. Methods: The OMEDT framework design was constructed according to the OSCE guide and the Chinese vocational skill standards for dental technicians. To develop the OMEDT system, we organized a new framework based on the virtual learning network platform, the haptic feedback system, and the real-time dental training and evaluation system. The effectiveness evaluation of the OMEDT system was divided into 2 phases: in the first phase, 36 students were recruited to use the test module to finish the task and their performance data were collected and analyzed; and in the second phase, a questionnaire was administered to 30 students who used the system for their studies and graduation exams. Results: The OMEDT and the corresponding skill training virtual simulation OMEDT system were developed, and preliminary user evaluation was performed to assess their effectiveness and usefulness. The OMEDT system was found to improve students? practical skills by training with the evaluation results. In addition, several key research topics were explored, including the effects of positive feedback of the knowledge of results on the improvement of the students? skill level and the common sense transformation of educators in the virtual simulation technology environment. Conclusions: The development of OMEDT and the OMEDT system has been completed and their effectiveness has been verified. UR - https://games.jmir.org/2022/3/e36079 UR - http://dx.doi.org/10.2196/36079 UR - http://www.ncbi.nlm.nih.gov/pubmed/36094803 ID - info:doi/10.2196/36079 ER - TY - JOUR AU - van Spreuwel, M. Peggy C. J. AU - Jerkovi?-?osi?, Katarina AU - van Loveren, Cor AU - van der Heijden, G. Geert J. M. PY - 2022/8/31 TI - Oral Health Coaches at Well-Baby Clinics to Promote Oral Health in Preschool Children From the First Erupted Tooth: Protocol for a Multisite, Pragmatic Randomized Controlled Trial JO - JMIR Res Protoc SP - e39683 VL - 11 IS - 8 KW - randomized clinical trial KW - dental caries KW - early childhood caries KW - oral health promotion KW - behavior change KW - motivational interviewing KW - dental public health KW - child health care KW - health inequality KW - prevention N2 - Background: Early childhood caries is considered one of the most prevalent diseases in childhood, affecting almost half of preschool-age children globally. In the Netherlands, approximately one-third of children aged 5 years already have dental caries, and dental care providers experience problems reaching out to these children. Objective: Within the proposed trial, we aim to test the hypothesis that, compared to children who receive usual care, children who receive the Toddler Oral Health Intervention as add-on care will have a reduced cumulative caries incidence and caries incidence density at the age of 48 months. Methods: This pragmatic, 2-arm, individually randomized controlled trial is being conducted in the Netherlands and has been approved by the Medical Ethics Research Board of University Medical Center Utrecht. Parents with children aged 6 to 12 months attending 1 of the 9 selected well-baby clinics are invited to participate. Only healthy children (ie, not requiring any form of specialized health care) with parents that have sufficient command of the Dutch language and have no plans to move outside the well-baby clinic region are eligible. Both groups receive conventional oral health education in well-baby clinics during regular well-baby clinic visits between the ages of 6 to 48 months. After concealed random allocation of interventions, the intervention group also receives the Toddler Oral Health Intervention from an oral health coach. The Toddler Oral Health Intervention combines behavioral interventions of proven effectiveness in caries prevention. Data are collected at baseline, at 24 months, and at 48 months. The primary study endpoint is cumulative caries incidence for children aged 48 months, and will be analyzed according to the intention-to-treat principle. For children aged 48 months, the balance between costs and effects of the Toddler Oral Health Intervention will be evaluated, and for children aged 24 months, the effects of the Toddler Oral Health Intervention on behavioral determinants, alongside cumulative caries incidence, will be compared. Results: The first parent-child dyads were enrolled in June 2017, and recruitment was finished in June 2019. We enrolled 402 parent-child dyads. Conclusions: All follow-up interventions and data collection will be completed by the end of 2022, and the trial results are expected soon thereafter. Results will be shared at international conferences and via peer-reviewed publication. Trial Registration: Netherlands Trial Register NL8737; https://trialsearch.who.int/Trial2.aspx?TrialID=NL8737 International Registered Report Identifier (IRRID): DERR1-10.2196/39683 UR - https://www.researchprotocols.org/2022/8/e39683 UR - http://dx.doi.org/10.2196/39683 UR - http://www.ncbi.nlm.nih.gov/pubmed/36044251 ID - info:doi/10.2196/39683 ER - TY - JOUR AU - Taramarcaz, Victor AU - Herren, Tara AU - Golay, Eric AU - Regard, Simon AU - Martin-Achard, Sébastien AU - Mach, Francois AU - Schnetzler, Nicolas AU - Ricci, Gaëtan AU - Zamberg, Ido AU - Larribau, Robert AU - Niquille, Marc AU - Suppan, Mélanie AU - Schiffer, Eduardo AU - Suppan, Laurent PY - 2022/5/18 TI - A Short Intervention and an Interactive e-Learning Module to Motivate Medical and Dental Students to Enlist as First Responders: Implementation Study JO - J Med Internet Res SP - e38508 VL - 24 IS - 5 KW - basic life support KW - cardiopulmonary resuscitation KW - first responder KW - undergraduate medical education KW - out-of-hospital cardiac arrest KW - medical education KW - e-learning KW - digital education KW - medical student KW - blended learning N2 - Background: Prompt and proficient basic life support (BLS) maneuvers are essential to increasing the odds of survival after out-of-hospital cardiac arrest. However, significant time can elapse before the arrival of professional rescuers. To decrease these delays, many countries have developed first responder networks. These networks are composed of BLS-certified lay or professional rescuers who can be dispatched by emergency medical communication centers to take care of those who experience out-of-hospital cardiac arrest. Many systems are, however, limited by a relatively low number of active first responders, and first-year medical and dental students may represent an almost untapped pool of potential rescuers. On top of providing an enhanced BLS coverage to the population, this could also help medical students be better prepared to their future role as certified health care providers and address societal expectations regarding health care students. Objective: Our objective was to describe the impact of a short motivational intervention followed by a blended BLS course (e-learning and practice session) designed to motivate first-year medical and dental students to enlist as first responders. Methods: A short, web-based, motivational intervention presenting this project took place, and first-year University of Geneva, Faculty of Medicine students were provided with a link to the study platform. Those who agreed to participate were redirected to a demographic questionnaire before registering on the platform. The participants were then asked to answer a second questionnaire designed to determine their baseline knowledge prior to following an interactive e-learning module. Upon completion, a web-based booking form enabling them to register for a 1-hour practice session was displayed. These sessions were held by senior medical students who had been trained and certified as BLS instructors. The participants who attended these practice sessions were asked to answer a postcourse questionnaire before receiving the certificate enabling them to register as first responders. Results: Out of the 529 first-year students registered at University of Geneva, Faculty of Medicine on January 14, 2021, 190 (35.9%) initially agreed to participate. Moreover, 102 (19.3%) attended the practice sessions, and 48 (9.1%) had completed all training and enlisted as first responders on the dedicated platform, Save a Life, at 6 months (July 14, 2021). Postcourse confidence in resuscitation skills was associated with a higher likelihood of registering as first responder (P=.03). No association was found between prior BLS knowledge and the probability of registering to a practice session (P=.59), of obtaining a course completion certificate (P=.29), or of enlisting as first responder (P=.56). Conclusions: This study shows that a motivational intervention associated with a short BLS course can convince medical students to enlist as first responders. Further studies are needed to understand the rather low proportion of medical students finally registering as first responders. International Registered Report Identifier (IRRID): RR2-10.2196/24664 UR - https://www.jmir.org/2022/5/e38508 UR - http://dx.doi.org/10.2196/38508 UR - http://www.ncbi.nlm.nih.gov/pubmed/35583927 ID - info:doi/10.2196/38508 ER - TY - JOUR AU - Li, Yaning AU - Ye, Hongqiang AU - Wu, Siyu AU - Zhao, Xiaohan AU - Liu, Yunsong AU - Lv, Longwei AU - Zhang, Ping AU - Zhang, Xiao AU - Zhou, Yongsheng PY - 2022/3/9 TI - Mixed Reality and Haptic?Based Dental Simulator for Tooth Preparation: Research, Development, and Preliminary Evaluation JO - JMIR Serious Games SP - e30653 VL - 10 IS - 1 KW - dental education KW - simulator KW - mixed reality KW - tooth preparation N2 - Background: Virtual reality (VR) dental simulators are currently used in preclinical skills training. However, with the development of extended reality technologies, the use of mixed reality (MR) has shown significant advantages over VR. Objective: This study aimed to describe the research and development of a newly developed MR and haptic?based dental simulator for tooth preparation and to conduct a preliminary evaluation of its face validity. Methods: A prototype of the MR dental simulator for tooth preparation was developed by integrating a head-mounted display (HMD), special force feedback handles, a foot pedal, computer hardware, and software program. We recruited 34 participants and divided them into the Novice group (n=17) and Skilled group (n=17) based on their clinical experience. All participants prepared a maxillary right central incisor for an all-ceramic crown in the dental simulator, completed a questionnaire afterward about their simulation experience, and evaluated hardware and software aspects of the dental simulator. Results: Of the participants, 74% (25/34) were satisfied with the overall experience of using the Unidental MR Simulator. Approximately 90% (31/34, 91%) agreed that it could stimulate their interest in learning, and 82% (28/34) were willing to use it for skills training in the future. Differences between the 2 study groups in their experience with the HMD (resolution: P=.95; wearing comfort: P=.10), dental instruments (P=.95), force feedback of the tooth (P=.08), simulation of the tooth preparation process (P=.79), overall experience with the simulation (P=.47), and attitude toward the simulator (improves skills: P=.47; suitable for learning: P=.36; willing to use: P=.89; inspiring for learning: P=.63) were not significant. The Novice group was more satisfied with the simulator?s ease of use (P=.04). There were significant positive correlations between the overall experience with the simulation and the HMD?s resolution (P=.03) and simulation of the preparation process (P=.001). Conclusions: The newly developed Unidental MR Simulator for tooth preparation has good face validity. It can achieve a higher degree of resemblance to the real clinical treatment environment by improving the positional adjustment of the simulated patients, for a better training experience in dental skills. UR - https://games.jmir.org/2022/1/e30653 UR - http://dx.doi.org/10.2196/30653 UR - http://www.ncbi.nlm.nih.gov/pubmed/35262501 ID - info:doi/10.2196/30653 ER - TY - JOUR AU - Krishna, Meenakshi AU - Sybil, Deborah AU - Shrivastava, Kumar Priyanshu AU - Premchandani, Shubhangi AU - Kumar, Himanshu AU - Kumar, Pintu PY - 2021/12/31 TI - An Innovative App (ExoDont) for Postoperative Care of Patients After Tooth Extraction: Prototype Development and Testing Study JO - JMIR Perioper Med SP - e31852 VL - 4 IS - 2 KW - ExoDont KW - Android app KW - teledentistry KW - mHealth KW - tooth extraction KW - postoperative KW - dentistry KW - dentist KW - teeth KW - dental surgery KW - oral surgery N2 - Background: The postoperative period is crucial for the initiation of healing and prevention of complications after any surgical procedure. Due to factors such as poor compliance, comprehension, and retention of instructions, and other unaccounted factors, the objectives of postoperative care are not always achieved. Therefore, an Android-based mobile health app (ExoDont) was developed to ensure a smooth postoperative period for patients after a dental extraction. The ExoDont app delivers reminders for postoperative instructions and drug intake at defined intervals, thus fostering self-reliance among patients in taking their prescribed dose of medication. Objective: The aim of this study is to design, develop, and validate ExoDont, an innovative app for improved adherence to postoperative instructions after tooth extraction. Methods: A postoperative treatment protocol was developed by a team of oral and maxillofacial surgeons and general dentists, following which the clinical and technological requirements of the app were determined along with the software engineers, graphic designers, and applications architect in the team. ExoDont was developed to provide timely reminders for medication and postoperative care. The app was field tested and validated using the User Version of the Mobile Application Rating Scale. Results: The ExoDont software design was divided into a 3-level architecture comprising a user interface application, logical layer, and database layer. The software architecture consists of an Android-based ExoDont app for patients and a web version of the admin panel. The testing and validation of the ExoDont app revealed that Perceived Impact received the highest mean score of all rated components (mean 4.6, SD 0.5), while Engagement received the lowest mean score (mean 3.5, SD 0.8). Conclusions: The testing and validation of the app support its usability and functionality, as well as its impact on users. The ExoDont app has been designed, keeping the welfare of patients in view, in a user-friendly manner that will help patients adhere to the prescribed drug regimen and ensure easy and efficient dissemination of postoperative instructions. It could play an instrumental role in fostering compliance among patients and significantly decrease the complication rate following dental extractions. UR - https://periop.jmir.org/2021/2/e31852 UR - http://dx.doi.org/10.2196/31852 UR - http://www.ncbi.nlm.nih.gov/pubmed/34982720 ID - info:doi/10.2196/31852 ER - TY - JOUR AU - Amosun, Seyi AU - Kimmie-Dhansay, Faheema AU - Geerts, Greta AU - Basson, Reneda PY - 2021/7/21 TI - Career Development of Academic Staff in Faculties of Dentistry by Means of Mentorship Programs: Protocol for a Scoping Review JO - JMIR Res Protoc SP - e27239 VL - 10 IS - 7 KW - scoping review protocol KW - academic staff development KW - mentorship KW - capacity development KW - dental education KW - dentistry KW - dental educators N2 - Background: Globally, the demands on dental educators continue to diversify and expand. Due to their importance and value, mentoring programs have been acknowledged as a means of recruiting, developing, and retaining academics in dental education. Objective: This protocol is for a scoping review that aims to identify the goals of mentoring programs for academic staff in dental faculties and determine how these programs were structured, delivered, and evaluated. Methods: The review will be performed in accordance with the Joanna Briggs Institute?s methodology for scoping reviews, which covers both qualitative and quantitative scientific literature as well as grey literature written in English and published between 2000 and 2020. The databases will include PubMed, Ovid, the Educational Resources Information Center database, Science Direct, Scopus, Google Scholar, Trove, Web of Science, Openthesis.org, and the website of the American Dental Education Association. A manual search will also be conducted by using the reference lists of included studies to identify additional articles. Working independently, the authors will participate iteratively in literature screening, paper selection, and data extraction. Disagreements between the reviewers will be resolved by discussion until a consensus is reached or after consultation with the research team. Key information that is relevant to the review questions will be extracted from the selected articles and imported into a Microsoft Excel file. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) will be used to guide the reporting of this protocol. Results: The search for appropriate literature has commenced, and we aim to present the results before the end of the 2021 academic year. Conclusions: The development of formal mentorship programs for academics in dental education will enhance the retention of academic staff. International Registered Report Identifier (IRRID): PRR1-10.2196/27239 UR - https://www.researchprotocols.org/2021/7/e27239 UR - http://dx.doi.org/10.2196/27239 UR - http://www.ncbi.nlm.nih.gov/pubmed/34287219 ID - info:doi/10.2196/27239 ER - TY - JOUR AU - Afrashtehfar, Ian Kelvin AU - Bryant, Ross Stephen PY - 2021/6/18 TI - Understanding the Lived Experience of North American Dental Patients With a Single-Tooth Implant in the Upper Front Region of the Mouth: Protocol for a Qualitative Study JO - JMIR Res Protoc SP - e25767 VL - 10 IS - 6 KW - esthetic dentistry KW - esthetics KW - implant dentistry KW - patient perception KW - patient-reported outcome measures KW - personal satisfaction KW - phenomenology KW - single-tooth dental implants KW - single-unit implant-supported restoration N2 - Background: Assessment of the subjective experiences of individuals with maxillary anterior (ie, the upper front region of the mouth) single-tooth implants is limited mainly to quantitative measurements of satisfaction with appearance. Interestingly, there is unexplained variability in the relationship between satisfaction and appearance. Objective: This qualitative study protocol aims to explore and better understand the satisfaction with appearance and function in a Canadian population with maxillary anterior single-tooth implants treated at a postgraduate university clinic. Thus, we aim to obtain diversity among participants relating to the identification of esthetically pleasing and displeasing cases from a clinician perspective. Methods: A qualitative research design using interpretative phenomenology analysis (IPA) will provide an adaptable inductive research approach. The participants will be recruited, and consent documents, photographs, digital intraoral scans, and self-administered questionnaire responses will be obtained from them. The transcribed verbatim data from audio-recorded, in-depth, semistructured, one-to-one interviews of the participants will be managed, coded, and analyzed thematically with computer-assisted qualitative data analysis software. The IPA will consider the COnsolidated criteria for REporting Qualitative (COREQ) guidelines when applicable. Results: For the qualitative interview, we plan to include at least eight patients to conduct up to 1.5 hours of open-ended interviews with each participant aided by an interview guide. Ethical approval was granted by the University of British Columbia Behavioral Research Ethics Board (H19-00107) in May 2019. Two American dental foundations funded this study. Conclusions: The analysis in this study will elucidate the aspects (including their value) that influence participant satisfaction at different dental implant treatment stages. This will be the first qualitative study on this group of the population to explore and obtain a better understanding of their satisfaction with appearance and function, as well as any other patient-reported outcome measures that could be identified. International Registered Report Identifier (IRRID): DERR1-10.2196/25767 UR - https://www.researchprotocols.org/2021/6/e25767 UR - http://dx.doi.org/10.2196/25767 UR - http://www.ncbi.nlm.nih.gov/pubmed/33886491 ID - info:doi/10.2196/25767 ER - TY - JOUR AU - Kanzow, Philipp AU - Krantz-Schäfers, Christiane AU - Hülsmann, Michael PY - 2021/5/14 TI - Remote Teaching in a Preclinical Phantom Course in Operative Dentistry During the COVID-19 Pandemic: Observational Case Study JO - JMIR Med Educ SP - e25506 VL - 7 IS - 2 KW - acceptance KW - COVID-19 KW - dental education KW - distance learning KW - effectiveness KW - e-learning KW - medical education KW - medical student KW - observational KW - screencasts KW - preclinical education KW - remote teaching N2 - Background: During the acute COVID-19 pandemic, physical access to the University Medical Center Göttingen was restricted for students. For the first time at our dental school, theoretical knowledge was imparted to students via asynchronous online screencasts and discussed via synchronous video meetings only. Objective: We aimed to assess the acceptance and effectiveness of distance education as a new teaching format for theoretical knowledge within the preclinical course in Operative Dentistry (sixth semester of the undergraduate dental curriculum in Germany). Methods: The phantom course comprised distance education (first phase, 11 weeks) and subsequent on-site practical demonstrations and training (second phase, 10 weeks). All theoretical knowledge was taught via online screencasts during distance education (except for the first week, 3 screencasts were uploaded per week resulting in a total of 30 screencasts). Until the end of the term, all students (N=33) were able to view the screencasts for an unlimited number of times. Theoretical knowledge was assessed in a summative examination after practical on-site teaching. Acceptance and effectiveness of the new curriculum and distance education were also measured based on an evaluation survey and students? self-perceived learning outcome, which was compared to the outcome from the two pre?COVID-19 terms. Results: Each screencast was viewed by a mean of 24 (SD 3.3) students and accessed a mean of 5.6 (SD 1.2) times per user (ie, by students who accessed the respective screencast at least once). During distance education, the number of accesses showed a linear trend over time. During the practical training phase, screencast views declined and increased again prior to the examination. Screencasts covering topics in Cariology, Restorative Dentistry, and Preventive Dentistry were viewed by more students than screencasts covering topics in Endodontology or Periodontology (both P=.047). Examination items in Periodontology showed inferior results compared to the other topics (P<.001). Within the different topics, students? self-perceived learning outcome did not differ from that during the pre?COVID-19 terms. Although most students agreed that the presented screencasts contributed to their learning outcome, pre?COVID-19 term students more strongly felt that lectures significantly contributed to their learning outcome (P=.03). Conclusions: Screencasts showed high acceptance and effectiveness among the students but were not used as a learning tool by all students. However, students who viewed the screencasts accessed each screencast more frequently than they could have attended a conventional lecture. Screencast views were mostly due to intrinsic motivation. UR - https://mededu.jmir.org/2021/2/e25506 UR - http://dx.doi.org/10.2196/25506 UR - http://www.ncbi.nlm.nih.gov/pubmed/33941512 ID - info:doi/10.2196/25506 ER - TY - JOUR AU - Nelson, Suchitra AU - Albert, M. Jeffrey AU - Milgrom, Peter PY - 2020/9/8 TI - Comparative Effectiveness of Two Nonsurgical Treatments to Reduce Oral Health Disparities From Untreated Tooth Decay in Older Adults: Protocol for a Cluster Randomized Trial JO - JMIR Res Protoc SP - e17840 VL - 9 IS - 9 KW - dental caries KW - older adults KW - atraumatic restorative treatment KW - silver diamine fluoride KW - fluoride varnish N2 - Background: The majority of dental caries lesions in older adults are at the gumline, at the edges of failed fillings and crowns, and in the surfaces of roots after gum recession. These lesions are difficult to restore with conventional surgical treatments using a dental drill and restorations often fail. Clinical guidelines are general and apply treatments that were designed for younger individuals in the dental care of older adults. Objective: This study will compare the effectiveness of 2 evidence-based nonsurgical strategies to manage dental caries lesions in adults aged 62 or older: (1) biannual topical application of silver diamine fluoride versus (2) atraumatic restorative treatment + biannual fluoride varnish. Methods: A cluster randomized clinical trial is being conducted in 22 publicly subsidized and other low-income housing facilities/sites (Arm 1: 11 sites, 275 participants; Arm 2: 11 sites, 275 participants). At baseline, participants will be screened for caries lesions. Those with nonurgent lesions will be treated according to the treatment arm to which the housing site was randomly assigned. The primary outcomes are caries lesion arrest, tooth sensitivity, and tooth pain at 52 weeks after treatment. Analytic methods for the primary aim include a generalized estimating equation approach to determine noninferiority of silver diamine fluoride relative to atraumatic restorative treatment + fluoride varnish treatment. Results: The trial was funded in April 2019. Enrollment began in September 2019 and results are expected in June 2023. Conclusions: This study will inform the standard of care for treating caries lesions in older adults. If effective, either of these interventions has broad applicability in clinical and community-based settings. Trial Registration: ClinicalTrials.gov NCT03916926; https://clinicaltrials.gov/ct2/show/NCT03916926 International Registered Report Identifier (IRRID): DERR1-10.2196/17840 UR - http://www.researchprotocols.org/2020/9/e17840/ UR - http://dx.doi.org/10.2196/17840 UR - http://www.ncbi.nlm.nih.gov/pubmed/32897236 ID - info:doi/10.2196/17840 ER - TY - JOUR AU - Shetty, Vivek AU - Morrison, Douglas AU - Belin, Thomas AU - Hnat, Timothy AU - Kumar, Santosh PY - 2020/6/24 TI - A Scalable System for Passively Monitoring Oral Health Behaviors Using Electronic Toothbrushes in the Home Setting: Development and Feasibility Study JO - JMIR Mhealth Uhealth SP - e17347 VL - 8 IS - 6 KW - health behaviors KW - oral self-care KW - digital tools KW - remote monitoring KW - passive measurement N2 - Background: Dental disease (including dental caries and periodontal disease) is largely preventable and closely linked to inadequate oral health behaviors. Digital health technologies have great potential for unobtrusively monitoring brushing behaviors in home settings and promoting optimal oral self-care routines at scale. Objective: The aim of this study is to leverage the ubiquity of electronic toothbrushes and smartphones with the development of a Remote Oral Behaviors Assessment System (ROBAS) and evaluate its feasibility for passively tracking brushing behaviors in real-world settings. Methods: We developed ROBAS by linking inertial sensors contained within consumer electronic toothbrushes to a scalable software platform comprised of a smartphone app linked to a cloud platform. First, the criterion validity of ROBAS for accurately capturing brushing details was established in a laboratory setting. Next, real-world performance and usability were evaluated in a stratified community sample of 32 participants who used ROBAS daily for 1 month and maintained a diary of their brushing episodes. Semistructured interviews at baseline and exit captured the user experience. We used regression models and Bland-Altman analyses to assess the criterion validity, functionality, accuracy, and consistency of ROBAS. Results: Using a stopwatch as the criterion reference, ROBAS showed a mean absolute percent error (MAPE) of 1.8%, an estimated bias of 0.64 seconds that was not statistically distinguishable from zero (95% CI ?0.93 to 2.22 seconds, SE 0.79), and a connection failure rate of 6.7% (95% CI 0.8%-22.1%, SE 4.6%). In real-world testing, ROBAS showed close agreement with the daily diary recordings of brushing episodes; estimated average discrepancies between the diary and ROBAS were 0.13 sessions per day (95% CI 0.01-0.26, SE 0.06), 8.0 seconds per brushing session (95% CI 1.4-14.7, SE 3.3), and 30 seconds of brushing per day (95% CI 9.3-50.1, SE 10.0). Retrospective self-reports produced substantially higher estimates of brushing frequency and duration compared to ROBAS measurements. Participants reported ROBAS was easy to use and expressed an interest in receiving ROBAS-delivered feedback on their brushing behaviors. Most participants were bothered by the use of an additional study phone, and some reported connectivity-related issues. Conclusions: ROBAS has a high criterion validity for measuring oral health behaviors. It can accurately and reliably monitor brushing patterns in home settings for extended periods. Unobtrusive data collection through ROBAS sets the stage for automated coaching and optimization of oral self-care practices at the individual and population level. UR - http://mhealth.jmir.org/2020/6/e17347/ UR - http://dx.doi.org/10.2196/17347 UR - http://www.ncbi.nlm.nih.gov/pubmed/32579118 ID - info:doi/10.2196/17347 ER - TY - JOUR AU - Lara, Sebastian Juan AU - Braga, Minatel Mariana AU - Zagatto, Gustavo Carlos AU - Wen, Lung Chao AU - Mendes, Medeiros Fausto AU - Murisi, Uribe Pedroza AU - Haddad, Estela Ana PY - 2020/5/22 TI - A Virtual 3D Dynamic Model of Caries Lesion Progression as a Learning Object for Caries Detection Training and Teaching: Video Development Study JO - JMIR Med Educ SP - e14140 VL - 6 IS - 1 KW - 3d virtual models KW - dental education KW - e-learning KW - learning object KW - caries KW - cariology N2 - Background: In the last decade, 3D virtual models have been used for educational purposes in the health sciences, specifically for teaching human anatomy and pathology. These models provide an opportunity to didactically visualize key spatial relations that can be poorly understood when taught by traditional educational approaches. Caries lesion detection is a crucial process in dentistry that has been reported to be difficult to learn. One especially difficult aspect is linking clinical characteristics of the different severity stages with their histological features, which is fundamental for treatment decision-making. Objective: This project was designed to develop a virtual 3D digital model of caries lesion formation and progression to aid the detection of lesions at different severity stages as a potential complement to traditional lectures. Methods: Pedagogical planning, including identification of objectives, exploration of the degree of difficulty of caries diagnosis?associated topics perceived by dental students and lecturers, review of the literature regarding key concepts, and consultation of experts, was performed prior to constructing the model. An educational script strategy was created based on the topics to be addressed (dental tissues, biofilm stagnation areas, the demineralization process, caries lesion progression on occlusal surfaces, clinical characteristics related to different stages of caries progression, and histological correlations). Virtual 3D models were developed using the Virtual Man Project and refined using multiple 3D software applications. In the next phase, computer graphic modelling and previsualization were executed. After that, the video was revised and edited based on suggestions. Finally, explanatory subtitles were generated, the models were textured and rendered, and voiceovers in 3 languages were implemented. Results: We developed a 6-minute virtual 3D dynamic video in 3 languages (English, Spanish, and Brazilian Portuguese) intended for dentists and dental students to support teaching and learning of caries lesion detection. The videos were made available on YouTube; to date, they have received more than 100,000 views. Conclusions: Complementary pedagogical tools are valuable to support cariology education. This tool will be further tested in terms of utility and usability as well as user satisfaction in achieving the proposed objectives in specific contexts. UR - http://mededu.jmir.org/2020/1/e14140/ UR - http://dx.doi.org/10.2196/14140 UR - http://www.ncbi.nlm.nih.gov/pubmed/32441661 ID - info:doi/10.2196/14140 ER - TY - JOUR AU - Melo, Paulo AU - Malone, Sinead AU - Rao, Arathi AU - Fine, Charlotte PY - 2020/2/21 TI - A 21-Day School-Based Toothbrushing Intervention in Children Aged 6 to 9 Years in Indonesia and Nigeria: Protocol for a Two-Arm Superiority Randomized Controlled Trial JO - JMIR Res Protoc SP - e14156 VL - 9 IS - 2 KW - school children KW - oral health KW - OHIs KW - DMFT KW - school program KW - knowledge transfer KW - behavior change N2 - Background: The World Health Organization reports that dental cavities affect 60% to 90% of children globally. FDI World Dental Federation and Unilever Oral Care have developed public health programs to improve brushing habits over their 12-year partnership. The last of these (phase III) named Brush Day & Night aimed to educate children on brushing twice daily with a fluoride toothpaste and gave useful information for a new project, phase IV. The 21-day Brush Day & Night program is an intense education activity designed to establish the habit of brushing day and night with a fluoride toothpaste. The program involves daily brushing instruction and includes free toothpaste and toothbrushes. Objective: The main objective of the study is to evaluate the impact of a 21-day school program on children?s oral health. As a secondary objective, we aim to evaluate the impact on the knowledge, behavior, toothbrushing habits, and quality of life in school children aged 6 to 9 years after a 21-day school program and compare with baseline and a control group as measured by the self-reported questionnaires issued to children (in particular, the self-reported brushing frequency and positive responses on fluoridated toothpaste use). The enduring nature of the program will be determined by the inclusion of 8- and 24-week time points. Methods: The study is a 2-arm superiority randomized controlled trial. Clusters in this study are infant and junior schools in Indonesia and Nigeria. The study aims to recruit 20 schools with children aged 6 to 9 years in each country. At baseline, children in both intervention and control schools will answer a questionnaire and have their clinical oral health assessed using the Simplified Oral Hygiene Index (OHI) and Decayed Missing and Filled Teeth index. Children in the intervention schools will then take part in a structured 21-day Brush Day & Night intervention. Children in the control schools will be provided with free toothpaste and toothbrushes but will not receive the 21-day intervention. The questionnaires and OHI assessments are repeated after the 21-day program is completed and again 8 weeks later and 24 weeks later for all participating children. Parents/carers/guardians of all children will sign the informed consent and complete questionnaires on their own experience and attitudes toward oral health and toothbrushing routine at each of the four times points (baseline, 21 days, 8 weeks, and 24 weeks). The study will be conducted by the national dental associations of Indonesia and Nigeria and was approved by the ethics committees of both countries. Results: The study is ongoing. Recruitment of schools started in Indonesia in February 2018 and in Nigeria in April 2018 for the first part of the study, which concluded in Indonesia in September 2018 and in Nigeria in November 2018. The second part of the study (the second half of the schools) started in November 2018 in Indonesia and December 2018 in Nigeria. Conclusions: We expect to collect all the data during 2019 and publish findings from the study by March 2020. Trial Registration: ClinicalTrials.gov NCT04001296; https://tinyurl.com/selxraa International Registered Report Identifier (IRRID): DERR1-10.2196/14156 UR - http://www.researchprotocols.org/2020/2/e14156/ UR - http://dx.doi.org/10.2196/14156 UR - http://www.ncbi.nlm.nih.gov/pubmed/32130186 ID - info:doi/10.2196/14156 ER - TY - JOUR AU - Kumar, Satheesh Preeti AU - KS, Kumar Satheesh AU - Grandhi, Venkatesh Vyoma AU - Gupta, Vrinda PY - 2019/6/8 TI - The Effects of Titanium Implant Surface Topography on Osseointegration: Literature Review JO - JMIR Biomed Eng SP - e13237 VL - 4 IS - 1 KW - implant interface KW - TPS KW - acid etching KW - alkaline etching KW - anodisation KW - polymer demixing KW - sol gel N2 - Background: A variety of claims are made regarding the effects of surface topography on implant osseointegration. The development of implant surfaces topography has been empirical, requiring numerous in vitro and in vivo tests. Most of these tests were not standardized, using different surfaces, cell populations, or animal models. The exact role of surface chemistry and topography on the early events of the osseointegration of dental implants remains poorly understood. Objective: The aim of this study was to consider the major claims made concerning the effects of titanium implant surface topography on osseointegration. The osseointegration rate of titanium dental implants is related to their composition and surface roughness. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants were reviewed. Important findings of consensus were highlighted, and existing controversies were revealed. Methods: This paper considered many of the research publications listed in Medical Literature Analysis and Retrieval System Online and presented in biomedical research publications and textbooks. Surface treatments, such as titanium plasma spraying, grit blasting, acid etching, alkaline etching, anodization, polymer demixing, sol-gel conversion, and their corresponding surface morphologies and properties were described. Results: Many in vitro evaluations are not predictive of or correlated with in vivo outcomes. In some culture models, increased surface topography positively affects proosteogenic cellular activities. Many studies reveal increase in bone-to-implant contact (BIC), with increased surface topography modifications on implant surfaces. Conclusions: Increased implant surface topography improves the BIC and the mechanical properties of the enhanced interface. UR - http://biomedeng.jmir.org/2019/1/e13237/ UR - http://dx.doi.org/10.2196/13237 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/13237 ER - TY - JOUR AU - Reddy, Shravya AU - Kumar, S. Preeti AU - Grandhi, V. Vyoma PY - 2018/10/02 TI - Relationship Between the Applied Occlusal Load and the Size of Markings Produced Due to Occlusal Contact Using Dental Articulating Paper and T-Scan: Comparative Study JO - JMIR Biomed Eng SP - e11347 VL - 3 IS - 1 KW - occlusal indicator KW - occlusal load KW - articulating paper KW - T-Scan N2 - Background: The proposed experimental design was devised to determine whether a relationship exists between the occlusal load applied and the size of the markings produced from tooth contact when dental articulating paper and T-Scan are interposed alternatively. Objective: The objective of our study was to compare the relationship between contact markings on an articulating paper and T-Scan for an applied occlusal load. Methods: In this in vitro study, dentulous maxillary and mandibular dies were mounted on a metal jig and articulating paper and T-Scan sensor were placed alternatively between the casts. Loads simulating occlusal loads began at 25 N and incrementally continued up to 450 N. The resultant markings (180 marks resulting from articulating paper and 138 from T-Scan) were photographed, and the marks were analyzed using MOTIC image analysis and sketching software. Descriptive statistical analyses were performed using one-way analysis of variance, Student t test, and Pearson correlation coefficient method. Results: Statistical interpretation of the data indicated that with articulating paper, the mark area increased nonlinearly with increasing load and there was a false-positive result. The characteristics of the paper mark appearance did not describe the amount of occlusal load present on a given tooth. The contact marking obtained using T-Scan for an applied occlusal load indicated that the mark area increased with increase in the load and provided more predictable results of actual load content within the occlusal contact. Conclusions: The size of an articulating paper mark may not be a reliable predictor of the actual load content within the occlusal contact, whereas a T-Scan provides more predictable results of the actual load content within the occlusal contact. UR - http://biomedeng.jmir.org/2018/1/e11347/ UR - http://dx.doi.org/10.2196/11347 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/11347 ER - TY - JOUR AU - Braga, Minatel Mariana AU - Lenzi, Larissa Tathiane AU - Ferreira, Rosche Fernanda AU - Mendes, Medeiros Fausto AU - Raggio, Prócida Daniela AU - Imparato, Carlos José AU - Bonecker, Marcelo AU - Magalhăes, Carolina Ana AU - Wang, Linda AU - Rios, Daniela AU - Pessan, Pelim Juliano AU - Duque, Cristiane AU - Rebelo, Bessa Maria Augusta AU - Alves Filho, Oliveira Ary AU - Lima, Moura Marina De Deus AU - Moura, Silva Marcoeli AU - De Carli, Diogo Alessandro AU - Sanabe, Emi Mariane AU - Cenci, Sergio Maximiliano AU - Oliveira, Ferreira Elenara AU - Correa, Britto Marcos AU - Rocha, Oliveira Rachel AU - Zenkner, Eduardo Julio AU - Murisí, Uribe Pedroza AU - Martignon, Stefania AU - Lara, Sebastian Juan AU - Aquino, Gabriela Fatima AU - Carrillo, Alfredo AU - Chu, Hung Chun AU - Deery, Chris AU - Ricketts, David AU - Melo, Paulo AU - Antunes, Ferreira José Leopoldo AU - Ekstrand, Rud Kim AU - PY - 2017/08/16 TI - Impact of a Tutored Theoretical-Practical Training to Develop Undergraduate Students? Skills for the Detection of Caries Lesions: Study Protocol for a Multicenter Controlled Randomized Study JO - JMIR Res Protoc SP - e155 VL - 6 IS - 8 KW - active learning KW - cariology KW - dental education KW - laboratory training N2 - Background: Tutored laboratorial activities could be a manner of improving the competency development of students. However, its impact over conventional theoretical classes has not yet been tested. Additionally, different university contexts could influence this issue and should be explored. Objective: To assess the impact of a tutored theoretical-practical training for teaching undergraduate students to detect caries lesions as compared with theoretical teaching activities. The impact of these teaching/learning activities will be assessed in terms of efficacy, cost/benefit, retention of knowledge/acquired competences, and student acceptability. Methods: Sixteen centers (7 centers from Brazil and 9 centers from other countries throughout the world) are involved in the inclusion of subjects for this protocol. A randomized controlled study with parallel groups will be conducted. One group (control) will be exposed to a 60- to 90-minute conventional theoretical class and the other group (test) will be exposed to the same theoretical class and also a 90-minute laboratory class, including exercises and discussions based on the evaluation of a pool of images and extracted teeth. The mentioned outcomes will be evaluated immediately after the teaching activities and also in medium- and long-term analyses. To compare the long-term outcomes, students who enrolled in the university before the participating students will be interviewed for data collection and these data will be used as a control and compared with the trained group. This stage will be a nonrandomized phase of this study, nested in the main study. Appropriate statistical analysis will be performed according to the aims of this study. Variables related to the centers will also be analyzed and used to model adjustment as possible sources of variability among results. Results: This ongoing study is funded by a Brazilian national funding agency (CNPq- 400736/2014-4). We expect that the tutored theoretical-practical training will improve the undergraduate students? performance in the detection of caries lesions and subsequent treatment decisions, mainly in terms of long-term retention of knowledge. Our hypothesis is that tutored theoretical-practical training is a more cost-effective option for teaching undergraduate students to detect caries lesions. Conclusions: If our hypothesis is confirmed, the use of laboratory training in conjunction with theoretical classes could be used as an educational strategy in Cariology to improve the development of undergraduate students? skills in the detection of caries lesions and clinical decision-making. UR - http://www.researchprotocols.org/2017/8/e155/ UR - http://dx.doi.org/10.2196/resprot.7414 UR - http://www.ncbi.nlm.nih.gov/pubmed/28814381 ID - info:doi/10.2196/resprot.7414 ER - TY - JOUR AU - Cunha-Cruz, Joana AU - Milgrom, Peter AU - Shirtcliff, Michael R. AU - Huebner, E. Colleen AU - Ludwig, Sharity AU - Allen, Gary AU - Scott, JoAnna PY - 2015/05/22 TI - ?Everybody Brush!?: Protocol for a Parallel-Group Randomized Controlled Trial of a Family-Focused Primary Prevention Program With Distribution of Oral Hygiene Products and Education to Increase Frequency of Toothbrushing JO - JMIR Res Protoc SP - e58 VL - 4 IS - 2 KW - oral hygiene KW - toothbrushing KW - dental devices, home care KW - dental care KW - communication KW - social support N2 - Background: Twice daily toothbrushing with fluoridated toothpaste is the most widely advocated preventive strategy for dental caries (tooth decay) and is recommended by professional dental associations. Not all parents, children, or adolescents follow this recommendation. This protocol describes the methods for the implementation and evaluation of a quality improvement health promotion program. Objective: The objective of the study is to show a theory-informed, evidence-based program to improve twice daily toothbrushing and oral health-related quality of life that may reduce dental caries, dental treatment need, and costs. Methods: The design is a parallel-group, pragmatic randomized controlled trial. Families of Medicaid-insured children and adolescents within a large dental care organization in central Oregon will participate in the trial (n=21,743). Families will be assigned to one of three groups: a test intervention, an active control, or a passive control condition. The intervention aims to address barriers and support for twice-daily toothbrushing. Families in the test condition will receive toothpaste and toothbrushes by mail for all family members every three months. In addition, they will receive education and social support to encourage toothbrushing via postcards, recorded telephone messages, and an optional participant-initiated telephone helpline. Families in the active control condition will receive the kit of supplies by mail, but no additional instructional information or telephone support. Families assigned to the passive control will be on a waiting list. The primary outcomes are restorative dental care received and, only for children younger than 36 months old at baseline, the frequency of twice-daily toothbrushing. Data will be collected through dental claims records and, for children younger than 36 months old at baseline, parent interviews and clinical exams. Results: Enrollment of participants and baseline interviews have been completed. Final results are expected in early summer, 2017. Conclusions: If proven effective, this simple intervention can be sustained by the dental care organization and replicated by other organizations and government. Trial Registration: Trial Registration: ClinicalTrials.gov NCT02327507; http://clinicaltrials.gov/ct2/show/NCT02327507 (Archived by WebCite at http://www.webcitation.org/6YCIxJSor). UR - http://www.researchprotocols.org/2015/2/e58/ UR - http://dx.doi.org/10.2196/resprot.4485 UR - http://www.ncbi.nlm.nih.gov/pubmed/26002091 ID - info:doi/10.2196/resprot.4485 ER - TY - JOUR AU - Antoniou, E. Panagiotis AU - Athanasopoulou, A. Christina AU - Dafli, Eleni AU - Bamidis, D. Panagiotis PY - 2014/06/13 TI - Exploring Design Requirements for Repurposing Dental Virtual Patients From the Web to Second Life: A Focus Group Study JO - J Med Internet Res SP - e151 VL - 16 IS - 6 KW - education KW - medical KW - dental KW - focus groups KW - patient simulation KW - problem-based learning KW - video games N2 - Background: Since their inception, virtual patients have provided health care educators with a way to engage learners in an experience simulating the clinician?s environment without danger to learners and patients. This has led this learning modality to be accepted as an essential component of medical education. With the advent of the visually and audio-rich 3-dimensional multi-user virtual environment (MUVE), a new deployment platform has emerged for educational content. Immersive, highly interactive, multimedia-rich, MUVEs that seamlessly foster collaboration provide a new hotbed for the deployment of medical education content. Objective: This work aims to assess the suitability of the Second Life MUVE as a virtual patient deployment platform for undergraduate dental education, and to explore the requirements and specifications needed to meaningfully repurpose Web-based virtual patients in MUVEs. Methods: Through the scripting capabilities and available art assets in Second Life, we repurposed an existing Web-based periodontology virtual patient into Second Life. Through a series of point-and-click interactions and multiple-choice queries, the user experienced a specific periodontology case and was asked to provide the optimal responses for each of the challenges of the case. A focus group of 9 undergraduate dentistry students experienced both the Web-based and the Second Life version of this virtual patient. The group convened 3 times and discussed relevant issues such as the group?s computer literacy, the assessment of Second Life as a virtual patient deployment platform, and compared the Web-based and MUVE-deployed virtual patients. Results: A comparison between the Web-based and the Second Life virtual patient revealed the inherent advantages of the more experiential and immersive Second Life virtual environment. However, several challenges for the successful repurposing of virtual patients from the Web to the MUVE were identified. The identified challenges for repurposing of Web virtual patients to the MUVE platform from the focus group study were (1) increased case complexity to facilitate the user?s gaming preconception in a MUVE, (2) necessity to decrease textual narration and provide the pertinent information in a more immersive sensory way, and (3) requirement to allow the user to actuate the solutions of problems instead of describing them through narration. Conclusions: For a successful systematic repurposing effort of virtual patients to MUVEs such as Second Life, the best practices of experiential and immersive game design should be organically incorporated in the repurposing workflow (automated or not). These findings are pivotal in an era in which open educational content is transferred to and shared among users, learners, and educators of various open repositories/environments. UR - http://www.jmir.org/2014/6/e151/ UR - http://dx.doi.org/10.2196/jmir.3343 UR - http://www.ncbi.nlm.nih.gov/pubmed/24927470 ID - info:doi/10.2196/jmir.3343 ER - TY - JOUR AU - Papadopoulos, Lazaros AU - Pentzou, Afroditi-Evaggelia AU - Louloudiadis, Konstantinos AU - Tsiatsos, Thrasyvoulos-Konstantinos PY - 2013/10/29 TI - Design and Evaluation of a Simulation for Pediatric Dentistry in Virtual Worlds JO - J Med Internet Res SP - e240 VL - 15 IS - 10 KW - virtual patient KW - virtual world KW - pediatric dentistry KW - simulation KW - Second Life KW - OpenSim KW - communication KW - tell-show-do KW - behavior management N2 - Background: Three-dimensional virtual worlds are becoming very popular among educators in the medical field. Virtual clinics and patients are already used for case study and role play in both undergraduate and continuing education levels. Dental education can also take advantage of the virtual world?s pedagogical features in order to give students the opportunity to interact with virtual patients (VPs) and practice in treatment planning. Objective: The objective of this study was to design and evaluate a virtual patient as a supplemental teaching tool for pediatric dentistry. Methods: A child VP, called Erietta, was created by utilizing the programming and building tools that online virtual worlds offer. The case is about an eight-year old girl visiting the dentist with her mother for the first time. Communication techniques such as Tell-Show-Do and parents? interference management were the basic elements of the educational scenario on which the VP was based. An evaluation of the simulation was made by 103 dental students in their fourth year of study. Two groups were formed: an experimental group which was exposed to the simulation (n=52) and a control group which did not receive the simulation (n=51). At the end, both groups were asked to complete a knowledge questionnaire and the results were compared. Results: A statistically significant difference between the two groups was found by applying a t test for independent samples (P<.001), showing a positive learning effect from the VP. The majority of the participants evaluated the aspects of the simulation very positively while 69% (36/52) of the simulation group expressed their preference for using this module as an additional teaching tool. Conclusions: This study demonstrated that a pediatric dentistry VP built in a virtual world offers significant learning potential when used as a supplement to the traditional teaching techniques. UR - http://www.jmir.org/2013/10/e240/ UR - http://dx.doi.org/10.2196/jmir.2651 UR - http://www.ncbi.nlm.nih.gov/pubmed/24168820 ID - info:doi/10.2196/jmir.2651 ER -