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From page 333... ... Index l A Academic health centers, 4, 33 challenges for, 200-202, 284 collaborative research in, 7, 15 in competitive markets, 105 consolidation of programs in, 216 contribution of dental schools to, 4, 30, 287 dental research in, 158 dental school clinics in, 196 historical development, 31-32 mission of, 31-32 patient care in, 8, 174- 175 strategic planning in, 16, 192, 226 See also Patient care in dental schools; University-affiliated dental schools Academy of General Dentistry, 121 Access to care average wait time, 262 care-seeking behaviors, 67 dental insurance and, 25-26, 56 in dental school clinics, 197198 333 geographic distribution of dentists and, 10, 276 licensure requirements and, 247 National Health Service Corps and, 56-57 opportunities for improvement, 73-76 supply of practitioners and, 56, 139 underserved populations, 11 - 12, 75, 189, 190 Accreditation ambulatory care programs, 16, 186, 196, 197 categories of, 233 concerns about, 9, 229, 234-237 confidentiality in, 233, 236, 251 in continuing education, 120122 cost of, 233, 235 current status of schools, 233, 235 curriculum guidelines and, 9394 of dental hygiene programs, 237 Read the entire page →
From page 334... ... 334 / INDEX in evolution of dentistry, 42, 43, 49-50 medical vs. dental, 231-232 opportunities for improvement 4, 291-292 organizational structure for, 230-231 patient care in schools and, 186, 195-196, 197 postgraduate training, 112 process, 231-233 professional interests in, 236-237 program innovation and, 236 recommendations for, 16, 17-18, 250-252 research standards, 145 role of, 228, 229 student performance trends and, 234-235 survey team, 233 Active learning techniques, 12 problem-based learning, 98-100 Advanced dental education access to, 114, 115, 116 accreditation, 231 costs, 118 current status, 91, 115 dental-medical integration, 107 in dental specialties, 116-118 educational debt and, 137-138 for faculty, 100-101 in general dentistry, 112- 116 licensure, 250 options, 111 - 112 patient care activities, 176 recommendations, 4, 14, 142143, 289 in research, 117 African Americans children, oral health of, 64-65 in dental work force, 260, 277, 278 enrollment trends, 132, 260, 277 oral cancer rate, 65 Aging of population, 4, 25 oral health complications, 64 oral health trends, 62, 63-64 service needs in, 74-75 socioeconomic factors, 65 AIDS, 64, 175 Allied dental personnel accreditation, 231-232, 237 dental team productivity, 272273, 293 in dentist training, 13 expanded role for, 111 practice regulation and, 4, 18, 253 professional development, 274 supply, 256-257, 263 training of, 19 See also Hygienists Alternative models of practice, 4, 30-31 Ambulatory care, accreditation for, 16, 186, 196, 197 American Association of Dental Examiners, 18, 121, 252 American Association of Dental Research, 157 American Association of Dental Schools, 16, 18, 43, 47, 48, 49-50, 89, 93-94, 112, 197, 252 on accreditation, 234 American Dental Association, 49, 51, 52, 53, 54, 73, 91, 230 on continuing education, 121 origins of, 41 American Dental Hygienists' Association, 43, 263 Asian Americans, 277 B Basic science clinical practice and, 7, 12, 289 clinical science integration, 94100, 216 current curriculum, 92-93 dental-medical integration, 13, 97, 108, 142, 166, 216 in dental research, 14, 79 recommendations, 12, 14, 141 Read the entire page →
From page 335... ... See Regionalization Continuing education, 90 accreditation, 120- 121 evaluation, 121, 247 importance of, 118-119 options for, 119-120 research role, 148 state requirements for, 122, 247 Continuous quality improvement, 193-194 Cost of care in academic health centers, 188-189 in dental schools, 175, 178, 188190 dentistry as medical specialty and, 110-111 early research, 56 insurance payment for, 67-68 out-of-pocket payment for, 67 trends, 23, 282 Read the entire page →
From page 336... ... 6-7, 140-141, 289 role of, 31-32, 33, 88 social trends and, 23-24, 282285 See also Advanced dental education; Evolution of dental education and dentistry Dental floss, 69-70 Dental Interactive Simulations Corporation, 249 Dental work force allied personnel, 263 composition, 257-260 concerns about, 10- 11, 254-255, 280, 284, 293-294 Read the entire page →
From page 337... ... IBEX / 337 current numbers, 255 demand/need estimates, 267 269 dental educators as, 5, 26, 55-56 in dental research, 7, 156 - 157, 162, 255 dental school faculty in, 127-128 estimated requirements, 261 263, 266 forecasting of requirements, 18 19, 263-270 minority populations in, 10- 11, 19, 29, 260, 276-278, 279, 293-294 monitoring supply and demand in, 5, 10, 18-19, 278, 279, 293 practice trends, 80-81 productivity of, 272-274 prospects for balanced supply, 275 prospects for oversupply, 270 271 prospects for undersupply, 271 275 recommendations, 18-19, 278 280 regional variation, 10, 58, 139, 257, 262-263, 275-276, 279 statistical trends, 255-257 supply issues, 4-5, 10, 18- 19, 26, 57-58, 139, 254, 256-257, 261 -263 team strategy, 272-273 work load, 262 See also Hygienists Disadvantaged populations access to care, 6, 11-12, 56, 79, 81-, 284-285 care in dental schools for, 197 198 in dental work force, 10- 11, 19, 29, 260, 276-279, 293-294 oral health, 24, 64-66, 284-285, 288 utilization rates, 67 Disciplinary action, 238 E Education, Department of, 231 Effectiveness of dental services. See Outcomes research; Quality of care Enrollment trends, 1, 26, 57-58, 131 -134, 179, 255-256 allied dental personnel, 263, 273 demographic, 257-260 projections, 267 prospects for undersupply of practitioners, 271-272 quality of applicants, 134-135 recommendations, 18-19 Epidemiological research current assessment, 63-64 data sources for current oral health assessment, 59-60 data trends, 61-63 goals, 147 historical development, 53-55 obstacles to, 60-61 Evolution of dental education and dentistry in ancient world, 38 curriculum development, 89-91 demographic trends, 257-260 dental hygiene education in, 4243 early institutions, 39-41 enrollment trends, 57-58, 179 postgraduate training, 112- 114 pre-modern Europe, 38-39 professionalization in, 41, 48-50 proprietary schools in, 42, 43, 46 reform efforts, 43-48 relations with medical schools in, 40 research base, 51-55 specialty programs, 116 standards development, 48-50 themes in, 35, 281-282 time line, 35-37 university affiliation, 199-201 Examinations. Read the entire page →
From page 338... ... 338 / INDEX F Faculty accountability, 142, 188, 192, 194-195 in accreditation process, 233 basic science, 97 compensation, 128-129, 212, 213 in comprehensive care programs, 104 diversity, 125 isolation of, 122- 123, 166 organizational structure, 123, 166 practice plans, 127-128, 129, 176, 183, 194-195, 212-213 recommendations for, 14, 142, 143 research role, 14, 128, 147-148, 156-157, 162, 165 resistance to change in, 100102, 223-224 as role models, 108, 127-128 specialization in, 118 statistical profile, 124- 125 tenure, 129- 131 Faculty development, 125- 127 clinical practice skills, 101 - 102 127, 128 licensure requirements and, 246 obstacles to, 126- 127 problems in, 7 recommendations for, 14 for research, 162, 165- 166 Fauchard, 39 Financial management challenges for dental schools, 4, 9, 26, 203-209, 291 cost analysis, 211 -212 cost of advanced specialty education, 118 cost of care research, 56 current statistical profile, 204208 curriculum changes in, 214 economics of dental research, 149-151 economics of research, 159- 162 expenditures per student, 204 207 faculty compensation, 128-129 faculty practice plans, 212-213 organizational consolidation, 216-218 philanthropic contributions, 215-216 policy constraints in, 218-219 public vs. private schools, 204 207, 220 recommendations for dental schools, 16- 17, 266-227 revenue sources, 204, 207 in school clinics, 178, 180, 181, 208-209, 213-214 simple research designs, 166 170 sponsored research as revenue, 215 strategic opportunities, 209-211 student educational debt load, 135-139 tuition in, 214-215 in universities, 200-201 Flexner Report, 43, 46 Fluoridation, 55, 62, 69 Fluorosis, 54 Forecasting models, 263-270 recommendations, 18- 19 Foreign schools, 135 Free care, 175 Future of dental education and dentistry access to care issues, 73-75 choices in, 1-2 development of interventions/ technologies, 69-72 opportunities for improvement, 286-287 patient care in dental schools, 175-176, 184, 191, 192-197 research opportunities, 144 social context, 282-285 See also Reform of dental education and dentistry Read the entire page →
From page 339... ... See Insurance/ health plans Healthy People 2000, 75-76, 82-84 Hispanic Americans, 65, 132, 260, 277 Hygienists accreditation concerns, 237 in dental team productivity, 272-273 educational programs, 207-208, 273 evolution of educational programs, 42-43 licensing issues, 248 professional development, 273, 274 supply, 263, 273 I Information management in financial management, 211212 in patient care, 194, 195, 283 Informed consent, 188 Insurance/health plans access to care and, 23, 73-74, 76 dental coverage trends, 25-26, 56 health care reform and, 77 patient care context, 174-175 quality of care and, 185 sources of, 68 student clinics and, 184, 185, 191, 197 utilization and, 67-68, 269, 275 International Association for Dental Research, 47 Joint Commission on the Accreditation of Health Care Organizations, 186 Josiah Macy, Tr., Foundation, 205 L Leadership, in medical and dental education, 221-224 Licensure access to care and, 247 clinical examination in, 237238, 242-244, 245, 246, 249, 252-253 Read the entire page →
From page 340... ... 340 / INDEX computer simulations in, 249250 concerns about, 9-10, 241 -242 continued competency, 247, 250 curriculum design and, 246 of dental hygienists, 248 disciplinary action, 238 evidence of competency in, 242244 in evolution of dentistry, 42, 43 failure rate, 243-244 opportunities for improvement, 4, 248-250, 291, 292 out- of- state credentialing, 5 0, 240, 247, 250, 253, 260 postgraduate training, 116 process, 238-240 professional interests in, 244245, 248 reciprocity in, 50, 240 recommendations for, 18, 252253 responsibility for, 244-245 role of, 228, 237 for specialty practice, 240-242 standardization in, 18, 240, 253, 292, 293 student performance trends, 134-135, 234-235 M Managed care, 8, 177, 188, 191, 283 Medicaid, 68, 178, 185 Medical education accreditation of, 231-232 dental clinic in, 189, 196 dental education in evolution of, 40 dental-medical integration, 13, 29-30, 81, 106-111, 142, 166, 216, 289 dentistry as specialty in, 44, 110-111, 216 Flexner report on, 43, 46 nurse practitioners, 80-81 revenue sources, 207 sharing of basic science faculty, 13, 97 Medical management, 70-71 Medical technologies, 25, 107 computer simulations for licensure, 249-250 dental-medical integration, 29 30 existing dental technologies, 69 70, 283 new dental technologies, 70-72, 283 in projecting supply requirements, 268 research, 146-147 technology transfer, 147-148 Medicare, 56, 68, 75 N National Academy of Sciences' 130 National Association of Dental Examiners, 48, 49 National Association of Dental Faculties, 48-49 National Board of Dental Examiners, 50 National Health and Nutrition Examination Survey, 53-54, 59-60 National Health Interview Study, 60 National Health Service Corps, 10, 56-57, 74, 139, 247, 276, 293 recommendations for, 12, 143, 279 tuition repayment and, 138 National Institute for Dental Research, 47, 52-53, 60, 145 recommendations for, 15 research spending, 150, 152-156, 159, 162-163 National Institutes of Health, 52, 53 Read the entire page →
From page 341... ... INDEX / 341 National Research Council, 2, 23, 51 Office of Scientific and Engineering Personnel, 162, 171 Native Americans, 64, 260, 277 Nurse practitioners, 80 o Oral health access to care and, 73-75 comorbid conditions, 64 current assessment, 63-64 data sources in assessment of 59-61 demographic trends, 24, 25 development of epidemiological research, 53-55 emergent interventions/ technologies, 70-72, 283 goals, 5-6, 11, 28, 78 Healthy People 2000 initiatives, 75-76 in loss of work days, 66 monitoring of, 11, 79-80 outcomes research, 17- 18, 28, 72-73, 77-78, 102, 286, 288289 preventive efforts, 6, 69-70, 7576, 78, 85, 285, 288 public support for programs, 288 recommendations for improving, 78-81, 288-289 role of dental education in, 79, 288 socioeconomic disparities, 6, 64-66, 284-285, 288 technology access/utilization, 69-70, 147-148, 283 in total health care management, 28, 110, 285 trends, 24, 61-63 See also Patient care in dental schools Oral Health 2000, 75, 78, 82-84 Orofacial pain, 63 Outcomes research clinical practice guidelines and, 77-78 dental education, 9, 17- 18, 251, 252, 292 need for, 28, 72-73, 102, 286, 288 problem-based learning, 98-99 recommendations, 17- 18, 288289 p Patient care in dental schools academic health centers and, 32, 196 access issues, 197-198 accountability in, 188, 194-195 accreditation, 186, 195-196, 197 administration, 195 challenges in, 175- 176, 182, 184, 196-197, 198, 208-209 community service efforts, 190 191 competition issues, 188 - 190, 286 conflicting needs in, 174- 175 continuous quality improvement in, 193- 194 efficiency of care in, 182- 184 faculty in, 127-128, 129, 176, 183, 194-195, 212-213 financing of, 178, 180, 181, 208 209, 212-214 individual differences in, 180 181, 191 informed consent issues in, 188 opportunities for improvement, 192, 290-291 organization of, 177 providers of, 176 quality assurance programs, 185-186, 193-194 quality of care, 181 - 182, 184 186 recommendations for, 196-198 Read the entire page →
From page 342... ... 342 / INDEX reimbursements, 175, 178, 188190 as revenue source, 181, 212 settings for, 176- 177 shortage of teaching patients, 188-190 statistical profile, 178- 181 strategic planning in, 192-193, 197 student enrollment trends and, 179 utilization, 179- 180 Patient-oriented care, 8 in comprehensive patient care model, 102- 104 in dental schools, 31 -32, 174175, 196-197, 198, 290-291 recommendations for, 13, 15, 142 research topics, 15 Periodontal disease, 60, 62-63, 7172 Pew National Dental Education Program, 90-91 Philanthropic contributions, 215216 Physician, role in oral health, 8081, 274 Practice guidelines, 72-73, 76-78, 86-87, 194-195 Prevention, 69-70, 75-76, 78, 85 Primary care in academic health centers, 188-189 oral health in, 78 Private dental schools, 1, 21, 181, 202, 204-207, 220 See also Schools of Dental Education Problem-based learning, 98-100 Provider Recognition Program, 121 Q Quality of care accreditation/licensure and, 228, 234-235, 291 allied dental personnel and, 111, 272, 273 definition, 184 in dental school clinics, 181182, 184-186, 193-196 documentation of, 8 future of dentistry, 283 overcare in, 184- 185 quality assurance, 185-186, 193194 R RAND Health Insurance Experiment, 60 Randomized clinical trials, 167 Reform of dental education and dentistry accreditation and licensure issues, 9- 10, 250-253 challenges in, 2, 21-22 dental work f orce issues, 10- 11, 293-294 educational mission, 6-7, 289 historical developments, 43-48 implementation of recommendations, 294-295 oral health objectives, 5-6, 68, 75-76, 78-81, 288-289 patient care issues, 8, 290-291 policy and strategic principles, 3-5, 28-29, 282 recommendations, 11 - 19 research practice, 7-8, 289-290 timetable, 5, 7, 12 university dental schools, 8-9, 291 Regionalization, 216-218 Research in dentistry accreditation standards, 145 advanced specialty preparation, 117 alternative models, 30-31 benefits of, 7, 289-290 collaborations in, 7-8, 15, 144, 172, 290 cost of care and, 56 Read the entire page →
From page 343... ... INDEX / 343 current status, 144- 145 dental education and, 170-171 development of dentist scientists, 162- 165 economics, 149- 151, 159- 162 epidemiological research in oral health, 53-55 faculty role, 14, 128, 147-148, 162, 165 focus, 151-156 goals, 7-8, 28-29, 145-149 historical development, 51-55 as interdisciplinary activity, 146-147 modeling of practitioner supply, 263-270 new interventions/technologies, 70-72 obstacles to, 157-159, 165-166, 171-172, 286 opportunities for improving, 44, 166-170 oral health, 6, 79-80 outcomes, 28, 72-73, 102, 288-289 patient care objectives in, 15 private s ector funding, 156, 161 promotion of, 15 publishing and, 150- 151 randomized clinical trials, 167 recommendations, 14-15, 80, 172-173 as revenue source, 150-151, 159, 215 role of schools in, 31-32, 289 290 training for, 148- 149, 165 work force in, 7, 156-157, 162, 255, 290 See also Epidemiological research Residency training, 112- 116, 262 Restructuring of health care system academic health centers and, 188-189 demand for dental services, 10, 26 dental coverage in, 74, 79 dental school clinics and, 105, 184, 285 information management in, 195 physician training in, 219 reform of dentistry in, 5, 30, 283 reimbursement systems in, 10 service demand and supply forecasts, 268-269 Rural practice, 257 S Schools of dental education accreditation/licensure, 4, 17- 18 ambulatory care in, 16 clinical practice in, 55-56 closure, 1, 8, 21, 26, 58, 199, 202, 219, 220 collaborative research, 7, 144 continuing education programs, 120 dental hygiene programs, 207208 expenditures per student, 204207 financial management, 4, 9, 1617, 26, 203-211 foreign schools, 135 geographic distribution, 58 inefficiencies in, 104- 105 private institutions, 1, 21, 181, 202, 204-207, 220 recommendations for, 12, 16-18, 141-143 regionalization, 216-218 research in, 7-8, 51-52, 54-55, 144-150, 157-159, 165-166, 171-173 revenue sources, 204, 207 status of students in, 131 strategic planning in, 15- 16 trends in, 1, 21, 31-32, 202 tuition, 135-138, 204-207, 214215 Read the entire page →
From page 344... ... 344 / INDEX See also Curriculum; Faculty; University-affiliated dental schools Sealants, 67, 69 Social trends, 23-24, 282-285 oral health monitoring, 79-80 Specialization current status, 116- 117 dentistry as medical specialty, 110-111, 216 early developments, 47 estimated requirements for, 261 -262 licensure, 240-242 minimum clinical competency and, 94 postgraduate education, 117- 118 postgraduate general dentistry and, 114 problems in, 117- 118 research training in, 117 Universities trends, 112, 116, 256 State practice acts, 42, 219, 238 241, 244-245 See also Government; Licensure Strategic planning in dental schools, 16 for patient care in dental schools, 192-193, 197 patient-centered objectives in, 15 role of, 192 in university-affiliated dental schools, 226 Students of dentistry attitude of educators toward, 131 educational debt load, 135-139 � as providers of care, 176, 178, 182-183, 194-195 quality of applicants, 134-135 quality of life issues, 139-140 school expenditures per student, 204-207 statistical profile, 131 - 134 T Technology transfer, 147 Tenure, 14, 129-131 Testing general dentistry license, 237 23g national uniformity in, 4 recommendations for, 18 Tooth brushing, 69-70 Tuition cost of education and, 204-207 dental hygiene education, 207 in financial management, 214 215 student choices and, 136-138 trends, 135-136, 200 U academic health centers in, 31 32 challenges for, 200-202, 284 current environment for, 24 Flexner report, 43 University-affiliated dental schools, 8-9, 16 collaborative research in, 7 consolidation strategies, 216218 contributions of, 30, 199, 224225, 226, 287, 291 dental school clinics and, 208209 evolution, 44-48, 199-200 financial challenges, 203-209, 225-226 financial strategies, 209-218 leadership issues, 221-224 opportunities for strengthening, 220-225, 291 philanthropic contributions to, 215-216 policy constraints in financial management of, 218-219, 284 Read the entire page →
From page 345... ... INDEX / 345 recommendations for, 225-227 risks for, 8-9,26,202-203,225226,286 sponsored research in, 215 Utilization age as factor in, 67 insurance coverage and, 67-68 models for estimating, 266-269 reducing, in undersupply of dentists, 274-275 in student clinics, 179-180 trends, 67 Vaccines, 71 -72 Variation in practice, 9, 72,99 Veterans Affairs, Department of, 68 W Women in dentistry, 257-260 Work force. See Dental work force Read the entire page →

From page 333...

... Index l A Academic health centers, 4, 33 challenges for, 200-202, 284 collaborative research in, 7, 15 in competitive markets, 105 consolidation of programs in, 216 contribution of dental schools to, 4, 30, 287 dental research in, 158 dental school clinics in, 196 historical development, 31-32 mission of, 31-32 patient care in, 8, 174- 175 strategic planning in, 16, 192, 226 See also Patient care in dental schools; University-affiliated dental schools Academy of General Dentistry, 121 Access to care average wait time, 262 care-seeking behaviors, 67 dental insurance and, 25-26, 56 in dental school clinics, 197198 333 geographic distribution of dentists and, 10, 276 licensure requirements and, 247 National Health Service Corps and, 56-57 opportunities for improvement, 73-76 supply of practitioners and, 56, 139 underserved populations, 11 - 12, 75, 189, 190 Accreditation ambulatory care programs, 16, 186, 196, 197 categories of, 233 concerns about, 9, 229, 234-237 confidentiality in, 233, 236, 251 in continuing education, 120122 cost of, 233, 235 current status of schools, 233, 235 curriculum guidelines and, 9394 of dental hygiene programs, 237

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From page 334...

... 334 / INDEX in evolution of dentistry, 42, 43, 49-50 medical vs. dental, 231-232 opportunities for improvement 4, 291-292 organizational structure for, 230-231 patient care in schools and, 186, 195-196, 197 postgraduate training, 112 process, 231-233 professional interests in, 236-237 program innovation and, 236 recommendations for, 16, 17-18, 250-252 research standards, 145 role of, 228, 229 student performance trends and, 234-235 survey team, 233 Active learning techniques, 12 problem-based learning, 98-100 Advanced dental education access to, 114, 115, 116 accreditation, 231 costs, 118 current status, 91, 115 dental-medical integration, 107 in dental specialties, 116-118 educational debt and, 137-138 for faculty, 100-101 in general dentistry, 112- 116 licensure, 250 options, 111 - 112 patient care activities, 176 recommendations, 4, 14, 142143, 289 in research, 117 African Americans children, oral health of, 64-65 in dental work force, 260, 277, 278 enrollment trends, 132, 260, 277 oral cancer rate, 65 Aging of population, 4, 25 oral health complications, 64 oral health trends, 62, 63-64 service needs in, 74-75 socioeconomic factors, 65 AIDS, 64, 175 Allied dental personnel accreditation, 231-232, 237 dental team productivity, 272273, 293 in dentist training, 13 expanded role for, 111 practice regulation and, 4, 18, 253 professional development, 274 supply, 256-257, 263 training of, 19 See also Hygienists Alternative models of practice, 4, 30-31 Ambulatory care, accreditation for, 16, 186, 196, 197 American Association of Dental Examiners, 18, 121, 252 American Association of Dental Research, 157 American Association of Dental Schools, 16, 18, 43, 47, 48, 49-50, 89, 93-94, 112, 197, 252 on accreditation, 234 American Dental Association, 49, 51, 52, 53, 54, 73, 91, 230 on continuing education, 121 origins of, 41 American Dental Hygienists' Association, 43, 263 Asian Americans, 277 B Basic science clinical practice and, 7, 12, 289 clinical science integration, 94100, 216 current curriculum, 92-93 dental-medical integration, 13, 97, 108, 142, 166, 216 in dental research, 14, 79 recommendations, 12, 14, 141

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From page 335...

... See Regionalization Continuing education, 90 accreditation, 120- 121 evaluation, 121, 247 importance of, 118-119 options for, 119-120 research role, 148 state requirements for, 122, 247 Continuous quality improvement, 193-194 Cost of care in academic health centers, 188-189 in dental schools, 175, 178, 188190 dentistry as medical specialty and, 110-111 early research, 56 insurance payment for, 67-68 out-of-pocket payment for, 67 trends, 23, 282

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From page 336...

... 6-7, 140-141, 289 role of, 31-32, 33, 88 social trends and, 23-24, 282285 See also Advanced dental education; Evolution of dental education and dentistry Dental floss, 69-70 Dental Interactive Simulations Corporation, 249 Dental work force allied personnel, 263 composition, 257-260 concerns about, 10- 11, 254-255, 280, 284, 293-294

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From page 337...

... IBEX / 337 current numbers, 255 demand/need estimates, 267 269 dental educators as, 5, 26, 55-56 in dental research, 7, 156 - 157, 162, 255 dental school faculty in, 127-128 estimated requirements, 261 263, 266 forecasting of requirements, 18 19, 263-270 minority populations in, 10- 11, 19, 29, 260, 276-278, 279, 293-294 monitoring supply and demand in, 5, 10, 18-19, 278, 279, 293 practice trends, 80-81 productivity of, 272-274 prospects for balanced supply, 275 prospects for oversupply, 270 271 prospects for undersupply, 271 275 recommendations, 18-19, 278 280 regional variation, 10, 58, 139, 257, 262-263, 275-276, 279 statistical trends, 255-257 supply issues, 4-5, 10, 18- 19, 26, 57-58, 139, 254, 256-257, 261 -263 team strategy, 272-273 work load, 262 See also Hygienists Disadvantaged populations access to care, 6, 11-12, 56, 79, 81-, 284-285 care in dental schools for, 197 198 in dental work force, 10- 11, 19, 29, 260, 276-279, 293-294 oral health, 24, 64-66, 284-285, 288 utilization rates, 67 Disciplinary action, 238 E Education, Department of, 231 Effectiveness of dental services. See Outcomes research; Quality of care Enrollment trends, 1, 26, 57-58, 131 -134, 179, 255-256 allied dental personnel, 263, 273 demographic, 257-260 projections, 267 prospects for undersupply of practitioners, 271-272 quality of applicants, 134-135 recommendations, 18-19 Epidemiological research current assessment, 63-64 data sources for current oral health assessment, 59-60 data trends, 61-63 goals, 147 historical development, 53-55 obstacles to, 60-61 Evolution of dental education and dentistry in ancient world, 38 curriculum development, 89-91 demographic trends, 257-260 dental hygiene education in, 4243 early institutions, 39-41 enrollment trends, 57-58, 179 postgraduate training, 112- 114 pre-modern Europe, 38-39 professionalization in, 41, 48-50 proprietary schools in, 42, 43, 46 reform efforts, 43-48 relations with medical schools in, 40 research base, 51-55 specialty programs, 116 standards development, 48-50 themes in, 35, 281-282 time line, 35-37 university affiliation, 199-201 Examinations.

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From page 338...

... 338 / INDEX F Faculty accountability, 142, 188, 192, 194-195 in accreditation process, 233 basic science, 97 compensation, 128-129, 212, 213 in comprehensive care programs, 104 diversity, 125 isolation of, 122- 123, 166 organizational structure, 123, 166 practice plans, 127-128, 129, 176, 183, 194-195, 212-213 recommendations for, 14, 142, 143 research role, 14, 128, 147-148, 156-157, 162, 165 resistance to change in, 100102, 223-224 as role models, 108, 127-128 specialization in, 118 statistical profile, 124- 125 tenure, 129- 131 Faculty development, 125- 127 clinical practice skills, 101 - 102 127, 128 licensure requirements and, 246 obstacles to, 126- 127 problems in, 7 recommendations for, 14 for research, 162, 165- 166 Fauchard, 39 Financial management challenges for dental schools, 4, 9, 26, 203-209, 291 cost analysis, 211 -212 cost of advanced specialty education, 118 cost of care research, 56 current statistical profile, 204208 curriculum changes in, 214 economics of dental research, 149-151 economics of research, 159- 162 expenditures per student, 204 207 faculty compensation, 128-129 faculty practice plans, 212-213 organizational consolidation, 216-218 philanthropic contributions, 215-216 policy constraints in, 218-219 public vs. private schools, 204 207, 220 recommendations for dental schools, 16- 17, 266-227 revenue sources, 204, 207 in school clinics, 178, 180, 181, 208-209, 213-214 simple research designs, 166 170 sponsored research as revenue, 215 strategic opportunities, 209-211 student educational debt load, 135-139 tuition in, 214-215 in universities, 200-201 Flexner Report, 43, 46 Fluoridation, 55, 62, 69 Fluorosis, 54 Forecasting models, 263-270 recommendations, 18- 19 Foreign schools, 135 Free care, 175 Future of dental education and dentistry access to care issues, 73-75 choices in, 1-2 development of interventions/ technologies, 69-72 opportunities for improvement, 286-287 patient care in dental schools, 175-176, 184, 191, 192-197 research opportunities, 144 social context, 282-285 See also Reform of dental education and dentistry

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From page 339...

... See Insurance/ health plans Healthy People 2000, 75-76, 82-84 Hispanic Americans, 65, 132, 260, 277 Hygienists accreditation concerns, 237 in dental team productivity, 272-273 educational programs, 207-208, 273 evolution of educational programs, 42-43 licensing issues, 248 professional development, 273, 274 supply, 263, 273 I Information management in financial management, 211212 in patient care, 194, 195, 283 Informed consent, 188 Insurance/health plans access to care and, 23, 73-74, 76 dental coverage trends, 25-26, 56 health care reform and, 77 patient care context, 174-175 quality of care and, 185 sources of, 68 student clinics and, 184, 185, 191, 197 utilization and, 67-68, 269, 275 International Association for Dental Research, 47 Joint Commission on the Accreditation of Health Care Organizations, 186 Josiah Macy, Tr., Foundation, 205 L Leadership, in medical and dental education, 221-224 Licensure access to care and, 247 clinical examination in, 237238, 242-244, 245, 246, 249, 252-253

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From page 340...

... 340 / INDEX computer simulations in, 249250 concerns about, 9-10, 241 -242 continued competency, 247, 250 curriculum design and, 246 of dental hygienists, 248 disciplinary action, 238 evidence of competency in, 242244 in evolution of dentistry, 42, 43 failure rate, 243-244 opportunities for improvement, 4, 248-250, 291, 292 out- of- state credentialing, 5 0, 240, 247, 250, 253, 260 postgraduate training, 116 process, 238-240 professional interests in, 244245, 248 reciprocity in, 50, 240 recommendations for, 18, 252253 responsibility for, 244-245 role of, 228, 237 for specialty practice, 240-242 standardization in, 18, 240, 253, 292, 293 student performance trends, 134-135, 234-235 M Managed care, 8, 177, 188, 191, 283 Medicaid, 68, 178, 185 Medical education accreditation of, 231-232 dental clinic in, 189, 196 dental education in evolution of, 40 dental-medical integration, 13, 29-30, 81, 106-111, 142, 166, 216, 289 dentistry as specialty in, 44, 110-111, 216 Flexner report on, 43, 46 nurse practitioners, 80-81 revenue sources, 207 sharing of basic science faculty, 13, 97 Medical management, 70-71 Medical technologies, 25, 107 computer simulations for licensure, 249-250 dental-medical integration, 29 30 existing dental technologies, 69 70, 283 new dental technologies, 70-72, 283 in projecting supply requirements, 268 research, 146-147 technology transfer, 147-148 Medicare, 56, 68, 75 N National Academy of Sciences' 130 National Association of Dental Examiners, 48, 49 National Association of Dental Faculties, 48-49 National Board of Dental Examiners, 50 National Health and Nutrition Examination Survey, 53-54, 59-60 National Health Interview Study, 60 National Health Service Corps, 10, 56-57, 74, 139, 247, 276, 293 recommendations for, 12, 143, 279 tuition repayment and, 138 National Institute for Dental Research, 47, 52-53, 60, 145 recommendations for, 15 research spending, 150, 152-156, 159, 162-163 National Institutes of Health, 52, 53

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From page 341...

... INDEX / 341 National Research Council, 2, 23, 51 Office of Scientific and Engineering Personnel, 162, 171 Native Americans, 64, 260, 277 Nurse practitioners, 80 o Oral health access to care and, 73-75 comorbid conditions, 64 current assessment, 63-64 data sources in assessment of 59-61 demographic trends, 24, 25 development of epidemiological research, 53-55 emergent interventions/ technologies, 70-72, 283 goals, 5-6, 11, 28, 78 Healthy People 2000 initiatives, 75-76 in loss of work days, 66 monitoring of, 11, 79-80 outcomes research, 17- 18, 28, 72-73, 77-78, 102, 286, 288289 preventive efforts, 6, 69-70, 7576, 78, 85, 285, 288 public support for programs, 288 recommendations for improving, 78-81, 288-289 role of dental education in, 79, 288 socioeconomic disparities, 6, 64-66, 284-285, 288 technology access/utilization, 69-70, 147-148, 283 in total health care management, 28, 110, 285 trends, 24, 61-63 See also Patient care in dental schools Oral Health 2000, 75, 78, 82-84 Orofacial pain, 63 Outcomes research clinical practice guidelines and, 77-78 dental education, 9, 17- 18, 251, 252, 292 need for, 28, 72-73, 102, 286, 288 problem-based learning, 98-99 recommendations, 17- 18, 288289 p Patient care in dental schools academic health centers and, 32, 196 access issues, 197-198 accountability in, 188, 194-195 accreditation, 186, 195-196, 197 administration, 195 challenges in, 175- 176, 182, 184, 196-197, 198, 208-209 community service efforts, 190 191 competition issues, 188 - 190, 286 conflicting needs in, 174- 175 continuous quality improvement in, 193- 194 efficiency of care in, 182- 184 faculty in, 127-128, 129, 176, 183, 194-195, 212-213 financing of, 178, 180, 181, 208 209, 212-214 individual differences in, 180 181, 191 informed consent issues in, 188 opportunities for improvement, 192, 290-291 organization of, 177 providers of, 176 quality assurance programs, 185-186, 193-194 quality of care, 181 - 182, 184 186 recommendations for, 196-198

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From page 342...

... 342 / INDEX reimbursements, 175, 178, 188190 as revenue source, 181, 212 settings for, 176- 177 shortage of teaching patients, 188-190 statistical profile, 178- 181 strategic planning in, 192-193, 197 student enrollment trends and, 179 utilization, 179- 180 Patient-oriented care, 8 in comprehensive patient care model, 102- 104 in dental schools, 31 -32, 174175, 196-197, 198, 290-291 recommendations for, 13, 15, 142 research topics, 15 Periodontal disease, 60, 62-63, 7172 Pew National Dental Education Program, 90-91 Philanthropic contributions, 215216 Physician, role in oral health, 8081, 274 Practice guidelines, 72-73, 76-78, 86-87, 194-195 Prevention, 69-70, 75-76, 78, 85 Primary care in academic health centers, 188-189 oral health in, 78 Private dental schools, 1, 21, 181, 202, 204-207, 220 See also Schools of Dental Education Problem-based learning, 98-100 Provider Recognition Program, 121 Q Quality of care accreditation/licensure and, 228, 234-235, 291 allied dental personnel and, 111, 272, 273 definition, 184 in dental school clinics, 181182, 184-186, 193-196 documentation of, 8 future of dentistry, 283 overcare in, 184- 185 quality assurance, 185-186, 193194 R RAND Health Insurance Experiment, 60 Randomized clinical trials, 167 Reform of dental education and dentistry accreditation and licensure issues, 9- 10, 250-253 challenges in, 2, 21-22 dental work f orce issues, 10- 11, 293-294 educational mission, 6-7, 289 historical developments, 43-48 implementation of recommendations, 294-295 oral health objectives, 5-6, 68, 75-76, 78-81, 288-289 patient care issues, 8, 290-291 policy and strategic principles, 3-5, 28-29, 282 recommendations, 11 - 19 research practice, 7-8, 289-290 timetable, 5, 7, 12 university dental schools, 8-9, 291 Regionalization, 216-218 Research in dentistry accreditation standards, 145 advanced specialty preparation, 117 alternative models, 30-31 benefits of, 7, 289-290 collaborations in, 7-8, 15, 144, 172, 290 cost of care and, 56

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From page 343...

... INDEX / 343 current status, 144- 145 dental education and, 170-171 development of dentist scientists, 162- 165 economics, 149- 151, 159- 162 epidemiological research in oral health, 53-55 faculty role, 14, 128, 147-148, 162, 165 focus, 151-156 goals, 7-8, 28-29, 145-149 historical development, 51-55 as interdisciplinary activity, 146-147 modeling of practitioner supply, 263-270 new interventions/technologies, 70-72 obstacles to, 157-159, 165-166, 171-172, 286 opportunities for improving, 44, 166-170 oral health, 6, 79-80 outcomes, 28, 72-73, 102, 288-289 patient care objectives in, 15 private s ector funding, 156, 161 promotion of, 15 publishing and, 150- 151 randomized clinical trials, 167 recommendations, 14-15, 80, 172-173 as revenue source, 150-151, 159, 215 role of schools in, 31-32, 289 290 training for, 148- 149, 165 work force in, 7, 156-157, 162, 255, 290 See also Epidemiological research Residency training, 112- 116, 262 Restructuring of health care system academic health centers and, 188-189 demand for dental services, 10, 26 dental coverage in, 74, 79 dental school clinics and, 105, 184, 285 information management in, 195 physician training in, 219 reform of dentistry in, 5, 30, 283 reimbursement systems in, 10 service demand and supply forecasts, 268-269 Rural practice, 257 S Schools of dental education accreditation/licensure, 4, 17- 18 ambulatory care in, 16 clinical practice in, 55-56 closure, 1, 8, 21, 26, 58, 199, 202, 219, 220 collaborative research, 7, 144 continuing education programs, 120 dental hygiene programs, 207208 expenditures per student, 204207 financial management, 4, 9, 1617, 26, 203-211 foreign schools, 135 geographic distribution, 58 inefficiencies in, 104- 105 private institutions, 1, 21, 181, 202, 204-207, 220 recommendations for, 12, 16-18, 141-143 regionalization, 216-218 research in, 7-8, 51-52, 54-55, 144-150, 157-159, 165-166, 171-173 revenue sources, 204, 207 status of students in, 131 strategic planning in, 15- 16 trends in, 1, 21, 31-32, 202 tuition, 135-138, 204-207, 214215

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From page 344...

... 344 / INDEX See also Curriculum; Faculty; University-affiliated dental schools Sealants, 67, 69 Social trends, 23-24, 282-285 oral health monitoring, 79-80 Specialization current status, 116- 117 dentistry as medical specialty, 110-111, 216 early developments, 47 estimated requirements for, 261 -262 licensure, 240-242 minimum clinical competency and, 94 postgraduate education, 117- 118 postgraduate general dentistry and, 114 problems in, 117- 118 research training in, 117 Universities trends, 112, 116, 256 State practice acts, 42, 219, 238 241, 244-245 See also Government; Licensure Strategic planning in dental schools, 16 for patient care in dental schools, 192-193, 197 patient-centered objectives in, 15 role of, 192 in university-affiliated dental schools, 226 Students of dentistry attitude of educators toward, 131 educational debt load, 135-139 � as providers of care, 176, 178, 182-183, 194-195 quality of applicants, 134-135 quality of life issues, 139-140 school expenditures per student, 204-207 statistical profile, 131 - 134 T Technology transfer, 147 Tenure, 14, 129-131 Testing general dentistry license, 237 23g national uniformity in, 4 recommendations for, 18 Tooth brushing, 69-70 Tuition cost of education and, 204-207 dental hygiene education, 207 in financial management, 214 215 student choices and, 136-138 trends, 135-136, 200 U academic health centers in, 31 32 challenges for, 200-202, 284 current environment for, 24 Flexner report, 43 University-affiliated dental schools, 8-9, 16 collaborative research in, 7 consolidation strategies, 216218 contributions of, 30, 199, 224225, 226, 287, 291 dental school clinics and, 208209 evolution, 44-48, 199-200 financial challenges, 203-209, 225-226 financial strategies, 209-218 leadership issues, 221-224 opportunities for strengthening, 220-225, 291 philanthropic contributions to, 215-216 policy constraints in financial management of, 218-219, 284

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From page 345...

... INDEX / 345 recommendations for, 225-227 risks for, 8-9,26,202-203,225226,286 sponsored research in, 215 Utilization age as factor in, 67 insurance coverage and, 67-68 models for estimating, 266-269 reducing, in undersupply of dentists, 274-275 in student clinics, 179-180 trends, 67 Vaccines, 71 -72 Variation in practice, 9, 72,99 Veterans Affairs, Department of, 68 W Women in dentistry, 257-260 Work force. See Dental work force

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Index Pages 333-345

Index
Pages 333-345