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Published in the Russian Federation
European Journal of Contemporary Education
ISSN 2219-8229
E-ISSN 2224-0136
Vol. 12, Is. 2, pp. 129-136, 2015
DOI: 10.13187/ejced.2015.12.129
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UDC 37
D e ve lo p m e n t o f P ro to typ e Ou tc o m e s -B a s e d Tra in in g Mo d u le s fo r Ae s th e tic D e n tis try
1 Maricar J oy T. Andres 2 Milagros L. Borabo
1 Centro Escolar University, Philippines Dr., Assistant Professor
Restorative Den tistry
9 Mendiola St., San Miguel, Manila 73420 73
E-m ail: m aricarjoyandres@yahoo.com 2 Centro Escolar University, Philippines Dr., Program Director
Professional and Con tin uing Education 9 Mendiola St., San Miguel, Manila E-m ail: m lborabo@ceu.edu.ph
Ab s tra ct
The objective of the study is to know the essen tial com pon ents of Aesthetic Dentistry that will be a basis for prototype Outcom es-based training m odules. Usin g a 5-point Likert scale, the researcher-m ade questionnaire assessed the different elem ents of Aesthetic Dentistry which are needed in the designin g of the training m odule, the m an ner of presentation an d the form of assessm en t that were n eeded in the trainin g m odule. Statistical tools that were used for the study are percentage, frequen cy, weighted m ean an d standard deviation. The inform ation gathered from the respon dents was relevan t in the developm en t of a Prototype Outcom es-based Training Modules in Aesthetic Den tistry
Ke yw o rd s : Aesthetic Dentistry, Outcom es-Based Education , Training Modules in Dentistry, Prototype Training Modules.
I
n tro d u ctio n
Enhancing one’s appearance is an enduring trend. During the tim e of the Rom an s, white teeth were adm ired and ivory was used to replace m issing teeth. This concept of beauty holds true in today’s society. The replacem ent of a tooth solely for fun ction such as m astication without the consideration of aesthetics is a thing of the past. A beautiful sm ile is a m ust nowadays. An aesthetic and pleasin g sm ile should com e hand in hand when replacing a m issin g, fractured or m alalign ed tooth in the oral cavity.
The history of Aesthetic Den tistry is said to be young because it was only decades ago that it was established. The advent of superior bon ding m aterials prom pted the birth of Aesthetic Den tistry. The new adhesive techniques m ade possible the restoration of anterior teeth with thin ceram ic ven eers and tooth-colored restoration. [1] Aesthetic Den tistry responds to the dem and of patients to have a perfect sm ile that aesthetic doctors and derm atologists cannot deliver. The m outh is central to one’s appearance. A sm ile is powerful. It can either m ake or break your look. It can com m unicate without words. It can also change the day of one person in a second.
Education as a field has grown to respond to the differen t dem ands of the learn er. Training dentists in today’s world does not stop in m ere lecturing an d hands-on training. Knowing the n eeds of the learn er will help the educator properly address the issue. Moreover, assessin g them in their work m otivates them to learn even m ore. “Classroom assessm en t provides valuable inform ation that allows the teacher to adapt instructional procedures to the learnin g needs of their studen ts.” [2] Dentists, as in any health profession, should contin uously learn throughout their lifetim e. In order to deliver quality dental services to the patients, dentists m ust undergo training in specific courses to ensure the best possible treatm ent will be effectively and efficiently delivered to the patient as a result of their learnin g experiences.
Training a dentist is different from undergraduate dental students. There is m uch expected from both the trainer and the train ees. There are existing program s in Aesthetic Dentistry but n on e of which are geared towards Outcom es-Based Education. Outcom es-Based Education, as defined by Spady, m ean s “clearly focusing and organizing everything in an educational system aroun d what is essential for all studen ts to be able to do successfully at the end of their learning experien ces.” [3] The field of education found answers as to how a person m ay be train ed regardless of profession . Outcom es-based education is said to focus on what the students learned rather than the inputs. This type of education is seen as appropriate by the researcher in the field of dentistry. The scarcity in Aesthetic Den tistry training m odules m otivated the researcher to develop one in order to ben efit the researcher’s trainin g program as well as its participants. The real test in Aesthetic Dentistry is not the m ere knowledge of beauty but whether the dentist successfully m ade a sm ile m ore pleasing.
M
a te ria ls a n d m e th o d s
The researcher obtained an approval sheet for the con duct of tscientific procedures using hum an subjects and was signed by four IERC m em bers. Afterwhich, the researcher sought the perm ission of the Dean of institution A, to con duct a study in the school. The researcher wrote a letter to the program heads of the in stitution B and institution C. A cover letter was then prepared for distribution to the responden ts to avail them of the official inform ation explained in the study. The researcher personally adm inistered the questionn aire to the responden ts an d gave them sufficient tim e to an swer the questionnaire.
The descriptive survey m ethod was used in conducting the study. The respondents were 10 licensed dentists, 15 faculty m em bers, 3 program directors and 52 participants of an Aesthetic Den tistry program held in the Philippines before October 20 14. The questionnaire was used as the instrum en t by the researcher in determ inin g the elem ents of Aesthetic Den tistry which becam e the basis for designing a prototype Outcom es-based training m odules.
The m ain data gatherin g instrum en t was the survey questionnaire which consisted of the following:
1. the different elem ents of Aesthetic Dentistry which are needed in the designin g of the training m odules;
2. the m anner of presentation
;3. the form of assessm ent that will be needed in the trainin g m odules; and 4. the training m odules for Aesthetic Dentistry.
Part I dealt on the con ten ts of the trainin g m odules which includes the introduction to Aesthetic Dentistry, cosm etic contouring, Minim al Invasive Dentistry and all- ceram ic restorations. Part II dealt on the m ode of presentation of training m odules in Aesthetic Den tistry. Part III dealt on the m odes of assessm en t. The three parts required the respondents to rate the com ponen ts of Aesthetic Dentistry using the scale 5 (VMI/ VMN) = Very m uch im portant/ Very m uch n eeded, 4 (MI/ MN) = Much im portant / Much needed, 3 (MoI/ MoN) = Moderately im portan t / Moderately needed, 2 (LI/ LN) = Least im portant/ Least needed, 1 (NI/ NN) = Not im portant/ Not needed.
The researcher requested five [5] experts for conten t validation of the questionnaire. These were adm inistrators and faculty in the School of Dentistry, a Curriculum and Supervision teacher from graduate school and on e of the Board of Directors of institution C. Furtherm ore, the researcher conducted a test on the validity of the instrum ent used. A dry-run was conducted to 30 Restorative dentistry faculty m em bers. Selected faculty m em bers who validated the questionn aires were not included in the study. The researcher asked the respondents for their feedback in answerin g the questions. The researcher im proved the questionnaire based on the respondents’ suggestion s.
The data were treated in relation to what was asked in the specific objectives. IBM SPSS version 21 was used for this purpose. The statistical data that were used in the study were the frequen cy count which was used to determ in e the num ber of occurrences in each item for the com ponen ts of the train ing m odules. Percen tage was utilized for the item s for the com ponents of the training m odules to standardize the frequen cy of occurrence per as fractions of 10 0 . Weighted m ean was em ployed to get the typicality of the responses on each com ponen t of the trainin g m odules from the set of options while standard deviation was used to determ in e the deviation of responses on the com ponen ts of the training m odules.
R
e s u lts
It could be gleaned from Table 1 that the respondents felt that the indications and lim itation s of bleachin g as well as external bleaching are “very m uch im portant/ very m uch needed” in designing a training m odule. Am on gst all others in the Introduction to Aesthetic Dentistry, these two got the highest m ean 4.57 an d 4.55 respectively. This is justified by Dr. J agyasi (20 14) who m en tioned in his article in 20 14 that cosm etic bleaching and bondin g are two of the m ost popular dental services provided by the dentists in Philippines. H e also added that discolored and stained teeth can m ake you look ugly an d it m akes the patients lack self-confidence. [4] The results also yielded that the concept of sm ile design an d digital photography is also “m uch im portant/ m uch needed”. Aesthetic analysis scored the highest m ean of 4.13 am on g the other con cepts of sm ile design followed by den tal analysis with a m ean of 3.79. Third is the facial analysis which was followed closely by den tolabial analysis with a m ean of 3.61. All of these con cepts are intertwin ed. This is because of the harm ony that each con tributes to beauty. The m ean s of the Principles of digital photography does not vary greatly from each other. The Practical Exercises in Digital Photography has the lowest m ean of 3.8 1 while profile photography has the highest m ean of 3.8 9. Dr. Patel (20 13) stated that clinical photography is a very im portant tool in general practice in docum entin g treatm ent, especially in aesthetic and cosm etic cases. [5]
Ta b le 1
:
In tro d u ctio n to Ae s th e tic D e n tis tryMean Standard Deviation
Verbal
Interpretation 1.1 Concept of sm ile design
1.1.1 Aesthetic Analysis
4.13 4.60 MI/ MN
1.1.2 Facial Analysis 3.64 .92 MI/ MN
1.1.3 Dentolabial An alysis 3.61 .8 9 MI/ MN
1.1.4 Den tal Analysis 3.79 .8 6 MI/ MN
1.2 Bleaching
1.2.1 Indications and Lim itations
4.57 .61 VMI/ VMN
1.2.2 In tern al Bleaching 4.0 3 1.0 4 MI/ MN
1.2.3 Extern al Bleaching 4.55 .57 VMI/ VMN
1.2.4 H om e Bleaching / In -Office Bleaching 3.99 .8 9 MI/ MN 1.3 Principles of Digital Photography
1.3.1 Requirem ents for the Photographic Docum en tation
3.8 3 .73 MI/ MN
1.3.2 Profile Photography 3.8 9 .71 MI/ MN
1.3.3 Practical Exercises in Digital Photography
3.8 1 .71 MI/ MN
Interestingly, Table 2 presents the m ost heterogenous response. With regard to direct aesthetic treatm ent using com posite, peg shaped lateral, diastem a closure and reconstruction following traum a elicited a “very m uch im portant/ very m uch n eeded” response with both peg shaped lateral and diastem a having the sam e m ean of 4.54. Black triangles gave a “least im portant/ least n eeded” response with a m ean of 2.0 5. A probable reason for this result is because of its dem an d. Nash (20 13) said that fees can generally be lower for direct than indirect procedures since there is no second appointm en t or tem porary restorations required an d no laboratory expenses. [6] For the adhesive, responden ts stated that the gen eration of den tal adhesives are “m oderately im portant/ m oderately needed” with a m ean of 3.40 . The technique using den tal adhesives has a m ean of 3.44 with a verbal interpretation of “m uch im portant/ m uch n eeded”. According to Nazarian (20 0 7), there a variety of aesthetic an d functional m aterials to choose from when faced with the need to perform aesthetic procedures. This m ay be the reason why the technique in using the dental adhesives scored higher rather than just sim ply knowing the gen erations of dental adhesives out in the m arket. [7]
Ta b le 2
:
Co s m e tic Co n to u rin gMean Standard
Deviation
Verbal In terpretation
2.1 Direct Aesthetic Treatm en t Usin g Com posite
2.1.1 Peg shaped Lateral 4.54 .67 VMI/ VMN
2.1.2 Diastem a Closure 4.54 .71 VMI/ VMN
2.1.3 Black Triangles 2.0 5 1.44 LI/ LN
2.1.4 Reconstruction Following Traum a 4.50 .69 VMI/ VMN
2.2 Adhesive
2.2.1 Gen eration of Dental Adhesive 3.40 .96 MoI/ MoN
2.2.2 Technique Usin g Dental Adhesive 3.44 .96 MI/ MN
From Table 3, we can see that in all aspects of all-ceram ic restorations, the responden ts stated that they are all “very m uch im portant/ very m uch needed in the training m odule. It can be seen in the table that the highest m ean of 4.45 corresponds to the installation an d cem entation of inlays. Ran ked second are the tooth preparation of ven eers and the diagnosis and treatm en t plannin g of ven eers with a m ean of 4.44. The aspect which ranked the least is the diagnosis an d treatm ent planning for inlays with a m ean of 4.38 . The findings of the Shenoy and Shenoy in 20 10 stated the disadvantage of den tal ceram ics as restorative m aterials is that it is not capable of withstandin g forces such as m astication. This lim itation does not pose as a barrier to the respondents because it is still ceram ics that give the utm ost aesthetic results. [8 ] Alternately, Yan g, Cook and Paddock in 20 0 5 justified the use of ceram ics when they said that patien ts often dem and aesthetic posterior restorations forcing the restorative dentist to utilize altern atives to tradition al direct or in direct m etallic restorative m aterials. Current porcelain system s provide outstan din g aesthetics and sufficien t strength to be considered for m an y posterior applications. [9]
Ta b le 3
:
All-Ce ra m ic Re s to ra tio nMean Standard
Deviation
Verbal In terpretation
4.1 Inlay
4.1.1 Diagnosis an d Treatm ent Plannin g
4.28 .76 VMI/ VMN
4.1.2 In dications an d Contraindications
4.34 .69 VMI/ VMN
4.1.3 Tooth Preparation s 4.44 .65 VMI/ VMN
4.1.4 Installation an d Cem en tation 4.45 .67 VMI/ VMN
4.2 On lay
4.2.1 Diagnosis an d Treatm ent Plannin g
4.43 .63 VMI/ VMN
4.2.2 In dications an d Contraindications
4.43 .65 VMI/ VMN
4.2.3 Tooth Preparation 4.40 .67 VMI/ VMN
4.2.4 In stallation an d Cem en tation 4.43 .69 VMI/ VMN
4.3 Ven eers
4.3.1 Diagnosis an d Treatm ent Plannin g
4.44 .59 VMI/ VMN
4.3.2 In dications an d Contraindications
4.36 .64 VMI/ VMN
4.3.3 Tooth Preparation 4.39 .67 VMI/ VMN
4.3.4 Installation an d Cem en tation 4.35 .66 VMI/ VMN
It could be disclosed in Table 4 that with regard to objectives, to dem onstrate the required skills and dexterity n eeded in aesthetic work is the on ly on e which respondents felt that is “very m uch im portant/ very m uch n eeded in the m ode of presentation . This garn ered a m ean of 4.24 while to apply the principles an d techniques in aesthetic den tistry in real world settin g and explain the im portance of aesthetic dentistry in relation to other disciplines in dentistry obtained a m ean of 4.20 an d 4.13 respectively. For the activities, all of which obtained a verbal interpretation of “very m uch im portant/ very m uch needed” with perform ing clinical practical training havin g the highest m ean of 4,26. Ricard (1990 ) em phasizes that for a m odule to be useful, congruence m ust be evident between learner n eeds and its con tent. Special attention should be directed to outcom es, activities, and evaluation procedures. Effective m odules outline m aterial clearly an d attractively. Content is distributed logically and creatively; inform ation is accessible. [10 ]
Ta b le 4
:
Mo d e s o f P re s e n ta tio nMean Standard
Deviation
Verbal
Interpretation
M ODES OF PR ESEN TATION
1. Objectives
1.1 Explain the im portance of Aesthetic Den tistry in relation to other Disciplines in Den tistry
4.13 .67 MI/ MN
1.2 Apply the principles and techniques in Aesthetic Dentistry in real world setting
4.20 .67 MI/ MN
1.3 Dem on strate the required skills an d dexterity n eeded in aesthetic work
4.24 .72 VMI/ VMN
2. Activities
1. Conducting and holdin g clinical conferences 4.21 .69 VMI/ VMN
2. Preparing sim ulated m odel cast and ivory
tooth
4.24 .73 VMI/ VMN
3. Perform ing clinical practical trainin g 4.26 .73 VMI/ VMN
It is apparent from Table 5 that tradition al assessm ent was seen to have m ore im portance/ need as com pared to authentic assessm ent. This is contrary to the conclusion of Varley (20 0 8 ) that the advantages of this assessm en t are that it m akes students strive and do things at higher level of standards which also fosters m astery of the subject m atter. [11] The objective type of test has a m ean of 4.24 with the only on e with the verbal in terpretation of “very m uch im portant/ very m uch n eeded. Dikli (20 0 3) on the other hand, stated that the disadvan tage of which, is that students m ay m isin terpret the question if it was not delivered clearly and precisely. [12] The portfolio has a m ean of 2.59 with a verbal interpretation of “least im portant/ least n eeded” perhaps because this is not a com m on type of assessm ent used in Den tistry or the faculty m em bers m ight not very fam iliar with this type of assessm ent.
Ta b le 5
:
Mo d e s o f As s e s s m e n tMe a n S ta n d a rd D e via tio n
Ve rb a l
In te rp re ta tio n M O D ES O F A S S ES S M EN T
1. TRADITIONAL ASSESSMENT
1.1 Objective-type of test
4.24 .68 VMI/ VMN
1.2 Alternative-answer type of test 4.10 .69 MI/ MN
1.3 Multiple choice 4.0 8 .63 MI/ MN
2. AUTH ENTIC ASSESSMENT 2.1 Perform ance type (hands-on)
4.20 .69 MI/ MN
2.2 Rubrics 3.8 9 .8 1 MI/ MN
2.3 Portfolio 2.58 1.29 LI/ LN
D
is cu s s io n
Based on the results of the data, the following fin dings are en um erated:
1. Different Com ponents of Aesthetic Dentistry which are Needed in Designing of the Training Module
The following com pon ents of Aesthetic Dentistry were rated very m uch n eeded by the participants:
• Bleaching
o indications and lim itations of bleaching o external bleaching
• Direct Aesthetic Treatm ent Using Com posite o peg shaped lateral
o diastem a closure
o reconstruction following traum a • All-Ceram ic Restoration
o inlay o onlay o ven eers
2. Presentation of Trainin g Modules.
The training m odules m ust contain the following: • Objectives
o Dem onstrate the required skills an d dexterity n eeded in aesthetic work • Activities
o Conducting and holdin g clinical conferences o Preparing sim ulated m odel cast an d ivory tooth o Perform ing clinical practical trainin g
3. Modes of Assessm ent Needed in the Trainin g Modules
The traditional assessm en t was seen to have m ore im portance/ need as com pared to authentic assessm ent.
4. Trainin g m odules to be prepared in Aesthetic Den tistry
A Prototype Outcom es-based Trainin g Modules in Aesthetic Den tistry was designed based on the study.
C
o n clu s io n s
Grounded on the findin gs of the study, the following conclusions were m ade:
1. External bleaching as well as its indications and lim itations , direct aesthetic treatm en t using com posite for peg-shaped lateral, diastem a closure an d reconstruction following traum a, all-ceram ic restoration of inlay, onlay and veneers are the com ponen ts needed in the Aesthetic Den tistry training m odules.
2. Dem onstration an d hands-on train ing is the preferred m ode of trainin g.
3. The train ors favored the objective type of assessm en t in the training. The objective type of assessm en t is needed in the Aesthetic den tistry training m odules.
4. The Outcom es-based trainin g m odules m ust be part of the Aesthetic Dentistry training m odules
The training m odules m ust contain the following parts: a. Training Outcom es
b. Training Content c. Training Procedures
d. Training Workshops and Activities e. Training Assessm ent
Furtherm ore, the train ing m odule m ust be pilot tested and validated for its usefulness Replication of the study m ay be don e at a larger scale.
R
e fe re n c e s :
Book1. Schm idseder, J . Color atlas of dental m edicine: aesthetic dentistry. Stuttgart: New York, 20 11.
2. Eggen , P. & Kauchack, D. Educational psychology: win dows on classroom s. 6th ed. New J ersey: Pearson, 20 0 4.
3. Fraser, B. J ., Tobin , K., & McRobbie, C. J . Second International H an dbook of Science Education Vol. 24. New York: Springer, 20 12.
Web Source
4. J agyasi, D. P. (20 14). M ed ica l Tou r ism .com. Retrieved J uly 20 , 20 14, from Medical
Tourisim .com : http:/ / www.m edicaltourism .com / blog/ m edical-tourists-flockin g-to-philippines-for-cosm etic-dental-surgery/ .
Newspaper
5. Patel, D. A. (20 13). Clinical digital dental photography. Den t a l Tribu n e.
Web Source
6. Nash DDS, R. W. (20 13). Direct Com posite Resin Restorations for Today’s Practice.
Retrieved J uly 29, 20 14, from Den tistry Today: http:/ / www.dentistrytoday.com / aesthetics/ 9591-direct-com posite-resin -restorations-for-todays-practice
7. Nazarian DDS, A. (20 0 7). The Progression of Dental Adhesives. Retrieved J uly 29, 20 14, from The Progression of Dental Adhesives: http:/ / www.kerrdental.com / cm sfilesystem -action?file=KerrDen tal-Products-Articles/ adhesives-n azarian.pdf
Article in a J ournal
8 . Shenoy, A., & Shenoy, N. (20 10 ). Den tal Ceram ics: An Update. J ournal of Conservative Den tistry.
9. Yang, S. C., Cook, N. B., & Paddock, C. W. (20 0 5, February). All ceram ic in lays an d onlays. Naval Post Graduate Dental School.
10 . Ricard, V. B. (1990 ). Techniques: Developing Learnin g Modules for Adults. J ourn al of Adult Education.
11. Varley, M. A. (20 0 8 ). Teachers' and Adm inistrators' Perceptions of Authentic
Assessm ent at a Career and Technical Education Center. Michigan: ProQuest LLC.
12. Dikli, S. (20 0 3). Assessm ent at a distance: Traditional vs. Alternative Assessm ents. The Turkish Onlin e J ournal of Educational Techn ology, 13-19.
