As part of a U.S. Health Resources and Services Administration-funded evaluation of the impact of federal funding on postgraduate general dentistry programs, a random sample of 6,725 dentists graduating in 1989, 1993, and 1997 were surveyed regarding practice patterns, advanced training, populations served, services provided, and their position on a mandatory fifth year of training. Responses (1,965) showed 48 percent supporting a mandatory year and 52 percent not supportive. Open-ended comments were provided by 1,626 respondents. The main reasons for supporting a mandatory fifth year were the need for more instructional time and need for a transition year. Individual choice, no value in a fifth year of dental school, mentoring available elsewhere, and cost were cited in opposition. The following respondents were significantly more likely than other respondents to support a mandatory fifth year: individuals who had completed an AEGD, GPR, or specialty program; were Asian; held salaried positions in a community clinic, nursing home, or hospital; or described themselves as a consultant. Graduates in 1993 and 1997 were less supportive of a mandatory fifth year than were 1989 graduates. Significant differences in the reasons offered in support of respondents' positions on the issue were observed among AEGD, GPR, specialists, and nonspecialists and the three cohort years.

Since the AIDS epidemic began, it has been determined that dental professionals can play an important role in the diagnosis and treatment of the disease and that they must meet ethical and legal obligations to offer treatment. Studies report, however, that dentists prefer not to treat AIDS patients, that they are only moderately knowledgeable about the disease and its oral manifestations, that they lack the skills to treat AIDS patients, and that their use of infection control procedures falls below established standards of care. It also appears that traditional forms of education have failed to improve this situation. In this article the authors propose educational interventions designed to influence knowledge, attitudes, and behaviors of dentists and thereby improve the delivery of dental care to the HIV-positive population.

We compared the funding granted by the federal government between 1985 and 1997 to stimulate the growth of AEGD and GPR programs across HRSA regions, states, and populations. Information regarding the number, size, and location of programs available during the time period of 1985 to 1997 was collected. During this period, although the number of programs remained constant, the composition of the programs changed, with AEGD programs increasing by 113 percent and GPR programs decreasing by 13 percent. HRSA Regions 2, 3, and 5 combined offered over 50 percent of all programs. The number of residency positions rose by 28 percent in civilian programs and dropped by 11 percent in Veterans and Military (VA/M) positions. Overall growth in AEGD positions increased 208 percent, while the civilian GPR positions remained constant and the number of VA/M GPR positions dropped by 30 percent. A higher percentage increase in programs occurred in cities of greater than 500,000 population than in less densely populated areas. HRSA spent $41,254,501 in the thirteen-year time frame, and funding by region varied by over a hundredfold. Programs in the least dense population groups were often the least funded. There was great variability in the amount of HRSA money received by state, with fifteen states receiving no funding during the thirteen years. Without HRSA dollars, it is apparent that the postgraduate general dental training program would not have gained the vitality it currently offers. However, attention must be paid to developing programs among states with a lack of infrastructure in dental education and training.

No abstract

No abstract