An evaluation of the geriatric dental curricula within Advanced Education in General Dentistry and General Practice Residency programs in the United States

Abstract

Aim To compare the geriatric dentistry curricula between Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs. Methods A 108‐item survey was developed to assess residents’ didactic and clinical experiences pertaining to geriatric patients. Surveys were mailed in 2018 to all AEGD (N = 89) and GPR (N = 180) program directors. Statistical analysis consisted of descriptive and bivariate analyses with the chi‐square test, Fisher's exact test, and the Wilcoxon rank sum test (alpha = .05). Results Twenty‐four AEGD and fifty‐eight GPR directors completed surveys (response rate = 30%). Seventy‐one percent of responding programs reported mandatory didactic training pertaining to frail and functionally dependent geriatric adults. Ninety‐nine percent of respondents reported that residents provided treatment to geriatric patients; however, they were less likely to perform procedures on frail and functionally dependent patients. Only 15% of respondents provided nursing home care. Considering all patient encounters, responding GPR programs were more likely than AEGD programs to treat patients using IV bisphosphonates (63% vs 25%; P < .01), undergoing chemotherapy (48% vs 16%; P = .02), and undergoing head and neck radiation therapy (55% vs 25%; P = .02). Conclusion A majority of responding AEGD and GPR programs reported providing educational experiences pertaining to geriatric patients; however, GPR programs reported treating more medically complex patients than AEGD programs.

Is dental education meeting the oral health needs of older adults?

“…Additionally, 52% of programs reported the geriatric didactic training was performed by individuals who did not have any formal geriatric dentistry training. Although 99% of respondents reported residents provide clinical treatment to older adults, only 29% include it in their core clinical competency 9 . GPR programs reported delivering more care to frail, medically complex patients, and functional dependent older adults; nonetheless, the time devoted to geriatric topics and clinical care is still limited in terms of forming a cadre of dentists with advanced training in geriatric dentistry 9,31 …”

“…Based 20,23,32 Besides the above-mentioned postdoctoral geriatric dental programs, it is important to also take into consideration the Advanced Education in General Dentistry residencies (AEGD) and General Practice Residencies (GPR) in the United States, as these are also venues where dentists are being trained to advance their skillset and knowledge within the clinical practice. 9 According to Muelderner et al's 2018 survey of AEGD and GPR programs, 71% of responding programs (n = 82; 24 AEGD, 58 GPR) reported mandatory didactic training concerning frail and functionally dependent older adults; however, more than 50% of those programs reported spending only 1 hour or less on seven geriatric topics. Additionally, 52% of programs reported the geriatric didactic training was performed by individuals who did not have any formal geriatric dentistry training.…”

“…9 GPR programs reported delivering more care to frail, medically complex patients, and functional dependent older adults; nonetheless, the time devoted to geriatric topics and clinical care is still limited in terms of forming a cadre of dentists with advanced training in geriatric dentistry. 9,31…”

“…In 2015, and according to Healthy People 2020, only 46% of people aged 65 and older in the United States had a dentist visit within a year 6 . Furthermore, 66% have periodontitis, and 16% have untreated tooth decay, which highlights the need for integral change by promoting oral health for the geriatric population 7–10 . As oral diseases demonstrate a strong association with systemic diseases, poor oral health has been linked to negative health outcomes 11,12 .…”

“…6 Furthermore, 66% have periodontitis, and 16% have untreated tooth decay, which highlights the need for integral change by promoting oral health for the geriatric population. [7][8][9][10] As oral diseases demonstrate a strong association with systemic diseases, poor oral health has been linked to negative health outcomes. 11,12 According to a systematic review, improved oral health can help to avoid respiratory infections and pneumonia-related deaths among older adults who live in hospitals and nursing homes.…”