Communication in Dental Practice (channels and forms)

1. Communication in Dental Practice(channels and forms) Lecture # 5

2. Aims Aims • To get a general idea of dentistry as professional discourse community； • To get a general idea of channels and forms of dentistry professional communication; • To understand the major genres of academic writing circulating within dentistry and their structure; • To become familiar with types of routine dental records

3. Nowadaysdentistryis described as a well established professional discourse community. A discourse community is essentially a group of people that shares mutual interests and beliefs H. B. McCauley considers that a true profession is built upona tripod: - a formal organization, - a formal professional education, - and a formal scientific literature*. From the standpoint of experts in dentistry, the dental community in the United States is the leader in all three. *McCauley, H. B. The first dental college: Emergence of dentistry as an autonomousprofession // J. Hist Dent. – 51(1). – 2003. – P. 41 – 45.

4. To run a successful practice today’s dentist/owner needs to have command of three basic skills: Clinical proficiency, Communication Skills, Management.

5. Dentist – Dentist (intra- professional communication Dentist – other Professional (inter- professional) Communication

6. DISCOURSE:(from Latindiscursus, "running to and from") is a mode of communication organizing knowledge, ideas, or experience (texts, genres)that is rooted in language and its concrete contexts (as history or institutions). Dentistry is a professional discourse, whichis more language-centred than others (e.g.,law and dentistry vs. architecture). Dentistry discourseencompasses a whole assemblage of activities, practices, events, instruments and settings referring to oral health

7. And within a specific professional context,certain sub-specialities may profess different degrees of language fronts (e.g.,General dentistry or pediatric dentistryvs.oral surgery or implantology).

8. Basic Components of Dentistry CommunicationDentist – Dentist aspects 1. PURPOSES: to develop and disseminate novel knowledgeof the anatomy and physiology of areas of dentist’s care, which include not only patients' teeth and gums but also the muscles of the head, neck and jaw, the tongue, salivary glands, the nervous system of the head and neck; of state-of-the-art approaches in diagnosis, treatment and prevention of diseases or conditions of the above mentioned areas.

9. basic components of Dentistry communicationDentist – Dentist aspects 2. AGENTS: • persons - DoctorofMedicineinDentistryorDoctorofDentalMedicine (DMD), DoctorofDentalSurgery (DDS), Doctor of Medical Science (DMSc); patients, their relatives, representatives, etc.; other professionals (managers, jurists, psychologists, etc.) • institutions - American Association of Orthodontists, British Dental Association, Commission on Dental Accreditation

10. 3. CONDITIONS and CHANNELS: Written communication is not limited by time and territory Oral communication – atdental surgeries, dental studious, meetings, congresses, conferences, meetings, workshops, (American Dental Congress, Greater New York Dental Meeting, Cologne Dental Exhibition).

11. 4. FORMS OF COMMUNICATION (oral or written genres): • (daily routine): dentists intercommunicate by talking across the room, by calls, sticky notes, patient charts, morning huddle, text message, email. If there are any major things or changes going on they have employee meetings; • (more official): lectures, presentations, conference speech,round table discussions, etc; • research articles, letters, case histories, service instructions, patents, avds, etc)

12. A few different texts and literacies that are exceptionally important to dentist community are books, medical websites, theses,special professional journals, official reports

13. Professional Academic Communication Through journals dentists are able to keep up on information in their field and learn what other dentists are doing innovatively all over the nation.  Also, these journals show how dentists communicate with each other on a larger scale.  They provide insighton methods of surgery, different effects that lasers have on the mouth and gums, experiments on gum tissue and bone structure, etc., and different studies held to help improve current practices and understandings. Academic publishing is undergoing major changes, as it makes the transition from the print to the electronic format. 

14. Professional Academic Communication Some journals, particularly newer ones, are now published in electronic forms only. Paper journals are now generally made available in electronic form as well, both to individual subscribers, and to libraries. "Online scientific interaction outside the traditional journal space is becoming more and more important to academic communication"* Most open access journals remove all the financial, technical, and legal barriers that limit access to academic materials to paying customers. The Public Libraryof Science and BioMed Central are prominent examples of this model. *Hendler, James (2008). “Reinventing Academic Publishing – Part 3”

15. Professional Academic Communication The part of academic written output that is not formally published but merely printed up or posted on the Internet is often called “gray literature“. Academic writing consists of a number of text types or genres, what they have in common. Genre is a type of art or speech based on some set of stylistic criteria. Genres are always associated with certain groups of people that have certain common goals and common ways of reaching these goals.

16. MAJOR GENRES OF ADACEMIC WRITING • Research article (scholary / scientific paper) – is an academic work that is usually published in an academic journal. It contains original research results (≈3200 words) • Review article (survey paper) – isto review existing results, rather than report on new results (≈ 4000 words) • Case report–is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. • Conference papers – is often both a written document and an oral presentation.

17. STRUSTURE OF RESEARCH ARTICLE • Title • Abstracts • Introduction • Materials and Methods • Results • Discussion and Conclusion • Acknowledgment • References *-additional structural blocks ** - core structural blocks

18. STRUSTURE OF RESEARCH ARTICLE

19. STRUSTURE OF RESEARCH ARTICLE • Title must be descriptive and concise. It the part of a paper that is read the most; it is usually read first and most often, it is the only thing that is read. R. Day (1983)defines a good title “as the fewest possible words that adequately describe the contents ofthe paper”*. Dental Burs and Endodontic Files: Are Routine Sterilization Procedures Effective? Archie Morrison, DDS, MS, FRCD(C), Susan Conrod, DDS Contact author: Dr. Conrod Email: sconrod@dal.ca JCDA • www.cda-adc.ca/jcda • February 2009, Vol. 75, No. 1 *Day, R.A. (1983) How to Write and Publish a Scientific Paper, ISI Press, Philadelphia, PA.

20. STRUSTURE OF RESEARCH ARTICLE Introduction • Background, known information ≈ paragraph 1; • Unknown information (knowledge gaps and limitations) ≈ paragraph 2; • Hypothesis, questions, purpose statement ≈ paragraph 3; • Why your experimental approach is new and different and important (fills in the gaps)≈ paragraph 4

21. STRUSTURE OF RESEARCH ARTICLE Dental Burs and Endodontic Files: Are Routine Sterilization Procedures Effective?Archie Morrison, DDS, MS, FRCD(C), Susan Conrod, DDS PURPOSE: The complex miniature architecture of dental burs and endodontic files makes precleaning and sterilization difficult. Devising a sterilization protocol for endodontic files and dental burs requires care, and some have suggested that these instruments be considered single-use devices. One purposeof this study was to determine the effectiveness of various sterilization techniques currently used in dentistry for the resterilization of dental burs and endodontic files. The second aim was to determine whether new dental burs and endodontic files, as supplied in packages from the manufacturer, are sterile.

22. STRUSTURE OF RESEARCH ARTICLE Methods and Materials • Give enough information to replicate the study (like a recipe!) • Describe study materials & Provide inclusion criteria • Materials: Drugs, chemicals, gases, reagents, cell lines, etc. • Participants / subjects:: - Animals (state that the research was approved by the appropriate committee at your institution); • Humans (state that the research was approved by the appropriate committee at your institution) • Give a clear overview of what was done !!!! • Present the Experimental protocol / study design / Measurements / analyses / Hardware / Instruments (telescope, microscope, weighing scale, questionnaire, etc.)

23. STRUSTURE OF RESEARCH ARTICLE Methods and Materials The sterility of new and used dental burs and endodontic files before and after sterilization procedures was analyzed. Previously used burs and files were gathered from 4 different dental offices after they had been packaged and sterilized for reuse. Sterilization was conducted by the staff of these clinics. Sterilization procedures were carried out according to theprotocols employed by each office, as the goal of this study was to see if the techniques currently being used are effective. The following groups of instruments were tested inthis study: new, unused and sterilized burs and files; new, unused and unsterilized burs and files; and used burs and files sterilized using a variety of techniques (Tables 1 and 2). Each group consisted of 40 items. There were many differences between the groups, such as methods of precleaning, type of packaging, length of sterilization cycle and type of sterilizer.

24. STRUSTURE OF RESEARCH ARTICLE Results Results ≠ Raw Data The results section should: • Summarize what the data show • Point out simple relationships / correlations / associations • Describe big-picture trends • Cite figures or tables that present supporting data • Avoid simply repeating the numbers that are already available in tables and figures!!!!!!!!!

25. STRUSTURE OF RESEARCH ARTICLE Results New items, as packaged by the manufacturer, were not sterile (Tables 3 and 4). However, sterilization procedures were 100% effective for unused burs (group B1) and unused files (group F1); no item in either of these groups showed contamination following the 72-hour incubation period. All sterilization procedures performed on previously used burs and files were less than 100% effective (Tables 3 and 4). Of the burs in group B3, used burs that were resterilized using a Harvey Chemiclave, 15% were contaminated (p = 0.01). Among the endodontic files in group F3, treated with disinfectant and dry heat sterilization, 58% showed contamination (p < 0.001).

26. STRUCTURE OF RESEARCH ARTICLE

27. STRUSTURE OF RESEARCH ARTICLE Discussion • Explain what the data mean, state if the findings are novel; • State strengthens and limitations; • Compare your results with other people’s results; • Discuss how your findings support or challenge the paradigm • Anticipate readers’ questions / criticism • Point out unanswered questions and future directions • Restate your main findings • Give a final take-home message

28. STRUSTURE OF RESEARCH ARTICLE Discussion The goal of instrument sterilization in dentistry is to protect patients from cross-contamination via instruments.2 Careful consideration is required when devising a sterilization protocol for endodontic files and dental burs, and some have suggested that these instruments be considered single-use devices.5 A single-use device is an instrument designed to be used on one patient only, and the packages for such devices carry a clear label stating that they are not to be resterilized.4In a recent study conducted in a hospital setting, the authors determined that the cleaning protocol was not entirely effective for some of the instruments used in an oral and maxillofacial surgery clinic.4 High rates of bacterial contamination were discovered following resterilization of bone burs by gas sterilization.4

29. STRUSTURE OF RESEARCH ARTICLE CONCLUSIONS • This block is the counterpart to the introduction since this part should lead the reader from narrow and/or very specific results to more general conclusions. • Conclusions or hypotheses are drawn from the results, with summary of evidence foreach conclusion. • Conclusions propose follow-up research questions and outlook on further work.

30. STRUSTURE OF RESEARCH ARTICLE CONCLUSIONS:Sterilization procedures were successful for burs and files that had not been previously contaminated by organic debris. This was demonstrated by the groups of new burs (B1) and new files (F1) that were sterilized before first use. However, dental burs and endodontic files are not sterile when purchased and should be cleaned and sterilized before use. Routine sterilization procedures for previously used burs and files were not effective, and further research is warranted to devise an effective sterilization protocol. Future studies should focus on determining the best method of precleaning these devices. If such procedures cannot be devised, perhaps the instruments should be considered single-use devices. This would reduce the risk of transmission of all infectious agents, including prions.

31. STRUSTURE OF RESEARCH ARTICLE Acknowledgementare special thanks • to Funding sources: grant funds, commercial sources, funds from a contributors’ institution. • to Contributors who did not get authorship (e.g. offered materials, advice, or consultation that was not significant enough to merit authorship). Acknowledgements should be grouped in a paragraph at the end of the text and before the references. Permission and approval of the wording must be obtained from the person thanked. Where the research project was supported by industry, this should be acknowledged in the covering letter to the Editor on submission of the manuscript.

32. STRUSTURE OF RESEARCH ARTICLE Acknowledgement EG:This research was supported by the New York University Center for AIDS Research (CFAR), an NIH-funded program (P30 AI027742) which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, NCCAM, FIC, and OAR. Support was also provided by the Center for Drug Use and HIV Research (CDUHR) funded by NIDA (P30 DA011041). EG: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

33. STRUSTURE OF RESEARCH ARTICLE REFERENCES • Embedding the own work in related literature is one of the essential parts of researchwriting. This is achieved by citing related work within the text and by listing all citedreferences at the end of the paper. • The most commonly usedreferencing systems are variations of the following: - Name and year system, e.g. ‘Chuck and Norris (2003) define …’. - Alphabet-number system, e.g. ‘Asreported in [4], …’. - Citation order system, i.e. the reference list is not sorted alphabetically, but in the orderof appearance (citation by number) in the text.

34. STRUSTURE OF RESEARCH ARTICLE References 1. Woods R. Sterilization: Part 1. Instrument preparation. FDI World 1996; 5(2):7–10. 2. Miller CH. Sterilization. Disciplined microbial control. Dent Clin North Am 1991; 35(2):339–55. 3. Whitworth CL, Martin MV, Gallagher M, Worthington HV. A comparison of decontamination methods used for dental burs. Br Dent J 2004; 197(10):635–40. 4. Hogg NJ, Morrison AD. Resterilization of instruments used in a hospital-based oral and maxillofacial surgery clinic. J Can Dent Assoc 2005; 71(3):179–82. 5. Smith A, Dickson M, Aitken J, Bagg J. Contaminated dental instruments. J Hosp Infect 2002; 51(3):233–5. 6. Bentley EM. The value of ultrasonic cleaners in dental practice. Br Dent J 1994; 177(2):53–6.

35. STRUSTURE OF RESEARCH ARTICLE Abstract • Abstract comprises a one-paragraph summary of the whole paper. Abstracts have become increasingly important, as electronic publication databases are the primary means of finding research reports in a certain subject area today. • Hence, everything of relevance to potential readers should be in the abstract, everything else not. • Abstracts should be able to stand alone. Do not insert references in the abstract and use few abbreviations. Abstracts ≈ 200 words in length, depending on the paper's complexity. Keywordsis a subpart of abstracts.

36. STRUSTURE OF RESEARCH ARTICLE • Title • Abstracts • Introduction • Materials and Methods • Results • Discussion and Conclusion • Acknowledgment • References

37. Dentist – Patient Communication Problems in a verbal communication (doctor- patient): • Technical language of medicine • Patient’s lack of knowledge

38. Dental Record Contents • Clinical records: - current and historical medical history (various forms); - diagnostic records (bite registrations, stents, diagnostic wax-ups etc); • results of investigations (pathology or radiology reports, pulse oximeter printouts, photos, prints from MRI or other imaging etc); - treatment plan & treatment information • Informed consent forms • Consultants’ reports

39. Dental Record Contents • Correspondence(referral letters, etc) • Financial responsibility forms • Practice documentation of various kinds • Appointment books / day lists • Advice & instructions given (notes of advice (including oral hygiene, dietary and/or general health advice

40. Dental Record Contents The information in the dental record should primarily be clinical in nature. The record includes a patient’s registration form with all the basic personal information. The dental team should be very meticulous and thorough in the dental office record keeping tasks.  All information in the dental record should be clearly written, and the person responsible for entering new information shouldsign and date the entry.

41. what is typically included in the dental clinical record? Medical history — a thorough investigation, to include a minimum of: • Name and phone number of physician • Patient’s complaints (by words of patient) • Dentists’ own evaluation of patient’s general health and appearance • List of systemic disease: (diabetes, rheumatic fever, hepatitis, others)

42. what is typically included in the dental clinical record? • Any ongoing medical treatment • Any bleeding disorders, drug allergies, smoking and alcohol history • Any cardiac disorders • Relevant family medical history • Physical and emotional tolerance for procedures • Pregnancy

44. Dental Record Contents The patient registration form contains: • date of birth, addresses and telephone numbers; • Marital status; • Employment Status; • Insurance information; • Consent to treatment: I hereby consent to evaluation, testing, and treatment as directed by my MedicalEdge physician or his or her designee.