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What is in store for the baby boomer generation?

AEGD Clinic

In the 6th floor clinic with AEGD resident Dr. Abigail Soto

Media Resources/Steven Doll

Tapias’ geriatric dentistry research expands with an upcoming presentation to an international audience in Brazil

It was four years ago, shortly after Dr. Helena Tapias started at the dental school, when a longtime thesis project of hers came to the fore: Just what is the confidence level of dental students in treating geriatric patients, and how does it shape up with actual knowledge and skill sets?

That was back in 2008. Now, two presentations later, Tapias, a full-time assistant professor in restorative sciences, is gearing up to present the newly expanded research to an international audience in Brazil. During the International Association for Dental Research General Session, which is from June 20 to 23, Tapias will discuss the findings of a survey given to D4s at the state’s three dental schools. The survey Tapias created predates her Texas A&M Health Science Center Baylor College of Dentistry days; it’s one she created as a graduate student in Minnesota.

The survey: by the numbers

The original pilot study, titled “D-4 Students Self-Assessment of Competence and Knowledge in Geriatric Dentistry,” was conducted in 2010 and centered on 84 D4s at Texas A&M Health Science Center Baylor College of Dentistry. The questionnaire had two parts: First, students read 10 statements about treating geriatric patients and rated their abilities and skills. Second, they read 10 general information statements relating to the elderly population’s demographics and morbidity and classified them as true or false.

The result: An overwhelming majority of students were found to have an inadequate level of knowledge of geriatric demographics and overall exhibited a poor correlation of perceived versus real knowledge. In other words, the students’ level of confidence was disproportionate to their actual knowledge.

“In the same way that pediatric dentistry is specialized to provide oral care for 1- to-17-year-old children, geriatric dentistry is needed to take care of the 65-year-and-older population.”

—Dr. Helena Tapias

In 2010, Tapias, who credits Drs. Eric Solomon, executive director of institutional research and her mentor Dr. Ronald Ettinger with the University of Iowa for their role in the study, shared those findings in a poster presentation during IADR’s session in Barcelona, Spain, and in 2011, in an oral presentation during the Special Care Dentistry meeting in Chicago.

“When I was there, people would tell me, ‘Why don’t you expand the study a little bit, because this is very interesting,’” Tapias says. “This is how the study with the three dental schools in the state of Texas came up.”

So Tapias got to work. She surveyed students at the UT Health Science Center at Houston School of Dentistry, which has a special patient clinic but no geriatric dentistry coursework. Then she got input from students at the UT Health Science Center San Antonio Dental School, which has both a mandatory geriatric dentistry course and clinical rotation. TAMHSC-BCD has neither. A total sample of 190 students participated.

While Tapias will wait until the IADR meeting to offer exact statistics, she offers some insight into the findings.

“The differences between the schools are obvious, but still we have a lack of training,” she says. “With the rotation and the class, even that is not enough. In general, we found a lack of training in geriatric dentistry.”

A concerning trend

“It’s just not in Texas; it’s all around,” Tapias says of this nationwide issue. “My main concern is we have the big wave of the baby boomer generation — more than 70 million strong, in total — that is beginning to reach retirement age.” The oldest baby boomers turned 65 in 2011.

That means during the next 15 years, dentists are going to get more patients with complex systemic problems and other health issues such as heart disease, hypertension and diabetes. Her forecast: For every 10 patients that future dentists will see, three or four will be baby boomers.

“They are not going to be easy patients,” Tapias adds. “It’s so important to get that good geriatric training here and at all the schools in the United States.

“In the same way that pediatric dentistry is specialized to provide oral care for 1- to-17-year-old children, geriatric dentistry is needed to take care of the 65-year-and-older population.”

What’s next

Before the concept of adding geriatric coursework and training to the curriculum can be explored, Tapias says, evidence of its need must be shown.

She’ll start with the IADR presentation and, upon her return from Brazil, plans to initiate another related project: a clinical research effort funded by a $50,000 grant from Delta Dental, which just recently received Institutional Review Board approval. That pilot study, which spun off from the D4 survey and could start as early as July, will evaluate the oral health status of elder residents at three different Metroplex-area assisted living facilities, which Tapias hopes will be the start of more in-depth research statewide.