Where can I learn how to place dental implants? Perspectives from Scandinavia and Canada Canada. Asbjørn jø Jokstad Professor and Head, Prosthodontics Faculty of Dentistry, University of Toronto Location of 5 Nordic countries + Grenland & Spitsbergen 8 May 2008 ACFD / CDA Teaching conference Demographics* Population (x1.000.000) Canada Denmark Finland Iceland Norway Sweden 33.11 33 (38) 55.5 5 (111) 55.2 2 (113) 00.3 3 (177) 44.6 6 (118) 99.0 0 (87) 323 (68) +61 (125) 4450 0 (56) 23.6 Area A (1000 km2) 9984 99 4 (2) 43 (135) +2166 (14) 338 33 (65) 103 (108) 1267 + 2227 * Source: The CIA Factbook. https://www.cia.gov/cia/publications/factbook/ 8 May 2008 ACFD / CDA Teaching conference Demographics Population (x1.000.000) Canada Denmark Finland Iceland Norway Sweden 33.1 (38) 5.5 (111) 5.2 (113) 0.3 (177) 4.6 (118) 9.0 (87) 323 (68) +61 (125) 450 (56) 19 66 15 38 17 66 18 41 23.6 Area (1000 km2) 9984 (2) 43 (135) +2166 (14) 338 (65) 103 (108) 1267 + 2227 0-14 y yrs. 15-64 yrs. >65 yrs. Median age 18 69 13 39 19 66 15 40 17 67 16 41 22 66 12 34 100 % 80 % 60 % 40 % 20 % 0% 8 May 2008 ACFD / CDA Teaching conference Canada Denmark Finland Iceland Norway Sweden Demographics* Canada Denmark Finland Iceland Norway Sweden Population (x1.000.000) 33 1 33.1 55 5.5 52 5.2 03 0.3 46 4.6 90 9.0 Area(x1000 km2) 9984 43 +2166 338 103 323+61 450 >65 yrs. Median age 13 39 15 40 16 41 12 34 15 38 18 41 Age expectancy 80.2 (12) 77.8 (48) 78.5 (38) 80.3 (11) 79.5 (20) 80.5 (7) Growth Rate (%) .88 .33 .14 .87 .38 .16 * Source: The CIA Factbook. https://www.cia.gov/cia/publications/factbook/ 8 May 2008 ACFD / CDA Teaching conference Demographics* Canada Denmark Finland Iceland Norway Sweden Population (x1.000.000) 33 1 33.1 55 5.5 52 5.2 03 0.3 46 4.6 90 9.0 Area (1000 km2) 9984 43 +2166 338 103 323+61 450 >65 yrs. Median age 13 39 15 40 16 41 12 34 15 38 18 41 Age expectancy 80 78 79 80 80 81 Growth Rate (%) .88 .33 .14 .87 .38 .16 GDP / capita (x1000) $38 (21) $37 (24) $36 (27) $39 (16) $55 (5) $37 (26) * Source: The CIA Factbook. https://www.cia.gov/cia/publications/factbook/ 8 May 2008 ACFD / CDA Teaching conference Undergraduate teaching situation 8 May 2008 ACFD / CDA Teaching conference (Public) undergraduate teaching institutions in Canada (n=10) ( 10) n map 8 May 2008 ACFD / CDA Teaching conference Public undergraduate teaching institutions in the 5 Nordic countries (n=12) 8 May 2008 ACFD / CDA Teaching conference Int J Prosthod 2002; 15: 145-53. 8 May 2008 ACFD / CDA Teaching conference Implant Dentistry - teaching 1 Lectures Hands-on 5 4 Bergen, No 4 Gøteborg, Sw ............................................................................................... Helsinki, Fi 5 København, Dk 4 3 2 R Malmø, Sw 5 Oslo, No O l Fi Oulo, ............................................................................................... Reykjavik, Ic ............................................................................................... Stockholm Sw ............................................................................................... Stockholm, Tromsø, No ............................................................................................... 5 Umeå Sw Umeå, 7 Aarhus, Dk 8 May 2008 ACFD / CDA Teaching conference R Postgraduate teaching situation 8 May 2008 ACFD / CDA Teaching conference Dental Demographics* Canada Denmark Finland Iceland Norway Sweden Population (Mill.) 33.1 5.5 5.2 0.3 4.6 9.0 Area (x1000 km2) 9984 43 +2166 338 103 323+61 450 >65 6 yrs. Median age 13 39 115 40 16 41 12 34 115 38 118 41 Age expectancy 80 78 78 80 80 80 G Growth th Rate R t (%) .88 88 .33 33 .14 14 .87 87 .38 38 .16 16 GDP/capita x1000 $38 $37 $36 $39 $55 $37 Dentists: total Patients/dentist Graduates/yr Dentists/new graduates d t 18340 1805 520 4900 1100 125 4590 1132 50 272 1068 6 4300 1070 140 7500 1250 150 35 30 92 45 31 50 Specialities OMSurg OMSurg Perio -Pros OMSurg OMSurg OMSurg OMSurg Clin Dent Clin.Dent Perio Perio Perio Pros Pros Pros . * Source: FDI World Dental Federation: http://www.fdiworldental.org/resources/3_0facts.html 8 May 2008 ACFD / CDA Teaching conference Dental Demographics – Dentists to Specialists Ratios Canada D ti t Dentists Oral Maxillofacial Surgeons (OMS) Denmark Finland 18340 4900 4587 Iceland Norway Sweden 272 4300 7500 44 250 (18) 339 60 84 3 Dentist : OMS 54 82 55 91 99 30 Periodontists 296 62 0 -- (268) | 8 34 90 48 200 38 171 107 0 -- | | 6 45 55 78 200 38 346 13 5 54 0 -- 0 -- Dentist : Periodontists P Prosthodontists h d i Dentist:Prosthodontists Denturists 2225 460 8 11 Dentist 8 May 2008: Denturists ACFD / CDA Teaching conference (Public) postgraduate teaching institutions in Canada *Source: CDA: http://www.cda-adc.ca/en/cda/cdac 8 May 2008 ACFD / CDA Teaching conference Public postgraduate teaching institutions in the 5 Nordic countries 8 May 2008 ACFD / CDA Teaching conference CONTINUING DENTAL EDUCATION PROVIDERS 1. 2. 3 3. 4. 5. 8 May 2008 University - affiliated Manufacturers Manufacturers & distributors Interest associations Private enterprises ACFD / CDA Teaching conference CE programs: quality ? The providers Academy of General Dentistry: PACE 8 May 2008 ACFD / CDA Teaching conference American Dental Association: CERP CE programs: quality appraisal ADMINISTRATION ADMISSIONS COMMERCIAL OR PROMOTIONAL CONFLICT OF INTEREST EDUCATIONAL METHODS EVALUATION FACILITIES FISCAL RESPONSIBILITY INSTRUCTORS MISSION/GOALS NEEDS ASSESSMENT OBJECTIVES PATIENT PROTECTION PUBLICITY 8 May 2008 ACFD / CDA Teaching conference RECORD KEEPING 9 12 5 1 6 14 6 4 8 10 7 1 7 12 8 2 10 3 2 4 3 13 11 14 5 9 11 13 CONTINUING DENTAL EDUCATION PROVIDERS 1. 2. 3 3. 4. 5. 8 May 2008 University - affiliated Manufacturers Manufacturers & distributors Interest associations Private enterprises ACFD / CDA Teaching conference CDE teaching institutions in Canada ( 10 + 1) (n=10 n map 8 May 2008 ACFD / CDA Teaching conference CONTINUING DENTAL EDUCATION PROVIDERS 1. 2. 3 3. 4. 5. 8 May 2008 University - affiliated Manufacturers Manufacturers & distributors Interest associations Private enterprises ACFD / CDA Teaching conference Manufacturers production facilities Dentatus Astra Tech Nobel Biocare Ospol 8 May 2008 ACFD / CDA Teaching conference Osfix T Tenax Implants I l t Simpler Implants (Pan Global Impl Corp.) Biomet 3i Innova Nobel Biocare Straumann 8 May 2008 ACFD / CDA Teaching conference ?Bi H Corp. ?BioHex C CONTINUING DENTAL EDUCATION PROVIDERS 1. 2. 3 3. 4. 5. 8 May 2008 University - affiliated Manufacturers Manufacturers & distributors Interest associations Private enterprises ACFD / CDA Teaching conference Approved Implant systems & manufacturer courses per 2.2008: 148 manufacturers >500 systems 8 May 2008 ACFD / CDA Teaching conference Germany: 32 USA: 31 Italy: 15 Korea: 10 Spain: 10 Brazil: 9 France: 7 Japan 6 Switzerland : 6 Canada: 4 Sweden: 4 Israel: 3 United Kingdom: 3 Other countries: 9 Approved implants – Nordic countries = approved d ffor sale l in Europe Finnish Implant Register 1994 – 2004 8 May 2008 ACFD / CDA Teaching conference CONTINUING DENTAL EDUCATION PROVIDERS 1. 2. 3 3. 4. 5. 8 May 2008 University - affiliated Manufacturers Manufacturers & distributors Interest associations Private enterprises ACFD / CDA Teaching conference Interest associations Canada Canadian Society of Oral Implantology Canadian Academy of Restorative Dentistry and Prosthodontics Denmark Danish Society of Oral Implantology Norway Norwegian Dental Association Norwegian Society of Oral Implantology Sweden Swedish Dental Association Swedish Society of Oral Implantology 8 May 2008 ACFD / CDA Teaching conference + + ++ + - CONTINUING DENTAL EDUCATION PROVIDERS 1. 2. 3 3. 4. 5. 8 May 2008 University - affiliated Manufacturers Manufacturers & distributors Interest associations Private enterprises ACFD / CDA Teaching conference CONTINUING DENTAL EDUCATION PROVIDERS 1. 2. 3 3. 4. 5. 8 May 2008 University - affiliated Manufacturers Manufacturers & distributors Interest associations Private enterprises ACFD / CDA Teaching conference In Canada: 69 CERP and/or PACE Providers 16 providers give course on implant dentistry 4 manufacturers 11 private Implant Resource Center, Vancouver 8 May 2008 ACFD / CDA Teaching conference 1 has both CERP and PACE 1. Canadian Implant Institute, Quebec 2. I.D.E.A.S. Institute for Dental Education & Advanced Surgeries Inc Inc, Richmond 3. Kennedy Professional Educational S i Seminars, Wi i Winnipeg 8 May 2008 ACFD / CDA Teaching conference 1. 2. 3. 4 4. Arlin Seminars, Toronto Implant Smile Center, Vancouver Seminar Marketing Services Toronto (T (Toronto t IImplant l t IInstitute tit t St Study d Cl Club b Toronto (ICOI)) 5 Toronto Implant Study Club 5. Club, Toronto 6. Toronto Institute for Dental Excellence, Toronto 7. Veisman Institute of Periodontics, Toronto 8 May 2008 ACFD / CDA Teaching conference A curriculum for implant dentistry ? 8 May 2008 ACFD / CDA Teaching conference A curriculum for implant dentistry ? 1. The differences between the countries approach to dental education and care suggests that it is questionable if one model will fit all. 2. If to proceed, apply the Ronald M Harden three-circle three circle model for competency assessment. 8 May 2008 ACFD / CDA Teaching conference Health personnel education: three-circle model 1. ”Practical skills”: 1. What the dentist is able to do • Clinical Cli i l information i f ti gathering ((”technical technical intelligencies intelligencies”)) • Treatment planning • Treatment T t t procedures d *RM Harden, 1999 8 May 2008 ACFD / CDA Teaching conference Health personnel education: three-circle model 2. How the Clinical dentist approaches information their practice gathering What the Treatment 1. What1.the dentist planning dentist is able to is able to do do (”technical intelligencies”) procedures reatment ((”technical technical intelligencies intelligencies”))TTreatment ((”intellectual, intellectual, emotional, analytical & creative intelligencies”) 8 May 2008 ACFD / CDA Teaching conference 2. ”What they bring to the treatment of each patient” •Application of basic clinical sciences •Clinical reasoning and judgment •Communication •Health Health promotion •Attitudes, ethical stance and legal responsibilities •Information handling *RM Harden, 1999 Health personnel education: three-circle model 3.The dentist as 2. How the 2 dentist approaches 1. What 1 Wh t the th dentist is able to do ”technical intelligencies” their practice ”intellectual, emotional, analytical & creative intelligencies” a professional ”personal intelligencies” 8 May 2008 ACFD / CDA Teaching conference Clinical information gathering g g Application of basic clinical sciences Treatment planning Clinical reasoning and judgment Treatment procedures Personal development The role of the dentist within the health service Health promotion Information handling Attitudes, A i d ethical stance and legal reponsibilities Communication *RM Harden, 1999 Thank you for your kind attention 8 May 2008 ACFD / CDA Teaching conference
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