Objectives:Smokeless tobacco (SLT) use is a phenomenon that is detrimental to the health of adults worldwide and dramatically impacts the health of resettled populations. The prevalence of SLT has exponentially grown as a public health threat for the refugee and immigrant populations and is worthy of addressing. This research study examined the SLT cultural drivers of the Texas immigrant and refugee community, which led to their knowledge, perception, awareness, and cessation practices. Methods:A convenience sample of refugee and immigrant community members resettled in San Antonio was recruited from the local Health Clinic and Center. Ninety-four consented participants completed a 29-item survey that gathered participants' demographics, SLT history, beliefs, knowledge, perceptions of the risk, awareness, availability of SLT, and cessation practices influenced by their culture. Results:Of the 94 participants, 87.2% identified as Asian or natives of Afghanistan, Myanmar, and Pakistan. 70% reported SLT as a 'feel good' or recreational use, while 33% used it to relieve stress. Thirty-five percent stated they continuously use or have the desire to use SLT first thing in the morning. 86.2% perceived SLT products as unsafe for their health, 83% believed that it caused oral cancer and periodontal disease, and 76.6% were aware that SLT contains nicotine. 63.8% wished to stop using them, and 36.2% attempted to quit but were unsuccessful. 54% sought cessation assistance from a family member, 32% from a friend, and only 12% from a healthcare provider. Conclusion:SLT use is culturally prevalent within the immigrant and refugee populations. Participants' quit attempts likely failed due to a lack of professional cessation support that was taxing due to language, interpretation, and literacy barriers. Healthcare providers are well-positioned to offer cessation interventions and reduce SLT use to achieve community well-being pathways.
Introduction:While significant progress has been made to decrease tobacco smoking among youth and young adults, e-cigarettes threaten to reverse the progress. The purpose of this study was to test the feasibility of the ReACH Assessment of Knowledge for E-Cigarettes (RAKE) e-cigarette cessation program targeting youth and young adults in Texas.Methods:Seven dental practitioners and 12 patients participated in this pilot study. Patients aged 15 to 29 who reported current e-cigarette use were recruited by their dental practitioner. All participants completed pre-and post-assessments-practitioners receiving the RAKE training and patients the RAKE cessation intervention. Descriptive statistics were calculated.Results:After RAKE training, all practitioners reported the RAKE cessation program as useful and an important part of patient care. In addition, after completing the program (5A's), 67% (n=9) patients reported that the program was helpful, and 100% (n=12) would recommend the program to other ENDS users.Conclusions:Practitioners and patients enhanced their knowledge of e-cigarettes and their harm to health. In addition, practitioners demonstrated their ability to implement the RAKE cessation program within the practice, and patients approved of the use of the program. This study illustrated the feasibility and acceptability of conducting an e-cigarette cessation study in dental practices and a critical need to develop and disseminate the program to young patients.
BACKGROUND:Dry mouth, also commonly known as "xerostomia", is a prominent symptom that is often overlooked by dental practitioners and patients. The purpose of this study was to pilot the development of a mobile application for assessing dry mouth symptoms. The application will allow patients to self-assess and enhance knowledge, awareness and communication with dental practitioners in their management of dry mouth. METHOD:The first phase of the study was to draw on common knowledge and awareness by conducting two focus groups of dental professionals and community members on content, practicality, functionality, design, and effectiveness. The second phase of the study was the development of the dry mouth mobile application followed by the third phase of the study that consisted of face-validity interviews to obtain feedback on the application. RESULTS:Fifty two percent (n=15) of the dental professionals estimated being aware of the prevalence of dry mouth in 40% or more of their patients. Thirty Nine percent of (n=9) community estimated being aware of the prevalence of dry mouth in 40% or more of the community. When asked about their awareness of the etiologies of dry mouth, 100% (n=29) of dental professionals reported that multiple medications and smoking were primary factors whereas the community members indicated that illness and dehydration (87%, n=20) were primary factors in dry mouth. Dental professional's (25% n=7) were very confident in recognizing symptoms and 28% (n=8) were very confident they knew how to manage dry mouth symptoms. Furthermore, 22% (n=5) of the community members were also very confident about recognizing dry mouth symptoms and 13% (n=3) were very confident knowing how managing it. The ToP report generated from the discussions identified "themes" that were utilized in the development of the mobile application. Most individuals who participated in the validity interviews agreed that the dry mouth mobile application was useful, appealing, easy to use and the self-assessment test gave clear and concise information. The application was made available to download from the iTunes Appstore (2019-2020). CONCLUSION:The dry mouth pilot study indicated that the mobile application was beneficial for self-assessment and easy to use. Development of advanced technology tools such as the dry mouth application can promote communication between patients and their dental practitioners to discuss management options for dry mouth.
PURPOSE:This study's purpose was to examine the processes and the potential for dental practitioners to address environmental health exposure risks to their patients through dental practice-based research participation. To explore this, the South Texas Oral Health Network (STOHN) initiated a collaboration with The Tooth Fairy National Study investigating toxicants stored in deciduous teeth as a potential neurodevelopmental risk factor. BACKGROUND:Neurodevelopmental disorders (ND), like Autism Spectrum Disorder (ASD), affect 1 in 68 live births. Evidence suggests that environmental chemicals may play a role in ASD risk and/or etiology by acting independently or through interactions with genetic vulnerabilities. Provider awareness of environmental exposure risk during pregnancy and early childhood in South Texas is low. Therefore, it is important to increase provider knowledge and awareness to enable greater communication with patients. STOHN serves as a conduit reaching large numbers of patients. This study also engaged practitioners in an ongoing national study with minimal impact on their practice. METHODS:The goal was to enroll twenty parents with children via ten dental practitioners. STOHN pediatric and general practitioners were recruited for the study. Practitioners were contacted by phone and in person. Upon completion of Human Subject Protection training, each practitioner participated in a study training taught by a public health educator in the department of Family and Community Medicine at University of Texas Health Science Center in San Antonio (UTHSCSA). Training topics included NDs, environmental health exposures, patient engagement, survey administration, and how to collect donated teeth. This collaboration allowed STOHN to gather control teeth as well as demographic and health information for the Tooth Fairy Study repository for future analyses. Participants received a thank you card from the Tooth Fairy and participating providers were highlighted in the monthly STOHN newsletter. EVALUATION RESULTS:Evaluation was threefold: Practitioner enrollment and retention; practitioner confidence in educating their patients about potential environmental risk exposures and completed surveys with donated teeth. CONCLUSION:The interdisciplinary collaboration between dental practitioners and medical researchers through STOHN provided an opportunity to increase practitioner knowledge and awareness of a novel health concern, while also raising their confidence and willingness to educate their patients about potential environmental exposure risks. UTHSCSA IRB Protocol # HSC20170132E.
The Soladey™ toothbrush has a moisture-permeable titanium dioxide (TiO2) resin core in the replacement brush end of a handle activated by light conversion power cells. Purported to have an antibacterial effect and remove more plaque than an ordinary toothbrush, this study was undertaken to establish output measurements of the dry and wet TiO₂ core of the toothbrush during typical illumination of the handle, then quantify lipid peroxidation in three distinct lipid-containing solutions, and bactericidal effects in a live bacterial suspension grown from suctioned oral secretions.METHODS:Within a range of illumination of the power cells in the handle, corresponding flow of electrons emitted from dry and wetted TiO2 cores was measured. The claim that an antibacterial effect can be attributed to generation of reactive oxygen-mediated lipid peroxidation of cell membranes was tested by exposing three lipid substrates to the light-activated ionic toothbrush tips for incremental periods of time. Products of lipid peroxidation were quantified using 3 commercially available assays, and bactericidal effects were assessed by scoring colony-forming units.RESULTS:Illumination of the handle generated quantifiable increases in electrons flowing from the wetted TiO₂ core. Immersion of the TiO₂ core end of illuminated toothbrush handles into lipid substrates showed linear effects of incremental exposure times on products of lipid peroxidation, but no evidence of a bactericidal effect occurring within 15 minutes.CONCLUSIONS:This validates capacity of the wetted current- activated TiO₂ core to generate time-dependent lipid peroxides, particularly in the sonicated matrix containing disrupted cell membranes. Finding no time-dependent reduction in colony- forming units and less lipid peroxidation in a suspension of intact cells casts doubt that the ionic toothbrush has an immediate antibacterial effect while brushing teeth. If a toothbrush with a TiO₂ core is self-disinfecting between uses, bactericidal effects requiring longer periods of exposure might still confer a hygienic advantage.
Personality Types of Pediatric Dentistry Residents and Residency Applicants PURPOSE: Dentists may possess unique personality traits that distinguish them from the general population. Within the profession, there may be personality traits that are more prevalent in one specialty than another. This project was designed to determine if personality profiling could be a predictor for success in a specialty field, i.e. pediatric dentistry. The Myers-Briggs Type Indicator (MBTI) was developed to make the theory of psychological types, described by Carl Jung, understandable and useful to people's everyday lives. Jung's theory is that much of what seems like random human behavior is due to basic differences in the . way people use their perception and judgment. The purpose of this study was to determine if interviewees to a pediatric dentistry residency program possessed similar personality traits to pediatric dentistry faculty/residents by comparing the Meyers-Briggs Type Indicator (MBTI) results of the 2 groups. METHODS: Thirty-one pediatric dentistry faculty/residents were.compared with 46 pediatric dentistry residency interviewees. Each member of both groups anonymously completed the MBTI profile. RESULTS: This study indicates that there are no significant differences in MBTI personality types between pediatric dentistry faculty/residents versus interviewees to a pediatric dentistry residency (p=0.168), except that interviewees were more likely to exhibit the ESFJ type than were faculty/ residents (p=0.015). ESFJ represents E, extrovert, S, sensing, F, feeling and J, judging. All comparisons were conducted with the asymptotic chi-square test, except when expected cell counts were <5. For the latter comparisons, the Fisher's exact version of the chi-square test was used, p< .05 CONCLUSION: It is concluded that no common personality type, as determined by the MBTI, exists between pediatric dentistry faculty/residents and interviewees for residency, and that personality characteristics cannot be used as predictive factors in selection of pediatric dentistry residents.
Background There has been increasing concern by the American Dental Association, state dental boards, regional legislators, and specialty groups about the current state of dental anesthesia. Specific interest has surrounded methods to improve patient safety during parental sedation and anesthesia. Many times in the history of dental anesthesia, monitoring advances begin in the hospital for general anesthesia, then downscale, become smaller, and find utility in outpatient anesthesia. Monitoring advances ultimately have been shown to improve patient safety and are subsequently universally adopted. Practitioners should be aware that an anesthetic spectrum exists in parenteral sedation and anesthesia. For instance, there is data suggesting that a large number of patients planned for moderate sedation, may progress to deep sedation during which ventilation is impaired. With each individual patient responding differently to the administration of oral sedatives, intravenous anesthesia agents, or inhalational agents, anesthetics can have the effect of sedation, analgesia, hypertension, hypotension, combativeness, amnesia, apnea, or any one of many other more life-threatening events. It is incumbent upon all dental anesthesia providers to offer the highest spectrum of anesthesia monitoring and care currently available to prevent sedation effects from progressing to more serious situations. The most recent advance in anesthesia monitoring is capnography. It has been used in the operating room for many years to verify endotracheal tube placement. The capnogram provides information about respiratory rate and effectiveness, as well as end-tidal carbon dioxide values. Since 2011, the American Society of Anesthesiologists, and other prominent anesthesia organizations, have mandated capnography for use in moderate sedation. Most recently, the Oregon Board of Dentistry mandated capnography for all licensees performing moderate sedation effective Jan. 1, 2016. Capnography is also used in cardiopulmonary resuscitation and is advocated by the American Heart Association as an indicator of return of spontaneous circulation. Conclusions: Given the current regulatory environment concerning patient safety and monitoring during dental anesthesia, capnography should be a mandatory monitoring requirement for any dentist performing moderate sedation in the office. This instrumentation is easily added to any dental sedation monitoring armamentarium as a stand-alone unit or as a vital signs monitor upgrade and will demonstrate to the public and legislators that the dental profession is in alignment with monitoring recommendations of other anesthesia organizations.
BACKGROUND:This retrospective case series describes the outcomes of anterior teeth with complicated fractures treated using mineral trioxide aggregate (MTA) in pulpotomy procedures.METHODS:33 teeth were treated with MTA pulpotomy procedures in an endodontic private practice. All patients had been referred to the practice for diagnosis and treatment of a pulpal exposure due to complicated crown fractures. The teeth were either recalled directly or "indirectly" by the referring dentist. Teeth recalled directly were categorized as healed, healing, non- surgical root canal treatment completed for either aesthetic or restorative reasons, or persistent disease. Teeth recalled indirectly were categorized as successful or failed.RESULTS:27 teeth were available for recall; 20 teeth directly and 7 teeth indirectly. The mean recall for teeth recalled directly was 3.94 years and the mean recall for teeth recalled indirectly was 5.9 years. The recall range for teeth recalled directly was 0.51 to 10.49 years and for teeth recalled indirectly was 3.58 to 10.66 years. Of the cases available for direct recall, 13 of 20 teeth were healed positive to pulp tests, 4 of 20 teeth were healed negative to pulp tests and 3 of 20 teeth had non-surgical root canal treatment completed. 15 of the 20 teeth recalled directly where discolored. 7 of 7 teeth recalled indirect were successful as determined by the radiographs and a report from the restorative dentist.CONCLUSIONS:MTA is a viable alternative to calcium hydroxide for pulpotomies.
Background. A prospective cohort study that included dentists in The National Dental Practice-Based Research Network was conducted to quantify 12-month failures of restorations that were repaired or replaced at baseline. The study tested the hypothesis that no significant differences exist in failure percentages between repaired and replaced restorations after 12 months. It also tested the hypothesis that certain dentist, patient, and restoration characteristics are significantly associated with the incidence of restoration failure.Methods. Dentists recorded data for 50 or more consecutive defective restorations. The restorations that were either repaired or replaced were recalled after 12 months and characterized for developing defects.Results. Dentists (N = 195) recorded data on 5,889 restorations; 378 restorations required additional treatment (74 repaired, 171 replaced, 84 teeth received endodontic treatment, and 49 were extracted). Multivariable logistic regression analysis indicated that additional treatment was more likely to occur if the original restoration had been repaired (7%) compared with replaced (5%) (odds ratio [OR], 1.6; P < .001; 95% confidence interval [CI], 1.2-2.1), if a molar was restored (7%) compared with premolars or anterior teeth (5% and 6%, respectively) (OR, 1.4; P =.010; 95% CI, 1.1-1.7), and if the primary reason was a fracture (8%) compared with other reasons (6%) (OR, 1.3; P =.033; 95% CI, 1.1-1.6).Conclusions. An additional treatment was more likely to occur within the first year if the original restoration had been repaired (7%) compared with being replaced (5%). However, repaired restorations were less likely to need an aggressive treatment (replacement, endodontic treatment, or extraction) than replaced restorations.Practical Implications. One year after repair or replacement of a defective restoration, the failure rate was low. However, repaired restorations were less likely to need an aggressive treatment than replaced restorations.
