Aim: The purpose of this in-vitro study was to look at the effectiveness of the ICON on prevention of caries on the smooth surface in comparison to resin based sealant. Methods: The study was an in-vitro study to compare the effectiveness of ICON and a sealant material in prevention of secondary demineralization. Sound teeth with no defects were cleaned and divided into 3 groups and lesions created. Both the groups were treated with respective materials (ICON and sealant), but the control group was left untreated. Once treated fresh demineralization solution was created and subject to deminralization cycles to see which material performed better in prevention of secondary demineralization. Results: In the present study, primary analysis was done using the quantitative light induced fluorescence technique. At the end of the secondary demineralization the results showed no statistically significant difference among the treatrment groups and the control group. However, the polarized light microscopy was done to assess the amont of infiltration of the material into the lesions. The ICON showed substantial penetration into the lesions where as the sealant material did not penetrate but formed resin tags on the surface of the lesion. Therefore, the ICON material did not fare any better than the sealant in prevention of secondary demineralization on smooth surface initial carious lesions.

Our study involved secondary analyses of the oral health-related quality of life data collected in the Iowa Fluoride Study at the 17-year time-point. Both adolescents and their parents filled out questionnaires related to the assessment of the OHRQoL of the adolescents. In addition, adolescents also underwent clinical examination to assess dental caries, dental fluorosis, orthodontic characteristics, and non-fluoride opacities. Dental casts were also made with the assent of the participants. These casts were later used to estimate the social acceptability of the participants' dental appearance and assess their malocclusion severity, using the Dental Aesthetic Index (Cons et al, 1978). This study assessed the relationships between the OHRQoL of Iowa adolescents and the presence of selected oral conditions, such as dental caries, dental fluorosis, and malocclusion. Based on the multivariable analyses, dental caries and malocclusion severity (reflected by DAI score) were the two oral conditions that were found to be significantly associated with poorer OHRQoL in adolescents. In addition, the influence of sex on adolescents' perceptions of OHRQoL was found to be statistically significant in our study and being female was associated with poorer OHRQoL. The findings of our study corroborate the results of other investigations that have demonstrated significant associations between: i) dental caries and OHRQoL (Arrow P, 2013; Barbosa et al, 2013; Bastos et al, 2012; Castro et al,2010; Do and Spencer, 2007; Martinis et al, 2012); ii) malocclusion and OHRQoL (Foster Page et al., 2005; Do and Spencer, 2007; Locker et al, 2007; Bernabe et al, 2008; Agou et al, 2008; O'Brien et al, 2006; Feu et al, 2010; Ukra et al, 2013); and iii) sex and OHRQoL (Foster Page et al, 2005; Calis et al, 2009; Bos et al, 2010; Barbosa et al, 2013; Ukra et al, 2013). Thus, oral conditions such as dental caries and malocclusion can be a source of stress and can have a negative impact on the life of an individual and can impede their ability to succeed. Females tend to be more sensitive to the negative impact of oral health conditions. Thus, in order to better understand the impact of oral health conditions, subjective measures should be used in conjunction with normative measures or clinical measures of assessing oral health. This can help in better treatment planning, and better allocation of resources, as oral health perceptions can vary for different individuals.

No description available.

With an aging population and with the number of patients with large prosthetic joints increasing, the recommendation of antibiotic use in this specific population has generated significant discussion. Dentists often treat patients with large prosthetic joints; however, little is known regarding the prescribing practices of dental providers. This cross-sectional study carried out in the State of Iowa, United States, evaluated whether dentists were familiar, followed, and were satisfied with the 2015 American Dental Association Clinical Guidelines and the 2016 American Academy of Orthopaedic Surgeons Appropriate Use Criteria (AUC), and whether dentists responses were associated with demographic and provider characteristics. Dentists’ concerns about antibiotic resistance, medical legal aspects, and adverse effects related to using antibiotic prophylaxis were also examined. Of the 1521 surveys that were sent by mail, a total of 635 were returned, for a response rate of 41.7%. Our results confirm that dental practitioners were very concerned about antibiotic resistance (43.9%) compared to 5.23% who were not at all concerned. In addition, female subjects were significantly more likely to be very concerned about antibiotic resistance than were male subjects (50.9% vs 41.4%; p=0.0376). Moreover, subjects that practiced in urban areas were more likely to be very concerned about antibiotic resistance that those practicing in rural areas (47.9%vs 37.5%; p=0.0157). We also observed that for a healthy patient, 28.9% of dentists would never recommend antibiotics. On the other hand, 44.9% of the respondents would recommend antibiotic premedication within the first 2 years since prosthetic joint replacement, 14.1% would recommend it within the first year, and 6.9% would recommend it for life. Dentists were aware of the lack of effectiveness of antibiotic prophylaxis in preventing prosthetic joint infection. However, premedication recommendations by physicians and patient preferences influenced dentist’s prescribing practices. Overall, dentists’ recommendations for the use of antibiotic for patients with prosthetic joints undergoing dental procedures varied depending on the health status of the patient, the dental procedure to be performed, the time since joint surgery, physician’s recommendations and patients preferences.

Objectives: To evaluate the oral health knowledge of legally authorized representatives of long term care facility residents to assess whether oral health knowledge is associated with the representatives’ understanding of the residents’ oral health status and treatment needs. Methods: The study participants were legally authorized representatives (LARs) of long term care facility (LTCF) residents who were visited by the Geriatric Mobile Unit (GMU) of the University of Iowa College of Dentistry & Dental Clinics. Once IRB approval was obtained, a mailing was sent out to the LARs after the GMU visited the LTCF. LARs were asked to complete a survey and were also asked permission to obtain dental records of the LTCF resident they represented. The survey contained questions pertaining to the LAR as well as the LTCF resident. With respect to the LAR, questions on socio-demographics, oral health literacy, oral health knowledge, oral health behavior and oral health status were asked. For questions about the LTCF resident, the LARs were asked about the resident’s prior oral health behavior, current oral health status, oral health treatment needs, and dental insurance status. They were also asked what factors would influence their decision to seek oral health care for the LTCF resident, and when they last spoke to the LTCF resident about their oral health. Bivariate analyses were conducted using Chi-square and Cochran-Mantel-Haenszel tests with LARs knowledge about the LTCF residents’ missing teeth and various oral health treatment needs being the outcome variables. Significant variables were entered into a multiple logistic regression model for each outcome variables. Statistical significance was set at p<0.05 and p=0.05-0.2. Results: Four hundred and thirty-one surveys were mailed out to the LARs. One hundred LARs consented to participate in the study and returned the completed questionnaire. Fifty-two percent of the LARs got all nine oral health knowledge questions correct. The questions that were the most frequently missed included “Losing teeth is a natural process of aging” (77% answered correctly), and “Blood on your toothbrush is a sign of gum disease” (74% answered in correctly). Thirty-eight percent of the LARs said they were extremely confident filling out medical forms by themselves, and 37% said they were quite a bit confident. When asked about the missing teeth of the LTCF resident, ten LARs reported that their LTCF resident had all teeth missing, while only 9 LTCF residents had all teeth missing as per chart review. Seventy-six residents had some upper back teeth missing and 71 residents had some lower back teeth missing. Twenty-eight LARs reported some upper back teeth were missing in their resident and 24 LARs reported some lower back teeth was missing. Treatment needs of the resident were in general underestimated by the LAR. Thirty-five LTCF residents needed a filling and 15 needed extractions, however LARs reported 21 residents needed fillings, and 8 needed extractions. Fifty-six LARs did not know if the resident needed a filling, and 49 LARs did not know if the resident needed an extraction. Bivariate analyses reported a number of significant variables in each domain for p values <0.05 and between 0.05 and 0.2. In the final logistic regression model, retirement status of the LAR and LARs’ confidence filling out medical forms were most commonly significant for LARs’ knowledge about treatment needs of the LTCF resident; and self-reported oral health status, age of the resident, and physical health status of the resident influencing the LARs decision to seek care dental care for the resident were significant for LARs’ knowledge about missing teeth of the LTCF resident. Conclusion: Although the majority of LARs indicated that oral health is important for nursing home residents, many LARs were unaware of the oral health status and the treatment needs of the LTCF residents. While a single variable was not found to be commonly associated across LARs’ knowledge of the oral health status and treatment needs of the residents, several variables were associated with the knowledge of one treatment need only as opposed to the knowledge of multiple treatment needs. Understanding if and how oral health literacy and oral health knowledge influence LARs’ and as well as nursing home caregivers’ decisions to seek dental care for LTCF residents may help address the gaps in oral health care for LTCF residents, thereby improving their quality of life.

Municipal water fluoridation began in 1945, and in the past 70 years, it appears to have decreased the rate of dental caries nationwide. Despite being deemed one of the top ten innovations of the 20th century, there continues to be misconceptions with this controversial practice. The intent of this thesis is to address some of the misconceptions with water fluoridation, and what possible solutions could be provided to alleviate the concerns. This was accomplished through a literature review of current research articles. Two main topics were explored: the public health and oral health concerns and how they contribute to the controversy. Results from the literature show that there was an increasing campaign from anti-fluoridators that use misleading information to advocate for ceasing water fluoridation. There was also a common concern about fluoridated water causing dental fluorosis. Furthermore, there was a trend with the lack of education and knowledge about water fluoridation, predominately in rural and low-income communities. Overall, it was reasoned that the best way to reduce the misconceptions of water fluoridation is to increase educational opportunities through medical professionals creating inter-department relationships and redirecting various government programs to target different populations.

Purpose This study assessed ETSU dental hygiene students’ perceptions and attitudes toward their careers after graduation in relation to underserved populations’ lack of access to dental care and nontraditional roles for dental hygienists. Methods A voluntary simple survey was used to assess the following: dental hygiene students’ exposure to and knowledge about underserved populations and nontraditional roles for dental hygienists, students’ favor or opposition toward these nontraditional roles, students’ interest in nontraditional roles, and students’ perceived preparedness to work outside of a traditional dental office in nontraditional roles to provide care for underserved populations. The survey data was aggregated and analyzed within the general context of the ETSU Dental Hygiene Program, and differences in responses based upon student classification were investigated using an independent samples t test. Results Between classes, a significant difference was seen in the responses for seven questions, all of which addressed either students’ knowledge about underserved populations and corresponding solutions to the lack of access to care or students’ perceived preparedness for nontraditional roles after graduation. The majority of the dental hygiene students responded as being in favor or completely in favor of expanded or nontraditional roles for dental hygienists and as being interested or highly interested in functioning in such roles. However, 88.89% of participants reported that they were either likely or highly likely to choose private practice as their primary place of employment. Conclusion The senior dental hygiene students both possess higher levels of knowledge about underserved populations and nontraditional roles for dental hygienists and feel more prepared to function in nontraditional roles after graduation than do the junior dental hygiene students. The program could consider focus areas, such as the reason for students’ high interest in nontraditional roles and simultaneous high likelihood to work primarily in private practice and ways to address this discrepancy.

The body of knowledge that exists regarding cracked teeth is limited. The purpose of this study was to determine the prevalence of cracks among extracted teeth. This retrospective longitudinal cohort study included patients of the Virginia Commonwealth University School of Dentistry that underwent extraction procedures over a 6 year period. The sample consisted of 20,408 patients and 40,870 teeth. Statistical analysis software was used to identify diagnoses of a crack, fracture, or split tooth prior to extraction of the tooth by analyzing the Electronic Health Record (EHR) (axiUm™, Version 6.03.03.1035, Exan Corporation, Vancouver, BC, Canada). There were 3,228 teeth identified as cracked in the 40,870 extracted teeth—an overall prevalence of 7.90%. The percentage of cracked teeth were compared using a chi-square test of homogeneity. The prevalence of cracked teeth varied according to tooth type (chi-square = 95.5, df = 7, p < .0001). Tukey’s multiple-comparison procedure identified the groups of tooth types with a significantly different cracked prevalence. The mandibular 2nd molar had the highest prevalence (9.72%). Age and gender were also significantly correlated with cracked teeth.

Abstract THE EFFECTIVENESS OF A PREVENTIVE RECALL STRATEGY IN CHILDREN FOLLOWING DENTAL REHABILITATION UNDER GENERAL ANESTHESIA By Amanda Kerns, DDS A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2016 Thesis Advisor: Elizabeth Berry, DDS, MPH, MSD Vice Chair, Assistant Professor, Department of Pediatric Dentistry Purpose: This was a prospective randomized controlled trial assessing the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) in children with early childhood dental caries. Methods: 130 patients completed FMDR and were included in the analysis. Caries risk assessment (CRA), dental exam, and a caregiver oral health knowledge (OHK) questionnaire was completed for each patient. Patients were randomized into two groups; intervention returned at 3 and 6 months and control returned at only 6 months post-surgery. At each recall, CRA and dental exam information was recorded, and at the six month recall, all caregivers completed the OHK questionnaire. Results: Actual recall data showed a statistically significant difference in CRA at six months, with 71.8% of patients in the control and 44.8% of patients in the intervention assessed as high caries risk. Conclusions: The actual recall data suggests this recall strategy is effective in reducing CRA level following FMDR.

Objective: To determine the demographic, economic, geographic, and health infrastructure factors related to the percentage of students by school who comply with state-mandated dental screenings in Iowa. Methods: An exploratory, cross-sectional study was conducted, utilizing secondary data sources from the Iowa Department of Public Health, the Iowa Department of Education, and the U.S. Department of Agriculture, to examine factors related to dental screening compliance rates for public school kindergarteners in Iowa (AY year 2014-15). Both school-level and county-level factors were considered. A ninety percent student compliance rate was established as the criteria for a school to satisfy the threshold for being compliant with screening requirement. Multivariable logistic regression analyses were conducted to evaluate the relationship of the independent variables on whether the schools satisfactorily met the criteria for compliance. Results: Fifty-six percent of the 504 schools included in the study satisfactorily met the established criteria. Schools located in dental health professional shortage areas or in urban adjacent areas were more likely to have a greater percentage of kindergarten students exceed the 90% compliance threshold (p<0.05). Schools where a greater percentage of students were screened by a dentist or where larger populations of children were eligible for free or reduced price lunch (FRPL) (≥40%) were less likely to meet the compliance threshold. Conclusions: Schools with more lower income students, those in metro areas, and those with a higher reliance on dentists performing the oral health screenings could benefit from targeted efforts to improve compliance with mandated dental screenings.