Dental hygiene students may struggle in dental hygiene curriculum in regards to hand function. Currently, this is not an aspect dental hygiene programs screen for or have protocol in place to help students. The research in the study examined if hand function could improve with hand function exercises and if exercises improved instrumentation scores. During a 6-week pilot study, an occupational therapist tested the hand function of a cohort of dental hygiene students. The results were recorded and the students began a 6-week hand function exercise regimen. After 6 weeks the same evaluations were preformed and the pre- and posttest data were compared. Statistical tests showed a significant improvement in hand function. After the hand function testing was complete, the scores of the cohort on the periodontal probe and 11/12 explorer were compared to students in the previous 5 cohorts. No significant improvement was made on the instrumentation scores.

Excerpt: According to the United States Centers for Disease Control and Prevention (CDC), approximately 20 million Americans are currently infected with human papillomavirus (HPV), and another 6 million will become newly infected each year.

Objective: To investigate and determine periodontal treatment needs by the use of the Community Periodontal Index of Treatment Needs (CPITN) of a Medicaid expansion population in the state of Iowa (DWP) in comparison with patients insured by the traditional Medicaid State Plan, patients with private dental insurance, and self-pay patients, while evaluating for systemic health conditions and socio-behavioral factors. Methods: A secondary data analysis of electronic health records (EHR) from the University of Iowa College of Dentistry was completed and analyzed. Univariate and bivariate analyses were conducted. Logistic regression models were used to analyze relationships between predictors and periodontal treatment need. Results: Out of the study population, 54% were indicated for scaling and root planing (SRP). Predictors of indicating the need for SRP treatment were found to be: Age (p< .0001), gender (p< .0001), medical diagnosis of diabetes (p=.031), smoking status (p< .0001), and not receiving regular dental check-ups (p< .0001). Discussion: Our findings are consistent with common periodontal disease predictors found in the literature. Interestingly, insurance status was not a significantly associated predictor of periodontal treatment needs. However, approximately 50% patients with all insurance types were indicated for SRP. Implications: DWP patients must earn benefits by maintaining dental appointments. This earned benefits approach delays periodontal treatment as patients must earn this procedure, potentially leading to deteriorating periodontal health. Further assessment of periodontal burden in the DWP population should be conducted and potential program structure evaluated.

Objectives: Tooth extraction initiates a cascade of events that often leads to local anatomic changes in the alveolar ridge. Ridge preservation is a surgical approach aimed at minimizing hard and soft tissue volume loss. There have been contradicting reports on the efficacy of socket grafting for alveolar ridge preservation. Interestingly, there is a paucity of adequately powered randomized controlled clinical trials. The purpose of this study was to assess the effect of the application of a socket grafting technique on alveolar ridge dimensional changes following tooth extraction. Methods: Healthy patients requiring the extraction of one single-rooted tooth on either arch, from second premolar to second premolar, excluding mandibular incisors, and who met the eligibility criteria were recruited. Patients were then randomly assigned to either the control group, consisting of tooth extraction alone, or the experimental group, which consisted of extraction and simultaneous ridge preservation using an allograft bone material to fill the socket and a dense polytetrafluoroethylene membrane (dPTFE) to seal it. Cone beam computed tomography (CBCT) was obtained immediately prior to extraction (baseline) and at 14 weeks. Linear measurements with the use of a tooth-supported stent were obtained immediately after extraction (baseline) and at 14 weeks. Linear and volumetric measurements were made using data obtained from the CBCTs. Masked, calibrated examiners performed all radiographic measurements. Measurements obtained included buccal keratinized tissue width, buccal and lingual plate height and width, alveolar ridge horizontal width (CBCT); and alveolar ridge volume changes. Digital planning of dental implants was performed in the ideal restorative location and need for additional grafting was virtually determined. The primary outcome of interest was volumetric reduction of the alveolar ridge at 14 weeks. Linear mixed model statistical analyses were used to compare the mean change in the measurements between the grafted and control groups. Results: A total of 59 subjects were recruited, of which 53 patients (27 control and 26 experimental) completed the study. No statistically significant difference was found between the two groups at baseline for any of the parameters analyzed. At the 14 week follow-up appointment there was an average loss in height of the buccal plate of 1.17 mm and 0.61 mm for the control (CG) and experimental (ARP) groups, respectively, showing statistical significance (p=0.012). The lingual plate height was reduced 0.7 mm in CG and 0.47 mm in ARP with no statistical significance (0.075). A linear loss in the buccal-lingual dimension of the alveolar ridge was noted radiographically in both groups, 1.68mm in CG and 1.07mm in ARP, which demonstrated a statistical significant difference between them (p=0.023). Volumetric analysis demonstrated a mean volume loss of 15.83% in the CG showing statistical significance from the 8.36% loss shown in the ARP group. This difference demonstrates a clinical significance when virtual planning of implant placement in the ideal restorative location revealed the need for additional grafting at 13/27 or 48% of CG and 3/26 or 11% of ARP sites. Additionally, a very robust, statistically significant correlation was noted between buccal bone plate width and reduction of alveolar bone volume after 14 weeks of healing (p< 0.0001). A multivariate regression analysis revealed that within the control group a buccal plate <1mm lead to >10% volumetric reduction, while the same reduction in the graft group was only seen when the buccal plate was less that 0.6mm. Conclusions: In this study, a novel volumetric analysis of alveolar ridge reduction after tooth extraction was performed, which demonstrated that socket grafting for alveolar ridge preservation does provide a therapeutic benefit. This finding was associated to a decreased probability of requiring additional grafting at the implant site. The thickness of the buccal plate at the time of extraction appears to be a valuable factor to predict the amount of resorption that will take place, meaning that more resorption should be expected, as the buccal plate gets progressively thinner.

Objective: To determine risk factors for cavitated caries incidence and extent of cavitated caries among adolescents. Methods: Three hundred and three Iowa Fluoride Study (IFS) subjects met inclusion criteria for interval between dental examination and the responses from the IFS (ages 13.5 to 17.0) and the Block Kids Food Frequency (ages 13.0 to 17.0) questionnaires, respectively. The analyses focused on the outcome variables of net cavitated caries incidence and net cavitated caries increment counts, respectively. The independent IFS questionnaire variables related to demographics, fluorides, oral hygiene, beverage intakes, dental visits, sealants and previous caries incidence variables, respectively, whereas, Block's questionnaire variables related to intakes of solid foods and beverages, respectively. Two sets of analyses, logistic and negative binomial regression analyses, were conducted to assess the associations between risk factors and net cavitated caries incidence and increment counts from 13 to 17, respectively. Results: In multivariable logistic regression analyses, significant (p<0.05) negative associations were found between age 13 to 17 net cavitated caries incidence and greater frequency of consumption of vegetables, greater brushing frequency and greater frequency of sugar-free beverage consumption. Additionally, significant (p<0.05) positive associations were found between age 13 to 17 net cavitated caries incidence and both net cavitated caries incidence from 9 to 13 and frequency of consumption of solid-foods in the combined category of presumed moderate cariogenicity. The significant interaction effect showed that the effect of the presence/ absence of sealants varied for girls vs. boys. In multivariable negative binomial analyses assessing the association between net cavitated caries increment count from 13 to 17 and risk factors, significant (p<0.05) positive associations were found with greater intake of foods predominant in starch, presence of sealants, greater baseline age, cavitated caries increment count from 9 to 13, and greater frequency of consumption of foods predominant in added sugar, respectively. Significant (p<0.05) negative associations were found between net cavitated caries incidence and greater frequency of consumption of foods predominant in fiber and natural sugar and greater daily fluoride intake from water. However, daily fluoride intake from water was not statistically significant with the significant interaction effect included between baseline age and net cavitated caries increment count from 9 to 13 (dichotomized as Y/N). Conclusion: Presence of sealants, frequency of consumption of vegetables and previous cavitated caries incidence from 9 to 13 were associated with outcomes of incidence and extent of cavitated caries observed among IFS adolescents. The differences in findings for risk factors for incidence and extent of cavitated caries are due in part to the nature of the outcome variables (count vs. dichotomous), emphasizing the need to consider both outcomes in future studies of adolescent caries.

The purpose of this study was to evaluate the effect of a school-based fluoride mouthrinse program in a fluoridated community. Such an evaluation is important because the effect of such programs may decrease over time due to the widespread use of fluoride. Two elementary schools were chosen. One had a fluoride mouthrinse program: the other did not. The subjects were children in grades one and six. Their caries experience was examined using dft. dfs. DFT, and DFS scores. There were no statistically significant differences between the two schools. The program had no significant effect in the community studied.

OBJECTIVE: The objective was to assess the role of socio-demographic, dietary, behavioral, and environmental factors in Mutans Streptococci (MS) colonization in young children from low socio-income families. METHODS: This study involves secondary analyses of data collected from 6 to 24 months old children (N=129) enrolled in the Supplemental Nutrition Program at WIC, Iowa. They were followed for 18 months assessing different socio-demographic, dietary, behavioral, and environmental factors at 5 time-points. Total 3 clinical examinations were conducted at baseline, 9 months, and 18 months. Salivary samples collected during the examinations by semi-quantitative method, serve to determine the subjects' MS levels, who were grouped into either 1) No MS at any time during the study (n=58); 2) MS at baseline (n=35); or 3) Acquired MS during the study period (n=36). Prediction of the group membership (1or3) over the three time points is used as outcome for this study. This paper reports important findings from pairwise comparison of the three groups at baseline, 9 months and 18 months. RESULTS: Consumption of sugar-rich beverages and tooth-related factors like plaque and number of teeth were significantly (p<0.05) higher in Group 2 children, than the others at baseline. Group 2 also had the oldest children (mean age at baseline - 16.7 months) than Group 1 (10.8 months) and Group 3 (12.6 months). The effect of age was reflected in longitudinal comparison of group1 and 3 as well. Different behavioral and dietary factors were significant at different time-points, specific to that age-group under observation. Higher maternal education was found to be a protective factor, whereas tooth-related factors such as, history of caries and number of teeth, were risk factor in longitudinal analyses. CONCLUSION: Time measured as age of the child is the key factor in MS infection in youg children. Dietary, behavioral, environmental, and tooth related factors acquire importance depending on age of the child. Future longitudinal analyses will further explore these relationships.

This study is aimed to evaluate service-learning program's impact on senior dental students' attitude to community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students' attitude to community service that will eventually lead into providing care to the underserved. Two surveys were administered to 105 senior dental students. For the first survey (post-test), students reported their attitude to community service after the service-learning program completion. For the second survey (pre-test), students reported their attitude prior to the program retrospectively. Seventy six students responded to the post-test and fifty six students responded to the pre-test. A repeated-measure mixed-model analysis indicated that overall there was a change between pre-test and post-test. Scales of connectedness, normative helping behavior, benefits, career benefits, and intention showed a significant pre-test and post-test difference. A relationship between attitude to community service and student characteristics such as age, gender, ethnicity, and volunteer activity was also examined. Only ethnicity showed a significant difference. In conclusion, service-learning program at VCU School of Dentistry has positively impacted senior dental students' attitude to community service.

AUTHORS: Stella Chukwu DDS, Daniel Caplan, DDS, PhD, Michelle R. McQuistan, DDS, MS, Alice M. Horowitz, PhD, Christopher Squier PhD, Fang Qian, PhD TITLE: KNOWLEDGE OF RISK FACTORS FOR ORAL CANCER AMONG ADULT IOWANS OBJECTIVE: To gather baseline data from adult Iowans regarding their knowledge, opinions and practices about oral cancer (OC) prevention and early detection; with a focus on their knowledge of risk factors for OC. METHODS: A statewide, computer assisted random-digit dial telephone survey was conducted to gather information about OC prevention and early detection among Iowans age 18 and older. The survey contained 36 questions and lasted about ten minutes per respondent. Telephone numbers included landline and cell phone sampling lists provided by a private survey research firm. RESULTS: Of the 89 % of respondents that answered "yes" when asked if they had ever heard of OC, 54% had high OC risk factor knowledge; while of the eleven percent of those who said they had never heard of OC, 33% had high knowledge (p=0.003). Those that had an OC exam were more likely to have high OC risk factor knowledge (59%) compared with those that answered "no or don't know" to having had an OC exam (45%; p=0.002). Those that were "very or extremely" confident filling out medical forms were more likely to have high OC risk factor knowledge compared to respondents who were "not at all, slightly or moderately" confident filling out forms (54% vs. 45 %; p=0.097). CONCLUSIONS: The results suggest strongly that educational interventions are needed to increase knowledge of OC risk factors, early signs of OC, and the need to promote comprehensive OC examinations by healthcare providers. SOURCE OF FUNDING: Delta Dental of Iowa Foundation

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