Thesis (M.S.)--University of Michigan, 2003. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Purpose: The purpose of this study was to assess if the topic of eating disorders is a part of post-graduate pediatric dental residency training curriculum. This study examined if there is a need for increased training of pediatric dental residents regarding the oral manifestations and treatment of patients with eating disorders.Methods: A cross-sectional online survey was used to compare data from all 66 post-graduate pediatric dental residency program directors. After thirty days a second emailing was conducted, with an additional thirty days to reply. Univariate distributions were obtained and percents for all items were based on the total number of respondents. The university-based programs and the hospital-based programs were compared and analyzed using chi-square analysis based on their percentages. Results: University-based programs were significantly less likely to offer curriculum on anorexia nervosa than hospital-based programs (13% versus 50%, pConclusion: An increase of clinically applicable eating disorder curriculum in post-graduate pediatric training is needed to enable residents to be more knowledgeable and effective practitioners.

Purpose: The purpose of this study was to evaluate esthetic posterior stainless steel crowns (EP-SSC) and compare their relative shear strengths.Methods: Sixty EP-SSC were compared. 15 crowns from NuSmile® Primary Crowns, Kinder Krowns, and Dental Innovators 1UP and EC Crowns were studied. The crowns were cemented to a typodont tooth then thermally cycled in water baths to simulate oral conditions. Shear strengths were evaluated by subjecting these crowns to simulated forces of occlusion.Results: The force required to cause shearing of the esthetic facings was statistically significant. With the 1UP crown being significantly weaker than the other crowns tested. Conclusion: The 1 UP crowns failed at lower levels of force than the other types of EP-SSC. The shear strengths for the three other crown types were not statistically different from each other. The esthetic facings do not likely fail from the single point load of a child's bite.

Purpose: The purpose of this study is to examine the baseline oral health status of infants and the level of their caregiver's oral health knowledge for families who received preventive oral health services in a medical setting. Methods: Using a prospective cohort study, children 0-3 years of age received an oral health screening, risk assessment, caregiver education, and a fluoride varnish treatment in an ambulatory pediatric medical clinic. A 16-item oral health knowledge and socio-demographic questionnaire was delivered to the caregiver of child. This questionnaire included knowledge, behavior and opinion items on risk factors for dental diseases, care of child's teeth, and socio-demographic characteristics of the family. Six-months after the medical visit, dental claims were examined to see if children had made a dental visit. Results: One hundred and ninety-five children received preventive oral health services in this clinic. Of these, 103 caregivers agreed to complete the oral health knowledge and socio-demographic questionnaire. Twenty-percent of children screening had visible signs of tooth decay, according to risk-assessment 72% were categorized as high-risk for tooth decay, and 83% received a fluoride varnish treatment. At 6-months, 9% of children were found to have had a dental visit. According to the caregiver questionnaire the likelihood of having a dental visit was correlated with the caregiver's knowledge of when a child should have their first dental visit and having been told by a medical professional when their child should be going to the dentist. Conclusion: Children are more likely to have a dental visit when caregivers are aware of the age 1 dental visit, or when advised to seek care by a medical professional. With increased education of medical providers, starting in medical residency training, more children can be seen for preventive oral health care resulting in an earlier establishment of a dental home.

Purpose: The purpose of this study was to compare the adverse events that occur with general anesthesia for dental rehabilitation between a hospital setting and dental clinic setting. Methods: A retrospective chart review was performed examining patients who had received dental rehabilitation with general anesthesia at the Virginia Commonwealth University Department of Pediatric Dentistry. Subjects were either treated in the Pediatric Dental Clinic or the Hospital Ambulatory Surgery Center (ASC) from July 2005 to December 2006. Anesthesia records of induction, intubation, maintenance, emergence and recovery were compared between the two settings.Results: There were a total of 422 charts reviewed with n=193 cases in the dental clinic and n=229 cases in the ASC. Patients in the dental clinic setting were slightly older (t = 2.63, df = 420, p-value = 0.0089), and healthier (chi-square = 45.9, df = 2, p-value Conclusion: Overall, the prevalence of adverse events occurring with dental rehabilitation under general anesthesia in the dental clinic setting was lower compared to adverse events in the hospital-based ambulatory surgical setting.

Purpose: The purpose of this study was to asses the oral health quality of life of children with special health care needs. This study examined the effects of oral health conditions on general well-being and family life of these children. A secondary aim of the study was to investigate correlations between specific health care conditions, gender, and age of these children and their global ratings of oral health and well-being.Methods: This study was a cross-sectional design with subjects who are members of the Virginia Care Connection for Children program, based at Virginia Commonwealth University. The oral health quality of life was measured using a shortened version of the Parental – Caregiver Perceptions Questionnaire (P-CPQ). The questionnaire includes measures of global ratings of oral health and well-being as well as effects of oral health on domains of oral symptoms, functional limitations, emotional well-being, and family well-being/parental distress. The parents/caregivers were asked to report on these domains as they related to their child's oral health within the past 3 months. Additional survey items included questions regarding demographic factors of the child (age, sex, special health care conditions) and parent (i.e. mother, father, or other). Results: The survey was sent out to 429 individuals and 137 usable surveys were returned for a response rate of 32%. Special health care conditions of the children were categorized and reported as follows: 1) Neurodevelopmental/Genetic/Neuro-muscular disorders, N=69 (59.13%); 2) Respiratory disorders, N=12 (10.43%); 3) Cardiac disorders, N=5 (4.35%); 4) Craniofacial disorders, N=12 (10.43%); 5) Metabolic disorders, N=15 (13.04%); 6) Psychological disorders, N=3 (2.61%). In general, caregivers reported the children to have a fair to good oral health quality of life in each domain. It was determined that two of the domains, functional limitations and emotional well-being, were not correlated with the child's oral health or well-being. However, the oral symptoms and family well-being/parental distress domains did have a positive correlation (p = 0.0340 and p = 0.0420, respectively). Conclusions: In a population of children with special health care needs it appears that oral symptoms and family well-being outweighed functional limitations and emotional well-being.

A comparison of the antimicrobial efficacy of silver diamine fluoride and silver nitrate on various cariogenic bacteria: an ex vivo study By: Reham AlNajjar, D.D.S. 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, 2019 Thesis Advisor: William Dahlke, D.M.D., Associate Professor and Chair of Pediatric Dentistry, School of Dentistry Purpose: The use of silver-based antimicrobials is an emerging method for the treatment of dental caries. In this study, the authors compare the efficacy of the two most prominent silver- based therapeutics, silver diamine fluoride (SDF) and silver nitrate (AgNO3), on cariogenic and non-cariogenic multispecies biofilms. Currently there is a lack of studies comparing the efficacy of SDF to AgNO3. Methods: Plaque samples from anterior and posterior tooth sites from children presenting both with early childhood caries and caries-free children were collected, pooled, and utilized to create four ex vivo biofilm systems in artificial saliva. SDF and AgNO3 were administered to these biofilms and bacterial survival was quantified and compared to untreated controls. Results: Each of the four pooled sample types was applied to plates coated in artificial saliva + 1% sucrose. Both SDF and AgNO3 were very effective against plaque derived biofilms when compared to untreated biofilms (P0.05) in the potency of each compound. Conclusions: SDF and AgNO3 significantly inhibit ex vivo cariogenic and non-cariogenic biofilms at similar levels.

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Purpose: The purpose of this study was to report the distribution of procedures provided to Virginia Medicaid children by three types of dental providers in rural and urban areas. Methods: Medicaid claims filed for dental patients younger than 21 were obtained and analyzed for fiscal years 1994 and 1995. Dental providers were categorized according to their practice type: general practice (GP), pediatric (PD) and public health (PH) dentists. Each type of practice was categorized as practicing in a Metropolitan, Urban, Rural or Completely Rural location and evaluated for percentages of preventive, diagnostic, and corrective services provided.Results: The number of procedures was shown to differ depending upon: year, practice type, location, significant provider status, and the type of procedure.Conclusion: General, pediatric and public health dentists in Metropolitan and Urban areas perform slightly more diagnostic services and much less corrective services than practitioners in more rural areas.