Search

The aim of this study was to evaluate the effectiveness of an innovative pediatric interprofessional education clinical experience using oral‐systemic health as the clinical population example for improving the self‐reported interprofessional competencies of family nurse practitioner, dental, and medical students. The objectives of the interprofessional experience were for students to apply pediatric oral health assessment, identify the pediatric oral‐systemic connection, and practice a team‐based approach to improve oral‐systemic outcomes. In spring 2015, fall 2015, and spring 2016, a total of 162 family nurse practitioner, dental, and medical students participated in this interprofessional experience at Bellevue Pediatric Outpatient Clinics together with a pediatric dental resident. Team members collaborated in reviewing the patient chart, taking the patient's medical and dental history, performing an oral assessment, applying fluoride varnish, and providing education and anticipatory guidance. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was used as a pretest and posttest to evaluate the degree to which students perceived changes in their attitudes about interprofessional competencies following the learning experience. In the results, all students had improved mean scores from pretest to posttest after the experience, and these changes were statistically significant for all students: nurse practitioner (p<0.01), dentistry (p<0.01), and medicine (p<0.001). The mean change from pretest to posttest was statistically significant for each of the six interprofessional competency domains (p<0.01). In both pediatric dental and primary care settings, the changes from pre‐ to posttest were significant (p<0.001). The experience was similarly effective for all groups of students in increasing their attitudes about interprofessional collaboration. These findings suggest that a clinical approach can be an effective strategy for helping health professions students develop interprofessional competence. [ABSTRACT FROM AUTHOR]

On March 15, 2020, routine dental care in New York State paused due to the COVID-19 pandemic. The pause lasted 10 weeks in part to preserve critical supplies of personal protective equipment (PPE). This interruption of access to dental care led to an overall deterioration of oral health, an increase in prescribing and use of antibiotics and analgesic medications, especially opiates, and a rise in visits to hospital emergency centers. New York University's College of Dentistry, an academic ambulatory dental center, normally sees over 1,000 patient visits per day. Most visits are patients who require urgent care or are in the process of treatment to restore debilitating oral health problems. NYU Dentistry responded to the State pause by creating a nascent teledentistry service that began operations on March 17, 2020. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the trends of pediatric dental rehabilitation in hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs) during the COVID-19 public health emergency (PHE) from 2019 to 2021 across states and demographic groups. Methods: This cross-sectional study utilized the 2019 to 2021 Transformed Medicaid Statistical Information System Analytical Files to examine trends in dental rehabilitation for children ages 12 years and younger enrolled in Medicaid or the Children's Health Insurance Program. The final analytic sample included 20,508,093 beneficiaries from 2019, 19,436,957 beneficiaries from 2020, and 20,416,440 beneficiaries from 2021. Chi-square tests were used to compare dental rehabilitation usage across groups (age, sex, race/ethnicity, and place of service). Results: Rehabilitation of Medicaid beneficiaries performed in HOPDs showed a decrease year over year (51 to 34 to 30; P<0.001), while the usage in ASCs increased (1,307 to 1,310 to 1,367; P<0.001). For all three years, the highest usage was seen in Non-Hispanic (NH) American Indian/Alaskan Native children (154, 66, 74; P<0.001), while the lowest usage was seen in NH Black children (21, 16, 17; P<0.001). Rehabilitation for Hispanic children had the greatest relative recovery over the three years (39 to 34 to 38; P<0.001). Conclusions: Dental rehabilitation usage in ambulatory surgery centers showed continued growth through the public health emergency. There was significant variation in rates across states and demographics. [ABSTRACT FROM AUTHOR]

Objectives: An overexpression of Tgf-β2 leads to calvarial hyperostosis and suture fusion in individuals with craniosynostosis. Inhibition of Tgf-β2 may help rescue fusing sutures and restore normal growth. The present study was designed to test this hypothesis. Design: Twenty-eight New Zealand White rabbits with delayed-onset coronal synostosis had radiopaque markers placed on either side of the coronal sutures at 10 days of age. The rabbits were randomly assigned to: (1) sham control rabbits (n = 10), (2) rabbits with control IgG (100 µg/suture) delivered in a collagen vehicle (n = 9), and (3) rabbits with Tgf-β2 neutralizing antibody (100 µg/suture) delivered in a collagen vehicle (n = 9). Longitudinal growth data were collected at 10, 25, 42, and 84 days of age. Sutures were harvested at 84 days of age for histomorphometry. Results: Radiographic analysis showed significantly greater (P < .05) coronal suture marker separation, craniofacial length, cranial vault length, height, shape indices, cranial base length, and more lordotic cranial base angles in rabbits treated with anti-Tgf-β2 antibody than in controls at 42 and 84 days of age. Histologically, rabbits treated with anti-Tgf-β2 antibody at 84 days of age had patent and significantly (P < .05) wider coronal sutures and greater sutural area compared to controls. Conclusions: These data support our hypothesis that antagonism of Tgf-β2 may rescue fusing coronal sutures and facilitate craniofacial growth in this rabbit model. These findings also suggest that cytokine therapy may have clinical significance in infants with progressive postgestational craniosynostosis. [ABSTRACT FROM AUTHOR]

A piano concert series and jazz reception program was organized at the College of Dentistry at New York University, in 2007. An anonymous survey to assess the response of faculty, staff, and students to the concert series was conducted during 2010 to 2011. Overwhelmingly, the respondents recommend that music concerts in the dental college be continued. Support is apparent in the overall recommendation and in questions dealing with stress, productivity, music, the auditorium, and the community. Differences between groups defined by status (student, faculty, other, or unknown) and by previous music study (yes, no, or unknown) were small. Events such as a concert series organized at the College of Dentistry apparently can have positive influence on work–life balance. [ABSTRACT FROM AUTHOR]

The introduction of mobile electronic devices, as opposed to paper forms, in pediatric outreach programs of the New York University College of Dentistry is discussed. Since 2007, students have been receiving training on how to operate a personal digital assistant (PDA) and use it in community outreach for non-invasive oral-facial screenings and patient education. The shift from using paper forms to electronic media had a positive impact among the academic community, as it resulted in saving time and reducing the possibility of data collection errors. It may represent a significant improvement in data collection and patient education; and it provides an opportunity to enhance research and quality assessment. [ABSTRACT FROM AUTHOR]

The article discusses the prevention of reynosyntosis and improvement of postoperative outcomes of craniosyntosis on rabbits by using Noggin protein. It also suggests the inhibition of bone morphogenetic proteins activity may prevent postoperative resynostosis and the use of Noggin therapy has potential for clinical use for infants with craniosyntosis.

The purpose of this study was to describe and assess the use of fissure sealant retention as a quality measure of the delivery system for pediatric dentistry. The Pediatric Dentistry Section at the Ohio State University College of Dentistry adopted Sealant retention as a measure of quality. Sealant retention in first and second molars was evaluated at each six-month recall appointment. Sealants were categorized as satisfactory or unsatisfactory. Two hundred five sealants were evaluated between March 1998 and March 1999. The mean age of the patients at the time of sealant evaluation was 14.0 ± 2.9. Mean sealant retention period was 29.8 ± 23.2 months, with a range of 0.9 to 148 months. Median sealant retention period was 23.2 months. Overall, 75.6 percent of the sealed teeth were classified as satisfactory. Use of this data in making improvements is discussed. Our results indicate that the use of sealant retention is a suitable measure for quality of care in pediatric dentistry. [ABSTRACT FROM AUTHOR]

A comprehensive oral health care program for Head Start children in New York City is described. Head Start is a federally funded pre-school program for low-income families and their children. It provides activities that help children grow mentally, socially, emotionally and physically. In 1994, a public-private partnership was created between New York Administration for Children's Services and New York University College of Dentistry. The program consists of periodic visits to different Head Start centers by a dental team composed of pediatric dentists, residents, hygienists and students. At the center, the team provides diagnostic and preventive services to children and oral health education to children, parents and staff. Referrals are then made to the College of Dentistry or to a community provider for treatment and follow-up. Free transportation is provided between Head Start centers and the college clinic. Over 13 years, 25,000 children have received diagnostic, preventive and treatment services. [ABSTRACT FROM AUTHOR]

SOCE mediated by ORAI1 affects the metabolism, redox status, and function of enamel cells in teeth. Preventing CRAC'd teeth: Store-operated Ca2+ entry (SOCE) through CRAC channels, specifically complexes formed by ORAI Ca2+ channels and STIM Ca2+ sensors, mediates Ca2+ uptake in enamel cells in teeth. Eckstein et al. described a patient with a null mutation in ORAI1 that likely accounted for the defective enamel mineralization in his teeth. In mice, deficiency of ORAI1, but not that of ORAI2, decreased SOCE in enamel cells and resulted in compromised enamel structure. In an enamel cell line, ORAI1 knockdown increased mitochondrial cellular respiration, resulting in altered redox status that increased the efficiency of Ca2+ uptake in the ER. These results indicate that ORAI1 is the major CRAC channel in enamel cells and reveal the mechanisms by which SOCE affects enamel cell function. Store-operated Ca2+ entry (SOCE) channels are highly selective Ca2+ channels activated by the endoplasmic reticulum (ER) sensors STIM1 and STIM2. Their direct interaction with the pore-forming plasma membrane ORAI proteins (ORAI1, ORAI2, and ORAI3) leads to sustained Ca2+ fluxes that are critical for many cellular functions. Mutations in the human ORAI1 gene result in immunodeficiency, anhidrotic ectodermal dysplasia, and enamel defects. In our investigation of the role of ORAI proteins in enamel, we identified enamel defects in a patient with an ORAI1 null mutation. Targeted deletion of the Orai1 gene in mice showed enamel defects and reduced SOCE in isolated enamel cells. However, Orai2−/− mice showed normal enamel despite having increased SOCE in the enamel cells. Knockdown experiments in the enamel cell line LS8 suggested that ORAI2 and ORAI3 modulated ORAI1 function, with ORAI1 and ORAI2 being the main contributors to SOCE. ORAI1-deficient LS8 cells showed altered mitochondrial respiration with increased oxygen consumption rate and ATP, which was associated with altered redox status and enhanced ER Ca2+ uptake, likely due to S-glutathionylation of SERCA pumps. Our findings demonstrate an important role of ORAI1 in Ca2+ influx in enamel cells and establish a link between SOCE, mitochondrial function, and redox homeostasis. [ABSTRACT FROM AUTHOR]

Purpose: To assess the oral health status of children with Down syndrome (DS) in the United States and evaluate the oral health needs of families with DS. Methods: Among 320 parents who consented to participate, 260 (81.2 percent) surveys were completed. A survey was distributed through the National Down Syndrome Society to parents of children with DS up to age 21 years, which asked questions about children’s general and oral health. Results: Parents who reported that their children had difficulty rinsing and spitting were more likely to report their child’s overall general health as poor (P<0.05). Parents’ frequency of daily toothbrushing was similar to their children’s toothbrushing habits (P<0.05). Conclusions: Dysphagia for children with Down syndrome may negatively impact oral health in addition to general health. Encouraging parental involvement in oral care for children with DS may lower their risk for oral disease. Continued support is needed to ensure dental school education includes training for the treatment and management of patients with DS. [ABSTRACT FROM AUTHOR]