Faculty Bibliography

This study tested the feasibility of using information technology to improve dentists' adherence to the Treating Tobacco Use and Dependence Clinical Practice Guidelines by offering a web-based computer-mediated clinical decision support system (CDSS) for tobacco use treatment in dental clinics. The authors developed a CDSS tool, deployed the software in one of New York University College of Dentistry's general practice clinics, interviewed associate student dentists, and reviewed a random selection of patients' charts to determine if, after implementation, there were changes in tobacco use screening and referral to treatment. Students reported that the CDSS was easy to use, increased their efficiency, and provided better quality of evidence than was available prior to the intervention. Chart reviews demonstrated that, after CDSS implementation, patients in the target clinic were significantly more likely to be screened for tobacco use (<0.001), and tobacco-using patients were more likely to be advised (<0.001), referred to the state's Quit Line (<0.001), and prescribed nicotine replacement therapy (0.035). This study concludes that it is feasible to implement a CDSS for tobacco use treatment in dental clinics. The CDSS is a promising method for improving adherence to tobacco use treatment guidelines and warrants further study.

New York University College of Dentistry utilizes a protocol for caries management by risk assessment. It includes guidelines for determining several indicators and factors that are used to identify whether a patient is at high, moderate or low risk for dental caries. This case report presents an assessment of a patient with high caries risk and the system used to treat the disease process and lower the patient's risk for future lesions.

In 2006, the Centers for Disease Control and Prevention (CDC) recommended routine HIV screening in health care settings regardless of the patient's level of risk. This pilot study was developed in response to the suggestion by some health care professionals that dental settings would be appropriate for expansion of HIV testing. This project consisted of two parts: oral fluid HIV testing of patients in the clinic of a dental school and a survey of the clinical dental faculty members' attitudes about acceptability of routine HIV testing in the dental clinic. When patients' agreement to participate in oral fluid HIV testing was examined, 8.2 percent of the patients contacted by the clinic administration staff completed testing. When approached by a faculty member or student during the dental visit admission and tested during the dental visit, however, 88.2 percent completed testing. Of the faculty members who took the survey, 27.4 percent were neutral, 26.4 percent were somewhat in agreement, and 32.1 percent were willing to incorporate HIV testing into routine dental care. In this pilot study, HIV testing of dental patients was most successful when a dental care provider approached patients about testing. If consent was given, the testing was performed during the visit. For the faculty members, the major barrier to testing was a lack of protocol familiarity.