Faculty Bibliography

Lesbian, gay, bisexual, and transgender (LGBT) persons are a diverse group, but they share a common need for competent, accessible health care, dispensed without intolerance and with an understanding of their unique health needs. Dental practitioners need to understanding that LGBT persons have distinctive health (and oral health) needs. This article reviews the literature on oral and overall health of LGBT persons in the United States, and discusses ways in which dentists can improve the health care they provide to this vulnerable population, including how interprofessional education and collaborative practice may help to reduce oral health disparities within this group.

INTRODUCTION: The goal of this project was to use the Consolidated Framework for Implementation Research (CFIR) as the theoretical foundation for developing a web-based clinical decision support system (CDSS) for primary care screening and care coordination by dental hygienists at chairside. METHODS: First, we appraised New York State education and scope of practice requirements for dental hygienists with input from health experts who constituted a Senior Advisory Board for the project, and reviewed current professional guidelines and best practices for tobacco use, hypertension and diabetes screening, and nutrition counseling at chairside. Second, we created algorithms for these four health issues (tobacco, hypertension, diabetes, and nutrition) using evidence-based guidelines endorsed by authoritative professional bodies. Third, an information technology specialist incorporated the algorithms into a tool using an iterative process to refine the CDSS, with input from dental hygienists, dentists, Senior Advisory Board members and research staff. RESULTS: An evidence-based CDSS for use by dental hygienists at chairside for tobacco use, hypertension and diabetes screening, and nutrition counseling was developed with the active participation of the individuals involved in the implementation process. CONCLUSIONS: CDSS technology may potentially be leveraged to enhance primary care screening and coordination by dental hygienists at chairside, leading to improved patient care. Using the CFIR as a pragmatic structure for implementing this intervention across multiple settings, the developed CDSS is available for downloading and adaptation to diverse dental settings and other primary care sensitive conditions.

BACKGROUND: Oral-systemic etiologies solely or disproportionally affect women's health; however, little communication between and among disciplines occurs. METHODS: To bridge this gap, an innovative conference, "Transforming Women's Health: Discovery, Development, and Delivery," was held in Tampa, Florida. The conference aimed to address complex oral-systemic women's health issues by bringing together researchers, providers, and policy experts in dentistry, medicine, nursing, public health, and allied health professions. The program was structured by three organizational themes: (a) discovery (i.e., oral-systemic research specific to women's health issues); (b) development (i.e., translation of oral-systemic research to practice); and (c) delivery (i.e., collaborative practice). RESULTS: Issues discussed during conference proceedings include oral-system health in children, pregnant women, and older women, and cardiovascular disease and human papillomavirus (HPV) as oral-systemic health issues. Team and system-based approaches to reducing disciplinary-specific research, developing cross-disciplinary strategies and methods for improving women's health, and the advantages of creating collaborative networks, as well as effective communication practices with patients, were addressed. CONCLUSION: Based on findings from this innovative conference, it is clear that creating a transdisciplinary paradigm of research and practice may be the most effective vehicle for addressing oral-systemic health issues.

PURPOSE: Although there is a bidirectional relationship between periodontal disease and diabetes, little is known about the diabetes-related knowledge of periodontal patients. This study examines what patients with periodontal disease know about diabetes and its association with periodontitis. It also examines their sources of diabetes-related information. METHODS: Patients (n=111) with or at risk for diabetes who were receiving care at a university-based periodontics and implant clinic completed a written survey assessing their socio-demographic characteristics, health-related activities, diabetes knowledge and sources of diabetes-related information. Survey results were summarized using descriptive statistics. Fisher's exact tests were used to compare patients who had and had not been diagnosed with diabetes according to responses on diabetes-related knowledge items and sources of diabetes information. RESULTS: Although respondents endorsed various diabetes-related information sources, including family and friends and health care providers, respondents demonstrated very limited knowledge about the diabetes and periodontal disease association. There were no statistically significant differences between patients who had, and had not been diagnosed with diabetes regarding their diabetes-related knowledge. As compared with patients not diagnosed with diabetes, patients with diabetes were significantly more likely to have learned about diabetes from a health care provider (p=0.05) and significantly less likely to have learned about it from friends or family (p=0.05). CONCLUSION: Periodontal patients need education about the periodontitis-diabetes relationship. Dental hygienists' regular and ongoing involvement with these patients and their primary role in the patients' periodontal care places them in an optimal position to provide this education.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review. Figuero E, Carrillo-de-Albornoz A, Martin C, Tobias A, Herrera D. J Clin Periodontol 2013;40(5):457-73. REVIEWER: Stefanie L. Russell, DDS, MPH, PhD PURPOSE/QUESTION: How large an effect does pregnancy have on gingival inflammation in healthy pregnant women? SOURCE OF FUNDING: This work was supported by a non-profit group: the Spanish Society on Periodontology (SEPA), a member group of the European Federation of Periodontology, one of the largest dental organizations in Europe TYPE OF STUDY/DESIGN: Systematic review with meta-analysis LEVEL OF EVIDENCE: Level 1: Good-quality, patient-oriented evidence STRENGTH OF RECOMMENDATION GRADE: Grade B: Inconsistent or limited-quality patient-oriented evidence.

This review highlights what is known regarding differences in tooth loss by sex/gender, and describes: gender-related tooth ablation (the deliberate removal of anterior teeth during life) found in skulls from history and prehistory; potential mediators of the relationship between sex/gender and tooth loss; the current epidemiology of gender differences in tooth loss (limited to North America); and risk factors for tooth loss in the general population and in women.