Faculty Bibliography

Some dental lesions are difficult to detect with traditional anatomical imaging methods, such as, with visual observation, dental radiography and X-ray computed tomography (CT). Therefore, we investigated the viability of using an optical imaging technique, Mesoscopic Fluorescence Molecular Tomography (MFMT) to retrieve molecular contrast in dental samples. To establish feasibility of obtaining 3-D images in teeth using MFMT, molecular contrast was simulated using a dye-filled capillary that was placed in the lower half of human tooth ex vivo. The dye and excitation wavelength were chosen to be excited at 650-660 nm in order to simulate a carious lesion. The location of the capillary was varied by changing the depth from the surface at which the dye, at various concentrations, was introduced. MFMT reconstructions were benchmarked against micro-CT. Overall; MFMT exhibited a location accuracy of ~15% and a volume accuracy of ~15%, up to 2 mm depth with moderate dye concentrations. These results demonstrate the potential of MFMT to retrieve molecular contrast in 3-D in highly scattering tissues, such as teeth.

With millions of at-risk people undiagnosed with pre-diabetes and diabetes, there is a need to identify alternate screening sites for out-of-range glucose values. We examined practical issues and accuracy (relative to High Performance Liquid Chromatography testing in a laboratory) in the use of the A1cNow point of care device for this screening in general practice dental clinics at a large University-based Dental College. Health care professionals obtained evaluable readings for only 70% of the subjects, even after two attempts, and its use according to manufacturer's instructions was often challenging in the busy environment of the dental clinic. At thresholds for pre-diabetes and diabetes established by the American Diabetes Association, sensitivities of the A1cNow kit relative to the HPLC method were 91.9% and 100%, respectively. However, specificities for pre-diabetes and diabetes were 66.7% and 82.4%, respectively, indicating many false positive results. A better strategy for diabetes screening may involve a laboratory-based analysis approach that is patient- and provider-friendly, with minimal burden to the dental team.

BACKGROUND: The authors tested hypotheses that more noxious family environments are associated with poorer adult and child oral health. METHODS: A community sample of married or cohabiting couples (N = 135) and their elementary school-aged children participated. Dental hygienists determined the number of decayed, missing and filled surfaces via oral examination. Subjective oral health impacts were measured by means of questionnaires completed by the parents and children. The parents completed questionnaires about interparental and parent-to-child physical aggression (for example, pushing) and emotional aggression (for example, derision), as well as harsh discipline. Observers rated the couples' hostile behavior in laboratory interactions. RESULTS: The extent of women's and men's caries experience was associated positively with their partners' levels of overall noxious behavior toward them. The extent of children's caries experience was associated positively with the level of their mothers' emotional aggression toward their partners. CONCLUSIONS: Noxious family environments may be implicated in compromised oral health. Future research that replicates and extends these findings can provide the foundation to translate them into preventive interventions. PRACTICAL IMPLICATIONS: Noxious family environments may help explain the limitations of routine oral health preventive strategies. Interprofessional strategies that also address the family environment ultimately may prove to be more effective than are single modality approaches.

OBJECTIVES: To review the current status of dental curricula on elder care, and the current curricula regarding elder care, and it's effect on altering practitioner behaviors while addressing the needs of a growing North American elder population. BACKGROUND: An impending crisis is looming over the oral healthcare of our aging population. At the same moment that life expectancy is being extended through increasingly complex healthcare improvements, the numbers of trained dental providers capable and interested in delivering the needed care is failing to grow at an adequate rate. DISCUSSION: The skills necessary to manage these increasingly complex patients require an interprofessional approach capable of delivering care to sicker patients, in a variety of living accommodations, while managing a variety of care givers. The dental skills necessary to treat these elderly are modifications of skills students routinely learn in dental school. As a matter of fact, the skills students acquire to treat an adult patient population may be contrary to the basic skills necessary to manage the elderly dependent adult patient. Teaching students the nuance differences needed to properly diagnose and care for this population is a difficult task that must be taught in a contextual environment. CONCLUSION: Significant changes in the teaching of dental management of the elderly are critical within much of the education community. Just as teaching students to care for the pediatric population as general dentists, the clinical education must involve a sufficient number of quality experiences to address issues of both competency, that of the graduate to perform care independently, and attitudes, the actually willingness to treat the elderly.

There is a need for a structured, evidence based approach to care for older dental patients. The following article describes the development of the Seattle Care Pathway based upon a workshop held in 2013. An overview is provided on the key issues of older persons dental care including the demography shift, the concept of frailty, the need for effective prevention and treatment to be linked to levels of dependancy and the need for a varied and well educated work force. The pathway is presented in tabular form and further illustrated by the examples in the form of clinical scenarios. The pathway is an evidence based, pragmatic approach to care designed to be globally applicable but flexible enough to be adapted for local needs and circumstances. Research will be required to evaluate the pathways application to this important group of patients.

In 2005, New York University Colleges of Dentistry and Nursing formed an organizational partnership to create a unique model of interprofessional education, research, service and practice. This paper describes the first eight years of experience, from the early reaction of the public to the partnership, to examples of success and past and current challenges.

OBJECTIVE:An intra-oral remineralization study was conducted to compare the ability of a dentifrice containing 8% arginine and calcium carbonate (Pro-Argin Technology), and 1450 ppm fluoride as sodium monofluorophosphate (MFP) to remineralize acid-softened bovine enamel specimens compared to a silica-based dentifrice with 1450 ppm fluoride as MFP. METHODS:The intra-oral clinical study employed a double blind, two-treatment, crossover design, and used an upper palatal retainer to expose the enamel specimens to the oral environment during product use and periods of remineralization. The retainer was designed to house three partially demineralized bovine enamel samples. The study population was comprised of 30 adults, ages 18 to 70 years. The study consisted of two treatment phases with a washout period lasting seven (+/- three) days preceding each treatment phase. A silica-based dentifrice without fluoride was used during the washout period. The Test Dentifrice used in this study contained 8% arginine, calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate (MFP). The Control Dentifrice was silica-based and contained 1450 ppm fluoride as MFP. The treatment period consisted of a three-day lead-in period with the assigned product. The panelists brushed two times per day during the three-day lead-in period with the assigned product. On the fourth day, the panelists began brushing with the assigned product with the retainer in their mouth. The panelists brushed for one minute, followed by a one-minute swish with the slurry and a rinse with 15 ml of water in the morning, in the afternoon, and night with the retainer in the mouth. The panelists brushed only their teeth and not the specimens directly. Changes in mineral content before and after treatment were measured using a Knoop microhardness tester. RESULTS:The results of the study showed that percent remineralization values for the Test Dentifrice and Control Dentifrice were 14.99% and 8.66%, respectively. A statistical analysis showed that the Test Dentifrice was statistically significantly more effective at remineralizing acid-softened enamel in comparison to the Control Dentifrice (p < 0.05). CONCLUSION/CONCLUSIONS:This study demonstrated that the Test Dentifrice with 8% arginine, calcium carbonate, and 1450 ppm fluoride as MFP is highly effective treatment for promoting remineralization of enamel that has been softened by an erosive challenge.

New York City has a large number of individuals seeking asylem who are victims of torture. In addition to dental needs, which include cases of severe trauma to the mouth, these individuasl require special support because of their fear of contact by those they do not know. A cooperative program between the New York University College of Dentistry and Bellevue NYU, known as the Program for Survivors of Torture, is described.