Faculty Bibliography

OBJECTIVES/OBJECTIVE:Diagnosis and treatment of non-odontogenic pain is challenging for endodontists. The purpose of the study was to investigate the outcomes of referrals to orofacial pain specialists made for patients with suspected non-odontogenic pain, after evaluation and/or treatment by an endodontist. MATERIALS AND METHODS/METHODS:A retrospective review of dental records was conducted for 60 patients referred from a postgraduate endodontic clinic to an orofacial pain clinic. Patient demographics, pain history, endodontic, and orofacial pain diagnoses were collected. Number of visits, length of treatment, and treatments prescribed were recorded. For analysis of outcomes, data pertinent to resolution/persistence of symptoms and patient compliance were analyzed. RESULTS:Thirty-five patients were included in the study. The most frequent pulpal and periapical diagnoses were previously treated (62%) and symptomatic apical periodontitis (72%), respectively. The most common orofacial pain diagnosis was temporomandibular disorder. The average time spent to diagnose and treat the pain was 17 months. Pain reduction varied and was documented for 51% of patients. Indications of non-compliance with orofacial pain appointments and treatments were documented for 66% of patients. CONCLUSIONS:Non-odontogenic pain diagnosis and treatment are challenging. Patients may have an increased predilection for developing persistent pain after endodontic treatment and/or have an undiagnosed, chronic orofacial pain condition as a true source of their chief complaint. It may be helpful for endodontists to set expectations of typical treatment times/plans when referring patients for evaluation and treatment of non-odontogenic pain.

OBJECTIVES/UNASSIGNED:This study investigated differences in the provision of root canal therapy and outcomes in a publicly insured cohort of children and adolescents. METHODS/UNASSIGNED:New York State Medicaid administrative claims from 2006 to 2018 were analyzed. Enrollees aged 6-18 were included in the study if they had initial non-surgical root canal therapy (NSRCT), in the permanent dentition, that allowed for at least 1 year of post-treatment follow-up. Descriptive analyses, multivariable logistic regression, and multivariable Cox proportional hazard models were used to examine the association between demographic variables (gender, age, race/ethnicity, and area-based factors) and dental treatment provision and outcomes. RESULTS/UNASSIGNED:Male gender was associated with having more than one initial NSRCT (adjusted odds ratio (aOR) = 1.06; 95% confidence interval (CI) = 1.02-1.10), as was rurality (aOR = 1.15; 95% CI = 1.06-1.24). Black/African American (AA) and Hispanic children were less likely than non-Hispanic white children to have multiple NSRCTs (aOR = 0.88; 95% CI = 0.83-0.93 and aOR = 0.78; 95% CI = 0.74-0.83). Being older or female conferred a lower hazard of an untoward event (aHR = 0.93; 95% CI = 0.92-0.94 and aHR = 0.86; 95% CI = 0.81-0.91). Compared to non-Hispanic white children, Hispanic and Black/AA children had a higher risk of untoward event (aHR = 1.31; 95% CI = 1.21-1.41 and aHR = 1.55; 95% CI = 1.43-1.67) while children of Asian descent had a lower incidence after initial NSRCT (aHR = 0.79; 95% CI = 0.71-0.88). CONCLUSION/UNASSIGNED:Race/ethnicity was the strongest demographic predictor of provision of initial non-surgical root canal therapy, subsequent placement of a permanent restoration and the occurrence of an untoward event after NSRCT in this cohort.

PURPOSE/OBJECTIVES/OBJECTIVE:This study describes and evaluates efforts to transition an established pre-dental pipeline program to a remote platform, in response to the coronavirus disease 2019 pandemic. METHODS:The semester-long pipeline program, Saturday Academy at New York University College of Dentistry, was conducted remotely through Zoom, and materials for hands-on, pre-clinical activities, were mailed to participants. Saturday Academy aims to educate underrepresented minority and low-income high school students about the college application process and the dental profession. After the program's completion, program applications and engagement data were analyzed. An anonymous online survey was administered to the high school student participants. The survey questions included topics about their interest in the profession of dentistry, satisfaction with the Saturday Academy programming, and program engagement. RESULTS:In its remote format, Saturday Academy had an average attendance of 87.8% at each session. All (60/60, 100%) of the high school student participants responded to the anonymous program satisfaction survey. Sixty-seven percent reported an interest in the profession of dentistry before participating in the program and 82% after participating in the program. Ninety-eight percent agreed with the statement "I enjoyed my experience participating in Saturday Academy." Additionally, 97% agreed with the statement "Saturday Academy's virtual programming was effective." There were no statistically significant differences in program satisfaction when data from the virtual program were compared to 2 years of in-person program satisfaction data. CONCLUSION/CONCLUSIONS:Challenges to fulfilling the missions of dental institutions in response to the coronavirus pandemic impact service and recruitment efforts, in addition to formal dental education. Transitioning pipeline programming efforts, with hands-on components, to a remote format is possible and was met with favorable engagement and responses from program participants.

PURPOSE/OBJECTIVES/OBJECTIVE:The aim of this study was to increase the understanding of perceived barriers to applying to dental school experienced by underrepresented minority (URM), pipeline program alumni. METHODS:A qualitative study of alumni of New York University College of Dentistry pipeline programs, aimed at increasing the number of URM and low-income students in the dental profession, was conducted in 2020. Focus groups were convened to examine perceived barriers to applying to dental school and identified through a combination inductive and deductive thematic analysis. RESULTS:Twenty-three pipeline program alumni, ranging in age from 18 to 30 years old, participated in focus groups held between January and April 2020. All students identified as underrepresented minorities and 78% were first generation college students. Fifteen (65%) of the participants had not yet applied to dental school. Eight participants (35%) had applied to dental school, 3 (13%) were currently enrolled in dental school, and 5 (22%) were matriculating into dental school in Fall 2020. The following themes emerged as the most prominent challenges to applying to dental school: pre-health advisors (e.g., lack of knowledge about the pre-dental process and discouragement), and the cost of the application process (e.g., application fees, DAT and DAT preparation course costs, and interview costs). CONCLUSION/CONCLUSIONS:Through pre-dental pipeline programs, participants have access to informational resources and mentorship; however, despite participation in these programs, perceived barriers are still prevalent. Identification of the alumni's perceived barriers offer targeted areas where increased intervention may be helpful to reduce challenges and strengthen the pipeline.

INTRODUCTION/BACKGROUND:The objective of this study was to evaluate the use of YouTube as a learning tool for clinical procedures among third- and fourth-year dental students. METHODS:A multiple choice survey was distributed through Qualtrics to third- and fourth-year dental students at 5 United States dental schools. Questions pertaining to YouTube use were asked related to the following categories: demographic information, general YouTube use, YouTube use as a tool to learn clinical procedures, YouTube video sharing, and validity. Descriptive and quantitative analyses were performed. RESULTS:Data were collected in 2019 and 2020 from 479 third- and fourth-year dental students (overall response rate 28.3%). Respondents ranged in age from under 23 to over age 50. Ninety-five percent of respondents considered YouTube videos on clinical procedures to be a helpful learning tool, and 89% would like for their dental school to post tutorials to YouTube/social media. No statistically significant differences were found between dental institutions; however, a statistically significant difference between third- and fourth-year students did exist regarding the frequency of YouTube use. While the use of YouTube as a learning tool for clinical procedures is high, 36% of students are uncertain about the evidence-base of the videos. CONCLUSIONS:As dental students use publicly available resources as adjuncts to the dental curriculum, it is important to analyze the quality of the material accessed. These findings may suggest a need for dental institutions to increase the development of evidence-based instructional videos as a part of their clinical educational curriculums.

Pipeline programs aim to increase the representation of underrepresented minorities in the dental profession. At New York University College of Dentistry (NYUCD), two dental students initiated the development of a pipeline program for high school students called Saturday Academy. The purpose of the program is twofold: to mentor and coach underrepresented minority and low-income high school students through the college application process, and to expose them to the field of dentistry as a viable career option through both didactic and hands-on learning. The aim of this pilot study was to determine outcomes for the first five years (2013-17) of the Saturday Academy pipeline program at NYUCD with regard to the high school students' experience with the program and their career interests after high school graduation. Across five cohorts, a total of 82 students participated in Saturday Academy. A "where are you now?" survey sent to 72 participants who reported high school graduation years between 2013 and 2018 received a response rate of 76%. The survey results showed that all (100%) of the responding Saturday Academy participants had graduated from high school and were enrolled in college, and 71% were interested in health profession careers. Almost half (47%) of the students self-identified as being pre-dental, and 96% reported that Saturday Academy had increased their interest in the dental profession. These pilot results justified an expansion of Saturday Academy at NYUCD in both size and creation of an alumni outreach initiative. Other dental schools may benefit from the strategies used by this program in establishing or expanding their pipeline programs.

INTRODUCTION/BACKGROUND:The aim of this study was to investigate changes in treatment planning decisions among different practitioner groups over 7 years for teeth with apical periodontitis and a history of endodontic treatment. METHODS:A Web-based survey was sent to dentists in Pennsylvania in 2009 consisting of 14 cases with nonhealing periapical lesions and intact restorations without evidence of recurrent caries. Participants selected among 5 treatment options: wait and observe, nonsurgical retreatment (NSRTX), surgical retreatment (SRTX), extraction and fixed partial denture, or extraction and implant (EXIMP). In 2016, the identical survey was resent to the original 2009 participants. RESULTS: = 11.2792, P < .05]). No significant changes were observed in the decision for tooth saving versus replacement treatment options (P = .520). CONCLUSIONS:No significant differences were noted between current and past treatment planning decisions in regard to tooth preservation by endodontic retreatment versus tooth extraction and replacement. However, individual practitioners lacked consistency in their decision making over time.

INTRODUCTION: The unique innervation and anatomic features of dental pulp contribute to the remarkable finding that any physical stimulation of pulpal tissue is painful. Furthermore, when pathological processes such as caries affect teeth and produce inflammation of the pulp, the pain experienced can be quite intense and debilitating. To better understand these underlying neurobiological mechanisms and identify novel analgesic targets for pulpally derived pain, we have developed a powerful ex vivo model using human tooth slices. METHODS: Noncarious, freshly extracted teeth were collected and sectioned longitudinally into 1-mm-thick slices containing both dental pulp and the surrounding mineralized tissues. Tooth slices from 36 patients were exposed to 60 mumol/L capsaicin to stimulate the release of calcitonin gene-related peptide (CGRP) from nerve terminals in the pulp. Patient factors were analyzed for their effects on capsaicin-stimulated CGRP release using a mixed model analysis of variance. RESULTS: Approximately one third of the variability observed in capsaicin-evoked CGRP release was attributable to differences between individuals. In terms of individual factors, there was no effect of anesthesia type, sex, or age on capsaicin-stimulated CGRP release. Using a within-subject study design, a significant effect of capsaicin on CGRP release was observed. CONCLUSIONS: Capsaicin-stimulated CGRP release from dental pulp is highly variable between individuals. A within-subject study design improves the variability and maximizes the potential of this powerful translational model to test the efficacy of novel pharmacotherapeutic agents on human peripheral nociceptors.