Faculty Bibliography

The weather-related disasters in 2017 in Texas, Florida, Puerto Rico, the 2017-2018 wildfire seasons in California and Hurricanes Florence and Michael in 2018 have challenged all healthcare professionals, to have plans in place to protect their facility, patients, and staff from all possible hazards. These were "slowly developing" events, with enormous media coverage, and yet the results were still horrific. The need to have both a good evacuation plan and a good shelter-in-place plan has previously been dramatically demonstrated. When planning for disasters, it is critical for healthcare providers to understand the nature of a particular event and its possible consequences. When the concern arises about either an individual medical facility, or a whole community's well-being, a proper response requires significant levels of preparedness, education, and training. Comprehension of the threat and an understanding of the resources available to combat an event can significantly mitigate the possible damage. This article reviews a dental school curriculum to prepare students to respond to such contingencies while describing the goals, and sources for a disaster preparedness syllabus.

The understanding of cuspal deflection and volumetric shrinkage of resin composites is necessary to assess and improve the placement techniques of resin-based materials. The aim of this study was to investigate the cuspal deflection and its relationship with volumetric polymerization shrinkage of different bulk-fill resin composites. The investigation was conducted using non-contact phase microscopy and micro-computed tomography. Thirty custom-milled aluminum blocks were fabricated for microscopy analysis and thirty-six tooth models with standardized Class I cavities were used for micro-computed tomography analysis. Results showed that high-viscosity composites present higher cuspal deflection compared to bulk-fill composites. The filler loading of resin composites seems to have an effect on cusp deflection, since the higher the filler content percentage, the higher the cusp deflection. On the other hand, it seems to have an opposite effect on volumetric shrinkage, since higher filler loadings produced lower volumetric shrinkage percentages.

Dental caries remains a world-wide disease despite the global distribution of fluoride. It has become apparent that the introduction of significant levels of sugar (fermentable carbohydrate) into the diet has resulted in a change in the biofilm, encouraging acid formation. Further, there has been a shift in the microbiota in the biofilm to a flora that produces acid, and thrives and reproduces in an acidic environment. The management of caries activity under these conditions has focused on brushing to remove the biofilm with fluoride pastes, and high-dose fluoride treatments. Kleinberg, in the 1970s, identified an arginine-containing compound in saliva that several oral biofilm bacterial species metabolize to produce base. Multiple in situ and in vivo studies have been conducted, and have discussed the ability of multiple bacteria to increase the resting pH of the biofilm and even reduce the decrease in pH when the biofilm is challenged with glucose. This shift in resting pH can shift the level of caries formation by the biofilm. Here, we present 8 clinical studies, with different clinical designs, measuring different clinical outcomes, for a diverse, world-wide population. Each of these studies demonstrates reductions in caries formation beyond that seen with fluoride alone and several demonstrate the reversal of early caries lesions. Significant clinical research has been shown that 1.5% arginine combined with fluoride toothpaste has superior anti-caries efficacy to toothpaste containing fluoride alone.

To help eliminate reported racial/ethnic and socioeconomic inequities in oral health care, listening to the perspectives of racial/ethnic minority older adults on their experiences with dental school clinics is needed. The aim of this study was to examine the experiences of African American, Puerto Rican, and Dominican older adults who attend senior centers in upper Manhattan, New York City, regarding the care received at dental school clinics. Focus groups were conducted from 2013 to 2015 with 194 racial/ethnic minority men and women aged 50 years and older living in upper Manhattan. All of the 24 focus group sessions were digitally audiorecorded and transcribed for analysis. Groups conducted in Spanish were transcribed first in Spanish and then translated into English. Analysis of the transcripts was conducted using thematic content analysis. Seven subthemes were manifest in the data related to these adults' positive experiences with dental school clinics: excellent outcomes and dentists, painless and safe treatment, affordable care, honest and reputable, benefits of student training, accepting and helpful, and recommended by family and friends. Negative experiences centered around four subthemes: multiple visits required for treatment, loss of interpersonal communication due to use of technology, inconvenient location, and perceived stigma with Medicaid. This study provided novel evidence of the largely positive experiences with dental schools of racial/ethnic minority senior center attendees. Interventions targeted at the organization and provider level, including organizational motivation, resources, staff attributes, climate, and teamwork plus payment programs and services, insurance and affordability, and provider- and system-level supports, may improve health care processes and patient experiences of care.