Faculty Bibliography

Aggression from patients is one of the risks faced by healthcare workers during a typical work week. This risk begins during training. Although rates of patient aggression have been estimated for nursing students and medical residents, studies of aggression toward dental students have not been conducted. To begin to address this knowledge gap, we surveyed 160 D.D.S. student dentists in their third- or fourth years who were attending a large urban college of dentistry during the 2018-2019 academic year. Each class had approximately 375 students, leading to a response rate of 21%. Approximately 28% of students reported experiencing at least 1 instance of physical aggression, 86% reported experiencing at least 1 instance of verbal aggression, and 36% reported experiencing at least 1 instance of reputational aggression. There were no differences in rates of experienced aggression by age or gender, but Hispanic or Latinx students were more likely to experience physical and reputational aggression than non-Hispanic White or Asian students. We discuss implications for dental education, including modifications to training clinic procedures and curriculum additions or modifications that may help prepare students to prevent and address patient aggression within the dental clinic environment.

OBJECTIVE:is associated with one or more particular comorbidities. STUDY DESIGN/METHODS:or DH lesion to a control patient who had a history of dentoalveolar surgery with uneventful healing and no history of antiresorptive therapy. Comorbidity data included medical conditions and smoking. RESULTS:and DH than in controls [M(SD) = 1.94 (1.2) and 2.0 (1.3) vs 1.26 (0.89); both P < .001]. CONCLUSIONS:and DH.

BACKGROUND:An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated evidence-based clinical recommendations for the arrest or reversal of noncavitated and cavitated dental caries using nonrestorative treatments in children and adults. TYPES OF STUDIES REVIEWED/METHODS:The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid, Cochrane CENTRAL, and Cochrane database of systematic reviews to identify randomized controlled trials reporting on nonrestorative treatments for noncavitated and cavitated carious lesions. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and move from the evidence to the decisions. RESULTS:The expert panel formulated 11 clinical recommendations, each specific to lesion type, tooth surface, and dentition. Of the most effective interventions, the panel provided recommendations for the use of 38% silver diamine fluoride, sealants, 5% sodium fluoride varnish, 1.23% acidulated phosphate fluoride gel, and 5,000 parts per million fluoride (1.1% sodium fluoride) toothpaste or gel, among others. The panel also provided a recommendation against the use of 10% casein phosphopeptide-amorphous calcium phosphate. CONCLUSIONS AND PRACTICAL IMPLICATIONS/UNASSIGNED:Although the recommended interventions are often used for caries prevention, or in conjunction with restorative treatment options, these approaches have shown to be effective in arresting or reversing carious lesions. Clinicians are encouraged to prioritize use of these interventions based on effectiveness, safety, and feasibility.

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.