25761 Lorain Rd Suite 102
North Olmsted OH 44070
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License #: 30-018768
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Incidence of Sleep Disorders Reported by Patients at UTHSC College of Dentistry: A Two-Year Follow-Up and Proposed Educational Program. - Journal of dental education
A 2011 study at one U.S. dental school found that patients were not routinely screened by dental students for obstructive sleep apnea and/or other related sleep disorders, nor were students being trained to screen. Consequently, the medical history questionnaire used in the clinic was updated to include five specific screening questions. The aim of this two-year follow-up study was to determine whether screening had improved at the school. A retrospective chart review of all patients (age 14-70+) in the third- and fourth-year dental clinics in 2012 and 2013 searched for "YES" responses to the five questions. Of 5,931 patients, 38% reported they snore or were told they snore. By age 50-59, their reports of snoring increased to 50%. About 5% reported incidents waking up choking. By age 50, between one-fifth and one-quarter indicated they woke up frequently during the night. One in six frequently felt overly tired during the daytime, often falling asleep. This problem was evenly reported by all age groups between ages 30 and 69. About half the patients reporting sleep problems also had hypertension and cardiovascular problems with an equal distribution between males and females. The results showed that updating the medical history form had dramatically improved screening for sleep-disordered breathing by these dental students. Though screening is neither a definitive diagnosis nor an attempt to distinguish among sleep disorders, the results correlate with national statistics. Screening is an important step to increase student awareness of this serious health trend as it prepares students to engage more constructively in its management and referral.
Deletion syndrome 22q13: what the dentist should know to manage children with Phelan-McDermid syndrome effectively. - The Journal of the Tennessee Dental Association
Deletion Syndrome 22q13 (or Phelan-McDermid Syndrome) is a very rare genetic disorder characterized by general neonatal hypotonia, absent to delayed speech, and global developmental delays. With only 600 cases reported worldwide, the disease remains largely under-diagnosed, but diagnosis is on the rise. Current thinking suggests that 22q13 Deletion Syndrome may be one of the principal causes of idiopathic mental retardation. Patients with Phelan-McDermid Syndrome, especially children, can be a challenge for dental professionals, as it is often associated with autism. Dentists see patients with all kinds of special needs, developmental conditions and disabilities. Children with Phelan-McDermid Syndrome need dental care just like every other child. As with other autism-related disorders, children with Phelan-McDermid Syndrome need sameness and continuity in their environment. The dental literature, however, offers very little information to aid the dentist in the management of these children. This article aims to make dentists aware of the disorder and provides tips and recommendations that dentists may find helpful to manage Phelan-McDermid children more effectively.
Breaking the fluoride diffusion barrier with combined dielectrophoresis and AC electroosmosis. - American journal of dentistry
To compare the deposition of fluoride particles into bovine enamel by diffusion (n = 20); dielectrophoresis (DEP) at 10 Hz and 5000 Hz (n = 10); and DEP (10 Hz and 5000 Hz) combined with AC electroosmosis (ACEO) at 400 Hz (DEP/ACE) (n = 10).Fluoride particle movements induced at 10, 400, and 5000 Hz frequencies, were analyzed with light microscopy and stack imaging in real time. Fluoride concentrations were measured at various enamel depths using wavelength dispersive spectrometry. Results were analyzed by ANOVA/Student-Newman-Keuls post hoc (P = 0.05).Fluoride levels in teeth treated with DEP were significantly higher than diffusion at depths 10 and 20 microm. DEP and diffusion were relatively ineffective at greater depths. The highest fluoride concentrations at 10, 20, and 50 microm depths were found in the DEP/ACE group. After 20 minutes, DEP/ACE increased fluoride uptake by 600% at 50 microm and 400% at 100 microm compared to baseline levels (P < 0.05). Fluoride particle movement was induced by negative DEP at 10 Hz; positive DEP at 5000 Hz; and ACEO at 400 Hz frequency.
Student perceptions about the mission of dental schools to advance global dentistry and philanthropy. - Journal of dental education
In this study, 491 dental students at one dental school in the United States and one in Bulgaria were surveyed to assess their perceptions about the mission of dental schools to advance global dentistry and philanthropy. The study included questions about prior involvement in charitable dental missions. Many respondents felt that their dental school does not advance global dentistry nor adequately teaches students the virtues of philanthropy and volunteerism. The majority agreed, however, that dental schools have a moral obligation to raise the level of oral health care worldwide and help underserved communities access basic dental care. They reported that an opportunity to spend a semester at a foreign dental school would enhance their dental education in ways that are not presently fulfilled; help them better understand cultural diversity; and teach them about philanthropy and volunteerism. In their opinion, international exchange programs that provide clinical rotations and field experiences in economically challenged and underserved areas of the world would a) foster the global advancement of dentistry; b) promote an appreciation for cultural diversity and socioeconomic disparity in the communities that graduates will be serving; and c) teach students the virtues of philanthropy and volunteerism. This study may contribute to understanding factors affecting student involvement in programs to advance global dentistry.
Fluoride uptake by human tooth enamel: topical application versus combined dielectrophoresis and AC electroosmosis. - American journal of dentistry
To compare fluoride uptake by enamel after applying 1.23% acidulated phosphate fluoride gel to human tooth enamel topically (n = 12) or with combined dielectrophoresis and AC electroosmosis (DEP/ACE) at frequencies of 10, 400 and 5,000 Hz (n = 12) for 20 minutes.DEP/ACE induced nonuniform electrical fields with three alternating current frequencies to polarize, orient, and motivate fluoride particles. Fluoride concentrations were measured at various enamel depths using wavelength dispersive spectrometry. Data were analyzed by ANOVA/Student-Newman-Keuls post hoc tests (P < or = 0.05).Fluoride concentrations in the diffusion group were significantly higher than baseline readings at 10, 20 and 50 microm depths. Fluoride concentrations in DEP/ACE-treated teeth were significantly higher than the diffusion group at 10, 20, 50, 100, 200 and 300 microm (ANOVA/Student-Newman-Keuls post hoc, P < 0.05). Fluoride uptake with DEP/ACE was substantially higher than diffusion at 10, 20, 50, 100, 200 and 300 microm depths (paired t test, P < 0.05). DEP/ACE transported fluoride up to 300 microm deep, whereas conventional fluoride application was comparatively ineffective beyond 20 microm depth (P < 0.05). Compared to passive diffusion, fluoride uptake in enamel was significantly higher in the DEP/ACE group at 10, 20, 50, 100, 200 and 300 microm depths (P < 0.05). DEP/ACE drove fluoride substantially deeper into human enamel with a difference in uptake 1,575 ppm higher than diffusion at 100 microm depth; 6 times higher at 50 microm depth; 5 times higher at 20 microm depth; and 7 times higher at 10 microm depth. Fluoride levels at 100 microm were equivalent to long-term prophylactic exposure.
Enhanced penetration of fluoride particles into bovine enamel by combining dielectrophoresis with AC electroosmosis. - Electrophoresis
Fluoride deposition into the pores of enamel is necessary at high concentrations to reduce enamel demineralization and with a high degree of penetration to account for loss by ingestion. Current diffusion and electrochemical methods are inadequate for effectively transporting fluoride greater than 20 Î¼m into enamel. The study explores the coupling of dielectrophoresis (DEP) and AC electroosmosis (ACEO) to selectively concentrate fluoride particles from fluoride gel excipients and enhance their penetration into enamel. By measuring the frequency response of approximately 10-Î¼m-sized sodium fluoride particles in an aqueous gel media, appropriate frequencies for positive DEP, negative DEP, and ACEO are identified. An assembly composed of two cross-planar interdigitated electrode (IDE) arrays with open slots is driven successively by fields at appropriate frequencies to drive fluoride particles through the slots of the IDE and into the enamel pores using a combination of DEP and ACEO methods. Fluoride uptake and penetration of 1.23% acidulated phosphate fluoride gel into bovine tooth enamel at various depths is measured using wavelength dispersive spectrometry to compare deposition by diffusion, DEP, and DEP plus ACEO. Fluoride levels in all DEP groups were significantly higher than diffusion groups at depths 10 and 20 Î¼m. The highest fluoride concentrations at 10, 20, 50, and 100 Î¼m depths occur under deposition conditions combining DEP with ACEO. Fluoride levels at 50 Î¼m were equivalent to long-term prophylactic exposure. These methods may potentially benefit populations at high risk for development of caries and periodontal disease, including underserved children and disparate groups.Â© 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
A four-tier problem-solving scaffold to teach pain management in dental school. - Journal of dental education
Pain constitutes a major reason patients pursue dental treatment. This article presents a novel curriculum to provide dental students comprehensive training in the management of pain. The curriculum's four-tier scaffold combines traditional and problem-based learning to improve students' diagnostic, pharmacotherapeutic, and assessment skills to optimize decision making when treating pain. Tier 1 provides underpinning knowledge of pain mechanisms with traditional and contextualized instruction by integrating clinical correlations and studying worked cases that stimulate clinical thinking. Tier 2 develops critical decision making skills through self-directed learning and actively solving problem-based cases. Tier 3 exposes students to management approaches taken in allied health fields and cultivates interdisciplinary communication skills. Tier 4 provides a "knowledge and experience synthesis" by rotating students through community pain clinics to practice their assessment skills. This combined teaching approach aims to increase critical thinking and problem-solving skills to assist dental graduates in better management of pain throughout their careers. Dental curricula that have moved to comprehensive care/private practice models are well-suited for this educational approach. The goal of this article is to encourage dental schools to integrate pain management into their curricula, to develop pain management curriculum resources for dental students, and to provide leadership for change in pain management education.
Comprehensive training in suspected child abuse and neglect for dental students: a hybrid curriculum. - Journal of dental education
Child abuse and neglect are tragic realities of American society. However, most U.S. dental schools do not provide students with adequate training to deal with the problem. This article proposes expanding the predoctoral dental curriculum with a problem-based learning model that can effectively stimulate critical thinking skills to assist graduates in screening and reporting suspected child abuse and neglect throughout their careers. The unique multicultural environment of dental school offers students an unprecedented opportunity to develop awareness about child abuse and domestic violence, while increased vigilance can potentially save innocent young lives. Educating students about proper protocol when they suspect child abuse or neglect is imperative, particularly for dental schools involving students in community sealant and other preventive programs in public schools. By expanding their curriculum to include recognition and intervention, dental schools can help break the cycle of violence and transform attitudes towards taking decisive action. Clinical curricula that have moved to private practice preceptor models are well suited to screen for child abuse. The goal is to motivate dental schools to deal with this critical issue, develop reporting protocols and procedures for appropriate response, and provide their students with consummate training.
Is there a place for teaching obstructive sleep apnea and snoring in the predoctoral dental curriculum? - Journal of dental education
The widespread prevalence of obstructive sleep apnea and apneic snoring is both alarming and well documented. Sleep disorders affect one out of five Americans. Yet, during an attempt to study the prevalence of obstructive sleep apnea and snoring among patients at the University of Tennessee Health Science Center College of Dentistry, a search through the entire school's database for the terms "sleep apnea" and "snoring" found only ninety-two patients who admitted to snoring. Currently, the condition "sleep apnea" is not even on the school's list of health/medical questions. These figures not only are inconsistent with national statistics, but confirm that more needs to be done to make dental students aware of these disorders, include them in patient medical histories, and ultimately educate patients about therapies that can help. Considering the health concerns related to this sleep disorder, the economic impact of insomnia and daytime sleepiness, as well as the fact that the dentist is well poised to reduce symptoms and increase the quality of life among sufferers, mandibular advancement devices should become an educational standard in the predoctoral clinical curriculum of dental schools. Predoctoral clinical curricula need to reflect this current health trend and train dentists to care for these patients comprehensively.
Microhardness recovery of demineralized enamel after treatment with fluoride gel or CPP-ACP paste applied topically or with dielectrophoresis. - American journal of dentistry
To evaluate the microhardness of demineralized enamel remineralized in saliva after applying 1.23% APF gel or CCP-ACP paste with dielectrophoresis (DEP) or diffusion for 3 minutes.In this laboratory study, 25 enamel blocks of bovine incisors were soaked in demineralizing solution (10 mM HCl pH 2.5) for 10 minutes and remineralized in saliva for 1 hour, after applying 1.23% APF gel or CPP-ACP paste without fluoride with dielectrophoresis or conventional topical application for 3 minutes. The mean and percentage changes of surface microhardness in pre-demineralization, post-demineralization and remineralization stages were measured in the five groups. The results of all five groups during the three stages were compared by ANOVA and paired t-tests (P = 0.05).The average surface microhardness recovery of APF gel (12,300 ppm fluoride) applied with DEP was higher than APF gel applied topically, or CPP-ACP paste applied with DEP or topically, and water control (P < 0.05). The percentage of surface microhardness recovery for APF+DEP, APF+Diffusion, CPP-ACP+DEP, CPP-ACP+Diffusion, and water control were 88.17%, 13.62%, 7.14%, 5.45%, and 4.02%, respectively. Demineralization treatment decreased the surface microhardness of enamel in all groups and the surface microhardness recovery in the APF+DEP group was significant (P < 0.001). The only significant paired difference was between APF+DEP and all other groups. No other paired difference approached significance. Surface microhardness recovery of enamel with APF+DEP was 12 times or 1,200% greater than APF gel applied topically, and CPP-ACP paste either applied topically or with DEP in one 3-minute application.
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25761 Lorain Rd Suite 102 North Olmsted, OH 44070
26777 Lorain Rd Suite 214
25761 Lorain Rd 3Rd Floor
24834 Lorain Rd