Digital Commons Network^™

Utilization Of Intraoral Scanners For Fabrication Of Obturators For Patients Born With Cleft Lip/ Palate (Clp), Swara Fadnis

Theses and Dissertations

Objective: The goal of this cross-sectional study was to assess the knowledge and attitude of providers regarding incorporating a digital scanner for impression taking in children born with cleft lip and/or palate (CLP). Methods: A survey was sent out to members of the American Association of Pediatric Dentistry (AAPD). The survey included questions regarding the providers’ perception of incorporating digital intraoral scanners for impressions for fabrication of obturators. The survey also included questions about the providers’ reservations in using this technology in practice, what their experience has been with the incorporation of this technology into practice, and what is …

Provider Racial Concordance And Medical Mistrust In Pediatric Dentistry, Chinelo Eke

Theses and Dissertations

Purpose: Studies have drawn varying conclusions on the importance of a racially concordant patient provider relationship. Medical mistrust has continued to garner attention as healthcare enterprises thread equity, diversity and inclusion throughout their organizational policies, practices and systems.

Methods: Parents/caregivers of pediatric patients at VCU Pediatric Dentistry were invited to participate. Surveys included questions about demographics, racial concordance, language preference, and the validated Group-Based Medical Mistrust Scale.

Results: A total of 246 guardians completed the survey. For guardians, 40% reported Black or African American, 31% Hispanic, and 19% Caucasian. Seventy-one percent of guardians reported speaking English, 18% Spanish, and 11% …

The Use Of Silver Diamine Fluoride In Dentistry In Virginia, Jessica Eisenberg

Theses and Dissertations

Purpose: The purpose of this research was to determine the use of silver diamine fluoride (SDF) in dentistry in Virginia and the factors that affect the practitioners’ decision. Methods: A survey was sent to the members of the Virginia Dental Association (VDA) by email and posted on the VDA social media accounts. The survey questions measured the practitioner’s demographics, knowledge, and factors that affect their utilization of SDF. Results: Most providers were general dentists (77%). The most common clinical situations for SDF use were to arrest caries in children with behavioral issues (77%), to delay restorative treatment (73%), in medically …

Food Deserts And Pediatric Oral Health Status In An Under-Resourced Urban Community, Jessica T. Mcauliffe

Theses and Dissertations

Purpose: The aim of this analysis of survey data was to assess the influence of living within a food desert as a predictor of oral health problems among children of East Henrico County, Virginia.

Methods: Survey participants were recruited and questionnaires applied online. Residing in a food desert, using access to affordable produce as a proxy value, was the independent variable, while self- reported assessment of the child’s oral health status was the primary outcome variable. Analyses controlled for other indirect factors of pediatric oral health. Logistic regression was used to model the association between the self-reported access to healthy …

The Effects Of Celiac Disease On Oral Health In Children And Adults, Marissa Balducci, Katarina Jones

Dental Hygiene Student Scholarship

Objectives: Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. To ensure affected patients receive optimal dental care, it is necessary for dental professionals to recognize the oral manifestations of celiac disease in both children and adults. Upon associating oral conditions with celiac disease, the dental provider should be able to present recommendations to the patient, contributing to an improvement in their oral health.

Methods: This review of the literature used PubMed to identify relevant professional research articles with publication after 2017. MesH terms utilized in the search process were …

Effect Of Moderate Sedation Regimen (Diazepam, Meperidine, And Hydroxyzine) Dosages On Patient Behavior And Outcome Of Sedation In Pediatric Dentistry: A Retrospective Study, Taibah M A M J Albaker

Theses and Dissertations

Purpose: To determine if behavior at consult visit and sedation medication dosages are associated with the success of sedation visits and patient’s behavior using the diazepam, meperidine, and hydroxyzine (DMH) regimen.

Methods: A retrospective chart review was conducted of 324 VCU Pediatric Dentistry Department patients who underwent 404 moderate conscious sedation visits with DMH regimen from April 2017 to June 2022. Sedation visits were graded as “Successful” or “Unsuccessful” and “Good” or “Poor behavior.” The primary variables of interest included Frankl behavior at consult visit and the sedation medication dosages. Logistic regression models were used to determine if these factors …

Use Of Passive Immobilization During Oral Conscious Sedation: Parental Perceptions And Utilization By Pediatric Dentists In The United States, Jennifer N. Levine

Theses and Dissertations

Use of Passive Immobilization During Oral Conscious Sedation: Parental Perceptions and Utilization by Pediatric Dentists in The United States, Levine J, Caudill, C (Virginia Commonwealth University School of Dentistry, Richmond, VA)

Research supported by the Alexander Fellowship

Purpose: To assess change in parental attitudes of passive immobilization after viewing an informational video and evaluate how pediatric dentists are currently using passive immobilization during oral conscious sedations (OCS).

Methods: A survey consisting of six statements on a 5-point Likert scale was completed by parents at their child’s OCS consultation appointment before and after viewing an educational video demonstrating benefits of passive …

Parental Attitudes Regarding The Primary Dentition, Dental Decay, And Trauma, Kathryn Dundervill

Theses and Dissertations

Purpose: The purpose of this study is to identify the ability of parents in the VCU Pediatric Dental Clinic to recognize signs of decay and trauma and to determine their knowledge regarding the primary dentition.

Methods: This is a cross-sectional study that determined parental attitude and knowledge toward the function of primary teeth, childhood dental decay and dental trauma. Study data was collected through REDCap, a secure web-based survey application. Parents who brought their child to the VCU Pediatric Dental Clinic for a new patient examination or a recall examination were included in the study. The survey was only formatted …

Threshold Levels Of Patient And Parent Esthetic Concern In The Mixed Dentition, Justin Josell

Theses and Dissertations

Purpose: The mixed dentition is a period of unique dental changes for developing children and their parents. The purpose of this study is to determine threshold levels of concern regarding diastema spacing and angulation of maxillary incisors during the “Ugly Duckling Stage” in pediatric patients and their parents.

Methods: This study is modeled as a cross sectional-survey among pediatric patients and parents. The surveys contain photographs of a sex-neutral, mixed-dentition smile with variations of midline spacing and incisal angulation which randomly differ in quantifiable values. Participants were asked to rate each photograph on a visual analog scale.

Results: The interaction …

Detection And Reporting Of Child Abuse And Neglect: A Survey Amongst Pediatric Dental Care Providers In The United States, Daniel J. Lander

Theses and Dissertations

Purpose: The purpose of this study is to survey pediatric dental care providers in the United States to evaluate their knowledge in the detection and reporting of child abuse and neglect (CAN). Methods: This study has been modeled as a cross sectional- survey based research study. Email invitations were sent to pediatric dentists, orthodontists, and others who work in pediatric dental practices in the United States through email lists of the American Association of Pediatric Dentists (AAPD) and the American Association of Orthodontists (AAO). The survey completion page included sample text and the public survey link for providers to use …

Knowledge, Perception, And Clinical Management Strategies Of Us Pediatric Dentists On Molar Incisor Hypomineralization, Courtney T. Brashier

Theses and Dissertations

Purpose: The purpose of this cross-sectional, survey-based study is to determine current US pediatric dentists’ knowledge, perceptions, and clinical management strategies for patients with molar incisor hypomineralization (MIH).

Methods: Following appropriate protocol and authorizations, all active pediatric dentists, general dentists, and post-doctoral student members identified by the 2020 American Academy of Pediatric Dentistry’s membership list were invited to partake in an anonymous email survey. Data regarding participants sociodemographic, education, and clinical backgrounds were collected in addition to information obtained from MIH-focused questions. Descriptive statistics and chi-square tests were used to compare and analyze data. A significance level was set at …

The Value Of Postoperative Appointments Following Full Mouth Dental Rehabilitation Under General Anesthesia, Priyanka Patel

Theses and Dissertations

Purpose: Follow-up appointments after full mouth dental rehabilitation under general anesthesia (GA) have been suggested as a method for preventing future caries and need for repeat treatment under GA. The purpose of this study is to determine current practitioner and parental perceived value of the postoperative GA appointment.

Methods: Three separate surveys were administered for this study. The pre-appointment survey asked about the guardian’s desire to have a follow-up appointment. At the follow-up appointment, the post-appointment survey ascertained the level of patient satisfaction with their follow-up appointment and postoperative experience. American Academy of Pediatric Dentistry (AAPD) members were e-mailed a …

Value Of Pediatric Sleep Questionnaire In Referrals For Obstructive Sleep Apnea At Vcu Pediatric Dental Clinic, Elizabeth H. Hering

Theses and Dissertations

Purpose: The purpose of this study is to determine the number of VCU pediatric dental patients screened for obstructive sleep apnea (OSA) relative to the number of referrals made for a pediatric sleep study.

Methods: This was a retrospective chart review of children between the ages of 1-18 years seen at the VCU Pediatric Dental Clinic between 2016-2020. Patients with a completed sleep apnea screening questionnaire in the health history form or sleep apnea form/referral were identified. The data was used to determine how many referrals were made for a pediatric sleep study in patients screening positive for sleep apnea. …

Repeat Full Mouth Dental Rehabilitation Under General Anesthesia For Medicaid Eligible Healthy Children Who Are High Caries Risk, Lajoi E. Wiggins

Theses and Dissertations

Purpose: To evaluate the treatment of healthy children who are high caries risk and of low socioeconomic status and who require repeat full mouth dental rehabilitation (FMDR) under general anesthesia (GA).

Methods: A retrospective chart review was performed on healthy Medicaid eligible patients who were initially between 18 months - 6 years of age who underwent FMDR under GA in the OR more than once at the Virginia Commonwealth University (VCU) School of Dentistry, Department of Pediatric Dentistry from January 2008 to December 2018. Biographical information for each patient was gathered into a REDCap™ Survey. Statistical analysis, chi-squared test with …

A Comparison In Pediatric Dental Website Design From A Guardian And Pediatric Dentists’ Perspective., David M. Voth

Theses and Dissertations

Purpose: This project aims to determine which aspects of pediatric dental practice websites are preferable to the guardians of pediatric dental patients and which of these aspects are currently available to guardians on the websites of pediatric dental practices across the United States. The comparison will reveal if practice websites are meeting the needs of the guardians of pediatric dental patients. Our hope is to provide meaningful guidance to pediatric dentists designing new practice websites and to provide the guardians of pediatric dental patients with an appealing online experience during their use of the aforementioned websites. Methods: A survey with …

Use Of Emoji In Pain Level Assessment In Pediatric Dental Patients, Manpreet K. Dhillon

Theses and Dissertations

USE OF EMOJI IN PAIN LEVEL ASSESSMENT IN PEDIATRIC DENTAL PATIENTS

Purpose: The purpose of this study is to determine the efficacy of a pain scale with Emoji images in comparison to the commonly used Wong-Baker FACES® pain scale. Methods: Healthy, English-speaking patients aged 4-17 presenting to the VCU Pediatric Dental clinic and the operating room and presenting to the MCV Pediatric Emergency Room were asked to rate their pain using the Wong-Baker FACES® and Emoji scales. These patients were then asked to select which pain scale they preferred. Results: A total of 151 children were enrolled in the study. …

Comparison Of Triple Combination Oral Sedation Regimens For Pediatric Dental Treatment, Brett H. Henderson

Theses and Dissertations

Purpose: Compare the efficacy of two benzodiazepines (diazepam or midazolam) in combination with meperidine and hydroxyzine for pediatric dental sedation. Methods: A randomized, double blind observation study of behaviors and outcomes related to two sedation groups. Frankl and Houpt behavior scores were recorded at three time points: injection time, initiation of treatment and at the end of treatment. Postoperative phone call surveys were conducted within eight hours of discharge to assess sleep, activity, and behavior. Results: A total of 40 sedation subjects were included in the study, of which 20 were treated with diazepam triple Combination (Di+M+H) and 20 with …

Perception Of Patient Cooperation Among Dentist, Guardian, And Child, Cole A. Staines Dds

Theses and Dissertations

Purpose: Evaluate behavior assessment and agreement among dentist, guardian, and child. Evaluate child behavior by appointment type.

Methods: Patients recruited from the pediatric dental department at Virginia Commonwealth University for this convenience sample. Inclusion criteria: patients presenting for clinical exams and/or restorative treatment without the use of advanced behavior guidance between August 29, 2018, and March 7, 2019; ages 4-12-years-old; and scheduled with a single clinician. Appointments were stratified by difficulty. Behavior was assessed by dentist and caregiver using the Frankl Scale. Patient self-assessed cooperation using an age-appropriate modified Frankl Scale, developed for this study. Agreement assessed among the 3 …

Got Caries? Breast Milk And Early Childhood Caries?, Megan L. Dean, Rebecca Fields, Hannah Fritz

Dental Hygiene Student Scholarship

Objective: To provide an analysis of the association between the longevity of breastfeeding and development of ECC. Determine the optimal time frame in which mothers should cease breastfeeding to reduce ECC development. Methods: Dr. Brickhouse, PubMed, Google Scholar and other scholarly databases were utilized to find current scientific evidence on the effects of breast milk on ECC. Relevant articles were summarized to write a review of literature. 16 articles published from 2015 to the present date were reviewed and cited. Results: From the studies, there is strong evidence to support breastfeeding beyond 12 months of age increases the prevalence …

Impact Of Sensory Adapted Dental Environment On Children With Developmental Disabilities, Gail Kim

Theses and Dissertations

Purpose: This was a pilot study assessing the impact of a sensory adapted dental environment (SADE) on children with developmental disabilities (DD) receiving routine dental care.

Methods: A crossover study of 22 children with DD, aged 6 through 21, was conducted at Virginia Commonwealth University Pediatric Dental clinic. Each participant was randomized to a sequence of two dental cleanings, one regular dental environment (RDE) and one SADE with a 3-4-month recall. Outcomes included physiological measures (heart rate and oxygen saturation) and cooperation (Frankl scores).

Results: Study subjects completed a total of 36 visits. None of the physiological measures differed at …

Prevalence And Factors Of Sibling-Recurrent Dental Treatment Under General Anesthesia, Brandy N. Edmonds

Theses and Dissertations

Objective/Aims: Assess the prevalence of sibling recurrent dental general anesthesia (DGA) at VCU Pediatric Dentistry. Assess factors that contribute to sibling recurrent dental general anesthesia. Methods: The guardian of patients with siblings were provided a questionnaire to assess the prevalence and factors associated with recurrent DGA. Results: A total of 40 families with a child presenting for GA and at least one sibling were included in the study. Of these, 45% had sibling-recurrent GA treatment (20% in one sibling; 25% in 2 or more siblings). Additionally, 13% of the children currently presenting for GA had already been treated under GA, …

Assessment Of Pediatric-Focused Brief Motivational Interviewing Training Of Dental Students And Pediatric Dental Residents, Victoria M. Onesty

Theses and Dissertations

Purpose: To assess dental students and pediatric dental residents’ knowledge and attitudes towards motivational interviewing and evaluate the efficacy of a pediatric-focused brief motivational interviewing training program.

Methods: A total of 66 participants were enrolled; 35% were third year dental students, 46% were fourth year dental students and 18% were pediatric dental residents. Participants completed three questionnaires: the first before the training, the second immediately after the training and the third approximately 3.5 months after the training.

Results: A significant increase in correct responses was found for 4 of the 5 questions assessing participants’ knowledge. Participants were satisfied with the …

Silver Diamine Fluoride And Oral Health-Related Quality Of Life, Nazafarin Javdan

Theses and Dissertations

Purpose: The purpose of this study was to study the association between Silver Diamine Fluoride (SDF) and Oral Health-Related Quality of Life as assessed by “The Early Childhood Oral Health Impact Scale” questionnaire. Methods: Parents of healthy children (ASA I and II) ages 1-5 with early childhood caries with reversible pulpitis who had application of SDF filled out a questionnaire at baseline and again after one month. The questionnaire was designed to evaluate the child’s behavior, physical abilities, pain, temperament, and how well the child gets along with others. Results: Wilcoxon Signed Rank Test was used to …

Provider Appearance: A Survey Of Guardian And Patient Preference, Joshua Westphal

Theses and Dissertations

Purpose: To understand guardian and child preferences for the appearance of their pediatric dentist. This was a cross-sectional descriptive study using survey methodology with patients and parents that attended the VCU Pediatric Dental clinic.

Methods: A total sample of 100 guardians and 97 pediatric patient participants completed the computer-based questionnaire. Four subjects were asked to pose for photographs wearing various combinations of attire (professional, casual, white coat, scrubs).

Results: Among guardians, 56% reported preferring a provider in scrubs, with white coat the second most preferred attire (39%) for their children. For pediatric patients, scrubs were still most often selected, …

Role Of The Pediatric Dental Provider In Human Papillomavirus (Hpv) Education, Meredith L. Dugoni

Theses and Dissertations

Purpose: This study investigates knowledge about HPV and examines if pediatric dental providers should include HPV education for guardians of patients 10-18 years.

Methods: Legal guardians of 10-18 year-old patients of the Virginia Commonwealth University Pediatric Dental Clinic were enrolled in this prospective cohort study. Participants completed a baseline survey, were provided HPV education, completed an initial follow-up survey, and then completed a 6-month follow-up survey.

Results: A total of 54 participants completed the baseline and initial follow-up surveys and 17 completed the 6-month follow-up survey. The average number of correct responses was 3.4 of 6 knowledge questions, which significantly …

A Comparison Of Treatment Planning Modalities For The Pediatric Dental Patient, Martha M. Holland

Theses and Dissertations

Purpose: To assess the treatment modalities of pediatric dentists for restoring Class II lesions in primary molars.

Methods: A survey of eight cases was emailed to AAPD members, who were asked to choose a stainless steel crown (SSC) or composite resin. Treatment choice was associated with provider type, years in practice, behavior management, lesion detection, and patient age.

Results: Clinically detectable caries restored under general anesthesia were treated more often with a SSC. Faculty and residents chose a SSC at a greater rate. Providers with 10 or more years experience chose a SSC more often.

Conclusions: The scope of treatment …

A Comparison Of Moderate Oral Sedation Drug Regimens For Pediatric Dental Treatment: A Pilot Study, Ojas A. Parikh

Theses and Dissertations

Purpose: Compare moderate oral sedation of pediatric patients using Hydroxyzine and Meperidine with either Diazepam or Midazolam in management of pediatric dental patients.

Methods: Randomized, double-blind, crossover pilot study of patients 3 to 7 years of age requiring two sedation visits. Frankl and Houpt behavior scores recorded at injection time, initiation of treatment and 100% oxygen at end of treatment. Postoperative phone call surveys conducted within eight hours and within 24 hours of discharge. Wilcoxon Signed-Rank tests, Fisher’s Exact Chi-squared test and 0.10 significance level.

Results: 25 subjects completed 35 sedations. Eight participants completed both treatments and demonstrated significantly higher …

Social Determinants Of Participation In A Home Visitation Fluoride Varnish Program, James E. Puryear, Tegwyn Brickhouse, Caroline Carrico

Theses and Dissertations

Purpose: The purpose of this study is to examine the social determinants of CHIP (Child Health Investment Partnership) of Roanoke Valley children who participated in the preventive oral health program compared to those who did not.

Methods: This is a retrospective cohort study of children (n=2,425) enrolled in CHIP of Roanoke Valley from September 2008-September 2014. Bivariate analysis and multivariable logistic regression models were used to compare age, gender, race, locality, parents’ education level, age at enrollment, and length of enrollment for oral health program participants versus those who did not participate.

Results: Children who were Hispanic …

Motivational Factors For Treating Patients With Special Health Care Needs, Arpi Patel

Theses and Dissertations

Purpose: The purpose of this study is to assess what training and motivational factors dental providers report in providing dental care to PSHCN (patients with special healthcare needs. Materials and Methods: An electronic questionnaire was sent to n=104 fourth year dental students, n=147 general dentists with a specific continuing education course pertaining to PSCHN, and n=140 pediatric dentists in Virginia. The questionnaire consisted of four sections including Demographics, Professional Attitudes, Special Needs Patients and Motivational Factors, and PSCHN Cases. Results: The overall response rate for our study was 21%. The response rates of dental students, general dentists, …

General Dentists' Role In Providing Care To Very Young Children:Pediatric Dentists' Perspective, Shinjni Razdan

Theses and Dissertations

To examine the pediatric dentists’ perspective on level of care to children 0-3 years old by general dentists, an electronic survey was sent out to 5185 AAPD members and 769 responded (response rate: 14.8%). Forty-six percent agreed with a general dentist providing a dental home to children 0-3 years old. Only 24% agreed that general dentists could perform complex restorative and behavior management procedures for 0-3 years old. Younger respondents, pediatric dentists who practice in rural areas or teaching pediatric dentistry, and those who perceived adequate exposure during dental school were more likely to agree on general dentists proving a …