Dentistry Commons^™

Acute Invasive Fungal Rhinosinusitis Related Orbital Infection Secondary To Odontogenic Infection, Dennis Levy, Melvyn Yeoh

Oral Health Science Faculty Publications

A 64-year old male presented to our institution with painful ophthalmoplegia. The initial differential diagnosis included orbital apex disorders, such as orbital apex syndrome (OAS), cavernous sinus thrombosis (CST), and superior orbital fissure syndrome (SOFS). Ultimately, the diagnosis was acute invasive fungal rhinosinusitis (AIFRS) secondary to an odontogenic infection from carious teeth in the maxilla. Significant overlap exists between AIFRS and orbital apex disorders, making it prudent to include AIFRS in the differential diagnosis for painful ophthalmoplegia. The purpose of this review is to detail this specific patient's presentation and hospital course along with a brief review of AIFRS and …

A Rare Case Of Idiopathic Painful Nervus Intermedius Neuropathy In A 13-Year-Old Female: A Case Report And Discussion In The Context Of The Literature, Diego Fernandez-Vial, Linda Sangalli, Christina Perez

Oral Health Science Faculty Publications

(1) Background: Painful nervus intermedius neuropathy involves continuous or near-continuous pain affecting the distribution of the intermedius nerve(s). The diagnosis of this entity is challenging, particularly when the clinical and demographic features do not resemble the typical presentation of this condition. To the best of our knowledge, only three case reports have described the occurrence of nervus intermedius neuropathy in young patients. (2) Case Description: A 13-year-old female referred to the orofacial pain clinic with a complaint of pain located deep in the right ear and mastoid area. The pain was described as constant, throbbing and dull, with an intensity …

Optimizing Mandibular Advancement Maneuvers During Sleep Endoscopy With A Titratable Positioner: Dise-Sam Protocol, Patricia Fernández-Sanjuán, Juan José Arrieta, Jaime Sanabria, Marta Alcaraz, Gabriela Bosco, Nuria Pérez-Martín, Adriana Pérez, Marina Carrasco-Llatas, Isabel Moreno-Hay, Marcos Ríos-Lago, Rodolfo Lugo, Carlos O’Connor-Reina, Peter Baptista, Guillermo Plaza

Oral Health Science Faculty Publications

Mandibular advancement devices (MAD) are an effective alternative treatment to CPAP. Different maneuvers were performed during drug sleep-induced endoscopy (DISE) to mimic the effect of MAD. Using the Selector Avance Mandibular (SAM) device, we aimed to identify MAD candidates during DISE using a titratable, reproducible, and measurable maneuver. This DISE-SAM protocol may help to find the relationship between the severity of the respiratory disorder and the degree of response and determine the advancement required to improve the collapsibility of the upper airway. Explorations were performed in 161 patients (132 males; 29 females) with a mean age of 46.81 (SD = …

Analysis Of Pretreatment Factors Associated With Stability In Early Class Iii Treatment, Yasuko Inoue, Toru Deguchi, James K. Hartsfield Jr., Wakako Tome, Noriyuki Kitai

Oral Health Science Faculty Publications

BACKGROUND: The purpose of this study was to identify pretreatment factors associated with the stability of early class III treatment, since most orthodontists start the treatment with their uncertain hypotheses and/or predictions. Subjects consisted of 75 patients with a class III skeletal relationship (ANB < 2° and overjet < 0 mm) who had been consecutively treated with rapid maxillary expansion and facemask and followed until their second phase treatment. The patients were divided into two groups according to whether they showed relapse in follow-up. The stable group maintained their positive overjet (n = 55), and the unstable group experienced relapse with a zero or negative overjet (n = 20). Two general, three dental, and 13 cephalometric pretreatment factors were investigated to determine which factors were associated with stability.

RESULTS: Sex, pretreatment age, and anteroposterior functional shift, which were hypothesized as associated factors, were not related to …

Heredity, Genetics And Orthodontics: How Much Has This Research Really Helped?, James K. Hartsfield Jr., George Jeryn Jacob, Lorri Ann Morford

Oral Health Science Faculty Publications

Uncovering the genetic factors that correlate with a clinical deviation of previously unknown etiology helps to diminish the unknown variation influencing the phenotype. Clinical studies, particularly those that consider the effects of an appliance or treatment regimen on growth, need to be a part of these types of genetic investigations in the future. While the day-to-day utilization of "testing" for genetic factors is not ready for practice yet, genetic testing for monogenic traits such as Primary Failure of Eruption (PFE) and Class III malocclusion is showing more promise as knowledge and technology advances. Although the heterogeneous complexity of such things …

Phylotoast: Bioinformatics Tools For Species-Level Analysis And Visualization Of Complex Microbial Datasets, Shareef M. Dabdoub, Megan L. Fellows, Akshay D. Paropkari, Matthew R. Mason, Sarandeep S. Huja, Alexandra A. Tsigarida, Purnima S. Kumar

Oral Health Science Faculty Publications

The 16S rRNA gene is widely used for taxonomic profiling of microbial ecosystems; and recent advances in sequencing chemistry have allowed extremely large numbers of sequences to be generated from minimal amounts of biological samples. Analysis speed and resolution of data to species-level taxa are two important factors in large-scale explorations of complex microbiomes using 16S sequencing. We present here new software, Phylogenetic Tools for Analysis of Species-level Taxa (PhyloToAST), that completely integrates with the QIIME pipeline to improve analysis speed, reduce primer bias (requiring two sequencing primers), enhance species-level analysis, and add new visualization tools. The code …

Ensuring Access To Oral Health Care For Children: School-Based Care By Dental Therapists - A Commentary, David A. Nash, Kavita R. Mathu-Muju, Jay W. Friedman

Oral Health Science Faculty Publications

No abstract provided.

Translating Neuroscience Research To Oral Medicine: Oxytocin And Human Behavior, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

Analgesic Effect Of Cathodal Transcranial Current Stimulation Over Right Dorsolateral Prefrontal Cortex In Subjects With Muscular Temporomandibular Disorders: Study Protocol For A Randomized Controlled Trial, Rivail Almeida Brandão Filho, Abrahão Fontes Baptista, Renata De Assis Fonseca Santos Brandão, Francisco Monteiro Meneses, Jeffrey P. Okeson, Eduardo Pondé De Sena

Oral Health Science Faculty Publications

BACKGROUND: Temporomandibular disorders are a group of orofacial pain conditions that are commonly identified in the general population. Like many other chronic pain conditions, they can be associated with anxiety/depression, which can be related to changes in the activity of the dorsolateral prefrontal cortex. Some studies have demonstrated clinical improvement in subjects with chronic pain who are given therapeutic neuromodulation. Transcranial direct current stimulation is a noninvasive brain stimulation technique that allows the modulation of neuronal membranes. This therapy can enhance or inhibit action potential generation in cortical neurons. In some instances, medications acting in the central nervous system may …

Can Dentistry Have Two Contracts With The Public?, David A. Nash

Oral Health Science Faculty Publications

The social contract is an implicit agreement between parts of society and society as a whole. Since the Middle Ages, the learned professions, recently including dentistry, have had a covenantal relationship with the public based on trust, exchanging monopoly privileges for benefiting the public good. Unlike commercial trade in commodities, professional relationships are grounded in ensuring an adequate level of oral health to all. A second contract is emerging where dentists relate to society as business operators, exchanging commodity services for a price. Recent actions by the Federal Trade Commission and the U.S. Supreme Court make it unlikely that dentistry …

On The Symbolism Of The White Coat, David A. Nash

Oral Health Science Faculty Publications

The white coat ceremony has become an academic ritual in the health professions: a ceremony that signals a transformation of status from ordinary student to that of one studying to become a health professional. While donning the white coat is a sign of a changed role, the white coat is also a powerful symbol of transformation. White is a symbol of purity, and the white coat symbolizes the purity of purpose being affirmed in becoming a health professional. Dentistry is afforded the status of a learned profession as a result of the power dentists possess over patients seeking care; this …

A Review Of The Global Literature On Dental Therapists, David A. Nash, Jay W. Friedman, Kavita R. Mathu-Muju, Peter G. Robinson, Julie Satur, Susan Moffat, Rosemary Kardos, Edward C. M. Lo, Anthony H. H. Wong, Nasruddin Jaafar, Jos Van Den Heuvel, Prathip Phantumvanit, Eu Oy Chu, Rahul Naidu, Lesley Naidoo, Irving Mckenzie, Eshani Fernando

Oral Health Science Faculty Publications

OBJECTIVE: Access to adequate oral health care is deficient in many parts of the world. Many countries are now using dental therapists to increase access, particularly for children. To inform the discussion on dental therapists in the workforce, particularly in the United States, the W.K. Kellogg Foundation funded a review of the global literature to identify as many documents as possible related to the practice of dental therapists since the establishment of the School Dental Service in New Zealand in 1921.

METHODS: Consultants in each of the countries considered to have a substantive literature on dental therapists were …

Alfred Owre: Revisiting The Thought Of A Distinguished, Though Controversial, Early Twentieth-Century Dental Educator, David A. Nash

Oral Health Science Faculty Publications

Many in dental education are unfamiliar with the professional life and thought of Dr. Alfred Owre, a distinguished though controversial dental educator in the early twentieth century. Owre served as dean of dentistry at both the University of Minnesota, 1905-27, and Columbia University, 1927-33. He was also a member of the Carnegie Foundation's commission that developed the report Dental Education in the United States and Canada, written by Dr. William J. Gies. Owre was a controversial leader due to his creative and original ideas that challenged dental education and the profession. His assessment and critique of the problems of dental …

Envisioning An Oral Healthcare Workforce For The Future, David A. Nash

Oral Health Science Faculty Publications

Health is critical to human well-being. Oral health is an integral component of health. One is not healthy without oral health. As health is essential to human flourishing, it is important that an oral healthcare delivery system and workforce be developed and deployed which can help ensure all citizens have the potential to access oral health care. As such access does not generally exist today, it is imperative to advance the realization of this goal and to develop a vision of an oral healthcare workforce to functionally support access. Public funding of basic oral health care is an important element …

Ethics And The 'Seasons Of My Life' As A Dental Educator, David A. Nash

Oral Health Science Faculty Publications

Perhaps the first comprehensive ethics program in American dental schools was created in 1990 at the University of Kentucky by then dean David Nash. Nash recounts the emergence of his personal and professional interest in ethics using the structure of Daniel Levinson's book The Seasons of a Man's Life. Each season brings tasks of evolving and deepening ethical engagement. Being ethical is important; helping others to be so is special. Nash still teaches the course.

Societal Expectations And The Profession's Responsibility To Reform The Dental Workforce To Ensure Access To Care For Children, David A. Nash

Oral Health Science Faculty Publications

Societal expectations raise the issue of the nature of a profession and a profession's relationship with society. Influential policy leaders want reform of the oral health workforce and delivery system in such a manner as to ensure that improvements are made for accessing care, particularly for vulnerable and disadvantaged populations, especially children. This essay is based on a presentation to the House of Delegates of the California Dental Association on Nov.13, 2009.

Ethics, Empathy, And The Education Of Dentists, David A. Nash

Oral Health Science Faculty Publications

Professional education in dentistry exists to educate good dentists-dentists equipped and committed to helping society gain the benefits of oral health. In achieving this intention, dental educators acknowledge that student dentists must acquire the complex knowledge base and the sophisticated perceptual-motor skills of dentistry. The graduation of knowledgeable and skilled clinicians in dentistry is a necessary, but not sufficient, condition for ensuring quality oral health care. The further requirement is the commitment of graduates to applying their abilities with moral integrity: providing appropriate and quality care in their patients' best interest. Ultimately, good dentistry depends on individuals committed to treating …

On Why The Dental Therapists' "Movement" In The United States Should Focus On Children--Not Adults, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

Adding Dental Therapists To The Health Care Team To Improve Access To Oral Health Care For Children, David A. Nash

Oral Health Science Faculty Publications

Oral Health in America: A Report of the Surgeon General, and the subsequent National Call to Action to Promote Oral Health, contributed significantly to raising awareness regarding the lack of access to oral health care by many Americans, especially minority and low-income populations, with resulting disparities in oral health. The problem is particularly acute among children. The current dental workforce in the United States is inadequate to meet the oral health care needs of children. It is inadequate in terms of numbers of dentists, as well as their geographic distribution, ethnicity, education, and practice orientation. Dental therapists, paraprofessionals …

A Larger Sense Of Purpose: Dentistry And Society, David A. Nash

Oral Health Science Faculty Publications

Dentistry is undergoing a subtle shift away from being a profession to becoming a business. The two cultures of professionalism and business are contrasted. Among the forces driving this change are the emphasis on esthetics in dentistry and the increasing inability of a large class of patients to access dentistry on a business basis. The shift toward dentistry as a business entails the unhealthy transition toward regarding patients as means to satisfy the dentist's ends rather than patients' health being an end in itself. Dentists run the risk of "objectivifying" rather than "humanizing" patients. This trend must be overcome with …

Why Dentists Should Become Oral Physicians: A Response To Dr. Donald Giddon's "Why Dentists Should Be Called Oral Physicians Now", David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

A Brief History And Current Status Of A Dental Therapy Initiative In The United States, David A. Nash, Ron J. Nagel

Oral Health Science Faculty Publications

No abstract provided.

Developing And Deploying A New Member Of The Dental Team: A Pediatric Oral Health Therapist, David A. Nash

Oral Health Science Faculty Publications

There are inadequate numbers of dentists able and willing to treat America's children, specifically children from low income and minority populations. This has led to the well-publicized disparities in oral health among children. In the early part of the 20^th century New Zealand faced a significant problem with oral disease among its children and introduced a School Dental Service, staffed by allied dental professionals with two years' training in caring for the teeth of children, "school dental nurses." A significant number of countries have adopted the model. This article reviews the history of attempts to develop such an approach …

Developing A Pediatric Oral Health Therapist To Help Address Oral Health Disparities Among Children, David A. Nash

Oral Health Science Faculty Publications

Oral Health in America: A Report of the Surgeon General documented the profound and significant disparities that exist in the oral health of children in the United States. Recently, the country has been issued a National Call to Action to Promote Oral Health, under the leadership of the Office of the Surgeon General. Among the significant factors contributing to the disparities problem is the access to oral health care by disadvantaged populations. There are inadequate numbers of dentists able and willing to treat children, particularly poor and minority children. In the early part of the twentieth century, New Zealand …

"And The Band Played On...", David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

"The Profession Of Dentistry:" The University Of Kentucky's Curriculum In Professional Ethics, David A. Nash

Oral Health Science Faculty Publications

Among the most important learning that occurs in our nation's colleges of dentistry is learning to be a professional. While knowledge, perceptual-motor skills, and problem-solving abilities are basic to becoming a dentist, helping aspiring colleagues to apply their newly developing skills with integrity must be a fundamental concern. Increasingly, we are realizing that the quality of health care depends as significantly on the character of the health professional as it does on the individual's knowledge and skills. Concern for character, virtue, and integrity is the domain of ethics. This paper advances a justification for including a curriculum in professional ethics …

The Oral Physician... Creating A New Oral Health Professional For A New Century, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

The Life-Long Learning Imperative... Ends And Means, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

A Tension Between Two Cultures ... Dentistry As A Profession And Dentistry As Proprietary, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

Health Care Reform.... Practical Manifestations Of Theoretical Values, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.