Digital Commons Network^™

Implementation Of A Cancer Education Program In Rural Counties With The Lowest Hpv Vaccination Rates And Health Rankings, Sarah Arezo, Shillpa Naavaal, Charlotte Garrett, Marcie S. Wright, Vanessa B. Sheppard, Michael A. Preston

Dental Public Health and Policy Publications

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection (STI). To address STIs, one rural county public school district developed a series of Family Life Programs to educate pre-teens about pertinent health information. The Schooling Cancer Program (SCP) was developed in partnership with the local Cancer Research and Resource Center to raise awareness about cancer risk factors including HPV-related cancers and HPV prevention methods. Methods: We collected a post-evaluation survey from students who attended a SCP session at one of the targeted middle schools. The SCP educated students about topics focusing on healthy lifestyles. The survey asked students’ …

Perceptions About Human Papillomavirus Vaccine And Oropharyngeal Cancers, And The Role Of Dental Care Providers In Human Papillomavirus Prevention Among Us Adults, Shillpa Naavaal, Christina A. Demopoulos, Abigail Kelly, Eric Tranby, Julie Frantsve-Hawley

Dental Public Health and Policy Publications

Background: The authors examined adults' perceptions about the importance of the human papillomavirus (HPV) vaccine in preventing oropharyngeal cancers and dental care providers' role in HPV prevention and identified associated factors.

Methods: Adults (≥ 18 years) completed a national survey of consumer and patient attitudes, experiences, and behaviors on oral health. Descriptive and multivariable logistic regression models determined associations between perceptions regarding HPV and attitudes toward dental care providers' role and HPV knowledge, HPV vaccine recommendation, and sociodemographic characteristics.

Results: One in 3 adults (32.8%; n = 5,320) said the HPV vaccine was very important, 1 in 2 said it …

Covid-19 Pandemic Impact On Us Childhood Caries And Potential Mitigation, Christina Scherrer, Shillpa Naavaal, Susan O. Griffin, Mei Lin

Dental Public Health and Policy Publications

Non-Hispanic Black (NHB) and Hispanic and low-income US children have a higher prevalence of untreated caries than their higher-income and non-Hispanic White (NHW) counterparts. Due to the COVID-19 pandemic, many dental offices and school sealant programs closed beginning March 2020. We examine the effect of reduced access to restorative care and sealants on the oral health of children from low-income households overall and by race/ethnicity and how increased sealant delivery in September 2022 could mitigate these effects. We used Markov chain Monte Carlo simulation to model COVID-19’s impact on first permanent molar (1M) caries incidence and loss in quality of …

Association Between Periodontal Disease And Oral Cancer Screening Among Us Adults: Nhanes 2011-2014, Shillpa Naavaal, Dina T. Garcia, Xiaoyan Deng, Dipankar Bandyopadhya

Dental Public Health and Policy Publications

Objectives:

To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD.

Materials and Methods:

We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥ 30 years. PD status was classified as no PD, mild/moderate PD, and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral …

Comprehensive Pregnancy Dental Benefits Improved Dental Coverage And Increased Dental Care Utilization Among Medicaid-Enrolled Pregnant Women In Virginia, Shillpa Naavaal, David W. Harless

Dental Public Health and Policy Publications

Objectives: To evaluate the changes in dental insurance and utilization among pregnant women before and after the pregnancy Medicaid dental benefit policy implementation in 2015 in Virginia.

Methods: We used pooled cross-sectional data from six cycles of the Virginia Pregnancy Risk Assessment Monitoring System on women aged ≥21 years. Using logistic regression models and a difference-in-difference design, we compared the effects of policy implementation on dental insurance and utilization between pre-policy (2013-2014) and post-policy period (2016-2019) among women enrolled in Medicaid (treatment, N = 1,105) vs. those with private insurance (control, N = 2,575). A p-value of 0.05 was …

A Scoping Review Of The Roles, Training, And Impact Of Community Health Workers In Oral Health Supplemental Tables, Dina T. Garcia, Jaime Lawson, Erica R. Brody, Susan C. Mckernan, Sarah E. Raskin, Nixon Arauz, Maghboeba Mosavel, Tegwyn Brickhouse

Health Behavior and Policy Publications

Objective: To synthesize English or Spanish-language literature on community health workers’ (CHWs’) roles, training, and impact in oral health. Basic research design: A scoping review conducted in accordance with the Arksey and O’Malley (2005) methodological framework. Method: Electronic literature searches were conducted in Medline (Ovid), Embase (Ovid), DOSS, CINAHL, Web of Science, and Global Health CAB from inception of the databases to April 2020. Three reviewers independently conducted the title and abstract and full-text reviews. This was followed by data charting by three reviewers and data summarizing by two reviewers. Results: Out of the 36 articles that met the inclusion …

Lucy Corr Dental Clinic: Addressing Dental Needs Of Uninsured Older Adults, Patricia B. Bonwell

Case Studies from Age in Action

Educational Objectives

1. Discuss the critical importance of oral health and the oral-systemic relationship in older adults.

2. Describe how dental insurance determines receipt of dental treatment in older adults.

3. Share how the Lucy Corr Dental Clinic (LCDC) increases access to dental care for uninsured older adults.

4. Describe valuable collaborations with community foundations, the Virginia Dental Association, and Virginia Commonwealth University that enable the success of the LCDC.

Improving Guardianship Practices Through Collaborative Stakeholder Action, Erica Wood, Shasta Douglass

Case Studies from Age in Action

Educational Objectives

1. Describe the purpose of adult guardianship and its effect on fundamental rights.

2. Explain the need for guardianship reform, the obstacles to reform, and what issues need attention in Virginia.

3. Discuss the purpose of state Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS) and the creation and accomplishments of Virginia WINGS.

4. Review cases in which a WINGS pilot project supported the needs and rights of adults with guardians.

The Contribution Of Different Permanent Tooth Types To Untreated Caries: Implications For Public Health Surveillance And Prevention, Susan O. Griffin, Liang Wei, Shillpa Naavaal, Eleanor Fleming

Dental Public Health and Policy Publications

Background: Untreated caries (UC), although highly prevalent, is largely preventable. Information on the contribution of different teeth to UC prevalence and severity could be helpful in evaluating UC surveillance protocols and the relative benefits of caries prevention interventions.

Methods: The authors combined data from 3 cycles (2011-2016) of the National Health and Nutrition Examination Survey for participants aged 6 through 11 years, 12 through 19 years, 20 through 34 years, 35 through 49 years, 50 through 64 years, 65 through 74 years, and 75 years and older. For each age group the authors calculated the contribution of successive permanent tooth …

Opioid And Nonopioid Analgesic Prescriptions For Dental Visits In The Emergency Department, 2015-2017 National Hospital Ambulatory Medical Care Survey, Shillpa Naavaal, Uma Kelekar, Shital Shah

Dental Public Health and Policy Publications

Introduction: Prescription and nonprescription opioid misuse and the rising number of dental visits in emergency departments (EDs) are growing public health concerns in the US. Our study objective was to examine the relationship between prescription analgesics (opioids and nonopioids) and the type of ED visits (dental and nondental) at the national level.

Methods: We used data from the 2015-2017 National Hospital Ambulatory Medical Care Survey to examine the association between opioid, nonopioid, and combination of opioid and nonopioid analgesic prescriptions and dental and nondental visits in the ED. Covariates included socioeconomic variables, time of visit, provider type, triage level, hospital …

For Medicaid Beneficiaries, The Ability To Find A Dentist Is A Key Component Of Access To Care, Julie C. Reynolds, Shillpa Naavaal

Dental Public Health and Policy Publications

No abstract provided.

Severe Drug-Induced Gingival Enlargement And Periodontitis: A Case Series With Clinical Presentation And Management, Janina Golob Deeb, Denver J. Lyons, Daniel M. Laskin, George R. Deeb

Periodontics Publications

Gingival enlargement (GE) is a condition in which the size of the gingiva increases in response to inflammation, systemic disease, or certain medications including anticonvulsants, calcium-channel blockers, and immunosuppressants. This report describes the management of two cases involving severe gingival enlargement related to the use of an anti-hypertensive calcium-channel blocker and an immunosuppressant. Besides taking amlodipine, one patient had undergone a heart transplantation seven years prior and has been taking two immunosuppressant drugs, mycophenolate and tacrolimus. The extent of the destruction of periodontal support, aggravated by gingival enlargement, resulted in extensive tooth loss. Periodontitis and gingival enlargement exacerbate and accelerate …

Utilization Of Dental Services Among Medicaid Enrolled Pregnant Women In Virginia, Shillpa Naavaal, Tegwyn Brickhouse, Jonathan W. Yu, Joann Wells

Philips Institute for Oral Health Research Publications

The study evaluated the impact of the Virginia Medicaid dental benefit on dental services utilization among pregnant women enrolled in Medicaid. Data from a total of 10,395 women who had at least one dental claim during the 2015-2017 period were included in the study. The number of dental visits and dental services utilized per person grew from an average of 2.2 visits and 7 services in 2015 to 3.1 visits and 10.5 services in 2017, respectively. In 2017, of all dental services used, 6% were for preventive services and 59% were for treatment services. Continued efforts and targeted interventions are …

Finite Element Analysis Of A One-Piece Zirconia Implant In Anterior Single Tooth Implant Applications, Georgi Talmazov, Nathan Veilleux, Aous Abdulmajeed, Sompop Bencharit

General Practice Publications

This study evaluated the von Mises stress (MPa) and equivalent strain occurring around monolithic yttria-zirconia (Zir) implant using three clinically simulated finite element analysis (FEA) models for a missing maxillary central incisor. Two unidentified patients’ cone-beam computed tomography (CBCT) datasets with and without right maxillary central incisor were used to create the FEA models. Three different FEA models were made with bone structures that represent a healed socket (HS), reduced bone width edentulous site (RB), and immediate extraction socket with graft (EG). A one-piece abutment-implant fixture mimicking Straumann Standard Plus tissue level RN 4.1 X 11.8mm, for titanium alloy (Ti) …

Exploring The Use Of Pulsed Erbium Lasers To Retrieve A Zirconia Crown From A Zirconia Implant Abutment, Ahmed Elkharashi, Kinga Grzech-Leśniak, Janina Golob Deeb, Aous A. Abdulmajeed, Sompop Bencharit

General Practice Publications

Background

Removal of cement-retained implant fixed restorations when needed, can be challenging. Conventional methods of crown removal are time consuming and costly for patients and practitioners. This research explored the use of two different types of pulsed erbium lasers as a non-invasive tool to retrieve cemented zirconia crowns from zirconia implant abutments. Materials and methods

Twenty identical zirconia crowns were cemented onto 20 identical zirconia prefabricated abutments using self-adhesive resin cement. The specimens were divided into two groups for laser assisted crown removal; G1 for erbium-doped yttrium aluminum garnet laser (Er:YAG), and G2 for erbium, chromium-doped yttrium, scandium, gallium and …

Oculodentodigital Dysplasia: A Case Report And Major Review Of The Eye And Ocular Adnexa Features Of 295 Reported Cases, Virang Kumar, Natario L. Couser, Arti Pandya

Ophthalmology Publications

Oculodentodigital dysplasia (ODDD) is a rare genetic disorder associated with a characteristic craniofacial profile with variable dental, limb, eye, and ocular adnexa abnormalities. We performed an extensive literature review to highlight key eye features in patients with ODDD and report a new case of a female patient with a heterozygous missense GJA1 mutation (c.65G>A, p.G22E) and clinical features consistent with the condition. Our patient presented with multiple congenital anomalies including syndactyly, microphthalmia, microcornea, retrognathia, and a small nose with hypoplastic alae and prominent columella; in addition, an omphalocele defect was present, which has not been reported in previous cases. …

Quiet A Puzzle: A Case Report Of 15 Year Old Female With Severe Anemia Due To Scurvy, Shaikha Alqahtani, Wang Zhihong

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Scurvy is historically thought of a disease affecting sailors in the seventeenth century. Vitamin C deficiency is rare in the developed world. It is mainly found in patients with poor nutrition and specifically those with developmental delay. The spectrum of scurvy is varied and includes dermatological, dental, bone and systemic manifestations. We present to you a case of a 15 year old female with a history of trisomy 21 presenting with severe anemia as a direct cause of vitamin C deficiency.

She presented with a one month history of progressive bilateral lower extremity bruising and inability to walk. Physical exam …

Lifestyle Risk Factor Related Disparities In Oral Cancer Examination In The U.S: A Population-Based Cross-Sectional Study, Aderonke A. Akinkugbe, Dina T. Garcia, Tegwyn H. Brickhouse, Maghboeba Mosavel

Dental Public Health and Policy Publications

Background: Oral cancers account for 3% of annual U.S. cancer diagnosis, 2 in 5 of which are diagnosed late when prognosis is poor. The purpose of this study was to report the population-level prevalence of oral cancer examination among adult smokers and alcohol drinkers and assess if these modifiable lifestyle factors are associated with receiving an oral cancer examination.

Methods: Adult participants ≥30 years (n = 9374) of the 2013–2016 cycles of the National Health and Nutrition Examination Survey were included. Oral cancer examination (yes/no), smoking (never, former, current) and alcohol use (abstainers, former, current) were self-reported. Survey-logistic regression …

Impact Of Making Dental Care Affordable On Quality Of Life In Adults Aged 45 Years And Older, Shillpa Naavaal, Susan O. Griffin, Judith A. Jones

Dental Public Health and Policy Publications

Objective:

The objective of this study was to examine the associations between self-reported ability to afford dental care and quality of life in adults aged 45 years and older.

Method:

We used publicly available cross-sectional data from the 2008 National Health Interview Survey and its oral health supplement for 11,760 adults aged 45+ years. The increased probabilities of reporting dental problems attributable to an inability to afford dental care were estimated from multivariate models and combined with respective dental problem disability weights from the Global Burden of Disease to measure loss in quality of life.

Results:

Prevalence of reported inability …

Using Er:Yag Laser To Remove Lithium Disilicate Crowns From Zirconia Implant Abutments: An In Vitro Study, Janina Golob Deeb, Sompop Bencharit, Nishchal Dalal, Aous Abdulmajeed, Kinga Grzech-Leśniak

Periodontics Publications

Background
When implants are restored with cement-retained restorations, prosthetic retrievability can be difficult and often requires sectioning using rotary instruments. Sometimes repeated removals of a cement-retained implant crown are needed such as for treatment of peri-implantitis or immediate implant provisionalization. The purpose of this study was to evaluate the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser as a non-invasive treatment modality to remove lithium disilicate crowns from zirconia implant abutments following long-term cementation, repetitive debonding and re-cementation, and short-term retrieval.

Material and methods
Twenty identical lithium disilicate crowns were cemented onto zirconia prefabricated abutments using composite resin cement. Ten …

Dental Dam Utilization By Dentists In An Intramural Faculty Practice, Terence A. Imbery, Caroline K. Carrico

General Practice Publications

Objectives: From casual observation of our colleagues, only a few individuals use the dental dam for operative procedures in their faculty practice. The purpose of this study was to obtain faculty perceptions of the dental dam, quantify its utilization in their intramural faculty practice, and determine the factors that influence dental dam usage.


Materials and Methods: A survey containing 11 questions was sent to 19 faculty members who teach full time and maintain an intramural dental practice involving operative dentistry. Thirty electronic dental health records of the 19 providers were reviewed to gather the following information from restorative procedures they …

Using A Mixed Methods Approach To Explore Perceptions Of Early Learners In Classroom-Based Interprofessional Education Experiences, Abigale Matulewicz

Health Sciences Education Symposium

Background:

- Interprofessional education (IPE) is a global imperative

- Health profession education programs, motivated by accreditation requirements, have added IPE activities into their required curricula.

- Curriculum development varies considerably across institutions and debate exists regarding appropriate timing for introducing learners to IPE in order to optimally improve health outcomes.

- Some evidence shows benefit of early learner IPE in professional identity development, interprofessional socialization and positive attitude development toward interprofessional practice.

- At Virginia Commonwealth University (VCU), IPE is integrated longitudinally through the curriculum for several of the health professions programs via IPEC courses.

Interprofessional Geriatrics: Improving The Health Of Older Adults, Edward F. Ansello

Director's Editorials from Age in Action

We have received a five-year award (2019-2024) from the federal Health Resources and Services Administration (HRSA) to grow our Virginia Geriatric Education Center (VGEC) project, which aims to improve health outcomes across Virginia for older adults by developing a healthcare workforce that maximizes patient and family engagement, integrating geriatrics and primary care, and demonstrating measurable impact.

Oral Cancer Has A New Risk Factor: Hpv, Tira Hanrahan, Shillpa Naavaal

Dental Public Health and Policy Publications

No abstract provided.

Fostering Transformative Learning, Self-Reflexivity And Medical Citizenship Through Guided Tours Of Disadvantaged Neighborhoods, E. Marshall Brooks, Mary Lee Magee, Mark Ryan

Family Medicine and Population Health Publications

Background and objectives: Medical school curricula increasingly seek to promote medical students’ commitment to redressing health disparities, but traditional pedagogical approaches have fallen short of this goal. The objective of this work was to assess the value of using community-based guided tours of disadvantaged neighborhoods to fill this gap.

Methods: A total of 50 second-year medical students participated in a guided tour of disadvantaged public housing neighborhoods in Richmond, Virginia. Students completed self-reflexive writing exercises during a post-tour debriefing session. Student writings were analyzed to assess the tour’s effect on their awareness of poverty’s impact on vulnerable populations’ health …

Medical Literary Messenger (Vol. 5, No. 2, Spring/Summer 2018)

Medical Literary Messenger

The Essentials / Dave Morrison -- Sometimes I Pretend / Emily Pineau -- Psalm for Anorexia / Elizabeth Gauffreau -- On Harvey Dent / Bryan Walpert -- On the Level / Jane Blanchard -- Cirrhosis / Arthur Ginsberg -- Open Microphone / Stuart M. Terman -- Guest Lavatory, Beaumont Hospital, Day Five / John Jeffire -- Change of Heart / Rosie Sorenson -- Code Blue / Caroline Mosher -- Beautiful Pulses / Paul Hostovsky -- The Hospital and After / Michele Levy -- Mouth to Mouth / Charles H. Halsted -- A Meditation on Memory and Morocco / Janie Breggin …

Hours Lost To Planned And Unplanned Dental Visits Among Us Adults, Uma Kelekar, Shillpa Naavaal

Dental Public Health and Policy Publications

Introduction

Poor oral health is associated with lost hours at work or school, which may affect a person’s productivity. The objective of our study was to estimate work or school hours lost to dental visits among adults aged 18 and older by the types of visits (emergency or unplanned; routine, planned, or orthodontic; or cosmetic) and to determine the factors associated with hours lost.

Methods

We used the most recent Oral Health Supplement data, from the 2008 National Health Interview Survey (NHIS), to estimate the total hours lost at work or school for dental visits among adults in the United …

Investigation Into The Role Of Manganese In The Growth Of The Opportunistic Pathogen Streptococcus Sanguinis, Brittany Spivey

Auctus: The Journal of Undergraduate Research and Creative Scholarship

While Streptococcus sanguinis plays a beneficial role in the oral cavity as a competitor of Streptococcus mutans and Streptococcus sobrinus, the bacteria that produce dental caries, it can cause deadly infective endocarditis if given the opportunity to colonize the vegetations that form over damaged endocardial tissue. Pre-existing heart conditions, surgery, and intravenous drug use predispose individuals to endocarditis. S. sanguinis growth and consequential virulence is significantly impeded by restriction to manganese. This is due to the resulting overwhelming oxidative stress and formation of reactive oxygen species which damage DNA and other cellular components. Manganese is essential for S. sanguinis proteins …

Splenic Trauma: Wses Classification And Guidelines For Adult And Pediatric Patients, Federico Coccolini, Giulia Montori, Fausto Catena, Yoram Kluger, Walter Biffl, Ernest E. Moore, Viktor Reva, Camilla Bing, Miklosh Bala, Paola Fugazzola, Hany Bahouth, Ingo Marzi, George Velmahos, Rao Ivatury, Kjetil Soreide, Tal Horer, Richard Ten Broek, Bruno M. Pereira, Gustavo P. Fraga, Kenji Inaba, Joseph Kashuk, Neil Parry, Peter T. Masiakos, Konstantinos S. Mylonas, Andrew Kirkpatrick, Fikri Abu-Zidan, Carlos Augusto Gomes, Simone Vasilij Benatti, Noel Naidoo, Francesco Salvetti, Stefano Maccatrozzo, Vanni Agnoletti, Emiliano Gamberini, Leonardo Solaini, Antonio Costanzo, Andrea Celotti, Matteo Tomasoni, Vladimir Khokha, Catherine Arvieux, Lena Napolitano, Lauri Handolin, Michele Pisano Pisano, Stefano Magnone, David A. Spain, Marc De Moya, Kimberly A. Davis, Nicola De Angelis, Ari Leppaniemi, Paula Ferrada, Rifat Latifi, David Costa Navarro, Yashuiro Otomo, Raul Coimbra, Ronald V. Maier, Frederick Moore, Sandro Rizoli, Boris Sakakushev, Joseph M. Galante, Osvaldo Chiara, Stefania Cimbanassi, Alain Chichom Mefire, Dieter Weber, Marco Ceresoli, Andrew B. Peitzman, Liban Wehlie, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni

Surgery Publications

Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be …

Elimination Of Pain Improves Specificity Of Clinical Diagnostic Criteria For Adult Chronic Rhinosinusitis, Scott D. Hirsch, Evan R. Reiter, Laurence J. Dinardo, Wen Wan, Theodore A. Schuman

Otolaryngology Publications

Objective

Determine whether the elimination of pain improves accuracy of clinical diagnostic criteria for adult chronic rhinosinusitis.

Study Design

Retrospective cohort study.

Methods

History, symptoms, nasal endoscopy, and computed tomography (CT) results were analyzed for 1,186 adults referred to an academic otolaryngology clinic with presumptive diagnosis of chronic rhinosinusitis. Clinical diagnosis was rendered using the 1997 Rhinosinusitis Taskforce (RSTF) Guidelines and a modified version eliminating facial pain, ear pain, dental pain, and headache.

Results

Four hundred seventy-nine subjects (40%) met inclusion criteria. Among subjects positive by RSTF guidelines, 45% lacked objective evidence of sinonasal inflammation by CT, 48% by endoscopy, …