Dentistry Commons^™

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 …

Interdisciplinary Collaboration With Music Therapy During Routine Pediatric Dental Procedures, Austin S. Robinson

Theses and Dissertations--Music

The incorporation of integrative medicine into traditional treatment options has steadily increased during the past two decades. This has resulted in a change in the dynamics of interdisciplinary teams creating the need to better understand the roles and responsibilities of team members. The purpose of this study was to examine the perceptions of dental treatment team members regarding the role and responsibilities of music therapy during treatment.

A total of 10 participants were included in this study. Participants completed a pre-music therapy survey to establish prior knowledge, experience with, and perceptions of music therapy. Following an experiential intervention, participants completed …

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 …

Use Of Social Media In Dental Schools: Pluses, Perils, And Pitfalls From A Legal Perspective, Joseph W. Parkinson, Sharon P. Turner

Oral Health Practice Faculty Publications

One of the ways dental education is changing the way it is preparing the next generation of learners is through efficient utilization of interactive social media. Social media, which facilitates interaction and sharing of new ideas, is being utilized to educate students, residents, and faculty. Unfortunately, as with most improvements in technology, there are growing pains. Faculty, student, and patient interaction on social media platforms, such as Facebook and Twitter, can lead to inappropriate or embarrassing situations. Striking the appropriate balance between free speech rights of students and faculty and the need for colleges and universities to have efficient operations …

Cytokine Gene Expression Profiles During Initiation, Progression And Resolution Of Periodontitis, Jeffrey L. Ebersole, Sreenatha S. Kirakodu, Michael John Novak, Arnold J. Stromberg, Shu Shen, Luis Orraca, Janis Gonzalez-Martinez, Armando Burgos, Octavio A. Gonzalez

Center for Oral Health Research Faculty Publications

AIM: Variations in the expression of cytokines during the progression of periodontitis remain ill-defined. We evaluated the expression of 19 cytokine genes related to T-cell phenotype/function during initiation, progression and resolution of periodontitis, and related these to the expression of soft and bone tissue destruction genes (TDGs).

MATERIALS AND METHODS: A ligature-induced periodontitis model was used in rhesus monkeys (M. mulatta) (n = 18). Gingival tissues were taken at baseline pre-ligation, 2 weeks and 1 month (Initiation) and 3 months (progression) post ligation. Ligatures were removed and samples taken 2 months later (resolution). Total RNA was isolated and the Rhesus …

Comparative Analysis Of Gingival Tissue Antigen Presentation Pathways In Ageing And Periodontitis, Octavio A. Gonzalez, Michael John Novak, Sreenatha S. Kirakodu, Luis Orraca, Kuey-Chu Chen, Arnold J. Stromberg, Janis Gonzalez-Martinez, Jeffrey L. Ebersole

Center for Oral Health Research Faculty Publications

AIM: Gingival tissues of periodontitis lesions contribute to local elevations in mediators, including both specific T cell and antibody immune responses to oral bacterial antigens. Thus, antigen processing and presentation activities must exist in these tissues to link antigen-presenting cells with adaptive immunity. We hypothesized that alterations in the transcriptome of antigen processing and presentation genes occur in ageing gingival tissues and that periodontitis enhances these differences reflecting tissues less capable of immune resistance to oral pathogens.

MATERIALS AND METHODS: Rhesus monkeys (n = 34) from 3 to 23 years of age were examined. A buccal gingival sample from healthy …

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 …

Expression Of Mir-15/107 Family Micrornas In Human Tissues And Cultured Rat Brain Cells, Wang-Xia Wang, Robert J. Danaher, Craig S. Miller, Joseph R. Berger, Vega G. Nubia, Bernard R. Wilfred, Janna H. Neltner, Christopher M. Norris, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

The miR-15/107 family comprises a group of 10 paralogous microRNAs (miRNAs), sharing a 5' AGCAGC sequence. These miRNAs have overlapping targets. In order to characterize the expression of miR-15/107 family miRNAs, we employed customized TaqMan Low-Density micro-fluid PCR-array to investigate the expression of miR-15/107 family members, and other selected miRNAs, in 11 human tissues obtained at autopsy including the cerebral cortex, frontal cortex, primary visual cortex, thalamus, heart, lung, liver, kidney, spleen, stomach and skeletal muscle. miR-103, miR-195 and miR-497 were expressed at similar levels across various tissues, whereas miR-107 is enriched in brain samples. We also examined the expression …

Bioerodible Calcium Sulfate Bone Grafting Substitutes With Tailored Drug Delivery Capabilities, Bryan R. Orellana

Theses and Dissertations--Biomedical Engineering

Bone regeneration or augmentation is often required prior to or concomitant with implant placement. With the limitations of many existing technologies, a biologically compatible synthetic bone grafting substitute that is osteogenic, bioerodible, and provides spacing-making functionality while acting as a drug delivery vehicle for bioactive molecules could provide an alternative to ‘gold standard’ techniques.

In the first part of this work, calcium sulfate (CS) space-making synthetic bone grafts with uniformly embedded poly(β-amino ester) (PBAE) biodegradable hydrogel particles was developed to allow controlled release of bioactive agents. The embedded gel particles’ influence on the physical and chemical characteristics of CS was …

A Diffusible Mobile Dental Services Model For Prevention-Focused Outreach For Underserved Children In Rural Communities, Nikki Stone, Frances J. Feltner, Willie Bates

Center of Excellence in Rural Health Presentations

Background: In 2006 a mobile dental outreach program began operating full-time at the UK North Fork Valley Community Health Center in Hazard, Kentucky, a federally-qualified health center administered by the University of Kentucky and located at the UK Center of Excellence in Rural Health. This program continues to provide preventive dental care to children at forty different elementary schools and Head Start centers in a four county area of southeastern Kentucky located in the heart of rural Appalachia. The counties are Leslie, Knott, Letcher and Perry (LKLP), which are part of the Kentucky River Development District and encompass the LKLP …

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 …

Effects Of Aging On Apoptosis Gene Expression In Oral Mucosal Tissues, Octavio A. Gonzalez, Michael John Novak, Sreenatha S. Kirakodu, Arnold J. Stromberg, Shu Shen, Luis Orraca, Janis Gonzalez-Martinez, Jeffrey L. Ebersole

Center for Oral Health Research Faculty Publications

Apoptotic processes are important for physiologic renewal of an intact epithelial barrier and contribute some antimicrobial resistance for bacteria and viruses, as well as anti-inflammatory effects that benefits the mucosa. The oral cavity presents a model of host-bacterial interactions at mucosal surfaces, in which a panoply of microorganisms colonizes various niches in the oral cavity and creates complex multispecies biofilms that challenge the gingival tissues. This report details gene expression in apoptotic pathways that occur in oral mucosal tissues across the lifespan, using a nonhuman primate model. Macaca mulatta primates from 2 to 23 years of age (n = …

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 …

Oral Microbial Biofilm Stimulation Of Epithelial Cell Responses, Rebecca Peyyala, Sreenatha S. Kirakodu, Karen F. Novak, Jeffrey L. Ebersole

Center for Oral Health Research Faculty Publications

Oral bacterial biofilms trigger chronic inflammatory responses in the host that can result in the tissue destructive events of periodontitis. However, the characteristics of the capacity of specific host cell types to respond to these biofilms remain ill-defined. This report describes the use of a novel model of bacterial biofilms to stimulate oral epithelial cells and profile select cytokines and chemokines that contribute to the local inflammatory environment in the periodontium. Monoinfection biofilms were developed with Streptococcus sanguinis, Streptococcus oralis, Streptococcus gordonii, Actinomyces naeslundii, Fusobacterium nucleatum, and Porphyromonas gingivalis on rigid gas-permeable contact lenses. Biofilms, as well as planktonic cultures …

Epithelial Interleukin-8 Responses To Oral Bacterial Biofilms, Rebecca Peyyala, Sreenatha S. Kirakodu, Lucia Novakova, Jeffrey L. Ebersole

Center for Oral Health Research Faculty Publications

An in vitro model of bacterial biofilms on rigid gas-permeable contact lenses (RGPLs) was developed to challenge oral epithelial cells. This novel model provided seminal data on oral biofilm-host cell interactions, and with selected bacteria, the biofilms were more effective than their planktonic counterparts at stimulating host cell responses.

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.

Novel Model For Multispecies Biofilms That Uses Rigid Gas-Permeable Lenses, Rebecca Peyyala, Sreenatha S. Kirakodu, Jeffrey L. Ebersole, Karen F. Novak

Center for Oral Health Research Faculty Publications

Oral biofilms comprise complex multispecies consortia aided by specific inter- and intraspecies interactions occurring among commensals and pathogenic bacterial species. Oral biofilms are primary initiating factors of periodontal disease, although complex multifactorial biological influences, including host cell responses, contribute to the individual outcome of the disease. To provide a system to study initial stages of interaction between oral biofilms and the host cells that contribute to the disease process, we developed a novel in vitro model system to grow biofilms on rigid gas-permeable contact lenses (RGPLs), which enable oxygen to permeate through the lens material. Bacterial species belonging to early- …

Aspirin Treatment Of Mice Infected With Trypanosoma Cruzi And Implications For The Pathogenesis Of Chagas Disease, Shankar Mukherjee, Fabiana S. Machado, Huang Huang, Helieh S. Oz, Linda A. Jelicks, Cibele M. Prado, Wade Koba, Eugene J. Fine, Dazhi Zhao, Stephen M. Factor, J. Elias Collado, Louis M. Weiss, Herbert B. Tanowitz, Anthony W. Ashton

Center for Oral Health Research Faculty Publications

Chagas disease, caused by infection with Trypanosoma cruzi, is an important cause of cardiovascular disease. It is increasingly clear that parasite-derived prostaglandins potently modulate host response and disease progression. Here, we report that treatment of experimental T. cruzi infection (Brazil strain) beginning 5 days post infection (dpi) with aspirin (ASA) increased mortality (2-fold) and parasitemia (12-fold). However, there were no differences regarding histopathology or cardiac structure or function. Delayed treatment with ASA (20 mg/kg) beginning 60 dpi did not increase parasitemia or mortality but improved ejection fraction. ASA treatment diminished the profile of parasite- and host-derived circulating prostaglandins in infected …

Identification Of Differential Pharyngeal Cytokine Profiles During Hiv Infection, R. A. P. M. Perera, P. C. S. Tsang, Craig S. Miller, P. Li, M. P. Lee, L. P. Samaranayake

Center for Oral Health Research Presentations

Significantly higher pharyngeal shedding of Epstein-Barr virus (EBV) is observed during HIV infection. Increased EBV shedding in pharynx is not affected even during highly active antiretroviral theyrapy (HAART). EBV positive monocyte populations have been shown to carry EBV to pharyngeal mucosa. Human cytokine profiles are often altered to facilitate herpes virus infection. Thus pharyngeal cytokine profiles may influence EBV reactivation and shedding during HIV infection. Our objective was to compare 37 pharyngeal cytokine profiles of HIV-seropositive patients who were or were not receiving HAART therapy.

Animal Models For Periodontal Disease, Helieh S. Oz, David A. Puleo

Center for Oral Health Research Faculty Publications

Animal models and cell cultures have contributed new knowledge in biological sciences, including periodontology. Although cultured cells can be used to study physiological processes that occur during the pathogenesis of periodontitis, the complex host response fundamentally responsible for this disease cannot be reproduced in vitro. Among the animal kingdom, rodents, rabbits, pigs, dogs, and nonhuman primates have been used to model human periodontitis, each with advantages and disadvantages. Periodontitis commonly has been induced by placing a bacterial plaque retentive ligature in the gingival sulcus around the molar teeth. In addition, alveolar bone loss has been induced by inoculation or …

Dental Service Utilization In An Academic Setting: An Analysis For Improved Oral Health, Paula R. Sandford

MPA/MPP/MPFM Capstone Projects

The National Oral Health Surveillance System (NOHSS) is the result of a collaborative effort between the Centers for Disease Control and Prevention and the Association of State and Territorial Dental Directors which is designed to monitor aspects of oral health and disease on both a national and state level. The NOHSS ranks Kentucky at or near the bottom in most oral health indicators. The primary message of the Surgeon General’s May 2000 report on Oral Health in America was to emphasize the link between oral health and overall health including the effect on day‐to‐day activities such as work and school …

Hiv-1 Reactivation Induced By The Periodontal Pathogens Fusobacterium Nucleatum And Porphyromonas Gingivalis Involves Toll-Like Receptor 2 And 9 Activation In Monocytes/Macrophages, Octavio A. Gonzalez, Mengtao Li, Jeffrey L. Ebersole, Chifu B. Huang

Center for Oral Health Research Faculty Publications

Although oral coinfections (e.g., periodontal disease) are highly prevalent in human immunodeficiency virus type 1-positive (HIV-1⁺) patients and appear to positively correlate with viral load levels, the potential for oral bacteria to induce HIV-1 reactivation in latently infected cells has received little attention. We showed that HIV-1 long terminal repeat (LTR) promoter activation can be induced by periodontopathogens in monocytes/macrophages; nevertheless, the mechanisms involved in this response remain undetermined. Since Toll-like receptor 2 (TLR2), TLR4, and TLR9 activation have been involved in HIV-1 recrudescence, we sought to determine the role of these TLRs in HIV-1 reactivation induced by …

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 …

Application Of Prodrugs To Inflammatory Diseases Of The Gut, Helieh S. Oz, Jeffrey L. Ebersole

Center for Oral Health Research Faculty Publications

Oral delivery is the most common and preferred route of drug administration although the digestive tract exhibits several obstacles to drug delivery including motility and intraluminal pH profiles. The gut milieu represents the largest mucosal surface exposed to microorganisms with 10^10-12 colony forming bacteria/g of colonic content. Approximately, one third of fecal dry matter is made of bacteria/ bacterial components. Indeed, the normal gut microbiota is responsible for healthy digestion of dietary fibers (polysaccharides) and fermentation of short chain fatty acids such as acetate and butyrate that provide carbon sources (fuel) for these bacteria. Inflammatory bowel disease (IBD) results …

Optimizing Qpcr For The Quantification Of Periodontal Pathogens In A Complex Plaque Biofilm, Sreenatha S. Kirakodu, M. Govindaswami, Michael John Novak, Jeffrey L. Ebersole, Karen F. Novak

Center for Oral Health Research Faculty Publications

Quantitative PCR (qPCR) has recently been used to quantify microorganisms in complex communities, including dental plaque biofilms. However, there is variability in the qPCR protocols being used. This study was designed to evaluate the validity of two of these variables with the intent of developing a more standardized qPCR protocol. The two variables evaluated were (1) the use of DNA content versus actual cell counts to estimate bacterial numbers in mixed plaque samples and (2) the effectiveness of three different universal primers versus species specific primers in amplifying specific target pathogens in these samples. Results lead to the development of …

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 …

Efficacy Of The De Novo-Derived Antimicrobial Peptide Wlbu2 Against Oral Bacteria, Karen F. Novak, William J. Diamond, Sreenatha S. Kirakodu, Rebecca Peyyala, Kimberly W. Anderson, Ronald C. Montelaro, Timothy A. Mietzner

Center for Oral Health Research Faculty Publications

The efficacy of a novel synthetic antimicrobial peptide (WLBU2) was evaluated against three oral microorganisms (grown planktonically): Streptococcus gordonii, Fusobacterium nucleatum, and Porphyromonas gingivalis. WLBU2 killed all three species, with F. nucleatum being the most susceptible. WLBU2 also reduced the bacterial burden of S. gordonii and F. nucleatum biofilms.