Dentistry Commons^™

Reimagining The Possible: What True Medical-Dental Integration Would Actually Require, Brett Kessler

Metro Denver Dental Society Articulator Magazine

This article explores the structural, financial and educational barriers preventing true medical-dental integration despite the overwhelming evidence linking oral health to systemic disease. Drawing from clinical experience and current research, Dr. Brett Kessler argues that dentistry must move beyond procedure-based care toward a collaborative, outcomes-driven healthcare model. The article examines reimbursement reform, interoperability between medical and dental records, expanded preventive screening and integrated care delivery systems. It also challenges the dental profession to embrace a broader role in whole-body health and chronic disease prevention.

Advancing Personalized Oral–Systemic Care Through Tongue Mapping, Lani Mcbeth Bs, Rdh

Metro Denver Dental Society Articulator Magazine

This article explores the role of Systemic Tongue Mapping (STM) as a complementary tool for advancing personalized oral-systemic care. Rooted in Traditional Chinese Medicine (TCM) and examined through an integrative healthcare lens, STM encourages clinicians to assess tongue characteristics as potential indicators of systemic imbalance and inflammation. Lani McBeth, BS, RDH, discusses how tongue mapping can enhance patient education, support preventive care conversations and encourage interdisciplinary collaboration. This article highlights how dental professionals can expand their role in whole-body wellness and early detection.

Integrated Thinking: How Mdds Is Connecting The Dots For Dentists In Oral-Systemic Health, Bryan Savage

Metro Denver Dental Society Articulator Magazine

In this President’s Message, Dr. Bryan Savage reflects on the growing importance of oral-systemic health education and the evolving role of dentistry in whole-body healthcare. The article highlights MDDS initiatives, including the Integrated Healthcare Summit and Diagnostic Testing Pavilion at the Rocky Mountain Dental Convention (RMDC), designed to help clinicians better understand the mouth-body connection and implement preventive strategies in practice. The article calls for dental professionals to remain engaged in lifelong learning and interdisciplinary care.

Articulator Volume 32, Issue 2

Metro Denver Dental Society Articulator Magazine

The 2nd Quarter 2026 issue of The Articulator explores the growing intersection between oral health and whole-body wellness, with a focus on oral-systemic health, interdisciplinary collaboration and the role of dentistry in preventive medicine. Articles include:

• A perspective from Dr. Brett Kessler examining what true medical-dental integration would require, including reimbursement reform, collaborative care models and expanded recognition of dentistry’s role in systemic health.
• An evidence-based article from Ms. Anne O. Rice exploring the connection between periodontal disease, inflammation and Alzheimer’s disease, including the role of dentistry in dementia risk reduction and preventive healthcare.
• Insights from Ms. Lani McBeth on …

Screen The Screener™, Susan Cotten Bsdh, Rdh, Omt

Metro Denver Dental Society Articulator Magazine

This article emphasizes the importance of oral cancer screening for the healthcare providers responsible for screening patients. Through an oral-systemic and airway-focused lens, Susan Cotton, BSDH, RDH, OMT, encourages clinicians to recognize signs of burnout, chronic stress and underlying health concerns within themselves and their teams. The article reinforces the idea that healthier providers are better equipped to deliver comprehensive, patient-centered care.

Operation Bite Block, Jennifer Aline Robles, Laura Marie Strobbe, William Pearce Graham, Annabelle Katherine Thalken

Mechanical Engineering

Current dental bite blocks, or mouth props, are typically manufactured in fixed sizes, and often result in patient discomfort, reduced procedural efficiency, and the need for dental offices to maintain multiple product sizes. This project sought to design, prototype, and validate an adjustable dental bite block capable of accommodating a wide range of patient mouth openings while maintaining comfort, structural integrity, sterilizability, and operator usability. Working in collaboration with Dr. Alan Latta, a practicing dentist in San Luis Obispo, the design process incorporated stakeholder feedback, patent and market research, engineering analysis, and iterative prototyping to develop a solution that addresses …

Comparative Evaluation Of Translucency, Fluorescence, And Structural Analysis Of 3d-Printed Vs. Conventionally Fabricated 3y, 4y And 5y Zirconia, Surabhi Chhabra

ETDs from 2020-2029

Statement of Problem: Additive manufacturing has emerged as an alternative to conventional milling for zirconia-based dental restorations because of its potential to reduce material waste and increase design flexibility. However, whether 3D-printed zirconia can provide optical and structural properties comparable with those of conventionally milled zirconia for esthetic applications remains unclear. Purpose: The purpose of this in vitro study was to compare the optical properties of 3D-printed zirconia and conventionally milled 3Y, 4Y, and 5Y zirconia, as measured by translucency and fluorescence, and to evaluate their structural characteristics, as measured by density, porosity, phase composition, and surface morphology. Materials and …

Facilitators And Barriers That Exist For Patients Receiving Dental Care In Rural Communities, Monse Sandoval Brumbaugh

University Honors Theses

Rising healthcare costs and limited access to care have exacerbated the shortage of healthcare providers. Although multiple factors contribute to a clinician’s preference for practicing in rural areas, the imbalance created leads to rural communities with significantly reduced access to essential services, particularly dental care. The disparity between urban and rural healthcare is a well-documented global problem, but it remains a pressing issue in the United States, particularly in Oregon. The Full Time Equivalents (FTE) count of full-time practicing dentists in rural regions is significantly lower than in urban areas. Statewide, there are about 0.48 dentists per 1,000 residents. However, …

Oral Health And Alzheimer’S Disease: The Systemic Connection, Anne O. Rice Bs, Rdh

Metro Denver Dental Society Articulator Magazine

This evidence-based article examines the research connecting oral inflammation and periodontal disease with Alzheimer’s disease and cognitive decline. The author, Anne O. Rice, explores inflammatory, vascular, microbial and airway-related pathways that may contribute to neurodegeneration. Practical applications for dental professionals are highlighted, including blood pressure screening, periodontal therapy, airway assessment and interdisciplinary collaboration. The article positions dentistry as an important contributor to preventive, whole-person healthcare and dementia risk reduction.

Leadership Revisited, Allen Vean Dmd

Metro Denver Dental Society Articulator Magazine

This Reflections examines the importance of communication, collaboration and human connection in dental practice management. Dr. Allen Vean draws parallels between healthcare teams and organizational leadership models, and discusses how trust, morale and team engagement directly impact patient care and practice culture. The article also explores the evolving role of AI and technology in dentistry while emphasizing that human interaction remains essential to long-term success. The author implores dentists to foster stronger team relationships to create patient-centered practice environments.

Age And Sex Affect The Prevalence And Severity Of Periodontal Conditions In An Academic Setting

Faculty, Staff and Student Publications

Background: The aim of the present study was to examine whether age and sex affected the prevalence and severity of periodontal conditions in patients attending an academic dental clinic.

Methods: Electronic health record (EHR) data on the demographic characteristics and periodontal conditions of patients presented for a comprehensive periodontal evaluation were extracted from the institutional dental EHR database. Retrospective analysis of independent associations of age, sex, and other subject characteristics with periodontal conditions was determined using multinomial logistic regression. The null hypothesis stating that age and sex were not associated with the increased prevalence and/or severity of periodontal conditions was …

Cytosignal Detects Locations And Dynamics Of Ligand-Receptor Signaling At Cellular Resolution From Spatial Transcriptomic Data

Faculty, Staff and Student Publications

Cells communicate through ligand-receptor (LR) signaling interactions, but identifying when and where these interactions are active remains challenging. We developed CytoSignal to infer the locations and dynamics of cell-cell communication at cellular resolution from spatial transcriptomic data. Here we show that our cellular resolution, spatially resolved signaling scores enable several important analyses-identifying spatial gradients in signaling strength, quantifying the locations of contact-dependent and diffusible interactions, detecting signaling-associated genes and identifying differential signaling across multisample data. Additionally, we can predict the temporal dynamics of a signaling interaction at each spatial location. We experimentally validate our results in situ by proximity ligation …

Outgoing President Newman: “The Future Of The Mda Is Defined By All Of Us”, David Foe

The Journal of the Michigan Dental Association

In her final address to the MDA House of Delegates, outgoing President Dr. Cheri Newman reviews the association's progress over the past administrative year. She highlights achievements in strengthening financial stability, advocating for solutions to dental workforce shortages, and expanding community access to care. Newman also discusses the ongoing strategic review of member values and a comprehensive governance review intended to position the association for the future of dentistry. She emphasizes that the organization's strength lies in the collective engagement of its membership.

Better Questions Make Better Dentists: Why Values-Based Conversations Lead To Better Outcomes, Anish Gupta Dds

The Journal of the Michigan Dental Association

Dr. Anish Gupta argues that technical proficiency in dentistry must be guided by values-based communication to ensure optimal patient outcomes. He critiques traditional informed consent that merely lists procedural options, suggesting it can lead to confusion if a patient's primary motivations—such as dignity or quality of life—are not addressed. By slowing down to uncover what truly matters to the patient, dentists can provide better guidance and clinical judgment. Gupta emphasizes that alignment with patient values removes obstacles to treatment acceptance.

From The Editor: The Journal: Supporting Michigan’S Dental Community, Romesh Nalliah

The Journal of the Michigan Dental Association

Editor-in-Chief Dr. Romesh Nalliah explores the concept of "community" as a shared responsibility within the dental profession. He positions the Journal of the Michigan Dental Association as a vital tool for connecting practitioners and delivering rigorously reviewed scientific content to guide clinical decision-making. While acknowledging technological advances like artificial intelligence, Nalliah maintains that "soft skills"—including listening, empathy, and critical thinking—remain the most essential factors for success. He encourages members to utilize the Journal for mentorship and professional support.

J Mich Dent Assoc June 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200-plus members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.

The June 2026 (Volume 108, No. 6) issue of the Journal is published in digital format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

The June 2026 issue of the Journal of the Michigan Dental Association provides association updates, legal advice, and clinical …

The Back Page: A Dental Road Trip To The Birthplace Of Fluoridation, Chris Smiley Dds

The Journal of the Michigan Dental Association

This historical feature details a visit by ADA and MDA leadership to the Monroe Avenue Water Filtration Plant in Grand Rapids. The plant achieved international significance on January 25, 1945, when Grand Rapids became the first city in the world to implement community water fluoridation. A subsequent 10-year study showed a 65% reduction in childhood tooth decay, establishing fluoridation as a primary public health measure of the 20th century. The article highlights the facility's legacy as the birthplace of a global health initiative.

Self-Reported Gum Bleeding, Oral Health Behaviors, And Cardiovascular Risk Indicators Among Adults Aged 45-70 In A Community Dental Setting., Kimberleigh Edwards

Population Health Leadership and Analytics Theses

Cardiovascular disease remains a leading cause of morbidity and mortality among adults in the United States, particularly during midlife and older adulthood. Periodontal inflammation and poor oral hygiene behaviors have been linked to increased cardiovascular risk through systemic inflammatory pathways. This exploratory cross-sectional study described patterns of self reported gum bleeding, oral hygiene behaviors, and cardiovascular risk factors among 29 adults aged 45 to 70 at a community dental clinic using the researcher-developed Oral and Heart Health Study Questionnaire. Fourteen participants reported both gum bleeding and at least one cardiovascular risk factor. Participants who reported inconsistent flossing and infrequent professional …

Age-Stratified Clinicopathological Associations Of P16 Expression, Tumourinfiltrating Lymphocytes And Foxp3 Cells In Oral Squamous Cell Carcinoma, Chong Wen Xin

Student Works (2020-2029)

Introduction: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy with a rising incidence in younger adults. Human Papillomavirus (HPV) infection has emerged as a notable risk factor, with p16 being a surrogate marker. Tumour-infiltrating lymphocytes (TILs), including regulatory T cells (Tregs) identified by Forkhead box P3 (FOXP3), contribute to immune modulation within the OSCC tumour microenvironment (TME). Objectives: The study aims to identify potential agespecific patterns in p16 expression, TILs, and FOXP3 cells in OSCC, and to examine their associations with clinicopathological and sociodemographic factors across different age groups. Methodology: 78 OSCC cases diagnosed at Universiti Malaya …

A Soft Diet Attenuates Exercise-Induced Increases In Cortical Bone Density And Formation In Long Bones In Growing Mice

Faculty, Staff and Student Publications

Bone and muscle are closely linked through functional interdependence. Training and regular exercise can improve and maintain optimal bone mass and strength. Here, we investigated the effects of exercise combined with soft versus hard diet (pellet) on long bones in mice. Four groups of male C57BL/6J mice (n = 5 per group) were studied: hard diet (pellet) with exercise, soft diet (powdered) with exercise, hard diet (pellet) without exercise, and soft diet (powdered) without exercise. Femur and tibia were analyzed using radiographic, micro-CT, and histomorphometric techniques. Exercise combined with a hard diet significantly increased cortical bone density, mineral apposition rate, …

Temporomandibular Joint Ganglion Cyst Causing Dynamic External Auditory Canal Obstruction And Position-Dependent Hearing Loss: A Case Report And Literature Review

Faculty, Staff and Student Publications

Purpose: Ganglion cysts of the temporomandibular joint (TMJ) are uncommon periarticular lesions and may be diagnostically challenging because symptoms are often nonspecific. When these lesions arise posterior to the joint, they can produce otologic complaints through dynamic narrowing of the external auditory canal (EAC). Herein, we report on a histologically confirmed TMJ ganglion cyst causing position-dependent hearing loss and review the relevant literature.

Case description: A 72-year-old woman presented with a 3-year history of bilateral preauricular pain, left-sided tinnitus, left aural fullness, and near-complete hearing loss in the left ear when the mandible was closed in occlusion. Clinical examination showed …

Dental Hygienists' Views On Salivary Diagnostics, Julie Justice

Dental Hygiene ETDs

This study assessed dental hygienists’ views on salivary diagnostic testing in the United States, including awareness, utilization, perceived barriers, and whether years of experience, clinical setting, or education level influenced these views. A descriptive cross-sectional design was used to collect data via an 18-item email survey distributed through the American Dental Hygienists’ Association’s mailing list. Eligible participants were licensed dental hygienists currently practicing in the United States. The survey included demographic items and Likert-scale questions on knowledge, clinical use, perceived value, and limitations of salivary diagnostic testing. Survey responses were analyzed using descriptive statistics, frequency distributions and Spearman correlations. Despite …

Policy Concerning Student Use Of Magnification Loupes By American Dental Hygiene Schools, Amye M. Burruss

Dental Hygiene ETDs

This descriptive study was to assess whether dental hygiene schools require students to purchase magnification loupes, at what point in the program they implement the use of loupes, and which type of loupes they require students to purchase. A survey link through Microsoft Forms consisting of nineteen multiple-choice questions was emailed to 327 dental hygiene program directors and was open for a total of three weeks. With a response rate of 13% (45 respondents), results indicate that most dental hygiene programs mandate or strongly encourage the use of magnification loupes and allow students to start wearing loupes in the first …

Does Adjunctive Low-Level Laser Therapy Provide Additional Benefit Following Temporomandibular Joint Arthrocentesis With Hyaluronic Acid? A Randomized Clinical Trial, Moataz Bahaa, Abdelrahman Fahmy Dr., Hesham Morsi, Mahmoud Elfaramawy

Dentistry

Purpose This study aimed to evaluate whether adjunctive low-level laser therapy (LLLT) provides additional clinical benefit over an optimized arthrocentesis protocol with hyaluronic acid in patients with ADDwoR. Materials and methods From December 2022 to December 2023, a single-blinded prospective randomized clinical trial was conducted at The British University in Egypt’s Department of Oral and Maxillofacial Surgery. The study involved 40 female participants diagnosed with Anterior Disc Displacement without Reduction (ADDwoR). Following TMJ arthrocentesis, subjects were assigned to one of two parallel cohorts: Group A received ten subsequent sessions of low-level laser therapy (LLLT), while Group B served as the …

Resilience Of Orthodontic Sealants Against Degradation And Microbial Adhesion: A Comparative Study, Michelle X. Cui

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background:

White spot lesions are one of the most common complications encountered during orthodontic treatment. These lesions begin as demineralization of enamel around the appliance due to plaque buildup, resulting in compromised aesthetics. As they continue to develop, white spot lesions progress to cavitation, potentially threatening pulpal vitality, resulting in an increased financial burden for patients. Preventative strategies include patient education, consistent oral hygiene protocols, and the use of fluoride-releasing agents. Orthodontic sealants such as Opal® Seal™ (Ultradent) (OS) and L.E.D. Pro Seal® (Reliance) (PS) have been developed to release and recharge fluoride, thereby reducing the incidence of white spot …

Cortical Bone Density And Thickness Assessment Of Intraradicular Sites In Adolescent Patients Using Cbct Imaging, Sara Endo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The indications for the use of cone beam computed tomography (CBCT) in orthodontics has grown since it was first introduced and dentists are discovering new ways that 3D images enhance diagnosis and treatment planning. Evaluating bone quality and quantity can be measured as bone density and thickness in CBCT imaging and is helpful for temporary anchorage device (TAD) placement in orthodontic treatment. TADs rely on primary stability and are commonly used in orthodontic treatment to increase anchorage and expand the limit that nonsurgical orthodontics can provide.

Objectives: This study aims to assess the bone thickness and density at different …

Correlation Of Buccolingual Angulation Of Posterior Teeth And Transverse Skeletal Width In Adult Orthodontic Patients: A Retrospective Cbct Study, Anya T. Hatfield

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective:

Accurate evaluation of transverse skeletal relationships is essential for orthodontic diagnosis and treatment planning. Dentition may compensate for skeletal discrepancies through buccolingual tipping of posterior teeth, potentially masking underlying transverse imbalance. The purpose of this study was to investigate the relationship between transverse skeletal width and posterior tooth angulation using cone-beam computed tomography (CBCT).

Methods:

Sixty-six pre-orthodontic adult CBCT scans were analyzed. Maxillary and mandibular transverse skeletal widths were measured at the level of the first molar furcation using buccal cortical plate– to–buccal cortical plate landmarks. Buccolingual angulation of the first and second premolars and first and second molars …

Correlation Between Maxillary Transverse Width, Alveolar Housing Width And Palatal Bone Thickness: A Cbct Retrospective Study, Eric G. Hollensbe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background:

Accurate assessment of transverse maxillary dimensions and surrounding bone morphology is critical for safe orthodontic treatment planning. Orthodontic expansion should remain within the biological limits of the alveolar housing and palatal bone to prevent adverse periodontal outcomes, including dehiscence, fenestration, and gingival recession. Standard diagnostic methods, such as dental casts and two-dimensional radiographs, offer limited information about the three-dimensional anatomy that restricts orthodontic tooth movement. Cone-beam computed tomography (CBCT) provides detailed evaluation of skeletal dimensions and cortical bone boundaries. This study aimed to examine the relationships among maxillary transverse width, alveolar housing thickness, and palatal thickness using CBCT imaging. …

A Comparison Of Changes In Vertical Cephalometric Measurements In Patients Treated With Invisalign And Traditional Fixed Orthodontic Appliances: A Retrospective Study, Shayna Mesko

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Since their introduction into the field, clear aligners have significantly grown in popularity in orthodontics as they offer enhanced esthetics, improved oral hygiene, and patient comfort. Clear aligners have allowed clinicians to simulate treatment outcomes, streamline treatment with reduced office visits, control force and movement per tray, and provide more precise control of focal tooth movements. This can enhance efficiency in achieving specific and very finite orthodontic goals. Since their inception, clear aligners have evolved from only accomplishing simple tooth movements to achieving more complex and comprehensive mechanics. While they have significantly advanced, there are still limitations in efficacy …

Correlation Between Maxillary Sinus Volume And Maxillomandibular Size, Position, And Dental Occlusion: A Cbct Retrospective Study, Philip Villanueva Punzalan

UNLV Theses, Dissertations, Professional Papers, and Capstones

This investigation used cone beam computed tomography (CBCT) based three dimensional imaging to evaluate correlations between maxillary sinus volume and maxillomandibular skeletal size, position, and dental occlusion in an adult orthodontic population. A retrospective sample of 107 pretreatment CBCT scans (40 males and 67 females), aged 18–59 years, was analyzed. Right and left maxillary sinuses were segmented independently using semi-automatic volumetric segmentation in ITK-SNAP software, and total sinus volume was calculated in cubic millimeters (mm³). Linear and angular skeletal measurements of the maxilla and mandible were obtained using Anatomage TxSTUDIOViewer application software. Patients were categorized according to anteroposterior (A-P) skeletal …