Collaboration Between Medical Providers and Dental Hygienists in Pediatric Health Care.

UNLABELLED: Basic preventive oral services for children can be provided within the medical home through the collaborative care of medical providers and dental hygienists to expand access for vulnerable populations. BACKGROUND: Because dental caries is a largely preventable disease, it is untenable that it remains the most common chronic disease of childhood. Leveraging the multiple visits children have with medical providers has potential to expand access to early preventive oral services. Developing interprofessional relationships between dental providers, including dental hygienists, and medical providers is a strategic approach to symbiotically expand access to dental care. Alternative care delivery models that provide dental services in the medical home expand access to these services for vulnerable populations. The purpose of this article is to explore 4 innovative care models aimed to expand access to dental care. METHODS: Current activities in Colorado and around the nation are described regarding the provision of basic preventive oral health services (eg, fluoride varnish) by medical providers with referral to a dentist (expanded coordinated care), the colocation of dental hygiene services into the medical home (colocated care), the integration of a dental hygienist into the medical care team (integrated care), and the expansion of the dental home into the community setting through telehealth-enabled teams (virtual dental home). Gaps in evidence regarding the impacts of these models are elucidated. CONCLUSION: Bringing preventive and restorative dental services to the patient both in the medical home and in the community has potential to reduce long-standing barriers to receive these services, improve oral health outcomes of vulnerable patients, and decrease oral health disparities.

Genomic anatomy of the hippocampus.

Availability of genome-scale in situ hybridization data allows systematic analysis of genetic neuroanatomical architecture. Within the hippocampus, electrophysiology and lesion and imaging studies demonstrate functional heterogeneity along the septotemporal axis, although precise underlying circuitry and molecular substrates remain uncharacterized. Application of unbiased statistical component analyses to genome-scale hippocampal gene expression data revealed robust septotemporal molecular heterogeneity, leading to the identification of a large cohort of genes with robust regionalized hippocampal expression. Manual mapping of heterogeneous CA3 pyramidal neuron expression patterns demonstrates an unexpectedly complex molecular parcellation into a relatively coherent set of nine expression domains in the septal/temporal and proximal/distal axes with reciprocal, nonoverlapping boundaries. Unique combinatorial profiles of adhesion molecules within these domains suggest corresponding differential connectivity, which is demonstrated for CA3 projections to the lateral septum using retrograde labeling. This complex, discrete molecular architecture provides a novel paradigm for predicting functional differentiation across the full septotemporal extent of the hippocampus.