Association between residual teeth number in later life and incidence of dementia: A systematic review and meta-analysis.

BACKGROUND: It has been suggested that tooth loss in later life might increase dementia incidence. The objective of this analysis is to systematically review the current evidence on the relationship between the number of remaining teeth and dementia occurrence in later life. METHODS: A search of multiple databases of scientific literature was conducted with relevant parameters for articles published up to March 25th, 2017. Multiple cohort studies that reported the incidence of dementia and residual teeth in later life were found with observation periods ranging from 2.4 to 32 years. Random-effects pooled odds ratios (OR) and 95% confidence intervals (CI) were estimated to examine whether high residual tooth number in later life was associated with a decreased risk of dementia. Heterogeneity was measured by I2. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the overall quality of evidence. RESULTS: The literature search initially yielded 419 articles and 11 studies (aged 52 to 75 at study enrollment, n = 28,894) were finally included for analysis. Compared to the low residual teeth number group, the high residual teeth number group was associated with a decreased risk of dementia by approximately 50% (pooled OR = 0.483; 95% CI 0.315 to 0.740; p < 0.001; I2 = 92.421%). The overall quality of evidence, however, was rated as very low. CONCLUSION: Despite limited scientific strength, the current meta-analysis reported that a higher number of residual teeth was associated with having a lower risk of dementia occurrence in later life.

Interprofessional faculty development: integration of oral health into the geriatric diabetes curriculum, from theory to practice.

BACKGROUND: Health care workforce shortages and an increase demand for health care services by an older demographic challenged by oral-systemic conditions are being recognized across health care systems. Demands are placed on health care professionals to render coordinated delivery of services. Management of oral-systemic conditions requires a trained health care workforce to render interprofessional patient-centered and coordinated delivery of health care services. The purpose of this investigation was to evaluate the effectiveness of an interprofessional health care faculty training program. METHODS: A statewide comprehensive type 2 diabetes training program was developed and offered to multidisciplinary health care faculty using innovative educational methods. Video-recorded clinically simulated patient encounters concentrated on the oral-systemic interactions between type 2 diabetes and comorbidities. Post-encounter instructors facilitated debriefing focused on preconceptions, self-assessment, and peer discussions, to develop a joint interprofessional care plan. Furthermore, the health care faculty explored nonhierarchical opportunities to bridge common health care themes and concepts, as well as opportunities to translate information into classroom instruction and patient care. RESULTS: Thirty-six health care faculty from six disciplines completed the pre-research and post-research assessment survey to evaluate attitudes, knowledge, and perceptions following the interprofessional health care faculty training program. Post-training interprofessional team building knowledge improved significantly. The health care faculty post-training attitude scores improved significantly, with heightened awareness of the unique oral-systemic care needs of older adults with type 2 diabetes, supporting an interprofessional team approach to care management. In addition, the health care faculty viewed communication across disciplines as being essential and interprofessional training as being vital to the core curriculum of each discipline. Significant improvement occurred in the perception survey items for team accountability and use of uniform terminology to bridge communication gaps. CONCLUSION: Attitude, knowledge, and perceptions of health care faculty regarding interprofessional team building and the team approach to management of the oral-systemic manifestations of chronic disease in older adults was improved. Uniform language to promote communication across health professionals, care settings, and caregivers/patients, was noted. Interprofessional team building/care planning should be integrated in core curricula.

Accuracy of successive casts for full-arch fixed prostheses.

This clinically simulated study examined the accuracy of full-arch impression materials using successive casts reproduced from single impressions. Materials tested included a polyether polyvinyl siloxane, medium viscosity material, and putty wash. Maxillary full-arch Dentoform models were created with four abutments prepared for complete crowns. Six impressions of each material produced successive first and second generation casts. Individual cast copings were then fabricated and assembled into full-arch fixed dental prostheses. Marginal discrepancies were measured on both the casts and Dentoform. Data analysis suggests insignificant differences between successive casts. However, among second generation casts, clinically similar marginal discrepancies were exhibited. Outcomes demonstrated that second generation casts enabled fabrication and assembly of full-arch restorations that were clinically equivalent to first generation casts obtained.