Nationwide 2.5-Year School-Based Public Health Intervention Program Designed to Reduce the Incidence of Caries in Children of Grenada.

UNLABELLED: This paper describes an innovative public health intervention, called 'Smile Grenada', targeting the oral health of children in Grenada utilizing the resources of a US dental school, several oral health care companies, local governmental and public health authorities, and Grenadian school personnel. METHODS: Preintervention visual/tactile caries examinations were collected from 1,092 schoolchildren (mean age 9.9 years, standard deviation, SD = 3.7) in 2010. The intervention included: (1) classroom-based toothbrushing with fluoridated toothpaste, (2) fluoride varnish applied by trained dental students, teachers and local providers 3 times a year and (3) glass ionomer sealants placed on first permanent molars in children aged 6-8 years. Postintervention data were collected in May, 2013 (n = 2,301, mean age 9.8 years, SD = 3.7). Decayed and demineralized surfaces were examined for the whole sample and decay/demineralization and sealant retention on 6-year molars were examined separately (ages 6-8 in 2013 cohort). RESULTS: The number of decayed/demineralized surfaces declined across all age groups. The average number of decayed surfaces dropped from 9 at baseline to just over 6 (F1, 3,393 = 69.8, p < 0.0001) and the average number of demineralized surfaces dropped from 6 to less than 2 (1.8 surfaces; F1, 3,393 = 819.0, p < 0.0001). For children aged 6-8 years, there were statistically significantly fewer decayed surfaces (t1, 2,086 = 12.40, p < 0.0001; mean baseline 0.93, SD = 1.75; mean follow-up 0.23, SD = 0.83) and demineralized surfaces (t1, 2,086 = 19.7, p < 0.0001; mean baseline 2.11, SD = 2.74; mean follow-up 0.50, SD = 0.97) on 6-year molars. The Smile Grenada program successfully demonstrated a locally sustainable model for improving oral health in children in a developing country.

Interdental Papilla Length and the Perception of Aesthetics in Asymmetric Situations.

The purpose of the study was to determine if there was a difference in the perception of aesthetics, by dental specialty, using computer assisted asymmetric alteration of the papilla length in the aesthetic zone with an apical alteration of the contact point of the clinical crowns. Standardized photographs were presented to sixty-five randomly selected dentists from New York University College of Dentistry on a computer screen for evaluation. Then, the dental professionals were asked to rate the smile in each picture. Control and experiment photographs were used. Data was analyzed using the statistical package SPSS version 21 and one-way ANOVA. The perception of esthetics depends on the dental professional specialty; results provide evidence that asymmetric deficiency in papilla length of 2 mm or more is perceived as "unattractive" by the dental specialists.

Dental implant placement by predoctoral dental students: a pilot program.

Dental implant education is increasingly becoming part of predoctoral dental curricula. New York University College of Dentistry has developed a pilot dental implant program that trains students in implant restorations for single-tooth restorations and mandibular overdentures. Fourth-year students have the option of applying for an implant honors program, which can include surgically placing posterior implants. Eight students were selected for the implant honors program for the 2010-11 academic year. Seven of the eight students fulfilled the didactic and simulation requirements, performing forty-seven surgeries and placing fifty-two implants. Surgical protocol events were recorded: three implants did not achieve 35 Ncm torque at placement, and ten implants required a change in direction following the initial 8 mm pilot drill. All direction changes were successfully performed and resulted in implant placements. This pilot program suggests that predoctoral dental students can be trained to successfully place posterior implants, which are becoming the standard of care.

Playground injury prevention.

Playground safety recently has received increasing attention from parents and municipalities. Orthopaedic surgeons treat a large number of the more than 350,000 injuries per year sustained on the play areas of this country's school, home, and community play areas. A parent brings a child to the playground for fun, healthy exercise, and imaginative play. Unfortunately, most parents may not be aware of recommended injury prevention methods. Data from the Consumer Product Safety Commission and other epidemiologic studies document frequency, identify at-risk activities and equipment, give direction for additional research, and guide regulations. It is appropriate for the medical community to lead in this safety effort and to contribute to additional research and advocacy efforts.