Effectiveness of a Preventive Recall Strategy for Children After Dental Rehabilitation with General Anesthesia.

PURPOSE: To test a more frequent preventive recall strategy following full-mouth dental rehabilitation (FMDR) in children with early childhood caries (ECC). METHODS: Patients were randomized into two groups: controls, who were scheduled to return at six-month intervals (6-MR); and the intervention group, who were scheduled to return at three-month intervals (3-MR and 6-MR). At baseline and at each recall, a caries risk assessment (CRA) and dental exam were completed. Analyses followed CONSORT recommendations, resulting in three analyses: intent-to-treat; per-protocol; and an actual recall analysis. RESULTS: Intent-to-treat analysis showed no significant difference in CRA at six months (P>0.7); per-protocol analysis showed borderline significance (P>.08); and actual recall analysis showed a statistically significant difference in CRA at six months (P=.021). For patients with both 3-MR and 6-MR, 44 percent were assessed at a high caries risk level; for patients with only a 6-MR, 72 percent were assessed as a high caries risk level (P=.021). No significant differences were found in caries incidence at six months. CONCLUSIONS: Following full-mouth dental rehabilitation, patients who returned for follow-ups at both three- and six-month intervals had a greater decrease in caries risk level compared to patients seen at six-month follow-up intervals.

Introduction of Prenatal Oral Health into Medical Students' Obstetrics Training.

The aim of this study was to examine the influence of the Prenatal Oral Health Program (pOHP) at the University of North Carolina at Chapel Hill on medical students' oral health-related knowledge, confidence, attitudes, and dental referral practices. Specifically, the study sought to determine these students' ability to screen, counsel, and refer their patients to a dental home and their overall knowledge regarding the safety of dental treatment for pregnant patients. The study used a pre- and post-intervention survey design with intervention and control groups. Third-year medical students enrolled in an obstetrics and gynecology clerkship were surveyed between 2012 and 2014. The questionnaire assessed students' confidence and behaviors related to prenatal oral health counseling, screening, referral to a dental home, and knowledge about treatment safety during pregnancy. Intervention and control groups were determined by clerkship site. The intervention consisted of a 50-minute seminar on prenatal oral health principles, referral guidelines, and clinical systems changes. A total of 53 intervention and 32 control group students participated (57.4% response rate). The two groups were not significantly different at baseline in age, gender, having children, and residency goals. The results showed that the pOHP positively and significantly influenced students in the intervention group on all clinical constructs except their knowledge about treatment safety during pregnancy. Clinically examining a woman's mouth for signs of dental disease resulted in greater likelihood of making referrals by 26.5 times. These findings suggest that implementing prenatal oral health in a multi-method manner can effectively promote interdisciplinary coordinated care, meet interprofessional education accreditation standards, and aid in implementing practice guidelines in medical school curricula.

Implementing a prenatal oral health program through interprofessional collaboration.

Interprofessional collaboration has become a critical component of accreditation standards in dentistry and medicine. This article reports on implementation in an academic setting of a prenatal oral health program (pOHP) that addresses coordinated care, accreditation standards, and new clinical practice guidelines. The pOHP is an educational intervention for third-year medical students, residents, and faculty members to deliver preventive oral health information and referral to a dental home for pregnant women. At the same time, senior dental students and faculty members are introduced to prenatal oral health principles and delivery of comprehensive oral health care to pregnant women. A systems-based approach was used to guide the pOHP implementation during the 2012-13 academic year. Participants were 96 third-year medical students (50% of the total in an obstetrics and gynecology clerkship) and all 81 fourth-year dental students. During that academic year, 126 dental referrals were made to the School of Dentistry, and 55 women presented for care, resulting in 50% (n=40) of dental students participating in the clinical experience and delivery of simple to complex oral health procedures. The prenatal period is a frequently missed opportunity to address oral health care. The pOHP is an interprofessional collaboration model designed to educate dental and medical providers and provide a system of referral for comprehensive clinical care of pregnant patients, including educating women about their oral health and that of their children. Such programs can help meet interprofessional accreditation standards and encourage implementation of practice guidelines.