An educational model for special patient care in dentistry.

Dental school graduates often have a basic knowledge in the management of patients with specialized healthcare needs. As of August 2019, CODA amended their accreditation standard 2-25: dental school graduates must be competent in the assessment and management of treatment of patients with specialized healthcare needs and disabilities. While the majority of these patients require modified dental care, many dental schools lack the facilities to provide both the proper care and education. This paper identifies improvements to dental education brought on by the innovations at Penn Dental Medicines' Personalized Care Suite for Persons with Disabilities (PCARE). Patient centered care is the emphasis of the PCARE curriculum. Although the clinic has special rooms and equipment to assist in accommodating the special needs of the patients, the program focuses on teaching dental students how to provide comfortable, safe, and effective care in a typical office setting. Detailed patient assessment, non-pharmacological management techniques, and treatment plans designed to meet the needs and abilities of the patients and caregivers are taught through lecture and direct patient care. Teaching assessment and management of this population is of great importance. Including treatment in Standard 2-25 creates another challenge to dental education. Penn Dental's facility allows multidisciplinary care in a cohesive and timely manner. The experience in PCARE offers unique opportunities to educate dental professionals in developing a patient centered approach in the treatment and maintenance of oral health in those patients who require accommodation.

Hemisection in the Age of Dental Implants: A Case Report.

With their popularity and documented success, dental implants have become a common treatment pathway that has allowed for the restoration of otherwise nonrestorable teeth. While dental implants are largely considered to be a modern marvel for treating prognostically difficult cases, advanced implant placement techniques can come with challenging drawbacks that may lead practitioners to explore other restorative options. Hemisection is a unique alternative to dental implants that practitioners can use to save a case where implants would be contraindicated. The case presented examines one such situation in which the patient was unable to undergo the surgery necessary for implant placement. A hemisection procedure enabled an otherwise hopeless situation to be salvaged and a fixed alternative to be provided. This procedure, while rarely considered, can be a viable treatment option in the clinician's armamentarium for fixed prosthodontic treatment planning in complex cases.

The dentist as the gatekeeper of systemic health: A case report.

Many in the dental field often practice with blinders-they focus on the decay in front of them, the crown that must be prepared, the canal that must be shaped. The series of events that led to that existing issue, the underlying habit, disease, etc. is often overlooked. Many in our profession have gotten into the habit of becoming "tooth mechanics," fixing several issues and ensuring that our patients leave with adequate oral health, rather than addressing the larger, often systemic issues that resulted in the state of their oral health. Although the steps within this large diagnostic process often require the formation of a multidisciplinary healthcare team comprised of different fields in healthcare unique to each patient, this idea is often overlooked. Our case report examines unique and surprising oral health findings that prompted the formation of such a team. Our role as a valued member of the healthcare team should be of paramount importance to our practice, and this case discusses a patient whose health required such. The conversation between physician and dentist is of continued importance and in this case one will be able to identify how systemic health is ultimately preserved and improved in this conversation.

Pretransplantation and posttransplantation considerations in the oral healthcare of a patient with non-Hodgkin B-cell lymphoma: a case report.

Dental practitioners must be comfortable with treating medically compromised patients, including those with cancer. In particular, dental practitioners must be aware of the comorbidities of non-Hodgkin lymphoma in order to treat patients with an appropriate standard of care. This case report describes the oral healthcare of a patient whose recurrent non-Hodgkin lymphoma created a degree of medical complexity that required a unique treatment path. As with many patients with non-Hodgkin lymphoma, the patient's compromised systemic health ultimately contributed to the deterioration of oral health, which in turn perpetuated the deleterious systemic concerns. As a result, both intensive medical and dental interventions were required to salvage the health of the patient. Secondary to the comprehensive medical treatment for managing the patient's cancer, there are several considerations that dentists must consider. This article explores those pretreatment and posttreatment considerations in the context of rehabilitative dentistry.

Insufficient evidence of effect of periodontal treatment on prevention or management of cardiovascular disease.

DATA SOURCES: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, OpenGrey, the Chinese BioMedical Literature Database, the China National Knowledge Infrastructure and the VIP database, the US National Institutes of Health Trials Register, the World Health Organisation (WHO) Clinical Trials Registry Platform and Sciencepaper Online databases were searched with no restrictions on language or date. STUDY SELECTION: Two reviewers independently selected studies and only randomised controlled trials (RCTs) and quasi-RCTs with follow-up times ≥ one year were considered. DATA EXTRACTION AND SYNTHESIS: Data extraction and risk of bias assessment were carried out independently and in duplicate. Standard Cochrane methodological approaches were used. RESULTS: Only one trial involving 303 patients that compared scaling and root andomiz (SRP) with community care was included. It was considered to be at high risk of bias. No data on deaths (all-cause or CVD-related) were reported. There was insufficient evidence to determine the effect of SRP and community care in reducing the risk of CVD recurrence in patients with chronic periodontitis (risk ratio (RR) 0.72; 95% confidence interval (CI) 0.23 to 2.22; very low quality evidence). The effects of SRP compared with community care on high-sensitivity C-reactive protein (hs-CRP) (mean difference (MD) 0.62; -1.45 to 2.69), the number of patients with high hs-CRP (RR 0.77; 95% CI 0.32 to 1.85) and adverse events (RR 9.06; 95% CI 0.49 to 166.82) were also not statistically significant. The study did not assess modifiable cardiovascular risk factors, other blood test results, heart function parameters or revascularisation procedures. CONCLUSIONS: We found very low quality evidence that was insufficient to support or refute whether periodontal therapy can prevent the recurrence of CVD in the long term in patients with chronic periodontitis. No evidence on primary prevention was found.