A best practices approach to caries management.

UNLABELLED: Caries management by risk assessment represents best practices and is an evidence-based model that focuses on treating and preventing disease at the patient level rather than a surgical/restorative approach at the tooth level. BACKGROUND: Dental caries is a multifactorial, biofilm and pH mediated disease that affects people of all ages and disproportionally affects certain populations at epidemic proportions. Simply restoring cavitated teeth does nothing to resolve the disease. At the heart of the CAMBRA philosophy is identifying the patient's unique risk level for future caries disease. This can be done by completing a caries risk assessment (CRA). Several easy to use CRA questionnaires are available. Once the patient's unique risk level has been determined, preventive and therapeutic interventions, based on the specific risk level, can then be implemented. METHODS: Landmark publications, original research, and systematic reviews are analyzed and reviewed to form the basis for this shift in patient care related to caries disease. CONCLUSIONS: Caries management by risk assessment has emerged as the new paradigm in patient care and represents an evidence-based, best practices approach with the potential for significant advantages over traditional methods.

Anticaries and Antigingivitis Properties of Cannabinoid-Containing Oral Health Products: A Review.

To evaluate the anticaries and antigingivitis properties of cannabinoid-containing oral health products. A systematic research strategy was employed. Specific search terms were used, including "Cannabinoids AND dental caries," "Cannabinoids AND oral health," "Cannabinoids AND dental plaque," "Cannabinoids AND gingivitis AND periodontitis," "Cannabinoids AND S. mutans," "Cannabidiol AND oral health," and "Cannabidiol AND oral biofilm." The search was conducted in PubMed, Cochrane, and EBSCO Host databases. The search yielded a total of 73 articles, out of which 15 articles (20.5%) were relevant to the scope of this systematic review. Among the relevant articles, only eight (10.9%) directly addressed the research question. The findings from these articles suggest that cannabinoids have the potential to reduce the metabolism of cariogenic bacteria, specifically Streptococcus mutans, and decrease the number of bacterial colonies in dental plaque. In vitro studies also demonstrated a significant inhibitory effect of cannabinoids on oral biofilms and create a considerable inhibitory zone of growth when investigated on oral biofilms in vitro. Furthermore, CBD exhibited antibacterial properties against Porphyromonas gingivalis, a primary pathogen associated with periodontal disease. The current review shows insufficient data to conclude on the anticaries and antigingivitis effects of cannabinoids. Despite extensive research on their systemic therapeutic benefits, their oral health impact remains underexplored, lacking clinical trials and primary research.

Perceptions of Incivility Among Dental Hygiene Students and Faculty/Administrators.

Purpose While incivility has been part of higher education for many years, there has been a documented increase as both students and educators have begun to recognize this behavior and its effects on student learning, faculty satisfaction and stress. The purpose of this descriptive study was to investigate the perceptions of incivility among dental hygiene students and faculty/administrators.Methods This study utilized a convenience sample of five dental hygiene programs in California. The Incivility in Higher Education-Revised survey (IHE-R) was adapted to obtain data regarding perceptions of incivility among dental hygiene students and faculty/administrators. The survey required participants to describe incivil encounters and the perceived reasons for and consequences of the incivil behavior. An online survey was used for faculty and a paper survey was administered for dental hygiene students. Data from the open-ended questions were reviewed, summarized, edited for redundancy, and analyzed using categories.Results Of the 196 participants, 81.63% were dental hygiene students (n = 160) and 18.37% were dental hygiene faculty and administrators (n = 36). Data analysis of participant responses related to the primary reason for incivil behavior in dental hygiene education revealed five categories including lack of consequences, personality traits, miscommunication, stress, and lack of professionalism. Upon data analysis of participant responses related to the most significant consequence of incivil behavior in dental hygiene education, five categories emerged including hostile environment, decreased student success, emotional distress, relationship damage, and professional damage.Conclusion Both faculty and students felt there was a lack of consequences for incivil behavior and did not feel adequately equipped to manage these situations when they arose. Dental hygiene institutions and professional organizations need to consider offering advanced training in creating a culture of civility to prevent and address incivil behaviors.

Changing the face and practice of dentistry: a 10-year plan.

Jan. 7 through 9, 2011, the California Dental Association Foundation hosted a symposium on caries management by risk assessment in which a diverse range of stakeholders from across the nation gathered to discuss current and future status of CAMBRA. The consensus of the group was to develop a national strategic plan for CAMBRA implementation which will chart the course to improve the standard in caries disease management within the next decade. This paper represents the initial start of this living document.

A survey of cariology education in U.S. dental hygiene programs: The need for a core curriculum framework.

OBJECTIVE: Dental hygienists play a key role in dental caries prevention and management. As the evidence of dental caries risk, prevention, and management becomes more complex, it is essential that dental hygiene (DH) programs have a strong cariology curriculum. This project aimed to assess current cariology content in U.S. DH programs, how content is taught, and interest in development/implementation of a common/core cariology curriculum framework. METHODS: Directors of 336 U.S. DH programs were invited to participate in a voluntary online survey using Qualtrics. The survey consisted of 41 items including demographics, details about the program's cariology content, and how it was delivered, and items related to a core cariology curriculum. RESULTS: The overall response rate used for analyses was 27.3%. Some findings include: 61.6% stated their program had a defined cariology curriculum, 35.2% did not have an individual cariology course, 61.5% had preclinical hands-on experiences in cariology, 79.7% are teaching management strategies related to salivary gland hypofunction, 68.3% are teaching use of silver diamine fluoride (SDF), and 64.2% felt cariology was adequately being taught. Only 17.7% are teaching the International Caries Detection and Assessment System (ICDAS) system. 87.3% indicated support for developing a core curriculum framework for teaching cariology in DH programs. CONCLUSIONS: This study indicated that, although DH programs reported that cariology concepts are being taught both didactically and clinically, discrepancies between concepts taught and the literature exist. Therefore, there is a need to create a more standardized curriculum framework for all U.S. DH programs.

California dental hygienists' knowledge, attitudes and practices regarding herbal and dietary supplements.

PURPOSE: As more Americans use dietary supplements, the potential for increased adverse effects increases. The purpose of this study was to identify the current knowledge, attitudes and practice behaviors among California dental hygienists regarding herbal and dietary supplements (HDS). METHODS: A stratified random sample of 1,203 registered California hygienists were surveyed. The survey included items about personal characteristics as well as questions regarding knowledge, attitudes and beliefs and practice behavior about HDS. Three primary outcomes were analyzed: dental hygienists' knowledge about HDS, attitudes (confidence) about HDS and behavior practices (communication) regarding HDS. Confirmatory factor analysis was performed. Personal characteristics were assessed in stepwise multiple linear regression analysis for impact on knowledge scores. RESULTS: The response rate was 21% (n=249). Dental hygienists have low levels of knowledge and confidence about HDS, as well as poor communication practices related to HDS. California dental hygienists scored a low mean of 38% on their knowledge of HDS. On the confidence scale (standardized range of 0 to 10 possible), hygienists scored 3.67±2.03. On the communication practices subscales (standardized range of 0 to 10 possible), hygienists scored 4.21±2.99 on general communication practices and 1.25±1.66 on specific communication practices. Dental hygienists who were members of the California Dental Hygienists' Association and attended a continuing education course on HDS within the last year or who personally used HDS scored significantly higher in knowledge, confidence and communication practices than their counter parts. These 3 attributes were identified as significant predicators for higher knowledge about HDS. CONCLUSION: There is a need to improve California dental hygienists' knowledge and involvement in the active management of patients who take HDS. Such actions can be expected to improve oral health outcomes. Focused training on HDS for hygienists should be designed to improve their knowledge and influence practice behaviors.