An innovative approach to assess comprehensive care: Temple University's patient wellness report.

PURPOSE: The transition from a paper-based to an all-electronic patient health record took a major step forward in 2018, with the implementation of an electronic health record that supports the School's patient-centered comprehensive care model and facilitates outcomes assessment. The Patient Wellness Report (PWR) summarizes findings of the patient assessment, and it does so automatically by locating data already entered in axiUm forms. This study aimed to describe the PWR implementation procedures and to examine outcomes and characteristics among patients with completed treatment plans during an 18-month period. METHODS: Outcome data were extracted from axiUm for patients aged ≥16 years who completed comprehensive care treatment plans. Each PWR contained 14 metrics related to "dimensions" of wellness (quality of life, general health factors, oral hygiene, caries risk, and degree of periodontal inflammation and pocketing), each of which is rated on a 3-point scale based on best available scientific evidence. RESULTS: A total of 2074 patients completed planned procedures between July 2018 and January 2020, and met the study eligibility criteria. Improvement of several conditions was observed between baseline and follow-up in caries lesions (21%), blood pressure (9%), and periodontal pocket (3.2%). A majority of patients rated in good condition at baseline had their scores unchanged at follow-up in the following areas: dental anxiety (92%), speaking (88%), smoking (87%), and alcohol consumption (79%). CONCLUSION: Improvements in dental caries and blood pressure metrics were easily monitored using the PWR. In addition, disparities exist in improvement of patient outcomes by race/ethnicity.

Magnification in dental practice and education: experience and attitudes of a dental school faculty.

The routine use of magnification and enhanced lighting by oral health care providers, educators, and students is growing, but there is little consensus regarding its implementation and use. Many students and faculty at the Temple University Kornberg School of Dentistry elect to use some form of magnification in their real and simulated patient care activities, even though the school does not mandate or suggest standards for its utilization. A questionnaire was administered to the clinical faculty to assess two parameters: experience with magnification, and attitudes concerning the value of enhanced vision. Eighty-two out of 124 eligible participants completed the questionnaire successfully for a 66 percent return rate. Sixty-one percent of respondents reported their primary practice or teaching activities as "general dentistry or restorative/prosthodontics." The remainder of the respondents represented a cross-section of other departments and specialists. All endodontists and periodontists who completed the survey and 56 percent of the general/restorative dentists indicated they use magnification. This group accounted for 91 percent of all magnification users. Thirty-nine percent in the magnification users group indicated that they avoid using magnification for some procedures. Faculty magnification users are not in full agreement about the value of enhanced vision in a dental education program. Nearly one-quarter of all magnification users indicated it is unlikely they would use magnification in the teaching environment, even though they may use it in private practice. Various explanations were given for this inconsistency. Only 61 percent of magnification users indicated they make a point to talk to students about the uses and benefits of magnification. While 91 percent of users said that magnification offers significant benefits, only 73 percent believe it should be a program requirement, and 61 percent think it should be required beginning in the first year of the curriculum. The findings of this survey suggest that educational institutions would be wise to address faculty concerns and reasons for resistance before moving to the mandated use of magnification.

Soft tissue management for difficult cervical restorations.

This article offers a rationale for choosing methods of isolation and soft tissue management that will result in the best possible operating conditions for treating cervical dental lesions. A surgical technique used in conjunction with rubber dam isolation is described for those Class V lesions that cannot be managed effectively in a routine manner.