A retrospective analysis of dental implant survival in HIV patients.

AIM: This 5 years retrospective cohort survival study compared failure rates of dental implants placed in HIV (+) and HIV (-) patients relative to several risk factors. MATERIALS AND METHODS: Between 2006 and 2015, 484 implants placed in HIV (+) patients and 805 implants placed in HIV (-) patients were assessed for survival. The effects of HIV were estimated using propensity weighting. The effects of age, smoking status, diabetes, restoration status, gender, implant type, placement site, hepatitis C status, baseline CD4 count and CD4%, post-placement average CD4%, nadir CD4%, nadir CD4 count and antiviral therapy were analysed. RESULTS: Implants placed in HIV (+) patients and HIV (-) patients had similar failure rates (HR = 1.4, p = 0.34). Increased failure rates were observed in HIV (+) patients with baseline CD4% ≤20 (HR = 2.72, p = 0.04), post-placement CD4% average ≤20% (HR = 2.71, p = 0.04), protease inhibitor administration (HR = 2.74, p = 0.04), smoking (HR = 2.61, p = 0.05) and anterior maxillary placement (HR = 5.82, p < 0.01). Hepatitis C coinfection, viral titre, baseline CD4 count, gender, implant type and restoration type were non-contributory. CONCLUSION: Implants placed in HIV (+) patients had similar survival rates as HIV (-) patients. Failure rates increase significantly when confounding risk factors are present in HIV (+) patients.

Career transition and dental school faculty development program.

Academic dentistry, as a career track, is not attracting sufficient numbers of new recruits to maintain a corps of skilled dental educators. The Faculty Development Program (FDP) at the University of Texas Health Science Center at San Antonio Dental School received federal funds to institute a 7-component program to enhance faculty recruitment and retention and provide training in skills associated with success in academics including:(1) a Teaching Excellence and Academic Skills (TExAS)Fellowship, (2) training in research methodology,evidence-based practice research, and information management, (3) an annual dental hygiene faculty development workshop for dental hygiene faculty, (4) a Teaching Honors Program and Academic Dental Careers Fellowship to cultivate students' interest in educational careers, (5) an Interprofessional Primary Care Rotation,(6) advanced education support toward a master's degree in public health, and (7) a key focus of the entire FDP, an annual Career Transition Workshop to facilitate movement from the practice arena to the educational arm of the profession.The Career Transition Workshop is a cap stone for the FDP; its goal is to build a bridge from practice to academic environment. It will provide guidance for private practice, public health, and military dentists and hygienists considering a career transition into academic dentistry. Topics will be addressed including: academic culture, preparation for the academic environment,academic responsibilities, terms of employment,compensation and benefits, career planning, and job search / interviewing. Instructors for the workshop will include dental school faculty who have transitioned from the practice, military, and public health sectors into dental education.Objectives of the Overall Faculty Development Program:• Provide training in teaching and research skills,career planning, and leadership in order to address faculty shortages in dental schools and under representation of minority faculty.• Provide resident and faculty training in cultural and linguistic competency.• Develop and conduct a collaborative inter professional education project with a Pediatric Medicine department, a nursing school, and other health professions' education programs.• Provide faculty and residents with financial support to pursue a master's degree in public health; and • Provide support and assistance for dental practitioners desiring to explore a transition into the educational environment.

An interprofessional education initiative: Introducing a local anesthesia dental course for nurse practitioner and physician assistant students.

PURPOSE/OBJECTIVE: To assess the impact of local anesthesia (LA) course for physician assistant (PA) and adult gerontology-acute care nurse practitioner (NP) program students on knowledge, attitudes, confidence, and intention to incorporate skills in clinical practice. METHODS: The course was conducted by dental faculty for forty-eight PA and seven NP students and consisted of two lecture hours on anatomy of the oral cavity, anesthesia and pain management, 2 hours of preclinic lab where participants practiced injection technique on mannikins, and a clinical practicum conducted by dental school faculty and residents where students observed dental treatment including administration of LA, and discussed symptom triage by NPs and PAs for patients with dental problems including orofacial pain, initial management including LA, and patient referral to dentists. An online survey was administered to all students before and after the course to assess changes in knowledge, attitudes, confidence, and intention to incorporate LA administration skills into clinical practice and elicit students' perception of program quality. Pre- to post-changes were analyzed by two-tailed t-tests and analysis of variance (ANOVA) with significance at 0.05. RESULTS: The response rate for pre- and post-course assessment was 96.4% and 87.3% respectively. Students' overall scale score for self-assessment of dental knowledge increased significantly from pre- (2.34) to post-assessment (4.19). An increase was seen in students' attitudes regarding management of dental emergencies (t = 2.181; p < 0.05). Furthermore, overall confidence of students related to managing patients with dental problems increased significantly (2.00 to 3.85) after taking the course. CONCLUSION: The LA course was well received by PA and NP students and resulted in increased knowledge and confidence in recognizing common oral health conditions, understanding dental pain management including administration of LA, and making referrals to dentists to optimize patient care.

Outcomes from the Health Resources and Services Administration's Dental Faculty Development Program.

PURPOSE/OBJECTIVES: While the Commission on Dental Accreditation (CODA) requires programs to conduct faculty development, implementation of faculty development activities vary widely. Faculty development programs can enhance teaching, research, and leadership skills needed to transition from clinical practice to teaching. In 2012, the Health Resources and Services Administration (HRSA) funded 6 institutions to plan, develop, and operate programs for training oral healthcare providers who plan to teach in general, pediatric, public health dentistry, or dental hygiene. This performance study examines the results of the dental faculty development programs. METHODS: After the 5-year grant program (2012-2017), we used descriptive analysis to examine annual performance data including trainee demographics, faculty development activities, post-completion intentions, and course development activities. RESULTS: Nearly 300 trainees participated across 6 funded grantees; the majority were female, aged 30-49 years, and non-Hispanic White. For those who completed, 80% intended to teach. Common faculty development activities included community-based training, curriculum enhancements, Web-based training, and interprofessional education methods. Faculty development modalities included faculty seminars, Master's degrees, and mentoring. Pipeline activities, online resources, and continuing education supported dental students and providers moving into academics. CONCLUSIONS: Faculty development better prepares individuals to compete in academic environments and develop faculty. Community-based programs may utilize faculty development to recruit community preceptors and achieve calibration. HRSA investment in faculty development programs builds resources and infrastructure to promote continuing engagement in clinical education, research, and administrative skills. Future research is needed to establish the impact of faculty development initiatives on practice change and patient outcomes.

Should Dental Schools Invest in Training Predoctoral Students for Academic Careers? Two Viewpoints: Viewpoint 1: Dental Schools Should Add Academic Careers Training to Their Predoctoral Curricula to Enhance Faculty Recruitment and Viewpoint 2: Addition of Academic Careers Training for All Predoctoral Students Would Be Inefficient and Ineffective.

This Point/Counterpoint considers whether providing dental students with academic career training and teaching experiences during their predoctoral education would be valuable to recruit dental academicians. While training the next generation of dentists continues to be the primary focus for dental schools, the cultivation and recruitment of dental faculty members from the pool of dental students remain challenges. Viewpoint 1 supports the position that providing dental students with exposure to academic career opportunities has positive value in recruiting new dental faculty. The advantages of academic careers training as a required educational experience in dental schools and as a potential means to recruit dental students into the ranks of faculty are described in this viewpoint. In contrast, Viewpoint 2 contends that such career exposure has limited value and argues that, across the board, allocation of resources to support preparation for academic careers would have a poor cost-benefit return on investment. Adding a requirement for educational experiences for all students would overburden institutions, students, and faculty according to this viewpoint. The authors agree that research is needed to determine how and where to make predoctoral curricular changes that will have maximum impact on academic recruitment.

SCDA task force on a special care dentistry residency.

The Special Care Dentistry Association (SCDA) has acted on a proposal regarding the status of training in the care of patients with special needs. Two phases of action were undertaken. Phase 1: (a) examination of the literature on existing training and curricula in the care of patients with special needs and (b) a survey of existing postdoctoral programs in special needs. Phase 2: establish a group of experts who: (a) submitted to the Commission on Dental Accreditation a request to approve a postdoctoral general dentistry residency program in Special Care Dentistry and (b) created suggested accreditation standards for such postdoctoral programs. This article describes efforts by the SCDA to evaluate: The status of existing training of dental students in the care of patients with special needs. The number and characteristics of postdoctoral general dentistry programs offering formal training in the care of patients with special needs. Whether additional training in the care of patients with special needs is needed for dental students and -dentists. Possible actions by SCDA to impact the numbers of dentists trained each year in the care of patients with -special needs.

Oral care of the patient with liver failure, pretransplant--a retrospective study.

Liver failure patients seeking liver transplant in our teaching hospital undergo dental clearance by our Hospital Dentistry Department. A retrospective analysis of 500 patient dental charts was performed. All patients were evaluated previously by physicians and the medical diagnosis of liver failure for each patient was determined. Patients were examined and a treatment plan was formed consisting of the oral care required prior to dental clearance for liver transplant. An oral care treatment algorithm was constructed that, along with clinical parameters, guided the oral care in the pretransplant period. The oral care necessary to clear the patient for transplant was completed for each patient. Besides computing the average cost of oral care necessary to clear patients, analyses were performed to look for correlations among laboratory tests required before oral surgical procedures.