Gap Analysis of Older Adults With Type 2 Diabetes Receiving Nonsurgical Periodontal Therapy.

OBJECTIVE: Twenty percent of the elderly US population is diagnosed with diabetes. The elderly are at a higher risk of developing serious complications from diabetes. Regular professional dental care may help control blood glucose levels and thereby diabetes complications. Since such potential benefits could play a clinically significant role in diabetes management, our aim was to identify and review relevant evidence among the older population. MATERIALS AND METHODS: Electronic databases were searched for periodontal intervention studies using modified search terms from previous systematic reviews. The final search date was October 31, 2016. RESULTS: Twenty-five publications (22 studies) were included in our final review. They varied in study design, duration, therapeutic interventions, and systemic outcomes measured. No study restricted its participants to seniors, and therefore, a mean age of 55 years or more was used. Fourteen studies showed significant reductions in serum glycated hemoglobin levels, but 8 studies showed nonsignificant changes. CONCLUSION: The evidence suggests a beneficial effect of receiving periodontal care on serum glycated hemoglobin and systemic biomarker levels in older persons with T2DM. Such care would be considered a novel, safe, and acceptable adjunct to current medical management of T2DM in older individuals. The dearth of studies restricted to the elderly represents a gap in knowledge that needs to be addressed in the United States.

Oral and emotional health experience of refugees' in the state of Massachusetts - A mixed methods approach.

OBJECTIVES: In this study, we aimed to explore the oral and emotional health challenges experienced by a sample of refugees in Massachusetts across different stages of resettlement using a mixed methods approach. METHODS: We collaborated with two Federally Qualified Health Centers to identify and recruit participants for either surveys (n = 69) or semi-structured interviews (n = 12). Data collection was conducted in 2018. We performed descriptive statistics using STATA 14, and analyzed the interviews using qualitative methods. RESULTS: Overall, cost and lack of structure were the largest barriers identified for accessing dental care in participants' home and host countries. In the US, participants reported receiving state-provided public health insurance, but still experienced disrupted access to dental care due to coverage limitations. We identified several mental health risk factors that may affect participants' oral health, including trauma, depression, and sleeping problems. Despite these challenges, participants also identified areas of resilience and adaptability in both attitude and actions. CONCLUSIONS: The themes identified in our study suggest that refugees have attitudes, beliefs, and experiences that contribute to their perspectives on oral health care. While some of the reported barriers to access dental care were attitudinal, others were structural. Access to dental care in the US was reported to be structured and available, but with limited coverage issues. This paper underscores the oral and emotional health aspects of refugees for future considerations and planning of appropriate, affordable and cost-effective policies in the global health care systems.

Collaborating and teaching a synchronous, multi-university, virtual course: Health policy and access to dental care.

PURPOSE: In response to COVID-19, dental educators have been tasked with maintaining the quality of education while reducing cost, increasing efficiency, and leveraging technology. METHODS: This collaborative, multisite virtual health policy course used the Staged Self-Directed Learning Model (SSDL) to lead a diverse group of students studying health policy. Twelve Core sessions were offered with three additional sessions in August or December for a total of 15 total synchronous Zoom sessions that covered policy issues on supply, demand, and need for dental care. RESULTS: Twenty-eight students, seven lead instructors, and two course directors from six schools reported positive feedback on the course format, use of technology and the SSDL model, and breadth of topics presented. Participation by universities in four states with differing health policies stimulated virtual classroom discussions. CONCLUSION: In conclusion, collaborative interinstitutional virtual teaching and learning is cost effective, efficient, and engaging for students. This model has the potential to continue even when institutions are no longer affected by COVID-19.