Oral health educators' reflections on teaching 2022 and beyond.

INTRODUCTION: The global pandemic prompted changes in health science education affecting both teaching and learning. This multi-institutional study assesses the near-term implications of these changes on faculty and faculty development. The project goals were to: (1) describe faculty experiences of teaching during the pandemic; (2) identify ways to sustain new pedagogical approaches, (3) describe the types of support faculty members need, and (4) offer recommendations to enhance oral health professions education. METHODS: A mixed-method approach using exploratory sequential design was conducted in two phases collecting qualitative and quantitative data. Focus group participants included didactic, pre-clinical, and clinical faculty in dental school (DMD/DDS), dental hygiene and dental therapy programs, and also faculty members serving in administrative roles in these programs (N = 37). One hundred forty-four faculty participated in the multi-institutional follow-up survey. RESULTS: Focus group and survey results led to 14 recommendations (nine structural and five individual) for oral health profession institutions and educators. CONCLUSION: Oral health profession education faculty were dramatically impacted by the pandemic and new faculty development needs were identified. Traditional faculty development topics and practices may be no longer applicable in the post-COVID-19 environment. Additionally, the pandemic stimulated creative approaches for curriculum design, teaching, and assessment in oral health profession education. Strategies need to be implemented to sustain these innovations.

Oral Health and Behavior Patterns of Women with Eating Disorders-A Clinical Pilot Study.

BACKGROUND: Chronic stomach regurgitation associated with eating disorders (EDs) poses a high risk for tooth erosion. This study investigated oral health conditions, behavioral patterns, and tooth erosion in women with EDs. METHODS: 16 ED and 13 healthy women were enrolled; 14 ED and 10 healthy control subjects completed the study. Subjects completed demographic, medical, oral, and behavioral health history questionnaires. Dental caries status was recorded as Decayed, Missing and Filled Teeth (DMFT)index and the severity of tooth erosion as Basic Erosive Wear Examination (BEWE) scores. Saliva was collected for flow rate, pH, and buffering capacity analysis. RESULTS: The ED group had a lower stimulated saliva flow rate and higher DMFT index but no significant difference in BEWE scores compared to the controls (t-test, significance level 0.05). Five of the fourteen ED subjects exhibited extensive tooth erosion, which may have been exacerbated by their tooth-brushing behavior. CONCLUSIONS: Although some ED subjects showed extensive tooth erosion in this pilot study, the average BEWE score of the ED group was not significantly different from the controls. Extensive tooth erosion in ED may relate to the low stimulated salivary flow. A larger-scale clinical study is necessary to validate these results.

Millennial drinks: acidity, fluoride content, and enamel softening.

This in vitro study aimed to evaluate the acidity and fluoride content of beverages commonly consumed by millennials and the enamel-softening effect of these drinks on tooth enamel. The study included 13 beverages in 4 categories: energy (sports) drink, flavored sparkling water, kombucha, and other (an unsweetened iced tea, a vegetable-fruit juice blend, and a soft drink). The acidity was measured with a pH/ion meter, and the fluoride concentration was measured with a combined fluoride electrode coupled to the meter (n = 10 measurements per beverage). The Vickers hardness number of extracted molars was measured before and after a 30-minute immersion in 4 representative beverages via 2 immersion protocols (n = 10 per beverage per protocol): (1) immersion in the beverage only and (2) immersion alternating between the beverage and artificial saliva every other minute. The pH and fluoride concentrations of the beverages ranged from 2.652 to 4.242 and from 0.0033 to 0.6045 ppm, respectively. One-way analysis of variance (ANOVA) revealed that all differences between beverages in pH values were statistically significant, as were the majority of differences in fluoride concentrations (P < 0.001). The beverages and the 2 immersion methods significantly affected enamel softening (2-way ANOVA, P = 0.0001 to 0.033). The representative energy drink (pH 2.990; 0.0102 ppm fluoride) caused the greatest enamel softening followed by the representative kombucha (pH 2.820; 0.2036 ppm fluoride). The representative flavored sparkling water (pH 4.066; 0.0098 ppm fluoride) caused significantly less enamel softening than the energy drink and kombucha. A root beer (pH 4.185; 0.6045 ppm fluoride) had the least enamel softening effect. All tested beverages were acidic and had a pH below 4.5; only some contained fluoride. Flavored sparkling water, likely due to its higher pH, caused less enamel softening than the tested energy drink and kombucha. The fluoride content of kombucha and root beer lower their enamel-softening effects. It is imperative that consumers be aware of the erosive potential of beverages they consume.

Evaluation of fluoride levels in commercially available tea in the United States.

The objective of this study was to compare fluoride levels in commercially available black tea, green tea, and matcha tea. Tea samples were purchased from a local supermarket in the United States and prepared according to the manufacturer's directions to mimic consumer activity. The selected products included 3 black teas (Bigelow Earl Grey, Twinings of London Lady Grey, and Lipton), 2 green teas (Bigelow and Lipton), and 3 matcha teas (Mighty Leaf, Celestial Seasonings, and Matcha Love). For all products except Mighty Leaf and Matcha Love, 250 mL of deionized water (DIW) was heated to boiling. One tea bag was added and stirred for 2 minutes. For Mighty Leaf matcha, 300 mL of DIW was used, but the sample was otherwise prepared as previously described. Matcha Love was prepared by stirring 0.5 tsp of green tea powder for 2 minutes in 30 mL of DIW heated to boiling. A 10-mL aliquot was taken from each tea group and from DIW alone (control) and combined with 10 mL of total ionic strength adjustment buffer (TISAB II) before it was measured with a combination fluoride electrode and pH/ion meter. The sample size was 5 separately prepared and independently measured tea servings per group. Fluoride concentrations were calculated from a calibration curve constructed from appropriate fluoride standards and then statistically analyzed using analysis of variance followed by the Student-Newman-Keuls post hoc test (α = 0.05). The DIW control group had negligible fluoride content. All tested tea samples contained fluoride in amounts ranging from 0.521 to 6.082 mg/L. The mean concentration differed significantly among brands and types of tea. Matcha green tea powder had the highest concentration of fluoride. Most teas contain a higher fluoride concentration than optimally fluoridated water (0.7 mg/L). Dental healthcare professionals should consider this information when advising caries prevention regimens for patients and determining the potential for dental or skeletal fluorosis in at-risk patients.

Protocol for measurement of enamel loss from brushing with an anti-erosive toothpaste after an acidic episode.

Tooth erosion from an acidic insult may be exacerbated by toothbrushing. The purposes of this study were to develop an in vitro methodology to measure enamel loss after brushing immediately following an acidic episode and to investigate the effect of brushing with an anti-erosive toothpaste. The null hypotheses tested were that tooth erosion after brushing with the toothpaste would not be different from brushing with water and that a 1-hour delay before brushing would not reduce tooth erosion. Forty bovine enamel slabs were embedded, polished, and subjected to baseline profilometry. Specimens were bathed in hydrochloric acid for 10 minutes to simulate stomach acid exposure before post-acid profilometry. Toothbrushing was then simulated with a cross-brushing machine and followed by postbrushing profilometry. Group 1 was brushed with water; group 2 was brushed with a 50:50 toothpaste-water slurry; and groups 3 and 4 were immersed in artificial saliva for 1 hour before brushing with water or the toothpaste slurry, respectively. The depth of enamel loss was analyzed and compared using 1-way analysis of variance and post hoc testing (α = 0.05). Greater enamel loss was measured in groups brushed with toothpaste than in groups brushed with water. One-hour immersion in artificial saliva significantly reduced enamel loss when teeth were brushed with water (group 3; P < 0.05) but not with toothpaste (group 4). This study established a protocol for measuring enamel loss resulting from erosion followed by toothbrush abrasion. The results confirmed the abrasive action of toothpaste on acid-softened enamel.

Neutralizing salivary pH by mouthwashes after an acidic challenge.

AIM: The aim of the present study was to test the neutralizing effect of mouthwashes on salivary pH after an acidic challenge. METHODS: Twelve participants were recruited for three visits, one morning per week. Resting saliva was collected at baseline and after 2-min swishing with 20 mL orange juice as an acidic challenge. Participants then rinsed their mouth for 30 s with 20 mL water (control), an over-the-counter mouthwash (Listerine), or a two-step mouthwash, randomly assigned for each visit. Saliva was collected immediately, 15, and 45 min after rinsing. The pH values of the collected saliva were measured and analyzed with anova, followed by Student-Newman-Keuls post-hoc test (significance level: 0.05). RESULTS: Orange juice significantly lowered salivary pH. Immediately after rinsing, Listerine and water brought pH back to baseline values, with the pH significantly higher in the Listerine group. The two-step mouthwash raised pH significantly higher than Listerine and water, and higher than the baseline value. Salivary pH returned to baseline and was not significantly different among groups at 15 and 45 min post-rinsing. CONCLUSIONS: Mouth rinsing after an acidic challenge increased salivary pH. The tested mouthwashes raised pH higher than water. Mouthwashes with a neutralizing effect can potentially reduce tooth erosion from acid exposure.

Comparing comprehensive care and departmental clinical education models: students' perceptions at the University of Tennessee College of Dentistry.

In summer 2012, the University of Tennessee Health Science Center College of Dentistry transitioned from a departmental clinical education model to a comprehensive care/group leader model. The aim of this study was to investigate the perspectives of the fourth-year class of dental students who, because the transition took place during their training, had experienced treating patients under both educational models. To achieve this objective, a questionnaire was designed to assess the students' opinions on the efficiency of their effort, availability of specialty faculty, stress, collaboration with classmates, and availability of exposure to different practice styles and techniques under the two systems. The students were also given an opportunity to provide open-ended feedback on the shortcomings and advantages of the systems. The Class of 2013 had 81 students, 55 of whom participated in the survey for a response rate of 67.9%. The majority (86%) of the respondents preferred the comprehensive care model and reported feeling that, in it, they were able to accomplish more comprehensive dentistry with greater consistency of supervision from faculty in a more patient-centered environment than in the departmental model. However, 56 percent considered having the same group leader for two years a disadvantage and recommended rotation of at least one group leader every six months. The results of this survey can help this college and other dental schools that are seeking to optimize their educational model to best serve students' educational experience and the dental needs of their patient population.

Technological Innovations in the Restorative Department at the University of Tennessee College of Dentistry.

The UT College of Dentistry has been one of the leaders in the introduction of the CAD/CAM delivery of dentistry to the dental students. The integration of technology into a dental school curriculum requires a change in thinking and a modification of the curriculum in order to introduce it to the present day students This article updates the integration of the CEREC system into the UT Dental School curriculum, discussing the changes in equipment and teaching techniques since the last article in 2012.

Integrating the CEREC technology at UT College of Dentistry.

The computer-aided design/computer-aided manufacturing (CAD/CAM) has evolved during the past 25 years, and this evolution has improved the speed and precision in which dentists can deliver high quality esthetic restorations. CEREC is an acronym for "ceramic reconstruction" and is one of the CAD/CAM systems available to dentists in private practice. The University of Tennessee College of Dentistry was one of the first dental schools in the United States to embrace this technology and integrate it into the four-year curriculum. In a dental school setting, this technology can prove to be an educational tool for the dental students, cost effective for the University and provide exceptional service for the patients.