The role of the dentist in the diagnosis and management of pediatric obstructive sleep apnea.

The objective of this article is to review the role of the dentist in the early diagnosis of pediatric obstructive sleep apnea (OSA) and to provide an in-depth review of the best evidence-based practices available to treat and/or to refer these patients for intervention. MATERIAL AND METHODS: A narrative review was performed using indexed data bases (PubMed, Medline, EMBASE, OVID, Scopus and Cochrane) up to year 2020, and approximately 1000 articles were reviewed. The articles included were those with the best information provided. RESULTS: Detailed review of the literature suggests that the role of the dentist has been redefined owing to their expertise in the orofacial region. Every patient consulting a dental practice is not merely a dental patient; he/she also requires a comprehensive medical review. The role of the dentist is pivotal in pediatric patients once diagnosed with OSA; as the patients grow, growth modification can be achieved, and future management will be easier. Initiating dental treatments during growth can benefit patients two-fold, saving them from malocclusion, and intervening in orofacial structural growth can help to avoid cumbersome treatments, such as CPAP and various surgeries. Proper diagnosis and management of systemic illnesses can prevent compromised quality of life, delays in treatment, morbidity and, in some cases, mortality.

Concordance Between Clinical Practice and Published Evidence: Findings From Virginia Commonwealth University School of Dentistry.

OBJECTIVES: To evaluate the concordance between clinical practice and published evidence by dental faculty and graduating students of the Virginia Commonwealth University School of Dentistry. METHODS: A questionnaire previously developed by the National Dental Practice-Based Research Network with 12 clinical scenarios was administered to VCU faculty and graduating students. Responses were scored as either consistent or inconsistent with published evidence and then analyzed for differences between dental faculty, graduating students, and the national results. RESULTS: There were 43 dental faculty members with at least half-time student contact who responded to the survey. Faculty concordance ranged from 33% to 100%, and general practice faculty had the highest concordance (82%). Eighty-five of the graduating class of 98 responded to the survey, and student concordance ranged from 18% to 92% and averaged 67%. General practice faculty had higher concordance with published evidence than recently graduated dental students. CONCLUSIONS: Graduating students and dental faculty demonstrated higher concordance with evidence-based practice than practitioners in the National Dental Practice-Based Research Network. General practice dental faculty demonstrated adequate concordance, but students demonstrated only a medium-level concordance. Practitioners involved in teaching dental students are better able to keep up with evolving evidence and are better able to demonstrate evidence-based practice.

The Effects of Faculty Calibration on Caries Risk Assessment and Quality Assurance.

Accurate caries risk assessment (CRA) plays a pivotal role in managing the disease of dental caries. The aim of this quality assurance study was to determine if faculty calibration training using a specific set of guidelines in a single session would improve the faculty members' CRA decision making. A calibration seminar was held in December 2014 at the Virginia Commonwealth University School of Dentistry, during which seven completed CRA forms for simulated patients were used to test 55 faculty members' risk assignment level before and after an instructional lecture was given. The results showed a statistically significant increase in the proportion of faculty members responding correctly for five of the seven cases on the pre- and posttests (p<0.01). One case showed no significant increase in correct responses (p=0.07), and on the seventh case, which presented low caries risk, there was a significant decrease in the percentage responding correctly (p<0.0001) due to an increase in the proportion overestimating caries risk. This study's findings were consistent with those in previous studies that, without calibration, faculty members are not necessarily accurate at CRA diagnosis. Since the calibration training improved these faculty members' caries risk assessment scoring, future studies should extend to evaluations for both faculty and students.