Use of a clinical decision support tool for the management of traumatic dental injuries in the primary dentition by novice and expert clinicians.

BACKGROUND/AIM: Studies reveal many dental students and general dentists have inadequate knowledge about treating children who sustain traumatic dental injuries. The aims of this study were to assess dental trauma knowledge among novice clinicians and expert pediatric dentists and determine the effectiveness of a clinical decision support tool (CDST) for the management of trauma scenarios. A secondary purpose was to compare the effects of a print and mobile app format of the CDST. METHODS: A print and mobile app CDST was developed based upon current AAPD and IADT clinical guidelines. Baseline knowledge for dental students (n = 84) and pediatric dentists (n = 60) was assessed using a multiple-choice Pre-test. A Post-test was used to evaluate changes in the knowledge level following the random assignment of participants into 3 groups: Group A (control) had no CDST provided; Group B (print CDST) had access to the print paper pamphlet; and Group C (mobile app CDST) had access to the mobile app on a handheld device for use during the Post-test. Test scores and time required to complete each test were recorded. RESULTS: Pediatric dentists scored significantly higher and required less time on both the Pre-test (P < .001) and Post-test (P < .05) compared to dental students. Dental students and pediatric dentists who had access to the mobile app CDST scored significantly higher (P < .05) in the Post-test compared to the control and the print CDST groups. Post-test time for the dental students in the mobile app group was significantly longer (P < .001) compared to the control and print format. CONCLUSION: Expert pediatric dentists demonstrated greater knowledge of dental trauma compared to novice clinicians. The mobile app clinical decision support tool was a more effective means of improving the diagnosis and management of traumatic dental injuries by both dental students and pediatric dentists than the print CDST.

Exposure to the Dietary Supplement N-Acetyl-L-Cysteine during Pregnancy Reduces Cyclophosphamide Teratogenesis in ICR Mice.

Cyclophosphamide (CP) is a complex multifaceted developmental toxicant, with mechanisms of teratogenesis thought to include production of excessive reactive oxygen species (ROS). N-acetyl-L-cysteine (NAC) is a powerful antioxidant that may decrease the toxicity of certain anticancer drugs, such as doxorubicin and CP. The current study explored the potential of NAC to attenuate CP-induced damage to the conceptus. Mated ICR mice were orally dosed with 150 mg/kg/d NAC, 150 mg/kg/d NAC + 20 mg/kg CP, CP only, or vehicle only. CP was administered by intraperitoneal injection on gestation day (GD) 10, and NAC was given by gavage on gestation days 6-13. Dams were sacrificed on GD 17, and their litters were examined for adverse effects. There were significant reductions in the incidences of digit, limb, and tail defects, as well as anasarca and macroglossia, in fetuses exposed to the combination of NAC and CP, compared to fetuses exposed to CP only. NAC did not increase the incidence of any defects when compared to control. Fetuses exposed to NAC weighed significantly more than the average vehicle control fetus. The data indicate that NAC, a well-tolerated, relatively inexpensive antioxidant, appears to reduce the incidence of specific cyclophosphamide-induced malformations when administered prior to, concurrently with, and after exposure to CP.