JDR Clinical & Translational Research最新文献

The National Dental Faculty Development Center, funded by the Health Resources and Services Administration, was developed and implemented by faculty at the Eastman Institute for Oral Health and the University of Rochester School of Medicine and Dentistry. Programs like this are critically needed, as many dental faculty positions remain unfilled across the United States. This initiative aims to address these shortages by providing junior faculty at dental schools with a first-of-its-kind center dedicated to preparing them as interprofessional clinical educators in today's evolving dental education landscape.Knowledge Transfer Statement:The recommendations from this article can be used by dental school leadership to improve junior faculty mentoring and increase dental faculty retention at their school.

Background: This rapid review assessed evidence to inform policy on the clinical effectiveness and optimal frequency of dental scaling and polishing (S&P) for adults, including those with low incomes eligible for the Canadian Dental Care Plan.

Methods: A rapid review was conducted according to Cochrane Recommendations for Rapid Reviews. Populations included all adults, adults with periodontitis, and those with inequitable access to dental care. Primary outcomes included gingival inflammation, probing depths, and tooth loss. Secondary outcomes included oral health-related quality of life and economic impact. Four databases were searched for randomized clinical trials, systematic reviews, cohort studies, and practice guidelines. Risk of bias was evaluated using Cochrane Risk of Bias, Newcastle-Ottawa, ROBIS, and AGREE II tools. A qualitative synthesis was planned.

Results: In total, 3,181 references were retrieved: 4 applied to "all adults" and 4 to those with periodontitis. All reports had low risk of bias. One systematic review and one multicenter trial of adults with regular dental care found no clinical benefit regardless of S&P interval; however, patients valued and were willing to pay for regular scaling. One claims-based study reported regular S&P reduced tooth loss, and 2 clinical practice guidelines found a reduced risk of future attachment and tooth loss, lower overall health care costs for diabetes, and reduced costs for and incidence of acute myocardial infarction in those with regular S&P. There were no studies of underserved populations.

Conclusions: For adults with no or early periodontal disease and regular access to dental care, routine S&P may have little clinical benefit but reduces tooth loss and some health care expenses. In patients with periodontitis, scaling intervals tailored to individual risk profile and periodontal status can maintain health. There is no evidence on the impact of routine S&P on patients with barriers accessing care.Knowledge Transfer Statement:In terms of the benefits of routine scaling and polishing in adults, this rapid review found mixed evidence with a high level of certainty due to minimal risk of bias in the appraised studies for "regular dental attenders" and those with a diagnosis of periodontal diseases. Tailored intervals for dental scaling are beneficial for those diagnosed with periodontitis but may not provide the clinical benefits previously expected for adults at low risk. There is no evidence that dental polishing is effective. No evidence was found to support recommendations about the clinical effectiveness of scaling or the most appropriate recall intervals for scaling for low-income Canadians eligible for dental services under the new Canadian Dental Care Plan.

Introduction: The adolescent diet is high in sugars compared with other age groups. Effective approaches to support sugar reduction by adolescents are needed as part of caries prevention.

Objective: To systematically review peer-reviewed evidence (1990 to 2023) to identify effective behavior change techniques (BCTs) for sugars reduction in adolescents aged 10 to 16 y.

Methods: Nine databases (CINAHL, Cochrane, Dental and Oral Sciences Source, EMBASE, MEDLINE, PubMed, PsycINFO, Scopus, and Web of Science) were searched. Identified articles were screened independently in duplicate for eligibility. Interventions were eligible if they aimed to change adolescent dietary behavior(s) and reported pre- and postsugar-relevant outcome measures. Interventions from included studies were coded using a 93-item BCT Taxonomy (Michie Taxonomy v1). Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Evidence synthesis by vote counting (number of studies showing positive versus null or negative effects) was applied to BCTs that were present in more than 5 interventions.

Results: Of 16,271 articles identified, 764 were screened in full, yielding 35 studies (in 43 papers), of which 3 were uncodeable. BCTs coded in interventions covered 11 of 16 BCT clusters and 25 of 93 individual BCTs in the BCT taxonomy. The median number of BCTs applied per study was 3 (interquartile range 2-6). Evidence synthesis indicated that the BCTs most positively associated with a positive reduction in sugars were (with the percentage of strong-/moderate-quality studies applying these techniques that successfully reduced sugars intake in brackets) feedback on behavior (100%), information on social and environmental consequences (100%), problem solving (75%), and social comparison (75%).

Conclusion: Notwithstanding limitations in available data, the current evidence most strongly supports the use of BCTs relating to feedback on behavior, providing information on the social and environmental consequences, include problem solving and making social comparisons, to lower sugars intake in adolescents.Knowledge Transfer Statement:The results of this study will enable clinicians to provide more effective dietary advice when supporting dietary behavior change to reduce sugars intake in adolescents. The results may also be used by researchers to guide future directions for research into effective sugars reduction in adolescents.

Objective: Dental caries is associated with immunologic response, yet its association with hematologic parameters and inflammatory markers is unclear. This study aimed to examine the relationship between some surrogate markers of inflammation and dental caries in the context of perinatal exposure to human immunodeficiency virus (HIV).

Methods: This cross-sectional study involved 2 groups of children aged 4 to 11 y who were (1) HIV exposed but uninfected (HEU) and (2) HIV unexposed/uninfected (HUU) and recruited from HIV pediatric and child outpatient clinics, respectively, at a tertiary health facility in Nigeria. Medical records were reviewed, and trained dentists conducted oral and dental examinations. Five milliliters of EDTA blood was obtained and used for CD4 and CD8 and complete blood analysis, from which other inflammatory markers such as the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic inflammatory index (SII), CD4/CD8 ratio were calculated using referenced formulas.

Results: In total, 245 (125 HEU and 120 HUU) children with a mean (standard deviation) age of 7 (2) y were included in this study. No differences in caries experience were observed in both groups of children (38 children [16%] were caries affected; 19 [16%] and 19 [15%] from the HEU and HUU groups, respectively). Examining the relationship between studied inflammatory markers and caries showed that leucocyte counts were slightly lower in caries-affected children compared with their caries-free counterparts (P = 0.05). Lower levels of neutrophils (P = 0.04) and higher levels of lymphocytes (P = 0.02) were associated with caries prevalence. Although not significant, NLR, PLR, and SII were lower in caries-affected children.

Conclusion: Caries is associated with leucocytes and some of its subsets in both groups of children and independent of perinatal HIV exposure, highlighting the potential of evaluating inflammatory markers in caries prevention, treatment, and research.Knowledge Transfer Statement:This study provides evidence that a relationship exists between dental caries, HIV exposure, and inflammation using affordable methods and advocates the inclusion of these markers in caries care in resource-limited settings.

Interdisciplinary education in dentistry has become essential as the profession evolves and patient demographics shift. The primary driving force behind this change is the aging population and the rising prevalence of chronic illnesses, which are due to improved medical treatments and longer life expectancy. This demographic shift necessitates a more comprehensive approach to dental education, integrating knowledge from various medical and health care disciplines. As we look to the future, it is essential to explore the need for enhanced collaboration with other health care professionals, the evolving nature of dentistry, and strategies for implementing interdisciplinary training in dental education.Knowledge Transfer Statement:Interdisciplinary education in dentistry is essential for adapting to evolving patient demographics and equipping dentists with the skills to collaborate effectively with other health care providers, leading to improved patient outcomes and comprehensive care. Despite challenges in implementation, strategies such as integrated curriculum design, faculty development, and collaborative research can facilitate the adoption of this model and prepare dental professionals for holistic, patient-centered care.

A shift toward integrated, interprofessional care models requires intentional action across multiple domains, most notably research, education, and community engagement. This commentary introduces the upcoming JDR CTR supplement titled "Advancing Interprofessional Primary Care through Research, Education, and Community: A Call to Action." The supplement will include detailed information on the topics described in this commentary and highlight current strategies and opportunities to advance oral health integration across education, clinical care, and community-based models. This commentary emphasizes interprofessional education, faculty development, and community engagement as key drivers of systemic change. Integration must move beyond rhetoric to structural implementation, redefining oral health as essential to equitable, person-centered primary care.Knowledge Transfer Statement:This commentary highlights the JDR CTR special supplement (available in July 2025), featuring influential research and expert contributions that advance dentistry interprofessional health care. It is a valuable resource for exploring the progress, challenges, and opportunities at the intersection of research, education, and community practice, all aimed to advance oral health integration and improve equitable access to care.

Objectives: This study evaluated the effectiveness of a health communication workshop recently introduced at the Columbia University College of Dental Medicine (CDM) in enhancing dental students' preparedness and attitude regarding communication training. Effective communication skills are essential for dentists to improve patient understanding, foster trust, and ultimately enhance treatment outcomes.

Methods: The E4 model focuses on managing patient-dentist relationships through patient engagement, empathetic understanding, effective education, and collaborative planning and served as the foundation for the communication workshop. The workshop began in 2020 to 2021 and included a brief online module on interpersonal communication, followed by four 2-h sessions featuring presentations, video analysis, and role-play. We administered a pre- and postworkshop survey to participating third-year DDS students and advanced standing students. We conducted descriptive, McNemar test, and multiple logistic regression analyses to assess changes in students' perceptions, and qualitative analysis of open-ended responses provided deeper insights into the workshop's quality and interpersonal strengths and weaknesses.

Results: Surveys from 73 of 95 third-year DDS and advanced standing respondents were matched after the workshop. The post-workshop survey showed significant improvements in students' perception of how well the CDM curriculum prepared them to be good communicators (20.5% vs 67.1%, P < 0.001) and the adequacy of their communication skills (69.9 vs 87.7%, P = 0.04). Approximately 88% of students (n = 64) reported that the E4 model helped them improve their communication skills, with around 85% (n = 62) stating that they acquired new skills. Qualitative analysis identified common communication strengths, such as active listening and rapport building, and weaknesses, such as difficulty in concise communication and confidence issues.

Conclusions: The health communication workshop at CDM effectively enhanced dental students' self-perceived communication skills and preparedness for communicating with patients. Student feedback provided valuable insights for refining the workshop.Knowledge Transfer Statement:The recommendations from this article can be used by dental training programs to enhance communication training within clinical teaching, ensuring that dental students develop strong communication skills and achieve educational competency.

The insufficient number of dental faculty teaching general dentistry, pediatric dentistry, and public health dentistry increases the pressure on current faculty to increase their teaching responsibilities, competing with other opportunities of faculty development. The Health Resources and Services Administration (HRSA) strengthens the primary care workforce by supporting the academic career development of faculty. This issue describes the innovative work done by dental faculty supported by HRSA programs and demonstrates the importance of investing in long-term faculty career development.Knowledge Transfer Statement:The recommendations from this article can be used by dental training programs to develop a resilient and effective academic workforce and improve the teaching of general dentistry, pediatric dentistry, and public health dentistry.

Introduction: Xerostomia is a subjective sensation of dry mouth affecting millions of people worldwide. Current management has limitations, often causing side effects. This study aims to investigate whether electrical stimulation of the lingual nerve could offer effective relief for xerostomia sufferers.

Methods: Eligible participants were randomly assigned (1:1) to either the experimental or sham group, receiving electrical stimulation of the lingual nerve (n = 24) or sham stimulation (n = 23) for 12 wk. The primary outcome is the changes in xerostomia score using a 100-mm visual analog scale throughout the therapy. Participants assessed their dryness and assigned corresponding scores, with lower scores indicating more severe dry mouth. Secondary outcomes included remission rate in dry mouth frequency, changes in stimulated/unstimulated salivary flow rate (SSFR/USFR), and changes in Oral Health Impact Profile-14 (OHIP-14) questionnaire scores, where higher scores indicate greater impact on oral quality of life.

Results: At week 12, the electrical stimulation group showed greater improvement in xerostomia score compared to the sham group, with a mean between-group difference of 13.8 (95% confidence interval [CI], 10.0-17.6). The therapeutic effect of electrical stimulation was also confirmed by secondary outcomes. The remission rate of dry mouth was higher at 12 wk in the electrical stimulation group (61.9% [95% CI, 40.9%-79.3%] vs. 28.6% [95% CI, 13.8%-50.0%]). Participants in the electrical stimulation group also experienced a greater increase in USFR, with a mean difference of 14.5 (6.1-23.0) μL/min. Moreover, they exhibited significant improvement in OHIP-14 score after 12 wk of therapy, with a mean between-group difference of -10.0 (-13.9 to -6.2). No significant difference was observed between the 2 groups for SSFR (P = 0.702).

Conclusions: Electric stimulation offers promise as a noninvasive, nonpharmacological strategy for the management of xerostomia. Further research is needed to understand its long-term effectiveness, optimal parameters, and underlying mechanisms.Knowledge Transfer Statement:The study confirmed that electrical stimulation of the lingual nerve is a promising noninvasive and nonpharmacological modality for relief of xerostomia.

Introduction: The effects of racism, oppression, and colonization in Australia are reflected in the inequitable experience of chronic kidney disease (CKD) among Aboriginal and Torres Strait Islander peoples. Despite having the highest incidence of CKD, Aboriginal and Torres Strait Islander people have the lowest rate of kidney transplant, with poor oral health commonly being an obstacle to receiving a transplant. This research reflects the exploratory phase of a larger project aimed at maximizing oral health outcomes for Aboriginal and Torres Strait Islander people living with CKD in Australia through the provision of culturally secure dental care.

Methods: The present research uses reflexive thematic analysis to analyze qualitative data from yarns, interviews, and focus groups with dental, renal, and Aboriginal and Torres Strait Islander stakeholders to generate a conceptual understanding of equity at the nexus of oral health and kidney health. NVivo software was used for organizing data and an inductive line-by-line coding approach.

Results: Twenty-eight stakeholders participated; 12 of the stakeholders identified as Aboriginal and/or Torres Strait Islander, and most were female. Factors at the nexus of oral health and CKD included the continuous effects of colonization, the centrality of cultural security for improved care, as well as several challenges and opportunities at a system level. Challenges included the luxury of oral health access, limited health care team involvement in oral health pathways, high-intensity engagement with medical systems, and no communication between dental and renal teams. Opportunities identified included the role of integrated care, cross-discipline knowledge sharing, Aboriginal and Torres Strait Islander leadership, clear referral pathways, prevention, and assistance with navigating the oral health system.

Conclusion: We argue that collective responsibility for the oral health of Aboriginal and Torres Strait Islander people living with CKD is required for improved health and eligibility for kidney transplant. Cross-discipline collaboration is required to overcome the rigidness of the current colonial and biomedical model that silos oral health and CKD.Knowledge Transfer Statement:The siloed approach to management of oral health for Aboriginal and Torres Strait Islander peoples with chronic kidney disease results in low knowledge sharing and communication across chronic disease management teams and can prevent kidney transplantation. Collective responsibility for oral health within this context is required to ensure that just and equitable access to kidney transplant can be achieved.