JDR Clinical & Translational Research最新文献

The COVID-19 pandemic enhanced the known importance of good interprofessional communication and cooperation to ensure proper patient care. In dentistry, there is often no proper integration across teaching, research, and care. There is too little communication and cooperation among the members of the dental team and the health care team in general. There is a critical need to improve coordination and cooperation among dental professionals and with medical professionals in general. Health in all policies should include addressing interprofessional medical and dental care at all stages of professional human resource training and service planning. Dentists should play a leadership role since they are frontline professionals in the prevention, early detection, and treatment of oral and systemic diseases.Knowledge Transfer Statement:Postgraduate dental training programs can use the recommendations from this article to improve clinical teaching and ensure the education and competency of dental residents.

Introduction: Obesity is associated with increased periodontal disease prevalence and incidence. This retrospective cohort study examined whether body mass index (BMI) is an effect modifier of periodontal treatment outcomes in patients attending an urban dental school clinic.

Methods: Data were extracted from electronic health records of 344 patients at a large urban dental school clinic who had at least 1 tooth with a probing pocket depth (PD) ≥5 mm at baseline and who subsequently received nonsurgical periodontal treatment. BMI was computed from self-reported weight and height and categorized as obese (≥30 kg/m²), overweight (25-29.9 kg/m²), or healthy (18-24.9 kg/m²). The primary treatment outcome of interest was defined as having no teeth with PD ≥5 mm in a quadrant on follow-up after nonsurgical periodontal therapy. That outcome was considered to represent treatment success in this study. Secondary outcomes included changes in mean PD and clinical attachment loss (CAL). Analyses included 879 treated quadrants among 344 patients (185 males, 159 females; mean age 49 ± 12 y at baseline; mean posttreatment follow-up of 6 ± 2 mo). Clinical outcomes in patients who were overweight or obese were compared to healthy-weight patients using generalized linear models for binary or continuous outcomes, accounting for clustering within patients. Covariates were age, gender, tobacco use, history of diabetes, insurance type, and number of baseline sites ≥5 mm.

Results: Obesity was associated with a significantly lower likelihood of successful nonsurgical treatment (odds ratio = 0.47; 95% confidence interval, 0.25-0.88) than healthy weight. Being overweight was not associated with treatment success. Posttreatment reductions in the percentage of sites with pockets ≥5 mm and CAL ≥5 mm were greater in patients with healthy weight as compared to those either overweight or obese. However, posttreatment changes in mean PD and CAL did not differ among the BMI groups.

Conclusions: Obesity adversely modifies the effectiveness of nonsurgical periodontal treatment among dental school clinic patients.Knowledge Transfer Statement:The results of this study may be used by dental providers to better understand and manage periodontal therapy in patients with obesity. Furthermore, patients will be better informed about their therapeutic options and outcome success.

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.