Case Report The Case for Improved Interprofessional Care: Fatal Analgesic Overdose Secondary to Acute Dental Pain during Pregnancy

Prenatal oral health extends beyond the oral cavity, impacting the general well-being of the pregnant patient and her fetus. This case report follows a 19-year-old pregnant female presenting with acute liver failure secondary to acetaminophen overdose for management of dental pain following extensive dental procedures. Through the course of her illness, the patient suffered adverse outcomes including fetal demise, acute kidney injury, spontaneous bacterial peritonitis, and septic shock before eventual death from multiple organ failure. In managing the pregnant patient, healthcare providers, including physicians and dentists, must recognize and optimize the interconnected relationships shared by the health disciplines. An interdisciplinary approach of collaborative and coordinated care, the timing, sequence, and treatment for the pregnant patient can be improved and thereby maximize overall quality of health. Continued efforts toward integrating oral health into general healthcare education through interprofessional education and practice are necessary to enhance the quality of care that will benefit all patients

The Role of Factors Associated With Apoptosis in Assessing Periodontal Disease Status

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141031/1/jper1086-sup-0003.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141031/2/jper1086-sup-0002.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141031/3/jper1086.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141031/4/jper1086-sup-0001.pd

Community-based assessment and intervention for early childhood caries in rural El Salvador.

ObjectiveThe objectives were to assess early childhood caries (ECC) in rural areas of El Salvador and to investigate the changes in caries and mouth pain in the presence of community-based interventions.MethodsThis study was a retrospective analysis of de-identified and anonymous data obtained from baseline and four annual follow-up visits that focused on the preventive oral health intervention and nutrition in a convenience sample of children 0-6 years of age. The decayed, missing and filled teeth (dmft) index for primary teeth was used as the survey tool. Caries was defined as a cavitated lesion. Descriptive statistics were used to describe the prevalence of ECC in the sample in relation to age and dmft score. Linear mixed model analysis of variance (ANOVA) and generalised linear mixed effects models were used to compare the pre-intervention and post-intervention outcomes.ResultsThe prevalence of caries was 58%. Incorporation of a community oral health education and fluoride supplementation programme contributed to significant reductions in caries experience (from 74% to 61%) and mouth pain (from 58% to 39%), in children 3-6 years of age.ConclusionsECC is a common public health problem in rural El Salvador. In an established community-based maternal-child health programme in El Salvador, there appears to be an association between the incorporation of preventive oral health intervention and improvement in children's oral health and quality of life over time

Communityâ based assessment and intervention for early childhood caries in rural El Salvador

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/133584/1/idj12228.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/133584/2/idj12228_am.pd

A systematic review to inform the development of a Canadian caries risk assessment tool for use by primary healthcare providers

BackgroundCaries risk assessment (CRA) tools may assist in identifying children at risk of early childhood caries.AimTo complete a systematic review of CRA and develop a Canadian CRA tool for preschool children for use in non‐dental clinical settings.DesignSystematic searches of relevant databases were conducted. Potential variables were based on strength of associations (odd ratios, relative risk, hazard ratios, etc), frequency of occurrence, and existing CRA tools. Quality of the evidence assessments were performed by at least two review teams through consensus following GRADE.ResultsOverall, 25 publications met the inclusion criteria, all prospective in design. Based on this review, variables to be considered when developing a new CRA tool for use with preschool children are as follows: age, socioeconomic status, family toothbrushing habits, fluoride exposure, infant feeding practices, dietary habits/behaviours, dental home, caries experience, visible plaque, and enamel defects. The environmental scan identified 22 CRA tools suggesting other additional variables to consider including in a CRA tool, including special healthcare needs, enamel defects, and dental attendance.ConclusionsThis review informed the development of a Canadian CRA tool for use by primary healthcare professionals, which may improve access to oral health assessments and increase interprofessional collaboration.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/171003/1/ipd12776_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/171003/2/ipd12776.pd

The role of factors associated with apoptosis in assessing periodontal disease status.

BackgroundLittle is known about the release of apoptotic proteins during periodontal breakdown. This pilot study investigates the presence of factors associated with apoptosis in serum, saliva, and gingival crevicular fluid (GCF) and their association with periodontal disease severity and activity.MethodsGCF, whole saliva, and serum were obtained from 47 adult patients with chronic periodontitis (CP) and 10 healthy controls. Clinical measurements, including probing depth (PD), clinical attachment level (CAL), and radiographs, were used to classify patients into healthy, mild, and moderate/severe CP groups. Enzyme-linked immunosorbent assays were used to measure apoptosis or DNA fragmentation in GCF and active caspase-3, soluble Fas (sFas), and sFas ligand (sFasL) in saliva and serum. Western immunoblotting was used to detect Fas, FasL, sFasL, and caspase-3 expression in GCF.ResultsDNA fragmentation was positively correlated with PD and CAL regardless of patient disease status (P <0.001). sFas and sFasL were present in saliva and serum, but there were no differences between groups. In GCF, the greater odds of detecting Fas, sFasL, and caspase-3 increased with increasing PD and CAL (P <0.05). In addition, sites with inflammation and PD ≥5 mm had significantly greater odds of exhibiting Fas, sFasL, and caspase-3 expression compared with sites without inflammation and PD <5 mm (P <0.05). Caspase-3 was not detected in saliva or serum. At the patient level, only FasL and disease status were significantly correlated (P <0.05).ConclusionFactors associated with apoptosis were detected in GCF in patients with CP