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Abstracts from the Special Care Dentistry 21st Annual Meeting can be accessed in the electronic version of this issue at interscience.wiley.com

Identifieur interne : 003E00 ( Istex/Corpus ); précédent : 003D99; suivant : 003E01

Abstracts from the Special Care Dentistry 21st Annual Meeting can be accessed in the electronic version of this issue at interscience.wiley.com

Auteurs :

Source :

RBID : ISTEX:7D50ECF454C418FA8BAEEDBC5A1873DDFE5E21D2

English descriptors

Abstract

SESSION ABSTRACTS

Url:
DOI: 10.1111/j.1754-4505.2009.00100.x

Links to Exploration step

ISTEX:7D50ECF454C418FA8BAEEDBC5A1873DDFE5E21D2

Le document en format XML

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<abstract>Ray Lyons, DDS, FADPD, DABSCD Although dental school teaches students how to treat “well patients” and “well behaved patients,” patient behavior may be the greatest barrier for a practitioner's willingness to treat patients with special needs. This symposium will summarize the art of behavioral support, which is based on scientific principles, and describe “tools” that can be utilized to treat patients with special needs. Attendees will be challenged to examine how we develop fear, learn to cope, and manipulate our environment. Emphasis will include consistency combined with a calm, confident, committed teaching approach that will help develop a supporting and trusting relationship with the patient. Participants will be able to list the traditional behavioral support techniques; define the term “escape extinction” as it applies to behavior, and the use of protective stabilization and medical immobilization in patients with special needs; and discuss how our ability to cope (limit anxiety) reflects a patient's trust in caregivers and the confidence they project.</abstract>
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<abstract>SESSION ABSTRACTS</abstract>
<abstract>Cyril Meyerowitz, DDS, MS</abstract>
<abstract>This keynote address will explore the philosophical basis for providing oral health care to patients with special needs. It will also cover the social, political, and economic landscape of special care, including future trends. Last, it will discuss the clinical and educational context for this important endeavor in oral health.</abstract>
<abstract lang="en">Ray Lyons, DDS, FADPD, DABSCD Although dental school teaches students how to treat “well patients” and “well behaved patients,” patient behavior may be the greatest barrier for a practitioner's willingness to treat patients with special needs. This symposium will summarize the art of behavioral support, which is based on scientific principles, and describe “tools” that can be utilized to treat patients with special needs. Attendees will be challenged to examine how we develop fear, learn to cope, and manipulate our environment. Emphasis will include consistency combined with a calm, confident, committed teaching approach that will help develop a supporting and trusting relationship with the patient. Participants will be able to list the traditional behavioral support techniques; define the term “escape extinction” as it applies to behavior, and the use of protective stabilization and medical immobilization in patients with special needs; and discuss how our ability to cope (limit anxiety) reflects a patient's trust in caregivers and the confidence they project.</abstract>
<abstract lang="en">Roseann Mulligan, DDS, MS, FADPD, DABSCD; Veronica Greene, BA, DDS, MPH; Janet Lent, DDS; Piedad Suarez, DDS; Jaqueline Venturin, DDS; Ana Wannarka, DDS When health care providers understand and demonstrate a geriatric patient's physical, mental, and social issues, they are more likely to influence improvements in their patient's quality of life. This case‐based workshop will focus on how to use information that is overtly and covertly given by patients and caregivers to modify a geriatric patient's dental treatment, or suggest resources, including a health professional or social service referral. The introduction will describe goals and objectives; a series of clinical scenarios will be discussed by attendees in groups of 12, with 6 available facilitators to allow greater engagement among attendees. The cases will consider common medical, physical, social, mental, and oral health factors in the elderly and how they affect dental and quality of life outcomes. This workshop will emphasize the importance of prevention, early recognition of disease and referral, and management of geriatric patients in association with other health and social practitioners. The workshop's goal is to help attendees recognize family, community, and collegial resources as compliments to oral health care. They will also recognize their own role in promoting quality of life outcomes for their geriatric patients that include successful aging and systemic and oral health.</abstract>
<abstract lang="en">Randy E Huffines, DDS, FAAHD, FASGD, DABSCD Our understanding of the caries process has greatly improved during the last few years. Although some of these chemotherapeutics products used to treat caries have been developed based on good science, others are merely a glossy marketing ad. Learn to distinguish between fact and fiction in the use of products containing ACP; CPP‐ACP; fluoride (varnish, gel, rinse, toothpaste, lozenges, and water); bioactive restoratives; calcium carbonate; chlorhexidine (varnish and rinse); bicarbonate; xyli‐tol; sodium calcium phosphosilicate; and herbal products.</abstract>
<abstract lang="en">Diana Belli, DDS Discover the power and use of Microsoft Outlook beyond e‐mailing and scheduling. Bring your personal laptop and learn functions that will simplify your daily activities.</abstract>
<abstract lang="en">Peter B. Lockhart, DDS, FAAHD This lecture will review the reported indications for antibiotic prophylaxis and examine data to support current practices.</abstract>
<abstract lang="en">Joseph A. Giovannitti, Jr., DMD Although many patients with special needs can receive dental treatment without pharmacological intervention, some cannot. For these patients, anesthetic management offers comprehensive quality care in a safe and efficient manner. This presentation will identify barriers to care for patients with special needs; discuss the capabilities and limitations of the drugs and techniques that are available for outpatient anesthetic practice; and detail anesthetic intervention as an adjunct to dental treatment both in private practice and in an institutional setting. A university‐based model representing a regional referral center for patients with special needs will also be presented.</abstract>
<abstract lang="en">Ronald Ettinger, BDS, MDS, DDSc, DABSCD This presentation will review some new products and innovations in prosthodontics, such as impression materials, specifically the stable alginates, the silicone products including the injectable silicones. Various types of flexible dentures will also be reviewed, along with their strengths and weaknesses. Discussion will include new retention systems for removable partial dentures (RPDs); implants that can be designed by CAD/CAM technology; Zirconia and alumina porcelains that are being produced with CAD/CAM technology; and how the various methods of scanning abutments have been developed.</abstract>
<abstract lang="en">Barbara Smith, PhD, RDH, MPH; Sandra Fitzler, RN; Ira Lamster, DDS, MMSc; Robert Henry, DMD, MPH; Gretchen Gibson, DDS, MPH The 2004 American Dental Association (ADA) House of Delegates adopted Resolution 73H requesting the appointment of a 2‐year task force to explore the challenges in providing comprehensible dental care to our aging population. The 2006 House of Delegates unanimously passed Resolution 5H‐2006, which contains 26 strategies that address oral health issues for vulnerable elders. In 2008, three ADA advisory groups addressed the relationship of advocacy, education and research to the oral health needs of the elderly. A member from each of the committees will highlight accomplishments and the progress that has been made within the three arenas: legislative initiatives; educational programs for dental professionals, patients, and caregivers; and research initiatives that are currently being promoted. Discussion will also include perspectives of other professions, like the long‐term care industry, that intersect with dentistry.</abstract>
<abstract lang="en">David Wong, DMD, DMSc Because of initiatives from the National Institute of Dental &c Craniofacial Research (NIDCR) over the past 5 years, saliva is now used for disease detection and monitoring as well as for health surveillance. Several research tools are now available to explore the clinical utilization and potential of saliva, including the development of two diagnostic alphabets: the salivary proteome and transcriptome. Nanotechnology‐based biosensors are also being developed to capture and optimize multiplex disease‐specific salivary biomarkers for chair‐ or bed‐side multiplex disease biomarker detection. This presentation will discuss how using these tools, the translational application of salivary biomarkers for oral cancer screening and detection, has resulted in the discovery of a panel of salivary biomarkers of proteomic and genomic origins that can identify early stage oral cancer with >90% clinical accuracy.</abstract>
<abstract lang="en">Raymond S. Garrison, DDS, MS; Scott Crews, Director of Operations, American Dental Partners, Inc.; Roger Horton, DDS; Conan C. Davis, DDS, MS This presentation will key the elements needed to ensure profitability. We will examine a practice model that integrates mission‐related care, community practice, and post‐doctoral general dentistry education. Software issues and suggestions will be reviewed as well as Medicaid strategies.</abstract>
<abstract lang="en">Howard E. Strasseler, DMD, FADM, FAGD The latest innovations in dentistry include LED and fluorescence, which make caries diagnosis more reliable. Adhesive restorative materials allow dentists to place posterior composites and achieve predictable anatomic contacts that eliminate postoperative sensitivity. Learn conservative one‐visit treatments with adhesive composites that will restore worn dentition in patients with bruxism or learn how to fabricate a 1‐hour chairside nightguard that equals or surpasses a two‐visit lab nightguard. Find out how to salvage restorations with predictable crown and bridge repair. Use fiber reinforcement ribbons to place a single visit, immediate fixed partial denture or to provide long‐lasting reinforced periodontal splints.</abstract>
<abstract lang="en">William Stewart, DDS, MPH; Paul Goodman, DMD As the population ages, the number of edentulous patients will increase, including patients with special needs. Because restoring the mandible with a complete denture is challenging, implants are invaluable for overcoming retention problems. Most general dentists can place two conventional implants or four small diameter implants in almost all patients with special needs at a reasonable cost. Several treatment options can be tailored to the needs of the special care population, including placing and attaching the implants to the lower denture in one visit or placing implants and later retrofitting them to an existing prosthesis. This hands‐on workshop will review the surgical techniques of implant placement in an edentulous mandible. Attendees will learn prosthetic techniques using models; use of an open tray impression to construct a new overdenture; use the locator and O‐ring attachment systems; and how to retrofit an existing denture with new attachments. They will also learn about maintaining over dentures, including relining techniques and replacement of the components of the attachment system.</abstract>
<abstract lang="en">Michael Reed, DDS, FAGD, FASGD, ABSCD; Alan Stark, DDS, PhD There are no established guidelines of appropriate oral care for the compromised geriatric patient or geriatric patients in long‐term care facilities. The Board and members of the American Society for Geriatric Dentistry (ASGD) are writing Guidelines for Geriatric Dentistry. ASGD will provide practitioners with an evidence‐based, practical guide for managing geriatric patients, including their end‐of‐life care. The ASDG finding will be presented and an open forum format will encourage attendee input and expertise.</abstract>
<abstract lang="en">Sheryl L. Syme, RDH, MS This presentation will discuss the many products available to help with dental care and prevention. Fluoride varnishes can provide a high concentration of fluoride directly to the teeth and calcium phosphate paste can reverse decalcification of teeth and prevent having to restore them. If a restoration is necessary, glass ionomers, such as liners and restorative material, can help prevent secondary decay. Medications that are delivered directly around the tooth can treat and control periodontal disease. When a tooth must be extracted, bone grafting can facilitate the success of future dentures or implants.</abstract>
<abstract lang="en">Peter C. Storandt, Director of Marketing and Program Development; Elliott Peranson, DMD; L. Stanley Brysh, DMD, FAAHD, DABSCD Evaluating residency program applicants can be challenging and understanding what motivates the current generation of graduates can be difficult for a program director when selecting and educating new residents. Developing methods and tools for evaluating residents’ performances can be time consuming. In this symposium, attendees will learn about the priorities and expectations of the current generation of graduates in order to better understand and educate them. Attendees will see how other programs establish expectations for professionalism, ethics, and performance and also learn about evaluations tools used by some programs and medical centers.</abstract>
<abstract lang="en">Maureen Romer, DDS, MPA, FADPD, DABSCD; Robert Levine, DDS; Todd Hartsfield, DDS Part 1 of this workshop will include a 1.5 hour PowerPoint presentation; a discussion of basic laser physics and how lasers work; information about the advantages of dental lasers versus traditional modalities; and a review of useful laser wavelengths for dentistry. Clinical case presentations will be used to demonstrate the proper use of dental lasers; and updates on the newest laser technology. Part 2 will consist of 1.5 hours of hands‐on instruction in the proper use of diode, erbium and CO2 dental lasers, utilizing pig mandibles.</abstract>
<abstract lang="en">Peter Kawamura, DDS, MS, FASCD, DABSCD; Kevin Hendler, DDS, FASGD, DABSCD; Alan Stark, DDS, PhD; Teresa Johnson, DDS, MPH, MS; Janet A. Yellowitz, DMD, MPH, FASGD, DABSCD; Ruth Goldblatt, DMD, FAGD, FASGD, DABSCD; Judith C. Corbin, CNA, RDH, BSDH, FADPD; Paula Friedman, DDS, MSD, MPH; Gretchen Gibson, DDS, MPH. This presentation will highlight several restorative dentistry procedures that may be adapted or modified to address demanding situations that arise with treating patients with special needs. Procedures will illustrate the need for simplifying tasks; organizing space and materials; understanding the properties of restorative materials; and designing and treating patients based on their expected functional outcomes.</abstract>
<abstract lang="en">Mercedes Porosnicu, MD; Katherine M. Greven, MD During the last 5 to 10 years, there have been significant advances in treatment for head and neck cancers. Diagnostic tools, including PET/CT and the use of chemotherapy, are becoming more common. The delivery of radiation therapy is also changing with the addition of Intensity Modulated Radiation Therapy (IMRT). As the medical treatment parameters change, dentists need to be aware of these advances and how they will impact their pretreatment recommendations for patients.</abstract>
<abstract lang="en">Paul Glassman, DDS, MA, MBA; Michael Helgeson, DDS; Susan McLearan, RDH, RDHAP This panel will describe how teledentistry technology can foster collaborative care systems involving dentists and community‐based oral health professionals. Projects in several states will illustrate how these systems reach special populations who currently lack adequate oral health care. Workforce models have been proposed by the Indian Health Service, the American Dental Association, and the American Dental Hygiene Association, and others are being developed to improve care for underserved populations. In this symposium, models from Minnesota and California will be presented to demonstrate how workforce systems based on distance technology foster relationships between dentists working in dental offices and clinics and dental hygienists and dental assistants working in community settings. By collecting and transmitting digital records (radiographs, photographs, and digital histories and charts), dentists can make a diagnosis and develop a treatment plan. Community‐based systems of care like these described in the panel discussion will be an increasingly important part of the oral health delivery system for people with special needs.</abstract>
<abstract lang="en">Allen Wong, DDS, FAAHD, FACD, FICD, DABSCD; Douglas Young, DDS, MBA, MS; Paul Subar, DDS While access to care for patients with special needs is increasing, diligence in preventive treatment strategies is important to keep the patient with special needs as disease free as possible. Our Special Care Clinic and the Hospital Dentistry Program at the University of the Pacific has adopted the CaMBRA (Caries by Risk Assessment) model into its program. We will review the current philosophy, techniques and recommendations, including new technology in minimally invasive dentistry from a practical standpoint, and discuss barriers and successes of the program. Attendees will learn how to incorporate the CaMBRA model into their practices.</abstract>
<abstract lang="en">Nancy Dougherty, DMD, MPH; Maureen Romer, DDS, MPA; Ruth Goldblatt, DMD Low health literacy has been identified as a public health threat in major health policy reports such as Healthy People 2010. Strong correlations have been established between low literacy, poor education, and poor health in the U.S. and elsewhere. What is “health literacy” and what effect does it have on health care in the U.S., particularly the dental profession's ability to maintain the oral health of patients with special needs? This symposium will provide the basic concepts of health literacy from the perspectives of both the patient and the health care provider. It will also address the health literacy issues of individuals who are culturally different or have little proficiency in English; patients with intellectual disabilities; or geriatric patients. Specific tools and techniques that can raise the health literacy skills of both care providers and patients and also improve health outcomes will be discussed.</abstract>
<abstract lang="en">William Stewart, DDS, MPH; Paul Goodman, DMD When placing dental implants, the absence of bone becomes the dominant feature on how, when and where implants can be placed. Bone grafting techniques increase the areas where implants can be successfully placed. Decision making, however, can be difficult because of the many types of bone grafting materials that are available. This hands‐on course will sort through various materials and techniques and offer suggestions for successful outcomes. Participants will use a variety of peritomes, elevators and specialized extraction forceps to atraumatically extract teeth. A step‐by‐step protocol for socket preservation and ridge augmentation will be provided. Finally, the use of membranes and suturing to obtain wound closure over the graft will be reviewed.</abstract>
<abstract lang="en">Marcia Manter, MA in Communication; Anita Nance, MSW; Karen Wilson; Doreen Eyler, RDH, ECPII Oral Health Kansas and the Kansas Association of Area Agencies on Aging are focusing on improving the oral health care for frail elders who receive services from Home and Community‐based Frail Elders (HCBS/FE). This initiative is a coordinated effort by Area Agencies on Aging in multi‐county regions, which utilizes Medicaid oral health funding for Kansas HCBS/FE participants, which is an effective case management system of Kansas Area Agencies, and county departments on aging. This initiative's goal is to ensure that frail elders maintain optimum oral health and relies on Medicaid funding. Case managers annually assess frail elders’ need for services, including oral health needs. Elders may enroll in oral health services, which are offered at locations convenient for them and/or transportation services to reach services. Elders are matched with oral health services in their county, such as dental hygiene services in areas where frail elders meet (e.g., senior housing). Safety‐net dental clinics provide restorative and denture dental services. Oral health education and skill training are offered to frail elders and caregivers. This presentation will describe the role that area agencies on aging can provide to improve the oral health of frail elders in their communities.</abstract>
<abstract lang="en">Randy F. Huffines, DDS, FAAHD, FASGD, DABSCD Glass ionomers are bioactive and have adhesive properties. These properties make glass ionomer restorative materials, luting cements, liners, and sealants significantly useful for clinicians who treat patients with special needs. Many clinicians, however, incorporate the principles they learned while using resin‐based composites into the techniques they use with glass ionomers—and this is a scenario destined to fail. Attendees will learn how to properly use these unique materials in their restorative and preventive practice based on the latest scientific research.</abstract>
<abstract lang="en">Jason Grinter, DDS The controversy surrounding oral sedation vs. IV sedation or general anesthesia continues to be a hot topic of discussion for dental professionals involved in the care of patients with special needs. Milestone Dental Clinic has been exclusively treating patients with special needs since 1999. This presentation will explore the sedation controversy from the perspective and experience of our clinic. Participants will be encouraged to explore all sides and debate the issue. The presentation will include video, showing patients with a variety of immobilization and sedation options and specific items used for immobilization. Attendees will learn why Milestone Dental Clinic uses the current system of assessing the need for immobilization; what ethical and practical issues should be considered; and what the clinic's argument is for using the least restrictive immobilization. After this presentation, participants will be able to make medical immobilization decisions in their respective clinical settings.</abstract>
<abstract>ORAL PAPER ABSTRACTS</abstract>
<abstract>Sukrita Matta, DDS; Ronald Burakoff, DMD; Renee Peckmazaris, PhD; Dale Chaikin, RN; Alec Thundercloud, MD; Sazeeda Itwaru, MBA</abstract>
<abstract>Lack of access to oral health care for the aging population is a growing concern nationwide. Factors include oral health not being perceived as a component of good systemic health, lack of early oral disease diagnosis, psychological issues, such as dementia or depression, and barriers to care such as transportation and geographic constraints. In 2007, the North Shore Long Island Jewish (NS‐LIJ) health system added a mobile dental unit to its Mobile Health Long Island program. The communities served include marginalized pediatric population and naturally occurring retirement communities (NORC). The Mobile Health Project evaluated factors that resulted in a lack of access to oral health care across Long Island and Queens. A needs assessment was completed for each of the communities using the Kayser Jones Brief Oral Health Status Examination (BOHSE) survey, a quality health indicators tools survey, and pre‐ and post‐visit questionnaires. During the examination, baseline needs and oral health status were analyzed using plaque indexes and decayed, missing, filled teeth (DMFT) scores. Dental services included preventive treatment and selective interventional treatment. The NS‐LIJ health system, local dentists, dental societies, and partner organizations worked with the mobile health program. This presentation will help participants recognize and address outstanding community health needs in their community; identify vulnerable population groups and also those factors that can be modified to improve their access to oral health care; and be able to cohesively use community and private resources in collaboration to improve the health status of these vulnerable populations.</abstract>
<abstract lang="en">Samuel Zwetchkenbaum, DDS, MPH The incidence of cleft palate occurs in approximately 1 in 1,000 live births, due to both genetic and environmental etiologies. For persons born during the last 40 years, surgical techniques have reduced the likelihood that a removable prosthesis, or any prosthodontic intervention beyond the replacement of a lateral incisor with a dental implant, would be required. There is a greater likelihood that older patients with a cleft palate have used a prosthesis, such as an obturator, to improve speech and function. With aging, significant changes in the supporting structures of older patients have created challenges for prosthetic rehabilitation: they may present with significant oral concerns. This paper will review the prosthodontic management of older patients with cleft palate; focus on the use of obturators to improve speech, swallowing, and esthetics; and discuss the availability of improved surgical modalities such as osseointegrated implants and surgical modification of the velopharyngeal complex.</abstract>
<abstract lang="en">Kishore Shetty, DDS, MS, DABSCD, MSNDRCS Human Immunodeficiency Virus (HIV) infection has been associated with oral manifestations. Since the advent of highly active antiretroviral therapy (HAART), people with HIV are living longer and the prevalence of oral lesions has shifted. This study's purpose was to note trends in the prevalence of oral manifestations of HIV and assess variations in the dental care of adults with HIV given the current use of antiretroviral therapy in both the industrialized world and developing nations. A comprehensive review of the English literature was completed on the incidence and prevalence of oral diseases and the types of dental services that provided comprehensive oral care to patients who have been HIV positive since 1980. The study concluded that significant and similar disparities exist in the use of dental health services for both patients with HIV and the general population. With the use of HAART, the incidence of oral mucosal lesions is also being reduced. In this presentation, attendees will learn what effect the existing medical literature has on routine dental care of the adult with HIV; how the dental professional can contribute to the overall health of a patient infected with HIV/AIDS; and how to apply scientific and clinical protocols to provide safe and appropriate dental care for the patient with HIV.</abstract>
<abstract lang="en">Terry Thines, DDS, MS Dentistry has changed more in the last 25 years than in the previous 100 years. Advances in dental materials and techniques have elevated patient expectations and priorities. Advances in health promotion and medical technology have contributed to people living longer. In many cases, however, these advances bring challenges that affect everyday dental practice. This presentation will review the latest issues and recommendations for dental management of the stroke patient. Participants will become familiar with the most recent dental management recommendations and protocols and become aware of potential complications, challenges, and unexpected adverse outcomes.</abstract>
<abstract>POSTER ABSTRACTS</abstract>
<abstract>Samera Ov/hadian, DMD</abstract>
<abstract>Patients who suffer from dementia often become incapable of making their own medical decisions. When an enduring power of attorney or an advanced directive is not available, treating a patient with dementia is challenging for his/her health care providers. This case study evaluates the decision‐making process of the special care dentists who were involved in the care of an elderly patient who had no assigned caregiver. The program will highlight the process of caring for an elderly patient with cognitive impairment and discuss how to meet the needs of a patient with special needs who has no assigned caregiver.</abstract>
<abstract lang="en">Stacy Hebert‐Schoener, DDS The presentation describes a 15‐year‐old Caucasian male with amelogenesis imperfecta who presented to the Dental Clinic at the University of Texas Science Center at Houston (UTHSC) for comprehensive care. The patient complained of pain in the posterior region of his mouth. An intraoral exam showed that all teeth were hypocalcified and the patient was congenitally missing #6 and #11. The patient lacked any other significant pathology; his only other significant medical history was asthma. In this case, enamel damage resulting from the disorder was managed; affected teeth were restored (prosthodontics); and the congenitally missing teeth were replaced using either implants or bridges. Attendees will be able to identify and diagnose signs and symptoms of amelogenesis imperfecta and be able to create a comprehensive treatment plan.</abstract>
<abstract lang="en">Allen Wong, DDS, FAAHD, FACD, FICD, DABSCD A case study will be presented of a teenager with anodontia who required dental care, which resulted in providing the patient with a fixed immediate load implant case. The challenges and the work up for the case will be discussed. A brief overview of anodontia will also be given as well as a description of the diagnosis and workup for the implant treatment plan. The concepts of immediate load will be described and also the surgical and restorative phases for immediate load of both the maxillary and mandibular arch.</abstract>
<abstract lang="en">Folakemi Oredugba, BDS, FWACS, MPH, MSND, RCSEd The oral health condition and treatment needs of individuals who participated in the Special Olympics Special Smiles program in Nigeria were evaluated. There were 1,204 consenting athletes (438 or 36.4% females; 766 or 63.6% males), aged 3–71 years (mean age 15.3 ± 6.3 years) who participated in the oral health screening in eight states of Nigeria from March 2007 to April 2008. Data were obtained and recorded by trained volunteers using the standardized Special Smiles screening form. Oral examinations and evaluations were conducted using the standardized procedures recommended in the Special Olympics Special Smiles Screening Manual provided by Special Olympics International. One thousand fifty‐seven (87.8%) athletes cleaned their mouths once daily; 31 (2.6%) twice daily; and 116 (9.6%) were not sure, while 148 (12.3%) reported having pain in their mouths. Two hundred fifty‐five (21.2%) had untreated caries and the majority, 234 (91.8%), were on molars. Only 4 (0.3%) athletes had filled teeth; 52 (4.3%) had missing teeth; 78 (6.5%) had injuries to their anterior teeth; 16 (1.3%) had fluorosis; and 581 (48.3%) had gingival disease. Four hundred eighty (39.9%) athletes required oral hygiene maintenance; 535 (44.4%) required non‐urgent care; and 189 (15.7%) required urgent care. Our conclusion was that the oral health condition of the athletes in this study was poor; they would benefit from improved preventive and restorative oral health care programs.</abstract>
<abstract lang="en">Mary Hartley; Nancy Murray, President, ARC of Greater Pittsburgh Many people with disabilities and their families, advocates, dental professionals and dental educators throughout Pennsylvania have been working to change the manner in which dental services are provided to people with disabilities. In conjunction with that work, and funded by the Pennsylvania Developmental Disabilities Council and the Federation of Independent School Alumnae (FISA) Foundation, the ACHIEVA organization will presenting information that focuses on solutions for resolving the critical health care access issue. ACHIEVA organized and hosted the Disability, Health Policy Forum on oral health care in 2005. At this event, experts, including Drs. Steven Perlman and Paul Glassman, presented their research and perspectives on the barriers to accessing dental care. In May 2008, ACHIEVA hosted the Strategies to Solutions forum, which included attendees, such as people with disabilities, family members, disability advocates, health insurance executives, dental school administrators, government officials, and private practice dentists. The meeting resulted in the formation of six committees to further develop strategies: Legislative Education; Loan Repayment; Professional Dental Education; Education for Consumers and Families; Levels of Care; and Dental Coordinator Position. Our poster will identify strategies to resolve the barriers for people with disabilities so they can access dental care and also present the process used to develop a plan of action for Pennsylvania.</abstract>
<abstract lang="en">Mandana Ziai, DDS; Abrey Lopez, DDS; Joyce Arevalo, DDS; Jeffrey Flores, DDS The uncooperative patient is defined as someone who is difficult to treat in a regular dental setting due to behavioral and/or psychological impairment. A dentist should be knowledgeable about available treatment modalities to safely and successfully treat these patients. Most uncooperative patients have an intellectual disability cerebral palsy, autism, or a combination of these syndromes. Rancho Los Amigos Dental Clinic specializes in the care and treatment of patients with special needs. The providers at this dental clinic accommodate difficult patients based on their level of cooperation and disability. Treatment modalities include a behavioral technique (tell, show, do); oral sedation; hand restraints/papoose board; nitrous oxide; and IV sedation. If a patient is severely uncooperative or needs extensive dental treatment, comprehensive dental care under general anesthesia may be the treatment of choice. Treatment should include compassion; patience; a team approach; safety; oral hygiene instructions for caregivers; regular recall visits; and knowing when to recommend the next approach of treatment.</abstract>
<abstract lang="en">Patricia Seagriff‐Curtin, DDS; Rosa Martinez‐Rosenberg, DDS; Jessica Levy, General Practice Resident, Westchester Medical Center (Valhalla, New York) Charge Syndrome is a very rare congenital disorder of multiple organ abnormalities, which can be life threatening. CHARGE is an acronym for Coloboma and cranial nerve abnormalities, heart defects, atresia of choanae, retardation of growth and development, genital and urinary abnormalities, and ear abnormalities and hearing loss. Most cases occur randomly, are rarely familial and unrelated to sex, race, nationality, religion, or socioeconomic status, with an incidence of 1 in 10,000 births. Many children are born with feeding, swallowing, and breathing difficulties and they are one of the major problems in CHARGE. Intubation can be very challenging if airway anomalies are not recognized prior to anesthesia. This presentation will review the case of a 21‐year‐old male with CHARGE Syndrome who required general anesthesia for complete dental care. We will also stress the importance of reviewing a particular syndrome thoroughly prior to general anesthesia.</abstract>
<abstract lang="en">Mina Habibian, DMD, MS, PhD; Roseann Mulligan, DDS, MS, FADPD, DABSCD; Laura Elizondo, DDS Homeless people have multiple barriers in accessing and utilizing health care services. It has been suggested that health care providers are reluctant to care for the homeless. While literature has shown that medical students develop negative attitudes towards homeless people, similar studies on dental students have been lacking. This 2‐year study's goal was to understand the attitude of dental students towards homeless people. Two hundred forty‐two dental students (60% male and 40% female) under faculty supervision spent 1 day per week for 7 weeks at the USC + Union Rescue Mission (URM) providing comprehensive dental services to homeless patients. Students completed a validated, structured pre‐ and post‐test survey entitled “Attitudes Towards the Homeless Questionnaire (ATHQ) on the first day and also at the end of their rotation. The questionnaire was designed to reveal the students’ attitudes, personal and societal, related to responsibilities toward the homeless. Dental students also completed an evaluation questionnaire on their views about the specifics of the program at the conclusion of their rotations. Overall, 95% of the students were satisfied by the rotation. Results suggest that dental students’ attitudes toward homeless people improved significantly after 7 days of providing care.</abstract>
<abstract lang="en">Robert Baker, MSc, MSND, MFDS, BDS The goals of this cross‐sectional study were to examine and compare the transverse palatal width dimension; vertical palatal height dimension; visible plaque index; gingival bleeding index; and caries experience of 28 boys with attention deficit disorder with hyperactivity (ADHD) and 23 boys without ADHD. The boys, who attended the Community Dental Service, received a dental examination for caries. Visible dental plaque and gingival bleeding indices were recorded. Dental study casts were made and measured at Level 1 [distal to the primary second molars/second premolars and Level 2 between primary first and second molar/first and second premolars]. There was no statistical difference [P= 0.541 at Level 1 and P= 0.807 at Level 2] in palatal height between the study [ADHD] and control groups. There was no statistical difference [P= 0.978 at Level 1 and P= 0.223 at Level 2] in palatal width between the study [ADHD] and control groups. There was a statistically significant difference in visible plaque index scores [P= 0.001] between the study [ADHD] and control groups. There was no statistical difference of gingival bleeding index scores [P= 0.180] between the study [ADHD] and control groups. There was strong statistical evidence that boys with ADHD had higher DMFT than boys in the control group [P≤ 0.001].</abstract>
<abstract lang="en">Rafaela A. Andrade, DDS, MS; Patricia L. Scabell Evans, DDS, MS; Anne L. Scabell Almeida, DDS; Juliana de Jesus Rodrigues‐Da Silva, DDS; Aurelino M. Lima Guedes, DDS, MS, PhD; Fábio R. Guedes, DDS, MS, PhD; Dennis N. Ranalli, DDS, MDS; Adriana Modesto, DDS, MS, PhD; Eduardo M. Barretto Tinoco, DDS, PhD This cross‐sectional epidemiological survey assessed the prevalence of trauma to the permanent teeth of athletes competing at the 2007 Para‐Pan American games (PARAPAN), which were held in Rio de Janeiro, Brazil. The study was approved by the institutional review board. The examiners participated in standardization and calibration training sessions before the field phase began. Invitations were sent to more than 1,300 participating athletes and 121 athletes were randomly selected (79.2% male; mean age 32.5 + 9.5 years). Fifty‐seven athletes (47.5%) reported previous dental trauma but only 15 athletes had injuries that were directly related to training or competition activities. The most common injury was enamel fracture. The most affected teeth were the maxillary permanent central incisors (N= 19 affected teeth), then maxillary permanent lateral incisors (N= 6). The athletes’ dental trauma was found in the following sports: Track and Field, 51.4; Basketball, 6.2; Soccer, 12.2; Judo, 4.3; Weightlifting, 20.1; Swimming, 11.2; Table Tennis, 8.1; Volleyball, 9.0. We concluded that the prevalence of dental trauma among these athletes was high and recommended that mouthguards be used more often.</abstract>
<abstract lang="en">Jonathan Bradshaw, DDS; Sonia Ali, DDS Amelogenesis imperfecta is a hereditary disorder that affects the formation of enamel in teeth and is caused by a malfunction in the proteins that make up enamel. Its prevalence ranges from 1:700 to 1:14,000, depending on the population. These teeth may be hypoplastic or hypomineralized and are often discolored and sensitive. Patients with this condition often present with social issues due to the appearance of their teeth. Primary teeth are often treated with stainless steel crowns and fully formed succedaneous teeth are often treated with full coverage permanent crowns. In this case, we addressed the social issues of a preteen male with the application of Snap on Smile, which allowed us to successfully enhance this patient's appearance without altering the dentition during his adolescent development.</abstract>
<abstract lang="en">Jeffrey Tanner, DDS; Krystal Benyamein, DDS; Melina Adamain, DDS; Lindsay Pfeffer, DMD For both bisphosphonate‐related osteonecrosis and osteoradionecrosis (ORN), conservative treatment is recommended when dealing with symptomatic, infected teeth. If patients are receiving bisphosphonates, tooth extraction should be avoided at all costs, and root canal treatment should be consider even in root tips. For irradiated patients, ORN will develop following extractions 5%–15% of the time. Hyperbaric oxygen therapy has been shown to improve the odds that ORN would not develop but has not diminished that possibility. Xerostomia may occur in irradiated patients whose salivary glands have been obliterated by radiation. Patients who use bisphosphonates may also have xerostomia that is usually caused by multiple medications. Dental caries can occur in a xerostomic oral cavity. We will discuss three cases where irradiated patients exhibited generalized caries. We will underline the difficulties we faced when endodontically treating carious root tips and emphasize the importance of treatment planning pre‐radiation as well as the need for the lifelong use of fluoride treatment. We will present the treatment challenges, including the difficulty of achieving a proper apical and coronal seal in carious root tips; not being able to use sodium hypochlorite without having a crown on which to place a rubber dam; and the incidence of caries progressing beneath the crestal bone height, making it impossible to restore the coronal portion of the tooth. In these cases, a risk and benefit analysis must be determined before the patient can consent to an extraction.</abstract>
<abstract lang="en">Norma Gutierrez, DDS; Nidal Abo Obied, DDS In April 2008, a 58‐year‐old female living in a nursing home was referred to the on‐site dental clinic because of retained roots in her mandible as well as painful and swollen gingival. Her medical history revealed she had breast cancer with metastatic skeletal bone disease and hypertension. Eight years before in Cuba, the patient underwent a mastectomy followed by radiation therapy. She continued treatment in the United States for metastatic disease and was receiving Taxol chemotherapy weekly plus Zometa intravenously for approximately 1 year (fall 2006‐November 2007). She visited a private dentist in October 2006 and subsequently had extractions in preparation for complete dentures. She received complete maxillary and mandibular dentures in June 2007. In February 2008, she noticed ulceration of the gingiva followed by swelling and purulent discharge. She had been treated with intravenous bisphosphonates to prevent bone resorption and was among the 4–10% of patients who develop osteonecrosis of the jaws as a side effect. This usually results from invasive dental procedures, such as extractions, dental implant placement, periapical surgery, and/or peri‐odontal surgery. With this case report, the presenters will document the course of the patient's pathologic condition. They will also present the therapeutic modalities used to reduce infection and maintain maximum oral comfort for the patient.</abstract>
<abstract lang="en">Jessica De Bord, DDS Sialorrhea is defined as saliva beyond the margin of the lip and is considered pathologic, if it persists past 4 years of age. The etiology can include oral motor dysfunction; neuromuscular dysfunction; poor head control; open mouth posture; malocclusion; and a lack of awareness of saliva. In children with cerebral palsy the incidence is between 10% and 37% and results from oral motor dysfunction, which results in poor swallowing. Sialorrhea can result in negative physical effects; destruction of belongings, including electronic assistive devices; increased demands on caregivers; and detrimental social effects. The severity of sialorrhea is related to the severity of the cerebral palsy and to lower functional skills. Those patients who need management most may least be able to cooperate. Management options for sialorrhea include behavioral management, appliance therapy, anticholinergic medications, botulinum toxin injections, and surgical treatment. Successful treatment can result in improved social interaction; self esteem; an improved condition for the use of electronic assistive devices; improved quality of life for the patient; and eased demands on caregivers. This presentation will help attendees understand the effects of sialorrhea on children and their families as well as familiarize them with available management options.</abstract>
<abstract lang="en">Deborah Jastrebski, CEO of Marketing and Outreach for Practice Without Pressure, Inc.; Jane Miller, Director of Marketing and Outreach for Practice Without Pressure, Inc.; Karen Bashkow, Practice without Pressure Director of Programming Services. Fear often prevents people with disabilities from receiving routine and preventive dental care. Practice Without Pressure (PWP) helps individuals with disabilities receive quality dental care by teaching them, through a systematic person‐centered approach, about the procedures they will face during a dental examination. PWP also allows them to practice those procedures until they have the self‐confidence to successfully complete examinations. Practice Without Pressure gives individuals the tools they need to become successful patients, gives dental professionals an at‐ease patient, and gives parents and support staff the skills they need to support the patient during future dental visits. We will demonstrate how person‐centered training for individuals with disabilities maximizes success for them and for dental professionals. We will also show how training patients, young and old, about dental procedures ensure better short‐ and long‐term health benefits to those patients.</abstract>
<abstract lang="en">Glen Goleburn, DMD, FAGD In 2008, I presented “A Forum on Dental Care for Persons with Disabilities.” The forum's purpose was to identify problems and propose solutions involving dental care for persons with disabilities; and increase awareness among the public and elected officials of the challenges faced by both patients and dentists. This presentation will describe how I organized and presented the meeting; made contacts; addressed costs; found sponsors; arranged publicity; teamed with other interested groups; and arranged post‐meeting activities such as media interviews and follow‐ups with politicians. Participants will develop a list of groups to partner with; identify potential sponsors; and learn how to outline a forum agenda with topics of interest in his/her own community.</abstract>
<abstract lang="en">Susan Proulx, PsyD; Dr. Walter Ngaji‐Okumu, DDS People with disabilities often have difficulty gaining access to quality dental care. These problems include finding an experienced dentist who serves people with disabilities or one who will accept patients’ insurance. Obtaining a timely appointment and ensuring wheelchair access are other issues. In 2005, Elwyn, who has been providing community dental care specifically for people with disabilities since 2002, led a team that studied the oral health needs of Pennsylvanians with disabilities. Currently, the program has two clinics in southeastern Pennsylvania that provide general dentistry for more than 2,800 people with intellectual, physical, autism, and mental disabilities. Elwyn successfully manages practices that meet a diverse range of needs by modifying dental procedures and office management and having clinic staff with extensive experience working with patients who have special needs. This program accepts a full range of patient insurance, including Pennsylvania Medicaid. Elwyn also provides clinical experience for dental students from two area dental schools. Participants will learn about access to care issues for patients with disabilities as well as specific strategies for providing quality care for people with disabilities in a community dental setting.</abstract>
<abstract lang="en">Sheila Stille, DMD, MAGD; Hugh Silk, MD; Robert Baldor, MD Despite recent acknowledgement of oral health as a priority in medical education and improvement in overall health in the United States, there still exists a silent epidemic of oral disease in the poor, minorities, elderly, and those with chronic health conditions. We developed a half‐day required oral health interclerkship for third‐year medical students near the beginning of their clinical training. This project was a collaboration between the dental residency and the Family Medicine department. The learning objectives included understanding dental pathophysiology and common oral diseases; performing an oral examination to determine the need for a referral; appreciating the impact of oral health on overall health; understanding how to diagnose and treat dental emergencies; and appreciating dental prevention and the use of fluoride. The session began with a knowledge pre‐test; a 2‐hour didactic seminar given by dental and medical faculty; and five interactive small group sessions: pediatric and adult examinations; urgent care; preventive care, including fluoride varnish; and access to a resource room. Post‐test results showed a statistically significant improvement in all areas, including caries identification; antibiotic choice; and knowledge of primary dentition. Recommendations included creating a joint dental‐medical interclerkship on oral health to increase physicians’ oral health knowledge and which could be expanded to include other health professionals.</abstract>
<abstract lang="en">Joan Lowbridge, RDH, BS; Nicole Laws, RDH, MS; Lynn Bethel, RDH, MPH Although the majority of oral diseases are preventable, children, especially those with special health care needs, are disproportionately affected by these diseases. Despite the relationship between oral and systemic health, most child health providers do not regularly address oral health. We developed an educational program designed for child health providers and their medical support staff. The goals of our program were to educate child health providers about oral and systemic health issues; motivate them to perform routine oral assessments and apply fluoride varnish; increase access to primary oral disease prevention; and increase coordination between medical and dental homes. After identifying significant barriers for the child health providers (time and lack of self‐efficacy), a comprehensive resource kit was developed, which included a CD‐ROM, clinical reference tools, and a poster that focused on oral disease prevention. This project illustrates the importance of including oral health assessments in routine preventive medical care; coordinating care with medical and dental professionals, and striving for positive, long‐term health outcomes.</abstract>
<abstract lang="en">Alicia Galvan, DDS; Aman Gideon, DMD Currently, the number of end stage liver disease patients who are waiting for a transplant is 16,565 according to the United Network for Organ Sharing (UNOS). Special care dentists who practice in hospitals or special care clinics work closely with physicians and understand the need for dental care before and after transplantation for these patients. Special care dentists, primarily hospital dentists, employ dental treatment plans and protocols based on medical concepts garnered through collaboration with a patient's physicians. Because variations exist in dental patient management of pre‐ and post‐liver transplant patients, which may affect disease sequelae and increase changes of organ rejection, UNOS proposes that official national guidelines be developed for patient treatment. During this presentation, our group will describe our protocol, including medical and dental parameters and decision‐making models for treating pre‐ and post‐liver transplant patients, in order that consensus guidelines may be introduced nationally.</abstract>
<abstract lang="en">Jeffrey Hicks, DDS, DABSCD; Jaime Long, DDS According to the United Network for Organ Sharing (UNOS), there are 82,959 pre‐kidney transplant patients. Special care dentists who practice in hospitals or special care clinics work closely with physicians and understand the need for dental care before and after transplantation for these patients. Special care dentists, primarily hospital dentists, employ dental treatment plans, and protocols based on medical concepts garnered through collaboration with a patient's medical doctors. Because variations exist in dental patient management of pre‐ and post‐kidney transplant patients, which may affect disease sequelae and increase changes of organ rejection, UNOS proposes that official national guidelines be developed for proper patient treatment. During this presentation, our group will describe our protocol, including medical and dental parameters and decision‐making models for treating pre‐ and post‐kidney transplant patients, important guidelines may be introduced nationally.</abstract>
<abstract lang="en">Allen Jahangiri, DDS; Stacey Smith, DDS; Alicia Galvan, DDS, FAAHD The lifespan of patients with HIV/AIDS has increased significantly due to advances in medical treatment. Advanced dental treatments are also becoming viable treatment options beyond emergency and preventive dental care. Our advanced general dentistry clinic performs periodontal treatment, such as bone grafts, sinus upfractures and other procedures, for the placement of dental implants in patients with HIV/AIDS who meet certain medical and dental criteria. During this presentation, we will discuss rationale, risks, and guidelines for using advanced dental treatments in this special patient population.</abstract>
<abstract lang="en">Andrea Patterson, DDS; Stacey Smith, DDS; Alicia Galvan, DDS, FAAHD Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary gland, throat, and lymph nodes in the neck. Treatments may include surgery, radiation therapy, chemotherapy, or a combination of these therapies. Dental examination and treatment of patients prior to any of these procedures are crucial to increasing life expectancy and quality of life, as well as decreasing post‐cancer treatment complications. The goal of this poster is to establish guidelines for dental clearance in patients with head and neck cancers prior to cancer treatment.</abstract>
<abstract lang="en">Andrea Patterson, DDS; Stacey Smith, DDS; Alicia Galvan, DDS, FAAHD According to data accumulated by the American Heart Association in 2005, it is estimated that the annual number of patients requiring heart valve replacement will triple from approximately 290,000 in 2003 to over 850,000 by 2050. In addition, coronary artery bypass grafts (CABG) performed in 2005 numbered approximately 500,000 and percutaneous coronary interventions (PCIs) were performed on more than a million cardiac patients. Special care dentists who practice in hospitals or special care clinics work closely with medicine services and understand how dental care before and after this type of cardiac surgery is prudent. Special care dentists, namely hospital dentists, employ treatment plans and dental treatment protocols based on medical concepts garnered through collaboration with a patient's medical doctors. Variations exist in dental patient management of pre‐ and post‐cardiac surgery patients, which may negatively impact disease sequelae as well as increase chances of bacterial endocarditis and lead to failure of valves, CABGs and PCIs. Given these possibilities, our group proposes the development of official national guidelines. We will describe our protocol, including medical and dental parameters, and decision making models for treating pre‐ and post‐cardiac surgery patients, so that consensus guidelines may be brought to the forefront and spur national discussions.</abstract>
<abstract lang="en">Ashley Matthews, DDS Oral cancer is the sixth most common cancer worldwide and 90% of these cases are specifically oral squamous cell carcinoma (OSCC). The overall five‐year survival rate for OSCC is less than 50% because it is frequently diagnosed in the advanced stages. Current literature reports that in two thirds of patients diagnosed with OSCC, the disease involves regional lymph nodes. Early diagnosis and treatment of OSCC can increase the survival rate to 80% but unfortunately, current screening and diagnostic methods have associated drawbacks and limitations. This poster reviews lab‐on‐a‐chip technology—an innovative and evolving field that uses a sample of saliva to detect pre‐malignant or early lesions and improve a patient's overall prognosis and quality of life.</abstract>
<abstract>LUNCH AND LEARNS</abstract>
<abstract>Thomas Leinbach, DDS</abstract>
<abstract>To be successful, a hospital dental service needs to satisfy customers from diverse backgrounds. Patients want comprehensive, timely dental care, regardless of their ability to pay General practice residency (GPR) trainees want a variety of dental experiences in preparation for private practice. Faculty of the Department of Dentistry want compensation that is competitive with their private sector colleagues. Strategies for satisfying our various constituents have evolved over time. We hope that some of our successful model can be adapted for other dental services. To survive and prosper, dentistry must define its own mission, explain medically necessary dental care to hospital administration, and remain responsive to referrals. Hospital dentistry departments must selectively market their private practice and solve the indigent care access problem in their community. GPR programs can limit their public health care to those patients who have educational value and attract high‐end teaching cases by selectively discounting fees. It is generally accepted that academic dentistry is not as financially rewarding as private practice. We discovered that modest base salaries combined with a significant, achievable yearly incentive payment will retain faculty and serve as a private practice model for house staff.</abstract>
<abstract lang="en">Carol Nguyen, MS, RDH; David Cappelli, DMD, MPH, PhD; Douglas Murphy, PhD; Kathy Voigt Geurink, RDH, MS; Christopher Johnson, RDH, MS Oral and craniofacial conditions in persons with developmental disabilities (DD) contribute to a compromised ability to bite, chew, and swallow foods. These persons are also at greater risk for developing oral diseases and caries. These limitations can lead to poor selections in food, bad nutrition, and compromised oral health care, which affect systemic health and quality of life. This study measured whether the oral disease prevention program, provided by students from the University of Texas Health Science Center at San Antonio, at the Willows Developmental Center, reduced oral disease in persons with DD when compared to a cohort of persons with DD who did not participate in the program. The 3‐year retrospective chart audit was conducted from a convenience sample of ninety residents to measure outcomes of the oral disease prevention program. The educational program offered screening, periodontal therapy, and referral services. Results showed short‐term improvements: less processed food in their diet; decreased decay; and an increased number of these patients found a permanent dental home. The impact of both outcomes and changes to the process of care should be measured in any oral health program, including quality of life variables. This study's approach is beneficial to clinical practitioners who select treatments and monitor outcomes. The approach also helps researchers identify determinants of health and track levels of health risk factors. To promote independence for persons with disabilities, oral health providers should meet the needs of their community by providing care to patients with special needs.</abstract>
<abstract lang="en">June Sadov/sky, DDS, MPH, FASGD Licensed nursing staff often delegate oral health care to nursing assistants or aides who may lack the knowledge or skills to perform oral hygiene. A majority of nurses’ knowledge about oral care is also incorrect. Additionally, detrimental practices and products, such as acidic lemon glycerin swabs and ineffective sponge toothettes are standard practice in nursing homes and hospitals. Problems related to stroke, the third leading cause of death in the United States, can manifest orally, including sensory and motor ability, dysphasia and speech impairment. These problems can interfere with oral care, which in turn can lead to increased periodontitis, pneumonia, and cardiovascular disease. The link between oral health and systemic disease has been documented through several clinical trials: bacteria can travel into the lungs via aspiration of bacteria‐laden saliva. Aspiration pneumonia may result, which is the most common systemic disease in the elderly derived from poor oral health. Studies have also shown a relationship between aspiration pneumonia, periodontal disease, dental caries, and poor oral hygiene. Halatosis and difficulty eating may result in decreased sociability, isolation, poor dietary intake, and malnutrition. The Geriatric Caregiver Oral Health Training Program is an interdisciplinary project at the University of Texas Health Science Center at Houston that educates nursing; dental and dental hygiene students; certified nursing assistants; home health aides; and family caregivers. The program's goal is to improve the oral health of dependent elderly by educating the caregivers.</abstract>
<abstract lang="en">Timothy McVaney, DDS The aging “Boomer” population has arrived at the threshold of geriatric dentistry with the full benefit of topically‐ to community‐applied fluoride. This nearly fully dentate population will soon begin experiencing the complications associated with medical issues and aging, which can affect their oral health. These issues may lead to gingival attachment loss, root exposure, and root caries. This presentation will review the etiological stage for this demographic group and evaluate the therapies that currently address root caries. Current treatments and future modifications of preventive philosophies and interventional clinical techniques will be assessed. It is hoped that early recognition of the potential development of this “epidemic” of root caries can stimulate a professional response to prevent its occurrence or reduce its consequences.</abstract>
<abstract lang="en">Ana Buendia‐Wannarka, DDS Elderly patients are a growing population in dental offices: people are living longer and they are better informed about having a quality of life. Thus, they look for dental care and treatment to improve their lives. Because some elderly patients are cognitively or physically impaired, dentists must recognize and ethically apply variations of informed consent. This roundtable luncheon will present the main principles of ethics in order to discuss concepts and basic knowledge among the attendees. By referring to the American Dental Association Code of Conduct, these principles will be applied to patients who are elderly and cognitively or physically impaired, as well as to patients of all ages who have special needs. Attendees will identify the main principles of ethics and ethical related issues; identify an ethical reasoning model; apply the model to a case; and be able to incorporate ethical principles to future dilemmas in their practices.</abstract>
<abstract lang="en">Gretchen Gibson, DDS, MPH, FASGD Several systematic reviews have been published, which the address the issue of fluoride use. Although fluoride has been established as part of the caries preventive and remineralization strategy for adults, the question of which fluorides to use have remained unanswered. The Veteran Affairs (VA) Dental Oral Health Quality Group completed a systematic review of the literature regarding these questions in order to provide guidance for VA Dental's program nationally. This presentation will describe the methods of the systematic review; the findings and subsequent information letter published for the VA in 2008; and strategies to incorporate the medical model of caries management for treating patients with moderate and high caries risk. Participants will learn about the process and findings of the systematic review; understand the positive benefits about using fluoride in moderate and high caries risk adults; be able to choose from several prescription and professionally applied options that are beneficial for these older adults; and learn how to use and prescribe these fluorides.</abstract>
<abstract lang="en">Carlton Horbelt, DDS, FADPD, FACD, FICD, FPFA, FADl, DABSCD Treating persons with developmental disabilities or patients with any special needs involves many unique challenges. Delivering care to these patients can involve complex behavior management situations; unexpected problems with safety and compliance; and unusual treatment planning decisions. Several dental products and materials can be helpful in streamlining the dental appointment experience for both the patient and the dental office staff. These commercially available products are readily affordable in an average dental practice. This presentation will discuss a variety of dental products that can increase patient and dental team member safety; enhance the speed and/or efficiency of actual treatment, and help improve patient compliance. All of the products and materials that will be shown and discussed were chosen solely by the presenter; their inclusion in this presentation is not intended to be an endorsement of any particular brand, product, or material by SCDA.</abstract>
<abstract lang="en">Ruth Goldblatt, DMD, FAGD, FASGD, DABSCD; Izabella Pulvermacher, RDH During the past few years, many groups in Connecticut have been working to improve the oral health of its citizens. Partners in this process have included the Department of Public Health's Office of Oral Health and the Department of Developmental Disabilities; the University of Connecticut School of Dental Medicine; and numerous others. In February 2008, the Task Force for Older Adults released Just the FACTS, which included ideas and strategies to provide dental care for older adults in Connecticut. Since the task force's report, the Department of Public Health Office of Oral Health has received a grant from the National Association of Chronic Disease Directors (NACDD) to continue the task force's work and promote oral health throughout Connecticut. The state is also working on another publication, OPEN WIDE for Older Adults, for educating non‐dental providers about oral health issues for older adults. The Department of Developmental Services recently hired a dental coordinator to focus on the oral health needs of the department's clients. By working with dental hygiene schools across the state and the Advanced Education in General Dentistry program at the University of Connecticut School of Dental Medicine, many patients have been seen. Many other new collaborative working relationships have resulted from the initial task force and as more relationships are built, the network will become stronger. This lunch and learn will discuss how these working relationships were built and how advocacy for oral health in Connecticut was organized.</abstract>
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   |texte=   Abstracts from the Special Care Dentistry 21st Annual Meeting can be accessed in the electronic version of this issue at interscience.wiley.com
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