June 2018
Evidence in the field of dentistry has demonstrated the importance of pain-related disability and psychological assessment in the development of chronic symptoms. The Diagnostic Criteria for Temporomandibular Disorders offer a brief assessment for the diagnostic process in patients with orofacial pain (Axis II). The authors describe relevant outcomes that may guide general oral health care practitioners toward tailored treatment decisions and improved treatment outcomes and provide recommendations for the primary care setting. The authors conducted a review of the literature to provide an overview of knowledge about Axis II assessment relevant for the general oral health care practitioner.

Key Words. Orofacial pain; primary health care; general practice.

June 2018
Few investigators have explored differences in oral health status between immigrants and natives. To address this gap, the authors used nationally representative data to characterize disparities in oral health among noncitizens, naturalized citizens, and native adults. The 2013 to 2014 National Health and Nutrition Examination Survey, a nationally representative in-person survey, provides oral health data for US natives, naturalized citizens, and noncitizens. Univariate and multivariate regression analyses were conducted to compare evidence of caries and periodontal disease, as well as recommendations for oral health care, stratified by immigration status for adults.

Key Words. Dental health services; caries; periodontal diseases; health policy; dental care; dental public health; minority groups; public policy; public health or community dentistry; vulnerable populations.

Key Points

• The demographic of older adults (i.e., 65 years of age and older) is growing and likely will be an increasingly large part of dental practice in the coming years.
• Although better than in years past, the typical aging patient’s baseline health state can be complicated by comorbid conditions (e.g., hypertension, diabetes mellitus) and physiologic changes associated with aging.
• Older adults may regularly use several prescription and/or over-the-counter medications, making them more vulnerable to medication errors, drug interactions or adverse drug reactions.
• Potential physical, sensory, and cognitive impairments associated with aging may make home oral health care and patient education/communications challenging.
• Dental conditions associated with aging include dry mouth (xerostomia), root and coronal caries, and periodontitis; patients may show increased sensitivity to drugs used in dentistry, including local anesthetics and analgesics.

This course discusses options for bulk fill composites that provides create quality restorations that are an aesthetic improvement, efficient, and affordable.  The course include a live patient demonstration of the entire process from anesthesia through polishing.  Also included is an article from the journal of Clinical Oral Investigations that reviews and analyses the performance of bulk-fill and conventional resin composite restorations in posterior teeth.

This course is sponsored by Bisco.

This program is based on a compilation of numerous reports based on research of the effects of sodium bicarbonate (baking soda) as a dentifrice ingredient. This program provides information of value to dental practitioners on the benefits of baking soda dentifrices on oral health. This information is applicable to our daily practice of dentistry in which the cornerstone of all our therapy is effective control of biofilm by our patients. This program summarizes the efficacy and safety of baking soda-containing dentifrices for a variety of uses. In reviewing the evidence presented, the following summary statements are appropriate:

• The low abrasivity of dentifrices containing baking soda makes them especially suited for safe daily use in oral hygiene regimens.
• Microbiological studies have shown that baking soda products have significant bactericidal activity against oral pathogens which explains benefits demonstrated in clinical studies on plaque biofilm and gingivitis reduction.
• Baking soda dentifrices favor patient compliance because they have stain reducing and whitening properties, a feature which motivates patients to brush as instructed by their oral care practitioner.
• Neutralization of plaque acids by baking soda supports caries reduction as well as facilitation of remineralization of incipient carious lesions.

This course is sponsored by Arm & Hammer.

May 2018
The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription.

Key Words. Antibiotics; dentistry; prophylaxis; treatment; epidemiology; public health.

November 2017
This six article annual JADA supplement explores the benefits of baking soda and oral health. This supplement has been sponsored by Church & Dwight Co., Inc. All content has been peer reviewed by the designated editors of The Journal of the American Dental Association (JADA). The opinions or views expressed in this supplement are those of the authors, and do not necessarily reflect the opinions or views of The Journal, Church & Dwight Co., Inc., or those of the American Dental Association.

November 2017
Objectives were to determine the likelihood that a clinician accepts an impression for a single-unit crown and document crown remake rates. The authors developed a questionnaire that asked dentists about techniques used to fabricate single-unit crowns. The authors showed dentists photographs of 4 impressions and asked them to accept or reject each impression. The authors correlated answers with dentist and practice characteristics. Other questions pertained to laboratory use and crown remake rates.

November 2017
The authors examined the relationship between education debt and career choice, particularly dentists’ decisions to specialize, participate in public health insurance programs, and join dental management service organizations (DMSOs). The authors used data from the American Dental Association 2015 office database, which contains dentist demographic information and identifies dentists who participate in public health insurance programs for pediatric dental care services. The authors merged this database with the 2002-2015 American Dental Association Survey of Dental Graduates, which contains information about education debt, to assess the relationship between education debt and career choices. The authors used probit and multinomial logit models to determine the relationships among education debt, demographic characteristics, and dentist career choices.

July 2017
Sugar-sweetened beverages (SSBs) are dietary sources of sugar that are factors in caries development and tooth loss. Dietary sugar also is linked to diabetes mellitus (DM). There is limited research related to SSBs and tooth loss in people with DM. The authors investigated the association between SSBs and tooth loss as it related to the presence or absence of DM. The authors used a cross-sectional design with data reported by adults (18 years and older) who responded to the 2012 Behavior Risk Factor Surveillance System questionnaire, which was used in 18 states (N = 95,897; 14,043 who had DM and 81,854 who did not have DM). The authors conducted c2 and logistic regression analyses to determine associations related to DM status.

August 2017
Except for a small increase in caries prevalence in young children from 1999 through 2004, the prevalence of pediatric caries in the United States has remained consistent for the past 3 decades. The authors used data from the National Health and Nutrition Examination Survey (NHANES) (from 1999 through 2004 and from 2011 through 2014) to ascertain changes in caries prevalence in youth aged 2 to 19 years. The authors evaluated changes in the prevalence of caries experience, untreated caries, and severe caries (3 or more teeth with untreated caries) in the primary, mixed, and permanent dentition according to poverty status.

December 2017
A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors’ objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically. Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted c2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster.

Key Words. Evidence-based dentistry; carious lesions; dentin.

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