Vital Record » Dentistry Your source for health news from the Texas A&M Health Science Center Mon, 20 Oct 2014 21:39:25 +0000 en-US hourly 1 Addressing disease hazards in the dental setting Thu, 09 Oct 2014 21:42:07 +0000 There are myriad factors dentists take into consideration in order to create a safe and sterile environment for patients, from the cleanliness of office surface areas to the water used for rinsing and the methods of instrument cleaning]]>

Time spent at a medical office, where illness is expected, can create a fair amount of apprehension. One person’s persistent sneezing causes another to reach for an extra dollop of hand sanitizer. A patient’s wracking cough makes those in the vicinity think twice before taking a deep breath.

Visiting the dentist’s office doesn’t necessarily prompt that reaction, but the risk of contracting a serious infectious disease is just as real as catching a minor cough or cold. There are myriad factors dentists take into consideration in order to create a safe and sterile environment for patients, from the cleanliness of office surface areas to the water used for rinsing and the methods of instrument cleaning.

tamhsc-cc-2Safeguarding dental instruments

While in recent decades a handful of global pandemics have spread through air and contact — like tuberculosis, H1N1 and severe acute respiratory syndrome (SARS) — serious infectious diseases such as HIV, AIDs and hepatitis are actually simpler to prevent than airborne illnesses, says Dr. Raghunath Puttaiah, an associate professor at Texas A&M University Baylor College of Dentistry.

“Infections spread through saliva and blood are easier to control, because there are so many adequate precautions,” says Puttaiah, who teaches infection control and occupational safety at the dental school and trains dentists internationally on the subject.

Chief among those measures at Texas A&M Baylor College of Dentistry is a centralized system for instrument sterilization. Because dental instruments come into direct contact with saliva and blood, they present the potential for conditions such as herpes, hepatitis and HIV. To mitigate this risk, instruments go through a stringent cleaning and steam heat sterilization process, which when used and monitored correctly, destroys all known bacteria.

After dental instruments are cleaned in washers, they are sealed into sterilization packs and placed into one of three large autoclaves, or pressurized chambers. Heat-sensitive tape on the packs indicates that the autoclave has reached the required temperature: 270 degrees.

In private practice, many dental offices use the same method, just on a smaller scale.

“Most dental practices do not have the volume of equipment that a school setting has; therefore, their needs are usually met through the use of a small autoclave such as a ‘Lisa,’” says Vickie Thompson, director of dispensing operations at the dental school. The college utilizes these smaller autoclaves — comparable in size to toaster ovens — in several of its dispensaries.

Monitoring water lines

Water goes hand in hand with a trip to the dental office. It is used to flush debris and polish from teeth during routine cleanings, and it acts as a coolant during lengthy procedures. But when water lines aren’t properly monitored and maintained, tiny microbes can form, leading to allergies or reactions in patients with compromised immune systems. Also at risk, Puttaiah says, are older patients and very young children.

Myra Spurgin is an infection control officer at the college and oversees water line maintenance and cleaning. Texas A&M Baylor College of Dentistry, like most dental schools, operates on a closed water system. Instead of running city water to each operatory, a water bottle is attached to every dental chair. Once filled, a preservative tablet is added, and water lines are cleaned only with products approved by the U.S. Food and Drug Administration and Environmental Protection Agency.

“You can regulate water lines better when you have a closed system,” Spurgin says. “Private practices may be hooked up directly to municipal water supplies, but they may only have three or four operatories.” Texas A&M Baylor College of Dentistry, by comparison, has 314 dental chairs.

Using protective equipment and common sense

Just as important for dentists, dental hygienists and assistants, Thompson says, is personal protective equipment, including gloves, a mask, and protective eyewear and apparel.

Avoiding common hazards in the dental environment begins with a shift in mindset, she says.

“Just because it’s not bloody doesn’t mean it’s not there,” Thompson says. “You have just as many infections in saliva and spray from your handpiece.”

Airborne diseases with the potential to spread at a rampant pace can be best prevented through basic tenants of infection control as well as common sense, says Puttaiah. Every dental practice is required to have a manual with occupational safety standards, which call for frequent hand washing and intermediate-level, hospital-grade disinfectants for cleaning equipment and work surfaces.

Don’t underestimate the importance of a phone call, he adds.

“We let the patients know that if they are not feeling well, it’s best not to come,” Puttaiah says. “If they have symptoms of not feeling good or feeling listless, we ask them to stay home. The same thing applies to staff.

“Constantly keep your ears open, eyes open and follow the fundamental principles of infection control.”

Puttaiah’s words mirror a unifying mindset in dental schools and dental practices nationwide: that infection control doesn’t just begin the moment the patient reclines in the dental chair. It’s an ongoing process of implementing, maintaining and refining with one priority in mind — the safety and comfort of patients.

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Q&A: Unraveling the mysteries of salivary dysfunction Tue, 07 Oct 2014 18:54:00 +0000 Patients often suffer a long time before coming to see Dr. Ibtisam Al-Hashimi, director of the Salivary Dysfunction Clinic at Texas A&M University Baylor College of Dentistry. The clinic is uniquely positioned as a hub to treat patients with salivary dysfunction and by default, Sjögren’s syndrome, a little-understood but extremely prevalent autoimmune condition. ]]>

Dr. Ibtisam Al-Hashimi directs the Salivary Dysfunction Clinic at TAMBCD.

There’s a case study Dr. Ibtisam Al-Hashimi likes to share with dental students. In it, the patient’s chief complaints are all over the place: seasonal allergies, asthma-like symptoms, sore mouth, reflux, irritable bowels, and aches and pains. Everything in the lab work comes back perfect, but the patient is miserable. The symptoms are seemingly unrelated, but if you look closer, there’s one commonality. The answer lies in the exocrine system, which includes the salivary glands.

Patients often suffer a long time before coming to see Al-Hashimi, professor in periodontics and director of the Salivary Dysfunction Clinic at Texas A&M University Baylor College of Dentistry. The clinic — formed in 1991, just after Al-Hashimi’s arrival at the college — is uniquely positioned as a hub to treat patients with salivary dysfunction and by default, Sjögren’s syndrome, a little-understood but extremely prevalent autoimmune condition. Almost immediately, patients with Sjögren’s, which causes the body’s white blood cells to attack moisture-producing glands, flocked to the clinic for its diagnostic services.

Because TAMBCD has one of the only noncommercial labs in the country dedicated to patient salivary analysis as a diagnostic tool, the opportunities for interprofessional collaboration and research are plentiful. A recent collaboration with the University of Toledo and its hospital in Ohio resulted in the publication of a study examining the type of comorbidities associated with Sjögren’s syndrome. An article currently in press examines a new diagnostic tool based on genetic markers, and a contribution to the August issue of The Journal of the American Dental Association details management of dry mouth and underactive salivary glands.

Now Al-Hashimi talks a bit more about what enticed her to devote her career to the study of saliva, just how important it is to our well-being and how salivary gland problems are invariably a manifestation of exocrine dysfunction.

Your education traces back to the University of Baghdad, where you received your bachelor’s degree in dental surgery and diploma in oral surgery, and to State University of New York at Buffalo, where you received a master’s in oral sciences and a doctoral degree in oral biology. What was it that enticed you to study saliva?

In Buffalo I ended up working in a lab that focused on salivary biochemistry. I came from a clinical background, and I wanted to see what happens when people have trouble with their saliva.

It really became a passion for me the more I got into this clinical practice and started seeing the issues that come along with it. I became more interested in understanding problems with salivary glands, and before I knew it, we started seeing a lot of patients with dryness that wasn’t limited to their mouths but also occurred in their eyes — a symptom of Sjögren’s. When I came here and started the salivary dysfunction clinic, before I knew it, it had become a referral center for Sjögren’s, which started as a consortium with UT Southwestern, Baylor University Medical Center and Texas Health Presbyterian Hospital Dallas and now includes several more physicians throughout the metroplex.

When you first joined the TAMBCD faculty in 1991, you re-energized the Dallas chapter of the Sjögren’s Syndrome Foundation Support Group. In that time period, what successes have you seen in terms of how people cope with the condition?

When I came to Dallas, I reactivated the support group, and we started having meetings and symposia. The school still hosts the quarterly meeting.

One really good resource for patients has been to talk with people who have exactly the same thing; not that everybody cries on everybody’s shoulder, but that they increase awareness and education. The benefit of the meetings is the educational programs where professionals come to educate the patients and make them knowledgeable of their condition and how to avoid potential complications. A lot of pulmonary and gastrointestinal problems come along with Sjögren’s syndrome. Not many people are aware of how easily you can prevent the complications that come with impaired exocrine dysfunction just by knowing what to do and how to take care of it.

In what ways can salivary dysfunction research and treatment stand to grow?

My dream is that one day we will have a specialty in the exocrine system just like the endocrine system. Medicine is expanding so much, and there are specialists for an organ and a disease, but there is no specialist for the exocrine glands, which are distributed throughout the body, including the respiratory system, starting from the nose, sinuses, and through the lungs; and the entire digestive system, gallbladder, digestive enzymes, liver, pancreas, and the genitourinary tract. Problems and dysfunction within the exocrine system have a wide range of impact on those systems and the entire body, however, neither medical nor dental education addresses this system as one entity. Considering the abundance and accessibility of the salivary glands in the mouth, I believe dentists can play a significant role in better understanding the underlying causes of exocrine dysfunction.

There are some interesting nicknames attributed to you — Spit Doctor, Spit Lady, Dr. Spit — to name a few. Where did these offbeat monikers originate?

I initiated it. Whichever one you want me to be, that’s me. I always award myself those titles. People think so little about saliva, but here we really know how valuable it is. Just ask a patient with dry mouth, and then one can appreciate the significance and systemic implications of salivary and exocrine dysfunction. It is not just saliva; it is the entire exocrine system.

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Follow-up oral care: The new normal for childhood cancer survivors Tue, 23 Sep 2014 15:51:18 +0000 Today, because of advances in treatment, more than eight out of 10 children treated for cancer survive at least five years, most into adulthood. However, the same treatments that help these children survive can also cause immediate and late-term health effects, even in the mouth]]>
Follow oral health care is essential for cancer survivors and offers the best chance for long-term, overall health.

Follow oral health care is essential for cancer survivors and offers the best chance for long-term, overall health.

Today, because of advances in treatment, more than eight out of 10 children treated for cancer survive at least five years, most into adulthood. However, the same treatments that help these children survive can also cause immediate and late-term health effects, even in the mouth.

Because childhood cancers tend to be fast growing and cancer therapies — chemotherapy and radiation — target rapidly dividing cells, children usually respond well to treatment. Besides, their bodies are generally better able to recover from higher doses of chemotherapy than adults, so using more intensive treatments gives oncologists a better chance of treating the cancer effectively. However, several parts of the human body including the mouth, hair and stomach are made up of these rapidly dividing cells and can be impacted by the treatment.

“The effects of cancer treatment on a child’s oral cavity depend largely upon the type of cancer treatment, chemotherapy versus radiation, and the timing of treatment,” said Carolyn Kerins, associate professor in pediatric dentistry at Texas A&M University Baylor College of Dentistry. “The effects of chemotherapy vary based on type of drugs used, their doses and frequency. The side effects of radiation will depend on the dose of radiation and location of the radiation beam.”

Oral complications that can occur during cancer therapy include cavities, dry mouth, changes in taste, bleeding, painful swelling and ulcers in the mouth. Although dentists can prescribe medications to manage these conditions, they often improve after treatment is discontinued. However, some complications are persistent or may not show up until months, or even years, after treatment.

“Chemotherapy interferes with the cell division and intracellular metabolism and will cause delayed dental development,” Kerins said. “This may be seen as stunting of tooth roots, absence of one or more teeth, abnormally small teeth or enlarged pulped chambers.”

Once teeth are fully developed, Kerins explained, chemotherapy and radiation has a dramatically reduced affect on them. It’s the teeth that are still forming that are impacted by the treatment, especially radiation, which has far more detrimental effects on the developing permanent teeth by halting their maturation.

“Radiation damage is non-reversible and affects the alveolar bone (the bone that contains the tooth sockets), the periodontal ligament (connective tissues that attach a tooth to the alveolar bone) and the pulp tissue (soft tissue that forms the center of a tooth that contains the nerves and blood vessels),” Kerins said.

It is likely that pediatric patients who have received radiation in the head/neck region may require prosthodontic management later in life. “The more focused the beam, the lesser the field of damage,” she said.

Childhood cancer survivors are also at risk of reduced bone mineral density, which persists into adulthood and may increase bone fracture risk at an older age. Prolonged high doses of radiation can lead to necrosis (death) of the bone.

It is worth noting that good oral health care is important before, during and after cancer treatment “Ideally, each child should have a comprehensive dental exam prior to the initiation of chemotherapy and/or radiation,” Kerins said. “Any decayed teeth should be restored prior to treatment and any teeth requiring extraction should be extracted prior to therapy.”

During chemotherapy, oncology patients should maintain routine dental visits. “As chemotherapy is usually administered in a cyclic nature, it is ideal to see the patient when the blood counts are close to normal, or the day before the next round of chemotherapy is administered,” Kerins said. “As the patient undergoing chemotherapy is immunocompromised, it is advisable to give antibiotic prophylaxis prior to the appointment. Patients should have routine dental cleaning and fluoride therapy every six months.”

If the patient develops swelling and ulcers in the mouth during treatment, mucosal coating agents or topical anesthetics may be prescribed.

According to Kerins, patients occasionally develop a secondary intraoral infection such as candida or herpes while undergoing chemotherapy. She said the pediatric dentist can prescribe the appropriate antifungal medication to treat the candida infection. To prevent herpes infection, cancer patients routinely take anti-viral drugs.

Although the side effects of cancer therapy can be frustrating, they are the result of life-saving treatment. It’s important to realize that follow-up care is essential and offers the best chance for long-term, overall health.

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Partnership provides care to uninsured in Irving, cuts down on dental-related emergency room visits Wed, 17 Sep 2014 18:21:06 +0000 A new partnership between Texas A&M University Baylor College of Dentistry and Baylor Health Care System is shifting patients out of the emergency room for dental-related pain and into the care of fourth-year dental students. On Aug. 18, TAMBCD dental students began seeing patients at the ... ]]>

A new partnership between Texas A&M University Baylor College of Dentistry and Baylor Health Care System is shifting patients out of the emergency room for dental-related pain and into the care of fourth-year dental students.

On Aug. 18, TAMBCD dental students began seeing patients at the Irving Community Clinic, across the street from Baylor Medical Center at Irving.


Photo: Irving Healthcare Foundation

Two students rotate through the clinic for a week at a time, providing cleanings, X-rays, extractions and fillings with the help of two dental assistants.

Plans are in the works to add more dental chairs and treatment options, such as endodontics and fixed prosthodontics procedures.

The partnership is part of a plan to cut down on the 1,500 dental-related emergency room visits at the Irving hospital every year. That figure mirrors national numbers from the American Dental Association, which reports that there are 2 million visits every year to hospital emergency rooms for dental pain. Since most hospitals do not have dentists on staff, patients are prescribed painkillers and antibiotics. It’s a temporary fix: 39 percent of these patients make return trips to the emergency room for recurring symptoms.

So far, numbers from the Irving initiative are encouraging.

Dr. Vanessa Williams, clinical assistant professor in public health sciences, supervises TAMBCD students at the Irving clinic. She began seeing patients there in mid-July, and by the end of August, she and students had treated more than 180 individuals. It’s nearly as many as the 250 dental patients seen in all of 2013 at the same location, which began years ago as the all-volunteer Irving Interfaith Clinic.

Because the dental clinic’s hours were previously on a volunteer-only basis, Williams says, many patients would have lengthy wait times between appointments.

“This in turn, would leave them with no other choice but to seek emergency treatment through the ER due to financial constraints,” says Williams. “Many of the patients have expressed their gratitude in having TAMBCD fulfill such a tremendous need.”

02connections-icc-2Cheryl Keith, director of operations with HealthTexas Provider Network, an affiliate of Baylor Health Care System, oversees the Baylor community care clinics and says 2,500 dental patients are anticipated to be seen at the Irving location this year alone.

For several years, HealthTexas has been involved with placing full-time physicians at the clinic, which is also dedicated to patients in need of medical care, most of whom suffer from chronic conditions such as diabetes and hypertension. Efforts began in early 2014 to expand the dental clinic’s reach beyond a volunteer capacity.

“Sustainability is a big buzz word — being able to sustain this service for this population of patients and having the ability to integrate different services that really affect each other,” Keith says. “Having the dental clinic sitting right inside the medical clinic, and having a physician full time, it’s just a great service. If there’s a medical issue with a patient in a dental suite, we’re able to take care of that, too.”

Thanks to Irving Healthcare Foundation, the primary fundraising organization for the Irving Community Clinic, care provided to uninsured residents in need doesn’t cost taxpayers a dime.

“Baylor employee giving, special events, annual giving memberships and grants are expected to make up most of the $170,000 needed this year to support the needs of the clinic,” says Kim Hanna Hollwedel, major gifts officer at the foundation.

The nonprofit was willing to support the project, Hanna says, because access to dental care ranks among the top needs of indigent Irving residents, alongside access to medical care and programs to battle obesity. Since 2008, the foundation has granted more than $1 million to these causes.

Paul Hoffmann, TAMBCD administrative director for extramural clinics, says the common mission and long-term mindset of all parties involved served as a springboard for the initiative.

“The needs for dental care among the underserved are so dramatic,” says Hoffmann. “We’re looking for partners who recognize that need but who also will help us with sustainability in the long term.

“This is a unique partnership. You have a large hospital system, physician network, health care foundation, community medical clinic and dental school involved in offering comprehensive dental care for the dentally underserved in Irving.”

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Adventurous dental students seek training opportunities in rural — and sometimes forbidding — locations Mon, 08 Sep 2014 22:13:53 +0000 From the Southwest to the Far North, students from Texas A&M University Baylor College of Dentistry serve Native American patient groups through a public health externship. ]]>

No roads lead into Barrow, Alaska, the northernmost city in the U.S., an outpost on the frozen tundra that clings to the edge of the Arctic Ocean. By Labor Day 2014, residents had already seen the lightest dusting of snow — which typically blankets the dirt roads from October through June.

Dr. Jonathan Oudin '11 with one pediatric patient

Dr. Jonathan Oudin ’11 with one pediatric patient

And yet, the Indian Health Service welcomes hardy dental students seeking an extern opportunity the likes of which they would not experience in any other clime. While remote, cold places with limited Internet and cell phone coverage are a distinct possibility, even more so are the rewards of providing oral health care for the region’s residents, say Drs. Jonathan Oudin ’11 and Kim Self ’09, who devoted three years as public health dentists with the Indian Health Service in Barrow. It all traces back to summer 2008, when Self completed the externship before her final year of dental school — and then promptly returned that December in the dark of the Alaskan winter.

The summer months in Alaska are more hospitable. That’s when fourth-year dental student Josh Morales traveled to Bethel and Hooper Bay, spending several weeks as an extern with the Indian Health Service in July 2014. He worked with a team of 10 rotating dentists and several dental students from the University of Colorado School of Dental Medicine.

Bethel, with a population that barely skirts 6,400, is the only city of its size for hundreds of miles. It’s large compared to Hooper Bay. Getting there requires a one-hour jaunt on a single-engine propeller plane. The village has no restaurants, a general store and one facility with running water. With no Wi-Fi and 19 hours of daylight, Morales had plenty of time to fish, kayak and brush up on card-playing skills when he wasn’t working at the clinics.

It was exciting to get up each morning, and not just because the sun had already hovered over the horizon for hours.

“I did more dentistry in that month than I did in all of third year,” says Morales, who wants to pursue pediatric dentistry. He treated approximately 12 children a day as opposed to two patients at the dental school.


Fourth-year dental student Josh Morales, en route to treat patients in Hooper Bay, Alaska

The experience exposed Morales to the cultural nuances of Native Alaskan Yup’ik culture in tandem with increasing his hand skills.

“The children won’t verbally answer you when you ask a question. Instead, they’ll raise their eyebrows,” Morales says. “You’ll put the sunglasses on them and ask them if something hurts; you’ll look for the normal body signs, but they’ll just raise their eyebrows. You have to learn to look out of your loops, to see if the sunglasses bob up and down.”

Training opportunities with the Indian Health Service aren’t limited to the Last Frontier.


Fourth-year TAMBCD student Abrefi Asare

Back in the Lower 48, four senior students from Texas A&M University Baylor College of Dentistry spent time at IHS clinics this summer. Britni Batisse and Abrefi Asare worked at the dental clinic in Clinton, Okla., and Christina Dawson and Lindsay Tilger at the Claremore, Okla., location. The students’ trips were arranged through the college’s preceptorship program, so theirs were abbreviated one-week versions of the IHS externships, which can last from a few weeks to several months.

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New oral and maxillofacial radiology residency to feature interprofessional training with Texas A&M College of Medicine Wed, 03 Sep 2014 20:37:52 +0000 With approval of a new oral and maxillofacial radiology residency, Texas A&M University Baylor College of Dentistry joins only a handful of dental schools in the U.S. with an advanced education program dedicated to the specialty]]>

With approval of a new oral and maxillofacial radiology residency, Texas A&M University Baylor College of Dentistry joins only a handful of dental schools in the U.S. with an advanced education program dedicated to the specialty. The news came on July 31 from the Commission on Dental Accreditation, the agency recognized by the U.S. Department of Education to accredit dental and dentally-related education programs.

tamhsc-vital-record-radiologyThe two-year certificate program will begin in July 2015 with one resident, says Regents Professor Dr. Byron Benson, D.D.S., M.S., and the dental school’s imaging center director, who adds there is potential to add more residents and graduate degree paths.

One of the hallmarks of the program is interprofessional training with the medical radiology residents at Baylor University Medical Center at Dallas, where residents in both programs will complete radiation physics and biology coursework.

Dr. Michael Opatowsky, M.D., M.B.A., is clinical associate professor of radiology at Texas A&M Health Science Center College of Medicine and instructs the medical radiology residents at the Dallas hospital. He anticipates the benefits of partnering with the dental school to be twofold. TAMBCD residents will leave the program with a better understanding of the interplay between the body, mouth and dental diseases, he says.

Medical radiology residents will benefit, too.

“We are starved for insightful interpretations of our dental-related findings, not having had any formal dental radiology training,” Opatowsky says.

Learning the nuts and bolts of oral and maxillofacial radiology could better equip medical radiologists in the referral process.

“Instead of the generic statement, ‘Formal dental evaluation is needed,’ we could provide a more useful recommendation such as, ‘This patient is in need of endodontal evaluation for radiology findings X, Y and Z,’” Opatowsky says.

The commission’s green light for the program makes TAMBCD’s residency the ninth of its kind in North America and the fourth new program in as many years.

It’s a sign of a shift within oral and maxillofacial radiology, which received American Dental Association recognition as a dental specialty in 1999.

“There is a trend for oral and maxillofacial radiologists to work in private practice as opposed to academic practice,” Benson says. “There are more and more private practice opportunities. This residency will help to fill that gap.”

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Operation Lone Star 2014 Thu, 21 Aug 2014 18:37:57 +0000 Students from Texas A&M University Baylor College of Dentistry joined the ranks of military and medical personnel to serve thousands in this full-scale emergency response exercise]]>

02connections-ols.jpgIn the waning weeks of summer break, disaster loomed along the Texas-Mexico border. Sort of. A massive cohort of military, medical and volunteer personnel descended upon the Rio Grande Valley Aug. 4 to 8, where they responded to a simulated bioterrorism threat with a medical countermeasure dispensing operation.

Created as a full-scale emergency response exercise, Operation Lone Star provides free health services to local residents at five sites located in four different counties in South Texas. Students and faculty from Texas A&M University Baylor College of Dentistry were a part of the event, now in its 16th year.

A vast collaborative effort of Texas county and state public health professionals, the operation is comprised of Texas Military Forces, U.S. military personnel, the Remote Area Medical Volunteer Corps and hundreds of volunteers, including faculty and 36 dental and dental hygiene students from Texas A&M Baylor College of Dentistry.

The experience is not for the faint of heart. Hopeful patients arrive in the middle of the night, waiting until dawn in lines that snake around the building. By 10 a.m. on Aug. 4, the first day of the weeklong event, the Palmview High School site in Mission, Texas, where TAMBCD students worked had already accepted 537 patients for medical, dental or vision appointments that day.

In total, volunteer dentists and dental students saw an estimated 737 patients at the high school throughout the week. A total of 2,948 patients received health care services at that single site.

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Healthy teeth for kids: 3 pointers every parent should know Wed, 20 Aug 2014 16:12:19 +0000 Make sure your child's dental health is as sparkling as his or her new school supplies in this back-to-school season]]>

BacktoSchool1resizedBack-to-school activities are in full swing. Amid shopping for supplies, selecting new clothes and ensuring immunizations are current, it can be easy for the condition of your kids’ pearly whites to get lost in the shuffle. Yet oral health has the potential to impact their success in school more than nearly any other health concern.

Parents can start with some simple preventive steps — fluoride toothpaste, fluoridated water and allowing fewer sodas and sticky, sugary snacks — so children are less likely to experience the pain or disruption of cavities. But dental health doesn’t stop at cavity prevention. With the hustle and bustle of the new school year often comes participation in contact sports, and protecting your child’s teeth is vital. Additionally, parents can do their part by being prepared for the unexpected dental emergency. A little bit of knowledge can go a long way in ensuring the best possible outcome when a child’s tooth gets knocked out or injured.

Consider the following pointers from faculty members at Texas A&M University Baylor College of Dentistry to make sure your child’s dental health is front and center this new school year.

1. Consider sealants

For long-lasting protection on the cavity-prone permanent molars and premolars, dental sealants are a great option. These thin, plastic coatings are painted on the chewing surfaces of the back teeth to shield their natural grooves and fissures from the bacteria that can cause cavities. Toothbrush bristles cannot fully reach inside these deep pits. Sealants should be applied as soon as the permanent molars fully emerge from the gums: between the ages of 5 and 7 and then between 11 and 14.

“Sealants are a cost-effective, noninvasive way to protect children while they are developing good oral health habits,” says Dr. Kathleen Pace, assistant professor of pediatric dentistry at Texas A&M Baylor College of Dentistry. “Many children even have access to sealants through their school’s partnership with a dental public health provider. When this is available, it’s a wonderful service.”

Texas A&M Baylor College of Dentistry offers such care through its school-based dental sealant program. Each year the college provides sealants for more than 10,000 Dallas schoolchildren.

Getting sealants is a simple, painless procedure. The American Dental Association’s MouthHealthy site advises that as long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and may last several years before reapplication is needed. Pace reassures parents that sealants are easily repaired if they become chipped or cracked.

According to the National Institutes of Health, however, less than one-third of children in the U.S. have sealants on their teeth.

2.  Sports safety counts

Mouthguards are indispensable for sports players of all ages. Dr. Danette McNew, clinical assistant professor of general dentistry at the Texas A&M Baylor College of Dentistry, asserts they are important even for solo sports like bike riding and waterskiing. As an Olympic Team USA dental provider and sports dentistry veteran, McNew knows a thing or two about the protection that mouthguards offer.

“Custom mouthguards can be adapted for different sports because each calls for different protection,” McNew explains. “In football, linebackers clench down on their teeth because they are prepping to take blows, so you need thickness in the posterior chewing region. With basketball, it needs to be thicker in the front because those athletes are taking elbows to the face.

“That’s why a custom mouthguard made by your dentist is better than an over-the-counter version or one that you boil and then bite to fit around your teeth.”

3.  Be prepared for a dental emergency

If your child’s permanent tooth gets knocked out, knowing in advance what to do can reduce stress for parents and children while allowing dentists to save the tooth. It is critical to act quickly and keep the tooth moist at all times.

When possible, Pace advises patients to try placing the tooth back in the socket without touching the root or scrubbing the surface. Biting on a cloth or towel can help keep the reinserted tooth in place.

“However, I caution parents to first be aware of where the tooth landed when it fell out,” Pace says. “You certainly don’t want to put it in your mouth if it’s covered with gravel or something like that.” The tooth can be rinsed gently under cold water for 10 seconds if needed.

Other options exist for keeping the tooth from drying out if it can’t be reinserted in the socket.

“A glass of milk, a special preservation solution such as Save-A-Tooth or your child’s own saliva in a cup can help save the permanent tooth, but in every case, it is important to get to the dentist’s office right away.”

Do not place a child’s baby tooth back into the socket because it might hurt a permanent tooth. Do make an immediate visit to the dentist whether the knocked out or damaged tooth was a baby tooth or a permanent one. Baby teeth are important not only for chewing but for saving space in the jaws for permanent teeth.

“Tooth trauma can be scary, but your child’s dentist will help see you through any dental emergency. Make sure your family members know who to call, whether it’s routine care or urgent,” Pace says.


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Dental students serve in Jamaica over summer break Mon, 11 Aug 2014 20:00:28 +0000 As summer clinic drew to a close, nine dental students boarded a flight bound for Jamaica, where many of their patients were treated in dental chairs unlike any the students had ever seen]]>

The dental chairs at the Hopewell clinic set it apart in more ways than one. In the main clinic, eight fully-functional, modern dental chairs allow dentists to perform restorative work in addition to extractions. They’re not too different from what one would find in the Third Floor Clinic at Texas A&M University Baylor College of Dentistry. This can be a welcome yet uncommon surprise at a far-flung dental mission staffed by volunteers. Five more dental chairs are housed in a smaller clinic tucked around the back of the building. Some are obviously beach chairs. The others are handmade. They can’t partially recline. Instead, they have only one setting: horizontal.

TAMBCD students provide dental care in Jamaica.

TAMBCD students provide dental care in Jamaica.

“They were made out of cardboard,” says Paul Jang, a fourth-year dental student. “Those chairs were used only for cleanings and extractions.”

From July 19 to 26, the nine Texas A&M Baylor College of Dentistry students — many of whom are members of the Christian Medical & Dental Association — stayed in Treasure Beach to provide extractions, cleanings and operative treatment for residents of the rural area along Jamaica’s southern coast. They teamed up with 16 dental students from Howard University College of Dentistry, as well as five supervising dentists and three dental assistants.

“Going into it I didn’t know what to expect. I felt like all of us walked away with more appreciation for the profession we’re entering, as well as humility to see the impact we had on that community,” third-year dental student Heena Gupta says of the trip, an initiative of the Christian Dental Society, a nonprofit that coordinates dental missions around the globe.

The four days spent in the clinic often stretched until 8 p.m. Electricity could be intermittent, and there wasn’t always time for lunch. During the trip, the volunteers cared for 500 adult and pediatric patients.

That number was reached because both schools worked together, Jang says.

“We shared a common goal; volunteers came for different reasons, wanting to get different things out of it,” says Jang. “But essentially it came down to serving the people.

“If someone didn’t like doing extractions, didn’t like doing cleanings, it didn’t matter. We just wanted to see more people.”

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