Bulletin of Dental Education

Around the Dental Education Community-July 2011

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U.S. Dental School Graduates Unprepared to Screen for Sleep Disorders

The majority of U.S. dental schools do not adequately prepare their graduates to screen for sleep disorders, according to new research presented at the 19th Annual Meeting of the American Academy of Dental Sleep Medicine.

Researchers from the University of California, Los Angeles (UCLA) School of Dentistry surveyed each of the 58 U.S. dental schools to determine the average number of curriculum hours offered in dental sleep medicine (DSM). DSM focuses on the management of sleep-related breathing disorders, such as snoring and obstructive sleep apnea (OSA), with oral appliance therapy (OAT) and upper-airway surgery.

Forty-eight schools responded to the survey, indicating that dental students spend an average of 2.9 instruction hours during their four years of dental school studying sleep disorders.

According to lead author Dr. Michael Simmons, a part-time instructor at both UCLA and the University of Southern California, sleep medicine is introduced at the majority of U.S. dental schools, but the total hours taught are inadequate given that more than 18 million Americans suffer from OSA. An estimated 80 to 90% of patients with OSA are undiagnosed, and more go untreated.

"Dental students and dentists need to screen for sleep-related breathing disorders as part of patients' routine work-ups. Then, with additional interest and adequate training, they can learn to co-treat these serious medical conditions with their patients' physicians as an integral part of the sleep medicine team," said Simmons. Untreated sleep apnea can raise patients' risk for heart attack, stroke, hypertension, diabetes, and obesity.

The survey asked which sleep topics were taught, which treatments were covered, and which departments were responsible for the teaching of dental sleep medicine. Results show that classroom topics covered diagnosis of obstructive sleep apnea, sleep bruxism, snoring, and upper-airway resistance syndrome, and treatments including oral appliance therapy, continuous positive airway pressure, and surgery. Eight schools also discussed at-home sleep tests, which dentists can use to monitor treatment success.

Oral surgery, TMJ/orofacial pain, oral medicine, prosthodontics, and orthodontics were the academic departments most commonly teaching sleep medicine. The researchers were surprised by the variety of dental departments teaching sleep disorders, and that DSM could not be attributed to any particular discipline.

New York University Receives Grant to Treat Older New Yorkers

The New York University College of Dentistry (NYUCD) has received a one-year grant from the United Hospital Fund that will involve dental, dental hygiene, and nursing students and faculty in developing and assessing a collaborative oral health care referral model whose goal is to provide community-dwelling, underserved older adults in New York City with better access to dental care.

According to the grant's principal investigator, Dr. Donna E. Shelley, Clinical Associate Professor of Cariology & Comprehensive Care and Director of Interdisciplinary Research and Practice, "Our project will fill large gaps in our knowledge about the oral health needs of community-dwelling older adults by screening over 300 adults over the age of 60 who either seek services from senior centers or live in Naturally Occurring Retirement Communities in Manhattan and Queens. Our ultimate goal is to create a seamless referral link between community settings serving older adults and dental health care settings in order to increase access to much-needed dental care."

Dental, dental hygiene, and nursing students will screen residents at each partnering site. The dental and dental hygiene students will conduct oral health assessments, and the nursing students will take medical histories and interview the seniors to identify potential barriers to care, such as lack of insurance and inadequate transportation to dental service delivery sites. As part of the project, NYUCD is collaborating with the New York State Dental Association to create a directory of dentists who will serve as a referral resource.

"The data we gather will enable us to estimate the prevalence of oral health problems in this population and the amount of uncompensated care needed to meet the seniors' basic oral health needs. We expect to find large numbers of older adults without dental insurance because Medicare does not cover dental treatment. But this is only one of the many barriers that older adults face in trying to access dental care," said Dr. Shelley. "We also intend to use the data to develop a referral model that could be replicated in the future on a larger scale citywide and to advocate for government funding to fill gaps in uncompensated care for seniors."

Dr. Shelley's co-investigators include Dr. Stefanie L. Russell, Assistant Professor of Epidemiology & Health Promotion; Dr. Donna Clemmens, Assistant Professor of Nursing; and Dr. Theresa Montini, Research Scientist in the Department of Cariology & Comprehensive Care.

Texas Dental Faculty Input Leads to Development of Portable Suction Device

Assistant Professor Dr. Dan Bentley, Department of Restorative Dentistry and Biomaterials, University of Texas Health Science Center at Houston Dental Branch. Photo by Ms. Rhonda Moran, UT Dental BranchWith input from faculty at The University of Texas Health Science Center at Houston Dental Branch, five Rice University seniors have created a portable dental suction device that is an inexpensive, battery-powered version of the vacuum system commonly used in dentists' offices to remove blood and saliva from a patient's mouth.

It's no surprise that big systems cost a lot, more than dental practitioners in developing countries can afford or even use, because of limited access to electricity. For clinicians who travel from village to village to treat patients, gauze usually serves the purpose of soaking up fluids. What is surprising is that many dentists in this country find themselves in the same situation. Dental Branch faculty members have long been aware of the need for a portable dental suction device and turned to Rice students to see how they could help.

Rice bioengineering students, along with a biochemistry and cell biology student, assembled a foot-operated portable system that will go on the road with Dental Branch faculty this summer for testing by rural Texas dentists. They hope the device will eventually become a standard part of Rice's dental Lab-in-a-Backpack, developed by Beyond Traditional Borders to fulfill needs in developing countries around the world.

"I can't adequately describe how motivated and enthusiastic the students were this year," said one of the team's advisors, Dr. Dan Bentley, Assistant Professor in the Department of Restorative Dentistry and Biomaterials at the Dental Branch. "It was amazing. I think their independent effort and willing attitude have produced exactly the desired outcome for the project."

Knowing the work would have immediate impact motivated the team. They took on the project at the request of Dental Branch faculty who took Rice's dental backpack to Nicaragua in summer 2009. The goal was clear: The unit had to be portable, low-cost, and run on alternative energy sources where AC power was limited or unavailable. It also had to handle multiple patients on one charge, use various tip sizes, and prevent fluids from flowing back into the patient's mouth. The team settled on an 18-volt DeWalt wet/dry unit. They split the battery from the main unit and put a foot switch between the two, so dentists could turn it on and off as needed without disrupting their work. All the materials for the device cost less than $200.

Extensive testing proved the vacuum would hold up for more than five hours of heavy-duty use. The students built in several ways to control backflow, adding a hand-operated valve at the tip, building in L-shaped joints at the top and bottom of the hose, and using tubing that won't kink. Future refinements, to be made by the senior team that takes over next year, will include streamlining the vacuum and adding the ability to charge the battery with solar or mechanical power.

Penn Dental Residency Program Receives One of the Largest Gifts Ever for a U.S. Dental School

Dr. Louis Schoenleber, Jr., an University of Pennsylvania School of Dental Medicine alumnus, left the majority of proceeds from his multimillion-dollar estate to the university's Department of Oral and Maxillofacial SurgeryThe University of Pennsylvania School of Dental Medicine's Department of Oral and Maxillofacial Surgery received the largest gift in the school's history and one of the largest ever given to a U.S. dental school. Dr. Louis Schoenleber, Jr., gave $17.3 million to the department's dual-degree residency program. Funds from the donation can be used by the Department of Oral and Maxillofacial Surgery to fund research, faculty construction and renovation, continuing education, new technology and equipment, and endowed professorships and faculty positions.

"The gift was the culmination of his lifelong passion for oral surgery and, fittingly, it will help to advance medicine in this field," said Dr. Peter Quinn, Senior Vice President for Clinical Practices at the University of Pennsylvania Health System and Vice Dean for Professional Services at the School of Medicine. Quinn is also the Founding Chairman of the Department of Oral and Maxillofacial Surgery and the first Louis Schoenleber Professor of Oral and Maxillofacial Surgery. He met Schoenleber at the doctor's 50th reunion in 1993. "What interested him most was our dual-degree program. He believed strongly that to be an oral surgeon in this day and age, you needed both dental and medical training. Our program seemed to fulfill his dreams of what should happen in this specialty."

The six-year, dual-degree program allows students to earn a medical degree from the University of Pennsylvania School of Medicine, a two-year certificate of general surgery, and a certificate in oral and maxillofacial surgery from the University of Pennsylvania School of Dental Medicine. Penn's program is one of a handful to offer a combined M.D. degree and maxillofacial surgery certificate.

"Typical community oral surgery units and, indeed, many teaching hospitals do not possess the level of medical equipment needed to perform the complex oral surgical procedures undertaken within Penn Dental's Oral Surgery Department," said Dr. Denis F. Kinane, Morton Amsterdam Dean of the University of Pennsylvania School of Dental Medicine. "Oral surgery is a vital aspect of dental medicine that requires specialized training. This gift means that Penn can remain at the forefront of this field and take on the complex cases that lie at the junction of surgery and dentistry."

Dr. Schoenleber was raised in North Arlington, New Jersey. He entered Penn as an undergraduate and began his studies at the School of Dental Medicine in 1940, when students could be admitted to dental school after completing two years at an undergraduate college. Upon graduating in 1943, he entered the Navy, where he gained much of his oral surgery experience serving during World War II. Schoenleber maintained an oral surgery practice in Ridgewood, New Jersey, where he practiced for 35 years.

University of Iowa Breaks Ground on Decade-Long Renovation

A groundbreaking ceremony for the first of a three-part renovation of the facilities at the University of Iowa College of Dentistry was held on April 23, 2010. The transformation of the College of Dentistry will include a new three-story clinic, renovation of existing clinical areas, and modernizing of research areas.

The first phase, scheduled for completion in fall 2011, will add 33,424 square feet to the existing College of Dentistry building, including a newly designed clinical wing, the Center for Excellence in Clinical Education, where students will gain experience with the latest dentistry equipment. Additional renovations include an entry compliant with the Americans with Disabilities Act (ADA), additional clinical space for geriatrics and special needs patients, and student study rooms for case-based learning.

The new building will house expanded capacity for digital imaging, including radiography and photography in operatories. A database to track student progress will be computerized and study areas, including computer labs, common areas, and lounges, will be added or upgraded. Laboratories will be able to support the cellular, molecular, and genetic testing needed for contemporary biomedical research methods. Also, the layout of the facility will support interdisciplinary and collaborative aspects of dental research. The entire renovation is scheduled to take about a decade to complete and cost $60 million.

MCG School of Dentistry Celebrates Topping-Out

 School of Dentistry Dean Dr. Connie L. Drisko gives remarks at the Topping-Out ceremony for the new home of the MCG School of Dentistry.]As one final bucket of concrete was poured on the roof of the Medical College of Georgia School of Dentistry's new home, hundreds were on hand to celebrate reaching the building's highest point on June 17.

Construction of the five-story facility for the state's only dental school began in October and is slated for completion in June 2011. The $112 million, 268,788-square-foot building will be more than 100,000 square feet larger than the existing building, which opened in 1970 on Laney Walker Boulevard.

BE&K Building Group, the facility's construction team, commemorated the milestone of completing the structure's concrete frame with a topping-out ceremony at the construction site. An evergreen tree was hoisted by crane to the structure's pinnacle to symbolize growth and good luck.

Since breaking ground 35 weeks ago, 13,500 cubic yards of concrete have been poured and 1,000 tons of rebar and 44 miles of cable have been placed. To date, $17 million has been invested into the community and the school, said Mr. Anthony Reed, General Superintendent at the site.

The ceremony honored approximately 130 workers who have completed 127,000 man hours on the project to date. "These workers are helping build the future of Georgia dentistry, and we are so very appreciative of their service," School of Dentistry Dean Dr. Connie L. Drisko said. She noted that some days the workers began pouring concrete at 2:00 a.m. and that dedication kept the project on track.

For more about the new facility, see coverage in the April 2010 Bulletin of Dental Education Online.

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