A novel caries risk test.

A diagnostic test is particularly beneficial if it reveals the level of susceptibility prior to onset of a disease process. In the case of childhood caries, such a diagnostic test affords the opportunity for preventive measures to be implemented before caries begins. Salivary glycoproteins contain a wealth of individually specific oligosaccharide motifs. Depending on microbial compatibilities and individual genotypes, the glycoproteins that form the pellicle coating of teeth may provide attachment sites that foster colonization leading to cariogenesis. Alternatively, certain oligosaccharides, when present in nonpellicle glycoproteins, can interact with planktonic bacteria and lower their ability to interact with the tooth surface. We have found that in young adults the ratio of the two classes of oligosaccharides present in resting saliva exhibits a strong correlation with caries history (DFT: number of decayed and filled teeth). Oligosaccharide moieties associated with the test are quantitated in dried spots of whole saliva on nitrocellulose using commercially available biotinylated lectins with a variety of reporters. A combination of multiple linear regression and neural net analyses were used to develop the algorithms that describe the relationship between oligosaccharide patterns and DFT. During test development several different groups of adults and children have been studied. The correlation algorithms routinely exceed an R(2) (coefficient of determination) of 0.96. When the test is applied to the saliva of children, it yields a projection of their future caries history. Modifying the test result metric to reflect the groups of teeth with caries in young adults, the test identifies those teeth at risk for future caries in children. This test outcome can then be accompanied with suggested specific preventive measures for each tooth group-based risk level.

A novel saliva test for caries risk assessment.

A new saliva test for caries risk assessment introduced in this study integrates a variety of host factors to predict for children, individual risk levels that are tooth-group specific. These various host factors correlate with caries history, DFT (decayed and filled teeth) or DFS (decayed and filled surfaces) in young adults. The test is based on the pattern of genetically determined oligosaccharides present on salivary glycoproteins. The mechanism behind the test is believed to be centered on the specific oligosaccharides that either facilitate bacterial attachment and colonization at the surface of teeth or protect against colonization by promoting agglutination and removal of free bacteria. It is the ratio of the two classes of oligosaccharides that is very strongly correlated with the numerical range of DFS or DFT observed in a young adult population.

The effect of an HIV/AIDS educational program on the knowledge, attitudes, and behaviors of dental professionals.

The Pacific AIDS Education and Training Center (PAETC) developed and tested over time a curriculum to meet the changed HIV/AIDS-related needs of dental health professionals. The objective of this study was to evaluate the HIV-related knowledge, attitudes/beliefs, and behaviors among the participants of a CE training course based on this curriculum, both before and six weeks after the completion of the course. The project recruited 106 participants who were dental health professionals over a ten and a half year period (1992-2003). The dental participants consisted of 79 percent dentists and 21 percent dental hygienists or dental assistants. The sample was 67 percent male, 33 percent female, 45 percent Caucasian, and 24 percent Asian. An adapted questionnaire was used before and after the training to assess the educational needs of the participants and evaluate the success of the program in meeting those needs. Approximately 81 percent of the participants completed both questionnaires. After the course, the participants significantly changed their knowledge, attitudes/beliefs, and behaviors (65 percent, 86 percent, 55 percent respectively, all at p=.0001). Overall, the educational program was successful in increasing and promoting the HIV/AIDS-related knowledge and attitudes/beliefs of the participants and enhancing their commitment to infection control and HIV risk screening behaviors.

Comprehensive training for hazard communication.

Long before the Bloodborne Pathogens Standard caught the attention of the dental profession, the Occupational Safety and Health Administration required all employers to collect information about hazardous chemicals in the workplace and provide information and training to employees regarding the materials. The Hazard Communication Standard requires employers to establish written programs, collect specific information regarding workplace chemicals, and conduct a formal training program for employees.

Dentists can contribute expertise in a major public health disaster.

BACKGROUND AND OVERVIEW: The time for dental professionals to educate themselves to respond to, and assist with, a catastrophic medical disaster is here. California dental healthcare workers must understand the various duties they may be asked to perform if a large-scale disaster were to occur. This article explores the various duties, which may need to be performed in the event of a medical disaster, and the duties a dentist, or dental auxiliary, may be able to complete, with minimal additional training. CONCLUSION: California dentists must be educated, at minimum, to recognize the symptoms of exposure to biological agents or naturally occurring diseases, such as avian flu and SARs, in their patients. Dentists must be further educated to correctly counsel their patients who exhibit such symptoms. Finally, dentists must alert the appropriate public health authorities of such exposure. California should consider amending the California Dental Practice Act to provide for the expansion of the definition of the practice of dentistry in the event of a declared healthcare emergency. The new definition should, at minimum, allow dentists to administer vaccines and dispense medications at a mass prophylactic distribution site. The definition could be further expanded to allow dentists to perform more complicated or invasive duties in the event of a disaster with large numbers of bodily injuries. In either event, California will also need to provide limited liability to dentists who do participate in emergency situations, similar to the Good Samaritan laws, which currently apply to physicians and surgeons. PRACTICE IMPLICATIONS: Dentists and their dental auxiliaries can augment the existing medical professionals, in responding to a declared medical emergency. In order to be ready to respond, dentists and their dental auxiliaries must receive additional training through continuing education courses developed specifically to train them in recognizing symptoms of exposure to biological agents.