An interprofessional education initiative: Introducing a local anesthesia dental course for nurse practitioner and physician assistant students.

PURPOSE/OBJECTIVE: To assess the impact of local anesthesia (LA) course for physician assistant (PA) and adult gerontology-acute care nurse practitioner (NP) program students on knowledge, attitudes, confidence, and intention to incorporate skills in clinical practice. METHODS: The course was conducted by dental faculty for forty-eight PA and seven NP students and consisted of two lecture hours on anatomy of the oral cavity, anesthesia and pain management, 2 hours of preclinic lab where participants practiced injection technique on mannikins, and a clinical practicum conducted by dental school faculty and residents where students observed dental treatment including administration of LA, and discussed symptom triage by NPs and PAs for patients with dental problems including orofacial pain, initial management including LA, and patient referral to dentists. An online survey was administered to all students before and after the course to assess changes in knowledge, attitudes, confidence, and intention to incorporate LA administration skills into clinical practice and elicit students' perception of program quality. Pre- to post-changes were analyzed by two-tailed t-tests and analysis of variance (ANOVA) with significance at 0.05. RESULTS: The response rate for pre- and post-course assessment was 96.4% and 87.3% respectively. Students' overall scale score for self-assessment of dental knowledge increased significantly from pre- (2.34) to post-assessment (4.19). An increase was seen in students' attitudes regarding management of dental emergencies (t = 2.181; p < 0.05). Furthermore, overall confidence of students related to managing patients with dental problems increased significantly (2.00 to 3.85) after taking the course. CONCLUSION: The LA course was well received by PA and NP students and resulted in increased knowledge and confidence in recognizing common oral health conditions, understanding dental pain management including administration of LA, and making referrals to dentists to optimize patient care.

Impact of Prenatal Health Conditions and Health Behaviors in Pregnant Women on Infant Birth Defects in the United States Using CDC-PRAMS 2018 Survey.

OBJECTIVE: To assess both individual and interactive effects of prenatal medical conditions depression and diabetes, and health behaviors including smoking during pregnancy on infant birth defects. METHODS: The data for this research study were collected by the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2018. Birth certificate records were used in each participating jurisdiction to select a sample representative of all women who delivered a live-born infant. Complex sampling weights were used to analyze the data with a weighted sample size of 4,536,867. Descriptive statistics were performed to explore frequencies of the independent and dependent variables. Bivariate and multivariable analyses were conducted to examine associations among the independent and dependent variables. RESULTS: The results indicate significant interaction between the variables smoking and depression and depression and diabetes (OR = 3.17; p-value < 0.001 and OR = 3.13; p-value < 0.001, respectively). Depression during pregnancy was found to be strongly associated with delivering an infant with a birth defect (OR = 1.31, p-value < 0.001). CONCLUSION: Depression during pregnancy and its interaction with smoking and diabetes are vital in determining birth defects in infants. The results indicate that birth defects in the United States can be reduced by lowering depression in pregnant women.

Multifaceted impact of COVID-19 on dental practice: American dental care professionals prepared and ready during unprecedented challenges.

BACKGROUND: The purpose of this study was to evaluate the multifaceted impact of the COVID-19 pandemic on dental practices and their readiness to resume dental practice during arduous circumstances. METHODS: The authors distributed an observational survey study approved by The University of Texas Health Science Center at San Antonio Institutional Review Board to dental care practitioners and their office staff members using Qualtrics XM software. The survey was completed anonymously. The authors analyzed the data using R statistical computing software, χ2 test, and Wilcoxon rank sum test. RESULTS: Nearly all participants (98%) felt prepared to resume dental practice and were confident of the safety precautions (96%). Only 21% of dentists felt the COVID-19 pandemic changed their dental treatment protocols, with at least two-thirds agreeing that precautions would influence their efficiency adversely. Although most participants were satisfied with the resources their dental practice provided for support during the pandemic (95%), most were concerned about the impact on their general health and safety (77%) and to their dental practice (90%), found working during the pandemic difficult (≈ 60%), and agreed there are challenges and long-term impacts on the dental profession (> 75%). CONCLUSIONS: Dental care professionals, although affected by the COVID-19 pandemic and at high risk of developing COVID-19, were prepared to resume dental practice during most challenging circumstances. PRACTICAL IMPLICATIONS: The pandemic has affected dental care practitioners substantially; thus, there is need to formulate psychological interventions and safety precautions to mitigate its impact. Further research should evaluate the long-term effects on dentistry and oral health and interceptive measures for better communication and programming around future challenges.