The impact of oral health literacy on periodontal health status.

OBJECTIVE: The objective of this study was to describe oral health literacy (OHL) among periodontal patients and to examine its association with periodontal health status. METHODS: This cross-sectional study included new and referred patients presenting to the University of North Carolina Graduate Periodontology Clinic. Sociodemographic and dental history information were collected. OHL was measured using a dental word recognition instrument, Rapid Estimate of Adult Literacy-30 (REALD-30). Clinical periodontal examinations were completed. RESULTS: One hundred and twenty-eight participants enrolled and 121 completed all study examinations and instruments. Despite a high level of education among participants in our study, low levels of OHL were found in one-third (33 percent) of the study population. Thirty-one percent had moderate OHL (score of 22-25), 37 percent had high OHL (score ≥ 26). The mean REALD-30 score was 23. Fifty-three percent of participants had severe periodontitis, 29 percent had moderate periodontitis, and 18 percent had mild or no periodontitis. Bivariate analysis showed a significant association between OHL and periodontal status (P < 0.05). The effect of OHL on periodontal health status remained statistically significant (P < 0.002) even after controlling for smoking, race, and dental insurance. CONCLUSION: Lower OHL was associated with more severe periodontal disease among new and referred patients presenting to the University of North Carolina Graduate Periodontology Clinics.

A randomized controlled trial of intensive periodontal therapy on metabolic and inflammatory markers in patients With ESRD: results of an exploratory study.

BACKGROUND: Periodontitis is a novel risk factor for inflammation and cardiovascular disease in the dialysis population. Limited information exists about the impact of periodontal therapy in patients receiving dialysis. STUDY DESIGN: Randomized controlled trial to assess feasibility and gather preliminary data. SETTING & PARTICIPANTS: Dialysis patients with moderate/severe chronic periodontitis. INTERVENTION: Intensive treatment, consisting of scaling and root planing, extraction of hopeless teeth, and placement of local-delivery antibiotics, was performed at the baseline visit for treatment-group patients and after study completion for control-group patients. OUTCOMES: Outcomes were feasibility (screening, recruitment, enrollment, adverse events, and study withdrawal/completion), clinical periodontal parameters (probing depth, clinical attachment level, bleeding on probing, gingival index, and plaque index), and serum albumin and interleukin 6 levels at 3 and 6 months postintervention. RESULTS: 342 dialysis patients were approached for participation: 53 were randomly assigned, with 26 participants assigned to immediate treatment and 27 assigned to a control arm for treatment after 6 months. 51 patients completed baseline appointments; 46 were available for 3-month follow-up, 45 were available for 6-month follow-up examinations, and 43 completed all visits. At 3 months, there was a statistically significant improvement for the treatment group compared to the control group for 3 periodontal parameters: mean probing depth (P = 0.008), extent of probing depth ≥4 mm (P = 0.02), and extent of gingival index ≥1 (P = 0.01). However, by 6 months, the difference between groups was no longer present for any variable except probing depth ≥4 mm (P = 0.04). There was no significant difference between groups for serum albumin or high-sensitivity interleukin 6 level at any time when adjusted for body mass index, diabetic status, and plaque index. LIMITATIONS: Small sample size and relatively healthy population, imbalance in diabetes. CONCLUSIONS: This small trial demonstrates successful cooperation between dentists and nephrologists and successful recruitment, treatment, and retention of dialysis patients with periodontitis. Larger studies with longer follow-up are needed to determine whether treatment can improve markers of inflammation and morbidity.

Reflections on academic careers by current dental school faculty.

During the inaugural year (2006-07) of the Academic Dental Careers Fellowship Program (ADCFP), 110 faculty members at ten different dental schools were interviewed by dental students who were participating as ADCFP fellows in this year-long program designed to introduce them to faculty roles and activities and help them gain an appreciation for the rewards and issues associated with academic life. The goals, format, and components of the ADCFP are described in a companion article in this issue of the Journal of Dental Education. One of the fellows' assignments during the ADCFP was to interview faculty at various academic ranks who had differing degrees of work emphasis in teaching, research, service/patient care, and administration. Sixty-nine (63 percent of the total) of these interviews were reviewed and analyzed by the authors, who were student fellows in the ADCFP during 2006-07. The purpose of these interviews was to provide the fellows with insight into the positive aspects and challenges in becoming and remaining a dental school faculty member. This aggregate perspective of the interviews conducted at ten dental schools highlights the motivations and challenges that confront a dentist during the process of choosing a career in academic dentistry and determining if dental education is a good fit for each individual who elects to pursue this pathway. Thematic analysis of the interviews revealed several factors consistently identified by faculty across the schools as being positive influences on the quality of the academic work environment and career satisfaction: mentorship and student interaction, opportunities for scholarship (research and discovery), job diversity, intellectual challenge, satisfaction with the nature of academic work, lifestyle/family compatibility, flexibility, lifelong learning, professional duty, and lab responsibility. A series of negative themes were also consistently identified: bureaucracy/administrative burdens and barriers, time commitment, financial frustration, political frustration, lack of mentorship, required research emphasis, lack of teaching skills development, student engagement, isolation, and funding uncertainty. This article reports the approximate frequency of each theme, presents representative statements that describe the motivations and attitudes of dental faculty members who were interviewed, and concludes with a review of programs/methods aimed at marketing academic careers to current students. The purpose of this review of the rewards, benefits, and challenges that current dental faculty face is to provide students who are considering dental education with a frame of reference to guide their further exploration of this career path and to help students appreciate the many positive aspects of academic life that may not be readily apparent from their own interactions with faculty members.