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Impact of a Tobacco CE Program for Indiana Healthcare Providers.
No full textPosterPurpose: To assess an evidence-based continuing education (CE) program for Indiana healthcare practitioners focusing on tobacco use and dependence which emphasized team-based tobacco dependence treatment. Methods: Program impact was assessed by changes in participants’ self-reported knowledge and clinical application of course concepts and strategies via a 26-item immediate post- CE survey and a 19 -item 3-month follow-up survey. Surveys included multiple-choice and 5-point Likert-style scaled items. The three month follow-up surveys were mailed / delivered electronically to participants; non-responders were sent two reminders. De-identified data were analyzed in aggregate using descriptive statistics, Spearman correlation coefficients, and Mantel-Haenszel chi-square tests. Results: CE programs were held in Tell City, Madison, Lafayette, Goshen, Richmond and Vincennes with a total of 252 participants. Initial survey response was 98.4% (n=248): dental assistants (2%), dental hygienists (83%), dentists (8.5%), and other healthcare professionals (6.45%). Overall, participants reported less knowledge before than immediately after (p<.0001) and 3 months after (p<.0001) the CE program. Reported knowledge at 3 months was less than immediately after the program (p<.002). Participants planned to apply CE program communication strategies (99%), implement brief tobacco intervention strategies (85%), and refer patients to local cessation resources (95%) or the Indiana Quitline (96%). Response rate for the 3 month survey was 54% (n=136). Respondents reported currently playing an active role in team-based tobacco cessation (48%,78), applying CE communication strategies (85%,109), and implementing brief tobacco interventions (71%,90). Sixty-eight respondents reported referring patients to local counselors; eighty-three referred to the Indiana Quitline. Conclusion: Tobacco dependence CE may be beneficial to enhance health care practitioners’ knowledge and willingness to integrate tobacco interventions in their healthcare settings. However, this does not assure that they will change their practice behaviors by utilizing the learned concepts and tobacco interventions with patients. (Funded by the Indiana State Dept. of Health
Effects of Stannous and Sodium Fluoride on Human Gingival Fibroblasts.
No full textPosterBackground: Periodontal diseases are inflammatory conditions of the tooth supporting tissues. Although bacterial byproducts have been linked to periodontal diseases, host responses have also been implicated. This includes the matrix metalloproteinases (MMPs) that are released from human gingival fibroblasts (HGFs) and induce connective tissue degradation. Fluoride has been shown to have inhibitory effects on MMPs in solution. The effects of fluoride on MMP expression from HGFs have not yet been examined. Methods: HGFs cultured from a sample of clinically non-inflamed gingival connective tissues were incubated with stannous fluoride and sodium fluoride to determine their effects on cell proliferation. HGFs were then incubated with or without stannous fluoride or stannous fluoride at the highest concentrations that did not affect cell proliferation and analyzed for MMP expression. Results: The highest concentrations that did not affect proliferation with respect to HGFs were 0.004% stannous fluoride and 0.0125% sodium fluoride. At these levels, MMP expression in HGFs did not differ significantly from untreated HGFs. Conclusions: MMP expression in HGFs was unaffected by treatment with stannous fluoride or sodium fluoride at the concentrations tested. Although these concentrations of sodium fluoride and stannous fluoride with respect to HGFs are lower than some fluoridated mouth rinses and dentifrices, the exact concentrations to which HGFs are exposed following exposure to a fluoridated medicament is unknown. This concentration is likely lower than the concentration of stannous fluoride or sodium fluoride in the medicament due to their position in the lamina propria
Diabetes and Periodontal Disease: The Need for Interprofessional Patient Care.
Full text linkPosterObjective: The objective of this clinical case presentation is to emphasize the importance of an interprofessional approach to health care. Specifically, this case will emphasize the importance of managing diabetes in a periodontal patient. Background: A 69 year old patient presented with the chief complaint of, “I want my teeth cleaned.” The medical history revealed several medications and conditions that could potentially impact the oral cavity. The patient presented with type II diabetes mellitus, which became uncontrolled during the treatment; was taking a calcium channel blocker to control his high blood pressure, and was using a bi-pap machine for his sleep apnea. The patient also was obese and gave a history of bariatric surgery, GERD, and recent back pain. Assessment: The initial clinical examination of this patient revealed generalized mild bone loss as evidenced by 3-4mm from the CEJ radiographically (generalized moderate plaque induced gingivitis with dark pink spongy tissue with bulbous papilla that did not adhere tightly to the tooth with bleeding) and generalized mild chronic periodontitis as evidenced by 4-5mm CAL and 6mm CAL associated with swollen gingiva. Localized severe periodontitis of 8mm CAL on tooth number 19 was present. Dental Hygiene Treatment Plan: Scaling and root planing was performed for selective areas along with a periodontal tissue re-evaluation. Treatment: The treatment was performed throughout three separate appointments. At the beginning of treatment the patient’s A1C was 8.5% and his blood glucose was 195 mg/dl. Results: The re-evaluation appointment revealed slight improvement in the health of the gingiva, but minimal to no improvement in probing depths. Conclusion: This case highlights the need for an interprofessional approach to patient care. Problems with diabetes management, as well as other contributing factors, have been known to impact periodontal therapy outcomes
Myasthenia gravis: a survey study with personality evaluation of twenty-three cases
Full text linkThis document only includes an excerpt of the corresponding thesis or dissertation. To request a digital scan of the full text, please contact the Ruth Lilly Medical Library's Interlibrary Loan Department ([email protected])