Dystrophic EB is a rare genetic disorder in which vesiculobullous lesions occur with erosions and scarring of cutaneous and extracutaneous surfaces in the oral cavity. Poor oral hygiene results from efforts to avoid mucosal trauma, resulting in decay. The comprehensive care of children with dystrophic EB impacts not only dental management but anaesthesia administration as well.
Obesity in the young is a public health priority. The prevalence of overweight children in the United States has risen almost threefold in the last two decades. An association between weight and oral health has been suggested in adults, whereas evidence supporting this association in children is controversial at best. The aim of our study was to evaluate the association between weight and dental caries in a random prospective cohort of children at their initial visit at an urban dental school. One hundred and thirty-five children were recruited in a four-month period. The DS/ds index was used to assess caries, and BMI percentile was calculated based on age and gender-adjusted published scales. Correlation analyses, linear, and multivariate regression including age, gender, and BMI were calculated with a significance threshold of p>0.05. No correlation between dental decay in obese and non-obese children was detected (p=0.99). These findings support recent U.S. population-based literature that reports an inverse association between caries and weight in certain pediatric groups. Nevertheless, the impact of interventions to address the epidemic in the dental setting has not been investigated. As part of a health care team, dental students should be exposed to the changing demographics and sequelae of overweight in children.
Hurler syndrome is a rare autosomal recessive disorder of mucopolysaccharide metabolism. It results from a deficiency in lysosomal enzymes responsible for the breakdown of glycosaminoglycans. Affected individuals may show progressive physical and mental deterioration as glycosaminoglycans are deposited in the organs of the body. Bone marrow transplantation (BMT) is effective in improving some of the clinical manifestations of Hurler syndrome. Death is caused by cardiorespiratory failure and usually occurs before the second decade of life. In this case report, the course of dental development was followed over 5 years, from the primary dentition into the permanent dentition, of a child who was successfully treated with a bone marrow transplant in infancy. The timing of bone marrow therapy has significant and variable effect on the stages of tooth development with implications for the long-term maintenance of the dentition.
Objectives To describe the social and cultural differences between Anglophone and Francophone African immigrants which define the impediments that Francophone African immigrants face trying to access health and human services in Philadelphia, Pennsylvania. Methods Surveys and personal interviews were administered to participants in social events, community meetings, and health centers. A Chi-squared analysis was used to contrast the communities. Results Francophone Africans demonstrated less acculturation, education, English fluency, and more legal documentation problems, and thus face greater challenges accessing health care. Anglophone Africans had a higher level of acculturation, fewer language problems, and perceived fewer barriers in accessing health care than Francophone Africans. Conclusions Educating new immigrants, through a more culturally sensitive infectious disease treatment and prevention program, is integral to achieving a higher access and utilization rates of available services; especially in recent Francophone immigrants. A larger study is needed to extend the findings to other cities where immigrants with similar backgrounds or acculturation issues reside.
Fibrodysplasia ossificans progressiva (FOP) is a rare and debilitating genetic disorder of skeletal malformations and progressive heterotopic ossification. Flare-ups are episodic, with bone formation in skeletal muscle and connective tissue leading to ankylosis of major joints of the axial and appendicular skeleton. This report outlines the management of a patient with FOP who had ankylosis of the temporomandibular joint and progressive ossification of the neck structures. The patient underwent two different surgical and anesthetic procedures within a 10-year period to manage his oral pain. The authors compare the surgical techniques, osteotomy versus the more conservative buccal approach, anesthesia techniques, and conventional intubation versus sedated fiberoptic intubation. This report emphasizes the importance of a less invasive surgical technique and an appropriate anesthetic management that reduces the risks, cost, and morbidity associated with routine surgical management of patients with FOP.
This study was designed to identify reasons underrepresented minority (URM) dental students select a dental school and to determine the factors that contribute to their resolve to complete their programs. A survey questionnaire developed from interviews with URM students was sent to Minority/Admissions Officers or deans of dental schools that enrolled URM students for distribution to their minority students. A total of 198 questionnaires were received from minority students in all levels of dental school. The results were that 74 percent said they selected a school for its reputation, and 49.5 percent chose a dental school even if the financial aid package was less than what was offered in other schools. African American, Hispanic, and Native American students prefer integrated interview days with nonminority applicants and disapprove of "special" days designated for URMs. The presence of other minority students was not an important factor in the selection of a school but is an important source of support while attending dental school. Dental school minority alumni also play a significant role in the selection of a school. Results of the study can be useful in planning recruitment and retention programs.
Recruitment of underrepresented minority (URM) students to dental schools has had limited success, so dental schools need to reach out to high school students with programs to extend the pipeline. The Short Term Enrichment Program (STEP) of the University of Pennsylvania School of Dental Medicine adds a new dimension to these efforts by involving parents, who directly or indirectly impact their children's career decisions. The program consists of an introductory two-day course that includes presentations of the dental profession, laboratory, and virtual classrooms. Biannual follow-up workshops are conducted for both children and parents. Outcomes are measured through pre-and post-program surveys, focus groups, and interviews. STEP attendance has increased over five years, with a total of 163 students participating and 56 percent of their parents attending the program. Eighty participants have graduated from high school, twenty-three of whom are enrolled in a predental program or dental school; twelve are in other prehealth programs. Students in predental programs or dental school have the highest percentage of parents who participated in STEP (96 percent) and engaged them in discussions over career goals (100 percent).
In 1989, the University of Pennsylvania School of Dental Medicine (UPSDM) found there was an urgent need for new programs that would be effective in recruiting highly qualified and talented underrepresented minority students and ensuring their retention. Major efforts focused on leadership, financial support, institutional commitment, and the creation of an inclusive environment. UPSDM also offers an accelerated program leading to combined bachelor's and dental degrees and has agreements with several undergraduate institutions, including Xavier University in Louisiana and Hampton University, to enroll students in this program. UPSDM encourages minority retention through a Peer Mentorship Program, a Minority Mentorship Program, and course offerings that focus on diversity. Over the past thirteen years, these efforts have successfully garnered a fivefold increase in the number of underrepresented minority students at UPSDM.
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