Sunday, September 26, 2010

Increase Preventive Oral Care to At-Risk Adults

Increase Preventive Oral Care to Most At-Risk Adults

Having dedicated my life to preventive oral care, peer-reviewed articles on the impact of preventive care for at risk seniors continues to peak my interest. After reviewing many articles, two of them in particular caught my attention; Investing in preventive care for the Medicare Population (Moeller, Chen, and Manski, 2010) and Prevalence and Demographic Correlates of Tooth Loss among the Elderly in the United States (Marcus, Kaste, and Brown, 1998). There are many barriers to dental care in the United States; income, education, geography (rural/urban), disability status, age and culture, to name a few. Based on research of our aging population, the most at-risk populations to target for preventive services are “those with the least education and income.”1

Across the board, this segment of the aging population is found to have the highest edentulous rate, regardless of other factors. To increase access to preventive care for this population, increasing dental coverage through Medicare is one proposed solution. Not only can this measure improve the oral health of older adults, it can also lead to the reduction of expensive restorative or emergency treatment.2

1 Prevalence and demographic correlates of tooth loss among the elderly in the United States.
Marcus SE, Kaste LM, Brown LJ.
Spec Care Dentist. 1994 May-Jun;14(3):123-7.PMID: 7871473 [PubMed - indexed for MEDLINE]

2 Investing in Preventive Dental Care for the Medicare Population: A Preliminary Analysis.
Moeller JF, Chen H, Manski RJ.
Am J Public Health. 2010 Sep 23. [Epub ahead of print]PMID: 20864712 [PubMed - as supplied by publisher]

Wednesday, May 5, 2010

Evidence-Based Dentistry conference news

Recently, I was selected to attend the 2010 Evidence-Based Dentistry conference in Chicago. It was sponsored by Proctor & Gamble and the American Dental Association. Having used general research methods for years as an educator, I read with interest the information on the ADA website in preparation for the conference.

Upon arrival, our 90 conference attendees were provided a hands-on introduction to the EBD website and various tools of research; this included how to create PICO questions, search for key terms, as well as locate pertinent systematic reviews and clinical recommendations.

Evidence-based dentistry (EBD) is an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the oral health professional's clinical expertise and the patient's treatment needs and preferences.

By saying “relating to the patient’s oral and medical condition and history”, this definition takes a patient-centered approach to treatment decisions. It is important to understand that EBD is an approach to practice, an approach to making clinical decisions, and is just one component used to arrive at the best treatment decision. EBD is about providing personalized dental care based on the most current scientific knowledge. ( , 2010)
Participating in this conference increased my abilities to provide authoritative, peer-reviewed information to colleagues, students, and the community. I plan to incorporate and expand the use of evidence-based practice mechanisms as a tool to be used by professionals and consumers to gain the most reliable information available on a wide variety of topics.

To read the conference news reported by ADA, go to ADA website.

Pam Cushenan, RDH, MS TDEV

Georgia Perimeter College

Department of Dental Hygiene FOLLOW MY BLOG!

Sunday, April 11, 2010

Physically or Cognitively Impaired Patient Care Success: Carer Involvement

Direct involvement of the carer in health care delivery is an important aspect of comprehensive care. Not only can pertinent information about the client be provided, but the continuance of patient care may be positively impacted.

Since the mid-90s, I've had the carer accompany their client or loved one into the treatment room to enhance patient communication, participate in the assessment phase, and assist during treatment, as needed. Otherwise, a disconnect occurs between professional care and daily care assistance of the client. This results in disease development and progression. By including the carer, as well as other health professionals, a true multidiciplinary health care team can be accomplished.

Alzheimer's Disease Diagnosis and Treatment: Promising Research

There have been many drugs being touted to reduce or slow the symptoms of Alzheimer's disease. Few of those tested or on the market are able to consistently live up to their claims.

However, the latest research from the Mayo Clinic, UCLA and the Blanchette Rockefeller Neurosciences Institute at West Virginia University has great promise.

The Mayo Clinic has developed a method of analying MRI's to "read" brain changes with up to 80% accuracy; UCLA have developed a blood test for AD; Blanchette Rockefeller Neurosciences Institute (BRNI) now has a skin test available to detect defective enzymes involved with memory function. These enzymes are found in brain and skin cells.

The accuracy of this new skin test is 98%, according to the Daniel Aikon, MD, the institute's scientific director. Early intervention treatment involves low doses of the chemotherapy drug Bryostatin to reactivate the defective enzymes to "...rewire broken connections in the brain and restore memory," says Aikon. He further states that this process could be used to reverse the negative consequences of many brain diseases. Clinical trials begin in 2010.

I'm excited about this level of AD research and potential for impact on the lives of patients, families and the community.

Pam Cushenan, RDH, MS
SOFT Smiles: Specialized Oral Focused Training

Thursday, April 8, 2010

EBD conference: Fact finding, thought-provoking treasure

Being selected to participate in the 100 attendee Champion’s conference held at ADA headquarters March 25-27 has given me a whole new perspective on research. Although I was acquainted with Evidence-Based Dentistry (EBD), I still had a lot to learn. It began with a hands-on walk-through of the American Dental Association EBD website, familiarization of EBD terms and links, and a practice session. Experts on EBD, including the founder of The Cochrane Collections (gold standard of EBD), shared their methods of EBD application in a variety of settings; these included dental practices, educational facilities, and more. Fourteen tables of attendees had brainstorming sessions and shared outcomes with conference attendees. This process and the information shared stimulated me to return to the internet for research every day.

Some of the common knowledge facts that I believed were challenged and I was able to use new tools and techniques to discover the most current information. As important, meeting and getting to know colleagues with whom to collaborate with on future EBD projects, is a valuable outcome of this conference.

My thanks go out to Proctor & Gamble and ADA for providing this excellent opportunity to combine evidence with clinical judgment and patient needs to enhance my ability to make better decisions, share valid information, and provide better patient guidance and care.

Wednesday, April 7, 2010

Relief to the underserved populations

Who am I?
With a Masters Degree in Training and Development and over 20 years experience as a dental hygienist and a dental hygiene educator, I have developed in-depth senior and special needs oral training programs that combine various learning methods to provide caregivers the opportunity to transfer new skills to their patients. Programs include oral care for patients with cognitive impairment, mental retardation, Down's syndrome, autism, cerebral palsy, and age-related issues. I founded a company in 2006 to help meet the needs of these individuals and care providers called SOFT Smiles: Specialized Oral Focused Training. My motto is "Good Oral Health for Life" ©

Why am I writing this blog?
Due to the documented need for improved access to care and provision of care to the underserved populations, I believe that more attention needs to be paid to making necessary changes to reduce this disparity. Cognitively impaired (dementia, Alzheimer’s disease), physically impaired (stroke, Parkinson’s disease, etc) and Special Patients (mental retardation, Down’s syndrome, cerebral palsy, autism, etc) are the focus of this blog. By writing this blog, I hope to hear from those of you who have personal experience with these population groups. What issues do you or someone you know have with access to care? How is research making a difference to these individuals, families, caregivers? Although I live in the world of academia, community service, patient care, as well as educating/training caregivers and families is my passion.