Dental professionals may be exposed to bloodborne pathogens in their work, and dental students may be a particularly vulnerable group. Fear of exposure has also been linked to discriminatory practices. A cross-sectional survey of dental students was conducted at one U.S. dental school to assess their knowledge about the transmission of bloodborne pathogens and management of exposures; the frequency of their bloodborne pathogen exposures (BBPEs); and associations among their prior exposure, knowledge, perception of knowledge, and attitudes toward practice. Overall, 220 students (72.1 percent) responded to the survey, and 215 (70.5 percent) answered questions about exposures. The prevalence of BBPE was 19.1 percent and was greater among clinical than preclinical students (p<0.01). Percutaneous injuries occurred in 87.5 percent of those exposed. All students (preclinical and clinical combined) answered more survey questions correctly about transmission of bloodborne pathogens (66.7 percent) than about post-exposure management (25.0 percent). Fewer than half reported adequate knowledge of transmission and management (47.5 percent and 37.3 percent, respectively). In this context, 8.2 percent of the respondents acknowledged an unwillingness to perform procedures on patients with HIV. Since knowledge gaps may lead to failure to report incidents and delays in appropriate exposure management and some negative attitudes towards treating individuals with HIV persist, these indings justify improving BBPE education at U.S. dental schools.

Dental school clinics, originally envisioned as closely similar to private practice, evolved instead as teaching clinics. In the former, graduate and licensed dentists perform the treatment while undergraduate dental students are assigned treatment within their capabilities. In the latter, dental students provide the treatment under faculty supervision. It is generally recognized that the care provided by the teaching clinics is inefficient. However, in the last quarter of the twentieth century, dental school clinics began to pay much more attention to how treatment is rendered. The comprehensive care movement and quality assurance systems are leading towards more efficient patient-centered care. Case studies at the University of Maryland, Columbia University, and University of Louisville describe activities to make their clinic programs more efficient and patient-friendly. This article explores whether the potential exists for faculty to take a direct patient care delivery role in dental clinics in order for those clinics to become efficient patient care delivery systems as originally envisioned in the early part of the twentieth century.

Aim To use linked electronic medical and dental records to discover associations between periodontitis and medical conditions independent of a priori hypotheses. Materials and Methods This case-control study included 2475 patients who underwent dental treatment at the College of Dental Medicine at Columbia University and medical treatment at NewYork-Presbyterian Hospital. Our cases are patients who received periodontal treatment and our controls are patients who received dental maintenance but no periodontal treatment. Chi-square analysis was performed for medical treatment codes and logistic regression was used to adjust for confounders. Results Our method replicated several important periodontitis associations in a largely Hispanic population, including diabetes mellitus type I (OR = 1.6, 95% CI 1.30–1.99, p < 0.001) and type II (OR = 1.4, 95% CI 1.22–1.67, p < 0.001), hypertension (OR = 1.2, 95% CI 1.10–1.37, p < 0.001), hypercholesterolaemia (OR = 1.2, 95% CI 1.07–1.38, p = 0.004), hyperlipidaemia (OR = 1.2, 95% CI 1.06–1.43, p = 0.008) and conditions pertaining to pregnancy and childbirth (OR = 2.9, 95% CI: 1.32–7.21, p = 0.014). We also found a previously unreported association with benign prostatic hyperplasia (OR = 1.5, 95% CI 1.05–2.10, p = 0.026) after adjusting for age, gender, ethnicity, hypertension, diabetes, obesity, lipid and circulatory system conditions, alcohol and tobacco abuse. Conclusions This study contributes a high-throughput method for associating periodontitis with systemic diseases using linked electronic records.

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