IMPORTANCE Dentists commonly prescribe opioids to relieve pain after tooth extraction.Understanding the differences in patient-reported outcomes between opioid users and nonusers could encourage the adoption of more conservative and appropriate prescribing practices in dental medicine.OBJECTIVE To evaluate whether pain and satisfaction scores reported by patients who used opioids after tooth extraction were similar to the levels reported by patients with no opioid use. DESIGN, SETTING, AND PARTICIPANTSThis quality improvement study was conducted in the 14 dental clinics of the University of Michigan School of Dentistry. Eligible adult patients of these clinics who underwent routine or surgical extractions between June 1, 2017, and December 31, 2017, were contacted by telephone within 6 months of the procedure. Patients were surveyed about the type of extraction, use of prescription opioid (if given), use of nonopioid analgesics, pain levels, and satisfaction with care after the procedure. Data analysis was conducted from February 1, 2018, to July 31, 2018. MAIN OUTCOMES AND MEASURES The primary outcome was self-reported pain as assessed by the question, "Thinking back, how would you rate your pain in the first week after your dental procedure?" with a 4-point pain scale of no pain, minimal pain, moderate pain, or severe pain. Secondary outcomes included self-reported satisfaction with care as assessed by a Likert scale ranging from 1 to 10, in which 1 was extremely dissatisfied and 10 was extremely satisfied. RESULTS The final cohort comprised 329 patients, of whom 155 (47.1%) underwent surgical extraction (mean [SD] age, 41.8 [18.1] years; 80 [51.6%] were men) and 174 (52.9%) underwent routine extraction (mean [SD] age, 52.4 [17.9] years; 79 [45.4%] were men). Eighty patients (51.6%) with surgical extraction and 68 (39.1%) with routine extraction used opioids after their procedure. In both extraction groups, patients who used opioids reported higher levels of pain compared with those who did not use opioids (surgical extraction group: 51 [64.6%] vs 34 [45.3%], P < .001; routine extraction group: 44 [64.8%] vs 35 [33.1%], P < .001). No statistically significant difference in satisfaction was found between groups after surgical extraction (median [interquartile range] scores: 9 [7-10] for nonopioid group vs 9 [8-10] for opioid group) and routine extraction (median [interquartile range] scores: 10 [8-10] for nonopioid group vs 9 [7-10] for opioid group).CONCLUSIONS AND RELEVANCE This study found that patients who used opioids after tooth extraction reported significantly higher levels of pain compared with nonusers, but no difference in satisfaction was observed.

Objectives: Due to lower fees, dental school clinics (DSCs) may provide dental care for vulnerable populations. This study evaluates factors associated with patients deciding to discontinue care at a DSC. Methods: This is a retrospective analysis of a patient transfer form that was implemented to smooth transition of a patient when their student provider graduated. Forms provided deidentified information about characteristics and unmet dental needs. Descriptive and bivariate statistics were used to identify associations between patient characteristics and deciding to continue treatment in the student practice. Results: Of 1894 patients, 73.4% continued care. Financial limitations were most commonly reported as the reason for discontinuing care (30.1%). Patients speaking a language other than English or who had reported financial barriers were significantly less likely to continue care. Conclusions: Dental school patients from vulnerable groups are more likely to discontinue care. Dental schools should implement programs that will assist patients in maintaining a dental home.

In 2000, the National Institutes of Health initiated the Protein Structure Initiative as a multi‐center structural biology program with “an initial goal to make the three‐dimensional, atomic‐level structures of most proteins easily obtainable from knowledge of their corresponding DNA sequences.” The third and final phase of this program concluded in 2015 with the publication and distribution of more than 5000 previously uncharacterized proteins.The work described here leverages the availability of high‐quality structures and pre‐cloned expression plasmids to combine forces of undergraduate biochemistry teaching lab courses across a diverse range of participating institutions. This consortium of undergraduate biochemistry faculty and students seeks to identify functional properties of a subset of these uncharacterized proteins, seeking to unify structure□ and □function relationships. Through structural and bioinformatics tools, an number of these proteins were characterized as putative hydrolases due to similarity to known hydrolase enzymes. Some appeared, by sequence homology, to possess features indicative of more specifically identifiable activity, such as halogenases and nucleases. Students in the current biochemistry laboratory class at Hope College have expressed and purified seven of these proteins, finding that structural information can guide, although not predict entirely, functional predictions regarding substrate specificity.Support or Funding InformationThis work was funded in part with support from the National Science Foundation IUSE program.

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