Research
Observation Grant: Study of prevention in dental practice
What we know about dental practice comes mostly from self- reported survey data mostly collected by the ADA . While this is an important source of knowledge about dentists there is little direct information about what dentists actually do in their offices. There are obviously a lot of questions that affect what clinicians do on a daily basis. The Department of Community Dentistry has organized a Practice Based Research Network of 255 dentists in Northern Ohio . This network has provided help to students for small studies during summer research fellowships and for a pilot project that directly observed what dentists actually do on a daily basis. During the last year the national Institute of Dental and Craniofacial Research has awarded the School 2.3 million dollars to directly observe what is actually done in 120 dental practices. The principle investigator for this $2.3 million grant is Stephen Wotman DDS.
This study will answer several questions concerning efforts of dentists in practice. It will gather both quantitative and qualitative data over the next sixteen months using observation, dental records, surveys of dentists and hygienists and billing records. Analysis will continue over a three year period. This will be the most comprehensive data-base about dental practice in the country and will be available for studies of dental practice by students and faculty. While the primary questions will concern specific activities and behaviors of dentists, the study will also compare the various methods for learning about dental practice, assess factors that influence what the dentist does and focus on similarities and differences between the practices of minority and non-minority dentists.
Prevention Curriculum for Smokeless Tobacco Use
Researchers in the School of Dental Medicine received pilot grant funding in January, 2004 from the Tobacco Use Prevention and Control Foundation to develop and test a school curriculum aimed at preventing the use of smokeless tobacco (ST) among youngsters in southern Ohio counties. Drs. Lance Vernon and Catherine Demko will pilot test an intervention program targeting 5th and 7th grade students in 15 schools in the rural Ohio counties of Athens, Hocking, Meigs, Morgan and Vinton where smokeless tobacco use is higher than in other parts of the state. The curriculum will be presented to the students over three days and then be evaluated by comparing the responses on surveys given before and after the presentation. The content for the curriculum was adapted from the Ohio Dental Association's program, Operation T.A.C.T.I.C. which stands for Teens Against Chewing Tobacco in the Community. The curriculum focuses on the negative consequences of ST use, understanding nicotine addiction, reading the advertising messages that make tobacco use look attractive, and practicing how to say "no" to offers of ST. In addition, the curriculum describes how to perform a self-exam to look for mouth sores and provides take-home information on resources for quitting ST use. The in-school curriculum is augmented with a parent-targeted brochure about ST use and a follow-up evaluation survey to be completed by parents.
The health risks associated with the use of smokeless tobacco (ST) products such as dip, oral snuff and chewing tobacco are oral lesions (non-cancerous mouth sores), oral cancer, dental caries, periodontal disease and nicotine addiction. The use of ST by young people in Ohio is of increasing concern. The initial use of these products is reported to be in the pre-adolescent years, ages 10-12, so that education and prevention messages need to be communicated early to assist our young people in making healthy decisions about the use of these substances. The purpose of this research study is to develop school-based education modules that address issues of knowledge, attitude, and social norms regarding the use of smokeless tobacco. Analyses of the year-long study results are underway.
Detection of Oral Lesions in Dental Practices
A 3-hour continuing education course about lesions in the oral cavity was recently offered at the Case School of Dental Medicine by Dr. Danny Sawyer to 24 community dentists and their hygienists as part of the Detection of Oral Lesions in Dental Practice Study. In addition to Dr. Sawyer, other study investigators are Drs. Catherine Demko and Steve Wotman in the Department of Community Dentistry. The objective of this pilot study is to1) formally train and evaluate the participating dentists and hygienists in order to measure their knowledge, opinions and behaviors regarding oral cancer and oral cancer screening before and after their training and 2) to determine the prevalence and type of oral lesions in patients who present in the general dentist's office. Screening all dental patients seen over a three-week period in this sample of 24 offices will provide an estimate of the frequency and type of possible lesions in the population of patients who present in the general dentist's office. Currently, it is likely that dentists underestimate the probability of lesions, particularly among young adults where a rise in the incidence of oral cancer has occurred, and thus do not routinely look for oral lesions. Importantly, we are including the patients seen by the hygienists as well as the dentists. Improving the information about the prevalence of lesions is critical to motivating dentists to implement appropriate screening and diagnostic procedures to identify potentially cancerous lesions. In addition, this study will provide preliminary data on the effectiveness of this type of continuing education course targeting dental providers.
Oral cancer is cancer that starts in the mouth, also called the oral cavity. The oral cavity includes the lips, the inside lining of the lips and cheeks (buccal mucosa), the teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, the bony roof of the mouth (hard palate), and the area behind the wisdom teeth (retromolar trigone). Oropharyngeal cancer develops in the part of the throat just behind the mouth, called the oropharynx. The oropharynx begins where the oral cavity stops. It includes the base of tongue (the back third of the tongue), the soft palate, the tonsils and tonsillar pillars, and the back wall of the throat (the posterior pharyngeal wall).
Oral cancer is responsible for almost 30,000 new cancer cases and 8,000 deaths each year in the United States. Five year survival rate for patients with advanced cases of oral cancer is 19% compared to 78 % for patients with early-detected, localized disease. Many cancers of the oral cavity and oropharynx can be found early, during routine screening examinations by a doctor or dentist, or by self-examination. Detection of small, pre-malignant lesions that can be more easily treated should help avoid the late stage diagnosis and poorer prognosis characteristic of many oral cancers.