Helping gather practice-based evidence through the National Dental PBRN


Round table discussion: Members of the National Dental Practice-Based Research Network discuss their projects at an annual meeting of Southwest region practitioners in San Antonio in February 2013. Participants are, from left, Dr. Michelle Martin, Houston; Dr. Dena Fischer, Bethesda, Md.; Kim Lovell, a dental hygienist, Mesa, Ariz.; Dr. Leonard Kinateder, Killeen, Texas; Dr. Malcolm Ray Scott, Austin, Texas; and Dr. Melissa Nevid, Austin, Texas. 

Birmingham, Ala.—New opportunities exist through the National Dental Practice-Based Research Network for dentists to gather evidence that may have chairside significance.

Dental practice-based research networks are the investigative union of practicing dentists and academic scientists who propose and participate in research studies addressing oral health care. The intent is to expand the profession’s evidence base through studies involving data collected in dental offices.

“We continue to be very impressed by the input that we receive from practitioners,” said Dr. Gregg Gilbert, network director and chair of the department of clinical and community sciences at the University of Alabama at Birmingham. “This input has come enthusiastically at every step of the study development process—from idea generation, to study design, to design of the data collection forms, to study implementation, all to be done in busy clinical practices.”

Before consolidation in 2012, three regional PBRNs coexisted under separate principal investigators. The three were the Dental Practice-Based Research Network; Practitioners Engaged in Applied Research and Learning; and Northwest Practice-Based Research Collaborative in Evidence-Based Dentistry. They operated with separate funding and support from the National Institute of Dental and Craniofacial Research.

 

NIDCR supports the new streamlined network, based at the University of Alabama at Birmingham, with a seven-year, $66.8 million grant.

Dentists nationwide can become network practitioners and have their practice participate in a network study—or even propose research. Dr. Sonia Makhija, an associate professor at UAB and network director of communications and dissemination, points out that dentists who were part of the three separate PBRNs must rejoin the united organization if they want to continue participation.

“You weren’t grandfathered in,” Dr. Makhija said. “So if you were in one of the previous networks, you still have to join the new network.”

Launched or soon-to-be launched projects include a cracked tooth registry, a questionnaire about isolation techniques used during root canal treatment, a study on suspicious occlusal carious lesions, and one about dentin hypersensitivity. Under the new national model, participating members also can earn continuing education credits.

The network will also host a three-hour program at ADA 2014—America’s Dental Meeting, Oct. 9 in San Antonio.

To enroll, visit NationalDentalPBRN.org. More information also is available through the network’s social media platforms on Facebook, Twitter (@DentalPBRN), LinkedIn and YouTube.

For more information, visit nidcr.nih.gov and search for National Dental Practice-Based Research Network.

ADA gives senior dental students free drug guide

 

To make the transition to practice a little easier, the ADA is providing senior dental students with a courtesy one-year subscription to the new ADA/PDR Dental Therapeutics Online, a comprehensive, user-friendly digital reference on drugs used in dentistry.

The Colgate Oral Health Network for Professional Education and Development provided a grant that enabled the ADA to provide the subscriptions.

Some 5,000 U.S. senior dental students will receive the complimentary subscription. A Colgate-Palmolive grant provided hard copy versions of the drug guide to senior dental students in previous years.


SCIENCE


“The value of the online version is ease of use,” said Phyllis Martina, Colgate’s senior academic relations manager. “Can you imagine a dental student bringing a printed version of the PDR to their dental clinic chair for each patient appointment? The book would be very heavy, impossible for a dental student to bring to their dental chair. With just a few key strokes, each dental student has quick access to information on medications for their clinic patients, prior to their board exams and to use as they begin their dental practices.”

Dr. Sebastian Ciancio, who edited the drug guide, also emphasized the ease of use of the online product for dental students.

“The student of today is well versed in the electronic publishing world,” said Dr. Ciancio, professor and chairman in the Department of Periodontology and director of the Center for Dental Studies at the State University of New York at Buffalo, in Buffalo, N.Y. “Since the content of the current edition is published electronically, students will find this edition especially easy to use as a rapid chairside reference relative to medications their patients are taking.

 

“The book was first published in 1998 and, over the years, students and clinicians gave us feedback as to their needs in terms of information on dental therapeutics. From students we learned that this book is not only a valuable chairside aid, but also serves as a useful resource in preparing for various board examinations.”

The students will have a handy resource that is valuable to both the practicing dentist and the dentist in training.

“Colgate also understands that dental students may not have the financial resources to purchase this essential reference on their own,” Ms. Martina said. “Providing the PDR Dental Therapeutics online for dental students will give them one of the indispensable references they require as they begin their dental careers.”

The ADA collaborated with Physician’s Desk Reference to post the content of Dental Therapeutics on the Internet, where subscribers can quickly locate dosages and information of clinical significance.

The ADA, PDR, editor Dr. Ciancio, 27 leading practitioners and Colgate-Palmolive transformed the content for digital use, building a database of more than 50,000 drugs.

The database is filled with brief, informative descriptions of drug categories. The online subscription provides access to PDR3D, a digital reference product that pairs the largest human drug label database available with an intuitive search platform allowing for access to critical label information.

Key features include crucial data on dosage, interactions, precautions and adverse effects; clear, well-organized tables on dental therapeutic agents that offer rapid access to information on common drugs used in dentistry; an evidence-based overview of herbs and dietary supplements; and appendices that cover drug-related issues that affect dental practice, including substance abuse, tobacco-use cessation, agents that affect fetuses and nursing infants and others.

Standards working group aims to clarify nickel-free label in dental products manufacturing

An International Organization for Standardization working group wants manufacturers to modify labels that proclaim a dental product nickel-free even as potentially harmful trace amounts remain in metal materials.

To that end, the working group seeks to clarify and redefine the term “nickel-free” in a revision of ISO 22674 Dentistry Metallic Materials, which allows manufacturers to employ the term if a product contains less than 0.1 percent nickel.

“One of the difficulties in defining nickel-free is that when extracting metals from their ores, nickel can be a naturally occurring impurity,” said Spiro Megremis, Ph.D., assistant director, research and laboratories, ADA Division of Science. “The allergic reaction to nickel can vary from patient to patient and even very minute amounts of nickel may cause a reaction in some patients, while being harmless to others.”

The working group’s revision to the standard would mean manufacturers must account for trace amounts of nickel in metal alloys with a label change, including the statement “nickel free: contains less than 0.1 percent nickel.”

“This is similar to packaging that is seen on food products that don’t have peanuts listed in their ingredients but contain the warning ‘made in a facility that processes peanuts,'” Dr. Megremis said.

For more information, contact standards@ada.org. ISO 22674 Dentistry Metallic Materials can be obtained through the ADA e-catalog at ADAcatalog.org.

Spotlight on practice-based research networks at ADA 2014


Dr. Gilbert

San Antonio—An Oct. 9 course at ADA 2014—America’s Dental Meeting will explore dental practice-based research networks.

The National Practice-Based Research Network is the sponsor for Practice-Based Research: How Can It Help My Practice? The 2.5-hour course is planned for 11:30 a.m.-2 p.m.

PBRNs are an investigative union of practicing dentists and academic scientists conducting studies in dental offices with consenting patients. The National Institute of Dental and Craniofacial Research first funded dental practice-based research networks in 2005 to provide practitioners with an opportunity to propose and participate in research studies addressing oral health care.

Representatives from the National Dental Practice-Based Research Network, headquartered at the University of Alabama at Birmingham School of Dentistry, will cover the fundamentals of dental PBRNs at ADA 2014 to help dentists understand the relevance to chairside dentistry. The course is designed to engage the dental audience in the network experience and will examine dental PBRN study findings for isolation techniques and the cracked tooth registry.

 

Planned speakers include dental PBRN practitioners Drs. Paul Benjamin, of Miami, and Walter Manning, of Portland, Ore.; and Dena Fischer of NIDCR. Dr. Gregg Gilbert, National Dental PBRN director and chair of the Department of Clinical and Community Sciences at University of Alabama at Birmingham, is also on the panel.

The no-fee course is worth 2.5 hours of continuing education credits; course code is 5385. To register for the course, visit ADA.org/meeting.

For more information on the network, visit NationalDentalPBRN.org.

ADA Standards committees announce drafts available for review and comment

Seven proposed standards in draft status are available for review and comment through June 7.

Developed and approved for circulation through the ADA Standards Committee on Dental Informatics and the ADA Standards Committee on Dental Products, the proposed standards span the areas of restorative materials, manual toothbrushes, impression materials, tooth bleaching and digital resources related to dentistry.

The ADA has played a key role in the development of dental standards since 1928 and is an American National Standards Institute accredited standards developer. ADA Standards Committee volunteers work together on documents that establish requirements for safe and effective dental products and technologies through a consensus-based process.

Diverse experts representing dental practitioners, industry, government and academia comprise the working groups that develop ADA standards. The ADA Standards Committee encourages professionals from all areas of interest to participate. Involvement is open to anyone who would like to contribute his or her expertise, anywhere from the initial planning phase through reviewing final drafts.

The seven draft proposals open to review and comment are:

• Proposed ANSI/ADA Standard No. 27 Polymer-based Restorative Materials will be a modified adoption of ISO 4049:2009 Dentistry–Polymer-based Restorative Materials. This standard specifies requirements for dental polymer-based restorative materials supplied in a form suitable for mechanical mixing, hand-mixing, or intra-oral and extra-oral external energy activation, and intended for use primarily for the direct or indirect restoration of cavities in the teeth and for luting. The standard covers polymer-based luting materials intended for use in the cementation or fixation of restorations and appliances such as inlays, onlays, veneers, crowns and fixed partial prostheses.

• Proposed ANSI/ADA Standard No. 119 for Manual Toothbrushes will be a modified adoption of ISO 20126:2012 Dentistry–Manual toothbrushes–General requirements and test methods and ISO 22254:2005 Dentistry–Manual toothbrushes–Resistance of tufted portion to deflection and will revise and replace the current ADA Standard No. 119:2008. This standard describes requirements and test methods for the physical properties of manual toothbrushes in order to promote the safety of these products for their intended use. This standard also specifies a test method for determining the resistance of the tufted portion of manual toothbrushes to deflection. This test method is applicable to toothbrushes having a conventional, flat trim design and may not be applicable to toothbrushes with other designs.

• Proposed ANSI/ADA Standard No. 128 for Hydrocolloid Impression Materials will be an identical adoption of ISO 21563:2013 of the same name and specifies the requirements and tests for helping determine whether the elastic aqueous agar and alginate hydrocolloid dental impression materials, as prepared for retail marketing, are of the quality needed for their intended purposes. The standard also specifies requirements for labeling and instructions for use.

• Proposed ANSI/ADA Standard No. 136 for Products for Tooth Bleaching will be an identical adoption of ISO 28399:2011 of the same name and specifies requirements and test methods for external tooth bleaching products. The standard covers products intended for use in the oral cavity, either by professional application (in-office tooth bleaching products) or consumer application (professional or nonprofessional home use of tooth bleaching products), or both. The standard also specifies requirements for packaging, labeling and instructions for use.

• Proposed ADA Technical Report No. 1030 for Dental Providers Guide to the Electronic Dental Record will provide information for dentists about key concepts of the electronic dental record; what can be done with computer-based systems that cannot be done with paper-based, analog records; and implementation issues surrounding the computer-based oral health record.

• Proposed ADA Technical Report No. 1041 Content of Electronic Laboratory Prescription will provide guidelines for the format and content of patient data disseminated offsite to the outsourced dental laboratory. The paper explains security concepts and the risks associated with the maintenance of data in storage and transit and over an Internet connection. The dental laboratory needs to ensure a proper data integrity, storage and accessibility protection plan, which involves creating, investing in and meticulously adhering to a well thought-out system, including proper archiving. The standard provides differing storage requirements by state for data.

• Proposed ADA Technical Report No. 1043 for Use of Computer-based Resources for Access to Information Supporting Oral Health Care will assist dental practitioners in understanding how to effectively access and utilize digital and Web-accessible knowledge resources for professional development and to support clinical decision-making and patient education. These new technologies for publishing have made it possible for false or highly biased information to be readily accessible. It is important for health care providers and patients to be cognizant of potential pitfalls related to the spectrum of the quality and the potential for conflicts in information found online and to be able to effectively appraise it. This report provides examples of computer-based resources (Web-enabled and other digital resources) of interest to those involved in oral health care, and it discusses issues related to the searching and utilization of computer-based resources to facilitate the effective transfer of oral health knowledge.

Copies of the draft standards are available by calling the ADA toll-free number, Ext. 2506, or sending an e-mail request to standards@ada.org. To learn more about ADA Standards Committees, visit www.ada.org/dentalstandards.