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PURPOSE/OBJECTIVES The aim of this study is to report data on the lack of a proper patient handoff system in dentistry and dental education and to present a possible solution to integrate this into curriculum using the "entrustable professional activities" (EPAs) framework. METHODS Delphi participants from seven US dental schools provided feedback on a preliminary definition of handoff, a mnemonic and an assessment rubric. 2019 American Dental Education Association Commission on Change and Innovation in Dental Education (ADEA CCI) participants further evaluated the handoff EPA using the EQual rubric for EPA quality and structure. RESULTS Delphi participants identified points of transition in dentistry, selected the D-PASS as a mnemonic, and agreed with the evaluation rubric. The ADEA CCI participants agreed the handoff EPA describes work that is essential for the profession and suitable for entrustment. CONCLUSION The D-PASS rubric is an effective way to assess patient handoffs.

Purpose/objectives The purpose of this study was to define and develop a set of Entrustable Professional Activities (EPAs) for dental education using a modified Delphi consensus approach. EPAs define the core tasks that a graduating dentist needs to perform independently in practice. The EPA framework facilitates assessment of competencies as they manifest in the tasks and independence needed to be ready for practice. Methods Feedback was obtained from participants about a list of EPAs, with modifications made after each of the 3 rounds, using a modified Delphi approach. Phase 1 included attendees at the ADEA Fall 2017 meeting (n = 35) who participated in an EPA workshop primarily composed of academic deans. The Phase 2 "reactor panel" consisted of 10 dental schools' academic deans and other individuals with expertise and interest in dental curriculum and assessment (n = 31). Phase 3 participants were attendees at the ADEA CCI 2019 meeting (n = 91) who also participated in a 2-day EPA workshop. Results In phase 1, overall ratings for acceptability of the EPAs were satisfactory. In phase 2, the next iteration of EPAs was judged as satisfactory for inclusion in curriculum, match well with clinical practice and clarity. In phase 3, the EPAs were judged as satisfactory for being an "entrustable, essential, and important task of the profession." Qualitative feedback suggested wording, measurability, and specific focus of EPA statements is important. Conclusions A preliminary set of EPAs was designed for predoctoral dental education through a systematic, careful consensus building approach involving a diverse set of participants.

BACKGROUND: Protective stabilization (PS) is a method of medical restraint used for behavior management for children and adults with special needs for dental care. With the increase in availability and options for behavior management techniques, PS has become less popular and more controversial. This scoping review analyzes the use of PS for dental care for adults with special needs within the literature. METHODS: A review of publications between 1990 and 2020 was conducted in Ovid Medline, Embase, and Dentistry and Oral Sciences Source using the search terms as follows: “protective stabilization,” “dentistry,” “restraint,” “patient positioning,” and “immobilization,” with Boolean operators “AND” and “OR.” Articles were screened by title and abstract and included by full read review with consensus from the research team. RESULTS: A total of 298 articles were reviewed and 29 were included as part of the scoping review. The articles include original research, policy guidelines, and clinical commentary reviews. CONCLUSION: There is variable evidence regarding the use of PS as a method of behavioral management for adults with special needs. It is less popular for use due to improvements in alternative methods such as pharmacologic intervention and general anesthesia. PS still has applicable use among this population and is dependent on patient and parental consent, patient selection and safety, and clinician training.

This reflection describes a life-limiting case of oral squamous cell carcinoma (SCC) that required thoughtful management facilitated by an advance care plan (ACP). A 70-year-old female was diagnosed with a T4aN2bM0 biopsy-proven invasive, well-differentiated keratinizing SCC. Surgical wide-local excision included teeth #11-16 with left unilateral neck dissection, levels I-V. She was rehabilitated with maxillary obturator prosthesis and underwent chemoradiation therapy. Her course was complicated by dysphagia and trismus. She experienced multiple recurrences. At a certain point, negative margins could not be achieved without facial disfigurement. The patient, her husband, and providers decided together that further management would be palliative. Before the additional surgical procedures, she communicated a thorough ACP with her husband and providers who were prepared to facilitate difficult care decisions on her behalf. The patient passed away at home with hospice care at the age of 74. This motivated patient with oral SCC and impactful postmanagement complications appreciated the clarity of an ACP. Her values and goals of care were incorporated with ongoing communication and documentation of this plan, which was instrumental in facilitating her person-centered care. The providers apply lessons learned here in future practice and education of residents and students.

Background and Overview A 9-year-old girl underwent comprehensive resection and rehabilitation of a central giant cell granuloma that required phased interprofessional collaborative care to optimize treatment decisions and outcome. Case Description The interprofessional treatment team included an oral and maxillofacial surgeon, maxillofacial prosthodontist, dentist, orthodontist, and speech-language pathologist, and treatment spanned 9 years. Treatment included surgical resection of a central giant cell granuloma and obturation with a removable interim prosthesis. After adequate growth and development, the patient then underwent a surgical free-tissue transfer reconstruction by using virtual surgical planning, followed by dental implant placement and a transitional restoration, subsequent orthodontic therapy, and eventual definitive rehabilitation with an implant-retained fixed hybrid prosthesis. Conclusions and Practical Implications The interprofessional phased and collaborative treatment facilitated an optimal functional and esthetic process in a young patient with transitional and definitive treatments that considered long-term quality-of-life implications.

Background Patients treated for breast cancer often experience severe oral complications, such as mucositis, xerostomia, and infections, which can result in dose reductions and treatment delays, affecting treatment outcomes. . Objectives The purpose of this article is to explore oncology nurses' perceptions of their educational experiences, professional attitudes, and behavior related to providing oral healthcare education to patients with breast cancer. . Methods The Oncology Nursing Society sent an email to 5,000 nursing team members who cared for patients with breast cancer, requesting participation in a web-based survey; 194 responses were received, with 164 meeting study eligibility. . Findings More oral health-related education was received during clinical experiences than during formal or continuing education. Although patient-driven oral care and diagnostic efforts were frequent, actual behavior was less frequent. No major barriers to providing oral care were indicated. Increased oral health-related education and behavior correlated with the reported importance of increased oral health education for nurses.

Engaging other health care providers in oral health-related activities and interprofessional care (IPC) could increase access to oral health care for underserved populations in the U.S. The aims of this study were to assess dental hygiene, dental, and medical students' intra- and interprofessional and oral and maxillofacial surgery (OMFS)/hospital dentistry-related knowledge/skills, attitudes, and behavior; determine whether first and second year vs. third and fourth year cohorts' responses differed; and explore how intra- and interprofessional knowledge was related to interprofessional education (IPE) and interprofessional attitudes and behavior. Data were collected between April 2014 and May 2015 from 69 dental hygiene, 316 dental, and 187 medical students. Response rates across classes for the dental hygiene students ranged from 85% to 100%; 24% to 100% for the dental students; and 13% to 35% for the medical students. The results showed that the medical students had lower oral health-related and interprofessional knowledge and less positive attitudes about oral health-related behavior, IPE, and interprofessional teamwork than the dental hygiene and dental students. While third- and fourth-year medical students' interprofessional knowledge/skills and behavior were higher than those of first- and second-year students, the two groups' IPE-related and interprofessional attitudes did not differ. The students' knowledge correlated with their IPE and interprofessional communication-related skills and behavior, but not with their interprofessional attitudes. These dental hygiene, dental, and medical students' OMFS/hospital dentistry-related knowledge/skills and behavior increased over the course of their academic programs, while their IPE-related and intra- and interprofessional attitudes, especially for medical students, did not improve over time. OMFS and hospital dentistry units in medical centers offer distinctive opportunities for IPE and IPC. Utilizing these units may be one way to ensure that graduating providers are motivated to engage in IPC in their practice, thus contributing to reducing oral health disparities and increasing access to oral care for underserved populations.

Peri-implant transmucosal tissue, an essential element of peri-implant esthetics, is critical to the success of prostheses in the esthetic zone. The optimal transmucosal tissue profile can be transferred to the master cast with the aid of custom impression posts. In this clinical technique, the initial cast used to fabricate provisional prostheses was conveniently used to aid in the time-efficient fabrication of multiple custom impression posts simultaneously using self-cured acrylic resin. This technique also applies to single restorations. In addition, the use of an initial cast as holder makes it easy to transfer custom impression posts to the mouth accurately and efficiently.

Extranodal non-Hodgkin lymphoma (NHL) in the oral region can present similarly to diseases of odontogenic origin. The objective of this report was to describe a rare case of maxillary and mandibular NHL that presented similarly to and concurrently with lesions of odontogenic origin.A unique case of extranodal NHL, which presented at the apices of maxillary and mandibular teeth in conjunction with lesions of odontogenic origin in a 68-year-old white man, is described. The patient sought care because of a lesion in the right maxillary paranasal region that caused him paresthesia. Radiographically, periapical radiolucencies were present along teeth #5-8, #23 and 24, and #30 and 31. Biopsies of the right maxillary and anterior mandibular lesions were completed and led to a diagnosis of NHL at the apices of teeth #5-8 extending to the hard palate and granulation tissue at the apices of teeth #23 and 24. Two years later, the patient returned because of pressure and sensitivity associated with teeth #30 and 31. Vestibular swelling was noted clinically, and a multilocular periapical radiolucency was present radiographically. Via endodontic therapy and a positron emission tomographic scan, the lesion associated with teeth #30 and 31 was determined to be of both odontogenic and nonodontogenic origin because it possessed both a sinus tract associated with tooth #30 and NHL. Lesions of odontogenic and nonodontogenic origin possess diagnostic and treatment challenges because they may present similarly and/or concurrently. Thoughtful and conservative management of odontogenic lesions with associated NHL is imperative. Interprofessional collaboration and communication among providers must be thorough and clear to properly coordinate care and prevent delays in diagnosis and treatment when these entities occur together.

Engaging other health care providers in oral health-related activities and interprofessional care (IPC) could increase access to oral health care for underserved populations in the U.S. The aims of this study were to assess dental hygiene, dental, and medical students' intra- and interprofessional and oral and maxillofacial surgery (OMFS)/hospital dentistry-related knowledge/skills, attitudes, and behavior; determine whether first and second year vs. third and fourth year cohorts' responses differed; and explore how intra- and interprofessional knowledge was related to interprofessional education (IPE) and interprofessional attitudes and behavior. Data were collected between April 2014 and May 2015 from 69 dental hygiene, 316 dental, and 187 medical students. Response rates across classes for the dental hygiene students ranged from 85% to 100%; 24% to 100% for the dental students; and 13% to 35% for the medical students. The results showed that the medical students had lower oral health-related and interprofessional knowledge and less positive attitudes about oral health-related behavior, IPE, and interprofessional teamwork than the dental hygiene and dental students. While third- and fourth-year medical students' interprofessional knowledge/skills and behavior were higher than those of first- and second-year students, the two groups' IPE-related and interprofessional attitudes did not differ. The students' knowledge correlated with their IPE and interprofessional communication-related skills and behavior, but not with their interprofessional attitudes. These dental hygiene, dental, and medical students' OMFS/hospital dentistry-related knowledge/skills and behavior increased over the course of their academic programs, while their IPE-related and intra- and interprofessional attitudes, especially for medical students, did not improve over time. OMFS and hospital dentistry units in medical centers offer distinctive opportunities for IPE and IPC. Utilizing these units may be one way to ensure that graduating providers are motivated to engage in IPC in their practice, thus contributing to reducing oral health disparities and increasing access to oral care for underserved populations.

The purpose of this case report is to demonstrate how the basic tenants of restorative dentistry can be applied to effectively and comprehensively treat a prosthetic rehabilitation after left maxillectomy for a maxillary squamous cell carcinoma.A 55-year-old female presenting with a T1 NOMO left maxillary squamous cell carcinoma was treated surgically and restored over a 3-year period.Restorative treatment involved treatment planning with mounted diagnostic casts and diagnostic wax-up to aid sequencing and execution of treatment, including the placement of surgical and interim obturators, endodontic therapy, fixed prosthodontic restorations, and placement of a definitive obturator.By using the basic principles of restorative dentistry including occlusion and prosthodontics, the restorative rehabilitation of a patient presenting with extensive restorative needs in addition to an acquired maxillary defect was successful in re-establishing esthetics and function.

The objectives of this correlational study were to explore whether the oral health-related quality of life (ohrqol) of adolescents/young adults with cleft lip/palate (CL/P) relates to their own and their parents' satisfaction with treatment and treatment outcomes. Data were collected using mailed surveys from 30 parents and 27 patients who completed CL/P treatment. Patients' ohrqol was assessed with the Michigan Oral Health-Related Quality of Life (MOHRQoL) Scale, treatment satisfaction with Kiyak's Post-Surgical Patient Satisfaction Questionnaire, and satisfaction with treatment outcomes with Noor and Musa's Cleft Evaluation Profile. Overall, patients reported a positive ohrqol. Their satisfaction scores ranged from low to high. Patient and parent treatment satisfaction was related, while their outcome satisfaction did not correlate. Patients' MOHRQoL scores correlated with parent and patient treatment satisfaction and parents' outcome satisfaction. Patients' MOHRQoL scores did not correlate with patients' outcome satisfaction. The patients' level of discomfort was strongly correlated with patients' and parents' treatment satisfaction and parents' outcome satisfaction. In conclusion, regardless of outcome satisfaction, young patients with CL/P report a quite positive ohrqol after treatment completion. There is a clear relationship between the ohrqol of these patients with CL/P and their own as well as their parents' treatment satisfaction assessments.