Dentistry is just the beginning
The mission of the Case Western Reserve University School of Dental Medicine is to provide outstanding programs in oral health education, patient care, focused research and scholarship, and service that are of value to our constituents. We accomplish this in an environment that fosters collegiality and professionalism and that enables a diverse group of students to become competent oral health care providers and contribute to the health and well-being of individuals and communities.
The School of Dental Medicine's core values are: collegiality; a culture of inquiry; diversity; innovation; integrity; and responsible stewardship.
Lectures in Virtual Reality Flip Learning Experience
As a dentist also trained as a computer technician, Renarto Roperto created enhanced 360-degree video versions of his lectures so students can experience them in virtual reality (VR) headsets any time they want. Visuals and video clips are embedded in the VR lectures to add depth and texture to class topics, such as offering a 3-D view of the nerves inside a tooth. This approach—an adaptation of the “flipped classroom” concept—allows Roperto to use class time for students to work together on projects, discuss what they learned during the VR lectures or ask questions.
This past spring, he created the videos during the dental school’s computer-aided design/manufacturing (CAD/CAM) course about new technologies that, for instance, can rapidly expedite crown creation. The videos became available to students on a rolling basis last semester. This fall, all lectures for the class will only be available via VR video. While some students already owned advanced VR headsets, such as Oculus Rift and ViVe HTC (often used for gaming), others bought inexpensive models, such as the Google Cardboard—available for $10 online—that use smartphones to create the 360-degree effect of being in the classroom.
“While nothing can truly compare to physically being in class,” said Nick Slezak, a fourth-year dental student, “VR allowed me to feel like I was in the front row again.”
“Seeing a 360-degree view of a root canal, and seeing the blood, nerves and decay, or simulating a surgery, could help tremendously once we come to work on real patients,” another student said.
In the meantime, Roperto is researching ways to extend the VR approach to teach courses on topics such as dental anatomy, envisioning how students can go “inside” teeth and gums. “In a few years, almost everyone will have access to either VR or augmented reality, or AR,” Roperto said. “This should play a big role in the future of training dentists.”
$1.5 Million Grant Targets Oral Complications of HIV
While advances in HIV treatment have dramatically improved patient lifespans and quality of life, nagging side effects remain; among the most common is chronic inflammation—essentially, when an immune system imbalance causes the body to attack itself. Case Western Reserve University researchers are taking aim at where inflammation can be especially harmful to patient health: in the mouth and throat, where it’s been linked with oral cancer, lesions, viral infections and other ailments that can make eating painful and further weaken immune systems through malnourishment.
“Restoring balance to an immune system is key after being altered by HIV and medications,” said Pushpa Pandiyan, an assistant professor of biological sciences, who will lead the research with a 5-year, $1.59 million NIH grant. “Otherwise, a person’s natural defenses can sometimes be too aggressive, especially in vulnerable areas like the gums and other oral tissues. Eventually, our findings could have the potential to help HIV patients lead even healthier, longer lives,” said Pandiyan.
By studying oral and throat tissues from HIV-positive patients taking common antiretroviral drugs used to treat the disease, researchers hope to pinpoint the origin of cells they suspect may promote inflammation or, at a minimum, don’t battle it. The knowledge could lead to new ways to fight HIV-related diseases, in part, by building on some of Dr. Pandiyan's previous findings. In 2014, her lab showed how specific T-cells can be manipulated outside the body to boost or suppress proteins that help the cells’ survival, which can then be re-inserted to help balance immune responses.
“Our bodies have many fine-tuned switches that keep defenses optimal,” she said. “The more we understand the mechanisms of these switches, and how they behave under a variety of circumstances, the better we can wish to control them to improve health.”
The research team includes HIV specialists at the university’s School of Medicine.
Professionals Day to Feature Dr. Elliot Hersh
The 37th Annual Professionals Day event will be held on March 30th, 2017 in the Wolstein Research Building. Dedicated to student achievement in dentistry, the event will feature oral and poster presentations of research by DMD students, residents, and fellows, and will feature a keynote address on Evidence-Based Analgesia Strategies for Avoiding Opioids by Elliot V. Hersh, DMD, MS, PhD, Professor of Oral Surgery at the University of Pennsylvania School of Dental Medicine. His topic is very timely in light of the opioid problem in Ohio and across our nation. The event also brings in a number of vendors and organizations with whom students can network ahead of their entry into the field of dentistry.
Dr. Hersh received his DMD degree from UMDNJ-NJDS in 1981 and his MS and PhD degrees from UMDNJ Graduate School of Biomedical Sciences in 1983 and 1988, respectively. Since arriving at PENN in 1988, Dr. Hersh has won the Dental School’s Excellence in the Teaching of Basic Science Award 20 times and was also presented with a University Lindback Award in 1993, the highest teaching honor in the entire University. He has published more than 150 scientific articles, abstracts and book chapters in the areas of dental pharmacology, drug interactions, analgesics and local anesthetics. His scholarly and research contributions in the areas of local anesthesia and pain control were recognized by the International Association of Dental Research in 2007, when he was presented with the Distinguished Scientist Award in Pharmacology, Therapeutics and Toxicology. Dr. Hersh states that, "while the research accolades are nice, the most important thing I do is sharing this knowledge with my students and other dental professionals.”
His presentation will review the biochemical and physiological mechanisms behind post-surgical dental pain and discuss various double-blind randomized controlled trials on the efficacy of various analgesic agents following the surgical removal of impacted third molar teeth. A discussion of the “drug seeking patient” and the prescription opioid abuse problem will be highlighted. The final portion will focus on meta-analysis data for various analgesics in both dental pain and other post-surgical pain models. In other words, which analgesics consistently lead the pack and which are consistently dogs.
Recording Selfies While Brushing Teeth Can Improve Oral Health, Study Shows
While most people have the motivation, innate ability and desire to brush their teeth properly, they often do not because they use an improper technique—and opportunities to improve such skills can be few. “Often, toothbrushing is learned and practiced without proper supervision,” said Lance T. Vernon, a senior instructor at the School of Dental Medicine and co-author of the study. “Changing toothbrushing behaviors—which are ingrained habits tied to muscle memory—can take a lot of time and guidance. Our study suggests that, in the future, recording selfies of brushing can help shift some of this time to technology. Later, patients could receive feedback from dental professionals,” he said.
Using smartphones propped on stands, study participants filmed their brushing at home. Researchers saw an increase in the accuracy of brush strokes, an increase in number of strokes and an overall 8 percent improvement in toothbrushing skill—but the length of time a person brushed did not change. While the results of this small pilot study, published in the Indian Journal of Dental Research, are promising, researchers suggest that these findings are of more importance in proving that the selfie concept is useful in a dental setting.
Video and picture selfies are increasingly being used in medical fields to assess, monitor and determine the progression of diseases and effectiveness of treatment—a new area of gathering data known as mobile health, or “mHealth”. Looking ahead, researchers envision a video-based monitoring app, which could record videos of patients brushing at home that are later reviewed by oral health professionals.
“The cost of an app could be minor, while there could, potentially, be major long-term benefits to a user’s oral health and quality of life,” Vernon said. “Dental care can be inaccessible because of cost and access. It’s possible dental selfies and other ‘mHealth’ strategies on phones can become an important part of oral health prevention and diagnosis in the future.”
In other research, Vernon explores the link between cardiovascular disease and periodontal disease in HIV-positive adults. His future research involves a prevention-focused coaching approach to promote oral health.
School Strikes Agreement to Train Faculty of Saudi Arabian University
In a move to expand its international presence and influence, the Case Western Reserve University School of Dental Medicine has signed a six-year agreement to train junior faculty from Qassim University—a public university in Saudi Arabia—in specialties of oral health and care. A delegation from Qassim joined more than 20 Case Western Reserve faculty, administrators and staff on campus Tuesday for a formal signing.
“Beyond the signing ceremony, our faculty and Qassim delegates are touring our facilities and developing robust, continuing personal relationships,” said David Fleshler, vice provost for international affairs. “The visit creates goodwill that cannot be duplicated by email or Skype,” added Fleshler.
The agreement marks the second international collaboration between the dental school and a partner university in the Middle East announced this month.
“We are careful about the partnerships we choose, and this endeavor adds to the strengths and resources of both institutions,” said School of Dental Medicine Dean Kenneth Chance. “We’re going to make a strong team.”
Starting in July, up to eight junior faculty from Qassim will study at the dental school in a one-year Fellowship of Advanced Clinical Education program, while also serving as teaching aides, assisting with research in biomedical, clinical and educational sciences, and completing other requirements. Qassim faculty who complete the fellowship are eligible to apply for up to two slots in one of the dental school’s highly-competitive Postdoctoral Education Programs in pedodontics, periodontics, endodontics, oral medicine or dental public health (leading to a Master of Science in Dentistry), or to an existing fellowship in oral and maxillofacial surgery.
“When international students come here—whatever the discipline—they gain an understanding and appreciation of new ways of problem-solving,” said Fleshler. “Their presence helps create an environment where all of our students—domestic and international—approach their disciplines from different perspectives and with open minds.”