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Penn Dental Medicine ASDA Newsletter Betty Yip ’15, Editor

ASDA PAL Event

INSIDE THIS ISSUE

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2

Volume 5: Issue 2

Gingival Groove 2013

3 Special Report: Intimate

Partner Violence

4 Dentistry On Board USNS Mercy

5 What’s cookin’?

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Penn SDM ASDA made a special trip to Lighthouse PAL on April 11th. The newest PAL center in the West Kensington section of Philadelphia was jazzed to host Penn Dental Medicine Night as their first event. More than 25 youngsters received free dental screenings and learned proper hygiene techniques.

Thanks to PAL for giving Penn SDM ASDA the opportunity to make a difference in the dental health of our young community.

Oral Cancer Walk/5K 2013

You Said It!

Each participant received a status report card and goodie bag with a brand new toothbrush, toothpaste, hygiene information and healthy snacks. Penn students like Liz Freund ’16 and Sarah Paje ’15 spoke to every PAL youngster about the importance of dental hygiene and how to brush and floss correctly. Children were able to practice proper brushing and flossing techniques on friendly fish and dragon puppets.

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ASDA  Gingival  Groove  2013   Photos provided by Dentography

Over 25 students performed and over 250 people attended Gingival Groove 2013. Tony Machani '16, won first place for his piano performance of "Moment Musical No. 4 in E minor: Presto" by Sergei Rachmaninoff while Adil Salik '15, won second place and had the whole crowd joining into his cover of "Last Kiss" by Pearl Jam. Third place went to Safira Breeze Belly Dancing, which included Julie Bharucha ‘13; Soohyung Flakes ’13, Mohamed Hassan ’14, and Betty Yip ‘15. Penn Dental Medicine faculty guest judges, Dr. Arthur Kuperstein, Dr. Arthur Steinberg, and Dr. Mark Koup had selected the winners based on creativity, level of difficulty and audience popularity. Thank you for making GG 2013 such a success!

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More than three women are murdered by their intimate partners in the United States every day1. The loss of just one life is tragic, but three murders every single day indicate a crisis. Intimate partner violence (IPV) puts the lives of 600,000 to 6 million American women at risk annually2. According to several studies, up to 75% of IPV injuries are to head and neck3.

Unfortunately, few dental professionals are knowledgeable of relationship between head and neck injury and IPV4.

One side of this public health dilemma is how widespread it is, while the other side is how little attention it is receiving. For example, few studies have been done to evaluate recognition of IPV abuse by dentists and types of assistance that they provide for their patients in this regard. Nelms et al found that a majority of IPV victims was not asked about abuse by their dentists when signs of trauma to the neck and head were present. Furthermore, his study confirmed that these victims want the abuse to be identified by their dentists4.

Health care provider lack of knowledge about the impact of violence on patients’ lives and their failure to recognize that they can help to remedy this situation makes this situation even more difficult to resolve. This complex public health dilemma requires comprehensive interventions. Yet few effective screening methods have been developed and few of those have been successfully implemented. Negative attitudes, such as stereotypical views of battered women, fear of offending, and lack of knowledge regarding how to handle the situation are among the barriers that health care providerface4.

Education can help us overcome some of these barriers. It gives us the knowledge to diagnose IPV based on the physical signs of trauma as well as behavioral and psychological signs. Armed with appropriate knowledge, providers can better serve a patient ‘s emotional needs and make appropriate referrals for follow-up. With two-third of adults visiting their dentists regularly, dentists and other oral care providers should be at the forefront in diagnosing patients who are the victims of IPV . We have the moral obligation to treat our patients as a whole. Seeking comprehensive education to learn about IPV is the first step a dental professional should take to fulfill this obligation.

References: 1. Catalano, Shannan. " Most intimate partner homicides occur between spouses, though boyfriends/girlfriends have committed about the same number of homicides in recent years." Bureau of Justice Statistics (BJS). 2006. Web. 17 Nov. 2011. <http://bjs.ojp.usdoj.gov/content/intimate/ipv.cfm>. 2. " Women ages 20-24 are at the greatest risk of nonfatal intimate partner violence." Bureau of Justice Statistics (BJS). 2006. Web. 17 Nov. 2011. <http://bjs.ojp.usdoj.gov/content/intimate/ipv.cfm>. 3. Rennison, Callie Marie and Sarah Welchans. 2003. Intimate Partner Violence 1993-2001. U.S. Department of Justice Bureau of Justice Statistics. Washington, DC. Retrieved January 9, 2004. http://www.ojp.usdoj.gov/bjs/abstract/ipv01.htm. 4. Nelms, Amy, Marylou Gutmann, et al. "Journal of Dental Education." Journal of Dental Education . 73.4 (2009). Print.

SPECIAL  REPORT  The  Dental  Professional:    

Forefront  of  Addressing  Intimate  Partner  Violence  

Maryam Akbari ‘14

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“Vivamus porta est sed est.”

With only one full summer, I knew I wanted to make the most of it and found the perfect way to travel without completely forgetting about dentistry.

Pacific Partnership 2012 (PP12), currently in its seventh year, is the largest dedicated annual humanitarian and civil assistance mission in the Asia Pacific. Our home away from home for 6 weeks was the USNS MERCY (T-AH-19), which served as the command platform. The abbreviation T-AH-19 is a civilian operated vessel and 19th auxiliary hospital ship constructed. PP12 seeks to build and strengthen alliances, partnerships and relationships with regional host nations: Indonesia (North Sulawesi), the Philippines (Samar), Vietnam (Vinh) and Cambodia (Sihanoukville), 13 Partner Nations and 23 Foreign Non-Government Organizations (NGO). MERCY, which bears the red cross symbol is impressive and spacious; 272 metres long. Bi-annually, sister ship USNS Comfort (T-AH-20) takes over the reins to provide identical services to South America which other UPSDM students Ross Ulrich (2014) and Kevin Lin (2016) were on the summer of 2011. Additionally, classmate Aiden McKinley (2015) was on a different ship in preparation for PP12 in the summer of 2011 as well.

After 18 hours transit to Calbyog, Phillipines, via Hawaii and Guam and Manila, I boarded USNS MERCY on 18 June 12 and disembarked in Vinh, Vietnam on 23 Jul 12, before a homeward bound flight via Ho Chi Min City and Seoul.

Delivery of Dental Services At each country there were five or six Medical Civil Action Projects (MEDCAP)s dispersed to different locations throughout the each country each spanning five days. MEDCAP’ provided Medical, Dental, Pharmacy and Optometry services to the local communities. Veterinary Civil Action Project (VETCAP)s, Surgical Civil Action Project (SURGCAP)s and Engineering Civil Action Project (ENGCAP)s also provided their respective services. Some MEDCAPs were allocated overnight accommodation in hotels, schools and jungle terrain in some very remote localities.

The first mission port in the Philippines comprised of daily transportation via hovercraft. We left in the early hours of the morning, which was exhausting all before a day’s work had even begun and returned in the evening. At any one time up to three concurrent MEDCAPs were operating ashore. If some cases were more extensive, the patients were referred onboard the ship. Additionally some surgeries in the OR onboard would

require dental procedures and a dentist would restore or extract with patients under general anesthesia. I was able to observe cleft lip and palate

surgeries onboard. The average temperature hovered around 100 degrees or greater resulting in a number of personnel being rotated back to the ship due to heat exhaustion. Of the six MEDCAPs in the Philippines, dental saw a total of 2685 patients and extracted 5336 teeth; not one restoration was placed.

The second port country in Vietnam was a very different experience. Patients would wait in a long line however would come in just for check up and leave. Very few wanted any work preformed on them, although for most cases they were in dire need of dental care due to abscesses and periodontal disease. The dental team was very large in Vietnam so I was able to assist a dermatologist in the OR instead of going out to MEDCAPs. It was an interesting experience to be in an OR and work with surgeon, nurses and medical students. I assisted a dermatologist who performs laser surgery on burn victims. My job like in dental assisting was…. suctioning but not saliva and blood, this time ablated skin tissue, blood and smoke. Dental wise in Vietnam the numbers were down, and I was not able to get the totals before I debarked the ship.

Clinical Cases Dentists would see on average of 15-40 patients per day and extracted 2-3 teeth per patient. With help from the local translators, we were able to grasp the basic dental terms. For many patients, it was their first time seen by a dentist as they do not have access to basic dental services. Beetle nut contributed to the diverse cases we were presented. Chewing beetle nut is a tradition in many Asian and South Pacific cultures which is

carcinogen.

According to North Carolina civilian dentist Stuart Whiddon, “The biggest thing overall that surprised me was the lack of people presenting with swollen faces. Considering the thousands of abscessed teeth we saw in each country, we rarely saw any worrisome cellulitis or acute abscesses. Their ability to wall off infections was impressive; lots of granulation tissue and chronic infection around these abscessed teeth and lots of fistulas. This also made a lot of teeth easier to extract due to bone loss secondary to infection. Periodontal disease was rampant, even in the adolescent population. This also made our job easier doing extractions due to the loss of bone support around these teeth. You would be hard pressed to ever see in the U.S. the kind of heavy calculus deposits we saw on posterior teeth in those 10 year old children in both Indonesia and the Philippines”.

“My most interesting case was the retained primary root (tooth 65) protruding apex first 1.5 cm laterally from the maxilla in a 10 year old Filipino boy, encased in a dense pocket of fibrotic tissue of the upper right cheek. This child could no longer move his right upper lip as it was locked around this root. Simply removing this root allowed normal lip movement to occur again”.

PP12 has given me the opportunity to become fulfilled personally and professionally. As a future Navy Dentist, I got a glimpse into what Navy/Military Dentistry will look like and the protocols within the Navy. I made some great new friends onboard and ashore, observed and unique dental cases as well as collect teeth for Endodontics.

PP12 has given me the opportunity to become

fulfilled personally and professionally.

Dentistry  On  Board  USNS  Mercy  in  Southeast  Asia  

Eunice Lee ‘15

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* Preheat oven to 375*F

* Break graham crackers in half, so they are squares. Lay crackers next to each other, in a single layer on a baking sheet (the size of your baking sheet will determine exactly how many crackers you need).

* Bake graham crackers in pre-heated oven for 4 minutes. Remove from oven and set aside to cool.

* Cream the butter and sugars together in the bowl of an electric mixer.

* Add egg and vanilla.

* In a separate bowl stir flour, baking soda, salt and cinnamon. Then add to butter mixture and mix until just combined.

* Fold in chocolate chips and 1 cup marshmallows.

* Use a large cookie scoop to scoop dough onto graham crackers (on baking sheet).

* Bake for 5 minutes. Then remove pan from oven and press about 2 pieces of chocolate and 2-3 marshmallows into each cookie.

* Bake for 5-7 minutes more. Cool completely, then cut cookies into squares (where the graham crackers meet). EAT AND REPEAT.

   What’s  Cookin’?  

S’MORES COOKIES

Alie Fishman‘15

Alie Fishman ’15 debuted these delicious beauties at Laurel Lee’s ’15 National Breast Cancer Foundation Bake Sale (which raised a whopping $623 during lunch break!). These were a hit and the perfect snack while marveling at Laurel’s new do.

YOU NEED: 2/3 cup butter, room temperature 1 cup brown sugar 1 cup white sugar 1 teaspoon vanilla 1 teaspoon baking soda ½ teaspoon salt ½ teaspoon cinnamon 2 ½ cups flour 1 cup chocolate chips 1 cup mini marshmallows, + ¼ cup for adding on top 2 regular sized Hershey bards, each piece printed with “Hershey” cut in half 2 packages graham crackers broken into squares (1/2 of a full graham cracker sheet)

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ASDA  Supports  Oral  Cancer  Walk/5K  2013     Photos provided by Dentography

Penn Dental Medicine students teamed with students from other area schools to present the Philly Oral Cancer Walk and 5K on April 6, building awareness of oral cancer and raising approximately $15,700 in support of the Oral Cancer Foundation. ASDA is a regular supporter of this worthy cause.

This was the fifth year that students in SDM’s Oral Cancer Society organized the event, and it was the most successful to date. The event drew a total of 203 participants – 104 runners in the 5K and 99 participants in the walk. Both the walk and the run started by Penn Dental Medicine at 40th and Locust Streets and wound through Penn’s campus and the new Penn Park. Bravo to organizing committee members Co-Chairs James Choi ‘14 and Kristopher Paik ‘14 along with Erica Damante ‘14, Sajini Sasthri-R ‘14, Kruti Patel ‘14, Alice Bassani ‘15, Yaniv Harel ‘14, Payal Varma ‘14, Betty Yip ‘15, and Chris Kim ‘15.

Free oral cancer screenings, conducted by SDM and Temple faculty and residents were also part of the day’s activities.

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WORD LIST

Alginate Impression Buccinator Calculus Caries

Dentistry Denture Enamel

Endodontics Floss

Implant Impression Lidocaine

Malocclusion Odontoblast

Papilla Plaque

Prosthesis Pulp

Toothbrush

YOU SAID IT! Any last words before you start clinic?

Good  luck…to  my  patients.  

                     Rakhee  Porecha  ‘15  

Here  goes  nothin’…shout  out  to  my  patients  ahead  of  time  for  being  patient  with  me.  LET’S  DO  THIS.  

Jacob  Britt  ‘15  

N B R A C E S K E K M E D D Y M K S Z O A O M J S W H C F N U G E M N H O E O R C L I W S L J A X Q D N G U K A I I M S A B G S N A O A A Y T O P C H V E R E X L J E I S P L L N U D L D H F N W A X O C F S V N E P L R U Q T H O I K F C P D U X L A D A R E I C D K U A N U E R C O L L V K R F T P I P U H C L W T O V N N U C A F D M R E M Z A O L F B S I P P T S A X L L D O D J I D P R V T Q H C D O M A L O C C L U S I O N L H H I W M S B F M Z S N D D D L E G X E Z S Q B Y M L K F J S Z S C Q T B D S G Q U H C Z A A D E N T I S T R Y N I L Z B R S M I Z S F E U C R E R W L S F T B D B S Q H P T V Q G V J R N H F T D C M K H F D U T M O L Y T R O T A N I C C U B T J L R X K G T M H X W E M M P G Y V B O P T A Y R H L M U V J O N F E W J L S O A H V M E T N A L P M I X C K L I R I T H B L G B