International Partners in Health
NYUCD-Henry Schein Cares Global Student Outreach Program Provides Free Care, Conducts Research in Bluefields, Nicaragua

From March 27 through April 2, the NYUCD-Henry Schein Cares Global Student Outreach Program provided oral health care to approximately 700 children and adults in collaboration with the local Moravian Church in Bluefields, Nicaragua. Located on the Atlantic "Mosquito Coast," Bluefields is the chief Caribbean port of Nicaragua. Bluefields and its surrounding communities are home to an estimated 70,000 inhabitants composed of the indigenous Miskito, Creole, and Mestizo peoples.

The event was open to all Bluefields residents, focusing primarily on children at the Moravian School and adults requiring emergency care. Treatment included oral hygiene instruction, screenings, composite and amalgam restorations, fluoride applications, sealants, stainless steel crowns, root canal therapy, X-rays, and extractions. The dental outreach team included 15 students, eight residents, and six faculty members.

In addition, NYU College of Dentistry and College of Nursing faculty members Vera W. L. Tang, DDS, MS, clinical assistant professor of cariology and comprehensive care, and Kelley Newlin, DNSc, ARNP-C, assistant professor of nursing, collaboratively conducted research designed to contribute to the growing science linking diabetes and oral disease. Three years ago, Dr. Newlin initiated a diabetes research project in partnership with the local Moravian Church. The project established a clinic to provide free diabetes screenings and treatment under the supervision of local nurses who specialize in diabetes management.

Both diabetes and periodontal screenings and treatment are available through the new, collaborative dental-nursing study, whose goals are to determine the correlation between the oral HbA1c tests and peripheral blood HbA1c tests, and whether a single intervention of subgingival scaling and root planing with Arestin,® a long-acting antibiotic, can result in lower HbA1c levels.

Seventy-five adults diagnosed with periodontal disease were offered diabetes testing performed by nurses using a peripheral blood HbA1c determination and by dentists using an oral HbA1c determination. The oral HbA1c results were compared with peripheral HbA1c results to determine the reliability of oral HbA1c testing. Patients diagnosed with diabetes were offered treatment including comprehensive diabetes education, evidence-based lifestyle interventions for promotion of physical activity, weight-control interventions targeting overall improvements in glycemic levels, and medications, if needed. Forty patients diagnosed with diabetes and severe periodontal disease were given the option for treatment by scaling and root planing with Arestin.® Follow-up visits coordinated with the local nursing staff will include peripheral HbA1c glucose monitoring every three months for one year.

Initial findings show that the oral HbA1c test and peripheral blood HbA1c test both have a high correlation and may be used interchangeably. This has the potential to enable dentists to make immediate therapeutic decisions and to offer education and intervention to periodontal patients, thus improving patient treatment outcomes.