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.