Shawn Adibi | The University of Texas Health Science Center at Houston (original) (raw)
Papers by Shawn Adibi
Journal of dental education, 2016
Temporomandibular disorders and orofacial pain (TMD/OFP) conditions are challenging to diagnose f... more Temporomandibular disorders and orofacial pain (TMD/OFP) conditions are challenging to diagnose for predoctoral dental students due to the multifactorial etiology, complexity, and controversial issues surrounding these conditions. The aim of this study was to determine if patients in the clinic of one U.S. dental school reported existing signs and symptoms of TMD/OFP, whether the dental students diagnosed the condition based on the reported signs and symptoms, and if the condition was then treated. The study was based on a retrospective analysis of electronic health record data over a three-year period. The results showed that, during the study period, 21,352 patients were treated by student providers. Of those patients, 5.33% reported signs or symptoms associated with TMD/OFP; 5.99% received a TMD/OFP diagnosis; and 0.26% received at least one form of TMD/OFP treatment that had either a diagnosis or signs/symptoms of TMD/OFP. In addition, a small percentage (0.24%) of patients with...
Texas dental journal, 2015
Texas dental journal, 2015
Texas Dental Journal, Dec 1, 2012
A key mission of a dental school is to train students to be competent dentists through the delive... more A key mission of a dental school is to train students to be competent dentists through the delivery of comprehensive care to patients. Comprehensive care is defined as a seamless and integrated dental treatment that addresses all patients' dental needs. Identification of a health care problem is the essential first step in quality improvement to medical education curriculum and its outcomes. It is critical for students to receive adequate clinical experience and for patients to receive needed treatment. This study assessed the degree to which comprehensive care was delivered from the patient and student perspective, and to determine why patients discontinue their course of treatment. We conducted a retrospective analysis of electronic health record (EHR) data in one group practice at the University of Texas School of Dentistry at Houston. Semistructured interviews of patients, students and faculty were also conducted. The results showed that 29% of assessed and admitted patients received comprehensive care. A large proportion of dropouts occurred after the third or fourth visit. It took on average 9.8 visits and 210 days for patients to complete their planned treatments. Dental students had a patient family of 25-29 patients, delivered 75% of their care in their fourth year, and predominantly provided restorative treatments compared with other dental disciplines. Interview transcripts were analyzed to determine strengths, weaknesses, and opportunities relating to the provision of comprehensive care. Patients perceived that they received cost effective and high quality care. Students and faculty provided suggestions for streamlining care. Findings from both the retrospective analysis of EHR data and semi-structured interviews revealed several areas for improvement. One solution that was subsequently piloted was to combine the separate assessment and treatment planning appointments into a single all-day session to reduce patient dropouts. During the pilot period over the summer session, 84 patients were scheduled in the combined assessment and treatment planning session. Of this population, 69% percent were accepted and deemed suitable for undergraduate care. And 83% among those accepted received a treatment plan on the first appointment. In the future we expect to integrate more formal evidence-based exercises and reassess the impact of these changes in improving educational and clinical care outcomes. In addition we expect to adopt evidence-based solutions and reassess the impact of these changes in improving educational and clinical care outcomes.
MD consists of a number of clinical conditions of the temporomandibular joint (TMJ), the masticat... more MD consists of a number of clinical conditions of the temporomandibular joint (TMJ), the masticatory muscles, and related structures (1). The etiology of TMD is said to be multifactorial, typically presenting with symptoms such as pain and/or tenderness of the muscles of mastication, clicking of the TMJ, limited jaw movements, orofacial pain, and other symptomatology. The prevalence of TMD in the general population is reported to be 5%-12% (2,3). There also are studies indicating that up to 75% of the population studied had at least one symptom/sign of Abstract Several etiologic routes have either been determined or proposed for Temporomandibular Disorders (TMD). Notable among these are myofascial, disc displacement, and arthritides disorders. The absence of concrete and universally accepted evidence-based treatment approaches means that debates as to the precise etiology and treatment of TMDs continue while practitioners attempt to treat and improve the lives of patients who present with these debilitating disorders. The use of oral splints (OS) by clinicians with responsibility to manage TMDs is quite popular, even though its mechanism of action and efficacy remains unclear. This article reviews the rationale for the continued use of OS for the management of TMDs.
Texas Dental Journal, Aug 1, 2010
Lack of transparency in funded research can compromise clinical decision-making in an evidence-ba... more Lack of transparency in funded research can compromise clinical decision-making in an evidence-based practice. Transparency can be defined as full disclosure of all financial assistance and support to authors and investigators. There is a perception that ethical principles are eroding and that research data can be biased due to conflicts of interest. These research outcomes biased or not, are used for clinical decision-making in the evidence-based practice. One suggested solution to this common ethical dilemma is to continue the dialogue on transparency in research and to create oversight bodies which include representatives from business and industry, private practice, academia, and research. There is increasing evidence of the need for more ethics education at all levels.
Journal of Dentistry, Oral Disorders & Therapy, 2014
Human growth and development of dentition generally follows an orderly pattern of an eruption seq... more Human growth and development of dentition generally follows an orderly pattern of an eruption sequence of primary dentition of 20 teeth, followed by an interim time of mixed dentition and concluding with 32 permanent teeth.
Journal of dental education
The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the ... more The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the Dental Diagnostic System (DDS) terminology in the axiUm electronic health record (EHR). This collaborative pilot study had two aims: 1) to investigate whether use of the DDS terms positively impacted predoctoral dental students' critical thinking skills measured by the Health Sciences Reasoning Test (HSRT), and 2) to refine study protocols. The study design was a natural experiment with cross-sectional data collection using the HSRT for 15 classes (2013-17) of students at three dental schools. Characteristics of students who had been exposed to the DDS terms were compared with students who had not, and the differences were tested by t-tests or chi-square tests. Generalized linear models were used to evaluate the relationship between exposure and outcome on the overall critical thinking score. The results showed that exposure was significantly related to overall score (p=0.01), with not-exposed students having lower mean overall scores. This study thus demonstrated a positive impact of using the DDS terminology in an EHR on the critical thinking skills of predoctoral dental students in three COHRI schools as measured by their overall score on the HSRT. These preliminary findings support future research to further evaluate a proposed model of critical thinking in clinical dentistry.
Journal of dental education, 2015
The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the ... more The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the Dental Diagnostic System (DDS) terminology in the axiUm electronic health record (EHR). This collaborative pilot study had two aims: 1) to investigate whether use of the DDS terms positively impacted predoctoral dental students' critical thinking skills measured by the Health Sciences Reasoning Test (HSRT), and 2) to refine study protocols. The study design was a natural experiment with cross-sectional data collection using the HSRT for 15 classes (2013-17) of students at three dental schools. Characteristics of students who had been exposed to the DDS terms were compared with students who had not, and the differences were tested by t-tests or chi-square tests. Generalized linear models were used to evaluate the relationship between exposure and outcome on the overall critical thinking score. The results showed that exposure was significantly related to overall score (p=0.01), with n...
Journal of dental education, 2012
Recent advances in cone beam computed tomography (CBCT) in dentistry have identified the importan... more Recent advances in cone beam computed tomography (CBCT) in dentistry have identified the importance of providing outcomes related to the appropriate use of this innovative technology to practitioners, educators, and investigators. To assist in determining whether and what types of evidence exist, the authors conducted PubMed, Google, and Cochrane Library searches in the spring of 2011 using the key words "cone beam computed tomography and dentistry." This search resulted in over 26,900 entries in more than 700 articles including forty-one reviews recently published in national and international journals. This article is based on existing publications and studies and will provide readers with an overview of the advantages, disadvantages, and indications/contraindications of this emerging technology as well as some thoughts on the current educational status of CBCT in U.S. dental schools. It is the responsibility of dental educators to incorporate the most updated informatio...
Texas dental journal, 2011
Texas dental journal, 2010
Lack of transparency in funded research can compromise clinical decision-making in an evidence-ba... more Lack of transparency in funded research can compromise clinical decision-making in an evidence-based practice. Transparency can be defined as full disclosure of all financial assistance and support to authors and investigators. There is a perception that ethical principles are eroding and that research data can be biased due to conflicts of interest. These research outcomes biased or not, are used for clinical decision-making in the evidence-based practice. One suggested solution to this common ethical dilemma is to continue the dialogue on transparency in research and to create oversight bodies which include representatives from business and industry, private practice, academia, and research. There is increasing evidence of the need for more ethics education at all levels.
Texas dental journal, 2012
A key mission of a dental school is to train students to be competent dentists through the delive... more A key mission of a dental school is to train students to be competent dentists through the delivery of comprehensive care to patients. Comprehensive care is defined as a seamless and integrated dental treatment that addresses all patients' dental needs. Identification of a health care problem is the essential first step in quality improvement to medical education curriculum and its outcomes. It is critical for students to receive adequate clinical experience and for patients to receive needed treatment. This study assessed the degree to which comprehensive care was delivered from the patient and student perspective, and to determine why patients discontinue their course of treatment. We conducted a retrospective analysis of electronic health record (EHR) data in one group practice at the University of Texas School of Dentistry at Houston. Semistructured interviews of patients, students and faculty were also conducted. The results showed that 29% of assessed and admitted patients...
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2012
The Journal of the Michigan Dental Association, 2014
Several etiologic routes have either been determined or proposed for temporomandibular disorders ... more Several etiologic routes have either been determined or proposed for temporomandibular disorders (TMD). Notable among these are myofascial, disc displacement, and arthritides disorders. The absence of concrete and universally accepted evidence-based treatment approaches means that debates as to the precise etiology and treatment of TMDs continue while practitioners attempt to treat and improve the lives of patients who present with these debilitating disorders. The use of oral splints (OS) by clinicians with responsibility to manage TMDs is quite popular, even though its mechanism of action and efficacy remains unclear. This article reviews the rationale for the continued use of OS for the management of TMDs.
General Dentistry, 2008
The irritation fibroma is a benign proliferation that occurs as a response to local irritation. I... more The irritation fibroma is a benign proliferation that occurs as a response to local irritation. It is an elevated pedunculated or sessile lesion that ranges in size from a few millimeters to a few centimeters and is normal in color, although it may appear to be more pale than the normal mucosa. This article describes the case of a 39-year-old woman with an asymptomatic nodular lesion that involved the left buccal mucosa. The lesion was removed using an Er,Cr:YSGG laser. Only topical anesthesia was applied to the fibroma and adjacent mucosa and no infiltration was required. No pain medication or antibiotics were required after surgery and wound healing was excellent and achieved rapidly. The oral pathology report confirmed the presurgical clinical diagnosis. Laser excision is a modern approach for treating oral soft tissue lesions and should be considered as an alternative to conventional scalpel surgery.
Journal of dental education, 2016
Temporomandibular disorders and orofacial pain (TMD/OFP) conditions are challenging to diagnose f... more Temporomandibular disorders and orofacial pain (TMD/OFP) conditions are challenging to diagnose for predoctoral dental students due to the multifactorial etiology, complexity, and controversial issues surrounding these conditions. The aim of this study was to determine if patients in the clinic of one U.S. dental school reported existing signs and symptoms of TMD/OFP, whether the dental students diagnosed the condition based on the reported signs and symptoms, and if the condition was then treated. The study was based on a retrospective analysis of electronic health record data over a three-year period. The results showed that, during the study period, 21,352 patients were treated by student providers. Of those patients, 5.33% reported signs or symptoms associated with TMD/OFP; 5.99% received a TMD/OFP diagnosis; and 0.26% received at least one form of TMD/OFP treatment that had either a diagnosis or signs/symptoms of TMD/OFP. In addition, a small percentage (0.24%) of patients with...
Texas dental journal, 2015
Texas dental journal, 2015
Texas Dental Journal, Dec 1, 2012
A key mission of a dental school is to train students to be competent dentists through the delive... more A key mission of a dental school is to train students to be competent dentists through the delivery of comprehensive care to patients. Comprehensive care is defined as a seamless and integrated dental treatment that addresses all patients' dental needs. Identification of a health care problem is the essential first step in quality improvement to medical education curriculum and its outcomes. It is critical for students to receive adequate clinical experience and for patients to receive needed treatment. This study assessed the degree to which comprehensive care was delivered from the patient and student perspective, and to determine why patients discontinue their course of treatment. We conducted a retrospective analysis of electronic health record (EHR) data in one group practice at the University of Texas School of Dentistry at Houston. Semistructured interviews of patients, students and faculty were also conducted. The results showed that 29% of assessed and admitted patients received comprehensive care. A large proportion of dropouts occurred after the third or fourth visit. It took on average 9.8 visits and 210 days for patients to complete their planned treatments. Dental students had a patient family of 25-29 patients, delivered 75% of their care in their fourth year, and predominantly provided restorative treatments compared with other dental disciplines. Interview transcripts were analyzed to determine strengths, weaknesses, and opportunities relating to the provision of comprehensive care. Patients perceived that they received cost effective and high quality care. Students and faculty provided suggestions for streamlining care. Findings from both the retrospective analysis of EHR data and semi-structured interviews revealed several areas for improvement. One solution that was subsequently piloted was to combine the separate assessment and treatment planning appointments into a single all-day session to reduce patient dropouts. During the pilot period over the summer session, 84 patients were scheduled in the combined assessment and treatment planning session. Of this population, 69% percent were accepted and deemed suitable for undergraduate care. And 83% among those accepted received a treatment plan on the first appointment. In the future we expect to integrate more formal evidence-based exercises and reassess the impact of these changes in improving educational and clinical care outcomes. In addition we expect to adopt evidence-based solutions and reassess the impact of these changes in improving educational and clinical care outcomes.
MD consists of a number of clinical conditions of the temporomandibular joint (TMJ), the masticat... more MD consists of a number of clinical conditions of the temporomandibular joint (TMJ), the masticatory muscles, and related structures (1). The etiology of TMD is said to be multifactorial, typically presenting with symptoms such as pain and/or tenderness of the muscles of mastication, clicking of the TMJ, limited jaw movements, orofacial pain, and other symptomatology. The prevalence of TMD in the general population is reported to be 5%-12% (2,3). There also are studies indicating that up to 75% of the population studied had at least one symptom/sign of Abstract Several etiologic routes have either been determined or proposed for Temporomandibular Disorders (TMD). Notable among these are myofascial, disc displacement, and arthritides disorders. The absence of concrete and universally accepted evidence-based treatment approaches means that debates as to the precise etiology and treatment of TMDs continue while practitioners attempt to treat and improve the lives of patients who present with these debilitating disorders. The use of oral splints (OS) by clinicians with responsibility to manage TMDs is quite popular, even though its mechanism of action and efficacy remains unclear. This article reviews the rationale for the continued use of OS for the management of TMDs.
Texas Dental Journal, Aug 1, 2010
Lack of transparency in funded research can compromise clinical decision-making in an evidence-ba... more Lack of transparency in funded research can compromise clinical decision-making in an evidence-based practice. Transparency can be defined as full disclosure of all financial assistance and support to authors and investigators. There is a perception that ethical principles are eroding and that research data can be biased due to conflicts of interest. These research outcomes biased or not, are used for clinical decision-making in the evidence-based practice. One suggested solution to this common ethical dilemma is to continue the dialogue on transparency in research and to create oversight bodies which include representatives from business and industry, private practice, academia, and research. There is increasing evidence of the need for more ethics education at all levels.
Journal of Dentistry, Oral Disorders & Therapy, 2014
Human growth and development of dentition generally follows an orderly pattern of an eruption seq... more Human growth and development of dentition generally follows an orderly pattern of an eruption sequence of primary dentition of 20 teeth, followed by an interim time of mixed dentition and concluding with 32 permanent teeth.
Journal of dental education
The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the ... more The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the Dental Diagnostic System (DDS) terminology in the axiUm electronic health record (EHR). This collaborative pilot study had two aims: 1) to investigate whether use of the DDS terms positively impacted predoctoral dental students' critical thinking skills measured by the Health Sciences Reasoning Test (HSRT), and 2) to refine study protocols. The study design was a natural experiment with cross-sectional data collection using the HSRT for 15 classes (2013-17) of students at three dental schools. Characteristics of students who had been exposed to the DDS terms were compared with students who had not, and the differences were tested by t-tests or chi-square tests. Generalized linear models were used to evaluate the relationship between exposure and outcome on the overall critical thinking score. The results showed that exposure was significantly related to overall score (p=0.01), with not-exposed students having lower mean overall scores. This study thus demonstrated a positive impact of using the DDS terminology in an EHR on the critical thinking skills of predoctoral dental students in three COHRI schools as measured by their overall score on the HSRT. These preliminary findings support future research to further evaluate a proposed model of critical thinking in clinical dentistry.
Journal of dental education, 2015
The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the ... more The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the Dental Diagnostic System (DDS) terminology in the axiUm electronic health record (EHR). This collaborative pilot study had two aims: 1) to investigate whether use of the DDS terms positively impacted predoctoral dental students' critical thinking skills measured by the Health Sciences Reasoning Test (HSRT), and 2) to refine study protocols. The study design was a natural experiment with cross-sectional data collection using the HSRT for 15 classes (2013-17) of students at three dental schools. Characteristics of students who had been exposed to the DDS terms were compared with students who had not, and the differences were tested by t-tests or chi-square tests. Generalized linear models were used to evaluate the relationship between exposure and outcome on the overall critical thinking score. The results showed that exposure was significantly related to overall score (p=0.01), with n...
Journal of dental education, 2012
Recent advances in cone beam computed tomography (CBCT) in dentistry have identified the importan... more Recent advances in cone beam computed tomography (CBCT) in dentistry have identified the importance of providing outcomes related to the appropriate use of this innovative technology to practitioners, educators, and investigators. To assist in determining whether and what types of evidence exist, the authors conducted PubMed, Google, and Cochrane Library searches in the spring of 2011 using the key words "cone beam computed tomography and dentistry." This search resulted in over 26,900 entries in more than 700 articles including forty-one reviews recently published in national and international journals. This article is based on existing publications and studies and will provide readers with an overview of the advantages, disadvantages, and indications/contraindications of this emerging technology as well as some thoughts on the current educational status of CBCT in U.S. dental schools. It is the responsibility of dental educators to incorporate the most updated informatio...
Texas dental journal, 2011
Texas dental journal, 2010
Lack of transparency in funded research can compromise clinical decision-making in an evidence-ba... more Lack of transparency in funded research can compromise clinical decision-making in an evidence-based practice. Transparency can be defined as full disclosure of all financial assistance and support to authors and investigators. There is a perception that ethical principles are eroding and that research data can be biased due to conflicts of interest. These research outcomes biased or not, are used for clinical decision-making in the evidence-based practice. One suggested solution to this common ethical dilemma is to continue the dialogue on transparency in research and to create oversight bodies which include representatives from business and industry, private practice, academia, and research. There is increasing evidence of the need for more ethics education at all levels.
Texas dental journal, 2012
A key mission of a dental school is to train students to be competent dentists through the delive... more A key mission of a dental school is to train students to be competent dentists through the delivery of comprehensive care to patients. Comprehensive care is defined as a seamless and integrated dental treatment that addresses all patients' dental needs. Identification of a health care problem is the essential first step in quality improvement to medical education curriculum and its outcomes. It is critical for students to receive adequate clinical experience and for patients to receive needed treatment. This study assessed the degree to which comprehensive care was delivered from the patient and student perspective, and to determine why patients discontinue their course of treatment. We conducted a retrospective analysis of electronic health record (EHR) data in one group practice at the University of Texas School of Dentistry at Houston. Semistructured interviews of patients, students and faculty were also conducted. The results showed that 29% of assessed and admitted patients...
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2012
The Journal of the Michigan Dental Association, 2014
Several etiologic routes have either been determined or proposed for temporomandibular disorders ... more Several etiologic routes have either been determined or proposed for temporomandibular disorders (TMD). Notable among these are myofascial, disc displacement, and arthritides disorders. The absence of concrete and universally accepted evidence-based treatment approaches means that debates as to the precise etiology and treatment of TMDs continue while practitioners attempt to treat and improve the lives of patients who present with these debilitating disorders. The use of oral splints (OS) by clinicians with responsibility to manage TMDs is quite popular, even though its mechanism of action and efficacy remains unclear. This article reviews the rationale for the continued use of OS for the management of TMDs.
General Dentistry, 2008
The irritation fibroma is a benign proliferation that occurs as a response to local irritation. I... more The irritation fibroma is a benign proliferation that occurs as a response to local irritation. It is an elevated pedunculated or sessile lesion that ranges in size from a few millimeters to a few centimeters and is normal in color, although it may appear to be more pale than the normal mucosa. This article describes the case of a 39-year-old woman with an asymptomatic nodular lesion that involved the left buccal mucosa. The lesion was removed using an Er,Cr:YSGG laser. Only topical anesthesia was applied to the fibroma and adjacent mucosa and no infiltration was required. No pain medication or antibiotics were required after surgery and wound healing was excellent and achieved rapidly. The oral pathology report confirmed the presurgical clinical diagnosis. Laser excision is a modern approach for treating oral soft tissue lesions and should be considered as an alternative to conventional scalpel surgery.