Dental caries and tooth loss are the two major dental problems in Sjgren's syndrome patients (SSP) that lead to high restorative treatments resulting in increased dental disease burden among these patients. Although caries is very common and largely attributed to xerostomia in these patients, existing studies have not evaluated the characteristics of caries (surface involvement and pattern of caries) and the influence of comorbidities and medications on caries. The Sjgren's Syndrome Foundation (SSF) and the American Dental Association recently developed clinical practice guidelines for the prevention of caries in SSP. However, this guideline is based on expert opinion and lacks clinical validation. Moreover, effectiveness of dental restorations (amalgam and composites) are unknown and no study has evaluated the longevity of direct restorative materials in SSP. In this project, we will validate the study cohort of Sjgren's syndrome (SS) diagnosis, and oral hard tissue findings, characterize dental caries outcomes and assess the longevity of dental restorations using linked dental and medical electronic health record (EHR) of patients with confirmed SS from the Indiana University School of Dentistry (IUSD) and Indiana Network for Patients Care (INPC) respectively. We will generate a dataset that include information such as patients' medical history, medications, and lab reports from electronic medical records at INPC and dental history, dental treatment history, and tooth-surfaces level data from electronic dental records at IUSD. This dataset will be utilized to: (1) generate a validated dataset of patients with confirmed SS diagnosis; 2) assess the role of co-morbidities, and medications on caries outcomes among SSP; 3) determine the longevity of restorations placed in SSP compared to those placed in non-SSP; and 4) assess differences in dental treatments and caries outcomes based on dental provider's awareness of their patient's SS diagnosis. Our project is innovative because it will use linked dental and medical EHR data to identify SSP and generate a large sample size of SSP. This project will address research questions important to patients, dentists and the research community on dental caries and suitable restorations for SSP; produce a generalizable method for linking dental and medical EHR data and extracting various clinical data for research purposes; and create future opportunities to investigate the oral health of patients with rare diseases.
This project will assess the role of co-morbidities, medications, and preventive treatments on caries outcomes among patients with confirmed Sjgren's syndrome (SS) by linking their dental and medical electronic health record data from the Indiana University School of Dentistry and Indiana Network of Patients Care-Research Database (INPC-R) respectively. We will also determine the longevity of restorations placed in patients with confirmed SS diagnosis compared to those placed in patients with non-SS diagnosis and evaluate the role of covariates such as comorbidities, medications, and preventive treatments on the longevity of amalgam, composite resins, and glass ionomer cements. The project will not only answer an important dental research question on dental caries and restorative treatments in SSPs, but also produce generalizable methods for identifying patients with confirmed SS diagnosis by linking dental and medical electronic health record data and extracting various clinical data for clinical, comparative effectiveness, and epidemiological research purposes.
