Joel M. White

Verified

Joel verified their affiliation via an institutional email.

Learn more

Verified

Joel verified their affiliation via an institutional email.

Learn more

• DDS, MS
• Professor (Full) at University of California, San Francisco

Background The objective of this study was to compare two new non-cavitated caries lesion detector methods, LumiCare (LC) and BlueCheck (BC), to each other and to the traditional visual/tactile method (TM) of non-cavitated enamel caries lesion detection on smooth surface lesions. Methods In this non-inferiority study, forty extracted human teeth w...

Objectives Dental decay is endemic in the United States, underscoring the need to measure the utilization of caries risk management tools to elucidate the effect of prevention interventions in reducing the dental decay rates of individuals. An academic institution partnered with a third‐party institute to call attention to the utilization and preve...

Background The objective of this study was to compare, in vitro, two dentinal caries lesion detector methods, Caries Finder and BlueCheck, to determine if they were substantially equivalent in their ability to aid visualization of demineralized dentin and to also to compare their performance compared to the traditional visual/tactile method of dent...

Background: The objective of this study was to compare two dentinal caries lesion detector methods, Caries Finder and BlueCheck, to determine if they were substantially equivalent in their ability to aid visualization of demineralized dentin and to also to compare their performance compared to the traditional visual/tactile method of dentinal carie...

Objectives Learning from clinical data on the subject of safety with regards to patient care in dentistry is still largely in its infancy. Current evidence does not provide epidemiological estimates on adverse events (AEs) associated with dental care. The goal of the dental practice study was to quantify and describe the nature and severity of harm...

Objectives This work describes the process by which the quality of electronic health care data for a public health study was determined. The objectives were to adapt, develop, and implement data quality assessments ( DQAs ) based on the National Institutes of Health Pragmatic Trials Collaboratory ( NIHPTC ) data quality framework within the three d...

Objectives The use of interactive mobile health (mHealth) applications to monitor patient-reported postoperative pain outcomes is an emerging area in dentistry that requires further exploration. This study aimed to evaluate and improve the usability of an existing mHealth application. Materials and methods The usability of the application was asse...

Background Dental Patient Reported Outcomes (PROs) relate to a dental patient’s subjective experience of their oral health. How practitioners and patients value PROs influences their successful use in practice. Methods Semi-structured interviews were conducted with 22 practitioners and 32 patients who provided feedback on using a mobile health (mH...

Aim To develop and validate an automated electronic health record (EHR)‐based algorithm to suggest a periodontal diagnosis based on the 2017 World Workshop on the Classification of Periodontal Diseases and Conditions. Materials and Methods Using material published from the 2017 World Workshop, a tool was iteratively developed to suggest a periodon...

Importance Process-based quality measures are generally intended to promote evidence-based practices that have been proven to improve outcomes. However, due to lack of standardized implementation of diagnostic codes in dentistry, assessing the association between process and oral health outcomes has been challenging. Objective To estimate the asso...

Purpose This study aims to report the development of a preclinical simulation laboratory Demonstration Video Series (DVS) for the 2021–2022 academic year, measure its usage and usefulness, and compare these findings to the usage and usefulness of the existing didactic lecture videos. Methods The DVS videos were intended to be viewed before each pr...

The overarching goal of the third scientific oral health symposium was to introduce the concept of a learning health system to the dental community and to identify and discuss cutting‐edge research and strategies using data for improving the quality of dental care and patient safety. Conference participants included clinically active dentists, dent...

BACKGROUND Post-operative dental pain is pervasive and can significantly affect a patient's quality of life. Adopting a patient-centric approach to pain management involves having contemporaneous information about the patient's experience of pain and using it to personalize care. OBJECTIVE In this study, we evaluated the use of an mHealth platform...

Background Postoperative dental pain is pervasive and can affect a patient’s quality of life. Adopting a patient-centric approach to pain management involves having contemporaneous information about the patient’s experience of pain and using it to personalize care. Objective In this study, we evaluated the use of a mobile health (mHealth) platform...

Importance: While large oral health disparities remain by race and ethnicity among children, the associations of race, ethnicity, and mediating factors with oral health outcomes are poorly characterized. Identifying the pathways that explain these disparities would be critical to inform policies to effectively reduce them. Objective: To measure...

Objective: This study assessed contributing factors associated with dental adverse events (AEs). Methods: Seven electronic health record-based triggers were deployed identifying potential AEs at 2 dental institutions. From 4106 flagged charts, 2 reviewers examined 439 charts selected randomly to identify and classify AEs using our dental AE type...

Background Patient-reported outcome measures provide an essential perspective on the quality of health care provided. However, how data are collected, how providers value and make sense of the data, and, ultimately, use the data to create meaningful impact all influence the success of using patient-reported outcomes. Objectives The primary objecti...

Objectives: To develop outcomes of care quality measures derived from the dental electronic health record (EHR) to assess the occurrence and timely treatment of tooth decay. Methods: Quality measures were developed to assess whether decay was treated within 6 months and if new decay occurred in patients seen. Using EHR-derived data of the state...

Background: To achieve high-quality health care, adverse events (AEs) must be proactively recognized and mitigated. However, there is often ambiguity in applying guidelines and definitions. We describe the iterative calibration process needed to achieve a shared definition of AEs in dentistry. Our alignment process includes both independent and co...

Background A learning health system (LHS) is a health system in which patients and clinicians work together to choose care on the basis of best evidence and to drive discovery as a natural outgrowth of every clinical encounter to ensure the right care at the right time. An LHS for dentistry is now feasible, as an increased number of oral health car...

Objectives: While adverse events (AEs) are all too prevalent, their underlying causes are difficult to assess because they are often multifactorial. Standardizing the language of dental AEs is an important first step toward increasing patient safety for the dental patient. Methods: We followed a multimodal approach building a dental AE inventory...

Objectives Bone level as measured by clinical attachment levels (CAL) are critical findings that determine the diagnosis of periodontal disease. Deep learning algorithms are being used to determine CAL which aid in the diagnosis of periodontal disease. However, the limited field-of-view of bitewing x-rays poses a challenge for convolutional neural...

Few clinical datasets exist in dentistry to conduct secondary research. Hence, a novel dental data repository called BigMouth was developed, which has grown to include 11 academic institutions contributing Electronic Health Record data on over 4.5 million patients. The primary purpose for BigMouth is to serve as a high-quality resource for rapidly...

Introduction: Chart review is central to understanding adverse events (AEs) in medicine. In this article, we describe the process and results of educating chart reviewers assigned to evaluate dental AEs. Methods: We developed a Web-based training program, "Dental Patient Safety Training," which uses both independent and consensus-based curricula...

Background Longitudinal patient level data available in the electronic health record (EHR) allows for the development, implementation, and validations of dental quality measures (eMeasures). Objective We report the feasibility and validity of implementing two eMeasures. The eMeasures determined the proportion of patients receiving a caries risk ass...

Deep learning algorithms has recently been used to determine clinical attachment levels (CAL) which aid in the diagnosis of periodontal disease. However, the limited field-of-view of dental bitewing x-rays poses a challenge for convolutional neural networks (CNN) because out-of-view anatomy cannot be directly considered. This study presents an inpa...

Background Our objective was to measure the proportion of patients for which comprehensive periodontal charting, periodontal disease risk factors (diabetes status, tobacco use, and oral home care compliance), and periodontal diagnoses were documented in the electronic health record (EHR). We developed an EHR-based quality measure to assess how well...

Poor oral health, and biological impact of oral disease, affects a person's general health and well-being. Using electronic dental health record data to identify high-risk dental caries patients coupled with a new oral health team member, the dental care advocate (DCA) facilitated the dental organization's ability to create TechQuity by enabling ou...

Background Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following the pilot’s success, a formal “dental c...

Objectives The study evaluates the efficacy to remineralize artificial and natural dentin lesions through restorative dental procedures that include the Polymer-Induced Liquid Precursor (PILP) method comprising polyaspartic acid (pAsp). Methods Novel ionomeric cement compositions based on bioglass 45S5 and pAsp mixtures, as well as conditioning so...

Background: Our objective was to measure the proportion of patients for which comprehensive periodontal charting, periodontal disease risk factors (diabetes status, tobacco use, and oral home care compliance), and periodontal diagnoses were documented in the electronic health record (EHR). We developed an EHR-based quality measure to assess how wel...

Objective: Our objective was to evaluate four different methods for monitoring annually defined quality measures on a monthly basis, so as to best predict year-end performance throughout the reporting year. Methods: We developed four methods for monitoring annual measures by month: 1) Monthly Proportion: The proportion of patients with one or more...

Objectives Learning health‐care systems are foundational for measuring and achieving value in oral health care. This article describes the components of a preventive dental care program and the quality of care in a large dental accountable care organization. Methods A retrospective study design describes and evaluates the cross‐sectional measures...

Background: Although sealants are an established and recommended caries-preventive treatment, many children still fail to receive them. In addition, research has shown that existing measures underestimate care by overlooking the sealable potential of teeth before evaluating care. To address this, the authors designed and evaluated 3 novel dental e...

Objectives: Despite a significant national investment in oral health, there is little understanding of the return in terms of quality. Value-based payments aim to refocus provider reimbursement based on the value created to the patient. Our objectives were to apply a set of dental quality measures to help determine the value of preventive dental c...

Background: Errors can happen during patient care, and some result in harm to the patient. Work place stress has been well established in dentistry, but its relation with errors in the delivery of patient care is less understood. The authors evaluated the relationship between burnout, work engagement, and self-reported dental errors among American...

Background This study addresses a gap in the literature regarding dental patients’ perceptions about safety at the dental office and their attitudes towards reporting of safety concerns and experiences. Methods We conducted a cross-sectional study with adult dental patients at an academic dental institution over a six-week study period. A 16-item...

Objectives Medical errors are among the leading causes of death within the United States. Studies have shown that patients can be harmed while receiving care, sometimes resulting in permanent injury or, in extreme cases, death. To reduce the risk of patient safety incidents, it is imperative that a robust culture of safety be established. The prima...

Background Patients may be inadvertently harmed while undergoing dental treatments. To improve care, we must first determine the types and frequency of harms that patients experience, but identifying cases of harm is not always straightforward for dental practices. Mining data from electronic health records is a promising means of efficiently detec...

Caries indices, the basis of epidemiologic caries measures, are not easily obtained in clinical settings. This study's objective was to design, test, and validate an automated program (Valid Electronic Health Record Dental Caries Indices Calculator Tool [VERDICT]) to calculate caries indices from an electronic health record (EHR). Synthetic use cas...

Process-of-care quality measure research can be used to identify gaps in the delivery of dental services to pregnant patients. The aim of this study was to evaluate the types of dental services that pregnant patients received in four dental clinics over five years as documented in the electronic health record (EHR). To accomplish this objective, th...

Introduction:: Electronic health record (EHR) systems provide investigators with rich data from which to examine actual impacts of care delivery in real-world settings. However, confounding is a major concern when comparison groups are not randomized. Objectives:: This article introduced a step-by-step strategy to construct comparable matched gr...

Background In recent years, several state dental programs, researchers and the Dental Quality Alliance (DQA) have sought to develop baseline quality measures for dentistry as a way to improve health outcomes, reduce costs and enhance patient experiences. Some of these measures have been tested and validated for various population groups. However, t...

Introduction: To fill the void created by insufficient dental terminologies, a multi-institutional workgroup was formed among members of the Consortium for Oral Health Research and Informatics to develop the Dental Diagnostic System (DDS) in 2009. The adoption of dental diagnosis terminologies by providers must be accompanied by rigorous usability...

Background: Although sealants are highly effective in preventing caries in children, placement rates continue to be low. The authors' goals were to implement and assess the performance of 2 existing sealant quality measures against a manual audit of charts at 4 dental institutions and to identify measurement gaps that may be filled by using data f...

Background We can now quantify and characterize the harm patients suffer in the dental chair by mining data from electronic health records (EHRs). Most dental institutions currently deploy a random audit of charts using locally developed definitions to identify such patient safety incidents. Instead, selection of patient charts using triggers and a...

Purpose We report on an accelerated and effective way of assimilating a new leader into a team at a large academic dental school department. Methods At University of California, San Francisco (UCSF), a new Chair was recruited through a national search to lead its largest department in the School of Dentistry. Two months after arrival, the new Chai...

The routine use of standardized diagnostic terminologies (DxTMs) in dentistry has long been the subject of academic debate. This paper discusses the strategies suggested by a group of dental stakeholders to enhance the uptake of DxTMs. Through unstructured interviewing at the ‘Toward a Diagnosis-Driven Profession’ National Conference held on 19 Mar...

Background Patients with diabetes are at increased risk of developing oral complications, and annual dental examinations are an endorsed preventive strategy. The authors evaluated the feasibility and validity of implementing an automated electronic health record (EHR)–based dental quality measure to determine whether patients with diabetes received...

Background: Dentists strive to provide safe and effective oral healthcare. However, some patients may encounter an adverse event (AE) defined as "unnecessary harm due to dental treatment." In this research, we propose and evaluate two systems for categorizing the type and severity of AEs encountered at the dental office. Methods: Several existin...

As dental schools continue to seek the most effective ways to provide clinical education for students, it is important to track the effects innovations have on students' clinical experience to allow for quantitative comparisons of various curricula. The aim of this study was to compare the impact of three successive clinical curricula on students'...

Background: Standardized dental diagnostic terminologies (SDDxTs) were introduced decades ago. Their use has been on the rise, accompanying the adoption of electronic health records (EHRs). One of the most broadly used terminologies is the Dental Diagnostic System (DDS). Our aim was to assess the adoption of SDDxTs by US dental schools by using th...

Background Documenting standardized dental diagnostic terms represents an emerging change for how dentistry is practiced. We focused on a mid-sized dental group practice as it shifted to a policy of documenting patients’ diagnoses using standardized terms in the electronic health record. Methods Kotter’s change framework was translated into interv...

Background: Although some patients experience adverse events (AEs) resulting in harm caused by treatments in dentistry, few published reports have detailed how dental providers describe these events. Understanding how dental treatment professionals view AEs is essential to building a safer environment in dental practice. Methods: The authors int...

A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this s...

Background: There is little agreement on a universally accepted periodontal risk assessment, periodontal diagnosis, and treatment management tool and their incorporation into dental practice to improve patient care. This article highlights the development and use of a practical periodontal management and risk assessment program that can be impleme...

Background: Quality improvement requires using quality measures that can be implemented in a valid manner. Using guidelines set forth by the Meaningful Use portion of the Health Information Technology for Economic and Clinical Health Act, the authors assessed the feasibility and performance of an automated electronic Meaningful Use dental clinical...

Objective: Secondary data are a significant resource for in-depth epidemiologic and public health research. It also allows for effective quality control and clinical outcomes measurement. To illustrate the value of structured diagnostic entry, a use case was developed to quantify adherence to current practice guidelines for managing chronic modera...

Attitudes and views are critical to the adoption of innovation. Although there have been broadening calls for a standardized dental diagnostic terminology, little is known about the views of private practice dental team members regarding the adoption of such a terminology. The authors developed a survey by using validated questions identified throu...

Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety o...

Research has demonstrated the validation of specific caries risk assessment (CRA) systems, but little is known about how dental practitioners assign a caries risk level to their patients. The aim of this study was to explore dental students' decision making in caries risk assignment when using the Caries Management By Risk Assessment (CAMBRA) syste...

The authors conducted a study to determine the frequency and type of adverse events (AEs) associated with dental devices reported to the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. The authors downloaded and reviewed the dental device-related AEs reported to MAUDE from January 1, 1996, through Dec...

Few oral health databases are available for research and the advancement of evidence-based dentistry. In this work we developed a centralized data repository derived from electronic health records (EHRs) at four dental schools participating in the Consortium of Oral Health Research and Informatics. A multi-stakeholder committee developed a data gov...

Objectives: To evaluate 6 months clinical performance of amalgam and atraumatic restorative treatment (ART) restorations in primary teeth. The long-term goal of the research is to compare 1 year survival rates and determinants of the survival rate of the restorations. Methods: 220 children aged 5 to 11 years, with at least one carious primary too...

Objective To comparatively evaluate the effectiveness of three different methods involving end-users for detecting usability problems in an EHR: user testing, semi-structured interviews and surveys. Materials and methods Data were collected at two major urban dental schools from faculty, residents and dental students to assess the usability of a d...

Although dentists perform highly technical procedures in complex environments, patient safety has not received the same focus in dentistry as in medicine. Cultivating a robust patient safety culture is foundational to minimizing patient harm, but little is known about how dental teams view patient safety or the patient safety culture within their p...

Objective: To compare baseline demographics and procedure times of amalgam and atraumatic restorative treatment (ART) restorations in primary teeth. The long-term goal of the research is to compare 1 year survival rates and determinants of the survival rate of the restorations. Method: Two hundred children aged 5 to 11 years, with at least one ca...

Objectives: Check lists are advocated as a means to improve quality, reduce errors and increase patient safety. Objectives: To assess the additive effectiveness of an educational checklist to instruction and clinical directives in dental patient care. Methods: Clinic directives (CD=memos, e mails, clinic oversight, accreditation preparation and cli...

Objective: To test the ability of the Consortium for Oral Health Research and Informatics Dental Data Repository (COHRI-DDR) to reproduce the analysis of the association between periodontal attachment loss and self-reported history of heart attack from the National Health and Nutrition Examination Survey (NHANES) III data. Method: Data from NHANE...

Objectives: To compare student clinical experience over four dental curricula, discipline based care (set requirements, R), comprehensive care (no set requirements, NR), patient centered care (hybrid, combination of requirements and comprehensive care, H) and H with externship (hybrid plus experience outside the on campus dental school clinics, HE)...

The need for a risk assessment has been reported in many domains in dentistry. Considerable research has been published related to the validation of specific caries risk assessment (CRA) systems but very little is known about how practitioners use a specific system to assign a caries risk level to their patients. “Objectives: ”, To explore the deci...

Treatment planning, an essential component of clinical practice, has received little attention in the dental literature and there appears to be no consistent format being followed in the teaching and development of treatment plans within dental school curricula. No investigation, to our knowledge, has been carried out to explore the subject of trea...

Although standardized terminologies such as the International Classification of Diseases have been in use in medicine for over a century, efforts in the dental profession to standardize dental diagnostic terms have not achieved widespread acceptance. To address this gap, a standardized dental diagnostic terminology, the EZCodes, was developed in 20...

Background: Poor usability is one of the major barriers for optimally using electronic health records (EHRs). Dentists are increasingly adopting EHRs, and are using structured data entry interfaces to enter data such that the data can be easily retrieved and exchanged. Until recently, dentists have lacked a standardized terminology to consistently...

This randomized parallel group clinical trial assessed whether combined antibacterial and fluoride therapy benefits the balance between caries pathological and protective factors. Eligible, enrolled adults (n = 231), with 1-7 baseline cavitated teeth, attending a dental school clinic were randomly assigned to a control or intervention group. Saliva...

The present manuscript presents the results of a six-year retrospective study validating caries risk assessment in a caries management by risk assessment program in a large predominantly adult patient population seeking dental care. CRA was successful in accurately identifying patients at high caries risk. Caries risk assessment in a CAMBRA program...

Standardized treatment procedure codes and terms are routinely used in dentistry. Utilization of a diagnostic terminology is common in medicine, but there is not a satisfactory or commonly standardized dental diagnostic terminology available at this time. Recent advances in dental informatics have provided an opportunity for inclusion of diagnostic...