As aging occurs, the maintenance of the genome slowly decreases in efficiency [1]. Since the mechanisms of aging are elusive, studies on premature aging diseases provide good models to unveil the mysteries of aging. Cockayne Syndrome/CS (mutation in Csa or Csb), Xeroderma pigmentosum group A (mutation in Xpa), and Ataxia-telangiectasia mutated (mutation in Atm) are segmental premature aging disorders [1]. Each protein is vital in either Double Strand Break repair (DSB), like ATM, or Nucleotide Excision Repair (NER) in CSA, CSB and XPA. Loss of these proteins cause failures in DNA repair and lead to early aging perhaps due to the accumulation of DNA damage [2-4]. The consequences of genomic instability are neurological and developmental issues as well as increased cancer risk among individuals (except in CS) [5].

As dentists, our first response to the public should be to serve as effectual and compassionate health care providers. This role is one that includes each of us taking the necessary steps to ensure that all populations are provided feasible and affordable quality oral health care. This challenge requires even more individual commitment when we consider the tasks necessary to develop policies and procedures, create training guidelines and establish appropriate facilities to provide this care. It is a challenge that is intensified particularly in caring for and treating some of our most venerably population, that being the elderly socially, economically and physically dependent and independent patients.

In the last few decades, growing interest has been generated in better understanding motor-cognitive integration and the effects exercise has upon cognition in healthy older adults as well as adults with Parkinson’s Disease (PD), a disorder with currently intractable cognitive and motor symptoms. In this perspective piece we will briefly summarize the current research landscape and explore possible mechanisms by which exercise may affect cognition in those with PD. We will then present suggestions on methodological issues that should be addressed to clarify the impact of exercise on function in individuals with PD as well as potential areas for future research aimed at determining ways to limit the motor and non-motor disease burden.

Background: Past research has produced conflicting results concerning the usage of medications and the associated oral health consequences. The authors examined non-cavitated and cavitated coronal and root carious lesions among subjects taking a variety of medications compared to those taking no medications to assess whether the effects of taking multiple medications had on carious lesion prevalence. Objective: The objective of this study was to assess how the different classes of medication adversely affected the oral cavity, specifically in the formation of dental carious lesions. Methods: A representative sample of 1028 volunteers aged 40-80 from the Greater Boston area, with at least 10 natural teeth were included in this study. After disqualifying subjects on medications with autoimmune conditions known to cause xerostomia, or a previous history of radiation to the head and neck area, 882 volunteers on medications known to cause salivary hypofunction and 146 volunteers taking no medications were enrolled. Non-cavitated and cavitated carious lesions were examined by a single calibrated dental examiner using visual and tactile methods. Major medication groups included psychiatric (N=258), single antihypertensive (N=180), multiple antihypertensive including cardiac medications (N=145), a combination of antihypertensive and psychiatric medications (N=85), anti-asthma medications (N=67), Non-Steroidal Anti-Inflammatory (NSAIDs) (N= 34) and all other medications (N=113). Results: Subjects on psychiatric medications had the highest number of total carious lesions (5.4±4.94) while those taking no medications had the least (2.6±2.92). Subjects on a combination of antihypertensive and psychiatric medications had the highest number of carious root surface lesions (1.18±4.06). Those subjects on anti-asthma medications exhibited the highest number of cavitated coronal surface lesions (1.41±2.06). Conclusion: This study found xerostomic medications vary in their deleterious effects on dental carious lesions. A combination of antihypertensive and psychiatric medications is the most detrimental, as evidenced by a higher prevalence of carious lesions in those participants taking them. Clinical significance: As usage of concomitant xerogenic medications is likely to continue to increase, educating clinicians and the general public about the effects on oral health is essential to limiting dental carious lesions by instituting appropriate preventive protocols.

Background: A challenge among today’s nursing educators is promoting student interest in the field of gerontology. Providing a dynamic, engaging experience in the classroom is vital to stimulate a vested interest for students caring for the older adult population. Aims and objectives: The purpose of this literature review seeks to identify innovative teaching strategies that engage undergraduate nursing students in a gerontology nursing course and promote positive attitudes toward caring for the older adult population. Methods: This literature review searched peer-reviewed articles from 2010 to 2015 utilizing CINAHL, MEDLINE, PubMed, EBSCOhost, Psych INFO, Scopus, and Science Direct databases. Relevant topics yielded 170 abstracts, of which 65 were deemed appropriate for full-text appraisal. Twenty-six final articles were included after inclusion and exclusion criteria applied. Findings: Innovative teaching strategies that focus on promoting quality intergenerational contact between student nurses and older adults’ results in improved student engagement with geriatric content facilitating positive attitudes toward caring for the elderly population. Conclusion: The result of the literature review revealed several common themes related to educational strategies to engage and promote positive attitudes of undergraduate student nurses toward older adults. These themes include intergenerational contact through a variety of teaching methods to encourage positive regard toward older adults and the integration of gerontology courses that dispel ageism and stereotypical views of the elderly.

Screening for Adverse Drug Events (ADEs) in nursing home setting is a crucial component of appropriate, quality care. This study examined potential differences in screening for ADEs by nurses and a physician-pharmacist consensus panel. A modified Harvard Medical Practice Study protocol was used in a two-stage screening process to identify ADEs in a retrospective chart review of 134 patients across four care facilities. The study nurse chart reviewers identified 17 of the 134 patients as having experienced an ADE. The total number of incidents identified among the 17 patients was 20. The two most frequent types of nurse identified ADEs were drug reactions (26.7%) and medication errors (10.0%). In contrast, the consensus panel reviewing the same nurse identified 17 patients identified a total of 69 ADE incidents. The largest discrepancy between the two screening groups was in the identification of adverse drug reactions (8 versus 46) and untreated conditions (none versus 7). The results underscore the need for further research examining how health care professionals use their clinical knowledge in identifying ADEs, and the development of protocols that address such possible professional differences.

The goal of the study was to identify and explore the social-ethnic and medical-biological factors underlying the formation of the ‘longevity phenomenon’ in the Azerbaijan region. The study involved 260 long-lived (90-112 years of age) and 3,700 younger-aged subjects (45-89 years) from the Azerbaijan population. The discussed findings highlight the role and interaction of specific social-environmental factors (gerontocratic character of traditional ethnic culture, type of nutrition and psychological personality structure) and molecular-biological mechanisms (anthropometric constitutional types, peculiarities of the bioelectrical brain activity and chromosome polymorphism by heterochromatin) in the Azerbaijanian ‘longevity phenomenon’.

Older adults as a group are on the negative side of the digital divide. The term “digital divide” not only identifies who uses the internet and who does not, but also gradations of digital exclusion, that is, the complexity, depth, and variety of internet use. Lower use rates of computers and the internet among older adults have important social and cost ramifications. As the internet becomes more integrated into everyday life, people who do not use the internet are more likely to become more disenfranchised and disadvantaged. The literature attributes the digital divide affecting older adults to internal characteristics of older adults, such as lower levels of computer literacy, technophobia, lack of perceived usefulness and physical and cognitive deficits. This paper reviews the literature on ageism and on technology adoption for older adults and expands the literature by discussing why ageism may also contribute to the digital divide among older adults.

Few studies have considered cognitive performance in older adults when assessing dietary intake with self-report measures. This pilot study used a small sample (N = 50) of predominantly African American older adults in a geriatric primary care center to better understand the role that cognition may play in obtaining an accurate assessment of dietary intake based on self-report. Two types of dietary self-report measures (Dietary Risk Assessment [DRA], Dietary Health Questionnaire [DHQ 11] Food Frequency Questionnaire [FFQ] combined with a Picture-Sort method) were used to compare the differences in self-report measurement of selected nutrients with two biochemical markers of nutritional status (total cholesterol, serum carotenoids) among participants grouped by levels of cognitive function. Two commonly used cognitive assessment tools (MMSE 11-SV, MiniCog) were found to identify dietary intake risk when cognitive function may be limited. Although the differences in dietary self-report measures and biochemical marker measures were not found to be related to cognitive function, the authors consider explanations to stimulate further research on this challenging topic.

Oxidative stress has been implicated in both aging and the development of pathological cardiovascular illness. Exercise’s role in the management of hypertension is well established and antioxidant supplementation may be beneficial to individuals with chronic health conditions. In combination, the effects of antioxidants and physical activity are controversial. Some studies have suggested that antioxidant supplementation inhibits exercise’s protective modulation of endogenous antioxidant enzymes. There is less research on the combined effects of exercise and antioxidant supplementation in older hypertensive individuals, who are under increased oxidative stress. The aim of our study was to further examine associations between antioxidant intake and exercise in the aetiology of hypertension in older adults. Hypertensive status, weekly physical activity levels and daily antioxidant consumption levels were assessed using questionnaires. We hypothesized that a greater number of normotensive individuals would report both adequate physical activity and adequate antioxidant consumption than hypertensive individuals. While endogenous antioxidants were not examined, results from this study were able to establish trends in antioxidant consumption and physical activity levels and a significant correlation between vitamin A consumption and hypertensive status.

Objective: The average life expectancy in Japan became similar to that in developed Western countries in 1980s. However, the nutritional status of Japanese individuals has continuously deteriorated since. This study evaluated these phenomena using the Japanese time-sequential data and worldwide cross-cultural data. Methods: Japanese trends data of total energy, protein, fat and carbohydrate intake were derived from Japanese National Nutrition Surveys between 1950 and 2014. Total energy intake according to sex and age was also analyzed using these same databases. Trends in average birth weight and the rate of low birth weight (<2,500g) were calculated from Japanese Vital Statistics between 1951 and 2015. A cross-cultural comparison regarding trends of total energy supply (Food Balance Sheets) was made using the 2013 Food and Agriculture Organization (FAO) database between 1992 and 2011. The rates of high (≥30) and low Body Mass Index (BMI) (<18.5) were compared among selected countries based on the WHO Global Database on Body Mass Index (1 November 2016). Results: The total energy intake of Japanese individuals increased until 1970, from which time it decreased progressively. Concordantly, the trend in the decrement of average birth weight and the marked increase of low birth weight (<2,500g) were observed since 1975. The total energy intake remained unchanged only among individuals aged ≥70 years, although it declined in other age groups over the past two decades. The total energy supply between 1992 and 2011 more or less increased worldwide. However, it declined only in Japan. Cross-cultural data revealed that there was a low proportion of Japanese individuals with high BMI (≥30) and a high rate with low BMI (<18.5) as commonly found in developing countries. Conclusion: The present Japanese longevity is a result of the low age-adjusted mortality among individuals aged ≥70 years. The optimistic perspective for longevity in the future should be viewed taking into consideration the deleterious effect on nutritional status in younger generations and low birth weight.

Introduction With advances in technology and our interconnectedness enhanced, the evolution of human life has created a new type of stress, Cultural Stress (CS) and this type of stress has given way to a recognizable syndrome, Cultural Stress Anxiety Syndrome (CSAS), where isolation, anxiety, sedentary lifestyles and depression are the norm and may hasten senescence. Objective The purpose of this pilot study is to explore the effectiveness of an inclusive health method to treat CSAS. Methods Six female patients were treated for 24 weeks with an inclusive health protocol (internal care, external care and emotional care) designed to reverse CSAS, rejuvenate cellular health and slow related degenerative cell aging processes. Clinical tests such as a comprehensive metabolic panel, blood pressure screenings, BMI/weight, stress test, as well as questionnaires, interviews and journaling were used to establish baseline measures, mid-point and final results. This included cohen perceived stress scale; patient health questionnaire PHQ-9; cultural stress questionnaire; dermatology self-reporting skin questionnaire; appearance questionnaire and video interviews; omnia photos; visia photos; clarity pro evaluations; blood pressure and body composition using an RJL system; skin biopsies and a global gene expression analysis using affymetrix microarrays. Results Subjects eliminated the symptoms of CSAS and gene expression examination showed positive results in down-regulation and up-regulation of the genes that influence senescence. Our findings show that inclusive treatment for CSAS can produce positive changes in total wellness and may reduce aging. In specific, we found that treatments that support the cellular water principle theory-which aims to fortify cells and connective tissue, Increase Intracellular Water (ICW) and boost cellular immunity-and address internal, external and emotional stress due to CS, may be useful to encourage maximal youth in aging patients and stave off age-related cellular degeneration. Discussion Accordingly, lifestyle and behavioral management therapies that improve cell health and fortification, in concert with medical treatments, may have the most profound effects on CSAS and epigenetic aging factors.

As aging occurs, the maintenance of the genome slowly decreases in efficiency [1]. Since the mechanisms of aging are elusive, studies on premature aging diseases provide good models to unveil the mysteries of aging. Cockayne Syndrome/CS (mutation in Csa or Csb), Xeroderma pigmentosum group A (mutation in Xpa), and Ataxia-telangiectasia mutated (mutation in Atm) are segmental premature aging disorders [1]. Each protein is vital in either Double Strand Break repair (DSB), like ATM, or Nucleotide Excision Repair (NER) in CSA, CSB and XPA. Loss of these proteins cause failures in DNA repair and lead to early aging perhaps due to the accumulation of DNA damage [2-4]. The consequences of genomic instability are neurological and developmental issues as well as increased cancer risk among individuals (except in CS) [5].

In the last few decades, growing interest has been generated in better understanding motor-cognitive integration and the effects exercise has upon cognition in healthy older adults as well as adults with Parkinsons Disease (PD), a disorder with currently intractable cognitive and motor symptoms. In this perspective piece we will briefly summarize the current research landscape and explore possible mechanisms by which exercise may affect cognition in those with PD. We will then present suggestions on methodological issues that should be addressed to clarify the impact of exercise on function in individuals with PD as well as potential areas for future research aimed at determining ways to limit the motor and non-motor disease burden.

Background: Past research has produced conflicting results concerning the usage of medications and the associated oral health consequences. The authors examined non-cavitated and cavitated coronal and root carious lesions among subjects taking a variety of medications compared to those taking no medications to assess whether the effects of taking multiple medications had on carious lesion prevalence. Objective: The objective of this study was to assess how the different classes of medication adversely affected the oral cavity, specifically in the formation of dental carious lesions. Methods: A representative sample of 1028 volunteers aged 40-80 from the Greater Boston area, with at least 10 natural teeth were included in this study. After disqualifying subjects on medications with autoimmune conditions known to cause xerostomia, or a previous history of radiation to the head and neck area, 882 volunteers on medications known to cause salivary hypofunction and 146 volunteers taking no medications were enrolled. Non-cavitated and cavitated carious lesions were examined by a single calibrated dental examiner using visual and tactile methods. Major medication groups included psychiatric (N=258), single antihypertensive (N=180), multiple antihypertensive including cardiac medications (N=145), a combination of antihypertensive and psychiatric medications (N=85), anti-asthma medications (N=67), Non-Steroidal Anti-Inflammatory (NSAIDs) (N= 34) and all other medications (N=113). Results: Subjects on psychiatric medications had the highest number of total carious lesions (5.4±4.94) while those taking no medications had the least (2.6±2.92). Subjects on a combination of antihypertensive and psychiatric medications had the highest number of carious root surface lesions (1.18±4.06). Those subjects on anti-asthma medications exhibited the highest number of cavitated coronal surface lesions (1.41±2.06). Conclusion: This study found xerostomic medications vary in their deleterious effects on dental carious lesions. A combination of antihypertensive and psychiatric medications is the most detrimental, as evidenced by a higher prevalence of carious lesions in those participants taking them. Clinical significance: As usage of concomitant xerogenic medications is likely to continue to increase, educating clinicians and the general public about the effects on oral health is essential to limiting dental carious lesions by instituting appropriate preventive protocols.

Background: A challenge among today’s nursing educators is promoting student interest in the field of gerontology. Providing a dynamic, engaging experience in the classroom is vital to stimulate a vested interest for students caring for the older adult population. Aims and objectives: The purpose of this literature review seeks to identify innovative teaching strategies that engage undergraduate nursing students in a gerontology nursing course and promote positive attitudes toward caring for the older adult population. Methods: This literature review searched peer-reviewed articles from 2010 to 2015 utilizing CINAHL, MEDLINE, PubMed, EBSCOhost, Psych INFO, Scopus, and Science Direct databases. Relevant topics yielded 170 abstracts, of which 65 were deemed appropriate for full-text appraisal. Twenty-six final articles were included after inclusion and exclusion criteria applied. Findings: Innovative teaching strategies that focus on promoting quality intergenerational contact between student nurses and older adults’ results in improved student engagement with geriatric content facilitating positive attitudes toward caring for the elderly population. Conclusion: The result of the literature review revealed several common themes related to educational strategies to engage and promote positive attitudes of undergraduate student nurses toward older adults. These themes include intergenerational contact through a variety of teaching methods to encourage positive regard toward older adults and the integration of gerontology courses that dispel ageism and stereotypical views of the elderly.

Screening for Adverse Drug Events (ADEs) in nursing home setting is a crucial component of appropriate, quality care. This study examined potential differences in screening for ADEs by nurses and a physician-pharmacist consensus panel. A modified Harvard Medical Practice Study protocol was used in a two-stage screening process to identify ADEs in a retrospective chart review of 134 patients across four care facilities. The study nurse chart reviewers identified 17 of the 134 patients as having experienced an ADE. The total number of incidents identified among the 17 patients was 20. The two most frequent types of nurse identified ADEs were drug reactions (26.7%) and medication errors (10.0%). In contrast, the consensus panel reviewing the same nurse identified 17 patients identified a total of 69 ADE incidents. The largest discrepancy between the two screening groups was in the identification of adverse drug reactions (8 versus 46) and untreated conditions (none versus 7). The results underscore the need for further research examining how health care professionals use their clinical knowledge in identifying ADEs, and the development of protocols that address such possible professional differences

In the last few decades, growing interest has been generated in better understanding motor-cognitive integration and the effects exercise has upon cognition in healthy older adults as well as adults with Parkinsons-Disease (PD), a disorder with currently intractable cognitive and motor symptoms. In this perspective piece we will briefly summarize the current research landscape and explore possible mechanisms by which exercise may affect cognition in those with PD. We will then present suggestions on methodological issues that should be addressed to clarify the impact of exercise on function in individuals with PD as well as potential areas for future research aimed at determining ways to limit the motor and non-motor disease burden.

As aging occurs, the maintenance of the genome slowly decreases in efficiency [1]. Since the mechanisms of aging are elusive, studies on premature aging diseases provide good models to unveil the mysteries of aging. Cockayne Syndrome/CS (mutation in Csa or Csb), Xeroderma pigmentosum group A (mutation in Xpa), and Ataxia-telangiectasia mutated (mutation in Atm) are segmental premature aging disorders [1]. Each protein is vital in either Double Strand Break repair (DSB), like ATM, or Nucleotide Excision Repair (NER) in CSA, CSB and XPA. Loss of these proteins cause failures in DNA repair and lead to early aging perhaps due to the accumulation of DNA damage [2-4]. The consequences of genomic instability are neurological and developmental issues as well as increased cancer risk among individuals (except in CS) [5].

As dentists, our first response to the public should be to serve as effectual and compassionate health care providers. This role is one that includes each of us taking the necessary steps to ensure that all populations are provided feasible and affordable quality oral health care. This challenge requires even more individual commitment when we consider the tasks necessary to develop policies and procedures, create training guidelines and establish appropriate facilities to provide this care. It is a challenge that is intensified particularly in caring for and treating some of our most venerably population, that being the elderly socially, economically and physically dependent and independent patients.

Background: Past research has produced conflicting results concerning the usage of medications and the associated oral health consequences. The authors examined non-cavitated and cavitated coronal and root carious lesions among subjects taking a variety of medications compared to those taking no medications to assess whether the effects of taking multiple medications had on carious lesion prevalence. Objective: The objective of this study was to assess how the different classes of medication adversely affected the oral cavity, specifically in the formation of dental carious lesions. Methods: A representative sample of 1028 volunteers aged 40-80 from the Greater Boston area, with at least 10 natural teeth were included in this study. After disqualifying subjects on medications with autoimmune conditions known to cause xerostomia, or a previous history of radiation to the head and neck area, 882 volunteers on medications known to cause salivary hypofunction and 146 volunteers taking no medications were enrolled. Non-cavitated and cavitated carious lesions were examined by a single calibrated dental examiner using visual and tactile methods. Major medication groups included psychiatric (N=258), single antihypertensive (N=180), multiple antihypertensive including cardiac medications (N=145), a combination of antihypertensive and psychiatric medications (N=85), anti-asthma medications (N=67), Non-Steroidal Anti-Inflammatory (NSAIDs) (N= 34) and all other medications (N=113). Results: Subjects on psychiatric medications had the highest number of total carious lesions (5.4±4.94) while those taking no medications had the least (2.6±2.92). Subjects on a combination of antihypertensive and psychiatric medications had the highest number of carious root surface lesions (1.18±4.06). Those subjects on anti-asthma medications exhibited the highest number of cavitated coronal surface lesions (1.41±2.06). Conclusion: This study found xerostomic medications vary in their deleterious effects on dental carious lesions. A combination of antihypertensive and psychiatric medications is the most detrimental, as evidenced by a higher prevalence of carious lesions in those participants taking them. Clinical significance: As usage of concomitant xerogenic medications is likely to continue to increase, educating clinicians and the general public about the effects on oral health is essential to limiting dental carious lesions by instituting appropriate preventive protocols.

Background: A challenge among today’s nursing educators is promoting student interest in the field of gerontology. Providing a dynamic, engaging experience in the classroom is vital to stimulate a vested interest for students caring for the older adult population. Aims and objectives: The purpose of this literature review seeks to identify innovative teaching strategies that engage undergraduate nursing students in a gerontology nursing course and promote positive attitudes toward caring for the older adult population. Methods: This literature review searched peer-reviewed articles from 2010 to 2015 utilizing CINAHL, MEDLINE, PubMed, EBSCOhost, Psych INFO, Scopus, and Science Direct databases. Relevant topics yielded 170 abstracts, of which 65 were deemed appropriate for full-text appraisal. Twenty-six final articles were included after inclusion and exclusion criteria applied. Findings: Innovative teaching strategies that focus on promoting quality intergenerational contact between student nurses and older adults’ results in improved student engagement with geriatric content facilitating positive attitudes toward caring for the elderly population. Conclusion: The result of the literature review revealed several common themes related to educational strategies to engage and promote positive attitudes of undergraduate student nurses toward older adults. These themes include intergenerational contact through a variety of teaching methods to encourage positive regard toward older adults and the integration of gerontology courses that dispel ageism and stereotypical views of the elderly.

Objective: The average life expectancy in Japan became similar to that in developed Western countries in 1980s. However, the nutritional status of Japanese individuals has continuously deteriorated since. This study evaluated these phenomena using the Japanese time-sequential data and worldwide cross-cultural data. Methods: Japanese trends data of total energy, protein, fat and carbohydrate intake were derived from Japanese National Nutrition Surveys between 1950 and 2014. Total energy intake according to sex and age was also analyzed using these same databases. Trends in average birth weight and the rate of low birth weight (<2,500g) were calculated from Japanese Vital Statistics between 1951 and 2015. A cross-cultural comparison regarding trends of total energy supply (Food Balance Sheets) was made using the 2013 Food and Agriculture Organization (FAO) database between 1992 and 2011. The rates of high (≥30) and low Body Mass Index (BMI) (<18.5) were compared among selected countries based on the WHO Global Database on Body Mass Index (1 November 2016). Results: The total energy intake of Japanese individuals increased until 1970, from which time it decreased progressively. Concordantly, the trend in the decrement of average birth weight and the marked increase of low birth weight (<2,500g) were observed since 1975. The total energy intake remained unchanged only among individuals aged ≥70 years, although it declined in other age groups over the past two decades. The total energy supply between 1992 and 2011 more or less increased worldwide. However, it declined only in Japan. Cross-cultural data revealed that there was a low proportion of Japanese individuals with high BMI (≥30) and a high rate with low BMI (<18.5) as commonly found in developing countries. Conclusion: The present Japanese longevity is a result of the low age-adjusted mortality among individuals aged ≥70 years. The optimistic perspective for longevity in the future should be viewed taking into consideration the deleterious effect on nutritional status in younger generations and low birth weight.

Screening for Adverse Drug Events (ADEs) in nursing home setting is a crucial component of appropriate, quality care. This study examined potential differences in screening for ADEs by nurses and a physician-pharmacist consensus panel. A modified Harvard Medical Practice Study protocol was used in a two-stage screening process to identify ADEs in a retrospective chart review of 134 patients across four care facilities. The study nurse chart reviewers identified 17 of the 134 patients as having experienced an ADE. The total number of incidents identified among the 17 patients was 20. The two most frequent types of nurse identified ADEs were drug reactions (26.7%) and medication errors (10.0%). In contrast, the consensus panel reviewing the same nurse identified 17 patients identified a total of 69 ADE incidents. The largest discrepancy between the two screening groups was in the identification of adverse drug reactions (8 versus 46) and untreated conditions (none versus 7). The results underscore the need for further research examining how health care professionals use their clinical knowledge in identifying ADEs, and the development of protocols that address such possible professional differences.

As dentists, our first response to the public should be to serve as effectual and compassionate health care providers. This role is one that includes each of us taking the necessary steps to ensure that all populations are provided feasible and affordable quality oral health care. This challenge requires even more individual commitment when we consider the tasks necessary to develop policies and procedures, create training guidelines and establish appropriate facilities to provide this care. It is a challenge that is intensified particularly in caring for and treating some of our most venerably population, that being the elderly socially, economically and physically dependent and independent patients.