Eastman Dental Loses Beloved Family Member – Dr. Subtelny

Dr. Subtelny

Dr. J. Daniel Subtelny passed away September 17.

Dr. J. Daniel Subtelny passed away peacefully in his sleep last night. He was 92.

His esteemed 60-year career and dedication to orthodontics, Eastman Dental and his students are truly unparalleled. Widely regarded as one of the world’s foremost educators in orthodontics, he continued to serve as chairman and program director of EIOH’s Orthodontics and Dentofacial Orthopedics Division.

Hundreds have benefited from his teaching style and leadership. Widely known and admired for the Hot Seat, an intense class Dr. Subtelny developed and became every orthodontics resident’s rite of passage. Many credit the Hot Seat experience for building confidence, knowledge and leadership unlike any other.

Year after year, residents and faculty express their gratitude for his endless support, guidance and kind mentorship. It’s no surprise he’s the only one who has earned all four of the highest honors in the orthodontics profession:
• American Association of Orthodontists’ research honor, the Milo Hellman Award (1959)
• AAO Foundation’s honor for teaching, the Louise Ada Jarabek Memorial International Orthodontic Teachers and Research Award (1993)
• American Board of Orthodontics – Albert H. Ketcham Memorial Award (1996)
• AAO’s James E. Brophy Distinguished Service Award (2006).

He also received the New York State Dental Association’s highest honor, the Jarvie-Burkhart Award, in recognition of the great service rendered to mankind in dentistry. The NYS Dental Association is a constituent of the American Dental Association and represents more than 13,000 dentists practicing in New York State.

Dr. Dan Subtelny will be deeply missed. As soon as we have details about a memorial service, we will share them. In the meantime, please keep his family and orthodontics family in your thoughts and prayers during this very difficult time.

Posted in Eastman Institute for Oral Health | 7 Comments

Toothbrush Techniques? EIOH Experts Weigh in

Only brush the teeth you want to keep, many dentists will quip.

man brushing teeth stockBut joking aside, how often and how well we brush our teeth can make a significantly positive or negative impact on our oral health. A study published recently in the British Dental Journal and gaining wide media attention, showed that there is little agreement among experts around the world on the technique that is best to prevent cavities and gum disease.

Eastman Institute for Oral Health experts say the best technique for one person may not be the best approach for another.

“Frankly, the best technique is whatever each person needs to do to for their particular dental situation,” stated Michael Yunker, DDS, EIOH assistant professor and assistant program director for the Advanced Education in General Dentistry program. “Most people think the purpose of brushing and cleaning between the teeth is to remove food particles, when the real purpose is to remove dental plaque–the almost invisible layer of fluids, cells, food debris, and microorganisms that collects on the surfaces of the teeth and gums, leading to dental disease if left in place.”

Because people are different, proper oral hygiene requires different approaches, depending on the oral conditions of each individual patient. In the past, Dr. Yunker said that patients were instructed to use the biggest, stiffest brush available and to brush hard. “This is no longer the case,” Dr. Yunker explained. “A smaller brush will contact difficult-to -reach areas and the soft bristles are best for use against the delicate gum tissues.”

Dr. Michael Yunker Eastman Institute for Oral Health

Dr. Michael Yunker
Eastman Institute for Oral Health

“Additionally, if there are spaces between the teeth that allow the bristles of the brush to extend to the areas between the teeth,” continued Dr. Yunker, “then more of the tooth surface can be reached by the toothbrush.” However, if the teeth are crowded or at least touching, then the bristles are only able to contact the part of the teeth that is visible, no matter how well a person brushes.

“And then there are some who need an electric toothbrush because they have a disability or simply don’t have the dexterity to use a regular toothbrush,” he added. “For some, another person may actually have to do the cleaning for them. You have to use whatever is easiest that still does the job. If the work becomes too hard or too time-consuming, a person’s natural instinct is to not do it.”

After surveying dental association guidelines in the United States, Australia, Brazil, Canada, Denmark, Finland, Japan, Norway, Sweden and the United Kingdom, British researchers and authors of the study learned that six different methods of manual tooth brushing are recommended (described below). They also reviewed guidelines published by toothpaste and toothbrush companies, and textbooks at Eastman Dental Hospital in London, among other sources. Many, including the American Dental Association, recommend the Bass technique, holding the brush at a 45-degree angle to the gum and making very short back-and-forth movements.

“Generally, I suggest a scrubbing technique similar to the Bass Technique for brushing with the bristles directed toward the gum and into the spaces between the teeth, trying to get the tips of the bristles to go into the area between the teeth and between the teeth and gums,” explained Dr. Yunker. “For the biting surfaces of the teeth, I suggest a back-and-forth scrubbing motion.”

Cleaning between the teeth depends on the condition of the gum tissues, and the size of the spaces between the teeth, Yunker added. “If there are minimal spaces between the teeth, then flossing is best, making sure to wrap the floss around the tooth to keep from cutting into the gum tissue,” he said. “But if there are larger spaces between the teeth or the patient has bone loss from periodontal disease, I suggest Stimudents or other types of interdental picks or circular bristle brushes for cleaning. They are easier to use than floss and cover more surface area.”

Joseph Fantuzzo, DDS, MD, chair, Oral and Maxillofacial Surgery Division, also said that recommendations will vary per person, especially if they are recovering from oral surgery or for effecting hygiene around their dental implants, for example. “I recommend minimally brushing twice daily using a modified bass technique. I encourage my patients to spend 10 seconds per each tooth surface, and always remind them about the critical importance of flossing.”

mother and son brushing teeth stockStill, brushing is only part of an effective system of oral hygiene that will prevent and reduce dental problems, Dr. Yunker emphasized “An effective system of oral hygiene includes good nutritional habits, limiting snacks between meals, cleaning between the teeth, getting enough fluoride and visiting a dentist regularly on a schedule individualized for the patient.

So many options! How does one know the best choice for a healthy smile?

Dr. Yunker suggests using fluoride-containing toothpaste that is not a tartar control paste, a stain removing paste, or a whitening paste. “These are too abrasive and if used by a vigorous brusher, will cause tooth and gum abrasion,” he said. “Some people are sensitive to the chemicals in tartar control toothpastes and notice gingival sensitivity and irritation after use.”

For more information about the wide range of toothpaste options, visit http://www.webmd.com/oral-health/guide/weighing-your-toothpaste-options
Toothbrushing Methods

Fones – this is the oldest method and is recommended mainly for children, using large sweeping circles over the teeth, with the toothbrush at right angles to the tooth surface.
Bass technique – emphasizes plaque removal from the area above and just below the gum line by holding the brush at a 45-degree angle to the gum and making very short back-and-forth movements.
Modified Bass – the bristle position and predominantly horizontal brush movements stay the same, but use vertical and sweeping motions to create circles
Stillman – similar to the Bass technique, but using vertical motions
Scrub – the simplest technique, the toothbrush is held parallel to the gingiva and horizontal motions are used to scrub the gingival crevice in an ordered fashion.
Hirschfield -circular motion is much smaller and concentrated

Other Brushing Tips:
Brush at least twice a day. One of those times should be just before you go to bed. When you sleep, your mouth gets drier. This makes it easier for acids from bacteria to attack your teeth.
Brush lightly. Brushing too hard can damage your gums. It can cause them to recede (move away from the teeth). Plaque attaches to teeth like jam sticks to a spoon. It can’t be totally removed by rinsing, but a light brushing will do the trick. Once plaque has hardened into calculus (tartar), brushing can’t remove it. If you think you might brush too hard, hold your toothbrush the same way you hold a pen. This encourages a lighter stroke.
Brush for at least two minutes. Set a timer if you have to, but don’t skimp on brushing time. Two minutes is the minimum time you need to clean all of your teeth. Many people brush for the length of a song on the radio. That acts as a good reminder to brush each tooth thoroughly.
Have a standard routine for brushing. Try to brush your teeth in the same order every day. This can help you cover every area of your mouth. If you do this routinely, it will become second nature. For example, you can brush the outer sides of your teeth from left to right across the top, then move to the inside and brush right to left. Then brush your chewing surfaces, too, from left to right. Repeat the pattern for your lower teeth.
Always use a toothbrush with soft or extra-soft bristle. The harder the brush, the greater the risk of harming your gums.
Change your toothbrush regularly. Throw away your old toothbrush after three months or when the bristles start to flare, whichever comes first. If your bristles flare much sooner than every three months, you may be brushing too hard. Try easing up.
Choose a brush that has a seal of approval by the American Dental Association. The type of brush you use isn’t nearly as important as brushing the right way and doing it twice a day. Any approved brush will be a good tool, but you have to know how to use it.

Sources: British Dental Journal (www.nature.com/bdj)
Simple Steps to Better Dental Health (simplestepsdental.com)

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Pediatric Dentist Learned to Address Barriers, Advocate for Patients at EIOH

Dr. Mathew

Dr. Mathew

When Moncy Mathew, DDS, MPH, who graduated from the Eastman Dental pediatric dentistry program, encountered patients with complex psychosocial issues, he sought consultation with Eastman Dental’s social worker.

During on-call one evening, Dr. Mathew recognized that a dentist’s responsibility does not end with providing emergency dental care in the hospital’s Emergency Department.

“While patients have dental needs, we rarely understand the obstacles families experience in trying to access dental care,” he said. “One of the most difficult challenges we face when treating children is addressing those barriers. Teamwork is very important in dentistry, and collaborating with social work allows us to address barriers and to be successful in treating children who otherwise would suffer from not being part of a dental home.”

The following scenario describes how the collaboration between Pediatric Dentistry and Social Work has benefited a patient.

Suspected Dental Neglect
little girl toothache stockDr. Mathew was called to the ED late one night when a 2 year-old female presented with a dental abscess, large facial swelling, and fever. Initially, the patient was brought to a local hospital emergency room; however was transported to Strong Hospital via ambulance.

During the oral assessment, Dr. Mathew identified extensive cavitation on multiple teeth, with some teeth requiring extraction.” The child’s mother reported that she obtained sole custody since leaving the relationship eight months ago and that the child’s father is incarcerated.

Following a psychosocial risk assessment the ED Social Worker filed a Child Protective Report for suspicion of medical neglect and lack of proper guardianship. The child was discharged the next morning and instructed to follow up at Eastman Dental.

Dr. Mathew and EIOH Sr. Social Worker Lenora Colaruotolo discussed the case and strategized how to approach the family. Despite two voice mail messages, the family failed to follow through or confirm the child received follow-up dental care with another dental provider. Due to the severity of the child’s treatment needs, along with the concern that the dental neglect was soon going to cause a subsequent visit to the ED, we collaborated on how to facilitate the child’s care.

The assigned Child Protective caseworker and Colaruotolo partnered to support the mother in obtaining insurance for the child, and follow up with Eastman Dental. As a result, the child received necessary dental care in the operating room under general anesthesia.

Getting to Know Dr. Mathew

Why do you want to be a pediatric dentist?
As a Public Health Dentist, my efforts had been focused on preventing dental caries at the population level. I had been involved with water fluoridation, school-based fluoride rinse programs and dental sealant programs at the state level. While working as faculty at the dental school, I was asked if I would work locum tenens for a school-based dental program to cover for a dentist on maternity leave. I began to enjoy working with children and wanted more. Over the next 5 years, I received more locum tenens requests and every experience was better than the previous one. I realized, although late in life, my calling was to working with children and decided to pursue pediatric dentistry.

How did you become interested in dentistry?
I always wanted a profession that included working with my hands. After exploring numerous options, I decided to pursue dentistry as it had more of an emphasis on the ‘art’ of dentistry within the science of the profession. It appeared very rewarding when something that you could do with your hands could help people attain a better quality of life with improved oral health.

Describe your experience with Eastman Dental.
During the residency match process, I had ranked EIOH as my first choice. One of the factors that influenced my decision was the presence of a social worker within the dental department. No other program that I interviewed at had a social worker.

The pediatric dentistry program has a perfect balance between didactic coursework and clinical experiences. Dentistry is so much more than just teeth – the resources available through the Strong Hospital made my experience more well-rounded and enjoyable. I hope the knowledge and skills learnt at EIOH will help me be a more compassionate dentist.

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$1.3 Million Prosthodontic Clinic Renovation Complete at Eastman Dental

prostho clinic entranceDental patients have begun to enjoy the recently completed $1.3 million renovation and expansion in Eastman Dental’s Prosthodontic clinic.  Additional treatment rooms, the latest technology and new equipment have improved patient privacy and comfort, and enhanced care provision.

“This is another example at Eastman and the Medical Center of our commitment to patient care excellence,” said UR Medicine CEO Bradford C. Berk, M.D., Ph.D., at the ribbon cutting ceremony. “Similar to the new children’s hospital and the new cancer center, Eastman Institute is undergoing a transformation to meet the same state-of-the-art standard we expect in all of our clinical spaces.”

A formal ceremony was held to celebrate the new space.

A formal ceremony was held to celebrate the new space.

University of Rochester employee Mary Hines, 55, decided to give Eastman Dental a try when her teeth and gums became very sensitive to cold air, along with discomfort when chewing hot or cold foods.

After she was examined by Eastman Dental’s periodontist (a dentist who specializes in treating gum disease and placing dental implants), Hines learned that she had severe gum disease, which was not only causing her sensitivity, but also causing her teeth to become loose (view her story on video).

Mary Hines teeth before

Mary Hines’ teeth before treatment

“Gum disease becomes severe when the plaque on the teeth isn’t treated properly,” expained Tal Rapoport, D.M.D., the periodontist who treated Hines. “The bacteria basically take over and travel down to where the teeth are attached and eat away at what’s holding the tooth in place. Bone loss, inflammation, gum bleeding, sensitivity and pain are definitely present at this point.”

Dr. Rapoport provided Hines with extensive periodontal treatment, including a thorough and deep cleaning.

“Severe periodontal disease almost always requires some surgery, as well,” Dr. Rapoport explained. “When everything is clean, the gums will attach back to the tooth and bone. In some cases, bone loss can be reversed with adding new bone to the area.”

This is one of several new rooms with the latest technology.

This is one of several new rooms with the latest technology.

“After the inflammation has been taken care of, it’s important to know that it’s critical to keep the gums healthy or the disease will recur,” she added. “In addition, placing dental implants while there is active periodontal disease will likely contribute to the failure of the implant.”

Now, with her periodontal disease treated and regularly monitored, Hines was ready to move forward with getting the dental implants she’s always wanted. A childhood injury caused her front tooth to die, and her gum disease created tooth movement, resulting in a large, undesirable space.

Between Eastman Dental’s reputation for excellent work, affordable rates, a discount as a UR employee, and some insurance coverage, Hines said the choice was easy.

Mary's teeth after

Mary Hines’ teeth after treatment at Eastman Dental.

To accomplish her esthetic goals with the limitations of her bone loss, Rapoport and Chief Prosthodontist Resident Elyce Link-Bindo, D.M.D., worked together using the latest technology in 3D surgical planning before removing Hines’ top teeth and placing six implants.

Over the next several months, Drs. Link-Bindo and Rapoport made sure Hines was comfortable with her ability to chew, speak and smile during the transition.

Dr. Tal Rapoport

Dr. Tal Rapoport, Eastman Dental Periodontist

“Throughout the year-long treatment time, I had to make removable

Dr. Elyce Link-Bindo, Prosthodontist

Dr. Elyce Link-Bindo, Prosthodontist

dentures to allow for healing after the implants were placed,” explained Dr. Link-Bindo. “When the implants were healed, I made her two different sets of temporary teeth to assess her esthetics and speech throughout the process.”

These temporary teeth attached to the implants and molded her gum gum tissue to make the teeth look as they were coming out of the gums. Dr. Link-Bindo and Hines had met several times to ensure all of the Hines’ esthetic desires were addressed. Once everything had healed and she was satisfied with her new look, Dr. Link-Bindo made her final teeth prosthesis.

“If I knew then, what I know now,” Hines reflected. “But I’ve become really passionate about my cleanings; they taught me how to brush my teeth right, and the importance of flossing. Overall, it’s been a wonderful experience.

“The care I received at Eastman Dental has been awesome, and felt like they cared about what I was going through,” Hines said. “They made my life different. Before, I wouldn’t even talk or smile. I would mumble because I didn’t want anyone to notice my teeth. Now I smile a lot more!”

For more information or to schedule a free screening, call 585-275-1147 or visit Eastman Dental.




Posted in Alumni, Clinical, Eastman Dental Center, Eastman Institute for Oral Health, Education | Tagged , , , , , | 2 Comments

Marit Aure, PhD, Shares 1st Place in World-Wide Dental Research Contest

Postdoctoral associate Marit Aure, PhD, of the Center for Oral Biology in the Eastman Institute for Oral Health, tied for first place at the highly-competitive International

Marit Aure, PhD

Marit Aure, PhD, tied for first place for her salivary gland research.

Association for Dental Research/Johnson & Johnson Hatton Awards Competition held recently in Cape Town, South Africa.

The judges determined that the science presented by Aure and Korea’s Joo-young Park, was exemplary in both projects, surpassing 36 other researchers from around the world in their category. This is the first time in IADR history that two first place winners were named, with no second place winner.

Aure had qualified for the international competition by earning second place in the American Association of Dental Research/Johnson & Johnson Hatton Awards Competition, held in Charlotte, North Carolina in March. For the international round of the competition, all participants were required to condense the research talk into a four-slide, 10-minute presentation to be given in front of three judges.

“Telling the whole story in 10 minutes and four slides was especially challenging,” said Aure, who said the poker-faced judges had some very tough questions. “My reaction to winning was a mix of surprise, excitement and joy! It feels really good to get positive feedback and exposure for the salivary research we’re doing.”

Aure, who works in the lab of Catherine Ovitt, PhD, associate professor in Biomedical Genetics in EIOH’s Center for Oral Biology, presented “Mechanisms of Acinar Cell Maintenance in the Adult Murine Salivary Gland,” which revealed that replacement of cells in the salivary gland depends primarily on the duplication of the secretory cells, rather than on stem cells. The outcome of this work is important for designing a strategy to repair damaged salivary glands, as it indicates this may be accomplished by using healthy salivary gland cells for transplant therapy. Park’s research involved the genetic basis for cervical lymph node enlargement.

Aure and Park

Aure (left) and Park shared first place at the International Association Dental Research conference in South Africa.

Aure and Park, who each won $1,600, competed in the Senior Basic Science Category, where entrants must be enrolled in a post-dental, post-graduate, or Ph.D. program or have performed the unpublished research submitted to the competition within three years of earning a PhD. All the meeting abstracts will be featured in a special edition of the Journal of Dental Research online.

Aure completed her undergraduate, master’s and PhD degrees in her native Norway. She met Ovitt a few years ago at a Gordon conference on Salivary Glands where she was presenting her PhD research.

Dr. Catherine Ovitt

Catherine Ovitt, PhD, has mentored Aure for the last couple years.

“Marit’s background training and her research interests made her a great postdoctoral candidate, and I invited her to apply for a position with us,” Ovitt said. “She came from Norway to join my laboratory after completing her PhD, and has put enormous effort into this project over the past two and a half years. We are thrilled with her accomplishments – both at the bench and in the competitions! Her results not only change the way we think about the renewal of salivary glands, but they also serve as the basis for a new R01 application just submitted to NIDCR, which proposes to follow the fate of acinar cells after radiation treatment.”

The International Association for Dental Research, headquartered in Alexandria, Va. is a nonprofit organization with more than 11,500 members worldwide. Its mission is to advance research and increase knowledge for the improvement of oral health worldwide, to support and represent the oral health research community; and to facilitate the communication and application of research findings.

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Five Recognized for Research Excellence

Five Eastman Institute for Oral Health professionals were recognized at this month’s American Association for Dental Research’s local meeting.

Dozens of visitors reviewed all the poster presentations.

Dozens of visitors reviewed all the poster presentations.

One of the coveted awards is named after Dr. William Bowen, who is seen here reviewing a research project.

Thirty researchers from the Rochester area participated in oral and poster presentations covering a wide range of basic and translational science topics, such as fluoride varnish effectiveness, use of therapy dogs in pediatric dental settings and the success of implants, among many others.

Twenty of these competed for one of the three coveted awards:

The Basil G. Bibby Award is given for outstanding scientific merit among oral and poster presentations by non-degree candidates, such as technical staff, international dental students, residents and those not currently enrolled in an MS or PhD program.

The Michael G. Buonocore Award is given for outstanding scientific merit among oral and poster presentations by degree candidates.

The Bowen Award is given for outstanding scientific merit among oral and poster presentations by candidates in postdoctoral programs.

Each award winner is selected by a panel of judges on the basis of outstanding scientific merit through relevance and originality of hypothesis, clarity of presentation, use of innovative experimental design, methods or data presentation and/or findings or results that contribute significantly to the field of interest.

Winner Leandro Carneiro, center, with Dr. Eli Eliav and Dr. Dorota Kopycka-Kedzierawski

Winner Leandro Carneiro, center, with Dr. Eli Eliav and Dr. Dorota Kopycka-Kedzierawski

Leandro Carneiro, DDS, a Periodontics resident, won the Basil G. Bibby award for his oral presentation on Biomechanical and Histological Evaluation of a New Dental Implant, An Experimental Study in Dogs.

Vanessa Munoz, Prep student, in Dr. Quivey’s lab, won the Basil G. Bibby award for her poster, “Coordinate Regulation of Acid Adaptive Genes in S. mutans. By CodY and CcpA.

Alejandro Aviles Reyes, a Microbiology and Immunology graduate student in Dr. Lemos’ lab, won the Michael G. Buonocore award for his oral presentation, “Modification of Streptococcus mutans Cnm by PgfS Contributes to adhesion, Endothelial Cell Invasin and Virulence.

(l to r) Brendaliz Santiago, Dr. Robert Quivey, Vanessa Munoz, Alejandro Aveiles Reyes, Dr. Jacqueline Abranches, Dr. Jose Lemos, and Marit Aure.

(l to r) Brendaliz Santiago, Dr. Robert Quivey, Vanessa Munoz, Alejandro Aveiles Reyes, Dr. Jacqueline Abranches, Dr. Jose Lemos, and Marit Aure.

Brendaliz Santiago, PhD, a Postdoctoral Fellow in Dr. Quivey’s lab, won the William H. Bowen award for her oral presentation on Amino Acid Metabolism Contriutes to acid Adaptation and Virulence in S. Mutans.

Marit Aure, PhD, a Postdoctoral Associate in Dr. Ovitt’s lab, also won the William H. Bowen award for her poster presentation, Mechanisms of Acinar Cell Maintenance in the Adult Salivary Gland.

Catherine E. Ovitt, PhD, associate professor of Biomedical Genetics in EIOH’s Center for Oral Biology, delivered the keynote address, “Saving Saliva: Where do We Start?” The awards were presented immediately after her presentation.

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EIOH Expands International Partnerships

EIOH and Dammam leaders

EIOH recently hosted visitors from Saudi Arabia’s Dammam University (from left: EIOH AEGD Chair Dr. Hans Malmstrom, Dammam Associate Dean Dr. Sulaiman Alagl, EIOH Director Dr. Eli Eliav, and Dammam Dean Dr. Fahad Al-Harbi

Eastman Institute for Oral Health is expanding its global impact through new partnerships with Universities in Kuwait and Saudi Arabia to establish an advanced general dentistry faculty development and training program.

Two dentists from both Kuwait University and Dammam University will travel to Rochester and participate in a four to five- year program which requires 1) completing the two-year Advanced Education in General Dentistry program, 2) earning a Master of Science or Master of Public Health degree, 3) passing the American Board of General Dentistry exam and 4) engaging in at least two years of part-time teaching. Participants will also be enrolled in graduate courses in education at the Warner School of Education.

“We’re very excited about this unique program to educate the future educators,” said Hans Malmstrom, DDS, professor and chair, General Dentistry and AEGD program director. “This initiative fits perfectly with our mission for faculty development and training in clinical-translational research, clinical care and teaching. It also fits their need for highly trained faculty to accommodate the several dental schools they are opening in both countries.”

Serious discussions began a couple years ago when visitors from Kuwait University visited EIOH to learn more about the AEGD program and a master’s degree to prepare them for an academic career.

Shortly thereafter, Malmstrom was invited to lecture at Dammam University in neighboring Saudi Arabia about esthetic and implant dentistry, where he had the opportunity to discuss the possibility of this program with the administration there. Like Kuwait University, the School of Dentistry at the University of Dammam is expanding and also has an increasing need for qualified faculty members.

saudi map“There are numerous mutual benefits for establishing a closer collaboration with our colleagues in Kuwait and Saudi Arabia,” said EIOH Director Eli Eliav, DMD, PhD, who plans to establish similar partnerships with other international universities. “Unlike traditional study abroad programs, our curriculum will include significant training in clinical and didactic teaching, both through coursework and practice. Trainees will also get substantial involvement in research including clinical trials, teaching and practicing dentistry. The result will be comprehensive preparation for a successful career in academia.”


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