Jolanta Aleksejuniene

Associate Professor

Relevant Degree Programs

 

Graduate Student Supervision

Doctoral Student Supervision (Jan 2008 - Mar 2019)
Fistula in cleft lip and palate patients (2018)

Introduction: The cleft lip and palate congenital malformation is a common condition, which poses a large burden of care on the young patients and their caregivers. The World Health Organization reported the prevalence of cleft lip with or without cleft palate to be 10 in 10,000 births in the United States and worldwide and 12 in 10,000 births in Canada (IPDTOC, 2011). Post-operative palatal fistula is frequently encountered after the surgical repair of a cleft lip and palate deformity. A wide range of fistula occurrence rates, have been reported in the literature with significant variability. After conducting a systematic scoping review of the cleft palate literature we found that high quality studies were needed in this field. Additionally there were very few Canadian studies available on this subject. We recognized the need to investigate the incidence of palatal fistula at British Columbia’s Children’s Hospital (BCCH) to be able to compare our rates with other centers worldwide. As a result of our research, we realized a gap in the literature, which was the lack of a standardized assessment protocol for the follow up of cleft lip and palate patients.Methods: A retrospective chart review was performed at British Columbia’s Children’s Hospital to examine the incidence of palatal fistula in children with non-syndromic clefts and to identify determinants associated with higher fistula rates.In preparation for the protocol development we conducted electronic database searches and contacted 13 major cleft centers worldwide.Conclusion: The systematic review concluded that the research mainly focused on surgeries and fistula-related risk determinants. The level of evidence was low and the quality was poor. No consistent pattern was detected between fistula occurrence and any of the studied risk determinants. The medical chart audit determined that almost a quarter of patients at BCCH presented with a palatal fistula. The significant risk determinants were severity of the cleft, less experienced surgeons, and the time period in which surgeries were performed. The structured protocol was developed and it will help facilitate data collection of cleft patients prospectively and prevent deficiencies in current medical reporting.

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Master's Student Supervision (2010-2017)
Improving the oral health of elderly long-term care residents with support of an oral health coordinator (2016)

Objective: The goal of this project was to determine whether an oral health coordinator (OHC) could improve the oral hygiene of residents in long term care facilities. Methods: This prospective study utilized 4 LTCFs in Courtenay, Comox Valley on Vancouver Island and included 126 residents with natural teeth (66% female, age range 63–101 years, and 34% male age range 62 -108 years). Residents’ oral hygiene was assessed at baseline and again at a 6-month using the Geriatrics Debris Index-Simplified (GDI-S) and Geriatrics Calculus Index-Simplified (GCI-S). The OHC provided in-service education & training of care aides and nursing staff with respect to daily mouth care over the six-months of the project. Results: The mean number of teeth per resident was 18. At baseline, 73% did not receive help for their daily mouth care, and after examination, 95.2% were recommended to receive assistance with their daily mouth care. A paired-samples t-test revealed no statistically significant difference in (GDI-S) and (GCI-S) measurements between baseline and 6-month follow-up. Conclusion: Although the OHC provided extensive training of care staff, the oral hygiene did not improve.

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Dental health needs and related factors in inner-city Vancouver elementary school aged children (2013)

Objectives: The aims of the study were: to describe the dental health and treatment needs of inner-city Vancouver elementary-school-aged children and to examine differences in dental health between socioeconomic and ethnic groups. Methods: Principals of all 10 elementary schools in inner-city Vancouver were approached. Principals of 7/10 inner-city Vancouver elementary agreed to have their schools participate in this project. Consent letters were sent to parents/guardians. The clinical data included assessment of dental health and treatment needs. Self-reported data comprised information about ethnicity, gender, place of birth, years lived in Canada, dental insurance, family education and income. Results: A total of 561 children of age 5-12 year were examined (kindergarten and grades 1-7). Of the children from ethnic minorities, 20% were Filipino, 18% south Asia and 14% Vietnamese. Overall, 57% of children had experienced caries. The mean number per child of decayed, missing or filled teeth was 2.67. In total, 32% of children needed dental treatment. Overall, there were no statistically significant differences among different demographic groups regarding dental treatment needs or dental health status, except that children born outside Canada had more decayed teeth as compared to their Canadian born counterparts.Conclusion: With the information from this study it is possible to conclude that there is a difference in dental health status between children born in Canada and foreign born children. On average, foreign born children present with poorer dental health status than their native counterparts. Further research should also aim to determine the cause of the disparity, so that a more targeted approach can be taken to improve dental health status.

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Improving the oral health of elderly long-term care residents with support of an oral health coordinator (2016)

Objective: The goal of this project was to determine whether an oral health coordinator (OHC) could improve the oral hygiene of residents in long term care facilities. Methods: This prospective study utilized 4 LTCFs in Courtenay, Comox Valley on Vancouver Island and included 126 residents with natural teeth (66% female, age range 63–101 years, and 34% male age range 62 -108 years). Residents’ oral hygiene was assessed at baseline and again at a 6-month using the Geriatrics Debris Index-Simplified (GDI-S) and Geriatrics Calculus Index-Simplified (GCI-S). The OHC provided in-service education & training of care aides and nursing staff with respect to daily mouth care over the six-months of the project. Results: The mean number of teeth per resident was 18. At baseline, 73% did not receive help for their daily mouth care, and after examination, 95.2% were recommended to receive assistance with their daily mouth care. A paired-samples t-test revealed no statistically significant difference in (GDI-S) and (GCI-S) measurements between baseline and 6-month follow-up. Conclusion: Although the OHC provided extensive training of care staff, the oral hygiene did not improve.

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Effect of Biotene® Oralbalance moisturizing liquid and MouthKote® oral moisturizer spray on human enamel measured by quantitative light-induced fluorescence method (2011)

Objectives: The purpose of this randomized controlled experimental study was to examine how the xerostomia products Biotene® Oralbalance moisturizing liquid and MouthKote® oral moisturizer spray influence mineral content of human enamel in vitro. Methods: 104 caries free extracted human teeth were selected and prepared, followed by baseline QLF imaging and exposure to an erosive solution of lactic acid (pH of 4.5) and/or Biotene®, MouthKote®, as well as Oral-B fluoridated rinse. Mineral loss was determined with respect to mean fluorescence loss (ΔF, %), maximum fluorescence loss (ΔQ, %), and lesion area (WS, %/mm²). Within-group and among-group comparisons were made employing independent sample t-tests, paired sample t-tests, and ANOVA for multiple comparisons with Bonferroni post hoc adjustment, or their non-parametric equivalents. For all tests, the threshold for the statistical significance was set at P
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