About

Carolyn Wehler is an Assistant Professor of General Dentistry at the Boston University Henry M. Goldman School of Dental Medicine. She holds an MPH in Epidemiology/Biostatistics and Health Services from Boston University, obtained in 2001. Her role involves teaching and practicing general dentistry within the school's clinical and academic settings. The information provided emphasizes her affiliation with the Department of General Dentistry and her involvement in the educational activities at the dental school, but does not detail specific research focus, key contributions, or additional background.

Research topics

• Computer Science
• Information Retrieval
• Medicine
• Physical therapy
• Medical emergency
• Anesthesia
• Data science
• Intensive care medicine
• Dentistry
• Internal medicine

Selected publications

• Effectiveness of fluorides in root caries prevention, Department of Veterans Affairs (2009–2018)

  Special Care in Dentistry · 2023-06-15 · 3 citations

  articleOpen access

  AIMS: The aim of this study was to examine the effectiveness of topical fluorides in prevention of root caries-related treatment in high caries risk Veterans. METHODS: This retrospective analysis of longitudinal data examined the effectiveness of professionally applied or prescription (Rx) fluoride treatment, in VHA clinics from FY 2009-2018. Professional fluoride treatments included 5% Sodium Fluoride (NaF) varnish (22 600 ppm fluoride), 2% NaF gel/rinse (9050 ppm fluoride), and 1.23% APF gel (12 300 ppm fluoride). The Rx for daily home use was 1.1% NaF paste/gel (5000 ppm fluoride). Outcomes studied were new root caries restorations or extractions and percent of patients with treatment over 1 year. Logistic regressions were adjusted for age, gender, race, ethnicity, chronic medical or psychiatric conditions, number of medication classes, anticholinergic drugs, smoking, baseline root caries treatment, preventive care, and time between first-last restoration in the index year. RESULTS: Root caries at baseline was associated with a high risk for new root caries. Veterans without root caries during the index year who received a fluoride gel/rinse intervention were 32-40% less likely to receive caries-related treatment for root caries during the follow-up period. Once Veterans had root caries, fluorides did not exhibit a positive effect. CONCLUSION: In older adults with high caries risk, early fluoride prevention is key, before root caries requires treatment.

  PublisherOA PDFDOI

• Addressing the discrepancy between efficacy and effectiveness of 1.1% sodium fluoride toothpaste or gel in adults as part of a caries prevention program

  The Journal of the American Dental Association · 2023-02-28 · 1 citations

  editorial
  PublisherDOI

• Providing Effective Dental Care for an Ageing Population

  International Dental Journal · 2022-08-01 · 9 citations

  reviewOpen access

  BACKGROUND: Effective treatment produces improved outcomes from the patient and clinician perspectives. The focus of this article is effective dental care for ageing patients. This concept must be embraced through research, education and, finally, clinical care. RESEARCH: Older adults often carry a higher burden of health and socioeconomic issues that limit their participation in clinical trials. This leaves providers to extrapolate care decisions from research in other age groups. However, electronic health records allow researchers to converge extensive medical, pharmacologic, and dental data, thereby including older patients in research questions. EDUCATION: Dental and medical educators are tasked with teaching skills specific to ageing patients. This requires teaching and active use of concepts such as whole health and patient-centred outcomes. PROVISION OF CARE: For ageing patients, effective care is precision care (the right care to the right patient at the right time). Clinicians must be trained and then actively participate in the interdisciplinary approach to assure good oral health for all older patients.

  PublisherDOI

• Topical Fluoride Effectiveness in High Caries Risk Adults

  Journal of Dental Research · 2022 · 13 citations

  • Medicine
  • Dentistry
  • Internal medicine

  This retrospective analysis of longitudinal data was developed to determine which types, combinations, and intensities of topical fluorides more effectively prevent new caries-related restorations and extractions in high caries risk adults. We included data from October 1, 2008, through June 30, 2018, from electronic dental and medical records and pharmacy database from the US Department of Veterans Affairs. Veterans who were eligible for continuing and comprehensive care, met the criteria of high caries risk (received 2 or more caries-related restorations within a 365-d period), and had 3 y of follow-up were included. Multivariable logistic regression models estimated the odds of caries-related treatment during the 1-y observation period, controlling for age, gender, race and ethnicity, illness burden (Selim comorbidity index), use of prescription medications, attendance at dental prophylaxis appointments, number of caries-related restorations during the index year, and time between first and last caries-related restoration during the index year. The study sample included 68,757 veterans, who were primarily male (91.5%), were White (73.6%), had a mean age of 59.2 ± 13.5 y, and had significant medical comorbidity as measured by the Selim index (3.7 ± 2.4 physical and 1.3 ± 1.2 mental diagnoses). They had 10.8 ± 6.3 prescription VA drug classes, took 0.6 ± 0.8 strong anticholinergic medications, and had 3.9 ± 2.6 teeth restored due to caries during the index year. Adjusted multivariable logistic regression models showed veterans who received a varnish or gel/rinse fluoride intervention versus no fluoride had an approximately 29% decreased odds of receiving caries-related treatment during the observation period (gel/rinse adjusted odds ratio [AOR] = 0.72; 95% confidence interval [CI], 0.67-0.76; varnish AOR = 0.71; 95% CI, 0.67-0.75). The receipt of a varnish and gel/rinse did not demonstrate statistically better odds than each intervention alone (AOR = 0.69; 95% CI, 0.64-0.75). A dose-response effect was observed. Two-plus applications of varnish versus none (AOR = 0.73; 95% CI, 0.69-0.77) and 2-plus applications of gel/rinse versus none (AOR = 0.71; 95% CI, 0.67-0.75) were more effective than 1 application of either modality versus none.

  PublisherOA PDFDOI

• 2021 JADA Reviewers List

  The Journal of the American Dental Association · 2022

  • Information Retrieval
  • Computer Science
  • Information Retrieval
  DOI

• Validation of a Subjective Caries Risk Assessment Tool

  Journal of Dentistry · 2021-07-16 · 6 citations

  article
  PublisherDOI

• Alternatives to opioids for acute pain management after dental procedures

  The Journal of the American Dental Association · 2021 · 7 citations

  1st authorCorresponding
  • Medicine
  • Intensive care medicine
  • Medical emergency
  PublisherDOI

• Department of Veterans Affairs Consensus: Preradiation dental treatment guidelines for patients with head and neck cancer

  Head & Neck · 2019-01-08 · 17 citations

  article

  Few protocols have been published for the dental management of patients with head and neck cancer to prevent complications from head and neck radiation therapy. Radiation therapy not only affects the tumor cells targeted, but also the dentition, bone, salivary gland, and oral soft tissue structures. A comprehensive dental evaluation prior to head and neck radiation therapy can help prevent many complications. The following clinical guidelines were established by a workgroup of oral health providers within the Department of Veterans Affairs. This workgroup focused on developing a set of recommendations regarding dental care prior to the initiation of head and neck radiation therapy based on the best clinical evidence and expert consensus. A systematic algorithm was developed for the evaluation including pre-exam data gathering, examination, education, and treatment, followed by maintenance and postradiation dental follow-up. This document is evidence-based, patient-centered, consistent with accepted practices of care and safety, and in accordance with applicable statutes and regulations.

  PublisherDOI

• Caries prevalence and associations with medications and medical comorbidities

  Journal of Public Health Dentistry · 2018-11-15 · 21 citations

  articleOpen access

  OBJECTIVES: To use extensive electronic dental, medical, and pharmacy databases to estimate the prevalence of dental caries in a cohort of new patients during a 5-year period (FY2010-FY2015) and determine whether medication use and medical comorbidities are associated with caries prevalence. METHODS: This was a retrospective analysis of existing data from the Department of Veterans Affairs (VA). The number of teeth treated due to a caries-related diagnosis was determined and outcomes were presented as number of teeth/person and proportion of patients receiving caries-related treatment. Logistic and negative binomial regression modeled teeth/person with caries-related treatment; covariates included age, gender, race, ethnicity, physical and mental comorbidities, and use of prescription medications and prescription drugs with strong anticholinergic properties. RESULTS: The study population included 95,850 dentate dental patients: 92.1 percent were male, mean age of 58.7 ± 12.6 years, 73.2 percent were White/Caucasian, and 21.3 percent were Black/African American. They were taking a mean of 10.6 ± 5.9 VA prescription drug classes, 0.6 ± 0.4 drugs with strong anticholinergic properties, and had 3.6 ± 2.2 physical and 1.4 ± 1.2 mental comorbidities. On average, 2.2 teeth/person received caries-related treatment and 58 percent of the study population received any caries-related treatment. An increase in the rate of caries-related treatment in Veterans was statistically significantly associated with increased prescription medication use; one or more drugs with strong anticholinergic properties and with 1+ mental comorbidities. Increased physical comorbidity was not statistically significantly associated with caries-related treatment. CONCLUSIONS: This study demonstrates a high prevalence of caries among Veteran dental patients, with an increased prevalence in those taking higher numbers of prescription medications.

  PublisherOA PDFDOI

• Salivary biomarkers and cardiovascular disease: a systematic review

  Clinical Chemistry and Laboratory Medicine (CCLM) · 2018-04-09 · 47 citations

  reviewSenior author

  BACKGROUND: The purpose of this systematic review is to summarize the literature examining associations between salivary biomarkers and cardiovascular disease (CVD) status. CONTENTS: An advanced search was conducted using MeSH terms related to salivary biomarkers and CVD, and entered into the PubMed, Web of Science, and Google Scholar search databases. Four hundred and thirty-three records were narrowed to 22 accepted articles. Included titles were assessed for quality using the Newcastle-Ottawa scale, and ranked into categories of low, moderate, or high. SUMMARY: A total of 40 salivary biomarkers were analyzed among accepted articles. The most studied markers were salivary creatine kinase isoform MB, C-reactive protein (CRP), matrix metalloproteinase-9, troponin I, myeloperoxidase, myoglobin, and brain natriuretic peptide. Salivary CRP provided the most consistent trends. Statistically significant increases of salivary CRP were present with CVD in every study that analyzed it. The remaining six markers demonstrated varying patterns. OUTLOOK: Existing studies provide insufficient data to draw definitive conclusions. Current research shows that there is an association between some salivary biomarkers and CVD, but the details of existing studies are conflicting. Despite inconclusive results, the diagnostic potential of saliva shows promise as a non-invasive means of cardiovascular risk assessment.

  PublisherDOI

Frequent coauthors

• M. Marianne Jurasic

  Veterans Health Administration

  36 shared

• Judith A. Jones

  University of Detroit Mercy

  35 shared

• Gretchen Gibson

  United States Department of Veterans Affairs

  25 shared

• Michelle B. Orner

  VA New England Healthcare System

  10 shared

• Raul I. García

  Boston University

  9 shared

• Elizabeth A. Krall

  Boston University

  7 shared

• Donald R. Miller

  North Dakota State University

  6 shared

• Neeraj Panchal

  6 shared

Education

• Other, Epidemiology/Biostatistics; Health Services

  Boston University

  2001