Hospitalized children with long-term airway support (HC-LAS) are one of the most medically complex pediatric populations. Compromised airway, nutritional support requirements, and polypharmacy predispose HC-LAS to enamel hypoplasia, xerostomia, calculus accumulation, and microbial dysbiosis that can increase pulmonary risk through the oral-lung axis 1, 2. Despite clear interconnections between oral and pulmonary health, pediatric dental education rarely integrates systematic training in airway-focused interdisciplinary care. The pulmonary–oral relationship can sometimes be overlooked during the management of HC-LAS in an outpatient setting 3, 4. This educational gap limits residents’ preparedness to participate in interdisciplinary rounds, communicate with pulmonary teams, or recognize how oral health can influence pulmonary outcomes. To address this gap, we developed the Healthy Lungs, Healthy Smiles (HLHS) educational initiative, a novel interdisciplinary program designed to train pediatric dental residents in comprehensive inpatient care for HC-LAS, admitted to the hospital at/after birth with a continuous stay ranging from 8–72 months. The HLHS initiative provided an innovative curriculum to a cohort of 16 pediatric dental residents. The cohort received didactic modules (anatomy-physiology, airway support, dental-pulmonary interface, and interdisciplinary care protocols) and workshops with pulmonary teams. Residents joined the hospital's pulmonary rounds and contributed to oral care for HC-LAS. The dental faculty reinforced interprofessional communication and reflective debriefing with the medical teams. After institutional clearance (#25-0189), resident knowledge and self-perceived preparedness for management of HC-LAS were evaluated at pre- and post-intervention with a five-question case-based multiple-choice questions clinical examination (Supporting Information S1) and survey (five questions with responses on a Likert scale, Table 1), respectively. Data were analyzed using t-tests and Wilcoxon signed-rank tests with an alpha of 0.05 using Python (SciPy 1.11.3-Matplotlib 3.9.0). After the intervention, residents’ knowledge scores (figure 1) improved from 3.1 ± 0.2 to 4.1 ± 0.3 (p = 0.012). A statistically significant improvement in the resident's knowledge from pre- to post-intervention highlighted the curricular impact of the HLHS. The self-perceived readiness increased from 3.6 ± 0.4 to 4.7 ± 0.3 (p = 0.002, figure 2). Post hoc power analysis indicated 90% power to detect the observed changes in knowledge and preparedness. Although initial improvement in preparedness was noted, long-term preparedness for hospital care among residents warrants further investigation. Medical staff were uncertain of dentistry's role on the interdisciplinary team, which warranted advocacy from the faculty-leadership. As an HLHS highlight, collaborative learning among medical-dental residents/staff facilitated dental residents to think beyond the oral implications. While the bedside delivery of oral care was challenging for HC-LAS with severely compromised pulmonary status, the availability of mobile dental examination and radiographic units allowed effective delivery of oral exams and prophylaxis. Furthermore, the collaboration between child-life specialists, pulmonary nurses, and medical-dental faculty was crucial to provide dental care without any apneic episodes. The success of the HLHS initiative relied on coordination between medical-dental services, innovative approaches for curricular integration, and outcomes assessment. Although the HLHS initiative was a valuable interdisciplinary approach, application at non-hospital institutions may be challenging and could be considered a limitation. Future work will examine the impact of HLHS on oral health of HC-LAS and reduced incidence of ventilator-associated infections, strengthening the oral-pulmonary disease/health link 3, 5. We would like to acknowledge financial support from the N. Sue Seale Pediatric Dentistry Research Award from the College of Diplomates of the American Board of Pediatric Dentistry. The authors declare no conflicts of interest. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Katebzadeh et al. (Mon,) studied this question.