John Timothy Wright

Objectives: To describe oral health status, sociodemographics, and history of dental general anesthesia (DGA) utilization, and to evaluate whether geographic distance to dental home was associated with DGA utilization among patients with cleft lip and/or palate (CL/P). Design: Cross-sectional study using caregiver questionnaires, dental examinations, and electronic health records. Setting: Institutional tertiary craniofacial center. Patients, Participants: 452 patients from birth to 19 years of age seen between August 2023 and October 2025. Exposures: Euclidean distance, driving distance, and driving time from residence to dental home. Main Outcome Measure(s): The association between geographic distance from patient residence to dental home and history of DGA utilization was investigated using a multivariable logistic regression model. Results: The study population included patients with cleft lip alone (14.4%), cleft palate alone (36.7%), and cleft lip and palate (48.9%). 19.3% had an associated condition, most commonly Pierre Robin sequence. Most patients were male (56.2%), White (46.2%), and Medicaid-insured (61.3%). The prevalence of dental caries, restorations, gingivitis, and dental trauma were 26.1%, 45.8%, 41.7%, and 10.8%, respectively. Most patients (84.0%) had an established dental home, and 21.7% had a history of DGA. DGA prevalence increased linearly across driving distance quartiles from 15.2% to 30.4%. Each quartile increase in driving distance was associated with higher odds of DGA use (adjusted odds ratio = 1.36; 95% confidence interval: 1.07-1.72). Conclusions: Greater distance to dental home was associated with history of DGA utilization among patients with CL/P, suggesting geographic access may be associated with patterns of dental care delivery and warranting further investigation.

Incontinentia pigmenti (IP) is a rare, X‐linked dominant condition characterized by a perinatal rash as well as abnormalities of the central nervous system (CNS), eyes, hair, nails, and teeth. The CNS and ophthalmic manifestations are potentially severe and may lead to neurologic impairment and vision loss. Due to the rarity of IP, there remains a limited understanding of its physiology, and the guidelines for screening, clinical staging, and management of complications remain controversial. To address these gaps, a multidisciplinary, international conference on IP was held in Charlotte, North Carolina, from February 21 to 23, 2025. The meeting was hosted by the National Foundation for Ectodermal Dysplasias and the Oregon Health Sciences University. This report summarizes the discussion and recommendations from the conference, including guidance for screening of ophthalmic complications, as well as next steps for pursuing therapeutic interventions.