J Public Health Dent [JOURNAL]
Sun
200 papers
Synergistic Effects of Social Determinants of Health and Periodontitis on Premature Cardiovascular Mortality: A Nationally Representative Cohort Study.
Qi D, Ouyang Y
J Public Health Dent · 2026 Jun · PMID 42289328 · Publisher ↗
BACKGROUND: Periodontitis, a prevalent chronic inflammatory disorder, is linked to an increased risk of cardiovascular disease (CVD). However, the impact of social determinants of health (SDoH) on premature CVD mortality...
BACKGROUND: Periodontitis, a prevalent chronic inflammatory disorder, is linked to an increased risk of cardiovascular disease (CVD). However, the impact of social determinants of health (SDoH) on premature CVD mortality in individuals with periodontitis remains poorly understood. METHODS: Data from 8277 US adults aged 30-74 years, collected from NHANES 2009-2014 with mortality follow-up through 2019, were analyzed. Periodontitis was defined according to CDC/AAP criteria, and premature CVD mortality was defined as death from CVD before age 75. A cumulative SDoH score was constructed based on eight indicators. Kaplan-Meier survival curves and log-rank tests compared survival probabilities across groups. Sensitivity analyses utilized Fine and Gray competing risk models. RESULTS: Periodontitis was independently associated with an elevated risk of premature CVD mortality (HR = 2.21; 95% CI = 1.01-4.86), particularly among those with multiple adverse SDoH. A significant dose-response relationship was observed between cumulative SDoH burden and premature CVD mortality in the periodontitis cohort (P for trend = 0.03), but not in those without periodontitis. Food insecurity emerged as the sole individual SDoH independently linked to increased mortality risk. Kaplan-Meier curves revealed significantly lower cumulative survival among adults with periodontitis burdened with high SDoH (p < 0.01). CONCLUSIONS: Periodontitis was associated with an increased risk of premature CVD mortality, especially in the presence of cumulative adverse SDoH, suggesting the need for integrated medical-dental care and broader strategies to address social inequities.
Incarceration History, Dental Care Utilization, and Oral Health Difficulties Among U.S. Military Veterans.
Testa A, Mijares L, Tsai J
J Public Health Dent · 2026 Jun · PMID 42289281 · Publisher ↗
OBJECTIVES: To examine whether a history of incarceration is associated with self-reported dental care utilization and oral health difficulties among low-income U.S. military veterans. METHODS: Data were from Wave 5 of t...
OBJECTIVES: To examine whether a history of incarceration is associated with self-reported dental care utilization and oral health difficulties among low-income U.S. military veterans. METHODS: Data were from Wave 5 of the National Veteran Homeless and Other Poverty Experiences study (N = 1384). Weighted logistic and multinomial logistic regression models were estimated to examine the association between a history of incarceration and (a) dental care utilization, and (b) oral health difficulties, adjusting for demographic, socioeconomic, military, and health insurance characteristics. RESULTS: In covariate-adjusted models, veterans with a history of incarceration had significantly higher odds of not having a dental visit in the past year compared to those without prior incarceration (adjusted odds ratio [aOR] = 2.393, 95% confidence interval [CI] = 1.357, 4.219, p = 0.003), and reporting a higher relative risk of occasional oral health difficulties in the past 3 months (RRR = 1.856, 95% CI = 1.027, 3.353, p = 0.034) compared to never/hardly ever experiencing difficulties. CONCLUSION: A history of incarceration may represent an important social driver of dental care utilization and oral health difficulties among veterans. Potential programmatic responses through the U.S. Department of Veterans Affairs and the criminal justice system are discussed.
Can Artificial Intelligence Substitute Dental Public Health Expertise? A Competency-Based Analysis Across Core DPH Domains.
AlDukhail S
J Public Health Dent · 2026 Jun · PMID 42289274 · Publisher ↗
BACKGROUND: Artificial intelligence (AI) is increasingly integrated into public health and dentistry, with a range of applications. While these developments raise questions about efficiency and scalability, uncertainty r...
BACKGROUND: Artificial intelligence (AI) is increasingly integrated into public health and dentistry, with a range of applications. While these developments raise questions about efficiency and scalability, uncertainty remains regarding whether AI can substitute for Dental Public Health (DPH) expertise. This paper aims to distinguish between AI-amenable and fundamentally human DPH competencies. METHODS: An analytical framework was applied to the 10 dental public health (DPH) specialty competencies. Current AI applications reported in the health literature were mapped across competencies including program management, systems evaluation, ethical decision-making, surveillance system design, communication, collaboration and leadership, policy advocacy, evidence appraisal, research, and integration of social determinants of health. RESULTS: AI demonstrated strong technical capacity across data-intensive and analytical competencies, including program management, systems evaluation, surveillance design, evidence appraisal, research, and integration of social determinants of health. These domains were classified as augmentable, as AI enhanced data integration, pattern recognition, and operational efficiency when accompanied by appropriate human oversight. In contrast, competencies grounded in ethical decision-making, communication, leadership and collaboration, and policy advocacy were identified as irreplaceable, as they require moral judgment, contextual interpretation, professional accountability, and relational engagement beyond current AI capabilities. CONCLUSIONS: The findings support the use of AI as a complementary tool in DPH while affirming that the specialists remain indispensable for governance, equity, public accountability, and strategic decision-making in population oral health policy and practice. Competency frameworks, accreditation standards, and workforce development efforts should explicitly define the appropriate role of AI while reinforcing the primacy of human judgment and ethical leadership in population oral health practice.
From Evidence to Engagement: Understanding Online Resistance to Community Water Fluoridation for Public Health Communication-A Qualitative Study.
Torwane N, Ha D, Lalloo R … +3 more , Ludlow K, Manchery N, Do L
J Public Health Dent · 2026 Jun · PMID 42246558 · Publisher ↗
OBJECTIVES: This study explored how individuals in an online anti-CWF community construct and sustain opposition narratives to inform evidence-based communication and policy engagement. METHODS: A qualitative study was u...
OBJECTIVES: This study explored how individuals in an online anti-CWF community construct and sustain opposition narratives to inform evidence-based communication and policy engagement. METHODS: A qualitative study was undertaken with adults who self-identified as not supportive of CWF. Fourteen participants from the United Kingdom, Australia, and the United States of America were recruited via the Fluoride Action Network Facebook page, a prominent global hub for anti-fluoridation discourse. Semi-structured interviews were conducted via Zoom between January and July 2025. Data were analyzed using inductive qualitative content analysis. Codes were organized into main, generic, and sub-categories and quantified by endorsement frequency. Reporting followed SRQR and COREQ guidelines. RESULTS: Five main categories were identified: (1) Knowledge, Attitudes, Perceptions, and Policy Views; (2) Information Sources and Trust; (3) Reasons for Opposition; (4) Grassroots and Community Actions; and (5) Alternatives and Conditions for Acceptability. Opposition to CWF was shaped by ethical, health, and institutional concerns rather than by scientific disagreement alone. Eight generic categories captured key reasons for opposition, including perceptions of mass medication without consent, health and social harms, institutional distrust, concerns about industrial waste, ethical objections, skepticism about benefits, preference for individualized alternatives, and experiences of professional dismissal. Anti-fluoride networks and social media were the most trusted sources of information (86%), while trust in mainstream science and health authorities was very low (< 15%). CONCLUSIONS: Opposition to CWF is sustained through network-mediated information ecosystems and reinforced by behavioral economic mechanisms, including loss aversion, autonomy bias, and default framing effects. Effective public health responses must therefore move beyond evidence dissemination to incorporate network-aware communication and behavioral insights-informed strategies that prioritize transparency, public participation, and equitable framing of CWF within broader oral health policy.
Custodial Dental Care in Federal Courts: A Systematic Review of Appellate Decisions and Implications for Public Health.
Shulman JD
J Public Health Dent · 2026 May · PMID 42219230 · Publisher ↗
OBJECTIVES: To examine how federal appellate courts evaluate constitutional claims concerning custodial dental care and to characterize the clinical and procedural features of these cases. METHODS: Decisions of the U.S....
OBJECTIVES: To examine how federal appellate courts evaluate constitutional claims concerning custodial dental care and to characterize the clinical and procedural features of these cases. METHODS: Decisions of the U.S. courts of appeals issued between 1980 and 2025 were identified through structured database searches. Cases substantively evaluating dental care were coded for severe pain, infection, abscess (coded separately), functional impairment, delay, custody type, representation status, defendant level, and appellate outcome. Descriptive statistics summarized case characteristics, and logistic regression evaluated associations between selected variables and appellate outcomes. RESULTS: A total of 182 appellate decisions met inclusion criteria, of which 174 evaluated adequacy of care. Severe pain was described in 86% of coded cases and functional impairment in 62%. Infection was documented in 41% of cases, with an abscess specifically identified in 16%. Delay was alleged in 73% of cases. Overall, 35% of decisions resulted in reversal or remand. Among cases with documented delay duration, the median delay was substantially longer in plaintiff-favorable cases, and delays exceeding 90 days were associated with higher odds of reversal or remand. CONCLUSIONS: Appellate review emphasizes documented awareness and response rather than equivalence to community standards. This legal threshold does not ensure timely clinical resolution. Public health evaluation of custodial dental systems should consider disease progression and access to definitive treatment in addition to legal compliance. Improvements are likely to depend on system-level monitoring of access and timeliness of care rather than litigation alone, reflecting the distinction between legal sufficiency and clinical adequacy.
From Policy Endorsement to Programmatic Delivery: The Persistent Implementation Gap of Silver Diamine Fluoride in the Global South.
Shankar BS
J Public Health Dent · 2026 May · PMID 42185218 · Publisher ↗
Abstract loading — click title to view on PubMed.
Periodontal Disease Among People Living With Diabetes: Examining Social Determinants of Health in an All of Us Study Sample.
Miller ME, Morales-Aleman MM, Marrero-Sierra AM … +2 more , Wang H, Bradley LJ
J Public Health Dent · 2026 Jun · PMID 42083104 · Publisher ↗
OBJECTIVES: Approximately 12% of the American population live with a form of diabetes mellitus (DM). People living with DM (PLD) are at a significantly higher risk of developing comorbid conditions, such as periodontal d...
OBJECTIVES: Approximately 12% of the American population live with a form of diabetes mellitus (DM). People living with DM (PLD) are at a significantly higher risk of developing comorbid conditions, such as periodontal disease (PD). The pathological link between DM and PD is well documented, but the social factors, or social determinants of health (SDH) which may contribute to the link between the diseases are less understood. Our objective is to examine the SDH factors associated with PD among PLD using a national database with the aim of informing intervention strategies for affected subpopulations. METHODS: Utilizing the All of Us national database, we drew a sample of PLD, including those with and without PD, that completed surveys regarding SDH, their overall health, and healthcare utilization. We calculated marginal odds ratios between each variable and PD diagnosis. Analyses were performed using the All of Us Workbench and R 4.3.1. RESULTS: The total cohort consisted of 7971 participants; 342 participants had PD. Significant variables found to increase PLD's risk of PD included male gender, being a current smoker, reporting inability to afford healthcare, and perceived discrimination in healthcare. CONCLUSIONS: Using a large, national cohort, we demonstrate the association between specific SDH and PD among PLD. Our work underscores the importance of considering these variables for intervention strategies and emphasizes the need for preventative oral care programs for PLD.
Expanding Care-Delivery: A SWOT Analysis of the Community Health Aide Program in Three Oklahoma Tribes.
Llaneza AJ, Stone KA, Burgess K … +4 more , Stephens LD, Eason K, Cothron A, Seward J
J Public Health Dent · 2026 Jun · PMID 42017449 · Publisher ↗
INTRODUCTION: American Indians and Alaska Natives have lower life expectancies, and poorer oral health compared to other US populations. These negative health outcomes are somewhat preventable with routine care, but prov...
INTRODUCTION: American Indians and Alaska Natives have lower life expectancies, and poorer oral health compared to other US populations. These negative health outcomes are somewhat preventable with routine care, but provider shortages, proximity to health services, and other factors create barriers. The Community Health Aide Program (CHAP) is a multidisciplinary system of certified mid-level behavioral, medical, and dental providers working alongside licensed providers to increase access to quality care. The objective was to evaluate benefits and challenges of integrating the CHAP model within existing Tribal health systems. METHODS: De-identified data from open-ended responses related to CHAP expansion efforts in three Tribal Nations residing in Oklahoma were qualitatively analyzed using a SWOT analysis framework. Themes were developed deductively under the umbrella of Strengths, Weaknesses, Opportunities, and Threats. Five subthemes commonly affecting existing Tribal healthcare systems were identified. A special emphasis on dental healthcare was highlighted. RESULTS: 99 strengths (36.4%), 52 weaknesses (19.1%), 69 opportunities (25.4%), and 52 threats (19.1%) were identified. Subthemes included: Interprofessional and Community Connections and Programs (n = 88); Technology, Physical Infrastructure, and Resource Capacity (n = 80); Workforce Staffing and Efficiency (n = 49); Scope of Administrative Coordination, Budget, and Funding (n = 30); and Cultural Responsiveness (n = 25). Specific to dental healthcare were 59 strengths (n = 20), weaknesses (n = 11), opportunities (n = 21), and threats (n = 7). DISCUSSION: CHAP has historically proven to be a successful healthcare delivery model for underserved populations. More strengths and opportunities than weaknesses and threats regarding the integration and expansion of CHAP to improve medical, behavioral, and dental healthcare access were identified.
A National Review of the Interim Canada Dental Benefit: Analyzing the Uptake Among Uninsured Children Under 12.
Goubran S, Youssef C, Menon A … +4 more , Cruz de Jesus V, Olatosi OO, Lee VHK, Schroth RJ
J Public Health Dent · 2026 Jun · PMID 41974556 · Full text
OBJECTIVES: The Interim Canada Dental Benefit (CDB) provided financial support for the dental needs of children < 12 years old, from low-income families in Canada. Funds were distributed during two periods, Regular Perio...
OBJECTIVES: The Interim Canada Dental Benefit (CDB) provided financial support for the dental needs of children < 12 years old, from low-income families in Canada. Funds were distributed during two periods, Regular Period 1 (October 2022 through June 2023) and the Regular Period 2 (July 2023 through June 2024). This study evaluated the adjusted rate of child participation across provinces and territories, proportionally for children aged 0-11 who lack dental insurance, from households with a net annual income < $90,000 (Canadian). METHODS: Publicly available data were sourced from the Government of Canada Open Data Portal. Variables of interest were presented as distributions by provinces and territories, age grouping of children, and family net income. Child participation rates were calculated based on Statistics Canada data (2025). RESULTS: A total of 452,460 applications were accepted, with $440.7 million distributed. The adjusted national rate of participation for children without private and public dental insurance from low-income households was 267.3/1000 children in Regular Period 1 and 273.2/1000 in Regular Period 2. The provinces and territories with the highest adjusted rates were Nova Scotia, Saskatchewan, Newfoundland and Labrador, and the Northwest Territories. Families earning less than $30,000 annually made up the largest share of applicants. CONCLUSIONS: Government-funded programs, like the Interim CDB, have the capacity to improve access to dental care for Canadians. The results show clear regional differences, with higher participation often found in regions where public dental programs for children are limited or absent.
Age at First Dental Visit of Preschool Children Utilizing Public Sector Dental Services in Southeast Queensland, Australia: A Retrospective Cohort Study.
Nation A, Stormon N, Foley M … +1 more , Lalloo R
J Public Health Dent · 2026 Jun · PMID 41946384 · Full text
OBJECTIVES: This retrospective cohort study describes public dental service use among children aged 0-4 years attending public sector oral health services in Metro North and Metro South Hospital and Health Services, Sout...
OBJECTIVES: This retrospective cohort study describes public dental service use among children aged 0-4 years attending public sector oral health services in Metro North and Metro South Hospital and Health Services, Southeast Queensland. This study analyzes age and reason for first dental visits, and whether access pathways, including Lift the Lip (LtL), influence access for key sociodemographic groups. METHODS: We analyzed electronic oral health records for 41,614 children with a first dental visit between January 2014 and December 2022. Age at first visit and reason for attendance were summarized descriptively. Early attendance (≤ 12 and ≤ 24 months) was compared across LtL and non-LtL pathways and risk groups using chi-square tests with risk differences and risk ratios. RESULTS: The mean age at first visit was 37.7 months (SD 17.0). Overall, 11% of children attended by 12 months and 27% by 24 months, and 83% first presented for general care. LtL-referred children were more likely to attend by 12 (27.7% vs. 4.7%) and 24 months (66.7% vs. 12.4%) than non-LtL children. Early attendance remained lower for Indigenous children, those living with greater disadvantage, and Child Dental Benefits Schedule-eligible children, and higher for children from culturally and linguistically diverse backgrounds. Attendance by 12 months increased after 2016, from 5.2% to 12.0%. CONCLUSION: Few children accessed public dental care by the recommended age of first visit. While LtL substantially improved early attendance, equity gaps persisted, highlighting the need to strengthen early-referral pathways and parent/carer awareness of the recommended timing for a first dental visit.
Monitoring Use of Medical Services for Oral Health Care to Assess an Expansion of Public Dental Programs in Canada.
Durbin A, Singhal S, Abrams S … +2 more , McConnachie I, Durbin J
J Public Health Dent · 2026 Jun · PMID 41944497 · Publisher ↗
OBJECTIVES: Oral health disparities disproportionately affect low-income populations, with cost a significant barrier to accessing dental care. In Canada, individuals with untreated oral conditions often visit publicly f...
OBJECTIVES: Oral health disparities disproportionately affect low-income populations, with cost a significant barrier to accessing dental care. In Canada, individuals with untreated oral conditions often visit publicly funded medical services, which are not designed to provide dental treatment. The recently launched Canadian Dental Care Plan (CDCP) is intended to expand access to dental services for low-income populations. This commentary argues that reduced medical service use for non-traumatic dental conditions (NTDCs) is a potential benefit that should be monitored to evaluate the impact of the CDCP. METHODS: Canadian studies reporting use and cost estimates of physician visits, emergency department use, and hospital-based care for dental conditions were described. Data sources for routine monitoring of use were identified. RESULTS: In Ontario Canada, use and costs of physician and emergency department visits, and hospital-based care for NTDCs were estimated at over $29M annually during 2003-2015 (population approximately 30 million). These estimates were conservative, with other studies suggesting higher visit volumes and costs depending on case definitions. National hospital and provincial physician billing databases are available for routine monitoring but indicators need to be standardized and data quality assessed. Stratified reporting can monitor equity impacts. CONCLUSIONS: Medical oral health care use is a potential indicator of effectiveness of public dental programs. A decline could signal improved access to dental services while persistent rates may highlight gaps in program reach. Monitoring this indicator is relevant to Canada and other jurisdictions seeking to advance oral health equity through expanded public coverage.
Moving Forward to Advance Health Equity: Elevating Best Practice in Science, Education, Public Health Practice, Workforce, and Advocacy.
Fleming E, Wolfe JO
J Public Health Dent · 2026 Mar · PMID 41866763 · Publisher ↗
Abstract loading — click title to view on PubMed.
Dental Public Health as Prime Catalyst for Advancing Solidarity and Accompaniment Within Dental Service-Learning and Community-Based Dental Education.
Raskin SE, Smith C
J Public Health Dent · 2026 Mar · PMID 41866761 · Full text
OBJECTIVES: This commentary examines US-based dental service learning (DSL), community-based dental education (CBDE), and dental public health residency education in light of the profession's ethical commitments, social...
OBJECTIVES: This commentary examines US-based dental service learning (DSL), community-based dental education (CBDE), and dental public health residency education in light of the profession's ethical commitments, social contract, and reparative obligations. Drawing on the introduction into US-based global dental education of Brocher Declaration principles including mutual partnership, capacity strengthening, humility, accountability, sustainability, responsiveness, and respect for local values, the authors consider how frameworks of solidarity and accompaniment can transform dental learning in domestic community settings to produce truly justice-centered ethical clinicians in future dental public health, community dentistry, and dental private practice spheres. METHODS: We critically assessed the APHA, AAPHD, and ADA professional codes of ethics, which guide DSL, CBDE, and dental public health residency education, and compared with frameworks of solidarity and accompaniment along the following dimensions: core focus, primary audience, values emphasized, ethical scope, reflection and deliberation, justice framing, veracity (truth-telling), and accountability. RESULTS: The APHA, AAPHD, and ADA codes of ethics emphasize justice, truth-telling, and professional responsibility but differ in scope, from individual clinical care to population-level health. We demonstrate how frameworks of solidarity and accompaniment can deepen dental professional codes of ethics by expanding traditional principles to include relationality, proximity to suffering, and structural critique. CONCLUSIONS: This commentary positions dental public health as a critical catalyst for transforming DSL/CBDE by embracing solidarity and accompaniment as guiding ethical frameworks and by redefining success through humility, shared purpose, authentic partnership, community-driven metrics, and culturally responsive pedagogy. Doing so will inculcate in dental professionals sustainable, responsive, accountable, and justice-oriented practices and will strengthen the future of public health dentistry by cultivating clinicians committed to equity beyond episodic outreach. The paper concludes with recommendations for curricular reform and institutional alignment to support this paradigm.
Association Between Perceived Racial Discrimination, Socioeconomic Status, and Oral Health Among Children: Evidence From the National Survey of Children's Health 2016-2022.
Evans LA, Gadwah-Meaden C, Geissler KH … +1 more , Kranz AM
J Public Health Dent · 2026 Mar · PMID 41866760 · Full text
OBJECTIVE: Examine the association between perceived racial discrimination and children's oral health outcomes by race-ethnicity and socioeconomic status (SES). METHODS: Using the National Survey of Children's Health (20...
OBJECTIVE: Examine the association between perceived racial discrimination and children's oral health outcomes by race-ethnicity and socioeconomic status (SES). METHODS: Using the National Survey of Children's Health (2016-2022), we examined the relationship between perceived racial discrimination (caregiver-reported child exposure) and two outcomes: a child's receipt of a dental visit and the presence of any oral health problem in the past year. Logistic regression models were estimated, stratified by race-ethnicity (Black, Hispanic, White), and adjusted for SES using the federal poverty level (FPL). We also interacted perceived racial discrimination and FPL to observe how associations differ by SES. RESULTS: Perceived racial discrimination was associated with lower rates of dental visits for White and Hispanic children, with no significant association for Black children. Perceived racial discrimination was associated with a higher likelihood of having an oral health problem for all three racial-ethnic groups. In interaction models, associations with dental visits were inconsistent. The association between perceived racial discrimination and having an oral health problem in the past year was primarily isolated to the lowest SES strata (< 200% FPL), with higher likelihoods of having an oral health problem for all three racial-ethnic groups among those who perceived racial discrimination. CONCLUSIONS: Perceived racial discrimination is associated with worse oral health and inconsistently with having a dental visit. The stronger association with oral health problems among children in the lowest SES strata highlights the need for targeted interventions addressing both racial discrimination and SES disparities to improve child oral health outcomes.
Expanding Oral Health Access and Equity: The Impact of Federally Qualified Health Centers.
Hilton I, Owen CLH, Johnston R … +12 more , Choi JH, Ruiz C, Maxwell D, Campbell K, Galvis A, Covato L, Bozzetti L, Jackson M, English R, Ford D, Scholtz M, Lampron C
J Public Health Dent · 2026 Mar · PMID 41866758 · Publisher ↗
BACKGROUND: FQHCs have a 60-year history of creating equitable pathways for underserved communities. The objective of this article is to provide an understanding of the role of federally qualified health centers (FQHCs)...
BACKGROUND: FQHCs have a 60-year history of creating equitable pathways for underserved communities. The objective of this article is to provide an understanding of the role of federally qualified health centers (FQHCs) in improving oral health equity and access to oral health care for underserved populations by highlighting innovative approaches to dental care delivery models, workforce and quality initiatives. METHODS: This article reviews national FQHC data, surveys of FQHC dental programs and findings from training and technical assistance programs aimed at supporting FQHCs in improving oral health equity and utilization of oral health services. RESULTS: FQHCs expand equitable access to oral health care through organizational characteristics that reduce barriers to care. Additionally, FQHCs further seek to increase oral health equity through innovation in oral health care delivery models, integration, quality, and workforce initiatives. CONCLUSION: The FQHC model can improve oral health access and equity for underserved populations.
Combating Misinformation in the Digital Age: A Machine Learning Approach to Protect Community Water Fluoridation and Promote Oral Health Equity.
Torwane N, Manchery N, Lalloo R … +2 more , Ha D, Do L
J Public Health Dent · 2026 Mar · PMID 41866756 · Publisher ↗
OBJECTIVES: Community water fluoridation (CWF) is an effective public health intervention for preventing dental caries. However, the widespread dissemination of misinformation on social media platforms, such as Twitter (...
OBJECTIVES: Community water fluoridation (CWF) is an effective public health intervention for preventing dental caries. However, the widespread dissemination of misinformation on social media platforms, such as Twitter (now "X"), threatens public acceptance and may exacerbate oral health inequities. This study aimed to develop, evaluate, and deploy machine learning (ML) and deep learning (DL) models to identify misinformation about CWF on Twitter and assess implications for public health communication and surveillance. METHODS: We collected 19,960 English-language tweets about CWF posted between 2014 and 2024 using keyword-based queries. Tweets originated globally; however, only US-based geotagged tweets were used for sociodemographic analysis because reliable demographic and oral health surveillance data (e.g., US Census, BRFSS, NHANES) were available for linkage. Veracity was determined using authoritative public health criteria from the CDC, WHO, and ADA, with a subset of tweets manually annotated as factually correct or misinformation. Six machine learning and deep learning models were trained and evaluated. Additional analyses included sentiment scoring, thematic content coding, and geospatial-demographic comparisons. RESULTS: The Support Vector Classifier achieved the highest accuracy (91.6%). A hybrid BERT + XGBoost model (89.9% accuracy) was selected for deployment due to its strong performance and interpretability. Overall, 78.8% of tweets were classified as misinformation, with dominant themes including fluoride toxicity, distrust of government, and individual autonomy. Misinformation tweets were shorter, more engaging, and concentrated in socioeconomically disadvantaged areas with a high prevalence of misinformation tweets, where poverty rates and untreated dental caries were also greater. Sentiment analysis showed pro-CWF tweets were, on average, more positive. CONCLUSIONS: ML and DL models can effectively detect CWF-related misinformation on social media. Integrated with equity-focused communication strategies, these tools may help sustain public trust in CWF and reduce misinformation-related oral health inequities.
Transforming Public Health Dentistry: Incorporating Social Mission Into Dental Education.
Oyeyemi T, Owen CLH, Anderson S … +1 more , Salsberg E
J Public Health Dent · 2026 Mar · PMID 41866753 · Publisher ↗
OBJECTIVES: This article examines how dental education and workforce development can be leveraged to advance health equity in oral health. Persistent disparities in access to dental care, particularly in underserved area...
OBJECTIVES: This article examines how dental education and workforce development can be leveraged to advance health equity in oral health. Persistent disparities in access to dental care, particularly in underserved areas, highlight the urgency of transforming public health dentistry. The concept of social mission provides a framework to align institutional strategies with equitable outcomes. METHODS: This article synthesizes data on dental workforce composition, enrollment trends, and representative case examples from U.S. dental schools. It reviews how dental education institutions have implemented comprehensive programs to diversify the workforce and improve care delivery in socioeconomically deprived communities. RESULTS: Despite incremental increases in enrollment of learners from underrepresented communities in healthcare, the dental workforce remains insufficiently diverse relative to population demographics. Schools/programs integrating admissions reforms, community-based training, socially accountable leadership, inclusive environments for faculty and students, and culturally responsive curricula demonstrated measurable outcomes, including increased provider representation in underserved areas and improved patient engagement. However, recent shifts in legislative policy have already been associated with threats to social mission areas in some programs, such as declining school diversity. CONCLUSIONS: Transforming public health dentistry requires intentional strategies that embed social mission into the core functions of dental schools. Institutional leadership, innovative partnerships, and policy advocacy are critical to building a workforce capable of addressing structural inequities in oral health. Comprehensive, data-driven approaches can guide institutional progress toward more equitable dental care access and outcomes through the power of dental education reform.
Combating the Silent Othering in Dental Education, Dental Public Health, and Community Health Practice to Advance Health Equity.
Nguyen A, Smith CS
J Public Health Dent · 2026 Mar · PMID 41866751 · Full text
OBJECTIVES: Achieving oral health equity continues to be a goal with seemingly intractable challenges. While interprofessional education and practice (IPE/IPP) have been strategies employed to address barriers underlying...
OBJECTIVES: Achieving oral health equity continues to be a goal with seemingly intractable challenges. While interprofessional education and practice (IPE/IPP) have been strategies employed to address barriers underlying persistent health disparities, there must be a recognition of the formation of dominant and subordinate cultures across learning and practice environments when diverse professionals are brought together to support diverse populations, creating an identity or professional othering. METHODS: A review of settings that feature IPE/IPP, particularly dental education, dental public health residency settings, and community health centers, demonstrate the need to acknowledge that this othering occurs. Combating the systemic and social processes that contribute to othering in these environments is key to delivering a sustainable dental public health workforce and advancing health equity. RESULTS: Interprofessional collaboration is a requisite for modern population health initiatives, and dental public health practice must include skills for cultural fluency, complex system navigation across disciplines, and ethical engagement with diverse communities for greater impact on health disparities. In these fields where collaboration across disciplines is commonly articulated, yet often fails to fully deliver on its promise, the issue of othering frequently goes unspoken. CONCLUSIONS: Commitments to health equity must make essential the acknowledgment of and address the subtle exclusion that persists across health disciplines. Without confronting the profound marginalization that othering permits across the oral health professions, efforts to improve oral health outcomes will fall short of their full potential in truly cultivating health equity.
Dental Therapy in the United States as a Public Health Imperative: Perspectives From the Front Lines.
Kuntzelman KA, Jordan A, Branca E … +1 more , Colville AAC
J Public Health Dent · 2026 Mar · PMID 41866749 · Publisher ↗
BACKGROUND: Millions of people across the US-especially in rural, Tribal, underserved, and under-represented communities-continue, historically, to face unnecessary barriers to basic preventive and emergency oral healthc...
BACKGROUND: Millions of people across the US-especially in rural, Tribal, underserved, and under-represented communities-continue, historically, to face unnecessary barriers to basic preventive and emergency oral healthcare. Dental therapy, a proven, community-centered oral healthcare provider model utilized in over 50 countries for more than 100 years has been legislatively authorized in 14 states across the US. For over 20 years, however, dental therapy in the U.S. has repeatedly been opposed by the American Dental Association and state dental boards, despite clear, documented evidence that dental therapists provide safe, high-quality, and in most cases culturally specific care, with a focus on prevention. OBJECTIVE: To describe the role of dental therapists, summarize the evidence supporting their saftey and effectiveness and explore reasons for limited adoption of dental therapy in the U.S. despite documented benefits. METHODS: This abstract unifies available historical, legislative and workforce literature on dental therapy, highlights the voices of dental therapists, elevating clinical practice outcomes, community impact and documented oposition from the American Dental Association and state dental boards. RESULTS: Evidence shows that dental therapy has diversified the oral healthcare workforce, elevating the voices of those that have been oppressed historically in the United States Black, Indigenous, and People of Color (BIPOC) communities that continue to suffer because of structural racism. Dental therapists have been practicing for over 20 years in the United States, and over 100 years worldwide. Who are dental therapists and why are they not embraced with the clear evidence in the United States? Despite the clear evidence, national adoption of dental therapy remains slow due to political, regulatory and professional opposition. CONCLUSION: Significant institutional opposition continues to slow national acceptance and implemnation of dental therapy. Dental therapy represents an effective, evidence based community driven solution to persistent oral health inequities.
Policy Levers to Support the Transition From Pediatric to Adult Dental Care for People With Intellectual and Developmental Disabilities.
Fosse C, Mann L, Veazie M … +4 more , Vartanian B, Gosnell ES, Webb J, Lee JY
J Public Health Dent · 2026 Mar · PMID 41866747 · Publisher ↗
People with intellectual and developmental disabilities (IDD) and their families and caregivers are faced with navigating two very different delivery and financing systems in dentistry: one during childhood and the other...
People with intellectual and developmental disabilities (IDD) and their families and caregivers are faced with navigating two very different delivery and financing systems in dentistry: one during childhood and the other-often very disjointed-in adulthood. Even in states that offer Medicaid dental coverage for adults, the services are often substantially reduced, and the provider base to find a dentist is drastically diminished. Pediatric dentists encounter difficulty finding colleagues willing to take on the care of their patients with IDD as they reach adulthood. As a nation, we prioritize the health and wellbeing of children with disabilities via Medicaid's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. By not establishing this bar of coverage through adulthood, U.S. policy limits the return on investment of EPSDT not only fiscally, but more importantly, in the health and quality of life of people with IDD as they progress into adulthood. Here we review policy prospects in disability services and dental care that could improve the transition experience and outcomes for patients, families, and providers. Within the disabilities realm, policies related to Home and Community Based Services, Long-Term Services and Supports, Dual-Eligible Special Needs Plans, HEADs UP Act, and EPSDT extension for IDD are considered. Dental policy opportunities explored relate to code development for transition implementation, quality measurement, and building upon existing clinical support tools for transition implementation. We assess the variety of stakeholder support and other inputs necessary and describe opportunities and challenges with our current day political environment.
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