J Public Health Dent [JOURNAL]
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200 papers
Workforce Equity and Dental Health Aides in CHAP: A Scoping Review.
Llaneza AJ, Stone KA, Ready P … +1 more , Seward J
J Public Health Dent · 2026 Mar · PMID 41866746 · Publisher ↗
INTRODUCTION: Oral health workforce shortages are a persistent challenge throughout the United States (US), disproportionately affecting American Indian/Alaskan (AI/AN) Native communities. Shortages limit access to routi...
INTRODUCTION: Oral health workforce shortages are a persistent challenge throughout the United States (US), disproportionately affecting American Indian/Alaskan (AI/AN) Native communities. Shortages limit access to routine and preventive dental care across settings, contributing to oral health inequities and systemic shortfalls. The integration of additional, community-based providers is a viable means of improving access and addressing these disparities. The objective of this study was to evaluate publications focused on community-based providers within the Community Health Aide Program (CHAP) through a workforce health equity lens, with an emphasis on their role serving AI/AN populations. METHODS: Article screening, and data extraction were done independently by two reviewers. Articles and documents that: (1) examined DHAs or other community-based providers' relation to workforce or health equity; (2) were published in the last 60 years; and/or (3) were peer-reviewed, government reports, and organizational reports, published curriculum, and other dental health aide program materials were included in the analysis. RESULTS: This scoping review yielded a total of 33 articles. Articles discussed recruitment (n = 10), retention (n = 6), curriculum (n = 23), and access to care (n = 24) of a range of mid-level providers. Provider types included the dental therapist (n = 28), primary DHA I and II (n = 5), expanded function DHA (n = 3), dental hygienist (n = 4), all DHAs (n = 3), or other mid-level providers generally (n = 4). CONCLUSION: This review synthesizes previous work to increase understanding of the integration of dental health aides, through the CHAP Framework. Findings outline the key oral health workforce concepts to increase access to oral healthcare through a culturally adapted approach.
Equity-A Commentary.
Evans CA
J Public Health Dent · 2026 Mar · PMID 41866743 · Publisher ↗
This editorial is an invited contribution to the JPHD Supplement focused on health equity. This editorial draws on scholarly and lived experience as well as critical insights related to health equity and future direction...
This editorial is an invited contribution to the JPHD Supplement focused on health equity. This editorial draws on scholarly and lived experience as well as critical insights related to health equity and future directions in dental public health. This editorial aims to support the specialty in work that is needed now more than ever.
Equitable Data Collection in Dental Public Health.
Chung-Bridges K, Heaton LJ, Rafia K … +2 more , Schroeder KL, Tranby EP
J Public Health Dent · 2026 Mar · PMID 41866741 · Publisher ↗
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Towards Prescribing Pathways for Oral Health Practitioners in Australia: Addressing Barriers to Patient-Centered Care.
Carlson-Jones W, Acret T, Ayo A … +6 more , Westhoff P, Church LA, Ratnaweera M, Christian B, Park J, Stormon N
J Public Health Dent · 2026 Jun · PMID 41863419 · Full text
BACKGROUND: Oral health practitioners (OHPs) provide essential preventive, periodontal, and restorative treatment within diverse settings in Australia. Despite their significant contribution to oral healthcare, regulator...
BACKGROUND: Oral health practitioners (OHPs) provide essential preventive, periodontal, and restorative treatment within diverse settings in Australia. Despite their significant contribution to oral healthcare, regulatory restrictions prevent OHPs from independent prescription of medicines, limiting efficiency, continuity of care, and patient access, particularly for underserved populations. ISSUE: Current prescibing limitations create structural barriers within oral healthcare delivery. In contrast, endorsed prescribing pathways have been successfully developed for other professions, including nurses, midwives, podiatrists, optometrists, and pharmacists, with nurse practitioners and dentists already holding established prescribing authority. APPROACH: This paper explores the case for an endorsed prescribing pathway for OHPs, drawing on national and international developments, patient equity considerations, and workforce reform. We argue that prescribing reform would strengthen patient-centered care, reduce structural barriers to access, and align OHP regulation with contemporary models of multidisciplinary healthcare. We also highlight necessary safeguards such as postgraduate training, regulatory oversight, and scope-appropriate medications to ensure safe and effective implementation. CONCLUSION: As independent practitioners, the persistence of restrictive prescribing frameworks for OHPs reflects outdated professional dominance rather than evidence-based workforce planning. Expanding prescribing rights for OHPs represents a logical evolution of their role and an opportunity to address entrenched oral health inequities.
Trends in Pit and Fissure Sealant Use and Decayed, Missing, and Filled Teeth Rates Among Korean Adolescents After Including Dental Sealants Under Insurance Coverage.
Kim M, Mun SJ, Han SY … +3 more , Kim HN, Kang JY, Noh H
J Public Health Dent · 2026 Jun · PMID 41807286 · Full text
OBJECTIVES: This study examined the effects of dental sealant insurance coverage on trends in pit and fissure sealant (PFS) use, decayed, missing, and filled teeth (DMFT) rates, and filled teeth (FT) rates among Korean a...
OBJECTIVES: This study examined the effects of dental sealant insurance coverage on trends in pit and fissure sealant (PFS) use, decayed, missing, and filled teeth (DMFT) rates, and filled teeth (FT) rates among Korean adolescents, using data from the Korean Youth Risk Behavior Survey (2005-2024) and the Korean National Health and Nutrition Examination Survey (2007-2015). METHODS: Data from participants aged 12-18 years were analyzed. The proportion of PFS use referred to the proportion of respondents who answered "yes" to the question "Have you received PFS in the past 12 months?" in the survey. DMFT and FT were classified based on oral examination criteria from 2007 to 2015. Statistical analyses were conducted using Joinpoint regression (version 4.8.0.1) and PROC SURVEYLOGISTIC in SAS 9.4 to estimate the annual percent change (APC), odds ratios, and 95% confidence intervals. RESULTS: PFS use increased until 2018 (APC = +1.5%) and declined slightly thereafter until 2024, whereas DMFT and FT rates decreased from 2007 to 2015. Dental sealant insurance coverage was significantly associated with higher PFS use and lower DMFT and FT rates (p < 0.05). CONCLUSIONS: Dental sealant insurance coverage effectively improved oral health and reduced dental caries among Korean adolescents.
Dental Care Utilization Among Sexual and Gender Minority Individuals.
Singh I, Afolayan O, S Jackson S … +1 more , Tamí-Maury I
J Public Health Dent · 2026 Jun · PMID 41800597 · Full text
OBJECTIVES: Sexual and gender minority (SGM) individuals can experience notable health disparities, including higher HIV prevalence, social isolation, substance abuse, lack of culturally competent providers, and poorer h...
OBJECTIVES: Sexual and gender minority (SGM) individuals can experience notable health disparities, including higher HIV prevalence, social isolation, substance abuse, lack of culturally competent providers, and poorer health outcomes compared to heterosexuals due to stigma and discrimination. This study aims to identify predictors of dental care utilization across sexual minorities using the 2023 TEXAS PRIDE Survey. METHODS: We analyzed data from 517 SGM individuals, assessing sociodemographic characteristics, health behaviors, and recent medical and dental visits. Multivariable logistic regression identified predictors of dental care utilization (i.e., a dental visit in the past year). RESULTS: Among sexual orientation groups, reported dental care utilization was highest among gay (23.7%) and lesbian (21%) individuals, followed by bisexual (18.3%), pansexual (11.1%), queer (9.9%), and other sexual orientations (16.2%). Those with a college degree were significantly more likely to report dental utilization compared to those with less education. Individuals who did not have a medical visit in the past year were 0.27 times as likely to utilize dental care than those who did. No significant disparities in dental care utilization were found based on sexual orientation in the regression analysis. CONCLUSIONS: Higher education and recent medical visits are significant predictors of dental care utilization among SGM individuals. Efforts to reduce oral health disparities should focus on affordable dental care coverage, improving health literacy, fostering inclusive dental environments, and training providers in SGM cultural sensitivity. Future research should explore integrated healthcare approaches and provider cultural competence training to address these gaps.
Factors Associated With Health Care Utilization Among Transgender Adults in Brazil.
Diniz TC, de Azevedo Branco LG, Cavadinha ET … +6 more , Mendonça AVM, de Sousa MF, Paiva SM, Ferreira FV, Drummond AMA, Mattos FF
J Public Health Dent · 2026 Jun · PMID 41776363 · Full text
OBJECTIVE: This study investigated the utilization of medical and dental services by transgender Brazilians and their associated factors. METHODS: A national cross-sectional survey was conducted in 2021 with 549 self-ide...
OBJECTIVE: This study investigated the utilization of medical and dental services by transgender Brazilians and their associated factors. METHODS: A national cross-sectional survey was conducted in 2021 with 549 self-identified transgender adults (231 male, 183 female, and 135 other gender) aged 18-61 years. Participants were recruited through social media using snowball sampling and answered an electronic structured questionnaire. Outcomes were the frequency of medical and dental appointments. Associated factors included sociodemographic characteristics, use of social name, partnership, children, religion, health information sources, perceived health needs, experience of gender-based violence, and type of health services used. Odds ratios (OR) with 95% confidence intervals (CIS) were estimated using backward stepwise logistic regression models. RESULTS: Respondents who attended public schools (OR 1.73; 95% CI 1.01-2.88), had no income (OR 1.96; 95% CI 1.01-3.85), and relied solely on the public health system (OR 2.48; 95% CI 1.36-4.50) were more likely to have semiannual medical consultations. Conversely, those who attended public schools (OR 1.89; 95% CI 1.09-3.31), had ≤ 9 years of schooling (OR 1.74; 95% CI 1.13-2.68), were unemployed (OR 1.88; 95% CI 1.04-3.42), or had experienced gender-based violence (OR 1.57; 95% CI 1.02-2.41) were more likely to rarely or never attend dental consultations. CONCLUSIONS: Transgender Brazilians predominantly used the public health system, attending medical consultations semiannually but rarely dental appointments. Lower education, unemployment, lack of income, and exposure to gender-based violence shaped healthcare utilization, highlighting persistent barriers to equitable and comprehensive health access.
Water Fluoridation: Institutional Arrangements and Regulatory Mechanisms in Three Selected Countries.
Frazão P, Tavares ABS, Morris AJ … +1 more , Pollick H
J Public Health Dent · 2026 Jun · PMID 41717800 · Full text
OBJECTIVE: To describe and compare regulatory processes for quality control of community water fluoridation (CWF) in three selected countries. METHODS: Documentary analysis of printed and online resources; correspondence...
OBJECTIVE: To describe and compare regulatory processes for quality control of community water fluoridation (CWF) in three selected countries. METHODS: Documentary analysis of printed and online resources; correspondence with key informants from Brazil, the United States of America (USA), and England; countries with tradition in water fluoridation implementation for dental caries prevention. RESULTS: The target and maximum allowable concentration of fluoride in drinking water was 0.7/4.0 mg/L in the USA; 0.7/1.5 mg/L in Brazil, and 1.0/1.5 mg/L in England. Concentration monitoring by the water companies varied; collection of samples at several points of the distribution network was required in England and the USA, while Brazil demanded only one point at the end of the water treatment. England and the USA relied on data generated by companies responsible for water treatment, while Brazil adopted an independent surveillance system that used data collected in the distribution network by the local health authority. A common point between the USA and Brazil was the construction of a nationwide information system under principles of health surveillance that could be disseminated for stakeholders. In England, annual quality reports for each water supply zone were accessible but not routinely collated and published. CONCLUSION: Institutional arrangements, regulatory mechanisms, and control, surveillance, and information disclosure procedures varied substantially among countries. There is potential for exchanging procedural and outcome information in order to improve the performance of fluoridation services.
Oral Health Professionals' Views on the Interim Canada Dental Benefit in Manitoba, Canada.
Baltus THL, Abdulrahman A, Fux S … +8 more , Goubran S, Mittermuller BA, Yerex K, Menon A, Monayao A, Hai-Santiago K, Singhal S, Schroth RJ
J Public Health Dent · 2026 Jun · PMID 41703436 · Full text
OBJECTIVE: The Interim Canada Dental Benefit (CDB) provided financial support to families to cover dental care expenses for children < 12 years of age. The purpose of this study was to investigate oral health professiona...
OBJECTIVE: The Interim Canada Dental Benefit (CDB) provided financial support to families to cover dental care expenses for children < 12 years of age. The purpose of this study was to investigate oral health professionals' (OHPs) views of the Interim CDB. METHODS: OHPs in Manitoba, Canada were invited by e-mail to complete an online questionnaire. Data analysis included descriptive statistics (frequencies, means, and standard deviations), bivariate analysis (chi-squared and t-test), and multivariable logistic regression. A p-value < 0.05 was considered significant. RESULTS: Overall, 383 OHPs participated, the majority being women (80.9%), from metropolitan areas (77.8%), and working for 16.6 ± 12.9 years. Main respondents included dentists (24.3%), dental hygienists (23.3%), and dental assistants (38.7%). Awareness of the benefit was high (92.7%) yet 45.8% were uncertain whether it increased public awareness of children's oral health. Encouragement to apply was low (39.3%), although 56.5% believed that the Interim CDB improved access to children's oral care. Multivariate logistic regression showed that rural OHPs encouraged application 43% more than those working in urban areas. Significantly more positive responses were observed among rural-based OHPs and women toward the benefit's ability to improve access to oral health for children. CONCLUSIONS: Overall, awareness was high among the OHPs, but uncertainty remained whether the benefit improved access to care for young children. OHPs in rural areas were more likely to believe that the Interim CDB improved access to care and were more likely to promote the program to families.
Trend Analysis of Medically Related Osteonecrosis of the Jaw in the United States Using US National Inpatient Data From 2016 to 2022.
Sheshashayee N, Rao MB, Holmes E … +1 more , Krishnan DG
J Public Health Dent · 2026 Mar · PMID 41615283 · Full text
OBJECTIVES: This study presents a trend analysis of Medication-Related Osteonecrosis of the Jaw (MRONJ) using US National Inpatient Sample (NIS) data from 2016 to 2022, providing insights into its epidemiology, comorbidi...
OBJECTIVES: This study presents a trend analysis of Medication-Related Osteonecrosis of the Jaw (MRONJ) using US National Inpatient Sample (NIS) data from 2016 to 2022, providing insights into its epidemiology, comorbidities, and economics. METHODS: A retrospective cross-sectional analysis was performed using US MRONJ hospital admissions. Prevalence rates were calculated relative to Bisphosphonate patient numbers in the United States and hospital-based denominators. Statistical analyses included two-sample proportion (Z) tests, Cochran-Armitage trend tests, Welch t-tests, and multivariable linear and ANOVA models with false discovery rate (FDR) correction for multiple comparisons, effect sizes, market basket analysis. RESULTS: Cochran-Armitage trend tests revealed significant increasing trends in MRONJ prevalence across all denominators: total NIS hospitalizations (p = 0.037), dental-related hospitalizations (p = 0.012), and bisphosphonate-exposed patients (p < 0.001). Females were more affected with MRONJ than males consistently across all years (p = 0.188). Whites had the highest number of cases across all years (p = 0.774). No region or income bracket stood out as highest or lowest. Medicare is the primary payer with 61%-80% of patients covered (p = 0.497). The average age of patients is around 70 years across all years. The average length of stay in the hospital ranged from 4 to 8 days and the average daily charges ranged from $15,000 to $20,000. Hypertension is the most common co-morbidity (except 2018). CONCLUSION: The study highlights the incidence of MRONJ, its demographic disparities, economics, and the need for enhanced prevention and cost-effective management strategies.
Trend in Opioid Analgesic Prescriptions and High-Risk Prescribing in the State of Illinois: An Eight-Year Descriptive Analysis.
Sangalli L, Bolch C, Rojas-Ramirez MV
J Public Health Dent · 2026 Mar · PMID 41612965 · Publisher ↗
OBJECTIVE: Given the significant opioid epidemic in the United States, we investigated opioid-analgesic prescription trends and high-risk prescriptions in Illinois between 2015-2022. METHODS: Data from the Illinois Presc...
OBJECTIVE: Given the significant opioid epidemic in the United States, we investigated opioid-analgesic prescription trends and high-risk prescriptions in Illinois between 2015-2022. METHODS: Data from the Illinois Prescription Monitoring Program were analyzed for opioid prescription rates and high-risk prescriptions (i.e., multiple-prescribing providers, concurrent benzodiazepine, ≥ 90MME dose). Demographics (sex, age, and rural/urban classification using the Illinois Primary Health Care Association-2020) of high-risk prescriptions between 2018-2020 were analyzed using chi-square tests. RESULTS: N = 45,522,885 opioid prescriptions were dispensed in Illinois between 2015-2022, declining by 47.1% (from 140.5 rate in 2015 to 74.4 in 2022). High-risk prescriptions comprise 12.6% of all prescriptions and decreased by 16.6% (from 16.9% in 2015 to 14.1% in 2022). Between 2018-2020, males received more high-risk prescriptions than females, although both males and females showed a reduction in ≥ 90MME prescriptions (19.5% vs. 15.9%, p < 0.0001) and multiple-provider prescriptions (36.1% vs. 27.3%, p < 0.0001). Individuals aged 56-70 received the highest high-risk prescriptions, while reductions in ≥ 90MME prescriptions occurred across all age groups. High-risk prescriptions were disproportionally dispensed in rural areas (67.8%), where reductions were greater in ≥ 90MME prescriptions (16.7% rural vs. 6.4% urban) and multiple-provider prescriptions (9.0% rural vs. 7.9% urban). CONCLUSIONS: Despite declines in opioid-analgesic prescriptions in Illinois from 2015 to 2022, high-risk prescribing persists, particularly in rural areas and among specific demographic groups. Targeted, region-specific interventions and continued regulatory oversights are necessary to address geographic and population-level disparities in high-risk opioid prescribing.
Attitudes About Administrative Burdens for Beneficiaries and Dental Care Providers in Medicaid.
Haeder SF, Herd P, Moynihan DP
J Public Health Dent · 2026 Mar · PMID 41607307 · Full text
OBJECTIVES: To assess public attitudes about a variety of burden-reducing policies related to oral health services in the Medicaid program. METHODS: We fielded a national survey (N = 5784) using Lucid from May 7 to 15, 2...
OBJECTIVES: To assess public attitudes about a variety of burden-reducing policies related to oral health services in the Medicaid program. METHODS: We fielded a national survey (N = 5784) using Lucid from May 7 to 15, 2024. Respondents were queried whether they supported seven burden-reducing policies for the Medicaid program focused on both beneficiaries and oral healthcare providers related to oral health services. The survey also contained an experiment that highlighted (1) the importance of dental care, (2) administrative burdens for beneficiaries, (3) dental challenges for children in poverty, (4) dental challenges for children of color, or (5) administrative burdens for dental providers. We relied on descriptive statistics as well as linear probability models to assess. RESULTS: Overall, we found substantial support for reducing burden, ranging from 73.2% for referral requirements for physicians to a high of 92.1% for facilitating dentist credentialing. We found no differences across the various informational treatments. Analysis of the pooled data indicated that Americans were broadly supportive of reducing burdens for both beneficiaries and providers. We identified consistent differences based on ideology, racial resentment, racial resentment, empathy, awareness of disparities, burden tolerance, administrative capital, and connection to the Medicaid program. CONCLUSION: The American public broadly supports burden reductions for both beneficiaries and providers. More research is needed to assess public attitudes related to oral health services policies.
Emergency Dental Care in the ACA Era: Rural-Urban Disparities and Their Association With State Medicaid Policy.
Akinlotan MA, Burch D, Ferdinand AO
J Public Health Dent · 2026 Mar · PMID 41607015 · Full text
OBJECTIVES: Rural US populations face greater barriers to dental care than urban residents. This study examines emergency department (ED) visits for nontraumatic dental conditions (NTDCs) among adults, comparing rural an...
OBJECTIVES: Rural US populations face greater barriers to dental care than urban residents. This study examines emergency department (ED) visits for nontraumatic dental conditions (NTDCs) among adults, comparing rural and urban areas. It also explores how Medicaid expansion and varying state Medicaid dental policies influence the likelihood of NTDC-related ED visits. METHODS: We conducted a cross-sectional analysis using 2019 ED data from eight states. Descriptive statistics characterized NTDC-related ED visits by patient, visit, and county-level variables across four Medicaid policy groups. Chi-squared tests and T-tests assessed rural-urban differences in visit characteristics and payer mix. Logistic regression models estimated the likelihood of NTDC ED visits by rurality and payer type, adjusting for sociodemographic factors and stratified by Medicaid expansion and adult dental benefit status. RESULTS: Rural NTDC ED visits were shorter (2.5 h) and less costly ($1602) than urban visits (over 3 h, $2532). Analysis of rurality and payer mix revealed three key patterns: (i) rural residents consistently had higher visit rates than urban residents in three of the four groups; (ii) uninsured patients-both rural and urban-had the highest probability of NTDC ED visits in three of the four groups; and (iii) among Medicaid-covered visits, rural enrollees in non-expansion states without adult dental benefits had the highest likelihood of NTDC ED visits. CONCLUSIONS: This study highlights continued ED reliance for NTDCs 5 years post-ACA, driven by Medicaid policy and access gaps. Expanding rural oral healthcare remains vital for improving access, especially for the uninsured.
Bridging Gaps in Oral Health Frameworks: Mapping With Hodges' Health Career - Care Domains - Model.
Bettiol S, Jones P, Onyedikachi HA … +1 more , Kernohan WG
J Public Health Dent · 2026 Mar · PMID 41589336 · Full text
OBJECTIVES: Despite decades of national and global strategies, persistent inequities in oral health outcomes, access, and service provision remain. Existing frameworks often fail to integrate clinical and behavioral fact...
OBJECTIVES: Despite decades of national and global strategies, persistent inequities in oral health outcomes, access, and service provision remain. Existing frameworks often fail to integrate clinical and behavioral factors with social, cultural, and political determinants. This study aimed to map and evaluate oral health frameworks using Hodges' Health Career-Care Domains-Model (HCM), a meta-framework that spans clinical, behavioral, sociological, and political domains. The goal was to identify conceptual gaps and opportunities for greater integration. METHODS: A structured scoping review was conducted using MEDLINE, CINAHL, EBSCO, and search engine Google Scholar (1995-2025) to identify oral health-related conceptual frameworks. Frameworks were eligible if they addressed oral health determinants, behaviors, policies, or interventions. Two reviewers independently screened records and analyzed full-text articles. Frameworks were categorized by theoretical orientation and mapped against the four HCM domains to identify patterns of emphasis or omission. RESULTS: Of 226 identified records, 21 frameworks met inclusion criteria. These were classified into three thematic groups: balanced (addressing all domains), clinically led (focused on clinical/behavioral aspects), and policy/public health-focused (emphasizing sociological/political factors). Seven cross cutting themes emerged, including health promotion, systems integration, social justice, and cultural safety. While many frameworks promoted equity and policy reform, few offered implementation guidance or had been empirically validated. CONCLUSIONS: HCM proved useful for systematically comparing frameworks and revealed consistent underrepresentation of political and structural domains. It offers a practical tool for oral health professionals, educators, and policymakers developing integrated oral health models that align with equity, sustainability, and universal health coverage goals.
Improving the Oral Healthcare Experience for Hong Kong and Macao Residents: A Practical Exploration of Specialized Nurse-Led Oral Care Clinics.
Zhao H, Wang H, Huang L … +2 more , Xie F, Yan J
J Public Health Dent · 2026 Mar · PMID 41586576 · Full text
OBJECTIVE: This study aims to evaluate the effectiveness of specialized oral nursing clinics for residents of Hong Kong and Macau. By optimizing the outpatient process to enhance treatment efficiency and improve the heal...
OBJECTIVE: This study aims to evaluate the effectiveness of specialized oral nursing clinics for residents of Hong Kong and Macau. By optimizing the outpatient process to enhance treatment efficiency and improve the healthcare experience of Hong Kong and Macau patients in mainland China, this research provides evidence-based insights to address the challenges of low cross-regional treatment efficiency and complex procedures. METHODS: A specialized oral nursing clinic was established by a hospital group, implementing an innovative "one center, multiple branches" referral model. This model integrates the Oral Medicine Center with community health clinics to optimize the allocation of healthcare resources. The outpatient nurses are all specialized oral nurses with prescriptive authority. A cluster sampling method was used to compare data from January to March 2023 (before implementation) and January to March 2024 (after implementation). The evaluation indicators included patient volume, waiting time for consultations, expected treatment completion rate, and patient satisfaction. RESULTS: After implementation, the proportion of patients from Hong Kong and Macau increased from 2.0% to 6.8% (p < 0.01). The average waiting time for consultations decreased from 40.16 ± 17.39 min to 33.19 ± 15.61 min (p < 0.01). The expected treatment completion rate increased from 83.6% to 90.1% (p < 0.01), and patient satisfaction improved from 90.9% to 96.9% (p < 0.01). CONCLUSION: The specialized oral nursing clinic, combined with the "one center, multiple branches" referral model, effectively simplifies the consultation process, improves service efficiency, and enhances patient satisfaction. This approach is innovative, scientifically sound, and replicable, providing practical evidence for the joint development and sharing of medical resources in the Greater Bay Area. TRIAL REGISTRATION: Not applicable.
Assessing Oral Health Awareness Among Arab Immigrants & Refugees.
Al-Obaidy R, Najjar T, Al-Jumaa I … +3 more , Chang J, Waks A, Thiel de Bocanegra H
J Public Health Dent · 2026 Mar · PMID 41582608 · Publisher ↗
BACKGROUND: There is limited information about oral health awareness among Arab immigrants and refugees (AIR) in the United States, though research conducted on this demographic globally has shown a major correlation bet...
BACKGROUND: There is limited information about oral health awareness among Arab immigrants and refugees (AIR) in the United States, though research conducted on this demographic globally has shown a major correlation between poor oral health outcomes and sociodemographic factors. This study examined oral health practices and awareness of the increased gingivitis risk during pregnancy among AIR in Southern California. METHODS: This was a cross-sectional survey on oral health knowledge and access barriers among male and female AIR participants recruited via community organizations and dental clinics. Bivariate and multivariate analyses evaluated the association between oral health awareness and demographics, oral health literacy, general health knowledge, and knowledge of pregnancy-related gingivitis risk. RESULTS: The sample included 73 participants (31 males, 42 females), mostly aged 18-30; 67% held bachelor's degrees or higher, and 41% had immigrated due to war or violence. Females showed higher Oral Health Risk Awareness Scores than males (0.75 vs. 0.61, p < 0.006), with no significant differences by age or ethnicity. Most respondents reported financial and language barriers to dental care. Although over 75% recognized a link between oral and general health, only 38% knew of the increased periodontal risk during pregnancy. CONCLUSION: The financial, linguistic, and educational obstacles that AIR populations must overcome to obtain dental care pose challenges and have an impact on their awareness of the risks to their oral health. These findings highlight the importance of culturally sensitive health education and outreach efforts. PRACTICAL IMPLICATIONS: Culturally appropriate programs and multilingual materials are necessary to improve care by addressing AIR's knowledge of gingivitis risks and promoting preventative dental care.
Perceptions and Interests of Dental Hygienists in Addressing Food Insecurity and HPV in Clinical Settings.
Khan T, Fleming A, Joyce JM … +2 more , Porter KJ, Liebe RA
J Public Health Dent · 2026 Mar · PMID 41582600 · Full text
PURPOSE: Few studies have explored dental hygienists' views on health behaviors like food insecurity or recommending preventive care such as the HPV vaccine. This study examined current practices, barriers, and readiness...
PURPOSE: Few studies have explored dental hygienists' views on health behaviors like food insecurity or recommending preventive care such as the HPV vaccine. This study examined current practices, barriers, and readiness to implement screenings for food insecurity (FI), HPV risk, and vaccine recommendation. METHODS: A cross-sectional survey was conducted (August 2024) among Oklahoma dental hygienists. Using concepts from the Transtheoretical Model and the Theory of Planned Behavior (TPB), an embedded mixed-methods survey evaluated respondent readiness to conduct FI screenings and HPV risk assessment/vaccine recommendation. Analyses included descriptive statistics and χ tests to determine associations between intent and constructs of TPB. Additionally, content analysis of open-ended questions identified barriers and facilitators to adopting these practices. RESULTS: Among respondents (n = 92), the majority were not yet considering (precontemplation) screening for FI (67%), risk assessment for HPV (58%), or providing the HPV vaccine recommendation (78%). Most hygienists displayed a positive attitude toward these practices, yet lacked intent due to low perceived behavioral control and subjective norms (p < 0.001). Qualitative content analysis revealed barriers, including a lack of knowledge (41%) and awareness (18%), low confidence (10%), and considering such practices outside the scope of dental care (15%). Despite this, hygienists reported education (13%) and access to resources (10%) as facilitators in initiating HPV and FI related conversations. IMPLICATIONS: Despite the low readiness, hygienists reported a willingness to engage in these critical public health issues with appropriate training and support. A stage-based training program in Oklahoma may enhance dental hygienists' knowledge and confidence, thereby improving preventive care and health outcomes.
Achieving Consensus on Oral Health in Aged Care: Findings From an Australian e-Delphi Study.
Pritchard L, Loc D, Nicole S
J Public Health Dent · 2026 Mar · PMID 41574623 · Full text
OBJECTIVE: To establish expert consensus on the critical factors shaping implementation of oral health assessment in Australian residential aged care (RAC) using an e-Delphi approach. METHODS: A modified electronic Delph...
OBJECTIVE: To establish expert consensus on the critical factors shaping implementation of oral health assessment in Australian residential aged care (RAC) using an e-Delphi approach. METHODS: A modified electronic Delphi (e-Delphi) process, informed by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, was conducted over two iterative survey rounds to refine expert perspectives. 60 experts were purposively sampled from oral health, aged care, policy, and implementation science. Quantitative responses were summarized with descriptive statistics, while qualitative feedback was analyzed through reflexive thematic analysis. RESULTS: Consensus was reached on the importance of mandating oral health care in national aged care accreditation standards, embedding oral health into broader aged care policies and requiring systematic oral health assessments as part of routine care. Participants highlighted workforce shortages, insufficient training, limited practitioner access, and organizational readiness as key barriers. Enablers included workforce development, simplified and standardized assessment tools, mobile and outreach dental services, policy mandates, and cultural change recognizing oral health as integral to person-centered care. Round two resolved areas of initial uncertainty, with consensus achieved on all outstanding items. CONCLUSION: This study provides the first consensus-based priorities for embedding oral health assessment tools in RAC, signaling sector-wide readiness for reform. Applying the EPIS framework, the findings highlight that enforceable accreditation standards must be paired with workforce training, oral health champions, and practical tools to ensure sustainable uptake. These insights offer an evidence-informed roadmap for policymakers and service providers, reframing oral health from a peripheral task to a regulated element of clinical governance and quality care.
A Cross-Sectional Investigation of Rural Dental Practice as Related to Gender, Hometown, and Career Stage.
McKenzie CT, Lockwood S
J Public Health Dent · 2026 Mar · PMID 41574458 · Full text
OBJECTIVES: This investigation explores how gender, career stage, and rurality of graduates' hometowns relate to dental practice location, specifically within Alabama's rural communities. METHODS: This cross-sectional st...
OBJECTIVES: This investigation explores how gender, career stage, and rurality of graduates' hometowns relate to dental practice location, specifically within Alabama's rural communities. METHODS: This cross-sectional study explored demographics and practice locations for 2000-2020 graduates (N = 1233) from the state's dental school. This investigation compared findings across multiple definitions of rural status. RESULTS: Gender emerged as a significant predictor of rural practice for only one of the rural definitions. Females were less likely than males (6% vs. 12%) to practice in a low-population county (< 50,000), χ = 11.03, p < 0.001. When controlling for both career stage and rurality of hometown, males are 2.04 times more likely (95% CI [1.29, 3.21]) to practice in a low-population county as compared to females, p = 0.002. Among graduates from rural or workforce shortage areas, no differences emerged in practice location based on either gender or career stage. Graduates from a rural county are significantly more likely than their non-rural peers to practice rural. Early-career dentists are not working in rural locations at significantly different rates from their mid-career peers. CONCLUSIONS: More providers are needed to serve rural residents and graduates with rural upbringing are the most likely to fulfill this need. Rural practice appears to attract males and females in similar proportions, but more males than females gravitate towards low-population counties. Given populations and workforce trends, dental educators, policy makers, organized dentistry, and rural communities must all implement initiatives incentivizing dental practice in Alabama generally and her rural communities specifically.
The Association Between Intensive Parenting Attitudes and Topical Fluoride Opposition.
Ko A, Carle AC, Tanbonliong TS … +1 more , Chi DL
J Public Health Dent · 2026 Mar · PMID 41556617 · Publisher ↗
OBJECTIVE: This study's goal was to investigate the association between intensive parenting attitudes and topical fluoride opposition. METHODS: This was a secondary analysis of data on caregivers' beliefs about fluoride...
OBJECTIVE: This study's goal was to investigate the association between intensive parenting attitudes and topical fluoride opposition. METHODS: This was a secondary analysis of data on caregivers' beliefs about fluoride for their children. An 85-item survey was administered from November 2020 to September 2021 (N = 1135). Participants were eligible if they were an English-speaking caregiver of a child under 18 years. The outcome variable was topical fluoride opposition, defined as how opposed the caregiver was to topical fluoride for their child (self-reported scale of 0-10). The explanatory variable was intensive parenting attitudes, defined as the extent of child-centered, time-intensive, and self-sacrificing parenting, measured through a composite score from three survey items. Linear regression was used to test the study hypothesis, adjusting for confounders. All analyses were performed in SPSS. RESULTS: The mean ± SD caregiver age was 41.7 ± 8.8 years, with most caregivers being women (73.0%), White (55.5%), non-Hispanic (79.3%), having greater than a 4-year degree (28.5%), and having private dental insurance (45.1%). The mean ± SD topical fluoride opposition score was 2.0 ± 3.1, and the mean ± SD intensive parenting attitudes score was 1.7 ± 0.4. After adjusting for confounders, a 1-point increase in intensive parenting attitudes score was associated with a 0.3-point increase in topical fluoride opposition score (95% CI: 0.1, 0.4; p < 0.001). CONCLUSIONS: Intensive parenting attitudes were significantly and positively associated with topical fluoride opposition. Clinicians can utilize these findings to assess caregivers' intensive parenting attitudes, learn about concerns, and address them by tailoring communication strategies to discuss appropriate risk-based recommendations about topical fluoride.
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