J Public Health Dent [JOURNAL]
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200 papers
Socioeconomic Status and Dental Care Utilization in Older Adults: A Comparison Between Australia and Japan.
Taguchi U, Tran M, Ono S … +4 more , Kowal P, Aida J, Hoshi K, Sugiura T
J Public Health Dent · 2026 Mar · PMID 41546439 · Full text
OBJECTIVES: With the growing emphasis on incorporating dental care into universal health coverage (UHC) worldwide, it is essential to understand the extent to which UHC can improve access to needed health services withou...
OBJECTIVES: With the growing emphasis on incorporating dental care into universal health coverage (UHC) worldwide, it is essential to understand the extent to which UHC can improve access to needed health services without financial hardship. Dental care services should be included in monitoring progress toward UHC, but are often left out, even in countries with UHC. This study will compare socioeconomics-related inequalities in dental care utilization among older Australians and Japanese, who experience contrasting universal dental insurance systems. METHODS: We used data from Australia and Japan to estimate socioeconomics-related inequalities in dental care utilization as the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) for community-dwelling adults aged 65 years and older. Socioeconomic status was measured using equivalized income and educational attainment. Dental care utilization was defined as visiting a dentist within the past 12 months. RESULTS: The study included 6104 Australian participants (mean age 73.8 years) and 19,043 Japanese participants (mean age 74.9 years). Income-related inequalities in dental care utilization were higher in Australia [SII (0.22, 95% CI = 0.18-0.27); RII (1.48, 95% CI = 1.36-1.59)] than in Japan [SII (0.16, 95% CI = 0.14-0.19); RII (1.28, 95% CI = 1.24-1.33)]. We found a similar pattern in educational attainment. CONCLUSIONS: Notwithstanding the differences between the two dental care systems, the lack of UHC in dental care in Australia may be a contributing factor to greater inequalities in dental care utilization among older adults.
Oral Health and Quality of Life Among Unhoused Residents in Chicago: Implications for Public Health Interventions.
Kim ES, McIntosh A, Chang R … +5 more , Patel EA, Holland K, Stubbs V, Jagasia A, Bhayani MK
J Public Health Dent · 2026 Mar · PMID 41403105 · Publisher ↗
OBJECTIVE: To investigate disparities in oral health and quality of life between unhoused and housed populations in Chicago, Illinois, and highlight potential areas for policy intervention. METHODS: Cross-sectional study...
OBJECTIVE: To investigate disparities in oral health and quality of life between unhoused and housed populations in Chicago, Illinois, and highlight potential areas for policy intervention. METHODS: Cross-sectional study using the modified Oral Health Impact Profile (OHIP-14), a 14-item validated survey assessing seven domains affected by oral health, such as functional limitation, pain, and social disability. Data were collected from unhoused patients at the Rush CURE Clinic and housed patients from the Rush University Department of Otolaryngology Clinic in Chicago, Illinois. Demographics, oral health, and quality of life perception data were collected through the OHIP-14 survey. Statistical analysis included descriptive statistics, binomial tests, and ANOVA. RESULTS: Housed patients had increased access to healthy food (97% vs. 51%, p < 0.001), health insurance (100% vs. 65%, p < 0.001), and employment (64% vs. 35%, p < 0.001). Unhoused patients reported greater challenges across multiple OHIP-14 domains, including dissatisfaction with diet (33.3% vs. 7.7%, p < 0.001), difficulty with occupational activities (22% vs. 5.2%, p < 0.001), and lower overall quality of life satisfaction (32% vs. 5.2%, p < 0.001). CONCLUSIONS: This study underscores the intersection of homelessness, oral health, and social determinants of quality of life. Findings may guide policymakers in designing targeted, community-based preventive interventions-particularly expanding oral health services, nutritional support, and employment resources for vulnerable populations. Structurally informed public health strategies are needed to reduce oral health inequities and their downstream effects on daily functioning and overall wellbeing.
Dental Care Utilization and Expenditures Among Individuals With Asthma.
Naavaal S, Mone V
J Public Health Dent · 2026 Mar · PMID 41376449 · Full text
OBJECTIVES: To examine dental care utilization and health and dental care expenditures among individuals with asthma. METHODS: Data from the 2022 Medical Expenditure Panel Survey (MEPS) (n = 21,405) were used to examine...
OBJECTIVES: To examine dental care utilization and health and dental care expenditures among individuals with asthma. METHODS: Data from the 2022 Medical Expenditure Panel Survey (MEPS) (n = 21,405) were used to examine dental care utilization (any dental, preventive dental, and treatment dental visit) among individuals ≥ 1 year with and without asthma, and mean expenditures were summarized. RESULTS: Overall, the asthma diagnosis was 13.2%, 14.7% in working-age adults compared to 9.5% in children. The percentage of treatment dental visits was higher overall (17.0% vs. 14.5%, p < 0.05) among the asthma group compared to the non-asthma group. Among individuals with asthma, those who had preventive dental visits had lower dental expenditures compared to those who had treatment dental visits for all age groups. CONCLUSION: Individuals with asthma had a higher prevalence of using dental treatment services. To support oral health among individuals with asthma, healthcare providers should educate and encourage the use of preventive dental care.
Factors Associated With Dentists' Intent to Stay Long-Term at Their Current Community Health Center.
Castelaz M, Warren J, Qian F … +2 more , Owen CLH, Reynolds J
J Public Health Dent · 2026 Mar · PMID 41371614 · Publisher ↗
OBJECTIVE: Community health centers (CHCs) are a critical component of the dental safety net for people with substantial barriers to dental care access. Recruiting and retaining dentists working in CHCs is essential to e...
OBJECTIVE: Community health centers (CHCs) are a critical component of the dental safety net for people with substantial barriers to dental care access. Recruiting and retaining dentists working in CHCs is essential to effectively serve this population. This study aimed to identify factors associated with dentists' intent to continue practicing in their current CHC in the long term. METHODS: The data were collected through an online survey administered to United States dentists practicing in CHCs in 2021 by the National Network for Oral Health Access. The dependent variable was dentists' intent to stay at their current CHC in the long term, with 42 independent variables across four domains: individual characteristics, perceptions, motivators, and organizational factors. Descriptive, bivariate, and multivariable logistic regression analyses were employed to determine factors associated with dentists' intent to stay at their CHC. RESULTS: A total of 248 dentists were in the final analytical sample. Multivariable regression results showed that dentists in leadership roles had 3.7 times the odds of intending to stay compared to staff dentists, and those with high professional autonomy had 2.6 times the odds of intending to stay compared to those with low to moderate autonomy. CONCLUSIONS: The study underscored the importance of dentists' autonomy and role in their intent to remain at CHCs. Factors typically associated with recruitment packages or length of time in clinical practice were not significantly associated with intent to stay. Distinguishing between recruitment and retention strategies is crucial for CHCs to fulfill their mission of ensuring equitable dental care access.
Exploring Oral Health Disparities in the 2022 BRFSS: The Impact of Rural/Urban Status and Adverse Childhood Experiences.
Song J, Kim JN
J Public Health Dent · 2025 Dec · PMID 41199153 · Publisher ↗
OBJECTIVES: To examine the association between rural/urban status, adverse childhood experiences (ACEs), and oral health outcomes, specifically focusing on inadequate dental visits and significant tooth loss. METHODS: Da...
OBJECTIVES: To examine the association between rural/urban status, adverse childhood experiences (ACEs), and oral health outcomes, specifically focusing on inadequate dental visits and significant tooth loss. METHODS: Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), including 79,571 U.S adults from 12 states, was analyzed. Inadequate dental visits were defined as having last visited a dentist more than one year ago. Significant tooth loss was defined as the loss of six or more permanent teeth due to decay or gum disease. Multivariable logistic regression models were applied to assess the effects of rural/urban status and ACEs on both outcomes, adjusting for sociodemographic factors. RESULTS: Rural residents had higher odds of reporting inadequate dental visits (AOR: 1.17, 95% CI: 1.07-1.29) and significant tooth loss (AOR: 1.36, 95% CI: 1.21-1.53) compared to urban residents. ACEs were significantly associated with both outcomes, with individuals reporting 4 or more ACEs showing the highest prevalence of inadequate dental visits and significant tooth loss. Although no statistically significant interaction between rural/urban status and ACEs was found, rural residents generally had worse oral health outcomes than their urban counterparts. CONCLUSIONS: Both rural/urban status and ACEs independently contribute to oral health disparities, with rural populations facing greater challenges in maintaining oral health. The findings emphasize the need for targeted interventions that address geographic and psychosocial determinants, particularly in rural areas, and highlight the importance of trauma-informed care in dental practice.
Pressing Issues for Oral Health Care Access and Quality Improvement During Pregnancy in Portugal-A Qualitative Study.
Frey-Furtado L, Melo P, Listl S … +1 more , Pereira ML
J Public Health Dent · 2025 Dec · PMID 41168938 · Full text
OBJECTIVE: To identify and prioritize pressing issues related to access and quality of oral healthcare during preconception, pregnancy, and postpartum in Portugal. METHODS: Ethical approval (number 8/2024) and data prote...
OBJECTIVE: To identify and prioritize pressing issues related to access and quality of oral healthcare during preconception, pregnancy, and postpartum in Portugal. METHODS: Ethical approval (number 8/2024) and data protection clearance (R-12/2024) were granted. Twelve stakeholders, including healthcare professionals, policymakers, representatives of nongovernmental organizations, and recent mothers, were recruited through snowball sampling. The Nominal Group Technique structured a four-step process: (1) online discussions at policy, community, and practice levels; (2) initial voting to screen pressing issues; (3) plenary discussion; and (4) final voting. RESULTS: At the policy level, the highest-ranked pressing issues were the lack of a mandatory oral health diagnostic appointment for early detection, limited coverage of the Cheque-Dentista program, which excludes the preconception period, and the absence of oral health education in childbirth and parenting courses. At the community level, pressing issues included the absence of oral health in family planning consultations, insufficient oral health training for midwives and nurses, and weak direct engagement with pregnant women through targeted promotion strategies. At the practice level, the most pressing issues were the exclusion of dentists from maternal healthcare teams, the lack of structured oral health appointments in primary healthcare centers, and the omission of oral health modules from childbirth preparation programs. CONCLUSION: The Nominal Group Technique enabled consensus-building and prioritization of concrete pressing issues, producing actionable strategies to strengthen maternal oral healthcare in Portugal. Literacy, accessibility, and collaboration have emerged as foundational elements for integrating oral health into maternal care pathways.
Recommitting Public Health Dentistry to Equity, Diversity, and Inclusion.
Laniado N, Iribarren S, Reynolds JC
J Public Health Dent · 2026 Mar · PMID 41063367 · Publisher ↗
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The Effect of a Rural Workforce Intervention to Improve Oral Health of Children: Evidence From an Interrupted Time Series Study of Southeast Alaska.
Pourat N, Chen X, Godwin J … +1 more , Spetz J
J Public Health Dent · 2025 Dec · PMID 41029846 · Publisher ↗
OBJECTIVES: Geographic isolation, limited resources, and inadequate access to dental care have led to poor oral health for Alaska Native children. In the early 2000s, the Alaska Native Tribal Health Consortium (ANTHC) be...
OBJECTIVES: Geographic isolation, limited resources, and inadequate access to dental care have led to poor oral health for Alaska Native children. In the early 2000s, the Alaska Native Tribal Health Consortium (ANTHC) began training alternative oral health practitioners including primary dental health aides (PDHAs) who provide dental education and preventive procedures and dental health aid therapists (DHATs) who provide additional specific treatments. Most members employ DHATs but only the Southeast Alaska Regional Health Consortium (SEARHC) systematically employed PDHAs starting in 2008. We evaluated whether the employment of PDHAs by SEARHC was associated with changes in the delivery of oral preventive and treatment procedures at the beginning of the program. METHODS: We analyzed Alaska Medicaid claims data for children ages 0-18 from 2003 to 2004 and 2008 to 2012. We compared procedure use of enrollees treated by SEARHC with remaining ANTHC members and other Medicaid dental providers. We used regression models to compare changes in the predicted rate of fluoride varnish (FV) and treatment procedures for each group before and after the employment of PDHAs at SEARHC. RESULTS: Significantly higher predicted rate of FVs (1.74 vs. 1.05 and 1.14) and lower rate of restorative treatment procedures (1.62 vs. 2.21 and 2.87) among SEARHC patients compared to other ANTHC patients or patients of other Medicaid providers in 2012. CONCLUSIONS: Findings highlighted likely benefits of employing PDHAs in the delivery of needed preventive procedures in remote areas like Alaska. Implementation of the SEARHC model requires multiple legislative and regulatory steps to establish the scope of practice, Medicaid reimbursement, and infrastructure to recruit, train, and place practitioners.
Adverse Childhood Experiences in the First 1000 Days of Life and Dental Caries Experience From Age 31 to 61 Months.
Jawad N, Golkari A, Bernabé E
J Public Health Dent · 2025 Dec · PMID 41025996 · Full text
OBJECTIVE: To investigate the association between early life adverse childhood experiences (ACEs) and dental caries among young children. METHODS: This study was a secondary analysis of longitudinal data from 927 childre...
OBJECTIVE: To investigate the association between early life adverse childhood experiences (ACEs) and dental caries among young children. METHODS: This study was a secondary analysis of longitudinal data from 927 children in the Children-In-Focus (CIF) sub-study of the Avon Longitudinal Study of Parents and Children (ALSPAC). ACEs were assessed through questionnaires from mothers and partners, covering the gestation period (prenatal ACEs) and the first 2 years of life (ACEs during infancy). Dental caries was assessed clinically at ages 31, 43, and 61 months and reported using the dmft index. The association between early life ACEs and dental caries was evaluated in mixed effects Poisson models adjusting for covariates. RESULTS: Overall, 342 (36.9%) and 441 (47.6%) children in the study sample were exposed to ACEs prenatally and during infancy, respectively. The mean dmft score was 0.03 ± 0.21 at age 31 months, increasing to 0.26 ± 0.94 at age 43 months and to 0.62 ± 1.51 at age 61 months. Neither exposure to ACEs prenatally (rate ratio: 1.11, 95% CI: 0.73-1.70) nor during infancy (1.08, 95% CI: 0.71-1.63) was associated with the dmft score, after adjustment for covariates. In addition, exposure to ACEs during both life periods was not associated with the dmft score (1.21, 95% CI: 0.74-1.98). CONCLUSION: This longitudinal study provided little support for the association between experience of ACEs during the first 1000 days of life and greater caries experience from age 31 to 61 months.
Advancing Oral Health in Puerto Rico: A Policy Success Story Featuring the Puerto Rico Oral Health Coalition.
Torres-Resto M, Reyes LR, Mercado F … +1 more , Pagán EM
J Public Health Dent · 2026 Mar · PMID 40955859 · Publisher ↗
INTRODUCTION: Puerto Rico has a higher prevalence of oral diseases compared to the U.S., underscoring the urgent need for preventive measures beyond the dentist's office. In response, the Puerto Rico Oral Health Coalitio...
INTRODUCTION: Puerto Rico has a higher prevalence of oral diseases compared to the U.S., underscoring the urgent need for preventive measures beyond the dentist's office. In response, the Puerto Rico Oral Health Coalition (PR-OHC) adopted a collaborative approach, bringing together public and private stakeholders to promote oral health across the archipelago. OBJECTIVE: This article showcases the impact of PR-OHC's efforts in reducing oral health disparities, promoting preventive services for children, and improving access to care by implementing Law No. 63-2017 and the Oral Exam Certificate (OEC) Program. METHODS: PR-OCH analyzed oral health needs and formulated a mission that included identifying disparities, expanding preventive services, and advocating for evidence-based public health policies. Efforts culminated in legislative action, elevating oral health as a public health issue. The law tasked the Department of Health with the implementation and tracking of an obligatory OEC for students in public and private schools. RESULTS: The law's implementation resulted in increased preventive dental visits among 1 to 16-year-old children who are beneficiaries of the Government Health Plan (Medicaid funds), the creation of an available and adequate oral health education delivery system, collaborative policy initiatives, and collaborations among stakeholders. After 7 years, 357,867 OEC's have been submitted. CONCLUSION: PR-OHC's initiatives tackled oral health disparities by promoting routine exams-ensuring early detection, prevention, and treatment-and highlighting the importance of dental homes among school-aged children. The Coalition remains actively engaged in advocating for this policy and maintains a leadership role in advancing oral health, fostering interagency collaboration, and improving access for underserved communities.
Predicting Group-Based Trajectories of Oral Health-Related Quality of Life From Late Adolescence to Early Adulthood Using K-Means Clustering Algorithm.
Ogwo C, Brown G, Warren J … +3 more , Zeng E, Thomson M, Levy S
J Public Health Dent · 2025 Dec · PMID 40955538 · Full text
OBJECTIVES: To identify and analyze the patterns of change in Oral Health-Related Quality of Life (OHRQoL) from late adolescence to early adulthood (ages 17 to 23) using a machine learning algorithm. METHODS: This longit...
OBJECTIVES: To identify and analyze the patterns of change in Oral Health-Related Quality of Life (OHRQoL) from late adolescence to early adulthood (ages 17 to 23) using a machine learning algorithm. METHODS: This longitudinal trajectory study used data from the Iowa Fluoride Study (IFS). Participants were recruited at birth from eight Iowa hospitals between 1992 and 1995. OHRQoL was assessed at ages 17, 19, and 23 using three validated questionnaires: the Child Perceptions Questionnaire (CPQ), Global Oral Health Rating (GOHR), and Visual Analog Scale of Quality of Life (VisQoL). Of the 437 individuals assessed at age 17, 402 were re-assessed at age 19 and 367 at age 23 (91% retention rate). The K-Means for Longitudinal data (KmL) algorithm was applied to identify distinct trajectory groups for each measure. Associations between trajectory group membership and sociodemographic variables were examined using logistic regression. All analyses were performed in R (version 4.1.3). RESULTS: Two distinct trajectory groups were identified for each OHRQoL measure, representing consistently better versus persistently worsening oral health experiences. For the CPQ, 84.8% of participants were in the "Favorable" group and 15.2% in the "Unfavorable" group. GOHR classified 57.2% as "Favorable" and 42.8% as "Unfavorable," while VisQoL showed 67.5% and 32.5%, respectively. Despite differing proportions, all instruments reflected similar directional trends. Higher socioeconomic status was associated with favorable trajectory group membership (p < 0.05). CONCLUSION: Most participants followed a favorable OHRQoL trajectory and were from higher socioeconomic backgrounds. These findings highlight the value of longitudinal, multi-measure approaches in identifying at-risk subgroups.
Quality Improvement as a Tool for Health Equity: Perspectives From North Carolina.
McLeod C, Clester S, Chokas C … +1 more , Mathews R
J Public Health Dent · 2026 Mar · PMID 40944303 · Publisher ↗
OBJECTIVES: Share lessons learned from using quality improvement (QI) and data-informed decision making to advance health equity in North Carolina. METHODS: Thirteen safety net dental practices implemented community-info...
OBJECTIVES: Share lessons learned from using quality improvement (QI) and data-informed decision making to advance health equity in North Carolina. METHODS: Thirteen safety net dental practices implemented community-informed QI initiatives from 2022 to 2024. They identified community needs, aligned goals and resources, made practice-level improvements, and used data to measure progress. Collective learnings were used to advocate for policy changes supporting health equity. RESULTS: QI initiatives engaged 87,000 patients across 47 counties. Practice-level care delivery improvements included telehealth, minimally invasive care, addressing social drivers of health, and bolstering care coordination and referral processes. Understanding community needs, organizational support, funding, QI tools, and data-informed decision-making drove success. Barriers included data collection and staffing challenges, as well as workforce and reimbursement policies. The QI processes generated evidence for collective action around policy changes to improve care access and health equity in the state. CONCLUSION: The QI process generated evidence that ultimately drove advocacy efforts aimed at improving health equity through systems change.
Beyond Charity: Systems-Change Philanthropy for Structural Health Equity in Oral Health.
Gabelus J, Simpson T
J Public Health Dent · 2026 Mar · PMID 40931906 · Publisher ↗
OBJECTIVES: Health philanthropy has traditionally emphasized downstream service delivery rather than addressing structural and policy-level determinants of health. In light of widening health disparities and increasing p...
OBJECTIVES: Health philanthropy has traditionally emphasized downstream service delivery rather than addressing structural and policy-level determinants of health. In light of widening health disparities and increasing political threats to public health and civil rights, there is a pressing need for philanthropy to evolve. This commentary introduces and explores an equity-centered philanthropic model as a framework for driving systems change, building community power, and advancing long-term transformation in oral health. METHODS: CareQuest Institute's philanthropic approach is grounded in the lived realities of racial, economic, and geographic oral health disparities, and the historical exclusion of oral health from broader equity agendas. The model prioritizes funding community-led organizations, centering lived experience, supporting multi-year partnerships, and embedding oral health within cross-sector health justice movements. Two grantee case studies are used to illustrate this approach. RESULTS: The case examples include: 1) Families USA's grassroots-informed federal policy advocacy and 2) Community Catalyst's capacity-building for BIPOC-led and community-rooted health justice campaigns. These examples demonstrate how equity-centered philanthropy can support structural change and amplify community leadership. CONCLUSION: Equity-focused philanthropy faces practical challenges, including the need for new evaluation frameworks, sustainable capacity-building, and resisting extractive or paternalistic dynamics. To truly advance health equity, philanthropy must move beyond transactional funding and become an active partner in redistributing power, elevating community voice, and sustaining systemic transformation across the oral health ecosystem.
Oral Health Literacy and Dental Caries Status in Adults.
Macek MD, Atchison K, Adunola F
J Public Health Dent · 2025 Dec · PMID 40772460 · Publisher ↗
OBJECTIVES: To assess the relationship between oral health literacy (OHL) and dental caries among a convenience sample of adult, first-time patients at two U.S. dental schools; we hypothesized that adults with low OHL wo...
OBJECTIVES: To assess the relationship between oral health literacy (OHL) and dental caries among a convenience sample of adult, first-time patients at two U.S. dental schools; we hypothesized that adults with low OHL would have fewer teeth, more untreated dental decay, and fewer restorations. METHODS: This cross-sectional analysis was part of the larger Multisite Oral Health Literacy Research (MOHLR) Study. OHL was assessed using the Comprehensive Measure of Oral Health Knowledge (CMOHK). The dental caries outcome variables (number of decayed, filled, decayed plus filled, and teeth present) were abstracted from electronic dental records and represented the clinical conditions at the initial visit. We calculated OHL prevalence estimates and crude and adjusted negative binomial regression parameters for the outcome variables, controlling for relevant sociodemographic covariates. RESULTS: We recruited 922 participants into the MOHLR Study, and 688 provided clinical data for this report. Crude analyses showed persons with low OHL had significantly fewer filled teeth (e = 0.67), decayed plus filled teeth (e = 0.76), and teeth present (e = 0.96) than those with high OHL. After controlling for covariates, the low versus high differences remained significant for the number of filled (e = 0.81) and decayed plus filled teeth (e = 0.84). There was no significant relationship between CMOHK and the number of decayed teeth. CONCLUSIONS: The relationship between OHL and dental caries in an adult population of dental school patients is complex. Additional research, likely involving qualitative studies and more precise epidemiological assessments, is needed to understand this complicated association.
Prevalence of Fluoride Treatments Among US Children, Associated Factors, and State-Level Variation.
Naavaal S, Mone V, Scherrer C
J Public Health Dent · 2025 Dec · PMID 40754786 · Publisher ↗
OBJECTIVES: Professional fluoride treatment effectively reduces caries, but uptake remains low. This study identified factors associated with the report of professional fluoride treatment at dental visits (hereon referre...
OBJECTIVES: Professional fluoride treatment effectively reduces caries, but uptake remains low. This study identified factors associated with the report of professional fluoride treatment at dental visits (hereon referred to as fluoride treatment) among children aged 1-17 and examined state-specific variation in its prevalence. METHODS: We used the National Survey of Children's Health data from 2022 (n = 51,630). The primary outcome was fluoride treatment. Chi-square tests examined associations between the outcome and sociodemographic and other included variables, and a logistic regression model was used to obtain adjusted odds ratio estimates. State-specific prevalence of fluoride treatment was estimated for all 50 US states and DC, and 2022 estimates were compared with 2017 to examine differences. All analyses were weighted, accounting for the complex survey design. RESULTS: The overall fluoride treatment prevalence in 2022 was 45.7%, and 32.7% of children had a preventive dental visit, but did not receive fluoride treatment. Children aged 1-5, non-Hispanic Black, non-Hispanic Asian and other, uninsured, in fair or poor health, with no preventive medical visit, living in low-income households, or with less-educated parents had a significantly lower report of fluoride treatment compared to their counterparts. State-specific fluoride treatment prevalence in 2022 varied widely. Compared to 2017, three states saw an increase and four states saw a decrease in prevalence in 2022 (p < 0.05). CONCLUSION: Fluoride treatment prevalence among US children remains low overall and varies greatly across states. To improve fluoride treatment uptake, dental and medical providers and parents should be educated about its importance and need.
Forward Outlook on Oral Health: The American Association of Public Health Dentistry's 2025 Research Agenda for Dental Public Health.
Banava S, Reynolds JC, Naavaal S … +3 more , Frantsve-Hawley J, Habibian M, Murphey C
J Public Health Dent · 2025 Dec · PMID 40751373 · Full text
OBJECTIVES: Dental public health (DPH) research is crucial in improving and promoting community oral health by generating and translating new knowledge into practice. Since the last AAPHD research agenda in 1992, the DPH...
OBJECTIVES: Dental public health (DPH) research is crucial in improving and promoting community oral health by generating and translating new knowledge into practice. Since the last AAPHD research agenda in 1992, the DPH field has made significant advancements. This research agenda aims to outline key research areas in DPH, including priority topics and evidence gaps in our scientific understanding of factors influencing population oral health and oral health equity. METHODS: A workgroup under the AAPHD Council on Scientific Information (CSI) surveyed 503 AAPHD members in September 2021 to gather feedback on seven draft research objectives. The survey used a Likert scale to assess agreement and included open-ended suggestions. RESULTS: A total of 115 AAPHD members responded to the survey, resulting in a response rate of about 23%. Six of the seven objectives were agreed or strongly agreed upon by respondents as important areas of focus for DPH research. The final research agenda includes six key areas: oral health policy and legislation, delivery system innovations and care models, oral health workforce, DPH education, social determinants of health, and epidemiology and surveillance systems. The research agenda describes advancements and gaps in these areas, existing evidence, example priority topics, and research questions. CONCLUSIONS: The AAPHD encourages DPH partners, including federal agencies, DPH organizations, foundations, and dental associations, to advocate for, support, use, and fund high-quality DPH research. This support is crucial for translating emerging evidence into oral health improvements and equity across the diverse US communities.
Prevalence of Dental Fluorosis in India: A Systematic Review and Meta-Analysis.
Mittal HC, Bajpai R, Singh RK … +2 more , Sardana D, Mohanty U
J Public Health Dent · 2025 Dec · PMID 40741788 · Publisher ↗
BACKGROUND: Dental fluorosis is considered to be a public health concern globally, including in India. This review aims to determine the prevalence of dental fluorosis in India and its distribution by geographical region...
BACKGROUND: Dental fluorosis is considered to be a public health concern globally, including in India. This review aims to determine the prevalence of dental fluorosis in India and its distribution by geographical region, water fluoride level, and severity. METHODS: A systematic search of major electronic databases and gray literature was undertaken until 29 May 2024. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data. RESULTS: Out of 6652 records identified, 55 studies including 108,678 individuals accounted for available data for meta-analysis. The pooled prevalence of overall dental fluorosis was estimated to be 34.5% (95% CI; 28.9-40.3) for all age groups, and in children (5 to 18 years) was 32.1% (95% CI; 26.6-37.9). The dental fluorosis commonly reported was in the very mild (10.6%) to mild (9.7%) category. There was a more than three-fold increase in prevalence in regions with water fluoride levels of more than 1 ppm compared to those with less than 1 ppm (50.3% versus 15.1%). Further, a higher prevalence was observed in males (40.7%), community settings (40.7%), rural populations (38.1%), and the western Indian region (43.9%). CONCLUSION: Dental fluorosis in India was found to be highly prevalent, with the milder forms being the most common. A high prevalence was found in regions with high water fluoride levels, with a wide variation across India. Drinking water is the main source of exposure studied, though the effect of other factors and fluoride intake pathways needs to be explored.
Improving Equity in Access to Dental Care in Canada: Historical Lessons for Policy Change.
Martine C, Quiñonez C, Marchildon GP
J Public Health Dent · 2025 Dec · PMID 40673682 · Full text
OBJECTIVES: This paper outlines and compares the major provincial initiatives on dental care from the 1970s-with emphasis on Saskatchewan's innovative children's dental program-and their relevance to the current changes...
OBJECTIVES: This paper outlines and compares the major provincial initiatives on dental care from the 1970s-with emphasis on Saskatchewan's innovative children's dental program-and their relevance to the current changes in Canadian dental policy. METHODS: Narrative review methodology. A snowball search was conducted on articles obtained through MEDLINE, Scopus, and ProQuest, followed by other databases such as Google Scholar. Primary data was collected from different sources: historical professional journals, archives, government reports, Hansard debates, and historical newspapers. RESULTS: Saskatchewan and Ontario were on opposite ends of a government-sponsored dental care policy continuum during the 1970s. While Ontario never implemented a large-scale public dental plan, Saskatchewan carried out an effective province-wide children's dental plan using an alternate model of delivery, despite strong opposition from the dental profession. Dental public initiatives in other provinces lie between these two poles. While several considered employing dental therapists, they faced opposition from the dental profession, which reinforced the traditional model, despite its inability to resolve issues of access to care. CONCLUSIONS: This study argues that while the current Canadian Dental Care Plan represents a major advancement towards more equality in dental care, it is unclear whether persistent issues of physical barriers to access will be fully resolved, and suggests employing an alternate model of delivery, proven to improve access to dental care in Canada. However, given organized dentistry's continuing resistance to dental therapists working largely independently, future studies should examine whether different levels of supervision and/or program format could yield greater acceptance.
Head and Neck Examinations Among Patients Presenting to HRSA-Funded Health Centers in the United States.
Leinbach LI
J Public Health Dent · 2025 Dec · PMID 40550637 · Full text
OBJECTIVE: Health centers funded by the Health Resources and Services Administration (HRSA) are a safety net for people who may not be able to access care elsewhere. Patients eligible for care at these facilities share s...
OBJECTIVE: Health centers funded by the Health Resources and Services Administration (HRSA) are a safety net for people who may not be able to access care elsewhere. Patients eligible for care at these facilities share some of the same risk factors for developing head and neck cancer. The objective of this study is to examine the prevalence of head and neck cancer examinations among patients of HRSA-funded health centers. METHODS: This is an analysis of the cross-sectional 2022 Health Center Patient Survey (HCPS). Self-reported data from this survey of patients of health centers regarding receipt of head and neck examinations is summarized, with results stratified by sociodemographic, behavioral, and health-related factors. RESULTS: Four thousand four hundred and fourteen unweighted patients (20,693,940 weighted) participated in the HCPS, 69.5% of whom answered questions about a head and neck exam. Of these, 9.9% of patients reported a history of a head and neck exam (HNE). Patients from minoritized racial/ethnic groups were less likely to report an HNE compared to White, non-Hispanic patients. Patients with Medicare, Medicaid, and lower incomes were also less likely to report an HNE compared to patients with private insurance and incomes above $50,000 per year. A dental exam anywhere within the last year was associated with a report of an HNE. CONCLUSIONS: Disparities in reported HNEs were observed by patient race/ethnicity, medical payor, income, and recency of dental visit among patients of US health centers. Health centers may be uniquely positioned to explore and generate evidence regarding HNEs that could inform changes in practice.
Racial/Ethnic Differences in the Joint Effect of Edentulism and Diabetes on All-Cause Mortality Risks: A 12-Year Prospective Cohort Analysis.
Qi X, Tan C, Luo H … +5 more , Plassman BL, Sloan FA, Kamer AR, Schwartz MD, Wu B
J Public Health Dent · 2025 Dec · PMID 40528296 · Full text
OBJECTIVES: Edentulism and diabetes mellitus (DM) are frequently seen among older adults. However, the joint effect of edentulism and DM on mortality was understudied. We aim to examine the joint effect of edentulism and...
OBJECTIVES: Edentulism and diabetes mellitus (DM) are frequently seen among older adults. However, the joint effect of edentulism and DM on mortality was understudied. We aim to examine the joint effect of edentulism and DM on all-cause mortality and to what extent the joint effect varies by race/ethnicity. METHODS: Analysis of US Health and Retirement Study (HRS) data (2006-2018) included 11,813 non-Hispanic Whites, 2216 non-Hispanic Blacks, and 1337 Hispanics aged ≥ 50 years old. Mortality data came from the National Death Index or HRS surveys. Edentulism was self-reported and DM was determined by self-reported diagnosis, medication use, or glycosylated hemoglobin. Cox proportional-hazard models with inverse probability treatment weighting were applied. RESULTS: During mean follow-up of 9.6 years, 2874 Whites, 703 Blacks, and 441 Hispanics died. DM was associated with higher mortality across all groups (Whites: HR = 1.43, 95% CI = 1.25-1.64; Blacks: HR = 1.62, 95% CI = 1.28-2.04; Hispanics: HR = 1.46, 95% CI = 1.07-1.99). However, edentulism predicted higher mortality only in Whites (HR = 1.65, 95% CI = 1.51-1.80). Having both conditions showed highest mortality risk in all groups (Whites: HR = 2.31, 95% CI = 1.56-3.42; Blacks: HR = 1.94, 95% CI = 1.45-2.59; Hispanics: HR = 1.77, 95% CI = 1.16-2.70), with a significant additive interaction observed only in Whites (relative excess risk due to interaction = 0.22, p < 0.05). CONCLUSIONS: DM and edentulism pose an additive risk for mortality in Whites, and there are racial/ethnic differences in edentulism-related mortality.
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