J Public Health Dent [JOURNAL]
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200 papers
Associations between longitudinal fluoride intakes from birth to age 23 and multi-row detector computed tomography bone densitometry outcomes at age 23.
Bhatia GK, Levy SM, Warren JJ … +4 more , Rysavy OA, Saha PK, Zhang X, Zeng E
J Public Health Dent · 2024 Dec · PMID 39243208 · Full text
OBJECTIVES: To assess the relationships between longitudinal fluoride intakes and bone densitometry outcomes in young adults. METHODS: Data were analyzed from the Iowa Fluoride Study and Iowa Bone Development Study, whic...
OBJECTIVES: To assess the relationships between longitudinal fluoride intakes and bone densitometry outcomes in young adults. METHODS: Data were analyzed from the Iowa Fluoride Study and Iowa Bone Development Study, which followed 1,882 infants from birth in 1992. Daily fluoride intakes were assessed using detailed questionnaires sent every 1.5-6 months, and multi-row detector computed tomography (MDCT) scans of distal tibia were obtained from 330 participants aged 23 years. Sex-specific bivariate and multivariable associations with MDCT outcomes were examined using linear regression. Because of the multiple statistical analyses being conducted, p-values < 0.01 were considered statistically significant. RESULTS: In fully adjusted analyses, no statistically significant (p < 0.01) or suggestive (0.01 < p < 0.05) associations were found between period-specific or cumulative fluoride intake and bone measures for either sex, although there were suggestive positive relationships in unadjusted analyses. CONCLUSIONS: Longitudinal fluoride intakes had little association with bone measures at age 23. As there were no adverse effects from fluoride intake on bone health in young adults, results support the continued use of fluorides, particularly community water fluoridation is the most cost-effective method of dental caries prevention.
Bridging oral health and nutrition: Assessing produce prescription programs in pediatric dental clinics serving low-income communities.
Houser ZL, Lyden E, Koukol CC … +1 more , Parks CA
J Public Health Dent · 2024 Dec · PMID 39225053 · Full text
OBJECTIVES: This study assesses the needs and feasibility of conducting a produce prescription (produce Rx) program in a pediatric dental clinic setting serving low-income patients. METHODS: We conducted a cross-sectiona...
OBJECTIVES: This study assesses the needs and feasibility of conducting a produce prescription (produce Rx) program in a pediatric dental clinic setting serving low-income patients. METHODS: We conducted a cross-sectional quantitative survey examining several household characteristics including demographics, benefits received, fruit and vegetable intake patterns, food security, feasibility of a produce Rx program, and respondents' answers to questions based on social cognitive theory constructs. The survey was administered at the University of Nebraska Medical Center (UNMC) pediatric dental clinic, a pediatric dental residency clinical training site. One hundred adult respondents with low income completed a 36-item questionnaire during their child's dental appointment. RESULTS: Almost half of respondents reported experiencing food insecurity (45%). Respondents who were food insecure experienced higher levels of nutrition insecurity (p = 0.012), less confidence in choosing fruits and vegetables (FVs) (p = 0.026), difficulty in purchasing FVs in their neighborhood (p = 0.012), and more concern that FVs cost too much (p < 0.001) when compared to respondents who were food secure. Notwithstanding the barriers they face, almost all respondents reported that they eat FVs because of health benefits (95%) and to set a good example for their family (91%). Additionally, most respondents expressed an interest in produce Rx programs (80%) and nutrition education activities (81%). CONCLUSIONS: This study demonstrated the potential for produce Rx program uptake in a pediatric dental clinic setting through positive caregiver-reported need and interest. Future studies should explore how produce Rx programs can be adapted most effectively in this novel setting.
Parental perceptions of an oral health promotion program in early childhood education and care settings: A qualitative study.
Heller LS, Pithavadian R, Micheal S … +6 more , Chandio N, Sanagavarapu P, Parmar J, Cartwright S, Slack-Smith L, Arora A
J Public Health Dent · 2024 Dec · PMID 39205609 · Full text
OBJECTIVES: Early Childhood Caries is a global health problem. The Bright Smiles Bright Futures (BSBF) program seeks to equip educators, children, and parents with skills and knowledge about oral health promotion habits...
OBJECTIVES: Early Childhood Caries is a global health problem. The Bright Smiles Bright Futures (BSBF) program seeks to equip educators, children, and parents with skills and knowledge about oral health promotion habits early in life. The aim of this study was to examine parental perceptions of the BSBF program and identify key facilitators and barriers for its implementation. METHODS: Twelve mothers of children who participated in the BSBF program in five Early Childhood Education and Care (ECEC) settings in NSW, Australia were recruited in this qualitative study. Data were collected via focus groups and interviews, transcribed verbatim and coded to categorize for inductive thematic analysis. RESULTS: Five major themes emerged: Promoters of the BSBF oral health program, barriers to the BSBF oral health program implementation and participation, online resources, impact of the BSBF oral health program, and strategies for enhancing the BSBF oral health program. While participants reported that the program encouraged their children's toothbrushing, they found issues with the program's materials, ECEC center attendance, and communication about the oral health program with their children. The program improved message retention, attitudes, routines, and family perceptions toward oral health. Participants recommended oral health literacy, changed delivery formats, increased dental access, and inclusion of interactive elements to enhance the program. CONCLUSIONS: The findings from this study provide insight to improve parents' experiences and engagement in oral health promotion. This can help to raise awareness of the importance of child oral health among policymakers, healthcare professionals, and the public to inform public health policy discussions.
Initial development of the Sugar-Sweetened Fruit Drink Questionnaire for examining beliefs, knowledge, and behaviors in an intervention to reduce sugar-sweetened fruit drink intake in Alaska Native children.
Edwards TC, Randall CL, Hill CM … +6 more , Hopkins S, Orr E, Cruz S, Lee J, Mancl L, Chi DL
J Public Health Dent · 2024 Dec · PMID 39187463 · Full text
OBJECTIVE: Alaska Native children may be at increased risk for dental caries because of added sugar intake from sugar-sweetened fruit drinks. This study describes development of a questionnaire to (a) assess Alaska Nativ...
OBJECTIVE: Alaska Native children may be at increased risk for dental caries because of added sugar intake from sugar-sweetened fruit drinks. This study describes development of a questionnaire to (a) assess Alaska Native caregivers' beliefs, knowledge, and behaviors regarding sugar-sweetened fruit drinks, and (b) describe behavior changes within a community-based intervention. METHODS: Questionnaire development was conducted in three phases with Yup'ik Alaska Native caregivers in Southwest Alaska: (1) initial selection and adaptation of questionnaire items; (2) cognitive testing; and (3) data collection. The Sugar-Sweetened Fruit Drink Questionnaire (SFDQ) contains 31 culturally-tailored items across six areas: beliefs/values, environment/skills, knowledge, motivation, self-efficacy, and behaviors. RESULTS: Eighty-one percent of caregivers gave their children sugar-sweetened fruit drinks. Motivations included: what they grew up with (52%), few other options (46%), makes child happy (46%), healthier than soda (45%), and others in community drink them (42%). On average, 93% of caregivers believed drinking a lot of sugar-sweetened fruit drinks leads to cavities in children and caregivers agreed (mean 4.1 on 5-point scale, 5 = strongly agree) it is important to limit sugar-sweetened fruit drinks. Among a sub-sample of respondents (n = 20), we found low to moderate temporal stability in some SFDQ items over a 10-14 day period, indicating respondent ambivalence and/or uncertainty. CONCLUSIONS: Using community-based participatory research methods, we developed a culturally tailored exploratory questionnaire that will be used to describe changes in caregiver knowledge, beliefs, attitudes, self-efficacy, and behavior within a planned intervention to reduce sugar-sweetened fruit drink intake in Alaska Native children.
Teledentistry utilization by oral health professionals and policy considerations: A mixed methods case study.
Schroeder K, Santoro M, Tranby EP … +4 more , Heaton L, Ludwig S, Martin P, Raskin SE
J Public Health Dent · 2024 Dec · PMID 39160450 · Full text
OBJECTIVES: To examine variations in the delivery of teledentistry after the COVID-19 pandemic and to explore oral health professionals' utilization of various teledentistry modes of delivery. METHODS: In this mixed meth...
OBJECTIVES: To examine variations in the delivery of teledentistry after the COVID-19 pandemic and to explore oral health professionals' utilization of various teledentistry modes of delivery. METHODS: In this mixed methods case study, we collected teledentistry claims data from patient electronic health records (n = 78,756) encompassing various types of teledentistry utilization in clinical settings and through community outreach from a Dental Support Organization (DSO) in Oregon from January 2021 to November 2022. We analyzed the patient demographic and claims data using descriptive statistics and logistic regression analyses to identify patterns of teledentistry service delivery. Qualitatively, we conducted virtual interviews (n = 13) through Microsoft Teams with oral health professionals about their experiences with teledentistry utilization. We used inductive and deductive coding to code individual transcripts and identify common themes among provider experiences. RESULTS: Out of the 78,756 electronic health record claims for teledentistry, 75.7% used synchronous audio, 13.4% used synchronous video, and 10.9% used asynchronous teledentistry methods. We observed a 8.6% increase in synchronous audio teledentistry utilization at the end of the study period, compared with a 4.2% increase in synchronous video and a 4.4% decrease in asynchronous teledentistry. Oral health professionals interviewed reported choosing the type of teledentistry delivery based on patient and provider access to the virtual teledentistry platform. CONCLUSION: Oral health professionals' knowledge of and experiences with teledentistry need to be considered when developing policy and best practices for the use of teledentistry for patient care.
The effect of antibiotic premedication on postoperative complications following dental extractions.
McGregor JC, Wilson GM, Gibson G … +3 more , Jurasic MM, Evans CT, Suda KJ
J Public Health Dent · 2024 Dec · PMID 39134053 · Full text
OBJECTIVES: We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System. METHODS: We conducted a retrospective cohort...
OBJECTIVES: We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System. METHODS: We conducted a retrospective cohort study of patients undergoing dental extractions in 2015-2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome. RESULTS: Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (p = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13-1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92-1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83-1.30). CONCLUSIONS: In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. These data suggest that use of antibiotic prophylaxis in similar settings may need to be re-evaluated to minimize unnecessary antibiotic use.
Examining dental providers counseling on human papillomavirus vaccine: Insights from parents and dental professionals.
Barrientos L, Shortall S, Williams J … +2 more , Hamilton S, Jack J
J Public Health Dent · 2024 Dec · PMID 39117566 · Publisher ↗
OBJECTIVES: To (1) assess perceptions of parents of patients ages 9-17 years regarding human papillomavirus (HPV) vaccine counseling and a same-day HPV vaccine program, and (2) assess perceptions among dental staff who a...
OBJECTIVES: To (1) assess perceptions of parents of patients ages 9-17 years regarding human papillomavirus (HPV) vaccine counseling and a same-day HPV vaccine program, and (2) assess perceptions among dental staff who actively participated in the same administration program. METHODS: We conducted a post-evaluation, convenience survey of parents of patients aged 9-17 and dental staff at a large-urban federally qualified healthcare center (FQHC) from July 25, 2022, to August 26, 2022. Parent and staff perceptions were assessed using validated instruments whenever possible. Data were analyzed descriptively. RESULTS: Overall, 101 parents participated (response rate: 89%). Overall, 80 parents (74.3%) reported wanting to discuss diseases prevented by the HPV vaccine with their dental provider. Twenty parents (20%) reported receiving counseling on the HPV vaccine by their dentist; 95% (n = 19) of those parents reported it did not change their comfort with their provider and 60% (n = 12) reported their child received the vaccine that day. Overall, 44 dental staff members (32% DDS/DMD, 14% RDH-BS-Dental Hygiene, 55% Other) completed surveys (response rate: 100%). Of these, 39 (88.6%) were willing to recommend the HPV vaccine and participate in a referral program. Nearly all dentists and hygienists (95%) reported discussing the vaccine was within their scope of practice, and most (65%) agreed vaccine administration should be within their scope. CONCLUSION: In a single site convenience survey within an urban, federally qualified health care system, most parents, and dental staff perceived HPV vaccine counseling and administration favorably and clinically appropriate during routine dental visits.
Feasibility of an innovative medical dental integration program to provide overdue adolescent vaccinations in a federally qualified health center.
Jack JL, Buban A, Krentz C … +3 more , Durniak M, Hamilton S, Williams JTB
J Public Health Dent · 2024 Dec · PMID 39099159 · Full text
OBJECTIVES: To determine the feasibility of a medical dental integration program to provide overdue vaccinations to adolescents ages 9-17 and evaluate the facilitators and barriers to the process. METHODS: The program wa...
OBJECTIVES: To determine the feasibility of a medical dental integration program to provide overdue vaccinations to adolescents ages 9-17 and evaluate the facilitators and barriers to the process. METHODS: The program was developed and implemented at one dental clinic co-located within a medical clinic at a federally qualified healthcare center in Denver, Colorado. Utilizing a shared electronic health record, human papillomavirus, meningococcal, and/or tetanus-diphtheria-acellular pertussis vaccines were recommended by dental providers and then administered by the medical team. Plan-do-study-act cycles informed implementation. Descriptive analyses of eligible patients were performed and run charts were used track process implementation outcomes. RESULTS: One hundred and sixty eligible adolescents were identified during a 6-month period. Overall, 29 patients (18%) received 41 vaccines. Process facilitators included staff buy-in and individual provider feedback and barriers included staff shortages and family vaccine refusal/preference to receive vaccines in the medical home. CONCLUSIONS: Many adolescents see dental providers more than their primary care providers, creating an opportunity to vaccinate adolescents overdue for immunizations during dental visits. A medical dental integration program to provide adolescent vaccinations was feasible in a federally qualified health center with co-located medical and dental services. Expansion to diverse healthcare settings is necessary to further explore implementation outcomes.
Variation in dentist participation between dental medicaid managed care organizations.
Nwachukwu PC, Damiano PC, Levy S … +5 more , Thomas JC, Shane D, Singhal A, Dabdoub SM, Reynolds JC
J Public Health Dent · 2024 Dec · PMID 39078227 · Full text
OBJECTIVES: Dentists' Medicaid participation is a critical factor affecting dental care access for Medicaid beneficiaries. An important gap in existing literature is the variation in participation across Medicaid dental...
OBJECTIVES: Dentists' Medicaid participation is a critical factor affecting dental care access for Medicaid beneficiaries. An important gap in existing literature is the variation in participation across Medicaid dental Managed Care Organizations (MCOs) in states with more than one. This study examined the variation in participation overall and in predictors of dentist participation between two MCOs in Iowa's Dental Medicaid program. METHODS: Data were obtained from a survey of Iowa private practice dentists (n = 1256). Responding general dentists (n = 497) were included in the final analytic sample. Univariate, bivariate, and multivariable logistic regression analyses were conducted to examine demographic and practice characteristics associated with dentist participation (acceptance of new Medicaid patients) between MCOs and by age category. RESULTS: Among respondents, the proportions accepting new adults with Medicaid were 26% (MCO 1) and 7% (MCO 2); for children, they were 40% (MCO 1) and 11% (MCO 2). For adults, dentists who were too busy (MCO1) and solo practice dentists (MCO2) were positively significantly associated with the acceptance of new patients. For children, group and rural practice dentists, as well as dentists who worked <32 h/week were positively significantly associated with acceptance of new patients with MCO1. CONCLUSIONS: There was considerable variation in dentist-reported acceptance of new adult and child Medicaid patients, and in the factors affecting acceptance of new patients between MCOs in Iowa dental Medicaid. Future studies of Medicaid participation should consider variations by MCO in states with more than one dental MCO so as not to miss important factors affecting Medicaid participation.
Dental care access for children in the United States.
Serban N, Ma S, Yu J … +4 more , Anderson A, Pospichel K, Solipuram SR, Tomar SL
J Public Health Dent · 2024 Dec · PMID 39011783 · Full text
OBJECTIVES: To evaluate access to dental care for children in the United States. METHODS: The study population included children in 48 states and the District of Columbia. Using multiple data sources, dental care access...
OBJECTIVES: To evaluate access to dental care for children in the United States. METHODS: The study population included children in 48 states and the District of Columbia. Using multiple data sources, dental care access was estimated at the community level by matching dental care supply and demand using mathematical modeling accounting for access constraints. Outcome measures included percent-met demand, travel distance, and percentage of underserved and unserved communities. Multiple scenarios to improve Medicaid/CHIP participation of dentists were evaluated. RESULTS: Medicaid-insured and CHIP-insured children exhibited lower access compared to those privately insured. The percent-met demand was lower than 50% for Medicaid-insured children and CHIP-insured children for 42 and 34 states, respectively. Percent-met demand was higher than 50% for private-insured children except for Texas and West Virginia. Increasing Medicaid/CHIP participation of dentists resulted in improving access for public-insured children. At 100% Medicaid/CHIP participation, all states exhibited different degrees of percent-met demand increase for publicly insured children, from 7% to 46%. The percent-met demand across all children ranged in 23.8%-82.9% under 70% participation rate versus 22%-83% under 100% participation rate. No single participation rate improved access for all children uniformly across all states. CONCLUSIONS: This study found that dental care access was lower for children with public insurance than those with private access across all states, although states responded differently to changes in Medicaid/CHIP participation. Increasing access for children with public insurance would reduce disparities, but overall children's access to dental care would be better improved by expanding the oral health workforce.
Dental anxiety and oral health in American Indian and Alaska natives.
Tiwari T, Wright CD, Heaton LJ … +2 more , Santoro M, Tranby EP
J Public Health Dent · 2025 Jun · PMID 38953889 · Full text
OBJECTIVE: American Indian and Alaska native (AI/AN) individuals report distrust of the healthcare system. This study explored associations between having either high levels of dental distrust or high levels of dental ca...
OBJECTIVE: American Indian and Alaska native (AI/AN) individuals report distrust of the healthcare system. This study explored associations between having either high levels of dental distrust or high levels of dental care-related fear and anxiety ("dental anxiety") and oral health outcomes in AI/AN adults. METHODS: The 2022 State of Oral Health Equity in America survey included the Modified Dental Anxiety Scale and asked to what extent respondents agreed with the statement, "At my last oral health visit, I trusted the oral health provider I saw", and asked about self-rated oral health and presence of a dental home. RESULTS: AI/AN individuals (N = 564) who reported low dental trust (n = 110) or with high dental anxiety (MDAS≥19; n = 113) reported significantly worse overall and oral health and were significantly less likely to have a dental home (p < 0.05 used for each analysis). CONCLUSION: Dental distrust and dental anxiety can significantly impact oral health and dental utilization in AI/AN communities and are important intervention targets to improve AI/AN oral health.
Evaluating the harmonization potential of oral health-related questionnaires in national longitudinal birth and child cohort surveys.
Sharma V, O'Sullivan M, Cassetti O … +3 more , Winning L, O'Sullivan A, Crowe M
J Public Health Dent · 2024 Sep · PMID 38953657 · Publisher ↗
BACKGROUND/OBJECTIVES: Effective use of longitudinal study data is challenging because of divergences in the construct definitions and measurement approaches over time, between studies and across disciplines. One approac...
BACKGROUND/OBJECTIVES: Effective use of longitudinal study data is challenging because of divergences in the construct definitions and measurement approaches over time, between studies and across disciplines. One approach to overcome these challenges is data harmonization. Data harmonization is a practice used to improve variable comparability and reduce heterogeneity across studies. This study describes the process used to evaluate the harmonization potential of oral health-related variables across each survey wave. METHODS: National child cohort surveys with similar themes/objectives conducted in the last two decades were selected. The Maelstrom Research Guidelines were followed for harmonization potential evaluation. RESULTS: Seven nationally representative child cohort surveys were included and questionnaires examined from 50 survey waves. Questionnaires were classified into three domains and fifteen constructs and summarized by age groups. A DataSchema (a list of core variables representing the suitable version of the oral health outcomes and risk factors) was compiled comprising 42 variables. For each study wave, the potential (or not) to generate each DataSchema variable was evaluated. Of the 2100 harmonization status assessments, 543 (26%) were complete. Approximately 50% of the DataSchema variables can be generated across at least four cohort surveys while only 10% (n = 4) variables can be generated across all surveys. For each survey, the DataSchema variables that can be generated ranged between 26% and 76%. CONCLUSION: Data harmonization can improve the comparability of variables both within and across surveys. For future cohort surveys, the authors advocate more consistency and standardization in survey questionnaires within and between surveys.
Educating long-term care staff on older adult oral health: Maine's oral team-based initiative vital access to education (MOTIVATE) program.
Crittenden JA, Nelligan LI, O'Connell D … +1 more , Brennan L
J Public Health Dent · 2024 Sep · PMID 38886183 · Publisher ↗
INTRODUCTION: The oral health status of older adults in the United States is a public health crisis and a silent epidemic. Maine's Oral Team-Based Initiative Vital Access to Education (MOTIVATE) Program is an innovative...
INTRODUCTION: The oral health status of older adults in the United States is a public health crisis and a silent epidemic. Maine's Oral Team-Based Initiative Vital Access to Education (MOTIVATE) Program is an innovative interprofessional oral health program aimed at enhancing oral health education and practice of interprofessional health care teams in nursing homes. Using a blended learning model, a combination of in-person and online learning, this program provides a foundation from which to implement evidenced based oral care in nursing homes. METHODS: Learning outcomes were assessed via a three-part timed series survey. A set of self-report assessment items measured skills implemented at baseline and post-training. RESULTS: Learning domain scores increased over time from baseline to post-training. Confidence in providing oral healthcare and role clarity in providing oral health care improved over time. Staff identified using new skills in daily oral care and communication across the interprofessional team. DISCUSSION: The MOTIVATE program is an effective collaborative-based model for developing oral health competencies and promoting evidence-based oral health care in nursing homes.
Integration of dental therapists in safety net practice increases access to oral health care in Minnesota.
Khan M, Catalanotto F, Singhal A … +1 more , Revere FL
J Public Health Dent · 2024 Sep · PMID 38886024 · Publisher ↗
OBJECTIVES: This study evaluates the impact of introducing dental therapists (DTs) into Children's Dental Services (CDS), a large non-profit organization in Minnesota. The aim is to assess the effect of DTs in improving...
OBJECTIVES: This study evaluates the impact of introducing dental therapists (DTs) into Children's Dental Services (CDS), a large non-profit organization in Minnesota. The aim is to assess the effect of DTs in improving access and reducing dental care costs in Minnesota by analyzing the trends in dental care delivery and procedures performed by CDS dentists and therapists. METHODS: Using 2009 to 2021 data from CDS, the study compares trends in patient volume, types of procedures, salary data and payments by dentists, DTs, and registered dental hygienists (RDH). Return on investment (ROI) trends are calculated using salary and revenues for each provider type. RESULTS: After introducing DTs at CDS and implementing mobile clinics, the number of patients served and volume increased steadily, demonstrating increased access. DTs provided an increasing proportion of fluorides, sealants, and extractions through 2020. Interestingly 2021, there was a decrease for DTs, possibly due to Covid related workforce shortages. ROI analysis showed that DTs' ROI dramatically rose, eventually surpassing dentists, while RDHs maintained a constant ROI. Dentists' ROI also initially increased after adopting DTs in the practice. CONCLUSION: Integrating DTs at CDS improved access by expanding mobile clinics, increasing patient volume, and redistributing procedures, while demonstrating a positive return on investment. Results suggest that adopting the DT model may be a promising practice for other organizations seeking to improve access to dental care, increase operational efficiency, and boost the dental care team's ROI.
Point-of-care diabetes testing in the dental setting: A national scope of practice survey.
Laniado N, Brodigan AE, Cloidt M
J Public Health Dent · 2024 Sep · PMID 38818943 · Publisher ↗
OBJECTIVES: The aim of this study was to assess the knowledge of state dental directors regarding their state's professional practice act, specifically scope of practice laws regarding point-of-care chairside screening f...
OBJECTIVES: The aim of this study was to assess the knowledge of state dental directors regarding their state's professional practice act, specifically scope of practice laws regarding point-of-care chairside screening for diabetes. METHODS: A cross-sectional study design was used to examine the 50 state dental directors' knowledge of policy around point-of-care diabetes testing in their state. A five-item survey instrument was designed in a web-based platform and electronically distributed in 2022. RESULTS: Thirty-seven states (74%) responded to the survey. Regarding whether it was within the scope of practice for dentists to provide chairside point-of-care HbA1c screening, 17 states (46.0%) responded "yes," 5 states (13.5%) responded "no," and 15 states (40.5%) responded "don't know." Of the 17 states who provide diabetes testing, four states (23.5%) reported that dentists were reimbursed, nine states (53.0%) reported they were not reimbursed, and four states (23.5%) reported they did not know regarding reimbursement. CONCLUSIONS: There is significant state heterogeneity with regard to laws, regulations, and reimbursement for chairside diabetes testing in the United States. This is accompanied by vagueness and lack of specificity in the state education laws. For more widespread promotion and adoption of this evidence-based screening, the entire dental community including clinicians, educators, policymakers, payers, and professional organizations at all levels are encouraged to work together to advocate for clarification and specificity in the language of state education laws as well as reimbursement for this vital service.
Dental service utilization in the general adult population in Bangladesh.
Pengpid S, Peltzer K
J Public Health Dent · 2024 Sep · PMID 38807250 · Publisher ↗
OBJECTIVES: With the help of a national community-based survey, the analysis aimed to estimate the number of adults in Bangladesh who used dental services (DSU). METHODS: The 8185 participants (18-69 years old) in the Ba...
OBJECTIVES: With the help of a national community-based survey, the analysis aimed to estimate the number of adults in Bangladesh who used dental services (DSU). METHODS: The 8185 participants (18-69 years old) in the Bangladesh cross-sectional STEPS survey in 2018 provided national data for analysis. Predisposing, enabling, and need factors for DSU were included in the interview data, physical examinations, and biochemical analyses. To estimate the DSU (last 12 months) predictors, Poisson regression was employed. RESULTS: Seven out of 10 participants (71.0%) had never DSU, 13.2% within the past 12 months, and 15.9% more than 12 months ago. In terms of predisposing factors, the final model showed a negative relationship between past 12-month DSU and living in the northern region (adjusted prevalence ratio-APR: 0.75, 95% CI: 0.59, 0.96). The enabling factors of living in an urban area (APR: 1.19, 95% CI: 1.01, 1.41) and seeing a doctor or other healthcare provider within the previous year (APR: 1.37, 95% CI: 1.08, 1.74) were positively correlated with DSU. In terms of need factors, dental pain (APR: 15.37, 95% CI: 9.68, 24.40), multimorbidity (APR: 1.26, 95% CI: 1.02, 1.55), oral health impact (OHI) speech problem (APR: 1.35, 95% CI: 1.13, 1.63), and OHI felt tense (APR: 1.34, 95% CI: 1.10, 1.64) were positively associated with DSU. CONCLUSIONS: A low proportion of participants had DSU in the past 12 months and several associated factors were identified.
Safety net patients' satisfaction with oral health services by provider type and intent to return for more care.
Zhao Y, Surdu S, Langelier M
J Public Health Dent · 2024 Sep · PMID 38795002 · Publisher ↗
OBJECTIVES: This study examined patients' satisfaction with services provided by different oral health providers, their intent to return for additional care, and associations with patients' demographics and service chara...
OBJECTIVES: This study examined patients' satisfaction with services provided by different oral health providers, their intent to return for additional care, and associations with patients' demographics and service characteristics. METHODS: Descriptive analyses and multivariable ordinal logistic regressions were conducted using survey data from 898 patients who received care at Apple Tree Dental (ATD) in Minnesota during 2021. The questionnaire included 12 statements on patient satisfaction with the clinician's ability to explain the dental diagnosis and treatment options, to be considerate of the patient's needs and dental anxiety, and to provide technically competent services. RESULTS: In general, patients reported high satisfaction with dental care and a strong intent to return to ATD for future services. No significant differences in patient satisfaction were observed by provider type. Patients' intent to return was higher among non-White respondents (OR = 1.76; 95% CI = 1.06-2.92) and patients who were more satisfied with their providers' technical competence/treatment (OR = 1.47; 95% CI = 1.37-1.57). The association between intent to return and patient satisfaction with providers' information/communication was stronger for patients treated by dental hygienists. The association between intent to return and patient satisfaction with providers' technical competence/treatment was also stronger for patients who were more satisfied with providers' information/communication and understanding/acceptance, and for those treated by their desired or usual provider. CONCLUSIONS: The study underscores the benefits of introducing dental therapists to the oral healthcare team, showing that this can be achieved without sacrificing either the quality of patient care or patient satisfaction.
Association between more complex special care needs and overweight status and adolescents' difficulty with dental caries.
Bhoopathi V, Wells C, Tripicchio G … +1 more , Tran NC
J Public Health Dent · 2024 Sep · PMID 38733308 · Publisher ↗
OBJECTIVE: Little is known about dental caries experience in adolescents with overweight and complex special health care needs (SHCNs). METHODS: Adolescent data (10-17 years) from the 2016-2020 National Survey of Childre...
OBJECTIVE: Little is known about dental caries experience in adolescents with overweight and complex special health care needs (SHCNs). METHODS: Adolescent data (10-17 years) from the 2016-2020 National Survey of Children's Health (n = 91,196) was analyzed. The sample was grouped into the following: more complex SHCN and overweight, more complex SHCN without overweight, less complex SHCN and overweight, less complex SHCN without overweight, no SHCN but with overweight, and neither SHCN nor overweight. A multivariable-adjusted logistic regression model was conducted. RESULTS: Adolescents with more complex SHCNs with (OR: 1.82, 95% CI: 1.44-2.30, p < 0.001) or without overweight (OR: 1.51, 95% CI: 1.30-1.76, p < 0.001) were at higher odds of experiencing dental caries compared to healthy adolescents. No significant associations were observed between adolescents with less complex or no SHCN regardless of the overweight status with healthy adolescents. CONCLUSIONS: Adolescents with more complex SHCNs, irrespective of overweight status, experienced a higher caries severity than adolescents with no SHCNs or overweight.
Association between food insecurity and edentulism for older adults: A pilot study.
Li SR, Lee JJ, Mancl LA … +1 more , Chi DL
J Public Health Dent · 2024 Sep · PMID 38716566 · Publisher ↗
OBJECTIVES: This pilot study examined the association between food insecurity and edentulism among older adults in Washington State. METHODS: This study focused on adults aged 50 years and older, who were recruited throu...
OBJECTIVES: This pilot study examined the association between food insecurity and edentulism among older adults in Washington State. METHODS: This study focused on adults aged 50 years and older, who were recruited through seven community-based organizations in Washington State. The exposure variable was food security level (high, marginal, and low/very low food security) assessed using the 10-item U.S. Adult Food Security Survey. The outcome was edentulism, defined as having zero natural teeth. Confounder-adjusted odds ratios (OR) and 95% confidence intervals (CIs) were generated using binary logistic regression models (α = 0.05). RESULTS: Of the 216 participants, 28.7% (n = 62) had low/very low food security and 7.9% (n = 17) had zero teeth. Older adults with low or very low food security had greater odds of being edentulous compared to those with marginal or high food security, although the difference was not statistically significant (OR: 1.39; 95% CI: 0.46, 4.20; p = 0.56). CONCLUSIONS: Future research should explore food insecurity-focused interventions aimed at preventing edentulism in older adults in a broader effort to address oral health inequities.
Age of first dental visits: A benefit of the pediatric medical home.
Bussard N, Casamassimo P, Amini H … +3 more , Peng J, Wapner A, Meyer BD
J Public Health Dent · 2024 Sep · PMID 38684462 · Publisher ↗
OBJECTIVE: This retrospective cohort study compared differences in age one dental visit use and age at first dental visit according to fluoride varnish receipt at the pediatric medical home. METHODS: Enrollment and claim...
OBJECTIVE: This retrospective cohort study compared differences in age one dental visit use and age at first dental visit according to fluoride varnish receipt at the pediatric medical home. METHODS: Enrollment and claims data were used from Partners For Kids, a pediatric accountable care organization covering Medicaid-enrolled children living in 47 of 88 counties in Ohio. The main outcomes were having an age one dental visit and the mean age at first dental visit. Descriptive statistics and bivariate comparisons were applied. RESULTS: Among 17,675 children, 2.8% had an age one dental visit. The mean age at first dental visit was 4.8 years. Children who received fluoride varnish from their medical home (12% of study population) were significantly younger at their first dental visit (4.1 vs. 4.9 years, p < 0.001). CONCLUSION: Despite longstanding recommendations for the age one dental visit, very few Medicaid-enrolled children in Ohio had one. The pediatric medical home lowered the age of first dental visit.
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