J Public Health Dent [JOURNAL]
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200 papers
Change in parental knowledge and beliefs about early childhood dental caries following a pragmatic community-based trial.
Lumsden CL, Edelstein BL, Leu CS … +3 more , Zhang J, Rubin MS, Andrews H
J Public Health Dent · 2024 Sep · PMID 38684426 · Publisher ↗
OBJECTIVES: To evaluate parent knowledge and belief changes following the MySmileBuddy (MSB) early childhood caries (ECC) intervention. METHODS: Pre- and post-intervention surveys were completed by 669 parents of childre...
OBJECTIVES: To evaluate parent knowledge and belief changes following the MySmileBuddy (MSB) early childhood caries (ECC) intervention. METHODS: Pre- and post-intervention surveys were completed by 669 parents of children with visually-evident ECC from among 977 participants in a 6-12-month pragmatic community-based caries management trial administered by community health workers (CHWs). Six domains of knowledge about caries and motivating and facilitating determinants were assessed via 26 survey items. Principal components analysis and reliability testing reduced dataset dimensionality. Parent and CHW characteristics were analyzed as potential moderators. Paired T-tests measured pre-to-post-intervention changes. Generalized estimating equations accounted for within-participant correlation with significance set at p < 0.05. RESULTS: Twenty items consolidated into five factors (saliva, hygiene, diet, seriousness/susceptibility, and outcome expectations). Six additional items were evaluated individually. Positive post-intervention changes (p < 0.0001) were observed across all factors and all but one individual item (tooth decay is very common). Greatest knowledge increases related to caries as a bacterial disease in two measures, the saliva factor and a single caries belief item tooth decay is an infectious disease (0.59 unit increase, 95% CI [0.55, 0.64] and 0.46 unit increase, 95% CI [0.4, 0.51], respectively), and in the value of fluoridated water over bottled (0.46 unit increase, 95% CI [0.39-0.53]). Most parents improved knowledge of ECC salivary (72%) and dietary risks (57%), and preventative hygiene behaviors (59%). CONCLUSIONS: MSB enhanced knowledge and beliefs about caries and confirmed hypothesized mediators of behavior change among parents of high-risk children. Engaging peer-like CHW interventionists may have moderated intervention effects, warranting further exploration.
Patient safety climate research in primary care dentistry: A systematic scoping review.
Ensaldo-Carrasco E, Álvarez-Hernandez LA, Peralta-Pedrero ML … +1 more , Aceves-González C
J Public Health Dent · 2024 Sep · PMID 38679565 · Publisher ↗
BACKGROUND: Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited. OBJ...
BACKGROUND: Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited. OBJECTIVE: To systematically explore the evidence regarding assessing patient safety climate in dentistry. METHODS: We developed a search strategy to explore MEDLINE, SCOPUS, and Web of Science databases from January 1st, 2002, to December 31st, 2022, to include observational studies on patient safety culture or patient safety climate assessment. Methodological features and item data concerning the dimensions employed for assessment were extracted and thematically analyzed. Reported scores were also collected. RESULTS: Nine articles out of 5584 were included in this study. Most studies were generated from high-income economies. Our analysis revealed methodological variations. Non-randomized samples were employed (ranging from 139 to 656 participants), and response rates varied from 28% to 93.7%. Three types of measurement instruments have been adapted to assess patient safety climate. These mainly consisted of replacing words or rewording sentences. Only one study employed an instrument previously validated through psychometric methods. In general, patient safety climate levels were either low or neutral. Only one study reported scores equal to or greater than 75. DISCUSSION: Despite diverse assessment tools, our two-decade analysis reveals a lag compared with medicine, resulting in methodological variations for assessing patient safety climate. Collaboration is vital to elevate standards, prioritize patient safety across oral healthcare services, and advocate for integrating safety climate into local and national quality and patient safety strategies.
Systematically assessing the quality of dental electronic health record data for an investigation into oral health care disparities.
Kookal KK, Walji MF, Brandon R … +7 more , Kivanc F, Mertz E, Kottek A, Mullins J, Liang S, Jenson LE, White JM
J Public Health Dent · 2024 Sep · PMID 38659337 · Full text
OBJECTIVES: This work describes the process by which the quality of electronic health care data for a public health study was determined. The objectives were to adapt, develop, and implement data quality assessments (DQA...
OBJECTIVES: This work describes the process by which the quality of electronic health care data for a public health study was determined. The objectives were to adapt, develop, and implement data quality assessments (DQAs) based on the National Institutes of Health Pragmatic Trials Collaboratory (NIHPTC) data quality framework within the three domains of completeness, accuracy, and consistency, for an investigation into oral health care disparities of a preventive care program. METHODS: Electronic health record data for eligible children in a dental accountable care organization of 30 offices, in Oregon, were extracted iteratively from January 1, 2014, through March 31, 2022. Baseline eligibility criteria included: children ages 0-18 with a baseline examination, Oregon home address, and either Medicaid or commercial dental benefits at least once between 2014 and 2108. Using the NIHPTC framework as a guide, DQAs were conducted throughout data element identification, extraction, staging, profiling, review, and documentation. RESULTS: The data set included 91,487 subjects, 11 data tables comprising 75 data variables (columns), with a total of 6,861,525 data elements. Data completeness was 97.2%, the accuracy of EHR data elements in extracts was 100%, and consistency between offices was strong; 29 of 30 offices within 2 standard deviations of the mean (s = 94%). CONCLUSIONS: The NIHPTC framework proved to be a useful approach, to identify, document, and characterize the dataset. The concepts of completeness, accuracy, and consistency were adapted by the multidisciplinary research team and the overall quality of the data are demonstrated to be of high quality.
Adverse childhood experiences and dental cleaning during pregnancy: Findings from the North and South Dakota PRAMS, 2017-2021.
Testa A, Jackson DB, Crawford A … +3 more , Mungia R, Ganson KT, Nagata JM
J Public Health Dent · 2024 Jun · PMID 38659075 · Full text
OBJECTIVE: Research demonstrates that adverse childhood experiences (ACEs)-that is, experiences of abuse, neglect, and household dysfunction-are related to lower preventive dental care utilization in childhood and adoles...
OBJECTIVE: Research demonstrates that adverse childhood experiences (ACEs)-that is, experiences of abuse, neglect, and household dysfunction-are related to lower preventive dental care utilization in childhood and adolescence. However, limited research has explored the connection between ACEs and preventive dental care utilization in adulthood, and no research has examined this relationship during pregnancy. The current study extends existing research by investigating the relationship between ACEs and dental cleaning and dental care utilization during pregnancy among a sample of women who delivered live births in North Dakota and South Dakota. METHODS: Data are from the 2017 to 2021 Pregnancy Risk Assessment Monitoring System (PRAMS) in North Dakota and South Dakota (n = 7391). Multiple logistic regression is used to examine the relationship between the number of ACEs (0, 1, 2, 3 or 4 or more) and dental cleaning during pregnancy. RESULTS: Relative to respondents with 0 ACEs, those with 4 or more ACEs were significantly less likely to report having dental care during pregnancy (OR = 0.757, 95% CI = 0.638, 0.898). By racial and ethnic background, the results showed that the significant associations are concentrated among White and Native American respondents. CONCLUSIONS: The results suggest that exposure to 4 or more ACEs is associated with a significantly lower likelihood of dental cleaning during pregnancy among women who delivered a live birth in North Dakota and South Dakota. Further investigations are necessary to understand the mechanisms underlying the relationship between ACEs and dental cleaning during pregnancy and replicate the findings in other geographic contexts.
Professionally applied fluorides for preventing and arresting dental caries in low- and middle-income countries: Systematic review.
Dhanapriyanka M, Kosgallana S, Kanthi RDFC … +4 more , Jayasekara P, Dao TMA, Ha DH, Do L
J Public Health Dent · 2024 Jun · PMID 38623701 · Publisher ↗
OBJECTIVES: This systematic review aimed to review the safety and effectiveness of professionally applied fluorides for preventing and arresting dental caries in low- and middle-income countries (LMICs). METHODS: Randomi...
OBJECTIVES: This systematic review aimed to review the safety and effectiveness of professionally applied fluorides for preventing and arresting dental caries in low- and middle-income countries (LMICs). METHODS: Randomized controlled trials conducted in LMICs, in which professionally applied fluorides were compared with placebo/no treatment/health education only or usual care with a minimum one-year follow-up period, were included. Any topically applied fluoride agents such as sodium fluoride (NaF), acidulated phosphate fluoride, silver diamine fluoride (SDF), and nano silver fluoride (NSF) were included. Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) were searched in May 2022. Meta-analysis was conducted using a random effect model. RESULTS: This review included 33 studies for qualitative synthesis, encompassing 16,375 children aged between 1.5 and 14 years. Nevertheless, the meta-analysis focused on only 17 studies, involving 4067 children. Fourteen papers assessed potential adverse events, none of which was reported as major adverse events. SDF and NSF were identified as effective in arresting caries on primary teeth (p < 0.05) compared with a placebo or no treatment. Fluoride varnish and gel were identified as effective in reducing new caries development on primary teeth (p < 0.05) but not on permanent teeth (p > 0.05). The certainty of the generated evidence obtained is low. CONCLUSION: The review provides valuable insights into the use of professionally applied fluorides in LMICs and contributes to recommendations for their use. However, the limited rigorous evidence suggests the need for further research to strengthen these findings and draw more robust conclusions.
Utilization of dental care and dentate status in diabetic and nondiabetic patients across US states: An analysis using the 2020 Behavioral Risk Factor Surveillance System.
Aldosari M, Archer HR, Almutairi FT … +3 more , Alzuhair SH, Aldosari MA, Kennedy E
J Public Health Dent · 2024 Jun · PMID 38599647 · Publisher ↗
OBJECTIVE: This study examines the differences, by state, in dental care utilization and tooth retention between adults with and without diabetes mellitus (DM). METHODS: We conducted a secondary analysis of data from the...
OBJECTIVE: This study examines the differences, by state, in dental care utilization and tooth retention between adults with and without diabetes mellitus (DM). METHODS: We conducted a secondary analysis of data from the 2020 Behavioral Risk Factor Surveillance System, an annual, state-based, random telephone survey of noninstitutionalized US civilian adults. The predictor variable was DM status. The outcome variables were time since the last dental appointment and tooth loss. We utilized multiple multinomial logistic regression models followed by postestimation procedures to determine state-level adjusted proportions for dental visits within the last year and complete teeth retention among DM and non-DM adults. RESULTS: Among adults with DM, 60.0% reported dentist visits within a year of survey participation, while 53.6% had complete tooth retention. As education and income levels increased, dental attendance and tooth retention increased among adults with DM. Most Southern states had a higher prevalence of DM, a lower proportion of dentist visits, and worse tooth retention among DM adults. Nationally, DM individuals were 4.3 percentage points less likely to visit a dentist and were 7 percent less likely to have complete teeth retention than non-DM adults. Compared with the national average, 25/50 states had greater disparities in dental visits between DM and non-DM adults, and 27/50 states had greater disparities in tooth loss between DM and non-DM adults. CONCLUSION: State-level variations indicate geographical and dental coverage influences on DM and dental outcomes. There is a need for state-specific interventions to improve dental access and outcomes for adults with DM.
Perceptions of mental health screening and referral to treatment in National Dental-Practice Based Research Network practices: A qualitative study.
Berryhill MB, Culmer N, Smith T … +3 more , Kopycka-Kedzierawski D, Gurganus R, Curry G
J Public Health Dent · 2024 Jun · PMID 38561327 · Full text
OBJECTIVES: Dental practices can have additional positive impacts on public health by implementing mental health screening and referral to treatment in dental care workflows. In this study, we examined how dental practic...
OBJECTIVES: Dental practices can have additional positive impacts on public health by implementing mental health screening and referral to treatment in dental care workflows. In this study, we examined how dental practices identify and address adult patient mental health concerns, attitudes about implementing mental health screening and referral, and potential barriers and facilitators to treatment. METHODS: We conducted semi-structured focus groups with 17 dentists, 10 dental hygienists, and 5 dental assistants/office staff in the South-Central region of the National Dental Practice-Based Research Network. Transcribed interviews were analyzed using thematic analysis. RESULTS: We identified five main themes from dental practitioners and office staff responses. Practitioners and office staff: (1) discover patient mental health concerns through record review, patient/caregiver disclosure, and patient observation; (2) respond to patients' mental health concerns by making the patient more comfortable, documenting the concern in the patient's chart, and directly addressing the mental health concern; (3) want a systematic process for mental health screening and referral to treatment in their dental office; (4) recognize potential barriers in implementing health screening and referral to treatment processes; (5) desire training on mental health matters. An overarching theme emerged: developing a trusting relationship with patients. CONCLUSIONS: Participants noted the importance of implementing systematic procedures for mental health screening and referral to services into dental practices, while also recognizing the potential barriers for integrating such processes. They also expressed a desire for quality training and resources that can support better care for patients with mental health concerns.
The role of community health workers in promoting oral health at school settings: A scoping review.
Molete MM, Malele-Kolisa Y, Thekiso M … +3 more , Lang AY, Kong A, George A
J Public Health Dent · 2024 Jun · PMID 38558304 · Publisher ↗
OBJECTIVES: The scoping review aimed to examine the literature on the role of Community Health Workers (CHW) in oral health interventions within school settings. The objectives were to identify the characteristics of sch...
OBJECTIVES: The scoping review aimed to examine the literature on the role of Community Health Workers (CHW) in oral health interventions within school settings. The objectives were to identify the characteristics of school oral health interventions where CHWs played a role; and to assess the outcomes derived from CHW participation in school oral health. METHODS: The scoping review was guided by the Levac et al (2010) framework. Articles selected for this review included all forms of study designs and gray literature. The search strategy included CHW and other non-dental personnel providing oral health activities within schools and the outcomes of these interventions from 1995. Databases included Pubmed, ProQuest, Scopus and EBSCO Host. RESULTS: There were eleven (n = 11) peer reviewed articles included. Only one study in this review related to CHW involvement in school oral health settings. The remaining involved teachers (n = 4), peer learners (n = 3) or a combination of both (n = 3). Characteristics of the interventions ranged from oral health screenings, education, supervised brushing, and community engagements. Three outcomes emerged; widening access to oral health services, acceptability of non-oral health personnel and learners in promoting oral health and improvement of oral health self-care. CONCLUSIONS: The review brought to light the benefits of utilizing non-dental personnel such as teachers and peer learners in augmenting staff capacity for school oral health interventions. In addition, the findings highlighted the need to further research on the feasibility and acceptability of integrating CHW in school oral health settings.
Barriers and facilitators to guideline concordant dental antibiotic prescribing in the United States: A qualitative study of the National Dental PBRN.
Ramanathan S, Yan C, Suda KJ … +7 more , Evans CT, Khouja T, Hershow RC, Rowan SA, Gross AE, Sharp LK, National Dental PBRN Collaborative Group
J Public Health Dent · 2024 Jun · PMID 38558016 · Full text
OBJECTIVES: While factors contributing to dental antibiotic overprescribing have previously been described, previous work has lacked any theoretical behavior change framework that could guide future intervention developm...
OBJECTIVES: While factors contributing to dental antibiotic overprescribing have previously been described, previous work has lacked any theoretical behavior change framework that could guide future intervention development. The purpose of this study was to use an evidence-based conceptual model to identify barriers and facilitators of appropriate antibiotic prescribing by dentists as a guide for future interventions aimed at modifying antibiotic prescribing. METHODS: Semi-structured interviews were conducted with dentists from the National Dental Practice Based Research Network (PBRN) exploring patient and practice factors perceived to impact antibiotic prescribing. Audio-recorded telephone interviews were transcribed and independently coded by three researchers. Themes were organized around the COM-B model to inform prospective interventions. RESULTS: 73 of 104 dentists (70.1%) were interviewed. Most were general dentists (86.3%), male (65.7%), and white (69.9%). Coding identified three broad targets to support appropriate dental antibiotic prescribing among dentists: (1) increasing visibility and accessibility of guidelines, (2) providing additional guidance on antibiotic prescribing in dental scenarios without clear guidelines, and (3) education and communication skills-building focused on discussing appropriate antibiotic use with patients and physicians. CONCLUSIONS: The findings from our study are consistent with other studies focusing on antibiotic prescribing behavior in dentists. Understanding facilitators and barriers to dental antibiotic prescribing is necessary to inform targeted interventions to improve appropriate antibiotic prescribing. Future interventions should focus on implementing multimodal strategies to provide the necessary support for dentists to judiciously prescribe antibiotics.
Tobacco products and oral conditions among US adults: NHANES 2017-2020.
Alamer NI, Alsaleh A, Alkhaldi S
J Public Health Dent · 2024 Jun · PMID 38548675 · Publisher ↗
OBJECTIVES: Smoking is a major global health problem with serious systemic and oral consequences. This study aims at assessing the influence of smoking cigarettes and other types of smoked tobacco on oral conditions (OCs...
OBJECTIVES: Smoking is a major global health problem with serious systemic and oral consequences. This study aims at assessing the influence of smoking cigarettes and other types of smoked tobacco on oral conditions (OCs) using a representative sample of US adults. METHODS: Pre-pandemic data from the National Health and Nutrition Examination Survey 2017-2020 were utilized, and 7840 adults aged ≥30 years were included in our analyses. Descriptive statistics, logistic, and negative binomial regression models were performed to assess the relationship between tobacco products and OCs including, tooth loss (TL), coronal (CC) and root caries (RC). RESULTS: Overall, 16.29% of our sample were current cigarette smokers (CCS). TL (17.25%) and untreated RC (28.26%) were more evident among CCS. In the adjusted regression models, smoking cigarettes was associated with RC (AOR: 3.20, 95% CI; 2.02, 5.09), untreated CC (IRR: 3.08, 95% CI: 1.50, 6.31), and TL (IRR: 2.18, 95% CI: 1.64, 2.88). Regarding the type of used tobacco product in the past 5 days, cigarettes were the most common type (15.03%). The adjusted model indicated that e-cigarette smokers had the highest odds of untreated RC (AOR: 5.17, 95% CI: 2.19, 12.23) and the highest rate of TL (IRR: 2.21, 95% CI: 1.45, 3.35). Further, cigar smokers had the highest rate of teeth with untreated CC (IRR: 3.25, 95% CI: 1.46, 7.25). CONCLUSIONS: Using tobacco products is associated with poor OCs. Dentists, being the primary oral health care providers, can play a crucial role in counseling and supporting smokers to quit as part of their routine dental examination.
Interviews with policymakers in Australian health policy: Understanding the process of policy development.
Ingram K, Aley MJ, Irving M … +1 more , Wallace J
J Public Health Dent · 2024 Jun · PMID 38523347 · Publisher ↗
OBJECTIVE: To determine the barriers and enablers oral health and chronic disease policymakers identify during policy development. METHODS: Semi-structured interview questions were developed utilizing an interview guide...
OBJECTIVE: To determine the barriers and enablers oral health and chronic disease policymakers identify during policy development. METHODS: Semi-structured interview questions were developed utilizing an interview guide and applying a knowledge mobilization framework. Reflective thematic analysis of the data was completed based on the research of Braun and Clarke encompassing a critical realist approach. RESULTS: Twelve policymakers were interviewed. Policymakers reported barriers to accessing evidence including the sheer volume of information and a lack of: research summaries, comprehensive oral health data sets, open access articles, consistency of reporting, and time. They did find relationships with experts and intermediaries crucial at times to policy development. Co-creation of research was also a key enabler for policymakers. CONCLUSIONS: This study highlights that policymakers find evidence crucial during the development of policy and often use it to advocate for policies. However, the links between poor oral health; and cardiovascular disease, diabetes, and cognitive impairment are not well recognized among chronic disease policymakers. It is important that oral health researchers and policymakers work to close this gap. The treatment of poor oral health is a global population health issue. It is imperative that evidence of these links is implemented into health policy for the treatment and prevention of chronic diseases and improved quality of life for individuals living with chronic diseases.
Adverse childhood experiences, dental insurance, and developmental disability: Association with unmet dental needs in Ohio.
Horter L, Richardson C, Paul M … +1 more , Meyer BD
J Public Health Dent · 2024 Jun · PMID 38517099 · Publisher ↗
OBJECTIVE: This study investigated whether insurance status and/or developmental disability moderated the association between adverse childhood experiences (ACE) and unmet dental needs among children aged 0 to 17 in Ohio...
OBJECTIVE: This study investigated whether insurance status and/or developmental disability moderated the association between adverse childhood experiences (ACE) and unmet dental needs among children aged 0 to 17 in Ohio. METHODS: We utilized cross-sectional data from the 2021 Ohio Medicaid Assessment Survey to assess the dental needs of children. ACE scores, dental insurance status, and developmental disability status were analyzed using multivariable logistic regression to identify their potential association with parental-reported unmet dental needs. RESULTS: The weighted sample represented 2,752,222 children in Ohio. Over half reported zero ACEs (55.8%) and no dental needs (56.1%). Approximately 1 in 9 lacked dental insurance (11.1%), and 1 in 10 had a developmental disability (9.9%). Children with one to three ACEs had three times the odds of unmet dental needs compared to children with zero ACEs (OR = 3.20; 95%CI [2.10, 4.89]), and children with four or more ACEs had eight times the odds of unmet dental needs (OR = 8.78; 95%CI [5.26, 14.67]). Children lacking dental insurance had over six times higher odds of unmet dental needs compared to children with dental insurance (OR = 6.10; 95%CI [3.92, 9.49]). The presence of developmental disability status did not moderate the presence of unmet dental needs; however, the lack of dental insurance status significantly moderated the association between ACEs and unmet dental needs. CONCLUSION: Insurance status, not developmental disability, moderated the association between ACEs and unmet dental needs among children in Ohio. Efforts to ensure continuous access to dental insurance are warranted.
Hospital usage for oral and dental conditions in Hawaii: A cross-sectional study using the 2021 Hawaii statewide hospital data.
Matsunaga M, Donnelly P, Chen JJ
J Public Health Dent · 2024 Jun · PMID 38509055 · Full text
OBJECTIVE: To investigate the frequency of emergency department (ED) usage primarily for oral/dental conditions in Hawaii and to examine social-demographic factors associated with the identified ED visits. METHODS: This...
OBJECTIVE: To investigate the frequency of emergency department (ED) usage primarily for oral/dental conditions in Hawaii and to examine social-demographic factors associated with the identified ED visits. METHODS: This was a cross-sectional study of the 2021 Hawaii Statewide Hospital data. We identified records indicating ED usage and a primary diagnosis of non-traumatic dental conditions (NTDC) and other oral dental conditions (OODC). Descriptive analyses of ED visits for NTDC and OODC were performed to identify vulnerable individuals based on age, sex, race/ethnicity, primary source of payment, county of residence, and total charges per hospital record. A multivariable negative binomial regression model included age, sex, and county of residence was used to obtain adjusted rate ratios (aRR) and 95% confidence intervals (CI) of ED visits for NTDC. RESULTS: Among hospital records with diagnoses for oral or dental conditions (n = 12,336), 97% indicated ED, of which half had an NTDC diagnosis, and the remaining half had an OODC diagnosis. Distinct differences in the characteristics of ED visits were observed between NTDC and OODC. The median total charges per record indicating ED for NTDC and OODC were $1439 and $2439, respectively. A higher rate of ED visits for NTDC was found for those aged 21-44 (aRR [95%CI] = 3.02 [2.41, 3.80], reference: 0-9 years) and those living in a less populous county (Hawaii: 1.73 [1.43, 2.07]; Kauai: 1.78 [1.45, 2.19], reference: Honolulu). CONCLUSIONS: Continued effort to improve dental health is required to reduce ED visits for oral and dental conditions among Hawaii residents, especially for vulnerable individuals.
Do dental anxiety and satisfaction with dental professionals modify the association between affordability and dental service use? A population-based longitudinal study of Australian adults.
Shahid M, Tadakamadla SK, Kroon J … +1 more , Peres MA
J Public Health Dent · 2024 Jun · PMID 38506129 · Publisher ↗
OBJECTIVES: This study aimed to assess the association between affordability in terms of difficulty paying dental bills in Australian dollars and dental service use in the presence of sociodemographic confounders, and to...
OBJECTIVES: This study aimed to assess the association between affordability in terms of difficulty paying dental bills in Australian dollars and dental service use in the presence of sociodemographic confounders, and to assess the role of dental anxiety and satisfaction with dental professionals as mediators. The second aim was to investigate how dental anxiety and satisfaction with dental professionals modify the association between affordability and use of dental services in Australian adults. METHODS: Longitudinal data from the Australian National Study of Adult Oral Health (2004-06 and 2017-18) was used. Poisson regression and path analysis were conducted to determine the association between affordability and frequency of use of dental services. Effect measure modification (EMM) analysis was performed by stratification of dental anxiety and satisfaction with dental professionals. RESULTS: The study included 1698 Australian adults and identified that the prevalence of low frequency of dental visits was 20% more for those who had difficulty paying dental bills. Adults with dental anxiety (prevalence ratio [PR] = 1.14) and those who were dissatisfied with dental professionals (PR = 1.17) had a higher prevalence of low frequency of dental visits in the presence of difficulty paying dental bills. This indicated that dental anxiety and dissatisfaction with dental professionals were effect modifiers on this pathway. CONCLUSIONS: Adults who experience dental anxiety and dissatisfaction with dental professionals are more likely to avoid dental visits when faced with difficulty paying dental bills. However, it is important to note that these associations do not necessarily imply a causal relationship.
The relationship between oral status and healthy aging in Chinese older adults: A community cohort study.
Jilili M, Cheng Y
J Public Health Dent · 2024 Jun · PMID 38488264 · Publisher ↗
OBJECTIVES: In recent years, there has been a growing academic interest in investigating the determinants of healthy aging. The main objective of this study was to investigate the association between oral status, as defi...
OBJECTIVES: In recent years, there has been a growing academic interest in investigating the determinants of healthy aging. The main objective of this study was to investigate the association between oral status, as defined by tooth loss and denture use, and healthy aging among Chinese older adults over a four-year duration. METHODS: The data were derived from the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Descriptive statistics and multivariate logistic regression analysis were employed for statistical analysis. RESULTS: The results suggest that older adults with ≥20 natural teeth have a higher likelihood of experiencing healthy aging compared to those with fewer than 20 natural teeth. In the fully adjusted model, only older adults with ≥20 natural teeth demonstrated a higher rate of healthy aging compared to those with 0 natural teeth, with an OR (95% CI): 2.09 (1.54-2.84). CONCLUSIONS: These results highlight the importance of maintaining ≥20 teeth for promoting healthy aging among Chinese older adults. Furthermore, wearing dentures can, to varying degrees, mitigate the adverse effects of tooth loss on healthy aging. Rehabilitative interventions, such as the utilization of dentures and other clinical strategies, play a pivotal role in enhancing the oral health status of older individuals.
Parents' perspectives on dental team as advisors to promote HPV vaccination among Spanish adolescents.
Lorenzo-Pouso AI, González-Palanca S, Palmeiro-Fernández G … +5 more , Dominguez-Salgado JC, Pérez-Sayáns M, González-Veiga EJ, Caponio VCA, Daley EM
J Public Health Dent · 2024 Jun · PMID 38485512 · Publisher ↗
PURPOSE: Human papillomavirus (HPV) is a prevalent sexually transmitted infection responsible for many anogenital and oropharyngeal cancers. Dental care providers have the potential to influence vaccine uptake, yet littl...
PURPOSE: Human papillomavirus (HPV) is a prevalent sexually transmitted infection responsible for many anogenital and oropharyngeal cancers. Dental care providers have the potential to influence vaccine uptake, yet little is known about how patients perceive their role in HPV education and prevention. METHODS: Parents of adolescents aged 9 to 17 years (n = 375) were recruited from Valdeorras District Hospital (Galicia, Spain) to investigate parents' attitudes concerning the involvement of dental care providers in discussions related to HPV. A survey was distributed to the participants, and 343 (91.5%) were included in the analysis. RESULTS: In general, nearly half of the parents reported feeling comfortable regarding discussing HPV with their dentist. Participants described more comfort with dentists than with dental hygienists. Parents' comfort levels were influenced by various social determinants of health, including education level, marital status, geographic origin, and child vaccination status (p > 0.05). CONCLUSION: Parents reported varying comfort levels when discussing HPV and its vaccine with dental professionals, displaying a preference for dentists. Dental settings have the potential to promote vaccination, but the existence of ongoing barriers needs to be addressed.
A scoping review of the economic impact of family oral health: Implications for public health, research, and policy.
Herndon JB, Rubin MS, Reusch C … +1 more , Edelstein BL
J Public Health Dent · 2024 Mar · PMID 38305646 · Publisher ↗
OBJECTIVES: To summarize evidence on the impact of oral health on individual and family economic outcomes, describe trends in the literature, and identify areas for additional research to inform public health research an...
OBJECTIVES: To summarize evidence on the impact of oral health on individual and family economic outcomes, describe trends in the literature, and identify areas for additional research to inform public health research and practice. METHODS: Searches were conducted within PubMed, CINAHL, EconLit, Cochrane Library, PsycInfo, and Web of Science databases. Article review, selection, abstraction, and reporting processes were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS: Of 2758 unduplicated records identified, 52 met inclusion criteria. Study outcomes included indicators of employment/employability (n = 9), earnings/earnings potential (n = 26), parent missed work and family financial impacts of child oral health (n = 19), and financial loss (n = 3). Dental caries-related variables were the most common predictors of poorer economic outcomes. Other oral health problems, such as poorer dental functioning or poorer self-reported oral health status, also were associated with adverse economic outcomes. Significant associations with employment were found among studies that assessed interventions designed to improve oral health. Only one study estimated the impact of oral health on earnings. One-third of studies conducted multivariable analyses, and 14% incorporated race and ethnicity variables. CONCLUSIONS: Although existing evidence suggests associations between oral health problems and poorer economic outcomes, there is a substantial need for more rigorous research to better understand the extent of economic impact of oral health problems and which populations are most affected. Additional high-quality research is needed to inform which interventions are most likely to improve oral health, reduce adverse economic impacts, and promote health and economic equity.
Sleep disorders, anxiety and obesity associated with untreated dental caries in children eight to ten years of age.
de Lima LCM, Bernardino VMM, Leal TR … +3 more , Granja GL, Paiva SM, Granville-Garcia AF
J Public Health Dent · 2024 Mar · PMID 38183329 · Publisher ↗
OBJECTIVE: To evaluate the presence of sleep disorders, obesity and anxiety associated with cavitated carious lesions in children aged 8 to 10 years. MATERIALS AND METHODS: A cross-sectional study was carried out in the...
OBJECTIVE: To evaluate the presence of sleep disorders, obesity and anxiety associated with cavitated carious lesions in children aged 8 to 10 years. MATERIALS AND METHODS: A cross-sectional study was carried out in the Northeast of Brazil. The sample was comprised of 793 schoolchildren randomly selected from public and private schools. Calibrated examiners (Kappa >0.80) performed the clinical examination of dental caries using the International Caries Detection and Assessment System and applied the Revised Children's Manifest Anxiety Scale and the Sleep Disturbance Scale for Children questionnaires. The anthropometric variables evaluated were weight and height. Negative binomial regressions (α ≤ 0.05) were performed. A Directed Acyclic Graph was prepared using DAGitty software (version 3.0), to select the co-variables for the statistical fits. RESULTS: The prevalence of tooth decay was 52.8%. The mean number of tooth surfaces with cavitated caries was 2.2(2.8), 58.9% of the schoolchildren had some type of sleep disorder, while 20.2% were anxious and 29.1% were obese. Sleep disturbance (RR = 1.38; 95% CI: 1.05-1.83), general anxiety (RR = 1.71; 95% CI: 1.32-2.21), obesity (RR = 1.48; 95% CI: 1.17-1.86) were associated with dental caries in the final model. CONCLUSION: The presence of carious lesions was higher in children with sleep disorders, anxiety, obesity, and those who experienced dry mouth.
Association between dental visits during pregnancy and setting for prenatal care.
Byrappagari D, Cohn L, Sailor L … +1 more , Clark S
J Public Health Dent · 2024 Mar · PMID 38173182 · Publisher ↗
OBJECTIVES: Federally Qualified Health Centers (FQHCs) may be well positioned to facilitate dental visits during pregnancy for low-income women. We sought to compare receipt of dental visits during pregnancy for women wh...
OBJECTIVES: Federally Qualified Health Centers (FQHCs) may be well positioned to facilitate dental visits during pregnancy for low-income women. We sought to compare receipt of dental visits during pregnancy for women who received prenatal care at an FQHC versus a non-FQHC setting. METHODS: We analyzed Michigan Medicaid administrative data for all live birth deliveries between April 2018 and December 2020. We used billing data to categorize the predominant setting for prenatal care as occurring at a FQHC or a non-FQHC and claims data to identify dental visits during pregnancy (in the 9 months prior to delivery). We employed bivariate and multivariate analyses to explore the relationship between setting for prenatal care and dental visits during pregnancy. RESULTS: Women who received prenatal care at an FQHC versus non-FQHC had a higher proportion of dental visits during pregnancy (31.85% vs. 19.37%, p < 0.0001). In multivariate analyses, the strongest predictors of having a dental visit during pregnancy were FQHC prenatal care setting, having a dental emergency visit, having ≥3 prenatal visits, and having Medicaid coverage throughout pregnancy. Hispanic or Black race/ethnicity and 2020 delivery year were predictors of a lower likelihood of a dental visit. These predictors were consistent for the overall population and for the subset who had no dental visits pre-pregnancy. CONCLUSION: Medicaid-enrolled women who receive prenatal care at an FQHC are more likely to have a dental visit during pregnancy than their counterparts who receive prenatal care in a non-FQHC setting.
Leveraging technology to increase the disseminability of evidence-based treatment of dental fear: An uncontrolled pilot study.
Heyman RE, Daly KA, Slep AMS … +1 more , Wolff MS
J Public Health Dent · 2024 Mar · PMID 38114444 · Full text
OBJECTIVES: U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic healt...
OBJECTIVES: U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic health. Although evidence-based cognitive-behavioral treatments for dental fear (CBT-DF) exist, they have little impact on the millions who seek dental care annually because they are not disseminable (6 h of in-chair time, delivered only in person at a few sites). We developed a disseminable CBT-DF stepped-care treatment comprising (Step 1) a mobile-health application and, for those who remain fearful, (Step 2) a 1-h, one-on-one psychological treatment session that allows practice during exposure to the patient's most-feared stimuli. We hypothesized that the treatment would (a) be rated highly on usability and credibility and (b) result in clinically consequential (i.e., lowering fear into the 0-3 "no/low fear" zone) and statistically significant changes in global dental fear. METHOD: Racially/ethnically diverse patients (N = 48) with moderate to severe dental fear were recruited; all completed Step 1, and n = 16 completed Step 2. RESULTS: As hypothesized, users found the stepped-care treatment highly usable, credible, and helpful. Critically, this stepped-care approach produced reductions in patients' dental fear that were both clinically consequential (with half no longer fearful) and statistically significant (d = 1.11). CONCLUSIONS: This usable, credible, stepped-care approach to dental fear treatment holds promise for liberating evidence-based CBT-DF from specialty clinics, allowing broad dissemination.
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