J Public Health Dent [JOURNAL]
Sun
200 papers
Social support and oral health among working-age and older adults in the United States.
Laniado N, Cloidt M, Shah P
J Public Health Dent · 2023 Jul · PMID 37303076 · Publisher ↗
OBJECTIVES: The purpose of this study was to examine the association of social support with untreated dental caries and severe tooth loss in adults in the United States. METHODS: This cross-sectional study was conducted...
OBJECTIVES: The purpose of this study was to examine the association of social support with untreated dental caries and severe tooth loss in adults in the United States. METHODS: This cross-sectional study was conducted by analyzing data obtained from 5,447 individuals, 40 years of age and older, in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008 who had both a complete dental examination and social support index measures. Sample characteristics, overall and by social support level, were examined through descriptive statistical analyses. Logistic regression analyses were performed to estimate the association of social support with untreated dental caries and severe tooth loss. RESULTS: In this nationally representative sample (mean age 56.5 years) the prevalence of low social support was 27.5%. The prevalence of individuals with moderate-to-high social support increased with higher levels of educational attainment and income level. In fully adjusted models, relative to those who had moderate-high social support levels, individuals with low social support had 1.49 higher odds of untreated dental caries (95% CI, 1.17-1.90, p=0.002) and 1.23 higher odds of severe tooth loss (95% CI, 1.05-1.44, p=0.011). CONCLUSIONS: Higher odds of untreated dental caries and severe tooth loss were found among U.S. adults with low levels of social support compared to those with moderate-to-high levels of social support. Additional studies are warranted to provide a more current perspective on the impact of social support on oral health so that programs may be developed and tailored to reach these populations.
Stressful life events, oral health, and barriers to dental care during pregnancy.
Testa A, Jackson DB, Simon L … +2 more , Ganson KT, Nagata JM
J Public Health Dent · 2023 Jul · PMID 37294070 · Publisher ↗
OBJECTIVES: Poor oral health during pregnancy poses risks to maternal and infant well-being. However, limited research has documented how proximate stressful life events (SLEs) during the prenatal period are associated w...
OBJECTIVES: Poor oral health during pregnancy poses risks to maternal and infant well-being. However, limited research has documented how proximate stressful life events (SLEs) during the prenatal period are associated with oral health and patterns of dental care utilization. METHODS: Data come from 13 states that included questions on SLEs, oral health, and dental care utilization in the Pregnancy Risk Assessment Monitoring System for the years 2016-2020 (n = 48,658). Multiple logistic regression analyses were used to assess the association between levels of SLE (0, 1-2, 3-5, or 6+) and a range of (1) oral health experiences and (2) barriers to dental care during pregnancy while controlling for socio-demographic and pregnancy-related characteristics. RESULTS: Women with more SLEs in the 12 months before birth-especially six or more-reported worse oral health experiences, including not having dental insurance, not having a dental cleaning, not knowing the importance of caring for teeth and gums, needing to see a dentist for a problem, going to see a dentist for a problem, and unmet dental care needs. Higher levels of SLEs were also associated with elevated odds of reporting barriers to dental care. CONCLUSIONS: SLEs are an essential but often understudied risk factor for poor oral health, unmet dental care needs, and barriers to dental care services. Future research is needed to understand better the mechanisms linking SLEs and oral health.
Impact of the COVID-19 pandemic on pediatric Medicaid dental claims in Arizona.
Mommaerts K, Roy I, Helm DM
J Public Health Dent · 2023 Jul · PMID 37046370 · Full text
OBJECTIVES: To examine the role COVID-19 had on access to dental services among children in Arizona by comparing paid pediatric dental claims made before and during the pandemic. METHODS: In a retrospective descriptive s...
OBJECTIVES: To examine the role COVID-19 had on access to dental services among children in Arizona by comparing paid pediatric dental claims made before and during the pandemic. METHODS: In a retrospective descriptive study, we examined Medicaid paid claims for dental services among pediatric patients from March through December 2019 and during the outbreak in 2020. Using dental claims data obtained from the Centers for Health Information and Research at Arizona State University (ASU), we analyzed Medicaid (Arizona Health Care Cost Containment System [AHCCCS]) reimbursed dental services. RESULTS: During the COVID-19 pandemic, paid preventive dental claims for children aged birth to 21 years decreased in 2020 compared to the same time period in 2019. Pediatric patients in Arizona utilized fewer dental services and had less access to credentialed Medicaid dental providers during the pandemic. Further, rural counties had statistically significant fewer preventive, minor restorative, major restorative, and endodontic claims compared to urban counties. Arizona rural counties also had fewer providers who were paid $10,000 or more per year during 2020 than in 2019. CONCLUSIONS: COVID-19 has had a detrimental impact on pediatric dental service utilization. While dental services were provided during the COVID-19 pandemic, preventive and restorative dental claims dropped for rural Arizona children aged birth to 21 years. This reveals potential negative impacts on oral health. Further research should examine the direct and indirect impact the COVID-19 pandemic has had on dental service utilization and oral health for the general pediatric population.
A certain protective effect of vitamin D against dental caries in US children and youth: A cross-sectional study.
Pu R, Fu M, Li N … +1 more , Jiang Z
J Public Health Dent · 2023 Jul · PMID 37005066 · Publisher ↗
OBJECTIVES: Recent studies reported that evidence of the association between caries and vitamin D was inconclusive. We investigated the relationship between dental caries and serum vitamin D levels in US children and you...
OBJECTIVES: Recent studies reported that evidence of the association between caries and vitamin D was inconclusive. We investigated the relationship between dental caries and serum vitamin D levels in US children and youth aged 5-19 years through the National Health and Nutrition Examination Survey (NHANES). The purpose of this study was to analyze the relations between serum 25-hydroxyvitamin-D [25(OH)D] level and dental caries in children and youth. METHODS: Data were collected from the NHANES dataset performed in 2011-2018. A total of 8896 subjects completed the examination was enrolled. Serum 25(OH)D was determined by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). All teeth examined and caries assessment was conducted by licensed dentists. Statistical analyses included complex samples Chi-square tests, analysis of variance, logistic regression analyses, and restricted cubic splines conducted by R software. RESULTS: There was a nonlinear relation between dental caries and age in youth. Vitamin D showed a relatively stable protective effect when the concentration exceeded 60 nmol/L. There was a dose-effect relation that a 10 nmol/L increase in serum 25(OH)D concentrations was associated with a decreased caries odd by 10%. CONCLUSIONS: Our findings suggested that vitamin D sufficiency may be a protective factor for dental caries.
Building effective public dental care programs: The critical role of implementation evaluation.
Durbin A, Root A, Lawrence HP … +3 more , Werb S, Abrams S, Durbin J
J Public Health Dent · 2023 Jun · PMID 36951541 · Publisher ↗
There are significant income-related inequities in oral health and access to oral health care. Public dental programs generally aim to increase access to oral health care for individuals with financial barriers through g...
There are significant income-related inequities in oral health and access to oral health care. Public dental programs generally aim to increase access to oral health care for individuals with financial barriers through government payments for appointments. Low engagement from both oral health care providers and intended patients are common challenges in delivery of public dental programs, and are impediments to program impact and outcomes. Still, these programs rarely address the systemic issues that affect the experiences of intended users. This accentuates the importance of monitoring of program delivery to refine or adapt programs to better meet needs of service providers and users. As such, specifying program goals and developing a related monitoring strategy are critical as Canada begins to implement a national public dental program. Drawing on an example of a pediatric public dental program for children from low-income families or with severe disabilities in Ontario, Canada, this article illustrates how an implementation and evaluation framework could be applied to measure implementation and impact of the national program. The RE-AIM framework measures performance across five domains: (1) Reach, (2) Effectiveness (patient level), (3) Adoption, (4) Implementation (provider, setting, and policy levels), and (5) Maintenance (all levels). Given the disparities in oral disease and access to oral health care, the results can be used most effectively to adapt programs if relevant stakeholders participate in reviewing data, investigating quality gaps, and developing improvement strategies.
Association between oral health knowledge, perceived oral health related quality of life, perceived oral health status and emergency department and/or urgent care visit: Results from the multi-site oral health literacy study.
Adunola F, Macek MD, Atchison K … +1 more , Akinkugbe A
J Public Health Dent · 2023 Jun · PMID 36938785 · Full text
OBJECTIVES: To assess the link between oral health knowledge (OHK), self-perceived oral health, and emergency room (ER)/urgent care utilization for a dental problem. METHODS: Data were analyzed from a convenience sample...
OBJECTIVES: To assess the link between oral health knowledge (OHK), self-perceived oral health, and emergency room (ER)/urgent care utilization for a dental problem. METHODS: Data were analyzed from a convenience sample of 790 adult participants who presented to two US dental schools and completed an interviewer-administered survey. Key independent variables were OHK assessed with the Comprehensive Measure of Oral Health Knowledge (CMOHK) instrument, self-perceived oral health status and quality of life determined using the General Oral Health Assessment Index (GOHAI) scores. The dependent variable was ER and/or urgent care utilization for a dental problem. Select sociodemographic variables such as age and gender were adjusted for in logistic regression models using SAS. RESULTS: 15.7% of the participants had ever visited an ER and/or urgent care for a dental problem. CMOHK scores were not significantly associated with visits to the ER and/or urgent care. In adjusted analysis, participants with unfavorable GOHAI scores were about three times as likely to have had an ER and/or urgent care visit (OR = 2.60, 95% CI: 1.66-4.09). Similarly, participants who were unsatisfied with their oral health were about twice as likely to have had an ER and/or urgent care visit (OR = 1.91, 95% CI: 1.21-3.00) as compared to those satisfied with their oral health status. CONCLUSION: Individuals unsatisfied with their oral health and those with unfavorable perceived oral health related quality of life could benefit from a greater awareness of dental service availability and extended hours including weekend hours at public dental clinics.
The association between adverse childhood experiences and oral health: A systematic review.
Bahanan L, Ayoub S
J Public Health Dent · 2023 Jun · PMID 36916213 · Publisher ↗
OBJECTIVE: It is well established that adverse childhood experiences (ACEs) negatively affect health and are associated with health-risk behaviors. This study aimed to provide a systematic review of the studies that exam...
OBJECTIVE: It is well established that adverse childhood experiences (ACEs) negatively affect health and are associated with health-risk behaviors. This study aimed to provide a systematic review of the studies that examine the relationship between ACE exposure and oral health among adults aged 18 years and older. METHODS: The following electronic databases were searched in January 2022: MEDLINE, Cochrane, Web of Science, CINAHL via EBSCOhost, ProQuest, ScienceDirect, and Google Scholar. Data were extracted independently by two reviewers. The quality of the studies was assessed using the Newcastle-Ottawa Scale. RESULTS: Among the 292 articles identified, four met the eligibility criteria. All included studies were cross-sectional and of satisfactory quality. The dental outcomes included: last dental visit, last dental cleaning, number of filled teeth, number of extracted teeth, and number of remaining teeth. The studies showed that exposure to ACE was negatively associated with oral health. The relationship between ACE score and oral health outcome measures was found to be directly proportional. CONCLUSION: There is an association between ACE and poor oral health. Moreover, the association was proven to have a dose-response relationship. Given that the studies in the literature were cross-sectional, causality cannot be determined with certainty, therefore interpretation of the results should be cautious. Longitudinal follow-up studies are needed to understand how ACEs contribute to oral diseases later in life.
Dental opioid prescription patterns in academic and community settings.
Oyler DR, Rojas-Ramirez MV, Nakamura A … +2 more , Quesinberry D, Miller CS
J Public Health Dent · 2023 Jun · PMID 36905202 · Publisher ↗
OBJECTIVES: Reports of interventions to improve dental opioid prescribing have come primarily from academic settings, but most opioid prescriptions are written by community dentists. This analysis compares prescription c...
OBJECTIVES: Reports of interventions to improve dental opioid prescribing have come primarily from academic settings, but most opioid prescriptions are written by community dentists. This analysis compares prescription characteristics between these two groups to inform interventions to improve dental opioid prescribing in community settings. METHODS: State prescription drug monitoring program data from 2013 to 2020 were used to compare opioid prescriptions from dentists at academic institutions (PDAI) to prescriptions from dentists in non-academic settings (PDNS). Linear regression was used to assess daily morphine milligram equivalents (MME), total MME, and days' supply, adjusting for year, age, sex, and rurality. RESULTS: Prescriptions from dentists at the academic institution accounted for less than 2% of over 2.3 million dental opioid prescriptions analyzed. Over 80% of prescriptions in both groups were written for <50 MME per day and for ≤3 days' supply. On average, in the adjusted models, prescriptions from the academic institution were written for about 75 additional MME per prescription and nearly a full day longer duration. Compared to adults, adolescents were the only age group who received both higher daily doses and longer days' supply. CONCLUSIONS: Prescriptions from dentists at academic institutions accounted for small percentage of opioid prescriptions, but prescription characteristics were clinically comparable between groups. Interventional targets to reduce opioid prescribing in academic institutions could be applied to community settings.
Auxiliary delivered school based oral health promotion among 12-14-year-old children from a low resource setting-A cluster randomized trial.
Narayan V, Thomas S, Gomez MSS … +2 more , Bhaskar BV, Rao AK
J Public Health Dent · 2023 Jun · PMID 36896639 · Publisher ↗
OBJECTIVES: This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12-14-year-old children who received a school based oral health pro...
OBJECTIVES: This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12-14-year-old children who received a school based oral health promotion delivered by auxiliaries in a rural setting in India. METHODS: The interventions in this school based cluster randomized trial were delivered using schoolteachers and school health nurses. Oral health education (once in 3 months), weekly classroom based sodium fluoride mouth rinsing and biannual oral health screening/ referral were provided for 1 year. The control arm did not receive these interventions. Oral health indicators and self-administered KAP questionnaire were evaluated at baseline and 1-year follow-up. Oral health indicators included oral hygiene index simplified, DMFT/DMFS net caries increments, prevented fraction, number of sites with gingival bleeding, changes in care index, restorative index, treatment index, and dental attendance. RESULTS: The improvement in total KAP score, oral hygiene, and gingival bleeding from baseline to follow up was higher in the intervention arm (p < 0.05). The prevented fraction for net caries increment were 23.33% and 20.51% for DMFT and DMFS, respectively. Students in the intervention group had a higher dental attendance (OR 2.92, p < 0.001). The change in treatment index, restorative index, and care index were significantly higher in the intervention arm (p < 0.001). CONCLUSIONS: Inclusion of available primary care auxiliaries like school health nurses and teachers in oral health promotion is a novel, effective, and sustainable strategy to improve oral health indicators and utilization in rural areas in low resource settings.
An interprofessional school-based initiative to increase access to oral health care in underserved Florida counties.
Morón EM, Singer R
J Public Health Dent · 2023 Jun · PMID 36891884 · Publisher ↗
OBJECTIVE: To examine and describe the effect of an oral health education program on school-based nurses' acquisition of oral health knowledge. METHODS: Three-hour synchronous videoconference sessions provided training f...
OBJECTIVE: To examine and describe the effect of an oral health education program on school-based nurses' acquisition of oral health knowledge. METHODS: Three-hour synchronous videoconference sessions provided training for nurses to conduct oral health risk assessments, screen for oral diseases, deliver oral health education, apply fluoride varnish, and refer children identified in need of further assessment and treatment to a dentist. Oral health knowledge acquisition was assessed by comparing pre-training and post-training examination scores. Analyses included descriptive statistics and the Wilcoxon signed-rank test. RESULTS: Seventeen nurses from Suwannee, Lafayette, and Hamilton counties participated in the oral health education training program. Analyses of the school-based nurses' test results showed a significant increase in correct answers on the post-training test (93%) compared to the pre-training test (56%). Six hundred forty-one children from six elementary public schools received oral health education, oral screenings, and fluoride varnish applications. Fifty-eight percent of the children had untreated caries, 43% had treated caries, 15% had sealant on permanent molars, and 3% required urgent care. Nurses successfully referred children identified in need of further assessment and treatment to a dentist. CONCLUSIONS: The synchronous videoconference oral health training program was effective in improving school-based nurses' oral health knowledge. The knowledge acquired by school-based nurses via oral health training programs can be leveraged to increase access to oral health care for vulnerable and unserved school-aged populations.
Engaging new partners in human papillomavirus (HPV) vaccine promotion: Considerations for training private practice dental professionals in HPV vaccine promotion.
Askelson N, Ryan G, McKernan S … +3 more , Scherer A, Daly E, Avdic L
J Public Health Dent · 2023 Jun · PMID 36891831 · Full text
OBJECTIVES: With rates of the human papillomavirus (HPV) vaccination remaining low and rates of oropharyngeal cancer rising, engaging new partners to promote vaccination is necessary. We aimed to identify dental hygienis...
OBJECTIVES: With rates of the human papillomavirus (HPV) vaccination remaining low and rates of oropharyngeal cancer rising, engaging new partners to promote vaccination is necessary. We aimed to identify dental hygienists' and dentists' knowledge about HPV, the HPV vaccine, and preferences for continuing education. METHODS: This mixed-methods study recruited dental hygienists and dentists working in private practice in Iowa to participate in a mailed cross-sectional survey (dental hygienists) and qualitative telephone interviews (dental hygienists and dentists). Survey and interview topics included existing knowledge about HPV vaccination, HPV vaccination promotion efforts, barriers to HPV vaccine promotion, and preferences for continuing education (CE). RESULTS: We received 470 surveys from dental hygienists (response rate = 22.6%) and interviewed 19 dental hygienists and 20 dentists. Vaccine efficacy and safety, along with communication strategies, were key topics of interest for CE. Dental hygienists' most commonly identified barriers were lack of knowledge (67%) and low comfort levels (42%). CONCLUSIONS: Knowledge was identified as a key barrier to providing a strong recommendation for HPV vaccination and convenience was the most important factor to consider for any future CE. Our team is in the process of designing a CE course based on this information to help dental professionals effectively engage in HPV vaccine promotion in their practices.
Racial/ethnic disparities in preventive dental services use and dental caries among children.
Luo H, Moss ME, Wright W … +3 more , Webb M, Pardi V, Lazorick S
J Public Health Dent · 2023 Jun · PMID 36883255 · Full text
OBJECTIVE: To assess disparities in preventive dental service use in four major racial/ethnic groups and assess whether racial/ethnic and income-related disparities among children were reduced from 2016 to 2020. METHODS:...
OBJECTIVE: To assess disparities in preventive dental service use in four major racial/ethnic groups and assess whether racial/ethnic and income-related disparities among children were reduced from 2016 to 2020. METHODS: Data were from the 2016 and 2020 National Survey of Children's Health (NSCH). The outcomes of interest were having dental sealants, fluoride treatment, and dental caries in the past 12 months. Racial/ethnic groups included non-Hispanic (NH) whites, blacks, Hispanics, Asians, and others. Family income level was categorized as below or above the 200% federal poverty level (low-income vs. high-income). Children ages 2-17 were included (N = 161,539). All data were self-reported by parents/guardians. We estimated the trends of racial/ethnic disparities in having fluoride treatment, dental sealants, and dental caries from 2016 to 2020 and tested two 2-way interactions (i.e., year by race/ethnicity, year by income) and one 3-way interaction (year by income by race/ethnicity) to assess the change in disparities from 2016 to 2020. RESULTS: Overall, no significant trends in receipt of fluoride treatment, dental sealants, or having dental caries were found from 2016 to 2020 among the racial/ethnic groups, except for a decreasing trend in dental sealants for Asian American children (p = 0.03). Overall, NH white children were more likely to have received preventive dental services than children from minority groups (all p < 0.05); Asian American children (AOR = 1.31) were more likely to have dental caries than NH white children. CONCLUSION: Disparities in receipt of evidence-based preventive services by children persisted. Continuous efforts are needed to promote the use of preventive dental services among children of minority populations.
Trends in dental insurance claims in the United States in the context of the COVID-19 pandemic: A 3-year perspective (2019-2022).
Maupome G, Scully AC, Yepes JF … +2 more , Eckert GJ, Downey T
J Public Health Dent · 2023 Jun · PMID 36880562 · Publisher ↗
OBJECTIVES: We showed in a previous analysis the patterns of disruption for private dental insurance claims in the United States caused by the SARS-CoV-2 pandemic in 2020. The present report examines trends during 2020 a...
OBJECTIVES: We showed in a previous analysis the patterns of disruption for private dental insurance claims in the United States caused by the SARS-CoV-2 pandemic in 2020. The present report examines trends during 2020 and 2021, that is, contrasting perspectives during 2019 with the acute phase of the pandemic in 2020, and 2021. METHODS: Private dental insurance paid claims from a data warehouse were obtained, encompassing a 5% random sample of records between January 2019 and December 2021 for child and adult insureds who filed a claim in 2019, 2020, and 2021. We classified claims into one of four categories based on the likelihood of being associated with urgent/emergency care. RESULTS: The precipitous reduction in dental care claims in March-June 2020 recovered to almost pre-pandemic levels by the fall of 2020. However, a downward decline in private dental insurance claims started in the late fall of 2020 and continued through 2021. Differential impacts in dental care categories-in terms of urgency of care-were evident 2021, closely resembling previous trends in 2020. CONCLUSIONS: Dental care claims from the first year of the 2020 SARS-CoV-2 pandemic were contrasted with perspectives in 2021. A downward trend in demand/availability changes in dental care insurance claims set in for 2021, perhaps linked to perceptions of the overall economic situation. Such downward trend has continued overall, even after considering seasonal changes and the acceleration of the pandemic during the Delta, Omicron, and other variants.
The future of Aboriginal and Torres Strait Islander oral health lies in the footprints of the past: Re-framing oral health discourse.
Poirier B, Hedges J, Jamieson L
J Public Health Dent · 2023 Jul · PMID 36869644 · Publisher ↗
OBJECTIVE: The history of oral health research and dental care provision for Aboriginal and Torres Strait Islander Peoples has been framed by oppressive colonial values and wrought with maltreatment and unethical behavio...
OBJECTIVE: The history of oral health research and dental care provision for Aboriginal and Torres Strait Islander Peoples has been framed by oppressive colonial values and wrought with maltreatment and unethical behavior. This commentary aims to collate evidence regarding the healthy history of Aboriginal and Torres Strait Islander oral health, the implications of colonization on oral health, and the current portrayal of oral health. CONCLUSION: We argue the need to reframe deficit focused discussions of Aboriginal and Torres Strait Islander oral health to strengths-based narratives by critically engaging with the ways in which the future of Aboriginal and Torres Strait Islander oral health lies in the footprints of the past.
Adverse outcomes associated with opioid prescription by dentists in the Veterans Health Administration: A national cross-sectional study from 2015 to 2018.
Solanki PA, Hubbard CC, Poggensee L … +2 more , Evans CT, Suda KJ
J Public Health Dent · 2023 Jun · PMID 36799865 · Publisher ↗
OBJECTIVES: Opioids prescribed by dentists have been associated with serious adverse events, including opioid-related overdose and mortality. However, the downstream outcomes of opioids prescribed by dentists to Veterans...
OBJECTIVES: Opioids prescribed by dentists have been associated with serious adverse events, including opioid-related overdose and mortality. However, the downstream outcomes of opioids prescribed by dentists to Veterans who are at high risk for opioid misuse and overdose have yet to be determined. METHODS: This was a national cross-sectional analysis of opioids associated with dental visits within the Veterans Health Administration from 2015 to 2018. Overprescribing was defined per guidelines as >120 morphine milligram equivalents (MME) or >3 days supply. The association of dental visit and patient characteristics was modeled separately for opioid-related poisoning and all-cause mortality using logistic regression. RESULTS: Of 137,273 Veterans prescribed an opioid by a dentist, 0.1% and 1.1% were associated with opioid-related poisoning and mortality, respectively. There was no difference in opioid poisoning within 6 months for Veterans with opioid prescriptions >120 MME (aOR = 1.25 [CI: 0.89-1.78]), but poisoning decreased in Veterans prescribed opioids >3-days supply (aOR = 0.68 [CI: 0.49-0.96]). However, Veterans with opioids >120 MME were associated with higher odds of mortality within 6 months (aOR = 1.17 [95% CI: 1.05-1.32]) while there was no difference in prescriptions >3-days supply (aOR = 1.12 [CI: 0.99-1.25]). CONCLUSION: Serious opioid-related adverse events were rare in Veterans and lower than other reports in the literature. Since nonopioid analgesics have superior efficacy for the treatment of acute dental pain, prescribing opioid alternatives may decrease opioid-related poisoning. Strategies for dentists to identify patients at high risk should be incorporated into the dental record.
Calibration and reliability testing of a novel asynchronous photographic plaque scoring system in young children.
Avenetti DM, Martin MA, Gansky SA … +7 more , Ramos-Gomez FJ, Hyde S, Van Horn R, Jue B, Rosales GF, Cheng NF, Shiboski CH
J Public Health Dent · 2023 Mar · PMID 36781405 · Full text
OBJECTIVES: The Simplified Oral Hygiene Index for Maxillary Incisors (OHI-MIS) is a novel plaque scoring system adapted for young children. This study describes calibration training and testing used to establish the inte...
OBJECTIVES: The Simplified Oral Hygiene Index for Maxillary Incisors (OHI-MIS) is a novel plaque scoring system adapted for young children. This study describes calibration training and testing used to establish the inter- and intra-rater reliability for OHI-MIS measured from clinical photographs. METHODS: Two raters from the Coordinated Oral Health Promotion Chicago (CO-OP) and one from the Behavioral EConomics for Oral health iNnovation (BEECON) randomized controlled trials (RCTs) underwent calibration with gold standard raters, followed by annual re-calibration. Raters from CO-OP also completed inter-rater reliability testing; all three raters completed intra-rater reliability testing rounds. Photographs were obtained from children aged 9-39 months. RESULTS: All three raters achieved greater than 0.77 Lin's Concordance Correlation (LCC) versus gold standard consensus during calibration. All three raters had LCC ≥0.83 at recalibration 1 year later. CO-OP trial raters scored 604 photos (151 sets of 4 photographs); mostly both raters were somewhat/very confident in their scoring (≥89%), describing the most photos as "clear" (90% and 81%). The CO-OP inter-rater LCC for total OHI-MIS score was 0.86, changing little when low quality or confidence photos were removed. All three raters demonstrated high intra-rater reliability (≥0.83). CONCLUSIONS: The OHI-MIS plaque scoring system on photos had good reliability within and between trials following protocol training and calibration. OHI-MIS provides a novel asynchronous plaque scoring system for use in young children. Non-clinicians in field or clinical settings can obtain photographs, offering new opportunities for research and clinical care.
Topical fluoride hesitancy among caregivers: Development of a content-valid topical fluoride hesitancy identification item pool.
Edwards TC, Carle A, Kerr D … +4 more , Carpiano RM, Nguyen DP, Orack JC, Chi DL
J Public Health Dent · 2023 Mar · PMID 36719013 · Full text
OBJECTIVES: To develop a content-valid set of items to characterize different types of topical fluoride hesitancy among caregivers. We will use this information to develop and test tailor-made interventions directed to c...
OBJECTIVES: To develop a content-valid set of items to characterize different types of topical fluoride hesitancy among caregivers. We will use this information to develop and test tailor-made interventions directed to caregivers with varied types and levels of topical fluoride hesitancy, to ultimately improve child oral health. METHODS: Caregivers participated in three study activities, in the following order: (1) semi-structured concept elicitation interviews (n = 56), (2) cognitive interviews (n = 9), and (3) usability interviews (n = 3). Interviews were conducted via telephone and audio-recorded and transcribed for qualitative analysis. Twelve pediatric dental providers and researchers participated in item review. An assessment of reading level of items was made with goal of 6th grade reading level or less. RESULTS: Based on elicitation interviews, we initially developed 271 items, which the investigative team evaluated for conceptual clarity, specificity to topical fluoride hesitancy, and sensitivity to potential interventions. After four rounds of review and cognitive interviews, we retained 33 items across five previously identified domains. Changes after cognitive interviews included item revision to improve comprehension and item re-ordering to avoid order effects. Changes after usability testing including clarification regarding referent child for families with multiple children. The reading level of the item pool is grade 3.2. CONCLUSIONS: The resulting 33-item fluoride hesitancy item pool is content valid and will address an important need for identifying and addressing topical fluoride hesitancy in the context of dental research and clinical practice. Next steps include psychometric evaluation to assess scale and test-retest reliability and construct validity.
Explaining income inequities in tooth loss among Brazilian adults.
Bomfim RA, Constante HM, Cascaes AM
J Public Health Dent · 2023 Mar · PMID 36700483 · Publisher ↗
OBJECTIVE: To determine the extent to which individual and contextual variables explain income inequities in tooth loss in Brazilian adults. METHODS: A nationally representative sample of 65,784 Brazilian adults aged 18-...
OBJECTIVE: To determine the extent to which individual and contextual variables explain income inequities in tooth loss in Brazilian adults. METHODS: A nationally representative sample of 65,784 Brazilian adults aged 18-59 who participated in the Brazilian National Health Survey 2019 was analyzed. Self-reported tooth loss was the outcome. Per capita income was the main exposure, and minimum wage was the cutoff point. Individual covariates included sex, race, and schooling, dental visits, smoking status, use of dental floss, and self-reported chronic conditions. Contextual covariates included access to treated water and geographic region of residence. Blinder-Oaxaca decomposition analysis was used to estimate the share of each factor in income-related tooth loss inequities by age groups. RESULTS: Age-standardized tooth loss showed large income inequities. The average difference in tooth loss related to income inequities in the 18-34-year-old group was 0.50 (95% CI 0.39; 0.60), increasing to 4.51 (95% CI 4.09; 4.93) in the 45-59 years. Individual and contextual covariates explained almost 90% of income inequities in the 45-59 year group. Use of dental floss, schooling, and geographic region of residence (a proxy for human development level) had a higher proportion of contribution to the inequities examined. CONCLUSIONS: Individual and contextual covariates (proxy for human development level and water fluoridation coverage) explained a large share of income-related tooth loss inequities. Tailored strategies to act at both levels can help reduce tooth loss inequities among Brazilian adults.
Food insecurity and consumption of cariogenic foods in mothers and their two-year-old children in Appalachia.
Bhaumik D, Wright CD, Marshall TA … +6 more , Neiswanger K, McNeil DW, Jones AD, Shaffer JR, Marazita ML, Foxman B
J Public Health Dent · 2023 Jun · PMID 36695472 · Full text
OBJECTIVES: To describe the association between household food insecurity and intake of cariogenic foods that increase risk of dental caries. METHODS: Cross-sectional analysis of 842 mothers in Appalachia and their child...
OBJECTIVES: To describe the association between household food insecurity and intake of cariogenic foods that increase risk of dental caries. METHODS: Cross-sectional analysis of 842 mothers in Appalachia and their children participating in the Center for Oral Health Research Cohort 2 between 2011 and 2017 when their children were ~ 24 months of age. Mothers completed a telephone interview regarding cariogenic food consumption and food insecurity. Associations between food insecurity and daily food intake were adjusted for education, income, state residence, and daily snacking. RESULTS: After adjustment for household income, state residence, daily snacking, and maternal education, mothers from moderately/severely food insecure households drank on average ½ more sugar-sweetened beverage servings per day (p = 0.005) and children drank almost 1/3 servings more (p = 0.006). Further, mothers and children from moderately/severely food insecure households had lower, but not statistically significant, daily average consumption of vegetables (mothers: 1/5 less of a vegetable serving per day, children: ~1/10 less) and fruits (mothers: 1/5 less of a fruit serving per day, children: ~ 1/10 les) and elevated consumption of sweets (mothers: ~ 1/25 more sweet servings per day, children: ~ 2/25 more); differences based on state residence were noted. CONCLUSIONS: Food insecurity is associated with higher consumption of foods that increase risk of dental caries, but this association is modified by maternal education, income, and state residence. Food insecurity, and its socioeconomic determinants, should be considered when designing and implementing interventions to prevent dental caries.
Participation in the CARES Act Provider Relief Fund policy by dentists in South Carolina's safety net.
Marshall JL, Riley A, Martin AB
J Public Health Dent · 2023 Mar · PMID 36680347 · Publisher ↗
OBJECTIVES: The Coronavirus Aid, Relief, and Economic Security (CARES) Act appropriated $100 billion to the Provider Relief Fund, allowing for direct payments to health care providers due to COVID-19. Few studies have ev...
OBJECTIVES: The Coronavirus Aid, Relief, and Economic Security (CARES) Act appropriated $100 billion to the Provider Relief Fund, allowing for direct payments to health care providers due to COVID-19. Few studies have evaluated participation in the Provider Relief Fund (PRF), and none have specifically looked at dental providers in the safety net. METHODS: We conducted a retrospective, secondary data analysis using a quasi-experimental cohort design of South Carolina dentists who received PRF payments, comparing those who did and did not participate in the safety net. Safety net practice was operationalized as those participating in Medicaid, and whether they provided care in dental health professional shortage areas, or rural communities. RESULTS: Of the 628 dental providers in South Carolina who received PRF payments, 34% were identified as Medicaid providers while 66% did not participate in Medicaid; we found no statistical difference between payments to Medicaid versus non-Medicaid dental providers. Of PRF payments to dental providers participating in South Carolina's Medicaid program, we found no difference between payments to rural and urban providers but did find that practices offering services in dental care shortage areas received less than providers practicing in counties not designated as a shortage area. CONCLUSIONS: The PRF achieved its goal of distributing financial support to providers affected by the COVID-19 pandemic. But without policy imperatives linked to need-based allocations or incentives for PRF recipients to serve safety net populations, we may later learn this was a missed opportunity for PRF.
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