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Barger SD, Kirby C, Thomas H, Camplain C, Young S, Morrison G, Hyeoma S, Bordeaux SJ, Horowitz C, Baldwin JA. Pre-Pandemic and Recent Oral and Medical Health Care Utilization among Young American Indian Children and Their Caregivers. J Community Health 2024; 49:914-925. [PMID: 38466490 PMCID: PMC11345317 DOI: 10.1007/s10900-024-01345-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/13/2024]
Abstract
Children from diverse ethnic groups are at significantly increased risk for dental caries. In particular, American Indian (AI) children have the highest incidence of detal caries of any ethnic group. The COVID-19 pandemic dramatically restricted health care access, including preventive oral health care. Given this context, it is unclear whether or not preventive oral health care for AI children has resumed since lockdown. To address this question, we surveyed adult AI caregivers (N = 152) of children aged 0-5 years, assessing recent (12-month) and pre-COVID (for caregivers of children aged 3-5 years) preventive oral and medical health services. We also examined medical health care access and utilization among caregivers. Among children aged 3-5 years old, both pre-pandemic and past year medical care utilization were generally high (80 and 90%, respectively) as was any oral health care utilization (64 & 78%, respectively). Oral health check-ups were more common over the last year (62%) compared to pre-COVID (44%). Recent health care utilization among children 1-5 years old in this sample were generally comparable to national estimates, except for higher reported preventive medical care (99% vs. 87.6%, respectively) and higher preventive oral care (96% vs. 59.6%, respectively). More caregivers reported delaying or foregoing needed health care due to COVID (28-38%) versus due to cost (8-17%). In this survey of AI caregivers, recent child preventive health care utilization was high, and changes in utilization following the lockdown phases of the pandemic were comparable for oral and medical health care.
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Affiliation(s)
- Steven D Barger
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, USA.
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, USA.
| | - Christine Kirby
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, USA
| | - Heather Thomas
- Department of Dental Hygiene, Northern Arizona University, Flagstaff, AZ, USA
| | - Carolyn Camplain
- Department of Community and Population Health, Lehigh University, Bethlehem, PA, USA
| | - Sara Young
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, USA
| | - Gerlinda Morrison
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, USA
| | - Stephanie Hyeoma
- Department of Health and Human Services, Hopi Tribe, Kykotsmovi, AZ, USA
| | - Skyler J Bordeaux
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, USA
| | - Chloe Horowitz
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Julie A Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, USA
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Ong YJ, Meyer B, Quek YTE, Wong ML, Hong CHL, Hu S. Perception of nurses applying silver diamine fluoride to children's teeth: A mixed methods study. Int J Paediatr Dent 2024; 34:534-545. [PMID: 38229230 DOI: 10.1111/ipd.13154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 11/11/2023] [Accepted: 12/23/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND No studies have evaluated the unique potential of nurse-led silver diamine fluoride (SDF) application for children to bridge the gap in interprofessional collaboration. AIM To investigate the attitudes, beliefs and perceptions of nurses regarding nurse-led SDF application at the well-child visit and identify possible barriers and make recommendations. DESIGN Mixed methods design involving a questionnaire and semi-structured individual interviews were conducted. RESULTS All eligible nurses (n = 110) completed the questionnaire, and 16 were interviewed. Questionnaire responses highlighted that nurses were not confident in providing oral health services (score: <3 of 5) beyond oral hygiene advice (score: ≥3.9 of 5) but believed that they should be providing these services for individuals with difficulty accessing care. Interviews reflected that most nurses viewed oral health care as an important part of paediatric health but were limited by knowledge, time and manpower. Most were willing to expand their job scope to include SDF application with formal education and training, competency assessments and approaches to counter time limitations. CONCLUSION Where nurses are already providing basic oral healthcare, nurse-led SDF application could be the next step. Findings suggest that systemic changes should include strategies to empower and motivate nurses to apply SDF at the well-child visit.
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Affiliation(s)
- Yu Jie Ong
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
- Restorative Department, National Dental Centre Singapore, Singapore City, Singapore
| | - Beau Meyer
- Division of Paediatric Dentistry, College of Dentistry, Ohio State University, Columbus, Ohio, USA
| | - Yu Ting Eline Quek
- National University Polyclinics, National University Health System, Singapore City, Singapore
| | - Mun Loke Wong
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | | | - Shijia Hu
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
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Luo H, Moss ME, Wright W, Webb M, Pardi V, Lazorick S. Racial/ethnic disparities in preventive dental services use and dental caries among children. J Public Health Dent 2023; 83:161-168. [PMID: 36883255 PMCID: PMC10258156 DOI: 10.1111/jphd.12563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/03/2023] [Accepted: 01/20/2023] [Indexed: 03/09/2023]
Abstract
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.
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Affiliation(s)
- Huabin Luo
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834
| | - Mark E. Moss
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, NC 27834
| | - Wanda Wright
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, NC 27834
| | - Michael Webb
- Department of Pediatric Dentistry and Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, East Carolina University, Greenville, NC 27834
| | - Vanessa Pardi
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, NC 27834
| | - Suzanne Lazorick
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834
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Goswami S, Tseveenjav B, Kaila M. Non-utilization of oral health services and associated factors among children and adolescents: an integrative review. Acta Odontol Scand 2023; 81:105-118. [PMID: 35841154 DOI: 10.1080/00016357.2022.2095020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To review publications exploring non-utilization of oral health services and to identify factors associated with non-utilization of oral health services among children and adolescents. MATERIALS AND METHODS An integrative review design was adopted. A search was conducted for research articles published during the period from 2000 to April 2021 in five databases, Medline via Ovid, Scopus, CINAHL, Cochrane Library and Web of Science. Inclusion criteria were original articles examining non-utilization of oral health services among 0-19 years old and studies published in peer-reviewed journals in English. Thematic analysis was undertaken to identify common themes. The Newcastle-Ottawa scale was used to evaluate the quality of the studies. RESULTS Twenty-one geographically diverse articles were included. Nineteen studies were cross-sectional, one was a prospective cohort and one a case-control study. Non-utilization of dental health services tended to be higher in children than adolescents. There were predisposing (age, gender, ethnicity, parent's level of education), enabling (family income, dental insurance) and need factors (subjective and objective oral health related parameters) that had been shown to be associated with non-utilization of dental services among children and adolescents. CONCLUSIONS This integrative review found predisposing, enabling and need factors to be associated with dental health service non-utilization.
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Affiliation(s)
- Shweta Goswami
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Battsetseg Tseveenjav
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,New Children's Hospital, Helsinki University Hospital, Helsinki, Finland.,Department of Maxillofacial Surgery, Päijät-Häme Central Hospital, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti, Finland
| | - Minna Kaila
- Clinicum, University of Helsinki, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
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Kranz AM, Gahlon G, Dick AW, Goff SL, Whaley C, Geissler KH. Variation in prices for an evidence-based pediatric preventive service. Health Serv Res 2022; 57:1175-1181. [PMID: 35467008 PMCID: PMC9441288 DOI: 10.1111/1475-6773.13995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To examine variation in prices paid by private medical insurers for fluoride varnish applications in medical settings, a newly reimbursed service that few children receive. DATA SOURCES Private-insurance medical claims from Connecticut, Maine, New Hampshire, and Rhode Island (2016-2018). STUDY DESIGN We examined prices paid for fluoride varnish by private insurers and compared these to prices paid by Medicaid. DATA COLLECTION/EXTRACTION METHODS Private claims for fluoride varnish during medical visits for children aged 1-5 years. State Medicaid rates for fluoride varnish were obtained from the American Academy of Pediatrics. PRINCIPAL FINDINGS Prices paid for fluoride varnish by private insurers varied within and across states, ranging from less than $5 to $50. Median prices closely followed Medicaid rates in three of the four states. In states covering a package of fluoride varnish plus additional preventive oral health services during medical visits, combined Medicaid rates were nearly double the median price paid by private insurers. CONCLUSIONS Fluoride varnish is a recommended service, but few children receive it. Price variation may contribute to the low uptake of this service. Ensuring sufficient Medicaid and private insurance rates could increase fluoride varnish applications in medical settings and improve oral health.
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Affiliation(s)
| | | | | | - Sarah L. Goff
- School of Public Health & Health SciencesUniversity of Massachusetts AmherstAmherstMassachusettsUSA
| | | | - Kimberley H. Geissler
- School of Public Health & Health SciencesUniversity of Massachusetts AmherstAmherstMassachusettsUSA
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Social Differences in Health Behaviours among Jordanian Adolescents. Eur J Investig Health Psychol Educ 2022; 12:1191-1204. [PMID: 36005232 PMCID: PMC9407352 DOI: 10.3390/ejihpe12080083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Social differences are evident in both developed and developing countries. During adolescence, there are limited differences in morbidity and mortality, but differences do appear in terms of health behaviours. This study aims to examine the relationship(s) between social differences and students’ health behaviours. A cross-sectional study was conducted in 2020 with a sample of high school students (N = 2741, aged 13–18 years) in Jordan. Besides descriptive statistics, bivariate logistic regression analysis was used to detect the odds risk for each social difference indicator. Females were engaged in more healthy dietary and hygienic behaviours and less engaged in smoking. Males were more physically active. Adolescents with a higher parental education level were more engaged in healthy behaviours; however, they drank carbonated soft drinks and ate fast food more often. Higher SES (socioeconomic status) self-evaluation was positively associated with eating breakfast and fruit and vegetables, being physically active, drinking carbonated soft drinks, eating fast food, and smoking. Our findings suggest that socioeconomic differences are important to understanding Jordanian adolescents’ health behaviours. While females tend to engage in more healthy behaviours, the role of parental education and perceived family affluence is not always beneficial in terms of adolescents’ dietary habits, hygienic behaviour, or smoking.
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Mamat N, Mani SA, Danaee M. T-shaped toothbrush for plaque removal and gingival health in children: a randomized controlled trial. BMC Oral Health 2022; 22:113. [PMID: 35392881 PMCID: PMC8991571 DOI: 10.1186/s12903-022-02137-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background To evaluate an experimental T-shaped toothbrush for plaque removal and gingival health when compared to a conventional toothbrush among children. Methods This single blind parallel randomized controlled trial was conducted on 8–10-year-old healthy schoolchildren with no history of recent antibiotic intake, proximal caries or more than 3 missing teeth per quadrant. A computer-generated randomization list allocated child to the 2 groups. Each child received detailed instructions for tooth brushing. Gingival health and plaque scores were recorded in school at baseline, 2 weeks, 1 month and 3 months in a portable dental chair by an examiner who was blind to the allocated toothbrush. A general feedback on the use of the T-shaped toothbrush was obtained at 3 months. Data was analyzed using two-way repeated measure ANOVA, Generalized estimating equation and Bonferroni test. Results A total of 195 eligible children were invited, 110 parents gave consent and 100 children completed the study; 50 in each group. There were statistically significant reductions in mean gingival and plaque scores at each visit when compared to baseline for both toothbrushes (p < 0.05). There were no statistically significant differences between scores for the two toothbrushes at each visit (p > 0.05). Majority of participants gave positive feedback regarding the T-shaped toothbrush. Conclusions Both toothbrushes had similar efficacy in removing plaque and improving gingival health among children. The T-shaped toothbrush is an alternative to the conventional toothbrush for oral hygiene in children. Trial registration Retrospectively registered at ClinicalTrials.gov Registry—NCT03989479 18/06/2019.
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Affiliation(s)
- Noraida Mamat
- Unit of Paediatric Dentistry, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150, Kota Bharu, Kelantan, Malaysia.,Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Shani Ann Mani
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
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Kranz AM, Goff SL, Dick AW, Whaley C, Geissler KH. Delivery of fluoride varnish during pediatric medical visits by rurality. J Public Health Dent 2022; 82:271-279. [DOI: 10.1111/jphd.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/04/2022] [Accepted: 03/22/2022] [Indexed: 12/01/2022]
Affiliation(s)
| | - Sarah L. Goff
- Department of Health Promotion and Policy School of Public Health and Health Sciences, University of Massachusetts Amherst Amherst Massachusetts USA
| | | | | | - Kimberley H. Geissler
- Department of Health Promotion and Policy School of Public Health and Health Sciences, University of Massachusetts Amherst Amherst Massachusetts USA
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Goldstein EV, Dick AW, Ross R, Stein BD, Kranz AM. Impact of state-level training requirements for medical providers on receipt of preventive oral health services for young children enrolled in Medicaid. J Public Health Dent 2022; 82:156-165. [PMID: 33410186 PMCID: PMC9288108 DOI: 10.1111/jphd.12442] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 12/02/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Young children enrolled in Medicaid make few dental visits and have high rates of tooth decay. To improve access to care, state Medicaid programs have enacted policies encouraging nondental providers to deliver preventive oral health services (POHS) in medical offices. Policies vary by state, with some states requiring medical providers to obtain training prior to delivering POHS. Our objective was to test whether these training requirements were associated with higher rates of POHS for Medicaid-enrolled children <6 years. METHODS This study took advantage of a natural experiment in which policy enactment occurred across states at different times. We used Medicaid Analytic eXtract enrollment and claims data, public policy data, and Area Health Resource Files data. We examined an unweighted sample of 8,711,192 (45,107,240 weighted) Medicaid-enrolled children <6 years in 38 states from 2006 to 2014. Multivariable logistic regression models estimated the odds a child received POHS in a calendar year. Results are presented as adjusted probabilities. RESULTS Five or more years after policy enactment, the probability of a child receiving POHS in medical offices was 10.7 percent in states with training requirements compared to 5.0 percent in states without training requirements (P = 0.01). Findings were similar when receipt of any POHS in medical or dental offices was examined 5 or more years post-policy-enactment (requirement = 42.5 percent, no requirement = 33.6 percent, P < 0.001). CONCLUSIONS Medicaid policies increased young children's receipt of POHS and at higher rates in states that required POHS training. These results suggest that oral health training for nondental practitioners is a key component of policy success.
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Affiliation(s)
- Evan V. Goldstein
- RAND Corporation, Arlington, VA,Ohio State University, College of Public Health, Columbus, OH
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Downing KF, Espinoza L, Oster ME, Farr SL. Preventive Dental Care and Oral Health of Children and Adolescents With and Without Heart Conditions — United States, 2016–2019. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:189-195. [PMID: 35143467 PMCID: PMC8830625 DOI: 10.15585/mmwr.mm7106a1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Anwar AI, Panna SS, Akbar FH. Differences in Early Childhood Caries Status on Parental Stress Levels and Socioeconomic Status in Makassar City, Indonesia, During the COVID-19 Pandemic. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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Claiborne DM, Chen C, Zhang Q. Caregivers' report of preventive dental care visits and services for US WIC-participating and non-participating children. J Public Health Dent 2021; 82:72-78. [PMID: 34859436 DOI: 10.1111/jphd.12487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/02/2021] [Accepted: 11/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) had more caregiver-reported preventive dental care visits (PDCVs) and preventive dental services (PDS) than nonparticipating children. METHODS A secondary data analysis was performed utilizing the National Survey of Children's Health 2017 and 2018 combined datasets. The analytic sample included 10,356 children aged 1-4 years. It was further stratified into three groups by WIC eligibility and participation to include WIC participation, income-eligible nonparticipants, and higher-income nonparticipants. The independent variables included child-level characteristics (age, sex, race/ethnicity, and insurance) and caregiver-level characteristics (age of mother and the highest level of education in the household). The dependent variable was the report of PDCV and PDS (dental cleaning, toothbrushing instructions, and fluoride treatment) in the past 12 months. RESULTS Of the 10,356 children aged 1-4 years, 3025 were eligible for WIC and nearly half of those eligible (49.5%) reported participating in the WIC program. Caregivers of WIC-participating children had a higher reported prevalence of PDCV for their children than those of income-eligible nonparticipants (57.6% vs. 49.6%, respectively) (p < 0.05). In addition, caregivers of WIC-participating children reported their children receiving more PDS than income-eligible nonparticipants, including dental cleanings (38.5% vs. 33.6%), toothbrushing instructions (25.5% vs. 22.7%), and fluoride treatments (22.7% vs. 21.2%) (p < 0.05). CONCLUSIONS WIC-participating children had a higher reported prevalence of PDCVs and PDS than income-eligible nonparticipating children. Further research is needed to understand differences in the reports of specific PDSs received.
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Affiliation(s)
- Denise M Claiborne
- Gene W. Hirschfeld School of Dental Hygiene, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Chashan Campus, Wenzhou, China
| | - Qi Zhang
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
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Vasireddy D, Sathiyakumar T, Mondal S, Sur S. Socioeconomic Factors Associated With the Risk and Prevalence of Dental Caries and Dental Treatment Trends in Children: A Cross-Sectional Analysis of National Survey of Children's Health (NSCH) Data, 2016-2019. Cureus 2021; 13:e19184. [PMID: 34873524 PMCID: PMC8635037 DOI: 10.7759/cureus.19184] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction In the United States of America, early childhood caries (ECC) is the most common chronic childhood disease of early onset, with dental caries being the most prevalent chronic disease among children aged 6-19 years. Children without an established medical home, from low-income households, and who are uninsured have historically shown to be prone to dental caries and attribute to higher health care costs. Early recognition of these risk factors by a pediatrician helps prevent the development of medical and psychosocial complications in the child. Methods The cross-sectional data of the prevalence of dental caries and dental treatment trends in children and three socioeconomic risk factors, namely establishment of a medical home, household income, and child's health insurance, were accessed from the National Survey of Children's Health (NSCH) for the years 2016-2019. The association of the risk factors with the prevalence of dental caries and with the prevalence of dental treatment were analyzed using two-sample proportion tests and chi-square (χ2) tests for dichotomous categorical variables and non-dichotomous categorical variables, respectively. Standardized residuals were calculated and analyzed as well. Furthermore, the odds ratios were calculated and utilized to quantify the influence of each category on the highly associated category with having teeth decay and not receiving dental treatment under each socioeconomic risk factor. Results The results of this study revealed that the three socioeconomic factors considered have statistically significant associations with tooth decay and dental treatment. The prevalence and associative risk of tooth decay and untreated caries were the highest in the children without a medical home. Additionally, the odds of having tooth decay was >50% higher for the children from the lowest household income category (0-99% federal poverty level [FPL]) compared to those from the high household income categories (200-399% FPL and >400% FPL). Public insurance coverage was associated with the highest prevalence of dental caries and not receiving fluoride treatment. Furthermore, the likelihood of not availing dental treatment is nearly two times or more higher for the uninsured children than children having public insurance, or private insurance, or a combination of both. Conclusion Our study findings reveal that children belonging to certain socioeconomic risk categories are at a higher risk of developing dental caries and not receiving dental treatment. As a consequence, the study implies that increased support and expansion of public health insurance will benefit oral health care for the children. Pediatricians play an integral part in developing a medical home for the child by providing preventative dental care and establishing continued care through dental referrals.
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Chopra K. Maslow’s theory for preventive healthcare in India – a content analysis approach. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2021. [DOI: 10.1108/ijphm-10-2020-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of the study was to apply Maslow’s hierarchy of needs to understand consumer motivation for preventive health care in India using content analysis.
Design/methodology/approach
Content analysis approach which is a qualitative-based approach was adopted. The responses were collected through semi-structured interviews using purposeful sampling method, and the responses were analyzed using content analysis approach. Sub themes and main themes were derived from the data which related to concepts in Maslow’s theory.
Findings
The results indicate the following: healthy food, healthy diet and health supplements are the basic need; sustainability of health and fitness and health security relate to safety and security need; feeling of pride in being fit, being a role model of fitness for others and influence of electronic media relate to social and self-esteem need; freedom from disease and peace of mind fulfill the need for self-actualization.
Research limitations/implications
To strengthen the external validity, a mix of alternate research methodologies adopting qualitative and quantitative approach need to be adopted.
Practical implications
This study will help to better understand motivation for preventive health care. It will enable health-care companies to design health-care marketing programs based on Maslow’s theory to motivate individuals to purchase health products. The public health-care departments can issue guidelines based on Maslow’s theory to motivate citizens toward preventive health care.
Originality/value
Maslow’s theory was applied in the context of preventive health care.
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Lebrun-Harris LA, Canto MT, Vodicka P, Mann MY, Kinsman SB. Oral Health Among Children and Youth With Special Health Care Needs. Pediatrics 2021; 148:peds.2020-025700. [PMID: 34290133 DOI: 10.1542/peds.2020-025700] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We sought to estimate the prevalence of oral health problems and receipt of preventive oral health (POH) services among children and youth with special health care needs (CYSHCN) and investigate associations with child- and family-level characteristics. METHODS We used pooled data from the 2016-2018 National Survey of Children's Health. The analytic sample was limited to children 1 to 17 years old, including 23 099 CYSHCN and 75 612 children without special health care needs (non-CYSHCN). Parent- and caregiver-reported measures of oral health problems were fair or poor teeth condition, decayed teeth and cavities, toothaches, and bleeding gums. POH services were preventive dental visits, cleanings, tooth brushing and oral health care instructions, fluoride, and sealants. Bivariate and multivariable logistic regression analyses were conducted. RESULTS A higher proportion of CYSHCN than non-CYSHCN received a preventive dental visit in the past year (84% vs 78%, P < .0001). Similar patterns were found for the specific preventive services examined. However, CYSHCN had higher rates of oral health problems compared with non-CYSHCN. For example, decayed teeth and cavities were reported in 16% of CYSHCN versus 11% in non-CYSHCN (P < .0001). In adjusted analyses, several factors were significantly associated with decreased prevalence of receipt of POH services among CYSHCN, including younger or older age, lower household education, non-English language, lack of health insurance, lack of a medical home, and worse condition of teeth. CONCLUSIONS CYSHCN have higher rates of POH service use yet worse oral health status than non-CYSHCN. Ensuring appropriate use of POH services among CYSHCN is critical to the reduction of oral health problems.
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Affiliation(s)
| | | | | | - Marie Y Mann
- Division of Services for Children with Special Health Care Needs, Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland
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Crouch E, Nelson J, Merrell MA, Martin A. The oral health status of America's rural children: An opportunity for policy change. J Public Health Dent 2021; 81:251-260. [PMID: 33501720 DOI: 10.1111/jphd.12444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of our study was to examine the association between rurality and select oral health care metrics: teeth condition, decay, and access measures such as preventive dental care among children in the United States. METHODS We conducted a cross-sectional study with a sample of 20,842 respondents from the 2017 to 2018 National Survey of Children's Health (NSCH), a nationally representative sample of U.S. children. Socio-demographic information, residence, and oral health and healthcare utilization information were used to create study variables. Descriptive statistics, bivariate analyses, and a multivariable regression model were performed. RESULTS Rural children were less likely to have a preventive dental visit than urban children (84.9 percent versus 87.5 percent, P = 0.03). Children residing in rural areas were more likely to have their teeth condition reported as fair or poor than children residing in urban areas (7.3 percent versus 6.6 percent, P = 0.02). Compared to their urban counterparts, rural children were also less likely to have received fluoride treatment (46.6 percent versus 52.5 percent, P = 0.0022) and less likely to have received a dental sealant (19.5 percent versus 22.5 percent, P = 0.0147). In adjusted analysis, there was no significant difference in receiving a preventive dental visit for rural children, compared to their urban counterparts. CONCLUSIONS As preparations are made for the 2020 Surgeon General's report on oral health, the current study provides important evidence to inform future advocacy and legislative priorities. To reduce urban-rural disparities among children, there must be enhanced dental care access, dental workforce expansion, and increased awareness about preventive oral health services.
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Affiliation(s)
- Elizabeth Crouch
- Rural and Minority Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Joni Nelson
- Department of Stomatology, Division of Population Oral Health, Medical University of South Carolina, Charleston, SC, USA
| | - Melinda A Merrell
- Rural and Minority Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Amy Martin
- Department of Stomatology, Division of Population Oral Health, Medical University of South Carolina, Charleston, SC, USA
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Stull C, Freese R, Sarvas E. Parent perceptions of dental care providers' role in human papillomavirus prevention and vaccine advocacy. J Am Dent Assoc 2020; 151:560-567. [PMID: 32718485 PMCID: PMC7478858 DOI: 10.1016/j.adaj.2020.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is the most common sexually transmitted infection and is responsible for most anogenital and oropharyngeal cancers. Dental care providers can be advocates for vaccine uptake, yet little is known about patients' perceptions of the role of dental care providers in HPV education and prevention. METHODS Parents of adolescents aged 9 through 17 years were recruited from the Minnesota State Fair to survey their awareness and knowledge of the HPV vaccine. Parents were also surveyed about their attitudes toward and comfort in receiving HPV vaccination recommendations and counseling from oral health care providers. RESULTS The authors interviewed 208 parents, most of whom felt that dentists were qualified to counsel about HPV (66.4%) and its vaccination (72.6%). A lower proportion felt similarly regarding dental hygienists. Parent age and sex were not correlated with comfort levels, but education levels (P = .021) and child vaccination statuses (P > .001) were. CONCLUSIONS Parents are comfortable having discussions about HPV and the vaccine in the dental setting, especially with dentists. This may represent an additional setting where strong recommendations increase vaccine uptake. PRACTICAL IMPLICATIONS Our findings emphasize an opportunity for the dental care team to improve the patient perspective on the role of dental care providers in HPV prevention. Continuing dental education can increase providers' knowledge, comfort, and confidence in discussing HPV with parents. Parents perceiving provider comfort and confidence might be more comfortable with HPV conversations. Training in collaborative, patient-focused communication techniques, such as motivational interviewing, can improve both providers' and patients' comfort and confidence in HPV counseling from oral health care providers.
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Label-Free Electrochemical Detection of S. mutans Exploiting Commercially Fabricated Printed Circuit Board Sensing Electrodes. MICROMACHINES 2019; 10:mi10090575. [PMID: 31480295 PMCID: PMC6780749 DOI: 10.3390/mi10090575] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/04/2019] [Accepted: 07/15/2019] [Indexed: 12/23/2022]
Abstract
This paper reports for the first time printed-circuit-board (PCB)-based label-free electrochemical detection of bacteria. The demonstrated immunosensor was implemented on a PCB sensing platform which was designed and fabricated in a standard PCB manufacturing facility. Bacteria were directly captured on the PCB sensing surface using a specific, pre-immobilized antibody. Electrochemical impedance spectra (EIS) were recorded and used to extract the charge transfer resistance (Rct) value for the different bacteria concentrations under investigation. As a proof-of-concept, Streptococcus mutans (S. mutans) bacteria were quantified in a phosphate buffered saline (PBS) buffer, achieving a limit of detection of 103 CFU/mL. Therefore, the proposed biosensor is an attractive candidate for the development of a simple and robust point-of-care diagnostic platform for bacteria identification, exhibiting good sensitivity, high selectivity, and excellent reproducibility.
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Floríndez LI, Floríndez DC, Floríndez FM, Como DH, Pyatak E, Baezconde-Garbanati L, Polido JC, Cermak SA. Oral Care Experiences of Latino Parents/Caregivers with Children with Autism and with Typically Developing Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2905. [PMID: 31416123 PMCID: PMC6721061 DOI: 10.3390/ijerph16162905] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/03/2019] [Accepted: 08/09/2019] [Indexed: 12/17/2022]
Abstract
As a result of various barriers, several pediatric populations are at risk for poor oral health, including children with disabilities and children from under-represented populations, such as Latinos. To this end, this study aimed to better understand the factors that affect the oral health experiences of 32 Latino parents/caregivers from 18 families (n = 8 with a typically developing child and n = 10 with a child with Autism). Using a qualitative descriptive methodology, each family was interviewed twice. Interviews were audio-recorded, transcribed verbatim, and coded thematically to identify the individual, social, systemic, and culturally rooted factors contributing to oral health disparities in the families. The three themes that arose were "Why would I want to start trouble?": Latino parents' dissatisfaction with dental treatments, costs, and fear of the dentist and health care providers because of their ethnic minority status as key factors inhibiting receipt of dental care; "We have to put our children first": prioritizing the oral care activities of their children over their own individual oral care needs; and "We always keep baking soda around": familial and cultural influences on oral care habits. Understanding the oral health beliefs and experiences of Latino parents and caregivers of children with and without autism is critical for developing targeted prevention and intervention programs and reducing oral health disparities.
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Affiliation(s)
- Lucía I Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA.
| | | | | | - Dominique H Como
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Elizabeth Pyatak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | | | - Jose C Polido
- Division of Dentistry, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Sharon A Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
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