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Peterson DE, Stout NL, Shulman LN, Perkins J, LeMarier G, Nekhlyudov L. Gaps in Access to Medically Necessary Dental Care for Patients Living With and Beyond Cancer: We Must Do Better. J Clin Oncol 2024; 42:2495-2499. [PMID: 38630949 DOI: 10.1200/jco.24.00162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 04/19/2024] Open
Abstract
Delivery of high-quality, evidence-based oral care for those living with and beyond cancer needed!
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Affiliation(s)
- Douglas E Peterson
- Department of Oral & Maxillofacial Diagnostic Sciences, School of Dental Medicine, UConn Health, Farmington, CT
| | - Nicole L Stout
- School of Medicine, West Virginia University Cancer Institute, Morgantown, WV
- School of Public Health, West Virginia University, Morgantown, WV
| | - Lawrence N Shulman
- Center for Global Cancer Medicine, Innovation Faculty, Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Jennifer Perkins
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California San Francisco, San Francisco, CA
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2
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Khoury ZH, Ferguson A, Price JB, Sultan AS, Wang R. Responsible artificial intelligence for addressing equity in oral healthcare. FRONTIERS IN ORAL HEALTH 2024; 5:1408867. [PMID: 39092200 PMCID: PMC11291357 DOI: 10.3389/froh.2024.1408867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
Oral diseases pose a significant burden on global healthcare. While many oral conditions are preventable and manageable through regular dental office visits, a substantial portion of the population faces obstacles in accessing essential and affordable quality oral healthcare. In this mini review, we describe the issue of inequity and bias in oral healthcare and discuss various strategies to address these challenges, with an emphasis on the application of artificial intelligence (AI). Recent advances in AI technologies have led to significant performance improvements in oral healthcare. AI also holds tremendous potential for advancing equity in oral healthcare, yet its application must be approached with caution to prevent the exacerbation of inequities. The "black box" approaches of some advanced AI models raise uncertainty about their operations and decision-making processes. To this end, we discuss the use of interpretable and explainable AI techniques in enhancing transparency and trustworthiness. Those techniques, aimed at augmenting rather than replacing oral health practitioners' judgment and skills, have the potential to achieve personalized dental and oral care that is unbiased, equitable, and transparent. Overall, achieving equity in oral healthcare through the responsible use of AI requires collective efforts from all stakeholders involved in the design, implementation, regulation, and utilization of AI systems. We use the United States as an example due to its uniquely diverse population, making it an excellent model for our discussion. However, the general and responsible AI strategies suggested in this article can be applied to address equity in oral healthcare on a global level.
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Affiliation(s)
- Zaid H. Khoury
- Department of Oral Diagnostic Sciences and Research, School of Dentistry, Meharry Medical College, Nashville, TN, United States
| | - Alexys Ferguson
- Department of Oral Diagnostic Sciences and Research, School of Dentistry, Meharry Medical College, Nashville, TN, United States
| | - Jeffery B. Price
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
- Division of Artificial Intelligence Research, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Ahmed S. Sultan
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
- Division of Artificial Intelligence Research, University of Maryland School of Dentistry, Baltimore, MD, United States
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, United States
| | - Rong Wang
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, United States
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Griffith A, Chande C, Kulkarni S, Morel J, Cheng YH, Shimizu E, Cugini C, Basuray S, Kumar V. Point-of-care diagnostic devices for periodontitis - current trends and urgent need. SENSORS & DIAGNOSTICS 2024; 3:1119-1134. [PMID: 39007012 PMCID: PMC11238172 DOI: 10.1039/d3sd00317e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/16/2024] [Indexed: 07/16/2024]
Abstract
Point of care (POC) diagnostic devices provide a method for rapid accurate identification of disease through analysis of biologically relevant substances. This review focuses on the utility of POC testing for early detection of periodontitis, a critical factor in treating the disease. Accessing the oral cavity for biological sampling is less invasive when compared to other internal test sites, and oral fluids contain biomarkers indicative of periodontitis. The ease of access makes the mouth an excellent target location for the development of POC devices. In this review, accepted standards in industry by which these devices must adhere, provided by the World Health Organization such as REASSURED and CLIA, are discussed. An overview is provided for many periodontal biomarkers currently being investigated as a means of predicting periodontal disease and its progression. POC devices currently being investigated for the identification and monitoring of periodontal disease such as paper-based and lab-on-a-chip based devices are outlined. Limitations of current POC devices on the market are provided and future directions in leveraging biomarkers as an adjunctive method for oral diagnosis along with AI-based analysis systems are discussed. Here, we present the ESSENCE sensor platform, which combines a porous non-planar electrode with enhanced shear flow to achieve unprecedented sensitivity and selectivity. The combination of the ESENCE chip with an automated platform allows us to meet the WHO's ASSURED criteria. This platform promises to be an exciting POC candidate for early detection of periodontitis.
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Affiliation(s)
- Alexandra Griffith
- Department of Biomedical Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
| | - Charmi Chande
- Department of Biomedical Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
- Department of Chemical and Materials Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
| | - Sahitya Kulkarni
- Department of Biological Sciences, New Jersey Institute of Technology Newark NJ 07102 USA
| | - Josuel Morel
- Department of Biomedical Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
| | - Yu-Hsuan Cheng
- Department of Chemical and Materials Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
| | - Emi Shimizu
- Department of Endodontics, Rutgers School of Dental Medicine Newark NJ 07103 USA
- Department of Oral Biology, Rutgers School of Dental Medicine Newark NJ 07103 USA
| | - Carla Cugini
- Department of Oral Biology, Rutgers School of Dental Medicine Newark NJ 07103 USA
| | - Sagnik Basuray
- Department of Biomedical Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
- Department of Chemical and Materials Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
| | - Vivek Kumar
- Department of Biomedical Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
- Department of Chemical and Materials Engineering, New Jersey Institute of Technology Newark NJ 07102 USA
- Department of Biological Sciences, New Jersey Institute of Technology Newark NJ 07102 USA
- Department of Endodontics, Rutgers School of Dental Medicine Newark NJ 07103 USA
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4
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McComas M, Burnett K, Zhang J, Hatfield E. The dental navigator: A necessary role in academic dental health care. J Dent Educ 2024. [PMID: 38943245 DOI: 10.1002/jdd.13633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/24/2024] [Accepted: 06/01/2024] [Indexed: 07/01/2024]
Affiliation(s)
- Martha McComas
- Department of Periodontics and Oral Medicine, Division of Dental Hygiene, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Karen Burnett
- Department of Patient Services, University of Michigan, Ann Arbor, Michigan, USA
| | - Jing Zhang
- Department of Academic Affairs, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Elizabeth Hatfield
- Department of Oral and Maxillofacial Surgery, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Hung M, Patel H, Lee S, Nguyen J, Mohajeri A. The Influence of Vitamin D Levels on Dental Caries: A Retrospective Study of the United States Population. Nutrients 2024; 16:1572. [PMID: 38892506 PMCID: PMC11174693 DOI: 10.3390/nu16111572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: This study examines vitamin D's impact on dental caries to inform prevention strategies, given its critical role in bone and calcium regulation, vital for dental health. (2) Methods: Data from 18,683 participants of the National Health and Nutrition Examination Survey (NHANES) 2011-2016 were analyzed. NHANES collects U.S. population data through interviews, physical exams, and tests, including vitamin D levels and dental health assessed using both the decayed, missing, and filled teeth (DMFT) index and the presence of untreated dental caries. Vitamin D levels were measured according to serum 25(OH)D concentrations, and the analyses adjusted for confounders such as body mass index (BMI) and socioeconomic status (SES) using Chi-square, Mann-Whitney U, Kruskal-Wallis tests, as well as logistic and Poisson regression. (3) Results: This study found a mean DMFT score of 7.36 and a 33.2% prevalence of untreated dental caries. A higher caries prevalence was correlated with a lower SES (p < 0.001), the male gender (p < 0.001), and a higher BMI (p < 0.001). Severe vitamin D deficiency (<25 nmol/L) doubled the risk of dental caries, with odds ratios of 2.261 and 1.953 after adjusting for demographic factors and BMI. (4) Conclusions: Our study confirms a significant relationship between low vitamin D levels and an increased risk of dental caries nationwide, even after accounting for sociodemographic factors, emphasizing the importance of maintaining sufficient vitamin D levels for preventing caries.
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Affiliation(s)
- Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
- Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT 84108, USA
- George E. Wahlen Department, Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Himani Patel
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
| | - Samantha Lee
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
| | - Justin Nguyen
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
| | - Amir Mohajeri
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
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Stewart MP, Powers R, Litten K. Dental Extractions Associated With Reduced Insulin Requirements in an Individual Using Concentrated Insulin: A Case Study. Clin Diabetes 2024; 42:458-462. [PMID: 39015156 PMCID: PMC11247038 DOI: 10.2337/cd23-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Affiliation(s)
- Morgan P. Stewart
- Division of Pharmacy Practice, University of Texas at Austin College of Pharmacy, Austin, TX
| | | | - Kathryn Litten
- Division of Pharmacy Practice, University of Texas at Austin College of Pharmacy, Austin, TX
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Hsieh ST, Cheng YA. Multimodal feature fusion in deep learning for comprehensive dental condition classification. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2024; 32:303-321. [PMID: 38217632 DOI: 10.3233/xst-230271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND Dental health issues are on the rise, necessitating prompt and precise diagnosis. Automated dental condition classification can support this need. OBJECTIVE The study aims to evaluate the effectiveness of deep learning methods and multimodal feature fusion techniques in advancing the field of automated dental condition classification. METHODS AND MATERIALS A dataset of 11,653 clinically sourced images representing six prevalent dental conditions-caries, calculus, gingivitis, tooth discoloration, ulcers, and hypodontia-was utilized. Features were extracted using five Convolutional Neural Network (CNN) models, then fused into a matrix. Classification models were constructed using Support Vector Machines (SVM) and Naive Bayes classifiers. Evaluation metrics included accuracy, recall rate, precision, and Kappa index. RESULTS The SVM classifier integrated with feature fusion demonstrated superior performance with a Kappa index of 0.909 and accuracy of 0.925. This significantly surpassed individual CNN models such as EfficientNetB0, which achieved a Kappa of 0.814 and accuracy of 0.847. CONCLUSIONS The amalgamation of feature fusion with advanced machine learning algorithms can significantly bolster the precision and robustness of dental condition classification systems. Such a method presents a valuable tool for dental professionals, facilitating enhanced diagnostic accuracy and subsequently improved patient outcomes.
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Affiliation(s)
- Shang-Ting Hsieh
- Department of Health Beauty, Fooyin University, Kaohsiung City, Taiwan
| | - Ya-Ai Cheng
- Department of Healthcare Administration, I-Shou University, Kaohsiung City, Taiwan
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Gardner J, Huang B, Ip RHL. Oral health knowledge is associated with oral health-related quality of life: a survey of first-year undergraduate students enrolled in an American university. BMC Oral Health 2023; 23:961. [PMID: 38044424 PMCID: PMC10693701 DOI: 10.1186/s12903-023-03721-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Oral health knowledge forms part of oral health literacy that enables individuals to inform appropriate oral health decisions and actions. Oral health-related quality of life (OHRQoL) characterizes self-perception of well-being influenced by oral health. This study aimed to examine the relationship between oral health knowledge and OHRQoL. METHODS A random sample of 19-to-24-year-old first-year undergraduate students (n = 372) in Minnesota, United States of America was used. Each student was assessed with an online survey using the Comprehensive Measure of Oral Health Knowledge (CMOHK) and the OHRQoL items of the World Health Organization (WHO) Oral Health Questionnaire for Adults. Relationships between OHRQoL parameters and CMOHK together with other covariates were assessed using ordinal regression models. Associations between OHRQoL parameters were examined with the Kendall's tau-b method. RESULTS Dry mouth (45%) was the most reported OHRQoL issue. The respondents showing good oral health knowledge were less likely to experience speech or pronunciation difficulty (β=-1.12, p = 0.0006), interrupted sleep (β=-1.43, p = 0.0040), taking days off (β=-1.71, p = 0.0054), difficulty doing usual activities (β=-2.37, p = 0.0002), or reduced participation in social activities due to dental or oral issues (β=-1.65, p = 0.0078). CONCLUSIONS This study suggested a protective effect of better oral health knowledge on specific OHRQoL issues. In addition to provision of affordable dental services, university-wide oral health education can be implemented to improve OHRQoL in undergraduate students.
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Affiliation(s)
- Jenna Gardner
- School of Dentistry, University of Minnesota Twin Cities, 515 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Boyen Huang
- School of Dentistry, University of Minnesota Twin Cities, 515 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Ryan H L Ip
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, Australia
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Burgette JM, Peralta E, Chew C, Watson KI, D’Alesio AM, Rosen D. Infant Oral Health Education Curriculum for Medical, Nursing, and Social Work Trainees. JOURNAL OF INTERPROFESSIONAL EDUCATION & PRACTICE 2023; 33:100682. [PMID: 38053817 PMCID: PMC10695352 DOI: 10.1016/j.xjep.2023.100682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Tooth decay is the most common chronic disease in children, and children often see their primary care practitioners more frequently than dentists (Adjaye-Gbewonyo and Black 2019-2020; National Center for Health Statistics 2019-2020). This Infant Oral Health Education Program included two online training sessions for trainees in social work, nursing, medicine, and dentistry. Trainees were assessed on anticipated changes to their practice related to children's oral health. During the first training session, trainees received a lecture on infant oral health, and then discussed a case study in interprofessional groups to reinforce the content. Trainees in medicine and nursing completed training to receive Medicaid reimbursement for performing preventive oral health services. The second training session was profession specific with tailored instructions in the form of videos, as well as a demonstration on fluoride varnish application. Of the 78 trainees (22 social work, 4 pediatric nurse practitioner, 38 pediatric medicine residents, and 14 pediatric dentistry residents), 91% (n=70) reported that they were introduced to at least one new health information resource or tool. Four-fifths of the eligible trainees (n=16/20, 80%) who completed the evaluation had fulfilled the State's requirements to receive Medicaid reimbursement for performing preventive oral health services. Three-fourths of trainees (n=22/29, 75%) reported that they are likely to promote children's oral health in future clinical practice. Trainees from all four professions provided positive feedback about the content.
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Affiliation(s)
- Jacqueline M. Burgette
- Departments of Dental Public Health and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15213, USA
| | - Emyli Peralta
- University of Pittsburgh, School of Dental Medicine, 3501 Terrace St, Pittsburgh, PA 15213, USA
| | - Cynthia Chew
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, 3500 Victoria St, Pittsburgh, PA 15213, USA
| | - Katherine I. Watson
- Division of General Academic Pediatrics, UPMC Children’s Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224, USA
| | - Alene M. D’Alesio
- Division Chief of Pediatric Dentistry UPMC Children’s Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224, USA
| | - Daniel Rosen
- School of Social Work, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA
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Chung J, Chen X, Zhang N, Zhou Y. Oral conditions and other symptoms among older persons in long-term care facilities during the end of life. SPECIAL CARE IN DENTISTRY 2023; 43:530-538. [PMID: 36446555 DOI: 10.1111/scd.12805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/02/2022]
Abstract
AIMS The purpose was to examine the association between oral conditions and other symptoms in long-term care facilities during the last days of life. METHODS A retrospective case-control study approach was used in this study, with the Minimum Data Set (MDS, ver. 3.0 2015) that was maintained and administrated by the Centers for Medicare and Medicaid Services (CMS). Residents with oral conditions (n = 4304) were selected with any oral conditions (e.g., ulcers, inflamed/bleeding gums, mouth/facial pain). The control cases (n = 12 912) were selected using propensity analysis. RESULTS Oral conditions had significant impacts on depression, poor appetite, pain, shortness of breath, and constipation. Although no statistically significant differences in trouble sleeping, vomiting, internal bleeding, and dehydration were found between the cases with oral conditions and the control, more residents with oral conditions reported trouble sleeping and dehydration compared to the control. CONCLUSIONS It is important to provide preventive and proactive intervention for oral conditions, not only to minimize the negative effects of oral conditions on other symptoms in long-term care facilities, but also to share philanthropic support with people who might be suffering other symptoms due to oral conditions at the end of life.
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Affiliation(s)
- Joohyun Chung
- University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Xi Chen
- University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Ning Zhang
- Northeastern University, Boston, Massachusetts, USA
| | - Yanhua Zhou
- University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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11
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Johnsen DC, Marchini L, Ettinger RL. How can dental research deliver better outcomes to frail older adults? Essay on considerations. SPECIAL CARE IN DENTISTRY 2023; 43:375-379. [PMID: 36715103 DOI: 10.1111/scd.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 01/31/2023]
Affiliation(s)
- David C Johnsen
- Department of Pediatric Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Leonardo Marchini
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
| | - Ronald L Ettinger
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
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12
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Verma A, Priyank H, P R, Kumari M, Sayed Abdul N, Shivakumar S. A Systematic Review and Meta-Analysis on Oral Health Disparities Among the Indigenous Paediatric Population. Cureus 2023; 15:e41673. [PMID: 37575701 PMCID: PMC10412898 DOI: 10.7759/cureus.41673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
There is a knowledge gap in the literature regarding oral health disparities (OHD) in minority and indigenous (IG) paediatric cohorts that needs to be addressed. Disparities in oral health among children are a pressing concern, highlighting inequities in access to dental care and meeting needs. The current systematic review aims to provide a comprehensive synthesis of the prevailing understanding of OHD in the minority and IG strata. A meticulous search strategy was formulated by a team of reviewers to identify pertinent studies from databases of PubMed, MEDLINE, Scopus, Google Scholar and EMBASE. Data extraction and article selection strictly adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Newcastle-Ottawa Scale (NOS) was employed to evaluate the methodological quality of the studies included. Review Manager version 5.4 was used to synthesise quantitative data. A total of five cross-sectional studies were included in the final analysis. The findings consistently demonstrated the existence of racial and socioeconomic disparities in oral health across varying age groups and geographical locations in the defined population. Significant disparities in oral health outcomes were observed between IG and non-IG populations, with IG and minority groups exhibiting a heightened vulnerability to oral health challenges. Through a meta-analysis of the compiled data, a statistically significant association was established between children (being a member of a minority group) and unmet oral health needs. Socioeconomic status (SES) and maternal education were factors that showed a significant impact on oral health disparity. All studies were graded to be of the low-risk category based on the NOS risk of bias tool. This review successfully identified several influential factors contributing to oral health disparities, such as cultural practices, dietary patterns and access to oral healthcare services. Additionally, discernible differences in oral health status were evident between IG and non-IG children, with IG children enduring a greater burden of oral health difficulties. These findings underscore the imperative for targeted interventions and policy measures aimed at addressing the specific oral health needs of minority and IG paediatric populations, with the overarching goal of mitigating the existing disparities.
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Affiliation(s)
- Ankita Verma
- Department of Pedodontics and Preventive Dentistry, Hazaribag College of Dental Sciences and Hospital, Ranchi, IND
| | - Harsh Priyank
- Department of Conservative, Endodontics and Aesthetic Dentistry, Dental Institute Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Renuka P
- Department of Pedodontics and Preventive Dentistry, Government Dental College, Dibrugarh, IND
| | - Minti Kumari
- Department of Public Health Dentistry, Patna Dental College and Hospital, Patna, IND
| | - Nishath Sayed Abdul
- Department of Oral Pathology, College of Dentistry, Oral Diagnostic Sciences, Riyadh Elm University, Riyadh, SAU
| | - Sahana Shivakumar
- Department of Public Health Dentistry, People's College of Dental Science and Research Center, Bhopal, IND
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13
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Semprini J, Williams JC. Community socioeconomic status and rural/racial disparities in HPV-/+ head and neck cancer. Tech Innov Patient Support Radiat Oncol 2023; 26:100205. [PMID: 36974082 PMCID: PMC10038787 DOI: 10.1016/j.tipsro.2023.100205] [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: 10/20/2022] [Revised: 03/01/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Background Head and Neck Cancer (HNC) is a major cause of cancer morbidity and mortality in the United States, but the burden is not evenly distributed. Rural and racial disparities are obvious across the HNC continuum. Most HNC disparities research have emphasized individual factors perpetuating rural and racial disparities, ignoring the role of community-level factors. Methods We analyzed data from the Surveillance Epidemiology and End Results (SEER) program's "Specialized HNC-Human Papillomavirus (HPV) Census-Tract SES" datafile (2010-2016). In addition to cancer patient characteristics, this data includes a socioeconomic status (SES) quintile based on the patient's census-tract. Our outcome variables included whether the HNC patient 1) was diagnosed at a distant stage, 2) received initial treatment two or more months after diagnosis, 3) received radiation therapy, 4) survived two years after diagnosis. We tested for differences across SES quintiles, in the full sample and then within rural/racial categories. We then tested for differences between each rural/racial category conditional on SES quintile. Results For both HPV(-) and HPV + HNCs, patients in higher SES census-tracts have 8-10% lower rates of distant stage diagnoses and delayed treatment initiation, and 12.0-14.5% higher survival rates than patients in lower SES census-tracts. Radiation treatment only varied across SES quintiles in HPV + HNC patients. We find little evidence of rural-urban differences within each socioeconomic quintile. However, within lower SES quintiles, we found significant racial disparities in delayed detection and treatment. These differences were largest in the lowest SES quintile, as non-Hispanic Black patients reported 10-11% higher rates of delayed detection and treatment initiation than non-Hispanic White patients. Conclusions Our research illustrates the value and constraints in leveraging community-level factors in health disparities research that can ultimately assist in designing effective policies that address and achieve rural and racial cancer equity.
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Affiliation(s)
- Jason Semprini
- University of Iowa College of Public Health, United States
- Corresponding author at: 145 N. Riverside Dr. N277, Iowa City, IA 52240, United States.
| | - Jessica C. Williams
- University of Boston School Henry M. Goldman School of Dental Medicine, United States
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Walkup TN, Winburn AP, Stock M. Antemortem tooth loss as a biomarker of poverty: Dental evidence of "weathering" in a contemporary U.S. skeletal sample. Forensic Sci Int Synerg 2023; 6:100333. [PMID: 37313393 PMCID: PMC10258239 DOI: 10.1016/j.fsisyn.2023.100333] [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: 12/22/2022] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 06/15/2023]
Abstract
In societies where resources are unequally distributed, structural inequities can be physically embodied over lifetimes. Lived experiences including racism, sexism, classism, and poverty can lead to chronic stress that prematurely ages body systems. This study tests the hypothesis that members of structurally vulnerable groups will exhibit premature aging in the form of antemortem tooth loss (AMTL). Analyzing Black, Indigenous, and People of Color (BIPOC) and white skeletal donors from the University of Tennessee, we predict that individuals from structurally vulnerable groups will exhibit more AMTL than individuals with more social privilege. We find some evidence for increased AMTL in BIPOC individuals, but significantly more AMTL in low-socioeconomic-status white individuals than either BIPOC or high-SES white individuals. We maintain that high rates of AMTL provide evidence of embodied consequences of social policies and utilize the violence continuum to theorize the ways in which poverty and inequity are normalized in U.S. society.
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Affiliation(s)
- Taylor Nicole Walkup
- University of Tennessee Department of Anthropology, 1621 Cumberland Avenue Strong Hall, Knoxville, TN, 37996, USA
| | - Allysha Powanda Winburn
- University of West Florida Department of Anthropology, 11000 University Parkway Building 13, Pensacola, FL, 32514, USA
| | - Michala Stock
- Metroplitan State University of Denver Department of Sociology and Anthropology, Campus Box 28, P.O. Box 173362, Denver, CO, 80217, USA
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15
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Costa SA, Ribeiro CCC, Leite FRM, Peres MA, Souza SDFC, Nascimento GG. Chronic oral diseases burden: The confluence of caries and periodontitis throughout life. J Clin Periodontol 2023; 50:452-462. [PMID: 36549902 DOI: 10.1111/jcpe.13761] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
AIM To investigate the confluence of caries and periodontitis indicators from adolescence to elderhood among Americans. MATERIALS AND METHODS This cross-sectional study explored the grouping among a set of caries and periodontitis indicators (the proportion of sites with bleeding on probing, moderate probing pocket depth [PPD, 4-5 mm], severe PPD [≥6 mm], moderate clinical attachment level [CAL, 3-4 mm], severe CAL [≥5 mm], number of teeth with furcation involvement, number of decayed teeth, number of teeth with pulp involvement, and the number of missing teeth) in 14,421 Americans from the NHANES III study. Exploratory factorial analysis was used to determine the constructs between those indicators (factorial loading ≥0.3). These analyses were stratified by age and confirmed with a confirmatory factorial analysis. We also performed a sensitivity analysis using the NHANES 2011-2014. RESULTS Two constructs were extracted. The first, Chronic Oral Diseases Burden, grouped caries indicators with moderate PPD and moderate CAL for the youngest subjects (13-39 years old), while for the subjects over 50 years, the Chronic Oral Disease Burden grouped caries indicators with severe CAL and PPD and furcation involvement. The second construct, Periodontal Destruction, grouped only periodontitis indicators. CONCLUSIONS Caries and periodontitis indicators grouped consistently across the different age ranges in lapse times of 25 years.
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Affiliation(s)
- Susilena Arouche Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Cecilia Claudia Costa Ribeiro
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Fábio Renato Manzolli Leite
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
| | | | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
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16
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Spencer P, Ye Q, Misra A, Chandler JR, Cobb CM, Tamerler C. Engineering peptide-polymer hybrids for targeted repair and protection of cervical lesions. FRONTIERS IN DENTAL MEDICINE 2022; 3. [PMID: 37153688 PMCID: PMC10162700 DOI: 10.3389/fdmed.2022.1007753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
By 2060, nearly 100 million people in the U.S. will be over age 65 years. One-third of these older adults will have root caries, and nearly 80% will have dental erosion. These conditions can cause pain and loss of tooth structure that interfere with eating, speaking, sleeping, and quality of life. Current treatments for root caries and dental erosion have produced unreliable results. For example, the glass-ionomer-cement or composite-resin restorations used to treat these lesions have annual failure rates of 44% and 17%, respectively. These limitations and the pressing need to treat these conditions in the aging population are driving a focus on microinvasive strategies, such as sealants and varnishes. Sealants can inhibit caries on coronal surfaces, but they are ineffective for root caries. For healthy, functionally independent elders, chlorhexidine varnish applied every 3 months inhibits root caries, but this bitter-tasting varnish stains the teeth. Fluoride gel inhibits root caries, but requires prescriptions and daily use, which may not be feasible for some older patients. Silver diamine fluoride can both arrest and inhibit root caries but stains the treated tooth surface black. The limitations of current approaches and high prevalence of root caries and dental erosion in the aging population create an urgent need for microinvasive therapies that can: (a) remineralize damaged dentin; (b) inhibit bacterial activity; and (c) provide durable protection for the root surface. Since cavitated and non-cavitated root lesions are difficult to distinguish, optimal approaches will treat both. This review will explore the multi-factorial elements that contribute to root surface lesions and discuss a multi-pronged strategy to both repair and protect root surfaces. The strategy integrates engineered peptides, novel polymer chemistry, multi-scale structure/property characterization and predictive modeling to develop a durable, microinvasive treatment for root surface lesions.
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