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Craquelin M, Marquillier T. Advanced practise dental assistant, a new profession in France, the new strength of prevention? Int J Dent Hyg 2024; 22:337-338. [PMID: 38394058 DOI: 10.1111/idh.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/12/2023] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Affiliation(s)
- Marie Craquelin
- Department of Pediatric Dentistry, School of Dentistry, CHU of Lille, University of Lille, Lille, France
- Laboratoire Éducations et Promotion de Santé, LEPS, UR 3412, Sorbonne Paris Nord University, Bobigny, France
| | - Thomas Marquillier
- Department of Pediatric Dentistry, School of Dentistry, CHU of Lille, University of Lille, Lille, France
- Laboratoire Éducations et Promotion de Santé, LEPS, UR 3412, Sorbonne Paris Nord University, Bobigny, France
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2
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Patro SK. Editorial: Integration of oral health care within the healthcare system. FRONTIERS IN ORAL HEALTH 2024; 5:1387141. [PMID: 38562402 PMCID: PMC10982479 DOI: 10.3389/froh.2024.1387141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- Sourabha K. Patro
- Department of Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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3
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Abstract
Oral health is an integral part of the overall health of children. Dental caries is a common and chronic disease process with significant short- and long-term consequences. The prevalence of dental caries remains greater than 40% among children 2 to 19 years of age. Although dental visits have increased in all age, race, and geographic categories in the United States, disparities continue to exist, and a significant portion of children have difficulty accessing dental care. As health care professionals responsible for the overall health of children, pediatricians frequently confront morbidity associated with dental caries. Because the youngest children visit the pediatrician more often than they visit the dentist, it is important that pediatricians be knowledgeable about the disease process of dental caries, prevention of disease, interventions to maintain and restore health, and the social determinants of children's oral health.
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Affiliation(s)
- David M Krol
- Medical Director, Connecticut Children's Care Network.,Medical Director, Care Integration, Connecticut Children's, Hartford, Connecticut
| | - Kaitlin Whelan
- Peak Pediatrics, Thornton Colorado.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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4
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Hackenberg B, Schlich MN, Gouveris H, Seifen C, Matthias C, Campus G, Wolf TG, Muthuraman M, Deschner J. Medical and Dental Students' Perception of Interdisciplinary Knowledge, Teaching Content, and Interprofessional Status at a German University: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:428. [PMID: 36612750 PMCID: PMC9819460 DOI: 10.3390/ijerph20010428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Although oral health is considered a key indicator of overall health, dentistry is still neglected in medical education at the university level. Interprofessional education (IPE) is an important tool to promote collaboration among health care providers and to reduce barriers to access in health care. In this cross-sectional study, medical and dental students at Mainz University, Germany, were surveyed regarding their perception of interdisciplinary knowledge, teaching content, interprofessional standing, and attitudes toward IPE. Spearman's rank correlation was used to identify associated statements. Structural equation modeling (SEM) was performed to understand how sex, study progress, and prior education might influence student attitudes. In total, 426 medical students and 211 dental students were included in the study. Dental students rated their interdisciplinary knowledge higher than medical students. The relevance of IPE as assessed by the students correlated significantly with their motivation to continue IPE after graduation. Both groups of students valued the other discipline but rejected a combined graduate program. Students with prior professional training valued the synergy of medicine and dentistry more the students without prior training. Interprofessional knowledge and interest in IPE was higher among dental students. Understanding students' attitudes toward IPE is an important prerequisite for adapting university curricula to strengthen students' attitudes and motivation.
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Affiliation(s)
- Berit Hackenberg
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Maximilian-Niclas Schlich
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Haralampos Gouveris
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Christopher Seifen
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Christoph Matthias
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, 07100 Sassari, Italy
| | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Muthuraman Muthuraman
- Neural Engineering with Signal Analytics and Artificial Intelligence (NESA-AI), Department of Neurology, University Clinic Würzburg, 97080 Würzburg, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
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5
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Atchison KA, Fellows JL, Inge RE, Valachovic RW. The Changing Face of Dentistry: Perspectives on Trends in Practice Structure and Organization. JDR Clin Trans Res 2022; 7:25S-30S. [PMID: 36121137 DOI: 10.1177/23800844221116836] [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: 11/15/2022] Open
Abstract
KNOWLEDGE TRANSFER STATEMENT This perspective is intended to stimulate thoughts by clinicians, researchers, and educators about needed trends to the dental profession. With consideration of changes needed within the dental profession, improvements and implementation of diagnostic coding and value-based care could result in improved oral health for numerous Americans.
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Affiliation(s)
- K A Atchison
- School of Dentistry and Fielding School of Public Health, University of California, Los Angeles, CA USA
| | - J L Fellows
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - R E Inge
- Delta Dental of Missouri, St. Louis, MO, USA
| | - R W Valachovic
- Center for Oral Health Policy and Management, New York University College of Dentistry, New York, NY, USA
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6
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Wang S, Yuan J, Pan C. Impact of big data resources on clinicians’ activation of prior medical knowledge. Heliyon 2022; 8:e10312. [PMID: 36105474 PMCID: PMC9465108 DOI: 10.1016/j.heliyon.2022.e10312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/10/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background Activating prior medical knowledge in diagnosis and treatment is an important basis for clinicians to improve their care ability. However, it has not been systematically explained whether and how various big data resources affect the activation of prior knowledge in the big data environment faced by clinicians. Objective The aim of this study is to contribute to a better understanding on how the activation of prior knowledge of clinicians is affected by a wide range of shared and private big data resources, to reveal the impact of big data resources on clinical competence and professional development of clinicians. Method Through the comprehensive analysis of extant research results, big data resources are classified as big data itself, big data technology and big data services at the public and institutional levels. A survey was conducted on clinicians and IT personnel in Chinese hospitals. A total of 616 surveys are completed, involving 308 medical institutions. Each medical institution includes a clinician and an IT personnel. SmartPLS version 2.0 software package was used to test the direct impact of big data resources on the activation of prior knowledge. We further analyze their indirect impact of those big data resources without direct impact. Results (1) Big data quality environment at the institutional level and the big data sharing environment at the public level directly affect activation of prior medical knowledge; (2) Big data service environment at the institutional level directly affects activation of prior medical knowledge; (3) Big data deployment environment at the institutional level and big data service environment at the public level have no direct impact on activation of prior knowledge of clinicians, but they have an indirect impact through big data quality environment and service environment at the institutional level and the big data sharing environment at the public level. Conclusions Big data technology, big data itself and big data service at the public level and institutional level interact and influence each other to activate prior medical knowledge. This study highlights the implications of big data resources on improvement of clinicians’ diagnosis and treatment ability.
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Affiliation(s)
- Sufen Wang
- Glorious Sun School of Business and Management, DongHua University, Shanghai, China
| | - Junyi Yuan
- Information Center, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
- Corresponding author.
| | - Changqing Pan
- Hospital's Office, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
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7
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Yuan J, Wang S, Pan C. Mechanism of Impact of Big Data Resources on Medical Collaborative Networks From the Perspective of Transaction Efficiency of Medical Services: Survey Study. J Med Internet Res 2022; 24:e32776. [PMID: 35318187 PMCID: PMC9073602 DOI: 10.2196/32776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/16/2022] [Accepted: 03/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background The application of big data resources and the development of medical collaborative networks (MCNs) boost each other. However, MCNs are often assumed to be exogenous. How big data resources affect the emergence, development, and evolution of endogenous MCNs has not been well explained. Objective This study aimed to explore and understand the influence of the mechanism of a wide range of shared and private big data resources on the transaction efficiency of medical services to reveal the impact of big data resources on the emergence and development of endogenous MCNs. Methods This study was conducted by administering a survey questionnaire to information technology staff and medical staff from 132 medical institutions in China. Data from information technology staff and medical staff were integrated. Structural equation modeling was used to test the direct impact of big data resources on transaction efficiency of medical services. For those big data resources that had no direct impact, we analyzed their indirect impact. Results Sharing of diagnosis and treatment data (β=.222; P=.03) and sharing of medical research data (β=.289; P=.04) at the network level (as big data itself) positively directly affected the transaction efficiency of medical services. Network protection of the external link systems (β=.271; P=.008) at the level of medical institutions (as big data technology) positively directly affected the transaction efficiency of medical services. Encryption security of web-based data (as big data technology) at the level of medical institutions, medical service capacity available for external use, real-time data of diagnosis and treatment services (as big data itself) at the level of medical institutions, and policies and regulations at the network level indirectly affected the transaction efficiency through network protection of the external link systems at the level of medical institutions. Conclusions This study found that big data technology, big data itself, and policy at the network and organizational levels interact with, and influence, each other to form the transaction efficiency of medical services. On the basis of the theory of neoclassical economics, the study highlighted the implications of big data resources for the emergence and development of endogenous MCNs.
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Affiliation(s)
- Junyi Yuan
- Information Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Sufen Wang
- Department of Management Science and Engineering, Glorious Sun School of Business & Management, Donghua University, Shanghai, China
| | - Changqing Pan
- Hospital's Office, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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8
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Burgette JM, Ok SH, Ray KN, Faulds S, Stiles A, Hoberman A, Martin B. Race and payor type for child visits with public health dental hygienist practitioners. J Public Health Dent 2021; 82:53-60. [PMID: 34378198 DOI: 10.1111/jphd.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/12/2021] [Accepted: 07/29/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine whether growth in visits to public health dental hygiene practitioners (PHDHPs) providing preventative dental services at a pediatric hospital clinic was predominantly among children receiving public insurance and children of minority background from 2013 to 2017. METHODS Longitudinal descriptive data analysis from electronic health records for 6856 children under age 18 years who visited PHDHPs co-located at a hospital clinic in Pittsburgh, PA, from 2013 to 2017. We compared visits between white versus non-white children and between children with public, private, and no or missing insurance by year. RESULTS Visit volume doubled from 2013 (n = 811) to 2017 (n = 1868). The proportion of PHDHP visits with non-white children increased from 77% (n = 625) in 2013 to 87% (n = 1472) in 2017 (p < 0.001). The proportion of PHDHP visits with children with public insurance increased from 72% (n = 585) in 2013 to 82% (n = 1377) in 2017 (p < 0.001). CONCLUSIONS PHDHPs co-located at a pediatric hospital clinic saw a high proportion of visits from children of non-white race and with public insurance. Visits from children of minority race and with public insurance increased disproportionately as visit volume grew from 2013 to 2017, depicting a vehicle through which historically underserved children increasingly accessed preventive dental services.
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Affiliation(s)
- Jacqueline M Burgette
- Departments of Dental Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sally H Ok
- Department of Pediatric Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Kristin N Ray
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,General Academic Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Samantha Faulds
- General Academic Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Amy Stiles
- Division of Pediatric Dentistry, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Alejandro Hoberman
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,General Academic Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian Martin
- Division of Pediatric Dentistry, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.,Medical Affairs, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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9
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Gupta A, Akiya K, Glickman R, Silver D, Pagán JA. How Patient-Centered Medical Homes Integrate Dental Services Into Primary Care: A Scoping Review. Med Care Res Rev 2021; 79:487-499. [PMID: 34238063 DOI: 10.1177/10775587211030376] [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: 11/16/2022]
Abstract
Integrated care delivery is at the core of patient-centered medical homes (PCMHs). The extent of integration of dental services in PCMHs for adults is largely unknown. We first identified dental-medical integrating processes from the literature and then conducted a scoping review using PRISMA guidelines to evaluate their implementation among PCMHs. Processes were categorized into workforce, information-sharing, evidence-based care, and measuring and monitoring. After screening, 16 articles describing 21 PCMHs fulfilled the inclusion criteria. Overall, the implementation of integrating processes was limited. Less than half of the PCMHs reported processes for information exchange across medical and dental teams, referral tracking, and standardized protocols for oral health assessments by medical providers. Results highlight significant gaps in current implementation of adult dental integration in PCMHs, despite an increasing policy-level recognition of and support for dental-medical integration in primary care. Understanding and addressing associated barriers is important to achieve comprehensive patient-centered primary care.
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Tiwari T, Marinucci J, Tranby EP, Frantsve-Hawley J. The Effect of Well Child Visit Location on Preventative Dental Visit. CHILDREN (BASEL, SWITZERLAND) 2021; 8:191. [PMID: 33802576 PMCID: PMC8000138 DOI: 10.3390/children8030191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 01/23/2023]
Abstract
Recent emphasis has been placed on the integration of dental and medical primary care in an effort to promote recommendations from both American Academy of Pediatrics (AAP) and American Academy of Pediatric Dentistry (AAPD) that highlight the importance of preventing, intervening, and managing oral disease in childhood. The study aims to provide a population level insight into the role of location of service of medical well-child visit (WCV) and its association to preventative dental visit (PDV) for children between the ages of 0-20 years. Administrative claims data for 3.17 million Medicaid-enrolled children aged 0 to 20 years of age in 13 states in 2016 and 2017 were identified from the IBM Watson MarketScan Medicaid Database. Descriptive and survival analysis reveals most Medicaid enrolled children receive their WCV at an office and hospital, as compared to federally qualified health center, or rural or public health clinic. Further, this study demonstrates increased utilization of dental preventive services for children who receive a WCV. Hispanic children, female children, and children 5-9 years of age had a higher rate of PDV after a WCV at all three locations. This study contributes to the understanding of medical-dental integration among Medicaid-enrolled children and offers insight into the promotion of oral health prevention within medical primary care.
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Affiliation(s)
- Tamanna Tiwari
- Department of Community Dentistry and Population Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - Eric P. Tranby
- DentaQuest Partnership for Oral Health Advancement, Boston, MA 02129, USA; (E.P.T.); (J.F.-H.)
| | - Julie Frantsve-Hawley
- DentaQuest Partnership for Oral Health Advancement, Boston, MA 02129, USA; (E.P.T.); (J.F.-H.)
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11
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Improvement of the Working Environment and Daily Work-Related Tasks of Dental Hygienists Working in Private Dental Offices from the Japan Dental Hygienists' Association Survey 2019. Dent J (Basel) 2021; 9:dj9020022. [PMID: 33669903 PMCID: PMC7923276 DOI: 10.3390/dj9020022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/18/2022] Open
Abstract
A dental hygienist performs various daily work-related tasks. The aim of this study was to elucidate the daily work-related tasks of Japanese dental hygienists and construct groups to understand the relationships between daily work-related tasks, the attractiveness of dental hygienist work, and the improvement of the working environment. The Japan Dental Hygienists’ Association has conducted a postal survey on the employment status of dental hygienists in Japan every five years since 1981. The data on the implementation of 74 daily work-related tasks in dental offices were analyzed from the survey carried out in 2019. The questionnaires were distributed to 16,722 dental hygienists and 8932 were returned (collection rate: 53.4%). The 3796 dental hygienists working at dental clinics were clearly classified into nine groups. Full-time workers requested a reduced workload. Part-time workers requested better treatment rather than reducing the workload. Salary and human relationships were common problems with the working environment. Full-time workers felt that job security was an attractive feature of the dental hygienist role. The data presented in this study may help with the improvement of working conditions for dental hygienists.
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12
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Meyer BD, Danesh DO. The Impact of COVID-19 on Preventive Oral Health Care During Wave One. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.636766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Early childhood caries burdens children, their families, and the health care system. Utilizing fluoride varnish at medical well-child visits with non-dental primary care providers can be an interprofessional strategy to combat early childhood caries. The COVID-19 pandemic dramatically altered preventive health care delivery and the effects on preventive oral health care delivery have not been previously described.Methods: This analysis used descriptive statistics and non-parametric Wilcoxon Mann-Whitney tests to compare preventive oral health utilization among 1 to 5-year old children in two state Medicaid agencies before and during the pandemic. Fluoride utilization rates at dental visits and medical well-child visits were calculated as number of users per 1,000 enrolled children. Additionally, the proportion of well-child visits that included fluoride application was calculated for each state.Results: During the pandemic, the quarterly fluoride utilization rate significantly decreased at dental visits (pre-pandemic = 153.5 per 1,000 enrolled children; pandemic = 36.1 per 1,000 enrolled children, p < 0.001) and signficantly decreased at medical well-child visits (pre-pandemic = 72.2 per 1,000 enrolled children; pandemic = 32.3 per 1,000 enrolled children, p = 0.03) during the pandemic.Conclusions: The findings highlight the importance of interprofessional collaboration among non-dental primary care providers and dental providers to provide access to preventive oral health services, particularly when access to dentists is limited. Future directions might include rigorous evaluations of co-located medical and dental services or the use of interprofessional telehealth technologies.
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Pourat N, Martinez AE, Haley LA, Crall JJ. Colocation Does Not Equal Integration: Identifying and Measuring Best Practices in Primary Care Integration of Children's Oral Health Services in Health Centers. J Evid Based Dent Pract 2020; 20:101469. [PMID: 33303098 DOI: 10.1016/j.jebdp.2020.101469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/22/2020] [Accepted: 06/20/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Improving oral health of low-income and uninsured young children remains challenging because of reluctance of general dentists to care for very young children or participate in Medicaid, limited involvement of primary care providers in children's oral health, and lack of parental awareness of the importance of early oral health care. These barriers can be addressed in health centers (HCs) that are the premier sources of primary care for low-income and uninsured populations and a significant Medicaid provider. Many HCs provide dental services on-site, but literature indicates that medical and dental services often remain siloed with limited interaction among providers in addressing the oral health needs of young patients including risk assessment, education, and caries prevention. Accordingly, we developed a conceptual framework and measuring tool for medical dental integration and sought to examine utility of this tool in a purposive sample of HCs. METHOD We developed a conceptual framework for integrated oral health delivery and designed a survey to measure this integration. We surveyed 12 HCs in Los Angeles County participating in a project to improve oral health-care capacity for young children after 2 years of implementation. We included measures of risk assessment, preventive interventions, communication and collaborative practice, and buy-in organized in structure and process domains. Two individuals independently scored the responses, and a third reviewed and finalized. We standardized final scores to range from 0 to 100. RESULTS Overall integration scores ranged from 31% to 73% (mean = 64%). Process scores were higher than structure scores for nearly all HCs. Processes contributing to higher scores included referrals with warm hand-offs, leadership support for medical-dental integration, and involvement in dental quality improvement projects. Structure factors contributing to higher scores included the presence of medical oral health champions, linked electronic health records, and referral protocols. CONCLUSION We found that high levels of integration could be achieved despite structure and process limitations and sustainable integration depends on leadership and provider commitment and embedding of best practices in daily operations. Further research can illustrate the reliability of our tool and the impact of integration on access.
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Affiliation(s)
- Nadereh Pourat
- UCLA Center for Health Policy Research, University of California, Los Angeles, Los Angeles, CA, USA; UCLA School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Ana E Martinez
- UCLA Center for Health Policy Research, University of California, Los Angeles, Los Angeles, CA, USA
| | - Leigh Ann Haley
- UCLA Center for Health Policy Research, University of California, Los Angeles, Los Angeles, CA, USA
| | - James J Crall
- UCLA School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
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Hachey S, Clovis J, Lamarche K. Children's Oral Health and Barriers to Seeking Care: Perspectives of Caregivers Seeking Pediatric Hospital Dental Treatment. ACTA ACUST UNITED AC 2020; 15:29-39. [PMID: 31629454 PMCID: PMC7008694 DOI: 10.12927/hcpol.2019.25940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To investigate the demographics of children (and their caregivers) requiring hospital-based tertiary dental care, oral health services use and perceptions of and barriers to oral healthcare in Nova Scotia. Method: A questionnaire was administered to caregivers (N = 62) on behalf of their child (N = 62). Results: Nearly half (45.8%, N = 27) of the caregivers experienced difficulty seeking oral healthcare for both themselves and their children. Less than a quarter (23.2%, N = 13) of the caregivers sought care for their child by the recommended age of one (mean age of first visit = 2.69 years). Alternate delivery in a school, community or primary healthcare setting was preferred by 53.3% (n = 32) of the caregivers for children's oral healthcare. Low-income families (53.8%, n = 28), rural areas (47.4%, n = 27) and Indigenous children (9.7%, n = 6) were over-represented in the study's sample. Conclusion: Socio-economically disadvantaged populations are more vulnerable to oral diseases. Oral health of priority populations in Nova Scotia appears to be inadequately addressed.
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Affiliation(s)
- Shauna Hachey
- Assistant Professor, School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, NS
| | - Joanne Clovis
- Professor Emeritus, School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, NS
| | - Kimberley Lamarche
- Associate Professor, Faculty of Health Disciplines, Athabasca University, Athabasca, AB
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15
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Chi DL, Kateeb ET. Factors influencing dentists' willingness to treat Medicaid-enrolled adolescents. J Public Health Dent 2020; 81:42-49. [PMID: 32893888 DOI: 10.1111/jphd.12391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To identify factors influencing dentists' willingness to treat Medicaid-enrolled adolescents with intellectual and developmental disabilities in Washington state. DATA SOURCES Primary data were collected by a survey instrument administered in 2017 to general and pediatric dentists who were Medicaid providers (N = 512). METHODS We administered a 40-item survey, which included 20 hypothetical scenarios involving a 12-year-old Medicaid-enrolled adolescent. Based on the characteristics of the potential patient, dentists were asked to rate their willingness to treat (1 = very likely; 5 = very unlikely). We used conjoint analytic techniques to examine the relative importance of six adolescent- and family-level factors (e.g., severity of intellectual and/or developmental disability [IDD], sugar intake, toothbrushing, caregiver beliefs about fluoride, restorative needs, appointment keeping) and state Medicaid reimbursement level (35 percent, 55 percent, 85 percent of usual, customary, and reasonable amount). Analyses focused on data from 178 dentists with complete and varied responses to the scenarios. RESULTS The mean age of participants was 53.8 ± 10.5 years and 10.7 percent were pediatric dentists. The holdouts correlation statistics indicated excellent fit for the conjoint model (Pearson's R = 0.99, P < 0.0001; Kendall's tau = 0.89, P < 0.0001). Reimbursement level and appointment keeping were the most important factors in dentists' willingness to treat Medicaid-enrolled adolescents (importance scores of 26.7 and 25.7, respectively). Restorative needs, caregiver beliefs about fluoride, and IDD severity were the next most important (importance scores of 15.4, 10.6, and 8.1, respectively). Sugar intake and toothbrushing behaviors were the least important. CONCLUSIONS Reimbursement and appointment keeping were the most important determinants of dentists' willingness to treat Medicaid-enrolled adolescents with IDD.
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Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, WA, USA.,Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Elham T Kateeb
- Oral Health Research and Promotion Unit, Al-Quds University School of Dentistry, East Jerusalem, State of Palestine
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Fisher-Owens SA. The Interprofessional Role in Dental Caries Management: Ways Medical Providers Can Support Oral Health (Perspectives from a Physician). Dent Clin North Am 2019; 63:669-677. [PMID: 31470921 DOI: 10.1016/j.cden.2019.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Medical providers are important allies in the prevention of dental caries. Through raising the issue by asking about risks and strengths, offering anticipatory guidance and counseling, encouraging and following up on referrals, and applying preventive fluoride, medical providers can have a direct, positive impact on oral health. Further, improving communication with referrals, bidirectionally, benefits patient care as well as provider satisfaction. By collaborating on advocacy efforts, medical and dental providers can broaden their impact while building relationships, with the end goal of improved health for patients throughout their lifetime. Reintegrating the mouth into the body and oral health into systemic health has benefits for patients and providers alike, and can and should be accomplished in the medical home.
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Affiliation(s)
- Susan A Fisher-Owens
- Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA.
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17
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Cuculescu M, Slusanschi O, Boscaiu VR, Luis HPS, Fernandes Ribeiro Graça SM, Ramos Esteves Gonçalves Dos Santos Albuquerque TMB, Abreu Assunção V, Galuscan A, Podariu AC, Malmqvist S, Johannsen G, Johannsen A. Self-reported oral health-related habits, attitudes and knowledge in adults from Portugal, Romania and Sweden-A comparative study. Int J Dent Hyg 2019; 17:359-368. [PMID: 31125488 DOI: 10.1111/idh.12408] [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: 12/19/2018] [Revised: 05/01/2019] [Accepted: 05/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of the present study was to compare the self-reported oral health knowledge, habits and attitudes of adults in Portugal, Romania and Sweden, each benefitting from a different oral health system. METHODS A cross-sectional study was conducted on 1081 adults in the three countries, using an adapted version of the WHO oral health questionnaire. This survey took place between November 2015 and June 2016. RESULTS The mean age of the respondents was 46.85 with 95% CI (45.84, 47.86). Over 85% of the Portuguese and the Swedish, but only 55% of the Romanians, reported having 20 or more teeth left (P < 0.001). Most Swedes visit the dental office regularly, but only 50.5% of the Portuguese and 20.6% of the Romanians do so (P < 0.001). Interdental cleaning aids and fluoridated toothpaste were used the most in Sweden and the least in Romania. Daily consumption of sweets was lowest for Portugal and highest for Romania (P < 0.001), and daily intake of fresh fruits and vegetables was lowest for Sweden (P < 0.001). CONCLUSIONS There is a difference between the three countries regarding oral health, diet, dental attendance and oral health-related quality of life, with Romania being in most need of improvement in these areas. The differences could be explained by the distinct healthcare systems adopted by the countries.
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Affiliation(s)
- Marian Cuculescu
- Department of Preventive Dentistry, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Oana Slusanschi
- Department of Preventive Dentistry, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Voicu Radu Boscaiu
- "Gheorghe Mihoc-Caius Iacob" Institute of Mathematical Statistics and Applied Mathematics of Romanian Academy, Bucharest, Romania
| | - Henrique Pedro Soares Luis
- Dental Hygiene Program, Faculty of Dental Medicine, University of Lisbon, Lisbon, Portugal.,ciTechCare - Center for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
| | | | | | - Victor Abreu Assunção
- Dental Hygiene Program, Faculty of Dental Medicine, University of Lisbon, Lisbon, Portugal.,ciTechCare - Center for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Atena Galuscan
- Preventive Dentistry Department, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Angela Codruta Podariu
- Preventive Dentistry Department, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Sebastian Malmqvist
- Division of Periodontology and Dental Hygiene, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | | | - Annsofi Johannsen
- Division of Periodontology and Dental Hygiene, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Tiwari T, Rai N, Brow A, Tranby E, Boynes S. Association between Medical Well-Child Visits and Dental Preventive Visits: A Big Data Report. JDR Clin Trans Res 2019; 4:239-245. [DOI: 10.1177/2380084419841850] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- T. Tiwari
- Department of Community Dentistry and Population Health, University of Colorado, School of Dental Medicine, Aurora, CO, USA
| | - N. Rai
- Department of Community Dentistry and Population Health, University of Colorado, School of Dental Medicine, Aurora, CO, USA
| | - A. Brow
- DentaQuest Partnership for Oral Health Advancement, Boston, MA, USA
| | - E.P. Tranby
- DentaQuest Partnership for Oral Health Advancement, Boston, MA, USA
| | - S.G. Boynes
- DentaQuest Partnership for Oral Health Advancement, Boston, MA, USA
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Prasad M, Manjunath C, Murthy AK, Sampath A, Jaiswal S, Mohapatra A. Integration of oral health into primary health care: A systematic review. J Family Med Prim Care 2019; 8:1838-1845. [PMID: 31334142 PMCID: PMC6618181 DOI: 10.4103/jfmpc.jfmpc_286_19] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Integration of oral health into primary health care holds the key to affordable and accessible health care as oral health is still a neglected component in many countries. This review aims to determine integration of oral health into primary health care and provide an evidence-based synthesis on a primary oral healthcare approach. Searches were conducted in various databases like Biomed Central, MEDLINE, Cochrane databases, NCBI (PubMed), Sci-Hub, Google Scholar, and WHO sites. The studies included in this review are according to the following eligibility criteria: the articles in English language, the articles published from January 2000 to October 2018, and only full text article. The search yielded 500 articles. After removal of duplicates: 410 articles screened based on title and abstract, 100 full text articles were assessed for eligibility, and 30 full text articles were included. This review showed evidence how oral health is related to general health: focused on common risk factor approach and bidirectional relationship. There are various ways of integration, such as interprofessional education, interprofessional collaborative practice, closed-loop referral process, and various public and private partnerships, and at the same time, there are a lot of barriers in integration. Thus, the primary oral health care needs to be developed as an integral part of primary health care. Consequently, there is a need to increase finance, health care workforce, government support, and public-private partnership to achieve the goal of affordable and accessible health care, i.e. health for all.
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Affiliation(s)
- Monika Prasad
- Department of Public Health Dentistry, The Oxford Dental College, Bengaluru, Karnataka, India
| | - C Manjunath
- Department of Public Health Dentistry, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Archana Krishna Murthy
- Department of Public Health Dentistry, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Aishwarya Sampath
- Department of Public Health Dentistry, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Shefali Jaiswal
- Department of Public Health Dentistry, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Ankit Mohapatra
- Department of Public Health Dentistry, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
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20
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Fisher-Owens SA, Mertz E. Preventing Oral Disease: Alternative Providers and Places to Address This Commonplace Condition. Pediatr Clin North Am 2018; 65:1063-1072. [PMID: 30213349 DOI: 10.1016/j.pcl.2018.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Oral health disease in young children has not decreased, despite adequate modalities for treatment and prevention. Because many children may not see a dentist before oral disease has begun, disease progression can be expected, affecting short-term and long-term oral health. However, most children are seen by other health professionals frequently in their youngest years, providing a unique opportunity to help weave a safety net of oral health care until they are established in a dental home. This article details ways primary care providers can promote oral health, including ways to integrate ancillary dental professionals into the primary care home.
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Affiliation(s)
- Susan A Fisher-Owens
- Department of Pediatrics, UCSF School of Medicine, Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue/MS6E37, San Francisco, CA 94110, USA; Department of Preventive and Restorative Dental Sciences, UCSF School of Dentistry, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Elizabeth Mertz
- Faculty, Healthforce Center for Research and Leadership Development, 3333 California Street, Suite 410, San Francisco, CA 94143, USA
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Burgette JM, Preisser JS, Rozier RG. Access to preventive services after the integration of oral health care into early childhood education and medical care. J Am Dent Assoc 2018; 149:1024-1031.e2. [PMID: 30243426 DOI: 10.1016/j.adaj.2018.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/12/2018] [Accepted: 07/21/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The effect of Early Head Start (EHS) on receipt of preventive oral health services (POHS) from both oral and medical health care providers is not known. METHODS The authors compared children enrolled in North Carolina EHS programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates. RESULTS Primary caregivers of children enrolled in EHS (n = 479) and Medicaid (n = 699) were interviewed when children were approximately 10 and 36 months of age. An average of 81% of EHS and non-EHS children received POHS from an oral or medical health care provider at follow-up. EHS children had greater odds of receiving an oral health assessment (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.74 to 3.13) and fluoride (OR, 1.53; 95% CI, 1.16 to 2.03) from an oral health care provider than children not enrolled. EHS children had decreased odds (OR, 0.73; 95% CI, 0.54 to 0.99) of receiving fluoride from a medical health care provider. CONCLUSIONS Both children enrolled in EHS and community control participants had high rates of POHS, but the source of services differed. EHS children had greater odds of receiving POHS from oral health care providers than non-EHS children. EHS and non-EHS children had equal rates for fluoride overall because of the greater percentage of non-EHS children with medical fluoride visits. PRACTICAL IMPLICATIONS The integration of POHS in early education and Medicaid medical benefits combined with existing dental resources in the community greatly improves access to POHS.
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Atchison KA, Weintraub JA, Rozier RG. Bridging the dental-medical divide: Case studies integrating oral health care and primary health care. J Am Dent Assoc 2018; 149:850-858. [PMID: 30057150 DOI: 10.1016/j.adaj.2018.05.030] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/02/2018] [Accepted: 05/17/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND The National Academies of Sciences, Engineering, and Medicine commissioned an environmental scan describing the status of health care integration of oral health and primary care services. METHODS The authors conducted an environmental scan of US integration activities with publications from January 2000 through August 2017. They categorized services as preventive oral health services (POHS) provided by medical care providers, POHS provided by dental providers in nondental settings, preventive health services provided by dental providers, or care coordination using dedicated personnel and technology. The authors chose 4 programs as case studies and interviewed key personnel in each program. One case study illustrates each category of integrated services; additional examples describe category variation. RESULTS The case study involving Into the Mouth of Babes illustrates medical professionals delivering POHS to children. The case study involving Grace Health presents dental hygienists embedded in the obstetrics-gynecology clinic to provide oral screening, prophylaxis, and education to pregnant women. At HealthPartners, medical care providers refer patients with diabetes to dentists and waive copays for periodontal care. The InterCommunity Health Network Coordinated Care Organization uses dedicated patient coordinators, technology, and coordinated payment and referral mechanisms to facilitate care. CONCLUSIONS Integration of dental and medical care increased access to and coordination of patient care by means of offering health care services traditionally provided by the other profession. PRACTICAL IMPLICATIONS Integration models demonstrate the incorporation of POHS by primary care professionals, the embedding of dental professionals into primary care clinics, and the incorporation of care coordination to increase the delivery of oral health care. Similarly, dentists identify and refer patients with medical needs or preventive gaps to medical homes.
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23
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Casamassimo PS, Hammersmith K, Gross EL, Amini H. Infant Oral Health: An Emerging Dental Public Health Measure. Dent Clin North Am 2018; 62:235-244. [PMID: 29478455 DOI: 10.1016/j.cden.2017.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Infant oral health (IOH) is a preventive service advocated by major medical and dental organizations. IOH aims to prevent early childhood caries (ECC) and impart health strategies to families for continued oral health and prevention of future caries. IOH reaches across disciplines, is low cost, and is covered by Medicaid and many private dental payers. Increasing evidence points to immediate and long-term positive oral health outcomes of reduced disease, reduction in costly care, and reduction in ECC-associated morbidities.
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Affiliation(s)
- Paul S Casamassimo
- The Ohio State University College of Dentistry, Nationwide Children's Hospital, 305 West 12th Avenue, Columbus, OH 43210, USA.
| | - Kimberly Hammersmith
- The Ohio State University College of Dentistry, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
| | - Erin L Gross
- The Ohio State University College of Dentistry, Nationwide Children's Hospital, 305 West 12th Avenue, Columbus, OH 43210, USA
| | - Homa Amini
- The Ohio State University College of Dentistry, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
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Naleway AL, Henninger ML, Waiwaiole LA, Mosen DM, Leo MC, Pihlstrom DJ. Dental provider practices and perceptions regarding adolescent vaccination. J Public Health Dent 2017; 78:159-164. [PMID: 29114884 DOI: 10.1111/jphd.12256] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess dental providers' clinical practices and perceptions regarding adolescent vaccinations. METHODS We surveyed 234 dental providers in an integrated health care setting in Portland, Oregon, in March-April 2015. We assessed participants' knowledge of adolescent vaccines, barriers to recommending vaccines, and their perceived role in the promotion of vaccination and preventive medical care. RESULTS Over 80 percent of respondents correctly identified influenza, tetanus-diphtheria-acellular pertussis, and human papillomavirus as vaccinations recommended for adolescents; 60 percent correctly identified meningococcal conjugate. Forty-four percent of providers reported previously discussing vaccination with their adolescent patients. Lack of knowledge (66 percent), uncertainty about whether patients would accept recommendations (62 percent), and lack of time (61 percent) were commonly reported barriers. While few providers expressed personal concerns about the safety (13 percent) and effectiveness (10 percent) of adolescent vaccines, most believed parents had concerns about safety (70 percent) and effectiveness (60 percent). Although 80 percent endorsed the premise that providers should discuss preventive medical care with their patients, only 54 percent said they should discuss vaccinations specifically. CONCLUSIONS Dental providers reported several barriers to recommending vaccines. While comfortable with discussing preventive medical care in general, providers are less comfortable making vaccine recommendations to their patients. Vaccine recommendations are not a traditional practice among dental providers and may require additional education and communication tools.
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Affiliation(s)
- Allison L Naleway
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | | | - Lisa A Waiwaiole
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - David M Mosen
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Michael C Leo
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR
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Braun PA, Widmer-Racich K, Sevick C, Starzyk EJ, Mauritson K, Hambidge SJ. Effectiveness on Early Childhood Caries of an Oral Health Promotion Program for Medical Providers. Am J Public Health 2017; 107:S97-S103. [PMID: 28661802 DOI: 10.2105/ajph.2017.303817] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess an oral health promotion (OHP) intervention for medical providers' impact on early childhood caries (ECC). METHODS We implemented a quasiexperimental OHP intervention in 8 federally qualified health centers that trained medical providers on ECC risk assessment, oral examination and instruction, dental referral, and fluoride varnish applications (FVAs). We measured OHP delivery by FVA count at medical visits. We measured the intervention's impact on ECC in 3 unique cohorts of children aged 3 to 4 years in 2009 (preintervention; n = 202), 2011 (midintervention; n = 420), and 2015 (≥ 4 FVAs; n = 153). We compared numbers of decayed, missing, and filled tooth surfaces using adjusted zero-inflated negative binomial models. RESULTS Across 3 unique cohorts, the FVA mean (range) count was 0.0 (0), 1.1 (0-7), and 4.5 (4-7) in 2009, 2011, and 2015, respectively. In adjusted zero-inflated negative binomial models analyses, children in the 2015 cohort had significantly fewer decayed, missing, and filled tooth surfaces than did children in previous cohorts. CONCLUSIONS An OHP intervention targeting medical providers reduced ECC when children received 4 or more FVAs at a medical visit by age 3 years.
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Affiliation(s)
- Patricia A Braun
- Patricia A. Braun, Katina Widmer-Racich, and Carter Sevick are with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz School of Medicine, Aurora. Erin J. Starzyk and Katya Mauritson are with the Colorado Department of Public Health and Environment, Denver. Patricia A. Braun is also with and Simon J. Hambidge is with Denver Health and Hospital, Denver, CO
| | - Katina Widmer-Racich
- Patricia A. Braun, Katina Widmer-Racich, and Carter Sevick are with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz School of Medicine, Aurora. Erin J. Starzyk and Katya Mauritson are with the Colorado Department of Public Health and Environment, Denver. Patricia A. Braun is also with and Simon J. Hambidge is with Denver Health and Hospital, Denver, CO
| | - Carter Sevick
- Patricia A. Braun, Katina Widmer-Racich, and Carter Sevick are with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz School of Medicine, Aurora. Erin J. Starzyk and Katya Mauritson are with the Colorado Department of Public Health and Environment, Denver. Patricia A. Braun is also with and Simon J. Hambidge is with Denver Health and Hospital, Denver, CO
| | - Erin J Starzyk
- Patricia A. Braun, Katina Widmer-Racich, and Carter Sevick are with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz School of Medicine, Aurora. Erin J. Starzyk and Katya Mauritson are with the Colorado Department of Public Health and Environment, Denver. Patricia A. Braun is also with and Simon J. Hambidge is with Denver Health and Hospital, Denver, CO
| | - Katya Mauritson
- Patricia A. Braun, Katina Widmer-Racich, and Carter Sevick are with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz School of Medicine, Aurora. Erin J. Starzyk and Katya Mauritson are with the Colorado Department of Public Health and Environment, Denver. Patricia A. Braun is also with and Simon J. Hambidge is with Denver Health and Hospital, Denver, CO
| | - Simon J Hambidge
- Patricia A. Braun, Katina Widmer-Racich, and Carter Sevick are with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz School of Medicine, Aurora. Erin J. Starzyk and Katya Mauritson are with the Colorado Department of Public Health and Environment, Denver. Patricia A. Braun is also with and Simon J. Hambidge is with Denver Health and Hospital, Denver, CO
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