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Selvaraj D, Agarwal N, Albert JM, Nelson S. Barriers to dental utilization among Medicaid-enrolled young children from primary care practices in Northeast Ohio. Community Dent Oral Epidemiol 2024; 52:699-707. [PMID: 38647184 PMCID: PMC11371537 DOI: 10.1111/cdoe.12964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/21/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES To evaluate the individual and community factors that contribute to dental utilization among young children on Medicaid utilizing the Anderson Model and the Socio-Ecological Framework. METHODS This observational cross-sectional study was conducted using baseline data (socio-demographics, clinical dental need) from a cluster-randomized hybrid effectiveness-implementation trial among 1021 child-parent dyads recruited from primary care practices across northeast Ohio. The baseline data were then linked to dental Medicaid claims data (categorized as any dental visit, volume, and type in the past 12 months) and ICD-10 codes from the child's EHR data (individual-level) together with Dental Health Provider Shortage Area (HPSA) status and Area Deprivation Index (ADI) which were obtained at the neighbourhood-level using home address of each dyad (community-level). Multivariable analyses using generalized estimating equations (GEE) accounted for clustering by practice, and models included individual-level alone, and individual + community-level factors to evaluate their effects on dental utilization. RESULTS Medicaid claims data indicated that among the 1021 children (mean age: 4.3 ± 1.1 years; 54.4% males; 43.8% Black, Non-Hispanic), a majority of children were seeing the dentist at least once a year by the age of 4 (56.1%). The mean ADI of their neighbourhoods was 109.22 (20.2) and 27.5% lived in a HPSA area. The GEE analyses revealed that individual factors such as older children, parents being married, and continuous Medicaid enrollment were associated with significantly higher dental utilization. Among community factors, being in a HPSA had an OR = 1.53 (CI: 1.03, 2.27) associated with higher dental utilization. CONCLUSIONS Being in a HPSA was associated with higher dental utilization possibly due to dentists or safety net dental clinics in these areas accepting Medicaid-eligible children.
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Affiliation(s)
- David Selvaraj
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Neel Agarwal
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
| | - Jeffrey M Albert
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Suchitra Nelson
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Kiuchi S, Takeuchi K, Saito M, Kusama T, Nakazawa N, Fujita K, Kondo K, Aida J, Osaka K. Differences in Cumulative Long-Term Care Costs by Dental Visit Pattern Among Japanese Older Adults: The JAGES Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae194. [PMID: 39101529 PMCID: PMC11369224 DOI: 10.1093/gerona/glae194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Long-term care (LTC) costs create burdens on aging societies. Maintaining oral health through dental visits may result in shorter LTC periods, thereby decreasing LTC costs; however, this remains unverified. We examined whether dental visits in the past 6 months were associated with cumulative LTC insurance (LTCI) costs. METHODS This cohort study of the Japan Gerontological Evaluation Study targeted independent adults aged≥65 years in 2010 over an 8-year follow-up. We used data from a self-reported questionnaire and LTCI records from the municipalities. The outcome was cumulative LTCI costs, and exposure was dental visits within 6 months for prevention, treatment, and prevention or treatment. A 2-part model was used to estimate the differences in the predicted cumulative LTCI costs and 95% confidence intervals (CIs) for each dental visit. RESULTS The mean age of the 8 429 participants was 73.7 years (standard deviation [SD] = 6.0), and 46.1% were men. During the follow-up period, 17.6% started using LTCI services. The mean cumulative LTCI cost was USD 4 877.0 (SD = 19 082.1). The predicted cumulative LTCI costs were lower among those had dental visits than among those who did not. The differences in predicted cumulative LTCI cost were -USD 1 089.9 (95% CI = -1 888.5 to -291.2) for dental preventive visits, -USD 806.7 (95% CI = -1 647.4 to 34.0) for treatment visits, and -USD 980.6 (95% CI = -1 835.7 to -125.5) for preventive or treatment visits. CONCLUSIONS Dental visits, particularly preventive visits, were associated with lower cumulative LTCI costs. Maintaining oral health through dental visits may effectively reduce LTCI costs.
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Affiliation(s)
- Sakura Kiuchi
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Aoba-ku, Sendai, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Mihama, Aichi, Japan
- Center for Well-Being and Society, Nihon Fukushi University, Nagoya, Aichi, Japan
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Noriko Nakazawa
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Kinya Fujita
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Katsunori Kondo
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Chiba, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
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Alzeer M, AlJameel A, Rosing K, Øzhayat E. The association between oral health literacy and oral health-related behaviours among female adolescents in the Kingdom of Saudi Arabia: A cross-sectional study. Saudi Dent J 2024; 36:1035-1042. [PMID: 39035552 PMCID: PMC11255937 DOI: 10.1016/j.sdentj.2024.05.007] [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: 11/23/2023] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives Oral health literacy (OHL) is suggested as an important denominator of oral health. This study aimed to identify ways to improve oral health by exploring the association between oral health literacy and oral health-related behaviours among female adolescents in the Eastern Province of the Kingdom of Saudi Arabia (KSA). Methods This cross-sectional study assessed OHL among 1,889 10th grade female students in the Eastern Province of the KSA. OHL was assessed using an Arabic version of the short version of the Health Literacy in Dentistry scale (A-HeLD-14). Self-reported socio-demographic information and oral health-related behaviours (toothbrushing, dental attendance, and sugary diet consumption) were also collected. The relationship between OHL and oral health-related behaviours was investigated using binary logistic regression, adjusted for socio-demographic information. Results The binary logistic regression analyses showed that poor OHL was significantly associated with infrequent toothbrushing (p < 0.001) and irregular dental attendance (p = 0.005) but not with consumption of sugary diets. All A-HeLD-14 domains were significantly associated with infrequent toothbrushing, and the domains concerning access, receptivity, and financial barriers were significantly associated with irregular dental attendance. The highest odds ratios (ORs) for infrequent toothbrushing were found in the domains of receptivity (OR = 4.19) and understanding (OR = 3.85) and for irregular dental attendance in the financial barriers (OR = 1.61) and access (OR = 1.49) domains, followed by the receptivity domain (OR = 1.35). Conclusion Poor OHL was significantly associated with infrequent toothbrushing and irregular dental attendance. Interventions focusing on OHL are warranted to improve oral health-related behaviours and thereby oral health in the population. The aspects that seem most vital to target are improved access to dental care, including the reduction of economic barriers, as well as increased awareness of oral health in the population.
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Affiliation(s)
- Muneera Alzeer
- Department of Odontology, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Copenhagen, Denmark
- Department of Dental Health, College of Applied Medical Sciences, King Saud University. P.O. Box: 10219, Riyadh 11433, Kingdom of Saudi Arabia
| | - AlBandary AlJameel
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Kingdom of Saudi Arabia
| | - Kasper Rosing
- Department of Odontology, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Copenhagen, Denmark
| | - Esben Øzhayat
- Department of Odontology, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Copenhagen, Denmark
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Allen F, Guarnizo-Herreño CC, Fan SY, Tsakos G. Does subsidizing the cost of care impact on dental attendance patterns among older adults? Community Dent Oral Epidemiol 2024; 52:328-335. [PMID: 38084824 DOI: 10.1111/cdoe.12934] [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: 05/04/2023] [Revised: 09/29/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To assess whether eligibility for an age-related universal (pioneer generation [PG]) subsidy incentivises dental attendance by older Singaporeans. METHODS Data were collected between 2018 and 2021 from in-person interviews of Singaporean adults aged 60-90 years using a questionnaire and a clinical examination. The questionnaire included details of age, gender, ethnicity, education, residential status, socio-economic status, marital status, eligibility for subsidy (community health assistance/CHAS, PG or both) and frequency of dental attendance. The clinical examination recorded number of teeth (categorized as edentulous, 1-9 teeth;10-19 teeth; ≥20 teeth). To estimate the effect of the PG subsidy on dental attendance pattern, a regression discontinuity (RD) analysis was applied using age as the assignment variable. RESULTS A total of 1172 participants aged 60-90 years (64.2% female) were recruited, with 498 (43%) being eligible for the PG subsidy. For those eligible for PG subsidy, there was a higher proportion of regular attenders than irregular attenders (53.6% vs. 46.4%). In age adjusted RD analysis, those eligible for the PG subsidy were 1.6 (95% CI: 1.0, 2.7) times more likely to report regular attendance than their PG non-eligible counterparts. The association remained strong (OR 2.1; 95% CI: 1.1-3.7) even after further controlling for demographics, socioeconomic factors, number of teeth and eligibility for the CHAS subsidy. CONCLUSIONS Being eligible for the PG subsidy substantially increased the odds of regular dental attendance.
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Affiliation(s)
- Finbarr Allen
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
- Cork Dental School and Hospital, University College Cork, Cork, Ireland
| | | | - Sim Yu Fan
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
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Zhang D, Li S, Zhang R. Effects of dental anxiety and anesthesia on vital signs during tooth extraction. BMC Oral Health 2024; 24:632. [PMID: 38811912 PMCID: PMC11134746 DOI: 10.1186/s12903-024-04404-5] [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: 12/31/2023] [Accepted: 05/23/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Anxiety is common preceding tooth extraction; hence, it is crucial to identify patients with dental anxiety (DA) and to manage DA. This study assessed the level of DA and influencing factors in tooth extraction patients in a dental hospital in China and changes in their blood pressure (BP) and heart rate (HR) during the tooth-extraction procedure. METHODS The study was a cohort study. The Dental Anxiety Scale (DAS) was used to assess the level of DA of 120 patients before tooth extraction. A Demographics and Oral Health Self-Assessment Form was used to assess factors influencing DA. The correlations of DAS scores with HR and BP were measured. The effects of local anesthesia and general anesthesia on HR and BP were also compared using a Datex-Ohmeda anesthesia monitor to detect HR and BP continuously before and after anesthesia. Independent sample t-tests, OLS multiple regression model and one-way analysis of variance were applied to analysis the results. RESULTS Based on the DAS score, 12.5% of the participants were identified as suffering from DA. DA was related to age, gender, and the self-assessment of oral health. The DAS score was correlated with increased BP (P < 0.05). BP showed an overall upward trend after local anesthesia, while it was generally stable after general anesthesia. The systolic BP at 4 and 5 min and the HR at 2 and 4 min increased remarkably (P < 0.05) after local anesthesia compared with those before anesthesia. The HR and BP of patients under local anesthesia were generally higher than those of patients under general anesthesia were during the operation. CONCLUSIONS The prevalence of DA in adults was 12.5% in this study population. DA was related to gender, age, and the self-assessment of oral health. The score of DAS was correlated with BP. Compare to local anesthesia, general anesthesia can make the vital signs of tooth extraction patients more stable.
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Affiliation(s)
- Diya Zhang
- Dental Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, Zhejiang, China.
| | - Shenglai Li
- Department of Oral and Maxillofacial Surgery, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
| | - Rui Zhang
- Dongfang College, Zhejiang University of Finance and Economics, Hangzhou, China
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Fukuda H, Kobori E, Miura H, Mizumoto K, Nozue M, Hazano S, Kamata K, Maeda Y. Regular dental check-up status and related factors among Thai residents in Japan. Odontology 2024:10.1007/s10266-024-00954-w. [PMID: 38805093 DOI: 10.1007/s10266-024-00954-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
The objectives of this online study were to determine the status of regular dental check-ups among Thai nationals living in Japan and to identify barriers to regular dental check-ups by comparing them with general health check-ups. We conducted the online survey twice, in 2021 and 2022, among Thai nationals aged 18 years and older living in Japan via social networking services by an organization that supports Thai nationals living in Japan. Respondents between the ages of 30 and 59 were included in this study. Independent factors included gender, age, length of stay in Japan, family economic status, confidence in Japanese and stay for work purposes. Dependent factors were regular dental check-ups and general health check-ups in the past year. Chi-square tests and multiple logistic regression analyses were used for analysis. 56.6% of respondents had regular dental check-ups. The adjusted odds ratio for the proportion of people with regular dental check-ups was significantly higher for those with high economic status, 2.15 (1.06-4.33), compared with those with low economic status. It was also significantly higher 1.88 (1.10-3.21) for those with confidence in the Japanese language compared with those without. The study suggested the need for Japanese language support in addition to financial support for dental health prevention programs for foreigners living in Japan.
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Affiliation(s)
- Hideki Fukuda
- National Institute of Public Health, 2-3-6 Minami, Wako-city, Saitama, 351-0197, Japan.
| | - Eiko Kobori
- Graduate School of Nursing, Setsunan University, 45-1 Nagaotoge-cho, Hirakata-city, Osaka, 573-0101, Japan
| | - Hiroko Miura
- Division of Disease Control and Epidemiology, School of Dentistry, Health Sciences University of Hokkaido, 1757 Kanazawa, Tobetsu-cho, Hokkaido, 061-0293, Japan
| | - Kaori Mizumoto
- Department of Food Management, Faculty of Nutritional Sciences, Nakamura Gakuen University, 5-7-1 Befu, Jonan-ku, Fukuoka-city, Fukuoka, 814-0198, Japan
| | - Miho Nozue
- Department of Health and Nutritional Sciences, Faculty of Health Promotional Sciences, Tokoha University, 1230 Miyakoda-cho, Hamana-ku, Hamamatsu-city, Shizuoka, 431-2102, Japan
| | - Sayaka Hazano
- Department of Health and Nutritional Science, Faculty of Human Health and Science, Matsumoto University, 2095-1 Niimura, Matsumoto-city, Nagano, 390-1295, Japan
| | - Kanami Kamata
- Graduate School of Nursing, Setsunan University, 45-1 Nagaotoge-cho, Hirakata-city, Osaka, 573-0101, Japan
| | - Yuko Maeda
- Institute for Liberal Arts and Sciences, Kyoto University, Yoshida-Nihonmatsu-cho, Sakyo-ku, Kyoto, 606-8316, Japan
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Mohd Khairuddin AN, Bogale B, Kang J, Gallagher JE. Impact of dental visiting patterns on oral health: A systematic review of longitudinal studies. BDJ Open 2024; 10:18. [PMID: 38448428 PMCID: PMC10917741 DOI: 10.1038/s41405-024-00195-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024] Open
Abstract
AIM To systematically review longitudinal studies investigating the impact of dental visiting patterns on oral health across the life course. METHODS Five databases (MEDLINE, Embase, Scopus, Web of Science, CINAHL) were searched up to March 2023. Results were screened based on eligibility criteria in a two-stage process: title and abstract, and full-text review. A backward search of reference lists and a forward search of citations of the included papers was also conducted. The quality of the included papers was assessed using the Newcastle-Ottawa Scale. Key study information was extracted and a narrative synthesis of the findings was performed. RESULTS Eleven papers from five longitudinal studies in five countries (Australia, Brazil, China, New Zealand, Sweden) met the inclusion criteria. Studies of moderate to high quality consistently reported that regular dental attendance was associated with having less dental caries experience, fewer missing teeth and better oral health-related quality of life. Inconsistent findings were observed for decayed teeth, and no association was found for periodontal condition. CONCLUSIONS This review highlights an association between regular dental visiting pattern and improved oral health, notably less dental caries experience and better oral health-related quality of life. Dental attendance emerges as an important predictor of oral health across the life course, underscoring the importance of routine dental care. REGISTRATION INFORMATION The PROSPERO registration number is CRD42023396380.
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Affiliation(s)
- Aina Najwa Mohd Khairuddin
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Birke Bogale
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
- Department of Dental and Maxillofacial Surgery, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Jing Kang
- Oral Clinical Research Unit, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | - Jennifer E Gallagher
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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