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Çiftçi BT, Aşantoğrol F. Utilization of machine learning models in predicting caries risk groups and oral health-related risk factors in adults. BMC Oral Health 2024; 24:430. [PMID: 38589865 PMCID: PMC11000438 DOI: 10.1186/s12903-024-04210-z] [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: 12/18/2023] [Accepted: 03/30/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND The aim of this study was to analyse the risk factors that affect oral health in adults and to evaluate the success of different machine learning algorithms in predicting these risk factors. METHODS This study included 2000 patients aged 18 years and older who were admitted to the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gaziantep University, between September and December 2023. In this study, patients completed a 30-item questionnaire designed to assess the factors that affect the decayed, missing, and filled teeth (DMFT). Clinical and radiological examinations were performed, and DMFT scores were calculated after completion of the questionnaire. The obtained data were randomly divided into a 75% training group and a 25% test group. The preprocessed dataset was analysed using various machine learning algorithms, including naive Bayes, logistic regression, support vector machine, decision tree, random forest and Multilayer Perceptron algorithms. Pearson's correlation test was also conducted to assess the correlation between participants' DMFT scores and oral health risk factors. The performance of each algorithm was evaluated to determine the most appropriate algorithm, and model performance was assessed using accuracy, precision, recall and F1 score on the test dataset. RESULTS A statistically significant difference was found between various factors and DMFT-based risk groups (p < 0.05), including age, sex, body mass index, tooth brushing frequency, socioeconomic status, employment status, education level, marital status, hypertension, diabetes status, renal disease status, consumption of sugary snacks, dry mouth status and screen time. When considering machine learning algorithms for risk group assessments, the Multilayer Perceptron model demonstrated the highest level of success, achieving an accuracy of 95.8%, an F1-score of 96%, and precision and recall rates of 96%. CONCLUSIONS Caries risk assessment using a simple questionnaire can identify individuals at risk of dental caries, determine the key risk factors, provide information to help reduce the risk of dental caries over time and ensure follow-up. In addition, it is extremely important to apply effective preventive treatments and to prevent the general health problems that are caused by the deterioration of oral health. The results of this study show the potential of machine learning algorithms for predicting caries risk groups, and these algorithms are promising for future studies.
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Affiliation(s)
- Burak Tunahan Çiftçi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Gaziantep, Türkiye, 27310
| | - Firdevs Aşantoğrol
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Gaziantep, Türkiye, 27310.
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Pouraskari Z, Yazdani R, Hessari H. Exploring the Challenges in Covering Dental Services through Complementary Insurance in Iran: A Qualitative Study. Int J Dent 2024; 2024:6982460. [PMID: 38500571 PMCID: PMC10948230 DOI: 10.1155/2024/6982460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/23/2024] [Accepted: 02/24/2024] [Indexed: 03/20/2024] Open
Abstract
Background Financial protection is crucial for attaining universal health coverage. The inclusion of costly dental services in insurance plans poses a significant challenge for all parties involved in the insurance sector. This study aimed to investigate the challenges of covering dental services by complementary insurance in Iran during 2020-2021. Materials and Methods This qualitative research was conducted in Iran during 2020-2021. A triangulation of methods and data sources were employed to achieve a comprehensive perspective. In-depth semistructured interviews were conducted on an individual basis, and all national documents, rules, regulations, and instructions pertaining to complementary dental insurance were thoroughly reviewed. Purposeful sampling was used to select participants from all stakeholder groups engaged in dental insurance coverage, including (1) health system policymakers, (2) insurers, (3) policyholders, (4) care providers (dentists), and (5) insured people. Six open-ended questions were formulated to explore various facets of dental insurance, including (1) development, (2) management, (3) population coverage, (4) premium calculation, (5) services coverage, and (6) payment and reimbursement mechanisms. With the consent of the participants, all interviews were recorded and transcribed verbatim. The gathered data were evaluated using a framework analysis approach in the MAXQDA20 software. Finally, the primary themes, each encompassing multiple subthemes, were identified and presented. Results A total of 26 interviews were conducted with five groups of interviewees, and nine national documents were evaluated. Six themes were extracted, which included 18 codes from the interviews and seven codes from the documents. The extracted themes were as follows: (1) Insurance commitments and service coverage, (2) reimbursement system, (3) information system, (4) economic issues, (5) population coverage, and (6) regulation and supervision. The high cost of dental services was the most frequent challenge, followed by the insurance commitments and service coverage. Conclusions The delivery of dental services through complementary insurance in Iran primarily faces economic and service coverage challenges. The resolution hinges on the collaboration between basic and complementary insurance sectors, the development of a unified information system for insured individuals, and the implementation of a risk-adjusted premium plan.
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Affiliation(s)
- Zahra Pouraskari
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Yazdani
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Hessari
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ayyildiz E, Aras D, Yagin FH, Gülü M, Yapici H, Alwhaibi R. Investigation of sports participation motivation in people with disabilities: a cross-sectional study of individuals with physical and hearing impairments. BMC Sports Sci Med Rehabil 2024; 16:56. [PMID: 38395979 PMCID: PMC10893699 DOI: 10.1186/s13102-024-00846-0] [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: 11/15/2023] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
While reading the literature, it is seen that there are not enough studies on the motivation of disabled individuals to participate in sports. This study aims to examine the sports participation motivations of hearing impaired and physically disabled athletes. This study was a cross-sectional study. The research group of the study consists of physically and hearing-impaired individuals between the ages of 18-47. The participants of this research group consisted of 253 volunteer disabled individuals, 150 of whom were men and 103 of whom were women. Sports participation motivation scale was used for disabled individuals. The scale consists of 3 dimensions and is a 5-point Likert type. The results of the study showed that hearing-impaired people have a higher high school rate and physically person with disability have a higher bachelor's degree rate, but the primary education rate did not change between hearing and physically person with disability. Physical activity participation differed between hearing and physically person with disability, and it was observed that hearing-impaired people participated in more physical activities. The level of well-being of the physically disabled was significantly better than the hearing impaired. As conclusion, it is observed that the people with the lowest motivation to participate in sports are primary school graduates and those with high welfare have a high motivation to participate in sports.
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Affiliation(s)
- Erdem Ayyildiz
- Department of Sports Management, Faculty of Sport Sciences, Tekirdag Namik Kemal University, Tekirdag, Turkey.
| | - Dicle Aras
- Ankara University Performance Analysis in Sports Application and Research Center, Department of Coaching Education, Faculty of Sport Sciences, Ankara University, Ankara, Turkey
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey.
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, 71450, Turkey.
| | - Hakan Yapici
- Department of Recreation, Faculty of Sport Sciences, Kirikkale University, Kirikkale, 71450, Turkey
| | - Reem Alwhaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
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Chandran DG, Muruganandam L, Biswas R. A review on adsorption of heavy metals from wastewater using carbon nanotube and graphene-based nanomaterials. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:110010-110046. [PMID: 37804379 DOI: 10.1007/s11356-023-30192-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/26/2023] [Indexed: 10/09/2023]
Abstract
The rampant rise in world population, industrialization, and urbanization expedite the contamination of water sources. The presence of the non-biodegradable character of heavy metals in waterways badly affects the ecological balance. In this modern era, the unavailability of getting clear water as well as the downturn in water quality is a major concern. Therefore, the effective removal of heavy metals has become much more important than before. In recent years, the attention to better wastewater remediation was directed towards adsorption techniques with novel adsorbents such as carbon nanomaterials. This review paper primarily emphasizes the fundamental concepts, structures, and unique surface properties of novel adsorbents, the harmful effects of various heavy metals, and the adsorption mechanism. This review will give an insight into the current status of research in the realm of sustainable wastewater treatment, applications of carbon nanomaterials, different types of functionalized carbon nanotubes, graphene, graphene oxide, and their adsorption capacity. The importance of MD simulations and density functional theory (DFT) in the elimination of heavy metals from aqueous media is also discussed. In addition to that, the effect of factors on heavy metal adsorption such as electric field and pressure is addressed.
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Affiliation(s)
- Drisya G Chandran
- Process Simulation Research Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Loganathan Muruganandam
- Process Simulation Research Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Rima Biswas
- Process Simulation Research Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
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Hamilton WN, Masud N, Kouambo C, Tarasenko YN. Perinatal Smoking and E-cigarette Use and Their Relationship with Breastfeeding: PRAMS 2015-2020. Breastfeed Med 2023; 18:855-863. [PMID: 37902988 DOI: 10.1089/bfm.2023.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Introduction: Electronic cigarette (e-cigarette) use poses concerns among women of child-bearing age. We examined prevalence of breastfeeding among the U.S. women and characteristics associated with exclusive use of cigarettes, e-cigarettes, or both products. Materials and Methods: Our study is based on pooled cross-sectional data from 2015-2020 Pregnancy Risk Assessment Monitoring System. Two outcomes were breastfeeding initiation and breastfeeding duration for over 6 months, as recommended by the American Academy of Pediatrics (AAP). Binary logistic regressions were used to examine associations between each outcome and type of tobacco products unadjusted and adjusted for potential confounders, with post hoc estimation of average adjusted predictions, marginal effects, and contrasts of margins in Stata. Results: Adjusted prevalence of breastfeeding initiation was significantly higher in women who used e-cigarettes (86.15%) than conventional cigarettes (72.16%) or both products (79.54%). Similarly, a significantly higher percentage of women who used e-cigarettes continued breastfeeding after 6 months (49.20%) than women who smoked conventional cigarettes (31.30%) or both products (29.83%). Among women who neither smoked nor used e-cigarettes, 85.29% initiated breastfeeding and 57.20% continued breastfeeding as recommended by the AAP. Conclusion: Likelihood of breastfeeding initiation and continuation in women using e-cigarettes was comparable to those who neither smoked nor used e-cigarettes. Future research needs to elucidate differences in breastfeeding by sociodemographic and health-related characteristics of women who smoke or use both products compared to those who use e-cigarettes. Understanding women's motivation behind use of a particular tobacco product is also important, so mothers who smoke e-cigarettes are not incorrectly perceived as safer users and excluded from tobacco cessation interventions.
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Affiliation(s)
- Whitney N Hamilton
- Department of Health Services Administration, Middle Georgia State University, Macon, Georgia, USA
| | - Nazish Masud
- Department of Biostatistics Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Cyrille Kouambo
- Department of Biostatistics Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Yelena N Tarasenko
- Department of Biostatistics Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
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Boodai H, ElSalhy M, Alsumait A, Ariga J, Al-Sharbati M. The relationship between children's oral health behaviours and oral health-related quality of life: a cross-sectional study. BMC Oral Health 2023; 23:757. [PMID: 37833726 PMCID: PMC10576284 DOI: 10.1186/s12903-023-03454-5] [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: 06/26/2022] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Understanding oral health behaviour s and their impact on Oral Health-Related Quality of Life (OHRQoL) may serve as an instrument to articulate the conventional oral health policy framework, thereby ameliorating the overall health of young individuals in the long term. OBJECTIVE The aim of this study was to investigate the relationship between children's oral health behaviour s and Oral Health-Related Quality of Life in the capital governorate, Kuwait. METHODS A cross-sectional study involving 607 children aged 12-14 years, randomly selected from schools in Kuwait Capital Region. A validated Oral Health Behaviour s and OHRQoL Child Perception Questionnaires (CPQ12-14) was used to collect the data. Chi-square, t-tests, and ANOVA were used to examine the association between oral behaviour s and children's OHRQoL. RESULTS About 52.2% of participants were males and the overall response rate was 93.8%. The mean ± SD for total OHRQoL impact was 3.1 ± 0.58, while the total mean for individual domains- for oral symptoms, functional limitations, emotional well-being and social well-being were 2.89 ± 0.63, 2.89 ± 0.72, 3.1 ± 0.91 and 3.4 ± 0.61, respectively. There was no significant difference in total OHRQoL impact score by frequency of last dental visit, flossing, use of mouth rinse or chewing gum (p > 0.05) but for the overall OHRQoL, frequency of soft drink intake was the only significant predictor associated with 0.2-unit decrease (B = -0.207, 95% CI, p = 0.002) in total OHRQoL scores. CONCLUSIONS High frequency of soft drink consumption was related to poorer OHRQoL. Behaviour changing interventions based on OHRQoL inferences coupled with clinical intervention are needed.
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Affiliation(s)
- Hanan Boodai
- School Oral Health, Dental Administration, Ministry of Health, Kuwait City, Kuwait.
| | - Mohamed ElSalhy
- College of Dental Medicine, University of New England, Portland, ME, USA
| | - Aishah Alsumait
- School Oral Health, Dental Administration, Ministry of Health, Kuwait City, Kuwait
| | - Jitendra Ariga
- School Oral Health, Dental Administration, Ministry of Health, Kuwait City, Kuwait
| | - Marwan Al-Sharbati
- Department of Social and Behaviour Al Sciences, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
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Ludovichetti FS, Zuccon A, Lucchi P, Signoriello AG, Stellini E, Mazzoleni S. Survey on Oral Health Education Knowledge of Family Members and Health Workers Dedicated to Patients with Disabilities. Eur J Dent 2023; 17:1325-1329. [PMID: 37172944 PMCID: PMC10756851 DOI: 10.1055/s-0043-1761188] [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: 05/15/2023] Open
Abstract
OBJECTIVE Over a billion people in the world live with some form of disability and this figure is destined to grow due to the increase in life expectancy. As consequence, the caregiver is taking on an increasingly important role that gains relevance also in the field of oral-dental prevention, being able to promptly identify needs for medical treatment. In some cases, however, the caregiver can be an obstacle to consider in case of a lack of adequate knowledge and commitment. The aim of this study is to evaluate the caregiver level of oral education comparing family members and health workers dedicated to people with disabilities knowledge. MATERIALS AND METHODS Anonymous questionnaires were distributed in five disability service centers and filled alternatively by family members of patients with disability and disability service centers health workers. RESULTS Two-hundred fifty questionnaires were collected, of which 100 were filled in by family members and 150 by health workers. Data were analyzed by applying the chi-squared (X2) independence test and the pairwise method for missing data. CONCLUSION Family members oral education appears better in terms of brushing frequency, toothbrush replacement, and number of dental visits.
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Affiliation(s)
| | - Andrea Zuccon
- Section of Dentistry, Department of Neurosciences, Università degli Studi di Padova, Padova, Italy
| | - Patrizia Lucchi
- Section of Dentistry, Department of Neurosciences, Università degli Studi di Padova, Padova, Italy
| | - Anna Giulia Signoriello
- Section of Dentistry, Department of Neurosciences, Università degli Studi di Padova, Padova, Italy
| | - Edoardo Stellini
- Section of Dentistry, Department of Neurosciences, Università degli Studi di Padova, Padova, Italy
| | - Sergio Mazzoleni
- Section of Dentistry, Department of Neurosciences, Università degli Studi di Padova, Padova, Italy
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Discepolo K, Melvin P, Ghazarians M, Tennermann N, Ward VL. Socioeconomic and Clinical Demography of Dental Missed Care Opportunities. JDR Clin Trans Res 2023; 8:356-366. [PMID: 35722931 DOI: 10.1177/23800844221104790] [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] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Missed care opportunities (MCOs) contribute to poor health outcomes, and pediatric dental patients are particularly vulnerable; identifying associated patient characteristics will help inform development of targeted interventional programs. OBJECTIVE To assess socioeconomic and demographic disparities associated with MCOs among children in an urban pediatric hospital's dental clinic. MCOs lead to a lack of continuous care and increased emergent needs, so understanding MCOs is required to achieve equitable pediatric dental health. METHODS A retrospective 2-y (2019-2020) cohort of MCOs in children 1 to 17 y old, with scheduled dental visits. MCOs were defined as appointments not attended or canceled and not rescheduled prior to initial scheduled visit. Multivariable mixed-effects logistic regression models with patient-level clustering assessed the associations of demographics, neighborhood-level socioeconomic factors (using social vulnerability index [SVI]), and clinic characteristics with MCOs. RESULTS Of 30,095 visits, 30.9% were MCOs. Multivariable logistic regression estimated increased likelihood of MCOs in Black/non-Hispanic (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.09-1.32) and Hispanic (OR, 1.18; 95% CI, 1.06-1.31) patients, patients with public insurance (OR, 1.25; 95% CI, 1.15-1.36) or no insurance (OR, 1.46; 95% CI, 1.15-1.85), patients with complex chronic conditions (OR, 1.11; 95% CI, 1.03-1.19), visits scheduled during the COVID-19 pandemic (OR, 9.48; 95% CI, 8.89-10.11), appointments with wait days over 21 d (OR, 4.07; 95% CI, 3.49-4.74), and children from neighborhoods of high social vulnerability (75th percentile SVI) (OR, 1.08; 95% CI, 1.01-1.16). CONCLUSIONS Children with highest dental MCOs were from neighborhoods with high SVI, had public insurance, and were from marginalized populations. MCOs contribute to inequities in overall health; hence, interventions that address barriers related to characteristics associated with pediatric dental MCOs are needed. KNOWLEDGE TRANSFER STATEMENT Missed care opportunities contribute to poor health outcomes; identifying associated patient characteristics will help inform development of targeted interventional programs. Providing these findings to stakeholders will better impart understanding access barriers and drive research and program development. Dissemination of this information in the form of altering appointment practices will better accommodate specific patient population needs.
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Affiliation(s)
- K Discepolo
- Department of Dentistry, Boston Children's Hospital, Boston, MA, USA
| | - P Melvin
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
| | - M Ghazarians
- Department of Dentistry, Boston Children's Hospital, Boston, MA, USA
| | - N Tennermann
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
| | - V L Ward
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Peled Y, Stewart CA, Glogauer M, Finer Y. The Role of Bacterial, Dentinal, Salivary, and Neutrophil Degradative Activity in Caries Pathogenesis. Dent J (Basel) 2023; 11:217. [PMID: 37754337 PMCID: PMC10528424 DOI: 10.3390/dj11090217] [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: 07/27/2023] [Revised: 08/28/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
Until recently, it was widely accepted that bacteria participate in caries pathogenesis mainly through carbohydrate fermentation and acid production, which promote the dissolution of tooth components. Neutrophils, on the other hand, were considered white blood cells with no role in caries pathogenesis. Nevertheless, current literature suggests that both bacteria and neutrophils, among other factors, possess direct degradative activity towards both dentinal collagen type-1 and/or methacrylate resin-based restoratives and adhesives, the most common dental restoratives. Neutrophils are abundant leukocytes in the gingival sulcus, where they can readily reach adjacent tooth roots or gingival and cervical restorations and execute their degradative activity. In this review, we present the latest literature evidence for bacterial, dentinal, salivary, and neutrophil degradative action that may induce primary caries, secondary caries, and restoration failure.
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Affiliation(s)
- Yuval Peled
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (Y.P.); (C.A.S.); (M.G.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (Y.P.); (C.A.S.); (M.G.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3E2, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (Y.P.); (C.A.S.); (M.G.)
- Department of Dental Oncology, Maxillofacial and Ocular Prosthetics, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (Y.P.); (C.A.S.); (M.G.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3E2, Canada
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Nelson S, Kim E, Kaelber D. Integrating Oral Health into Primary Care: Perspectives for Older Adults. J Dent Res 2023; 102:849-853. [PMID: 37085982 PMCID: PMC10399081 DOI: 10.1177/00220345231165011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Affiliation(s)
- S. Nelson
- Department of Community Dentistry and Population and Quantitative Health Sciences, Case Western Reserve University School of Dental Medicine and School of Medicine, Cleveland, OH, USA
| | - E.G.R. Kim
- Departments of Family Medicine and the Center for Clinical Informatics Research and Education, The Metrohealth System and Case Western Reserve University, Cleveland, OH, USA
| | - D.C. Kaelber
- Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Science and the Center for Clinical Informatics Research and Education, The MetroHealth System and Case Western Reserve University, Cleveland, OH, USA
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Taani MH, Ellis J, Okunseri C, Wagner KL. Oral Care Among Older Adults in Assisted Living Facilities. Res Gerontol Nurs 2023; 16:106-107. [PMID: 37224446 DOI: 10.3928/19404921-20230515-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
| | - Julie Ellis
- University of Wisconsin-Milwaukee, College of Nursing Milwaukee, Wisconsin
| | | | - Kathryn L Wagner
- Department of Economics, College of Business Administration Marquette University Milwaukee, Wisconsin
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Seligman LD, Geers AL, Kramer L, Clemens KS, Pituch KA, Colagiuri B, Marusak HA, Rabinak CA, Turner N, Nedley M. Study protocol of an investigation of attention and prediction error as mechanisms of action for latent inhibition of dental fear in humans. BMC Psychol 2023; 11:23. [PMID: 36698206 PMCID: PMC9875450 DOI: 10.1186/s40359-023-01054-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Evidence suggests that dental anxiety and phobia are frequently the result of direct associative fear conditioning but that pre-exposure to dental stimuli prior to conditioning results in latent inhibition of fear learning. The mechanisms underlying the pre-exposure effect in humans, however, are poorly understood. Moreover, pain sensitivity has been linked to dental fear conditioning in correlational investigations and theory suggests it may moderate the latent inhibition effect, but this hypothesis has not been directly tested. These gaps in our understanding are a barrier to the development of evidence-based dental phobia prevention efforts. METHODS Healthy volunteers between the ages of 6 and 35 years will be enrolled across two sites. Participants will complete a conditioning task in a novel virtual reality environment, allowing for control over pre-exposure and the examination of behaviour. A dental startle (a brief, pressurized puff of air to a tooth) will serve as the unconditioned stimulus. Using a within-subjects experimental design, participants will experience a pre-exposed to-be conditioned stimulus, a non-pre-exposed to-be conditioned stimulus, and a neutral control stimulus. Two hypothesized mechanisms, changes in prediction errors and attention, are expected to mediate the association between stimulus condition and fear acquisition, recall, and retention. To ascertain the involvement of pain sensitivity, this construct will be measured through self-report and the cold pressor task. DISCUSSION Dental phobia negatively affects the dental health and overall health of individuals. This study aims to determine the mechanisms through which pre-exposure retards conditioned dental fear acquisition, recall, and retention. A randomized control trial will be used to identify these mechanisms so that they can be precisely targeted and maximally engaged in preventative efforts.
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Affiliation(s)
- Laura D. Seligman
- grid.449717.80000 0004 5374 269XDepartment of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX 78539 USA
| | - Andrew L. Geers
- grid.267337.40000 0001 2184 944XDepartment of Psychology, University of Toledo, Toledo, OH USA
| | - Lauren Kramer
- grid.267337.40000 0001 2184 944XDepartment of Psychology, University of Toledo, Toledo, OH USA
| | - Kelly S. Clemens
- grid.267337.40000 0001 2184 944XDepartment of Psychology, University of Toledo, Toledo, OH USA
| | - Keenan A. Pituch
- grid.215654.10000 0001 2151 2636Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ USA
| | - Ben Colagiuri
- grid.1013.30000 0004 1936 834XDepartment of Psychology, University of Sydney, Sydney, Australia
| | - Hilary A. Marusak
- grid.254444.70000 0001 1456 7807Department of Psychiatry and Behavioral Neuroscience, School of Medicine, Wayne State University, Detroit, MI USA
| | - Christine A. Rabinak
- grid.254444.70000 0001 1456 7807Department of Pharmacy Practice, Wayne State University, Detroit, MI USA
| | - Natalie Turner
- grid.267337.40000 0001 2184 944XDepartment of Pediatric Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH USA
| | - Michael Nedley
- grid.267337.40000 0001 2184 944XDepartment of Pediatric Dentistry, University of Toledo College of Medicine and Life Sciences, Toledo, OH USA
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Griner SB, Vamos CA, Phillips AC, Puccio JA, Thompson EL, Daley EM. Assessing college students' interest in university-based oral health information and services. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:5-9. [PMID: 33577423 DOI: 10.1080/07448481.2021.1876706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/18/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Objective: To assess US college students' (1) oral health behaviors and (2) interest in university-based oral health information and services. Participants: Students at a large public university in the southeast participated in the survey (n = 102). All participants were over the age of 18 and able to speak and read English. Methods:An online quantitative survey was administered to collect information on oral health behaviors, interest in university-based oral health information and services, and sociodemographic factors. Frequencies, descriptive statistics, and bivariate analyses were utilized for this study. Results: Approximately 11% of students rated their oral health as fair/poor and 27% currently had a dental problem. Over half (53%) were interested in receiving oral health information from the university, 87% felt campus-based dental services were important, and 79% were likely to use campus-based dental services. Conclusions: College students may benefit from information and services to promote oral health within the college context.
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Affiliation(s)
- Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Amelia C Phillips
- Director of Wellbeing, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Joseph A Puccio
- Division of Adolescent Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA
- Executive and Medical Director, University of South Florida Student Health Services, Tampa, FL, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
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14
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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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15
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Henni SH, Skudutyte-Rysstad R, Ansteinsson V, Hellesø R, Hovden EAS. Oral health and oral health-related quality of life among older adults receiving home health care services: A scoping review. Gerodontology 2022; 40:161-171. [PMID: 35943193 DOI: 10.1111/ger.12649] [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: 01/26/2022] [Revised: 04/25/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To map the literature on subjective and objective oral health indicators and oral health-related quality of life (OHRQoL) in older adults receiving home health care services (HHCS). BACKGROUND The proportion of older adults in need of HHCS will increase in the coming years. Previous studies indicate that frail and dependent older adults are at increased risk for oral diseases, due to challenges with daily oral hygiene and regular access to dental services. MATERIALS AND METHODS Four databases were searched in November 2020 for relevant literature. Search terms included a comprehensive list of terms for adults 65 years or older receiving HHCS, clinical and subjective oral health indicators, and OHRQoL. The literature was reviewed based on inclusion and exclusion criteria. RESULTS Of the 3114 sources identified, 18 were included. Data on oral diseases and symptoms among older adults receiving HHCS were limited and heterogeneous. Overall, older adults often lacked some of their natural teeth and often had removable dentures that needed repair. In addition, plaque, caries, xerostomia, and chewing and swallowing problems were common among the population group. Data on OHRQoL were scarce and indicated a positive association with a higher number of present teeth, while decayed teeth, root remnants, and dry mouth had substantial negative impacts on the daily activities of older adults receiving HHCS. CONCLUSION This scoping review show that older adults above 65 years receiving HHCS generally have poor oral health status and that there is a knowledge gap regarding their OHRQoL.
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Affiliation(s)
- Silje Havrevold Henni
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Rasa Skudutyte-Rysstad
- Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway.,Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Vibeke Ansteinsson
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway
| | - Ragnhild Hellesø
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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16
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What happens to full mouth extraction patients? A retrospective review of patient mortality at an academic medical center. J Oral Maxillofac Surg 2022; 80:1827-1835. [PMID: 35922012 DOI: 10.1016/j.joms.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE When providers are forced to address the growing oral healthcare needs of an aging and sick population, full mouth extractions (FMEs) are often sought as a solution. The purpose of this observational study was to evaluate mortality rates, mortality timeline, and to identify associated risk factors. METHODS A single-center retrospective cohort study was conducted at the University of Cincinnati Medical Center. All patients who underwent FMEs at the Oral and Maxillofacial Surgery clinic from July 1, 2012 to December 31, 2019 due to caries or periodontal disease were included. Predictor variables recorded included a medical history, social history, and patient demographics. The main outcome variable was post-FME death, including the elapsed time from procedure to death. Deaths were identified using the National Death Index. Data were analyzed using simple descriptive statistics and Cox proportional hazard models. Deceased FME patients were compared to living FME patients to identify potential risk factors. Mortality risk index was derived from multivariable logistic regression. RESULTS One thousand eight hundred twenty nine patients were included in the study. Nine hundred seventy six were female with a median age of 49 years (interquartile range 38-58). One thousand seven hundred nine were diagnosed with more than 1 comorbidity and 89% were on medicaid or medicare insurance. One hundred seventy patients (9.3%) were identified as deceased as of December 31, 2019. Of those who died, 87 patients were deceased within 2 years of the procedure and 147 within 5 years of the procedure. Statistically significant factors associated with mortality (P value < .01) included age (hazards ratio [HR] 1.01, 95% confidence interval [CI] 1.01-1.03), ASA score >3 (HR 3.12, 95% CI 2.2-4.42), nursing home residence (HR 2.66, 95% 1.67-4.28), hepatic disease (HR 1.81, 95% CI 1.18-2.78), and oncologic disease (HR 1.91, 95% 1.32-2.77). CONCLUSIONS Approximately 1 in 10 patients died within 5 years of FME at our center. These patients may be medically and socially compromised. More research is needed to develop FME-specific mortality indices, which may serve useful for clinical decision-making and surgical palliative care.
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17
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Felgner S, Dreger M, Henschke C. Reasons for (not) choosing dental treatments—A qualitative study based on patients’ perspective. PLoS One 2022; 17:e0267656. [PMID: 35613130 PMCID: PMC9132305 DOI: 10.1371/journal.pone.0267656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/12/2022] [Indexed: 11/19/2022] Open
Abstract
Oral health is increasingly seen as a public health challenge due to the remarkable prevalence of oral diseases worldwide, the impact on general health, and health consequences that can arise for individuals. Compared to other health services, oral health services are usually not fully covered by statutory health insurance, which is seen as one reason in decision-making on dental treatments. Nevertheless, patients’ reasons for treatment decisions are not well understood although they can provide valuable insights. The objective of this study was to identify reasons of choice for dental treatments and to explore patients’ view on cost coverage in Germany. We conducted four focus group interviews with a total of 27 participants. The interviews were audiotaped and transcribed verbatim. Data was analyzed performing conventional content analysis. As part of a qualitative analysis, subcategories and categories were formed from identified reasons using an inductive approach. Our study supports and expands research in exploring patients’ decision-making on dental treatments. It highlights a variety of 53 reasons of choice for dental treatments from patients’ perspective, split in two categories “health care service”, and “dentist & dental office”. First category includes reasons regarding dental care performance (subcategories: “preconditions”, “treatment”, “costs”, and “outcomes”). Second category demonstrates reasons regarding dentists, office structures and processes (subcategories: "professional skills", "social skills", "office staff & equipment", and "office processes”). Reasons named “most important” by the participants are out-of-pocket payments, dentists’ training, and a relationship of trust between patient and dentist. Although the participants use incentive measures to lower financial burden, several perceived challenges exist. Identified reasons for choosing dental treatments provide a basis for further studies to quantify the relevance of these reasons from patients’ perspective. Based on this, the various reasons identified can be considered in future policies to improve patients’ utilization behavior, which can range from improved information sources to increased incentive measures.
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Affiliation(s)
- Susanne Felgner
- Department of Health Care Management, Berlin Centre of Health Economics Research Technische Universität Berlin, Berlin, Germany
- * E-mail:
| | - Marie Dreger
- Department of Health Care Management, Berlin Centre of Health Economics Research Technische Universität Berlin, Berlin, Germany
| | - Cornelia Henschke
- Department of Health Care Management, Berlin Centre of Health Economics Research Technische Universität Berlin, Berlin, Germany
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18
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Toothbrushing and Oral Care Activities of Autistic and Non-Autistic Latino Children. CHILDREN 2022; 9:children9050741. [PMID: 35626918 PMCID: PMC9139190 DOI: 10.3390/children9050741] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 12/17/2022]
Abstract
Background: Oral care activities, e.g., toothbrushing, are habitual occupations often considered routine. However, for autistic children, performing these routine dental practices can be challenging due to the child’s sensory sensitivities, unique executive function, and the complicated way in which autistic children conceptualize structure and habits. Limited research exists exploring the nuances of oral care routines in the autistic population, and more knowledge is needed to support targeted education interventions to improve oral care and address health inequities. The purpose of this study was to examine videos of oral care routines in the home to understand how oral care activities, such as toothbrushing, were performed by autistic and non-autistic Latino/a children. Methods: Parents/caregivers from eighteen Latino/a families with children between 6 and 12 years old (n = 10 autistic children and n = 8 non-autistic children) video recorded their child’s oral care routines for three days. The research team blindly coded and analyzed these videos using an oral care observation template to understand how these activities were uniquely performed by the children. Results: Eighty-five oral care videos were analyzed for this study. In addition to noting areas of oral care that can be improved, which included length of brushing and using the correct brushing technique, we identified two themes related to the differences between oral care practices in the autistic and non-autistic children: parent involvement and modifications. Conclusions: Qualitative findings show that parental involvement was documented especially in the case of autistic children, and that two types of modifications, habitual and sensory, were observed that demonstrated parents being aware of the needs of their autistic child and modifying the oral care activity to meet those needs. By synthesizing observations from the oral care videos into suggestions for practitioners working with families, we hope to supplement knowledge about effective oral care practices for autistic and non-autistic Latino/a children, thereby improving overall oral health and reducing oral health inequities in this population.
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19
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Phillips LA, Coan LL, Wijesuriya UA. Oral health in primary care: Integration of enhanced oral health education in a nurse practitioner residency program. J Am Assoc Nurse Pract 2021; 34:624-630. [PMID: 34864784 DOI: 10.1097/jxx.0000000000000677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/28/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Access to oral health care is challenging, especially for vulnerable populations and those in rural and underserved areas. The purpose of this brief report is to discuss the implementation strategies of enhanced content in oral health educational materials and share results of acquisition of knowledge and confidence in oral health content by residents in a nurse practitioner residency program. The method included the use of 3 surveys of 34 questions administered at different time points measuring confidence levels and sustainability. Results showed the average level of confidence obtained in Posttest1 and in Posttest 2 after 6 months is greater than the pretest. The paired-sample t-test provides significant evidence of improving mean responses for Questions 10, 11, 16, and 32 in Posttest 1 (p-values: .04 each) and Questions 10, 17, 25, and 31 in Posttest2 (p-values: .04 each) compared with the pretest. In conclusion, the addition of enhanced oral health educational materials in our program resulted in improved knowledge and confidence in the residents to incorporate oral health care in their practices.
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Affiliation(s)
- Lori A Phillips
- College of Nursing and Health Professions, University of Southern Indiana
| | - Lorinda L Coan
- College of Nursing and Health Professions, University of Southern Indiana
| | - Uditha A Wijesuriya
- Pott College of Science, Engineering, and Education, University of Southern Indiana
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20
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DEMİR P, BİLMEZ SELEN M. Knowledge and Management of Pediatricians About Children’s Oral Health. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.885580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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21
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Zinah E, Al-Ibrahim HM. Oral health problems facing refugees in Europe: a scoping review. BMC Public Health 2021; 21:1207. [PMID: 34162351 PMCID: PMC8223339 DOI: 10.1186/s12889-021-11272-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/09/2021] [Indexed: 02/19/2023] Open
Abstract
Introduction Europe has been experiencing a flow of refugees and asylum seekers driven by conflicts or poverty. Their oral health is often neglected despite its clear impact on quality of life. Objective To explore the status of oral health among refugees and asylum seekers groups by examining the available literature and to determine which evidence exists regarding the problems they face in terms of oral health. Methods The current paper followed PRISMA guidelines. A scoping review methodology was followed to retrieve 2911 records from five databases and grey literature. Twelve articles met the following inclusion criteria: experimental research concentrated on the oral and dental health of refugees and/or asylum seekers between 1995 and 2020 in English. Analysis was both descriptive and thematic, whilst a critical appraisal was applied using the Critical Appraisal Skills Program (CASP). Results Seven studies (58,3%) were quantitative, while five studies (41,6%) were qualitative. In general, the quality of most of the studies (83.3%) was good. Limited access to oral health care services was shown with a higher prevalence of oral diseases compared to the native populations of the host countries. Approaches to improve oral health have been implemented in some studies and have shown positive outcomes. Conclusions Oral health care strategies should consider the oral health problems facing refugees in Europe, and oral health promotion campaigns are essential to give adequate guidance on how to access oral health care in the host countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11272-z.
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Affiliation(s)
- Eiad Zinah
- Dental Public Health Department, University College London, London, UK.
| | - Heba M Al-Ibrahim
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria
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22
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Langelier M, Surdu S. Does Education in Oral Health Competencies in Physician Assistant Education Programs Translate to Delivery of Oral Health Services in Clinical Practice? J Physician Assist Educ 2021; 32:79-86. [PMID: 34004645 DOI: 10.1097/jpa.0000000000000351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to determine the extent to which physician assistants (PAs) are educated in oral health competencies and the relationship of education to providing oral health services to patients. METHODS The study was conducted in 2016 by administering an Internet-based survey to a nationwide sample of 2014 graduates of programs accredited by the Accreditation Review Commission on Education for the Physician Assistant. The survey response rate was 12.7% (N = 304). RESULTS More than half of the PAs who received education in oral health in their professional education programs indicated that oral health curricula were either integrated into one or several topical areas in the base curriculum or delivered in stand-alone lectures. The majority of PA respondents rated their educational preparation as good or excellent in helping them provide oral health education to their patients (54.8%), make appropriate referrals to oral health providers (53.7%), and provide preventive oral health services (51.2%), while more than 40% rated their preparation as good or excellent in helping them identify oral diseases, conditions, and intervention strategies. More than one-third (35.7%) of all PA respondents reported that they provided oral health services in their clinical practices. PAs who received instruction in oral health competencies through the PA education curriculum or from other sources were 2.82 times more likely to provide oral health assessment and screening services to their patients (95% confidence interval, 1.19-6.67). The PA respondents' provision of oral health services was also significantly associated with working in primary medicine or urgent care practice specialties but not with the work setting. CONCLUSIONS PAs educated in oral health competencies are more likely to provide such services to patients, especially in primary medicine or urgent care settings.
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Affiliation(s)
- Margaret Langelier
- Margaret Langelier, MSHSA, is co-deputy director of the Oral Health Workforce Research Center, Center for Health Workforce Studies, at the University at Albany School of Public Health, Rensselaer, New York
- Simona Surdu, MD, PhD , is co-deputy director of the Oral Health Workforce Research Center, Center for Health Workforce Studies, at the University at Albany School of Public Health, Rensselaer, New York
| | - Simona Surdu
- Margaret Langelier, MSHSA, is co-deputy director of the Oral Health Workforce Research Center, Center for Health Workforce Studies, at the University at Albany School of Public Health, Rensselaer, New York
- Simona Surdu, MD, PhD , is co-deputy director of the Oral Health Workforce Research Center, Center for Health Workforce Studies, at the University at Albany School of Public Health, Rensselaer, New York
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23
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Pawloski C, Hilgert J, Senturia K, Davis S, Koday M, Cunha-Cruz J. Medical-Dental Integration in a Rural Community Health Center: A Qualitative Program Evaluation. Health Promot Pract 2021; 23:416-424. [PMID: 33853397 DOI: 10.1177/15248399211002832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND A community health center (CHC) implemented a medical-dental integration (MDI) program where children were seen at a pediatric medical clinic or women, infants, and children program location by medical and dental providers in the same visit. Our study aims were to elicit the perspectives and experiences of providers and administrators involved in the MDI program to assess the acceptability, feasibility, and success of a CHC integration strategy in Eastern Washington. METHODS This is a qualitative study where we conducted semistructured interviews over the phone over a period of 2 months with 12 medical and dental providers and clinical administrators who were involved with the MDI program. Questions addressed perspectives on workflow, patient identification and engagement, leadership support, and barriers and facilitators of the initiative. Qualitative data were analyzed, and emergent themes were identified. RESULTS The emergent themes included (a) the MDI program is feasible and acceptable albeit with key considerations regarding the setting, including charting and service integration, progressive leadership and effective communication, and appropriate providers; (b) implementation included structural, systemic, and individual behavior barriers, (c) the program is seen as a benefit to the clinic and patients and a success to date as a way to increase access to quality care. CONCLUSIONS Findings from this study helped identify facilitators, such as cultural relevancy and progressive office systems, as well as barriers, such as reimbursement, associated with integrating medical and dental care in a rural CHC setting, is acceptable by providers, and can inform future studies and implementation strategies for others wishing to integrate these services.
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Affiliation(s)
| | - Juliana Hilgert
- University of Washington, Seattle, WA, USA.,Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Stephen Davis
- Yakima Valley Farm Workers Clinic, Toppenish, WA, USA
| | - Mark Koday
- Yakima Valley Farm Workers Clinic, Toppenish, WA, USA
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24
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Understanding oral health disparities in children as a global public health issue: how dental health professionals can make a difference. J Public Health Policy 2021; 41:114-124. [PMID: 32054981 DOI: 10.1057/s41271-020-00222-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Oral disease in children is an urgent public health issue worldwide. Early childhood caries (ECC) affects 600 million children globally, yet it is entirely preventable. Dental health professionals around the world need to act to improve use of measures to prevent ECC and of quality dental health care to improve oral health worldwide. The University of California/Los Angeles (UCLA) Center for Children's Oral Health hosted an interprofessional innovation forum to discuss and recommend options. We present the policy, educational, and public health-related suggestions for improving outcomes and professional collaboration and five key areas for action: (1) increase advocacy efforts, (2) support interprofessional education and practice, (3) promote oral health education and increase health literacy, (4) increase collaboration with community and school-based oral health care workers, and (5) use of technology to increase access to dental care and health information.
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25
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Ortiz FR, Ardenghi TM, Maroneze MC, Paiva SM, Pordeus IA. Structuring adolescent's oral health effects on labour market entry in a cohort study. Int J Paediatr Dent 2021; 31:262-269. [PMID: 32969545 DOI: 10.1111/ipd.12729] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/14/2020] [Accepted: 08/28/2020] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the influence of the oral conditions and oral health-related quality of life (OHRQoL) on the entry of adolescents on labour. DESIGN This cohort study was performed in southern Brazil, within a random sample of 12-year-old adolescents (n = 1134). Oral health (dental caries, malocclusion, and toothache), OHRQoL (Child Perceptions Questionnaire 11-14), demographic factors, and family's socioeconomic status (household income and mother's education) were collected at baseline (2012). Education level and employment outcomes, such as labour market entry and earnings from work, were collected at 6-year follow-up. Path analysis was used to estimate the overall fit measurement, standardized coefficients (SC), and its direct and indirect effects. RESULTS Among 1134 participants, 768 adolescents with mean of age 17.5 years old were reassessed (retention rate of 68%). There was direct effect from poor OHRQoL on labour market entry (SC 0.057; P = .02). Sex and age also had a direct effect on employment outcomes. Socioeconomic status impacts oral health conditions as well as OHRQoL scores (P < .01). Household income, malocclusion, and toothache had indirect effects on labour market entry. CONCLUSION Oral health indirectly affects employment outcomes, through its effects on OHRQoL. Moreover, OHRQoL directly affects labour market entry in adolescents.
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Affiliation(s)
- Fernanda Ruffo Ortiz
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Saul Martins Paiva
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Isabela Almeida Pordeus
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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26
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Wright WG, Averett PE, Benjamin J, Nowlin JP, Lee JGL, Anand V. Barriers to and Facilitators of Oral Health Among Persons Living With Mental Illness: A Qualitative Study. Psychiatr Serv 2021; 72:156-162. [PMID: 33234051 DOI: 10.1176/appi.ps.201900535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Persons with mental illness have poorer oral health and are less likely to receive oral health care than those in the general population. A comprehensive understanding of barriers to and facilitators of accessing oral health care from a multidisciplinary perspective is lacking. The authors of this qualitative study sought to explore barriers and facilitators in addressing the oral health needs of individuals with mental illness from the perspectives of patients, psychiatrists, and dentists. METHODS A thematic content analysis approach was used to triangulate the perspectives of the three groups. Face-to-face semistructured interviews were conducted in 2018-2019 with patients with mental illness (N=20), psychiatrists (N=20), and dentists (N=25) at an academic medical campus in rural eastern North Carolina. Participants were recruited until thematic saturation for each group was reached. RESULTS Reported barriers to oral health care were categorized under emerging themes: access to dental care, fear of dental care, characteristics of mental illness, lack of oral health screening by psychiatrists, lack of education and training, stigma of mental illness, and lack of communication. Facilitators of oral health care were linked to the reported need for education and training, financial support, dentists' chairside manner, community support, and interprofessional communication. CONCLUSIONS The findings highlight health system gaps between oral health and mental health. The barriers and facilitators identified can help inform the development of interventions to improve oral health of patients with mental illness. Interventions should include interdisciplinary education and training, improved communication, and strategies to reduce financial barriers and anxiety in dental practice.
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Affiliation(s)
- Wanda G Wright
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Paige E Averett
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Janet Benjamin
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Jonathan P Nowlin
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Joseph G L Lee
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Vivek Anand
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
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Tabrizi M, Lee WC. A Pilot Study of an Interprofessional Program Involving Dental, Medical, Nursing, and Pharmacy Students. Front Public Health 2020; 8:602957. [PMID: 33363094 PMCID: PMC7758200 DOI: 10.3389/fpubh.2020.602957] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/12/2020] [Indexed: 11/30/2022] Open
Abstract
Objective: The silent epidemic of oral diseases disproportionately affects disadvantaged communities, especially the elderly who have complex needs for healthcare. This study was to evaluate a pilot oral health interprofessional program that provided hands-on experiences for students across four disciplines: dentistry, medicine, nursing, and pharmacy. Methods: The 8-weeks program was built on four pedagogical principles: care, critical thinking, communication, and collaboration coupled with the 4Ms model: what matters, medication, mentation, and mobility. The curriculum contained four scenarios of a dental complication in an elderly: Alzheimer's Disease, oral cancer, Parkinson's Disease, and stroke. A mixed-methods approach was used to evaluate this pilot program. Results: The average score of knowledge and attitude has increased from 2.94 to 4.39 (p < 0.05) on a 5-point Likert scale. The qualitative responses also showed that students became more confident in practicing within the Age-Friendly health system. Discussion: By the end of the program, all students recognized the significance of the interprofessional program to improve their knowledge and skills to work with professionals across disciplines. Two key features that contributed to the success of the program were (1) an interprofessional education that increased students' awareness of other types of services and (2) four scenarios that allowed students to solve the case and gain hands-on experience. Conclusion: An interprofessional education may equip students with competence to address the health of geriatric patients. Materials used in this study could be shared and adapted to prepare learners for other scenarios that require interprofessional team practice.
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Affiliation(s)
- Maryam Tabrizi
- General Practice and Dental Public Health, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Wei-Chen Lee
- Office of Health Policy and Legislative Affairs, The University of Texas Medical Branch, Galveston, TX, United States
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Pourat N, Chen X, Lu C, Zhou W, Hoang H, Hair B, Bolton J, Sripipatana A. The role of dentist supply, need for care and long-term continuity in Health Resources and Services Administration-funded health centres in the United States. Community Dent Oral Epidemiol 2020; 49:291-300. [PMID: 33230861 DOI: 10.1111/cdoe.12601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/07/2020] [Accepted: 11/02/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Health Resources and Services Administration-funded health centres (HCs) are an important source of dental services for low-income and vulnerable patients in the United States. About 82% of HCs in 2018 had dental workforce, but it is unclear whether this workforce meets the oral health needs of HC patients. Thus, we first examined (a) whether dental workforce was associated with any dental visits vs none and (b) whether HC patients with any visits were more likely to have a visit at the HC vs elsewhere. We then examined (c) if need for oral health care and long-term continuity at the HC were associated with dental visits and visits at the HC. METHODS This study used the 2014 Health Center Patient Survey, a nationally representative study of US HC patients, and the 2013 Uniform Data System, an administrative dataset of HC characteristics. We also used the 2013 Area Health Resource File to measure the contribution of local supply of dentists. We included working-age adult patients (n = 5006) and used multilevel structural equation models with Poisson specification. RESULTS Larger dental workforce at the HC was significantly associated with 1% higher likelihood (relative risk [RR]: 1.01, 1.00-1.02) of any visits and 10% higher likelihood of a visit at the HC among those with a visit (RR: 1.10, 1.06-1.14). Patient self-reported oral health need was positively associated with 157% higher likelihood of dental visits (RR: 2.57, 2.29-2.88), and 42% higher likelihood of dental visit at the HC vs elsewhere (RR: 1.42, 1.19-1.69). Long-term continuity with the HC was not significantly associated with likelihood of dental visits, but was associated with 26% higher likelihood of visits at the HC among those who had any visits (RR: 1.26, 1.02-1.56). DISCUSSION The findings highlight the potential impact of increasing dental workforce at HCs to promote access; the high level of need for oral health care at HCs; and the increased effort required to promote access among newer patients who may be less familiar with the availability of oral health care at HCs. Together, these findings reinforce the importance of addressing barriers of use of oral health services among low-income and uninsured patients.
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Affiliation(s)
- Nadereh Pourat
- UCLA Center for Health Policy Research, University of California, Los Angeles, CA, USA.,Department of Health Policy and Management, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Xiao Chen
- UCLA Center for Health Policy Research, University of California, Los Angeles, CA, USA
| | - Connie Lu
- UCLA Center for Health Policy Research, University of California, Los Angeles, CA, USA
| | - Weihao Zhou
- UCLA Center for Health Policy Research, University of California, Los Angeles, CA, USA
| | - Hank Hoang
- Bureau of Primary Health Care, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD, USA
| | - Brionna Hair
- Bureau of Primary Health Care, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD, USA
| | - Joshua Bolton
- Bureau of Primary Health Care, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD, USA
| | - Alek Sripipatana
- Bureau of Primary Health Care, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD, USA
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Farquhar DR, Lenze NR, Masood MM, Divaris K, Tasoulas J, Blumberg J, Lumley C, Patel S, Hackman T, Weissler MC, Yarbrough W, Zanation AM, Olshan AF. Access to preventive care services and stage at diagnosis in head and neck cancer. Head Neck 2020; 42:2841-2851. [DOI: 10.1002/hed.26326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/17/2020] [Accepted: 05/27/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Douglas R. Farquhar
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Nicholas R. Lenze
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Maheer M. Masood
- Department of Otolaryngology‐Head and Neck Surgery University of Kansas Medical Center Kansas City Kansas USA
| | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry University of North Carolina Chapel Hill North Carolina USA
- Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Jason Tasoulas
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Jeffrey Blumberg
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Catherine Lumley
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Samip Patel
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Trevor Hackman
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Mark C. Weissler
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Wendell Yarbrough
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Adam M. Zanation
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Andrew F. Olshan
- Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
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Shrivastava R, Couturier Y, Girard F, Papineau L, Emami E. Two-eyed seeing of the integration of oral health in primary health care in Indigenous populations: a scoping review. Int J Equity Health 2020; 19:107. [PMID: 32605562 PMCID: PMC7329486 DOI: 10.1186/s12939-020-01195-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indigenous people experience significant poor oral health outcomes and poorer access to oral health care in comparison to the general population. The integration of oral health care with primary health care has been highlighted to be effective in addressing these oral health disparities. Scoping studies are an increasingly popular approach to reviewing health research evidence. Two-eyed seeing is an approach for both Western and Indigenous knowledge to come together to aid understanding and solve problems. Thus, the two-eyed seeing theoretical framework advocates viewing the world with one eye focused on Indigenous knowledge and the other eye on Western knowledge. This scoping review was conducted to systematically map the available integrated primary oral health care programs and their outcomes in these communities using the two-eyed seeing concept. METHODS This scoping review followed Arksey and O'Malley's five-stage framework and its methodological advancement by Levac et al. A literature search with defined eligibility criteria was performed via several electronic databases, non-indexed Indigenous journals, Indigenous health organizational websites, and grey literature. The charted data was classified, analyzed, and reported using numeral summary and qualitative content analysis. The two-eyed seeing concept guided the interpretation and synthesis of the evidence on approaches and outcomes. RESULTS A total of 29 publications describing 30 programs conducted in Australia and North America from 1972 to 2019 were included in the final analysis. The following four program categories emerged from the analysis: oral health promotion and prevention programs (n = 13), comprehensive dental services (n = 13), fly in, fly out dental services (n = 3), and teledentistry (n = 1). Biomedical approaches for integrated primary oral health care were leadership and governance, administration and funding, capacity building, infrastructure and technology, team work, and evidence-based practice. Indigenous approaches included the vision for holistic health, culturally appropriate services, community engagement, shared responsibility, and cultural safety. The program outcomes were identified for biological, mental, and emotional dimensions of oral health; however, measurement of the spiritual dimension was missing. CONCLUSION Our results suggest that a multiple integrated primary oral health care approach with a particular focus on Indigenous culture seems to be efficient and relevant in improving Indigenous oral health.
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Affiliation(s)
- Richa Shrivastava
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Yves Couturier
- School of Social Work, Université de Sherbrooke, Sherbrooke, J1H 4C4, Québec, Canada
| | - Felix Girard
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Lucie Papineau
- Cree Board of Health and Social Services of James Bay, Oujé-Bougoumou Healing Centre, Oujé-Bougoumou, Québec, G0W 3C0, Canada
| | - Elham Emami
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, H3C 3J7, Canada. .,Faculty of Dentistry, McGill University, Montreal, Québec, H3A 1G1, Canada.
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Shrivastava R, Couturier Y, Girard F, Bedos C, Macdonald ME, Torrie J, Emami E. Appreciative inquiry in evaluating integrated primary oral health services in Quebec Cree communities: a qualitative multiple case study. BMJ Open 2020; 10:e038164. [PMID: 32595166 PMCID: PMC7322273 DOI: 10.1136/bmjopen-2020-038164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The Strategic Regional Plan of the Cree Board of Health and Social Services of James Bay (CBHSSJB), serving the Quebec Cree communities, mandates the objective of integrating oral health within primary healthcare. Emerging evidence suggests that the integration of oral health into primary healthcare can decrease oral health disparities. This research study aimed to answer the following research question: how and to what extent does the integration of oral health into primary healthcare address the oral health needs of the Cree communities? DESIGN We used a multiple-case study design within a qualitative approach and developmental evaluation methodology. The Discovery, Dream, Design and Destiny model of appreciative inquiry was selected as a study framework among existing frameworks of the developmental evaluation. SETTING Four purposefully selected Cree communities. PARTICIPANTS Healthcare providers, administrators and patients at the community wellness centres and hospital. OUTCOME MEASURES Integration of oral health into primary healthcare. RESULTS A total of 36 interviews and 6 focus group discussions were conducted. We identified ten themes in discovery and dream phases. The Discovery phase identified the strengths of the organisation in facilitating enablers of integration including strategic planning, organisational structure, cultural integration, coordinated networks and colocation. In the Dream phase, participants' oral healthcare stories expressed various dimensions of integration and their wish for strengthening integration via extending public oral healthcare programmes, increasing resources and improving organisational management. In the Design phase, recommendations were formulated for a future action plan within the CBHSSJB. CONCLUSION This study results suggested that the CBHSSJB has been successful in implementing oral health integration into primary care following its strategic planning. At present, the organisation could extend the level of integration into full integration by following study recommendations derived from the perspective of local stakeholders.
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Affiliation(s)
- Richa Shrivastava
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Yves Couturier
- School of Social Work, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Felix Girard
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Christophe Bedos
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | | | - Jill Torrie
- Public-Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Québec, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
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Padilla R, Kowlowitz V, Quinonez RB, Ciarrocca K, Gilchrist MJ, Gilliland KO, Koonce TF, Lampiris L, Beck Dallaghan GL. Working collaboratively across schools to promote oral health education through interprofessional education. J Dent Educ 2020; 84:1108-1116. [PMID: 32585048 DOI: 10.1002/jdd.12252] [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: 05/04/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 11/06/2022]
Abstract
PURPOSE The Association of American Medical Colleges and American Dental Education Association have identified oral health knowledge, skills, and attitudes shared by both medical and dental professionals. Although oral health was deemed an essential competency for medical practitioners, our state struggled to ensure learners received proper training. This training deficit resulted in conducting a needs assessment and implementing an oral health interprofessional module at our schools. METHODS First-year medical students and clinical faculty were emailed surveys in 2016 to obtain baseline information. A team of faculty and students from the Schools of Medicine and Dentistry reviewed the curriculum to determine where to augment oral health content. An oral health module to teach a basic head, neck, and oral examination to first-year medical students during their patient-centered care small-group sessions was implemented and evaluated. RESULTS Only 13.6% of faculty respondents were aware of national oral health competency recommendations, and <50% rated oral health important for primary care physicians (PCPs) to include in history, physical exam, or oral health counseling. On baseline, ≤25% of PCP respondents reported integrating the listed skills in their practice, and most indicated lacking expertise to teach oral health. Teaching sessions were rated helpful by students and faculty. After the teaching sessions, ratings on the importance of including oral health significantly increased from baseline. CONCLUSION Collaboration between Schools of Dentistry and Medicine successfully integrated oral health into medical school curriculum and improved the tutors' attitudes of its importance.
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Affiliation(s)
- Ricardo Padilla
- Oral and Maxillofacial Pathology Graduate Program, UNC Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Vicki Kowlowitz
- UNC Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Rocio B Quinonez
- Educational Leadership and Innovation, UNC Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Katharine Ciarrocca
- Interprofessional Education and Practice, UNC Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Michael J Gilchrist
- Department of Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Kurt O Gilliland
- Cell Biology and Physiology, and Curriculum, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Thomas F Koonce
- Department of Family Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Lewis Lampiris
- Community Engagement, UNC Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Gary L Beck Dallaghan
- Educational Scholarship, and Pediatrics, UNC School of Medicine, Chapel Hill, North Carolina, USA
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Chamut S, Boroumand S, Iafolla TJ, Adesanya M, Fazio EM, Dye BA. Self-Reported Dental Visits Among Older Adults Receiving Home- and Community-Based Services. J Appl Gerontol 2020; 40:902-913. [PMID: 32525439 DOI: 10.1177/0733464820925320] [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] [Indexed: 11/16/2022] Open
Abstract
Objective: To investigate factors associated with infrequent dental use among older adults receiving home- and community-based services. Method: This cross-sectional study analyzed responses from the 2014 National Survey of Older Americans Act participants who received home- and community-based services. Descriptive and multivariable analyses were conducted to examine the association between infrequent dental use and key sociodemographic and health indicators. Results: Infrequent dental use was highest among adults participating in case management and home-delivered meals (63%); the lowest among those participating in congregate meals (41%). Participants who did not complete high school were 2 to 5 times more likely to be infrequent dental users compared to those with educational attainment beyond high school. Discussion: Among older adults receiving home- and community-based services, improving oral health knowledge and health literacy may reduce infrequent dental use.
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Affiliation(s)
| | - Shahdokht Boroumand
- National Institutes of Health, National Institute of Dental and Craniofacial Research (NIH/NIDCR), Bethesda, MD, USA
| | - Timothy J Iafolla
- National Institutes of Health, National Institute of Dental and Craniofacial Research (NIH/NIDCR), Bethesda, MD, USA
| | - Margo Adesanya
- National Institutes of Health, National Institute of Dental and Craniofacial Research (NIH/NIDCR), Bethesda, MD, USA
| | - Elena M Fazio
- National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Bruce A Dye
- National Institutes of Health, National Institute of Dental and Craniofacial Research (NIH/NIDCR), Bethesda, MD, USA
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Dental Phobia among Pregnant Women: Considerations for Healthcare Professionals. Int J Dent 2020; 2020:4156165. [PMID: 32351567 PMCID: PMC7171664 DOI: 10.1155/2020/4156165] [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] [Received: 02/02/2020] [Accepted: 03/23/2020] [Indexed: 12/25/2022] Open
Abstract
Objective To report the prevalence of dental phobia and associated factors among pregnant women. Materials and Methods This cross-sectional study included pregnant women visiting hospitals in Dhahran, Khobar, and Dammam in Saudi Arabia. The Modified Dental Anxiety Scale (MDAS) was used to assess dental anxiety and phobia. The score of MDAS ranges from 5 to 25, and a cutoff value of 19 was used to identify participants with dental phobia. Results The study analyzed data of 825 participants with mean age of 29.08 ± 5.18 years. The prevalence of dental phobia was 16.1%. About 46.9% of the sample believed that dental treatment should be avoided during pregnancy, and the importance of regular dental checkup was recognized by 16.4% of the participants. Dental phobia was associated with the perception of the health of teeth (P 0.004) and gums (P 0.016). Multiple logistic regression showed that being under the age of 30 years (OR 0.63, P 0.019) and updating knowledge about oral health (OR 0.49, P 0.006) were significantly associated with reduced likelihood of dental phobia. However, having bad dental experience (OR 2.13, P 0.001) and being in first trimester of pregnancy (OR 1.57, P 0.033) were significantly associated with increased odds of dental phobia. Conclusions A considerable proportion of pregnant women reported dental phobia. The bad dental experience was associated with increased dental phobia. However, reduced likelihood of dental phobia was associated with updating oral health knowledge. Healthcare professionals may consider these factors to reduce dental phobia and improve oral health of pregnant women.
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Dudovitz R, Teutsch C, Holt K, Herman A. Improving parent oral health literacy in Head Start programs. J Public Health Dent 2020; 80:150-158. [PMID: 32083725 DOI: 10.1111/jphd.12361] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/11/2020] [Accepted: 02/07/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Parental low oral health literacy is thought to contribute to child oral health disparities. Few large-scale interventions can improve oral health literacy for diverse, high-risk populations. We sought to determine whether an oral health literacy intervention aimed at parents of children attending Head Start programs improved oral health literacy and behaviors. METHODS Staff from 29 Head Start agencies across the country were trained to deliver a parent oral health literacy intervention. Parent surveys were conducted at baseline and approximately 6 months later, following intervention completion. Surveys measured parent and child demographics, oral health knowledge, behaviors, information sources, and health care utilization. Paired t tests and mixed-effects regression models controlling for agency, child age, and race/ethnicity evaluated whether measures improved after the intervention. In addition, at follow-up, agency staff were asked to complete an open-ended survey reporting how the intervention impacted their site. Responses were coded using a grounded theory approach. RESULTS A total of 2,011 (87%) parents completed both the baseline and follow-up surveys. All oral health knowledge and behaviors improved significantly from baseline to follow-up. In addition, parents reported using more oral health information sources, using more preventative oral health care, and less emergency room (ER) use for child dental problems. Head Start staff perceived that the intervention increased parental oral health literacy, enhanced parental oral health engagement, improved child oral health behaviors, and facilitated health communication with parents. CONCLUSIONS Findings suggest that this intervention successfully improved oral health literacy for diverse parents of children at high risk for dental caries.
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Affiliation(s)
- Rebecca Dudovitz
- Department of Pediatrics and Children's Discovery and Innovations Institute, UCLA Mattel Children's Hospital, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Carol Teutsch
- UCLA Health Care Institute, Anderson School of Management, University of California, Los Angeles, CA, USA
| | - Katrina Holt
- National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC, USA
| | - Ariella Herman
- UCLA Health Care Institute, Anderson School of Management, University of California, Los Angeles, CA, USA
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Luo H, I Garcia R, Moss ME, Bell RA, Wright W, Wu B. Trends of children being given advice for dental checkups and having a dental visit in the United States: 2001-2016. J Public Health Dent 2020; 80:123-131. [PMID: 31951026 DOI: 10.1111/jphd.12356] [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: 07/11/2019] [Revised: 12/06/2019] [Accepted: 12/23/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The objectives of this study were to describe trends of children being given dental checkup advice by primary care providers (PCPs) and having dental visits and to assess factors associated with being given dental checkup advice and having a dental visit. METHODS Data were from the annual, cross-sectional Medical Expenditure Panel Survey (MEPS) from 2001 to 2016. The sample included 126,773 children ages 2-17 years. We used predictive margins to estimate the probability of being given dental checkup advice and having a dental visit. We examined time trends of the proportion of children being given dental checkup advice from PCPs, as well as trends in the proportion of children having a dental visit from 2001 to 2016. Multiple logistic regression was used to assess the association between being given dental checkup advice and having a dental visit. RESULTS Overall, the proportion of children being given dental checkup advice increased from 31.4% in 2001 to 51.8% in 2016 (Trend P < 0.001). No significant increasing trend was found for having a dental visit among those being given dental checkup advice (Trend P > 0.05). Children being given dental checkup advice were more likely to have a dental visit (AOR = 1.54, P < 0.001). CONCLUSIONS Although there was an increase in the proportion of children being given advice to have dental checkups by PCPs from 2001 to 2016, there was no significant increase in having a dental visit among children being given the advice. More research is needed to better understand how dental care advice from a PCP can effectively motivate and facilitate dental care for children.
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Affiliation(s)
- Huabin Luo
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Raul I Garcia
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - Mark E Moss
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, NC, USA
| | - Ronny A Bell
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Wanda Wright
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, NC, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York City, NY, USA
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Yonenaga K, Iwanabe Y, Masaki C, Hosokawa R, Yonehara Y, Takato T, Masukawa R, Masukawa S. Cost of establishing a general dentistry department in a small or medium-sized hospital. J Oral Sci 2019; 61:558-559. [PMID: 31588096 DOI: 10.2334/josnusd.18-0261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
To contribute to future dental healthcare policies, this study compiled data on hospital expenses and follow-ups conducted after a hospital dentistry department was established. In addition, the management status and reports on the utility and challenges of establishing a dentistry department were analyzed. The dentistry department was established through fund raising and inaugurated in May 2009. The depreciation period was set at 7 years, and income and expenditure during the 7 years 8 months after opening were compiled. In total, 17.22 million yen was needed for the dentistry department. The average income from dental care was 21.59 million yen per year, and expenditure amounted to 21.54 million yen per year. The findings indicated that a general dentist able to systemically manage patients was essential in a chronic-care hospital. Moreover, the present findings indicate that if general dentistry consultations were performed without excessive investments, after adjusting for personnel expenses, such an initiative would neither yield considerable income nor produce a substantial deficit. Finally, it is imperative to develop staff who are familiar with the costs and management of hospital dentistry and to increase medical fees for consultations with elderly patients.
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Affiliation(s)
- Kazumichi Yonenaga
- Towa Hospital.,Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo
| | - Yujiro Iwanabe
- Towa Hospital.,Department of Oral Reconstruction and Rehabilitation, Kyushu Dental College
| | - Chihiro Masaki
- Department of Oral Reconstruction and Rehabilitation, Kyushu Dental College
| | - Ryuji Hosokawa
- Department of Oral Reconstruction and Rehabilitation, Kyushu Dental College
| | - Yoshiyuki Yonehara
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
| | - Tsuyoshi Takato
- Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo
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Ho MH, Montayre J, Chang HCR, Joo JY, Naghibi Sistani MM, Lin YK, Traynor V, Chang CC, Liu MF. Validation and evaluation of the Mandarin version of the oral health literacy adult questionnaire in Taiwan. Public Health Nurs 2019; 37:303-309. [PMID: 31742791 DOI: 10.1111/phn.12688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/06/2019] [Accepted: 10/17/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to translate the Oral Health Literacy Adult Questionnaire into a Mandarin version (MOHL-AQ) and to examine its psychometric properties. METHODS A methodological research using psychometric testing and evaluation of a translated instrument. A convenience sample of 402 participants from northern Taiwan were recruited for the validation of the MOHL-AQ. Internal consistency reliability, split-half reliability, inter-rater reliability, face validity, content validity, and construct validity were evaluated. RESULTS The value of internal consistency and split-half reliability of the MOHL-AQ were 0.77 and 0.78, respectively. Content validity reported a high content validity index (CVI = 95%). Exploratory factor analysis (EFA) and parallel analysis (PA) were used to determine a unidimensional model and confirmatory factor analysis (CFA) was employed to confirm the model. The indices of good fit model were achieved at GFI = 0.93, AGFI = 0.92, RMSEA = 0.04, CFI = 0.90, PGFI = 0.73, χ2 /df = 1.86 (p < .001). Most of the item-total correlations indicated adequate and acceptable convergent validity (r > .30). CONCLUSION MOHL-AQ demonstrates adequate psychometric properties for measuring the oral health literacy in Mandarin-speaking population. Public health nurses can use MOHL-AQ to assess oral health literacy in the community settings and further screen potential population with inadequate oral health literacy.
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Affiliation(s)
- Mu-Hsing Ho
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.,School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Campbelltown, NSW, Australia.,AUT Centre for Active Ageing, Auckland University of Technology, Auckland, New Zealand
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Jee Young Joo
- College of Nursing, Gachon University, Incheon, Korea
| | | | - Yen-Kuang Lin
- Research Center of Biostatistics, Taipei Medical University, Taipei, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.,College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan
| | - Megan F Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Shimpi N, Glurich I, Panny A, Acharya A. Knowledgeability, attitude, and practice behaviors of primary care providers toward managing patients' oral health care in medical practice: Wisconsin statewide survey. J Am Dent Assoc 2019; 150:863-872. [PMID: 31446976 DOI: 10.1016/j.adaj.2019.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND In this study, the authors sought to explore the receptivity, preparedness, and rates of adoption of integrated medical-dental models of care (MOCs) in the practice setting among primary care providers (PCPs) treating patients with diabetes mellitus (DM). METHODS The authors conducted an anonymous statewide survey targeting PCPs across a range of Wisconsin-based practice settings to evaluate knowledgeability, attitude, practice behaviors, and perceived barriers to oral health screening in a medical setting. Qualitative analytical approaches included thematic analyses applied to evaluate the status of and barriers to integrated medical-dental MOC adoption. RESULTS The integrated medical-dental MOC adoption rate was 34%. Top perceived barriers to integrated medical-dental MOC adoption included insurance coverage (71%) and care access (70%). A total of 39% indicated competency for educating patients about the association between DM and periodontitis. Although 72% of PCPs indicated optimal periodicity for oral health assessment as frequent, 39% reported frequently conducting such assessments. CONCLUSIONS Although PCPs indicate receptivity to integrated medical-dental MOCs, PCPs identify suboptimal education, lack of adequate training in oral-systemic disease assessment, and barriers to oral health care access as barriers to integrated medical-dental MOC adoption. PRACTICAL IMPLICATIONS Integrated medical-dental MOC adoption in care delivery to patients with DM remains below average. Interdisciplinary efforts and education are needed to address identified barriers to care integration.
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Ho MH, Rita Chang HC, Lin YK, Traynor V, Tsai HH, Buckwalter K, Liu MF, Chang CC. Application of the Integrated Behavioral Model to oral self-care behavior of community-dwelling middle-aged and older people in Taiwan. Public Health Nurs 2019; 36:726-734. [PMID: 31348558 DOI: 10.1111/phn.12646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/22/2019] [Accepted: 06/25/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study evaluated the Integrated Behavioral Model and examined oral self-care behavior of community-dwelling middle-aged and older people. DESIGN A cross-sectional design was used. SAMPLE Purposive sampling was employed to recruit middle and older age community-dwelling individuals, with research locations in public health centers in northern Taiwan. MEASUREMENTS Structured questionnaires comprised: participant demographics, oral health literacy, oral self-care attitude, self-efficacy, intention, and behavior, and significant others' perceptions and beliefs as well as environmental constraints. The Model verification was evaluated by path analysis. RESULTS Two hundred and sixty-three participants (N = 263) completed the questionnaire survey. Results identified significant direct effects of the independent variables of oral health care literacy, intention of oral self-care, and perception of environmental constraints on the dependent variable of oral self-care behavior; and significant indirect effects on attitude of oral self-care, perception of significant other beliefs, self-efficacy of oral self-care. CONCLUSION Public health nurses work with the whole community and can potentially improve the oral self-care behavior of middle-aged and older adults by enhancing their oral health knowledge, maintaining their positive attitudes, assisting acceptance of recognition and support from others, increasing their ability to perform oral self-care, reducing environmental constraints, and thereby enhancing their oral self-care awareness.
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Affiliation(s)
- Mu-Hsing Ho
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.,School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Yen-Kuang Lin
- Research Center of Biostatistics, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Hung-Huey Tsai
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | | | - Megan F Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.,College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan
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Guarnizo-Herreño CC, Lyu W, Wehby GL. Children's Oral Health and Academic Performance: Evidence of a Persisting Relationship Over the Last Decade in the United States. J Pediatr 2019; 209:183-189.e2. [PMID: 30926152 PMCID: PMC6667186 DOI: 10.1016/j.jpeds.2019.01.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/17/2019] [Accepted: 01/29/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the association between children's oral health and academic performance using the most recent US national data, a decade after the last assessment using similar previous data. STUDY DESIGN Data from the 2016-2017 National Survey of Children's Health for 45 711 children aged 6-17 years were analyzed. Children's oral health measures were indicators of specific oral health problems and parent-rated oral health. Academic performance measures included problems at school and missing school days. Regression models were employed adjusting for relevant demographic, socioeconomic, and health characteristics and state effects. Analyses also were conducted stratifying by child's age, sex, household income, and type of health insurance. RESULTS We found significant associations across all the evaluated academic outcomes and oral health measures. Children with oral health problems were more likely to have problems at school (OR 1.56, 95% CI 1.32-1.85), miss at least 1 school day (OR 1.54, 95% CI 1.28-1.85), and miss more than 3 or 6 school days (OR 1.39, 95% CI 1.20-1.61 and OR 1.39, 95% CI 1.14-1.69; respectively). These associations were generally larger when using the child's oral health rating. Poor oral health was consistently related to worse academic performance across age, sex, household income, and health insurance type subgroups. CONCLUSIONS Children's oral health status continues to be strongly linked to their academic outcomes. This evidence highlights the need for broad population-wide policies and integrated approaches to reduce academic deficits and promote children's health and development, of which oral health is an important component.
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Affiliation(s)
- Carol Cristina Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia; Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Wei Lyu
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA
| | - George L Wehby
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA; National Bureau of Economic Research, Cambridge, MA.
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Haber J, Dolce MC, Hartnett E, Savageau JA, Altman S, Lange‐Kessler J, Silk H. Integrating Oral Health Curricula into Midwifery Graduate Programs: Results of a US Survey. J Midwifery Womens Health 2019; 64:462-471. [DOI: 10.1111/jmwh.12974] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 01/22/2019] [Accepted: 02/21/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Judith Haber
- Rory Meyers College of NursingNew York University New York New York
| | - Maria C. Dolce
- School of NursingStony Brook University Stony Brook New York
| | - Erin Hartnett
- Rory Meyers College of NursingNew York University New York New York
| | | | - Susan Altman
- Rory Meyers College of NursingNew York University New York New York
- School of Dental MedicineHarvard University Boston Massachusetts
| | - Julia Lange‐Kessler
- School of Nursing and Health StudiesGeorgetown University Washington District of Columbia
| | - Hugh Silk
- Medical SchoolUniversity of Massachusetts Worcester Massachusetts
- School of Dental MedicineHarvard University Boston Massachusetts
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Thompson L, Jiang T, Savageau JA, Silk H, Riedy CA. An Assessment of Oral Health Training Among Geriatric Fellowship Programs: A National Survey. J Am Geriatr Soc 2019; 67:1079-1084. [PMID: 30693943 DOI: 10.1111/jgs.15755] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 02/06/2023]
Abstract
Oral health (OH) has profound effects on the overall health of elderly people. While oral disease is prevalent in the geriatric population and access to care is a major issue, it is unclear the extent of OH training among US geriatric fellowship programs. A 19-item electronic survey was sent to all 148 accredited geriatric fellowship training programs via the Association of Directors of Geriatric Medicine. Directors were asked about hours of trainings, barriers, and evaluation of trainees among other topics. Univariate and bivariate analyses were performed. Seventy-five directors completed the survey (51% response rate). Sixty-three percent (46/73) report their fellows receive 1 to 2 hours of OH instruction (ie, lectures, workshops) during their training. Almost a quarter (23%; 17/73) reported 0 hours of OH content. Only 17% (13/75) have clinical experiences in a dental setting. Barriers to more OH education include competing priorities or lack of time (57%; 43/75), lack of faculty expertise (55%; 41/75), and no clear geriatric national educational competencies (44%; 33/75). Programs with an OH champion or dental school/residency affiliation had more hours of OH instruction. Geriatric fellowships appear to need more OH training, which could be achieved by creating OH champions and connecting fellowships with dental schools/residencies. Barriers could be overcome by exposing fellowships to existing resources and creating national competencies. J Am Geriatr Soc 67:1079-1084, 2019.
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Affiliation(s)
- Lisa Thompson
- Harvard School of Dental Medicine, Department of Oral Health Policy and Epidemiology, Boston, Massachusetts
| | - Tien Jiang
- Harvard School of Dental Medicine, Department of Oral Health Policy and Epidemiology, Boston, Massachusetts
| | - Judith A Savageau
- University of Massachusetts Medical School, Department of Family Medicine and Community Health, Worcester, Massachusetts
| | - Hugh Silk
- University of Massachusetts Medical School, Department of Family Medicine and Community Health, Worcester, Massachusetts
| | - Christine A Riedy
- Harvard School of Dental Medicine, Department of Oral Health Policy and Epidemiology, Boston, Massachusetts
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44
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Alsubaie AR. Oral health-related behaviors and dental pain among children in Saudi Arabia. J Int Oral Health 2019. [DOI: 10.4103/jioh.jioh_253_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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45
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Integrating oral health curricula into nurse practitioner graduate programs: Results of a US survey. J Am Assoc Nurse Pract 2018; 30:638-647. [DOI: 10.1097/jxx.0000000000000079] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Watt RG, Mathur MR, Aida J, Bönecker M, Venturelli R, Gansky SA. Oral Health Disparities in Children: A Canary in the Coalmine? Pediatr Clin North Am 2018; 65:965-979. [PMID: 30213357 DOI: 10.1016/j.pcl.2018.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite being largely preventable, oral diseases are still a major public health problem in child populations in many parts of the world. Increasingly, however, oral diseases disproportionately affect socially disadvantaged groups in society. It is unjust and unfair that children and families from disadvantaged backgrounds experience high levels of oral diseases. This article analyzes oral diseases through a health disparities lens. Action to combat oral health disparities requires a radical multifaceted strategy that addresses the shared underlying root causes of oral diseases, the social determinants of health inequality.
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Affiliation(s)
- Richard G Watt
- Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Manu Raj Mathur
- Department of Dental Public Health, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area Gurgaon, Gurgaon, Haryana 122002, India
| | - Jun Aida
- Department of International Health, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Marcelo Bönecker
- Dental Faculty, Av. Prof Lineu Prestes 2227 - University of Sao Paulo, Sao Paulo 05508-900, Brazil
| | - Renato Venturelli
- Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Stuart A Gansky
- Division of Oral Epidemiology and Dental Public Health, Center to Address Disparities in Children's Oral Health (Known As CAN DO), Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, Box #1361, San Francisco, CA 94143, USA
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Simmer-Beck M. Thinking inside the mouth: Public health nurses solve the dental crisis. Public Health Nurs 2018; 35:259-260. [PMID: 29998479 DOI: 10.1111/phn.12412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/03/2018] [Indexed: 11/29/2022]
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Kaste LM, Halpern LR. The Barber Pole Might Have Been an Early Sign for Patient-Centered Care: What Do Interprofessional Education and Interprofessional Collaborative Practice Look Like Now? Dent Clin North Am 2018; 60:765-88. [PMID: 27671953 DOI: 10.1016/j.cden.2016.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In 2009, the Interprofessional Education Collaborative (IPEC) was initiated. Its release of interprofessional collaborative practice (ICP) core competencies in 2011 was pivotal for the engagement of health care professionals, including dentistry; in patient-centered, collaborative efforts for interprofessional education (IPE); and ICP. Thereby, IPEC is helping to put into application, in North America, the 2010 World Health Organization (WHO) Framework for Action on Interprofessional Education and Collaborative Practice. This article introduces IPE/ICP in 5 phases of evolution, emphasizing dental influence and inclusion, from historical perspectives through current applications that are expanded on in the accompanying articles elsewhere in this issue.
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Affiliation(s)
- Linda M Kaste
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois at Chicago, 801 South Paulina Street, MC 850, Room 563A, Chicago, IL 60612, USA.
| | - Leslie R Halpern
- Department of Oral and Maxillofacial Surgery, Meharry Medical College, 1005 DB Todd Jr. Boulevard, Nashville, TN 37208, USA
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Abstract
This article describes federal programs, initiatives, and partnerships that have the demonstrated potential to initiate and institutionalize interprofessional practice that includes oral health providers as integral to the provider team. A discussion of landmark documents and reports, the role of legislation and statutory authority, and the influence of federal program priorities towards a national movement to increase access to care to bridge the chasms between the medical health care system, dental delivery system, and oral health is presented.
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Nandakumar VA, Chattu VK, Kumary S, Naidu R. Addressing the Bottle Necks of Global Oral Health to Tackle the Growing Epidemic of Noncommunicable Diseases. JOURNAL OF ADVANCED ORAL RESEARCH 2018. [DOI: 10.1177/2320206818798912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Oral health touches every aspect of our lives and still it is been taken for granted. The access and affordability to oral health care services are very limited and expensive especially in developing countries. Objectives: The article highlights the importance of global oral health and how it can tackle the growing noncommunicable diseases (NCDs) epidemic. Dental caries remains a significant problem even among the developed nations affecting 60% to 70 % of the children. Oral cancers, Qat chewing, craniofacial anomalies, and dental trauma contribute significantly to the global burden of diseases. Despite the magnitude of oral illness, there is neglect in global oral health, resulting in lack of combined action and support within the arena. Conclusions: Oral conditions share many common risk factors with NCDs and are also affected by similar social determinants. The Political Declaration of the High-level Meeting on the prevention and control of NCDs recognizes that oral diseases pose a significant burden for many countries and these diseases also share common risk factors of NCDs and can benefit from the multisectoral and multipronged approaches to NCDs. To address the existing inequities and inequalities in oral health care services globally, it is vital to ensure coverage for the poor and disadvantaged populations. Recommendations: There is a great need to develop some measurable oral health goals for global comparison in order to track, reduce oral disease burden, and to promote good oral health thereby advancing global public health.
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Affiliation(s)
| | - Vijay Kumar Chattu
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Soosanna Kumary
- Public Health Researcher, St. Augustine, Trinidad and Tobago
| | - Rahul Naidu
- School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
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