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Journal of the American Dental... Feb 2024The authors aimed to develop and validate 2 Dental Quality Alliance measures of dental care access during pregnancy (Utilization of Services During Pregnancy, Oral...
BACKGROUND
The authors aimed to develop and validate 2 Dental Quality Alliance measures of dental care access during pregnancy (Utilization of Services During Pregnancy, Oral Evaluation During Pregnancy) using claims and enrollment data and to report performance on these measures for a sample of Medicaid and Children's Health Insurance Program beneficiaries.
METHODS
The authors used Transformed Medicaid Statistical Information System enrollment and claims data for 7,767,806 people enrolled in 5 state Medicaid programs and Children's Health Insurance Programs during 2018. The authors used split-half reliability testing to assess measure reliability. The authors calculated 95% CIs to assess statistically significant variation in performance between programs.
RESULTS
The intraclass correlation coefficient used to assess agreement between the split samples was 0.992 (95% CI, 0.941 to 0.999; P < .0001) for Utilization of Services During Pregnancy and 0.983 (95% CI, 0.879 to 0.998; P < .0001) for Oral Evaluation During Pregnancy. Performance scores ranged from 20% through 34% of beneficiaries receiving any dental service during pregnancy (Utilization of Services During Pregnancy) and from 14% through 23% of beneficiaries receiving a periodic or comprehensive oral evaluation during pregnancy (Oral Evaluation During Pregnancy), with statistically significant differences between programs.
CONCLUSIONS
The measures reliably assessed access to dental services and can distinguish performance between programs.
PRACTICAL IMPLICATIONS
These measures can be used to advance population health by means of supporting national efforts to improve access to dental care during pregnancy.
Topics: Child; United States; Humans; Pregnancy; Female; Reproducibility of Results; Insurance, Health; Medicaid; Child Health; Dental Care; Health Services Accessibility
PubMed: 38180426
DOI: 10.1016/j.adaj.2023.10.010 -
The Chinese Journal of Dental Research Sep 2023Nanotechnology is a rapidly evolving field with numerous biological applications and is becoming increasingly significant due to its immense potential to enhance the... (Review)
Review
Nanotechnology is a rapidly evolving field with numerous biological applications and is becoming increasingly significant due to its immense potential to enhance the properties of orthodontic and biomaterials. It is employed in various emerging areas of orthodontics, focusing on improving the performance of diverse orthodontic appliances and accessories, as well as nanoelectromechanical systems (NEMS) and nanorobots. Nevertheless, the biocompatibility and cytotoxicity of nanomaterials in orthodontic applications require further investigation. This paper reviews the latest applications of nanomaterials in orthodontics, elucidates their unique features and synergistic applications in orthodontics, and outlines prospective developments in the field.
Topics: Humans; Orthodontics; Prospective Studies; Nanostructures; Nanotechnology; Dental Care
PubMed: 37732680
DOI: 10.3290/j.cjdr.b4330821 -
Journal of Dental Hygiene : JDH Oct 2023Increased awareness of oral health disparities in the United States has highlighted the need to expand the workforce and access to both primary and preventive dental...
Increased awareness of oral health disparities in the United States has highlighted the need to expand the workforce and access to both primary and preventive dental care. Achieving oral health equity will require new dental team members with appropriate clinical skills dedicated to reaching historically marginalized populations through intra and interprofessional practice. Collective efforts by health care advocates in Minnesota led to legislation that created a dental hygiene-based workforce model inspired by the vision and foresight of the American Dental Hygienists' Association's "Advanced Dental Hygiene Practitioner." In July 2023, there were 141 licensed dental therapists and 99 certified advanced dental therapists, with the majority being dual-licensed dental hygienists/dental therapists, providing primary care services in a variety of settings throughout the state. Current data confirm their contributions to increasing access to primary oral health care services for Minnesotans across the lifespan. While surmountable challenges remain, new opportunities are emerging for dental therapists within Minnesota's transforming health care system. The purpose of this paper is to describe the implementation of this new workforce model in Minnesota, its challenges and successes to assist other states in developing new models for intraprofessional dental team members.
Topics: United States; Humans; Health Services Accessibility; Minnesota; Dental Care; Clinical Competence; Workforce; Dental Hygienists
PubMed: 37816612
DOI: No ID Found -
Journal of Public Health Dentistry Sep 2023To determine if relationships exist between the total dental treatment needs of incoming Air Force recruits and non-clincal demographic and oral-health related factors.
OBJECTIVE
To determine if relationships exist between the total dental treatment needs of incoming Air Force recruits and non-clincal demographic and oral-health related factors.
METHODS
Data from the 2018 Air Force Recruit Oral Health Study (ROHS) was used, an anonymized sample of 1330 AF recruits that included a comprehensive oral exam and survey collecting demographic and oral health behavior information. The primary outcome variable was the total number of dental treatment needs for recruits, and independent predictor variables included select socio-demographic factors and wellness behaviors. Along with descriptive statistics, a multivariable negative binomial regression analysis was performed to assess the relationship between variables with a normalized weight making the final results representative of all incoming recruits.
RESULTS
The final adjusted analysis showed that an incoming recruit's self-rated oral health, dental coverage prior to enlistment, need for a dental visit within the last 12 months, sugar intake, and tobacco use increased their risk for dental treatment needs.
CONCLUSION
This is the first study to assess the relationship between specific risk indicators and increased dental treatment needs while adjusting other related covariates. Factors associated with dental treatment needs were identified that provide Air Force leaders with actionable information to directly improve recruit oral health and military readiness by identifying new airmen at the highest risk for excessive dental care needs while at basic military training.
Topics: Humans; Oral Health; Military Personnel; Health Behavior; Dental Care; Risk Factors
PubMed: 37906178
DOI: 10.1111/jphd.12590 -
Special Care in Dentistry : Official... 2023Dental school graduates often have a basic knowledge in the management of patients with specialized healthcare needs. As of August 2019, CODA amended their accreditation...
Dental school graduates often have a basic knowledge in the management of patients with specialized healthcare needs. As of August 2019, CODA amended their accreditation standard 2-25: dental school graduates must be competent in the assessment and management of treatment of patients with specialized healthcare needs and disabilities. While the majority of these patients require modified dental care, many dental schools lack the facilities to provide both the proper care and education. This paper identifies improvements to dental education brought on by the innovations at Penn Dental Medicines' Personalized Care Suite for Persons with Disabilities (PCARE). Patient centered care is the emphasis of the PCARE curriculum. Although the clinic has special rooms and equipment to assist in accommodating the special needs of the patients, the program focuses on teaching dental students how to provide comfortable, safe, and effective care in a typical office setting. Detailed patient assessment, non-pharmacological management techniques, and treatment plans designed to meet the needs and abilities of the patients and caregivers are taught through lecture and direct patient care. Teaching assessment and management of this population is of great importance. Including treatment in Standard 2-25 creates another challenge to dental education. Penn Dental's facility allows multidisciplinary care in a cohesive and timely manner. The experience in PCARE offers unique opportunities to educate dental professionals in developing a patient centered approach in the treatment and maintenance of oral health in those patients who require accommodation.
Topics: Humans; Models, Educational; Dental Care for Disabled; Curriculum; Education, Dental; Patient Care
PubMed: 37544886
DOI: 10.1111/scd.12914 -
BMC Oral Health Jun 2024Global neglect of oral healthcare services (OHCS) provision, mainly in Low- and Middle-Income Countries, exacerbates the deterioration of health systems and increases... (Review)
Review
Global neglect of oral healthcare services (OHCS) provision, mainly in Low- and Middle-Income Countries, exacerbates the deterioration of health systems and increases global health inequality.ObjectivesThe objective is to explore the profiles of available oral healthcare services in the WHO Eastern Mediterranean Region (EMR) countries.MethodsA systematic literature search was conducted of grey literature and databases (PubMed, Medline, Embase, and the Cochrane Library). Peer-reviewed articles that reviewed and/or evaluated OHCS in WHO-EMR countries were identified. No time or language limitations were applied. Two independent reviewers conducted the screening and data extraction. A third reviewer arbitrated disagreement. The evaluation of the OHCS provision followed the WHO framework for health system performance assessment. The extraction included socio-demographic characteristics of the studied population, OHCS profile, responsiveness, and health insurance coverage.ResultsOne hundred and thirty-seven studies were identified. The studies that met the inclusion criteria were fifteen published between 1987 and 2016. In addition, two reports were published in 2022. The included studies were conducted in Pakistan, Saudi Arabia, Iran, Libya, Egypt, Oman, Syria, Jourdan, Kuwait, and Tunisia. Generally, Ministries of Health are the main providers of OHCS. The provision for national dental care prevention programmes was highly limited. Furthermore, most of these Ministries of Health have struggled to meet their local populations' dental needs due to limited finances and resources for OHCS.ConclusionsOral and dental diseases are highly prevalent in the WHO-EMR region and the governments of the region face many challenges to meeting the OHCS needs of the population. Therefore, further studies to assess and re-design the OHCS in these countries to adapt dental care prevention into national health programmes are crucial.
Topics: Humans; World Health Organization; Dental Health Services; Middle East; Health Services Accessibility; Mediterranean Region; Oral Health; Developing Countries; Dental Care
PubMed: 38890617
DOI: 10.1186/s12903-024-04446-9 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Apr 2024Improper diagnosis and design, misusing orthodontic technique, relapse after orthodontic treatment, and poor patient compliance may lead to treatment failure, requiring...
Improper diagnosis and design, misusing orthodontic technique, relapse after orthodontic treatment, and poor patient compliance may lead to treatment failure, requiring orthodontic retreatment. While in such cases, patients usually have already had their teeth extracted, or are with periodontal, joint, and other dental problems, which often require multidisciplinary treatment. The retreatment of orthodontic patients is difficult, and the treatment options are limited. The characteristics of clear aligner treatment, such as comfortable and beautiful appearance, high degree of digital precision, and personalized tooth arrangement to simulate the final outcome, make it popular in the orthodontic retreatment. This article discusses and summarizes the details of orthodontic design, case monitoring, and the application of clear aligner in orthodontic retreatment of failed cases. Before starting treatment, the difficulty assessment tool (clear aligner treatment complexity assessment tool) can be used to evaluate the difficulty of clear aligner treatment. Orthodontists are recommended to treat orthodontic patients with clear aligners within their ability to avoid treatment failure. The key to the success of the extraction case treatment with clear aligner is to make the correct diagnosis and select the right cases. In the treatment planning, attention should be paid to the restoration of anterior tooth torque, making good use of molar distalization to obtain the space, vertical control, and improving posterior tooth relationship. Proper selection of cases and reasonable design in clear aligner treatment are expected to obtain tooth alignment, good intercuspation, normal overbite and overjet, periodontal health, parallel roots, and to achieve the goal of aesthetic, functional, stable, and healthy orthodontic treatment.
Topics: Humans; Esthetics, Dental; Orthodontic Appliances, Removable; Tooth Movement Techniques; Dental Care; Retreatment
PubMed: 38548599
DOI: 10.3760/cma.j.cn112144-20240109-00017 -
British Dental Journal Aug 2023Providing restorative dental care for patients with tooth wear can, at times, seem complex and demanding. The key to this process lies in a systematic approach that...
Providing restorative dental care for patients with tooth wear can, at times, seem complex and demanding. The key to this process lies in a systematic approach that breaks down the component parts. In this chapter, the importance of a comprehensive assessment at the outset will be highlighted. This should include identification of the patient's chief complaint, taking a thorough history, completing the clinical examination, undertaking any special tests and arriving at clinical diagnoses. Together, this information will influence the treatment planning process, identify appropriate treatment concepts and options available and the individual stages that may be involved. The process should be both holistic and thorough to enable the patient and clinician to build a clear pathway and vision. In parallel, and with patient input throughout, it is essential to manage patient expectations as best as possible whilst remaining pragmatic and honest about treatment outcomes, longevity of restorations and the risks of failure.
Topics: Humans; Tooth Wear; Tooth Attrition; Patient Care Planning; Dental Care; Dental Restoration, Permanent
PubMed: 37563386
DOI: 10.1038/s41415-023-6116-y -
American Journal of Orthodontics and... Sep 2023Motivations, perceptions, and psychosocial states of adult patients with orthodontic disorders in China have not been widely studied. The study assessed the psychosocial...
INTRODUCTION
Motivations, perceptions, and psychosocial states of adult patients with orthodontic disorders in China have not been widely studied. The study assessed the psychosocial states and perceptions of adult patients undergoing orthodontic treatments with different motivations.
METHODS
Two hundred forty-three adult patients (mean age, 30.2 ± 7.4 years; women, 79.0%) undergoing orthodontic treatment were recruited from a tertiary stomatology hospital. The patients answered a patient-centered questionnaire regarding motivations and perceptions of orthodontic treatment and the Psychosocial Impact of Dental Aesthetics Questionnaire. Data were analyzed using the chi-square test on the basis of multiple responses. Multiple linear regression analyses were performed to determine the association between motivation factors and the Psychosocial Impact of Dental Aesthetics Questionnaire subscale scores (P <0.05).
RESULTS
Patients with various motivations were as follows: occlusal function reason (70.4%), dental esthetic reason (54.7%), facial esthetic reason (24.3%), and following others' suggestions (18.5%). Patients with esthetic or occlusal motivations exhibited significantly greater need and interest for orthodontic treatment (P <0.001). Multiple linear regression analyses revealed that the scores of social impact, psychological impact, and esthetic concern subscales were significantly associated with both dental and facial esthetic motivations (P <0.001).
CONCLUSIONS
The primary motivations of Chinese patients were observed to be improved esthetics and occlusal function. Patients with esthetic or occlusal motivations exhibited significantly greater need and interest in treatment. Patients with facial or dental esthetic motivations experienced greater impacts of psychosocial states. Therefore, the patient motivations and impacts of esthetic-related psychosocial states on them should be considered during treatment.
Topics: Humans; Adult; Female; Young Adult; Malocclusion; Motivation; Esthetics, Dental; Dental Care; Surveys and Questionnaires; Self Concept
PubMed: 37341669
DOI: 10.1016/j.ajodo.2023.05.021 -
Community Dentistry and Oral... Oct 2023With elimination of the financial burden of dental services, one can expect an increase in utilization of dental services. This study aimed to investigate the effective...
OBJECTIVES
With elimination of the financial burden of dental services, one can expect an increase in utilization of dental services. This study aimed to investigate the effective mechanisms of financial barriers to the utilization of dental services in an Australian adult population.
METHODS
South Australian survey data from the Dental Care and Oral Health Study (2015) were analysed. Following the flexible mediation approach, the direct effect of income and indirect effect of income through mediators (insurance, concession card and service sector) on the outcomes (visit avoidance and treatment prevention due to the cost) were calculated.
RESULTS
Findings showed that around half of the low-income people and one-third of the high-income South Australians experienced a financial burden on receiving a dental visit or service. The indirect effect of income on both outcomes of financial burden was negligible, while the direct effect was significant. By changing the potential outcome distribution to their counterfactual exposure distribution and if the mediators are drawn from their counterfactual exposure (lower/higher income) distribution, the odds of visit avoidance and treatment prevention due to the cost were almost twice (Odds Ratio: 2.13, 95% CI 1.72-2.60) and 98% (Odds Ratio: 1.98, 95% CI 1.67-2.35) than in the lower-income individuals, respectively.
CONCLUSIONS
It can be concluded that the level of household income, directly and regardless of insurance status, concession card ownership and whether the service sector was public or private, affected the financial burden on utilization of dental services.
Topics: Adult; Humans; Mediation Analysis; Health Services Accessibility; Australia; Income; Dental Care
PubMed: 35681256
DOI: 10.1111/cdoe.12767