Journal of public health dentistry最新文献

Exploring Oral Health Disparities in the 2022 BRFSS: The Impact of Rural/Urban Status and Adverse Childhood Experiences 探索2022年BRFSS中的口腔健康差异：农村/城市状况和不良童年经历的影响。

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-11-06 DOI: 10.1111/jphd.70019

Jihee Song, Jeong Nam Kim

Objectives

To examine the association between rural/urban status, adverse childhood experiences (ACEs), and oral health outcomes, specifically focusing on inadequate dental visits and significant tooth loss.

Methods

Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), including 79,571 U.S adults from 12 states, was analyzed. Inadequate dental visits were defined as having last visited a dentist more than one year ago. Significant tooth loss was defined as the loss of six or more permanent teeth due to decay or gum disease. Multivariable logistic regression models were applied to assess the effects of rural/urban status and ACEs on both outcomes, adjusting for sociodemographic factors.

Results

Rural residents had higher odds of reporting inadequate dental visits (AOR: 1.17, 95% CI: 1.07–1.29) and significant tooth loss (AOR: 1.36, 95% CI: 1.21–1.53) compared to urban residents. ACEs were significantly associated with both outcomes, with individuals reporting 4 or more ACEs showing the highest prevalence of inadequate dental visits and significant tooth loss. Although no statistically significant interaction between rural/urban status and ACEs was found, rural residents generally had worse oral health outcomes than their urban counterparts.

Conclusions

Both rural/urban status and ACEs independently contribute to oral health disparities, with rural populations facing greater challenges in maintaining oral health. The findings emphasize the need for targeted interventions that address geographic and psychosocial determinants, particularly in rural areas, and highlight the importance of trauma-informed care in dental practice.

目的：研究农村/城市状况、不良童年经历（ace）和口腔健康结果之间的关系，特别关注不充分的牙科就诊和严重的牙齿脱落。方法：来自2022年行为风险因素监测系统（BRFSS）的数据，包括79,571名美国人。来自12个州的美国成年人的数据进行了分析。看牙医次数不足的定义是上一次看牙医是在一年多以前。严重的牙齿脱落被定义为由于蛀牙或牙龈疾病而失去六颗或更多的恒牙。采用多变量logistic回归模型评估城乡状况和ace对两种结果的影响，并对社会人口因素进行调整。结果：与城市居民相比，农村居民报告牙科就诊不足（AOR: 1.17, 95% CI: 1.07-1.29）和严重牙齿脱落（AOR: 1.36, 95% CI: 1.21-1.53）的几率更高。ace与两种结果均显著相关，报告4次或4次以上ace的患者就诊不足和牙齿严重脱落的发生率最高。虽然没有发现农村/城市状况与ace之间有统计学意义的相互作用，但农村居民的口腔健康状况通常比城市居民差。结论：农村/城市状况和ace都是导致口腔健康差异的独立因素，农村人口在维持口腔健康方面面临更大的挑战。研究结果强调需要有针对性的干预措施，解决地理和社会心理决定因素，特别是在农村地区，并强调创伤知情护理在牙科实践中的重要性。

{"title":"Exploring Oral Health Disparities in the 2022 BRFSS: The Impact of Rural/Urban Status and Adverse Childhood Experiences","authors":"Jihee Song, Jeong Nam Kim","doi":"10.1111/jphd.70019","DOIUrl":"10.1111/jphd.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the association between rural/urban status, adverse childhood experiences (ACEs), and oral health outcomes, specifically focusing on inadequate dental visits and significant tooth loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), including 79,571 U.S adults from 12 states, was analyzed. Inadequate dental visits were defined as having last visited a dentist more than one year ago. Significant tooth loss was defined as the loss of six or more permanent teeth due to decay or gum disease. Multivariable logistic regression models were applied to assess the effects of rural/urban status and ACEs on both outcomes, adjusting for sociodemographic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Rural residents had higher odds of reporting inadequate dental visits (AOR: 1.17, 95% CI: 1.07–1.29) and significant tooth loss (AOR: 1.36, 95% CI: 1.21–1.53) compared to urban residents. ACEs were significantly associated with both outcomes, with individuals reporting 4 or more ACEs showing the highest prevalence of inadequate dental visits and significant tooth loss. Although no statistically significant interaction between rural/urban status and ACEs was found, rural residents generally had worse oral health outcomes than their urban counterparts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both rural/urban status and ACEs independently contribute to oral health disparities, with rural populations facing greater challenges in maintaining oral health. The findings emphasize the need for targeted interventions that address geographic and psychosocial determinants, particularly in rural areas, and highlight the importance of trauma-informed care in dental practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"473-481"},"PeriodicalIF":1.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pressing Issues for Oral Health Care Access and Quality Improvement During Pregnancy in Portugal—A Qualitative Study 在葡萄牙怀孕期间口腔卫生保健获取和质量改善的紧迫问题-一项定性研究。

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-10-30 DOI: 10.1111/jphd.70014

Leonor Frey-Furtado, Paulo Melo, Stefan Listl, Maria Lurdes Pereira

Objective

To identify and prioritize pressing issues related to access and quality of oral healthcare during preconception, pregnancy, and postpartum in Portugal.

Methods

Ethical approval (number 8/2024) and data protection clearance (R-12/2024) were granted. Twelve stakeholders, including healthcare professionals, policymakers, representatives of nongovernmental organizations, and recent mothers, were recruited through snowball sampling. The Nominal Group Technique structured a four-step process: (1) online discussions at policy, community, and practice levels; (2) initial voting to screen pressing issues; (3) plenary discussion; and (4) final voting.

Results

At the policy level, the highest-ranked pressing issues were the lack of a mandatory oral health diagnostic appointment for early detection, limited coverage of the Cheque-Dentista program, which excludes the preconception period, and the absence of oral health education in childbirth and parenting courses. At the community level, pressing issues included the absence of oral health in family planning consultations, insufficient oral health training for midwives and nurses, and weak direct engagement with pregnant women through targeted promotion strategies. At the practice level, the most pressing issues were the exclusion of dentists from maternal healthcare teams, the lack of structured oral health appointments in primary healthcare centers, and the omission of oral health modules from childbirth preparation programs.

Conclusion

The Nominal Group Technique enabled consensus-building and prioritization of concrete pressing issues, producing actionable strategies to strengthen maternal oral healthcare in Portugal. Literacy, accessibility, and collaboration have emerged as foundational elements for integrating oral health into maternal care pathways.

目的：确定和优先考虑与访问和口腔保健质量在孕前，怀孕和产后在葡萄牙紧迫的问题。方法：获得伦理批准（编号8/2024）和数据保护许可（R-12/2024）。通过滚雪球抽样方法招募了12名利益攸关方，包括卫生保健专业人员、政策制定者、非政府组织代表和新妈妈。名义小组技术构建了一个四步流程：(1)在政策、社区和实践层面进行在线讨论；(2)对筛选紧迫问题进行初步投票；（三）全体讨论；(4)最终投票。结果：在政策层面，排名最高的紧迫问题是缺乏强制性的早期口腔健康诊断预约，检查-牙科计划的覆盖面有限，不包括孕前期，以及在分娩和育儿课程中缺乏口腔健康教育。在社区一级，紧迫的问题包括计划生育咨询中缺乏口腔保健，助产士和护士的口腔保健培训不足，以及通过有针对性的促进战略与孕妇的直接接触不足。在实践层面，最紧迫的问题是将牙医排除在孕产妇保健团队之外，初级保健中心缺乏结构化的口腔健康预约，以及分娩准备方案中遗漏了口腔健康模块。结论：名义小组技术使建立共识和确定具体紧迫问题的优先次序，产生可操作的战略，以加强葡萄牙的产妇口腔保健。扫盲、可及性和协作已成为将口腔卫生纳入孕产妇保健途径的基本要素。

{"title":"Pressing Issues for Oral Health Care Access and Quality Improvement During Pregnancy in Portugal—A Qualitative Study","authors":"Leonor Frey-Furtado, Paulo Melo, Stefan Listl, Maria Lurdes Pereira","doi":"10.1111/jphd.70014","DOIUrl":"10.1111/jphd.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify and prioritize pressing issues related to access and quality of oral healthcare during preconception, pregnancy, and postpartum in Portugal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ethical approval (number 8/2024) and data protection clearance (R-12/2024) were granted. Twelve stakeholders, including healthcare professionals, policymakers, representatives of nongovernmental organizations, and recent mothers, were recruited through snowball sampling. The Nominal Group Technique structured a four-step process: (1) online discussions at policy, community, and practice levels; (2) initial voting to screen pressing issues; (3) plenary discussion; and (4) final voting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the policy level, the highest-ranked pressing issues were the lack of a mandatory oral health diagnostic appointment for early detection, limited coverage of the <i>Cheque-Dentista</i> program, which excludes the preconception period, and the absence of oral health education in childbirth and parenting courses. At the community level, pressing issues included the absence of oral health in family planning consultations, insufficient oral health training for midwives and nurses, and weak direct engagement with pregnant women through targeted promotion strategies. At the practice level, the most pressing issues were the exclusion of dentists from maternal healthcare teams, the lack of structured oral health appointments in primary healthcare centers, and the omission of oral health modules from childbirth preparation programs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Nominal Group Technique enabled consensus-building and prioritization of concrete pressing issues, producing actionable strategies to strengthen maternal oral healthcare in Portugal. Literacy, accessibility, and collaboration have emerged as foundational elements for integrating oral health into maternal care pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"464-472"},"PeriodicalIF":1.5,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145411228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effect of a Rural Workforce Intervention to Improve Oral Health of Children: Evidence From an Interrupted Time Series Study of Southeast Alaska 农村劳动力干预对改善儿童口腔健康的影响：来自阿拉斯加东南部中断时间序列研究的证据。

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-09-30 DOI: 10.1111/jphd.70011

Nadereh Pourat, Xiao Chen, James Godwin, Joanne Spetz

Objectives

Geographic isolation, limited resources, and inadequate access to dental care have led to poor oral health for Alaska Native children. In the early 2000s, the Alaska Native Tribal Health Consortium (ANTHC) began training alternative oral health practitioners including primary dental health aides (PDHAs) who provide dental education and preventive procedures and dental health aid therapists (DHATs) who provide additional specific treatments. Most members employ DHATs but only the Southeast Alaska Regional Health Consortium (SEARHC) systematically employed PDHAs starting in 2008. We evaluated whether the employment of PDHAs by SEARHC was associated with changes in the delivery of oral preventive and treatment procedures at the beginning of the program.

Methods

We analyzed Alaska Medicaid claims data for children ages 0–18 from 2003 to 2004 and 2008 to 2012. We compared procedure use of enrollees treated by SEARHC with remaining ANTHC members and other Medicaid dental providers. We used regression models to compare changes in the predicted rate of fluoride varnish (FV) and treatment procedures for each group before and after the employment of PDHAs at SEARHC.

Results

Significantly higher predicted rate of FVs (1.74 vs. 1.05 and 1.14) and lower rate of restorative treatment procedures (1.62 vs. 2.21 and 2.87) among SEARHC patients compared to other ANTHC patients or patients of other Medicaid providers in 2012.

Conclusions

Findings highlighted likely benefits of employing PDHAs in the delivery of needed preventive procedures in remote areas like Alaska. Implementation of the SEARHC model requires multiple legislative and regulatory steps to establish the scope of practice, Medicaid reimbursement, and infrastructure to recruit, train, and place practitioners.

目的：地理隔离、资源有限和获得牙科保健的机会不足导致阿拉斯加土著儿童口腔健康状况不佳。21世纪初，阿拉斯加土著部落健康联盟（ANTHC）开始培训替代口腔健康从业者，包括提供牙科教育和预防程序的初级牙科健康助理（PDHAs）和提供额外特定治疗的牙科健康辅助治疗师（dhat）。大多数成员采用dhat，但只有东南阿拉斯加地区卫生联盟（SEARHC）从2008年开始系统地采用pdha。我们评估了在项目开始时，SEARHC使用pdha是否与口服预防和治疗程序的递送变化有关。方法：我们分析了2003 - 2004年和2008 - 2012年阿拉斯加州0-18岁儿童的医疗补助申请数据。我们比较了接受SEARHC治疗的入组者与其他ANTHC成员和其他医疗补助牙科提供者的手术使用情况。我们使用回归模型比较了在SEARHC使用pdha前后各组氟化清漆（FV）预测率和治疗程序的变化。结果：2012年，与其他ANTHC患者或其他医疗补助提供者的患者相比，SEARHC患者的FVs预测率（1.74 vs 1.05和1.14）和恢复性治疗程序的预测率（1.62 vs 2.21和2.87）显著高于其他ANTHC患者。结论：研究结果强调了在阿拉斯加等偏远地区使用pdha提供所需预防程序的可能好处。SEARHC模式的实施需要多个立法和监管步骤来确定实践范围，医疗补助报销，以及招募、培训和安置从业人员的基础设施。

{"title":"The Effect of a Rural Workforce Intervention to Improve Oral Health of Children: Evidence From an Interrupted Time Series Study of Southeast Alaska","authors":"Nadereh Pourat, Xiao Chen, James Godwin, Joanne Spetz","doi":"10.1111/jphd.70011","DOIUrl":"10.1111/jphd.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Geographic isolation, limited resources, and inadequate access to dental care have led to poor oral health for Alaska Native children. In the early 2000s, the Alaska Native Tribal Health Consortium (ANTHC) began training alternative oral health practitioners including primary dental health aides (PDHAs) who provide dental education and preventive procedures and dental health aid therapists (DHATs) who provide additional specific treatments. Most members employ DHATs but only the Southeast Alaska Regional Health Consortium (SEARHC) systematically employed PDHAs starting in 2008. We evaluated whether the employment of PDHAs by SEARHC was associated with changes in the delivery of oral preventive and treatment procedures at the beginning of the program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed Alaska Medicaid claims data for children ages 0–18 from 2003 to 2004 and 2008 to 2012. We compared procedure use of enrollees treated by SEARHC with remaining ANTHC members and other Medicaid dental providers. We used regression models to compare changes in the predicted rate of fluoride varnish (FV) and treatment procedures for each group before and after the employment of PDHAs at SEARHC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significantly higher predicted rate of FVs (1.74 vs. 1.05 and 1.14) and lower rate of restorative treatment procedures (1.62 vs. 2.21 and 2.87) among SEARHC patients compared to other ANTHC patients or patients of other Medicaid providers in 2012.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings highlighted likely benefits of employing PDHAs in the delivery of needed preventive procedures in remote areas like Alaska. Implementation of the SEARHC model requires multiple legislative and regulatory steps to establish the scope of practice, Medicaid reimbursement, and infrastructure to recruit, train, and place practitioners.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"449-456"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adverse Childhood Experiences in the First 1000 Days of Life and Dental Caries Experience From Age 31 to 61 Months 儿童出生后1000天的不良经历与31 ~ 61个月的龋齿经历。

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-09-30 DOI: 10.1111/jphd.70012

Noora Jawad, Ali Golkari, Eduardo Bernabé

Objective

To investigate the association between early life adverse childhood experiences (ACEs) and dental caries among young children.

Methods

This study was a secondary analysis of longitudinal data from 927 children in the Children-In-Focus (CIF) sub-study of the Avon Longitudinal Study of Parents and Children (ALSPAC). ACEs were assessed through questionnaires from mothers and partners, covering the gestation period (prenatal ACEs) and the first 2 years of life (ACEs during infancy). Dental caries was assessed clinically at ages 31, 43, and 61 months and reported using the dmft index. The association between early life ACEs and dental caries was evaluated in mixed effects Poisson models adjusting for covariates.

Results

Overall, 342 (36.9%) and 441 (47.6%) children in the study sample were exposed to ACEs prenatally and during infancy, respectively. The mean dmft score was 0.03 ± 0.21 at age 31 months, increasing to 0.26 ± 0.94 at age 43 months and to 0.62 ± 1.51 at age 61 months. Neither exposure to ACEs prenatally (rate ratio: 1.11, 95% CI: 0.73–1.70) nor during infancy (1.08, 95% CI: 0.71–1.63) was associated with the dmft score, after adjustment for covariates. In addition, exposure to ACEs during both life periods was not associated with the dmft score (1.21, 95% CI: 0.74–1.98).

Conclusion

This longitudinal study provided little support for the association between experience of ACEs during the first 1000 days of life and greater caries experience from age 31 to 61 months.

目的：探讨儿童早期生活不良经历与龋病的关系。方法：本研究是对雅芳父母与儿童纵向研究（ALSPAC）中儿童焦点（CIF）子研究中927名儿童的纵向数据进行二次分析。通过对母亲和伴侣的问卷调查来评估ace，包括妊娠期（产前ace）和生命前2年（婴儿期ace）。在31个月、43个月和61个月时进行临床龋病评估，并使用dmft指数进行报告。在混合效应泊松模型中对协变量进行了调整，评估了早期ace和龋齿之间的关系。结果：总体而言，研究样本中分别有342（36.9%）和441（47.6%）名儿童在产前和婴儿期暴露于ace。31月龄时dmft平均评分为0.03±0.21,43月龄时为0.26±0.94,61月龄时为0.62±1.51。调整协变量后，产前暴露于ace（比率比：1.11,95% CI: 0.73-1.70）和婴儿期暴露于ace （1.08, 95% CI: 0.71-1.63）与dmft评分均无相关性。此外，在两个生命周期中暴露于ace与dmft评分无关（1.21,95% CI: 0.74-1.98）。结论：这项纵向研究对出生后1000天的ace经历与31 - 61个月的更大龋病经历之间的关系提供了很少的支持。

{"title":"Adverse Childhood Experiences in the First 1000 Days of Life and Dental Caries Experience From Age 31 to 61 Months","authors":"Noora Jawad, Ali Golkari, Eduardo Bernabé","doi":"10.1111/jphd.70012","DOIUrl":"10.1111/jphd.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association between early life adverse childhood experiences (ACEs) and dental caries among young children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a secondary analysis of longitudinal data from 927 children in the Children-In-Focus (CIF) sub-study of the Avon Longitudinal Study of Parents and Children (ALSPAC). ACEs were assessed through questionnaires from mothers and partners, covering the gestation period (prenatal ACEs) and the first 2 years of life (ACEs during infancy). Dental caries was assessed clinically at ages 31, 43, and 61 months and reported using the dmft index. The association between early life ACEs and dental caries was evaluated in mixed effects Poisson models adjusting for covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 342 (36.9%) and 441 (47.6%) children in the study sample were exposed to ACEs prenatally and during infancy, respectively. The mean dmft score was 0.03 ± 0.21 at age 31 months, increasing to 0.26 ± 0.94 at age 43 months and to 0.62 ± 1.51 at age 61 months. Neither exposure to ACEs prenatally (rate ratio: 1.11, 95% CI: 0.73–1.70) nor during infancy (1.08, 95% CI: 0.71–1.63) was associated with the dmft score, after adjustment for covariates. In addition, exposure to ACEs during both life periods was not associated with the dmft score (1.21, 95% CI: 0.74–1.98).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This longitudinal study provided little support for the association between experience of ACEs during the first 1000 days of life and greater caries experience from age 31 to 61 months.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"457-463"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting Group-Based Trajectories of Oral Health-Related Quality of Life From Late Adolescence to Early Adulthood Using K-Means Clustering Algorithm 使用K-Means聚类算法预测青少年晚期至成年早期口腔健康相关生活质量的群体轨迹

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-09-16 DOI: 10.1111/jphd.70007

Chukwuebuka Ogwo, Grant Brown, John Warren, Erliang Zeng, Murray Thomson, Steven Levy

Objectives

To identify and analyze the patterns of change in Oral Health-Related Quality of Life (OHRQoL) from late adolescence to early adulthood (ages 17 to 23) using a machine learning algorithm.

Methods

This longitudinal trajectory study used data from the Iowa Fluoride Study (IFS). Participants were recruited at birth from eight Iowa hospitals between 1992 and 1995. OHRQoL was assessed at ages 17, 19, and 23 using three validated questionnaires: the Child Perceptions Questionnaire (CPQ_11-14), Global Oral Health Rating (GOHR), and Visual Analog Scale of Quality of Life (VisQoL). Of the 437 individuals assessed at age 17, 402 were re-assessed at age 19 and 367 at age 23 (91% retention rate). The K-Means for Longitudinal data (KmL) algorithm was applied to identify distinct trajectory groups for each measure. Associations between trajectory group membership and sociodemographic variables were examined using logistic regression. All analyses were performed in R (version 4.1.3).

Results

Two distinct trajectory groups were identified for each OHRQoL measure, representing consistently better versus persistently worsening oral health experiences. For the CPQ_11-14, 84.8% of participants were in the “Favorable” group and 15.2% in the “Unfavorable” group. GOHR classified 57.2% as “Favorable” and 42.8% as “Unfavorable,” while VisQoL showed 67.5% and 32.5%, respectively. Despite differing proportions, all instruments reflected similar directional trends. Higher socioeconomic status was associated with favorable trajectory group membership (p < 0.05).

Conclusion

Most participants followed a favorable OHRQoL trajectory and were from higher socioeconomic backgrounds. These findings highlight the value of longitudinal, multi-measure approaches in identifying at-risk subgroups.

目的：利用机器学习算法识别和分析从青春期晚期到成年早期（17至23岁）口腔健康相关生活质量（OHRQoL）的变化模式。方法：这项纵向轨迹研究使用了爱荷华州氟化物研究（IFS）的数据。1992年至1995年期间，参与者在出生时从爱荷华州的八家医院招募。在17岁、19岁和23岁时使用三份有效问卷进行OHRQoL评估：儿童感知问卷（CPQ11-14）、全球口腔健康评分（GOHR）和视觉模拟生活质量量表（VisQoL）。在17岁时接受评估的437人中，402人在19岁时重新评估，367人在23岁时重新评估（保留率为91%）。采用K-Means纵向数据（KmL）算法来识别每个测量的不同轨迹组。轨迹群体成员与社会人口学变量之间的关联使用逻辑回归进行检验。所有分析均在R（4.1.3版）中进行。结果：每项OHRQoL测量确定了两个不同的轨迹组，代表了持续改善的口腔健康体验和持续恶化的口腔健康体验。在CPQ11-14中，84.8%的参与者为“赞成”组，15.2%的参与者为“不赞成”组。GOHR的57.2%为“有利”，42.8%为“不利”，VisQoL分别为67.5%和32.5%。尽管比例不同，但所有仪器都反映出类似的方向趋势。较高的社会经济地位与良好的轨迹群体成员关系相关(p)。结论：大多数参与者遵循良好的OHRQoL轨迹，并且来自较高的社会经济背景。这些发现强调了纵向、多测量方法在识别高危亚组方面的价值。

{"title":"Predicting Group-Based Trajectories of Oral Health-Related Quality of Life From Late Adolescence to Early Adulthood Using K-Means Clustering Algorithm","authors":"Chukwuebuka Ogwo, Grant Brown, John Warren, Erliang Zeng, Murray Thomson, Steven Levy","doi":"10.1111/jphd.70007","DOIUrl":"10.1111/jphd.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify and analyze the patterns of change in Oral Health-Related Quality of Life (OHRQoL) from late adolescence to early adulthood (ages 17 to 23) using a machine learning algorithm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This longitudinal trajectory study used data from the Iowa Fluoride Study (IFS). Participants were recruited at birth from eight Iowa hospitals between 1992 and 1995. OHRQoL was assessed at ages 17, 19, and 23 using three validated questionnaires: the Child Perceptions Questionnaire (CPQ<sub>11-14</sub>), Global Oral Health Rating (GOHR), and Visual Analog Scale of Quality of Life (VisQoL). Of the 437 individuals assessed at age 17, 402 were re-assessed at age 19 and 367 at age 23 (91% retention rate). The K-Means for Longitudinal data (KmL) algorithm was applied to identify distinct trajectory groups for each measure. Associations between trajectory group membership and sociodemographic variables were examined using logistic regression. All analyses were performed in R (version 4.1.3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two distinct trajectory groups were identified for each OHRQoL measure, representing consistently better versus persistently worsening oral health experiences. For the CPQ<sub>11-14</sub>, 84.8% of participants were in the “Favorable” group and 15.2% in the “Unfavorable” group. GOHR classified 57.2% as “Favorable” and 42.8% as “Unfavorable,” while VisQoL showed 67.5% and 32.5%, respectively. Despite differing proportions, all instruments reflected similar directional trends. Higher socioeconomic status was associated with favorable trajectory group membership (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most participants followed a favorable OHRQoL trajectory and were from higher socioeconomic backgrounds. These findings highlight the value of longitudinal, multi-measure approaches in identifying at-risk subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"440-448"},"PeriodicalIF":1.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oral Health Literacy and Dental Caries Status in Adults 成人口腔健康素养与龋齿状况

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-08-07 DOI: 10.1111/jphd.70006

Mark D. Macek, Kathryn Atchison, Folasayo Adunola

Objectives

To assess the relationship between oral health literacy (OHL) and dental caries among a convenience sample of adult, first-time patients at two U.S. dental schools; we hypothesized that adults with low OHL would have fewer teeth, more untreated dental decay, and fewer restorations.

Methods

This cross-sectional analysis was part of the larger Multisite Oral Health Literacy Research (MOHLR) Study. OHL was assessed using the Comprehensive Measure of Oral Health Knowledge (CMOHK). The dental caries outcome variables (number of decayed, filled, decayed plus filled, and teeth present) were abstracted from electronic dental records and represented the clinical conditions at the initial visit. We calculated OHL prevalence estimates and crude and adjusted negative binomial regression parameters for the outcome variables, controlling for relevant sociodemographic covariates.

Results

We recruited 922 participants into the MOHLR Study, and 688 provided clinical data for this report. Crude analyses showed persons with low OHL had significantly fewer filled teeth (e^x = 0.67), decayed plus filled teeth (e^x = 0.76), and teeth present (e^x = 0.96) than those with high OHL. After controlling for covariates, the low versus high differences remained significant for the number of filled (e^x = 0.81) and decayed plus filled teeth (e^x = 0.84). There was no significant relationship between CMOHK and the number of decayed teeth.

Conclusions

The relationship between OHL and dental caries in an adult population of dental school patients is complex. Additional research, likely involving qualitative studies and more precise epidemiological assessments, is needed to understand this complicated association.

目的：评估口腔健康素养（OHL）和龋齿之间的关系，在两所美国牙科学校的成人首次患者的方便样本中；我们假设低OHL的成年人牙齿更少，龋齿未经治疗的更多，修复的也更少。方法：本横断面分析是大型多站点口腔健康素养研究（MOHLR）研究的一部分。使用口腔健康知识综合测量（CMOHK）评估OHL。从电子牙科记录中提取龋齿结局变量（蛀牙数、补牙数、蛀牙加补牙数和存在的牙齿数），代表首次就诊时的临床情况。我们计算了OHL患病率估计值，并对结果变量进行了粗糙和调整的负二项回归参数，控制了相关的社会人口统计学协变量。结果：我们招募了922名参与者进入MOHLR研究，其中688名为本报告提供了临床资料。粗略分析显示，与高OHL患者相比，低OHL患者的补牙（ex = 0.67）、蛀牙加补牙（ex = 0.76）和牙齿存在（ex = 0.96）明显较少。在控制协变量后，补牙数量（ex = 0.81）和蛀牙加补牙数量（ex = 0.84）的高低差异仍然显著。CMOHK与蛀牙数无显著相关。结论：在牙科学校的成年患者中，OHL与龋齿之间的关系是复杂的。需要进一步的研究，可能涉及定性研究和更精确的流行病学评估，以了解这种复杂的关联。

{"title":"Oral Health Literacy and Dental Caries Status in Adults","authors":"Mark D. Macek, Kathryn Atchison, Folasayo Adunola","doi":"10.1111/jphd.70006","DOIUrl":"10.1111/jphd.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the relationship between oral health literacy (OHL) and dental caries among a convenience sample of adult, first-time patients at two U.S. dental schools; we hypothesized that adults with low OHL would have fewer teeth, more untreated dental decay, and fewer restorations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional analysis was part of the larger Multisite Oral Health Literacy Research (MOHLR) Study. OHL was assessed using the Comprehensive Measure of Oral Health Knowledge (CMOHK). The dental caries outcome variables (number of decayed, filled, decayed plus filled, and teeth present) were abstracted from electronic dental records and represented the clinical conditions at the initial visit. We calculated OHL prevalence estimates and crude and adjusted negative binomial regression parameters for the outcome variables, controlling for relevant sociodemographic covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We recruited 922 participants into the MOHLR Study, and 688 provided clinical data for this report. Crude analyses showed persons with low OHL had significantly fewer filled teeth (<i>e</i><sup><i>x</i></sup> = 0.67), decayed plus filled teeth (<i>e</i><sup><i>x</i></sup> = 0.76), and teeth present (<i>e</i><sup><i>x</i></sup> = 0.96) than those with high OHL. After controlling for covariates, the low versus high differences remained significant for the number of filled (<i>e</i><sup><i>x</i></sup> = 0.81) and decayed plus filled teeth (<i>e</i><sup><i>x</i></sup> = 0.84). There was no significant relationship between CMOHK and the number of decayed teeth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The relationship between OHL and dental caries in an adult population of dental school patients is complex. Additional research, likely involving qualitative studies and more precise epidemiological assessments, is needed to understand this complicated association.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"432-439"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of Fluoride Treatments Among US Children, Associated Factors, and State-Level Variation 美国儿童氟化物治疗的流行程度、相关因素和州际差异

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-08-03 DOI: 10.1111/jphd.70003

Shillpa Naavaal, Vaibhavi Mone, Christina Scherrer

Objectives

Professional fluoride treatment effectively reduces caries, but uptake remains low. This study identified factors associated with the report of professional fluoride treatment at dental visits (hereon referred to as fluoride treatment) among children aged 1–17 and examined state-specific variation in its prevalence.

Methods

We used the National Survey of Children's Health data from 2022 (n = 51,630). The primary outcome was fluoride treatment. Chi-square tests examined associations between the outcome and sociodemographic and other included variables, and a logistic regression model was used to obtain adjusted odds ratio estimates. State-specific prevalence of fluoride treatment was estimated for all 50 US states and DC, and 2022 estimates were compared with 2017 to examine differences. All analyses were weighted, accounting for the complex survey design.

Results

The overall fluoride treatment prevalence in 2022 was 45.7%, and 32.7% of children had a preventive dental visit, but did not receive fluoride treatment. Children aged 1–5, non-Hispanic Black, non-Hispanic Asian and other, uninsured, in fair or poor health, with no preventive medical visit, living in low-income households, or with less-educated parents had a significantly lower report of fluoride treatment compared to their counterparts. State-specific fluoride treatment prevalence in 2022 varied widely. Compared to 2017, three states saw an increase and four states saw a decrease in prevalence in 2022 (p < 0.05).

Conclusion

Fluoride treatment prevalence among US children remains low overall and varies greatly across states. To improve fluoride treatment uptake, dental and medical providers and parents should be educated about its importance and need.

目的：专业氟化物治疗可有效减少龋齿，但吸收率仍然很低。本研究确定了与1-17岁儿童在牙科就诊时接受专业氟化物治疗（以下简称氟化物治疗）报告相关的因素，并检查了其流行率在各州的具体差异。方法：我们使用2022年全国儿童健康调查数据（n = 51,630）。主要结局是氟化物治疗。卡方检验检验结果与社会人口学和其他纳入变量之间的关联，并使用逻辑回归模型获得调整后的优势比估计值。对美国所有50个州和哥伦比亚特区的氟化物治疗的具体州患病率进行了估计，并将2022年的估计与2017年的估计进行了比较，以检查差异。考虑到复杂的调查设计，所有的分析都是加权的。结果：2022年氟化治疗总体患病率为45.7%，其中32.7%的儿童进行了预防性牙科就诊，但未接受氟化治疗。1-5岁儿童、非西班牙裔黑人儿童、非西班牙裔亚裔儿童和其他儿童、没有保险、健康状况一般或较差、没有预防性医疗访问、生活在低收入家庭或父母受教育程度较低的儿童接受氟化物治疗的报告明显低于同龄儿童。2022年各州氟化物处理普及率差异很大。与2017年相比，2022年有3个州的患病率上升，4个州的患病率下降(p结论：美国儿童的氟化物治疗患病率总体上仍然很低，各州差异很大。为了提高氟化物治疗的接受程度，应教育牙科和医疗提供者以及家长了解其重要性和必要性。

{"title":"Prevalence of Fluoride Treatments Among US Children, Associated Factors, and State-Level Variation","authors":"Shillpa Naavaal, Vaibhavi Mone, Christina Scherrer","doi":"10.1111/jphd.70003","DOIUrl":"10.1111/jphd.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Professional fluoride treatment effectively reduces caries, but uptake remains low. This study identified factors associated with the report of professional fluoride treatment at dental visits (hereon referred to as fluoride treatment) among children aged 1–17 and examined state-specific variation in its prevalence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the National Survey of Children's Health data from 2022 (<i>n</i> = 51,630). The primary outcome was fluoride treatment. Chi-square tests examined associations between the outcome and sociodemographic and other included variables, and a logistic regression model was used to obtain adjusted odds ratio estimates. State-specific prevalence of fluoride treatment was estimated for all 50 US states and DC, and 2022 estimates were compared with 2017 to examine differences. All analyses were weighted, accounting for the complex survey design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall fluoride treatment prevalence in 2022 was 45.7%, and 32.7% of children had a preventive dental visit, but did not receive fluoride treatment. Children aged 1–5, non-Hispanic Black, non-Hispanic Asian and other, uninsured, in fair or poor health, with no preventive medical visit, living in low-income households, or with less-educated parents had a significantly lower report of fluoride treatment compared to their counterparts. State-specific fluoride treatment prevalence in 2022 varied widely. Compared to 2017, three states saw an increase and four states saw a decrease in prevalence in 2022 (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fluoride treatment prevalence among US children remains low overall and varies greatly across states. To improve fluoride treatment uptake, dental and medical providers and parents should be educated about its importance and need.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"399-409"},"PeriodicalIF":1.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Forward Outlook on Oral Health: The American Association of Public Health Dentistry's 2025 Research Agenda for Dental Public Health 口腔健康展望：美国公共卫生协会牙科2025年牙科公共卫生研究议程。

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-08-02 DOI: 10.1111/jphd.70005

Sepideh Banava, Julie C. Reynolds, Shillpa Naavaal, Julie Frantsve-Hawley, Mina Habibian, Christina Murphey

Objectives

Dental public health (DPH) research is crucial in improving and promoting community oral health by generating and translating new knowledge into practice. Since the last AAPHD research agenda in 1992, the DPH field has made significant advancements. This research agenda aims to outline key research areas in DPH, including priority topics and evidence gaps in our scientific understanding of factors influencing population oral health and oral health equity.

Methods

A workgroup under the AAPHD Council on Scientific Information (CSI) surveyed 503 AAPHD members in September 2021 to gather feedback on seven draft research objectives. The survey used a Likert scale to assess agreement and included open-ended suggestions.

Results

A total of 115 AAPHD members responded to the survey, resulting in a response rate of about 23%. Six of the seven objectives were agreed or strongly agreed upon by respondents as important areas of focus for DPH research. The final research agenda includes six key areas: oral health policy and legislation, delivery system innovations and care models, oral health workforce, DPH education, social determinants of health, and epidemiology and surveillance systems. The research agenda describes advancements and gaps in these areas, existing evidence, example priority topics, and research questions.

Conclusions

The AAPHD encourages DPH partners, including federal agencies, DPH organizations, foundations, and dental associations, to advocate for, support, use, and fund high-quality DPH research. This support is crucial for translating emerging evidence into oral health improvements and equity across the diverse US communities.

目的：牙科公共卫生（DPH）的研究是至关重要的，通过产生和转化新知识为实践，改善和促进社区口腔健康。自1992年AAPHD最后一次研究议程以来，DPH领域取得了重大进展。本研究议程旨在概述口腔卫生的关键研究领域，包括我们对影响人群口腔健康和口腔健康公平因素的科学理解中的优先主题和证据差距。方法：AAPHD科学信息委员会（CSI）下属的一个工作组于2021年9月对503名AAPHD成员进行了调查，以收集对7项研究目标草案的反馈。该调查使用李克特量表来评估是否同意，并包括开放式建议。结果：共有115名AAPHD会员回应了调查，回复率约为23%。受访者同意或强烈同意七个目标中的六个是DPH研究的重要重点领域。最终的研究议程包括六个关键领域：口腔卫生政策和立法、提供系统创新和护理模式、口腔卫生人力、口腔卫生教育、健康的社会决定因素以及流行病学和监测系统。研究议程描述了这些领域的进展和差距、现有证据、示例优先主题和研究问题。结论：AAPHD鼓励DPH合作伙伴，包括联邦机构、DPH组织、基金会和牙科协会，倡导、支持、使用和资助高质量的DPH研究。这种支持对于将新出现的证据转化为改善美国不同社区的口腔健康和公平至关重要。

{"title":"Forward Outlook on Oral Health: The American Association of Public Health Dentistry's 2025 Research Agenda for Dental Public Health","authors":"Sepideh Banava, Julie C. Reynolds, Shillpa Naavaal, Julie Frantsve-Hawley, Mina Habibian, Christina Murphey","doi":"10.1111/jphd.70005","DOIUrl":"10.1111/jphd.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Dental public health (DPH) research is crucial in improving and promoting community oral health by generating and translating new knowledge into practice. Since the last AAPHD research agenda in 1992, the DPH field has made significant advancements. This research agenda aims to outline key research areas in DPH, including priority topics and evidence gaps in our scientific understanding of factors influencing population oral health and oral health equity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A workgroup under the AAPHD Council on Scientific Information (CSI) surveyed 503 AAPHD members in September 2021 to gather feedback on seven draft research objectives. The survey used a Likert scale to assess agreement and included open-ended suggestions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 115 AAPHD members responded to the survey, resulting in a response rate of about 23%. Six of the seven objectives were agreed or strongly agreed upon by respondents as important areas of focus for DPH research. The final research agenda includes six key areas: oral health policy and legislation, delivery system innovations and care models, oral health workforce, DPH education, social determinants of health, and epidemiology and surveillance systems. The research agenda describes advancements and gaps in these areas, existing evidence, example priority topics, and research questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The AAPHD encourages DPH partners, including federal agencies, DPH organizations, foundations, and dental associations, to advocate for, support, use, and fund high-quality DPH research. This support is crucial for translating emerging evidence into oral health improvements and equity across the diverse US communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"419-431"},"PeriodicalIF":1.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of Dental Fluorosis in India: A Systematic Review and Meta-Analysis 印度氟斑牙患病率：系统回顾和荟萃分析。

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-07-31 DOI: 10.1111/jphd.70004

Hitesh Chander Mittal, Ram Bajpai, Rajesh Kumar Singh, Divesh Sardana, Utkal Mohanty

Background

Dental fluorosis is considered to be a public health concern globally, including in India. This review aims to determine the prevalence of dental fluorosis in India and its distribution by geographical region, water fluoride level, and severity.

Methods

A systematic search of major electronic databases and gray literature was undertaken until 29^th May 2024. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data.

Results

Out of 6652 records identified, 55 studies including 108,678 individuals accounted for available data for meta-analysis. The pooled prevalence of overall dental fluorosis was estimated to be 34.5% (95% CI; 28.9–40.3) for all age groups, and in children (5 to 18 years) was 32.1% (95% CI; 26.6–37.9). The dental fluorosis commonly reported was in the very mild (10.6%) to mild (9.7%) category. There was a more than three-fold increase in prevalence in regions with water fluoride levels of more than 1 ppm compared to those with less than 1 ppm (50.3% versus 15.1%). Further, a higher prevalence was observed in males (40.7%), community settings (40.7%), rural populations (38.1%), and the western Indian region (43.9%).

Conclusion

Dental fluorosis in India was found to be highly prevalent, with the milder forms being the most common. A high prevalence was found in regions with high water fluoride levels, with a wide variation across India. Drinking water is the main source of exposure studied, though the effect of other factors and fluoride intake pathways needs to be explored.

背景：氟牙症被认为是全球（包括印度）关注的公共卫生问题。本综述旨在确定氟牙症在印度的患病率及其按地理区域、水氟化物水平和严重程度划分的分布。方法：到2024年5月29日，系统检索主要电子数据库和灰色文献。纳入研究的质量采用乔安娜布里格斯研究所（JBI）报告患病率数据的研究关键评估清单进行评估。结果：在确定的6652条记录中，55项研究包括108,678名个体用于荟萃分析。总体氟斑牙的总患病率估计为34.5% (95% CI；28.9-40.3)，儿童（5 - 18岁）为32.1% (95% CI；26.6 - -37.9)。氟牙症一般为非常轻微（10.6%）至轻微（9.7%）。在水氟化物含量超过1 ppm的地区，患病率是低于1 ppm地区的三倍多（50.3%对15.1%）。此外，男性（40.7%）、社区（40.7%）、农村人口（38.1%）和西印度地区（43.9%）的患病率较高。结论：氟斑牙在印度是非常普遍的，以较轻的形式是最常见的。在水氟化物含量高的地区，发病率很高，在印度各地差异很大。饮用水是研究的主要暴露来源，但其他因素的影响和氟化物摄入途径需要探索。

{"title":"Prevalence of Dental Fluorosis in India: A Systematic Review and Meta-Analysis","authors":"Hitesh Chander Mittal, Ram Bajpai, Rajesh Kumar Singh, Divesh Sardana, Utkal Mohanty","doi":"10.1111/jphd.70004","DOIUrl":"10.1111/jphd.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dental fluorosis is considered to be a public health concern globally, including in India. This review aims to determine the prevalence of dental fluorosis in India and its distribution by geographical region, water fluoride level, and severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of major electronic databases and gray literature was undertaken until 29<sup>th</sup> May 2024. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 6652 records identified, 55 studies including 108,678 individuals accounted for available data for meta-analysis. The pooled prevalence of overall dental fluorosis was estimated to be 34.5% (95% CI; 28.9–40.3) for all age groups, and in children (5 to 18 years) was 32.1% (95% CI; 26.6–37.9). The dental fluorosis commonly reported was in the very mild (10.6%) to mild (9.7%) category. There was a more than three-fold increase in prevalence in regions with water fluoride levels of more than 1 ppm compared to those with less than 1 ppm (50.3% versus 15.1%). Further, a higher prevalence was observed in males (40.7%), community settings (40.7%), rural populations (38.1%), and the western Indian region (43.9%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dental fluorosis in India was found to be highly prevalent, with the milder forms being the most common. A high prevalence was found in regions with high water fluoride levels, with a wide variation across India. Drinking water is the main source of exposure studied, though the effect of other factors and fluoride intake pathways needs to be explored.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"410-418"},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Equity in Access to Dental Care in Canada: Historical Lessons for Policy Change 改善公平获得牙科护理在加拿大：政策变化的历史教训。

IF 1.5 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2025-07-17 DOI: 10.1111/jphd.70002

Christiana Martine, Carlos Quiñonez, Gregory P. Marchildon

Objectives

This paper outlines and compares the major provincial initiatives on dental care from the 1970s—with emphasis on Saskatchewan's innovative children's dental program—and their relevance to the current changes in Canadian dental policy.

Methods

Narrative review methodology. A snowball search was conducted on articles obtained through MEDLINE, Scopus, and ProQuest, followed by other databases such as Google Scholar. Primary data was collected from different sources: historical professional journals, archives, government reports, Hansard debates, and historical newspapers.

Results

Saskatchewan and Ontario were on opposite ends of a government-sponsored dental care policy continuum during the 1970s. While Ontario never implemented a large-scale public dental plan, Saskatchewan carried out an effective province-wide children's dental plan using an alternate model of delivery, despite strong opposition from the dental profession. Dental public initiatives in other provinces lie between these two poles. While several considered employing dental therapists, they faced opposition from the dental profession, which reinforced the traditional model, despite its inability to resolve issues of access to care.

Conclusions

This study argues that while the current Canadian Dental Care Plan represents a major advancement towards more equality in dental care, it is unclear whether persistent issues of physical barriers to access will be fully resolved, and suggests employing an alternate model of delivery, proven to improve access to dental care in Canada. However, given organized dentistry's continuing resistance to dental therapists working largely independently, future studies should examine whether different levels of supervision and/or program format could yield greater acceptance.

目的：本文概述并比较了20世纪70年代以来主要的省级牙科护理计划，重点是萨斯喀彻温省创新的儿童牙科计划，以及它们与加拿大牙科政策当前变化的相关性。方法：叙述回顾法。对通过MEDLINE、Scopus和ProQuest获得的文章进行滚雪球搜索，然后是谷歌Scholar等其他数据库。主要数据来自不同的来源：历史专业期刊、档案、政府报告、议事录辩论和历史报纸。结果：在20世纪70年代，萨斯喀彻温省和安大略省处于政府资助的牙科保健政策连续体的两端。虽然安大略省从未实施过大规模的公共牙科计划，但萨斯喀彻温省实施了一项有效的全省儿童牙科计划，使用另一种交付模式，尽管牙科专业人士强烈反对。其他省份的牙科公共倡议介于这两个极端之间。虽然有几个人考虑聘请牙科治疗师，但他们面临着牙科行业的反对，尽管传统模式无法解决获得护理的问题，但它却强化了传统模式。结论：本研究认为，虽然目前的加拿大牙科保健计划代表了在牙科保健方面更加平等的重大进步，但尚不清楚能否完全解决持续存在的物理障碍问题，并建议采用另一种交付模式，证明可以改善加拿大牙科保健的可及性。然而，考虑到牙科组织对牙科治疗师在很大程度上独立工作的持续抵制，未来的研究应该检查不同水平的监督和/或程序格式是否可以产生更大的接受度。

{"title":"Improving Equity in Access to Dental Care in Canada: Historical Lessons for Policy Change","authors":"Christiana Martine, Carlos Quiñonez, Gregory P. Marchildon","doi":"10.1111/jphd.70002","DOIUrl":"10.1111/jphd.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This paper outlines and compares the major provincial initiatives on dental care from the 1970s—with emphasis on Saskatchewan's innovative children's dental program—and their relevance to the current changes in Canadian dental policy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Narrative review methodology. A snowball search was conducted on articles obtained through MEDLINE, Scopus, and ProQuest, followed by other databases such as Google Scholar. Primary data was collected from different sources: historical professional journals, archives, government reports, Hansard debates, and historical newspapers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Saskatchewan and Ontario were on opposite ends of a government-sponsored dental care policy continuum during the 1970s. While Ontario never implemented a large-scale public dental plan, Saskatchewan carried out an effective province-wide children's dental plan using an alternate model of delivery, despite strong opposition from the dental profession. Dental public initiatives in other provinces lie between these two poles. While several considered employing dental therapists, they faced opposition from the dental profession, which reinforced the traditional model, despite its inability to resolve issues of access to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study argues that while the current Canadian Dental Care Plan represents a major advancement towards more equality in dental care, it is unclear whether persistent issues of physical barriers to access will be fully resolved, and suggests employing an alternate model of delivery, proven to improve access to dental care in Canada. However, given organized dentistry's continuing resistance to dental therapists working largely independently, future studies should examine whether different levels of supervision and/or program format could yield greater acceptance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"85 4","pages":"388-398"},"PeriodicalIF":1.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0