Matthew M. Oishi DMD, MPH, MS, Rachelle Robley BS, Megan K. Inada DrPH, Jason Hiramoto DDS
Limited data exists on Pacific Islander (PI) health, but a growing body of literature reports the existence of racial discrimination and inequities and mistrust of the healthcare system, leading to poor health outcomes. When COVID-19 restricted health services, such inequities and mistrust due to historical trauma were magnified. This report describes one federally qualified health center's dental department's response utilizing culture-based approaches, community relationships, and the social determinants of health (SDOH) to dispel the stigma of COVID and restrictions on in-person care in order to lower barriers to accessing care. When the dental department transitioned to emergency-only care, staff were redeployed to address significant inequities facing the PI community. Redeployment activities included building relationships with the most vulnerable patients, delivering healthy foods, supplies, oral hygiene kits to households, and canvasing neighborhood businesses with public health education. The mobile dental clinic, a trusted symbol in the community, also brought public health education to community testing events and food distributions. From March 2020 to July 2020, staff conducted over 800 outreach calls for health and food security, delivered over 2000 care packages and oral hygiene kits. Also, frequent community outreach by the mobile dental clinic led to a 10-fold increase in COVID testing. Investing in relationship building can maintain access to health care and build trust in the health care system for PI communities. This approach may be relevant to others serving other communities experiencing racism.
{"title":"Anti-racist approaches to increase access to general and oral health care during a pandemic in the Pacific Islander community","authors":"Matthew M. Oishi DMD, MPH, MS, Rachelle Robley BS, Megan K. Inada DrPH, Jason Hiramoto DDS","doi":"10.1111/jphd.12519","DOIUrl":"10.1111/jphd.12519","url":null,"abstract":"<p>Limited data exists on Pacific Islander (PI) health, but a growing body of literature reports the existence of racial discrimination and inequities and mistrust of the healthcare system, leading to poor health outcomes. When COVID-19 restricted health services, such inequities and mistrust due to historical trauma were magnified. This report describes one federally qualified health center's dental department's response utilizing culture-based approaches, community relationships, and the social determinants of health (SDOH) to dispel the stigma of COVID and restrictions on in-person care in order to lower barriers to accessing care. When the dental department transitioned to emergency-only care, staff were redeployed to address significant inequities facing the PI community. Redeployment activities included building relationships with the most vulnerable patients, delivering healthy foods, supplies, oral hygiene kits to households, and canvasing neighborhood businesses with public health education. The mobile dental clinic, a trusted symbol in the community, also brought public health education to community testing events and food distributions. From March 2020 to July 2020, staff conducted over 800 outreach calls for health and food security, delivered over 2000 care packages and oral hygiene kits. Also, frequent community outreach by the mobile dental clinic led to a 10-fold increase in COVID testing. Investing in relationship building can maintain access to health care and build trust in the health care system for PI communities. This approach may be relevant to others serving other communities experiencing racism.</p>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9349547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40121903","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}
Patrick D. Smith DMD, MPH, Marcus Murray MPH, La Shawn Hoffman BA, Todd V. Ester DDS, MA, Richie Kohli BDS, MS
Background
Racism negatively affects the life experiences and subsequent health of Black men, including oral disease prevalence and outcomes. Few examples in the literature discuss how racism may affect successful, unsuccessful, and non-attempts to address Black men's oral health.
Aims
This commentary describes anti-racism approaches to address Black men's oral health through community-based participatory research, oral health promotion, and workforce recruitment.
Materials and Methods
Stakeholders from two organizations and one dental school share their experiences and key insights on how to strengthen efforts while minimizing the influence of racism on Black men's participation.
Results
Common insights identified were a need to engage a diverse range of Black men within varying social and economic contexts, race and gender concordance among program leaders and participants, and the value of partnership to reach Black men in places where they feel comfortable and supported.
Discussion and Conclusion
These examples stress the imperative of addressing racism among Black men in the development and improvement of targeted oral health interventions. They also emphasize the value of commitment from institutional leadership, relationship building with Black men, and the empowerment of Black men to lead program development and implementation efforts.
{"title":"Addressing Black men's oral health through community engaged research and workforce recruitment","authors":"Patrick D. Smith DMD, MPH, Marcus Murray MPH, La Shawn Hoffman BA, Todd V. Ester DDS, MA, Richie Kohli BDS, MS","doi":"10.1111/jphd.12508","DOIUrl":"10.1111/jphd.12508","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Racism negatively affects the life experiences and subsequent health of Black men, including oral disease prevalence and outcomes. Few examples in the literature discuss how racism may affect successful, unsuccessful, and non-attempts to address Black men's oral health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This commentary describes anti-racism approaches to address Black men's oral health through community-based participatory research, oral health promotion, and workforce recruitment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Stakeholders from two organizations and one dental school share their experiences and key insights on how to strengthen efforts while minimizing the influence of racism on Black men's participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Common insights identified were a need to engage a diverse range of Black men within varying social and economic contexts, race and gender concordance among program leaders and participants, and the value of partnership to reach Black men in places where they feel comfortable and supported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>These examples stress the imperative of addressing racism among Black men in the development and improvement of targeted oral health interventions. They also emphasize the value of commitment from institutional leadership, relationship building with Black men, and the empowerment of Black men to lead program development and implementation efforts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/1f/JPHD-82-83.PMC9543032.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40121904","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}
Sonya G. Smith EdD, JD, Pamela Berry Banks DHA, Emilia C. Istrate PhD, MAIS, Alysha J. Davis MPM, Kelli R. Johnson JD, Karen P. West DMD, MPH
Objectives
The purpose of this paper is to describe the racialized barriers to recruiting and retaining historically underrepresented racially/ethnically diverse (HURE) faculty at U.S. dental schools and the linkages of these barriers to structural racism to assist dental schools in eliminating these hurdles through an antiracism framework.
Methods
Data is used to describe the trends in the racial/ethnic composition of dental school faculty and the parity gaps by race/ethnicity between dentists and the U.S. population. Literature on the recruitment and retention of faculty of color at higher education institutions is reviewed to identify challenges and best practices. Barriers to the full participation of HURE faculty, outlined in the American Dental Education Association's Faculty Diversity Toolkit, are also identified. Research on antiracism frameworks is also investigated to denote their uses and key components.
Results
There is a critical shortage of HURE faculty at dental schools and active HURE dentists in the U.S. A history of racism and its legacy reinforce biases, stereotypes, and power structures that harm HURE faculty at U.S. dental schools. An anti-racism framework is needed to holistically eliminate inequities and racialized policies and practices that persists as barriers for HURE faculty.
Conclusions
Increasing the representation of HURE dentists in the workforce and dental school faculty requires a major disruption to culture and institutional practices that mask centuries of structural racism embedded within complex academic systems. Dental schools must use antiracism models to create strategic initiatives that support a humanistic, equitable, and antiracism environment where HURE faculty can thrive.
{"title":"Anti-racism structures in academic dentistry: Supporting underrepresented racially/ethnically diverse faculty","authors":"Sonya G. Smith EdD, JD, Pamela Berry Banks DHA, Emilia C. Istrate PhD, MAIS, Alysha J. Davis MPM, Kelli R. Johnson JD, Karen P. West DMD, MPH","doi":"10.1111/jphd.12509","DOIUrl":"10.1111/jphd.12509","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The purpose of this paper is to describe the racialized barriers to recruiting and retaining historically underrepresented racially/ethnically diverse (HURE) faculty at U.S. dental schools and the linkages of these barriers to structural racism to assist dental schools in eliminating these hurdles through an antiracism framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data is used to describe the trends in the racial/ethnic composition of dental school faculty and the parity gaps by race/ethnicity between dentists and the U.S. population. Literature on the recruitment and retention of faculty of color at higher education institutions is reviewed to identify challenges and best practices. Barriers to the full participation of HURE faculty, outlined in the <i>American Dental Education Association's Faculty Diversity Toolkit,</i> are also identified. Research on antiracism frameworks is also investigated to denote their uses and key components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There is a critical shortage of HURE faculty at dental schools and active HURE dentists in the U.S. A history of racism and its legacy reinforce biases, stereotypes, and power structures that harm HURE faculty at U.S. dental schools. An anti-racism framework is needed to holistically eliminate inequities and racialized policies and practices that persists as barriers for HURE faculty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Increasing the representation of HURE dentists in the workforce and dental school faculty requires a major disruption to culture and institutional practices that mask centuries of structural racism embedded within complex academic systems. Dental schools must use antiracism models to create strategic initiatives that support a humanistic, equitable, and antiracism environment where HURE faculty can thrive.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/3e/JPHD-82-103.PMC9328398.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40121905","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}
João L. Bastos DDS, PhD, Helena M. Constante DDS, PhD, Helena S. Schuch DDS, PhD, Dandara G. Haag DDS, PhD, Lisa M. Jamieson DDS, PhD
Objective
Research on racial oral health inequities has relied on individual-level data with the premise being that the unequal distribution of dental diseases is an intractable problem. We address these insufficiencies by examining the relationships between structural racism, structural sexism, state-level income inequality, and edentulism-related racial inequities according to a structural intersectionality approach.
Methods
Data were from two sources, the 2010 survey of the U.S. Behavioral Risk Factor Surveillance System, and Patricia Homan et al.'s (2021) study on the health impacts from interlocking systems of oppression. While the first contains information on edentulism from a large probabilistic sample of older (65+) respondents, the second provides estimates of racism, sexism, and income inequality across the US states. Taking into account a range of individual characteristics and contextual factors in multilevel models, we determine the extent to which structural forms of marginalization underlie racial inequities in edentulism.
Results
Our analysis reveals that structural racism, structural sexism, and state-level income inequality are associated with the overall frequency of edentulism and the magnitude of edentulism-related racial inequities, both individually and intersectionally. Coupled with living in states with both high racism and sexism (but not income inequality), the odds of edentulism were 60% higher among non-Hispanic Blacks, relative to Whites residing where these structural oppressions were at their lowest.
Conclusions
These findings provide evidence that racial oral health inequities cannot be disentangled from social forces that differentially allocate power and resources among population groups. Mitigating race-based inequities in oral health entails dismantling the multifaceted systems of oppression in the contemporary U.S. society.
{"title":"How do state-level racism, sexism, and income inequality shape edentulism-related racial inequities in contemporary United States? A structural intersectionality approach to population oral health","authors":"João L. Bastos DDS, PhD, Helena M. Constante DDS, PhD, Helena S. Schuch DDS, PhD, Dandara G. Haag DDS, PhD, Lisa M. Jamieson DDS, PhD","doi":"10.1111/jphd.12507","DOIUrl":"10.1111/jphd.12507","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Research on racial oral health inequities has relied on individual-level data with the premise being that the unequal distribution of dental diseases is an intractable problem. We address these insufficiencies by examining the relationships between structural racism, structural sexism, state-level income inequality, and edentulism-related racial inequities according to a structural intersectionality approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were from two sources, the 2010 survey of the U.S. Behavioral Risk Factor Surveillance System, and Patricia Homan et al.'s (2021) study on the health impacts from interlocking systems of oppression. While the first contains information on edentulism from a large probabilistic sample of older (65+) respondents, the second provides estimates of racism, sexism, and income inequality across the US states. Taking into account a range of individual characteristics and contextual factors in multilevel models, we determine the extent to which structural forms of marginalization underlie racial inequities in edentulism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis reveals that structural racism, structural sexism, and state-level income inequality are associated with the overall frequency of edentulism and the magnitude of edentulism-related racial inequities, both individually and intersectionally. Coupled with living in states with both high racism and sexism (but not income inequality), the odds of edentulism were 60% higher among non-Hispanic Blacks, relative to Whites residing where these structural oppressions were at their lowest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings provide evidence that racial oral health inequities cannot be disentangled from social forces that differentially allocate power and resources among population groups. Mitigating race-based inequities in oral health entails dismantling the multifaceted systems of oppression in the contemporary U.S. society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.12507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40122469","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}
Addressing inequities in oral health care requires identification of which populations are experiencing performance gaps and the extent of those gaps. This study used Dental Quality Alliance (DQA) measures to examine variations in quality by race and ethnicity.
Methods
We used eligibility and claims data for 2018 for children aged <21 years for state Medicaid/CHIP programs available through the Transformed Medicaid Statistical Information System. For a subset of states with sufficient data quality, we calculated DQA measures of utilization of services, oral evaluation, and topical fluoride. The measures were stratified by race and ethnicity, age, sex, geographic location, and language. We used bivariate logistic regression to analyze relative disparities.
Results
Variations in measure scores were noted between racial and ethnic groups. Measure scores were typically lower for non-Hispanic black and American Indian/Alaskan Native children and higher for non-Hispanic Asian and Hispanic children compared with non-Hispanic white children. There also was variation in the patterns of disparities between states. More than two-thirds of states had insufficient race and ethnicity data (>10% missing) to reliably report stratified measure scores.
Conclusions
Because disparities vary by state, each Medicaid/CHIP program should evaluate variations in care quality in the context of the population it serves. A critical first step is to improve collection of race and ethnicity. These measurements can be used to set improvement goals that not only raise quality of care for the population overall but also close gaps in performance between racial and ethnic groups.
要解决口腔卫生保健方面的不公平现象，就必须确定哪些人群正在经历绩效差距以及这些差距的程度。本研究使用牙科质量联盟(DQA)的措施来检查不同种族和民族的质量差异。方法:我们使用了2018年通过医疗补助统计信息系统(Transformed Medicaid Statistical Information System)获得的21岁儿童参加州医疗补助/CHIP项目的资格和索赔数据。对于具有足够数据质量的州子集，我们计算了服务利用率、口腔评估和局部氟化物的DQA措施。这些措施按种族、民族、年龄、性别、地理位置和语言分层。我们使用双变量逻辑回归分析相对差异。结果不同种族和民族的测量得分存在差异。与非西班牙裔白人儿童相比，非西班牙裔黑人和美洲印第安人/阿拉斯加土著儿童的测试分数通常较低，而非西班牙裔亚裔和西班牙裔儿童的测试分数则较高。各州之间的差异模式也有所不同。超过三分之二的州没有足够的种族和民族数据(缺失10%)来可靠地报告分层测量分数。由于各州的差异不同，每个医疗补助/CHIP项目都应该根据所服务人群的情况评估护理质量的变化。关键的第一步是改善种族和民族的收集。这些测量可以用来设定改进目标，不仅提高总体人口的护理质量，而且缩小种族和民族群体之间的表现差距。
{"title":"Racial and ethnic disparities in oral healthcare quality among children enrolled in Medicaid and CHIP","authors":"Jill Boylston Herndon PhD, Diptee Ojha BDS, PhD","doi":"10.1111/jphd.12522","DOIUrl":"10.1111/jphd.12522","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Addressing inequities in oral health care requires identification of which populations are experiencing performance gaps and the extent of those gaps. This study used Dental Quality Alliance (DQA) measures to examine variations in quality by race and ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used eligibility and claims data for 2018 for children aged <21 years for state Medicaid/CHIP programs available through the Transformed Medicaid Statistical Information System. For a subset of states with sufficient data quality, we calculated DQA measures of utilization of services, oral evaluation, and topical fluoride. The measures were stratified by race and ethnicity, age, sex, geographic location, and language. We used bivariate logistic regression to analyze relative disparities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Variations in measure scores were noted between racial and ethnic groups. Measure scores were typically lower for non-Hispanic black and American Indian/Alaskan Native children and higher for non-Hispanic Asian and Hispanic children compared with non-Hispanic white children. There also was variation in the patterns of disparities between states. More than two-thirds of states had insufficient race and ethnicity data (>10% missing) to reliably report stratified measure scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Because disparities vary by state, each Medicaid/CHIP program should evaluate variations in care quality in the context of the population it serves. A critical first step is to improve collection of race and ethnicity. These measurements can be used to set improvement goals that not only raise quality of care for the population overall but also close gaps in performance between racial and ethnic groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/f0/JPHD-82-89.PMC9543656.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40122470","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}
Norman Tinanoff DDS, MS, Harry Goodman DMD, MPH, Barbara Klein MPA
{"title":"The legacy of Deamonte Driver","authors":"Norman Tinanoff DDS, MS, Harry Goodman DMD, MPH, Barbara Klein MPA","doi":"10.1111/jphd.12535","DOIUrl":"10.1111/jphd.12535","url":null,"abstract":"","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42332150","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}
Radhakrishnan Nagarajan PhD, Aloksagar Panny BDS, MS, Richard Berg MS, Amit Acharya BDS, MS, PhD, FAMIA, Greg Nycz BS
Objective
The objective of the study was to investigate temporal trends in non-traumatic dental condition (NTDC) related emergency visits at Emergency Department (ED), urgent care (UC), and at a Federally Qualified Health Center (FQHC) that providing dental services to a mid-sized rural community.
Methods
Temporal trends over a 9-year period (2008–2016) in NTDC rates at ED, UC, FQHC and in a region around the FQHC were determined. Statistically significant changes (α = 0.05) in the proportion of NTDC visits between FQHC and UC across each of the time points were investigated.
Results
Proportion of NTDC ED visits was relatively stable over the study period; whereas those at FQHC exceeded those at UC site beginning 2012 and were significantly (α = 0.05) higher than that of UC subsequently (2015–2016).
Conclusions
NTDCs are preventable dental conditions and the care provided in treating NTDCs in emergency settings is palliative and does not address the underlying conditions resulting in poor outcomes. The results presented elucidate the critical role of FQHCs in significantly reducing NTDC visits. These might be precursors to a potential shift in NTDC care seeking behavior and expected to favorably impact oral health outcomes.
{"title":"Variations in temporal trends in non-traumatic dental condition related emergencies","authors":"Radhakrishnan Nagarajan PhD, Aloksagar Panny BDS, MS, Richard Berg MS, Amit Acharya BDS, MS, PhD, FAMIA, Greg Nycz BS","doi":"10.1111/jphd.12528","DOIUrl":"10.1111/jphd.12528","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of the study was to investigate temporal trends in non-traumatic dental condition (NTDC) related emergency visits at Emergency Department (ED), urgent care (UC), and at a Federally Qualified Health Center (FQHC) that providing dental services to a mid-sized rural community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Temporal trends over a 9-year period (2008–2016) in NTDC rates at ED, UC, FQHC and in a region around the FQHC were determined. Statistically significant changes (<i>α</i> = 0.05) in the proportion of NTDC visits between FQHC and UC across each of the time points were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Proportion of NTDC ED visits was relatively stable over the study period; whereas those at FQHC exceeded those at UC site beginning 2012 and were significantly (<i>α</i> = 0.05) higher than that of UC subsequently (2015–2016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NTDCs are preventable dental conditions and the care provided in treating NTDCs in emergency settings is palliative and does not address the underlying conditions resulting in poor outcomes. The results presented elucidate the critical role of FQHCs in significantly reducing NTDC visits. These might be precursors to a potential shift in NTDC care seeking behavior and expected to favorably impact oral health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47337471","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}
Daisy Patiño Nguyen RDH, MS, Michelle R. McQuistan DDS, MS, Fang Qian PhD, MA, MPhil, Marcela Hernández DDS, MS, MBA, Mark D. Macek DDS, DrPh, Donald L. Chi DDS, PhD
Objective
Assess whether there is an interactive effect between oral health literacy and acculturation on dental care use for Hispanic adults.
Methods
Self-identifying Hispanic adults participated in this observational study (N = 338). Oral health literacy (low vs. high) was measured using the Comprehensive Measure of Oral Health Knowledge (CMOHK). Acculturation (low vs. high) was measured using the Short Acculturation Scale for Hispanics (SASH) and operationalized a second way by the language in which the survey was completed (English or Spanish). The outcome was dental care use in the past year (yes/no). Confounder-adjusted modified Poisson regression models were run to generate risk ratios (RR) and to test the hypothesis that participants with high oral health literacy and high acculturation would be more likely to have used dental care in the past year than participants with low oral health literacy and low acculturation.
Results
About 65% of participants used dental care in the past year. The final models failed to show that participants with high oral health literacy and high acculturation were more likely to have used dental care than other participants. However, in the language proxy interaction model, participants with high oral health literacy and low acculturation were significantly more likely to have used dental care than participants with low oral health literacy and low acculturation.
Conclusion
There may be an interaction between oral health literacy and acculturation when modeling dental care use for Hispanic adults that should be further explored.
{"title":"The interactive effects of oral health literacy and acculturation on dental care use among Hispanic adults","authors":"Daisy Patiño Nguyen RDH, MS, Michelle R. McQuistan DDS, MS, Fang Qian PhD, MA, MPhil, Marcela Hernández DDS, MS, MBA, Mark D. Macek DDS, DrPh, Donald L. Chi DDS, PhD","doi":"10.1111/jphd.12529","DOIUrl":"10.1111/jphd.12529","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Assess whether there is an interactive effect between oral health literacy and acculturation on dental care use for Hispanic adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Self-identifying Hispanic adults participated in this observational study (<i>N</i> = 338). Oral health literacy (low vs. high) was measured using the Comprehensive Measure of Oral Health Knowledge (CMOHK). Acculturation (low vs. high) was measured using the Short Acculturation Scale for Hispanics (SASH) and operationalized a second way by the language in which the survey was completed (English or Spanish). The outcome was dental care use in the past year (yes/no). Confounder-adjusted modified Poisson regression models were run to generate risk ratios (RR) and to test the hypothesis that participants with high oral health literacy and high acculturation would be more likely to have used dental care in the past year than participants with low oral health literacy and low acculturation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>About 65% of participants used dental care in the past year. The final models failed to show that participants with high oral health literacy and high acculturation were more likely to have used dental care than other participants. However, in the language proxy interaction model, participants with high oral health literacy and low acculturation were significantly more likely to have used dental care than participants with low oral health literacy and low acculturation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There may be an interaction between oral health literacy and acculturation when modeling dental care use for Hispanic adults that should be further explored.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.12529","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44855690","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}
Carlos Quiñonez DMD, MSc, PhD, FRCD(C), Judith A. Jones DDS, MPH, DScD, Marko Vujicic PhD, Scott L. Tomar DMD, DrPH, Jessica Y. Lee DDS, MPH, PhD
In the two decades between Oral Health in America: A Report of the Surgeon General and Oral Health in America: Advances and Challenges much good happened but intractable challenges persist. Inequity in oral health status, utilization, and access to care continue to negatively affect the health and economic wellbeing of Americans and their families, local, state, and federal health care systems, and American society overall. To move the nation forward, we argue that: more emphasis is needed in prevention; access to care must be improved to mitigate inequity; newer understandings of oral disease must be leveraged in the service of health and health care; the value that oral health brings to economic wellbeing must be elucidated; better policy choices must be made in all of the above; and more effective oral health care leaders in driving policy change must be trained.
{"title":"The 2021 report on oral health in America: Directions for the future of dental public health and the oral health care system","authors":"Carlos Quiñonez DMD, MSc, PhD, FRCD(C), Judith A. Jones DDS, MPH, DScD, Marko Vujicic PhD, Scott L. Tomar DMD, DrPH, Jessica Y. Lee DDS, MPH, PhD","doi":"10.1111/jphd.12521","DOIUrl":"10.1111/jphd.12521","url":null,"abstract":"<p>In the two decades between <i>Oral Health in America: A Report of the Surgeon General</i> and <i>Oral Health in America: Advances and Challenges</i> much good happened but intractable challenges persist. Inequity in oral health status, utilization, and access to care continue to negatively affect the health and economic wellbeing of Americans and their families, local, state, and federal health care systems, and American society overall. To move the nation forward, we argue that: more emphasis is needed in prevention; access to care must be improved to mitigate inequity; newer understandings of oral disease must be leveraged in the service of health and health care; the value that oral health brings to economic wellbeing must be elucidated; better policy choices must be made in all of the above; and more effective oral health care leaders in driving policy change must be trained.</p>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47082330","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}
Gonzalo A. Rodriguez DDS, MDSc, Rodrigo A. Cabello DDS, MDSc, Catalina P. Borroni DDS, Raul A. Palacio DDS, MHA, PhD
Objectives
The purpose of this study was to evaluate the cost-effectiveness of two preventive interventions aimed at increasing the proportion of caries-free preschool children of low socioeconomic status using a decision analytic model.
Methods
Two scenarios were tested, one with a school milk program (SMP) and one without (non-SMP). Fluoride varnish (FV) and a probiotic (PB) were compared to a do-nothing alternative among children in public nurseries/schools over a 4-year period. FV was applied biannually and a PB (Lactobacillus rhamnosus) added to milk powder prepared daily. A Markov decision tree model was utilized. Several sources of data were used to populate the model. Probabilistic and deterministic sensitivity analyses were performed, and a public provider perspective was used.
Results
In the SMP scenario, PB was more effective and less costly than FV and, compared with do-nothing, increased the proportion of caries-free children by 14.5%, with a cost of USD 12.5 per child (June 2018). PB presented an incremental cost-effectiveness ratio (ICER) or cost per extra caries-free child of USD 86.2. In the non-SMP scenario, both interventions were cost-effective. FV (compared with do-nothing) increased the percentage of caries-free children by 8.3% with an ICER of USD 338.3 and PB (compared with FV) increased the effect by 6.2% with an ICER of USD 1400.2.
Conclusions
The findings showed that PB was most effective and less costly than FV in the SMP scenario only. This type of analysis and its results provide essential information for decision-makers to improve the oral health of preschool children.
{"title":"Cost-effectiveness of probiotics and fluoride varnish in caries prevention in preschool children","authors":"Gonzalo A. Rodriguez DDS, MDSc, Rodrigo A. Cabello DDS, MDSc, Catalina P. Borroni DDS, Raul A. Palacio DDS, MHA, PhD","doi":"10.1111/jphd.12526","DOIUrl":"10.1111/jphd.12526","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate the cost-effectiveness of two preventive interventions aimed at increasing the proportion of caries-free preschool children of low socioeconomic status using a decision analytic model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two scenarios were tested, one with a school milk program (SMP) and one without (non-SMP). Fluoride varnish (FV) and a probiotic (PB) were compared to a do-nothing alternative among children in public nurseries/schools over a 4-year period. FV was applied biannually and a PB (<i>Lactobacillus rhamnosus)</i> added to milk powder prepared daily. A Markov decision tree model was utilized. Several sources of data were used to populate the model. Probabilistic and deterministic sensitivity analyses were performed, and a public provider perspective was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the SMP scenario, PB was more effective and less costly than FV and, compared with do-nothing, increased the proportion of caries-free children by 14.5%, with a cost of USD 12.5 per child (June 2018). PB presented an incremental cost-effectiveness ratio (ICER) or cost per extra caries-free child of USD 86.2. In the non-SMP scenario, both interventions were cost-effective. FV (compared with do-nothing) increased the percentage of caries-free children by 8.3% with an ICER of USD 338.3 and PB (compared with FV) increased the effect by 6.2% with an ICER of USD 1400.2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings showed that PB was most effective and less costly than FV in the SMP scenario only. This type of analysis and its results provide essential information for decision-makers to improve the oral health of preschool children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42717958","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}
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