Journal of public health dentistry最新文献_第2页

Variation in dentist participation between dental medicaid managed care organizations 牙医医疗补助管理性护理组织之间牙医参与情况的差异。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-07-30 DOI: 10.1111/jphd.12636

Pamela C. Nwachukwu BDS, Peter C. Damiano DDS, MPH, Steven Levy DDS, MPH, James C. Thomas MS, Dan Shane PhD, Astha Singhal BDS, MPH, PhD, Shareef M. Dabdoub PhD, Julie C. Reynolds DDS, MS

Objectives

Dentists' Medicaid participation is a critical factor affecting dental care access for Medicaid beneficiaries. An important gap in existing literature is the variation in participation across Medicaid dental Managed Care Organizations (MCOs) in states with more than one. This study examined the variation in participation overall and in predictors of dentist participation between two MCOs in Iowa's Dental Medicaid program.

Methods

Data were obtained from a survey of Iowa private practice dentists (n = 1256). Responding general dentists (n = 497) were included in the final analytic sample. Univariate, bivariate, and multivariable logistic regression analyses were conducted to examine demographic and practice characteristics associated with dentist participation (acceptance of new Medicaid patients) between MCOs and by age category.

Results

Among respondents, the proportions accepting new adults with Medicaid were 26% (MCO 1) and 7% (MCO 2); for children, they were 40% (MCO 1) and 11% (MCO 2). For adults, dentists who were too busy (MCO1) and solo practice dentists (MCO2) were positively significantly associated with the acceptance of new patients. For children, group and rural practice dentists, as well as dentists who worked <32 h/week were positively significantly associated with acceptance of new patients with MCO1.

Conclusions

There was considerable variation in dentist-reported acceptance of new adult and child Medicaid patients, and in the factors affecting acceptance of new patients between MCOs in Iowa dental Medicaid. Future studies of Medicaid participation should consider variations by MCO in states with more than one dental MCO so as not to miss important factors affecting Medicaid participation.

目标：牙医参与医疗补助计划（Medicaid）是影响医疗补助计划受益人获得牙科保健服务的一个关键因素。现有文献中的一个重要空白是，在有多个医疗补助牙科管理护理组织（MCOs）的州中，不同医疗补助牙科管理护理组织的参与情况存在差异。本研究考察了爱荷华州牙科医疗补助项目中两个 MCO 之间参与度的总体差异以及牙医参与度的预测因素：数据来自对爱荷华州私人执业牙医（n = 1256）的调查。回复的普通牙医（n = 497）被纳入最终分析样本。我们进行了单变量、双变量和多变量逻辑回归分析，以研究与牙医参与（接受新的医疗补助患者）相关的人口统计学特征和执业特征：在受访者中，接受新的医疗补助成人患者的比例分别为 26%（MCO 1）和 7%（MCO 2）；接受儿童患者的比例分别为 40%（MCO 1）和 11%（MCO 2）。就成人而言，太忙的牙医（MCO1）和单独执业的牙医（MCO2）与接受新病人呈显著正相关。对于儿童来说，集体和乡村执业牙医以及有结论的牙医与接受新病人呈正相关：在爱荷华州牙科医疗补助计划中，牙医报告的对成人和儿童医疗补助计划新患者的接受程度以及影响新患者接受程度的因素在不同的 MCO 之间存在很大差异。今后对医疗补助参与情况的研究应考虑在有一个以上牙科医疗补助组织的州中各医疗补助组织之间的差异，以免遗漏影响医疗补助参与情况的重要因素。

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引用次数: 0

Dental care access for children in the United States 美国儿童获得牙科保健的情况。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-07-16 DOI: 10.1111/jphd.12635

Nicoleta Serban PhD, Simin Ma PhD, Jiaxi Yu BS, Annalea Anderson MS, Katrine Pospichel MS, Shalini R. Solipuram MS, Scott L. Tomar DMD, MPH

Objectives

To evaluate access to dental care for children in the United States.

Methods

The study population included children in 48 states and the District of Columbia. Using multiple data sources, dental care access was estimated at the community level by matching dental care supply and demand using mathematical modeling accounting for access constraints. Outcome measures included percent-met demand, travel distance, and percentage of underserved and unserved communities. Multiple scenarios to improve Medicaid/CHIP participation of dentists were evaluated.

Results

Medicaid-insured and CHIP-insured children exhibited lower access compared to those privately insured. The percent-met demand was lower than 50% for Medicaid-insured children and CHIP-insured children for 42 and 34 states, respectively. Percent-met demand was higher than 50% for private-insured children except for Texas and West Virginia. Increasing Medicaid/CHIP participation of dentists resulted in improving access for public-insured children. At 100% Medicaid/CHIP participation, all states exhibited different degrees of percent-met demand increase for publicly insured children, from 7% to 46%. The percent-met demand across all children ranged in 23.8%–82.9% under 70% participation rate versus 22%–83% under 100% participation rate. No single participation rate improved access for all children uniformly across all states.

Conclusions

This study found that dental care access was lower for children with public insurance than those with private access across all states, although states responded differently to changes in Medicaid/CHIP participation. Increasing access for children with public insurance would reduce disparities, but overall children's access to dental care would be better improved by expanding the oral health workforce.

目标：评估美国儿童获得牙科保健的情况：评估美国儿童获得牙科保健的情况：研究对象包括美国 48 个州和哥伦比亚特区的儿童。利用多种数据来源，通过数学建模对牙科保健的供需进行匹配，并考虑到获得牙科保健的限制因素，在社区层面对牙科保健的可及性进行估算。结果衡量指标包括满足需求的百分比、旅行距离以及服务不足和无服务社区的百分比。评估了提高牙医参与医疗补助计划（Medicaid）/儿童医保计划（CHIP）的多种方案：结果：与私人投保的儿童相比，参加医疗补助计划和儿童医疗保险计划的儿童就医率较低。在 42 个州和 34 个州中，参加医疗补助计划和儿童医疗保险计划的儿童的需求满足率分别低于 50%。除德克萨斯州和西弗吉尼亚州外，私人保险儿童的需求满足率高于 50%。提高牙医参与《医疗补助计划》/《儿童医保计划》的比例，可改善公共保险儿童的就医条件。在 100%参与《医疗补助计划》/《儿童医保计划》的情况下，各州对公共保险儿童的需求满足率都有不同程度的提高，从 7% 到 46% 不等。在 70% 的参与率下，所有儿童的需求满足率为 23.8%-82.9%，而在 100% 的参与率下，满足率为 22%-83%。在所有州中，没有任何一种参与率能一致地改善所有儿童的就医机会：本研究发现，在所有州中，参加公共保险的儿童获得牙科保健的机会低于参加私人保险的儿童，尽管各州对医疗补助/医疗保险计划参与率的变化反应不同。增加参加公共保险的儿童获得牙科保健的机会将缩小差距，但通过扩大口腔保健队伍，儿童获得牙科保健的总体机会将得到更好的改善。

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引用次数: 0

Evaluating the harmonization potential of oral health-related questionnaires in national longitudinal birth and child cohort surveys 评估国家纵向出生和儿童队列调查中口腔健康相关问卷的协调潜力。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-07-02 DOI: 10.1111/jphd.12632

Vinay Sharma MPH, Michael O'Sullivan PhD, Oscar Cassetti PhD, Lewis Winning PhD, Aifric O'Sullivan PhD, Michael Crowe PhD

Background/Objectives

Effective use of longitudinal study data is challenging because of divergences in the construct definitions and measurement approaches over time, between studies and across disciplines. One approach to overcome these challenges is data harmonization. Data harmonization is a practice used to improve variable comparability and reduce heterogeneity across studies. This study describes the process used to evaluate the harmonization potential of oral health-related variables across each survey wave.

Methods

National child cohort surveys with similar themes/objectives conducted in the last two decades were selected. The Maelstrom Research Guidelines were followed for harmonization potential evaluation.

Results

Seven nationally representative child cohort surveys were included and questionnaires examined from 50 survey waves. Questionnaires were classified into three domains and fifteen constructs and summarized by age groups. A DataSchema (a list of core variables representing the suitable version of the oral health outcomes and risk factors) was compiled comprising 42 variables. For each study wave, the potential (or not) to generate each DataSchema variable was evaluated. Of the 2100 harmonization status assessments, 543 (26%) were complete. Approximately 50% of the DataSchema variables can be generated across at least four cohort surveys while only 10% (n = 4) variables can be generated across all surveys. For each survey, the DataSchema variables that can be generated ranged between 26% and 76%.

Conclusion

Data harmonization can improve the comparability of variables both within and across surveys. For future cohort surveys, the authors advocate more consistency and standardization in survey questionnaires within and between surveys.

背景/目标：有效使用纵向研究数据具有挑战性，因为不同时期、不同研究和不同学科之间的建构定义和测量方法存在差异。克服这些挑战的方法之一就是数据统一。数据协调是一种用于提高变量可比性和减少不同研究间异质性的做法。本研究介绍了用于评估每次调查中口腔健康相关变量协调潜力的过程：方法：选取过去二十年中开展的主题/目标相似的全国儿童队列调查。方法：选择在过去二十年中进行的主题/目标相似的全国儿童队列调查，并遵循《Maelstrom 研究指南》进行协调潜力评估：结果：纳入了七项具有全国代表性的儿童队列调查，并对 50 次调查中的问卷进行了研究。问卷分为三个领域和 15 个结构，并按年龄组进行了汇总。数据模式（代表口腔健康结果和风险因素合适版本的核心变量列表）由 42 个变量组成。对于每个研究浪潮，对生成每个 DataSchema 变量的潜力（或不生成）进行了评估。在 2100 项协调状态评估中，543 项（26%）已完成。大约 50% 的 DataSchema 变量可在至少四次队列调查中生成，而只有 10% (n = 4) 的变量可在所有调查中生成。对于每项调查，可生成的 DataSchema 变量在 26% 到 76% 之间：结论：数据协调可提高调查内和调查间变量的可比性。对于未来的队列调查，作者主张在调查内部和调查之间提高调查问卷的一致性和标准化。

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引用次数: 0

Educating long-term care staff on older adult oral health: Maine's oral team-based initiative vital access to education (MOTIVATE) program 对长期护理人员进行老年人口腔健康教育：缅因州以口腔团队为基础的重要教育（MOTIVATE）计划。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-06-17 DOI: 10.1111/jphd.12630

Jennifer A. Crittenden PhD, MSW, Labrini I. Nelligan MS, Denise O'Connell MSW, LCSW, CCM, CCP, Leonard Brennan DMD

Introduction

The oral health status of older adults in the United States is a public health crisis and a silent epidemic. Maine's Oral Team-Based Initiative Vital Access to Education (MOTIVATE) Program is an innovative interprofessional oral health program aimed at enhancing oral health education and practice of interprofessional health care teams in nursing homes. Using a blended learning model, a combination of in-person and online learning, this program provides a foundation from which to implement evidenced based oral care in nursing homes.

Methods

Learning outcomes were assessed via a three-part timed series survey. A set of self-report assessment items measured skills implemented at baseline and post-training.

Results

Learning domain scores increased over time from baseline to post-training. Confidence in providing oral healthcare and role clarity in providing oral health care improved over time. Staff identified using new skills in daily oral care and communication across the interprofessional team.

Discussion

The MOTIVATE program is an effective collaborative-based model for developing oral health competencies and promoting evidence-based oral health care in nursing homes.

导言：美国老年人的口腔健康状况是一场公共卫生危机，也是一种无声的流行病。缅因州以口腔团队为基础的活力教育计划（MOTIVATE）是一项创新的跨专业口腔健康计划，旨在加强养老院跨专业医疗团队的口腔健康教育和实践。该计划采用混合学习模式，将现场学习和在线学习相结合，为在疗养院实施循证口腔护理奠定了基础：学习成果通过三部分定时系列调查进行评估。一组自我报告评估项目测量了基线和培训后的技能实施情况：结果：从基线到培训后，学习领域的得分不断增加。提供口腔保健的信心和提供口腔保健的角色清晰度随着时间的推移而提高。员工发现在日常口腔护理和跨专业团队沟通中使用了新技能：讨论：MOTIVATE 计划是一种有效的基于合作的模式，可用于培养疗养院的口腔保健能力并促进循证口腔保健。

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引用次数: 0

Integration of dental therapists in safety net practice increases access to oral health care in Minnesota 在明尼苏达州，将牙科治疗师纳入安全网实践增加了口腔保健的可及性。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-06-17 DOI: 10.1111/jphd.12628

Mishal Khan MHA, Frank Catalanotto DMD, Astha Singhal BDS, MPH, PhD, F. Lee Revere PhD, MS

Objectives

This study evaluates the impact of introducing dental therapists (DTs) into Children's Dental Services (CDS), a large non-profit organization in Minnesota. The aim is to assess the effect of DTs in improving access and reducing dental care costs in Minnesota by analyzing the trends in dental care delivery and procedures performed by CDS dentists and therapists.

Methods

Using 2009 to 2021 data from CDS, the study compares trends in patient volume, types of procedures, salary data and payments by dentists, DTs, and registered dental hygienists (RDH). Return on investment (ROI) trends are calculated using salary and revenues for each provider type.

Results

After introducing DTs at CDS and implementing mobile clinics, the number of patients served and volume increased steadily, demonstrating increased access. DTs provided an increasing proportion of fluorides, sealants, and extractions through 2020. Interestingly 2021, there was a decrease for DTs, possibly due to Covid related workforce shortages. ROI analysis showed that DTs' ROI dramatically rose, eventually surpassing dentists, while RDHs maintained a constant ROI. Dentists' ROI also initially increased after adopting DTs in the practice.

Conclusion

Integrating DTs at CDS improved access by expanding mobile clinics, increasing patient volume, and redistributing procedures, while demonstrating a positive return on investment. Results suggest that adopting the DT model may be a promising practice for other organizations seeking to improve access to dental care, increase operational efficiency, and boost the dental care team's ROI.

研究目的本研究评估了明尼苏达州一家大型非营利组织--儿童牙科服务机构（CDS）引入牙科治疗师（DTs）的影响。目的是通过分析儿童牙科服务机构牙医和治疗师提供的牙科医疗服务和程序的趋势，评估牙科治疗师在改善明尼苏达州牙科医疗服务的可及性和降低牙科医疗成本方面的效果：该研究利用 2009 年至 2021 年的 CDS 数据，比较了牙医、牙科治疗师和注册牙科保健师 (RDH) 的患者数量、手术类型、工资数据和支付趋势。投资回报率（ROI）趋势是根据每类提供者的工资和收入计算得出的：在 CDS 引入牙科医生并实施流动诊所后，所服务的患者人数和数量稳步增长，这表明就诊率有所提高。到 2020 年，牙科医生提供的氟化物、密封剂和拔牙服务的比例不断增加。有趣的是，到 2021 年，DTs 的服务量有所下降，这可能是由于 Covid 导致的劳动力短缺。投资回报率分析表明，牙科医生的投资回报率急剧上升，最终超过了牙医，而注册牙医的投资回报率则保持不变。牙医在采用 DT 后，投资回报率最初也有所上升：结论：在 CDS 中整合 DT，通过扩大流动诊所、增加患者数量和重新分配治疗程序，改善了就医条件，同时还显示出积极的投资回报。研究结果表明，对于其他寻求改善牙科医疗服务、提高运营效率和提升牙科医疗团队投资回报率的机构来说，采用 DT 模式可能是一种很有前景的做法。

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引用次数: 0

Point-of-care diabetes testing in the dental setting: A national scope of practice survey 牙科环境中的床旁糖尿病检测：全国实践范围调查。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-05-31 DOI: 10.1111/jphd.12631

Nadia Laniado DDS, MPH, MS, Ashley E. Brodigan DDS, MPH, Megan Cloidt DDS, MPH

Objectives

The aim of this study was to assess the knowledge of state dental directors regarding their state's professional practice act, specifically scope of practice laws regarding point-of-care chairside screening for diabetes.

Methods

A cross-sectional study design was used to examine the 50 state dental directors' knowledge of policy around point-of-care diabetes testing in their state. A five-item survey instrument was designed in a web-based platform and electronically distributed in 2022.

Results

Thirty-seven states (74%) responded to the survey. Regarding whether it was within the scope of practice for dentists to provide chairside point-of-care HbA1c screening, 17 states (46.0%) responded “yes,” 5 states (13.5%) responded “no,” and 15 states (40.5%) responded “don't know.” Of the 17 states who provide diabetes testing, four states (23.5%) reported that dentists were reimbursed, nine states (53.0%) reported they were not reimbursed, and four states (23.5%) reported they did not know regarding reimbursement.

Conclusions

There is significant state heterogeneity with regard to laws, regulations, and reimbursement for chairside diabetes testing in the United States. This is accompanied by vagueness and lack of specificity in the state education laws. For more widespread promotion and adoption of this evidence-based screening, the entire dental community including clinicians, educators, policymakers, payers, and professional organizations at all levels are encouraged to work together to advocate for clarification and specificity in the language of state education laws as well as reimbursement for this vital service.

研究目的本研究的目的是评估各州牙科主任对本州专业执业法案的了解程度，特别是关于糖尿病床旁护理点筛查的执业范围法律：方法：采用横断面研究设计，考察 50 个州的牙科主任对本州糖尿病就诊点检查政策的了解程度。在网络平台上设计了一个五项调查工具，并在 2022 年以电子方式分发：结果：37 个州（74%）对调查做出了回应。关于牙医提供椅旁护理点 HbA1c 筛查是否属于执业范围，17 个州（46.0%）回答 "是"，5 个州（13.5%）回答 "否"，15 个州（40.5%）回答 "不知道"。在提供糖尿病检测的 17 个州中，有 4 个州（23.5%）表示牙医可以报销费用，9 个州（53.0%）表示不报销费用，4 个州（23.5%）表示不知道报销费用：结论：美国各州在椅旁糖尿病检测的法律、法规和报销方面存在很大差异。同时，各州的教育法也模糊不清，缺乏针对性。为了更广泛地推广和采用这种循证筛查，我们鼓励包括临床医生、教育工作者、政策制定者、付款人和各级专业组织在内的整个牙科界共同努力，倡导各州教育法的语言要明确、具体，并为这项重要的服务提供报销。

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引用次数: 0

Dental service utilization in the general adult population in Bangladesh 孟加拉国普通成年人的牙科服务使用情况。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-05-28 DOI: 10.1111/jphd.12616

Supa Pengpid DrPH, Karl Peltzer PhD

Objectives

With the help of a national community-based survey, the analysis aimed to estimate the number of adults in Bangladesh who used dental services (DSU).

Methods

The 8185 participants (18–69 years old) in the Bangladesh cross-sectional STEPS survey in 2018 provided national data for analysis. Predisposing, enabling, and need factors for DSU were included in the interview data, physical examinations, and biochemical analyses. To estimate the DSU (last 12 months) predictors, Poisson regression was employed.

Results

Seven out of 10 participants (71.0%) had never DSU, 13.2% within the past 12 months, and 15.9% more than 12 months ago. In terms of predisposing factors, the final model showed a negative relationship between past 12-month DSU and living in the northern region (adjusted prevalence ratio-APR: 0.75, 95% CI: 0.59, 0.96). The enabling factors of living in an urban area (APR: 1.19, 95% CI: 1.01, 1.41) and seeing a doctor or other healthcare provider within the previous year (APR: 1.37, 95% CI: 1.08, 1.74) were positively correlated with DSU. In terms of need factors, dental pain (APR: 15.37, 95% CI: 9.68, 24.40), multimorbidity (APR: 1.26, 95% CI: 1.02, 1.55), oral health impact (OHI) speech problem (APR: 1.35, 95% CI: 1.13, 1.63), and OHI felt tense (APR: 1.34, 95% CI: 1.10, 1.64) were positively associated with DSU.

Conclusions

A low proportion of participants had DSU in the past 12 months and several associated factors were identified.

目的：借助一项全国性社区调查，分析旨在估算孟加拉国使用牙科服务（DSU）的成年人数量：借助一项基于社区的全国性调查，分析旨在估算孟加拉国使用牙科服务（DSU）的成年人数量：2018 年孟加拉国横断面 STEPS 调查的 8185 名参与者（18-69 岁）为分析提供了全国数据。DSU的诱发因素、有利因素和需求因素均包含在访谈数据、体检和生化分析中。为了估计 DSU（过去 12 个月）的预测因素，采用了泊松回归法：结果：10 位参与者中有 7 位（71.0%）从未有过 DSU，13.2% 在过去 12 个月内，15.9% 超过 12 个月。在易感因素方面，最终模型显示，过去 12 个月的 DSU 与居住在北部地区之间存在负相关（调整患病率比-APR：0.75，95% CI：0.59，0.96）。居住在城市地区（APR：1.19，95% CI：1.01，1.41）和在过去一年中看过医生或其他医疗服务提供者（APR：1.37，95% CI：1.08，1.74）这两个有利因素与 DSU 呈正相关。在需求因素方面，牙痛（APR：15.37，95% CI：9.68，24.40）、多病（APR：1.26，95% CI：1.02，1.55）、口腔健康影响（OHI）语言问题（APR：1.35，95% CI：1.13，1.63）和口腔健康影响感觉紧张（APR：1.34，95% CI：1.10，1.64）与 DSU 呈正相关：结论：在过去 12 个月中，有较低比例的参与者患有 DSU，并确定了几个相关因素。

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引用次数: 0

Safety net patients' satisfaction with oral health services by provider type and intent to return for more care 安全网患者对口腔保健服务的满意度（按提供者类型和返回接受更多护理的意向分列）。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-05-25 DOI: 10.1111/jphd.12629

Yunhan Zhao PhD, Simona Surdu MD, PhD, Margaret Langelier MSHSA

Objectives

This study examined patients' satisfaction with services provided by different oral health providers, their intent to return for additional care, and associations with patients' demographics and service characteristics.

Methods

Descriptive analyses and multivariable ordinal logistic regressions were conducted using survey data from 898 patients who received care at Apple Tree Dental (ATD) in Minnesota during 2021. The questionnaire included 12 statements on patient satisfaction with the clinician's ability to explain the dental diagnosis and treatment options, to be considerate of the patient's needs and dental anxiety, and to provide technically competent services.

Results

In general, patients reported high satisfaction with dental care and a strong intent to return to ATD for future services. No significant differences in patient satisfaction were observed by provider type. Patients' intent to return was higher among non-White respondents (OR = 1.76; 95% CI = 1.06–2.92) and patients who were more satisfied with their providers' technical competence/treatment (OR = 1.47; 95% CI = 1.37–1.57). The association between intent to return and patient satisfaction with providers' information/communication was stronger for patients treated by dental hygienists. The association between intent to return and patient satisfaction with providers' technical competence/treatment was also stronger for patients who were more satisfied with providers' information/communication and understanding/acceptance, and for those treated by their desired or usual provider.

Conclusions

The study underscores the benefits of introducing dental therapists to the oral healthcare team, showing that this can be achieved without sacrificing either the quality of patient care or patient satisfaction.

研究目的本研究调查了患者对不同口腔医疗服务提供者提供的服务的满意度、他们再次就诊的意向以及与患者人口统计学和服务特征的关联：利用 2021 年期间在明尼苏达州苹果树牙科（ATD）接受治疗的 898 名患者的调查数据进行了描述性分析和多变量序数逻辑回归。调查问卷包括 12 项陈述，内容涉及患者对临床医生解释牙科诊断和治疗方案的能力、考虑患者需求和牙科焦虑的能力以及提供技术合格服务的能力的满意度：总体而言，患者对牙科治疗的满意度很高，并强烈希望今后再次到 ATD 就诊。不同提供者类型的患者满意度没有明显差异。非白人受访者（OR = 1.76; 95% CI = 1.06-2.92）和对提供者的技术能力/治疗更满意的患者（OR = 1.47; 95% CI = 1.37-1.57）的复诊意愿更高。由牙科保健师治疗的患者的复诊意向与患者对医疗服务提供者的信息/沟通满意度之间的关联更强。对提供者的信息/沟通和理解/接受程度更满意的患者，以及由其希望或惯常提供者治疗的患者，其复诊意愿与提供者的技术能力/治疗满意度之间的关联也更强：这项研究强调了在口腔医疗团队中引入牙科治疗师的益处，表明可以在不牺牲患者护理质量或患者满意度的情况下实现这一目标。

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引用次数: 0

Association between more complex special care needs and overweight status and adolescents' difficulty with dental caries 更复杂的特殊护理需求和超重状况与青少年龋齿困难之间的关系。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-05-11 DOI: 10.1111/jphd.12622

Vinodh Bhoopathi BDS, MPH, DScD, Christine Wells PhD, Gina Tripicchio PhD, MSEd, Nini Chaichanasakul Tran DDS, PhD

Objective

Little is known about dental caries experience in adolescents with overweight and complex special health care needs (SHCNs).

Methods

Adolescent data (10–17 years) from the 2016–2020 National Survey of Children's Health (n = 91,196) was analyzed. The sample was grouped into the following: more complex SHCN and overweight, more complex SHCN without overweight, less complex SHCN and overweight, less complex SHCN without overweight, no SHCN but with overweight, and neither SHCN nor overweight. A multivariable-adjusted logistic regression model was conducted.

Results

Adolescents with more complex SHCNs with (OR: 1.82, 95% CI: 1.44–2.30, p < 0.001) or without overweight (OR: 1.51, 95% CI: 1.30–1.76, p < 0.001) were at higher odds of experiencing dental caries compared to healthy adolescents. No significant associations were observed between adolescents with less complex or no SHCN regardless of the overweight status with healthy adolescents.

Conclusions

Adolescents with more complex SHCNs, irrespective of overweight status, experienced a higher caries severity than adolescents with no SHCNs or overweight.

摘要人们对超重和有复杂特殊健康护理需求（SHCNs）的青少年的龋齿经历知之甚少：分析了 2016-2020 年全国儿童健康调查中的青少年数据（10-17 岁）（n = 91,196 人）。样本分为以下几组：较复杂的 SHCN 和超重、较复杂的 SHCN 但不超重、较不复杂的 SHCN 和超重、较不复杂的 SHCN 但不超重、无 SHCN 但超重、既无 SHCN 也不超重。结果显示，患有较复杂 SHCN 的青少年体重超重，而患有较不复杂 SHCN 的青少年体重超重：结果：具有较复杂 SHCN 的青少年（OR：1.82，95% CI：1.44-2.30，P 结论：具有较复杂 SHCN 的青少年体重较轻：与没有 SHCN 或超重的青少年相比，有较复杂 SHCN 的青少年（无论是否超重）的龋齿严重程度更高。

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引用次数: 0

Association between food insecurity and edentulism for older adults: A pilot study 老年人粮食不安全与牙齿缺失之间的关系：一项试点研究。

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2024-05-08 DOI: 10.1111/jphd.12623

Sophie R. Li, Jane J. Lee PhD, MSW, Lloyd A. Mancl PhD, MS, Donald L. Chi DDS, PhD

Objectives

This pilot study examined the association between food insecurity and edentulism among older adults in Washington State.

Methods

This study focused on adults aged 50 years and older, who were recruited through seven community-based organizations in Washington State. The exposure variable was food security level (high, marginal, and low/very low food security) assessed using the 10-item U.S. Adult Food Security Survey. The outcome was edentulism, defined as having zero natural teeth. Confounder-adjusted odds ratios (OR) and 95% confidence intervals (CIs) were generated using binary logistic regression models (α = 0.05).

Results

Of the 216 participants, 28.7% (n = 62) had low/very low food security and 7.9% (n = 17) had zero teeth. Older adults with low or very low food security had greater odds of being edentulous compared to those with marginal or high food security, although the difference was not statistically significant (OR: 1.39; 95% CI: 0.46, 4.20; p = 0.56).

Conclusions

Future research should explore food insecurity-focused interventions aimed at preventing edentulism in older adults in a broader effort to address oral health inequities.

目的：本试验性研究探讨了华盛顿州老年人的食物不安全与牙齿缺失之间的关系：本试验性研究探讨了华盛顿州老年人的食物不安全与牙齿缺损之间的关系：这项研究主要针对华盛顿州七个社区组织招募的 50 岁及以上的成年人。暴露变量为食品安全水平（高、边缘和低/极低食品安全水平），使用 10 个项目的美国成人食品安全调查进行评估。结果是无牙症，即天然牙齿为零。使用二元逻辑回归模型（α = 0.05）得出混杂因素调整后的几率比（OR）和 95% 置信区间（CI）：在 216 名参与者中，28.7%（n = 62）的食物安全性较低/极低，7.9%（n = 17）的牙齿为零。与食品安全处于边缘或较高水平的老年人相比，食品安全处于低水平或极低水平的老年人出现牙齿缺失的几率更大，但差异并无统计学意义（OR：1.39；95% CI：0.46，4.20；P = 0.56）：未来的研究应探索以粮食不安全为重点的干预措施，旨在预防老年人的牙齿缺损，从而更广泛地解决口腔健康不平等问题。

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引用次数: 0