Journal of public health dentistry最新文献_第3页

Mapping the “X” Debate: Water Fluoridation Sentiment Analysis With Advanced Machine Learning 映射“X”辩论：用水氟化情绪分析与先进的机器学习。

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

Journal of public health dentistry

Pub Date : 2025-05-07 DOI: 10.1111/jphd.12669

Nilesh Torwane, Ratilal Lalloo, Diep Ha, Loc Do

Objectives

This study aimed to examine public sentiment regarding community water fluoridation (CWF) using data from “X” (formerly Twitter) over the past decade. The goal was to understand public opinion trends and identify opportunities for targeted public health communication.

Methods

We conducted a sentiment analysis utilizing a natural language processing technique. Specifically, we applied the Sentiment Intensity Analyzer tool to classify tweets related to CWF into negative, positive, or neutral categories. Additionally, a word co-occurrence network analysis was performed to explore key discussion themes. We also compared machine learning models to assess their accuracy in classifying tweet sentiments.

Results

Analysis of the tweets revealed a balanced distribution of sentiments: 37.4% negative, 34.4% positive, and 28.2% neutral. Peaks in public engagement occurred between 2015 and 2016, with a subsequent decline after 2018. Sentiment spikes were often associated with significant events, including policy changes and media coverage. The word co-occurrence network highlighted recurring themes related to safety and dental health. Among the machine learning models evaluated, Logistic Regression demonstrated the highest accuracy in sentiment classification.

Conclusions

Our findings highlight the polarized nature of public sentiment toward CWF and the temporal fluctuations in public engagement. These insights can inform public health policymakers in developing timely, targeted communication strategies. Specifically, efforts to engage neutral audiences through transparent messaging and counter misinformation during key periods may strengthen public trust in CWF. The application of machine learning in this analysis underscores its value in enhancing real-time monitoring and supporting evidence-based public health strategies.

目的：本研究旨在利用“X”（以前的Twitter）在过去十年中的数据，调查公众对社区水氟化（CWF）的看法。目的是了解公众舆论趋势，确定有针对性地进行公共卫生宣传的机会。方法：我们利用自然语言处理技术进行情感分析。具体来说，我们应用了情绪强度分析工具将与CWF相关的推文分为消极、积极或中性三类。此外，进行词共现网络分析以探索关键的讨论主题。我们还比较了机器学习模型，以评估它们在分类推特情绪方面的准确性。结果：对推文的分析显示了情绪的平衡分布：37.4%的负面，34.4%的正面，28.2%的中性。公众参与的高峰出现在2015年至2016年，随后在2018年之后下降。情绪波动通常与重大事件有关，包括政策变化和媒体报道。“共现网络”一词强调了与安全和牙齿健康有关的反复出现的主题。在评估的机器学习模型中，逻辑回归在情感分类方面表现出最高的准确性。结论：我们的研究结果突出了公众对CWF的两极分化性质和公众参与的时间波动。这些见解可为公共卫生政策制定者制定及时、有针对性的传播战略提供信息。具体而言，通过透明的信息传递和在关键时期打击错误信息来吸引中立受众的努力可能会加强公众对CWF的信任。机器学习在这一分析中的应用强调了其在加强实时监测和支持循证公共卫生战略方面的价值。

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引用次数: 0

Pharmacologic Management of Non-Traumatic Dental Conditions in US Emergency Departments, 2018–2022 美国急诊部门非创伤性口腔疾病的药物管理，2018-2022。

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

Journal of public health dentistry

Pub Date : 2025-04-11 DOI: 10.1111/jphd.12668

Leah I. Leinbach, Xiaobai Li, Timothy Iafolla, Hosam Alraqiq

Objective

This study examines opioid and antibiotic prescribing by United States emergency departments (EDs) for non-traumatic dental conditions (NTDCs) between 2018 and 2022.

Methods

This is a secondary analysis of nationally representative ED visits using the National Hospital Ambulatory Medical Care Survey (NHAMCS) with an NTDC as the primary discharge diagnosis. Descriptive statistics and odds ratios using chi-squared testing and multivariable logistic regression were used to examine analgesic and antibiotic prescriptions, as well as patient, visit, and hospital characteristics.

Results

There were 1,838,729 weighted ED visits for NTDCs between 2018 and 2022, 1.3% of all visits. Findings demonstrate a continued decline in NTDC visits resulting in an opioid, with an increase in those with non-opioids. Overall, 25% of NTDC visits included an opioid analgesic in 2022, compared to 33% in 2018. The proportion of visits with non-opioid analgesics increased over the study period; nearly 60% of NTDCs seen in 2020 included a non-opioid analgesic. Overall, 63% included an antibiotic, with the highest proportion observed in 2020 (70%). No increase in the proportion of ED visits for NTDCs was seen between the pandemic years (2020–2022) and the pre-pandemic period (2018–2019).

Conclusions

Antibiotics and non-opioid analgesics were a common approach used by ED providers during the pandemic years. Opioid prescriptions for NTDCs declined between 2018 and 2022, while antibiotic prescriptions remained roughly stable. Reducing avoidable opioid and antibiotic prescriptions, and more broadly ED visits for NTDCs, requires a comprehensive approach.

目的：本研究调查了2018年至2022年间美国急诊科（EDs）对非创伤性牙科疾病（ntdc）的阿片类药物和抗生素处方。方法：采用国家医院门诊医疗调查（NHAMCS），以NTDC作为主要出院诊断，对具有全国代表性的急诊科就诊进行二次分析。使用卡方检验和多变量logistic回归的描述性统计和优势比来检查镇痛药和抗生素处方，以及患者、就诊和医院特征。结果：2018年至2022年期间，ndc的加权ED访问量为1,838,729次，占所有访问量的1.3%。调查结果表明，因阿片类药物就诊的国家结核控制中心人数持续下降，而因非阿片类药物就诊的人数有所增加。总体而言，2022年25%的NTDC就诊包括阿片类镇痛药，而2018年这一比例为33%。在研究期间，使用非阿片类镇痛药的就诊比例有所增加；到2020年，近60%的非阿片类药物包括一种非阿片类止痛药。总体而言，63%包括抗生素，2020年观察到的比例最高（70%）。在大流行年份（2020-2022年）和大流行前时期（2018-2019年）之间，非被结核控制国家的急诊科就诊比例未见增加。结论：抗生素和非阿片类镇痛药是大流行期间急诊科医生常用的方法。2018年至2022年期间，非被结核控制国家的阿片类药物处方有所下降，而抗生素处方大致保持稳定。减少可避免的阿片类药物和抗生素处方，以及更广泛地减少非被结核结核国家的急诊科就诊，需要采取综合方法。

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引用次数: 0

Positive Parent–Child Interaction and Children's Oral Health: Findings From the National Survey of Children's Health (NSCH), 2020–2021 积极的亲子互动与儿童口腔健康：来自2020-2021年全国儿童健康调查（NSCH）的发现。

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

Journal of public health dentistry

Pub Date : 2025-04-10 DOI: 10.1111/jphd.12675

Alex Sheen, Parth Shah, Tracy L. Finlayson, Patricia A. Braun, Nadia Laniado

Objective

The role of family relationships in oral health care management for children has received increasing attention as health systems and policy makers seek to improve outcomes and decrease disparities by addressing the social determinants of oral health. The aim of this study was to examine the association of positive parent–child interaction, represented by two age-specific objectives from Healthy People 2030, with oral health problems and unmet oral health needs in children ages 1–17 years in the U.S. from 2020 to 2021.

Methods

This cross-sectional, population-based study analyzed 83,977 children ages 1–17 years from the National Survey of Children's Health, 2020–2021. The exposure variable, parent–child interaction, and the two outcome variables, oral health problems and unmet oral health need, were measured using parent/caregiver survey responses. Weighted simple and multiple logistic regression analyses were performed. Final models were adjusted for demographic characteristics as well as parental, household, and neighborhood factors.

Results

Children from families who experience positive parent–child interaction had 25% lower odds of having any oral health problems (OR 0.75; 95% CI, 0.68–0.83) compared with children who did not experience positive parent–child interaction.

Conclusions

Experiencing positive parent–child interaction was associated with lower odds of children having any oral health problems. Future investigation to explore the specific mechanisms through which positive parent–child interaction is associated with children's oral health is warranted.

目的：家庭关系在儿童口腔卫生保健管理中的作用受到越来越多的关注，因为卫生系统和政策制定者寻求通过解决口腔健康的社会决定因素来改善结果并减少差距。本研究的目的是研究积极的亲子互动与2020年至2021年美国1-17岁儿童口腔健康问题和未满足的口腔健康需求之间的关系，以《Healthy People 2030》的两个年龄特定目标为代表。方法：这项基于人群的横断面研究分析了来自2020-2021年全国儿童健康调查的83977名1-17岁儿童。暴露变量，亲子互动，以及两个结果变量，口腔健康问题和未满足的口腔健康需求，通过父母/照顾者的调查回答来测量。进行加权单逻辑回归和多元逻辑回归分析。最后的模型根据人口特征以及父母、家庭和邻里因素进行了调整。结果：来自积极的亲子互动家庭的儿童出现任何口腔健康问题的几率低25% (OR 0.75；95% CI, 0.68-0.83)，与没有经历积极亲子互动的儿童相比。结论：经历积极的亲子互动与儿童出现任何口腔健康问题的几率较低有关。未来的研究将探索亲子积极互动与儿童口腔健康相关的具体机制。

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引用次数: 0

The Role of Public Oral Health Services and Socioeconomic Factors in Oral Cancer Mortality in Brazil 公共口腔卫生服务和社会经济因素在巴西口腔癌死亡率中的作用。

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

Journal of public health dentistry

Pub Date : 2025-04-06 DOI: 10.1111/jphd.12676

José Mário Nunes da Silva, Maria Eduarda Macedo Vila-Castro, Antônio Borges Nunes-Neto, Fabrício Dos Santos Menezes

Objective

To assess the relationship between socioeconomic factors and the provision of oral health services in Primary Healthcare with mortality due to oral cancer in Brazil.

Methods

This ecological study was conducted across 1105 Brazilian municipalities, encompassing 11,412 oral health teams (OHTs). The outcome variable was the oral cancer mortality rate, standardized by age and sex. Socioeconomic factors and variables related to the oral health services provided by municipal OHTs were considered explanatory variables. We employed multilevel Poisson regression models with random effects at the municipal level to assess the association between oral cancer mortality rates and explanatory variables.

Results

At the municipal level, oral cancer mortality was negatively associated with higher human and social development and greater income inequality but positively linked to higher rates of population aging and greater coverage of primary and oral healthcare services. At the OHT level, mortality reduction was observed among those who received specialized support and had greater availability of consultations. Active case-finding for cancerous lesions and care monitoring were also linked to lower mortality. Conversely, the identification of high-risk vulnerable patients by these teams was associated with higher mortality.

Conclusion

This study suggests that oral cancer mortality in Brazilian municipalities is influenced by socioeconomic factors and the availability of oral health services.

目的：评估巴西社会经济因素和初级卫生保健机构提供口腔卫生服务与口腔癌死亡率之间的关系。方法：这项生态研究在1105个巴西城市进行，包括11412个口腔卫生团队（OHTs）。结果变量是口腔癌死亡率，按年龄和性别标准化。社会经济因素和与市政OHTs提供的口腔卫生服务相关的变量被认为是解释变量。我们在市级采用随机效应的多水平泊松回归模型来评估口腔癌死亡率与解释变量之间的关系。结果：在城市一级，口腔癌死亡率与较高的人类和社会发展水平以及更大的收入不平等呈负相关，但与较高的人口老龄化率和更大的初级和口腔保健服务覆盖率呈正相关。在OHT一级，那些得到专门支助和有更多咨询机会的人的死亡率下降。癌症病变的主动病例发现和护理监测也与降低死亡率有关。相反，这些团队对高危易感患者的识别与更高的死亡率相关。结论：本研究表明，巴西城市口腔癌死亡率受社会经济因素和口腔卫生服务的可获得性的影响。

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引用次数: 0

An Oral Health Promotion Strategy for Persons With Intellectual and Developmental Disability: An Exploratory Randomized Trial Comparing Intervention and Control Group Homes 智力和发育障碍者的口腔健康促进策略：一项比较干预和对照组家庭的探索性随机试验。

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

Journal of public health dentistry

Pub Date : 2025-03-25 DOI: 10.1111/jphd.12673

Stephen R. Shamblen, Bonnie O. Richard, Melissa H. Abadi, Kirsten T. Thompson, Camila Aramburu, Linda C. Young, Jamie Ely, HimaBindu Dukka, Knowlton W. Johnson

Introduction

Individuals with intellectual or developmental disabilities (IDD) often experience more negative oral health outcomes.

Methods

We implemented and tested a comprehensive strategy in 39 IDD group homes to examine whether skills-based training for direct support professionals (DSP) and individualized oral health planning for residents could improve DSP assistance and provision of oral health care for residents and oral health status. Our sample comprised 19 intervention homes and 20 control group homes, with 61 residents with IDD and 77 DSP. The strategy involved providing didactic and experiential skills-based training, combined with in-home coaching to DSP with resident participation over the course of 16 weeks. DSP in control homes received educational brochures. DSP attitudes, skills, and behaviors; and resident oral health outcomes were measured at baseline, 4 months later (post-intervention), and 12 months after baseline. Analyses compared the intervention and control conditions at 4-months and 12-months.

Results

Results suggest that the intervention influenced DSP skills and behaviors. Among residents, results showed improved outcomes for teeth in the lower anterior sextant only; intervention effects largely abated by 12-month follow-up.

Discussion

Findings demonstrate that skills-based, experiential training with coaching can be effective in enhancing skill sets and increasing behaviors about oral health among DSP. In addition, results showed that the strategy used can improve oral health outcomes for residents. However, given that there were only improved outcomes in residents' lower anterior sextant, more research is needed to determine how to adequately assess and improve resident outcomes.

简介：智力或发育障碍（IDD）患者的口腔健康状况不佳：智力或发育障碍（IDD）患者的口腔健康往往会受到更多负面影响：我们在 39 家 IDD 群体之家实施并测试了一项综合策略，以研究直接支持专业人员（DSP）的技能培训和为居民制定的个性化口腔健康计划是否能改善 DSP 的协助和为居民提供的口腔保健服务以及口腔健康状况。我们的样本包括 19 所干预院舍和 20 所对照组院舍，其中有 61 名患有 IDD 的院友和 77 名直接支持专业人员。干预策略包括提供以说教和体验技能为基础的培训，并在居民参与的情况下对社区保健员进行上门指导，为期 16 周。对照组家庭中的 DSP 则接受教育手册。分别在基线、4 个月后（干预后）和基线后 12 个月对 DSP 的态度、技能和行为以及居民的口腔健康结果进行了测量。在 4 个月和 12 个月时，对干预条件和对照条件进行了分析比较：结果表明，干预对 DSP 的技能和行为产生了影响。在居民中，结果显示只有下前六分体的牙齿情况有所改善；干预效果在 12 个月的随访中基本减弱：讨论：研究结果表明，以技能为基础的体验式培训加上辅导，可以有效提高 DSP 的口腔健康技能和行为。此外，研究结果表明，所采用的策略可以改善居民的口腔健康状况。然而，鉴于仅在居民的下前牙六分仪方面有所改善，因此需要进行更多的研究，以确定如何充分评估和改善居民的成果。

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引用次数: 0

Appalachian Numeracy and Literacy and Oral Health, an Ecological Study, PIAAC and BRFSS 阿巴拉契亚人的计算能力和读写能力与口腔健康，一项生态研究，PIAAC和BRFSS。

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

Journal of public health dentistry

Pub Date : 2025-03-22 DOI: 10.1111/jphd.12672

R. Constance Wiener, Christopher Waters, Meghan Bastin

Objectives

Social determinants of health (SDOH) include healthcare access, neighborhood/built environment, social context, economic stability, and education (including literacy and numeracy). These are known factors for health outcomes. The purpose of this research is to consider one SDOH category: general literacy/numeracy levels, with poor oral health indicators in a comparison of U.S. national and Appalachia data, a region with many poor healthcare indicators.

Methods

For this ecological study, literacy/numeracy data were from the Programme for the International Assessment of Adult Competencies (PIAAC) Survey of Adult Skills, 2012–2017. Oral health indicators were from the Behavioral Risk Factor Surveillance System, 2012–2016.

Results

Of a possible score of 500 for literacy/numeracy, the mean national scores were 263.5(95% CI: 262.0, 265.1) and 249.1 (95% CI: 247.5, 250.6), respectively. The mean scores for all Appalachian counties were similar (262.2; 95% CI: 261.3, 263.1; p = 0.7258) and (247.6; 95% CI: 246.6, 248.6; p = 0.6872), respectively. However, within state comparisons had several non-Appalachian counties with higher literacy/numeracy scores than their Appalachian counties (Kentucky, Ohio, and Virginia) while in Alabama, the reverse occurred. Overall, state-wide, dental visits were not significantly different from national levels in crude percentages; however, missing any permanent teeth and edentulism were higher than the nation.

Conclusion

Health concerns, and oral health concerns in particular, are significant for the Appalachian region. However, dental visits and the mean overall general literacy/numeracy skills were not significantly different from the nation's, indicating that other factors are driving poor health outcomes within Appalachia from an ecological perspective.

目标：健康的社会决定因素（SDOH）包括医疗保健获取、社区/建筑环境、社会背景、经济稳定和教育（包括识字和算术）。这些都是影响健康结果的已知因素。本研究的目的是考虑一个SDOH类别：一般识字/计算水平，在美国国家和阿巴拉契亚数据的比较中，口腔健康指标较差，这是一个医疗保健指标较差的地区。方法：在这项生态研究中，读写/计算数据来自2012-2017年国际成人能力评估计划（PIAAC）成人技能调查。口腔健康指标来源于2012-2016年行为危险因素监测系统。结果：在识字/计算的可能得分为500分中，全国平均得分分别为263.5（95% CI: 262.0, 265.1）和249.1 （95% CI: 247.5, 250.6）。所有阿巴拉契亚县的平均得分相似(262.2；95% ci: 261.3, 263.1；P = 0.7258)和(247.6；95% ci: 246.6, 248.6；P = 0.6872)。然而，在州内比较中，有几个非阿巴拉契亚县的读写/计算成绩高于阿巴拉契亚县（肯塔基州、俄亥俄州和弗吉尼亚州），而在阿拉巴马州，情况正好相反。总体而言，在全州范围内，牙科就诊在粗百分比上与全国水平没有显著差异；但是，缺恒牙和缺牙率高于全国。结论：健康问题，尤其是口腔健康问题，在阿巴拉契亚地区是非常重要的。然而，看牙医和平均总体识字/算术技能与全国没有显著差异，这表明从生态角度来看，其他因素正在导致阿巴拉契亚地区的健康状况不佳。

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引用次数: 0

COVID-19 Vaccination in Canadian Dental Schools 加拿大牙科学校的 COVID-19 疫苗接种。

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

Journal of public health dentistry

Pub Date : 2025-03-21 DOI: 10.1111/jphd.12670

Isabella Turquete, Sreenath Madathil, Paul J. Allison

Background

Oral Healthcare workers, including dental students, face a great risk of COVID-19 infection. High COVID-19 vaccination coverage is essential for a protected workforce. This study, which aims to document the COVID-19 vaccination experience among dental students and employees from Canadian dental schools during the COVID-19 pandemic, provides crucial insights that can significantly impact future vaccination strategies.

Methods

This study used data from a prospective cohort conducted between April 2021 and May 2022. We recruited 600 participants, including dental students, faculty, and support staff from 10 Canadian dental schools. Data were collected monthly from all subjects. Vaccination acceptance and vaccination time were assessed. Logistic regression models were performed to identify predictors of COVID-19 vaccine acceptance and late vaccination. In order to detect hesitation tendencies, descriptive statistics were used to observe the distribution of time to vaccination between age groups of employees and students.

Results

Out of 600 participants at baseline (70% female; average age 36 years old), 91% received at least one dose of the COVID-19 vaccine. No associations were found between sociodemographic factors and COVID-19 vaccine acceptance. Individuals aged 50–59 were less likely to delay the vaccination than most of our sample. Students presented more outliers for later vaccination times, particularly in younger age groups.

Conclusion

High vaccination acceptance among dental students is crucial for promoting professionalism and influencing patients. Integrating vaccine advocacy into their education might enhance vaccination uptake in the general population.

背景：口腔卫生工作者，包括牙科学生，面临着很大的COVID-19感染风险。高COVID-19疫苗接种覆盖率对于受保护的劳动力至关重要。这项研究旨在记录2019冠状病毒病大流行期间加拿大牙科学校牙科学生和员工的COVID-19疫苗接种经历，提供了可以显著影响未来疫苗接种策略的重要见解。方法：本研究使用了2021年4月至2022年5月期间进行的前瞻性队列数据。我们招募了600名参与者，包括来自加拿大10所牙科学校的牙科学生、教师和支持人员。每月收集所有受试者的数据。评估疫苗接种接受程度和接种时间。采用Logistic回归模型确定COVID-19疫苗接受率和晚期疫苗接种的预测因素。为了检测犹豫倾向，采用描述性统计方法观察雇员和学生年龄组之间接种疫苗的时间分布。结果：在基线的600名参与者中(70%为女性；平均年龄36岁)，91%至少接种了一剂COVID-19疫苗。未发现社会人口学因素与COVID-19疫苗接受度之间存在关联。与我们的大多数样本相比，50-59岁的个体推迟接种疫苗的可能性较小。学生在较晚的疫苗接种时间中表现出更多的异常值，特别是在较年轻的年龄组中。结论：牙科学生对疫苗接种的高接受度对提高专业水平和影响患者至关重要。将疫苗宣传纳入他们的教育可能会提高一般人群的疫苗接种率。

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引用次数: 0

Association of Oral Microbiome Diversity With Depression Status: NHANES 2009–2012 口腔微生物群多样性与抑郁症状态的关系：NHANES 2009-2012。

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

Journal of public health dentistry

Pub Date : 2025-03-19 DOI: 10.1111/jphd.12671

Cuifeng Zhang, Lingli Qu, Yanhua Huang, Lan Tang, Jie Ma, Kaipeng Xie, Huaying Wu

Objectives

To investigate the relationship between oral microbial diversity and depression symptoms in the U.S. population.

Methods

We utilized the US National Health and Nutrition Examination Survey (NHANES; 2009–2012) to assess the association between oral microbial diversity and depression symptoms. A cut-off PHQ-9 score of 15 was used to define severe depression symptoms. We conducted the multivariate linear regression to explore the association of the amplicon sequence variants (ASVs) with PHQ-9 scores. A restricted cubic spline (RCS) model was introduced to curve the dose-response relationship. A logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) of the association between ASVs and the risk of severe depression symptoms. Based on Bray-Curtis dissimilarity of beta diversity, analysis of similarity (ANOSIM) is used to assess the dissimilarity between different depression groups.

Results

A total of 1497 participants were included, with 111 (7.41%) meeting the criteria for severe depression. After adjusting for confounders, we found that ASVs were negatively correlated with PHQ-9 scores (β = −0.008, p = 0.014). The RCS plot showed a linear relationship (p _non-linear = 0.232). Logistic regression showed that ASVs were associated with a decreased risk of severe depression symptoms (OR = 0.992, p = 0.003). Analysis of β diversity identified a statistically significant difference (R = 0.087, p = 0.003). Additionally, we developed a nomogram to estimate an individual's risk of severe depression symptoms.

Conclusions

Alpha diversity of the oral microbiota was associated with a reduced risk of severe depression symptoms, which could contribute to the early identification and intervention of severe depression.

目的：调查美国人群口腔微生物多样性与抑郁症状之间的关系。方法：我们利用美国国家健康与营养检查调查(NHANES；2009-2012)评估口腔微生物多样性与抑郁症状之间的关系。PHQ-9分值为15分的临界值被用来定义严重的抑郁症状。我们进行了多元线性回归来探讨扩增子序列变异（asv）与PHQ-9评分的关系。引入限制三次样条（RCS）模型来描述剂量-反应关系。采用logistic回归模型计算asv与重度抑郁症状风险之间的比值比（OR）和95%置信区间（CI）。基于beta多样性的Bray-Curtis差异，采用相似性分析（ANOSIM）来评估不同抑郁组之间的差异。结果：共纳入1497例受试者，其中111例（7.41%）符合重度抑郁标准。在调整混杂因素后，我们发现asv与PHQ-9评分呈负相关（β = -0.008, p = 0.014）。RCS图显示线性关系（p非线性= 0.232）。Logistic回归分析显示，asv与重度抑郁症状发生风险降低相关（OR = 0.992, p = 0.003）。β多样性分析显示差异有统计学意义（R = 0.087, p = 0.003）。此外，我们开发了一个nomogram来评估个体出现严重抑郁症状的风险。结论：口腔微生物群α多样性与严重抑郁症状风险降低相关，有助于早期识别和干预严重抑郁症。

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引用次数: 0

Understanding Utilization and Prevention Measures Associated With a Caries Risk Assessment in Oral Health Transformation 了解口腔健康转型中龋病风险评估相关的利用和预防措施。

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

Journal of public health dentistry

Pub Date : 2025-02-26 DOI: 10.1111/jphd.12666

Melody McGee, Ryan Brandon, Muhammad Walji, Joel White, Kristen Moses, Eric P. Tranby, Lisa J. Heaton, Kristen Simmons

Objectives

Dental decay is endemic in the United States, underscoring the need to measure the utilization of caries risk management tools to elucidate the effect of prevention interventions in reducing the dental decay rates of individuals. An academic institution partnered with a third-party institute to call attention to the utilization and prevention measures associated with caries risk assessment (CRA) used with children 0–18 years. This environmental scan examined claims across the United States to evaluate the proportion of dental examinations, CRAs, and caries prevention procedures within a calendar year.

Methods

A 12-month deidentified participant list categorized by age, race, sex, state of residence, and treatment dates was provided from the third-party database containing 14,625,751 Medicaid and commercial claims for dental examinations, CRAs, and caries prevention procedures performed in the calendar year 2022.

Results

The final data set (N = 9,351,848 patient examinations), 86.8% had a caries prevention procedure completed at the examination visit. Still, only 29.4% had a CRA Current Dental Terminology (CDT) coded on the same day of the dental examination. There were higher numbers of CRAs in the Medicaid payor group in states that require CRAs in conjunction with a dental examination.

Conclusions

The utilization of the ADA CRA CDT codes, designed to stratify patients into caries risk categories of low, moderate, or high, was relatively low compared to the examination and prevention procedure claims. Consistent utilization of these codes would allow for more effective monitoring of patient outcomes, supporting a data-driven approach to assessing oral health over time.

目的：龋齿在美国是一种地方病，强调有必要衡量龋齿风险管理工具的使用情况，以阐明预防干预措施在降低个人龋齿率方面的效果。一个学术机构与一个第三方机构合作，呼吁关注0-18岁儿童龋齿风险评估的使用和预防措施。这项环境扫描检查了美国各地的索赔，以评估一年内牙科检查，CRAs和龋齿预防程序的比例。方法：根据年龄、种族、性别、居住州和治疗日期，从第三方数据库中提供了一份12个月的确定参与者名单，该数据库包含14,625,751份医疗补助和商业索赔，其中包括2022年进行的牙科检查、CRAs和龋齿预防手术。结果：最终数据集（N = 9,351,848例患者检查），86.8%的患者在检查访视时完成了龋预防程序。然而，只有29.4%的人在牙科检查当天编码了CRA当前牙科术语（CDT）。在要求牙科检查同时进行cra的州，医疗补助支付者组的cra数量更高。结论：ADA CRA CDT编码旨在将患者分为低、中、高三种龋病风险类别，与检查和预防程序的要求相比，其使用率相对较低。持续使用这些代码将允许更有效地监测患者的结果，支持以数据为导向的方法来评估长期口腔健康。

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引用次数: 0

Dental Care Utilization Among Middle Eastern and North African Children in the United States 美国中东和北非儿童牙科保健使用情况。

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

Journal of public health dentistry

Pub Date : 2025-02-25 DOI: 10.1111/jphd.12667

Kyrah K. Brown, Florence J. Dallo, Tiffany B. Kindratt

Objectives

This cross-sectional secondary analytical study estimated dentist visits among foreign-born Middle Eastern and North African (MENA) children compared to US-born White and foreign-born White, Black, Hispanic, and Asian children. This is the first known study to provide national estimates for dental visits among MENA children who have historically been aggregated with the White population.

Methods

We used 2000–2018 National Health Interview Survey data (N = 358,686 children). We calculated age- and sex-adjusted prevalence estimates and performed multivariable logistic regression to test the odds of dentist visit utilization by race, ethnicity, and nativity. Covariates included age, family poverty level, health insurance coverage, and special health care needs.

Results

Dental visits at 6 months were approximately 64% for US-born White and foreign-born MENA children. Most (77.4%) foreign-born MENA children had a dentist visit in the past 12 months. Results were similar for US- and foreign-born White (80.8% and 79.9%, respectively) children. Fewer foreign-born Black (49.5%), Hispanic (47.7%), and Asian (54.6%) children had a dentist visit in the past 12 months. Results from logistic regression modeling showed that foreign-born MENA children's receipt of dental visits at 12 months was similar to US-born White children after adjustment (OR = 0.98; 95% CI = 0.76–1.27). Findings were similar for foreign-born White children. Foreign-born Black, Hispanic, and Asian children had lower odds of receiving dental visits at 12 months compared to US-born White children.

Conclusions

Findings suggest high dental care utilization among foreign-born MENA children. Additionally, dental care utilization for foreign-born MENA children was similar to their US- and foreign-born White peers. This study has implications for national health policy and policy reform for federal reporting standards for MENA populations.

目的：本横断面二级分析研究估计了外国出生的中东和北非（MENA）儿童与美国出生的白人和外国出生的白人、黑人、西班牙裔和亚洲儿童的牙医就诊情况。这是已知的第一项研究，提供了中东和北非儿童牙科就诊的全国估计，这些儿童历来与白人人口聚集在一起。方法：使用2000-2018年全国健康访谈调查数据（N = 358,686名儿童）。我们计算了年龄和性别调整后的患病率估计值，并进行了多变量逻辑回归，以检验种族、民族和出生的牙医就诊率。协变量包括年龄、家庭贫困水平、健康保险覆盖率和特殊卫生保健需求。结果：美国出生的白人和外国出生的中东和北非儿童6个月时的牙科就诊率约为64%。大多数（77.4%）外国出生的中东和北非儿童在过去12个月内看过牙医。美国和外国出生的白人儿童的结果相似（分别为80.8%和79.9%）。外国出生的黑人（49.5%）、西班牙裔（47.7%）和亚裔（54.6%）儿童在过去12个月内看牙医的人数较少。逻辑回归模型的结果显示，调整后，外国出生的中东和北非儿童12个月时的牙科就诊次数与美国出生的白人儿童相似(OR = 0.98；95% ci = 0.76-1.27)。在外国出生的白人儿童中也有类似的发现。与美国出生的白人儿童相比，外国出生的黑人、西班牙裔和亚洲儿童在12个月时接受牙科检查的几率较低。结论：研究结果表明，中东和北非地区外国出生儿童的牙科保健使用率较高。此外，外国出生的中东和北非儿童的牙科保健使用率与他们在美国和外国出生的白人同龄人相似。本研究对国家卫生政策和中东和北非地区人口联邦报告标准的政策改革具有启示意义。

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引用次数: 0