Journal of public health dentistry最新文献_第8页

The impact of dentists' availability in delivering dental care in Florida Elementary Schools 牙医在佛罗里达州小学提供牙科护理的可用性的影响

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-10-11 DOI: 10.1111/jphd.12551

Simin Ma MS, Nicoleta Serban PhD, Amin Dehghanian PhD, Scott L. Tomar DMD, MPH

Objective

This study evaluates the dentists' availability to deliver preventive dental care to children in schools and the impact of school-based programs on access.

Methods

The study population included Florida elementary-school children, differentiated by dental insurance (Medicaid, CHIP, private, or none). We considered the implementation of school-based programs using optimization modeling to (re)allocate the dentists' caseload to schools to meet demand for preventive care under resource constraints. We considered multiple settings for school-based program implementation: (i) school prioritization; and (ii) dentists' participation in public insurance. Statistical inference was used to identify communities to improve access and reduce disparities.

Results

School-based programs reduced unmet demand (3%–12%), being more efficient if prioritizing schools in communities targeted to improve access. The access improvement varied by insurance status and geography. Uninsured urban children benefited most from school-based programs, with 15%–75% unmet need reduction. The percentage of urban communities targeted to improve access decreased by 12% against no-school program. Such percentage remained large for suburban (15%–100%) and rural (50%–100%) communities. Disparity in access for public-insured vs. private-insured children persisted under school-based programs (32%–84% identified communities).

Conclusion

School-based programs improve dental care access; the improvement was however different by insurance status, with uninsured children benefiting the most. Accounting to the dentists' availability in prioritizing schools resulted in effective resource allocation to school-based programs. Access disparities between public and private-insured children did not improve; school-based programs shifted resources from public-insured to uninsured. School-based programs are effective in addressing access barriers to those children experiencing them most.

目的本研究评估牙科医生在学校为儿童提供预防性牙科护理的可获得性，以及学校为基础的项目对可获得性的影响。方法研究人群包括佛罗里达州小学儿童，根据牙科保险(医疗补助、CHIP、私立或无)进行区分。我们考虑实施以学校为基础的项目，使用优化模型(重新)分配牙医的病例量到学校，以满足资源限制下对预防保健的需求。我们考虑了以学校为基础的项目实施的多种设置:(1)学校优先级;以及(ii)牙医参加公共保险的情况。统计推断用于确定社区，以改善获取和减少差距。结果:以学校为基础的项目减少了未满足的需求(3%-12%)，如果优先考虑以改善入学为目标的社区的学校，则效率会更高。获得改善的情况因保险状况和地理位置而异。未参保的城市儿童从学校项目中受益最多，未满足的需求减少了15%-75%。与无学校计划相比，改善教育机会的城市社区比例下降了12%。这一比例在郊区(15%-100%)和农村(50%-100%)社区仍然很高。在以学校为基础的项目中，公共保险与私人保险儿童获得机会的差距仍然存在(32%-84%确定的社区)。结论:校本项目提高了牙科保健的可及性;然而，不同的保险状况也有不同的改善，没有保险的孩子受益最多。考虑到牙医在优先考虑学校方面的可用性，有效地将资源分配给以学校为基础的项目。公立和私立医疗保险儿童在获取医疗服务方面的差距没有改善;以学校为基础的项目将资源从公共保险转移到无保险人群。以学校为基础的项目有效地解决了那些经历最多障碍的儿童的入学障碍。

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引用次数: 0

Dentist attitudes toward an annual benefit maximum in Iowa's adult Medicaid program 牙医对爱荷华州成人医疗补助计划年度最高福利的态度

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-10-11 DOI: 10.1111/jphd.12543

Morgan Scholtes BS, Carissa Comnick MS, Julie C. Reynolds DDS, MS, Aparna Ingleshwar BDS, MPH, Susan C. McKernan DMD, MS, PhD, Peter C. Damiano DDS, MPH

Objectives

The Dental Wellness Plan (DWP) provides dental coverage for adult Medicaid enrollees in Iowa. In September 2018, a $1000 annual benefit maximum (ABM) was implemented in the DWP program. The aim of this study was to explore private dentists' attitudes toward ABMs and factors associated with ABM attitudes.

Methods

The data source was a mailed survey administered in spring 2019 to all private practice dentists in Iowa. The two dependent variables were (1) attitude toward the $1000 ABM and (2) attitude toward any ABM generally. Independent variables included demographic and practice-related factors, and participation in and attitudes toward the DWP. Descriptive, bivariate, and multivariable analyses were conducted.

Results

While over half (56%) of providers reported a positive attitude toward “Any ABM,” less than half (40%) reported a positive attitude toward the “$1000 ABM.” Attitudes toward both “$1000 ABM” and “Any ABM” were significantly and positively associated with attitudes toward DWP overall and toward DWP structure. Independent variables that were significantly associated with both the “$1000 ABM” and “Any ABM” included overall attitude toward the DWP, attitude toward DWP structure, and practice busyness.

Conclusions

Utilizing an ABM, particularly one set at $1000 for a Medicaid program, elicits mixed attitudes among dentists. Future research should evaluate the impact of Medicaid ABMs on long term dentist participation and patient's ability to receive needed care.

目的牙科健康计划（DWP）为爱荷华州的成年医疗补助注册者提供牙科保险。2018年9月，DWP计划实施了1000美元的年度最高福利（ABM）。本研究的目的是探讨私人牙医对ABM的态度以及与ABM态度相关的因素。方法数据来源是2019年春季对爱荷华州所有私人执业牙医进行的邮寄调查。两个因变量是（1）对1000美元ABM的态度和（2）对任何ABM的总体态度。自变量包括人口统计学和实践相关因素，以及对DWP的参与和态度。进行了描述性、双变量和多变量分析。结果超过一半（56%）的提供者表示对“任何ABM”持积极态度，但不到一半（40%）的提供者报告对“1000美元ABM”持有积极态度。对“1000加元ABM”和“任何ABM”的态度与对DWP整体和DWP结构的态度显著正相关。与“1000美元ABM”和“任何ABM”显著相关的自变量包括对DWP的总体态度、对DWP结构的态度和练习繁忙程度。结论使用ABM，尤其是医疗补助计划的ABM，会引起牙医的不同态度。未来的研究应该评估医疗补助ABM对长期牙医参与和患者接受所需护理能力的影响。

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引用次数: 0

Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016–2019 2016-2019年美国口腔颌面外科医生开具的阿片类药物处方

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-10-09 DOI: 10.1111/jphd.12544

Tumader Khouja BDS, MPH, PhD, Deborah E. Polk PhD, Katie J. Suda PharmD, MS, FCCP

Objective

To describe opioid prescribing trends among oral and maxillofacial surgeons (OMFS).

Methods

Prescriptions by OMFS were identified from IQVIA Longitudinal Prescription Dataset, 2016–2019. OMFS-based, patient-based and population-based prescribing rates and changes in high-risk opioid prescribing were calculated annually. We used linear regression to describe trends.

Results

There were 13.9 million opioid prescriptions among 12.5 million patients (627 prescriptions/OMFS/year). Hydrocodone and oxycodone decreased by 20.9% and 39.2% (p < 0.05), while tramadol and codeine increased by 24.3% and 6.1% (p < 0.05), respectively. Opioid prescribing rates significantly decreased by 27 prescriptions/OMFS/year, 18.6 patients/OMFS/year and by 0.9 prescriptions/100,000 population/year (p < 0.05 for all). From 2016 to 2019, the proportion of opioids >3 days decreased by 54.2% (p < 0.05) and prescriptions ≥50 MME/day decreased by 66.3% (p < 0.05). Although the number of opioid prescriptions by OMFS decreased in most states, 12% of states experienced increases.

Conclusion

Opioid prescribing, especially high-risk prescribing, by OMFS has decreased. However, targeted interventions are warranted in some areas.

目的了解口腔颌面外科医生(OMFS)的阿片类药物处方趋势。方法选取2016-2019年IQVIA纵向处方数据集中经OMFS鉴定的处方。每年计算基于omfs、基于患者和基于人群的处方率和高危阿片类药物处方的变化。我们用线性回归来描述趋势。结果1250万例患者中有1390万张阿片类药物处方(627张/OMFS/年)。氢可酮和羟考酮分别下降20.9%和39.2% (p < 0.05)，曲马多和可待因分别上升24.3%和6.1% (p < 0.05)。阿片类药物处方率显著下降，分别为27张/OMFS/年、18.6名患者/OMFS/年和0.9张/10万人/年(均p < 0.05)。2016 - 2019年阿片类药物使用3天的比例下降54.2% (p < 0.05)，处方≥50 MME/天的比例下降66.3% (p < 0.05)。虽然OMFS开出的阿片类药物处方数量在大多数州有所减少，但12%的州出现了增加。结论OMFS开具阿片类药物处方，特别是高危处方有所减少。然而，在某些领域有针对性的干预是必要的。

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引用次数: 3

An assessment of compliance with optimal fluoride levels for oral health benefit by New Zealand drinking water suppliers 评估新西兰饮用水供应商遵守口腔健康最佳氟化物水平的情况

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-10-07 DOI: 10.1111/jphd.12548

Tim Chambers PhD, Matt Hobbs PhD, Jonathan M. Broadbent BDS, PhD, PGDipComDent

Objectives

Community water fluoridation (CWF) has proven oral health benefits. We investigated whether drinking water suppliers are meeting New Zealand CWF targets (0.7–1.0 ppm) to ensure these benefits.

Methods

We retrieved fluoride testing data from 25 supplies serving 2,059,000 people (82% of people on a fluoridated supply), for the years 1992–2022 (22,220 weekly observations). We descriptively assessed compliance with fluoride targets in this convenience sample.

Results

The mean fluoride level was 0.66 ppm (SD 0.28). Water suppliers achieved fluoride targets 54.1% of the time (range 4.2%–77.9%). Fluoride concentration fell short of the target in 42.2% of observations, exceeded but under the maximum acceptable value (MAV) in 3.6%, and in excess of the MAV in 0.1%. The percentage of compliant observations was greater in larger than smaller supplies.

Conclusions

Noncompliance with CWF targets was common. Epidemiological studies that rely on fluoridation status as their exposure may underestimate the oral health benefits of CWF. Our results highlight future challenges with the feasibility of expanding CWF under new legislation as well as the weaknesses in drinking water surveillance.

目的社区水氟化(CWF)已被证明对口腔健康有益。我们调查了饮用水供应商是否达到新西兰CWF目标(0.7-1.0 ppm)以确保这些效益。方法:我们检索了1992-2022年(每周22,220次观察)期间为2,059,000人(82%的人使用氟化供应)提供的25个供应的氟化物检测数据。我们描述性地评估了这个方便样本对氟化物目标的依从性。结果平均氟含量为0.66 ppm (SD 0.28)。供水商在54.1%的时间内实现了氟化物目标(范围为4.2%-77.9%)。42.2%的监测值未达到目标，3.6%的监测值超过但低于最大可接受值(MAV)， 0.1%的监测值超过最大可接受值。在较大的供应中，依从性观察的百分比大于较小的供应。结论不符合CWF指标是常见的。依赖于氟化状态的流行病学研究可能低估了CWF对口腔健康的益处。我们的研究结果突出了在新立法下扩大CWF可行性的未来挑战以及饮用水监测方面的弱点。

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引用次数: 1

Oral healthcare visits among sexual minority adolescents ages 14–18, 2019, USA 2019年美国14-18岁性少数群体青少年口腔保健就诊情况

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-10-07 DOI: 10.1111/jphd.12546

Stacey B. Griner PhD, MPH, RDH, Robert A. Yockey PhD, MS, Caylee N. Forschner BS

Objective

Health disparities persist among sexual minority (SM) adolescents (i.e., bisexual, lesbian/gay) compared to heterosexual adolescents, however, research is limited on oral health. The purpose of this study was to examine reported recency of dental visits by sexual orientation among a national sample of adolescents.

Methods

Data from the 2019 Youth Risk Behavior Surveillance Survey (n = 12,673 adolescents, 14–18 years old) were analyzed. We assessed dental care in the past 12 months or more based on sexual orientation (“lesbian/gay,” “bisexual,” “not sure”). Adjusted, sex-stratified, multinomial logistic regression analyses were used to determine conditional associations.

Results

Bisexual boys (aRR:2.50), “not sure” boys (aRR:3.55), and “not sure” girls (aRR:2.32) were at increased relative risk for not going to the dentist compared to heterosexual adolescents.

Conclusions

Findings indicate gaps in oral healthcare access among SM adolescents, specifically bisexual and not sure youth. Results can be used to increase access to preventive dental care among SM adolescents.

目的:与异性恋青少年相比，性少数(SM)青少年(即双性恋、女同性恋/男同性恋)的健康差距仍然存在，然而，对口腔健康的研究有限。本研究的目的是在全国青少年样本中，根据性取向检查最近的牙科就诊报告。方法对2019年青少年危险行为监测调查(n = 12673名14-18岁青少年)数据进行分析。我们根据性取向(“女同性恋/男同性恋”、“双性恋”、“不确定”)对过去12个月或更长时间的牙齿护理进行了评估。采用调整、性别分层、多项逻辑回归分析来确定条件关联。结果与异性恋青少年相比，双性恋男孩(aRR:2.50)、“不确定”男孩(aRR:3.55)和“不确定”女孩(aRR:2.32)不去看牙医的相对风险增加。结论:调查结果表明SM青少年，特别是双性恋和不确定青少年在口腔保健获取方面存在差距。结果可用于增加SM青少年获得预防性牙科保健的机会。

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引用次数: 0

Dental providers' perceptions of the feasibility and acceptability of implementing vaccine administration programs in dental settings: A qualitative study 牙科服务提供者对在牙科环境中实施疫苗管理计划的可行性和可接受性的看法:一项定性研究

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-07-22 DOI: 10.1111/jphd.12540

Inga Gruß PhD, Dea Papajorgji-Taylor MA, MPH, Natalia P. Tommasi MA, LPC, Daniel J. Pihlstrom DDS, Brian P. Hendrickson DMD, PC, Jana Ikeda DDS, MPH, Walter Manning DMD, Theresa Madden DDS, PhD, Jeffrey L. Fellows PhD

Objectives

Involving dental offices in routine vaccinations could have a positive impact on public health. In this study, we assessed dental providers' attitudes and perceptions regarding implementing vaccination in dental settings.

Methods

We performed semi-structured interviews with 31 dental providers (25 dentists and 6 dental hygienists) enrolled in the Western region of the National Dental Practice-Based Research Network as of June 28, 2021. Interviews were recorded and transcribed. We analyzed transcripts using deductive and inductive coding approaches.

Results

We identified three main themes that captured the perceptions of dental practitioners regarding the feasibility of implementing vaccine administration in a dental setting: (1) dental practitioners perceive contributing to the public health mission of disease prevention as having high value, (2) dental practitioners face considerable complexity when deciding whether to implement vaccine administration, and (3) dental practitioners do not understand current laws and associated reimbursement models related to vaccine administration.

Conclusions

To make vaccination commonplace in dental practices, legal changes to allow dental practitioners to administer vaccines should be followed by concrete guidance and relevant trainings to help interested dental practitioners successfully implement vaccination programs in their clinical settings.

目的让牙科诊所参与常规疫苗接种可对公众健康产生积极影响。在这项研究中，我们评估了牙科服务提供者的态度和观念，在牙科设置实施疫苗接种。方法:截至2021年6月28日，我们对31名牙科提供者(25名牙医和6名牙科卫生员)进行了半结构化访谈，这些牙科提供者登记在国家牙科实践基础研究网络的西部地区。采访被记录下来并记录下来。我们使用演绎和归纳编码方法分析转录本。结果:我们确定了三个主要主题，这些主题捕获了牙科医生对在牙科环境中实施疫苗接种可行性的看法:(1)牙科医生认为为预防疾病的公共卫生使命做出贡献具有很高的价值;(2)牙科医生在决定是否实施疫苗接种时面临相当大的复杂性;(3)牙科医生不了解与疫苗接种相关的现行法律和相关的报销模式。结论:为了使疫苗接种在牙科实践中普及，应修改法律，允许牙科医生接种疫苗，并提供具体指导和相关培训，以帮助有兴趣的牙科医生在其临床环境中成功实施疫苗接种计划。

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引用次数: 0

A psychometric network perspective to oral health literacy: Examining the replicability of network properties across the general community and older adults from Brazil 口腔健康素养的心理测量网络视角:检查巴西普通社区和老年人网络属性的可复制性

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-07-14 DOI: 10.1111/jphd.12539

Gustavo Hermes Soares DDS, MSc, PhD, Fernanda Maria Rovai Bado DDS, MSc, PhD, Carla Fabiana Tenani DDS, MSc, PhD, Pedro Henrique Ribeiro Santiago BPsychSc, MSc, PhD, Lisa M. Jamieson DDS, MSc, PhD, Fábio Luiz Mialhe DDS, MSc, PhD

Objectives

To evaluate the replicability of oral health literacy (OHL) network models across the general community and a sample of older adults from Brazil.

Methods

Data were obtained from two oral health surveys conducted with a total of 1138 participants. OHL was measured using the short form Health Literacy in Dentistry scale (HeLD-14). A regularized partial correlation network was estimated for each sample. Dimensionality and structural stability were examined via exploratory graph analysis. Network properties compared included global strength, edge weights, and centrality estimates. Model replicability was examined fitting the general community model to the older participants' data.

Results

Six dimensions with the exact same item composition were detected in both network models. Only the Receptivity domain in the older adults sample yielded low structural stability. Strong correlations were observed between edge weights (τ: 0.68; 95% CI: 0.62–0.74) and between node strength estimates (τ: 0.63; 95% CI: 0.36–0.89). No statistically significant differences were found for global strength. The fit of the older adults sample to the HeLD-14 network structure of the general community sample was satisfactory.

Conclusion

Network models OHL replicated across the general community and a sample of older adults. The psychometric network approach is a useful tool to evaluate the measurement equivalence of OHL instruments across populations.

目的评估口腔健康素养(OHL)网络模型在普通社区和巴西老年人样本中的可复制性。方法收集两项口腔健康调查资料，共1138人。OHL采用牙科健康素养简易量表(HeLD-14)进行测量。对每个样本估计一个正则化的部分相关网络。通过探索性图分析检验了维数和结构稳定性。比较的网络属性包括全局强度、边缘权重和中心性估计。将一般社区模型与老年参与者的数据相拟合，检验了模型的可复制性。结果在两种网络模型中均检测到具有完全相同项目组成的六个维度。在老年人样本中，只有接受域的结构稳定性较低。边缘权重之间存在强相关性(τ: 0.68;95% CI: 0.62-0.74)和节点强度估计之间(τ: 0.63;95% ci: 0.36-0.89)。全球强度没有发现统计学上的显著差异。老年人样本与一般社区样本的赫德-14网络结构吻合良好。结论网络模型OHL可在普通社区和老年人样本中复制。心理测量网络方法是评估OHL工具在人群中的测量等效性的有用工具。

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引用次数: 1

How do dental students perceive the role of dental professionals? 牙科专业学生如何看待牙科专业人员的角色?

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-07-07 DOI: 10.1111/jphd.12537

Astha Shah BDS, MSc, FRCD(C), Laura Dempster BScD, MSc, PhD, Sonica Singhal BDS, MPH, MSc, PhD, FRCD(C), Carlos Quiñonez DMD, MSc, PhD, FRCD(C)

Objectives

To explore dental students' perceptions of the role of dental professionals as healthcare providers and/or businesspersons.

Methods

A cross-sectional online survey collected information from undergraduate dental students at the Faculty of Dentistry, University of Toronto (N = 430). PPR was assessed through a visual analog scale (VAS) question, with the two ends labeled as “Healthcare Provider” (0) and “Business Person” (100), which asked respondents to point where they perceived dental professionals to be. Association of students' PPR with environmental, institutional and student-related factors was investigated using Chi-square and Spearman's correlation tests and logistic regression. Additionally, information on students' professional attitudes was gathered using: (i) the same VAS question, which asked students what they themselves aspired to be; and (ii) level of agreement with two sets of Likert-type questions highlighting healthcare provider and businessperson attitudes.

Results

The survey yielded a response rate of 51.4% (n = 221). The majority of respondents perceived dental professionals as healthcare providers and aspired to be healthcare providers themselves. Results of multivariable logistic regression suggested that perceiving dental professionals as businesspersons was significantly associated with perceiving future patients as consumers. Those who strongly agreed with healthcare provider statements had lesser odds of perceiving dental professionals as businesspersons.

Conclusion

In this sample of students, perceptions of professionalism appear to be congruent with the normative role of dental professionals as healthcare providers. Dental education should prepare graduates who strongly identify with this role even in the presence of dental care market pressures.

目的探讨牙科专业学生对牙科专业人员作为医疗保健提供者和/或商人角色的看法。方法采用横断面在线调查方法，对多伦多大学牙科学院牙科专业本科学生(430人)进行调查。PPR通过视觉模拟量表(VAS)问题进行评估，两端标记为“医疗保健提供者”(0)和“业务人员”(100)，要求受访者指出他们认为牙科专业人员在哪里。采用卡方检验、斯皮尔曼相关检验和logistic回归分析学生小反刍反应与环境、制度和学生相关因素的关系。此外，关于学生职业态度的信息是通过以下方式收集的:(i)相同的VAS问题，该问题询问学生他们自己渴望成为什么;(ii)对两组李克特式问题的认同程度，这些问题突出了医疗保健提供者和商人的态度。结果调查回复率为51.4%(221例)。大多数受访者认为牙科专业人员是医疗保健提供者，并希望自己成为医疗保健提供者。多变量logistic回归结果显示，将牙科专业人员视为商人与将未来患者视为消费者显著相关。那些强烈同意医疗保健提供者陈述的人将牙科专业人员视为商人的几率较小。结论在这个学生样本中，专业的看法似乎与牙科专业人员作为医疗保健提供者的规范角色是一致的。牙科教育应该准备毕业生强烈认同这一角色，即使在牙科保健市场压力的存在。

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引用次数: 0

Prevalence of non-cavitated lesions and progression, regression, and no change from age 9 to 23 years 从9岁到23岁，非空化病变的患病率、进展、消退和无变化

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-07-04 DOI: 10.1111/jphd.12538

Mahrukh Zafar BDS, MS, Steven M. Levy DDS, MPH, John J. Warren DDS, MS, Xian Jin Xie PhD, Justine Kolker DDS, MS, PhD, Chandler Pendleton MS

Objectives

Some non-cavitated caries lesions (D₁), the initial stage of caries, progress to cavitation. This article reports participant-level and surface-level D₁ prevalence and changes in status of D₁ lesions through different periods from age 9 to 23.

Methods

The Iowa Fluoride Study (IFS) participants were followed longitudinally; all permanent tooth surfaces were examined clinically for caries at ages 9, 13, 17, and 23 using standardized criteria for sound (S), questionable (D₀), non-cavitated (D₁), cavitated (D₂₊), filled (F), or missing due to decay (M). D₁ lesions at the beginning of each interval were reassessed at each follow-up age to determine transitions (to the 5 categories or no transition).

Results

The sample had relatively high socioeconomic status (SES), with about 52%–55% high SES, 32–35% middle SES, and 12–13% low SES. Person-level prevalences of D₁ lesions were 23%, 38%, 60%, and 45% at ages 9, 13, 17, and 23, respectively. Surface-level prevalences were less than 1% at ages 9 and 13, 3% at 17, and 2% at 23. Thirteen percent of D₁s at age 9 progressed at 13, 18% progressed from 13 to 17, and 11% progressed from 17 to 23. The percentages regressing (to sound or D₀) were 72%, 54%, and 72%, respectively.

Conclusion

Non-cavitated lesions were more prevalent at age 17 than at ages 9, 13, and 23. The high rates of regression compared to progression or no change suggest that many non-cavitated lesions do not progress to cavitated lesions and could be reversed; therefore, surgical intervention should not be the treatment of choice for incipient lesions.

目的部分非空泡性龋病变(D1)，由初期龋向空泡性龋发展。本文报道了9 - 23岁不同时期D1水平和表面水平的患病率及D1病变状态的变化。方法对艾奥瓦州氟化物研究(IFS)参与者进行纵向随访;在9岁、13岁、17岁和23岁时，采用标准化标准对所有恒牙表面进行临床检查，以确定是否有龋齿，标准分为健全(S)、可疑(D0)、无空化(D1)、空化(D2+)、填充(F)或因龋齿而缺失(M)。每个间隔开始时的D1病变在每个随访年龄重新评估，以确定过渡(向5类或无过渡)。结果样本社会经济地位较高，高社会经济地位占52% ~ 55%，中等社会经济地位占32 ~ 35%，低社会经济地位占12 ~ 13%。D1病变在9岁、13岁、17岁和23岁时的个人水平患病率分别为23%、38%、60%和45%。地表患病率在9岁和13岁时低于1%，在17岁时为3%，在23岁时为2%。13%的9岁儿童在13岁时发病，18%从13岁到17岁发病，11%从17岁到23岁发病。回归(声音或D0)的百分比分别为72%、54%和72%。结论17岁非空化病变发生率高于9岁、13岁和23岁。与进展或无变化相比，高退行率表明许多非空化病变不会进展为空化病变，并且可以逆转;因此，手术干预不应该是早期病变的治疗选择。

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引用次数: 0

Slipping through the cracks: Just how underrepresented are minorities within the dental specialties? 从裂缝中溜走:在牙科专业中，少数族裔的代表性到底有多低?

IF 2.3 4区医学 Q2 Dentistry

Journal of public health dentistry

Pub Date : 2022-06-21 DOI: 10.1111/jphd.12520

Tera Poole DDS, Matthew Jura MS, PhD, George Taylor DMD, MPH, DrPH, Paul Gates DDS, MBA, Elizabeth Mertz MA, PhD

Objective

There is a lack of diversity in the dental workforce. Efforts to enhance underrepresented minority (URM) recruitment and retention within dental school exist, but little effort has been made to track URM providers through education and practice. This study assesses the status of workforce diversity in the dental specialties and the predictors of URM dentist specialization.

Methods

The primary data used were a 2012 national sample survey of Hispanic/Latino (H/L), Black, or American Indian/Alaska Native (AI/AN) dentists in the US, supplemented by publicly available workforce data. Descriptive and multivariate statistical analyses were performed to describe the demographic composition of URM clinical general and specialist dentists and analyze changes in proportions of URMs specializing among age cohorts, differences in specific type of specialization, and racial concordance between specialists and their patients.

Results

The pathway continues to winnow with fewer URM dentists in specialty practice. Among all URM clinical dentists being first in his/her family to obtain a college degree, having a strong desire to work in his/her own cultural community or joining a loan repayment program due to debt load independently predicted lower odds of specialization. Alternatively, being initially foreign trained as a dentist and valuing professional training were independently predictive of higher odds of specialization.

Conclusion

The lack of diversity within the dental specialties is a critical flaw in our education and care delivery systems demanding clear actions toward improving the pathway into residency programs for URM students.

目的牙科工作人员缺乏多样性。努力提高代表性不足的少数民族(URM)的招聘和保留在牙科学校存在，但很少努力跟踪URM提供者通过教育和实践。本研究评估了牙科专业劳动力多样性的现状和URM牙医专业化的预测因素。方法使用的主要数据是2012年美国西班牙/拉丁裔(H/L)、黑人或美洲印第安/阿拉斯加原住民(AI/AN)牙医的全国抽样调查，辅以公开的劳动力数据。采用描述性和多变量统计分析来描述临床全科牙医和专科牙医的URM人口组成，并分析年龄队列中专科牙医比例的变化、特定专科类型的差异以及专科医生和患者之间的种族一致性。结果专科执业医师数量不断减少，专科执业医师数量不断减少。在所有URM临床牙医中，家庭中第一个获得大学学位、强烈希望在自己的文化社区工作或因债务负担而参加贷款偿还计划的牙医独立预测专业化的可能性较低。另外，最初在国外接受牙医培训和重视专业培训独立预测更高的专业化几率。结论:牙科专业缺乏多样性是我国教育和医疗服务体系的一个重大缺陷，需要采取明确的行动，改善URM学生进入住院医师项目的途径。

{"title":"Slipping through the cracks: Just how underrepresented are minorities within the dental specialties?","authors":"Tera Poole DDS, Matthew Jura MS, PhD, George Taylor DMD, MPH, DrPH, Paul Gates DDS, MBA, Elizabeth Mertz MA, PhD","doi":"10.1111/jphd.12520","DOIUrl":"10.1111/jphd.12520","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There is a lack of diversity in the dental workforce. Efforts to enhance underrepresented minority (URM) recruitment and retention within dental school exist, but little effort has been made to track URM providers through education and practice. This study assesses the status of workforce diversity in the dental specialties and the predictors of URM dentist specialization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The primary data used were a 2012 national sample survey of Hispanic/Latino (H/L), Black, or American Indian/Alaska Native (AI/AN) dentists in the US, supplemented by publicly available workforce data. Descriptive and multivariate statistical analyses were performed to describe the demographic composition of URM clinical general and specialist dentists and analyze changes in proportions of URMs specializing among age cohorts, differences in specific type of specialization, and racial concordance between specialists and their patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The pathway continues to winnow with fewer URM dentists in specialty practice. Among all URM clinical dentists being first in his/her family to obtain a college degree, having a strong desire to work in his/her own cultural community or joining a loan repayment program due to debt load independently predicted lower odds of specialization. Alternatively, being initially foreign trained as a dentist and valuing professional training were independently predictive of higher odds of specialization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The lack of diversity within the dental specialties is a critical flaw in our education and care delivery systems demanding clear actions toward improving the pathway into residency programs for URM students.</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/fd/3b/JPHD-82-53.PMC9545059.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40121902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4