Journal of public health dentistry最新文献

Objectives: To investigate the effect of water filter pitchers on the concentration of different minerals in tap water.

Methods: Nine water filter pitchers (A-I) were chosen based on consumer preferences and Amazon reviews. Each filter was tested for its ability to modify the concentrations of fluoride, calcium, magnesium, potassium, and sodium in tap water. Tap water samples were collected before and after filtration, at various intervals (1, 5, 10, 30, 50, 75, and 100 L) during filtration, and analyzed using an ion-specific electrode (fluoride) and atomic absorption spectrometry (other minerals). Statistical analyses were conducted to compare filtered and unfiltered water mineral concentrations.

Results: Water filter pitcher effect: Filters F (p < 0.001) and G (p = 0.030) decreased fluoride concentrations. All filters except I (p = 0.235) and H (p = 0.717) decreased calcium concentrations (p < 0.01). Filters E (p = 0.018), D (p = 0.014), and G (p = 0.010) decreased magnesium concentrations. Filters I (p = 0.028) and D (p = 0.009) increased potassium concentrations. Filter A (p = 0.002) increased sodium concentrations, while C (p = 0.034) decreased sodium concentrations. Effect of filter aging: All filters affected mineral concentrations over time but to varying extents. Filter G had the most pronounced effect on reducing mineral concentrations compared to all others. No filter was able to completely remove fluoride from tap water, contrary to the claims made by three manufacturers.

Conclusions: The present study highlighted that water filter pitchers vary greatly in their ability to affect mineral concentrations in tap water during their use. Further research is needed to develop more effective water treatment solutions.

Objective: This retrospective chart review evaluated the relationship between specific dietary questions used in caries risk assessment and planned restorative treatment among patients attending a dental school's clinic.

Methods: Records for 6,218 adult patients attending the University of Iowa College of Dentistry who completed caries risk assessments and comprehensive oral examinations during 2018-2019 were included. The number of planned caries restorative treatments were compared between groups based on responses to specific dietary questions on the caries risk assessment. Analyses included chi-square and Wilcoxon rank-sum tests and logistic regression for factors associated with caries treatments.

Results: About 20% of subjects needed caries treatment, and regression analyses found that younger age, having unstructured meals, drinking sugared beverages daily, and drinking them for more than 30 min were significantly (p < 0.01) associated with having caries.

Conclusions: Specific and focused questions on dietary practices are strongly associated with caries, and may be useful in improving caries risk assessments.

Objectives: Social Determinants of Health (SDoH) have been linked to health, including oral health and oral health behaviors. Objectives of this retrospective records review were to evaluate the relationships between self-reported unmet social needs and (1) oral health measures and (2) dental service utilization in a pediatric population at a hospital-based dental clinic.

Methods: Children 2-5 years of age whose families had completed a SDoH survey and who had an encounter with one United States (U.S.) urban children's hospital dental clinic within 6 months (± 3 months) of the survey date were included. A chart review was performed, and information was collected about the child's (1) oral health (e.g., plaque level, presence of caries) and (2) dental service utilization (e.g., no-show rates, number of dental surgeries). The data of patients with one or more parental/caretaker-reported unmet social needs were compared with that of patients with no unmet social needs.

Results: Inclusion criteria were met by 2646 children. Those with unmet social needs had significantly higher no-show rates at scheduled appointments than those without unmet social needs (p-value <0.001). Patients who identified as African/Black were more likely to report unmet social needs. There was no statistically significant difference in oral health measures of patients with or without unmet social needs.

Conclusions: Children in this population demonstrated varying associations between unmet social needs, health measures, and health behaviors, suggesting a likely complicated association between unmet social needs and health.

Objectives: To describe the trends in antibiotic prescribing by dental practitioners and to investigate the relationship between these trends and some factors of public oral health services in Minas Gerais (MG), Brazil.

Methods: This was a time-series analysis of antibiotics prescribed by dental practitioners between January 2011 and December 2021. The outcome variables were number of defined daily doses (DDD) and DDD/1000 population/year in a sample of cities in MG. Covariates were public oral healthcare factors, such as coverage, estimates of dental procedures, and frequency of dental pain. Linear time-series regression models were used to examine trends and the influence of covariates on antibiotic prescribing.

Results: Overall, the number of prescriptions increased by 334.69% between 2011 and 2021, with amoxicillin being the most commonly prescribed drug (78.53%). The number of DDD for all antibiotics increased from 17,147.13 to 77,346.67 and the average DDD/1000 inhabitants/year was 126.66 (SD: 130.28). The linear time-series regression model showed that for each one-year increase, the average log DDD/1000 inhabitants increased by 0.35 (standard error = 0.07, p < 0.001). No covariates were found to be associated with the outcome.

Conclusions: In Minas Gerais, Brazil, a significant upward trend was observed in the number of prescriptions and the number of DDD of antibiotics prescribed by dental practitioners. No influence of factors related to public oral healthcare services on the outcome was observed, thereby emphasizing the need for further research on factors influencing medication use in dental practice.

Objectives: To assess the relationships between longitudinal fluoride intakes and bone densitometry outcomes in young adults.

Methods: Data were analyzed from the Iowa Fluoride Study and Iowa Bone Development Study, which followed 1,882 infants from birth in 1992. Daily fluoride intakes were assessed using detailed questionnaires sent every 1.5-6 months, and multi-row detector computed tomography (MDCT) scans of distal tibia were obtained from 330 participants aged 23 years. Sex-specific bivariate and multivariable associations with MDCT outcomes were examined using linear regression. Because of the multiple statistical analyses being conducted, p-values < 0.01 were considered statistically significant.

Results: In fully adjusted analyses, no statistically significant (p < 0.01) or suggestive (0.01 < p < 0.05) associations were found between period-specific or cumulative fluoride intake and bone measures for either sex, although there were suggestive positive relationships in unadjusted analyses.

Conclusions: Longitudinal fluoride intakes had little association with bone measures at age 23. As there were no adverse effects from fluoride intake on bone health in young adults, results support the continued use of fluorides, particularly community water fluoridation is the most cost-effective method of dental caries prevention.

Objectives: This study assesses the needs and feasibility of conducting a produce prescription (produce Rx) program in a pediatric dental clinic setting serving low-income patients.

Methods: We conducted a cross-sectional quantitative survey examining several household characteristics including demographics, benefits received, fruit and vegetable intake patterns, food security, feasibility of a produce Rx program, and respondents' answers to questions based on social cognitive theory constructs. The survey was administered at the University of Nebraska Medical Center (UNMC) pediatric dental clinic, a pediatric dental residency clinical training site. One hundred adult respondents with low income completed a 36-item questionnaire during their child's dental appointment.

Results: Almost half of respondents reported experiencing food insecurity (45%). Respondents who were food insecure experienced higher levels of nutrition insecurity (p = 0.012), less confidence in choosing fruits and vegetables (FVs) (p = 0.026), difficulty in purchasing FVs in their neighborhood (p = 0.012), and more concern that FVs cost too much (p < 0.001) when compared to respondents who were food secure. Notwithstanding the barriers they face, almost all respondents reported that they eat FVs because of health benefits (95%) and to set a good example for their family (91%). Additionally, most respondents expressed an interest in produce Rx programs (80%) and nutrition education activities (81%).

Conclusions: This study demonstrated the potential for produce Rx program uptake in a pediatric dental clinic setting through positive caregiver-reported need and interest. Future studies should explore how produce Rx programs can be adapted most effectively in this novel setting.

Objectives: Early Childhood Caries is a global health problem. The Bright Smiles Bright Futures (BSBF) program seeks to equip educators, children, and parents with skills and knowledge about oral health promotion habits early in life. The aim of this study was to examine parental perceptions of the BSBF program and identify key facilitators and barriers for its implementation.

Methods: Twelve mothers of children who participated in the BSBF program in five Early Childhood Education and Care (ECEC) settings in NSW, Australia were recruited in this qualitative study. Data were collected via focus groups and interviews, transcribed verbatim and coded to categorize for inductive thematic analysis.

Results: Five major themes emerged: Promoters of the BSBF oral health program, barriers to the BSBF oral health program implementation and participation, online resources, impact of the BSBF oral health program, and strategies for enhancing the BSBF oral health program. While participants reported that the program encouraged their children's toothbrushing, they found issues with the program's materials, ECEC center attendance, and communication about the oral health program with their children. The program improved message retention, attitudes, routines, and family perceptions toward oral health. Participants recommended oral health literacy, changed delivery formats, increased dental access, and inclusion of interactive elements to enhance the program.

Conclusions: The findings from this study provide insight to improve parents' experiences and engagement in oral health promotion. This can help to raise awareness of the importance of child oral health among policymakers, healthcare professionals, and the public to inform public health policy discussions.

Objective: Alaska Native children may be at increased risk for dental caries because of added sugar intake from sugar-sweetened fruit drinks. This study describes development of a questionnaire to (a) assess Alaska Native caregivers' beliefs, knowledge, and behaviors regarding sugar-sweetened fruit drinks, and (b) describe behavior changes within a community-based intervention.

Methods: Questionnaire development was conducted in three phases with Yup'ik Alaska Native caregivers in Southwest Alaska: (1) initial selection and adaptation of questionnaire items; (2) cognitive testing; and (3) data collection. The Sugar-Sweetened Fruit Drink Questionnaire (SFDQ) contains 31 culturally-tailored items across six areas: beliefs/values, environment/skills, knowledge, motivation, self-efficacy, and behaviors.

Results: Eighty-one percent of caregivers gave their children sugar-sweetened fruit drinks. Motivations included: what they grew up with (52%), few other options (46%), makes child happy (46%), healthier than soda (45%), and others in community drink them (42%). On average, 93% of caregivers believed drinking a lot of sugar-sweetened fruit drinks leads to cavities in children and caregivers agreed (mean 4.1 on 5-point scale, 5 = strongly agree) it is important to limit sugar-sweetened fruit drinks. Among a sub-sample of respondents (n = 20), we found low to moderate temporal stability in some SFDQ items over a 10-14 day period, indicating respondent ambivalence and/or uncertainty.

Conclusions: Using community-based participatory research methods, we developed a culturally tailored exploratory questionnaire that will be used to describe changes in caregiver knowledge, beliefs, attitudes, self-efficacy, and behavior within a planned intervention to reduce sugar-sweetened fruit drink intake in Alaska Native children.

Objectives: To examine variations in the delivery of teledentistry after the COVID-19 pandemic and to explore oral health professionals' utilization of various teledentistry modes of delivery.

Methods: In this mixed methods case study, we collected teledentistry claims data from patient electronic health records (n = 78,756) encompassing various types of teledentistry utilization in clinical settings and through community outreach from a Dental Support Organization (DSO) in Oregon from January 2021 to November 2022. We analyzed the patient demographic and claims data using descriptive statistics and logistic regression analyses to identify patterns of teledentistry service delivery. Qualitatively, we conducted virtual interviews (n = 13) through Microsoft Teams with oral health professionals about their experiences with teledentistry utilization. We used inductive and deductive coding to code individual transcripts and identify common themes among provider experiences.

Results: Out of the 78,756 electronic health record claims for teledentistry, 75.7% used synchronous audio, 13.4% used synchronous video, and 10.9% used asynchronous teledentistry methods. We observed a 8.6% increase in synchronous audio teledentistry utilization at the end of the study period, compared with a 4.2% increase in synchronous video and a 4.4% decrease in asynchronous teledentistry. Oral health professionals interviewed reported choosing the type of teledentistry delivery based on patient and provider access to the virtual teledentistry platform.

Conclusion: Oral health professionals' knowledge of and experiences with teledentistry need to be considered when developing policy and best practices for the use of teledentistry for patient care.

Objectives: We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System.

Methods: We conducted a retrospective cohort study of patients undergoing dental extractions in 2015-2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome.

Results: Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (p = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13-1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92-1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83-1.30).

Conclusions: In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. These data suggest that use of antibiotic prophylaxis in similar settings may need to be re-evaluated to minimize unnecessary antibiotic use.