Journal of public health dentistry最新文献

Background: Oral health practitioners (OHPs) provide essential preventive, periodontal, and restorative treatment within diverse settings in Australia. Despite their significant contribution to oral healthcare, regulatory restrictions prevent OHPs from independent prescription of medicines, limiting efficiency, continuity of care, and patient access, particularly for underserved populations.

Issue: Current prescibing limitations create structural barriers within oral healthcare delivery. In contrast, endorsed prescribing pathways have been successfully developed for other professions, including nurses, midwives, podiatrists, optometrists, and pharmacists, with nurse practitioners and dentists already holding established prescribing authority.

Approach: This paper explores the case for an endorsed prescribing pathway for OHPs, drawing on national and international developments, patient equity considerations, and workforce reform. We argue that prescribing reform would strengthen patient-centered care, reduce structural barriers to access, and align OHP regulation with contemporary models of multidisciplinary healthcare. We also highlight necessary safeguards such as postgraduate training, regulatory oversight, and scope-appropriate medications to ensure safe and effective implementation.

Conclusion: As independent practitioners, the persistence of restrictive prescribing frameworks for OHPs reflects outdated professional dominance rather than evidence-based workforce planning. Expanding prescribing rights for OHPs represents a logical evolution of their role and an opportunity to address entrenched oral health inequities.

Objectives: This study examined the effects of dental sealant insurance coverage on trends in pit and fissure sealant (PFS) use, decayed, missing, and filled teeth (DMFT) rates, and filled teeth (FT) rates among Korean adolescents, using data from the Korean Youth Risk Behavior Survey (2005-2024) and the Korean National Health and Nutrition Examination Survey (2007-2015).

Methods: Data from participants aged 12-18 years were analyzed. The proportion of PFS use referred to the proportion of respondents who answered "yes" to the question "Have you received PFS in the past 12 months?" in the survey. DMFT and FT were classified based on oral examination criteria from 2007 to 2015. Statistical analyses were conducted using Joinpoint regression (version 4.8.0.1) and PROC SURVEYLOGISTIC in SAS 9.4 to estimate the annual percent change (APC), odds ratios, and 95% confidence intervals.

Results: PFS use increased until 2018 (APC = +1.5%) and declined slightly thereafter until 2024, whereas DMFT and FT rates decreased from 2007 to 2015. Dental sealant insurance coverage was significantly associated with higher PFS use and lower DMFT and FT rates (p < 0.05).

Conclusions: Dental sealant insurance coverage effectively improved oral health and reduced dental caries among Korean adolescents.

Objectives: Sexual and gender minority (SGM) individuals can experience notable health disparities, including higher HIV prevalence, social isolation, substance abuse, lack of culturally competent providers, and poorer health outcomes compared to heterosexuals due to stigma and discrimination. This study aims to identify predictors of dental care utilization across sexual minorities using the 2023 TEXAS PRIDE Survey.

Methods: We analyzed data from 517 SGM individuals, assessing sociodemographic characteristics, health behaviors, and recent medical and dental visits. Multivariable logistic regression identified predictors of dental care utilization (i.e., a dental visit in the past year).

Results: Among sexual orientation groups, reported dental care utilization was highest among gay (23.7%) and lesbian (21%) individuals, followed by bisexual (18.3%), pansexual (11.1%), queer (9.9%), and other sexual orientations (16.2%). Those with a college degree were significantly more likely to report dental utilization compared to those with less education. Individuals who did not have a medical visit in the past year were 0.27 times as likely to utilize dental care than those who did. No significant disparities in dental care utilization were found based on sexual orientation in the regression analysis.

Conclusions: Higher education and recent medical visits are significant predictors of dental care utilization among SGM individuals. Efforts to reduce oral health disparities should focus on affordable dental care coverage, improving health literacy, fostering inclusive dental environments, and training providers in SGM cultural sensitivity. Future research should explore integrated healthcare approaches and provider cultural competence training to address these gaps.

Objective: This study investigated the utilization of medical and dental services by transgender Brazilians and their associated factors.

Methods: A national cross-sectional survey was conducted in 2021 with 549 self-identified transgender adults (231 male, 183 female, and 135 other gender) aged 18-61 years. Participants were recruited through social media using snowball sampling and answered an electronic structured questionnaire. Outcomes were the frequency of medical and dental appointments. Associated factors included sociodemographic characteristics, use of social name, partnership, children, religion, health information sources, perceived health needs, experience of gender-based violence, and type of health services used. Odds ratios (OR) with 95% confidence intervals (CIS) were estimated using backward stepwise logistic regression models.

Results: Respondents who attended public schools (OR 1.73; 95% CI 1.01-2.88), had no income (OR 1.96; 95% CI 1.01-3.85), and relied solely on the public health system (OR 2.48; 95% CI 1.36-4.50) were more likely to have semiannual medical consultations. Conversely, those who attended public schools (OR 1.89; 95% CI 1.09-3.31), had ≤ 9 years of schooling (OR 1.74; 95% CI 1.13-2.68), were unemployed (OR 1.88; 95% CI 1.04-3.42), or had experienced gender-based violence (OR 1.57; 95% CI 1.02-2.41) were more likely to rarely or never attend dental consultations.

Conclusions: Transgender Brazilians predominantly used the public health system, attending medical consultations semiannually but rarely dental appointments. Lower education, unemployment, lack of income, and exposure to gender-based violence shaped healthcare utilization, highlighting persistent barriers to equitable and comprehensive health access.

Background: Millions of people across the US-especially in rural, Tribal, underserved, and under-represented communities-continue, historically, to face unnecessary barriers to basic preventive and emergency oral healthcare. Dental therapy, a proven, community-centered oral healthcare provider model utilized in over 50 countries for more than 100 years has been legislatively authorized in 14 states across the US. For over 20 years, however, dental therapy in the U.S. has repeatedly been opposed by the American Dental Association and state dental boards, despite clear, documented evidence that dental therapists provide safe, high-quality, and in most cases culturally specific care, with a focus on prevention.

Objective: To describe the role of dental therapists, summarize the evidence supporting their saftey and effectiveness and explore reasons for limited adoption of dental therapy in the U.S. despite documented benefits.

Methods: This abstract unifies available historical, legislative and workforce literature on dental therapy, highlights the voices of dental therapists, elevating clinical practice outcomes, community impact and documented oposition from the American Dental Association and state dental boards.

Results: Evidence shows that dental therapy has diversified the oral healthcare workforce, elevating the voices of those that have been oppressed historically in the United States Black, Indigenous, and People of Color (BIPOC) communities that continue to suffer because of structural racism. Dental therapists have been practicing for over 20 years in the United States, and over 100 years worldwide. Who are dental therapists and why are they not embraced with the clear evidence in the United States? Despite the clear evidence, national adoption of dental therapy remains slow due to political, regulatory and professional opposition.

Conclusion: Significant institutional opposition continues to slow national acceptance and implemnation of dental therapy. Dental therapy represents an effective, evidence based community driven solution to persistent oral health inequities.

Background: There is limited information about oral health awareness among Arab immigrants and refugees (AIR) in the United States, though research conducted on this demographic globally has shown a major correlation between poor oral health outcomes and sociodemographic factors. This study examined oral health practices and awareness of the increased gingivitis risk during pregnancy among AIR in Southern California.

Methods: This was a cross-sectional survey on oral health knowledge and access barriers among male and female AIR participants recruited via community organizations and dental clinics. Bivariate and multivariate analyses evaluated the association between oral health awareness and demographics, oral health literacy, general health knowledge, and knowledge of pregnancy-related gingivitis risk.

Results: The sample included 73 participants (31 males, 42 females), mostly aged 18-30; 67% held bachelor's degrees or higher, and 41% had immigrated due to war or violence. Females showed higher Oral Health Risk Awareness Scores than males (0.75 vs. 0.61, p < 0.006), with no significant differences by age or ethnicity. Most respondents reported financial and language barriers to dental care. Although over 75% recognized a link between oral and general health, only 38% knew of the increased periodontal risk during pregnancy.

Conclusion: The financial, linguistic, and educational obstacles that AIR populations must overcome to obtain dental care pose challenges and have an impact on their awareness of the risks to their oral health. These findings highlight the importance of culturally sensitive health education and outreach efforts.

Practical implications: Culturally appropriate programs and multilingual materials are necessary to improve care by addressing AIR's knowledge of gingivitis risks and promoting preventative dental care.

Objectives: Achieving oral health equity continues to be a goal with seemingly intractable challenges. While interprofessional education and practice (IPE/IPP) have been strategies employed to address barriers underlying persistent health disparities, there must be a recognition of the formation of dominant and subordinate cultures across learning and practice environments when diverse professionals are brought together to support diverse populations, creating an identity or professional othering.

Methods: A review of settings that feature IPE/IPP, particularly dental education, dental public health residency settings, and community health centers, demonstrate the need to acknowledge that this othering occurs. Combating the systemic and social processes that contribute to othering in these environments is key to delivering a sustainable dental public health workforce and advancing health equity.

Results: Interprofessional collaboration is a requisite for modern population health initiatives, and dental public health practice must include skills for cultural fluency, complex system navigation across disciplines, and ethical engagement with diverse communities for greater impact on health disparities. In these fields where collaboration across disciplines is commonly articulated, yet often fails to fully deliver on its promise, the issue of othering frequently goes unspoken.

Conclusions: Commitments to health equity must make essential the acknowledgment of and address the subtle exclusion that persists across health disciplines. Without confronting the profound marginalization that othering permits across the oral health professions, efforts to improve oral health outcomes will fall short of their full potential in truly cultivating health equity.

Objectives: Health philanthropy has traditionally emphasized downstream service delivery rather than addressing structural and policy-level determinants of health. In light of widening health disparities and increasing political threats to public health and civil rights, there is a pressing need for philanthropy to evolve. This commentary introduces and explores an equity-centered philanthropic model as a framework for driving systems change, building community power, and advancing long-term transformation in oral health.

Methods: CareQuest Institute's philanthropic approach is grounded in the lived realities of racial, economic, and geographic oral health disparities, and the historical exclusion of oral health from broader equity agendas. The model prioritizes funding community-led organizations, centering lived experience, supporting multi-year partnerships, and embedding oral health within cross-sector health justice movements. Two grantee case studies are used to illustrate this approach.

Results: The case examples include: 1) Families USA's grassroots-informed federal policy advocacy and 2) Community Catalyst's capacity-building for BIPOC-led and community-rooted health justice campaigns. These examples demonstrate how equity-centered philanthropy can support structural change and amplify community leadership.

Conclusion: Equity-focused philanthropy faces practical challenges, including the need for new evaluation frameworks, sustainable capacity-building, and resisting extractive or paternalistic dynamics. To truly advance health equity, philanthropy must move beyond transactional funding and become an active partner in redistributing power, elevating community voice, and sustaining systemic transformation across the oral health ecosystem.