Journal of public health dentistry最新文献

Objective: To investigate disparities in oral health and quality of life between unhoused and housed populations in Chicago, Illinois, and highlight potential areas for policy intervention.

Methods: Cross-sectional study using the modified Oral Health Impact Profile (OHIP-14), a 14-item validated survey assessing seven domains affected by oral health, such as functional limitation, pain, and social disability. Data were collected from unhoused patients at the Rush CURE Clinic and housed patients from the Rush University Department of Otolaryngology Clinic in Chicago, Illinois. Demographics, oral health, and quality of life perception data were collected through the OHIP-14 survey. Statistical analysis included descriptive statistics, binomial tests, and ANOVA.

Results: Housed patients had increased access to healthy food (97% vs. 51%, p < 0.001), health insurance (100% vs. 65%, p < 0.001), and employment (64% vs. 35%, p < 0.001). Unhoused patients reported greater challenges across multiple OHIP-14 domains, including dissatisfaction with diet (33.3% vs. 7.7%, p < 0.001), difficulty with occupational activities (22% vs. 5.2%, p < 0.001), and lower overall quality of life satisfaction (32% vs. 5.2%, p < 0.001).

Conclusions: This study underscores the intersection of homelessness, oral health, and social determinants of quality of life. Findings may guide policymakers in designing targeted, community-based preventive interventions-particularly expanding oral health services, nutritional support, and employment resources for vulnerable populations. Structurally informed public health strategies are needed to reduce oral health inequities and their downstream effects on daily functioning and overall wellbeing.

Objectives: To examine dental care utilization and health and dental care expenditures among individuals with asthma.

Methods: Data from the 2022 Medical Expenditure Panel Survey (MEPS) (n = 21,405) were used to examine dental care utilization (any dental, preventive dental, and treatment dental visit) among individuals ≥ 1 year with and without asthma, and mean expenditures were summarized.

Results: Overall, the asthma diagnosis was 13.2%, 14.7% in working-age adults compared to 9.5% in children. The percentage of treatment dental visits was higher overall (17.0% vs. 14.5%, p < 0.05) among the asthma group compared to the non-asthma group. Among individuals with asthma, those who had preventive dental visits had lower dental expenditures compared to those who had treatment dental visits for all age groups.

Conclusion: Individuals with asthma had a higher prevalence of using dental treatment services. To support oral health among individuals with asthma, healthcare providers should educate and encourage the use of preventive dental care.

Objective: Community health centers (CHCs) are a critical component of the dental safety net for people with substantial barriers to dental care access. Recruiting and retaining dentists working in CHCs is essential to effectively serve this population. This study aimed to identify factors associated with dentists' intent to continue practicing in their current CHC in the long term.

Methods: The data were collected through an online survey administered to United States dentists practicing in CHCs in 2021 by the National Network for Oral Health Access. The dependent variable was dentists' intent to stay at their current CHC in the long term, with 42 independent variables across four domains: individual characteristics, perceptions, motivators, and organizational factors. Descriptive, bivariate, and multivariable logistic regression analyses were employed to determine factors associated with dentists' intent to stay at their CHC.

Results: A total of 248 dentists were in the final analytical sample. Multivariable regression results showed that dentists in leadership roles had 3.7 times the odds of intending to stay compared to staff dentists, and those with high professional autonomy had 2.6 times the odds of intending to stay compared to those with low to moderate autonomy.

Conclusions: The study underscored the importance of dentists' autonomy and role in their intent to remain at CHCs. Factors typically associated with recruitment packages or length of time in clinical practice were not significantly associated with intent to stay. Distinguishing between recruitment and retention strategies is crucial for CHCs to fulfill their mission of ensuring equitable dental care access.

Introduction: Puerto Rico has a higher prevalence of oral diseases compared to the U.S., underscoring the urgent need for preventive measures beyond the dentist's office. In response, the Puerto Rico Oral Health Coalition (PR-OHC) adopted a collaborative approach, bringing together public and private stakeholders to promote oral health across the archipelago.

Objective: This article showcases the impact of PR-OHC's efforts in reducing oral health disparities, promoting preventive services for children, and improving access to care by implementing Law No. 63-2017 and the Oral Exam Certificate (OEC) Program.

Methods: PR-OCH analyzed oral health needs and formulated a mission that included identifying disparities, expanding preventive services, and advocating for evidence-based public health policies. Efforts culminated in legislative action, elevating oral health as a public health issue. The law tasked the Department of Health with the implementation and tracking of an obligatory OEC for students in public and private schools.

Results: The law's implementation resulted in increased preventive dental visits among 1 to 16-year-old children who are beneficiaries of the Government Health Plan (Medicaid funds), the creation of an available and adequate oral health education delivery system, collaborative policy initiatives, and collaborations among stakeholders. After 7 years, 357,867 OEC's have been submitted.

Conclusion: PR-OHC's initiatives tackled oral health disparities by promoting routine exams-ensuring early detection, prevention, and treatment-and highlighting the importance of dental homes among school-aged children. The Coalition remains actively engaged in advocating for this policy and maintains a leadership role in advancing oral health, fostering interagency collaboration, and improving access for underserved communities.

Objectives: Share lessons learned from using quality improvement (QI) and data-informed decision making to advance health equity in North Carolina.

Methods: Thirteen safety net dental practices implemented community-informed QI initiatives from 2022 to 2024. They identified community needs, aligned goals and resources, made practice-level improvements, and used data to measure progress. Collective learnings were used to advocate for policy changes supporting health equity.

Results: QI initiatives engaged 87,000 patients across 47 counties. Practice-level care delivery improvements included telehealth, minimally invasive care, addressing social drivers of health, and bolstering care coordination and referral processes. Understanding community needs, organizational support, funding, QI tools, and data-informed decision-making drove success. Barriers included data collection and staffing challenges, as well as workforce and reimbursement policies. The QI processes generated evidence for collective action around policy changes to improve care access and health equity in the state.

Conclusion: The QI process generated evidence that ultimately drove advocacy efforts aimed at improving health equity through systems change.

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.