bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dental Public Health: New Opportunities–New Responsibilities*
Authors: Wotman Stephen 
Published: May 2007

AbstractMajor changes affecting oral health in the United States have provided new leadership challenges for public health dentistry. Two new roles for dental public health are proposed: leadership in the incorporation of expanded public health skills into the education of every clinical dentist; and a broadening of the specialty in a manner similar to that of preventive medicine, involving the creation of subspecialties in public health dentistry, occupational environmental dentistry, and management policy dentistry. The current status of community dentistry departments in dental schools and programs of public health education for dental personnel in schools of public health are reviewed. Content is suggested for the incorporation of expanded public health skills into the education of every clinical dentist.
University of North Carolina Caries Risk Assessment Study. III. Multiple Factors in Caries Prevalence
Authors: Graves Richard C. , Abernathy James R. , Disney Judith A. , Stamm John W. , Bohannan Harry M. 
Published: May 2007

AbstractThe baseline caries experience of approximately 5,000 children in South Carolina and Maine was used as the dependent variable in caries risk assessment analyses. Clinical, microbiologic, and demographic factors served as independent variables in a multivariate relationship to caries through regression and discriminant function analyses. Four factors–number of dental visits by the child in the past year, presence of white spot lesions, and both the urgency of need for restorative care and the future caries increment predicted by the examiner–associated significantly and consistently with caries prevalence in primary and permanent teeth of first and fifth graders at both study sites. Several factors associated significantly with caries prevalence at only one site or grade within a site, suggesting that wide applicability of a specific caries risk assessment model may be limited. In these analyses, sensitivity ranged from .60 to .72 and specificity varied from .86 to .91 in the four grade‐site groups. The ultimate goal of this longitudinal study is to identify highly caries‐prone children in time to prevent the occurrence of a future caries increment. Although the lack of consistent association of many variables, including microbiologic factors, with baseline caries prevalence was unexpected, it is expected that some of these variables will contribute predictive power in the prospective study.
Educating Dentists about Fissure Sealants: Effects on Knowledge, Attitudes, and Use
Authors: Lang W. Paul , Farghaly Mahassen M. , Woolfolk Marilyn W. , Ziemiecki Thomas L. , Faja Barbara W. 
Published: May 2007

AbstractThis study evaluated the effects of three modes of education on dentists' knowledge, attitudes, and use of pit and fissure sealants. A randomly selected group of dentists was invited to participate in a sealant education initiative. During a 12‐month period, a total of 662 dentists either (1) attended continuing education courses, (2) received written materials and videotapes by mail, or (3) received only written materials by mail. A comparison group (n=337) received no materials until after the education phase and evaluation had been completed. Pre‐and postintervention surveys were used to measure changes in knowledge, attitudes, and sealant use. Response rates to the two surveys were 62 percent and 76 percent, respectively. Preintervention values for knowledge scores, an attitude scale, and sealant use were similar among the four groups. At followup, the three education groups had significantly higher knowledge scores than the comparison group. Attitude values for all but one group were not significantly different, and sealant use by all groups was identical. The numbers of respondents not using sealants declined slightly between surveys in the three education groups while rising slightly in the No‐Education Group. Because program outcomes were similar to those of another sealant initiative, it can probably be concluded that continuing education will increase dentists' knowledge about sealants, but have little effect upon their attitudes or their use of the technique. The changes observed in this investigation maybe due to the particular capacity for cognitive and affective change's of participants, characteristics of the technology being promoted, and external forces in the professional environment.
The Estimated Cost of Treating Unmet Dental Restorative Needs of Mexican‐American Children from Southwestern US HHANES, 1982‐83
Authors: Pollick Howard F. , Pawson Ivan G. , Martorell Reynaldo , Mendoza Fernando S. 
Published: May 2007

AbstractThe dental restorative treatment needs of Mexican‐American children, aged 1‐17years, were assessed from the 1982‐83 Southwestern US Hispanic Health and Nutrition Examination Survey (HHANES). This report analyzed those needs and applied a dollar cost to them, using 1982 median fees of US general practitioners. The total estimated cost required to meet those needs for the population estimate of 3,396,770 children was $236,856,772(95% CI:$198,575,174 to $275,138,370). The mean cost per child was $69.73 (SE: 5.75). Although a majority of the children had no unmet need, 15‐, 16‐, and 17‐year‐olds had extensive needs for crowns, endodontics, and prosthetic replacement of teeth, with accompanying high costs: mean total cost per examinee was $177 (SE: 28.97), $161 (SE: 32.20), and $237 (SE: 33.26), respectively. The treatment needs were compared with the previously published regional data from the 1979‐80 NIDR survey, which used the same dental restorative treatment needs (DRTN) index. The findings indicated a great need for dental treatment among Mexi‐can‐American children that appeared to exceed that of the general school‐aged population. Our analysis, in providing estimates of the cost of needed treatment, might be useful in planning dental treatment programs and in comparing surveys.
Dental Treatment Needs in an Elderly Population
Authors: Drake Claude W. , Beck James D. , Graves Richard C. 
Published: May 2007

AbstractA random sample of 1,019 adults 65 years of age and older, living in their own homes, consented to a clinical dental examination and an interview. Eight hundred nine subjects were dentate and 210 were edentulous. Each dentate person was examined for caries and periodontal conditions, as well as a separate determination of restorative and extraction treatment needs. Most people in this study lacked restorative treatment needs of any kind. Blacks required restorative treatment and extractions more often than whites. Carious coronal and root surfaces, pocket depths, number of teeth, as well as educational level and time since last visit to the dentist were related to treatment needs. While clinical findings were related to treatment needs, precise determinations of treatment needs of this elderly population generally could not be based solely on clinical findings. Additional behavioral, social, and health factors appear to play a role in dentists' decisions when determining treatment needs of older persons.
Ultraconservative Sealed Restorations: Three‐year Results
Authors: Mertz‐Fairhurst Eva J. , Williams J. Earl , Schuster George S. , Smith C. Douglas , Pierce Karen L. , Mackert J. Rodway , Sherrer Jack D. , Wenner Karen K. , Davis Quince B. , Garman Thomas A. , Ergle Janet W. 
Published: May 2007

AbstractThe overall objective of this clinical study was to determine the feasibility of using a sealed composite restoration to arrest caries without the removal of the carious lesion and without the traditional cavity preparation. The minimal tooth preparation (a bevel in enamel) usually did not require any anesthetic injection and conserved tooth structure. These ultraconservative sealed composite restorations placed over caries (CompS/C) have been compared with ultraconservative sealed amalgam restorations (AGS) and with the traditional outline form (unsealed) amalgam restorations (AGU). This clinical study has shown that: (1) caries can be arrested by the CompS/C restoration for a period of three years; (2) the marginal integrity of the AGS restorations showed a definite trend toward improvement as compared to the AGU restorations; and (3) complete sealant retention over posterior restorations was similar in both the CompS/C and the AGS groups during the first two years; however, at Year 3 complete sealant retention was 16 percent higher in the CompS/C than in the AGS group.
An Epidemiologic Estimate of the Critical Period during which Human Maxillary Central Incisors Are Most Susceptible to Fluorosis
Authors: Evans R. Wendell , Stamm John W. 
Published: May 2007

AbstractThe temporal relation between a declining fluorosis gradient and an abrupt downward shift in community drinking water fluoride concentration was evaluated through multiple correlation analysis to determine the critical time frame during which developing maxillary central incisors are most susceptible to fluoride challenge. Fluorosis data were scrutinized through a time‐related series of epidemiologic “windows” or time frames of varying lengths. The placement of these time frames was in turn related to the presumed start of enamel mineralization (at birth), and ranged from zero to 60 months later. In this way, the susceptibility of developing enamel to changes in water fluoride concentration was localized. The greatest risk was associated with a four‐month critical period commencing at 22 months following birth. The risk of fluorosis from exposures to a fluoride challenge acting during shorter periods was better localized than risk associated with longer exposures. We concluded (1) that human maxillary central incisors are most susceptible to fluorosis during a critical period of as little as four months' duration, commencing at 22 months of age; and (2) that for these incisors, fluoride exposure during the months prior to this period carries less risk than continued exposure for up to 36 months beyond this critical time.
Expanding Health Insurance Coverage and the Implications for Dentistry
Authors: Damiano Peter C. , Shugars Daniel A. , Johnson Jeffrey D. 
Published: May 2007

AbstractNumerous proposals have been suggested for expanding health insurance coverage to the over 30 million Americans without health insurance. These proposals range from establishing a program of national health insurance modeled after the Canadian system to establishing statewide risk pools. Many of these proposals could have an impact on financial access to dental care for the approximately 120 million people without dental insurance. Dental insurance coverage has been shown to increase access to dental services and improve oral health status. Oral health professionals could facilitate discussions concerning health insurance expansion by informing policymakers about important preventive benefits to be gained by improving access to dental services. Dental public health professionals can serve as a bridge between organized dentistry and health policymakers by providing information to help formulate the priorities and characteristics of a dental health insurance program. This visibility and influence in the health policy arena would be beneficial to dentistry and could ultimately result in greater access to dental services and improved oral health for the uninsured.
A Mobile Dental System in Southern Africa
Authors: Rudolph Michael J. , Chikte Usuf M. E. , Lewis Helen A. 
Published: May 2007

AbstractRecent studies indicate a great need for dental treatment and preventive services in dentally underserved communities in southern Africa. Geographic inaccessibility, limited financial resources, and a maldistribution of dental personnel are the main barriers to oral health care. This project describes the evolution and utilization of unique, purpose‐built, mobile dental unit (MDU). From a compact 2 times 2.5 meter box trailer, an enclosed area of 8 times 9 meters is formed by deploying a cover system housed on top of the trailer. Once deployed, the unit becomes four fully equipped dental operatories and a combined waiting and educational area, with all‐weather protection. Comprehensive care is provided by dental auxiliaries. The underlying philosophy of the service is based on the primary oral health care approach. To date, the MDU has visited a wide variety of rural and urban communities where several thousand patients have been examined and treated. Assessment of the MDU indicates that it is an effective and viable alternative oral health delivery system.
Dental Caries and Sealant Prevalences in Schoolchildren in Tennessee
Authors: Gillcrist James A. , Collier Durward R. , Wade George T. 
Published: May 2007

AbstractThis article presents findings on the prevalence of dental caries and dental sealants from the 1988 oral health survey of schoolchildren in Tennessee. The purpose of the study was to describe the prevalence of dental caries, dental sealants, and periodontal disease, as well as the need for restorative, exodontia, and periodontal treatment among schoolchildren. A multistage probability sample was designed to represent 927,000 children en‐rolled in grades K–12 in public and private schools across the state. Analyses of the data collected from the examination of 2,588 children aged 5–17 revealed that 55 percent were caries free in their permanent dentition and that the mean DMFS score was 2.86. For those aged 5–9, the mean dfs score was estimated to be 5.52. Only 10 percent of schoolchildren in Tennessee had dental seal‐ants on their teeth. Comparisons of the results of this survey with those reported from earlier state surveys indicated that caries levels have declined steadily. We assumed that the reduction in caries experience observed in Tennessee is the result of widespread exposure of children to systemic and topical fluorides. Further reduction in caries experience is possible with continued fluoridation of community water supplies, in conjunction with increased utilization of pit and fissure sealants.
Maryland Residents' Attitudes Toward AIDS and the Use of Dental Services
Authors: Cohen Leonard A. , Grace Edward G. , Ward Michael A. 
Published: May 2007

AbstractThis project was conducted to examine the impact of Maryland residents' attitudes about AIDS on dental services utilization. A telephone survey of 1,477 households was conducted (response rate 68.9%). Less than 7 percent of the respondents volunteered a concern about contracting AIDS in the dental office. When asked directly, approximately 35 percent stated they would change dentists if their dentist were treating AIDS patients. Respondents who were most aware of the wide‐spread treatment of AIDS patients by dentists were more likely to believe their dentist was treating AIDS patients. Also, they were less likely to report that they would leave the practice of dentists with AIDS or those who treated AIDS patients. It is critical for the public to be educated properly about the continued safety of the dental office and to receive accurate information about AIDS.
Understanding Dentists' Restorative Treatment Decisions
Authors: Bader James D. , Shugars Daniel A. 
Published: May 2007

AbstractA critical review of the literature is presented that examines variation in dentists' restorative treatment decisions and the factors associated with this variation. Substantial variation has been documented in dentists' assessment of caries, in dentists' decisions to intervene, and in the selection of treatment recommended to the patient. However, the factors associated with this variation are not well documented. Following discussion of this review, a model is proposed to help guide further studies of dentists' restorative treatment decisions. This explanatory model incorporates the factors identified in the review, as well as others either observed informally or found in the medical literature. The implications of variation in dentists' treatment decisions highlight the importance of a full explication of the process dentists follow in making treatment decisions. Understanding this process, which heretofore has been examined only superficially because it has been regarded as a function of “clinical judgment” is fundamental to determinations of normative treatment needs, to interventions designed to reduce the frequency of inappropriate treatment, and to the development of valid practice parameters.
A Comparison of the Caries‐preventive Effects of Fluoride Mouthrinsing, Fluoride Tablets, and Both Procedures Combined: Final Results after Eight Years
Authors: Driscoll William S. , Nowjack‐Raymer Ruth , Selwitz Robert H. , Li Shou‐Hua , Heifetz Stanley B. 
Published: May 2007

AbstractThis paper presents final results of an eight‐year clinical trial designed to compare the caries‐preventive benefits of two self‐administered fluoride procedures when used separately and in combination with one another. Children in kindergarten and first grade residing in Spring‐field, Ohio, a nonfluoridated community, were assigned randomly within school to one of three groups that either (a) rinsed once a week in school with a 0.2 percent neutral NaF solution; (b) chewed, rinsed with, and then swallowed daily in school a neutral 2.2 mg NaF tablet; or (c) carried out both procedures. At baseline (1981), 1,640 participants were examined clinically using the DMF surface index. Findings for 640 children remaining after eight years show that subjects in the combination group experienced a mean caries increment of 2.40 DMFS, 15.2 percent lower than the mean score of 2.83 DMFS for children in the tablet group and 32.8 percent lower than the 3.57 DMFS for those in the rinse group. Only the difference in incremental caries scores between the combined fluoride procedure and the fluoride rinse was statistically significant (P < 05). The pattern of these findings is similar to that found on the two interim examinations. Even though the combined regimen showed an additional caries‐preventive benefit compared with the rinse, considerations of cost effectiveness and feasibility do not support changing an ongoing rinse program to one that employs both procedures. For new programs the best choice appears to be the tablet procedure alone.
A Pilot Study of Dental Students' Esthetic Perceptions of Computer‐generated Mild Dental Fluorosis Compared to Other Conditions
Authors: McKnight Carrie B. , Levy Steven M. , Cooper Stephanie E. , Jakobsen Jane R. , Warren John J. 
Published: May 2007

Abstract Objective: Few studies have considered people's opinions about the esthetics of dental fluorosis. Assessments of fluorosis esthetics can be confounded by differences in a number of clinical factors, including tooth shape, color, contour, and gingival status. This pilot study compared esthetic perceptions of mild fluorosis and other conditions using computer‐generated images made from a base set of normal appearing teeth. Methods: Entering dental students (n=61) completed questionnaires about four sets of paired photographs. Three sets consisted of fluorotic teeth (very mild to mild) versus other conditions (diastema, isolated enamel opacity, “normal”/control) and the other pair compared two presentations of mild fluorosis (generalized versus limited to incisal one‐third). Six questions, both qualitative and quantitative, were asked about each pair of photographs. Results: Mild fluorosis was assessed less favorably than normal/control, midline diastema was less favorable than mild fluorosis, and mild fluorosis was less favorable than isolated opacity. Conclusions: This approach allows fluorosis to be better compared with other oral conditions because the images are standardized. Additional research with this method is warranted, including more variations in conditions, more comparisons, and other study populations.
Hepatitis B Prevalence and Infection Control Among Dental Health Care Workers in a Community in South Korea
Authors: Song Keun Bae , Choi Kum Suk , Lang W. Paul , Jacobson Jed J. 
Published: May 2007

Abstract Objective: The objectives of this study were to investigate the prevalence of hepatitis B vaccine and use of infection control procedures by dental health care workers in Taegu, South Korea. Methods: Information was obtained with a mailed questionnaire sent to 300 private dental practices. Surveys were received from 177 dentists, 104 dental hygienists, and 46 dental assistants. All dental health care workers were asked to donate a blood sample for analysis of hepatitis B surface antigen (HBsAg) and antibody (anti‐HBs). Results: Vaccination against hepatitis B virus was reported by 63 percent of the respondents. About 40 percent of all participants answered that they were anti‐HBs positive, while another 43 percent did not know their status. About 89 percent of dentists reported that they wore a mask with all patients, while hygienists (13.6%) and assistants (13.0%) were less likely to do so. Reported use of gloves (4.5%) and protective eyewear (14%) with all patients was extremely low in every group. Among the 56 dentists who were tested for HB V markers, 23 did not receive the vaccine against hepatitis B, and 13 percent (3 of 23) were positive for HBsAg as carriers. Conclusions: About 37 percent (120 of 327) of dental health care workers surveyed in this study in Korea did not receive the vaccine against HBV infection. Basic barrier techniques to prevent cross‐contamination were not being used consistently. Nationwide guidelines for barrier techniques and hepatitis vaccinations should be developed and disseminated to dental personnel.
Willingness to Pay for Periodontal Therapy: Development and Testing of an Instrument
Authors: Matthews Debora C. , Sci Dipl Periodont , Birch Stephen , Gafni Amiram , DiCenso Alba 
Published: May 2007

Abstract Objective: The objective of this study was to develop and test the feasibility and validity of a willingness to pay (WTP) tool in a dental setting. Methods: A questionnaire measured individuals' preferences among alternative treatments for periodontal disease and the maximum they would be willing to pay for their treatment of choice in terms of dental insurance premiums. The questionnaire provides detailed information, in probabilistic terms, of the risks and benefits of treatment choices for moderate to advanced adult periodontitis. It was pilot tested on 23 periodontal patients and 18 dental school faculty and staff. Results: The majority (92.6%) felt the questionnaire was an accurate representation of treatments and outcomes, establishing face and content validity. In terms of construct validity, four hypotheses were tested: (1) manipulation of the outcomes of the preferred treatment led to a predictable shift in preferences for 38 subjects (92.7%); (2) although periodontal patients were not more likely to choose periodontal surgery than nonpatients (P=.14), those with a history of surgery were more likely to choose surgery again (P=.06); (3) WTP was positively related to income level (P=.05); and (4) subjects were willing to pay more for coverage for themselves than for others. Periodontal surgery was the preferred treatment for moderate to advanced periodontal disease, and was more strongly preferred than other choices (i.e., a higher WTP) for all income groups. The intraclass correlation coefficient for treatment preferences was 0.95 (P<.001) and the kappa for WTP was 0.78 (P<.001). Conclusion: This pilot study supports some of the criteria concerning validity of the WTP questionnaire to measure preferences for alternative periodontal therapies. Further testing on larger samples is required to confirm these results.