bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful Implementation of Community Water Fluoridation via the Community Diagnosis Process
Authors: Brumley David E. , Hawks Rebecca W. , Gillcrist James A. , Blackford Jennifer U. , Wells William W. 
Published: May 2007

AbstractObjectives: This paper describes the community diagnosis process and how it was used to implement community water fluoridation in Tennessee. Methods: Public health dental staff developed a survey instrument to collect community‐specific data on the oral health status of schoolchildren. Key survey findings were presented to county health councils who were determining and prioritizing the health needs of their communities. Results: Community‐specific data showed higher caries levels in children without access to an optimally fluoridated community water supply. Presentation of local survey findings to county health councils resulted in fluoridation being a high‐priority health issue in several counties. With health council support, opposition to fluoridation by utility district officials was overcome when decision makers were challenged with local survey findings. The community diagnosis process resulted in the successful fluoridation of six community water systems serving a total of 33,000 residents. Conclusions: The community diagnosis approach was successful in implementing community water fluoridation in geographic areas historically opposed to this public health measure. The success of these fluoridation initiatives was attributed to: (1) current, community‐specific assessments of children's oral health; (2) identification of communities with disparate oral health needs, problems, and resources; and (3) effective presentation of community‐specific oral health survey data to community leaders, stakeholders, and decision makers.
A Community Participatory Oral Health Promotion Program in an Inner‐city Latino Community
Authors: Watson Maria Rosa , Horowitz Alice M. , Garcia Isabel , Canto Maria T. 
Published: May 2007

AbstractObjectives: This paper reports the planning, implementation, process evaluation, and refinement of an oral health community participatory project in Mount Pleasant, an inner‐city Latino neighborhood of Washington, DC. The main goal was to explore the feasibility of implementing such a project. Methods: The PRECEDE‐PROCEED model was used to guide the planning and process evaluation of this project, in conjunction with community organizational methods. A steering committee, which met periodically, was formed to assist in program planning, implementation, and evaluation. The needs assessment of the community identified extensive dental health problems among children and deficiencies in their parents' oral health knowledge, opinions, and practices. In response, culturally appropriate health education and promotion activities were planned and implemented in collaboration with local community organizations, volunteers, and local practitioners. Process evaluation was used to provide feedback into the refinement of the community approach, which included record keeping and an inventory approach to activities completed and resources used. The overall impact and usefulness of this program were assessed informally using an anonymous open‐ended questionnaire directed to members of the steering committee, and an outreach survey using a convenience sample at a local Latino health fair. Results: The implementation of such a community participatory approach was feasible and useful for building upon existing local resources and addressing oral health concerns in a community not reached by traditional dental care and health promotion initiatives. Individuals in this community showed a substantial interest in oral health matters and participated in a variety of oral health prevention activities. The community approach adhered to community‐based research principles.
Patterns of Fluoride Intake from Birth to 36 Months
Authors: Levy Steven M. , Warren John J. , Davis Charles S. , Kirchner H. Lester , Kanellis Michael J. , Wefel James S. 
Published: May 2007

AbstractObjectives: Dental fluorosis prevalence has increased in the United States, Canada, and other nations due to the widespread availability of fluoride in many forms, with fluoride ingestion during the first three years of life appearing most critical in fluorosis etiology. With few contemporary studies of fluoride ingestion in this age group, the purpose of this paper is to describe patterns of estimated fluoride ingestion from birth to 36 months of age from water, dentifrice, and dietary fluoride supplements and combined. Methods: Repeated responses to separate series of questions about water intake, use of fluoride dentifrice, and use of fluoride supplements were collected by questionnaire as part of the longitudinal Iowa Fluoride Study and used to estimate fluoride intake. Estimated intake is reported by source and combined at different ages. Effects of subject age and other covariates on fluoride intake were assessed using regression methods appropriate for the analysis of correlated data. Results: For most children, water fluoride intake was the predominant source, especially through age 12 months. Combined daily fluoride intake increased through 9 months, was lower at 12 and 16 months, and increased again thereafter. Mean intake per unit body weight (bw) was about 0.075 mg F/kg bw through 3 months of age, 0.06 mg F/kg bw at 6 and 9 months, 0.035 mg F/kg bw at 12 and 16 months, and 0.043 mg F/kg bw from 20–36 months. Depending on the threshold chosen (e.g., 0.05 or 0.07 mg F/kg bw), variable percentages of the children exceeded the levels, with percentages greatest during the first 9 months. Regression analyses showed fluoride intake (mg F/kg bw) from 1.5–9 months to decrease with increasing child's age, mother's age, and mother's education, with a complex three‐way interaction among these factors. From 12–20 months, fluoride intake increased with increasing child age and decreased with increasing mother's age. No statistically significant relation‐ships were found for fluoride intake from 24–36 months. Conclusions: There is considerable variation in fluoride intake across ages and among individuals. Longitudinal studies may be necessary to fully understand the relationships between fluoride ingestion over time and development of fluorosis.
An Economic Evaluation of Community Water Fluoridation
Authors: Griffin Susan O. , Jones Kari , Tomar Scott L. 
Published: May 2007

AbstractObjective: The purpose of this research was to assess the local cost savings resulting from community water fluoridation, given current exposure levels to other fluoride sources. Methods: Adopting a societal perspective and using a discount rate of 4 percent, we compared the annual per person cost of fluoridation with the cost of averted disease and productivity losses. The latter was the product of annual dental caries increment in nonfluoridated communities, fluoridation effectiveness, and the discounted lifetime cost of treating a carious tooth surface. We obtained or imputed all parameters from published studies and national surveys. We conducted one‐way and three‐way sensitivity analyses. Results: With basecase assumptions, the annual per person cost savings resulting from fluoridation ranged from $15.95 in very small communities to $18.62 in large communities. Fluoridation was still cost saving for communities of any size if we allowed increment, effectiveness, or the discount rate to take on their worst‐case values, individually. For simultaneous variation of variables, fluoridation was cost saving for all but very small communities. There, fluoridation was cost saving if the reduction in carious surfaces attributable to one year of fluoridation was at least 0.046. Conclusion: On the basis of the most current data available on the effectiveness and cost of fluoridation, caries increment, and the cost and longevity of dental restorations, we find that water fluoridation offers significant cost savings.
Fluid Consumption Related to Climate among Children in the United States
Authors: Sohn Woosung , Heller Keith E. , Burt Brian A. 
Published: May 2007

AbstractObjective: Recommended fluoride concentrations in US public water systems are between 0.7–1.2 ppm, depending on the mean daily maximum temperature. This range assumes that water intake is higher in warmer than in cooler climates, based on research from the 1950s. The aim of this analysis is to relate fluid consumption among American children aged 1–10 years to the local climate under modern conditions. Methods: The quantities of daily total fluid intake per body weight (ml/kg) and plain water intake per body weight (ml/kg) of children were calculated from the 24‐hour recall diet survey in the third National Health and Nutrition Examination Survey (NHANES III, 1988–94). The mean daily maximum temperature from 1961 to 1990, averaged for the month during which the NHANES III exam was conducted, was obtained for each survey location from the US Local Climate Historical Database. Multiple regression analysis was conducted using SAS and SUDAAN. Results: Fluid intake was significantly associated with age, sex, socioeconomic status (SES), and race and ethnicity. No significant association could be found between the amount of either total fluid or plain water intake and mean daily maximum temperature, either before and after controlling for sex, age, SES, and race or ethnicity. Conclusions: Results indicate that there is no evidence that fluid consumption among children is significantly related to mean temperature in modern conditions. This suggests that the national temperature‐related guidelines for fluoride concentration in drinking water may be due for reevaluation.
Training Status and Interest in Certification of Nondiplomate Faculty Teaching Predoctoral Dental Public Health
Authors: Kaste Linda M. , Sadler Zara E. , Weintraub Jane A. , Niessen Linda C. , Narendran Sena , Hayes Kathy L. 
Published: May 2007

AbstractObjectives: A survey was conducted to better understand the training needs of faculty members without dental public health (DPH) specialty board certification who teach DPH to dental students. Methods: An 11‐item questionnaire was sent to 193 non‐DPH diplomate faculty members at US dental schools who were dentists and at least one of the following: a member of the American Association of Dental Schools Community and Preventive Dentistry Section, a referral from an academic American Board of Dental Public Health diplomate, a DPH faculty listed on the school's Web pages, a DPH contact from the AADS Institutional Directory, or the school's dean if no other contact. Results: A 70 percent response rate was obtained. Seventy‐nine percent of the respondents taught at least one national board‐related DPH topic. Among these faculty members, 67 percent have or are in training for the master of public health, 26 percent have completed or are in a DPH residency, and 63 percent desire training in one or more of the DPH topics. The majority (64%) does not plan to take the specialty exam, while 28 percent plan to take the exam within five years. About half reported no personal incentives to take the exam and 39 percent perceived no institutional incentives. Conclusions: These nondiplomate teachers of predoctoral DPH desire training, but appear to have barriers and perceive few benefits to achieving DPH board certification.
A Two‐year Longitudinal Study of Dental Caries in Permanent First Molars of Korean Elementary Schoolchildren
Authors: Cho Bon‐Kyoung , Kwon Ho‐Keun , Kim Kwon‐Soo , Kim Young‐Nam , Caplan Daniel J. 
Published: May 2007

AbstractObjective: This longitudinal study investigated dental caries increment in permanent first molars of Korean elementary schoolchildren. Methods: A convenience sample of 722 children aged 7–9 years attending one urban elementary school was examined at baseline, with follow‐up examinations at one and two years. Coronal surfaces of permanent first molars were scored with regard to caries experience and sealant status. Results: Among sound occlusal surfaces at baseline, 21 percent of upper and 25 percent of lower surfaces developed caries during the two‐year interval. In teeth that erupted between baseline and the first follow‐up exam, over 10 percent of occlusal surfaces developed caries. Pit and fissure caries accounted for 93 percent of all new carious surfaces, while sealants had been placed on 16 percent of occlusal surfaces during the study. Conclusions: Recognizing the limitations of this convenience sample, dental sealants should be used more widely in this Korean population, and should be applied soon after tooth eruption.
Community Fluoridation Status and Caries Experience in Children
Authors: Gillcrist James A. , Brumley David E. , Blackford Jennifer U. 
Published: May 2007

AbstractObjective: This study compares dental caries experience in fluoridated and nonfluoridated communities. Methods: A dental health survey designed to collect data on caries experience and treatment needs for community‐specific public health planning purposes was conducted in public elementary schools during the 1996–97 school year. Oral examinations of 17,256 children were completed, representing 93 percent of children residing in 62 East Tennessee communities. Results: The analysis showed that water fluoridation was significantly related to caries experience in the primary (dfs) and permanent (DMFS) dentitions and to the proportion of caries‐free children in the primary and permanent dentitions. When the data were adjusted for socioeconomic status, race, and age, caries levels were 21 percent lower in the primary dentition and 25 percent lower in the permanent dentition in fluoridated communities than in nonfluoridated communities. In addition, the proportion of children who were caries free was larger in fluoridated as compared with non fluoridated communities by 19 percent in the primary dentition and 6 percent in the permanent dentition. Conclusion: Although the design of the study prevented the collection of individual fluoride and residency histories, findings suggest there was substantially lower caries experience in fluoridated communities than in non fluoridated communities.
Identifying Communities with Low Dentist Supply in California
Authors: Mertz Elizabeth A. , Grumbach Kevin 
Published: May 2007

AbstractObjectives: This study estimates the supply and geographic distribution of dentists in California and examines the community characteristics associated with supply of dentists. Methods: The number of practicing dentists was estimated from American Dental Association data on licensed dentists in California. Each dentist's address was geocoded and matched to a Medical Service Study Area (MSSA). Dentist‐to‐population ratios were computed, and the association between dentist supply and community characteristics was analyzed in regression models. Results: Approximately 20 percent of California communities may have a shortage of dentists. Two‐thirds of dental shortage communities are rural. Communities with a lower supply of dentists have higher percentages of minorities, children, and low‐income persons. Minority dentists were more likely to practice in minority communities. Conclusions: Geographic maldistribution of dentists may contribute to poor access to dental care in many communities, especially in rural, low‐income, and minority communities. Minority dentists are more likely to practice in minority communities, but are a small portion of the dental workforce.
Is Depressive Symptomatology Associated with Worse Oral Functioning and Well‐being Among Older Adults?
Authors: Kressin Nancy R. , III Avron Spiro , Atchison Kathryn A. , Kazis Lewis , Jones Judith A. 
Published: May 2007

AbstractObjectives: Although depression negatively affects individuals' physical functioning and well‐being, its association with oral functioning and well‐being has not been examined previously. The objective of this study was to examine the association between depressive symptomatology and oral quality of life. Methods: We utilized data from two samples of older adults: community‐dwelling participants who used community primary care physicians in Los Angeles (n=7,653) and individuals who sought ambulatory care through four Department of Veterans Affairs facilities in the Boston metropolitan area (n=212). Depressive symptomatology was measured with the CES‐D scale; Oral Quality of Life was measured with the Geriatric Oral Health Assessment Instrument and the Oral Health‐related Quality of Life measure. We conducted hierarchical regression analyses to examine the effects of depression on oral quality of life, controlling for self‐reported oral health, age, education, income, and marital status. Results: Individuals with more depressive symptoms reported worse oral quality of life, controlling for socio demographic factors and self‐reported oral health. This finding persisted across multiple samples and both sexes, and using two measures of oral quality of life. Conclusion: These findings further emphasize the importance of treating depression among older adults, and suggest that both dentists and physicians have a role in recognizing and referring patients for such treatment.
Determinants of Dropout in a Community Intervention Trial on the Caries‐preventive Effect of Chewing Gums
Authors: Machiulskiene Vita , Nyvad Bente , DDS Vibeke Baelum 
Published: May 2007

AbstractObjectives: This study describes determinants of dropout in a three‐year community intervention trial of the effects of sugar‐substituted chewing gums on caries progression rates. Methods: A total of 602 children aged 9–14 years from 28 school classes in five secondary schools in Kaunas, Lithuania, were given a clinical and radiographic baseline caries examination. The schools were assigned randomly to one of the following interventions: sorbitol/carbamide gum, sorbitol gum, xylitolgum, placebo gum, or no gum. Children in the four intervention schools were asked to chew at least five pieces of chewing gum per day, preferably after meals. The children were reexamined clinically after one, two, and three years of study, and radio graphically after three years. Results: A total of 33 children (6%) had dropped out before the one‐year clinical examination, an additional 29 children (5%) dropped out before the two‐year examination, and a further 108 children (18%) dropped out before the final three‐year clinical examination. A total of 230 children (39%) were not available or refused to participate in the three‐year radiographic examination. Analyses using random effect logit models showed that, irrespective of time of follow‐up, most of the cluster variation in dropout was related to school classes within the primary randomization units, the schools. The most important predictors of individual dropout were age and baseline caries experience, whereas sex was not associated with dropout. Conclusions: The results show that a community intervention trial of chewing gums carried out among schoolchildren is subject to cluster effects. Dropout was not primarily related to the randomization units themselves, i.e. the schools, but rather to sub clusters of classes within the schools. These findings should be considered when designing community intervention trials and practical preventive programs among schoolchildren.
On Adding a Dental Practice Component to an Ongoing Longitudinal Population‐based Study of Oral Health
Authors: Gilbert Gregg H. , Rose John S. , Cantey Elmire D. , Earls Janet L. , Eiford Ellen I. , Eldreth Mary Anne , Shelton Brent J. 
Published: May 2007

AbstractObjective: To determine the feasibility and effectiveness of adding a dental practice component to the Florida Dental Care Study (FDCS). Methods: The FDCS was a study of dental health in which no treatment was provided. In‐person interviews and clinical examinations were conducted at baseline, 24 months, and 48 months, with six‐month telephone interviews between those times. Participants reported any dentists visited and treatment received. All but four of the 764 participants at the 24‐month session gave written permission to review their dental records. Dental hygienist research assistants abstracted information on treatment that was received during the 48‐month interval. Results: Of the 286 practices named by FDCS subjects, all but 10 (of whom five refused) practices participated. Eight practices allowed access to records, but did not allow us to record fees. Fees were unavailable at another 13 practices. Of the 764 persons who participated for the 24‐month interview, 677 ultimately reported at least one dental visit during the first 48 months of the study. Of those 677, we located dental records on 619. We also found records on four of the 111 persons who reported no dental visits, by querying practices while recording information on other participants. Charts varied in comprehensiveness; nevertheless, in conjunction with office staff consultation, all practices had adequate record of what procedures were performed. Conclusions: Although time intensive, this method of collecting data substantially increased information about dental treatment received, compared to relying on participant self‐report and clinical examination.
General Health Status and Changes in Chewing Ability in Older Canadians over Seven Years
Authors: Locker David , Matear David , Lawrence Herenia 
Published: May 2007

AbstractObjectives: The purpose of this study was to describe the onset of and recovery from chewing problems in an older adult population over a seven‐year period and to describe factors associated with these changes. Of particular interest was the relationship between general health and changes in oral functioning‐ Methods: The data came from a longitudinai study of community‐dwelling individuals who were aged 50 years and older when first recruited. Data were collected at baseline (n=907) and at three (n=611) and seven‐year (n=425) follow‐ups. Oral function was assessed by means of a six‐item index of chewing ability. Data were weighted to account for loss to follow‐up using weights derived from the seven‐year response proportions for dentate and edentulous subjects. Logistic regression analysis using backward stepwise selection was used to identify. predictors of onset and recovery. Results: At baseline, 25 percent of subjects reported a problem chewing. This rose to 26 percent at three years and 34 percent at seven years. The seven‐year incidence of chewing dysfunction was 19 percent. Of those with a chewing problem at baseline, 21 percent did not have a problem at seven years. A logistic regression model predicting the seven‐year incidence of chewing problems indicated that subjects aged 65 years or older, the edentulous, those rating their oral health as poor, those without dental insurance and those without a regular source of dentai care were more likely to be an incident case. In addition, a variable denoting the number of chronic medical conditions at baseline also entered the model. A logistic regression model predicting recovery indicated that older subjects, the edentulous, those from low‐income households, and those with limitations in activities of daily living were less likely to recover over the observation period. Conclusion: The results of this study indicate a marked increase in the prevalence of chewing problems in this older adult population over the seven‐year observation period. Poorer general health at baseline increased the probability of the onset of a chewing problem and decreased the probability of recovery.