bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Assumptions Concerning IP As and Cost of Dental Care
Authors: Hazelkorn Herbert M. , Jovanovic Borko D. , Macek Mark D. , Chouinard Joanne 
Published: April 2007

Abstract Objectives: Previous studies suggest that fee‐for‐service (FFS) patients receive more treatment and at a greater cost than capitation patients. In this study treatment plans of dentists who are members of an independent practice association (IPA), a preferred provider organization (PPO), or who are paid their usual fee for service are compared. Methods: A carefully selected and trained professional actor, with actual dental disease and recent radiographs, was sent to the offices of general practice dentists for an examination and treatment plan. To one group of dentists (n=21) the patient said he was a member of a PPO plan served by that dentist, to a second group (n=15) he said he was a member of an IPA plan served by that dentist, and to the third group (n=19) he said he would pay by the traditional FFS method. Results: IPA dentists recommended more restorations (mean=9.60) than those in the PPO program (mean=5.95) or those paid by the traditional FFS method (mean=5.58). The anticipated mean cost to the patient was higher for the IPA dentists ($1,815.20) compared to the other two types (PPO=$1,186.24, FFS=$1,470.42). Conclusion: The IPA models studied in this investigation permitted dentists to charge copayments for most treatments beyond basic services. This type of IPA might be similar to a fee‐for‐service model that provides practitioners with an incentive to do more rather than less treatment.
Racial Differences in Stage at Diagnosis of Screenable Oral Cancers in North Carolina
Authors: Arbes Samuel J. , Slade Gary D. 
Published: April 2007

Abstract Objective: This study examined differences between blacks and whites in stage at diagnosis of screenable oral cancers. Methods: Data for 1,137 North Carolina residents with first primary tumors of the oral cavity (excluding the lip and salivary glands) or oropharynx diagnosed from 1990–92 were obtained from the North Carolina Central Cancer Registry. The outcome variable was stage at diagnosis dichotomized as localized and advanced. The explanatory variables were race, sex, age, year diagnosed, tumor site, and county‐level socioeconomic and health care resource factors. Bivariate, stratified, and multiple regression analyses were conducted. Results: In the regression analysis, the odds of advanced stage was 2.1 (95% Cl=1.5, 2.9) times greater for blacks than whites. Other multivariable effects were sex [males compared to females: OR=1.5 (95% Cl=1.2, 2.0)] and tumor site [oropharynx compared to palate: OR=4.2 (95% Cl=2.5, 7.0)]. Conclusion: Among black and white residents of North Carolina diagnosed with cancer of the oral cavity or oropharynx, blacks had a greater odds of diagnosis at advanced stage.
Prevalence and Distribution of Dental Restorative Materials in US Air Force Veterans
Authors: Albertini Tullio F. , Kingman Albert , Brown L. Jackson 
Published: April 2007

Abstract Objectives: Millions of restorative procedures are performed annually in the United States, yet very little is known about their distribution in the general population. With increasing concern about potential adverse health effects of some restorative materials, a better understanding of the extent of exposure to these materials in the population is important. The purpose of this study is to report the prevalence, patterns, and distribution of dental restorative materials in a population of male veterans. Methods: This collaborative study with the US Air Force examined 1,166 male veterans to assess exposure to dental amalgam and other restorative materials. An inventory of dental materials in the study population was obtained through oral examinations. Dental materials were classified into five categories: (1) amalgam; (2) resin; (3) porcelain, cement, or temporary, including ionomer (PCT); (4) cast gold alloys/direct filling gold; and (5) other metals (OM). The mean age of the study participants was 52.9 years. Over 94 percent of the study participants were dentate. Results: The study participants averaged 45.8 restored/replaced surfaces. Restored/replaced surfaces increased with age while the number of teeth decreased with age. The most frequently used restorative material was amalgam, averaging 19.89 surfaces per subject, followed by PCT (9.38), resins (8.99), OM (5.52), and gold (4.91). The distributions of restorative materials varied by age, arch type, and location in the mouth. Conclusion: The study population experienced substantial exposure to dental materials.
Restorative Treatments Received by Children Covered by a Universal, Publicly Financed, Dental Insurance Plan
Authors: Ismail Amid , Brodeur Jean‐Marc , Gagnon Pierre , Payette Martin , Picard Daniel , Hamalian Talia , Olivier Marie 
Published: April 2007

Abstract Objectives: This study sought to identify risk markers associated with the provision of new restorations in children and to investigate whether the carious status of a tooth surface is associated with the restorative decisions of dentists. Methods: A total of 911 schoolchildren in grades one, two, and three were randomly selected from the island of Montreal, Quebec, Canada. Dental examinations were carried out in 1990, 1991, and 1992. Tooth surfaces of first permanent molars were classified as sound, noncavitated, and cavitated. The carious status of a tooth was matched with restorative decisions reported to the insurance board. Results: The presence of a carious cavity was a strong risk marker for placement of new restorations (odds ratios ≥4.11). After one year, less than 2 percent of sound tooth surfaces of first permanent molars were restored and about 21 percent of noncavitated tooth surfaces were restored. When new class I restorations placed in maxillary first permanent molars within 3–6 months after the baseline examination were evaluated, we found that between 73 percent and 86 percent of these new restorations were placed in sound or noncavitated tooth surfaces. A similar trend also was observed in mandibular first permanent molars. Poor agreement between epidemiologic diagnosis and restorative decisions was found. The restorative profile of dentists was a significant risk marker for placement of new restorations. Conclusion: The majority of new restorations in first permanent molars were placed in sound and noncavitated tooth surfaces because of the ubiquitous prevalence of these tooth surfaces and the validity problems of current caries diagnosis methods.
Dissatisfaction with Oral Health Status in an Older Adult Population
Authors: Jokovic Aleksandra , Locker David 
Published: April 2007

Abstract Objectives: The aim of this study was to assess dissatisfaction with oral health in an older adult population and to identify factors associated with dissatisfaction. Methods: Data were obtained from 907 community‐dwelling older adults aged 50 years and older using personal interviews and clinical examinations. Bivariate and multivariate analyses examined the relationships among dissatisfaction with oral health and a variety of sociodemographic variables, clinical oral health measures, and measures of the functional and psychosocial impact of oral disorders. Results: Overall, 14.3 percent of respondents were dissatisfied with their ability to chew, 21.6 percent with their dental appearance, and 5.6 percent with their ability to speak clearly. Almost one‐third (30.8%) were dissatisfied with at least one of these dimensions of oral health. Edentulous subjects were more likely to be dissatisfied than dentate subjects. The multivariate regression model for dentate subjects contained seven variables that explained 31 percent of the variance in dissatisfaction scores. For the edentulous, the model contained three variables that accounted for 53 percent of the variance. Conclusions: These results suggest that demographic, clinical, and psychosocial impact variables are associated with dissatisfaction with oral health. However, psychosocial impact variables had by far the strongest independent effect.
Nonresponse Bias in a Survey of Ontario Dentists' Infection Control and Attitudes Concerning HIV
Authors: McCarthy Gillian M. , Koval John J. , MacDonald John K. 
Published: April 2007

Abstract Objective: This study investigated late response and nonresponse bias in an HIV‐related survey of dentists. Methods: Questionnaires with ID numbers were mailed to all dentists in Ontario (N=5,997) with additional mailings four and seven weeks later. Results: Proportionately more respondents who returned questionnaires less than four weeks after the first mailing reported that they knowingly treated (P<.05) or were willing to treat HIV‐infected patients (P<.05); that they had an accurate perception of risk of HIV infection after a needlestick injury (P<.01), and preferred not to refer HIV‐infected patients (P<.01). Linear extrapolation of cumulative percent responses indicated nonresponse bias in terms of attitude and knowledge items; however, the magnitude was low. Conclusion: The effects of late response and nonresponse bias on the results of this study were small. However, these results cannot be generalized beyond the study population, and obtaining high response rates and testing for nonresponse bias in surveys of attitudes related to HIV are recommended.
Characteristics of Patients Seeking Care from Independent Dental Hygienist Practices
Authors: Perry Dorothy A. , Freed James R. , Kushman John E. 
Published: April 2007

Abstract Objectives: This study determined demographic characteristics, satisfaction with care, and likelihood of follow‐up dentist visits for patients seen in office‐based, independent, dental hygienist practices. Methods: New patients were surveyed after their initial visits to independent hygienist practices to assess their demographic characteristics and satisfaction with care at both the beginning of practice operations and 18 months after the start of these practices. Follow‐up surveys were sent to patients 12 and 24 months after their initial visits to the independently practicing dental hygienists to determine if patients had visited a dentist. Results: Most respondents were white, female, had attended some college, and reported high family incomes. Ninety‐eight percent of respondents were satisfied with their dental hygiene care. Follow‐up questionnaires revealed that over 80 percent of respondents visited the dentist within 12 months of receiving dental hygiene care in independent settings. This level of follow‐up care with dentists was found both for respondents who reported having a regular dentist at their initial visits with the hygienists and for those who reported not having a regular dentist. Conclusion: Independent practice by dental hygienists provided access to dental hygiene care and encouraged visits to the dentist.
The Influence of Various Fluoride Exposures on the Prevalence of Esthetic Problems Resulting from Dental Fluorosis
Authors: Clark D. Christopher , Berkowitz Jonathan 
Published: April 2007

Abstract Objectives: This study sought to determine the prevalence of esthetic problems due to dental fluorosis, and determine the relationship of different fluoride exposure histories to the occurrence of these problems. Methods: In 1993–94 2,715 children in grades 2 and 3 and 3,297 adolescents in grades 8 and 9 were examined by four dentists. Questionnaires detailing exposures to various fluoride technologies were collected from 3,022 of these study participants. Esthetic ratings of the participants' maxillary anterior teeth were made by the examiners, the participants themselves, and their parents using questionnaires designed for this purpose. Results: Data indicate that 46 percent of the participants had dental fluorosis. Only 40 percent had fluorosis on anterior maxillary teeth. The prevalence of esthetic problems ranged from about 1 percent to 4 percent, depending on how an esthetic problem was defined. Esthetic problems as defined by the participant were more prevalent for the “over 11′’age group. Logistic regression results demonstrated significant associations between several of the classifications of esthetic problems and the use of fluoride supplements and dentifrices, and exposure to fluoridated water during the third year of life. Conclusion: Results suggest that the prevalence of esthetic problems is low in the communities surveyed, and that exposure to any number of fluoride technologies in the third year of life can increase a child's risk for this problem.
Comparing Predictors of Willingness to Treat HIV+ Patients for New York City Male and Female General Practice Dentists 50 Years of Age or Younger
Authors: Kunzel Carol , Sadowsky Donald , Tseng Chin‐Lin 
Published: April 2007

Abstract Objectives: This article develops and compares gender‐specific predictive models for willingness to treat HIV‐infected patients (PHIV+) for male and female private general practice dentists (GPDs). Methods: Based on mail survey data collected in Manhattan and Queens, New York City (73.3% response rate), hierarchical multiple regression analyses were conducted for male and female dentists 50 years of age or younger (n=763) and for those in solo practice. Results: The gender‐specific predictive models (R2s=0.72) do not differ, except for the influence of practice viability, a moderately strong, statistically significant predictor for men, while the least powerful, statistically nonsignificant predictor for women. This distinction remains for solo male and female practitioners. Informal/formal collegial norms are more influential predictors within the solo female model than within the solo male model. Conclusion: Findings are encouraging for further work in developing predictive models for clinician subpopulations, with an eye toward developing intervention strategies that reflect key predictive factors for each group.
The Relationship Between the Number of Sound, Decayed, and Filled Permanent Tooth Surfaces and the Number of Sealed Surfaces in Children and Adolescents
Authors: Clark D. Christopher , Berkowitz Jonathan 
Published: April 2007

Abstract Objectives: The purpose of this investigation was to determine the prevalence of sound, decayed, filled, and sealed permanent tooth surfaces for children and adolescents from three fluoridated communities in British Columbia and to develop a predictive model of sealant use that included the dental caries status of tooth surfaces. Methods: Children in grades 2 and 3 (n=2,715) and adolescents in grades 8 and 9 (3,317) were surveyed to determine the prevalence of sound, decayed, filled, and sealed permanent tooth surfaces. The DMFS index, modified to include incipient (D1) and cavitated (D2) lesions, was used to measure the status of all tooth surfaces. The prevalence of D1D2MF and sealed tooth surfaces was estimated by age group and tooth type. Logistic regression models were developed to analyze the association between a number of independent variables and sealant use. Results: About 60 percent of surveyed students had one or more sealants present, with a mean of 3.2 sealants per subject. Of all pit and fissure surfaces on permanent first molars, 23.4 percent and 20.1 percent were sealed for the 11 years and younger and 12 years and older age groups, respectively. For these same two age groups, the percentages of pit and fissure surfaces that were decayed and filled were 6.7 percent and 19.7 percent, respectively. For both age groups combined, 10.8 percent and 23.7 percent of all pit and fissure surfaces on second molars and premolars, respectively, were sealed. The prevalence of decayed and filled pit and fissure surfaces was 5.6 percent and 1.8 percent, respectively, for second molars and premolars. Premolars were being sealed at a rate of 13 to 1 compared to the number of decayed and filled surfaces. Logistic regression failed to identify meaningful predictors of sealant use. Conclusion: Results from this study found an increase in the prevalence of sealants in the three communities surveyed, yet failed to identify criteria used by dentists or auxiliaries when making decisions about sealant placement. Professional education in the appropriate use of sealants may be necessary.
Effect of an Amine Fluoride Dentifrice on Dental Caries Used in a Community‐based Oral Health Education Program
Authors: Pakhomov Guennadi N. , Moller Ingolf J. , Atanassov Nicola P. , Kabackchieva Rositza I. , Sharkov Nikolai I. 
Published: April 2007

Abstract Objectives: The purpose of this study was to investigate the caries‐reducing effect of an amine fluoride toothpaste when used under real‐life conditions in a community preventive program. Methods: Approximately 12,500 children 3–12 years of age were provided with toothpaste (four tubes or 360 grams annually during three years) to be used in kindergartens or schools and once a day at home. The teachers supervised daily toothbrushing sessions. Random samples of children in each of the ages 3, 6, 9, and 12 years were selected from the intervention and the reference communities at both the start of the study and after three years, and examined for dental caries experience. Results: Amine fluoride dentifrice seemed to provide a reduction in dental caries prevalence compatible to the most commonly used fluoride dentifrice compounds. Conclusion: The implemented fluoride toothpaste program is a feasible and practical method of improving the oral health status of children.
A 24‐month Study Comparing Sealant and Fluoride Varnish in Caries Reduction on Different Permanent First Molar Surfaces
Authors: Bravo Manuel , Baca Pilar , Llodra Juan Carlos , Osorio Estrella 
Published: April 2007

Abstract Objective: The aim of this study was to determine the separate effects of dental sealants and fluoride varnish on dental caries in fissured and nonfissured surfaces of permanent first molars. Methods: A clinical trial was conducted with three groups of 6‐ to 8‐year‐old schoolchildren: a sealant group (n=100), in which Delton was applied to first molars; a varnish group (n=98), in which Duraphat was applied to first molars; and a control group (n=116), which had no intervention as part of the study. Absolute and percent caries reductions were compared at 24 months. Results: Compared to the controls, sealants resulted in a 68 percent and 87 percent reduction on fissured and nonfissured surfaces, respectively. The corresponding figures for varnish were 38 percent and 66 percent. Conclusion: Sealant and fluoride varnish are effective in preventing caries in both fissured and nonfissured surface.
Establishing Maternal and Child Health Data Collection Priorities for State and Local Oral Health Programs
Authors: Kuthy Raymond A. , Siegal Mark D. , Wulf Colleen A. 
Published: April 2007

Abstract Objective: This paper identifies specific data items for use by state and local agencies in a maternal and child oral health needs assessment model. Methods: A modified Delphi approach was used to develop consensus on items for inclusion in the data set and their relative importance. Initially, 31 data items were chosen from several national sources. All state dental directors, along with other selected administrators and advisory committee members for this process, were asked to categorize each of the data items as core (essential), important but optional, or of lesser importance. Short comments about each data item were accepted, as were additions to the list of data items. Two rounds of comments were held. Results: Eleven data items/types of information were selected as core items to be included in all needs assessments. All but one of these items were determined by the scores of the respondents. The advisory committee strongly recommended that at least one core item relate to the public's perception of oral health. Some differences in perceived importance of several items existed among the state dental directors, local dental directors, and the advisory committee. Twenty‐one items were identified as being important, but optional, and seven were considered less than important and not included in the model data set. Conclusions: A modified Delphi approach facilitated the development of core and optional data items for a model oral health needs assessment. This model has potential for a common reporting mechanism so that states and local dental programs can share data.
Taking Dental Self‐care to the Extreme: 24‐month Incidence of Dental Self‐extractions in the Florida Dental Care Study
Authors: Gilbert Gregg H. , Duncan R. Paul , Earls Janet L. 
Published: April 2007

Abstract Objective: A common response to health‐related symptoms is to treat oneself in lieu of or prior to seeking formal health care. Among the more extreme forms of dental self‐care is dental self‐extraction. To our knowledge, no study of the incidence of this behavior has been conducted. The objective of this study was to determine if one form of dental self‐care, dental self‐extraction, is a real phenomenon, and if so, to determine its incidence. Methods: The Florida Dental Care Study is a longitudinal study of changes in oral health, whose subjects participated for an interview and clinical examination at baseline and 24 months after baseline. Results: Of the 739 persons who participated through 24 months, 176 lost one or more teeth. Of these 176 persons, 13 (7%) extracted one or more of their own teeth. The clinical status at baseline of the self‐extracted teeth was consistent with the ability to self‐extract. Conclusion: The phenomenon of dental self‐extraction is real and is not limited to residents of developing nations or geographically isolated areas. Because of the potential for prolonged bleeding or bacterial endocarditis in certain population groups, community health clinicians and officials should be cognizant of this behavior.
Residency Training in Dental Public Health: Assessment of Status, Needs, and Issues
Authors: Wotman Stephen , Pyle Marsha , Duffy Rosemary 
Published: April 2007

AbstractThe opportunities for public health training have declined over the years while the need for public health skills is likely to increase. This paper reports the results of a project, sponsored by the Health Resources and Services Administration, which answers the question of “how best to invest in the dental public health education system so as to fulfill the profession's responsibilities to protect and improve the oral health of individuals and society.’’ An information base on dental public health education, practice, and specialization was developed from an extensive review of the literature and a survey of dentists concerning employment and practice requirements for public health dentists. An advisory group considered this information, met to discuss the issues involved in dental public health training, and provided advice to the project staff. Based on the information gathered as part of the project, recommendations were made to: (1) develop a grant program to support advanced education in dental public health; (2) increase the competencies of dentists who are working in public health positions and not eligible for board certification via off‐site residencies; (3) develop model programs in areas of great need, such as general public health, management, policy, prevention, environmental health and research, that in conjunction with a basic public health core, could satisfy the eligibility requirements of the American Board of Dental Public Health; (4) develop student loan forgiveness programs for dentists and dental hygienists working in public health; and (5) develop additional credential recognition programs for dental public health workers.