bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of the Women, Infants, and Children's Supplemental Food Program on Dentally Related Medicaid Expenditures
Authors: Lee Jessica Y. , Rozier R. Gary , Norton Edward C. , Kotch Jonathan B. , Vann William F. 
Published: May 2007

Abstract Objective: This study estimates the effects of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on dentally related Medicaid expenditures for young children. Methods: We used a five‐year cohort study design to compare dentally related Medicaid expenditures for children enrolled in WIC versus those not enrolled for each year of life up to age 5 years. There were 49,795 children born in North Carolina in 1992 who met the inclusion criteria for the study. Their birth records were linked to Medicaid enrollment and claims files, WIC master files, and the Area Resource File. Our analysis strategy included a logit and OLS two‐part model with CPI dollar adjustments. Results: Children who participated in WIC at ages 1 and 2 years had significantly less dentally related expenditures than those who did not participate. WIC participation at age 3 years did not have a significant effect. Fewer WIC children received dental care under general anesthesia than non‐WIC children. Conclusions: The WIC program has the potential for decreasing dentally related costs to the Medicaid program, while increasing use of dental services.
Financing of Dental Services in Turkey: Opinions and Expectations of Dentists, Residents, and Patients
Authors: Hayran Osman , Mumcu Gonca , Sur Haydar , Yildirim Celal , Söylemez Didem , Atli Hakki 
Published: May 2007

Abstract Objectives: This study investigates the attitudes of dentists, residents, and patients on the financing of dental services in Turkey. Methods: In this descriptive study, randomly selected groups of 860 dentists, 641 patients, and 866 residents from 9 provinces of Turkey were interviewed. Their agreement on various statements on financing issues of dental services were recorded and analyzed. Results: Eighty‐two percent of the dentists, 83.8 percent of the patients, and 76.4 percent of the residents agreed that “governments should finance all dental services.” The majority of the dentists (83.6%), patients (74.7%), and residents (84.4%) stated that patients should pay a copayment for their dental treatment. Conclusion: Survey results indicate that the current financing system of dental services in Turkey is not satisfactory either for the providers or for the users.
Caries Prevalence in a Rural Chilean Community after Cessation of a Powdered Milk Fluoridation Program
Authors: Mariño Rodrigo J. , Villa Alberto E. , Weitz Andrea , Guerrero Sonia 
Published: May 2007

Abstract Objective: The milk fluoridation scheme established in Codegua, Chile, between 1994 and 1999 demonstrated the effectiveness of powdered milk as a community‐based vehicle for fluoride to prevent dental caries. The present study aimed to compare caries prevalence in both the Codeguan control and test communities, three years after ending fluoride distribution through the powdered milk fluoridation scheme, to assess whether the benefits of such milk fluoridation were still present in the test community. Methods: Children 3–6 years old living in Codegua (test community) and La Punta (control community) were examined for dental caries at their educational facilities by three trained and calibrated examiners using natural light, dental mirrors, and sickle probes. Differences in caries prevalence (dmfs) by year of the study were tested for statistically significant differences using the Mann‐Whitney U test. Results: Findings from Codegua (1999–2002) indicate that the dental caries experience increased in all age groups following the termination of powdered milk fluoridation. These differences reached levels of statistical significance in the 3‐, 4‐, and 5‐ year old group (P<.03). Comparing results from Codegua and La Punta (2002), no statistically significant differences were found. Conclusions: Termination of the powdered milk fluoridation scheme resulted in a deterioration of the dental health of children. After three years, dental caries prevalence was higher than that reached at the end of the scheme and equivalent to that of the control community without fluoride exposure. These results emphasize the need to establish and maintain an alternative mechanism of community‐based fluoridation of proven effectiveness for the prevention of dental caries in communities where water fluoridation is not available.
A Comparison of the Costs and Patient Acceptability of Professionally Applied Topical Fluoride Foam and Varnish
Authors: Hawkins Robert , Noble James , Locker David , Wiebe David , Murray Heather , Wiebe Peter , Frosina Carolyn , Clarke Martha 
Published: May 2007

Abstract Objectives: In Canada and the United States, professionally applied topical fluorides (PATF) are usually applied as a gel or foam. However, fluoride varnish has also been found to be effective for caries prevention and may be a preferred method because less time is required and fluoride exposure can be better controlled. The goal of this study was to compare the costs and patient acceptability of two methods of PATF (foam and varnish). Methods: The study population was a convenience sample of high‐risk children from the York Region and the city of Hamilton, Ontario, Canada, who had been identified as requiring fluoride therapy (n=256). Children received from dental hygienists either fluoride foam applied in trays or fluoride varnish painted on tooth surfaces. An observer recorded the time to perform each procedure, adverse outcomes, and the satisfaction of children with treatment. Results: The varnish technique took significantly less time compared to foam (5.81 vs 7.86 minutes; P<.0001). Significant differences between procedure times were found in all age groups, but the largest difference was for children aged 3–6 years (5.22 vs 8.61 minutes; P<.0001). Signs of gagging were observed in a lower proportion of participants who received varnish (3.8% vs 15.1 % P<.01), and this difference was largest for children aged 3–6 years (2.6% vs 29.7% P<.01). The cost per varnish application, for children aged 3–6 years, was substantially less after labor costs were considered ($3.43 vs $4.43, CDN). Conclusions: Varnish applications were found to take less time and resulted in fewer signs of discomfort. These results support the use of fluoride varnish in caries prevention programs, especially for younger children.
Oral Health in the Pediatric Practice Setting: a Survey of Washington State Pediatricians
Authors: Lewis Charlotte W. , Cantrell Diana C. , Domoto Peter K. 
Published: May 2007

Abstract Background: Pediatric health care providers may be the only source of preventive oral health education for families of young children who lack access to professional dental care. Objective: We surveyed Washington State pediatricians in order to characterize their oral health‐related educational needs and anticipatory guidance practices. Methods: A 38‐question survey was mailed to all 606 general pediatricians in Washington State. Topics included anticipatory practices and confidence in oral health‐related activities. Results: Of 483 eligible participants, 271 returned completed surveys (response rate: 57%). A median of 30 percent of the well‐child visit was devoted to providing anticipatory guidance. A majority (83.7%) of respondents reported providing anticipatory guidance on oral health. Conclusion: Washington State pediatricians are already involved in providing oral health anticipatory guidance. Certain factors are identified that should be addressed to allow pediatricians to promote oral health more effectively.
Acceptability of Powered Toothbrushes for Elderly Individuals
Authors: Verma Suchita , Bhat K. Mahalinga 
Published: May 2007

Abstract Objectives: This study evaluated the usefulness of powered toothbrushes in elderly individuals for removing supragingival plaque and improving gingival health and comparing this to the use of regular manual toothbrushes. Methods: Fourteen persons aged 68–85 years having moderate gingivitis were included in the study. A crossover clinical trial consisting of two phases of three months' duration each was carried out. All the participants were given an oral prophylaxis, following which they were instructed to use the manual toothbrush for three months. Again, for the same subjects, an oral prophylaxis was given and they were asked to use the powered toothbrush for the next three months. Plaque Index and Gingival Index scores were recorded one, two, and three months after the use of each toothbrush. Oral hygiene instruction was reinforced only at baseline. Results: The powered toothbrush was more effective than a regular manual toothbrush in removing plaque and controlling gingivitis. Conclusion: The powered toothbrush may prove to be a good alternative to the manual toothbrush for this segment of the population, as it does not require any special dexterity to use.
Changing Dentate Status of Adults, Use of Dental Health Services, and Achievement of National Dental Health Goals in Denmark by the Year 2000
Authors: Petersen Poul Erik , Kjøller Mette , Christensen Lisa Bøge , Krustrup Ulla 
Published: May 2007

ABSTRACT Objectives: This study analyzes the current profile of dentate status and use of dental health services among adults in Denmark at the turn of the millennium, assesses the impact on dentate status of sociodemographic factors and use of dental health services in adulthood and in childhood, and highlights the changes over time in dental health conditions among adults. Finally, the intention of the study was to evaluate the Danish dental health care system's level of achievement of the official goals for the year 2000 as formulated by the World Health Organization and the National Board of Health. The subjects of this study included a national representative sample of 16,690 Danish citizens aged 16 years and older (response rate=74.2%). A subsample (n=3,818) took part in a survey of dental care habits in childhood and prevalence of removable dentures; 66 percent of persons selected responded. Methods: Personal interviews were used to collect information on dentate status, use of dental health services and living conditions; data on dental care habits in childhood and prevalence of removable dentures were collected by self‐administered questionnaires. Results: In all, 8 percent of interviewed persons were edentulous, while 80 percent had 20 or more natural teeth. At age 65–74 years, 27 percent were edentulous and 40 percent had 20 teeth or more; 58 percent wore removable dentures. Dentate status and prevalence of dentures were highly related to educational background and income, particularly for older age groups. Among persons interviewed, 80 percent paid regular dental visits and visits were most frequent among persons of high education and income. At age 35–44 years 95 percent had participated in regular dental care in childhood compared to 49 percent of 65–74‐year‐olds. Multivariate analyses revealed that sociobehavioral factors had significant effects on dentate status. Conclusions: Compared to similar studies carried out in 1987 and 1994, the present survey indicates a positive trend of improved dentate status in adult Danes in general and regular use of dental health services increased considerably over time. The WHO goals for better dental health by the year 2000 were achieved for 35–44‐year‐olds, whereas the goal of more people with functional dentitions at age 65 years or older was not achieved. It remains a challenge to the Danish dental health system to help even out the social inequalities in dental health.
Efficacy of Educational Interventions Targeting Primary Care Providers' Practice Behaviors: an Overview of Published Systematic Reviews
Authors: Sohn Woosung , Ismail Amid I. , Tellez Marisol 
Published: May 2007

ABSTRACT Objectives: Primary care providers (e.g., family physicians, pediatricians, registered nurses, physician assistants, and nurse practitioners) could play a pivotal role in the provision of preventive services, especially for very young children (younger than 3 years old) and population groups with limited access to dental care. Given the current problems with access to dental care among low‐income Americans, we contend there is a need to involve nondental primary health care providers in screening for and preventing oral health problems. The objective of this overview is to present findings from systematic reviews on the efficacy of continuing medical education, printed educational material, academic outreach, reminders, and local opinion leaders on the adoption of new knowledge and practices by primary care providers. Methods: A search was conducted using the Cochrane Library and MEDLINE. The search aimed to locate systematic reviews published between January 1988 and March 2003. Two researchers independently extracted data and assessed study quality using a modified version of the QUOROM statement. Results: Eleven systematic reviews were included in this overview. The evidence from the included systematic reviews showed that formal continuing medical education (CME) and distributing educational materials did not effectively change primary care providers' behaviors. There are effective interventions available to increase knowledge and change behaviors of primary care providers, such as small group discussion, interactive workshops, educational outreach visits, and reminders. Conclusion: There is a limited knowledge base on the efficacy of the selected interventions on oral health screening by primary care providers. Considering the potential role of primary care providers in improving oral health of underserved populations, this research area should receive more attention.
The Association Between Environmental Tobacco Smoke and Primary Tooth Caries
Authors: Shenkin Jonathan D. , Broffitt Barbara , Levy Steven M. , Warren John J. 
Published: May 2007

ABSTRACT Objective: Environmental tobacco smoke (ETS) has been associated with a number of negative health outcomes for exposed children. The goal of this study was to assess the association between ETS and dental caries in a pediatric population. Methods: This study included 637 Iowa Fluoride Study children whose parents provided socioeconomic information, completed at least three questionnaires during the first year of life, and had a primary dentition exam at age 4–7 years. Households reporting in all questionnaires that someone smoked in the home were categorized as regularly smoking homes. Socioeconomic status (SES) was divided into three groups (low, middle, and high) based on family income and mother's education. Children were classified as having caries if any of the primary teeth had fillings or cavitated lesions at the primary dentition exam. Results: Overall, children residing in regularly smoking homes had a higher prevalence of caries. For the middle SES group and overall, the children from smoking homes had a significantly higher prevalence of caries compared to nonregular/nonsmoking homes (52% vs 24%, P=.05 and 44% vs 25%, P=.002, respectively). After adjusting for age, SES, toothbrushing frequency, total ingested fluoride, and combined intake of soda pop and powdered drink beverages, the relationship of smoking and caries still remained significant (odds ratio [OR]=3.38; P=.001). Conclusions: Environmental tobacco smoke was associated with an increased risk of caries among children.
Effect of Different Diagnostic Thresholds on Dental Caries Calibration
Authors: Assaf Andrea Videira , Meneghim Marcelo de Castro , Zanin Luciane , Cortelazzi Karine Laura , Pereira Antonio Carlos , Ambrosano Glaucia Maria Bovi 
Published: May 2007

AbstractObjectives: a)to analyze the intra‐ and inter‐examiner reproducibility (reliability) of a calibration trial, at different diagnostic thresholds of dental caries; b) to verify the accuracy (benchmark validity) though sensitivity (S), specificity (SP), positive (PPV) and negative predictive (NPV) values. Participants: A group of dental examiners (n=11), who had previous experience in epidemiological surveys and six to seven‐year‐old children. Children were selected according to the dmft and dental caries activity. Methods: Theoretical and clinical training and calibration exercises were arranged for a total of 28 hours. WHO criteria including the active initial lesions (IL) were used. Main outcome measures: WHO and WHO+IL diagnostic thresholds according to tooth and dental surface. Results: Excellent mean results of intra and inter‐examiner Kappa values were found for both diagnostic thresholds, according to tooth and surface, during the calibration phase. The most relevant errors were related to IL diagnosis and to the first permanent molars. When assessed against a benchmark examiner, moderate to high validity values were observed (0.71–1.00), with some loss mainly for sensitivity and positive predictive value, when including IL. Conclusion: It was possible and feasible to use the proposed methodology of this study in epidemiological surveys, even with the inclusion of IL. However, further examiner calibration studies are still needed in order to improve and establish a methodology of calibration with this new diagnostic threshold.
Assessment of the Relationship between Neighborhood Characteristics and Dental Caries Severity among Low‐Income African‐Americans: A Multilevel Approach
Authors: Tellez Marisol , Sohn Woosung , Burt Brian A. , Ismail Amid I. 
Published: May 2007

AbstractObjectives: To assess the relationship between neighborhood effects and the severity of dental caries among low‐income African‐Americans. Methods: A multistage probability sample of African‐American families living in the poorest 39 census tracts in Detroit was drawn. During 2002–03, cross‐sectional data of a cohort that includes 1021 caregivers were collected in the first of three waves of interviews and examinations. Multilevel analyses focused on 27 neighborhood clusters and involved a combination of individual (Level‐1) and neighborhood (Level‐2) data including census and geocoded (address matching to census geographic areas) information. Results: There is significant variation in the severity of caries between low‐income neighborhood clusters. Caries severity decreases with a higher number of churches, while it increases with a higher number of grocery stores in the clusters after accounting for individual characteristics. Only 14% of the inter‐individual variability in caries was explained by classical individual risk factors for this condition. Conclusion: Neighborhoods contribute something unique to caregivers' oral health, beyond socioeconomic position and individual risk factors. Multilevel interventions are necessary to reduce disparities among African‐Americans and churches may offer a promising venue from which to conduct them.
The Relationship Between Cardiovascular Xerogenic Medication Intake and the Incidence of Crown/Root Restorations
Authors: Maupomé Gerardo , Peters Dawn , Rush William A. , Rindal D. Brad , White B. Alex 
Published: May 2007

AbstractObjectives: This retrospective, longitudinal cohort study quantified the strength of the association between xerogenic cardiovascular medication use and dental restorations, using the latter as a proxy measure for dental caries experience. Methods: Study data were collected from 11 years of electronic clinical/pharmacy records in two large dental group practices associated with managed care organizations (MCO). Records were extracted for all members who were at least 55 years old at the end of the 11 year window, and had at feast 48 months of concurrent dental, medical, and pharmacy coverage. The authors identified 4,448 individuals whose only xerogenic medication exposure was to drugs treating a cardiovascular condition. This group was compared to a group not taking any medications (n=1,183), and a group taking medications with no known xerostomic side effect (n=5,622). Poisson regression compared restoration incidence and mean restoration rates among the three groups. Results: MCO members taking cardiovascular or non‐xerogenic medications had higher restoration incidence and mean restoration rates than individuals taking no medications. A small difference in mean restoration rate between the non‐xerogenic medication group and the cardiovascular drug group was observed; no significant difference in restoration incidence was seen between these two groups. Conclusions: This study provides objective quantification of cardiovascular medication's long‐term effects on increased restorations in older adults. When grouped under a single category labeled “cardiovascular,” drugs with effects targeting the cardiovascular system did not appear to unequivocally lead to higher restorative experiences.
Are Oral Health Status and Care Associated with Anxiety and Depression? A Study of Portuguese Health Science Students
Authors: Marques‐Vidal Pedro , Milagre Virginia 
Published: May 2007

AbstractThe relationship between oral health and anxiety/depression were assessed in a cross‐sectional study conducted in 38% Portuguese students from the Health Sciences (age: 21 ± 3 years, 75% women). Oral health included prevalence of reported tooth pain/gum bleeding, dentist attendance, and dentifrice and dental floss use. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. Subjects with anxiety or depression had a higher frequency of perceived gum bleeding and reported a higher dentist attendance than normal subjects. On multivariate analysis, anxiety was significantly and independently related to perceived toothache (OR=2.90, 95%CI: 1.25–6.72) and dentist attendance (OR=2.15, 95%CI: 1.18–3.91) whereas depression was associated with perceived gum bleeding (OR=4.96, 95%CI: 1.68–14.59), and no differences were found regarding teeth brushing or dental flossing. The author concludes that anxiety and depression are related to perceived toothache and gum bleeding, but this association cannot be explained by decreased dental care.
Dental Caries Experience and Factors among Preschoolers in Southeastern Mexico: A Brief Communication
Authors: Segovia‐Villanueva América , Estrella‐Rodríguez Ramón , Medina‐Solís Carlo Eduardo , Maupomé Gerardo 
Published: May 2007

Abstract Objective: To examine the Association between dental caries prevalence and selected variables in preschool children. Methods: A cross‐sectional study was carried out with 1,303 preschoolers (ages 3–6 years old), and the mothers completed questionnaires. The children were examined by one of three standardized dental examiners. Logistic regression was performed to identify Associations between dental caries and other factors. Results: Mean dmft was 1.54+2.47, with 44.1% of children having dmft>O. Caries prevalence was Associated with older children (OR=1.39); medium (OR=1.66) and low (OR=2.41) socioeconomic levels; mediocre (OR=l.71) and inadequate (OR=2.25) hygiene; negative attitude toward oral health (OR=1.51); and the presence of enamel defects (OR= 1.74). Conclusion: Both overall caries prevalence and dmft index were relatively low. The results of this study substantiate previous reports in the international literature for clinical, behavior, socio‐demographic, and socio‐economic variables that contribute to dental caries in Mexican children.