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Moca AE, Iurcov R, Ciavoi G, Moca RT, Șipoș LR. Pediatric Dental Emergencies during the COVID-19 Pandemic in Romania: A Retrospective Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050807. [PMID: 37238355 DOI: 10.3390/children10050807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Pediatric dental emergencies can occur as a result of untreated dental caries, or can be caused by trauma or periodontal issues. The lockdown imposed during the COVID-19 pandemic reduced the number of centers authorized to deliver dental services in Romania, with only a small number of dentists delivering dental emergency treatments. The aim of this study was to investigate the demographic characteristics of children and adolescent patients who were treated in the dental emergency department of Oradea, Romania and to compare the patients who were treated in the dental emergency department in the pre-lockdown (2019), lockdown (2020) and post-lockdown year (2021). All patients who were treated in the dental emergency department were included in the study except for adults and medical files that did not contain all relevant information. Several variables were investigated (age, gender, living environment, location of affected teeth, type of emergency). In 2019, 257 children and adolescents were treated, in 2020, 198, and in 2021, 136. Most patients were aged 7-12 years in all investigated years (2019-47.9%; 2020-50.5%; 2021-43.4%), and the most affected teeth were located in the lower posterior arch (2019-53.3%; 2020-53%; 2021-48.5%). The most frequent emergencies were pulpitis (2019-40.5%; 2020-43.9%) and acute apical periodontitis (2021-42.6%). It was observed that in 2019, patients aged between 0 and 6 years were more frequently associated with trauma (p < 0.001), and in 2019 and 2020, patients aged between 7 and 12 years were more frequently associated with periodontal emergencies (p < 0.001). In 2020, patients from rural areas were more frequently associated with pulpitis (p = 0.025), and in 2021, patients from rural areas were more frequently associated with pulpitis or acute apical periodontitis, and patients from urban areas were associated more frequently with periodontal emergencies (p = 0.042). Pediatric patients with ages between 7 and 12 years old, who lived in an urban environment were most affected. Teeth located in the lower and upper posterior dental arches were most affected, and pulpitis or acute apical periodontitis were the most common pathologies.
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Affiliation(s)
- Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Raluca Iurcov
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Gabriela Ciavoi
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Rahela Tabita Moca
- Doctoral School of Biomedical Sciences, University of Oradea, 1 Universității Street, 410087 Oradea, Romania
| | - Lucian Roman Șipoș
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
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Burns LE, Gencerliler N, Terlizzi K, Wu Y, Solis-Roman C, Gold HT. A comparative analysis of outcomes of root canal therapy for pediatric medicaid beneficiaries from New York State. FRONTIERS IN ORAL HEALTH 2022; 3:1031443. [PMID: 36479449 PMCID: PMC9720667 DOI: 10.3389/froh.2022.1031443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/28/2022] [Indexed: 08/03/2023] Open
Abstract
Objectives This study investigated differences in the provision of root canal therapy and outcomes in a publicly insured cohort of children and adolescents. Methods New York State Medicaid administrative claims from 2006 to 2018 were analyzed. Enrollees aged 6-18 were included in the study if they had initial non-surgical root canal therapy (NSRCT), in the permanent dentition, that allowed for at least 1 year of post-treatment follow-up. Descriptive analyses, multivariable logistic regression, and multivariable Cox proportional hazard models were used to examine the association between demographic variables (gender, age, race/ethnicity, and area-based factors) and dental treatment provision and outcomes. Results Male gender was associated with having more than one initial NSRCT (adjusted odds ratio (aOR) = 1.06; 95% confidence interval (CI) = 1.02-1.10), as was rurality (aOR = 1.15; 95% CI = 1.06-1.24). Black/African American (AA) and Hispanic children were less likely than non-Hispanic white children to have multiple NSRCTs (aOR = 0.88; 95% CI = 0.83-0.93 and aOR = 0.78; 95% CI = 0.74-0.83). Being older or female conferred a lower hazard of an untoward event (aHR = 0.93; 95% CI = 0.92-0.94 and aHR = 0.86; 95% CI = 0.81-0.91). Compared to non-Hispanic white children, Hispanic and Black/AA children had a higher risk of untoward event (aHR = 1.31; 95% CI = 1.21-1.41 and aHR = 1.55; 95% CI = 1.43-1.67) while children of Asian descent had a lower incidence after initial NSRCT (aHR = 0.79; 95% CI = 0.71-0.88). Conclusion Race/ethnicity was the strongest demographic predictor of provision of initial non-surgical root canal therapy, subsequent placement of a permanent restoration and the occurrence of an untoward event after NSRCT in this cohort.
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Affiliation(s)
- Lorel E. Burns
- Department of Endodontics, New York University College of Dentistry, New York, NY, United States
| | - Nihan Gencerliler
- Department of Endodontics, New York University College of Dentistry, New York, NY, United States
| | - Kelly Terlizzi
- Health Evaluation and Analytics Lab, New York University, New York, NY, United States
| | - Yinxiang Wu
- Department of Population Health, New York University Langone Health, New York, NY, United States
| | - Claudia Solis-Roman
- Health Evaluation and Analytics Lab, New York University, New York, NY, United States
| | - Heather T. Gold
- Department of Population Health, New York University Langone Health, New York, NY, United States
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Simon L, Ahern J, Fox K, Barrow J, Palmer N. Variation in dental services by rurality among privately insured adults in the United States. J Public Health Dent 2020; 81:50-56. [PMID: 32918758 DOI: 10.1111/jphd.12398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/30/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Rurality is associated with reduced dental access and worse oral health outcomes. It is unknown whether there is variation in dental services received by rural adults who visit a dentist. METHODS This was a retrospective analysis of claims data from a large private insurer. All individuals who had at least one dental visit in 2018 were included. Patient demographics, whether or not a patient's ZIP code was rural as defined by the Federal Office of Rural Health Policy, as well as ZIP code demographics were collected. Differences in the frequency of dental services received were evaluated using χ2 tests. Multilevel logistic regressions were used to evaluate the individual and ZIP code-level correlates of receiving a preventive dental procedure, a tooth extraction, or a denture-related dental procedure. RESULTS Rates of preventive, oral and maxillofacial surgery, and denture-related procedures were higher among rural adults. Accounting for individual age and gender, and ZIP code average income and dentist density, rural dwellers were more likely to receive a preventive procedure [odds ratio (OR) 1.15, P < 0.0001] or tooth extraction (OR 1.08, P < 0.0001), and less likely to have a denture-related procedure (OR 0.94, P = 0.015) compared to nonrural dwellers. Female gender was the strongest predictor of receiving a preventive procedure (OR 1.30, P < 0.0001). CONCLUSIONS Even among privately insured individuals with known access to dental care, rurality was associated with significant differences in the frequency of various dental procedures. Rural dental patients may have higher needs for oral surgical procedures, even when they have access to preventive care.
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Affiliation(s)
- Lisa Simon
- Harvard School of Dental Medicine, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| | - John Ahern
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Kathe Fox
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Jane Barrow
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Nathan Palmer
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
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Blackburn J, Bennett A, Fifolt M, Rucks A, Taylor H, Wolff P, Sen B. Pediatric dental care use and parent- or caregiver-rated oral health among Alabama children enrolled in Medicaid. J Am Dent Assoc 2020; 151:416-426. [PMID: 32450980 PMCID: PMC9743449 DOI: 10.1016/j.adaj.2020.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Reducing caries and improving access to dental care is a public health challenge. Understanding low use of dental care is of critical importance. This study estimated parent- or caregiver-reported prevalence and identified factors associated with children's dental care use, including the association with children's oral health. METHODS A cross-sectional analysis of children enrolled in Medicaid in Alabama, using data from the 2017 statewide Consumer Assessment of Healthcare Providers and Systems Health Plan Survey, was conducted. Associations were measured using adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) from logit regression and generalized linear model postestimation of least-squares means. RESULTS The 6-month prevalence of children receiving dental care was 70.4%. Children aged 0 through 3 years (aPR, 0.72; 95% CI, 0.53 to 0.91) had lower prevalence of care than other age groups. The prevalence of low-rated oral health was 9.2%. Low-rated oral health was associated with not receiving dental care (aPR, 1.50; 95% CI, 1.12 to 1.87) and parental education of 8th grade or less (aPR, 2.59; 95% CI, 1.20 to 3.98). Falsification tests determined that dental care use was not associated with ratings for overall health (aPR, 1.18; 95% CI, 0.83 to 1.52) or emotional health (aPR, 1.06; 95% CI, 0.79 to 1.33). CONCLUSIONS It was observed that children not receiving dental care had low-rated oral health; however, as a cross-sectional study, it was not possible to assess the temporality of this relationship. PRACTICAL IMPLICATIONS Oral health care providers should continue to recognize their role in educating parents and providing anticipatory guidance on children's oral health.
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Affiliation(s)
| | - Aleena Bennett
- University of Alabama at Birmingham School of Public Health
| | - Matt Fifolt
- University of Alabama at Birmingham School of Public Health
| | - Andrew Rucks
- University of Alabama at Birmingham School of Public Health
| | - Heather Taylor
- Indiana University Richard M. Fairbanks School of Public Health
| | - Paul Wolff
- University of Alabama at Birmingham School of Public Health
| | - Bisakha Sen
- University of Alabama at Birmingham School of Public Health
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Oral Health Problems and Utilization of Dental Services Among Spanish and Immigrant Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030738. [PMID: 31979248 PMCID: PMC7036804 DOI: 10.3390/ijerph17030738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 01/12/2023]
Abstract
Spanish and immigrant children and adolescents vary widely in their frequency of dental visits and occurrence of dental problems. The aims of this study were to discover the prevalence of dental problems and utilization of dental services in the Spanish and immigrant child population, identify the type of treatment received, and analyze the socioeconomic and demographic variables which are associated with dental problems and non-regular utilization of dental services, based on data from the 2017 National Health Survey in Spain. The sample consisted of 4568 children aged between 3 and 14 years old. Utilization of dental services and dental problems were assessed against socioeconomic and demographic characteristics using logistic regression models. The prevalence of caries in Spanish children was 9.29% compared with 18.58% (p < 0.001) in their immigrant counterparts. The most common reason for dental visits was a check-up (Spanish: 65.05%; immigrants: 54.94%). In both groups, from the age of 7, there was a lower probability of non-regular utilization of dental services, although this increased when the social class was lower. The probability of presenting dental problems was lower in Spanish children living in towns with over 10,000 inhabitants and was higher, in both groups, over the age of 7 and in lower social classes.
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Abstract
OBJECTIVE This study aimed to calculate the distance patients travel to dental clinics, the rate of bypassing nearby dental clinics and the distance covered when bypassing nearby dental clinics, and explored factors associated with patients' spatial access to dental clinics. DESIGN A secondary data analysis. SETTING Korea Health Panel. PARTICIPANTS We included users of dental care services from 2008 to 2011. A total of 2375 patients and 15 978 dental visits were analysed. PRIMARY OUTCOME MEASURES Korea Health Panel data (2008-2011) were used to geocode patients' and healthcare facilities' addresses. The distance travelled was calculated using road network information. To analyse the panel data, we adopted a generalised estimating equation: geographical measures on the choice of dental care facility were examined based on sex, age, educational level, equivalent income, treatment details and regional classification. RESULTS The median distance travelled to a dental clinic was 1.8 km, which is farther for rural (8.4 km) than for urban (1.5 km) patients. The bypass rate was 58.9%. Patients bypassing nearby dental clinics travelled 9.6 times farther for dental care (p<0.001). Unlike bypass distance, travel distance was not associated with equivalent income. People with higher education and those with implants/orthodontic treatment were more likely to bypass nearby dental clinics and travelled 1.27 times and 1.17 times farther (p<0.01), respectively. CONCLUSIONS Given the spatial barrier to available dental resources, factors associated with spatial access were mostly the same between travel and bypass distance except for equivalent income. The findings of this study suggest that spatial distance acts as a utilisation barrier and demands additional opportunity cost. At the same time, patients' preferences for services also increase their willingness to bypass nearby dental clinics and travel greater distances.
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Affiliation(s)
- Hosung Shin
- Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, Iksan, Korea (the Republic of)
| | - Han-A Cho
- Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, Iksan, Korea (the Republic of)
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Chertok IRA, Chertok N, Haile ZT, Chavan B. Association of Youth Characteristics and Recent Utilization of Dental Services in the United States. Front Pediatr 2018; 6:104. [PMID: 29780790 PMCID: PMC5945861 DOI: 10.3389/fped.2018.00104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/03/2018] [Indexed: 11/30/2022] Open
Abstract
Background: Oral health is important for overall health of youth, although dental service utilization is lower than national goals. The purpose of the study was to identify sociodemographic and health behavioral characteristics of youth in the United States who reported having at least one dental visit in the past 12 months. Methods: Secondary data analysis was conducted using the 2015 Youth Risk Behavior Survey (YRBS) to examine factors associated with dental care utilization using Andersen's theory-based Behavioral Model of Health Care Utilization. Results: Among 5,814 youth, nearly 78 percent reported visiting a dentist in the past 12 months. After adjusting for potential confounders, characteristics significantly associated with higher likelihood of dental care utilization were: predisposing factors of non-Hispanic white ethnicity and health behavior characteristics of not using tobacco, not using illegal substances, not drinking soda, and wearing a seat belt; enabling factor of speaking English well; and perceived health of not being overweight. Discussion: Use of the Healthcare Utilization Model identified significant factors classified as predisposing, enabling, and need-related factors associated with youth's utilization of dental care services. Findings from the theory-based population-based study informs healthcare providers of factors to consider when promoting dental care among youth.
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Affiliation(s)
- Ilana R A Chertok
- School of Nursing, College of Health Sciences and Professions, Ohio University, Athens, OH, United States
| | - Nathaniel Chertok
- School of Dentistry, West Virginia University, Morgantown, WV, United States
| | - Zelalem T Haile
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, United States
| | - Bhakti Chavan
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, United States
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Bhagavatula P, Xiang Q, Szabo A, Eichmiller F, Okunseri C. Differences in utilization of dental procedures by children enrolled in Wisconsin Medicaid and Delta Dental insurance plans. J Public Health Dent 2016; 77:86-92. [DOI: 10.1111/jphd.12191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/13/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Pradeep Bhagavatula
- Department of Clinical Services; Marquette University School of Dentistry; Milwaukee WI USA
| | - Qun Xiang
- Division of Biostatistics, Institute for Health and Society; Medical College of Wisconsin; Milwaukee WI USA
| | - Aniko Szabo
- Division of Biostatistics, Institute for Health and Society; Medical College of Wisconsin; Milwaukee WI USA
| | | | - Christopher Okunseri
- Department of Clinical Services; Marquette University School of Dentistry; Milwaukee WI USA
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