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Petrac L, Gvozdanovic K, Perkovic V, Petek Zugaj N, Ljubicic N. Antibiotics Prescribing Pattern and Quality of Prescribing in Croatian Dental Practices-5-Year National Study. Antibiotics (Basel) 2024; 13:345. [PMID: 38667021 PMCID: PMC11047605 DOI: 10.3390/antibiotics13040345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/24/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
PURPOSE Antibiotic resistance is one of the biggest threats to global health today. The aim of this study was to analyze antibiotic prescribing patterns and quality of prescribing in Croatian dental practices over a 5-year period. METHODS This is a retrospective observational study based on the analysis of the electronic prescriptions (medicines in ATC groups J01 and P01) from dental practices in Croatia prescribed from 1 January 2015 to 31 December 2019. Prescriptions were retrieved from the Croatian Health Insurance Fund (HZZO). The analyses included the number of prescriptions, type and quantity of prescribed drugs, indication, and the patient's and prescriber's characteristics. RESULTS The consumption increased from 1.98 DID in 2015, to 2.10 DID in 2019. The most prescribed antibiotic was Amoxicillin with clavulanic acid followed by Amoxicillin, Clindamycin, Metronidazole and Cefalexin. The analyses showed that 29.79% of antibiotics were not prescribed in accordance with the contemporary guidelines for the proper use of antibiotics. Additionally, 22% of antibiotics were prescribed in inconclusive indications. CONCLUSION The research showed an increase in antibiotic consumption over five years along with unnecessary prescribing of antibiotics in cases with no indications for its use. The development of national guidelines for antibiotic use is necessary.
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Affiliation(s)
- Lucija Petrac
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | | | - Vjera Perkovic
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | | | - Neven Ljubicic
- Department of Internal Medicine, Clinical Hospital Sisters of Mercy, 10000 Zagreb, Croatia;
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Heaton B, Bond JC, Bae J, Cozier Y. Perceived experiences of racism linked to dental fear and anxiety among Black women. Community Dent Oral Epidemiol 2023; 51:896-907. [PMID: 35964228 PMCID: PMC9925613 DOI: 10.1111/cdoe.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Dental fear and anxiety are known determinants of delaying or avoiding dental care and vary considerably based on factors such as age and gender. However, little is known about dental fear and anxiety in racial/ethnic minority populations, which bear a disproportionate burden of poor oral health outcomes. Structural and social pathways responsible for producing these disparities are also understudied. Experiences of racism over the lifecourse may contribute to poor oral health outcomes through a pathway of dental fear and anxiety. This paper aimed to evaluate perceived experiences with racism, dental fear and anxiety, and the utilization of dental services, in the Black Women's Health Study (BWHS), a United States-based prospective cohort. METHODS Analysis of prospective data obtained from a geographic subset of participants in the BWHS was conducted. In 2014, BWHS participants residing in Massachusetts responded to a mailed oral health questionnaire that included the Index of Dental Anxiety and Fear (IDAF-4C+) instrument (N = 484; 69% response rate). Previously collected demographic and health information, along with reported experiences of everyday and lifetime racism, obtained from national BWHS questionnaires between 1995 and 2009, were merged with the Massachusetts-based sub-sample. Associations between high dental anxiety (HDA) (mean IDAF-4C+ score ≥2.5 on the dental fear and anxiety module) and oral health outcomes and perceived racism and HDA were explored via prevalence ratios (PR) calculated using log-binomial regression models, including adjustment for potential confounders. RESULTS Reported exposures to everyday racism occurred weekly on average for the top 25% of the sample, while 13% of participants reported exposure to multiple (n = 3) experiences of unfair treatment due to their race over their lifetime. HDA was prevalent among 17.8% of the sample and was significantly associated with indicators of poor oral health status. High exposures to everyday and lifetime experiences of racism were positively associated with HDA (PR = 1.08; 95% CI: 0.90, 1.58 and PR = 1.72; 95% CI: 1.03, 2.88, respectively). CONCLUSIONS Significant associations between racism and HDA, and between HDA and poor oral health and reduced utilization of dental care were observed. Dental anxiety may be a pathway through which perceived experiences with racism may impact oral health outcomes.
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Affiliation(s)
- Brenda Heaton
- Department of Health Policy & Health, Services Research, Boston University, Henry M. Goldman School of Dental, Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston, University School of Public Health, Boston, Massachusetts, USA
| | - Julia C. Bond
- Department of Health Policy & Health, Services Research, Boston University, Henry M. Goldman School of Dental, Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston, University School of Public Health, Boston, Massachusetts, USA
| | - Jaeyoung Bae
- Department of Health Policy & Health, Services Research, Boston University, Henry M. Goldman School of Dental, Medicine, Boston, Massachusetts, USA
| | - Yvette Cozier
- Department of Epidemiology, Boston, University School of Public Health, Boston, Massachusetts, USA
- Slone Epidemiology Center, Boston, University, Boston, Massachusetts, USA
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Sukalski JMC, Askelson NM, Reynolds JC, Damiano PC, Shi W, Xie XJ, McKernan SC. Perceived social status, socioeconomic status, and preventive dental utilization among a low-income Medicaid adult population. J Public Health Dent 2023; 83:363-370. [PMID: 37965907 DOI: 10.1111/jphd.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/29/2023] [Accepted: 09/15/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Perceived Social Status (PSS) is a measure of cumulative socioeconomic circumstances that takes perceived self-control into account. It is hypothesized to better capture social class compared to socioeconomic status (SES) measures (i.e., education, occupation, and income). This study examined the association between PSS and dental utilization, comparing the strength of associations between dental utilization and PSS and SES measures among a low-income adult Medicaid population. METHODS A cross-sectional survey was administered to a random sample of low-income adults in Iowa, United States with Medicaid dental insurance (N = 18,000) in the spring of 2018. Respondents were asked about PSS, dental utilization, and demographics. A set of multivariable logistic regression models examined the relative effects of PSS and SES measures on dental utilization, controlling for age, sex, health literacy, whether the respondent was aware they had dental insurance, transportation, and perceived need of dental care. RESULTS The adjusted response rate was 25%, with a final sample size of 2252. Mean PSS (range 1-10) was 5.3 (SD 1.9). PSS was significantly associated with dental utilization (OR = 1.11; CI = 1.05, 1.18) when adjusting for control variables, whereas other SES measures-education, employment, and income-were not. CONCLUSIONS PSS demonstrated a small positive association with dental utilization. Results support the relative importance of PSS, in addition to SES measures, as PSS may capture aspects of social class that SES measures do not. Results suggest the need for future research to consider the effects of PSS on oral health outcomes and behaviors.
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Affiliation(s)
- Jennifer M C Sukalski
- Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Natoshia M Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Julie C Reynolds
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Peter C Damiano
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Wei Shi
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Xian Jin Xie
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Susan C McKernan
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, Iowa, USA
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Sadiq N, Probst JC, Martin AB, Khan MM, Merchant AT. Untreated Dental Caries May be Associated with Subsequent Mortality among Working-Age Adults: Evidence from NHANES III. Community Dent Oral Epidemiol 2020; 49:377-383. [PMID: 33341956 DOI: 10.1111/cdoe.12612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/21/2020] [Accepted: 11/29/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Poor oral health has been shown to be associated with selected adverse health outcomes. This study assessed the association between untreated dental caries and mortality and examined whether having dental insurance mitigates the risk of mortality among working-age US adults with dental caries. METHODS Analysis used the publicly available linked mortality file for NHANES III, an observational study conducted in 1988-1994, with follow-up through December 2015. Propensity score matching was conducted to create similar populations of insured and uninsured adults, resulting in a sample of 4420 matched observations. The Cox proportional hazard model was used to investigate the effect of untreated dental caries and that of dental insurance on risk of all-cause mortality. The descriptive and final outcome statistical analyses were adjusted for complex sampling technique using weights, strata and cluster variables. RESULTS Adults with untreated dental caries had a higher risk of mortality (HR: 1.33; 95% CI: 1.06-1.68) than those with no dental caries. Having dental insurance was associated with a lower risk of mortality (HR: 0.73; 95% CI: 0.59-0.92). An interaction between caries treatment status and dental insurance was not statistically significant. CONCLUSIONS Adults with untreated dental caries have a higher risk of mortality, even in the presence of dental insurance. Untreated caries may be an indicator for multiple risk factors, including personal attitudes regarding health and healthcare-seeking behaviour.
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Affiliation(s)
- Naveed Sadiq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Janice C Probst
- Department of Health Services, Policy & Management, University of South Carolina, Columbia, SC, USA
| | - Amy B Martin
- Medical University of South Carolina, Columbia, SC, USA
| | - M Mahmud Khan
- Department of Health Policy & Management, University of Georgia, Athens, GA, USA
| | - Anwar T Merchant
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC, USA
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Kohli R, Howk S, Davis MM. Barriers and Facilitators of Dental Care in African-American Seniors: A Qualitative Study of Consumers' Perspective. JOURNAL OF ADVANCED ORAL RESEARCH 2020; 11:23-33. [PMID: 33365339 DOI: 10.1177/2320206819893213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective To identify African-American seniors' perceptions of the barriers and facilitators to their dental care. Materials and Methods In this cross-sectional qualitative study, we conducted in-depth interviews with 16 community-based, self-identified African-American seniors from March 2017 to August 2017 in Oregon. We coded data in ATLAS. ti and used thematic analysis to identify emergent themes within the social ecological framework and a cross-case comparative analysis to explore variation by participant characteristics. Results Regardless of dental insurance status, cost and perceived urgency of treatment were the primary drivers of participant's ability and interest in seeking dental care. Participants identified four solutions to improve oral health care in African-American seniors: affordable/free care and vouchers for dental work, better oral health education at a younger age, onsite community dental services, and navigators who can educate patients about insurance and dental providers who see low-income patients. Conclusions Oral health decisions by African-American seniors were primarily driven by cost and perceived urgency irrespective of insurance coverage. Affordable dental care, early intervention, on-site services, and navigation may help to address key barriers and reduce oral health disparities faced by African-Americans.
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Affiliation(s)
- Richie Kohli
- Department of Community Dentistry, School of Dentistry, Oregon Health & Science University, Portland, Oregon, USA
| | - Sonya Howk
- Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon, USA
| | - Melinda M Davis
- Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon, USA.,Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA.,School of Public Health, Oregon Health & Science University (OHSU), Portland State University (PSU), Portland, Oregon, USA
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Lam PC, John DA, Galfalvy H, Kunzel C, Lewis-Fernández R. Oral Health-Related Quality of Life Among Publicly Insured Mental Health Service Outpatients With Serious Mental Illness. Psychiatr Serv 2019; 70:1101-1109. [PMID: 31522632 DOI: 10.1176/appi.ps.201900111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study investigated factors associated with unmet need for dental care and oral health-related quality of life (OHQoL) among individuals with serious mental illness receiving outpatient care in a public mental health program serving a largely low-income population, mostly from racial-ethnic minority groups. METHODS Cross-sectional interview data were collected from a convenience sample (N=150) of outpatients. Adjusted risk ratios (ARRs) and adjusted risk differences (ARDs) were estimated by logistic regression models to examine the independent contribution of sociodemographic and clinical factors to low OHQoL and past-year unmet dental need, defined as inability to obtain all needed dental care. RESULTS More than half of participants reported low OHQoL (54%) and a past-year dental visit (61%). Over one-third (39%) had past-year unmet dental need. Financial barriers (ARR=3.16) and nonfinancial barriers (ARR=2.18) were associated with greater risk for past-year unmet dental need after control for age, gender, high dental anxiety, and limited English proficiency. ARDs for financial and nonfinancial barriers indicated absolute differences of 40 and 27 percentage points, respectively. Unmet dental need (ARR=1.31), xerostomia severity (ARR=1.20), and a schizophrenia spectrum diagnosis (ARR=1.33) were associated with low OHQoL, after control for age and current smoking, with ARDs ranging from 11 to 15 percentage points. CONCLUSIONS Improving oral health promotion, oral health service access, and the integration of the mental and oral health systems may help reduce the high prevalence of low OHQoL in this population, given that low OHQoL is partly driven by unmet dental need.
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Affiliation(s)
- Peter C Lam
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Dolly A John
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Hanga Galfalvy
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Carol Kunzel
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Roberto Lewis-Fernández
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
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Lutfiyya MN, Gross AJ, Soffe B, Lipsky MS. Dental care utilization: examining the associations between health services deficits and not having a dental visit in past 12 months. BMC Public Health 2019; 19:265. [PMID: 30836954 PMCID: PMC6402128 DOI: 10.1186/s12889-019-6590-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/25/2019] [Indexed: 12/15/2022] Open
Abstract
Background A growing literature supports the contention that closing the divide between dental and medical care can improve access to and coordination of patient care. Health service deficits (HSDs) entail: no routine medical exam, no personal healthcare provider (HCP), no health insurance, and/or delaying medical care because of cost all within the last 12 months. Examining the associations between HSDs and dental care utilization could inform strategies and interventions aimed at narrowing the gap between the medical and dental professions. This study explored whether HSDs are associated with not having a dental care visit within the last 12 months. In addition, the study sought to provide an updated analysis of the characteristics and factors associated with dental care utilization. Methods Two thousand sixteen Behavioral Risk Factor Surveillance System survey data were analyzed using bivariate and multivariable techniques. The outcome variable for this study was: last dental visit was longer than 12 months ago. Results US adults without healthcare insurance, without a personal HCP, who had delayed medical care because of cost, and who had their last routine medical visit longer than 12 months ago had greater odds of not having a dental visit within the last 12 months. Further, this study identified disparities in dental care utilization among males, rural residents, those earning less than $50,000 per year, Non-Hispanic Blacks and Non-Hispanic other races. Individuals with six or more and/or all of their permanent teeth removed and current smokers also had greater odds of not having had a dental care visit in the past 12 months. Conclusions Findings suggest that a stronger integration of medical and dental care might increase dental care utilization. In addition, persistent disparities in dental care utilization remain for several demographic groups. Targeted interventions offer the promise of helping achieve HP 2020 goals for improved oral health.
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Affiliation(s)
- M Nawal Lutfiyya
- Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA. .,College of Dental Medicine, Roseman University of Health Sciences, 10920 S. River Front Parkway, South Jordan, Utah, 84095, USA.
| | - Andrew J Gross
- College of Dental Medicine, Roseman University of Health Sciences, 10920 S. River Front Parkway, South Jordan, Utah, 84095, USA
| | - Burke Soffe
- College of Dental Medicine, Roseman University of Health Sciences, 10920 S. River Front Parkway, South Jordan, Utah, 84095, USA
| | - Martin S Lipsky
- College of Dental Medicine, Roseman University of Health Sciences, 10920 S. River Front Parkway, South Jordan, Utah, 84095, USA
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Assari S. Socioeconomic Status and Self-Rated Oral Health; Diminished Return among Hispanic Whites. Dent J (Basel) 2018; 6:E11. [PMID: 29695074 PMCID: PMC6023433 DOI: 10.3390/dj6020011] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 04/20/2018] [Accepted: 04/20/2018] [Indexed: 12/12/2022] Open
Abstract
Background. An extensive body of knowledge has documented weaker health effects of socio-economic status (SES) for Blacks compared to Whites, a phenomenon also known as Blacks’ diminished return. It is, however, unknown whether the same diminished return also holds for other ethnic minorities such as Hispanics or not. Aim. Using a nationally representative sample, the current study aimed to compare Non-Hispanic and Hispanic Whites for the effects of SES on self-rated oral health. Methods. For the current cross-sectional study, we used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001⁻2003. With a nationally representative sampling, CPES included 11,207 adults who were either non-Hispanic Whites (n = 7587) or Hispanic Whites (n = 3620. The dependent variable was self-rated oral health, treated as dichotomous measure. Independent variables were education, income, employment, and marital status. Ethnicity was the focal moderator. Age and gender were covariates. Logistic regressions were used for data analysis. Results. Education, income, employment, and marital status were associated with oral health in the pooled sample. Although education, income, employment, and marital status were associated with oral health in non-Hispanic Whites, none of these associations were found for Hispanic Whites. Conclusion. In a similar pattern to Blacks’ diminished return, differential gain of SES indicators exists between Hispanic and non-Hispanic Whites, with a disadvantage for Hispanic Whites. Diminished return of SES should be regarded as a systemically neglected contributing mechanism behind ethnic oral health disparities in the United States. Replication of Blacks’ diminished return for Hispanics suggests that these processes are not specific to ethnic minority groups, and non-White groups gain less because they are not enjoying the privilege and advantage of Whites.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor 48109-2700, MI, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor 48109-2700, MI, USA 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
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Rezaei S, Woldemichael A, Zandian H, Homaie Rad E, Veisi N, Karami Matin B. Dental health-care service utilisation and its determinants in West Iran: a cross-sectional study. Int Dent J 2017; 68:176-182. [PMID: 29171015 DOI: 10.1111/idj.12346] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Dental health care is not only an effective strategy for the prevention, early diagnosis and treatment of oral diseases but also contributes to the general health of communities. This study aimed to investigate the situation of dental health-care service utilisation and its determinants in Kermanshah city, western Iran, in 2015. METHODS AND MATERIALS A cross-sectional study on a total of 894 household heads was conducted. The participants were selected using a multistage sampling technique. A self-administered questionnaire was used to collect the data. Multiple logistic regression was performed to assess factors associated with utilisation of dental-care services and a negative binomial regression was carried out to identify the main factor associated with the frequency of visiting a dentist for dental health care. A statistically significant association was considered at a value of P < 0.05. All the analyses were performed using STATA version 12. FINDING Of the total household heads who participated in the study, 60.3% and 9.9% reported visiting a dentist for dental treatment in the past year and for 6-monthly dental check-ups, respectively. The average ± standard deviation number of visits by a respondent was 2.08 ± 2.97. Of the total number of respondents, 281 (31.4%) reported visiting a dentist once or twice in the last 12 months for dental health-care services, while 28.9% reported visiting a dentist more than twice in the same time period. Ageing, having dental insurance, higher income, being a university graduate, self-rated poor oral health and not regularly brushing own teeth were the main factors associated with utilisation of dental health-care services. CONCLUSION Our study indicates that dental health-care utilisation among households in the study area was influenced by a number of factors, including being socio-economically disadvantaged, self-rated poor oral health and not regularly brushing own teeth. Therefore, in this setting, dental-intervention programmes, including dental health insurance, should focus on mechanisms that can strengthen utilisation of preventive dental health-care services among disadvantaged households.
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Affiliation(s)
- Satar Rezaei
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abraha Woldemichael
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Hamed Zandian
- School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Navid Veisi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Rezaei S, Ghahramani E, Hajizadeh M, Nouri B, Bayazidi S, Khezrnezhad F. Dental care utilization in the west of Iran: a cross-sectional analysis of socioeconomic determinants. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTH CARE 2016. [DOI: 10.1108/ijhrh-06-2016-0008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Oral health is a major public health problem, both in developed and developing countries. The purpose of this paper is to examine the utilization of dental care and identify the main socioeconomic factors affecting the use of these services in the city of Sanandaj, west of Iran, in 2015.
Design/methodology/approach
A cross-sectional survey using multistage sampling was conducted to obtain information on the dental care visits of 520 head of households in Sanandaj. A self-administered questionnaire was used to collect data on the utilization of dental visits. Multivariable logistic regression was used to identify the main socioeconomic factors affecting the utilization of dental care in Sanandaj.
Findings
Results showed that 61.3 percent of the respondents visited a dentist at least once in the last year, of which 45 percent visited dentist for restoration, 27.9 percent had extraction and 10.3 percent had a dental checkup. The average number of dentist visits by respondents was 1.9. Regression results indicated a significant association between socioeconomic factors (e.g. income, educational level and employment status) and utilization of dental care.
Originality/value
This study suggested that dental care visit was influenced by socioeconomic status of households. Therefore, strategies aimed at improving dental care utilization for socioeconomically disadvantaged households (e.g. dental health insurance) are required to promote oral health among socioeconomically disadvantaged groups.
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Moosazadeh M, Amiresmaili M, Karimi S, Arabpoor M, Afshari M. APPRAISAL OF ACCESS TO DENTAL SERVICES IN SOUTH EAST OF IRAN USING FIVE AS MODEL. Mater Sociomed 2016; 28:196-200. [PMID: 27482161 PMCID: PMC4949035 DOI: 10.5455/msm.2016.28.196-200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/15/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Access to dental services not only refers to utilization but also to the extent by which the utilization is judged according to professional norms. This study aimed to study the access to dental services using the Five As model. METHODS This cross sectional study was conducted in southeast of Iran. A sample of 400 subjects participated in the study according to a multistage sampling method. A questionnaire was used for data collection. Data were analyzed using independent T test, ANOVA and multivariate linear regression models by means of SPSS V.20 software. FINDINGS Affordability, availability, accessibility, accommodation and acceptability mean scores were 58.2±12.2, 53.9±12.9, 59.4±15.7, 60.2±8.6, 70±11.5 and 60.3±7.4 respectively. According to multivariate linear regression models, there was significant associations between affordability and age, education level, having basic insurance and family income. Moreover, total accessibility was significantly correlated with education and monthly family income. CONCLUSION This study showed that access to dental services was at the moderate level among the studied population. It also revealed that age, basic insurance coverage, family income and level of education, are determinants of this accessibility.
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Affiliation(s)
- Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammadreza Amiresmaili
- Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Karimi
- School of Management and Medical Informatics, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahboobeh Arabpoor
- School of Management and Medical Informatics, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdi Afshari
- Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran
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12
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Abstract
Aim: In order to facilitate planning for dental health services and to progress strategies to continue the reduction in tooth loss, it is important to identify the factors that result in such loss. therefore the aim of the study is to investigate the major cause for tooth extraction. Objective: to examine whether the major reason for tooth extraction is dental caries or periodontal disease. Materials and Methods: The study is carried out among the dental practitioners in our district. A questionnaire containing 10 items was distributed to the dental practitioners, which included age, gender, no of teeth indicated for extraction, the reason for extraction, and the periodontal parameters that are involved with the extracted tooth and were requested to complete the form on every extraction they were to undertake. the study form was collected at the end of the study period and data was subjected to statistical analysis. Results: A total of 502 patients were enrolled during the study period, and a total of 1055 teeth were extracted for several reasons. we found that 51.14%extractions are due to dental caries in case of 20-30years age groups, which is more when compared to tooth loss due to periodontal diseases in this age group. whereas in case of >40years of age group periodontal diseases account for 54.11%, and dental caries accounts for only 29.11%. Showing more teeth were lost due to periodontal disease. Conclusion: therefore we concluded that, caries is the dominant reason for extraction in patients with 20–30 years of age while periodontal disease accounts for the majority of tooth extraction in patients older than 40 years.
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Affiliation(s)
- Sailavanya Nuvvula
- Department of Periodontics, Narayana Dental College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - Vijay Kumar Chava
- Department of Periodontics, Narayana Dental College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - Sivakumar Nuvvula
- Department of Pedodontics, Narayana Dental College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
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13
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Al-Sudani FYH, Vehkalahti MM, Suominen AL. Association of current employment status with oral health-related behaviors: findings from the Finnish Health 2000 Survey. Eur J Oral Sci 2016; 124:368-76. [DOI: 10.1111/eos.12276] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Fouad Y. H. Al-Sudani
- Department of Oral Public Health; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Miira M. Vehkalahti
- Department of Oral and Maxillofacial Diseases; Faculty of Medicine; University of Helsinki; Helsinki Finland
| | - Anna L. Suominen
- Department of Oral Public Health; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- The Living Environment and Health Unit; National Institute for Health and Welfare (THL); Kuopio Finland
- The Health Monitoring Unit; National Institute for Health and Welfare (THL); Helsinki Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
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14
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Kaul S, Fair D, Wright J, Kirchhoff AC. Dental Care for Survivors of Adolescent and Young Adult Cancer: Special Considerations. J Adolesc Young Adult Oncol 2016; 5:152-8. [PMID: 27028878 DOI: 10.1089/jayao.2015.0064] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Oral health is important for quality of life, but may be undermanaged for survivors of cancer. We examine dental care use and barriers among long-term survivors of adolescent and young adult (AYA) cancer in comparison to individuals without a history of cancer. METHODS The 2008-2012 Medical Expenditure Panel Survey (MEPS) identified 1216 individuals diagnosed with cancer at AYA ages (15-39 years), who were at least 5 years from diagnosis. A comparison group was matched using age, sex, and other factors. We evaluated self-reported dental visits in the previous 12 months, and inability and delay in receiving necessary dental care among survivors and the comparison group. Furthermore, individual factors associated with dental care use were identified using multivariable logistic regressions. RESULTS Of survivors, 60.86% reported no dental visits in the previous year compared to 51.96% of the comparison individuals (p < 0.001). Survivors were more likely to report inability (10.71% vs. 6.29%, p = 0.001) and delay (8.12% vs. 4.45%, p = 0.001) in getting necessary dental care than the comparison group. Notably, survivors without dental insurance were more likely to report inability and delay. Female survivors were more likely to use dental care than males (odds ratio = 1.76, 95% confidence interval 1.15-2.71, p = 0.01). Hispanic survivors, those diagnosed at younger ages, and uninsured survivors were less likely to have at least one dental visit. CONCLUSION Survivors of AYA cancer need timely surveillance to manage late effects, including dental complications. Yet, these survivors, particularly those who are uninsured, delay dental care more often than individuals from the general population. Survivor-specific interventions are needed to reduce dental care barriers.
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Affiliation(s)
- Sapna Kaul
- 1 Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas
| | - Douglas Fair
- 2 Pediatric Hematology/Oncology, University of Utah , Salt Lake City, Utah
| | - Jennifer Wright
- 3 Huntsman Cancer Institute and Pediatric Hematology/Oncology, University of Utah , Salt Lake City, Utah
| | - Anne C Kirchhoff
- 3 Huntsman Cancer Institute and Pediatric Hematology/Oncology, University of Utah , Salt Lake City, Utah
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Mosen D, Pihlstrom D, Snyder J, Smith N, Shuster E, Rust K. Association of Dental Care with Adherence to HEDIS Measures. Perm J 2015; 20:33-40. [PMID: 26580145 PMCID: PMC4732792 DOI: 10.7812/tpp/15-075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT The dental setting represents an unrealized opportunity to increase adherence to preventive services and improve health outcomes. OBJECTIVE To compare adherence to a subset of Healthcare Effectiveness Data and Information Set (HEDIS) measures among a population that received dental care with a population that did not receive dental care. DESIGN Using a retrospective cohort design, we identified 5216 adults who received regular dental care and 5216 persons who did not. The groups were matched on propensity scores, were followed for 3 years, and retained medical and dental benefits. Receipt of dental care was defined as 1 or more dental visits in each 12-month period. MAIN OUTCOME MEASURES Outcome measures were assessed in a subpopulation that qualified for 1 of 5 HEDIS denominator groups (dental = 4184 patients; nondental = 3871 patients). They included 3 preventive measures (cervical, colorectal, and breast cancer screening), 4 chronic disease management services (hemoglobin A1c and low-density lipoprotein cholesterol testing, and nephropathy and retinopathy screening among the diabetes mellitus [DM] population), and 4 health outcome measures (poor glycemic control, low-density lipoprotein cholesterol control, blood pressure control in the DM population, and blood pressure control in the hypertensive population). RESULTS Dental care was associated with higher adherence to all three cancer screening measures, one of four disease management services (higher retinopathy screening), and three of four health outcomes (better glycemic control in the DM population and better blood pressure control in the DM and hypertensive populations). CONCLUSIONS Dental care was associated with improved adherence to 7 of 11 HEDIS measures.
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Affiliation(s)
- David Mosen
- Senior Program Evaluation Consultant and Affiliate Investigator at The Center for Health Research in Portland, OR.
| | - Dan Pihlstrom
- Associate Director for Evidence-Based Care and Oral Health Research for Permanente Dental Associates in Portland, OR.
| | - John Snyder
- CEO and Dental Director for Permanente Dental Associates in Portland, OR.
| | - Ning Smith
- Biostatistician and Investigator for The Center for Health Research in Portland, OR.
| | - Elizabeth Shuster
- Research Analyst for The Center for Health Research in Portland, OR.
| | - Kristal Rust
- Statistical Research Analyst for The Center for Health Research in Portland, OR.
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Asgari F, Majidi A, Koohpayehzadeh J, Etemad K, Rafei A. Oral hygiene status in a general population of Iran, 2011: a key lifestyle marker in relation to common risk factors of non-communicable diseases. Int J Health Policy Manag 2015; 4:343-52. [PMID: 26029893 DOI: 10.15171/ijhpm.2015.18] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/28/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND To estimate Oral Hygiene (OH) status in the Iranian population in 2011, and to determine the influence of socio-economic characteristics on OH, and its interrelation with common risk factors of Non-Communicable Diseases (NCDs). METHODS Data including a total of 12,105 individuals aged 6-70 years were obtained from the sixth round of the surveys of NCDs risk factors in Iran. OH was recorded through a structured questionnaire measuring daily frequencies of tooth brushing and dental flossing. Descriptive analyses were performed on demographic characteristics in the complex sample survey setting. We also employed weighted binary logistic regression to compute Odds Ratio (OR) as a measure of association between the response and explanatory factors. Furthermore, to construct an asset index, we utilized Principal Component Analysis (PCA). RESULTS The percentage with minimum recommended daily OH practices was 3.7% among men and 7.7% among women (OR= 2.3; P<0.001). Urban citizens were more likely to have their teeth cleaned compared to rural people (OR= 2.8; P<0.001). For both genders, a relatively better condition was observed in the 25-34 age group (male: 5.6%; female: 10.3%). In addition, OH status improved significantly by increase in both level of education (P<0.001) and economic status (P<0.001). There were also apparent associations between self-care practices and specific behavioral risk factors, though the correlation with dietary habits and tobacco use could be largely explained by socio-economic factors. CONCLUSION OH situation in Iran calls for urgent need to assign proper interventions and strategies toward raising public awareness and reducing disparities in access to health facilities.
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Affiliation(s)
- Fereshteh Asgari
- Center for Disease Control and Prevention, Deputy for Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Azam Majidi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Jalil Koohpayehzadeh
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health, Shahid-Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Rafei
- National Program for Disease Registries and Health Outcomes, Deputy for Research, Ministry of Health and Medical Education, Tehran, Iran
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17
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Thompson B, Cooney P, Lawrence H, Ravaghi V, Quiñonez C. Cost as a barrier to accessing dental care: findings from a Canadian population-based study. J Public Health Dent 2014; 74:210-8. [DOI: 10.1111/jphd.12048] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 12/05/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Brandy Thompson
- Discipline of Dental Public Health; Faculty of Dentistry; University of Toronto; Toronto ON Canada
| | - Peter Cooney
- Office of the Canadian Oral Health Advisor; Public Health Agency of Canada; Ottawa ON Canada
| | - Herenia Lawrence
- Discipline of Dental Public Health; Faculty of Dentistry; University of Toronto; Toronto ON Canada
| | - Vahid Ravaghi
- Oral Health & Society Research Unit; Faculty of Dentistry; McGill University; Montreal QC Canada
| | - Carlos Quiñonez
- Discipline of Dental Public Health; Faculty of Dentistry; University of Toronto; Toronto ON Canada
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18
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Wu B, Liang J, Luo H, Furter R. Racial and Ethnic Variations in Preventive Dental Care Utilization among Middle-Aged and Older Americans, 1999-2008. Front Public Health 2013; 1:65. [PMID: 24386632 PMCID: PMC3866511 DOI: 10.3389/fpubh.2013.00065] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 11/21/2013] [Indexed: 12/22/2022] Open
Abstract
Objective: This study examined recent trends of preventive dental care utilization among Americans aged 50 and above, focusing on variations across racial and ethnic groups including Whites, Blacks, Hispanics, American Indians/Alaska Natives, and Asians. Methods: Self-reported information on oral health behaviors was collected from 644,635 participants in the Behavioral Risk Factor Surveillance System between 1999 and 2008. Results: Despite a significant upward trend of frequency of dental cleaning from 1999 to 2008 (OR = 1.02), in 2008 still only 56–77% of any ethnic or racial group reported having had a dental cleaning in the previous 12 months. Relative to Whites, Blacks (OR = 0.65) were less likely to have a dental cleaning in the previous 12 months. These variations persisted even when SES, health conditions, health behaviors, and number of permanent teeth were controlled. In contrast, Hispanics, Asians, and American Indians/Alaskan Natives did not differ from Whites in dental cleanings. Discussion: This is the first study to provide national estimates of the frequency of dental cleaning and associated trends over time for five major ethnic groups aged 50 and above in the U.S. simultaneously. Our findings suggest that public health programs with an emphasis on educating middle-aged and older minority populations on the benefits of oral health could have a large impact, as there is much room for improvement. Given the importance of oral health and a population that is rapidly becoming older and more diverse, the need for improved dental care utilization is significant.
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Affiliation(s)
- Bei Wu
- School of Nursing, Global Health Institute, Duke University , Durham, NC , USA
| | - Jersey Liang
- School of Public Health, University of Michigan , Ann Arbor, MI , USA
| | - Huabin Luo
- East Carolina University , Greenville, NC , USA
| | - Robert Furter
- University of North Carolina at Greensboro , Greensboro, NC , USA
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The association between maternal oral health experiences and risk of preterm birth in 10 states, Pregnancy Risk Assessment Monitoring System, 2004-2006. Matern Child Health J 2013; 16:1688-95. [PMID: 21847677 DOI: 10.1007/s10995-011-0870-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aim of this study is to investigate the association between oral health experiences of women in the peripartum period and the risk of preterm delivery (<37 weeks). We analyzed 2004-2006 data from the CDC Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based surveillance system that collects data on pregnancy and postpartum experiences of mothers who have recently delivered a live infant. Ten states included in the analysis had a ≥70% weighted response rate and three standard questions pertaining to oral health. White non-Hispanic (WNH), Black non-Hispanic (BNH), and Hispanic women were selected for analysis. Chi-squared analysis was performed for our bivariate analysis and multivariate logistic regression models were created to calculate adjusted odds ratios, controlling for socio-demographic characteristics and peripartum morbidities. Weighted percentages and standard errors were used for all analyses. Among the 35,267 women studied, in the multivariate analysis, mothers who did not receive dental care during pregnancy and did not have a teeth cleaning during pregnancy were at higher risk for delivering a preterm infant (OR 1.15, CI 1.02-1.30; OR 1.23, CI 1.08-1.41). In this population-based study, women who did not receive dental care or have a teeth cleaning during pregnancy were at slightly higher risk for preterm delivery after adjustment for pertinent confounders.
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20
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Lockhart PB, Blizzard J, Maslow AL, Brennan MT, Sasser H, Carew J. Drug cost implications for antibiotic prophylaxis for dental procedures. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:345-53. [DOI: 10.1016/j.oooo.2012.10.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 10/01/2012] [Accepted: 10/12/2012] [Indexed: 11/28/2022]
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21
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Vashisth S, Gupta N, Bansal M, Rao NC. Utilization of services rendered in dental outreach programs in rural areas of Haryana. Contemp Clin Dent 2012; 3:S164-6. [PMID: 23230354 PMCID: PMC3514936 DOI: 10.4103/0976-237x.101076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: The availability of oral health services are very scarce in rural India; therefore the unmet treatment needs of rural population are very high. Hence, a retrospective study was conducted to evaluate the types of patients, disease pattern, and services rendered in outreach programs in rural areas of Haryana. Materials and Methods: A The data were obtained from records of outreach programs conducted, in last 3 months, by Swami Devi Dyal Hospital and Dental College. The data from were analyzed using descriptive statistics. Results: A total of 1371 individuals in the age group of 4--70 years (56.8% males and 43.2% females) attended the outreach program seeking the treatment. Dental caries (43.7%), gingivitis (27.2%), and periodontitis (22.9%) were commonly observed dental diseases. The services provided were oral prophylaxis (51.2%), restoration (22.9%), referral (20%), and extractions (8.8%). Conclusion: The attendance and utilization of dental services in the out reach programs seem to be influenced by sociodemographic characteristics of the population.
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Affiliation(s)
- Shelja Vashisth
- Department of Public Health Dentistry, Swami Devi Dyal Hospital and Dental College, Golpura, Barwala, Distt. Panchkula, India
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Respondents in an epidemiologic survey had fewer psychotropic prescriptions than nonrespondents: an insight into health-related selection bias using routine health insurance data. J Clin Epidemiol 2012; 65:1181-9. [DOI: 10.1016/j.jclinepi.2012.05.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 04/25/2012] [Accepted: 05/09/2012] [Indexed: 01/03/2023]
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23
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Siegel K, Schrimshaw EW, Kunzel C, Wolfson NH, Moon-Howard J, Moats HL, Mitchell DA. Types of dental fear as barriers to dental care among African American adults with oral health symptoms in Harlem. J Health Care Poor Underserved 2012; 23:1294-309. [PMID: 24212175 PMCID: PMC3859136 DOI: 10.1353/hpu.2012.0088] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To examine the types of dental fear experienced by African American adults and the role of these fears in the utilization of dental care, in-depth interviews were conducted with a street-intercept sample of 118 African Americans living in Harlem, New York City, who had experienced at least one oral health symptom in the past six months. Despite their oral symptoms, participants delayed or avoided dental care (often for years) due to a variety of dental fears, including fears of: 1) pain from needles; 2) the dental drill; 3) having teeth extracted; 4) contracting an illness (e.g., HIV/AIDS) from unsanitary instruments; 5) X-rays; 6) receiving poor quality care or mistreatment. These findings provide insights into the situations that provoke fears about dental treatment among African Americans and suggest strategies to address these fears in order to remove these barriers and increase the utilization of dental care by African American adults.
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24
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Anderson CN, Noar SM, Rogers BD. The persuasive power of oral health promotion messages: a theory of planned behavior approach to dental checkups among young adults. HEALTH COMMUNICATION 2012; 28:304-313. [PMID: 22742562 DOI: 10.1080/10410236.2012.684275] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although routine dental checkups are important for both oral and overall health, several factors influence young adults' use or nonuse of dental services. The two studies included in this report tested the theory of reasoned action (TRA), the theory of planned behavior (TPB), and an expanded TPB model in predicting young adults' routine dental checkups. Additionally, the study tested the perceived message effectiveness of TPB-based messages. Results support the use of an expanded TPB model (particularly adding satisfaction with the dentist and environmental constraints to the traditional model) for an understanding of routine dental checkup intention and behavior, and, most notably, provide support for the use of subjective norm-based messages to prompt dental checkups. This study lays the groundwork for a health communication campaign encouraging routine dental checkups among young adults. The use of targeting and tailoring to design effective oral health media campaign messages is discussed.
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Affiliation(s)
- Christina N Anderson
- Department of Communication, Costal Carolina University, 133 W. Chanticleer Drive, Edwards College of Humanitres and Fine Arts, Conway, SC 29528-6054, USA.
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25
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Grytten J, Holst D, Skau I. Demand for and utilization of dental services according to household income in the adult population in Norway. Community Dent Oral Epidemiol 2012; 40:297-305. [PMID: 22239170 DOI: 10.1111/j.1600-0528.2011.00659.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to describe the effect of income on demand and utilization of dental services according to household income in the adult population. METHODS The data were collected using a questionnaire, which was sent to a random sample of Norwegians aged 20 years or older living at home, 1861 persons in total. Demand was measured according to whether the person had been to the dentist during the last year. Utilization was measured as expenditure for dental treatment for those who had been to the dentist during the last year. The independent variables were the respondents' household income, age, gender, education, dental status and the mean fee for a dental consultation in the municipality. In the first stage, we carried out a logistic regression analysis of the log odds of having demanded dental services during the last year. In the second stage, we carried out a multiple regression analysis of expenditure for dental treatment for those who had been to the dentist during the last year. RESULTS Altogether, 80% of the respondents had been to the dentist during the last year. Demand during the last year varied most according to dental status. There was little difference between men and women. The results of the logistic regression showed that the probability of having been to the dentist was 0.82 for those with a household income of €25 000 and 0.85 for those with a household income of €100 000. Mean expenditure for dental treatment was €355. There was no statistically significant relationship between household income and expenditure for dental treatment. CONCLUSIONS Differences in demand for dental services according to household income are small, and there are no differences in utilization according to income. The findings are interesting, because in a population in which people have to pay almost all the costs for dental treatment themselves, one would expect the income differences in demand and utilization to be greater.
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Affiliation(s)
- Jostein Grytten
- Department of Community Dentistry, University of Oslo, Oslo, Norway.
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26
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Schrimshaw EW, Siegel K, Wolfson NH, Mitchell DA, Kunzel C. Insurance-related barriers to accessing dental care among African American adults with oral health symptoms in Harlem, New York City. Am J Public Health 2011; 101:1420-8. [PMID: 21680926 DOI: 10.2105/ajph.2010.300076] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Although ability to pay is associated with dental care utilization, provision of public or private dental insurance has not eliminated dental care disparities between African American and White adults. We examined insurance-related barriers to dental care in interviews with a street-intercept sample of 118 African American adults in Harlem, New York City, with recent oral health symptoms. Although most participants reported having dental insurance (21% private, 50% Medicaid), reported barriers included (1) lack of coverage, (2) insufficient coverage, (3) inability to find a dentist who accepts their insurance, (4) having to wait for coverage to take effect, and (5) perceived poor quality of care for the uninsured or underinsured. These findings provide insights into why disparities persist and suggest strategies to removing these barriers to dental care.
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Affiliation(s)
- Eric W Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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27
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Eke PI, Jaramillo F, Thornton-Evans GO, Borgnakke WS. Dental visits among adult Hispanics - BRFSS 1999 and 2006. J Public Health Dent 2011. [DOI: 10.1111/j.1752-7325.2011.00259.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Wu B, Liang J, Plassman BL, Remle RC, Bai L. Oral health among white, black, and Mexican-American elders: an examination of edentulism and dental caries. J Public Health Dent 2011; 71:308-17. [PMID: 22320289 PMCID: PMC3281551 DOI: 10.1111/j.1752-7325.2011.00273.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To examine racial/ethnic disparities in oral health among older Americans. METHODS Differences in frequency of edentulism and number of decayed, missing, and filled teeth were assessed in 2,679 non-Hispanic white, 742 non-Hispanic black, and 934 Mexican-American individuals aged 60 and older from the National Health and Nutrition Examination Survey (1999-2004). RESULTS Controlling for potential confounding variables, blacks and Mexican-Americans had significantly higher numbers of decayed teeth but fewer numbers of filled teeth than whites. Although blacks had a lower likelihood of being edentulous than whites, dentate blacks had a higher number of missing teeth. Compared with whites, Mexican-Americans were less likely to be edentulous, and dentate Mexican-Americans had fewer missing teeth. Our study also showed that blacks and Mexican-Americans had less frequent dental checkups than whites. CONCLUSIONS Oral health disparities are persistent across racial/ethnic groups for older Americans despite the fact that the differences between groups typically diminish when socioeconomic, health-related, and behavioral factors are considered in the models. Our study suggests that reducing racial/ethnic oral health disparities requires multiple clinical approaches.
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Affiliation(s)
- Bei Wu
- School of Nursing, Duke University, Durham, NC, USA.
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Kaylor MB, Polivka BJ, Chaudry R, Salsberry P, Wee AG. Dental insurance and dental service use by U.S. women of childbearing age. Public Health Nurs 2011; 28:213-22. [PMID: 21535106 DOI: 10.1111/j.1525-1446.2010.00914.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Oral health has a significant effect on health, and for women, poor oral health can lead to poor birth outcomes and can affect their child's health. Nursing interventions to improve the oral health of at-risk women have the potential to increase maternal and child systemic and oral health. The identification of women at a high risk for poor oral health is a necessary to develop and evaluate these interventions. DESIGN AND SAMPLE This study examined the factors related to dental insurance and dental service use for women of childbearing age in the United States. A secondary analysis of the 2003-2004 National Health and Nutrition Examination Survey was completed to examine the predisposing, enabling, and need variables associated with dental insurance status and dental service use in a representative random sample of 1,071 women. RESULTS The results showed that over 40% of women had no dental insurance. Women with less education, lower income, and dental need were significantly less likely to have dental insurance. Dental utilization by the uninsured was low and a racial/ethnic disparity was noted. CONCLUSION A lack of dental insurance and dental service utilization is a significant concern. Nurses working with low-income women should educate the population about oral health and advocate for policies to increase dental insurance coverage.
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Affiliation(s)
- Mary Beth Kaylor
- Wright State University College of Nursing and Health, Dayton, Ohio 45435, USA.
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Racial/Ethnic Disparities in Maternal Oral Health Experiences in 10 States, Pregnancy Risk Assessment Monitoring System, 2004–2006. Matern Child Health J 2010; 15:722-9. [DOI: 10.1007/s10995-010-0643-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dental Services Utilization by Women of Childbearing Age by Socioeconomic Status. J Community Health 2009; 35:190-7. [DOI: 10.1007/s10900-009-9214-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Medina-Solís CE, Villalobos-Rodelo JJ, Márquez-Corona MDL, Vallejos-Sánchez AA, Portillo-Núñez CL, Casanova-Rosado AJ. Desigualdades socioeconómicas en la utilización de servicios de salud bucal: estudio en escolares mexicanos de 6 a 12 años de edad. CAD SAUDE PUBLICA 2009; 25:2621-31. [DOI: 10.1590/s0102-311x2009001200009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 09/30/2009] [Indexed: 11/21/2022] Open
Abstract
El objetivo del estudio fue evaluar la asociación entre diversos indicadores socioeconómicos y la utilización de servicios de salud bucal. Se realizó un estudio transversal en 3.048 escolares. La variable utilización de servicios de salud bucal y las variables sociodemográficas y socioeconómicas se colectaron a través de un cuestionario dirigido a las madres. Para determinar las necesidades de salud se realizó un examen clínico bucal a los niños. Las asociaciones ajustadas fueron evaluadas con regresión logística politómica. Las variables asociadas a servicios preventivos y curativos fueron mayor edad, mayor frecuencia de cepillado y menor edad al inicio de cepillado dental, tener seguro público o privado, y mejor nivel socioeconómico. Además, sólo para los servicios preventivos, también se asoció estar inscrito en una escuela privada, y sólo para los servicios curativos, la posesión de automóvil y tener necesidades de salud bucal entre moderadas y muy altas. Los resultados sugieren la existencia de desigualdades socioeconómicas en la utilización de servicios de salud bucal en niños mexicanos.
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Affiliation(s)
| | | | | | | | - Carlos López Portillo-Núñez
- Delegación del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, México; Universidad Autónoma de Sinaloa, México
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Fletcher JM, Frisvold DE. Higher Education and Health Investments: Does More Schooling Affect Preventive Health Care Use? JOURNAL OF HUMAN CAPITAL 2009; 3:144-176. [PMID: 22368727 PMCID: PMC3285406 DOI: 10.1086/645090] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
While it is well-known that individuals with higher levels of education consume more preventive medical care, there are several potential explanations for this stylized fact. These explanations include causal and non-causal mechanisms, and distinguishing among explanations is relevant for accessing the importance of educational spillovers on lifetime health outcomes as well as uncovering the determinants of preventive care. In this paper, we use regression analysis, sibling fixed effects, and matching estimators to examine the impact of education on preventive care. In particular, we use a cohort of 10,000 Wisconsin high school graduates that has been followed for nearly 50 years and find evidence that attending college is associated with an increase in the likelihood of using several types of preventive care by approximately five to fifteen percent for college attendees in the early 1960s. We also find that greater education may influence preventive care partly through occupational channels and access to care. These findings suggest that increases in education have the potential to spillover on long-term health choices.
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Affiliation(s)
- Jason M. Fletcher
- School of Public Health, Division of Health Policy and Administration, Yale University, 60 College Street, New Haven, CT 06510, USA
| | - David E. Frisvold
- Department of Economics, Emory University, Atlanta, GA 30322-2240, USA
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Martins AMEDBL, Haikal DS, Pereira SM, Barreto SM. Uso de serviços odontológicos por rotina entre idosos brasileiros: Projeto SB Brasil. CAD SAUDE PUBLICA 2008; 24:1651-66. [DOI: 10.1590/s0102-311x2008000700020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Accepted: 12/21/2007] [Indexed: 11/22/2022] Open
Abstract
Investigou-se o uso de serviços odontológicos por rotina entre idosos brasileiros participantes do Projeto SB Brasil. Desses, 2.305 eram dentados, 2.704, edentados, a prevalência do uso foi de 20% e 17%, respectivamente. A regressão logística mostrou que, entre dentados, o uso foi maior entre aqueles com maior escolaridade e menor entre residentes no Norte e Nordeste; na zona rural; que não usaram no último ano; que não foram informados sobre como evitar problemas bucais; que relataram dor; que necessitavam de próteses e de tratamento periodontal; que autoperceberam sua mastigação regular; cuja condição bucal afetava o relacionamento; que autoperceberam sua fala ruim/péssima. Entre edentados, o uso por rotina foi maior entre aqueles com maior escolaridade e entre usuários de serviços pagos. Foi menor entre não brancos; residentes no nordeste; na zona rural; que não usaram no último ano; que não foram informados sobre como evitar problemas bucais; os com menor renda; que necessitavam de prótese; cuja condição bucal afetava o relacionamento. Iniqüidades, barreiras financeiras e falta de informações parecem prejudicar o uso rotineiro, indicando necessidade de políticas públicas.
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Acculturation and orofacial pain among Hispanic adults. THE JOURNAL OF PAIN 2008; 9:750-8. [PMID: 18456564 DOI: 10.1016/j.jpain.2008.03.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 03/20/2008] [Accepted: 03/21/2008] [Indexed: 11/22/2022]
Abstract
UNLABELLED This study examined the associations between acculturation and orofacial pain and healthcare among Hispanic adults. Understanding the effects of acculturation on Hispanic oral health may improve understanding of oral health disparities in the United States. Data were collected from 911 Hispanic adults reporting tooth pain and painful oral sores who were part of a larger study of South Florida residents conducted using random-digit dialing methodology. The survey was conducted in Spanish or English by bilingual interviewers per the choice of each respondent. Greater use of the Spanish language was associated with disparities in healthcare visits for orofacial pain, not having a usual dentist, having greater pain, increased difficulty eating and sleeping, and more depression. Respondents' and their parents' nativity (families that had been in the United States longer) and those identifying more closely to Hispanic culture were also predictive of several of the outcomes. Gender, financial status, and age, independent of acculturation, were also associated with orofacial pain, accessing health care, and pain-related loss of functioning among Hispanics. The data support the hypothesis that Hispanics with less acculturation are less able to access needed oral health care. This study highlights the need for outreach programs targeting recent Hispanic immigrants focusing on oral health care. PERSPECTIVE This study found that lower levels of acculturation, particularly less frequent use of English, were associated with greater oral pain and depression for Hispanics adults. This emphasizes the need to provide Hispanic patients with information in Spanish and the importance of having bilingual materials and staff in dental clinics.
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Oosterink FMD, de Jongh A, Aartman IHA. What are people afraid of during dental treatment? Anxiety-provoking capacity of 67 stimuli characteristic of the dental setting. Eur J Oral Sci 2008; 116:44-51. [PMID: 18186731 DOI: 10.1111/j.1600-0722.2007.00500.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Relatively little is known about the anxiety-provoking capacity of the various objects and situations characteristic of the dental setting. The aims of the current study were to establish a hierarchy of anxiety-provoking capacities of a large set of dental stimuli and to determine the differences in relation to gender, age, ethnicity, and level of dental trait anxiety. An additional aim was to derive an estimate of the number of stimuli to be presented to anxious patients in order to obtain full coverage of their dental fears. A questionnaire describing 67 potentially anxiety-provoking stimuli was constructed and presented to 960 adults. The results indicated that invasive stimuli (e.g. surgical procedures) were rated as the most anxiety provoking and that non-invasive stimuli (e.g. the dentist as a person) were the least anxiety provoking. The fear-evoking capacity of the dental stimuli varied with gender, age, ethnicity, and level of dental trait anxiety, whereas the rank order of these stimuli appeared to be independent of these factors. Furthermore, it appeared that the top 25 most anxiety-provoking objects and situations found in the current study contained only eight (28%) stimuli, which had been taken into account in previous research. The present findings support the need for assessment procedures using a broad spectrum of potentially anxiety-provoking stimuli.
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Affiliation(s)
- Floor M D Oosterink
- Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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Christensen LB, Petersen PE, Steding-Jessen M. Consumption of dental services among adults in Denmark 1994?2003. Eur J Oral Sci 2007; 115:174-9. [PMID: 17587291 DOI: 10.1111/j.1600-0722.2007.00453.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of the present study was to measure the consumption of dental services among adults in Denmark and to analyze at what level socio-demographic/socio-economic factors influence dental attendance and oral examinations. A sample of 10% of the total population of 18 yr or older was randomly drawn from a population register, based on a cross-sectional design. Information on the use of dental services was retrieved from public registers along with data on gender, age-group, regions, ethnicity, education, marital status, and income. In addition, a cohort of persons was drawn from the sample in 1999 including only persons who were registered as residents in Denmark from 1999 to 2003. Over time, an increase in the number of dental visits and oral examinations was found among persons older than 45 yr, whereas a decrease was observed in the younger age-groups. Logistic regression analysis was applied to determine the effect of various variables on the experience of dental visits and oral examinations, and relatively high odds for dental attendance and oral examinations was found for the following: younger adults; women; married persons; high income; high education; and persons of Danish origin. The present dental healthcare system does not yet seem to have established mechanisms to address social inequalities in the consumption of dental services.
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Affiliation(s)
- Lisa B Christensen
- Department for Community Dentistry and Graduate Studies, University of Copenhagen, Copenhagen, Denmark.
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Tilashalski KR, Gilbert GH, Boykin MJ, Litaker MS. Racial differences in treatment preferences: oral health as an example. J Eval Clin Pract 2007; 13:102-8. [PMID: 17286731 DOI: 10.1111/j.1365-2753.2006.00661.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Recent analyses from the Florida Dental Care Study found that response to a hypothetical scenario at baseline strongly predicted: (a) tooth loss during follow-up; and (b) subsequent receipt of either a dental extraction or Root Canal Therapy (RCT). The scenario ('CHOICE') required choosing either to: (1) extract the tooth before even knowing the cost of treatments; (2) extract, but after knowing the cost of all treatments; or (3) have RCT despite knowing costs. OBJECTIVE The purpose of this study was to identify factors associated with CHOICE and quantify their effects. METHODS As part of the baseline phase of the study, 873 subjects with at least one tooth and who were 45 years or older participated for an interview and dental examination. A multinomial multivariable regression of CHOICE quantified effects due to hypothesized predictors. RESULTS CHOICE was strongly associated with race (African-Americans were significantly less likely to choose RCT). Results from the multivariable regression suggest that the race effect could be explained by racial differences in patient preference, treatment acceptability and ability to afford treatment. CONCLUSIONS There were substantial racial differences in treatment preference even in this hypothetical scenario where racial differences in patient-provider interaction and clinical factors were not relevant. Certain predisposing and enabling variables explained these racial differences in treatment preference.
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Affiliation(s)
- Ken R Tilashalski
- Department of Diagnostic Sciences, School of Dentistry, University of Alabama at Birmingham, AL 35294-0007, USA.
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MacDonald DE. Principles of geriatric dentistry and their application to the older adult with a physical disability. Clin Geriatr Med 2006; 22:413-34; x. [PMID: 16627086 DOI: 10.1016/j.cger.2005.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The older adult living with a physical disability faces many daily challenges. Limited hand function or impaired cognition often has profound effects on activities of daily life including oral hygiene. This article explores age-related changed in dentition and common causes of pathology of the oral cavity with special emphasis in populations with impaired hand function or cognition. This article will also assist the treating physician as it relates to oral diagnosis and patient management.
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Affiliation(s)
- Daniel E MacDonald
- Division of Periodontology, Columbia University College of Dental medicine, and Division of Mineralized Tissue Research, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
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Holm-Pedersen P, Vigild M, Nitschke I, Berkey DB. Dental Care for Aging Populations in Denmark, Sweden, Norway, United Kingdom, and Germany. J Dent Educ 2005. [DOI: 10.1002/j.0022-0337.2005.69.9.tb03995.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Poul Holm-Pedersen
- Copenhagen Gerontological Oral Health Research Center; University of Copenhagen; School of Dentistry; Copenhagen Denmark
| | - Merete Vigild
- School of Oral Health Care; University of Copenhagen; Copenhagen Denmark
| | - Ina Nitschke
- Department of Prosthetic Dentistry and Dental Materials; University of Leipzig; Germany
| | - Douglas B. Berkey
- Department of Applied Dentistry; University of Colorado School of Dentistry; Total Longterm Care; Denver Colorado U.S.A
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Siqueira JF, Jung IY, Rôças IN, Lee CY. Differences in prevalence of selected bacterial species in primary endodontic infections from two distinct geographic locations. ACTA ACUST UNITED AC 2005; 99:641-7. [PMID: 15829891 DOI: 10.1016/j.tripleo.2004.07.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study intended to compare the prevalence of 7 putative endodontic pathogens in samples of primary endodontic infections taken from patients of 2 distant geographic locations. STUDY DESIGN Samples from infected root canals associated with asymptomatic periradicular lesions or from pus aspirated from acute periradicular abscesses were collected from patients in Rio de Janeiro, Brazil, and Seoul, South Korea. South Korean samples were frozen and delivered to Brazil, where all steps in the molecular analysis were performed. DNA was extracted and a species-specific nested polymerase chain reaction assay was used to detect 7 target bacterial species. RESULTS The most prevalent species detected in Brazilian samples were Porphyromonas endodontalis (79% of the cases) , Treponema denticola (79%), and Dialister pneumosintes (76%). The most prevalent species found in South Korean samples were Fusobacterium nucleatum (38% of the cases) , Tannerella forsythia (26%), and Treponema maltophilum (24%). Overall, P endodontalis, D pneumosintes, Filifactor alocis, T denticola, and T forsythia were significantly more detected in Brazilian samples than in South Korean samples ( P < .05). CONCLUSIONS Findings indicated that the prevalence of some species in infections of endodontic origin may significantly differ from one geographic location to another.
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Affiliation(s)
- José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Federal University of Rio de Janeiro, Brazil.
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Ståhlnacke K, Söderfeldt B, Unell L, Halling A, Axtelius B. Changes over 5 years in utilization of dental care by a Swedish age cohort. Community Dent Oral Epidemiol 2005; 33:64-73. [PMID: 15642048 DOI: 10.1111/j.1600-0528.2004.00198.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the temporal development of the utilization of dental care, in relation to socio-economic factors and also considering perceived oral health, attitudes to dental care, dental anxiety, care organisation and changes in the way that dental care is paid for. A conflict model was used as a theoretical framework. METHODS In 1992, a mail questionnaire was sent to all 50-year-old persons in two counties in Sweden, Orebro and Ostergotland, as part of a cross-sectional study. This study group numbered 8888 persons. In 1997, the same population was sent a new questionnaire. There were 5363 persons who completed the questionnaire in both 1992 and 1997. Changes in utilization of dental care were analysed. RESULTS An increase in personal expenditure for care was obvious, 42% paid more in 1997 compared with 1992. In the study, 7% had prolonged their time since most recent visit and 12% had less frequent visits. In regression models, education, occupation, place of residence, country of birth, marital status, gender, dental anxiety, having poor perceived oral health and poor general health were associated with utilization. Care organisation factors showed there was a greater probability of having higher utilization and higher cost of care when private practitioners provided the care. CONCLUSION Small changes in the utilization of dental care occurred during this study time. Inequality in utilization existed and socio-economic factors affected utilization as well as health perception and dental anxiety. Changes in the cost of care did not affect utilization appreciably, probably because of a selected population with high price elasticity. Having a private care provider compared with one in the public system affected the probability of having higher utilization and higher cost for care.
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Affiliation(s)
- Katri Ståhlnacke
- Community Dental Office, Orebro County Council, Box 1613, SE-70116 Orebro, Sweden.
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Slaughter A, Smith VJ, Taylor L. Progressing toward a more culturally competent approach to dental care for African American elders. SPECIAL CARE IN DENTISTRY 2005; 24:301-7. [PMID: 15686280 DOI: 10.1111/j.1754-4505.2004.tb01709.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study was conducted to understand perceptions that may influence oral self-care behaviors among elderly African American adults living in an urban community. Four focus groups at two senior centers were recruited, involving a total of 25 participants. Content analysis and ethnographic summaries were used to identify themes, common concepts and language. The results indicated that although the participants recognized the advantages of routine brushing, the importance of keeping teeth clean to prevent gum disease was not widely acknowledged. On the basis of these focus groups, the authors suggest that health promotion approaches for adults who are elderly should be linked to the audience's cultural norms and perceptions regarding the benefits of oral hygiene practices.
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Affiliation(s)
- Ann Slaughter
- Dept. of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104-6030 USA.
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Heaton LJ, Smith TA, Raybould TP. Factors Influencing Use of Dental Services in Rural and Urban Communities: Considerations for Practitioners in Underserved Areas. J Dent Educ 2004. [DOI: 10.1002/j.0022-0337.2004.68.10.tb03853.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Lisa J. Heaton
- Departments of Psychology and Behavioral Science; University of Kentucky
| | - Timothy A. Smith
- Department of Behavioral Science; University of Kentucky College of Medicine
| | - Ted P. Raybould
- General Dentistry and Preventive Medicine and Director General Practice Residency and Adult Special Patient Care; University of Kentucky College of Dentistry
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Riley JL, Gilbert GH, Heft MW. Oral health attitudes and communication with laypersons about orofacial pain among middle-aged and older adults. Pain 2004; 107:116-24. [PMID: 14715397 DOI: 10.1016/j.pain.2003.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Communication patterns with persons outside the health care system during a pain episode are poorly understood, yet can have a significant influence on patient behavior. This study examined associations between attitudes and beliefs about oral disease and dental care and talking about orofacial pain with laypersons and health care professionals. The subjects were 724 participants in the Florida Dental Care Study, a longitudinal study of oral health among community-dwelling adults. This study used a prospective design with data collected at baseline and the 42-month follow-up using a standardized interview format. Persons with negative attitudes and beliefs were more likely to have talked to a layperson about pain and less likely to have talked to a health care provider. In addition, the attitude that most consistently differentiated between respondents who had communicated only with a layperson from those who had talked to a health care provider was quality of recent visits, a variable representing more of the interpersonal aspects of a health care visit than the eventual outcomes from the treatment received. Our data are consistent with the hypothesis that lay consultation during a pain episode may substitute for formal care for persons with less positive views of the health care system. Intensity ratings and temporal characteristics of pain were also important determinants of these pain-related communication patterns. These findings emphasize the importance of understanding the communication between persons with pain and non-health care professionals, and how these attitudes and communication preferences relate to the management of pain.
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Affiliation(s)
- Joseph L Riley
- Division of Public Health Services and Research, College of Dentistry, University of Florida, P.O. Box 100404 HSC, Gainesville, FL 32610-0404, USA.
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Griffith J. Establishing a Dental Practice in a Rural, Low-Income County Health Department. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2003; 9:538-41. [PMID: 14606194 DOI: 10.1097/00124784-200311000-00015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Historically, county health departments have not been responsible for providing dental care to needy citizens. However, as the need for dental care among indigent and low-income citizens has grown health departments are being called on to provide these necessary services. This article describes one local board of health's effort to establish a dental program within a large rural county. The board of health directed the local county health department to purchase and operate a mobile dental clinic, build a permanent dental facility, recruit a dental staff, and most important, provide the financial resources to pay for the program.
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Affiliation(s)
- Jack Griffith
- Pender County Health Department, 803 S. Walker Street, Burgaw, NC 28425, USA
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Gilbert GH, Shah GR, Shelton BJ, Heft MW, Bradford EH, Chavers LS. Racial differences in predictors of dental care use. Health Serv Res 2002; 37:1487-507. [PMID: 12546283 PMCID: PMC1464042 DOI: 10.1111/1475-6773.01217] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To test five hypotheses that non-Hispanic African Americans (AAs) and non-Hispanic whites (NHWs) differ in responsiveness to new dental symptoms by seeking dental care, and differ in certain predictors of dental care utilization. DATA SOURCES/STUDY SETTING Florida Dental Care Study, comprising AAs and NHWs 45 years old or older, who had at least one tooth, and who lived in north Florida. STUDY DESIGN We used a prospective cohort design. The key outcome of interest was whether dental care was received in a given six-month period, after adjusting for the presence of certain time-varying and fixed characteristics. DATA COLLECTION/EXTRACTION METHODS In-person interviews were conducted at baseline and 24 months after baseline, with six-monthly telephone interviews in between. PRINCIPAL FINDINGS African Americans were less likely to seek dental care during follow-up, with or without adjusting for key predisposing, enabling, and oral health need characteristics. African Americans were more likely to be problem-oriented dental attenders, to be unable to pay an unexpected $500 dental bill, and to report postbaseline dental problems. However, the effect of certain postbaseline dental signs and symptoms on postbaseline dental care use differed between AAs and NHWs. Although financial circumstance was predictive for both groups, it was more salient for NHWs in separate NHW and AA regressions. Frustration with past dental care, propensity to use a homemade remedy, and dental insurance were significant predictors among AAs, but not among NHWs. The NHWs were much more likely to have sought care for preventive reasons. CONCLUSIONS Racial differences in responsiveness to new dental symptoms by seeking dental care were evident, as were differences in other predictors of dental care utilization. These differences may contribute to racial disparities in oral health.
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Affiliation(s)
- Gregg H Gilbert
- Department of Diagnostic Sciences, University of Alabama School of Dentistry, Birmingham 35294-0007, USA
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Riley JL, Gilbert GH, Heft MW. Race/ethnic differences in health care use for orofacial pain among older adults. Pain 2002; 100:119-30. [PMID: 12435465 DOI: 10.1016/s0304-3959(02)00256-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to describe race/ethnic differences in the use of formal health care services for painful oral symptoms by older adults. We also considered the sex of the respondent rather than assuming that males and females within a specific racial group would use health care services similarly. To our knowledge, these specific utilization patterns have never been reported before in the pain literature.Telephone interviews were conducted on a stratified random sample of 1,636 community dwelling older (65+) north Floridians. A total of 5,860 households were contacted and screened, with 75.3% participating to the point where their eligibility for the study could be determined. Overall race/ethnic differences in patterns of health care use for orofacial pain were not found. However, when we stratified race/ethnicity by sex, Black females (37.6%) were the least likely to have visited a health care provider, followed by non-Hispanic White females (47.2%), non-Hispanic White males (49.3%), and Black males (62.7%). Point estimates of odds ratio, adjusting for financial differences, indicate that more non-Hispanic White males (OR=1.79) and Black males (OR=2.74) visited a health care provider than Black females. Our results also suggest that for older Black adults, financial constraints have a more significant impact on decisions about health care for orofacial pain than they do for non-Hispanic Whites. For non-Hispanic White respondents, characteristics of the pain symptoms were significant determinates of health care use for their painful oral symptoms. Pain at its worst was a positive predictor for four of the five analyses (jaw joint pain, painful oral sores, temperature sensitivity, and toothache pain). The duration variable (years with pain) was a negative predictor of health care use. This is consistent with the conclusion that individuals seek care early in the course of the symptom, i.e. an active care seeking phase, make emotional or physical adjustments, and then resign themselves to the symptoms.
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Affiliation(s)
- Joseph L Riley
- Division of Public Health Services and Research, College of Dentistry, University of Florida, P.O. Box 100404, Gainesville, FL, USA.
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Riley JL, Gilbert GH, Heft MW. Orofacial pain-related communication patterns: sex and residential setting differences among community-dwelling adults. Pain 2002; 99:415-422. [PMID: 12406516 DOI: 10.1016/s0304-3959(02)00155-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study documented orofacial pain-related communication patterns among community-dwelling dentate adults, health care providers, and persons in the respondent's social network. We report communication patterns for orofacial pain by symptom (toothache pain, pain when chewing, temperature sensitivity of the teeth, painful oral sores, and jaw joint pain). The subjects for the study were 724 participants in the 42-month interview of the Florida Dental Care Study, a longitudinal study of oral health among dentate adults, age 45 and older at baseline. The data were collected using a standardized telephone interview. Pain was more likely to be discussed with a lay consultant (41-66% depending on the symptom) than a health care professional (21-62%). Consistent with studies that report females tend to rely on social networks to cope with pain, more female respondents than males reported having talked to a lay consultant about orofacial pain for most of the symptoms. We also found that rural Black adults were less likely to speak to a health care professional about their orofacial pain. The findings highlight the importance of family, friends, and neighbors within the lay consultation and support network for persons with pain. Recent interest in self-care and the use of complementary and alternative approaches to treatment suggest the importance of considering influences acting within the environment of persons with pain.
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Affiliation(s)
- Joseph L Riley
- Division of Public Health Services and Research, College of Dentistry, P.O. Box 100404 HSC, University of Florida, Gainesville, FL 32610-0404, USA Department of Diagnostic Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA Claude Pepper Center for Research of Oral Health in Aging, College of Dentistry, University of Florida, Gainesville, FL, USA
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Mertz E, O'Neil E. The growing challenge of providing oral health care services to all Americans. Health Aff (Millwood) 2002; 21:65-77. [PMID: 12224910 DOI: 10.1377/hlthaff.21.5.65] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
By many measures, the practice of dentistry has improved for the dentist over the past decade. Hours of work are down, and compensation is increasing. However, there is a growing disconnect between the dominant pattern of practice of the profession and the oral health needs of the nation. To address these needs, the profession will need to take some radical steps toward redefinition, or the responsibility for many for these needs and special populations may shift to other providers and other institutions.
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Affiliation(s)
- Elizabeth Mertz
- Center for the Health Profession, University of California, San Francisco, USA
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