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Background: For certain conditions, treatments aim to lessen deterioration over time. A trial outcome could be change in a continuous measure, analysed using a random slopes model with a different slope in each treatment group. A sample size for a trial with a particular schedule of visits (e.g. annually for three years) can be obtained using a two-stage process. First, relevant (co-) variances are estimated from a pre-existing dataset e.g. an observational study conducted in a similar setting. Second, standard formulae are used to calculate sample size. However, the random slopes model assumes linear trajectories with any difference in group means increasing proportionally to follow-up time. The impact of these assumptions failing is unclear. Methods: We used simulation to assess the impact of a non-linear trajectory and/or non-proportional treatment effect on the proposed trial's power. We used four trajectories, both linear and non-linear, and simulated observational studies to calculate sample sizes. Trials of this size were then simulated, with treatment effects proportional or non-proportional to time. Results: For a proportional treatment effect and a trial visit schedule matching the observational study, powers are close to nominal even for non-linear trajectories. However, if the schedule does not match the observational study, powers can be above or below nominal levels, with the extent of this depending on parameters such as the residual error variance. For a non-proportional treatment effect, using a random slopes model can lead to powers far from nominal levels. Conclusions: If trajectories are suspected to be non-linear, observational data used to inform power calculations should have the same visit schedule as the proposed trial where possible. Additionally, if the treatment effect is expected to be non-proportional, the random slopes model should not be used. A model allowing trajectories to vary freely over time could be used instead, either as a second line analysis method (bearing in mind that power will be lost) or when powering the trial. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to identify the social cognitive predictors of regular dental visits and mouth self-examination behaviors among the elderly population, based on the Health Action Process Approach (HAPA) model. Background: Regular dental visits and mouth self-examination can prevent oral and dental problems among the elders. Little information is available regarding the social cognitive predictive factors of these two behaviors. Materials and methods: A cross-sectional study was conducted in 24 municipality centers in Tehran, Iran in 2021. The centers were selected randomly using a multi-stage cluster sampling method and 301 elderly attendants aged 60≥years participated in the study. Data collection was done using a researcher-made questionnaire including demographic characteristics and the HAPA model constructs for two target behaviors. Data were analyzed using the Smart-PLS version 3.3.9 via correlation and PLS-SEM analysis. Results: The mean age of the participants was 65.3±5.33 years and 79.7% were female. The SEM analysis showed that Action Self-Efficacy [b (SD) = 0.595 (0.065), P< 0.001] and Risk Perception [b (SD) = 0.218 (0.070), P< 0.002] were predictors of Intention for mouth self-examination but only Action Self-Efficacy [b (SD) = 0.651 (0.043), P< 0.001] was predictor of Intention for regular dental visits. Recovery Self-Efficacy and Planning directly contributed to the prediction of Mouth Self-Examination. The relationship between Maintenance Self-Efficacy and both behaviors is mediated by Planning. Also, the mediating role of Planning between Intention and target behaviors was confirmed. Conclusion: Action self-efficacy predicted the intention for regular dental visits and mouth self-examination behaviors. The relationship between intention and both behaviors was mediated by Planning. Emphasis on improving Action Self-Efficacy and Intention formation will enhance the effectiveness of interventions aiming at promoting the oral health of the elderly population. [ABSTRACT FROM AUTHOR]

Introduction: A 2015 survey of the Japan Osteoporosis Society (JOS) on medication-related osteonecrosis of the jaw (MRONJ) revealed that cooperation between physicians and dentists was poor. Discontinuation of antiresorptive agents before tooth extraction was found to increase adverse events without preventing MRONJ. We compared this 2015 survey with a new survey conducted in 2022 to investigate cooperation between physicians and dentists for MRONJ. Materials and methods: A web-based structured questionnaire including 13 key queries was sent to 3813 physicians who were members of JOS, and 1227 (32.2%) responses were received. Results: Of the 1227 respondents, 909 (74.1%) had complied with a discontinuation request from a dentist before tooth extraction, although 25.4% of medications were not related to the incidence of MRONJ. Of these, 177 respondents reported 252 adverse events including 10 (1.3%) cases of MRONJ. The prevalence of fractures increased from 4.8% in 2015 to 8.2% in 2022. The rates of respondents who requested oral health care by a dentist before antiresorptive agent therapy and reported cooperation between physicians and dentists were 72.7% and 42.4% in 2022 compared with 32.9% and 24.8% in 2015, respectively. The rates of cooperation among the 47 prefectures in Japan were significantly different, ranging from 10.0 to 83.3% (p = 0.02). Conclusion: This study confirmed increased cooperation between physicians and dentists for MRONJ in Japan. However, a more equal distribution of cooperation across Japan is necessary to optimally manage MRONJ. Discontinuation of antiresorptive agents is no longer necessary because fractures during discontinuation continue to increase in Japan. [ABSTRACT FROM AUTHOR]

Background: Community health depends on the leadership duties of a diverse population, such as village volunteers. Hence, a study was conducted to assess oral health status, treatment needs, and patterns of utilization of dental services among village volunteers in Andhra Pradesh state. Methodology: A cross-sectional study was conducted among 400 village volunteers in Andhra Pradesh state, India. A multi-stage cluster sampling procedure was employed in sample selection. A questionnaire was used to review the pattern of utilization of dental services. World Health Organization Oral Health assessment form 1997 was used to evaluate oral health status and treatment needs. Data collected were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Descriptive statistics were done. Results: Out of 400, 18% had never visited the dental clinic in their lifetime. The majority (33.5%) considered that dental problems were not a serious concern. Dental caries was seen in 69.5%, and 78.5% were presented with periodontal conditions. About 19.8% and 24.3% had crowding and spacing in incisal segments, respectively. The prevalence of oral mucosal disorders and dental fluorosis was 4.25% and 8.75%, respectively. Overall, 94% of the study participants needed dental treatment for various reasons. Conclusion: This study provides sufficient evidence to conclude that this population's oral health was poor, with increasing unmet dental treatment needs. Selected interventions and strategies should focus on these factors to decrease the burden of oral diseases among village volunteers. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of a dental desensitization clinical program on the ability of children with autism spectrum disorder (ASD) to complete a routine preventive dental visit. Methods: English-speaking children with a diagnosis of ASD were enrolled in a prospective cohort study as part of a dental desensitization program. A task analysis (TA) and desensitization plan breaking down a routine dental visit into seven steps was designed and implemented. At each dental visit over a two-year period, the child's comfort level with each step of the TA was collected. Results: Fifty-two patients participated in this program (average age equals 7.9±3.6 years, 80 percent male). Each participant completed, on average, 6.7 desensitization visits. Approximately half of the study participants were able to complete all steps of the TA during the study period. There was a statistically significant positive relationship between the number of desensitization visits and the number of steps of the dental visit the child could complete comfortably. Children with expressive and receptive language skills were more likely to complete all steps of the TA. Conclusion: Dental desensitization is a behavior guidance intervention that can support children with autism spectrum disorder to complete routine preventive dental visits. [ABSTRACT FROM AUTHOR]

Background: Root caries is a prevalent oral health concern among adults, yet there remains a need for a comprehensive understanding of its occurrence and associated risk indicators. The present study was aimed to investigate the prevalence of root caries and to determine significantly associated indicators with it among adults. Methods: The residents aged 35-74 years old were enrolled in a cross-sectional study in which dental examination were taken and structured questionnaires were collected in Zhejiang Province, China. All data were recorded in an electronic system and analyzed. Results: The prevalence of decayed and filled root caries in 1,076 respondents was 31.9%. Elder age, greater attachment loss, and exposed root surface were associated with higher odds of incidence for decayed/filled roots and decayed roots. In the last 12 months, 27.4% of adults with decayed or filled roots and 23.2% of others utilized oral health services. Carious adults who had a very poor/poor oral health status were 2.905 times likely to report dental visits. People with sound roots who were female (OR = 2.103, P < 0.001), perceived their oral health status as moderate (OR = 1.802, P = 0.015), or poor/very poor (OR = 4.103, P < 0.001) were more likely to visit a dentist in the past 12 months. Conclusions: Age, attachment loss and root exposure were most significantly associated with the prevalence of root caries. Individuals who recognize their poor or very poor oral health status should feel encouraged to make use of oral health services. [ABSTRACT FROM AUTHOR]

The patients' fear of the dentist plays an important role in the everyday life of a dentist. The anxiety level of children in relation to dental treatment/visits and to their parents' dental fear was evaluated in three different centers. Assessments of a modified CFSS-DS (mCFSS-DS) were performed by questionnaire with 60 children and their parents. Children's dmft/DMFT scores, age and gender were evaluated in relation to the parents' perception of their child's anxiety levels. For statistical evaluation, Kruskal–Wallis and Wilcoxon tests as well as Spearman's correlation coefficient (Spearman) were used. The significance level was set at 0.05. There were no significant differences regarding children's mCFSS-DS between the three centers (p = 0.398, Kruskal–Wallis). The parents' mCFSS-DS scores correlated significantly with their children's mCFSS-DS scores (p = 0.004, Spearman). However, the mean mCFSS-DS score of the children was significantly higher than the mean score of parents' perception of their child's anxiety (p = 0.000, Wilcoxon). The age of the child had an influence on the mCFSS-DS score (p = 0.02, Kruskal–Wallis) but neither the children's gender (p = 0.170, Kruskal–Wallis), nor the dmft/DMFT showed an impact (p < 0.725, Spearman). Although a positive correlation was found between the results of the children's and parents' questionnaire, many parents underestimated the anxiety level of their children. [ABSTRACT FROM AUTHOR]

The many branches of nanoscience have made significant strides and advancements during the past ten years, as has the entire scientific community. Zirconia nanoparticles have several uses as adsorbents, nanosensors, nanocatalysts, and other types of nanomaterials. Their outstanding biomedical uses in dental care and drug delivery, as well as their intriguing biological characteristics, such as their anti-cancer, anti-microbial, and antioxidant activity, have further encouraged researchers to investigate their physicochemical properties using various synthetic pathways. Due to the popularity of zirconia-based nanomaterials, the current research comprehensively examines several synthesis techniques and their effects on the composition, dimensions, forms, and morphologies of these nanomaterials. In general, there are two methods for creating zirconia nanoparticles: chemical synthesis, which uses hydrothermal, solvothermal, sol-gel, microwave, solution combustion, and co-precipitation processes; and a greener method, which uses bacteria, fungi, and plant components. The aforementioned techniques have been evaluated in the present review for achieving particular phases and shapes. A thorough analysis of zirconia-based nanomaterial's uses is also included in the review. Furthermore, comparisons with their equivalent composites for various applications as well as the influence of particular phases and morphologies have been added. The final portion includes the summary, future outlook, and potential application. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: According to the American Academy of Pediatric Dentistry guidelines, the first dental visit of a child is within 6 months of age. The need of such early visits is to help dentists to detect and treat incipient lesions, to educate parents about proper oral hygiene maintenance and the importance of diet and fluorides. Moreover, the visit helps the child to understand and adapt to the dental setup, thereby showing a positive dental attitude in future visits. Aim: The aim of this study was to find out the age at which children receive dental care for the first time and the reasons for such dental visits. Subjects and Methods: A cross-sectional study was conducted at the Department of Pedodontics and Preventive Dentistry, wherein a questionnaire was provided to the parents of pediatric patients attending the outpatient department for their first dental visit, which included the sociodemographic details along with the questions related to their first dental visit, reason, and experiences regarding their visit. Results: On average, children reported for their first dental visit only after 5 years of age for the complaints such as pain and dental caries. Thus, indicating oral health education and preventive treatment program are yet to reach the general population. Conclusion: From the present study, it was evident that necessary awareness regarding the first dental visit is very low, with the subjects approaching the dentist after the establishment of ill oral health, thus demanding interception rather than prevention of diseases. [ABSTRACT FROM AUTHOR]

Introduction: Among the traditional herbal medicines and products, very few have been marketed for conventional use in dental care because of limited publication data. Moringa oleifera (MO), an indigenous plant from Indonesia, exhibits antimicrobial and anti-inflammatory properties, rendering it beneficial in the treatment of gingival diseases. Objective: The objective of the study is to assess and compare the effectiveness of 4% MO gel and 1% chlorhexidine (CHX) gel as an adjunct to scaling and root planing (SRP) in the treatment of moderate-to-severe gingivitis. Materials and Methods: Thirty individuals, aged between 18 and 55 years, who presented with moderate-to-severe gingivitis, were randomly allocated into two groups: the test group (MO) and the control group (CHX). Following the completion of SRP, the test group received 4% MO gel, while the control group received 1% CHX gel for local application twice daily over a span of 15 days. Clinical parameters including the plaque index, gingival index, and papillary bleeding index were assessed and recorded at baseline, on the 15th day, and on the 30th day. Results: Statistical analysis was done using Student's t-test. On intragroup comparison, statistically significant difference was observed in the parameters while on intergroup comparison, no significant difference was observed both on the 15th and 30th day. Conclusion: MO gel when applied along with SRP in cases of gingivitis, it exhibits effects that are comparable to those of CHX gel, indicating that it may be utilized as an herbal substitute for CHX. [ABSTRACT FROM AUTHOR]

Objectives One of the key indicators of the effectiveness of a country's healthcare system is the delivery of accessible and impactful health services, particularly in the field of oral and dental healthcare. Among the barriers to the utilization of oral and dental healthcare services within healthcare systems, the most prominent obstacles are a lack of awareness and insufficient financial resources. The objective of this research is to investigate the factors that influence the extent to which individuals in Iran make use of dental insurance services. Methods The research employed a linear probability model to evaluate how eight independent variables influence the utilization of dental insurance services. These variables included possession of supplementary dental insurance, age, parenthood, marital status, gender, level of education, DMFT index, and accessibility. The study encompassed data from 384 policyholders who participated across 20 dental clinics located in Tehran. Sampling was conducted using a stratified random sampling method, covering individuals with dental insurance from mid-2022 to mid-2023. The Kolmogorov-Smirnov test ensured data normality. One-sample examined hypotheses, while Pearson's Chi-Square tested relationships. The Gamma coefficient assessed relationship strength, and the Friedman test ranked factors influencing dental service utilization. Results Possessing supplementary dental insurance with an average rank of 5.2 is the most influential factor in the extent of utilization of dental services. The DMFT index, ranking on average at 2.5, is identified as the third factor (following accessibility to dental services as the second factor) in the utilization of dental services. Conclusion Possessing insurance emerges as a crucial factor compared to the DMFT index when it comes to dental visits. In other words, Iranians with a DMFT index but lacking insurance coverage show a lower likelihood of seeking dental treatment. This observation holds true even in the more affluent northern areas of Tehran, contrasting with regions spanning from center to lower Tehran. [ABSTRACT FROM AUTHOR]

Background: Procrastination is a psychological trait that causes individuals to put off doing things that need to be done. It has recently shown to result in the worsening of symptoms due to delays in seeking medical care. However, it is not clear how perception of dental disease influences dental visits. This study examined the associations of procrastination and personality traits with delayed dental visits for both acute and chronic conditions. Methods: Of 599 university students queried, the data of 549 subjects (mean age 19.7 years) were analyzed. A general procrastination scale (GPS), the Big Five personality traits, and oral hygiene habits were used for analysis. The participants were asked about illness awareness conditions related to dental disease, perception of pain in the oral region due to acute oral symptoms and chronic symptoms. The participants were asked the number of days until they decided that treatment was required. Based on the bimodal shape of the distribution, those who answered at least eight days for acute or chronic conditions were classified as the procrastination (P) group and the others as the non-procrastination (Non-P) group. Results: Significant differences in GPS scores were found between the groups for both acute and chronic conditions, with significant differences in the Big Five traits of extraversion, agreeableness, and neuroticism for an acute condition and extraversion, openness, and neuroticism for a chronic condition. There were no significant differences regarding oral hygiene habits between the groups for either condition. Next, using a Bayesian network, the probabilistic causal relations among procrastination, the Big Five traits, and delays in dental visits for both acute and chronic conditions were analyzed. Among the Big Five traits, conscientiousness and neuroticism were directly related to GPS score. Interestingly, agreeableness was directly related to delays in dental visits only for an acute condition and showed a negative effect, while dental student status had a positive effect on delays in dental visits. Conclusions: The results showed that procrastination and dentistry department are factors that directly influence delays in dental visits, while agreeableness, a Big Five trait, has a negative effect on individuals with an acute condition. [ABSTRACT FROM AUTHOR]

Background: People with severe mental illness (e.g. psychosis, bipolar disorder) experience poor oral health compared to the general population as shown by more decayed, missing and filled teeth and a higher prevalence of periodontal disease. Attending dental services allows treatment of oral health problems and support for prevention. However, people with severe mental illness face multiple barriers to attending routine dental appointments and often struggle to access care. Link work interventions use non-clinical support staff to afford vulnerable populations the capacity, opportunity, and motivation to navigate use of services. The authors have co-developed with service users a link work intervention for supporting people with severe mental illness to access routine dental appointments. The Mouth Matters in Mental Health Study aims to explore the feasibility and acceptability of this intervention within the context of a feasibility randomised controlled trial (RCT) measuring outcomes related to the recruitment of participants, completion of assessments, and adherence to the intervention. The trial will closely monitor the safety of the intervention and trial procedures. Methods: A feasibility RCT with 1:1 allocation to two arms: treatment as usual (control) or treatment as usual plus a link work intervention (treatment). The intervention consists of six sessions with a link worker over 9 months. Participants will be adults with severe mental illness receiving clinical input from secondary care mental health service and who have not attended a planned dental appointment in the past 3 years. Assessments will take place at baseline and after 9 months. The target recruitment total is 84 participants from across three NHS Trusts. A subset of participants and key stakeholders will complete qualitative interviews to explore the acceptability of the intervention and trial procedures. Discussion: The link work intervention aims to improve dental access and reduce oral health inequalities in people with severe mental illness. There is a dearth of research relating to interventions that attempt to improve oral health outcomes in people with mental illness and the collected feasibility data will offer insights into this important area. Trial registration: The trial was preregistered on ISRCTN (ISRCTN13650779) and ClinicalTrials.gov (NCT05545228). [ABSTRACT FROM AUTHOR]

Dental trauma is injury to the mouth, including teeth, lips, epoxies, lingo, and jawbones. Soft towel injuries to the mouth and dental trauma are generally veritably painful and should admit prompt treatment. It's a single centered retrospective study. Data was collected from the case record system used in private dental institutions and following parameters similar as gender, age of the children with post traumatic history. Case details were analyzed between June 2020 to January 2021 out of which 287 cases who fulfilled the addition and rejection criteria were included in the study. The data obtained was statistically analyzed using SPSS software. In this study, it is observed that time taken by maximum patients was more than 2 months and male children are prone to traumatic injury. Awareness on earlier dental visits with respect to dental trauma and complication of time delay should be improved among general society. [ABSTRACT FROM AUTHOR]

Objectives: Constructing and validating a theoretical model of relationships between dental services use and socioeconomic characteristics, oral health status, primary care coverage, and public dental services. Methods: The first stage of the study consisted of developing a theoretical-conceptual model to demonstrate the expected relationships between variables based on the literature. In the second stage, we tested the proposed theoretical model using the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique, using data from the Brazilian National Health Survey conducted in 2019 with a sample of 41,664 individuals aged 15 or older. Results: This study successfully defined a theoretical model that explains the systematic relationships involving public dental services utilization. Socioeconomic status was negatively associated with oral health status (β = -0.376), enrollment in primary care facilities (β = -0.254), and the use of public dental consultations (β = -0.251). Being black, indigenous, or living in a rural area was directly associated with lower socioeconomic status and greater use of public dental services. Conclusions: The identified relationships, establishing a theoretical basis for further investigations, also provide evidence of a public access policy's effect on oral health services on equity, supporting the construction of more effective and equitable public policies. [ABSTRACT FROM AUTHOR]

Introduction: Early school-aged children are in a transitional phase from primary to permanent dentition. Established dietary and oral hygiene habits will influence the condition of the oral cavity in the future. Aim: This study aimed to evaluate alterations in early school children's dietary and oral hygiene practices during the COVID-19 pandemic and to anticipate potential long-term health implications. Material and Methods: This cross-sectional online study involved guardians of Polish children aged 6–10 years, living in Western Poland, who were socially isolated at home during the COVID-19 pandemic. A total of 180 guardians were invited to participate in this study. The questionnaire included 17 questions divided into four different sections—the child's anthropometric data, dietary habits, oral health, and attitude to dental visits. Results: The survey was completed by 106 guardians. The mean (standard deviation) age of the children was 8.12 (0.93) years (range 6–10 years). Overall, 24.5% of the surveyed individuals reported buying healthy products (fresh vegetables, fruit) more frequently during the pandemic. Furthermore, 35.8% admitted to snacking between meals more frequently and 16.0% less frequently. Almost one-quarter of the parents acknowledged that their children were less motivated to maintain oral hygiene during the pandemic and 28.3% declared a lower frequency of visits to the dentist from the outbreak of the pandemic for two main reasons: a fear of coronavirus transmission and economic reasons. Conclusions: In the group studied, the results of the assessment indicate that the COVID-19 pandemic had some effects on oral health that may lead to an increased risk of oral disease development, such as tooth decay in children. None of the respondents noticed an increase in their child's motivation about good oral hygiene despite spending more time at home. The irregularity of follow-up visits for one-third of the respondents hindered preventive measures and the continuation of dental treatment. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction is crucial for assessing healthcare quality and identifying strengths and weaknesses in healthcare organizations. In Saudi Arabia, the Ministry of Health (MOH) implemented the Patient Experience Measurement Program to enhance patient experience and healthcare quality. This study aimed to identify specific aspects of patient satisfaction with dental visits in Saudi Arabia to improve dental care quality and inform dental services development.Methods: The study used a standardized self-administered questionnaire (Health Links/Press Ganey) and analyzed surveys from patients who visited MOH-specialized dental clinics in Saudi Arabia during the first half of 2022. The dental section comprised 20 questions across five domains, with patients rating their experience on a 5-point Likert scale. Statistical analysis was performed using IBM SPSS Statistics 25.Results: A total of 964 patients were surveyed. The overall patient satisfaction with dental settings was 3.61 out of 5.0 (72.2%). The highest satisfaction score was for personal issues with the dental clinic domain (3.93/5; 78.6%), while the least satisfaction score was for access to the dental clinic domain (3.29/5; 65.8%). Among all items, the cleanliness of the facility showed the highest satisfaction score (4.11/5; 82.2%). The least satisfaction was for the ease of contacting the dental clinic (2.71/5; 54.2%).Conclusion: The study found high levels of satisfaction among Saudi patients with dental services provided through MOH facilities across various component domains. This highlights the crucial role of dentists in ensuring high-quality dental care and serves as an indication of the overall healthcare quality in MOH facilities. [ABSTRACT FROM AUTHOR]

Purpose: To assess factors associated with the dental utilization of refugee children in Washington state who received oral health care. Methods: This study used Medicaid data of newly arrived children who resettled in 2015. Demographics, refugee population density groups, special care needs, dates of dental encounters, and dental claim variables were analyzed using descriptive statistics, analysis of variance (ANOVA), regression analysis, and the Cox proportional-hazard ratios (P<0.05). Results: Among 1,125 children, 78 percent had at least one dental claim. The majority were under six years (37 percent), male (55 percent), and without disabilities (98 percent). On average children started using dental care within 6.0 months (±4.0 standard deviation) of resettlement (median equals 4.4; interquartile range [IQR] equals 2.6 to 10.3). White children had the greatest mean number of dental claims, whereas Black children had the least (P<0.001). Children from the low-volume refugee population density group were significantly less likely to have a dental claim than children from the medium-volume refugee population density group (P<0.001). Compared to 13- to 21-year-olds, children aged zero to seven years and seven to 13 years had a 46.7 percent (95 percent confidence interval [95% CI] equals 24.9 to 72.3 percent) and 54.8 percent (95% CI equals 30.3 to 83.9 percent) significantly increased likelihood of having their first dental claim (P<0.001). Conclusions: A large percentage (78 percent) of children newly resettled in the state of Washington utilized at least one dental service. Age, race, and refugee population density group were significantly associated with utilization within the initial 12 months after resettlement. [ABSTRACT FROM AUTHOR]

Objectives: Although food deserts are known to impact health and healthcare utilization, no research has investigated the relationship between food deserts and dental care utilization. This study aimed to fill this gap by assessing the relationship between living in a food desert and self‐reported dental care utilization in the past year. Methods: Data are from the National Longitudinal Study of Adolescent to Adult Health (N = 10,495). The association between food deserts and dental care utilization was assessed using covariate‐adjusted multiple logistic regression. Results: Living in a food desert was associated with higher odds of not utilizing dental care in the past year. This association was concentrated among high‐poverty areas (≥20% poverty rate). Conclusions: The current study is the first to assess the relationship between living in a food desert and dental care utilization. The findings demonstrate that individuals living in low‐income urban food deserts may be at increased risk for not utilizing dental care. [ABSTRACT FROM AUTHOR]

Objective: To determine if relationships exist between the total dental treatment needs of incoming Air Force recruits and non‐clincal demographic and oral‐health related factors. Methods: Data from the 2018 Air Force Recruit Oral Health Study (ROHS) was used, an anonymized sample of 1330 AF recruits that included a comprehensive oral exam and survey collecting demographic and oral health behavior information. The primary outcome variable was the total number of dental treatment needs for recruits, and independent predictor variables included select socio‐demographic factors and wellness behaviors. Along with descriptive statistics, a multivariable negative binomial regression analysis was performed to assess the relationship between variables with a normalized weight making the final results representative of all incoming recruits. Results: The final adjusted analysis showed that an incoming recruit's self‐rated oral health, dental coverage prior to enlistment, need for a dental visit within the last 12 months, sugar intake, and tobacco use increased their risk for dental treatment needs. Conclusion: This is the first study to assess the relationship between specific risk indicators and increased dental treatment needs while adjusting other related covariates. Factors associated with dental treatment needs were identified that provide Air Force leaders with actionable information to directly improve recruit oral health and military readiness by identifying new airmen at the highest risk for excessive dental care needs while at basic military training. [ABSTRACT FROM AUTHOR]

Introduction: Underutilization of dental services is a global concern that is frequently reported in developing countries among different groups of subpopulations but it is unclear if the same have been studied among population in the university community. Aim: The aim of the study was to determine the pattern and barriers to the utilization of dental services among Nigerian population in the University of Benin. Materials and Methods: This was a descriptive cross-sectional study conducted between October 2021 and January 2022 that involved all consecutive staff of the University of Benin, Benin City. The data were collected with an 18-item, structured, close-ended, self-administered questionnaire which was pretested for feasibility. Descriptive and inferential statistics were performed. Data were entered into a computer and analyzed using the Statistical Package for the Social Sciences (SPSS) version 21 (IBM, Chicago, USA). Results and Discussion: The age range was 25–55 years, with a mean age of 42.8 ± 8.8 years. There were more males (51.8%) than females. Higher (58.4%) proportions of the respondents claimed to have visited the dentist before this study compared to those who claimed never to have visited for any dental services. Long waiting time was ranked highest (27.1%) as the barrier to good utilization of dental services, and this was followed by high cost of treatment (21.1%), fear of dental treatments (12.8%), and poor staff–patient interaction (11.2%). Most (28.5%) of the respondents answered that a reduction in the cost of treatment can help to improve the utilization of dental services, and this was followed by adequate staff–patient interaction (25.3%) and procurements of hospital equipment (24.2%). More males significantly poorly utilized dental services compared to their female counterparts (P = 0.01). Furthermore, more Christians poorly utilized dental services compared to Muslims (P = 0.03). Conclusion: The prevalence of university staff with poor utilization of dental services is relatively high, and this was significantly more in males and among Muslims. Long waiting time and high cost of treatment were the most common barriers mitigating the optimal utilization of dental services. [ABSTRACT FROM AUTHOR]

Aims: To determine if adolescents with developmental disabilities (DDs) who experienced difficulty with dental caries differed by dental visits in the past 12 months and receipt of preventive services (fluoride treatment and dental sealants) during those visits compared to adolescents with no DDs or difficulty with dental caries. Methods and Results: A cross‐sectional study was conducted using data of 91 196 adolescents aged 10–17 years from the 2016–2020 National Survey of Children's Health. Descriptive and bivariate statistics and multivariable regression models were conducted. We derived the odds ratio for visiting a dental office (OR: 0.76, 95% CI: 0.57–1.03, p =.07), receiving fluoride treatments (OR: 1.20, 95% CI: 1.01–1.43, p =.04), and dental sealants (OR: 1.44, 95% CI: 1.19–1.75, p <.001) for DD adolescents who experienced difficulty with dental caries compared to adolescents with no DDs or difficulty with dental caries. Conclusions: DD adolescents who experienced difficulty with dental caries were more likely to receive fluoride treatments and sealants during dental visits but were equally likely to have a dental visit in the past 12 months than adolescents with no DDs or difficulty with dental caries. [ABSTRACT FROM AUTHOR]

Objectives: To determine factors influencing regular dental attendance in aged adults 65 and over according to Andersen's Behavioural Model. Background: Regular attendance for dental visits is vital to improve and maintain oral health, quality of life and general well‐being. Aged adults 65 years and older experience barriers to regular dental attendance, which in turn leads to an increased risk for oral diseases. Materials and Methods: An electronic search was undertaken in April 2021 in Cochrane, Embase, Medline, Cinahl, Dentistry & Oral Science Source via EBSCOhost and Embase for papers on factors influencing the frequency of attendance by older people. Risk of bias was assessed according to the Newcastle‐Ottawa Scale for cohort and case–control studies, and with modified version of this tool for cross‐sectional studies. Frequency effect size was calculated for factors described in Andersen's Behavioural Model (predisposing, enabling and needs‐related). Results: Twenty‐one studies were eligible for inclusion. Factors frequently investigated affecting regular dental attendance included: age, gender, education (predisposing); income, and social support (enabling); and remaining teeth, pain, perceived health (needs‐related). Income was the only factors with a 100% positive association with regular dental attendance. Conclusions: This systematic review confirms the complex interconnectedness of several factors and dental attendance in older adults. A number of factors were identified which warrant further investigation to improve access to dental care to socio‐economically vulnerable older populations. [ABSTRACT FROM AUTHOR]

Abstract Objective This study examined the dental care utilization and self-preserved dental health of Asian immigrants relative to non-immigrants in Canada. Factors associated with oral health-related disparities between Asian immigrants and other Canadians were further examined. Methods We analyzed 37,935 Canadian residents aged 12 years and older in the Canadian Community Health Survey 2012–2014 microdata file. Factors (e.g., demographics, socioeconomic status, lifestyles, dental insurance coverage, and year of immigration) associated with disparities in dental health (e.g., self-perceived teeth health, dental symptoms during past one month, and teeth removed due to decay in past one year) and service utilization (e.g., visiting dentist within the last three years, visiting dentist more than once per year) between Asian immigrants and other Canadians were examined using multi-variable logistic regression models. Results The frequency of dental care utilization was significantly lower in Asian immigrants than their non-immigrant counterparts. Asian immigrants had lower self-perceived dental health, were less likely to be aware of recent dental symptoms, and more likely to report tooth extractions due to tooth decay. Low education (OR = 0.42), male gender(OR = 1.51), low household income(OR = 1.60), non-diabetes(OR = 1.87), no dental insurance(OR = 0.24), short immigration length (OR = 1.75) may discourage Asian immigrants from dental care utilization. Additionally, a perceived lack of necessity to dentist-visiting was a crucial factor accounting for the disparities in dental care uptake between Asian immigrants and non-immigrants. Conclusion Asian immigrants showed lower dental care utilization and oral health than native-born Canadians.

Aim: The present research was carried out to evaluate the amount of usage of dental care opportunities and also to assess the problems faced by health care workers (HCWs) of a south Indian district in using dental services. Methodology: This study had around 500 participants who belonged from various health care sectors who were selected with the help of multistage sampling. The data obtained from this cross-sectional research was analysed statistically using SPSS 22.0. Results: It was noticed that around 35% of participants went for a dentist's appointment in past 1 year where male members predominated (45%). One of the commonest reasons for utilizing dental care services was pain as an dental emergency factor (70%). Other reasons were dental caries (18%) restoration, breakage of tooth (10%) and a host of other factors (11%). Around 350 participants felt that going to the dentist was only necessary when there was an emergency (61%). Conclusion: The target population less frequently visited the dentist to maintain their teeth as they believed when you have pain, that is the time you go to a dental specialist. [ABSTRACT FROM AUTHOR]

Background and rationale: As general health care is publicly funded in Canada and oral health care is not, many people seek care from hospitals for their dental problems. This study assessed if the unprecedented times of Coronavirus disease (COVID-19) affected the hospital visits for dental emergencies, making disadvantaged populations further vulnerable for attendance of their dental problems. Methods: Data from IntelliHealth Ontario for emergency department (ED) visits, day surgery visits, and hospitalizations associated with non-traumatic dental conditions (NTDCs) were retrieved for years 2016 to 2020 to assess trends before COVID-19 and changes, if any, for the year 2020. Trends by month, for the years 2019 and 2020, to make straight comparisons and understand the effects of lockdown in Ontario, was also analyzed. Results: In the year 2020, there was a reduction of 40% in day surgeries, 21% in ED visits and 8% in hospitalizations compared to 2019. Stratified by month, largest reductions were observed in April 2020: 96% in day surgeries; 50% in ED visits; and 38% reductions in hospitalizations when compared to the same month of 2019. In May 2020, day surgeries and ED visits though remained reduced, hospitalization rates increased by 31%. Conclusion: Hospital EDs are inefficient avenues for handling dental emergencies. Nevertheless, they do remain a care setting that is sought by many for dental problems, and if the need for hospitalization and day surgery is there, this care setting is an important avenue for dentally related medical care. Perhaps unsurprisingly, COVID-19 has lessened the opportunity and capacity for such care. Practical implications: Administrators and policy makers can utilize this information to strategize on augmenting community infrastructure for building more effective, and cost-efficient avenues of care for timely management of dental problems. [ABSTRACT FROM AUTHOR]

Objectives: The present study aims to describe the dental visiting patterns in a Norwegian adult population and their associations with sociodemographic and oral health variables, including oral pain. We further explore if the utilization of dental health services and oral pain predicts caries and periodontitis, the most common oral diseases. Materials and Methods: We use data from the seventh wave of the Tromsø study performed in 2015–2016. In this cross‐sectional survey, all residents 40 years or older in Tromsø municipality in Norway were invited, of whom 21,083 (65%) participated. All participants answered questionnaires assessing sociodemographic characteristics, use of health services, and self‐reported health measures, including pain. Almost 4000 participants underwent a dental examination with registration of caries and periodontitis. Associations of dental visiting patterns and utilization of dental services the past 12 months with sociodemographic‐, self‐reported‐, and clinical oral health measures were analyzed by cross‐tabulation and Pearson's χ2 tests, as well as with logistic regression analyses with caries and periodontitis as outcomes. Results: A regular, annual dental visiting pattern was the most common, but among respondents with severe dental anxiety and poor dental health, visiting for acute problems only or never (symptomatic visiting) was the most common. Intervals of more than 24 months between visits and a symptomatic visiting pattern were associated with caries, whereas shorter than 12‐month intervals and a symptomatic visiting pattern were associated with periodontitis. Many characteristics were shared among respondents with the lowest and the highest utilization of dental services, including oral pain, a difficult financial situation and poorer self‐reported and clinical dental health. Conclusions: Regular dental visits at 12–24 month intervals were associated with beneficial oral health parameters, compared with more frequent, rarer, and symptomatic dental visiting patterns. Oral pain was an unreliable predictor of caries and periodontitis. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess, whether patients prior to endoprosthesis (EP) visit their dentist for need-oriented therapy and whether this would be associated with the occurrence of complications. Based on a cohort of patients, which was orally investigated prior to EP surgery between 04/2020 and 12/2021, a telephone interview was performed at least six months after EP implantation. Patients were classified into either low-risk (LR), moderate-risk (MR), or high-risk (HR) groups. Participants were interviewed based on a structured questionnaire regarding dental visits, dental therapy, and potential complications during the observational period. Out of the 311 patients from the baseline cohort, 96 patients after EP implantation could be included (participation rate of 31%). Nineteen patients were in LR (20%), 41 in MR (43%), and 36 in the HR group (37%). Overall, 79% (n = 76) of the patients followed the recommendation to visit their dentist; 94% of patients within the HR group visited the dentist (p = 0.02). Dental treatment procedures included tooth cleaning (57%), periodontal treatment (31%), restorative therapy/filling (28%), and tooth extraction (28%). In 64% of the HR patients (n = 23), the potential oral foci with a risk of EP infection were eliminated by their general dentist. Fourteen different complications occurred within the observation period, without any group effect (p > 0.05). In conclusion, most patients prior to EP visit their general dentist following referral, especially if they have a potential oral focus. The effect of dental clearance on infectious complications of EP remains unclear, whereby further clinical studies are needed. [ABSTRACT FROM AUTHOR]

Objectives: Ambulatory antibiotic stewardship generally aims to address the appropriateness of antibiotics prescribed at in-person visits. The prevalence and appropriateness of antibiotics prescribed outside of in-person visits is poorly studied. Design and setting: Retrospective cohort study of all ambulatory antibiotic prescribing in an integrated health delivery system in the United States. Participants: Antibiotic prescribers and patients receiving oral antibiotic prescriptions between January 2016 and December 2019. Main outcome measures: Proportion of antibiotics prescribed with in-person visits or not-in-person encounters (e.g., telephone, refills). Proportion of prescriptions in in 5 mutually exclusive appropriateness groups: 1) chronic antibiotic use; 2) antibiotic-appropriate; 3) potentially antibiotic-appropriate; 4) non-antibiotic-appropriate; and 5) not associated with a diagnosis. Results: Over the 4-year study period, there were 714,057 antibiotic prescriptions ordered for 348,739 unique patients by 2,391 clinicians in 467 clinics. Patients had a mean age of 41 years old, were 61% female, and 78% White. Clinicians were 58% women; 78% physicians; and were 42% primary care, 39% medical specialists, and 12% surgical specialists. Overall, 81% of antibiotics were prescribed with in-person visits and 19% without in-person visits. The most common not-in-person encounter types were telephone (10%), orders only (5%), and refill encounters (3%). Of all antibiotic prescriptions, 16% were for chronic use, 15% were antibiotic-appropriate, 39% were potentially antibiotic-appropriate, 22% were non-antibiotic-appropriate, and 8% were not associated with a diagnosis. Antibiotics prescribed in not-in-person encounters were more likely to be chronic (20% versus 15%); less likely to be associated with appropriate or potentially appropriate diagnoses (30% versus 59%) or non-antibiotic-appropriate diagnoses (8% versus 25%); and more likely to be associated with no diagnosis (42% versus <1%). Conclusions: Ambulatory stewardship interventions that focus only on in-person visits may miss a large proportion of antibiotic prescribing, inappropriate prescribing, and antibiotics prescribed in the absence of any diagnosis. [ABSTRACT FROM AUTHOR]

Background: The burden of oral disease requires collaboration between health care professionals. Nurses are frequently exposed to patients and can play a vital role in prevention of oral diseases. This study aimed to investigate nurses' attitudes towards their role in dental care and its associated factors. Methods: This cross-sectional, survey-based study recruited a total of 525 nurses in Eastern Saudi Arabia, using a snow-ball sampling technique. Data was collected using an online, pre-validated 40-item questionnaire with four domains (attitudes, knowledge, practices, and demographic data). Results: Nurses showed satisfactory attitudes (52.8 ± 8.2) and average knowledge (13.4 ±3.9). More than two thirds (70.3%) reported responding to patients' questions about oral health conditions, 47.1% and 19.7% conducted oral health screening and education respectively. Referral practices were reported by 266 (50.7%) of the participants with pain being the main reason for referrals. Attending lectures/ trainings on oral health and having a formal education about oral health were significantly associated with nurses' positive attitudes towards their role in dental care (P<0.001). Conducting oral health screening or education were also significantly associated with positive attitudes (P = 0.001). Conclusion: Positive attitudes were observed among those with undergraduate oral health backgrounds, in continuous education, and those who were involved in oral health screenings. There is a need for under and postgraduate inclusion of oral health training in nurses' education. [ABSTRACT FROM AUTHOR]

Good oral health is essential for healthy aging. Regular dental care utilization is instrumental to good oral health. Older immigrants tend to experience poorer oral health and less dental care use as compared with their native-born counterparts in the host country. Older immigrants are particularly vulnerable to interrupted or lost social ties and acculturation challenges after immigration to a new country. This study examined whether and to what extent social relations, acculturation, and perceived oral health needs are associated with dental care utilization in foreign-born older Chinese Americans. Data came from the Population Study of Chinese Elderly in Chicago, which were collected between 2017 and 2019 (N = 3,000). Dental care utilization was dichotomized into "yes" versus "no" in the past 2 y. Social relations were measured by positive and negative relations with spouse, family, and friends. Acculturation was measured by length of stay, behavioral acculturation, and residence in Chinatown. Perceived oral health needs were measured by the presence of problems related to teeth, gums, or bleeding. As guided by the Andersen model, separate logistic regression models were used to investigate factors of dental care utilization. An overall 23.1% reported dental care utilization. Individuals with no negative relations with spouse, family, and friends were 31%, 36%, and 38% less likely to visit a dentist, respectively. Individuals with higher levels of behavioral acculturation were 4% more likely to visit a dentist; individuals living in Chinatown were 45% less likely; and individuals with perceived oral health needs were 2.5 times more likely. Findings illustrate the importance of understanding social relations, immigration-related factors, and perceived oral health needs in dental care utilization in older immigrants. [ABSTRACT FROM AUTHOR]

This longitudinal cohort study examines if 1) cognitive decline varies by birth cohort, adjusting for covariates, and 2) edentulism and nonuse of dental care predict 10-y cognitive decline (2008–2018). The Health and Retirement Study (HRS) features a representative sample of US adults over age 50. Eligibility criteria included having cognitive interview data available and responding to the question, "Have you lost all of your upper and lower natural permanent teeth?" at 2+ time points between 2006 and 2018. Use of dental care in the past 2 y was assessed. Linear mixed models for repeated measures estimated the trajectories of mean cognition over time for the birth cohorts, adjusted for baseline cognition, dentition status, dental care use, and covariates (demographic characteristics, health behaviors, and medical conditions). Cohort-by-time interaction terms were included to assess if cognitive decline varied by birth cohort. Ten-year change in cognition status (measured by HRS Cogtot27)—categorized as dementia (<7); cognitive impairment, not demented (7-11) 7≤Cogtot27<12; and normal (≥12)—was also investigated according to birth cohort, dentition status, and dental care use. Mean (SD) baseline age was 63.4 (10.1) y (n = 22,728). Older birth cohorts had greater cognitive decline than younger cohorts. Linear mixed-model estimates and 95% confidence intervals for protective factors for cognitive decline included higher baseline cognition (HRS Cogtot27) (0.49; 0.48–0.50), use of dental care in the past 2 y (0.17; 0.10–0.23), and covariates such as greater household wealth and being married. Risk increased with being edentulous (−0.42; −0.56 to −0.28), history of stroke or diabetes, less education, Medicaid recipient, current smoker, loneliness, and poor/fair self-rated health. Edentulism and irregular dental care are among important predictors of cognitive decline. Tooth retention and regular dental care throughout life appear to be important for maintaining oral and cognitive health. [ABSTRACT FROM AUTHOR]

Background: The affordability of dental care continues to receive attention in Canada. Since most dental care is privately financed, the use of dental care is largely influenced by insurance coverage and the ability to pay-out-of pocket. Objectives: i) to explore trends in self-reported cost barriers to dental care in Ontario; ii) to assess trends in the socio-demographic characteristics of Ontarians reporting cost barriers to dental care; and iii) to identify the trend in what attributes predicts reporting cost barriers to dental care in Ontario. Methods: A secondary data analysis of five cycles (2003, 2005, 2009–10, 2013–14 and 2017–18) of the Canadian Community Health Survey (CCHS) was undertaken. The CCHS is a cross-sectional survey that collects information related to health status, health care utilization, and health determinants for the Canadian population. Univariate and bivariate analyses were conducted to determine the characteristics of Ontarians who reported cost barriers to dental care. Poisson regression was used to calculate unadjusted and adjusted prevalence ratios to determine the predictors of reporting a cost barrier to dental care. Results: In 2014, 34% of Ontarians avoided visiting a dental professional in the past three years due to cost, up from 22% in 2003. Having no insurance was the strongest predictor for reporting cost barriers to dental care, followed by being 20–39 years of age and having a lower income. Conclusion: Self-reported cost barriers to dental care have generally increased in Ontario but more so for those with no insurance, low income, and aged 20–39 years. [ABSTRACT FROM AUTHOR]

Background and Aim: Smoking leads to a very unhealthy lifestyle and has many deleterious effects on the body and surroundings. Studies have indicated that aiding contemplating smokers using behavior counseling and nicotine replacement therapy has shown positive results for abstaining from the habit. We aimed to assess and carry out smoking cessation for smokers using behavioral counseling, motivational interviewing, and nicotine replacement therapy (NRT) and assess their carbon monoxide (CO) cutoff level, Fagerstrom nicotine dependence test (FTND) scoring, and transtheoretical model (TTM) of change at baseline and 6 months, along with abstinence from the habit. Materials and Methods: CO cutoff, FTND scoring, and TTM of change were assessed at baseline and 6 months for smokers. Behavioral counseling with motivational interviewing was provided to the participants on the day of recruitment, and baseline data were recorded. All smokers included in the study were in the precontemplation and contemplation stages to quit smoking. Based on the frequency of smoking, NRT was prescribed to them in the form of a patch (21, 14, or 7 mg), only gums (2 mg), or a combination of both. Counseling was provided telephonically every month for 6 months. Urine cotinine assessment was carried out to verify the self-reported smoking status of the participants at the sixth month. Results: The CO cutoff, FTND scoring, and TTM of change showed statistically significant difference from baseline to the sixth month. Also, 20% (confidence interval [CI] 0.10-0.33) of participants who abstained from the habit were in the action and maintenance stages of change. Among 20% of participants, 16% (CI 0.10-0.36) of participants self-reported quitting within 6 months using combination therapy. Two percent (CI 0.00-0.40) each abstained by using nicotine gums and combination therapy of patch and gums, which was validated through urine cotinine. Conclusion: The cotinine test provided negative results, confirming the self-reported abstinence of 20% of participants, who were mostly male students and professionals in the age group of 20-40 years and those who used NRT. Nicotine patches provided the highest point prevalence of abstinence compared to gums and combination therapy. [ABSTRACT FROM AUTHOR]

Objective Trigeminal neuralgia (TN) is a neurological disorder that often presents as severe toothache. The majority of TN patients visit dental clinics first, so TN represents a potential pitfall for dental practitioners. This report describes the development of a trigeminal neuralgia questionnaire (TNQ), assessing 10 characteristics of TN, to assist dentists in screening for TN in dental clinics, and evaluates the effectiveness of TNQ. Materials and Methods Fifty-three patients who visited the TN outpatient department in our institute and completed the TNQ were included in this study. All patients were examined by two neurosurgeons and neuroimaging was performed. Statistical Analysis Patients were classified into a TN group and a non-TN group. TNQ score was retrospectively compared between groups. Furthermore, history and characteristics of TN were investigated in the TN group to clarify the status of the reference situation. Results Thirty-seven cases were assigned to the TN group, and 16 cases to the non-TN group. Mean TNQ score was 8.3 in the TN group and 6.6 in the non-TN group. Setting a TNQ cutoff score of 7 offered 91% sensitivity and 56% specificity for TN. Investigation of the history of the present illness indicated that 39.2% of TN cases were improperly triaged and referred from initial dental clinics, and interdisciplinary practice was insufficient. Conclusion TNQ offers a reliable, convenient method to triage TN patients, and may assist dentists in screening for TN. Multidisciplinary practice is necessary for total management of TN and the TNQ is expected to connect dentists and TN specialists. [ABSTRACT FROM AUTHOR]

This is the second article of the series with the analysis of all known to-date data on the dental health of the historical adult population of Tver (12th-19th centuries, European Russia). Report 2 covers the antemortem tooth loss. Analysis is based on 1007 individuals (619 males and 388 females). All the groups ranging from the 12th to 19th centuries show high frequency of AMTL in both men and women. The percentage of AMTL in both genders increase to the 19th century due to the higher caries rated probably because of the better accessibility of simple sugars. [ABSTRACT FROM AUTHOR]

Summary: Background: Several studies have shown dental disease to have a high prevalence and severity in donkeys. Limited studies have assessed the possible relationships between poor dental health and the management and health care of donkeys. Objective: The aim of this study was to identify relationships between dental health and current management of donkeys in the UK and to provide recommendations to improve practices to help donkey welfare. Study design: Observational cross‐sectional survey. Methods: A total of 596 donkeys surrendered to The Donkey Sanctuary (TDS) over a period of 30 months were included. Analysis was performed on three categories of information: entrance information submitted by previous owners and welfare professionals, pre‐admission clinical examination records and arrival medical examination data. Results: No statistically significant differences were identified between dental health and provision of bedding, or diet types. Agreement between external professionals and experienced TDS staff was weak in reference to recognition of dental pathology, age and body condition score (BCS). Over 25% of donkeys with severe dental pathology also had poor BCS (1–1.5). The majority of donkeys had no indication of previous dental examination. Main limitations: Entrance information was not gathered and recorded in a structured manner. Conclusions: Regular prophylactic dental care seems to have poor uptake amongst the owners of the study population, but this is perhaps, in part, aligned to the nature of the sanctuary. Owners are yet to take dental health into consideration when allocating a diet or bedding types to their donkeys, presenting a risk of colic/choke in those fed long fibres with an inability to process them adequately. The Donkey Sanctuary should continue to offer accessible means of education to reach both professionals and owners alike, and this may be well served by the implementation of the new, online, Donkey Academy. [ABSTRACT FROM AUTHOR]

Many children experienced anxiety during their initial dental visits, often fearing medical equipment and the procedures they would undergo. The Dental Explosion Box served as an alternative approach to enhance oral health awareness and functioned as an educational tool integrated with a game. This study aimed to assess the effectiveness of the Dental Explosion Box in introducing oral health concepts to early childhood. This research employed a pre-experimental design featuring a one-group pretest and post-test approach. Sampling relied on the purposive sampling technique, with the sample size determined using the Isaac and Michael formula, resulting in a cohort of 25 preschool students. Variables examined in this study encompassed the Dental Explosion Box and Oral health Awareness. Oral health awareness in preschool children was measured using a checklist of questions. The Dental Explosion Box had undergone rigorous testing and had been endorsed by media and material experts. The study's hypotheses were tested using the Wilcoxon Sign Rank Test. The average pre-intervention oral health introduction score was 6.68, while the post-intervention score increased to 11.00. Analysis through the Wilcoxon Sign Rank Test revealed a significant difference (p-value of 0.000, <0.05) between the level of oral health awareness in early childhood before and after receiving intervention with the Dental Explosion Box. The findings from this study highlighted the effectiveness of the Dental Explosion Box in introducing oral health concepts to early childhood. It enhanced children's familiarity with oral health and motivated them to regularly visit the dentist. [ABSTRACT FROM AUTHOR]

Dental caries is one of the most common oral diseases in children worldwide, especially in Taiwan. This study investigated dental professionally topical fluoride application (PTFA) and children's dental use for dental caries under the National Health Insurance (NHI) system in Taiwan from 2008 to 2021. The population data and medical records of the NHI system were obtained from the websites of the Ministry of the Interior and the Ministry of Health and Welfare, respectively. The dental PTFA services and dental use indicators for dental caries were analyzed from 2008 to 2021. The number of out-patient visits for dental PTFA services increased from 221,675 in 2008 to 1,078,099 in 2021. The total increase of the out-patient visits was 856,424 with a total increase rate of 386.34%. The one-year increase was 65,879 with a one-year increase rate of 29.72%. Among the 3 age groups of children, their dental use indicators almost presented decreasing trends from 2008 to 2021. Moreover, in general, the dental use indicators showed a negative correlation with the number of the overall out-patient visits for dental PTFA services from 2008 to 2021. In Taiwan, there is a negative correlation between the dental use indicators in NHI system and the number of the overall out-patient visits for dental PTFA services from 2008 to 2021. However, the problem of dental caries in children is still serious and there is still a space for improvement in the oral health education for child caregivers and children. [ABSTRACT FROM AUTHOR]

As esthetic demands with direct restorations, tooth-colored materials were used to replace amalgam filling gradually. However, little is known about the tooth-colored restorative materials for decayed teeth in Taiwan. In this study, the use of composite resin, glass ionomer cement, and compomer was analyzed by National Health Insurance Research Database (NHIRD). A retrospective study was conducted to analyze the registered database compiled by Taiwanese NHIRD from 1997 to 2013. The results were further to analyze the application of tooth-colored restorative materials by sex and age. In addition, time trends of dental visits for each tooth-colored restorative material were also investigated. The average annual composite resin filling (CRF) ratio was 18.41% of nationwide population in Taiwan. The prevalence of CRF stratified by sex and age was significantly increased from 1997 to 2013 (P for trend <0.0001). The time trends of dental visits for CRF were significantly increased (P for trend <0.0001). The average annual glass ionomer cement filling (GICF) ratio was 1.79% of Taiwanese population. The prevalence of GICF stratified by sex and age was demonstrated a decreased pattern (P for trend <0.0001). The time trends of dental visits for GICF were significantly decreased (P for trend <0.0001). The average annual compomer filling ratio was 0.57% of whole population in Taiwan. Form the results of this registry-based study, a significant increased trend of CRF for decayed teeth was observed in Taiwanese population during past 17 years. [ABSTRACT FROM AUTHOR]

Objectives: Early Childhood Caries (ECC) can negatively impact the lives of young children, despite being preventable. The purpose of this study was to utilize available data in Alaska to describe changes in parent reports of ECC, and identify factors related to ECC. Methods: The Childhood Understanding Behaviors Survey (CUBS) is a population‐based survey of parents of 3‐year‐old children and was utilized to describe changes in: parent‐reported ECC among children with a dental visit, access to and or utilization of dental care, and consumption of three or more cups of sweetened beverages between 2009–2011 and 2016–2019. Logistic regression modeling was used to explore factors associated with parent‐reported ECC among children with a dental visit. Results: Over time, a significantly smaller proportions of parents whose 3‐year‐old child had seen a dental professional reported ECC. Additionally, a smaller proportion of parents reported three or more cups of sweetened beverage consumption by their child, while larger proportions had seen a dental professional by age 3. Factors associated with parent‐reported ECC included consumption of three or more cups of sweetened beverages, and enrollment in Medicaid or Tribal health care insurance, while protective factors included a parent earning a college degree, and military insurance. Conclusions: Although at the statewide level, improvements were observed in parent‐reported measures over time, regional disparities were apparent. Social and economic factors as well as excessive consumption of sweetened beverages appear to play important roles in ECC. CUBS data can help identify trends in ECC within Alaska. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the relationship between preventive dental care utilization and untreated dental caries for Medicaid‐enrolled adolescents and to determine if the relationship is moderated by chronic conditions (CC). Methods: This analysis was based on 2015–2016 Medicaid claims files and survey data collected from adolescents ages 12–18 years enrolled in Oregon Medicaid, who received a dental screening between December 2015 and December 2016 (n = 240). To assess the relationship between preventive dental care utilization and untreated dental caries (defined as decayed tooth surfaces), prevalence ratios (PR) and 95% confidence intervals (CI) were generated using log‐linear regression models. We also tested for an interaction between preventive dental care utilization and CC. Results: About 60.4% of adolescents utilized preventive dental care, 21.7% had CC, and 29.6% had ≥1 decayed tooth surfaces. There were no significant differences in untreated dental caries between adolescents who did and did not utilize preventive dental care (PR: 0.73, 95% CI: 0.33–1.60; p = 0.43). There was not a significant interaction between preventive dental care utilization and CC (p = 0.65). Preventive dental care utilization was not significantly associated with untreated dental caries for adolescents with CC (PR: 0.51, 95% CI: 0.10–2.65; p = 0.42) nor among adolescents without CC (PR: 0.79, 95% CI: 0.33–1.91; p = 0.61). Conclusions: Preventive dental care was not shown to be associated with lower untreated dental caries for Medicaid‐enrolled adolescents or those with CC. Future work that is adequately powered should continue to elucidate this relationship in Medicaid enrollees. [ABSTRACT FROM AUTHOR]

Objectives: Poor oral health during pregnancy poses risks to maternal and infant well‐being. However, limited research has documented how proximate stressful life events (SLEs) during the prenatal period are associated with oral health and patterns of dental care utilization. Methods: Data come from 13 states that included questions on SLEs, oral health, and dental care utilization in the Pregnancy Risk Assessment Monitoring System for the years 2016–2020 (n = 48,658). Multiple logistic regression analyses were used to assess the association between levels of SLE (0, 1–2, 3–5, or 6+) and a range of (1) oral health experiences and (2) barriers to dental care during pregnancy while controlling for socio‐demographic and pregnancy‐related characteristics. Results: Women with more SLEs in the 12 months before birth—especially six or more—reported worse oral health experiences, including not having dental insurance, not having a dental cleaning, not knowing the importance of caring for teeth and gums, needing to see a dentist for a problem, going to see a dentist for a problem, and unmet dental care needs. Higher levels of SLEs were also associated with elevated odds of reporting barriers to dental care. Conclusions: SLEs are an essential but often understudied risk factor for poor oral health, unmet dental care needs, and barriers to dental care services. Future research is needed to understand better the mechanisms linking SLEs and oral health. [ABSTRACT FROM AUTHOR]

Objectives: To examine the role COVID‐19 had on access to dental services among children in Arizona by comparing paid pediatric dental claims made before and during the pandemic. Methods: In a retrospective descriptive study, we examined Medicaid paid claims for dental services among pediatric patients from March through December 2019 and during the outbreak in 2020. Using dental claims data obtained from the Centers for Health Information and Research at Arizona State University (ASU), we analyzed Medicaid (Arizona Health Care Cost Containment System [AHCCCS]) reimbursed dental services. Results: During the COVID‐19 pandemic, paid preventive dental claims for children aged birth to 21 years decreased in 2020 compared to the same time period in 2019. Pediatric patients in Arizona utilized fewer dental services and had less access to credentialed Medicaid dental providers during the pandemic. Further, rural counties had statistically significant fewer preventive, minor restorative, major restorative, and endodontic claims compared to urban counties. Arizona rural counties also had fewer providers who were paid $10,000 or more per year during 2020 than in 2019. Conclusions: COVID‐19 has had a detrimental impact on pediatric dental service utilization. While dental services were provided during the COVID‐19 pandemic, preventive and restorative dental claims dropped for rural Arizona children aged birth to 21 years. This reveals potential negative impacts on oral health. Further research should examine the direct and indirect impact the COVID‐19 pandemic has had on dental service utilization and oral health for the general pediatric population. [ABSTRACT FROM AUTHOR]

Health status during the reproductive years influences fecundity, fertility, and the future health of males and their offspring. There remains a dearth of literature examining men's preconception health, especially among high-risk populations, such as those with disabilities. The objective of this study was to examine indicators of preconception health, including chronic medical conditions, lifestyle behaviors, and health care utilization, among males of reproductive age with and without disabilities in the United States. Data were from 3,702 males of reproductive age (18-44 years) who participated in the National Health and Nutrition Examination Surveys, 2013-2018. Approximately 14% of males reported having at least one disability related to vision, hearing, cognition, mobility, self-care, or independent living. Among all men, suboptimal preconception health indicators were prevalent including poor or fair self-rated health; low education and household income status; lack of health insurance and no recent utilization of health care and dental care; cigarette smoking; frequent alcohol consumption and binge drinking; marijuana and illegal drug use; obesity; low fruit and vegetable intake and no multi-vitamin use; low physical activity; short sleep durations; depressive symptoms; and hypertension and asthma. Compared to males with no disabilities, males with any disabilities were more likely to have suboptimal preconception health indicators. Strategies to promote and improve sexual health, preconception care, and family planning services among all men are needed. For males with disabilities, specifically, further investigation of their specific health needs related to sex, reproduction, family planning, and fatherhood, as well as interactions with health care providers, is required. [ABSTRACT FROM AUTHOR]

Access to dental clinics is a feature of the neighborhood service environment that may influence oral health care utilization. However, residential selection poses a challenge to causal inference. By studying the involuntary relocation of survivors of the 2011 Great East Japan Earthquake and Tsunami (GEJE), we examined the association between changes in geographic distance to dental clinics and dental visits. Longitudinal data from a cohort of older residents in Iwanuma City directly impacted by the GEJE were analyzed in this study. The baseline survey was conducted in 2010, 7 mo before the occurrence of GEJE, and a follow-up was conducted in 2016. Using Poisson regression models, we estimated the incidence rate ratios (IRR) and 95% confidence intervals (CIs) for the uptake of denture use (as a proxy for dental visits) according to changes in distance from the nearest dental clinic to their house. Age at baseline, housing damage by the disaster, deteriorating economic conditions, and worsened physical activity were used as confounders. Among the 1,098 participants who had not worn dentures before the GEJE, 495 were men (45.1%), with a mean ± SD age at baseline of 74.0 ± 6.9 y. During the 6-year follow-up, 372 (33.9%) participants initiated denture use. Compared to those who experienced a large increase in distance to dental clinics (>370.0–6,299.1 m), a large decrease in distance to dental clinics (>429.0–5,382.6 m) was associated with a marginally significantly higher initiation of denture use among disaster survivors (IRR = 1.28; 95% CI, 0.99–1.66). The experience of major housing damage was independently associated with higher initiation of denture use (IRR = 1.77; 95% CI, 1.47−2.14). Improved geographic access to dental clinics may increase dental visits of disaster survivors. Further studies in non-disaster-affected areas are needed to generalize these findings. [ABSTRACT FROM AUTHOR]

Children's dental fear (CDF) has become one of the main reasons affecting the quality of dental treatment. In order to reduce the incidence of CDF in China before and after children's dental visits, this review applies literature analysis and empirical summary methods to analyze and summarize academic discussions on this topic, including occurrence mechanism, prevention guidance, and the conclusion that the occurrence and prevention of CDF is closely related with children's internal characteristics and external influences. In the end, we propose a breakthrough of combining the CFSS-DS scale and three-grade prevention theory together in the future to provide new ideas and hypotheses for the prevention of CDF. [ABSTRACT FROM AUTHOR]