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Jonathan D Shenkin,1 John Warren,2 Charles Spanbauer,3 Elaye Okunseri,4 Aniko Szabo,3 Christopher Okunseri4 1Department of Health Policy and Health Services Research, Boston University School of Dental Medicine, Boston, MA, USA; 2Department of Preventive and Community Dentistry, University of Iowa, College of Dentistry and Dental Clinics, Iowa City, IA, USA; 3Division of Biostatistics, Institute of Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA; 4Department of Clinical Services, Marquette University School of Dentistry, Milwaukee, WI, USA Objective: This study examined the prevalence of ambulance use for nontraumatic tooth pain (NTP) visit to emergency departments (EDs) and the factors associated with ambulance use for NTP in the USA. Materials and methods: Data from the National Hospital Ambulatory Medical Care survey conducted in the USA from 2003 to 2012 were analyzed. Descriptive statistics were obtained, and multivariable logistic regression was used to determine associations with ambulance use for NTP. Results: The total proportion of ED visits due to NTP by ambulance was 1.1%, lowest in 2008 (0.43%) and highest in 2011 (2.28%). The proportion of ED visits due to NTP by ambulance was highest among public insurance enrollees (1.9%), Hispanics (2.3%) and those aged 45–64 years (2.7%). In the multivariable analysis, those aged 45–64 years had approximately four times higher odds of an ED visit for NTP by ambulance compared to those aged 25–44 years. Conclusion: This study demonstrates that transport to EDs by ambulance for NTP does occur at a measurable rate and adults aged 45–64 years had significantly higher odds of ED visits for NTP by ambulance. Keywords: adults, dental caries, toothache, emergency department services

Purpose/question: To determine the outcomes of completing a pulpectomy on primary teeth that have been determined to have a necrotic pulp., Source of Funding: Information not available., Type of Study/design: Case series., Level of Evidence: Level 3: Other evidence., Strength of Recommendation Grade: N/A: Not applicable., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Article Title and Bibliographic Information: Dietary fluoride intake by children receiving different sources of systemic fluoride. Rodriques MH, Leite AL, Arana A, Villena RS, Forte FD, Sampaio FC, Buzalaf MA, et al. J Dent Res 2009;88(2):142-5., Reviewer: Jonathan D. Shenkin, DDS, MPH PURPOSE/QUESTION: To determine fluoride intake of preschool children from traditional sources of systemic fluoride., Source of Funding: Foundation support was from the Borrow Foundation, Hampshire, UK., Type of Study/design: Cross-sectional study, Level of Evidence: Level 3: Other evidence, Strength of Recommendation Grade: Not applicable.

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

Background: As a result of the introduction of multiple fluoride vehicles and other preventive agents, caries prevalence rates in young children have been declining over the past two decades in the United States. However, changing dietary patterns in young children may offset some of the oral health benefits of fluoridation. The objective of this study was to examine the relationship between caries in primary teeth and healthful eating practices in young children., Methods: The authors used data from the third National Health and Nutrition Examination Survey to investigate the relationship between healthful eating practices (such as breast-feeding, eating breakfast and consuming five servings of fruits and vegetables a day) and dental caries (untreated tooth decay and overall caries experience) in the primary dentition among children aged 2 through 5 years., Results: The odds of experiencing caries in primary teeth were significantly greater in nonpoor children who did not eat breakfast daily or ate fewer than five servings of fruit and vegetables per day (odds ratio, or OR = 3.77; 95 percent confidence interval, or CI, 1.80 to 7.89 and OR = 3.21; 95 percent CI, 1.74 to 5.95, respectively). No association was found between breast-feeding and caries in primary teeth., Conclusion: Young children with poor eating habits are more likely to experience caries. Overall, the findings support the notion that dental health education should encourage parents, primary caregivers and policy-makers to promote healthful eating practices, such as eating breakfast daily, for young children., Practice Implications: Dental professionals are well-positioned to inform parents and caregivers regarding age-appropriate healthful eating practices for young children entrusted in their care.

Purpose: The purpose of this study was to obtain pilot information concerning the attitudes of pediatric dentists regarding their role in tobacco intervention for children and adolescent patients., Methods: A 1-page survey, which was adapted and pretested from a previous, comprehensive survey, was distributed to all registrants at the 2001 American Academy of Pediatric Dentistry Annual Meeting in Atlanta, Ga. Descriptive and exploratory multivariable techniques were used to analyze the data., Results: Of the 173 respondents, only 18% had ever received training in tobacco cessation counseling. Although most dentists agreed that they should play a role in tobacco intervention with their young patients, the majority was not comfortable with this task. Pediatric dentists with tobacco counseling training were more likely to accept their role in tobacco prevention and cessation efforts and were more confident in their ability to do so than were their counterparts. Pediatric dentists consider tobacco cessation an important role in their practices, but do not consider themselves well prepared to act on this responsibility., Conclusions: The results of this pilot survey strongly suggest that a similar, national, comprehensive study should be conducted among pediatric dentists.

Soft drink consumption has increased dramatically in the United States over the last two decades. This increase in the consumption of soft drinks has led to a decrease in dairy consumption among children and adolescents and increased the risk for dental caries and a host of systemic complications. This paper addresses the changing consumption of beverages among children and adolescents, the health consequences of such a change, and a new caries risk assessment tool that can be utilized in a private practice setting.

Purpose: The purpose of this investigation was to describe and assess the disparities, if any, in parental perceived cost barriers to oral health care among developmentally disabled children using a national data set., Methods: Data from the 1997 National Health Interview Survey (NHIS) were analyzed using a SUDAAN statistical package., Results: After adjusting for age and sex, parental perception of unmet need was significantly associated with developmentally disabled children 2-17 years in lower socioeconomic groups., Conclusions: Though most children from lower socioeconomic groups are eligible for Medicaid coverage, parents of these children perceive cost barriers to dental care. Children with developmental disabilities face even more perceived barriers to care based on family income.