Systems mapping of multilevel factors contributing to dental caries in adolescents.

Unlabelled: Dental caries is a prevalent chronic disease among adolescents. Caries activity increases significantly during adolescence due to an increase in susceptible tooth surfaces, immature permanent tooth enamel, independence in pursuing self-care, and a tendency toward poor diet and oral hygiene. Dental caries in permanent teeth is more prevalent among adolescents in low-income families and racial/ethnic minority groups, and these disparities in adolescent dental caries experience have persisted for decades.

Measurement of Early Childhood Oral Health for Research Purposes: Dental Caries Experience and Developmental Defects of the Enamel in the Primary Dentition.

Epidemiological investigations of early childhood oral health rely upon the collection of high-quality clinical measures of health and disease. However, ascertainment of valid and accurate clinical measures presents unique challenges among young, preschool-age children. The paper presents a clinical research protocol for the conduct of oral epidemiological examinations among children, implemented in ZOE 2.

A Developmental Approach to Pediatric Oral Health.

Orofacial growth and development is a complex process spanning the life course. This article provides an oral health overview in the context of overall growth, physical and social development from infancy through adolescence. It reviews oral health-specific developmental milestones during childhood (0-12 years) and adolescence (≥13 years).

Oral literacy demand of preventive dental visits in a pediatric medical office: a pilot study.

Purpose: The purpose of this study was to examine the oral literacy demands placed on parents of young children during preventive dental visits in a pediatric medical office.

Methods: Transcripts of audio recordings for 15 pediatric medical visits were analyzed to assess the oral literacy demand of the visit, as measured by use of terminology, language complexity, and structural characteristics of the dialogue. Parent-completed surveys were used to determine recall of dental concepts discussed during the visit.

Cost-effectiveness of preventive oral health care in medical offices for young Medicaid enrollees.

Objective: To estimate the cost-effectiveness of a medical office-based preventive oral health program in North Carolina called Into the Mouths of Babes (IMB).

Design: Observational study using Medicaid claims data (2000-2006).

Setting: Medical staff delivered IMB services in medical offices, and dentists provided dental services in offices or hospitals.

Effectiveness of preventive dental treatments by physicians for young Medicaid enrollees.

Objective: To estimate the effectiveness of a medical office-based preventive dental program (Into the Mouths of Babes [IMB]), which included fluoride varnish application, in reducing treatments related to dental caries.

Methods: We used longitudinal claims and enrollment data for all children aged 72 months or younger enrolled in North Carolina Medicaid from 2000 through 2006. Regression analyses compared subgroups of children who received up to 6 IMB visits at ages 6 to 35 months with children who received no IMB visits.

Impact of poor oral health on children's school attendance and performance.

Objectives: We examined school days missed for routine dental care versus dental pain or infection to determine the relationship between children's oral health status and school attendance and performance.

Methods: We used 2008 data from the North Carolina Child Health Assessment and Monitoring Program. The study sample, weighted to reflect the state's population, included 2183 schoolchildren.

How a North Carolina program boosted preventive oral health services for low-income children.

Dental caries (tooth decay), the most common chronic disease affecting young children, is exacerbated by limited access to preventive dental services for low-income children. To address this problem, North Carolina implemented a program to reimburse physicians for up to six preventive oral health visits for Medicaid-enrolled children younger than age three. Analysis of physician and dentist Medicaid claims from the period 2000-2006 shows that the program greatly increased preventive oral health services.

Multiple imputation of dental caries data using a zero-inflated Poisson regression model.

Unlabelled: Excess zeros exhibited by dental caries data require special attention when multiple imputation is applied to such data.

Objective: The objective of this study was to demonstrate a simple technique using a zero-inflated Poisson (ZIP) regression model, to perform multiple imputation for missing caries data.

Methods: The technique is demonstrated using data (n = 24,403) from a medical office-based preventive dental program in North Carolina, where 27.

Agreement between structured checklists and Medicaid claims for preventive dental visits in primary care medical offices.

For program evaluation purposes, the feasibility of matching Medicaid claims with physician-completed structured checklists (encounter forms, EFs) was assessed in a pediatric office-based preventive dental program. We examined agreement on visits (weighted kappa) and predictors of a match between EFs and claims (multinomial logit model with practice-level clustering). In total, 34,171 matches occurred between 41,252 EFs and 40,909 claims, representing 82.

Patient- and population-reported outcomes in public health dentistry: oral health-related quality of life.

At present no process is in place in the United States to comprehensively monitor the national burden of oral diseases from the perspective of oral health-related quality of life (OHRQoL), yet available evidence shows that a substantial percentage of the adult population rates their oral health poorly. This article reviews applications of OHRQoL in dental public health. The authors specifically review its use, contributions, and needed advances in: (1) monitoring the impacts of oral diseases on OHRQoL at the national level, and in public health surveillance at the state and local levels; (2) treatment outcomes research and program evaluation; and (3) clinical practice.

Follow-up preventive dental visits for Medicaid-enrolled children in the medical office.

Objective: To describe the frequency and determinants of follow-up preventive oral health visits at medical offices among children screened for dental disease, receiving fluoride varnish and counseling.

Methods: Parents of Medicaid children enrolled in a clinical trial completed a baseline questionnaire before their child's medical visit. The providers completed patient dental encounter forms at each visit, documenting dental services, caries risk, and dental disease.

Development and testing of the Test of Functional Health Literacy in Dentistry (TOFHLiD).

Objective: This study aims to evaluate the reliability and validity of the Test of Functional Health Literacy in Dentistry (TOFHLiD), a new instrument to measure functional oral health literacy.

Methods: TOFHLiD uses text passages and prompts related to fluoride use and access to care to assess reading comprehension and numerical ability. Parents of pediatric dental patients (n = 102) were administered TOFHLiD, a medical literacy comprehension test (TOFHLA), and two word recognition tests [Rapid Estimate of Adult Literacy in Dentistry (REALD), Rapid Estimate of Adult Literacy in Medicine (REALM)].

Evaluation of a word recognition instrument to test health literacy in dentistry: the REALD-99.

Objective: This study aims to evaluate a dental health literacy word recognition instrument.

Methods: Based on a reading recognition test used in medicine, the Rapid Estimate of Adult Literacy in Medicine (REALM), we developed the Rapid Estimate of Adult Literacy in Dentistry (REALD-99). Parents of pediatric dental patients were recruited from local dental clinics and asked to read aloud words in both REALM and REALD-99.

Parental perceptions of children's oral health: the Early Childhood Oral Health Impact Scale (ECOHIS).

Background: Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is available to measure these negative influences in very young children. The objective of this research was to develop the Early Childhood Oral Health Impact Scale (ECOHIS) to measure the OHRQL of preschool children and their families.