Assessing oral health content in nondental professional association websites.

Objectives: Determine the prevalence and type of oral health (OH) content among nondental health professional associations' websites.

Methods: Fifty-nine organizations were selected from three lists of health professional associations and categorized as physician-, nurse- and other healthcare-related professions. Eight dental search terms were used on searchable websites.

The Evolving Role of Health Literacy in Improving Oral Health.

This chapter provides a review of the evolution of oral health literacy including its impact on oral health outcomes, the current status of oral health literacy initiatives and future research needs. Using the Healthy People 2010 definition, the chapter describes opportunities needed to improve oral health literacy among health providers as well as individuals/patients, communities and policy-makers. Studies of the two most prevalent dental diseasesâĂŤdental caries and periodontal diseases - reveal that increasing the oral health literacy of the public and health care providers can play a major role in reducing these diseases.

A Clinical Vignette-Based Study of Physicians' Adherence to Guidelines for Dental Referrals of Young Children.

Objectives: The American Academy of Pediatrics (AAP) recommends an oral health risk assessment and referral to a dental home by a child's first birthday. We evaluated the adherence of primary care providers (PCPs) to AAP dental referral guidelines for children age <4 years and barriers to implementation of these guidelines.

Methods: A cross-sectional survey of PCPs randomly selected from the 435 practices in North Carolina identified as providing well-child visits for Medicaid children age <4 years was completed in 2013.

Access to preventive services after the integration of oral health care into early childhood education and medical care.

Background: The effect of Early Head Start (EHS) on receipt of preventive oral health services (POHS) from both oral and medical health care providers is not known.

Methods: The authors compared children enrolled in North Carolina EHS programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates.

Implementing an early childhood oral health program in a federally qualified health center in North Carolina.

Objectives: To examine the Baby Oral Health Program's (bOHP) influence on dental visits for children 0 to 3 years and overall dental visits in four federally qualified health center (FQHC) clinics.

Methods: Using an interrupted time series study design, administrative data were obtained for the year prior and following the intervention. The intervention included dental staff training on early childhood oral health, quality improvement, and monthly visits during the follow-up intervention period.

Bridging the dental-medical divide: Case studies integrating oral health care and primary health care.

Background: The National Academies of Sciences, Engineering, and Medicine commissioned an environmental scan describing the status of health care integration of oral health and primary care services.

Methods: The authors conducted an environmental scan of US integration activities with publications from January 2000 through August 2017. They categorized services as preventive oral health services (POHS) provided by medical care providers, POHS provided by dental providers in nondental settings, preventive health services provided by dental providers, or care coordination using dedicated personnel and technology.

Absence of a moderating effect of parent health literacy on Early Head Start enrollment and dental use.

Objectives: To examine the moderating effect of parents' health literacy (HL) on the effectiveness of North Carolina Early Head Start (EHS) in improving children's dental use.

Methods: Parents of 479 children enrolled in EHS and 699 Medicaid-matched parent-child dyads were interviewed at baseline when children were approximately 10 months old and 24 months later. We used in-person computer-assisted, structured interviews to collect information on sociodemographic characteristics, dental use, and administer the Short Assessment of Health Literacy - Spanish and English (SAHL-S&E).

Prenatal Oral Health Counseling by Primary Care Physicians: Results of a National Survey.

Objectives Limited information exists on the extent oral health is addressed in the context of prenatal care. This study sought to investigate characteristics of primary care physicians (PCP) who provide oral health counseling to pregnant women. Methods The study relied upon data from the 2013 Survey of PCP on Oral Health.

Providers' preferences for pediatric oral health information in the electronic health record: a cross-sectional survey.

Background: The majority of primary care physicians support integration of children's oral health promotion and disease prevention into their practices but can experience challenges integrating oral health services into their workflow. Most electronic health records (EHRs) in primary care settings do not include oral health information for pediatric patients. Therefore, it is important to understand providers' preferences for oral health information within the EHR.

Perspectives on Innovations in Oral Health Care.

A downward trend in dental caries in permanent teeth of children that began in the 1970s has leveled out at historic lows. Severe periodontal disease affects a small percentage of people, and tooth loss has plummeted so that complete tooth loss, once a common occurrence, now is almost non-existent in upper socioeconomic groups. But not all people have benefited equally from these positive trends.

Trends in Oral Diseases in the U.S. Population.

This article reviews trends in dental caries, periodontal disease, and tooth loss for the United States along with population dynamics and risk factors that might influence these trends going forward. Dental caries experience remains high in the primary dentition. Caries severity in permanent teeth of children has declined to historically low levels, and long-standing inequalities in untreated caries appear to be narrowing.

Science, Politics, and Communication: The Case of Community Water Fluoridation in the US.

Community water fluoridation (CWF) and its effect in reducing the burden of dental caries (tooth decay) is considered one of the 10 public health achievements in the 20th century. In the U.S.

Enrollment in early head start and oral health-related quality of life.

Purpose: Dental problems in young children are widespread and can negatively impact quality of life. We examined the effect of enrollment in North Carolina Early Head Start (EHS)-a federally funded early education program for children under three years of age and their families-on oral health-related quality of life (OHRQoL).

Methods: In this quasi-experimental study, we interviewed 479 EHS and 699 Medicaid matched parent-child dyads at baseline (children's average age 10 months) and 24 months later.

Impact of Early Head Start in North Carolina on Dental Care Use Among Children Younger Than 3 Years.

Objectives: To examine the effects of North Carolina Early Head Start (EHS), an early education program for low-income children younger than 3 years and their families, on dental care use among children.

Methods: We performed a quasi-experimental study in which we interviewed 479 EHS and 699 non-EHS parent-child dyads at baseline (2010-2012) and at a 24-month follow-up (2012-2014). We estimated the effects of EHS participation on the probability of having a dental care visit after controlling for baseline dental care need and use and a propensity score covariate; we included random effects to account for EHS program clustering.

Training Requirements and Curriculum Content for Primary Care Providers Delivering Preventive Oral Health Services to Children Enrolled in Medicaid.

Background And Objectives: Despite the emphasis on delivery of preventive oral health services in non-dental settings, limited information exists about state Medicaid policies and strategies to educate practicing physicians in the delivery of these services. This study aims to determine: (1) training requirements and policies for reimbursement of oral health services, (2) teaching delivery methods used to train physicians, and (3) curricula content available to providers among states that reimburse non-dental providers for oral health services.

Methods: Using Web-based Internet searches as the primary data source, and a supplemental e-mail survey of all states offering in-person training, we assessed training requirements, methods of delivery for training, and curriculum content for states with Medicaid reimbursement to primary care providers delivering preventive oral health services.

Influences on preschool children's oral health-related quality of life as reported by English and Spanish-speaking parents and caregivers.

Objective: This study examined young, preschool children's oral health-related quality of life (OHRQoL) among a community-based cohort of English and Spanish-speaking parent-child dyads in North Carolina, and sought to quantify the association of parent/caregiver characteristics, including spoken language, with OHRQoL impacts.

Methods: Data from structured interviews with 1,111 parents of children aged 6-23 months enrolled in the Zero-Out Early Childhood Caries study in 2010-2012 were used. OHRQoL was measured using the overall score (range: 0-52) of the Early Childhood Oral Health Impact Scale (ECOHIS).

Provision of Preventive Dental Services in Children Enrolled in Medicaid by Nondental Providers.

Objectives: Aims of this study are to determine (1) the association of oral health services (OHS) provided by nontraditional providers with the percentage of Medicaid children 0 to 5 years of age who receive ≥1 preventive services from all provider types in the United States; and (2) characteristics of state Medicaid policies associated with provision of OHS.

Methods: We conducted a time-series cross-sectional study of preventive services provided by nontraditional (OHS) and dental (PDS) providers for Medicaid-enrolled children from birth to 5 years of age in all states during 2010 to 2013 (204 observations). We applied panel data multiple regression analysis techniques to exploit year and state variation in aggregate data available in Centers for Medicare and Medicaid Services reports (form CMS-416).

Dental Caries: Racial and Ethnic Disparities Among North Carolina Kindergarten Students.

Objectives: We examined racial/ethnic disparities in dental caries among kindergarten students in North Carolina and the cross-level effects between students' race/ethnicity and school poverty status.

Methods: We adjusted the analysis of oral health surveillance information (2009-2010) for individual-, school-, and county-level variables. We included a cross-level interaction of student's race/ethnicity (White, Black, Hispanic) and school National School Lunch Program (NSLP) participation (< 75% vs ≥ 75% of students), which we used as a compositional school-level variable measuring poverty among families of enrolled students.

Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

Background: Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS.

Methods: We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006).

Propensity score weighting: an application to an Early Head Start dental study.

Objectives: Nonrandomized group assignment in intervention studies can lead to imbalances in preintervention covariates and biased effect estimates. We use propensity score estimation to account for such imbalances in an Early Head Start (EHS) dataset with rich pretreatment information. We compare propensity score results using standard logistic regression models (LRMs) versus generalized boosted models (GBMs).

Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study.

Background And Objectives: Recent evidence supports a link between caregivers' health literacy and their children's health and use of health services. Disruptions in children's health insurance coverage have been linked to poor health care and outcomes. We examined young children's Medicaid enrollment patterns in a well-characterized cohort of child/caregivers dyads and investigated the association of caregivers' low health literacy with the incidence of enrollment gaps.

Barriers to pediatricians' adherence to American Academy of Pediatrics oral health referral guidelines: North Carolina general dentists' opinions.

Purpose: The purposes of this study were to: (1) assess knowledge, attitudes, and behaviors of North Carolina general dentists (GDs) regarding American Academy of Pediatrics (AAP) dental referral guidelines; and (2) determine factors that influence pediatricians' ability to comply with AAP guidelines.

Methods: One thousand GDs were surveyed to determine barriers toward acceptance of physician referrals of infants and toddlers. The primary outcome using ordered logistic regression was GDs' acceptance of children described in five case scenarios, with different levels of risk and oral health status.

Comparing medical and dental providers of oral health services on early dental caries experience.

Objectives: Most state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children. We examined the association between who (PCP, dentist, or both) provides these services to Medicaid enrollees before age 3 years and oral health at age 5 years.

Methods: We linked North Carolina Medicaid claims (1999-2006) to oral health surveillance data (2005-2006).

Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.

Children living in poverty encounter barriers to dentist visits and disproportionally experience dental caries. To improve access, most state Medicaid programs reimburse pediatric primary care providers for delivering preventive oral health services. To understand continuity of oral health services for children utilizing the North Carolina (NC) Into the Mouths of Babes (IMB) preventive oral health program, we examined the time to a dentist visit after a child's third birthday.

Influence of caregivers and children's entry into the dental care system.

Objectives: Early preventive dental visits are essential in improving children's oral health, especially young children at high risk for dental caries. However, there is scant information on how these children enter the dental care system. Our objectives were as follows: (1) to describe how a population-based cohort of young Medicaid-enrolled children entered dental care; and (2) to investigate the influence of caregiver characteristics on their children's dental care-seeking patterns.