Breaking the cycle in Maryland: oral health policy change in the face of tragedy.

In response to the death of a young child, efforts by many partners have enabled Maryland to institute oral health reforms that ensure that low-income children remain visible and have continued access to dental services. This paper shows how proponents of oral health in Maryland used issues that were already on the oral health policy agenda to break the cycle of nonaction and become a role model for other states. Deriving from the knowledge and advice of an advisory committee, Maryland administrators and state and federal legislators, with the support of many community partners, took appropriate action to elevate the oral health agenda.

Outcomes of oral cancer early detection and prevention statewide model in Maryland.

A high oral cancer mortality rate and a moderately high oral cancer incidence rate prompted Maryland to develop a statewide approach to oral cancer early detection and prevention. This approach can serve as a model for other states. Key lessons learned include the need to: develop a comprehensive plan that focuses on actions to increase awareness, education and training for the public, dental and non-dental providers and policy makers; include oral cancer in the state's comprehensive cancer control plan to keep attention focused on this disease; and maintain high vigilance among stakeholders to keep oral cancer prevention and early detection a high priority within the state.

Survey of dental sealants in Maryland third graders.

The Survey of the Oral Health Status of Maryland Schoolchildren, 2000-2001 was used to describe dental sealant prevalence among third-grade public schoolchildren in Maryland. The presence/absence of dental sealants on permanent molars was scored according to visual criteria. Descriptor variables included gender, race/ethnicity, parent/guardian level of education, and dental insurance status.

Dental visits and access to dental care among Maryland schoolchildren.

Background: Regular dental visits afford an opportunity for dentists to provide preventive services and to diagnose and treat disease. Not all children, however, have equal access to these services.

Methods: The authors conducted this study to describe access to and utilization of oral health care services for Maryland schoolchildren in kindergarten and third grade.

An analysis of preventive dental visits by provider type, 1996.

Background: Understanding preventive dental visit utilization patterns facilitates planning of the dental health services delivery system. The authors examine these patterns by analyzing the receipt of preventive dental services in the United States by type of dental provider.

Methods: The authors analyzed data from the 1996 Medical Expenditure Panel Survey (MEPS) for the U.

Dental pain in Maryland school children.

Objective: To describe the lifetime prevalence of dental pain among Maryland's school age children.

Methods: Data come from the Survey of Oral Health Status of Maryland School Children conducted in 2000-01. History of dental pain, as reported by an adult respondent, was analyzed for 2,411 kindergarten and third grade students.

Self-reported awareness of unrestored dental caries. Survey of the Oral Health Status of Maryland Schoolchildren, 2000--2001.

Purpose: The purpose of this study was to assess and compare parental awareness of unrestored dental caries needs in a schoolchildren population according to socioeconomic status.

Methods: Subjective and normative unrestored dental caries data of kindergarten and third-grade children were collected from parental awareness questionnaires and clinical examinations, respectively, used in a 2000--2001 statewide survey of Maryland schoolchildren. Descriptive, bivariate, and multivariate analyses were performed to assess awareness of unrestored dental caries.

Dental insurance visits and expenditures among older adults.

Objectives: We examined the effect of age, income, and coverage on dental service utilization during 1996.

Methods: We used data from the 1996 Medical Expenditure Panel Survey.

Results: Edentulous and poorer older adults are less likely to have coverage and less likely to report a dental visit than dentate or wealthier older adults.

A national survey of the oral health status of homeless veterans.

Objectives: This study reports results from a survey designed to (1) assess the oral health needs of a national sample of homeless veterans and (2) compare the dental needs of homeless veterans participating in VA-sponsored rehabilitation programs with domiciled veterans in VA substance addiction programs.

Methods: Homeless veterans enrolled in a nationwide rehabilitation program (n = 1,152) completed a survey including questions concerning patients' perceptions of their oral health, dental service needs and use, and alcohol and tobacco use. A sample of these veterans (n = 281) subsequently received dental exams.

Maryland family physicians' knowledge, opinions and practices about oral cancer.

The objective of this study was to assess family physicians' knowledge, opinions and practices regarding oral cancers in the state of Maryland, USA. A 40-item, self-administered questionnaire was mailed to all members of the Maryland Academy of Family Physicians. Unweighted data (n=240) were analyzed using SAS and SUDAAN software; results were evaluated using an alpha < or =0.