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.

Exploring the genomic basis of early childhood caries: a pilot study.

Objective: A genetic component in early childhood caries (ECC) is theorized, but no genome-wide investigations of ECC have been conducted. This pilot study is part of a long-term research program aimed to: (1) determine the proportion of ECC variance attributable to the human genome and (2) identify ECC-associated genetic loci.

Methods: The study's community-based sample comprised 212 children (mean age=39 months; range = 30-52 months; males = 55%; Hispanic/Latino = 35%, African-American = 32%; American Academy of Pediatric Dentistry definition of ECC prevalence = 38%).

Framing Young Childrens Oral Health: A Participatory Action Research Project.

Background And Objectives: Despite the widespread acknowledgement of the importance of childhood oral health, little progress has been made in preventing early childhood caries. Limited information exists regarding specific daily-life and community-related factors that impede optimal oral hygiene, diet, care, and ultimately oral health for children. We sought to understand what parents of young children consider important and potentially modifiable factors and resources influencing their children's oral health, within the contexts of the family and the community.

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).

Oral Health Literacy Assessment: development of an oral health literacy instrument for Spanish speakers.

Objective: To develop an oral health literacy instrument for Spanish-speaking adults, evaluate its psychometric properties, and determine its comparability to an English version.

Methods: The Oral Health Literacy Assessment in Spanish (OHLA-S) and English (OHLA-E) are designed with a word recognition section and a comprehension section using the multiple-choice format developed by an expert panel. Validation of OHLA-S and OHLA-E involved comparing the instrument with other health literacy instruments in a sample of 201 Spanish-speaking and 204 English-speaking subjects.

Oral health activities of Early Head Start and Migrant and Seasonal Head Start programs.

Guidelines recommend that Migrant and Seasonal Head Start programs (MSHS) address the dental needs of children of migrant and seasonal farmworkers. This study describes parent- and child-oriented oral health activities of North Carolina's MSHS programs and compares them with non-migrant Early Head Start (EHS) programs using data collected from a questionnaire completed by teachers and family services staff. Migrant and Seasonal Head Start staff reported engaging in more oral health activities than EHS staff, which was confirmed by results of logit and ordered logit regression models.

Oral health activities of early head start teachers directed toward children and parents.

Objectives: This cross-sectional study examined Early Head Start (EHS) teachers' oral health program activities and their association with teacher and program characteristics.

Methods: Self-completed questionnaires were distributed to the staff in all EHS programs in North Carolina. Variables for dental health activities for parents (four items) and children (four items) were constructed as the sum of responses to a 0-4 Likert-type scale (never to very frequently).

Dental care for pregnant women: an assessment of North Carolina general dentists.

Background: The authors conducted a study to examine factors associated with general dentists' provision of care for pregnant women and the extent to which they provide comprehensive dental care.

Methods: The authors mailed an 86-item questionnaire to 1,000 practicing general dentists in North Carolina. Survey domains included provider knowledge about pregnancy and dental health, dental treatment practices, barriers to providing care, outcome expectancy, and personal and practice demographics.

Barriers to the adoption and implementation of preventive dental services in primary medical care.

Objective: To determine the barriers to adopting preventive oral health procedures in medical primary care.

Methods: Medical providers who participated in a Medicaid demonstration in North Carolina completed questionnaires reporting their experiences with providing preventive dental services for children from birth to 3 years of age. Eleven factors were established as possible obstacles to the adoption of an oral health program.

Oral health of early head start children: a qualitative study of staff, parents, and pregnant women.

Objectives: We explored the oral health knowledge, attitudes, and activities of Early Head Start (EHS) staff members, parents, and pregnant women, along with their suggestions related to future oral health educational interventions targeting EHS children.

Methods: Nine focus groups were conducted with EHS staff, parents, and pregnant women. Audiotapes of sessions were transcribed and entered into ATLAS.

Opinions of Early Head Start staff about the provision of preventive dental services by primary medical care providers.

Objective: This study investigates the opinions of the Early Head Start (EHS) staff about physicians and nurses providing preventive dental services for children in EHS.

Methods: A cross-sectional survey was undertaken of the EHS staff having contact with families in EHS programs in North Carolina (NC). A self-completed questionnaire solicited their opinions (agree, disagree, don't know) about whether physicians and nurses can "provide preventive dental care" and "identify dental problems" in infants and toddlers.

Training pediatric health care providers in prevention of dental decay: results from a randomized controlled trial.

Background: Physicians report willingness to provide preventive dental care, but optimal methods for their training and support in such procedures are not known. This study aimed to evaluate the effect of three forms of continuing medical education (CME) on provision of preventive dental services to Medicaid-enrolled children by medical personnel in primary care physician offices.

Methods: Practice-based, randomized controlled trial.

Parents' satisfaction with preventive dental care for young children provided by nondental primary care providers.

Purpose: The purpose of this study was to assess parents' satisfaction with the preventive dental care their children received in medical offices.

Methods: Caregivers accompanying Medicaid children for their medical visits at 30 practices, with at least 1 physician providing dental services, completed questionnaires just before and 12 months after initial dental care visits. Information at follow-up was obtained on the type of dental services received and parents' satisfaction with this care using questions adapted from the Consumer Assessment of Health Plans Survey.