Mitigating Global Oral Health Inequalities: Research Training Programs in Low- and Middle-Income Countries.

Although oral diseases are largely preventable, they are among the most non-communicable diseases globally, and they disproportionately burden disadvantaged communities, specially within low- and middle-income nations. The COVID-19 pandemic has highlighted the social, economic, and health inequalities in our society, including the existing global oral health inequalities. There is a shortage of dentist-scientist all around the world, especially in developing countries, such as Thailand.

Breastfeeding Duration and Childhood Caries: A Cohort Study.

This cohort study was conducted in Khon Kaen, Thailand, to test the hypothesis that a longer breastfeeding duration increases the risk for dental caries in primary teeth. We collected information on infant feeding practices and potential confounders using a structured questionnaire to interview mothers or caregivers during the second trimester of pregnancy and after birth at 21 days and at 3, 12, 18, 24, and 36 months. Regardless of other liquids and foods, full breastfeeding was defined as feeding breast milk but not formula, while any breastfeeding was feeding breast milk with or without formula.

Case-control study of nutritional and environmental factors and the risk of oral clefts in Thailand.

Background: One infant in 700 is born with an oral cleft. Prior studies suggest low micronutrient status is associated with an increased risk of oral clefts. Environmental factors such as passive smoke exposure or supplement use may also affect oral cleft risk.

Adverse birth outcomes and childhood caries: a cohort study.

Objectives: To examine the association between adverse birth outcomes and dental caries in primary teeth.

Methods: This study included children in Khon Kaen, Thailand, who participated in the Prospective Cohort Study of Thai Children. Preterm was defined as a birth at <37 weeks gestation, low birthweight (LBW) as birthweight <2500 g, and small-for-gestational age (SGA) as birthweight <10th percentile of expected weight for gestational age.

Prevalence of pain in the orofacial regions in patients visiting general dentists in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network.

Background: This study aimed to measure prevalence of pain in the orofacial regions and determine association with demographics, treatment history, and oral health conditions in dental patients visiting clinics in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) research network.

Methods: Data were recorded in a survey with systematic random sampling of patients (n = 1,668, 18 to 93 years old, 56% female) visiting 100 general dentists in the Northwest PRECEDENT research network. Prevalence ratios (PR) of orofacial pain by each variable were estimated by generalized estimating equations for Poisson regression.

Dental sealants and restorations and urinary bisphenol A concentrations in children in the 2003-2004 National Health and Nutrition Examination Survey.

Background: Resin-based dental sealants and composites contain bisphenol A-glycidyl methacrylate, a bisphenol A (BPA) derivative. The authors hypothesized that a greater number of sealants or restorations would be associated with higher urinary BPA concentrations.

Methods: The authors examined urinary BPA measurements (in nanograms per milliliter) and oral examination data for 1,001 children aged 6 to 19 years from data sets of the 2003-2004 National Health and Nutrition Examination Survey (NHANES).

Associations of periodontitis and oral manifestations with CD4 counts in human immunodeficiency virus-pregnant women in Thailand.

Objectives: To investigate the associations of CD4 count with chronic periodontitis and human immunodeficiency virus (HIV)-related oral lesions in pregnant HIV-infected Thai women.

Study Design: Two hundred ninety-two HIV-infected pregnant women were interviewed for health information and examined for their periodontal condition and HIV-related oral lesions during weeks 16-34 of gestation. Logistic regression, t tests and Chi-squared tests were used to examine the associations of CD4 count with oral lesions and periodontal conditions.

Risk factors for osteonecrosis of the jaws: a case-control study from the CONDOR Dental PBRN.

Case reports and cohort studies have linked bisphosphonate therapy and osteonecrosis of the jaws (ONJ), but neither causality nor specific risks for lesion development have been clearly established. We conducted a 1:3 case-control study with 3 dental practice-based research networks, using dentist questionnaires and patient interviews for collection of data on bisphosphonate therapy, demographics, co-morbidities, and dental and medical treatments. Multivariable logistic regression analyses tested associations between bisphosphonate use and other risk factors with ONJ.

The summer institute in clinical dental research methods: still going and growing after twenty years.

The first Summer Institute in Clinical Dental Research Methods, a faculty development program at the University of Washington, was offered in the summer of 1992 for sixteen participants. The primary objective of the program was to give clinical faculty members in dentistry an introduction to and an understanding of the fundamental principles and methods used in good clinical research. In the twentieth offering of the institute in 2011, there were thirty-five participants, and over the twenty institutes, there has been a cumulative total of 463 participants who have come from thirty U.

Increased risks of preterm birth and a low-birth-weight baby in Thai human immunodeficiency virus-positive pregnant women with periodontitis.

Background: Many studies have investigated the risks of adverse neonatal outcomes associated with the presence of periodontitis in non-human immunodeficiency virus (HIV)-infected pregnant women. To the best of our knowledge, there has been no study to investigate the risk of neonatal outcomes associated with periodontitis in HIV-infected pregnant women. The aim of this study is to measure the risk of having adverse neonatal outcomes: preterm delivery (<37 weeks of gestation), low birth weight (<2500 g at birth), and preterm and low-birth-weight baby (<37 weeks of gestation and <2500 g at birth) associated with the presence of periodontitis in HIV-infected women.

Risk factors for osteonecrosis of the jaws: a case-control study from the CONDOR dental PBRN.

Case reports and cohort studies have linked bisphosphonate therapy and osteonecrosis of the jaws (ONJ), but neither causality nor specific risks for lesion development have been clearly established. We conducted a 1:3 case-control study with three dental Practice-based Research Networks, using dentist questionnaires and patient interviews for collection of data on bisphosphonate therapy, demographics, co-morbidities, and dental and medical treatments. Multivariable logistic regression analyses tested associations between bisphosphonate use and other risk factors with ONJ.

What's in a dental practice-based research network? Characteristics of Northwest PRECEDENT dentists, their patients and office visits.

Objectives: The authors conducted a study to describe the general dentists, practices, patients and patient care patterns of the dental practice-based research network (PBRN) Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT).

Methods: Northwest PRECEDENT is a dental PBRN of general and pediatric dentists and orthodontists from five U.S.

The conduct of practice-based research in community clinics compared to private practices: similarities, differences, and challenges.

Practice-based research should be performed in all practice settings if the results are to be applied to all settings. However, some practice settings, such as community clinics, have unique features that may make the conduct of such research more challenging. The purpose of this article is to describe and compare the similarities and unique challenges related to conducting research in community clinics compared to private practices within the Northwest Practice-Based REsearch Collaborative in Evidence-Based DENTistry (PRECEDENT) network.

Urinary porphyrin excretion in children with mercury amalgam treatment: findings from the Casa Pia Children's Dental Amalgam Trial.

Increases in the urinary concentrations of pentacarboxyl- and coproporphyrins and the appearance of the atypical precoproporphyrin have been defined in relation to mercury (Hg) body burden in animal studies, and this change in the porphyrin excretion pattern has been described as a biomarker of occupational Hg exposure and toxicity in adult human subjects. In the present studies, urinary porphyrins were determined in relation to Hg exposure in children and adolescents, 8-18 yr of age, over the 7-yr course of a clinical trial designed to evaluate the neurobehavioral and renal effects of dental amalgam in children. Subjects were randomized to either dental amalgam or composite resin treatments.

Urinary porphyrin excretion in normal children and adolescents.

Background: Urinary porphyrins are diagnostic of various metabolic disorders and xenobiotic exposures, but comprehensive normative data for urinary porphyrin concentrations in children are currently unavailable.

Methods: Subjects were participants in a prospective, randomized, controlled clinical trial of dental materials safety, 8 to 12 y at inception, who were followed longitudinally for 7 y after baseline with an extensive battery of neurobehavioral, neurological, renal function and urinary porphyrin assessments. Porphyrins were quantified by HPLC.

The serial use of child neurocognitive tests: development versus practice effects.

When serial neurocognitive assessments are performed, 2 main factors are of importance: test-retest reliability and practice effects. With children, however, there is a third, developmental factor, which occurs as a result of maturation. Child tests recognize this factor through the provision of age-corrected scaled scores.

A longitudinal study of neurological soft signs from late childhood into early adulthood.

Neurological examination of children includes the screening for soft neurological signs (NSS). There is little knowledge about their evolution during adolescence, except that their lasting presence has been associated with developmental, psychological, and cognitive disorders. We report the results of a NSS exam (assessing gross and fine motor function and the presence of hyperactivity and motor impersistence) over a 5-year period, among a group of healthy children who were followed annually as part of a dental study.

Biomarkers of kidney integrity in children and adolescents with dental amalgam mercury exposure: findings from the Casa Pia children's amalgam trial.

Mercury is toxic to the kidney, and dental amalgam is a source of mercury exposure. Few studies have evaluated the effects of dental amalgam on kidney function in a longitudinal context in children. Here, we evaluated urinary concentrations of glutathione S-transferases (GSTs) alpha and pi as biomarkers of renal proximal and distal tubular integrity, respectively, and albumin as a biomarker of glomerular integrity in children and adolescents 8-18 years of age over a 7-year course of dental amalgam treatment.

Preparing practicing dentists to engage in practice-based research.

Background: The authors describe an educational program designed to prepare practicing dentists to engage in practice-based research in their practices--a trend receiving more emphasis and funding from the National Institute of Dental and Craniofacial Research (NIDCR).

Methods: The Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT), an NIDCR-funded network of which the authors are members, developed a one-day educational program to educate practitioners in principles of good clinical research. The program has four components built around the following questions: "What is the question?"; "What are the options?"; "How do you evaluate the evidence?"; and "How do you conduct a study?"

Results: The intensive one-day program initially offered in early 2006, which concluded with applications of research principles to research topics of interest to practitioners, was well-received.

Neurological outcomes in children with and without amalgam-related mercury exposure: seven years of longitudinal observations in a randomized trial.

Background: Although large-scale, randomized trials involving children have been completed and their results demonstrate an absence of neurobehavioral effects from clinical exposure to mercury amalgam, neurological findings from such studies have not been reported.

Methods: The authors conducted a randomized, prospective trial examining the safety of dental amalgam in which 507 children aged 8 through 12 years were assigned to treatment with either amalgam or resin-based composite. During seven years of follow-up, the authors performed annual clinical neurological examinations, including an evaluation of neurological hard signs (NHSs), presence of tremor and neurological soft signs (NSSs).

Longitudinal urinary creatinine excretion values among preadolescents and adolescents.

To present longitudinal urinary creatinine excretion data for developmentally normal children 9-17 years of age. Only extremely limited data have been presented of a longitudinal nature for this age group. Overall, 507 children who participated in a prospective, randomized, controlled trial of dental materials safety were followed longitudinally for 7 years with renal measures, including creatinine excretion.

Repeat test scores on neurobehavioral measures over an eight-year period in a sample of Portuguese children.

Normative data were collected on a sample of 503 Portuguese children who were taking part in a dental study. At the outset, the children were aged 8-11.9 years, with an average of just over 10.

The contribution of dental amalgam to urinary mercury excretion in children.

Background: Urinary mercury concentrations are widely used as a measure of mercury exposure from dental amalgam fillings. No studies have evaluated the relationship of these measures in a longitudinal context in children.

Objective: We evaluated urinary mercury in children 8-18 years of age in relation to number of amalgam surfaces and time since placement over a 7-year course of amalgam treatment.