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1
Oliveira, Deise Cruz. "Minimally invasive dentistry approach in dental public health." Thesis, University of Iowa, 2011. https://ir.uiowa.edu/etd/1047.
Full textAbstract:
Dental caries is the main reason for placement and replacement of restorations (Keene, 1981). More than 60 percent of dentists' restorative time is spent replacing existing restorations. The replacement of restorations can result in a cavity preparation larger than its predecessor which leads to weakening of the remaining tooth structure (Mjör, 1993). Considering the traditional surgical dental caries management philosophy, it was based on "extension for prevention" and restorative material needs rather than on preserving the healthy tooth structure (Black, 1908). In the 1970s, the surgical dental paradigm began shifting to a new approach for caries management: Minimally Invasive Dentistry (MID). It was based on the medical model that prioritizes caries risk assessment, early caries detection, remineralization of tooth structure, and especially preservation of tooth structure through minimal intervention in the placement and replacement of restorations (Yamaga et al, 1972). The minimal intervention paradigm emphasizes use of adhesive restorative materials in order to minimize the size of cavity preparation (Murdoch-Kinch & McLean, 2003).
Hence, a cross-sectional study using an online survey instrument (30-item) was conducted among National Network for Oral Health Access (NNOHA) and American Association Community Dental Programs (AACDP) members. Besides demographics, the survey addressed the following items using a 5-point Likert scale: knowledge, attitudes and behavior concerning MID among general practitioners. Specific questions focused on practitioner and practice characteristics, previous training and knowledge of MID, knowledge use of restorative, diagnostic and preventive techniques and whether MID was considered to meet the standard of care in the U.S., which was the main outcome of the study.
Chi-square, Fisher's exact test, Wilcoxon rank-sum test, and two-Sample t-test were used to identify factors associated with beliefs that MID meets the standard of care. Overall, 86% believed MID met the standard of care for primary teeth, and 77% believed this for permanent teeth. The study found that those with more favorable opinions of fluoride to be more likely to believe MID met the standard of care, but no demographic or practice characteristics were associated MID standard of care beliefs.
2
Patino, Daisy. "Oral health knowledge and dental utilization among Hispanic adults in Iowa." Thesis, University of Iowa, 2015. https://ir.uiowa.edu/etd/1997.
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Objectives: To determine oral health literacy levels among Hispanic adults living in Iowa, and assess the relationship between oral health literacy and dental utilization.
Methods: This cross-sectional study included a convenience sample of self-identifying Hispanic/Latino adults. Participants were recruited via mass email, word of mouth, and from faith-based organizations that provided church services in Spanish. Participants were recruited from urban and rural communities in Central and Eastern Iowa. Participants were asked to complete a questionnaire, in either English or Spanish, that contained questions pertaining to: oral health literacy, dental utilization, acculturation, language proficiency, demographic information, country of origin, number of years living in the United States, and preferences pertaining to the characteristics of their dental providers (e.g. importance of dentist to be able to speak Spanish). Oral health literacy was assessed using the Comprehensive Measure of Oral Health Knowledge (Macek and colleagues). Oral health knowledge levels were categorized as low (0-14) or high (15-23). Dental utilization was defined as visiting a dental provider within the past 12 months or more than 12 months ago. Bivariate analyses were conducted using the Chi-square test with oral health knowledge and dental utilization being the two main outcome variables. Multiple logistic regression models were created to identify the variables related to low oral health knowledge irregular dental utilization. Statistical significance was set as p<0.05. IRB approval was obtained prior to conducting the study.
Results: Three hundred thirty-eight participants completed the questionnaire. Sixty-seven percent of participants (n=228) completed the questionnaire in Spanish. The mean oral health knowledge score was 14 (low knowledge =51% vs. high knowledge = 49%). Thirty-five percent reported visiting the dentist <12 months ago. Bivariate analyses revealed that the following respondents were more likely to have low oral health knowledge (p<0.05): being older (i.e. 55-71 years of age), male, self-reporting low health literacy, having less than a high-school education, earning ≤$25,000, not having dental insurance, having low acculturation, being born outside of the United States, preferring a dental provider who speaks Spanish, perceiving one’s oral health to be fair/poor/or not knowing the status of one’s oral health, seeking dental care someplace other than a private dental office, and being more likely to seek care for a problem related visit rather than routine care. Having low oral health knowledge was statistically significantly associated visiting a dentist >12 months ago. Many other variables were also associated (p<;0.05) with infrequent dental utilization: low health literacy, being male, having <12th grade degree or a high school diploma, earning ≤$25,000, not having dental insurance, having low acculturation, reporting fewer years living in the United States, preferring a dental provider who speaks Spanish, perceiving one’s oral health to be fair/poor/or not knowing the status of one’s oral health, and seeking dental care someplace other than a private dental office. Final logistic regression analyses indicated that having less than a 12th grade education, lack of dental insurance, and a preference for receiving care from a Spanish speaking dental provider were associated with low oral health literacy. Furthermore, final logistic regression results predicting irregular dental utilization demonstrated that the following variables were statistically significant: being male, earning ≤$25,000 per year, not having dental insurance and having a history of tooth decay.
Conclusion: Dental utilization and oral health knowledge appear to be associated. Patients with low oral health literacy may be less likely to utilize dental care, thus decreasing the opportunity to increase dental knowledge. Dental teams should recognize which patients are more likely to have low oral health literacy and provide dental education in patients’ preferred language.
3
Ahuja, Vinti. "Oral health related quality of life among Iowa adolescents." Thesis, University of Iowa, 2013. https://ir.uiowa.edu/etd/4943.
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Our study involved secondary analyses of the oral health-related quality of life data collected in the Iowa Fluoride Study at the 17-year time-point. Both adolescents and their parents filled out questionnaires related to the assessment of the OHRQoL of the adolescents. In addition, adolescents also underwent clinical examination to assess dental caries, dental fluorosis, orthodontic characteristics, and non-fluoride opacities. Dental casts were also made with the assent of the participants. These casts were later used to estimate the social acceptability of the participants' dental appearance and assess their malocclusion severity, using the Dental Aesthetic Index (Cons et al, 1978). This study assessed the relationships between the OHRQoL of Iowa adolescents and the presence of selected oral conditions, such as dental caries, dental fluorosis, and malocclusion.
Based on the multivariable analyses, dental caries and malocclusion severity (reflected by DAI score) were the two oral conditions that were found to be significantly associated with poorer OHRQoL in adolescents. In addition, the influence of sex on adolescents' perceptions of OHRQoL was found to be statistically significant in our study and being female was associated with poorer OHRQoL.
The findings of our study corroborate the results of other investigations that have demonstrated significant associations between: i) dental caries and OHRQoL (Arrow P, 2013; Barbosa et al, 2013; Bastos et al, 2012; Castro et al,2010; Do and Spencer, 2007; Martinis et al, 2012); ii) malocclusion and OHRQoL (Foster Page et al., 2005; Do and Spencer, 2007; Locker et al, 2007; Bernabe et al, 2008; Agou et al, 2008; O'Brien et al, 2006; Feu et al, 2010; Ukra et al, 2013); and iii) sex and OHRQoL (Foster Page et al, 2005; Calis et al, 2009; Bos et al, 2010; Barbosa et al, 2013; Ukra et al, 2013).
Thus, oral conditions such as dental caries and malocclusion can be a source of stress and can have a negative impact on the life of an individual and can impede their ability to succeed. Females tend to be more sensitive to the negative impact of oral health conditions. Thus, in order to better understand the impact of oral health conditions, subjective measures should be used in conjunction with normative measures or clinical measures of assessing oral health. This can help in better treatment planning, and better allocation of resources, as oral health perceptions can vary for different individuals.
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Broughton, John, and n/a. "Oranga niho : a review of Maori oral health service provision utilising a kaupapa maori methodology." University of Otago. Dunedin School of Medicine, 2006. http://adt.otago.ac.nz./public/adt-NZDU20070404.165406.
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The goal of this study was to review Maori oral health services utilising a kaupapa Maori framework.
The aims of the study were to identify the issues in the development, implementation and operation of Maori dental health services within each of the three types of Maori health providers (mainstream, iwi-based, partnership). The three Maori oral health services are: (i) Te Whare Kaitiaki, University of Otago Dental School, Dunedin. (ii) Te atiawa Dental Service, New Plymouth. (iii) Tipu Ora Dental Service, in partnership with the School Dental Service, Lakeland Health, Rotorua.
Method: A literature review of kaupapa Maori research was undertaken to provide the Maori framework under which this study was conducted. The kaupapa Maori methodology utilised the following criteria: (i) Rangatiratanga: The assertion of Maori leadership; (ii) Whakakotahitanga: A holistic approach incorporating Te Whare Tapa Wha; (iii) Whakapapa: The origins and development of oranga niho; (iv) Whakawhanuitanga: Recognising and catering for the diverse needs of Maori; (iv) Whanaungatanga: Culturally appropriate forms of relationship management; (v) Maramatanga: Raising Maori awareness, health promotion and education; and (vi) Whakapakiri: Recognising the need to the build capacity of Maori health providers.
Ethical approval was granted by the Otago, Bay of Plenty and Taranaki Ethics Committees to undertake interviews and focus groups with Maori oral health providers in Dunedin, Rotorua and New Plymouth. Information was also sought from advisors and policy analysts within the Ministry of Health. A valuable source of information was hui korero (speeches and/or discussion at Maori conferences). An extensive literature was undertaken including an historical search of material from private archives and the now defunct Maori Health Commission.
Results: An appropriate kaupapa Maori methodology was developed which provided a Maori framework to collate, describe, organise and present the information on Maori oral health.
In te ao tawhito (the pre-European world of the Maori) there was very little if any dental decay. In te ao hou (the contemporary world of the Maori) Maori do not enjoy the same oral health status as non-Maori across all age groups. The reasons for this health disparity are multifactorial but include the social determinants of health, life style factors and the under-utilisation of health services. In order to address the disparities in Maori oral health, Maori providers have been very eager to establish kaupapa Maori oral health services. The barriers to the development, implementation, and operation of a kaupapa Maori oral health service are many and varied and include access to funding, and racism. Maori health providers have overcome the barriers through two strategies: firstly, the establishment of relationships within both the health sector and the Maori community; and secondly, through their passion and commitment to oranga niho mo te iwi Maori (oral health for all Maori). The outcome of this review will contribute to Maori health gain through the recognition of appropriate models and strategies which can be utilised for the future advancement of Maori oral health services, and hence to an improvement in Maori oral health status.
Conclusion: This review of Maori oral health services has found that there are oral health disparities between Maori and non-Maori New Zealanders. In an effort to overcome these disparities Maori have sought to provide kaupapa Maori oral health services. Whilst there is a diversity in the provision of Maori oral health services, kaupapa Maori services have been developed that are appropriate, effective, accessible and affordable. They must have the opportunity to flourish.
5
Balakrishnan, Nyla. "Legally authorized representatives’ awareness of the oral health needs of long term care facility residents." Thesis, University of Iowa, 2018. https://ir.uiowa.edu/etd/6363.
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Objectives: To evaluate the oral health knowledge of legally authorized representatives of long term care facility residents to assess whether oral health knowledge is associated with the representatives’ understanding of the residents’ oral health status and treatment needs.
Methods: The study participants were legally authorized representatives (LARs) of long term care facility (LTCF) residents who were visited by the Geriatric Mobile Unit (GMU) of the University of Iowa College of Dentistry & Dental Clinics. Once IRB approval was obtained, a mailing was sent out to the LARs after the GMU visited the LTCF. LARs were asked to complete a survey and were also asked permission to obtain dental records of the LTCF resident they represented. The survey contained questions pertaining to the LAR as well as the LTCF resident. With respect to the LAR, questions on socio-demographics, oral health literacy, oral health knowledge, oral health behavior and oral health status were asked. For questions about the LTCF resident, the LARs were asked about the resident’s prior oral health behavior, current oral health status, oral health treatment needs, and dental insurance status. They were also asked what factors would influence their decision to seek oral health care for the LTCF resident, and when they last spoke to the LTCF resident about their oral health. Bivariate analyses were conducted using Chi-square and Cochran-Mantel-Haenszel tests with LARs knowledge about the LTCF residents’ missing teeth and various oral health treatment needs being the outcome variables. Significant variables were entered into a multiple logistic regression model for each outcome variables. Statistical significance was set at p<0.05 and p=0.05-0.2.
Results: Four hundred and thirty-one surveys were mailed out to the LARs. One hundred LARs consented to participate in the study and returned the completed questionnaire. Fifty-two percent of the LARs got all nine oral health knowledge questions correct. The questions that were the most frequently missed included “Losing teeth is a natural process of aging” (77% answered correctly), and “Blood on your toothbrush is a sign of gum disease” (74% answered in correctly). Thirty-eight percent of the LARs said they were extremely confident filling out medical forms by themselves, and 37% said they were quite a bit confident. When asked about the missing teeth of the LTCF resident, ten LARs reported that their LTCF resident had all teeth missing, while only 9 LTCF residents had all teeth missing as per chart review. Seventy-six residents had some upper back teeth missing and 71 residents had some lower back teeth missing. Twenty-eight LARs reported some upper back teeth were missing in their resident and 24 LARs reported some lower back teeth was missing. Treatment needs of the resident were in general underestimated by the LAR. Thirty-five LTCF residents needed a filling and 15 needed extractions, however LARs reported 21 residents needed fillings, and 8 needed extractions. Fifty-six LARs did not know if the resident needed a filling, and 49 LARs did not know if the resident needed an extraction. Bivariate analyses reported a number of significant variables in each domain for p values <0.05 and between 0.05 and 0.2. In the final logistic regression model, retirement status of the LAR and LARs’ confidence filling out medical forms were most commonly significant for LARs’ knowledge about treatment needs of the LTCF resident; and self-reported oral health status, age of the resident, and physical health status of the resident influencing the LARs decision to seek care dental care for the resident were significant for LARs’ knowledge about missing teeth of the LTCF resident.
Conclusion: Although the majority of LARs indicated that oral health is important for nursing home residents, many LARs were unaware of the oral health status and the treatment needs of the LTCF residents. While a single variable was not found to be commonly associated across LARs’ knowledge of the oral health status and treatment needs of the residents, several variables were associated with the knowledge of one treatment need only as opposed to the knowledge of multiple treatment needs. Understanding if and how oral health literacy and oral health knowledge influence LARs’ and as well as nursing home caregivers’ decisions to seek dental care for LTCF residents may help address the gaps in oral health care for LTCF residents, thereby improving their quality of life.
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Rowell, Olivia. "ETSU Dental Hygiene Students’ Interest in and Perceived Preparedness for Nontraditional or Expanded Roles after Graduation." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/honors/452.
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Purpose
This study assessed ETSU dental hygiene students’ perceptions and attitudes toward their careers after graduation in relation to underserved populations’ lack of access to dental care and nontraditional roles for dental hygienists.
Methods
A voluntary simple survey was used to assess the following: dental hygiene students’ exposure to and knowledge about underserved populations and nontraditional roles for dental hygienists, students’ favor or opposition toward these nontraditional roles, students’ interest in nontraditional roles, and students’ perceived preparedness to work outside of a traditional dental office in nontraditional roles to provide care for underserved populations. The survey data was aggregated and analyzed within the general context of the ETSU Dental Hygiene Program, and differences in responses based upon student classification were investigated using an independent samples t test.
Results
Between classes, a significant difference was seen in the responses for seven questions, all of which addressed either students’ knowledge about underserved populations and corresponding solutions to the lack of access to care or students’ perceived preparedness for nontraditional roles after graduation. The majority of the dental hygiene students responded as being in favor or completely in favor of expanded or nontraditional roles for dental hygienists and as being interested or highly interested in functioning in such roles. However, 88.89% of participants reported that they were either likely or highly likely to choose private practice as their primary place of employment.
Conclusion
The senior dental hygiene students both possess higher levels of knowledge about underserved populations and nontraditional roles for dental hygienists and feel more prepared to function in nontraditional roles after graduation than do the junior dental hygiene students. The program could consider focus areas, such as the reason for students’ high interest in nontraditional roles and simultaneous high likelihood to work primarily in private practice and ways to address this discrepancy.
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Serna, Claudia A. "Exploring Oral Health Problems in Adult Hispanic Migrant Farmworkers: A Mixed-Methods Approach." FIU Digital Commons, 2014. http://digitalcommons.fiu.edu/etd/1593.
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This mixed-methods study examined patterns of dental health care utilization in adult Hispanic migrant farmworkers (AHMFW) with special emphasis on non-compliance with the American Dental Association (ADA) and the American Dental Hygienists Association (ADHA) recommendation of visiting the dentist at least once a year; while also exploring the group’s social and cultural construction of oral health.
A total of 278 farmworkers responded to a close ended survey. Binary and hierarchical logistic regression analysis were employed in identifying predisposing, enabling, and needs factors associated with non-compliance. Following the survey, fourteen ethnographic interviews were conducted with respondents who volunteered to participate in this phase of the study.
Most participants (79.5%) were non-compliant with the ADA and the ADHA recommendation. Binary logistic regression results indicated that AHFW reporting need for dental treatment were compliant with the recommendation. In contrast, those who brushed their teeth more often, experienced oral health impact, and reported poor perception of their mouth condition were non-compliant. Hierarchical logistic regression results pointed to those who used floss and reported need for dental treatment as compliant with the recommendation. Participants reporting poor perception of their mouth condition were non-compliant. Eight themes emerged from the qualitative analysis (understanding of the mouth, meaning of oral health, history of dental care; dental problems, barriers to dental care, caring of the teeth/mouth, medications, oral health quality of life).
Farmworkers were knowledgeable of oral health, however, this knowledge, particularly the practice of brushing twice a day, made them less likely to seek regular dental care. Ultimately, a dental visit hinged on their limited finances, lack of dental insurance, and family responsibilities. Together, these decreased access to preventive dental services and increased risk of experiencing oral health problems.
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Teixeira, Erica Cappelletto Nogueira. "Dentists’ prescribing practices for antibiotic prophylaxis in patients with large prosthetic joints." Thesis, University of Iowa, 2018. https://ir.uiowa.edu/etd/6509.
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With an aging population and with the number of patients with large prosthetic joints increasing, the recommendation of antibiotic use in this specific population has generated significant discussion. Dentists often treat patients with large prosthetic joints; however, little is known regarding the prescribing practices of dental providers. This cross-sectional study carried out in the State of Iowa, United States, evaluated whether dentists were familiar, followed, and were satisfied with the 2015 American Dental Association Clinical Guidelines and the 2016 American Academy of Orthopaedic Surgeons Appropriate Use Criteria (AUC), and whether dentists responses were associated with demographic and provider characteristics. Dentists’ concerns about antibiotic resistance, medical legal aspects, and adverse effects related to using antibiotic prophylaxis were also examined.
Of the 1521 surveys that were sent by mail, a total of 635 were returned, for a response rate of 41.7%. Our results confirm that dental practitioners were very concerned about antibiotic resistance (43.9%) compared to 5.23% who were not at all concerned. In addition, female subjects were significantly more likely to be very concerned about antibiotic resistance than were male subjects (50.9% vs 41.4%; p=0.0376). Moreover, subjects that practiced in urban areas were more likely to be very concerned about antibiotic resistance that those practicing in rural areas (47.9%vs 37.5%; p=0.0157). We also observed that for a healthy patient, 28.9% of dentists would never recommend antibiotics. On the other hand, 44.9% of the respondents would recommend antibiotic premedication within the first 2 years since prosthetic joint replacement, 14.1% would recommend it within the first year, and 6.9% would recommend it for life. Dentists were aware of the lack of effectiveness of antibiotic prophylaxis in preventing prosthetic joint infection. However, premedication recommendations by physicians and patient preferences influenced dentist’s prescribing practices. Overall, dentists’ recommendations for the use of antibiotic for patients with prosthetic joints undergoing dental procedures varied depending on the health status of the patient, the dental procedure to be performed, the time since joint surgery, physician’s recommendations and patients preferences.
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Bidarkar, Atul. "In vitro prevention of secondary demineralization by icon (infiltration concept)." Thesis, University of Iowa, 2011. https://ir.uiowa.edu/etd/3262.
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Aim: The purpose of this in-vitro study was to look at the effectiveness of the ICON on prevention of caries on the smooth surface in comparison to resin based sealant.
Methods: The study was an in-vitro study to compare the effectiveness of ICON and a sealant material in prevention of secondary demineralization. Sound teeth with no defects were cleaned and divided into 3 groups and lesions created. Both the groups were treated with respective materials (ICON and sealant), but the control group was left untreated. Once treated fresh demineralization solution was created and subject to deminralization cycles to see which material performed better in prevention of secondary demineralization.
Results: In the present study, primary analysis was done using the quantitative light induced fluorescence technique. At the end of the secondary demineralization the results showed no statistically significant difference among the treatrment groups and the control group.
However, the polarized light microscopy was done to assess the amont of infiltration of the material into the lesions. The ICON showed substantial penetration into the lesions where as the sealant material did not penetrate but formed resin tags on the surface of the lesion.
Therefore, the ICON material did not fare any better than the sealant in prevention of secondary demineralization on smooth surface initial carious lesions.
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Ghazal, Tariq Sabah AbdulGhany. "Prevalence, Incidence and Risk Factors for Early Childhood Caries Among Young African-American Children in Alabama." Thesis, University of Iowa, 2013. https://ir.uiowa.edu/etd/4848.
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Reynolds, Julie Christine. "Neighborhood and family social capital and oral health status of children in Iowa." Thesis, University of Iowa, 2013. https://ir.uiowa.edu/etd/5048.
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Oral health disparities in children is an important public health issue in the United States. A growing body of evidence exists supporting the social determinants of oral health, moving beyond individual predictors of disease to family- and community-level influences.
The goal of this study is to examine one such social determinant, social capital, at the family and neighborhood levels and their relationships with oral health in Iowa children. A statewide representative data source, the 2010 Iowa Child and Family Household Health Survey, was analyzed cross-sectionally for child oral health status as the outcome, a four-item index of neighborhood social capital and four separate indicators for family social capital as the main predictors, and seven covariates. Soda consumption was checked as a potential mediator between the social capital variables and oral health status. A significant association was found between oral health status and the neighborhood social capital index (p=0.005) and family frequency of eating meals together (p=0.02) after adjusting for covariates. Neighborhood social capital and family function, a component of family social capital, may independently influence child oral health outcomes.
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Kelly, Grief Mary C. "Utilization of preventive oral health care by Medicaid-enrolled senior adults during their transition from community-dwelling to nursing facility residence." Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/2231.
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OBJECTIVE: To establish baseline data of dental utilization and determine the predictors of receipt of dental procedures by Medicaid-enrolled senior adults who reside in Iowa nursing facilities.
METHODS: This was a longitudinal retrospective analysis of Iowa Medicaid claims data for SFY 2007-2014 of senior adults who were 68 years or older upon entry to a nursing facility and continuously enrolled (eligible 58 out of 60 months) in Medicaid for three years prior to and at least two years after admission.
RESULTS: Controlling for the subject and nursing facility level variables, the strongest predictor of dental utilization after entry was the receipt of a dental procedure before entry (p< 0.001). Subjects residing in a facility located in an urban area (p< 0.002) or in two regions of Iowa (p=0.035, p=0.019, respectively) also had increased odds of receiving a dental procedure.
CONCLUSION: Our results show that approximately 50% of the subjects never received a dental procedure in the 5-year study period. The strongest predictor of receipt of dental procedures in the 2 years after entry was the receipt of dental procedures in the 3 years before entry. It is important for Medicaid-enrolled senior adults to establish a dental home while community-dwelling.
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Kim, MyungJoo. "Service-learning's impact on dental students' attitude to community service." Thesis, University of Iowa, 2012. https://ir.uiowa.edu/etd/3324.
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This study is aimed to evaluate service-learning program's impact on senior dental students' attitude to community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students' attitude to community service that will eventually lead into providing care to the underserved. Two surveys were administered to 105 senior dental students. For the first survey (post-test), students reported their attitude to community service after the service-learning program completion. For the second survey (pre-test), students reported their attitude prior to the program retrospectively. Seventy six students responded to the post-test and fifty six students responded to the pre-test. A repeated-measure mixed-model analysis indicated that overall there was a change between pre-test and post-test. Scales of connectedness, normative helping behavior, benefits, career benefits, and intention showed a significant pre-test and post-test difference. A relationship between attitude to community service and student characteristics such as age, gender, ethnicity, and volunteer activity was also examined. Only ethnicity showed a significant difference. In conclusion, service-learning program at VCU School of Dentistry has positively impacted senior dental students' attitude to community service.
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Drouillard, Peter Noel Vincent. "Factors associated with state-mandated dental screening compliance." Thesis, University of Iowa, 2019. https://ir.uiowa.edu/etd/6938.
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Objective: To determine the demographic, economic, geographic, and health infrastructure factors related to the percentage of students by school who comply with state-mandated dental screenings in Iowa.
Methods: An exploratory, cross-sectional study was conducted, utilizing secondary data sources from the Iowa Department of Public Health, the Iowa Department of Education, and the U.S. Department of Agriculture, to examine factors related to dental screening compliance rates for public school kindergarteners in Iowa (AY year 2014-15). Both school-level and county-level factors were considered. A ninety percent student compliance rate was established as the criteria for a school to satisfy the threshold for being compliant with screening requirement. Multivariable logistic regression analyses were conducted to evaluate the relationship of the independent variables on whether the schools satisfactorily met the criteria for compliance.
Results: Fifty-six percent of the 504 schools included in the study satisfactorily met the established criteria. Schools located in dental health professional shortage areas or in urban adjacent areas were more likely to have a greater percentage of kindergarten students exceed the 90% compliance threshold (p<0.05). Schools where a greater percentage of students were screened by a dentist or where larger populations of children were eligible for free or reduced price lunch (FRPL) (≥40%) were less likely to meet the compliance threshold.
Conclusions: Schools with more lower income students, those in metro areas, and those with a higher reliance on dentists performing the oral health screenings could benefit from targeted efforts to improve compliance with mandated dental screenings.
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Harrington, Maureen Patricia McWeeney. "Oral Health Care: An Autoethnography Reflecting on Dentistry's Collective Neglect and Changes in Professional Education Resulting in the Dental Hygienist Being the Prevention-focused Primary Oral Health Care Provider." Scholarly Commons, 2019. https://scholarlycommons.pacific.edu/uop_etds/3636.
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Many factors influence poor oral health among disadvantaged populations including socioeconomic circumstances, knowledge of disease prevention strategies and ability to implement those strategies, public policies, insurance status, insurance policies, dental providers and other challenges to accessing dental care. Often these issues converge and result in early disadvantages to achieving good oral health (Horton & Barker, 2010). Addressing even some of the factors that contribute to poor oral health may provide ways to change the dental health status of historically underserved populations. The purpose of this research is to explore my role as a practitioner and researcher in the creation of a hygienist-based, community-site located, teledentistry supported system of dental care for underserved populations and the intersection of my experiences with cultural, societal and educational occurrences. This autoethnography examined my own experiences and also explored the experiences of a small sample of others who participated in onsite dental care systems utilizing hygienists as the prevention-focused primary care provider.
As Ellis and Bochner (1996) note “Autoethnography stands as a current attempt to, quite literally, come to terms with sustaining questions of self and culture” (p. 193). The findings that emerged from my work included a realization that the dental industry creates and perpetuates the collective neglect of large portions of the US population. Some of this neglect is embedded in traditional power structures in dentistry, gender bias and distrust in professional skills as a result of separate professional education structures. The result for many people is untreated dental disease, a profound lack of health equity, increased shame due to poor oral health as well as missing school. There are ways to address the collective neglect of the dental industry through the reframing of the dental hygienist as the prevention-focused primary care oral health provider in professional education programs then integrating this provider type into community settings like schools.
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Sharuga, Constance R., Tabitha Price, and Deborah Dotson. "Educate Your Patients about HPV." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/2531.
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Excerpt: According to the United States Centers for Disease Control and Prevention (CDC), approximately 20 million Americans are currently infected with human papillomavirus (HPV), and another 6 million will become newly infected each year.
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Smith, Angel. "Oral Health Literacy of Parents and Dental Service Use for Children Enrolled in Medicaid." ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/73.
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Many people in the United States have untreated dental disease due to a lack of dental insurance, a lack of oral health knowledge, and a lack of priority placed on dental health. Despite an increase in dental service use by Medicaid recipients as a result of local programs, children enrolled in Medicaid often have low rates of use of dental services. Using the health literacy framework of the Paasche-Orlow and Wolf (POW) model, the purpose of this study was to explore to the relationship between oral health literacy of parents and dental service use for children enrolled in Medicaid and the differences in use rates between preventive and restorative services. A cross-sectional research design was employed within a convenience sample of parents who presented to a nonprofit clinic for a medical appointment. Participants completed a demographic profile, an oral health questionnaire, and REALD-30 survey. Responses were correlated with dental claims retrieved from 1 reference child for each parent. Pearson's correlation revealed no significant relationship between oral health literacy and dental service utilization, r = -.056 (p = .490). An ANOVA revealed no difference in utilization between preventive and restorative services, F (2, 149) = .173, p = .841, ç2 = .002. However, high rates of use for restorative services were observed, suggesting a high prevalence of tooth decay in children. Although this study did not find a significant relationship between oral health literacy and dental utilization, barriers continue to exist that contribute to the high rates of tooth decay in children enrolled in Medicaid. This study impacted social change by highlighting the importance of preventive care in reducing the prevalence of tooth decay.
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Mani, Simi. "Impact of insurance coverage on dental care utilization of Iowa children." Thesis, University of Iowa, 2015. https://ir.uiowa.edu/etd/1689.
Full textAbstract:
Objective: To understand the association between dental insurance coverage and dental care utilization in Iowa children.
Methods: The 2010 Iowa Child and Family Household Health Survey (IHHS) data was used to assess the association between dental insurance coverage and dental care utilization in Iowa children. Andersen’s model of health services utilization was used as a framework for determining the predictors of dental care utilization. Chi-square test was used for determining bivariate associations and Logistic regression analysis was used to determine factors associated with dental care utilization.
Results: The results from the multivariable logistic regression model indicate that children with private dental insurance (p<0.001) and 4-9 years of age (p=0.005) were more likely to have a dental visit. Additionally, respondents who were always able to get dental appointments for their child (p<0.001), had a regular source of dental care for the child (p<0.001) and perceived dental need for their child (p<0.001), were more likely to report having a dental check-up for their child in the past 12 months.
Conclusion: Dental insurance was significantly associated with having a dental visit in the past year in Iowa children 4-17 years of age. Some of the other predictors of dental care utilization were: having a regular source of dental care for the child, ease of getting dental appointment for the child, younger child’s age and having perceived dental need for the child.
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Taft, Sara. "Hand Function Evaluation for Dental Hygiene Students." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etd/2326.
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Dental hygiene students may struggle in dental hygiene curriculum in regards to hand function. Currently, this is not an aspect dental hygiene programs screen for or have protocol in place to help students. The research in the study examined if hand function could improve with hand function exercises and if exercises improved instrumentation scores. During a 6-week pilot study, an occupational therapist tested the hand function of a cohort of dental hygiene students. The results were recorded and the students began a 6-week hand function exercise regimen. After 6 weeks the same evaluations were preformed and the pre- and posttest data were compared. Statistical tests showed a significant improvement in hand function. After the hand function testing was complete, the scores of the cohort on the periodontal probe and 11/12 explorer were compared to students in the previous 5 cohorts. No significant improvement was made on the instrumentation scores.
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Shelley, Johnette Joy. "Significant indicators of intent to leave among army dental corps junior officers." Thesis, University of Iowa, 2010. https://ir.uiowa.edu/etd/739.
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Objective: To identify the significant predictors associated with Army Dental Corps Junior Officers' intent to leave the military. Methods: A secondary data analysis was conducted utilizing the responses from the 2009 Army Dental Officer Retention Survey. The 92 item questionnaire consisted of questions addressing retention issues. Although the survey was distributed to all Army dental officers, only results from junior officers were considered for this study. Results: Forty-six percent of junior officers completed the survey (N=577; n=267).Fifty-eight percent of respondents reported an intent to leave the military prior to retirement. In the final regression model, six variables were significantly (p < .05) associated with an officer's intent to leave: unit of assignment (p<.009, Beta=.144); specialty training status or area of concentration (AOC) (p< .047, Beta=.098) ; age (p<.002, Beta= -.133); military lifestyle (p<.001, Beta=.236); benefits (p<.000, Beta= -.408) and professional development (p<.023, Beta=.194). The model accounted for 45.7% of the total variance. Conclusion: Variables other than pay, bonuses, deployments, frequent moves and student debt were significantly associated with intent to leave. Future studies should be conducted to more fully understand how the identified significant predictor variables impact intent to leave so that policies can be developed to help reduce turn-over among junior dental officers.
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Cornett, Micaela J. "Dental Disparities and the Safety Net in Blount County." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/honors/381.
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This qualitative study focused on the dental disparities in Blount County, TN and sought to determine if there are enough dental clinics within the dental safety net. Interviews were conducted with 18 individuals who were either service providers or clients of organizations such as the Salvation Army, Alcoa Good Samaritan Clinic, the local health department, Trinity Dental Clinic, Volunteer Ministry Center, Remote Area Medical, and Blount Memorial Hospital. Inclusion criteria for clients included: homeless or living below the poverty level, uninsured, 18 to 65 years of age, has not seen a dentist in the past year and currently suffering a dental problem. The most obvious common theme among the 11 clients interviewed was that they struggle with getting dental care. Patients were asked when the last time they had seen a dentist and they answered years ago, most over ten years ago. Eight of the eleven clients did not know of any facilities they could go to. Cost was the main reason for these clients not seeking dental care. Two dentists were asked about the reasons for disparities in dental care. The major common themes between the dentists were cost, access to care, and education. All five case managers said that they had clients experiencing dental needs ranging from a simple cleaning to an abscess. Currently in Blount County only one dental clinic serves over 17,000 residents who live in poverty.
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Pendharkar, Bhagyashree. "Fourth year dental students' barriers to tobacco intervention services." Thesis, University of Iowa, 2009. https://ir.uiowa.edu/etd/419.
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In order to facilitate effective tobacco cessation services within dental school clinics, it is necessary to understand the perceived barriers encountered by dental students while providing these services. The aim of this study was to identify which factors fourth year dental students perceive to be associated with barriers to providing tobacco intervention services. A written survey was developed and completed by the incoming fourth year dental students at the University of Iowa College of Dentistry in 2008. The survey assessed the perceived barriers to providing tobacco intervention services and related factors. Descriptive, bivariate and logistic regression analyses were conducted. The response rate was 97 percent. Some of the most frequently reported barriers included: patient's resistance to tobacco intervention services (96%), inadequate time available for tobacco intervention services (96%) and forgetting to give tobacco intervention advice (91%). The following variables were significantly (p<0.05) related to greater perceived barriers in providing tobacco intervention services: lower "adequacy of tobacco intervention curriculum coverage of specific topics covered over the previous three years" and "perceived importance of incorporating objective structured clinical examination teaching method for learning tobacco intervention." Students could benefit from additional didactic training and enhanced clinical experience in order to facilitate effective intervention services in the dental school.
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White, Megan. "Exploring the Risk Factors that Influence the Parental Dental Deferment Decision." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/206.
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When caregivers defer their personal routine dental care (RDC) in order to provide RDC for their children, they risk detrimental consequences in their personal health and the health of their children. The purpose of this qualitative case study was to identify the risk factors that led to the parental dental deferment decision. The oral health and personal care services conceptual models guided the development of the research questions, facilitated the selection of risk factors on the decision-making process, and provided the basis for the data analysis thematic categories. Ten caregivers who made the decision to defer their personal RDC for the sake of their children's RDC participated in the study. Interviews were transcribed verbatim and analyzed thematically. According to the results of the study, the oral health beliefs of caregivers shaped their decision to seek RDC for their children while financial barriers, dental fear, and distrust obstructed their capacity to seek RDC for themselves. Caregivers placed a higher priority on their children's wellbeing--including dental care--than on their own health, despite knowing the association between poor oral health and serious health conditions. These findings indicated, for caregivers, deferring personal RDC was not a lack of desire, education, or care but striving for constant balance between affordability and providing their children with every healthy opportunity in life. The positive social change implications of this study include increasing the proportion of adults receiving RDC yearly through development of targeted interventions that increase caregivers' access to and utilization of dental care services. Such efforts would support the strategies implemented to achieve Healthy People 2020 objectives.
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Nakanaga, Motoki. "The Evaluation of the School-Based Flouride Mouthrinse Program in a Fluoridated Community." TopSCHOLAR®, 1991. https://digitalcommons.wku.edu/theses/2678.
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The purpose of this study was to evaluate the effect of a school-based fluoride mouthrinse program in a fluoridated community. Such an evaluation is important because the effect of such programs may decrease over time due to the widespread use of fluoride.
Two elementary schools were chosen. One had a fluoride mouthrinse program: the other did not. The subjects were children in grades one and six. Their caries experience was examined using dft. dfs. DFT, and DFS scores.
There were no statistically significant differences between the two schools. The program had no significant effect in the community studied.
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Kavand, Golnaz. "Assessment of adolescents' and their parents' dental esthetic perceptions: a longitudinal study." Thesis, University of Iowa, 2012. https://ir.uiowa.edu/etd/3480.
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Morgan, Trina J. "Minority College Students’ Attitudes and Beliefs Regarding the Profession of Dental Hygiene in Comparison to their Oral Health and Dental Knowledge." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etd/2564.
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The purpose of this study was to find out the attitudes and beliefs of minority college students enrolled at Missouri College in Brentwood, Missouri in reference to the dental hygiene profession. In particular, does their oral health and dental knowledge relate to their knowledge of profession of dental hygiene? One hundred and six students gave their consent to participate in the study via Survey Monkey. The study was conducted in May 2015 for a period of four weeks. Four statements were designed to gauge minority students’ knowledge of dental hygiene as a career. No differences were found based on gender, age, education and ethnicity. A difference was found based upon the respondent’s program of study. Further research is needed spread the word about dental hygiene programs and to explain the role of the dental hygienist.
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Holt, Nicole. "An Investigation of the Relationship Between Child, Family, and Community Factors and Early Childhood Oral Health and the Utilization of Dental Health Services." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etd/3242.
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Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community levels. Binary logistic methods were applied to each outcome and predictor variable. Stepwise logistic regression models were constructed for child, family, and community variables. Additionally the mediating effect of oral health services utilization in the association between child, family and community factors and parental perception of child’s oral health was evaluated. National results and Health Resource Service Area (HRSA) region IV results were compared.
Results: In the national (n=24,875) and HRSA region IV sample (n=4,017) 9.7% and 10.2% of caregivers, reported that the child had an oral health problem in the past 12 months. Fewer than half (46.7%) of caregivers reported that their child had visited a dentist in the past 12 months. Absence of neighborhood cohesion, neighborhood amenities, and residence in metropolitan statistical area all had positive significant effects on children seeing a dentist. There was a mediating effect by utilization of oral health services between child with special health care needs (p=0.005), number of children (p=0.045) and adults (p=0.046) in the household, and tobacco use (p=0.018) and parents perception of oral health in the HRSA region IV population.
Conclusion: This study identified several factors as correlates of poor oral health outcomes. Our results expand our knowledge of early childhood oral health by studying how oral health is impacted not only by child factors but also the family and community at large. Our results begin identifying the unique constellation of risk factors that contribute to early childhood oral health.
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Gadde, Divya. "Assessment of Ergonomics in Indian Dental Practice: A Workplace Analysis." TopSCHOLAR®, 2018. https://digitalcommons.wku.edu/theses/2332.
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Dental practice requires unique working conditions such as prolonged working hours, strained body postures and laborious, high finesse dental techniques. However, it can be more efficiently performed by the application of ergonomics, rather than physically forcing the worker's body to fit the job. Posture is highly influenced by factors such as inadequate working level, incorrect patient positioning, and poor visual comfort. In order to eliminate musculoskeletal disorders it is necessary to control these and other factors, and design the human work environment to be more ergonomic. The aim of this study was to assess ergonomics within Indian dental practice and elucidate factors that prevented application of ergonomics.
An observational study was conducted among 58 Indian dentists, both from a private dental hospital and clinics. A questionnaire that consisted of 37 open-ended and closed-ended questions was used as a research tool for the study. Information on background characteristics, work environment, equipment, work administration, and ergonomic awareness was collected using the questionnaire. Sampling consisted of observing 37 male and 21 female dentists. A total of 58 individuals, 62 % ( 36), worked for a private dental hospital, and 38% (22) for dental clinics. A majority, 84.5% (49), of the dentists reported that they did not receive ergonomic training from their work administration. Most dentists, 96% (56), reported that there was no system of recordkeeping for workplace accidents. Lack of proper ergonomic training and no system of recordkeeping for workplace accidents were found to be the primary factors for not applying ergonomics by Indian dentists. Ergonomic training programs are needed in India to help educate dentists on workplace safety and health, and thus aid in reducing musculoskeletal pain. Finally, a system is needed in Indian dental practice to promote workplace safety and health by identifying workplace hazards that result in injuries.
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Brent, Barbara K. "A Survey of the Implementation and Usage of Electronic Dental Records and Digital Radiographs in Private Dental Practices in Mississippi." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etd/3365.
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Implementation of electronic health records by the Health Information Technology for Economic and Clinical Health has led to the implementation of electronic dental records (EDRs) and digital radiography in dental offices. The purpose of this study was to determine the state of the implementation and usage of EDRs and digital radiographs by the private general and pediatric dental practices in Mississippi as well as reasons why the dental practices are not moving forward with the advanced technology.
A survey was emailed to 712 dental practices: 116 responded (16% response rate), and 104 consented to participate (89.66%). Results indicated dental practices in Mississippi using EDRs was 46.07%, EDRs with paper records was 42.70%, and only paper records was 11.24%. Results indicated dental practices using digital radiography was 76.40%, conventional radiography was 13.48%, and both was 10.11%. Common reasons for not advancing were cost, insufficient training, computer/software issues, and “too old.”
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Walstead, Brenda Kaye. "Faculty Perceptions Regarding Best Practices in Clinical Dental Hygiene Assessment." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/424.
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This qualitative case study explored faculty perceptions regarding best practices and uses of assessment in a dental hygiene program at a small northwestern college. It was discovered that faculty in the program were assessing students in their clinical courses using widely varied methods, designs, and scoring tools. Faculty neither calibrated processes nor communicated about this problem. In addition, a review of the assessments in this local setting indicated a significant gap in the current guidelines for best practices in clinical assessment procedures. Knowles' adult learning theory served as the foundation for this study. Research questions were designed to obtain clinical faculty's perceptions of their knowledge of best practices in assessment, assessment design, methods including scoring tools, and how faculty could work collaboratively to implement clearly and consistently designed best-practice assessments in their clinical courses. Interviews and reviews of assessment documents were conducted with a purposeful sample of 8 faculty participants. Data were coded and analyzed for common themes. Results indicated that instructors did not collaborate and had little knowledge of assessment criteria based on best practices, administration, and scoring procedures. At the request of the dean, a position paper was created as a project. The paper outlined strategies for designing clinical skills assessments with criteria that is consistent, clear, and based on best practices. Also included were procedures for ongoing faculty professional development and collaboration, insuring that faculty are calibrated and that assessments are valid and reliable. The results of this study can promote positive social change as faculty in this program will be increasingly confident in assessment practices, and graduates will consistently provide greater quality patient and community care.
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Kerns, Amanda Dr. "The Effectiveness of a Preventive Recall Strategy in Children Following Dental Rehabilitation Under General Anesthesia." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4108.
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Abstract
THE EFFECTIVENESS OF A PREVENTIVE RECALL STRATEGY IN CHILDREN FOLLOWING DENTAL REHABILITATION UNDER GENERAL ANESTHESIA
By Amanda Kerns, DDS
A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.
Virginia Commonwealth University, 2016
Thesis Advisor: Elizabeth Berry, DDS, MPH, MSD
Vice Chair, Assistant Professor, Department of Pediatric Dentistry
Purpose: This was a prospective randomized controlled trial assessing the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) in children with early childhood dental caries.
Methods: 130 patients completed FMDR and were included in the analysis. Caries risk assessment (CRA), dental exam, and a caregiver oral health knowledge (OHK) questionnaire was completed for each patient. Patients were randomized into two groups; intervention returned at 3 and 6 months and control returned at only 6 months post-surgery. At each recall, CRA and dental exam information was recorded, and at the six month recall, all caregivers completed the OHK questionnaire.
Results: Actual recall data showed a statistically significant difference in CRA at six months, with 71.8% of patients in the control and 44.8% of patients in the intervention assessed as high caries risk.
Conclusions: The actual recall data suggests this recall strategy is effective in reducing CRA level following FMDR.
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Murray, Lacy. "Tobacco Cessation Counseling Practices amongst Dental Hygienists in Central Texas." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/etd/3926.
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Although tobacco cessation is an uphill battle for almost everyone who attempts to quit, it is important that dental hygienists do not assume that patients are not interested. Dental hygienists are in an ideal position to offer cessation help to their tobacco using patients. The purpose of this study was to gain a better understanding of the tobacco cessation practices among central Texas dental hygienists. Specifically, dental hygienists were asked about beliefs, motivation, and confidence with regard to their tobacco cessation practice. A positive significant, moderate, relationship was found between beliefs and confidence (r=0.647), beliefs and practices (r=0.704), knowledge and capability (r=0.579), motivation and capability (r=0.529), motivation and practice (r=0.605), and years of practice and capability (r=0.699). The mean confidence scores for hygienists with more than 20 years of experience differed from those with 1-5 years of experience (p=.003) and 6-10 years of experience (p=.025).
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Rustvold, Susan Romano. "Oral Health Knowledge, Attitudes, and Behaviors: Investigation of an Educational Intervention Strategy with At-Risk Females." PDXScholar, 2012. https://pdxscholar.library.pdx.edu/open_access_etds/612.
Full textAbstract:
A self-perpetuating cycle of poor health literacy and poor oral health knowledge and behavior affects approximately 90 million people in the United States, most especially those from low-income groups and other at-risk populations such as those with addiction. Poor oral health can result from lack of access to regular preventive dental appointments, lack of access to restorative care when dental diseases are treatable, and low oral health knowledge that leads to poor oral health self-care behaviors. In addition, patients' dental anxiety can impede care, because highly anxious people often avoid dental appointments. To address these issues, this inquiry examined oral health knowledge, attitudes toward oral health, and levels of dental anxiety among women in two residential chemical dependency treatment programs. Participants engaged in oral health intervention sessions to determine possible efficacy of the educational intervention. Results indicate positive outcomes in increases in oral health knowledge and behavior. The frequency of high-to-severe dental anxiety is much higher in this sample than in the general population. Implications are discussed, including use of economically efficient small-group oral health education training.
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Attanasi, Kim. "Perceived Parental Barriers to Preventive Dental Care Programs for Children." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4417.
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Dental caries is the most prevalent childhood illness and disproportionately affects children from low socioeconomic backgrounds. Dental organizations are collaborating within communities to decrease oral health disparities among children by offering free preventive oral health events. These programs face the problem of low enrollment due to lack of informed parental consent. Also, gaps in the literature indicated the need to examine oral health perceptions and dental-care-seeking practices of culturally diverse low-income parents regarding preventive care for their children. The purpose of this qualitative case study was to explore the reasons why parents are not allowing their children to participate in the aforementioned programs. This inquiry examined how perceived barriers impede parents from seeking free preventive dental care for their children. The transtheoretical model and social cognitive theory were used in this study. Open-ended questions were used to interview 20 purposefully sampled parents regarding perceptions of free preventive dental care programs until saturation. Interviews were audio recorded, and all data were transcribed verbatim, coded, and analyzed thematically. The main themes revealed through this analysis were lack of trust and cultural dissimilarities as potential barriers. Additional themes of money, fear, lack of insurance, transportation, time, and access to care were also confirmed. This study may contribute to positive social change by increasing knowledge that may inform the development of clinical and policy solutions aimed at improving parents' awareness regarding children's oral health, ultimately enabling a reduction in childhood caries and oral health disparities.
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Asbury, Janeime Necole. "Effect of Reduced-Fee Dental Hygiene Treatment and Oral Health Perceptions Among Socioeconomically Deprived Persons." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2952.
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Access to oral health care remains problematic for millions of Americans. Factors such as socioeconomic status, age, race, and lack of dental insurance benefits inhibit the ability of many to obtain preventative oral health care. The aim of this study was to explore the effect of preventive oral health treatment and education at reduced-fee dental hygiene facilities on the oral health behaviors and perceptions of socioeconomically deprived persons within the state of Georgia. This study was based on the health belief model constructs. A convenience sample of 102 participants was recruited from the individuals who visited two dental hygiene colleges to seek treatment for the first time. The independent variable was the receipt of reduced-fee dental hygiene treatment/education. The dependent variables were the oral health perceptions and behaviors of socioeconomically deprived persons, as well as the perceptions and behaviors of patients provided with a referral for follow-up treatment with a dentist. Mediating variables were sex, age, race, and socioeconomic status. Wilcoxon Signed Rank test and logistic regression were applied to detect potential differences in the dependent variables before and after treatment. The most significant changes were found in categories dealing with self-efficacy measures that patients could take to improve their own oral health. Also, the oral health behaviors and perceptions of younger, African-American of low educational and financial background were significantly more improved after treatment. The social change implication of this research may be that oral health practitioners can use these results to create preventative interventions more tailored for socioeconomically deprived persons who face complicated oral health issues.
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Valencia, Alejandra. "Racial and ethnic disparities in access and utilization of dental services among children in Iowa:." Thesis, University of Iowa, 2010. https://ir.uiowa.edu/etd/754.
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Even though the oral health of Americans has improved greatly in the last 50 years, some specific groups of the population have been left behind. Latinos, children and adults, bear a disproportionate burden of oral diseases. Latino children, the fastest growing minority group of children in the US, are affected disproportionately by oral diseases like dental caries compared to other groups. Understanding the difficulties and barriers that these children have to utilize dental care will help us in the future to develop effective programs to reduce health disparities in this segment of the population.
The purpose of this study is to identify the factors that determine dental services access and utilization by children in the state of Iowa. Emphasis will be given to differences in utilization of dental services among different racial/ethnic groups. Additionally, the study will describe and compare difficulties in utilization of care among Latino children whose parents answered the survey in English (LE) and those who answered it in Spanish (LS). In order to address these objectives existing data from the Iowa Child and Family Household Health Survey 2005 (HHS) were analyzed.
The dependent variable for the study was utilization of dental services. This outcome variable was dichotomized as whether or not the child had a dental visit in the last year. Characteristics of study subjects were first analyzed through descriptive statistics. Bivariate analyses were conducted to assess associations between the dependent variable and independent variables. Multiple logistic regression was used to identify factors associated with utilization of dental services in Iowa's children, and for each different racial and ethnic group.
Seven factors were related to the time of the last dental visit for Iowa children: Having a regular source of dental care, dental insurance status, having a dental need in the past 12 months, brushing habits, the age of the children, and family income. The same seven factors were correlated to having a dental visit for white children. For African-American children, having a regular source of dental care, dental insurance status, and having a dental need in the last 12 months were the factors that were found associated to the time of the last dental check-up. For the Latino Spanish children, having a regular source of dental care and the age of the children were factors associated to dental utilization. Finally, for the Latino English children, the only factor associated with having a dental visit was having a regular source of dental care.
Information from this research gives policy makers, public health workers, and clinicians an overview of oral health disparities affecting children in the state. For those agencies in Iowa interested in the improvement of access and utilization of dental services for minority children, this project gives important inside about the factors related to the use of services for different racial/ethnic groups in the state.
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Byrum, Mary Kristine. "America Addicted: The Relationship Between Dental School Education and the Opiate Prescribing Practices of Dentists in Ohio." Walsh University Honors Theses / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=walshhonors1524605016944778.
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Leverich, Cynthia S. "Mid-level Dental Care Provider: Awareness and Attitudes of Ohio’s Dental Hygienists." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etd/3148.
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The purpose of this study was to determine the awareness and attitudes of dental hygienists in Ohio regarding the Advanced Dental Hygiene Practitioner (ADHP) as an occupation proposed by the American Dental Hygienists’ Association and to determine whether the ADHP could be a viable career option for Ohio dental hygienists.
I developed a survey to assess dental hygienists’ awareness, attitudes, and their views regarding the new mid-level dental provider. The study was limited to licensed dental hygienists in Ohio. The study included a simple random sample of 400 of the 4100 dental hygienists in Ohio obtained by a systematic approach, a random start and selection of subjects at a constant interval. The method of data collection was electronic surveys. Fifty-four dental hygienists (13% of the sample) participated in the study.
The results show that most of those responding were aware of the ADHP. Also, their attitude regarding the new mid-level dental provider was positive. Attitudes varied more when the respondents provided data on the adoption of legislation for the new provider. There was no consensus among respondents regarding the ADHP as a viable career option. More robust research is needed on the viability of the ADHP in Ohio.
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Zhang, Min H. "The Effect of Change in Medi-Cal Dental Coverage on Dental Care Utilization Among Medi-Cal Beneficiaries." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/6045.
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One of the most important factors in accessing dental care is having dental insurance. For people with low incomes, Medicaid is the main source of health insurance. Medi-Cal is California’s Medicaid program. Adult dental services were mostly eliminated in Medi-Cal in 2009 due to the economic downturn and partially restored in 2014. The objective of this study is to evaluate the effect of change in Medi-Cal dental coverage, specifically the partial restoration of adult dental coverage in 2014, on dental care utilization among Medi-Cal beneficiaries. The partial restoration significantly increased the utilization rates in dental clinics from 2014 to 2017 (22% in 2017 vs. 12% in 2013) for the overall population. However, the magnitude of increase differs in different age groups and ethnic groups. More statistically significant findings show greater utilization rates among beneficiaries of 19-64 than 65-74 and 75+ years old. Also, more significant findings show lower utilization among Black than White, Hispanic or Asian beneficiaries. The partial restoration significantly reduced the dental related ER visits among Medi-Cal beneficiaries from 2015 to 2017. However, the reduction is largely seen in beneficiaries of 19-64 years old in the ethnic groups of White and Black with reductions of 20 and 15 visits per 1,000 enrollees respectively in 2017 comparing to 2013. The dental related ER visits were lower for Hispanics and Asians, and remained very low among those 65 years old and above. In addition, the partial restoration resulted in increases in participation of dental care providers in the Medi-Cal program.
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Bhoopathi, Vinodh. "Determining the Level of Patient Satisfaction in a Dental Hygiene Setting." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etd/1035.
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Not many studies have been conducted in the past to determine patients' level of satisfaction in academic dental hygiene settings. This patient satisfaction study analyzed the level of patient satisfaction with the dental hygiene clinic at East Tennessee State University, Johnson City, TN. The purpose of the study was to determine if there was a statistically significant influence of demographic characteristics of the patients and the affective behavior of the care providers on level of patient satisfaction. It was concluded that except for age, other demographic variables did not have any statistically significant influence on patient satisfaction. Also, care provider's affective behavior significantly influenced patient satisfaction. Overall, the dental hygiene patients were satisfied with the clinic. As patients' needs are prioritized in this customer-driven industry, such positive patient satisfaction data can be used for the welfare of the patients, the care providers, and the health care organization.
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Jennings, Adrienne Douglas. "Variables associated with the hours worked by Iowa dentists." Thesis, University of Iowa, 2011. https://ir.uiowa.edu/etd/2720.
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There are many factors that affect the hours worked by various professions. The literature discusses some of these factors in professions such as management and various fields of medicine. However, no information has been gathered on factors that affect the practice of dentists. A survey was disseminated to all Iowa dentists inquiring about various factors that may affect the number of hours they spend at work. The survey inquired about demographics, educational indebtedness, caregiving responsibilities of both children and dependent adults, contribution to household income, relationship status, domestic responsibilities, busyness and type of practice. The data was collected and analyzed. It was hypothesized that there was no difference in the number of hours worked between male and female Iowa dentists and there was no difference in the number of hours worked between female Iowa dentists with minor children (18 years old or younger) and female dentists without minor children. When hypotheses were statistically analyzed, the data showed there was no difference between male and female dentists' working hours in the bivariate analysis. In the multiple logistic regression model, while controlling for various factors such as age and busyness, gender was statistically significant in the number of hours worked. When evaluating the hours worked between female dentists with and without minors, there was a statistically significant difference in the number of hours worked between women with minor children and women without minors. However, in the multiple logistic regression model, presence of minors was not statistically significant. This lack of statistical significance is likely attributed to the small sample size of women dentists. As such, there was not enough power to have more than 2 variables and minor children was not included. The data suggests that young male dentists, who are responsible for 61% or more of their household income and are solo practitioners are the most likely to work full-time (32+ hours/week).
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Slashcheva, Lyubov Daniilovna. "Geographic trends in severe early childhood dental caries of Native American children." Thesis, University of Iowa, 2019. https://ir.uiowa.edu/etd/6858.
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This study investigated the effect of geographic location on Severe Early Childhood Caries (S-ECC) in Native American Children three years of age from a Norther Plains Tribal Community. Geographic location of study participants was ascertained by postal district and categorized into geographic regions as well as dental clinic accessibility, defined as dental services present or absent in that district. The association of location category and dental caries (dmfs) was evaluated cross-sectionally at 36 months of age.
Descriptive statistics demonstrated differences in dental caries distribution by geographic region and accessibility category. Bivariate analysis of disease by location showed a significant difference in dmfs between 4 geographic regions (p=0.0159) but not between accessibility categories (p=0.0687). Multivariable regression modeling for geographic region demonstrated the unique effect of geographic region on dental caries experience as well as five other key risk factors. Incident Rate Ratios (IRR) were computed for each of the risk factors, including number of erupted teeth (IRR=1.89, p=0.0147), fluoride exposure from tap water (IRR=1.70, p=0.0173), annual family income (IRR=1.58, p=0.0392), maternal DMFS (IRR=1.02, p=0.0040), and Mean Adequacy Ratio (IRR=1.05, p=0.1042).
This study demonstrated statistically significant variation in cumulative dental caries experience of Native American children aged 36 months among geographic regions and identified the specific unites of association through multivariate modeling. These findings can be used for local dental caries prevention programs and contribute to a broader understanding of S-ECC among very young Native American children.
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Bhagavatula, Naga V. R. N. Pradeep. "Fluorosis in the early permanent dentition: evaluating gene-environment interactions." Thesis, University of Iowa, 2009. https://ir.uiowa.edu/etd/281.
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Strandberg, Oskar, and Ahmed Azzawi. "Community-based clinical teaching set in a Swedish public dental service – Students and mentors perception regarding their experience." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19613.
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Introduktion: Under den tionde terminen av tandläkarprogrammet på Malmö högskola genomgår studenterna verksamhetsförlagd utbildning (VFU) sedan 2004. Detta sker i samarbete med Folktandvården Skåne och under 15 veckor arbetar studenterna en dag i veckan under handledning på folktandvårdens kliniker i närliggande område.Syfte: Att utvärdera erfarenheter efter genomgången VFU ur deltagarnas perspektiv.Metod: Alla tandläkarstudenter och handledare som genomgått VFU 2006 och 2015 tillfrågades om att besvara en utvärderingsenkät med numerisk bedömningsskala och utrymme för tillhörande kommentarer. Sex studenter och fem handledare som genomgått VFU år 2015 intervjuades även med en semistrukturerad intervjumetodik som sammanfördes genom en tematiserad innehållsanalys. Resultat: Enkät: Poängsättningen var genomgående hög för både 2006 och 2015. Studenterna poängsatte påstående 6 ”Det nuvarande upplägget med 15 veckor och en dags tjänstgöring i veckan är tillfredställande.” signifikant högre 2015 än 2006. Påstående 8 ”Det finns en samsyn avseende metoder och behandlingsval mellan skola och folktandvård.” poängsatte studenterna signifikant lägre än handledarna 2015. 2006 poängsatte studenterna påstående tre ”Sammansättningen av patienter var bra.” signifikant lägre än vad handledarna gjorde. Intervju: Studenter och handledare ansåg att VFU är fördelaktigt i utbildningssyfte och ger studenterna självsäkerhet och trygghet i ansvarstagande. Förslag på förbättringar förekom även under intervjuerna.Slutsats: Verksamhetsförlagd utbildning ger fördelaktigheter både för studenter och deras handledare. Studenter och handledare uttrycker uppskattning och är generellt nöjda efter VFU.<br>Introduction: The tenth semester of the dentistry program at Malmö university students undergoes an outreach program (internship) since 2004 and this is in collaboration with Folktandvården Skåne. During 15 weeks the students work at their assigned clinics one day a week under supervision from their tutors.Objective: To evaluate experiences after placement from the participants' perspective.Method: All dental students and tutors who have completed internship in 2006 and 2015 were asked to answer an evaluation questionnaire with numeric rating scale and scope for comments. Six students and five mentors who have completed internship in 2015 were interviewed with a semi-structured interview methodology, later analysed by content analysis method.Results: Questionnaire: rating was consistently high for both 2006 and 2015. The students scored significantly higher on question six “The set-up of one day of clinical work over 15 weeks were satisfying.” 2015 than in 2006. Students scored question eight“There is a consensus regarding methods and treatment options between the dental school and Folktandvården Skåne” significantly lower than their supervisors in 2015. In 2006 students scored question three “The composition of patients was good” significantly lower than the supervisors did. Interview: Students and tutors felt that the internship had been beneficial for training purposes, giving the students more self-esteem and confidence in taking responsibility. Improvements for the outreach program where proposed. Conclusion: The clinical training program is favourable, both for the students and their tutors. In general terms, the students and the supervisors were satisfied with the cooperation.
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Orsini, Cesar A. "The self-determination theory of motivation in dental education : testing a model of social factors, psychological mediators, academic motivation and outcomes." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8022/.
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Background: Motivation plays a vital role in dental students' learning experience and wellbeing. Self-determination theory differentiates between autonomous and controlled motivation and amotivation, where autonomous motivation corresponds to the most selfdetermined form of regulation. Previous research has found that several social educational factors, mediated by students' satisfaction of their basic psychological needs of feeling autonomous, competent and related to important others, predicts autonomous motivation. In turn, autonomous motivation leads to more positive educational outcomes compared to controlled motivation or amotivation. So far, however, few studies have investigated the process of motivation in health professions education from the perspective of the Selfdetermination Theory. A systematic review was conducted within this thesis, identifying determinants, such as an autonomy supportive learning climate and feedback, that predicted students' autonomous motivation. No studies were found that tested mediation effects between determinants and motivation. In turn, students' self-determined motivation was found to predict different affective, behavioural and cognitive outcomes. These studies, however, came mainly from medical education. Despite its relevance for students' development, very little is known about the process of motivation in dental students. This indicates a need to understand its various aspects, which may lead to evidence-based interventions to foster students optimal functioning. Purpose: To test a model of academic motivation in dental education by analysing the associations between autonomy-support and quantity and quality of feedback, as determinants, and self-determined motivation, mediated by students' basic psychological needs satisfaction. This, followed by testing the associations between self-determined motivation and the behavioural outcomes of deep and surface study strategies and academic performance, and the affective outcomes of vitality and self-esteem. Finally, we aimed to test whether the model worked different for female and male students, and by year of curriculum. Methods: We conducted a correlational cross-sectional survey study at the dental school of the University San Sebastian in Chile. All dental students from year 1 to 6 were invited to participate and to answer a questionnaire package containing demographic data and previously validated self-reported instruments. Data on academic performance were obtained from the administrative department. Data analysis involved five phases. First, internal consistency of all measures was assessed by means of Cronbach alpha. Second, descriptive and group comparisons were computed by means of independent t-test to assess gender differences and MANOVA to assess year-of-curriculum differences. Third, bivariate correlations were assessed amongst all measures. Fourth, mediation was tested through a series of regression analyses. Finally, the entire model was assessed by means of structured equation modelling, for the overall student sample as well as for the subgroups of females and males and different years of study. Data were analysed with the PASW and AMOS software. Results: A total of 924 students (90.2% response rate) agreed to participate and completed the questionnaires. Cronbach's alpha values of all instruments ranged from .641 to .912. Students' autonomous motivation for attending university was higher than controlled motivation and amotivation, showing an overall self-determined profile. Females endorsed higher than men both autonomous and controlled motivation, while men endorsed amotivation higher. The overall motivation profile, however, did not show significant gender differences. Across the six years, students showed an overall self-determined profile, in which autonomous motivation decreased when transitioning to clinical years, to rise again in the final year. The contrary was found for students' amotivation scores, while controlled motivation declined as they entered clinical-based years. Bivariate correlations showed that both determinants were positively correlated with students' basic psychological needs satisfaction and with autonomous motivation. In turn, the latter was positively associated with behavioural and affective outcomes. All these associations showed a decreasingly positive correlation from autonomous motivation to amotivation. Mediation regression analyses showed both determinants predicting dental students' autonomous motivation, however, this influence was not direct, it was mediated by students' perceptions of the satisfaction of their basic psychological needs. Finally, structured equation modelling indicated that the data fitted the model well, and showed both determinants positively predicting students' satisfaction of their basic psychological needs, which positively influenced autonomous motivation over controlled motivation. In turn, the gradual shift from controlled to autonomous motivation positively predicted affective and behavioural outcomes. Moreover, the associations followed a similar pattern, with minor deviations, when tested by gender and by year of study. Discussion and conclusion: In the context of this research, dental students' autonomous motivation was indirectly predicted by the social educational factors of teachers' autonomysupport and quantity and quality of feedback, being mediated by students' satisfaction of their basic psychological needs. Students' acting out of autonomous motivation showed enhanced deep study strategies and better academic performance, experienced higher vitality and self-esteem, and showed lower surface study strategies. This suggests that autonomous motivation leads to important outcomes, decreasing from controlled motivation to amotivation. Whilst students in different years of study showed an autonomous motivation profile, there were important differences that showed that students' transition from basic/preclinical to clinical years influenced their motivation and should therefore be taken into account when planning interventions to enhance students' motivation. Results are discussed in light of self-determination theory and considering its implications on curriculum development, teaching and learning, clinical training, assessment, faculty development, peer-assisted-learning and dentist-patient relationship. Significance: This is the first study, in health professions education, to test a Selfdetermination theory-based model including determinants, mediators, motivation and outcomes. This research also expands to dental education the study of motivation based on an empirically verified psychological theory. The results provide strong support for the Selfdetermination theory of motivation in dental education and provide acceptable evidence that the quality of motivation and satisfying students' psychological needs are important in determining positive educational outcomes amongst dental students. Therefore, many successes and failures in a number of elements of dental and health professions education may be understood through the lens of this theory. As such, efforts should be made in various aspects of dental education to support learners' sense of autonomy, competence and relatedness, which may have an extensive influence on dental education and on students' wellbeing. Future research should confirm or refute our results in other dental education settings.
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Fielden, Jennifer E. "An Evaluation of the Quality Assurance Plan at East Tennessee State University’s Dental Hygiene Program." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etd/2298.
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Quality assurance in healthcare is fundamental in ensuring the achievement of desired outcomes for patients. In 2011 a quality assurance plan was created at the East Tennessee State University (ETSU) dental hygiene program in order to meet accreditation standards. The purpose of this study was to evaluate this plan in order to determine its effectiveness in improving the quality of patient care indicators. One hundred fifty patient charts were selected and audited. Deficiencies were counted in the categories of assessment, treatment, documentation, referral, caries management, perio management, patient education, and follow-up. Research findings were varied; however, external variables with the potential to affect the study’s results were identified. Furthermore, statistical process control procedures indicated that the quality assurance program was effective or had the potential to be effective. Although further research is warranted, this study could be used to improve quality assurance practices at the ETSU dental hygiene program.
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Oishi, Matthew Masayoshi. "A national study of dental care delivery and utilization at programs of all-inclusive care for the elderly (PACE)." Thesis, University of Iowa, 2018. https://ir.uiowa.edu/etd/6481.
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Background: The Program of All-inclusive Care for the Elderly (PACE) is a program of care that enrolls nursing home eligible and offers them community-based long-term services and supports (LTSS). Many PACE enrollees are “dual eligibles” (DEs) meaning they qualify for Medicare and Medicaid services. Dental care is a unique feature of PACE among LTSS, as many LTSS do not include dental care, even though this population has difficulty in accessing these services. However, little is known about the delivery of dental care at PACE and how dental care and oral health promotion and prevention is being integrated into PACE. Thus, the purpose of this study is to describe the delivery and integration of dental care at PACE.
Methods: Based on ten preliminary interviews and the PACE manual from the Centers for Medicare and Medicaid Services (CMS), a 56-question survey was developed to describe the delivery and integration of dental care at PACE across the country. In addition, the survey asked programs to rank their focus among five specialties (dentistry, mental health, optometry, audiology, podiatry), to determine if a program’s focus on dental care would influence the delivery and integration of dental services at PACE, and if this would lead the program to have a very high percentage of new and continuous enrollees with regular dental examinations. A publicly available contact list was obtained from CMS and the survey was distributed to all 124 PACE programs via email.
Results: Respondents in this study represented 35 programs (28.2%) in 23 states (74.2%). Most programs had no limits for dental care, minimal waitlists, and provide most dental services without exclusions. This is evident by the 51.4% of programs that have no dental budget, 100% of programs providing preventive and basic restorative dental care, and nearly 100% offering advanced restorative services. Many programs also did not have a waitlist for non-emergent dental care. Few programs include a dentist in the routine operations of the PACE program, as evidenced by few programs having dentists conduct the dental assessment for the initial comprehensive assessment or having a dental director.
A statistically significant association with a high percentage of reported utilization of dental examinations was detected with programs having a system for quality assurance for dental care (t=0.358, p=0.024), a protocol for a dental cleaning every 6-12 months (t=0.595, p<0.001), mandating a comprehensive dental examination (t=0.390, p=0.007), and providing preventive dental services onsite with built-in equipment (t=0.454, p=0.001). No factors were statistically associated with the focus ranking for dentistry among the other specialties.
Conclusion: This study suggests that compared to nursing homes, PACE enrollees may have greater ability to receive dental care without limitations of the state adult Medicaid dental benefit. Dentistry also appears to be a high focus for some PACE programs. This study has begun to identify structures that support positive outcomes that can be used to develop best practices and guidelines for the delivery of dental care in PACE and other LTSS. Future studies are needed to better understand barriers and facilitators to the delivery of dental care and other specialty services.
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Blackwelder, Aaron Christian. "Association between dietary factors and malocclusion." Thesis, University of Iowa, 2013. https://ir.uiowa.edu/etd/2440.
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Associations Between Dietary Factors and Malocclusion. Blackwelder AC*, Warren JJ, Levy SM, Marshall TA, Bishara SE (University of Iowa, Iowa City, IA)
Purpose: Malocclusions, including crowding, have a multifactorial etiology, but it has been suggested that dietary factors may be a risk factor for malocclusion. Thus, the objective was to assess associations between dietary factors and dental crowding in a sample of Iowa Fluoride Study participants.
Methods: As participants in the Iowa Fluoride Study, subjects were followed up from birth to 102 months using questionnaires and diet diaries periodically to gather information on dietary intake. Subjects were also examined clinically around age 5 (n=168) and 9 (n=125) with dental casts made to gather information on malocclusion such as Tooth Size Arch Length Discrepancy (TSALD) and Canine Arch Width (CAW), as well as body mass index (BMI). Relationships between dietary factors and malocclusion were assessed.
Results: The maxillary and mandibular TSALD values for the age 5 and age 9 exams were correlated with the dietary data. The age 5 maxillary TSALD (1.74 mm) was statistically significant when correlated with kilocalories (P=.031) before and after adjusting for BMI. Further examination of the extreme TSALD values with dietary data was completed using Student's t-test. The age 9 mandibular extreme TSALD value and kilocalories was also statistically significant (P=.028). The age 5 CAW was correlated with the dietary data and kilocalories was also statistically significant (P=.012). Other dietary factors were found to approach statistical significance but were not significant at the alpha=0.05 level.
Conclusions: The findings from this study suggest that dietary factors may be associated with crowding of the dentition as measured by TSALD and CAW; however, further research is needed.
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Yaduwanshi, Kalyani Raj. "Risk factors for adolescent caries incidence in the Iowa Fluoride Study." Thesis, University of Iowa, 2014. https://ir.uiowa.edu/etd/1808.
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Objective: To determine risk factors for cavitated caries incidence and extent of cavitated caries among adolescents.
Methods: Three hundred and three Iowa Fluoride Study (IFS) subjects met inclusion criteria for interval between dental examination and the responses from the IFS (ages 13.5 to 17.0) and the Block Kids Food Frequency (ages 13.0 to 17.0) questionnaires, respectively. The analyses focused on the outcome variables of net cavitated caries incidence and net cavitated caries increment counts, respectively. The independent IFS questionnaire variables related to demographics, fluorides, oral hygiene, beverage intakes, dental visits, sealants and previous caries incidence variables, respectively, whereas, Block's questionnaire variables related to intakes of solid foods and beverages, respectively. Two sets of analyses, logistic and negative binomial regression analyses, were conducted to assess the associations between risk factors and net cavitated caries incidence and increment counts from 13 to 17, respectively.
Results: In multivariable logistic regression analyses, significant (p<0.05) negative associations were found between age 13 to 17 net cavitated caries incidence and greater frequency of consumption of vegetables, greater brushing frequency and greater frequency of sugar-free beverage consumption. Additionally, significant (p<0.05) positive associations were found between age 13 to 17 net cavitated caries incidence and both net cavitated caries incidence from 9 to 13 and frequency of consumption of solid-foods in the combined category of presumed moderate cariogenicity. The significant interaction effect showed that the effect of the presence/ absence of sealants varied for girls vs. boys.
In multivariable negative binomial analyses assessing the association between net cavitated caries increment count from 13 to 17 and risk factors, significant (p<0.05) positive associations were found with greater intake of foods predominant in starch, presence of sealants, greater baseline age, cavitated caries increment count from 9 to 13, and greater frequency of consumption of foods predominant in added sugar, respectively. Significant (p<0.05) negative associations were found between net cavitated caries incidence and greater frequency of consumption of foods predominant in fiber and natural sugar and greater daily fluoride intake from water. However, daily fluoride intake from water was not statistically significant with the significant interaction effect included between baseline age and net cavitated caries increment count from 9 to 13 (dichotomized as Y/N).
Conclusion: Presence of sealants, frequency of consumption of vegetables and previous cavitated caries incidence from 9 to 13 were associated with outcomes of incidence and extent of cavitated caries observed among IFS adolescents. The differences in findings for risk factors for incidence and extent of cavitated caries are due in part to the nature of the outcome variables (count vs. dichotomous), emphasizing the need to consider both outcomes in future studies of adolescent caries.
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Sukalski, Jennifer Michelle Cecelia. "Periodontal treatment needs in a Medicaid expansion population." Thesis, University of Iowa, 2017. https://ir.uiowa.edu/etd/5651.
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Objective: To investigate and determine periodontal treatment needs by the use of the Community Periodontal Index of Treatment Needs (CPITN) of a Medicaid expansion population in the state of Iowa (DWP) in comparison with patients insured by the traditional Medicaid State Plan, patients with private dental insurance, and self-pay patients, while evaluating for systemic health conditions and socio-behavioral factors.
Methods: A secondary data analysis of electronic health records (EHR) from the University of Iowa College of Dentistry was completed and analyzed. Univariate and bivariate analyses were conducted. Logistic regression models were used to analyze relationships between predictors and periodontal treatment need.
Results: Out of the study population, 54% were indicated for scaling and root planing (SRP). Predictors of indicating the need for SRP treatment were found to be: Age (p< .0001), gender (p< .0001), medical diagnosis of diabetes (p=.031), smoking status (p< .0001), and not receiving regular dental check-ups (p< .0001).
Discussion: Our findings are consistent with common periodontal disease predictors found in the literature. Interestingly, insurance status was not a significantly associated predictor of periodontal treatment needs. However, approximately 50% patients with all insurance types were indicated for SRP.
Implications: DWP patients must earn benefits by maintaining dental appointments. This earned benefits approach delays periodontal treatment as patients must earn this procedure, potentially leading to deteriorating periodontal health. Further assessment of periodontal burden in the DWP population should be conducted and potential program structure evaluated.