To investigate whether there is an association between sense of coherence levels and early weanin... more To investigate whether there is an association between sense of coherence levels and early weaning. This study had a quantitative nature and a cross-sectional design. Factors associated with early weaning (interruption of maternal breastfeeding) were investigated in a sample of 425 women older than 18 years, mothers of children up to 36 months of age who were not twins, with no sensory or motor deficiencies, without distinction of ethnicity or social class. The chi-squared test, with a significance level of 5%, was used to evaluate the association between the dependent variable (early weaning) and the independent variables (socioeconomic, demographic factors. and sense of coherence level). Variables with p≤0.20 were tested by the multiple logistic regression model. Odds ratio and the respective 95% confidence intervals were estimated. All statistical tests were performed using the SAS 9.2 software. The results showed that mothers with greater sense of coherence were 1.82 times more ...
Resumo Introdução A perda dentária é considerada um evento grave na vida dos pacientes e pode lev... more Resumo Introdução A perda dentária é considerada um evento grave na vida dos pacientes e pode levá-los à reclusão social. A reabilitação por meio de próteses pode contribuir para a melhora da autoimagem de edêntulos totais. Objetivo Este estudo teve como objetivo conhecer os fatores associados aos sentimentos decorrentes da perda de dentes e às expectativas quanto à nova prótese. Métodos Estudo transversal analítico com 119 pacientes edêntulos totais (faixa etária entre 29 e 87 anos) em tratamento para confecção de prótese em uma clínica-escola. Resultados Os pacientes que relataram ter perdido seus dentes devido ao medo de submeter-se ao tratamento ou a dificuldades de acesso foram os que mais sofreram com a perda dentária (OR=2,57). Os pacientes mais jovens (OR=3,33) e do sexo feminino (OR=3,89) foram aqueles que demonstraram mais expectativas em relação à prótese que estava sendo confeccionada. Conclusão As mulheres e as pessoas mais jovens são aquelas que manifestaram mais raiva...
OBJECTIVES: The purpose of this study was to provide estimates of the cumulative incidence of ini... more OBJECTIVES: The purpose of this study was to provide estimates of the cumulative incidence of initiation of smokeless tobacco use in a cohort of young persons and to explore sociodemographic, environmental, behavioral, and personal predictors of experimentation with and regular use of snuff or chewing tobacco. METHODS: The data for this cohort study were derived from the 1989 Teenage Attitudes and Practices Survey and its 1993 follow-up. The study included 7830 young people 11 through 19 years of age at baseline. RESULTS: During the 4 years, 12.7% of participants (20.9% of male participants) first tried smokeless tobacco, and 4.0% (8.0% of male participants) became self-classified regular users. This suggests that, each year, approximately 824000 young people in the United States 11 to 19 years of age experiment with smokeless tobacco and about 304 000 become regular users. Cumulative incidence was highest for male non-Hispanic Whites. Predictors of regular use included age, geograp...
OBJECTIVES: This study examined whether there are systematic differences between the Behavioral R... more OBJECTIVES: This study examined whether there are systematic differences between the Behavioral Risk Factor Surveillance System (BRFSS) and the Current Population Survey (CPS) for state cigarette smoking prevalence estimates. METHODS: BRFSS telephone survey estimates were compared with estimates from the US Census CPS tobacco-use supplements (the CPS sample frame includes persons in households without telephones). Weighted overall and sex- and race-specific BRFSS and CPS state estimates of adults smoking were analyzed for 1985, 1989, and 1992/1993. RESULTS: Overall estimates of smoking prevalence from the BRFSS were slightly lower than estimates from CPS (median difference: -2.0 percentage points in 1985, -0.7 in 1989, and -1.9 in 1992/1993; P < .05 for all comparisons), but there was variation among states. Differences between BRFSS and CPS estimates were larger among men than among women and larger among Blacks than among Hispanics or Whites; for most states, these differences ...
OBJECTIVES: Trends in smokeless tobacco use were examined for men in Indiana, Iowa, Montana, and ... more OBJECTIVES: Trends in smokeless tobacco use were examined for men in Indiana, Iowa, Montana, and West Virginia from 1988 through 1993. METHODS: State survey data from the Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. RESULTS: Demographic characteristics associated with smokeless tobacco use included age less than 35 years, a high school education or less, and rural residence. Overall, there was little change in smokeless tobacco use among men in these states (range = -0.4-0.4 percentage points annually); only West Virginia had a significant decline. CONCLUSIONS: Reasons for the overall lack of decline may include increased advertising and promotional expenditures or substitution of smokeless tobacco for cigarettes. Increased prevention and cessation efforts are needed.
Background In the USA, consumption of moist snuff continues to increase and cigarette manufacture... more Background In the USA, consumption of moist snuff continues to increase and cigarette manufacturers now control nearly its entire market. Manufacturers have developed new products that represent cigarette brand extension and in test marketing are promoting dual use of cigarettes and snuff. This study examined patterns of concurrent use of smokeless tobacco (ST) and cigarettes among young people and adults in the USA just before cigarette companies' control of the nation's ST market. Methods Data were drawn from four US nationally representative surveys. Stratified analyses applied sampling weights and accounted for the complex sample designs. Results Cigarette smoking was substantially more prevalent among young males who used ST than among those who did not. Among adult males, those who smoked daily were less likely than others to have used snuff every day. Men who used moist snuff daily had the lowest prevalence of daily smoking, but the prevalence of daily smoking was relatively high among men who used moist snuff less than daily. Unsuccessful past-year attempts by daily smokers to quit smoking were more prevalent among non-daily snuff users (41.2%) than among those who had never used snuff (29.6%). Conclusions Although dual daily use of ST and cigarettes is relatively uncommon in the USA, concurrent ST use is more common among adolescent and young adult male smokers than among more mature tobacco users. Among adult males, daily smoking predominates and non-daily ST use is very strongly associated with current smoking. Adult male smokers who also use ST daily tend to have relatively high levels of serum cotinine and high prevalence of a major indicator for tobacco dependence.
International Journal of Environmental Research and Public Health
The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health ... more The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health insurance and decrease health care cost while improving health care quality. With more articles examining the relationship between one of the ACA provisions and dental health outcomes, we systematically reviewed the effect of the ACA on dental care coverage and access to dental services. We searched literature using the National Library of Medicine’s Medline (PubMed) and Thomson Reuters’ Web of Science between January 2010 and November 2020. We identified 33 articles related to dental coverage, and access/utilization of dental care services. This systematic review of studies showed that the ACA resulted in gains in dental coverage for adults and children, whereas results were mixed with dental care access. Overall, we found that the policy led to a decrease in cost barriers, an increase in private dental coverage for young adults, and increased dental care use among low-income childless ...
OBJECTIVE To test the hypothesis that the level of healthcare trust does not differ between Black... more OBJECTIVE To test the hypothesis that the level of healthcare trust does not differ between Blacks and Whites. DESIGN Cross-sectional telephone-based survey. METHODS This study recruited low-income residents of Miami-Dade and Duval counties in Florida by using random-digit dialing (RDD). One thousand and five residents participated; however, analyses were limited to Black (n=550) or White (n=374) respondents. Trained interviewers used a structured questionnaire to obtain information about respondent demographics, trust in health care, perception of racism, and access to care. RESULTS Black respondents included fewer males (P=.0146) and younger subjects (P < or = .05); otherwise, they were similar to White respondents. Compared to Duval County respondents, Miami-Dade respondents were younger (< or = .05), richer (< or = .05), and mostly males (P=.0355). Blacks perceived more racism than did Whites (P<.0001). Healthcare trust differed by race and respondents' county (P...
The high prevalence of early childhood caries and many general dentists' reluctance to treat youn... more The high prevalence of early childhood caries and many general dentists' reluctance to treat young children and pregnant women demand new educational programs to foster delivery of oral health services. The aim of this study was to evaluate the impact of an Infant Oral Health Program (IOHP) at the University of Florida College of Dentistry on dental students' knowledge about and willingness to provide dental care for infants, children up to three years of age, and pregnant women. A total of 233 dental students in the first through fourth years and recent graduates completed a survey that assessed the educational outcomes of the IOHP; only the fourth-year students had received IOHP training. The results showed that females were more likely than males to provide counseling to caregivers about dental and physical development (p=0.024) and to offer restorative treatment to young children (p=0.021). Older students were more likely than younger students to provide restorative treatment (p=0.013). A greater percentage of IOHP-trained students (96%) reported knowing how to use the lap examination technique compared with untrained students (71%; p<0.001). IOHP-trained students were the most uncomfortable dealing with a crying child in the dental chair (p=0.0175). The graduates and fourth-year students were significantly more likely than the other cohorts to provide preventive (p=0.001) and restorative (p<0.001) care for pregnant women. The graduates were least likely to use some form of caries risk assessment (p<0.001). These findings highlight the need for earlier and greater exposure to the IOHP and the importance of promoting awareness about risk assessment and oral disease management.
The incorporation of web-based learning into the dental curriculum has been consistently recommen... more The incorporation of web-based learning into the dental curriculum has been consistently recommended in the literature on reform in dental education. There has been growing support for web-based learning in dental and dental hygiene education as demonstrated by deans' identifying this as a planned curricular innovation. The purpose of our study was to explore characteristics of e-courses that may serve to increase adoption among dental and dental hygiene faculty members. Eight ninety-minute focus groups (three dental; five dental hygiene) were conducted with dental (n=27) and dental hygiene (n=23) faculty members from six academic institutions. The resulting data were analyzed to identify two overarching themes and associated subthemes with regard to benefits and barriers influencing adoption of e-courses. A working conceptual framework, based
This report describes the research productivity of the members of the International Association f... more This report describes the research productivity of the members of the International Association for Dental Research (IADR) Behavioral Sciences and Health Services Research Group and examines personal and professional factors related to greater productivity. The findings from previous studies suggested there might be gender discrimination in opportunities for women faculty. Members on the active membership list for this IADR group were surveyed by email. Most were dentists, and threequarters had external funding for their research. The primary outcome measure was the number of self-reported published articles in PubMed in the preceding twenty-four months. The mean number of these publications was 4.9 (SD=5.1). Gender and time in research were the best predictors of research productivity of this population. There was no difference in time for research between the men and women in this study. Controlling for gender, the best single predictor of research productivity remained percent time spent in research. Overall, the members of the IADR group spent almost three times as much time in research and were more than twice as productive as faculty members as a whole as described in earlier studies. In view of the current emphasis in many countries on addressing the social and behavioral determinants of oral health disparities, the productivity of this area of dental research is very important. Trends toward clinically oriented, non-researchintensive dental schools in the United States and reductions in time and funding available to conduct research should be of concern.
Objective The objective of this quasi-experimental study was to determine the impact of the Promo... more Objective The objective of this quasi-experimental study was to determine the impact of the Promotora Model (PM) as an educational strategy to increase oral health knowledge in parents/caregivers of children aged 2–5 years at high risk for dental caries. Materials and Methods Sixty-three caregivers who provided informed consent were included in the study. A structured 37-item survey was administered prior to conducting the Promotora educational intervention (PEI) that covered oral health topics and behaviors. Three (3) months after the PEI session, during their child’s next dental visit, the same instrument was administered to 46 of the parents/caregivers that had completed the first instrument. Results Most caregivers were Hispanic (73.9%) and 50% reported completing high school. Before PEI, 56.5% of participants scored as having “good” general knowledge. Three months after PEI, 82.6% achieved that score (paired sample T-test, p< 0.00001). Conclusion Based on the results, it was...
To explore cost-effective options for pulpotomy, chamber fillings, and crowns in primary molars u... more To explore cost-effective options for pulpotomy, chamber fillings, and crowns in primary molars using bioactive cements. Thirty extracted primary molars were divided into five groups, each having two sets of three teeth (one first molar and two second molars). Pulpotomy and restorative options were randomly assigned: Biodentine plus Ketac Molar; NuSmile NeoMTA plus Tempit LC; NeoMTA Plus plus Fuji IX; MTA Angelus plus IRM capsule; MTA Flow plus IRM powder and liquid. After mixing one dose, pulp chambers of the first molar and one second molar were filled with a two-millimeter layer of bioactive cement and filling material (protocol A). The other second molar's chamber was solo filled by a single mixed dose of bioactive cement (protocol B). The cost for each material was calculated independently, regardless of the group to which they belonged. A market assessment for primary molar crowns was performed, and a comparison table was produced. For protocol A, the lowest mean cost per ...
To examine differences between Hispanics and non-Hispanics in Florida in the dental-related use o... more To examine differences between Hispanics and non-Hispanics in Florida in the dental-related use of hospital emergency departments (EDs). We used ambulatory ED discharge records from 2013 to 2015 to compute rates of ED visits for dental complaints per 10 000 population, by region, age, gender, and the percentage distribution visits by primary payer, day of the week, and hour of arrival. There were 64 100 ED visits for dental complaints by Hispanics and 425 162 by non-Hispanics. Medicaid was the most common primary payer for Hispanics (42.2%) and for non-Hispanics (38.1%). Rates of ED utilization for dental problems per 10 000 population were 45.5 for Hispanics and 95.2 for non-Hispanics. Rates of ED utilization for dental problems were different between Hispanics and non-Hispanics. Public Health Implications. Effective interventions need to be developed in the context of a social-ecological model to better understand factors such as health, economics, and education, among others. Und...
Demand for dental care is expected to outpace supply through 2025. The objectives of this study w... more Demand for dental care is expected to outpace supply through 2025. The objectives of this study were to determine the extent of pediatric dental care shortages in Georgia and to develop a general method for estimation that can be applied to other states. We estimated supply and demand for pediatric preventive dental care for the 159 counties in Georgia in 2015. We compared pediatric preventive dental care shortage areas (where demand exceeded twice the supply) designated by our methods with dental health professional shortage areas designated by the Health Resources & Services Administration. We estimated caries risk from a multivariate analysis of National Health and Nutrition Examination Survey data and national census data. We estimated county-level demand based on the time needed to perform preventive dental care services and the proportion of time that dentists spend on pediatric preventive dental care services from the Medical Expenditure Panel Survey. Pediatric preventive den...
This article provides an example of interprofessional collaboration for policy development regard... more This article provides an example of interprofessional collaboration for policy development regarding environmental global health vis-à-vis the Minamata Convention on Mercury. It presents an overview of mercury and mercury-related environmental health issues; public policy processes and stakeholders; and specifics including organized dentistry's efforts to create global policy to restrict environmental contamination by mercury. Dentistry must participate in interprofessional collaborations and build on such experiences to be optimally placed for ongoing interprofessional policy development. Current areas requiring dental engagement for interprofessional policy development include education, disaster response, HPV vaccination, pain management, research priorities, and antibiotic resistance.
The inability to access regular dental care may lead to care seeking at hospital emergency depart... more The inability to access regular dental care may lead to care seeking at hospital emergency departments (EDs). However, EDs generally are not equipped or staffed to provide definitive dental services. This study examined trends and patterns of hospital ED use for dental-related reasons in Florida, a large, diverse state with serious barriers to accessing dental care. Data for this study were drawn from ambulatory ED discharge records compiled by Florida's Agency for Health Care Administration for 2005-2014. Visits for dental-related reasons in Florida were defined by the patient's reported reason for seeking care or the ED physician's primary diagnosis using ICD-9-CM codes. We calculated frequencies, age-specific and age-adjusted rates per 100,000 population, and secular trends in dental-related ED visits and their associated charges. The number of dental-related visits to Florida EDs increased each year, from 104,642 in 2005 to 163,900 in 2014; the age-adjusted rate incr...
Objectives: The purpose of this study was to provide a systematic evaluation of a theory-driven o... more Objectives: The purpose of this study was to provide a systematic evaluation of a theory-driven oral cancer awareness media campaign. Methods: We surveyed a cohort of residents in an intervention city (250) and a control city (250) immediately prior to and after the media campaign. Participants (125 black/ African American and 125 white) in each city completed surveys at baseline and follow-up. Oral cancer campaign awareness was assessed in both cities, along with 4 hypothetical health campaigns. Oral cancer awareness, oral cancer exam awareness, intent to receive an oral cancer exam, interest in exam, and receipt of exam were also assessed in both cities, both at baseline and follow-up. Results: Intervention city residents showed a significant increase in recognition of the campaign, awareness of the oral cancer exam, and interest in getting an exam, while no significant changes in those topics were found for the control city. Blacks/African Americans in the intervention city were significantly more likely than whites to demonstrate increases in awareness of the campaign, oral cancer awareness, and interest in receiving an oral cancer exam. Conclusions: A theory-driven media campaign was successful in increasing awareness of the oral cancer exam and interest in the exam among blacks/African Americans.
To investigate whether there is an association between sense of coherence levels and early weanin... more To investigate whether there is an association between sense of coherence levels and early weaning. This study had a quantitative nature and a cross-sectional design. Factors associated with early weaning (interruption of maternal breastfeeding) were investigated in a sample of 425 women older than 18 years, mothers of children up to 36 months of age who were not twins, with no sensory or motor deficiencies, without distinction of ethnicity or social class. The chi-squared test, with a significance level of 5%, was used to evaluate the association between the dependent variable (early weaning) and the independent variables (socioeconomic, demographic factors. and sense of coherence level). Variables with p≤0.20 were tested by the multiple logistic regression model. Odds ratio and the respective 95% confidence intervals were estimated. All statistical tests were performed using the SAS 9.2 software. The results showed that mothers with greater sense of coherence were 1.82 times more ...
Resumo Introdução A perda dentária é considerada um evento grave na vida dos pacientes e pode lev... more Resumo Introdução A perda dentária é considerada um evento grave na vida dos pacientes e pode levá-los à reclusão social. A reabilitação por meio de próteses pode contribuir para a melhora da autoimagem de edêntulos totais. Objetivo Este estudo teve como objetivo conhecer os fatores associados aos sentimentos decorrentes da perda de dentes e às expectativas quanto à nova prótese. Métodos Estudo transversal analítico com 119 pacientes edêntulos totais (faixa etária entre 29 e 87 anos) em tratamento para confecção de prótese em uma clínica-escola. Resultados Os pacientes que relataram ter perdido seus dentes devido ao medo de submeter-se ao tratamento ou a dificuldades de acesso foram os que mais sofreram com a perda dentária (OR=2,57). Os pacientes mais jovens (OR=3,33) e do sexo feminino (OR=3,89) foram aqueles que demonstraram mais expectativas em relação à prótese que estava sendo confeccionada. Conclusão As mulheres e as pessoas mais jovens são aquelas que manifestaram mais raiva...
OBJECTIVES: The purpose of this study was to provide estimates of the cumulative incidence of ini... more OBJECTIVES: The purpose of this study was to provide estimates of the cumulative incidence of initiation of smokeless tobacco use in a cohort of young persons and to explore sociodemographic, environmental, behavioral, and personal predictors of experimentation with and regular use of snuff or chewing tobacco. METHODS: The data for this cohort study were derived from the 1989 Teenage Attitudes and Practices Survey and its 1993 follow-up. The study included 7830 young people 11 through 19 years of age at baseline. RESULTS: During the 4 years, 12.7% of participants (20.9% of male participants) first tried smokeless tobacco, and 4.0% (8.0% of male participants) became self-classified regular users. This suggests that, each year, approximately 824000 young people in the United States 11 to 19 years of age experiment with smokeless tobacco and about 304 000 become regular users. Cumulative incidence was highest for male non-Hispanic Whites. Predictors of regular use included age, geograp...
OBJECTIVES: This study examined whether there are systematic differences between the Behavioral R... more OBJECTIVES: This study examined whether there are systematic differences between the Behavioral Risk Factor Surveillance System (BRFSS) and the Current Population Survey (CPS) for state cigarette smoking prevalence estimates. METHODS: BRFSS telephone survey estimates were compared with estimates from the US Census CPS tobacco-use supplements (the CPS sample frame includes persons in households without telephones). Weighted overall and sex- and race-specific BRFSS and CPS state estimates of adults smoking were analyzed for 1985, 1989, and 1992/1993. RESULTS: Overall estimates of smoking prevalence from the BRFSS were slightly lower than estimates from CPS (median difference: -2.0 percentage points in 1985, -0.7 in 1989, and -1.9 in 1992/1993; P < .05 for all comparisons), but there was variation among states. Differences between BRFSS and CPS estimates were larger among men than among women and larger among Blacks than among Hispanics or Whites; for most states, these differences ...
OBJECTIVES: Trends in smokeless tobacco use were examined for men in Indiana, Iowa, Montana, and ... more OBJECTIVES: Trends in smokeless tobacco use were examined for men in Indiana, Iowa, Montana, and West Virginia from 1988 through 1993. METHODS: State survey data from the Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. RESULTS: Demographic characteristics associated with smokeless tobacco use included age less than 35 years, a high school education or less, and rural residence. Overall, there was little change in smokeless tobacco use among men in these states (range = -0.4-0.4 percentage points annually); only West Virginia had a significant decline. CONCLUSIONS: Reasons for the overall lack of decline may include increased advertising and promotional expenditures or substitution of smokeless tobacco for cigarettes. Increased prevention and cessation efforts are needed.
Background In the USA, consumption of moist snuff continues to increase and cigarette manufacture... more Background In the USA, consumption of moist snuff continues to increase and cigarette manufacturers now control nearly its entire market. Manufacturers have developed new products that represent cigarette brand extension and in test marketing are promoting dual use of cigarettes and snuff. This study examined patterns of concurrent use of smokeless tobacco (ST) and cigarettes among young people and adults in the USA just before cigarette companies' control of the nation's ST market. Methods Data were drawn from four US nationally representative surveys. Stratified analyses applied sampling weights and accounted for the complex sample designs. Results Cigarette smoking was substantially more prevalent among young males who used ST than among those who did not. Among adult males, those who smoked daily were less likely than others to have used snuff every day. Men who used moist snuff daily had the lowest prevalence of daily smoking, but the prevalence of daily smoking was relatively high among men who used moist snuff less than daily. Unsuccessful past-year attempts by daily smokers to quit smoking were more prevalent among non-daily snuff users (41.2%) than among those who had never used snuff (29.6%). Conclusions Although dual daily use of ST and cigarettes is relatively uncommon in the USA, concurrent ST use is more common among adolescent and young adult male smokers than among more mature tobacco users. Among adult males, daily smoking predominates and non-daily ST use is very strongly associated with current smoking. Adult male smokers who also use ST daily tend to have relatively high levels of serum cotinine and high prevalence of a major indicator for tobacco dependence.
International Journal of Environmental Research and Public Health
The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health ... more The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health insurance and decrease health care cost while improving health care quality. With more articles examining the relationship between one of the ACA provisions and dental health outcomes, we systematically reviewed the effect of the ACA on dental care coverage and access to dental services. We searched literature using the National Library of Medicine’s Medline (PubMed) and Thomson Reuters’ Web of Science between January 2010 and November 2020. We identified 33 articles related to dental coverage, and access/utilization of dental care services. This systematic review of studies showed that the ACA resulted in gains in dental coverage for adults and children, whereas results were mixed with dental care access. Overall, we found that the policy led to a decrease in cost barriers, an increase in private dental coverage for young adults, and increased dental care use among low-income childless ...
OBJECTIVE To test the hypothesis that the level of healthcare trust does not differ between Black... more OBJECTIVE To test the hypothesis that the level of healthcare trust does not differ between Blacks and Whites. DESIGN Cross-sectional telephone-based survey. METHODS This study recruited low-income residents of Miami-Dade and Duval counties in Florida by using random-digit dialing (RDD). One thousand and five residents participated; however, analyses were limited to Black (n=550) or White (n=374) respondents. Trained interviewers used a structured questionnaire to obtain information about respondent demographics, trust in health care, perception of racism, and access to care. RESULTS Black respondents included fewer males (P=.0146) and younger subjects (P < or = .05); otherwise, they were similar to White respondents. Compared to Duval County respondents, Miami-Dade respondents were younger (< or = .05), richer (< or = .05), and mostly males (P=.0355). Blacks perceived more racism than did Whites (P<.0001). Healthcare trust differed by race and respondents' county (P...
The high prevalence of early childhood caries and many general dentists' reluctance to treat youn... more The high prevalence of early childhood caries and many general dentists' reluctance to treat young children and pregnant women demand new educational programs to foster delivery of oral health services. The aim of this study was to evaluate the impact of an Infant Oral Health Program (IOHP) at the University of Florida College of Dentistry on dental students' knowledge about and willingness to provide dental care for infants, children up to three years of age, and pregnant women. A total of 233 dental students in the first through fourth years and recent graduates completed a survey that assessed the educational outcomes of the IOHP; only the fourth-year students had received IOHP training. The results showed that females were more likely than males to provide counseling to caregivers about dental and physical development (p=0.024) and to offer restorative treatment to young children (p=0.021). Older students were more likely than younger students to provide restorative treatment (p=0.013). A greater percentage of IOHP-trained students (96%) reported knowing how to use the lap examination technique compared with untrained students (71%; p<0.001). IOHP-trained students were the most uncomfortable dealing with a crying child in the dental chair (p=0.0175). The graduates and fourth-year students were significantly more likely than the other cohorts to provide preventive (p=0.001) and restorative (p<0.001) care for pregnant women. The graduates were least likely to use some form of caries risk assessment (p<0.001). These findings highlight the need for earlier and greater exposure to the IOHP and the importance of promoting awareness about risk assessment and oral disease management.
The incorporation of web-based learning into the dental curriculum has been consistently recommen... more The incorporation of web-based learning into the dental curriculum has been consistently recommended in the literature on reform in dental education. There has been growing support for web-based learning in dental and dental hygiene education as demonstrated by deans' identifying this as a planned curricular innovation. The purpose of our study was to explore characteristics of e-courses that may serve to increase adoption among dental and dental hygiene faculty members. Eight ninety-minute focus groups (three dental; five dental hygiene) were conducted with dental (n=27) and dental hygiene (n=23) faculty members from six academic institutions. The resulting data were analyzed to identify two overarching themes and associated subthemes with regard to benefits and barriers influencing adoption of e-courses. A working conceptual framework, based
This report describes the research productivity of the members of the International Association f... more This report describes the research productivity of the members of the International Association for Dental Research (IADR) Behavioral Sciences and Health Services Research Group and examines personal and professional factors related to greater productivity. The findings from previous studies suggested there might be gender discrimination in opportunities for women faculty. Members on the active membership list for this IADR group were surveyed by email. Most were dentists, and threequarters had external funding for their research. The primary outcome measure was the number of self-reported published articles in PubMed in the preceding twenty-four months. The mean number of these publications was 4.9 (SD=5.1). Gender and time in research were the best predictors of research productivity of this population. There was no difference in time for research between the men and women in this study. Controlling for gender, the best single predictor of research productivity remained percent time spent in research. Overall, the members of the IADR group spent almost three times as much time in research and were more than twice as productive as faculty members as a whole as described in earlier studies. In view of the current emphasis in many countries on addressing the social and behavioral determinants of oral health disparities, the productivity of this area of dental research is very important. Trends toward clinically oriented, non-researchintensive dental schools in the United States and reductions in time and funding available to conduct research should be of concern.
Objective The objective of this quasi-experimental study was to determine the impact of the Promo... more Objective The objective of this quasi-experimental study was to determine the impact of the Promotora Model (PM) as an educational strategy to increase oral health knowledge in parents/caregivers of children aged 2–5 years at high risk for dental caries. Materials and Methods Sixty-three caregivers who provided informed consent were included in the study. A structured 37-item survey was administered prior to conducting the Promotora educational intervention (PEI) that covered oral health topics and behaviors. Three (3) months after the PEI session, during their child’s next dental visit, the same instrument was administered to 46 of the parents/caregivers that had completed the first instrument. Results Most caregivers were Hispanic (73.9%) and 50% reported completing high school. Before PEI, 56.5% of participants scored as having “good” general knowledge. Three months after PEI, 82.6% achieved that score (paired sample T-test, p< 0.00001). Conclusion Based on the results, it was...
To explore cost-effective options for pulpotomy, chamber fillings, and crowns in primary molars u... more To explore cost-effective options for pulpotomy, chamber fillings, and crowns in primary molars using bioactive cements. Thirty extracted primary molars were divided into five groups, each having two sets of three teeth (one first molar and two second molars). Pulpotomy and restorative options were randomly assigned: Biodentine plus Ketac Molar; NuSmile NeoMTA plus Tempit LC; NeoMTA Plus plus Fuji IX; MTA Angelus plus IRM capsule; MTA Flow plus IRM powder and liquid. After mixing one dose, pulp chambers of the first molar and one second molar were filled with a two-millimeter layer of bioactive cement and filling material (protocol A). The other second molar's chamber was solo filled by a single mixed dose of bioactive cement (protocol B). The cost for each material was calculated independently, regardless of the group to which they belonged. A market assessment for primary molar crowns was performed, and a comparison table was produced. For protocol A, the lowest mean cost per ...
To examine differences between Hispanics and non-Hispanics in Florida in the dental-related use o... more To examine differences between Hispanics and non-Hispanics in Florida in the dental-related use of hospital emergency departments (EDs). We used ambulatory ED discharge records from 2013 to 2015 to compute rates of ED visits for dental complaints per 10 000 population, by region, age, gender, and the percentage distribution visits by primary payer, day of the week, and hour of arrival. There were 64 100 ED visits for dental complaints by Hispanics and 425 162 by non-Hispanics. Medicaid was the most common primary payer for Hispanics (42.2%) and for non-Hispanics (38.1%). Rates of ED utilization for dental problems per 10 000 population were 45.5 for Hispanics and 95.2 for non-Hispanics. Rates of ED utilization for dental problems were different between Hispanics and non-Hispanics. Public Health Implications. Effective interventions need to be developed in the context of a social-ecological model to better understand factors such as health, economics, and education, among others. Und...
Demand for dental care is expected to outpace supply through 2025. The objectives of this study w... more Demand for dental care is expected to outpace supply through 2025. The objectives of this study were to determine the extent of pediatric dental care shortages in Georgia and to develop a general method for estimation that can be applied to other states. We estimated supply and demand for pediatric preventive dental care for the 159 counties in Georgia in 2015. We compared pediatric preventive dental care shortage areas (where demand exceeded twice the supply) designated by our methods with dental health professional shortage areas designated by the Health Resources & Services Administration. We estimated caries risk from a multivariate analysis of National Health and Nutrition Examination Survey data and national census data. We estimated county-level demand based on the time needed to perform preventive dental care services and the proportion of time that dentists spend on pediatric preventive dental care services from the Medical Expenditure Panel Survey. Pediatric preventive den...
This article provides an example of interprofessional collaboration for policy development regard... more This article provides an example of interprofessional collaboration for policy development regarding environmental global health vis-à-vis the Minamata Convention on Mercury. It presents an overview of mercury and mercury-related environmental health issues; public policy processes and stakeholders; and specifics including organized dentistry's efforts to create global policy to restrict environmental contamination by mercury. Dentistry must participate in interprofessional collaborations and build on such experiences to be optimally placed for ongoing interprofessional policy development. Current areas requiring dental engagement for interprofessional policy development include education, disaster response, HPV vaccination, pain management, research priorities, and antibiotic resistance.
The inability to access regular dental care may lead to care seeking at hospital emergency depart... more The inability to access regular dental care may lead to care seeking at hospital emergency departments (EDs). However, EDs generally are not equipped or staffed to provide definitive dental services. This study examined trends and patterns of hospital ED use for dental-related reasons in Florida, a large, diverse state with serious barriers to accessing dental care. Data for this study were drawn from ambulatory ED discharge records compiled by Florida's Agency for Health Care Administration for 2005-2014. Visits for dental-related reasons in Florida were defined by the patient's reported reason for seeking care or the ED physician's primary diagnosis using ICD-9-CM codes. We calculated frequencies, age-specific and age-adjusted rates per 100,000 population, and secular trends in dental-related ED visits and their associated charges. The number of dental-related visits to Florida EDs increased each year, from 104,642 in 2005 to 163,900 in 2014; the age-adjusted rate incr...
Objectives: The purpose of this study was to provide a systematic evaluation of a theory-driven o... more Objectives: The purpose of this study was to provide a systematic evaluation of a theory-driven oral cancer awareness media campaign. Methods: We surveyed a cohort of residents in an intervention city (250) and a control city (250) immediately prior to and after the media campaign. Participants (125 black/ African American and 125 white) in each city completed surveys at baseline and follow-up. Oral cancer campaign awareness was assessed in both cities, along with 4 hypothetical health campaigns. Oral cancer awareness, oral cancer exam awareness, intent to receive an oral cancer exam, interest in exam, and receipt of exam were also assessed in both cities, both at baseline and follow-up. Results: Intervention city residents showed a significant increase in recognition of the campaign, awareness of the oral cancer exam, and interest in getting an exam, while no significant changes in those topics were found for the control city. Blacks/African Americans in the intervention city were significantly more likely than whites to demonstrate increases in awareness of the campaign, oral cancer awareness, and interest in receiving an oral cancer exam. Conclusions: A theory-driven media campaign was successful in increasing awareness of the oral cancer exam and interest in the exam among blacks/African Americans.
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