Prevalence of complete edentulism among US adults 65 years and older: A Behavioral Risk Factor Surveillance System study from 2012 through 2020.

BACKGROUND: The rapid growth of the older adult population in the United States and their increased risk of edentulism make it essential to analyze trends and factors associated with edentulism. METHODS: Data were obtained from the Behavioral Risk Factor Surveillance System from 2012 through 2020. US- and state-level trend lines were reported. Multiple logistic regression analyses were used to evaluate the association between self-reported complete edentulism and demographic characteristics, chronic diseases, smoking status, and health insurance status. Multiple imputations were used to address the missing data. RESULTS: A total of 771,513 (weighted n = 50,410,576) participants were included in the study. There was a significant (P = .021) downward trend in the prevalence of edentulism from 2012 (16.36%) through 2020 (13.54%). Having less than a high school education, being a smoker, being non-Hispanic Black, having an annual household income less than $75,000, and having chronic conditions, including diabetes, myocardial infarction, arthritis, depression, and stroke, were significantly associated with complete edentulism. CONCLUSIONS: Despite a decrease in prevalence of edentulism, disparities based on race, income, and education still exist. Edentulism is associated with chronic diseases in older adults. PRACTICAL IMPLICATIONS: Public health initiatives should be aimed at reducing the impact of edentulism and improving overall quality of life among older adults. Community health programs allocating resources to improve access to affordable care, reducing precursors to edentulism, expanding dental coverage, and promoting oral and general health awareness are vital components of these efforts.

Prevalence, Trends, and Severity of Early Childhood Caries in The United States: National Health and Nutritional Examination Survey Data 2013 to 2018.

Purpose: The purpose of this study was to report the prevalence of early childhood caries (ECC) and severe early childhood caries (S-ECC) in the United States and to examine trends from 2013 to 2018 in children under six years of age. Methods: Data were obtained from National Health and Nutrition Examination Survey (NHANES). Data from three consecutive cycles (2013 to 2014, 2015 to 2016, and 2017 to 2018) were analyzed. A total of 3,157 children younger than six years of age were included in the analysis. The proportion of children with ECC who developed S-ECC was calculated to assess the severity of the disease burden. Multivariable logistic models were used to determine the significance of both linear and quadratic trends. Subgroup analyses were done to test trends in different population groups. Results: The overall prevalence of ECC from 2013 to 2018 was 18.6 percent; the overall prevalence of S-ECC during this interval was 10.6 percent. The prevalence of ECC decreased from 2013 to 2014 (19.6 percent) to 2015 to 2016 (17.4 percent) but increased from 2017 to 2018 (to 18.7 percent). By contrast, the prevalence of S-ECC increased substantially from 2013 to 2014 (9.8 percent) through 2017 to 2018 (11.9 percent). The proportion of children with S-ECC among those with ECC increased from 2013 (49.9 percent) to 2018 (63.4 percent; linear P=0.048) with a significant linear increase among five-year- old (P=0.013), males (P=0.037) and children in families with income 100 percent of the Federal Poverty Guideline (P=0.003). Conclusion: A greater proportion of children with early childhood caries developed from 2017 to 2018 versus 2013 to 2014.

Association between vaping and untreated caries: A cross-sectional study of National Health and Nutrition Examination Survey 2017-2018 data.

BACKGROUND: With the rise in the prevalence of electronic cigarette (e-cigarette) and vaping products and the emergence of evidence indicating their cariogenic potential, it is essential to examine the association between vaping and untreated caries at a population level. METHODS: The authors obtained data from the 2017-2018 National Health and Nutrition Examination Survey and investigated the outcome variable-untreated caries-using oral health examination data. The authors applied multiple logistic regression analyses to assess the association between untreated caries and smoking (cigarette smoking, vaping, and both) while controlling for education, race or ethnicity, income, age, sex, and time since previous dental visit. RESULTS: A total of 4,618 participants were included in the analyses for this cross-sectional study. Participants who currently smoked e-cigarettes were more likely to have untreated caries (odds ratio, 1.69; 95% CI, 1.24 to 2.29) than those who had never smoked, when adjusted for demographic variables. Similarly, dual smokers (e-cigarette and conventional smokers) were more likely to have untreated caries compared with nondual smokers (odds ratio, 2.43; 95% CI, 1.36 to 4.36). CONCLUSION: Both vaping and dual smoking are associated with an increased occurrence of untreated caries. PRACTICAL IMPLICATIONS: Vaping status should be included as a part of health history questionnaires for patients. Dental professionals should be informed of the potential oral health implications of vaping and, in turn, impart this knowledge to patients.

Neighborhood Disadvantage and Allostatic Load in African American Women at Risk for Obesity-Related Diseases.

INTRODUCTION: African American women have higher rates of obesity and related chronic disease than other demographic groups. The poorer health of African American women compared with other groups may be explained by allostatic load, or cumulative physiologic stress, due to chronic socioeconomic disadvantage. The objective of this study was to evaluate neighborhood and individual factors contributing to allostatic load in African American women at risk for obesity-related diseases. METHODS: This study evaluated the relationship of allostatic load with neighborhood disadvantage, individual socioeconomic determinants, and synergism between neighborhood and socioeconomic disadvantage, along with health behaviors and other factors as mediators in African American women. Our sample consisted of 220 African American women at risk of obesity-related diseases enrolled in the Better Me Within program (mean [standard deviation] age, 50.1 [11.2] y; mean [standard deviation] body mass index, 36.7 [8.4] kg/m2). Allostatic load score for each participant was calculated by summing the number of biomarkers (of 9 biomarkers) that were determined to be in the high-risk quartile. RESULTS: Poisson regression of neighborhood disadvantage and individual socioeconomic determinants found that neighborhood disadvantage, but not education level or household income, was significantly associated with allostatic load (ß = 0.22, SE, 0.10, P = .04). Tests for mediators showed that household income and alcohol consumption partially mediated the relationship between allostatic load score and neighborhood disadvantage but were not significant. CONCLUSION: More research is necessary to determine the mechanisms by which neighborhoods can exacerbate and attenuate cumulative disadvantage among African American women. Policies and interventions that focus on neighborhood health may improve the outcomes of individual-level health interventions among women who reside in disadvantaged communities.