Patterns and correlates of spit tobacco use among high school males in rural California.

OBJECTIVE: To assess patterns and correlates of spit [smokeless tobacco (ST)] use among high school males in rural California. METHODS: An 18-item, self-administered questionnaire was used to assess ST use among young males in 41 randomly selected high schools in 21 rural counties in California. To ensure confidentiality, students were instructed to seal their completed questionnaire in an attached envelope prior to returning it to the questionnaire administrator. RESULTS: Overall prevalence of ST use was 9.8 percent, significantly increasing with year in school from 5 percent among freshmen to 15 percent among seniors. ST use was highest among rodeo athletes at 42 percent compared with <6 percent among nonathletes; ST use was significantly higher among smokers (32 percent) who were 2.5-30 times more likely to use ST compared with nonsmokers, depending on race/ethnicity as a result of a significant race/ethnicity x smoking interaction of degree/magnitude. In addition, students who believed there was no, or slight risk of, harm from ST use were significantly more likely to use ST than students perceiving moderate or great risk, depending on race/ethnicity (odds ratios 3.6-13). Among all ST users, 40 percent used ST on at least 5 days in the previous week, 80 percent of those reporting a brand used the brand Copenhagen, and 41 percent (189) used ST within 30 minutes of waking. CONCLUSION: Dental public health practitioners, scholars, and policy-makers need to promote dental health through organized community efforts targeting high school male subgroups in rural areas that are at risk for ST-associated adverse health effects.

Temporomandibular joint and muscle disorder-type pain in U.S. adults: the National Health Interview Survey.

AIMS: To compare prevalences of self-reported temporomandibular joint and muscle disorders (TMJMD)-type pain in the 2002 U.S. National Health Interview Survey (NHIS) by age and gender for non-Hispanic whites (Caucasians) and non-Hispanic blacks (African Americans). METHODS: Data from the 2002 NHIS included information on gender, age, race, ethnicity, education, and TMJMD-type pain. Rao-Scott survey chi-square and survey logistic regression analyses using sampling weights and accounting for the complex design were used to analyze variables relating to prevalences. RESULTS: A total of 30,978 people, 17,498 females and 13,480 males, 20,389 non-Hispanic whites and 4179 non-Hispanic blacks, were included. The overall prevalence of TMJMD-type pain was 4.6%, with 6.3% for women and 2.8% for men. However, based on age, a significant but modest racial/ethnic difference emerged after adjusting for socioeconomic status. For non-Hispanic white women up to age 50, the prevalence was approximately 7% to 8%, but it decreased after age 55. Non-Hispanic black women had much lower prevalence at younger ages (approximately 4% at 25 to 34 years), which increased thereafter up to 55 to 64 years of age. A similar racial pattern seemed to emerge for non-Hispanic black men, with the lowest prevalence at ages 25 to 34 years, while non-Hispanic white men had higher prevalences. Overall, however, age seemed to play more of a role in women than men. CONCLUSION: This is the first report of findings from a nationally representative US sample for TMJMD-type pain by age and race/ethnicity. TMJMD-type pain differed significantly by race, age, and gender after adjusting for socioeconomic status.

Identification and description of mobile dental programs--a brief communication.

OBJECTIVES: The purpose of this study was to identify and describe mobile dental programs in California. METHODS: The programs were identified by Internet searches, county health officers, local dental society directors, mobile program directors, and others. A cross-sectional survey was mailed to program directors if their programs provide clinical dental services beyond screening and education. RESULTS: In California, 33 programs were identified; survey response rate was 70 percent. The populations most likely to be served were those with low-income (100 percent), elementary (77 percent) and preschool (68 percent) children, non-English speakers (64 percent), and the Medicaid-eligible (64 percent). At least half of the programs were providing services in designated Dental Health Professional Shortage Areas. Most program directors indicated that if their program was discontinued, it would be "very difficult" (61 percent) or "difficult" (35 percent) for the target populations to get dental services. CONCLUSIONS: Mobile dental programs are a highly variable, but important, strategy for bringing dental care to many underserved populations.

Patterns and correlates of tobacco control behavior among american association of pediatric dentistry members: a cross-sectional national study.

BACKGROUND: To determine the tobacco-related knowledge, attitudes, and practice behaviors among US pediatric dentists. METHODS: A survey was conducted in 1998 among a national, random sample of 1500 American Academy of Pediatric Dentistry members. Chi-square tests and logistic regression with odds ratios (ORs) and 95% confidence intervals assessed factors related to pediatric dentists' tobacco control behaviors. RESULTS: Response was 65% for the survey. Only 12% of respondents had prior tobacco prevention/cessation training. Of those untrained, 70% were willing to be trained. Less than two-thirds correctly answered any of four tobacco-related knowledge items. Over one-half agreed pediatric dentists should engage in tobacco control behaviors, but identified patient resistance as a barrier. About 24% of respondents reported always/often asking their adolescent patients about tobacco use; 73% reported always/often advising known tobacco users to quit; and 37% of respondents always/often assisting with stopping tobacco use. Feeling prepared to perform tobacco control behaviors (ORs = 1.9-2.8), a more positive attitude score (4 points) from 11 tobacco-related items (ORs = 1.5-1.8), and a higher statewide tobacco use prevalence significantly predicted performance of tobacco control behaviors. CONCLUSION: Findings suggest thatraining programs on tobacco use and dependence treatment in the pediatric dental setting may be needed to promote tobacco control behaviors for adolescent patients.

Dental check-up of California's State Children's Health Insurance program.

PURPOSE: The purpose of this study was to compare dental utilization rates and related factors for children in California's State Children's Health Insurance dental program (SCHIP) to those for children with other types of dental insurance coverage or no coverage. METHODS: Data from the cross-sectional 2001 California Health Interview Survey for 10,454 children 2 to 11 years old were used. Data analyzed included: (1) the child's most recent dental visit; (2) dental insurance status; and (3) type of health insurance coverage. RESULTS: In 2001, 5% (+/-SE=0.3) of California children had SCHIP dental coverage, 19% had Medicaid dental insurance (Denti-CAL), and 52% had private dental insurance. Twenty-three percent (+/-0.5) of children, however, had no dental insurance. Dental utilization rates varied significantly according to type of dental insurance. Compared to uninsured children, SCHIP children were more likely to use dental services within the past year (58% vs 72%). Annual dental utilization rates were even higher for Denti-CAL and privately insured children (76% and 80%, respectively). Factors associated with disparities in dental utilization included lack of a usual source of health care and lack of continuous health insurance. CONCLUSIONS: Significant disparities occurred by dental insurance status and type. Annual dental utilization rates for SCHIP children lagged behind those of children with Denti-CAL or private dental insurance.

Determinants of dental service utilization among 2 to 11-year-old California children.

OBJECTIVE: The 2001 California Health Interview Survey (CHIS) was designed to elicit population-based estimates about health care access and insurance coverage. This study aimed to determine factors associated with dental service utilization among children ages 2 to 11 years in California. METHODS: CHIS was a random digit dialing telephone survey. Interviews were conducted with the adult in the household that was most knowledgeable about the child's care, and information was collected on the child's last dental visit. RESULTS: Data on dental visits were collected on 10,569 children ages 2-11 years. In 2001, 73.5 (+/- 0.6)% of children had a dental visit, 58.2 (+/- 0.6)% a preventive dental visit, while 18.3 (+/- 0.5)% had never visited the dentist. Nearly 1 million children had never visited the dentist, primarily children ages 2-5 years. Overall, 76.3 (+/- 0.6)% of children had dental insurance. Children with a past-year dental visit were likely to be school age, insured and from high-income households. Other predictors of utilization were the responding adult's age and educational attainment. CONCLUSION: Dental service utilization is determined by a mix of parental, child and household factors.