Factors associated with seeking preventive dental care: an integrative model exploration of behaviors in Mexican immigrants in Midwest America.

BACKGROUND: Mexican immigrants in the United States suffer from poor oral health. The objective of the current study was to explore the utility of applying theory-based factors associated with seeking preventive dental care in a sample of Mexican American adults. METHODS: Data were collected from a cross-sectional survey of a sample of 157 people of Mexican origin (64% female; age 34 ± 11 years) recruited primarily from church congregations and lay community organizations in Central Indiana. Using the Integrative Model of Behavioral Prediction as the guiding framework, structural equation modeling was used to test factors associated with intention to seek preventive dental care. RESULTS: Attitude towards seeking preventive dental care (estimate = 0.37; p < .0001) and self-efficacy for seeking preventive dental care (estimate = 0.68; p < .0001) were associated with intention to seek preventive dental care. The association between dental beliefs and intention to seek preventive dental care was mediated by attitude and self-efficacy (indirect effect = 0.26, p = .002), and the association between past behavior and intention to seek preventive dental care was mediated by self-efficacy (indirect effect = 0.26, p = .003). CONCLUSIONS: These findings suggest that interventions to increase preventive dental care seeking behavior among Mexican Americans should focus on changing attitudes toward seeking preventive dental care and on increasing self-efficacy to seek preventive dental care. Findings also support the use of interventions to influence dental beliefs.

Use of Internet for General and Dental Health along Acculturation Features in a Sample of Mexican Americans.

The objectives of this study were to explore self-reported Internet and electronic platforms used to search for and store medical and dental information among people of Mexican origin. A sample of adults self-identified as European American (250) and as Mexican American (255), residing in Central Indiana, answered a one-time survey that included technology use questions and measured acculturation via the Psychological-Behavioral Acculturation Scale. Overall use of information technologies was estimated through an Information and Communication Technology score. Overall, participants with higher scores searched online for general and oral health information at higher rates than those with lower scores. Younger Mexican Americans and those with higher use scores were more likely to search online for general health information, as were those more psychologically and behaviorally acculturated. Interestingly, Mexican Americans were more likely than European Americans to search online for dental health information. All participants demonstrated high interest in accessing and storing their own health information especially on paper format; storage in other places, such as personal computers, smartphones, or USB flash drives, was less endorsed. Most participants would allow spouses access to their health records; however, there were significant differences between both population groups regarding access given to physicians, dentists and other family members, with Mexican Americans reporting more restrictions. Our findings provide initial information on differential use pattern of electronic health resources among Mexican Americans and suggest that new information technologies reach population groups traditionally underserved; such features may help address disparities in general and dental health.

Impact of caries and dental fluorosis on oral health-related quality of life: a cross-sectional study in schoolchildren receiving water naturally fluoridated at above-optimal levels.

PURPOSE: The purpose of this study was to evaluate the impact of caries and fluorosis on oral health-related quality of life (OHRQoL) among schoolchildren living in areas with high concentrations of fluoride in water. METHODS: Five hundred and twenty-four schoolchildren (8-12 year olds) residing in rural communities in central Mexico were examined for oral hygiene, caries (International Caries Detection and Assessment System, ICDAS II), and fluorosis (Thylstrup and Fejerskov Index, TFI). OHRQoL was evaluated with the Child Perceptions Questionnaire for two age groups (CPQ8-10 and CPQ11-14). Generalized structural equation models were constructed for data analysis. RESULTS: Overall prevalence of caries was 88.5% and fluorosis 46.9%. In the group of 8-10 year olds, 48% of the children had advanced carious lesions in primary or permanent teeth (ICDAS ≥4), 22.6% had moderate/severe fluorosis, and 59.9% of children had an impact on OHRQoL. Schoolchildren with ICDAS ≥4 were more likely [OR = 1.75, (95% CI 1.34-2.28)] to suffer a negative impact on OHRQoL. In the group of 11-12 year olds, 19.9% of children had advanced carious lesions and 23.2% showed moderate/severe fluorosis; 67.3% of children reported had an impact on OHRQoL. Children 11-12 year olds with fluorosis (TFI ≥4) [OR = 2.39 (95% CI 2.12-2.69)], caries (ICDAS ≥4) [OR = 2.18 (95% CI 2.13-2.24)], and low brushing frequency [OR = 2.04 (95% CI 1.21-3.44)] were more likely to have deterioration on OHRQoL. CONCLUSION: A negative impact on OHRQoL was observed in children with caries and fluorosis. CLINICAL RELEVANCE: Deterioration on OHRQoL found in children as a sequel of caries and fluorosis should be considered when designing health policies leading to prevention and effective health promotion programs and incorporated to clinical guidelines for timely dental treatment.

Prevalence of Functional Dentition in a Group of Mexican Adult Males.

OBJECTIVE: To determine the prevalence of functional dentition and associated periodontal variables in a sample of Mexican adult males. METHODS: A cross-sectional study of 161 policemen in Campeche, Mexico, was carried out. A clinical examination using an electronic probe was used to collect variables (dental plaque, periodontal pockets, gingival recession, suppuration, and bleeding on probing) on 6 periodontal sites (a maximum of 168 sites, excluding third molars). Sociodemographic, socioeconomic, and behavioral variables were collected through a self-administered survey. Functional dentition was defined as having 21 or more natural teeth. Data were analyzed with STATA 11.0, using logistic regression models. RESULTS: Mean age was 38.3 (±10.9) years. The prevalence of having a functional dentition was 83.8% in the sample. The odds of having a functional dentition declined with age (odds ratio [OR] = 0.93), having diabetes (OR = 0.27) and with having a high percentage of sites with plaque (OR = 0.77), with bleeding on probing (OR = 0.97), and with gingival recession (OR = 0.82). CONCLUSION: While a large proportion of subjects had a functional dentition in this community-dwelling sample of adult Mexican males, the likelihood of their having a functional dentition decreased with age, with their having been diagnosed with diabetes, and with assorted negative indicators of periodontal/gingival status.

Tooth-Loss Experience and Associated Variables among Adult Mexicans 60 Years and Older.

OBJECTIVE: This study was conducted to determine the experience of tooth loss, as well as its associated variables, in a sample of adult Mexicans, aged 60 years and older. MATERIALS AND METHODS: This cross-sectional study was part of a larger project to measure diverse oral health indicators in a convenience sample: it included 139 adult Mexican seniors (69.1% of whom were women), ages 60 years and older, either living in long-term care facilities or living independently and participating in adult day care services. Each participant underwent an oral examination to determine the number of missing teeth. Questionnaires were administered to collect sociodemographic, socioeconomic, and behavioral data. Statistical analyses were performed using nonparametric tests and negative binomial regression. RESULTS: The mean age was 79.06 (±9.78 years). The mean number of missing teeth was 20.02 (±8.61; median, 24); 99.3% of the participants had at least 1 missing tooth, and only 14 had 20 teeth or more. Using a negative binomial regression multivariate model, we found that for each year's increase in age, the mean number of teeth lost increased by 1% (p<0.05). In individuals who brushed their teeth fewer than two times a day, who had received radiotherapy, or who were currently smokers, the average tooth loss increased 49.2%, 22.6%, and 19.0%, respectively (p<0.01). CONCLUSION: Tooth-loss experience in these Mexican seniors was very high (20.02±8.61). Older age (within the range of this group of seniors), tooth-brushing patterns, the receipt of radiation therapy, and (current) tobacco use were associated with higher experience of tooth loss.

Edentulism and other variables associated with self-reported health status in Mexican adults.

BACKGROUND: To determine if edentulism, controlling for other known factors, is associated with subjective self-report health status (SRH) in Mexican adults. MATERIAL AND METHODS: We examined the SRH of 13 966 individuals 35 years and older, using data from the National Survey of Performance Assessment, a cross-sectional study that is part of the technical collaboration between the Ministry of Health of Mexico and the World Health Organization, which used the survey instrument and sampling strategies developed by WHO for the World Health Survey. Sociodemographic, socioeconomic, medical, and behavioral variables were collected using questionnaires. Self-reported health was our dependent variable. Data on edentulism were available from 20 of the 32 Mexican states. A polynomial logistic regression model adjusted for complex sampling was generated. RESULTS: In the SRH, 58.2% reported their health status as very good/good, 33.8% said they had a moderate health status, and 8.0% reported that their health was bad/very bad. The association between edentulism and SRH was modified by age and was significant only for bad/very bad SRH. Higher odds of reporting moderate health or poor/very poor health were found in women, people with lower socio-economic status and with physical disabilities, those who were not physically active, or those who were underweight or obese, those who had any chronic disease, and those who used alcohol. CONCLUSIONS: The association of edentulism with a self-report of a poor health status (poor/very poor) was higher in young people than in adults. The results suggest socioeconomic inequalities in SRH. Inequality was further confirmed among people who had a general health condition or a disability. Dentists and health care professionals need to recognize the effect of edentulism on quality of life among elders people.

Tooth brushing frequency in Mexican schoolchildren and associated socio-demographic, socioeconomic, and dental variables.

BACKGROUND: Tooth brushing (with fluoridated toothpaste) is the most cost-effective intervention in dentistry and it is widely recommended to preserve good oral health. We aimed to determine the frequency of tooth brushing and the variables associated with this practice in schoolchildren living in southeast Mexico. MATERIAL AND METHODS: A cross-sectional study was carried out in 1644 schoolchildren, 6 to 13 years old. Questionnaires with socio-demographic, socioeconomic, and dental variables were administered to mothers/guardians of children. The dependent variable was the frequency of tooth brushing, which was categorized as 0 = tooth brushing less than once a day and 1 = tooth brushing at least once a day. A logistic regression model was used to evaluate the final results. RESULTS: Mean age was 9.06±2.02 years and 49.1% were girls. The prevalence of tooth brushing at least once a day was 49.8%. In the multivariate model, characteristics related to tooth brushing frequency (p<0.05) were: older age (OR=1.11), being female (OR=1.64), having a larger family (OR=0.87), having had a visit to a dentist during the year preceding the study (OR=1.37), and having had fluoride applications by a professional (OR=1.39). CONCLUSIONS: The results suggested that different variables (demographic, socioeconomic and dental) are associated with the frequency of tooth brushing. Family size (proxy variable for socioeconomic status) may indicate certain oral health inequalities in this population.

Impact of socio-demographic, socioeconomic, and water variables on dental fluorosis in adolescents growing up during the implementation of a fluoridated domestic salt program.

The objective of this study is to determine the impact of socio-demographic, socioeconomic, and other risk indicators on dental fluorosis (DF) among Mexican adolescents. A cross-sectional study was carried out in 1,538 adolescents 12 and 15 years of age in semi-rural communities located at high altitude (>2,000 m) and with high concentration of fluoride in water (1.38-3.07 ppm) in Hidalgo, Mexico. DF was determined by means of Dean's Index and all teeth were examined. Remaining variables were collected using a questionnaire. The adjusted final model was performed using ordered logistic regression. After adjusting for sex, the variables associated with DF were (p < 0.05): being 12 years old (OR = 1.10) versus 15 years old; having lived the first 6 years of life in El Llano (3.07 F ppm) (OR = 3.19) or San Marcos (1.38 F ppm) (OR = 1.63) versus Tula (1.42 F ppm); having public (OR = 1.35) or private health insurance (OR = 1.36) versus those without insurance; belonging to the lower quartiles of socioeconomic position (SEP) [1st quartile (OR = 2.48), 2nd quartile (OR = 1.81), 3rd quartile (OR = 1.49)] versus the highest quartile; having drunk tap water (OR = 1.83) or from a well or spring (OR = 2.30) versus those who drank water purchased in large containers or bottles. Demographic and socioeconomic variables were associated with DF. While better SEP appeared to play an important role in DF, a pattern of water intake associated with water purchased in large containers or bottles (which have different connotations to the use of bottled water in industrialized Western countries) did reduce DF risk in these high fluoride content, high altitude communities.

Social support associated with restorative treatment, professionally applied fluoride and flossing: A cross-sectional analysis including recent immigrants from Central America and Mexico in the Midwest USA.

OBJECTIVES: This study examined how Mexican and Central American immigrants' social support was associated with three selected dental outcomes among recent immigrants, prior to the 2020 COVID-19 pandemic. METHODS: Using baseline wave data from the 2017-2022 VidaSana study about the health and social networks of Mexican and Central American immigrants living in Indiana, this study utilized logistic and ordinal logistic regression to predict lifetime fluoride use, lifetime dental restoration and flossing frequency, across levels of social support and differences between Mexican and Central American immigrants. RESULTS: Data from 547 respondents were included in the present analysis (68% women; mean age 34.4 years [SD 11.2]; Central American 42%; Mexican 58%). Results show a high level of social support was associated with increased probability of fluoride use, dental restoration and higher flossing frequency for Mexican immigrants. However, social support for Central American immigrants was associated with a decreased likelihood of fluoride use, more infrequent flossing, and had no significant association with dental restorations experience. What would be a negative association between Central American immigrants and dental restoration was accounted for by education level and never having been to a dentist. CONCLUSIONS: While higher social support was linked to beneficial outcomes for oral health in Mexican immigrants, the opposite was found in Central Americans. These findings highlighted the complexities of social relationships among new immigrants, and potential heterogeneity within the Hispanic population, particularly regarding social and behavioural measures as they pertain to oral health. Further research is needed to identify the underlying mechanisms producing both differences in social support and oral health outcomes.

Longitudinal Follow-up Comparing Future Care of Primary Teeth Treated with Silver Diammine Fluoride: A Private Dental Claims Review.

Purpose: The purpose of this study was to longitudinally evaluate follow-up treatment on primary teeth initially treated with silver diammine fluoride (SDF). Methods: This retrospective cohort evaluated private insurance (not Medicaid) claims data from 2018 to 2019 for children no older than 12 years with at least one primary tooth initially treated with SDF. Additional treatment per tooth was recorded over a follow-up of at least 24 months. Results: The mean and standard deviation (±SD) age of 46,884 patients was 5.7±2.3 and for SDF-treated teeth per patient was 2.6±2.1. Forty percent (95 percent confidence interval [95% CI] equals 39 to 40.7 percent) of teeth initially treated with SDF received additional treatment. The odds of SDF-treated teeth receiving future treatment significantly decreased with patient age by 22 percent per year (odds ratio equals 0.78; 95% CI equals 0.077 to 0.79; P<0.001). Pediatric dentists had only slightly lower odds than general dentists for providing additional treatment (0.91, P<0.001). Posterior teeth and teeth expected to exfoliate in two or more years had significantly higher odds of receiving additional treatment (2.47 and 1.27, respectively, P<0.001). Conclusions: Beginning at age four, patient age at placement of silver diammine fluoride was inversely proportional to future treatment provided. Posterior teeth and teeth expected to exfoliate in two or more years were more likely to receive additional treatment.

Self-reported dental pain in Mexican schoolchildren: a national ecological study.

The objective of this study was to quantify the prevalence of and identify the factors associated with dental pain among elementary- and middle-school students in Mexico. An ecological study was carried out with data from the 2008 National School-based Student-Health Survey. Information on dental pain from schoolchildren (aged 5 to 16 years) was collected from public schools across the 32 states of Mexico. In the original study, a questionnaire was used to explore various factors that affect the oral and dental health status of schoolchildren. The outcome variable was the prevalence rate (for dental pain) reported at state level. Various contextual socioeconomic variables were included, in addition to dental caries. Analyses were performed using Stata software. 52.9% of interviewees were girls; 26.9% of male and female schoolchildren in Mexico experienced gum or dental pain during the period analyzed (95% Confidence Interval = 26.02, 27.77%); according to the Spearman correlation results, self-reported dental pain was unrelated (p > 0.05) to the socioeconomic and sociodemographic variables that make up the Gross Domestic Product (GDP) and the Human Development (HDI), as well as the marginalization and the Gini indices. However, the estimated percentages of self-reported dental pain and caries were positively correlated in the elementary- (r = 0.8958, p < 0.0001), middle-school (r = 0.8958, p < 0.0001) and total populations (r = 0.8542, p < 0.0001). Prevalence of self-reported dental pain was 28%, or about one in three, of the Mexican children and adolescents in the study sample. The state-level sociodemographic and socioeconomic risk indicators were not associated with the prevalence of dental pain. Self-reported caries was positively correlated with self-reported dental pain.

Dental plaque, preventive care, and tooth brushing associated with dental caries in primary teeth in schoolchildren ages 6-9 years of Leon, Nicaragua.

BACKGROUND: Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. MATERIAL/METHODS: A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. RESULTS: Mean age was 7.49 ± 1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54 ± 3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. CONCLUSIONS: The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators.

Malocclusion and TMJ disorders in teenagers from private and public schools in Mexico City.

OBJECTIVE: To identify, among Mexican teenagers from public and private schools, the frequency, severity of malocclusion and orthodontic treatment needs, and their possible association with temporomandibular joint disorders. MATERIAL AND METHODS: Fifteen-year-old students were recruited from public and private schools. Clinical findings were registered as follows: oral hygiene status with the Oral Hygiene Index-Simplified, malocclusion using the Dental Aesthetic Index (DAI), and TMJ disorders following WHO criteria. Negative binomial and logistic regression models were constructed for data analysis. RESULTS: A total of 249 fifteen-year old students were included in the study (118 female 47.4%). 68% had a DAI score ≤ 25 (minor or no occlusal anomalies), 18% scored 26-30 (mild anomalies), 7% scored 31-35 (evident anomalies), and 6% scored ≥ 36 (major malocclusion). The most frequent anomalies were dental crowding in 50%, maxillary dental irregularity in 44.6%, mandible irregularity in 41.2% and excessive maxillary overjet in 37.8%. Among the students, 26.1% had clicking/muscle or TMJ pain, of these 12.3% showed pain during palpation. OHI-S > 1 was found in 34% of the participants. The negative binomial model showed an association between DAI score and TMJ disorders (P=0.041). Also the logistic regression model showed an association between malocclusion (DAI>25) and TMJ disorders (OR=2.58, p=0.002). Malocclusion was associated also with poor oral hygiene (OR=1.65, p=0.007), and with attendance to public schools (OR=1.97, p=0.039). CONCLUSIONS: TMJ disorders and DAI scores were significantly associated. Screening/Diagnostic programs for orthodontic and TMJ-disorders are needed, to identify and offer treatment to teenagers with major malocclusion and TMJ/muscle pain.

[Experience, prevalence and severity of dental caries and its association with nutritional status in Mexican infants 17-47 months]. / Experiencia, prevalencia y severidad de caries dental asociada con el estado nutricional en infantes mexicanos de 17 a 47 meses de edad.

OBJECTIVE: To determine the experience, prevalence and severity of dental caries and its relationship with nutritional status in nursery infants 17 to 47 months of age. MATERIAL AND METHODS: A cross-sectional study in 152 infants 17 to 47 months of age attending one of five day care centers of the city of Pachuca, Hidalgo was performed. Clinical examinations were performed using the methods recommended by the World Health Organization for epidemiologic studies on dental caries. We calculated the caries index (dmft), the significant caries index (SiC) as well as the treatment needs index (TNI) and the care index (CI). Nutritional status was determined using the weight and height for age, in Federico Gomez's scale. In the statistical analysis nonparametric tests were used. RESULTS: Mean age was 2.52 ± 0.76 years; 51.3% were boys. With regard to nutritional status, 19.1% were classified as malnourished and 19.1% were overweight/obese. The dmft index was 1.53 ± 2.52. The SiC index was 4.14, the TNI 86.3% and the CI 13.7%. Caries prevalence was 48.0%. It was observed that 33.5% of children had 1 to 3 teeth with caries experience and 14.5% had 4 or more teeth affected. Statistically significant differences for tooth decay were identified (p < 0.05) by age, height and weight but not (p> 0.05) by sex and nutritional status. CONCLUSIONS: This study shows that nearly half of children examined had caries experience. High treatment needs for dental caries were observed. A correlation was found between dmft index and age, weight and height. No association was identified between experience, prevalence and severity of dental caries and nutritional status of infants. It appears necessary to improve oral health preventive measures in these infants.

[Principal reasons for extraction of permanent tooth in a sample of Mexicans adults]. / Principales razones de extracción de dientes permanentes en una muestra de adultos mexicanos.

BACKGROUND: Tooth extractions are one of the most common procedures in oral surgery. The objective of this study was to identify the reasons for tooth extraction in adult patients seeking care at teaching dental clinics. MATERIAL AND METHODS: A cross-sectional study was carried out in 331 subjects between 18 and 85 (45.37 +/- 13.85) years of age seeking dental care in dental clinics of the Universidad Autónoma del Estado de Hidalgo, from January 2009 to December, 2009. Data pertaining to age, sex, tooth number and the reason for extraction according to Kay & Blinkhorn were analyzed with non-parametric tests. RESULTS: 779 extractions were undertaken. The main reason for extraction was dental caries (43.1%), periodontal disease (PD) (27.9%), and prosthetic reasons (21.5%). There was no significant difference across sex for reasons of extraction (p > 0.05). Significant differences (p < 0.001) were found for age (extraction due to periodontal disease increased with age); in patients attending in a single visit vs. patients attending a series of dental appointments (caries reasons were more common in patients having a single appointment vs. PD in those attending a series of appointments); for type of teeth (upper, posterior, and molars were extracted primarily because of caries, while lower, anterior and incisors were more often extracted because of PD). CONCLUSIONS: Dental caries was the most common reason for tooth extraction, followed by periodontal disease. Differences in the reasons for extraction were observed across patient characteristics and type of tooth.

[Dental fluorosis prevalence in eight cohorts of Mexicans born during the implementation of the Fluoridated Domestic Salt National Program]. / Prevalencia de fluorosis dental en ocho cohortes de mexicanos nacidos durante la instauración del Programa Nacional de Fluoruración de la Sal Doméstica.

OBJECTIVE: to determine the effect of birth cohort on dental fluorosis in Mexican schoolchildren during the implementation of the national program to fluoridate domestic salt. MATERIAL AND METHODS: in a cross-sectional study we examined 1,644 schoolchildren 6-13 years old born between 1985-1992 in Campeche, México; a community where there is negligible naturally available fluoride in water supplies. Dental fluorosis was assessed with the Dean's index in the permanent dentition. Questionnaires were used to identify diverse socio-demographic and socio-economic variables. In the statistical analysis logistic regression was used. RESULTS: the prevalence of fluorosis was 15.5%. In the multivariate model,we observed fluorosis was associated with larger family sizes (OR: 0.91; 95% CI: 0.84-0.99) and female sex (OR: 0.74; 95%CI: 0.57-0.98). Furthermore, using the cohort of 1985 as a comparison group, no significant dental fluorosis differences were found with those born between 1986-1987; in contrast, in the cohorts born between 1989-1992 the risk of dental fluorosis increased by almost four times (p < 0.05). CONCLUSION: the prevalence of fluorosis was low compared to other studies in Mexico. In this community with negligible fluoride in water supplies the likelihood of dental fluorosis increased as the windows of susceptibility in birth cohorts were closer to the chronologic beginning of the national domestic salt fluoridation program in 1991. This trend was more apparent after 1991.

Trends in dental insurance claims in the United States in the context of the COVID-19 pandemic: A 3-year perspective (2019-2022).

OBJECTIVES: We showed in a previous analysis the patterns of disruption for private dental insurance claims in the United States caused by the SARS-CoV-2 pandemic in 2020. The present report examines trends during 2020 and 2021, that is, contrasting perspectives during 2019 with the acute phase of the pandemic in 2020, and 2021. METHODS: Private dental insurance paid claims from a data warehouse were obtained, encompassing a 5% random sample of records between January 2019 and December 2021 for child and adult insureds who filed a claim in 2019, 2020, and 2021. We classified claims into one of four categories based on the likelihood of being associated with urgent/emergency care. RESULTS: The precipitous reduction in dental care claims in March-June 2020 recovered to almost pre-pandemic levels by the fall of 2020. However, a downward decline in private dental insurance claims started in the late fall of 2020 and continued through 2021. Differential impacts in dental care categories-in terms of urgency of care-were evident 2021, closely resembling previous trends in 2020. CONCLUSIONS: Dental care claims from the first year of the 2020 SARS-CoV-2 pandemic were contrasted with perspectives in 2021. A downward trend in demand/availability changes in dental care insurance claims set in for 2021, perhaps linked to perceptions of the overall economic situation. Such downward trend has continued overall, even after considering seasonal changes and the acceleration of the pandemic during the Delta, Omicron, and other variants.

Topical fluoride impact in future restorative dental procedures: A claim study.

BACKGROUND: Caries is one of the most prevalent diseases affecting children. Topical fluoride is used to decrease the incidence of caries. The purpose of this study was to investigate the impact of fluoride varnish and gel applications on future restorative dental treatment claims. METHODS: The data were obtained in conjunction with a dental data warehouse through a partnership agreement. A retrospective analysis of dental claims made from 2010 through 2018 was completed. Data were extracted for patients aged 1 through 8 years with topical fluoride application and its subsequent impact on restorative dental claims. RESULTS: Data for 672,889 patients were included in the analysis. Patients who received topical fluoride had significantly lower numbers (P < .001) of restorative procedures and extractions per year and significantly increased time (P < .001) to their first restorative procedure or extraction after the index visit than patients who did not receive topical fluoride. CONCLUSIONS: The application of fluoride varnishes and gels increased the time to future restorative and extraction dental claims and decreased the number of future restorative and extraction dental claims. PRACTICAL IMPLICATIONS: This study is important because it found that the use of topical fluoride decreased the number of future restorative and extraction dental claims.

Amalgam or composite in pediatric dentistry: Analysis of private insurance claims data.

BACKGROUND: Advancements in dental materials and changing parental preferences are modifying the frequency of use of restorative materials. This insurance claims analysis examined the trends in the use of amalgam and resin composite in the United States. METHODS: Commercial dental insurance claims were analyzed to compare 505,994 restorations, corresponding with procedure codes for 1-, 2-, and 3-surface amalgam or resin restorations. Paid claims collected nationwide from January 2010 through March 2020 were analyzed. Data for children aged 3 through 12 years were used, resulting in 219,632 unique patient identification numbers. Generalized estimating equation models applied to logistic regression were used. All tests were conducted using a 2-sided 5% significance level. RESULTS: In general, girls were less likely to receive amalgam than boys. A $20,000 increase in median household income was associated with a 16% decrease in the odds of amalgam being placed. Pediatric dentists (performing 15.1% of all restorations) were not as likely as general dentists (18.4%) to use amalgam. Having more surfaces in a restoration was associated with higher probability of amalgam placement. The percentage of amalgam restorations was higher for 2010 (26.9%) than for 2011 through 2020, and this pattern recurred in several of the years analyzed. Generally, patient age at time of amalgam restoration increased over time. CONCLUSION: The use of amalgam is trending down; the sharpest decline was noted in 2014. Pediatric dentists were less likely to use amalgam than general dentists. Girls and patients with higher socioeconomic status were less likely to have amalgam. PRACTICAL IMPLICATIONS: The findings of this study can inform and support clinical decisions and the formation of public policies.

Financial Impact of COVID-19 on Dental Care for Pediatric Patients: a Dental Claims Review.

PURPOSE: The purpose of this study was to quantify the impact of the COVID-19 pandemic on private dental insurance claims for pediatric dental care. METHODS: Commercial dental insurance claims for patients in the United States ages 18 and younger were obtained and analyzed. The claims dates ranged from January 1, 2019, to August 31, 2020. Total claims paid, average paid amount per visit, and the number of visits were compared between provider specialties and patient age groups from 2019 to 2020. RESULTS: Total paid claims and total number of visits per week were significantly lower in 2020 compared to 2019 from mid-March to mid-May (P<0.001). There were generally no differences from mid-May through August (P>0.15), except for significantly lower total paid claims and visits per week for "other" specialists in 2020 (P<0.005). The average paid amount per visit was significantly higher during the COVID shutdown period for 0-5 year-olds (P<0.001) but significantly lower for all other ages. CONCLUSIONS: Dental care was greatly reduced during the COVID shutdown period and was slower to recover for "other" specialties. Younger patients ages zero to five years had more expensive dental visits during the shutdown period.