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1.
Artigo em Inglês | MEDLINE | ID: mdl-33704655

RESUMO

The objective of the present study was to characterize socioeconomic inequalities in the patterns of professionally applied topical fluoride (PATF) in Mexican schoolchildren. A cross-sectional study was carried out on 3029 Mexican schoolchildren. A questionnaire was administered to caregivers to determine sociodemographic, socioeconomic, and behavioral variables. The dependent variable was prevalence of PATF, coded as 0 = without PATF and 1 = with PATF, at any point in life, and separately, in the previous year. Various indicators of socioeconomic position were included. Logistic regression was used in the final multivariate analysis. The prevalence of PATF any time in life was 33.8%, while in the previous year it was 11.4%. The variables associated (p < 0.05) with PATF any time in life were child's older age (OR = 1.12), older age when tooth brushing started (OR = 1.57), higher brushing frequency (OR = 1.60), having health insurance [public (OR = 1.61) or private (OR = 1.45)], if family owned a car (OR = 1.29) and better socioeconomic position [parents' education, second (OR = 1.48) and third (OR = 1.75) tertile]. For PATF in the previous year, the variables associated were older age of mother (OR = 1.03), older age when tooth brushing started (OR = 1.99), higher brushing frequency (OR = 1.68), having health insurance [public (OR = 1.62)] and better socioeconomic position (parents' education, second (OR = 1.57) and third (OR = 1.97) tertile). This study suggests the existence of socioeconomic inequalities in PATF, manifested through socioeconomic position, access to health insurance and household having a car. Identifying and addressing PATF inequalities would improve oral health in the child population.

2.
Children (Basel) ; 8(2)2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33546186

RESUMO

OBJECTIVE: To describe the experience and prevalence of dental caries in schoolchildren aged 6-12 years belonging to agricultural manual worker households. MATERIAL AND METHODS: A comparative cross-sectional study was conducted in two groups of schoolchildren: One considered "children of agricultural worker migrant parents" (n = 157) and the other "children of agricultural worker non-migrant parents" (n = 164). Epidemiological indices for dental caries were calculated for primary (dmft) and permanent (DMFT) dentitions, and compared in terms of age, sex, and the Simplified Oral Hygiene Index (SOHI). Two binary logistic regression models for caries prevalence in primary and permanent dentitions were generated in Stata. RESULTS: For primary dentition, we observed the following dmft index: Non-migrants = 1.73 ± 2.18 vs. migrants = 1.68 ± 2.14. Additionally, we recorded the following caries prevalence: Non-migrants = 59.1% vs. migrants = 51.3%. For permanent dentition, we observed the following DMFT index: Non-migrants = 0.32 ± 0.81 vs. migrants = 0.29 ± 0.95. Further, we recorded the following caries prevalence: Non-migrants = 17.6% vs. migrants = 12.8%. No differences were observed for either dentition (p > 0.05) in caries indices and their components or in caries prevalence. When both caries indices (dmft and DMFT) were combined, the non-migrant group had a higher level of caries experience than the migrant group (p < 0.05). No relationship (p > 0.05) with migrant status was observed in either multivariate models of caries prevalence. However, age did exhibit an association (p < 0.05) with caries. Only the plaque component of SOHI was associated (p < 0.05) with caries in permanent dentition. CONCLUSIONS: Although over half of school children from agricultural manual worker households had caries in either or both dentitions and a considerable proportion were untreated lesions, the prevalence levels were somewhat lower than other reports from Mexico in similar age groups. No statistically significant differences were found in caries experience or prevalence in either dentition between non-migrant and migrant groups.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33274563

RESUMO

OBJECTIVES: We sought to determine whether American Indian tribe-based interventions that successfully prevented toddler dental caries in a 2005 cohort study (the Toddler Overweight and Tooth Decay Prevention Study, or TOTS) influenced the prevalence of dental caries in children ages 11 to 13 in the same communities ten years later (the TOTS-to-Tweens study). METHODS: We recruited original TOTS participants and conducted school- and community-based dental screenings at tribal communities that received family plus community-wide interventions (F + CW), community interventions only (CW) or were control communities. We also enrolled children who did not participate in TOTS, but were exposed to CW interventions or to the control environment. Trained clinicians examined children's teeth and recorded whether each tooth was decayed, missing or filled (DMFT). We calculated DMFT scores for each child and evaluated differences in DMFT incidence rate ratios (IRR) and components of DMFT by intervention group. RESULTS: We observed lower age- and sex-adjusted DMFT scores among F + CW children (a mean of 2.1 DMFT; 95% confidence interval [CI]: 1.4-2.7) and among CW children (2.2; 95% CI: 1.9-2.6), than control children (3.0; 95% CI: 2.3-3.7). The F + CW group had 32% lower DMFT scores than control children (IRR = 0.68; 95% CI: 0.46-1.01), and CW children had 26% lower DMFT scores than control (IRR = 0.74; 95% CI: 0.55-1.00). The proportion of children with filled teeth was higher in control than intervention communities (37.9% in F + CW, 47.1% in CW, and 67.1% in control, P = .002). CONCLUSIONS: Our findings suggest modest yet significant long-term effects of interventions that prevented toddler dental caries on the DMFT scores of tweens evaluated ten years later. Further study of effective interventions and their sustainability is clearly warranted among tribal children, who remain at high risk for dental caries.

4.
J Dent Child (Chic) ; 87(3): 147-152, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-33349298

RESUMO

Purpose: The purposes of this study were to: (1) examine the longevity of resin crowns (RCs), pre-veneered stainless steel crowns (PVSSCs), and stainless steel crowns (SSCs) in primary maxillary incisors in a nationwide sample of private insurance claims; and (2) explore whether longer survival rates are related to the type of treating practitioner.
Methods: Private dental insurance claims were obtained from a national data warehouse. The paid insurance claims (2005 to 2016) included the treatment provided, number of teeth treated at an appointment, patient's age, and type of dentist.
Results: All three restoration types had acceptable longevity; however, SSCs and PVSSCs had significantly better longevity than RCs, with no significant difference in longevity between SSCs and PVSSC. The most common restoration of choice was SSCs (48 percent), followed by RCs (29.8 percent) and PVSSCs (22.2 percent).
Conclusion: SSCs and PVSSCs had greater longevity than resin crowns. The survival rate after six years was higher than 90 percent for all types of restorations. Teeth restored with SSCs lasted longer when placed by pediatric dentists than those placed by general dentists.


Assuntos
Coroas , Aço Inoxidável , Criança , Falha de Restauração Dentária , Restauração Dentária Permanente , Humanos , Incisivo , Estudos Retrospectivos , Dente Decíduo
5.
Pediatr Dent ; 42(6): 457-463, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-33369557

RESUMO

Purpose: A Current Dental Terminology (CDT) code, D1354, for silver diamine fluoride was made effective on January 1, 2016. The purpose of this study was to investigate the utilization of silver diamine fluoride (SDF) by pediatric dentists (PDs) and general dentists (GDs) in the United States. Methods: Data were obtained from a commercial dental insurance claims warehouse in the United States. Deidentified data for CDT code D1354 were collected from January 2016 to July 2019. Descriptive statistics and chi-square tests were used. Results: A total of 321,726 D1354 claims were found. Data showed that SDF use measured by average monthly claims, unique number of dentists, and percent of paid claims increased each year. Patients zero to nine years old were the most likely to receive SDF treatment. SDF was significantly more likely to be placed on posterior teeth and in children zero to eight years old (P<0.001). PDs were more likely than GDs to submit claims for SDF in children (P<0.001). Conclusions: Silver diamine fluoride use is increasing, especially in patients age zero to nine years. Pediatric dentists are more likely to use SDF in children than general dentists. Posterior teeth receive the majority of SDF treatment.


Assuntos
Cárie Dentária , Revisão da Utilização de Seguros , Cariostáticos , Criança , Pré-Escolar , Cárie Dentária/prevenção & controle , Odontólogos , Fluoretos Tópicos , Humanos , Lactente , Recém-Nascido , Compostos de Amônio Quaternário , Compostos de Prata , Estados Unidos
6.
Int Dent J ; 70(6): 455-461, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32737891

RESUMO

OBJECTIVE: To identify the factors associated with the prevalence of dental pain in Mexican adolescents and young adults. MATERIAL AND METHODS: This is a cross-sectional study in which data from 638 Mexican subjects, 16-25 years of age, who were randomly selected from college applicants, were analysed. Questionnaires were administered to collect sociodemographic, economic and behavioural variables. Clinical examinations were carried out to determine the decayed, missing and filled teeth (DMFT) index. The outcome variable was dichotomised as 0 (no dental pain in the last 12 months) or 1 (dental pain in the last 12 months). Statistical analyses included binary logistic regression. RESULTS: Average age was 18.76 ± 1.76 years, and 49.2% of participants were women. Prevalence of dental pain was 34.0%. In the final model, variables significantly (P < 0.05) associated with the experience of dental pain were the use of preventive dental services (OR = 0.34), being a former smoker (OR = 2.37), self-report of very poor/poor oral health (OR = 1.94) or fair oral health (OR = 1.94), self-reported dental disease (OR = 2.06) or gingival disease (OR = 2.84). CONCLUSIONS: The prevalence of dental pain was associated with self-reported oral health status, preventive dental visits and smoking; these results have implications for dental practice. We found that recent experience of dental pain was common in young adults, being reported by one out of three subjects.


Assuntos
Cárie Dentária , Adolescente , Adulto , Estudos Transversais , Índice CPO , Cárie Dentária/epidemiologia , Feminino , Humanos , México/epidemiologia , Saúde Bucal , Dor/epidemiologia , Dor/etiologia , Prevalência , Adulto Jovem
7.
Pediatr Dent ; 42(4): 288-292, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32847668

RESUMO

Purpose: The purpose of this study was to examine if there are differences in the success rate of primary teeth treated with pulpotomies performed by general dentists (GDs) versus pediatric dentists (PDs), using submitted paid insurance dental claims. The extraction time after pulpotomy was examined. Methods: Data for this study were obtained from a private dental insurance claims warehouse. The insurance claims data were retrieved, and a retrospective analysis was performed over seven years (2008 to 2015). The survival rate was estimated using proportional hazard survival analysis. Results: The total number of paid dental claims that used the CDT code for pulpotomy was 401,638. For teeth that received pulpotomy, the average time between pulpotomy and extraction was 1.1 years if the pulpotomies were performed by GDs. The average time was 1.3 years if the pulpotomies were performed by PDs (P<0.0001). GDs had an extraction rate of 7.83 percent after pulpotomies and the placement of stainless steel crowns, while PDs had an extraction rate of 4.09 percent. Conclusions: There is a significant difference in the success rate of teeth treated with pulpotomies performed by pediatric dentists versus general dentists, with pulpotomies performed by the former having a longer survival rate.


Assuntos
Análise de Dados , Pulpotomia , Criança , Coroas , Odontólogos , Humanos , Dente Molar , Estudos Retrospectivos , Dente Decíduo , Resultado do Tratamento
8.
J Dent ; 100: 103424, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32619570

RESUMO

OBJECTIVE: Erosive tooth wear (ETW) is an irreversible loss of dental hard tissue. This pilot study examined dentists' ability to diagnose and manage ETW relative to sound and caries-affected teeth. METHODS: Dentists recruited through the Indiana Dental Association (N = 36) participated in an internet-based survey, containing twenty-two standardized images of buccal and occlusal surfaces of teeth (sound, ETW, or caries). For each image, they provided diagnosis (presence and differentiation) of dental condition, confidence in their judgment, management need, and likelihood to recommend specific management strategies. Dentists made these judgments for teeth with no, initial, moderate, or severe ETW/caries. RESULTS: Dentists demonstrated poor detection of ETW compared to sound teeth and caries at each level of severity. The dentists were less confident, less able to correctly diagnose and manage ETW, and less likely to recommend most management strategies for ETW than caries at each level of severity. CONCLUSIONS: Dentists had difficulty correctly diagnosing (both detection and differentiation) and managing ETW, across all severity levels and particularly in early stages. These difficulties were particularly apparent when compared to caries. The current results are clinically relevant given the importance of early diagnosis for ETW management.

9.
Artigo em Inglês | MEDLINE | ID: mdl-32679717

RESUMO

A cross-sectional, self-administered survey was used to gather information about dental outcomes, sugar-containing food behaviors and intake, and sociodemographic characteristics of adults of Mexican and Central-American (Guatemala, El Salvador, Honduras) origin (n = 517). Bivariate and multiple-variable logistic regressions were used to examine the associations of behaviors related to added sugar-containing foods/beverages (overall intake and consumption before bed) with dental outcomes. Outcome measures involved dental outcomes, dental self-care practices, and added sugar intake. Estimated daily added sugar intake among all participants was 98 (SD = 99) g, with no difference in consumption among participants from different countries. The majority of added sugar (63 (SD = 74) g) was provided by sugar-sweetened beverages. Participants who reported consuming sugar-containing foods or beverages within an hour before bed were more likely to report having a fair/poor/very poor condition of teeth and gums and having felt dental pain (p < 0.05 for all). The amount of sugar intake was associated with being prescribed medication for oral or dental problems (p = 0.008) and dental pain (p = 0.003). Findings support the association between sugar containing food-related behaviors and dental problems among Hispanic immigrants to the U.S. Health promotion and preventive interventions for this population should consider these behaviors as modifiable contributors to adverse dental outcomes.


Assuntos
Sacarose na Dieta/administração & dosagem , Emigrantes e Imigrantes , Hispano-Americanos , Saúde Bucal , Adulto , Bebidas , Estudos Transversais , El Salvador , Ingestão de Energia , Feminino , Honduras , Humanos , Seguro Odontológico , Masculino , México/epidemiologia , Açúcares
10.
Odovtos (En línea) ; 22(1): 71-79, ene.-abr. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1091507

RESUMO

ABSTRACT The aim of this study was to explore the remineralizing effect of toothpastes based on Xilitol, Camellia Sinensis and Juniperus Communis. An in vitro experimental study was carried out in an 18 human premolars sample, which were treated with one of the 3 evaluated toothpastes and a control fluoride one. The atomic percentages of Ca and P were evaluated by Energy Dispersive X-ray Spectroscopy (EDS). In addition, the enamel surface of treated teeth was visualized by Scanning Electron Microscopy (SEM). The evaluations were carried out in three stages: pre-treatment, after an artificial demineralization process and after the treatment with the toothpastes. In the statistical analysis, the one-way ANOVA and Pearson correlation tests were used. Xilitol and Juniperus Communis showed the greatest gain of P ions compared to the control group (p<0.01). As for Ca, the group treated with xylitol-based toothpaste showed more ion gain compared with the control group (p<0.01). In the Pearson correlation test between Ca and P, statistically significant correlations were observed in all groups (p<0.01), ranging between r=0.7413 (Xylitol Group) and r=0.9510 (Control Group). We concluded that Xylitol paste showed the highest remineralizing property, both in the EDS analysis and in the SEM images.


RESUMEN El objetivo de este studio fue explorer el efecto remineralizante de las cremas dentales compuestas de Xilitol, Camelia Sinensis y Juniperus Communis. Se llevó a cabo un estudio experimental in vitro en una muestra de 18 premolares humanos, los cuales fueron tratados con una de las tres pastas dentales evaluadas y una fluorada. Los porcentajes atomicos de Ca y P fueron evaluados por Espectroscopia de rayos X de energía dispersive (EDS). Además, la superficie del esmalte de los dientes tratados fue examinada por Microscopia Electronica de Barrido (SEM). Las evaluaciones fueron llevadas a cabo en tres etapas: pre-tratamiento, despues de un proceso artificial de desmineralizacion y después del tratamiento con las pastas dentales. Se usaron ANOVA de una via y correlacion de Pearson para el analisis estadistico. Xilitol y Juniperus Communis mostraron la mayor ganancia de iones P comparados con el grupo control (p<0.01), con rangos entre r=0.7413 (Grupo con Xylitol) and r=0.9510 (Group Control). Se concluyó que la pasta con Xilitol mostró las mayores propiedades remineralizantes, tanto en el analisis EDS y las imágenes SEM.

11.
Medicine (Baltimore) ; 99(7): e19092, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049814

RESUMO

To determine the treatment needs and the care index for dental caries in the primary dentition and permanent dentition of schoolchildren and to quantify the cost of care that would represent the treatment of dental caries in Mexico.A secondary analysis of data from the First National Caries Survey was conducted, which was a cross-sectional study conducted in the 32 states of Mexico. Based on dmft (average number of decayed, extracted, and filled teeth in the primary dentition) and DMFT (average number of decayed, extracted, and filled teeth in permanent dentition) information, a treatment needs index (TNI) and a caries care index (CI) were calculated.At age 6, the TNI for the primary dentition ranged from 81.7% to 99.5% and the CI ranged from 0.5% to 17.6%. In the permanent dentition, the TNI ranged from 58.8% to 100%, and the CI ranged from 0.0% to 41.2%. At age 12, the TNI ranged from 55.4% to 93.4%, and the CI ranged from 6.5% to 43.4%. At age 15, the TNI ranged from 50.4% to 98.4%, and the CI ranged from 1.4% to 48.3%. The total cost of treatment at 6 years of age was estimated to range from a purchasing power parity (PPP) of USD $49.1 to 287.7 million in the primary dentition, and from a PPP of USD $3.7 to 24 million in the permanent dentition. For the treatment of the permanent dentition of 12-year-olds, the PPP ranged from USD $13.3 to 85.4 million. The estimated cost of treatment of the permanent dentition of the 15-year-olds ranged from a PPP of USD $10.9 to 70.3 million. The total estimated cost of caries treatment ranged from a PPP of USD $77.1 to 499.6 million, depending on the type of treatment and provider (public or private).High percentages of TNI for dental caries and low CI values were observed. The estimated costs associated with the treatment for caries have an impact because they represent a considerable percentage of the total health expenditure in Mexico.


Assuntos
Cárie Dentária/epidemiologia , Cárie Dentária/terapia , Adolescente , Criança , Custos e Análise de Custo , Estudos Transversais , Índice CPO , Cárie Dentária/economia , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência
12.
J Am Dent Assoc ; 151(1): 10-15, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31784028

RESUMO

BACKGROUND: Erosive tooth wear (ETW) is irreversible loss of dental hard tissue. The authors examined patients' ability to recognize ETW relative to sound teeth and teeth with caries. METHODS: Using Amazon's crowdsourcing service, the authors recruited participants (N = 623) to view standardized images of buccal surfaces of teeth (sound, ETW, or caries). Participants reported whether a dental condition existed (yes or no), likelihood to seek care, and esthetic attractiveness for teeth with no, initial, moderate, or severe signs of ETW or caries. RESULTS: Dental patients showed poor recognition of cases of ETW, especially compared with sound and caries-affected teeth at each level of severity. Patients were less likely to schedule a dental appointment for care or treatment of teeth with ETW than for teeth with caries at each level of severity. Patients also found ETW more esthetically attractive than caries at each level of severity and found initial ETW more attractive than sound teeth. CONCLUSIONS: Dental patients struggle to recognize ETW, in general and compared with caries, at each level of severity and particularly for early stages of ETW. These recognition difficulties likely arise, in part, from tooth esthetic attractiveness standards (smooth and shiny teeth look more esthetic), possibly leading to lack of appropriate care-seeking behavior. PRACTICAL IMPLICATIONS: This internet-based tool may be used to assess dental patients' awareness and ability to recognize cases of ETW. Improved patient awareness might lead to seeking professional care to prevent or delay ETW progression.


Assuntos
Cárie Dentária , Erosão Dentária , Desgaste dos Dentes , Humanos , Internet , Prevalência , Inquéritos e Questionários
13.
BMJ Open ; 9(9): e027101, 2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31537556

RESUMO

OBJECTIVE: The present study aimed to identify preventive and curative dental health service utilisation (DHSU) in the context of associated clinical and non-clinical factors among adolescents and young adults in Mexico. DESIGN: Cross-sectional study. SETTING: Applicants to a public university in Mexico. PARTICIPANTS: Participants were 638 adolescents and young adults aged 16-25 randomly selected from university applicants. INTERVENTIONS: Data were collected using a self-administered questionnaire filled out by the students. For assessment of dental caries experience, we used the index of decayed, missing and filled teeth. PRIMARY OUTCOME: The dependent variable was DHSU in the previous 12 months, coded as 0=non-use, 1=use of curative services and 2=use of preventive services. RESULTS: The mean age was 18.76±1.76 years, and 49.2% were women. The prevalence of DHSU was 40.9% (95% CI 37.1 to 44.8) for curative services and 22.9% (95% CI 19.7 to 26.3) for preventive services. The variables associated with curative services were age, sex, mother's education, dental pain in the previous 12 months, caries experience, use of self-care devices and oral health knowledge. For preventive services, the variables associated were mother's education, dental pain in the previous 12 months, caries experience, use of self-care devices and self-perception of oral health. CONCLUSIONS: While differences emerged by type of service, a number of variables (sociodemographic and socioeconomic characteristics as well as dental factors) remained in the final model. Greater oral health needs and socioeconomic inequalities remained as predictors of both types of DHSU. Given the differences revealed by our study, oral health policies should refer those seeking dental care for oral diseases to preventive services, and promote the use of such services among the poorer and less educated population groups.


Assuntos
Assistência Odontológica , Serviços de Saúde Bucal/estatística & dados numéricos , Saúde Bucal , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Serviços Preventivos de Saúde , Doenças Estomatognáticas , Adolescente , Estudos Transversais , Assistência Odontológica/métodos , Assistência Odontológica/estatística & dados numéricos , Inquéritos de Saúde Bucal , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , México/epidemiologia , Prevalência , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Doenças Estomatognáticas/epidemiologia , Doenças Estomatognáticas/terapia , Adulto Jovem
14.
Med Care Res Rev ; : 1077558719860708, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291823

RESUMO

Although patient-provider language concordance has the potential to reduce health disparities for people with limited English proficiency, no previous work has synthesized this literature. Our systematic review sought to describe the characteristics of studies examining relationships between language concordance and health outcomes, summarize the nature of observed associations, and propose an evidence map and research agenda. A comprehensive search of published articles identified 38 quantitative studies for inclusion. Most studies were cross-sectional, conducted in primary care, concentrated in Western states, and focused on Spanish speakers and physician providers. Results were split between supporting a positive association versus no association of language concordance with patient behaviors, provider behaviors, interpersonal processes of care, and clinical outcomes. Several methodological limitations were identified. Based on these results, we developed an evidence map, identified knowledge gaps, and proposed a research agenda. There is a particular need for quasi-experimental longitudinal studies with well-characterized samples.

15.
Artigo em Inglês | MEDLINE | ID: mdl-31195612

RESUMO

Aim: The objective of this study was to estimate the Out-Of-Pocket Expenditures (OOPEs) incurred by households on dental care, as well as to analyze the sociodemographic, economic, and oral health factors associated with such expenditures. Method: A cross-sectional study was conducted among 763 schoolchildren in Mexico. A questionnaire was distributed to parents to determine the variables related to OOPEs on dental care. The amounts were updated in 2017 in Mexican pesos and later converted to 2017 international dollars (purchasing power parities-PPP US $). Multivariate models were created: a linear regression model (which modeled the amount of OOPEs), and a logistic regression model (which modeled the likelihood of incurring OOPEs). Results: The OOPEs on dental care for the 763 schoolchildren were PPP US $53,578, averaging a PPP of US $70.2 ± 123.7 per child. Disbursements for treatment were the principal item within the OOPEs. The factors associated with OOPEs were the child's age, number of dental visits, previous dental pain, main reason for dental visit, educational level of mother, type of health insurance, household car ownership, and socioeconomic position. Conclusions: The average cost of dental care was PPP US $70.2 ± 123.7. Our study shows that households with higher school-aged children exhibiting the highest report of dental morbidity-as well as those without insurance-face the highest OOPEs. An array of variables were associated with higher expenditures. In general, higher-income households spent more on dental care. However, the present study did not estimate unmet needs across the socioeconomic gradient, and thus, future research is needed to fully ascertain disease burden.


Assuntos
Assistência Odontológica/economia , Países em Desenvolvimento/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Seguro Saúde , Masculino , México , Fatores Socioeconômicos , Inquéritos e Questionários
16.
Pediatr Dent ; 41(2): 127-131, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992110

RESUMO

Purpose: Dental caries affects 23 percent of U.S. children aged two to five years old. 1 Stainless steel crowns (SSCs) are used for extensive caries and offer greater longevity than other restorations; however, disparity exists between pediatric and general dentists in restoration type provided. The purpose of this study was to evaluate utilization of stainless steel crowns among pediatric and general dentists by reviewing insurance claims. Methods: Data were obtained from a commercial dental insurance claims data warehouse from more than 50 dental insurance plans and multiple carriers in the United States for children 12 years old and younger. Data were examined for treatment of the primary dentition using SSCs or direct restorations. A generalized linear mixed effects model tested differences in the utilization of SSCs by general dentists (GDs) versus pediatric dentists (PD). Results: The data included 107,487 GDs and 5,395 PDs. The records included 2,555,726 claims for direct restorations and 440,423 claims for SSCs. PDs are more likely to place SSCs compared to GDs (odds ratio equals 3.2; P<0.0001). Conclusions: Pediatric dentists are more likely to restore carious primary dentitions with stainless steel crowns than general dentists. Perhaps increased training at the dental undergraduate level and access to more continuing education courses for general dentists would increase the utilization of SSCs.


Assuntos
Coroas , Odontologia Geral/estatística & dados numéricos , Odontopediatria/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Aço Inoxidável , Criança , Pré-Escolar , Humanos , Lactente , Estados Unidos
17.
Artigo em Inglês | MEDLINE | ID: mdl-30558280

RESUMO

We disseminate the recruitment strategies used in the five-year VidaSana study (started in 2017) in the Midwest region of the United States, targeting recently arrived Hispanic immigrants. VidaSana aims to follow immigrants within six months of arrival for 24 months to (1) characterize features of networks (personal and community) that improve or undermine dental health; and (2) further refine methods to quantify the evolution of egocentric networks, using social network methodology. We implemented several strategies to promote and recruit potential participants into the study. We collaborate with agents serving Indiana's Hispanic communities using three levels of visibility. The broad level includes radio advertisements, TV interviews, newspaper advertisements, and targeted Facebook advertisements. Intermediate level visibility includes posting flyers in schools, employment agencies, immigrant welcome centers, and Hispanic businesses; making announcements at church/temple and school events; tabling at community, church and school events; and a pervasive adaptation of our strategies to the requirements of our partners. Lastly, the individualized level includes direct referrals by partners through word of mouth. From the initial 13 months of recruitment (494 screened contacts and 202 recruited participants), the most successful recruitment strategies appear to be a combination of intermediate- and individual-level strategies; specifically, face-to-face recruitment at school events, direct referrals from our community partners, and tabling at community/school/church events. The current interim findings and future final findings will help guide recruitment and retention strategies for studies focused on immigrants in the current climate of heightened immigration regulations and enforcement.


Assuntos
Assistência Odontológica , Emigrantes e Imigrantes , Hispano-Americanos , Saúde Bucal/estatística & dados numéricos , Odontologia Preventiva , Rede Social , Humanos , Estudos Longitudinais , Seleção de Pacientes , Estados Unidos
18.
J Dent Educ ; 82(5): 492-500, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29717073

RESUMO

With the increased number of elderly and medically compromised individuals receiving dental care and the presence of systemic comorbidities and associated treatment modalities in this patient population, it is imperative that dentists be prepared to manage a variety of medical emergencies. The aim of this study was to assess the knowledge of and preparedness to manage common medical emergencies of cohorts of practicing periodontists, specialty residents, and faculty members, both for comparative purposes and as an aid to refining a dental school's standardized case scenarios. The study, conducted in 2017, was designed for four groups of randomly selected participants with at least 20 in each group; the actual number of voluntary participants was 28 private practice periodontists, 22 residents in specialty programs, 21 specialist faculty members, and 24 general practice faculty members. Participants were asked to evaluate ten clinical emergency cases and identify the diagnosis and indicated intervention for each. Groups were also evaluated for differences among correct responses for each case. Overall, there were no statistically significant differences for number of correct diagnoses or interventions among the four groups. However, several cases had varying degrees of incorrect diagnoses and management across all groups. Participants who had recently graduated or were still in school were able to treat cases appropriately more often than the other participants. Further refinement of cases to assess provider preparedness to correctly diagnose and manage medical emergencies is needed, specifically establishing case-specific features and addressing areas of potential confusion before the cases are used for educational purposes.


Assuntos
Defesa Civil , Competência Clínica , Odontólogos , Docentes de Odontologia , Internato e Residência , Humanos , Autorrelato
19.
J Dent Educ ; 82(3): 291-298, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29496808

RESUMO

Diagnosis and treatment planning for periodontal disease are fraught with challenges because of the complex and multifactorial nature of the disease as well as the inherent variability in interpretation of clinical findings. It is important for all practitioners to be accurate and consistent in formulating diagnoses based on the American Academy of Periodontology classification guidelines and to implement treatment plans to adequately address patients' needs. The aim of this study was to compare diagnoses and treatment plans among four groups of participants: full-time and part-time periodontology faculty at Indiana University School of Dentistry (IUSD), full-time and part-time IUSD general practice faculty, full-time periodontists in private practice, and full-time general practitioners in private practice. The study, conducted September 2016 to February 2017, also sought to determine if the calibrated participants had more correct diagnoses and treatment plans than those who had not received calibration training. Each of the four groups had 20 participants each. Participants evaluated ten de-identified case records and selected a diagnosis and treatment plan for each case. In the results, the 20 IUSD periodontal faculty members, most of whom had participated in calibration sessions, had overall better agreement and more correct responses for diagnoses and treatment plans than the IUSD general practice faculty members, private practice general practitioners, and private practice periodontists (only one of those 60 participants had participated in calibration sessions). The results supported the notion that periodic calibration is needed to standardize faculty criteria, facilitate better agreement and accuracy, and enhance consistency in the use of clinical criteria during training for dental students and in practice.


Assuntos
Odontólogos , Docentes de Odontologia , Planejamento de Assistência ao Paciente , Doenças Periodontais/diagnóstico , Odontólogos/estatística & dados numéricos , Docentes de Odontologia/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Humanos , Indiana , Doenças Periodontais/terapia , Faculdades de Odontologia
20.
BMC Oral Health ; 18(1): 37, 2018 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-29530026

RESUMO

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.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Odontologia Preventiva/estatística & dados numéricos , Adulto , Estudos Transversais , Emigrantes e Imigrantes/psicologia , Feminino , Humanos , Indiana , Masculino , Americanos Mexicanos/psicologia , Modems
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