Determinants of Dental Care Utilization for Diverse Ethnic and Age Groups

Dental services utilization in the past 12 months was compared across population-based samples of African-American, Navajo, Lakota, Hispanic, and White adults participating in the WHO International Collaborative Study of Oral Health Outcomes (ICS-II) at USA research locations. Bivariate results revealed that ethnic minority groups in both age cohorts reported significantly fewer dental visits in the past 12 months compared with White adults. When dentate status was controlled for, age cohort differences were not significant in Baltimore (African-American and White) and San Antonio (Hispanic and White) research locations. In contrast, older Native Americans (65-74 years) reported visiting the dentist significantly less often compared with their middle-aged (35-44 years) counterparts. Multivariate results indicated that generalizable variables were associated with dental contact in every ICS-II USA ethnic group (i.e., dentate, usual source of dental care, oral pain). Among the diverse ethnic groups, other determinants presented a varied pattern of risk factors for underutilizing dental care. Information on ethnic-specific risk factors can be used to design culturally appropriate and acceptable oral health promotion programs. Generalizable risk factors across ethnic groups inform oral health policy-makers about changing national priorities for promoting oral health.

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Oral Health Policy and Programmatic Implications: Lessons From ICS-II

Advances in Dental Research ◽

10.1177/08959374970110021201 ◽

1997 ◽

Vol 11 (2) ◽

pp. 291-303 ◽

Cited By ~ 5

Author(s):

R.M. Andersen ◽

P.L. Davidson ◽

T.T. Nakazono

Keyword(s):

Health Promotion ◽

Native American ◽

Health Status ◽

Oral Health ◽

Conceptual Model ◽

Ethnic Groups ◽

Oral Health Status ◽

Policy Implications ◽

Oral Health Promotion ◽

Dental Floss

The conceptual model used in the ICS-II USA Ethnicity and Aging project helps to identify who among the elderly should be targeted for oral health promotion initiatives and the kinds of initiatives most likely to promote positive oral health outcomes. Outcomes have been measured in this study as perceived by the individual and as clinically assessed by the oral epidemiologists. For policy purposes, achieving both types of outcomes is important. A typology of oral health promotion priorities is used to rank the diverse racial-ethnic groups. In the analysis, groups with both low perceived and low evaluated oral health status receive highest priority. By these criteria, the older Native American populations have the highest priority, followed, in order, by Hispanics. African-Americans, and non-Hispanic Whites. Policy implications of the empirical analyses presented in earlier articles are discussed by use of the conceptual model and the typology of oral health promotion priorities. Having a usual source of care and/or regular dental visits appears to be a promising avenue for the promotion of better-perceived oral health status among most older ethnic groups. Improved oral hygiene practices, as represented by both regular toothbrushing and dental floss use, promote better clinically evaluated oral health status among many older ethnic groups.

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Mobile Apps for Oral Health Promotion: Content Review and Heuristic Usability Analysis (Preprint)

10.2196/preprints.11432 ◽

2018 ◽

Author(s):

Brooks Tiffany ◽

Paula Blasi ◽

Sheryl L Catz ◽

Jennifer B McClure

Keyword(s):

Risk Factors ◽

Health Promotion ◽

Oral Health ◽

Theoretical Basis ◽

Mobile Apps ◽

Oral Disease ◽

Oral Health Promotion ◽

Health Technologies ◽

Mhealth Apps

BACKGROUND There has been an increase in consumer-facing mobile health (mHealth) apps in recent years. Prior reviews have characterized the availability, usability, or quality of popular mHealth apps targeting a range of health behaviors, but none has examined apps that promote better oral health care. Oral disease affects billions of people worldwide and mobile phone use is on the rise, so the market for well-designed and effective oral health apps is substantial. OBJECTIVE We examined the content and usability of popular oral health promotion apps to better understand the current state of these self-help interventions and inform the need and opportunity for future app development. METHODS Between February and March 2018, we identified oral health-focused apps that were designed for Android or iOS, available in English, and targeted adult consumers (as opposed to children or dental health professionals). The sample was limited to the most popular and highly rated apps on each platform. For each app reviewed, we assessed its basic descriptive characteristics (eg, platform, cost), evidence of a theoretical basis or empirical validation, key program functionality, and the extent to which the app addressed diet and tobacco and alcohol use as risk factors for oral disease. We characterized the framing (ie, gain vs loss) of all persuasive messaging and conducted a heuristic analysis to assess each app’s usability as a persuasive health technology. RESULTS Thirty-three apps were eligible for review based on the selection criteria. Two-thirds (22/33, 67%) were geared toward the general public as opposed to dental clinic patients, insurance plan members, or owners of specific electric toothbrushes. Most (31/33, 94%) were free to download, and a majority (19/33, 58%) were sponsored by software developers as opposed to oral health experts. None offered any theoretical basis for the content or had been empirically validated. Common program features included tools for tracking or reminding one to brush their teeth and assistance scheduling dental appointments. Nineteen apps (58%) included educational or persuasive content intended to influence oral health behavior. Only 32% (6/19) of these included a larger proportion of gain-framed than loss-framed messaging. Most of the apps did not mention diet, alcohol or tobacco—important risk factors for oral disease. Overall, the apps performed poorly on standard usability heuristics recommended for persuasive health technologies. CONCLUSIONS The quality of the reviewed apps was generally poor. Important opportunities exist to develop oral health promotion apps that have theoretically grounded content, are empirically validated, and adhere to good design principles for persuasive health technologies.

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Prevention for people with disabilities and vulnerable groups

Essential Dental Public Health ◽

10.1093/oso/9780199679379.003.0022 ◽

2013 ◽

Author(s):

Blánaid Daly ◽

Paul Batchelor ◽

Elizabeth Treasure ◽

Richard Watt

Keyword(s):

Risk Factors ◽

Oral Health ◽

Dental Care ◽

Homeless People ◽

People With Disabilities ◽

Social Impairment ◽

Vulnerable Groups ◽

Oral Diseases ◽

Disabled People ◽

Department Of Health

In this chapter we will look briefly at the prevention needs of people with disabilities and people who are vulnerable and require special care dental services for reasons that may be social. Within this group there will be a spectrum of people with needs and dependencies. Not everyone described as belonging to a vulnerable group in this chapter would identify themselves as disabled; nevertheless, what they have in common are a range of factors that put their oral health at risk, make accessing dental care complicated, or make the provision of dental care complicated. These factors may include a ‘physical, sensory, intellectual, mental, medical, emotional or social impairment or disability, or more often a combination of these factors’ (GDC 2012). People with disabilities have fewer teeth, more untreated disease, and more periodontal disease when compared to the general population in the UK (Department of Health 2007). Good oral health can contribute to better communication, nutrition, self-esteem, and reduction in pain and discomfort, while poor oral health can lead to pain, discomfort, communication difficulties, nutritional problems, and social exclusion (Department of Health 2007). As discussed in previous chapters, the important risk factors for oral diseases include: high-sugar diets, poor oral hygiene, smoking, and alcohol misuse. They are also shared risk factors for chronic non-communicable diseases such as respiratory diseases, cardiovascular diseases, diabetes, and cancers. The basic principles and approaches for the prevention of oral diseases in disabled people and vulnerable groups are similar to those described in previous chapters; however, there is a need to recognize that the context, the circumstances, the settings, and the opportunities for prevention will be slightly different, depending on the groups. For example, some disabled people (e.g. people with learning disabilities) may be reliant on others, such as family, carers, health care workers, to support basic self-care and to access health services. Other vulnerable groups such as homeless people live independent lives but lack access to basic facilities such as drinking water, and a place to store toothbrushes and toothpaste.

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The Role of Race on Survival after Alternative Donor Hematopoietic Progenitor Cell Transplant for Pediatric Acute Leukemia: Provocative Single Center Data.

Blood ◽

10.1182/blood.v104.11.5323.5323 ◽

2004 ◽

Vol 104 (11) ◽

pp. 5323-5323

Author(s):

David A. Margolis ◽

Mary Eapen ◽

Jeanette Carreras ◽

Julie-An Talano ◽

Meghen Browning ◽

...

Keyword(s):

Risk Factors ◽

African American ◽

African Americans ◽

Acute Leukemia ◽

Children And Adolescents ◽

Ethnic Groups ◽

Hematopoietic Progenitor Cell ◽

Unrelated Donor ◽

Alternative Donor ◽

Related Donor

Abstract Allogeneic blood or bone marrow transplant (BMT) can be a curative treatment for many children and adolescents with acute leukemia. With advances in unrelated donor transplant, others and we have shown that unrelated donor BMT can have similar survival to matched sibling BMT. There are several reports describing outcomes after matched related donor transplantation among various ethnic groups. Thus far, there are no published studies comparing outcomes among ethnic groups after alternative donor transplantation. Anecdotally, however, there have been concerns regarding outcomes among racial and ethnic groups, especially African-Americans. In order to address this question, we utilized our institutional database to analyze survival among children and adolescents receiving an alternative donor BMT at Children’s Hospital of Wisconsin from 1988-present. We compared survival in Caucasians and African-Americans undergoing unrelated donor and mismatched related donor transplantation (including haploidentical donors). One hundred and twenty four Caucasians underwent matched and mismatched unrelated donor transplantation compared to 11 African Americans. The 2-year probabilities of overall survival were significantly better for Caucasians at 53% (95% CI 44–62) than for African Americans, 18% (95% CI 2–45), p=0.01. Fifty-four Caucasians and 9 African Americans received mismatched family donor transplantation. Corresponding probabilities of overall 2-year survival were 38% (95% CI 25–51) and 30% (95% CI 5–64), respectively. Interestingly, our data show no statistically significant difference in survival after mismatched related donor transplantation between the Caucasian and African-American cohorts. Our data should be interpreted cautiously as the number of African Americans transplanted at our institution is few. Additionally, our analysis is limited by our inability to adjust for disease status at transplantation, HLA disparity and other known risk factors that may impact survival. Nevertheless these observations from a single institution cannot be ignored and warrant further analysis in a larger cohort such that outcomes after transplantation may be adjusted appropriately for relevant risk factors. We believe that a national database/registry study will have the numbers necessary to answer the questions that need to be asked regarding outcomes with alternative donor transplantation in the African-American population. We also believe that as cell processing and supportive care technologies improve mismatched family member transplantation outcomes, these advances could have a significant impact in improving leukemia-free survival for African-American children and adolescents.

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unfolding consequences of postponing routine dental care

ARS MEDICA Revista de Ciencias Médicas ◽

10.11565/arsmed.v46i2.1752 ◽

2021 ◽

Vol 46 (2) ◽

pp. 6-7

Author(s):

Duniel Ricardo Ortuño Borroto ◽

Juan Pablo Vargas Buratovic ◽

Alonso Carrasco-Labra

Keyword(s):

Oral Health ◽

Health Systems ◽

Dental Care ◽

Record Time ◽

The Past ◽

The World

The COVID-19 pandemic represents some of the most distressing challenges for health systems all over the world in the past decades, forcing clinicians to modify standards, prioritise treating conditions that require immediate care, and implement elements of remote attention in record time (Douglas et al., 2020). These challenges have also had an impact in the population’s oral health.

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Evaluation of oral health promotion in the workplace: the effects on dental care costs and frequency of dental visits

Community Dentistry And Oral Epidemiology ◽

10.1034/j.1600-0528.2001.290307.x ◽

2001 ◽

Vol 29 (3) ◽

pp. 213-219 ◽

Cited By ~ 22

Author(s):

Reiko Ide ◽

Tetsuya Mizoue ◽

Yuji Tsukiyama ◽

Masato Ikeda ◽

Takesumi Yoshimura

Keyword(s):

Health Promotion ◽

Oral Health ◽

Dental Care ◽

Oral Health Promotion ◽

Dental Visits ◽

Care Costs

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Maternal Oral Health: An Examination Survey Conducted in Three Referral Hospitals in Bhutan

Bhutan Health Journal ◽

10.47811/bhj.53 ◽

2018 ◽

Vol 4 (1) ◽

pp. 23-32

Author(s):

Sonam Ngedup ◽

Mary Alice Lee ◽

Dorji Phurpa ◽

Neyzang Wangmo

Keyword(s):

Risk Factors ◽

Oral Health ◽

Pregnant Women ◽

Dental Care ◽

Periodontal Diseases ◽

Permanent Teeth ◽

Modifiable Risk Factors ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Referral Hospitals

Background: Good oral health is important for women during pregnancy and throughout their lives. Mothers with good oral health are less likely to transmit cariogenic bacteria to their infants and toddlers. Thus, maternal oral health is directly related to family health. Objective: To determine the prevalence of dental caries, periodontal diseases and modifiable risk factors among pregnant women seeking antenatal care in three referral hospitals in Bhutan. Methods: A descriptive cross-sectional survey of pregnant women was conducted in April-May 2017. We used a non-probability sampling method to recruit pregnant women (n=443). Oral examinations were done according to methods recommended by the WHO. Participants completed a questionnaire for modifiable risk factors. Results: Overall, caries prevalence was 40% among pregnant women, ranging from 54% in those under 25 to 81% in women 35 and older. The mean decayed, missing and filled permanent teeth (DMFT) was 1.93 (SD=2.66). Nearly 72% of women had calculus on their teeth. Just over 2% had periodontitis. Most women rated their oral health as good to excellent (89%) versus poor (11%). Just 11% reported having had dental care during pregnancy. Conclusions: There is an urgent need for professional dental care during pregnancy, especially among older and multiparous women. Increasing awareness on the importance of oral health during pregnancy will improve maternal health and the health of their young children.

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Oral Health, Cognitive Function, and Mortality: Findings From National Surveys

Innovation in Aging ◽

10.1093/geroni/igab046.790 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 206-206

Author(s):

Bei Wu ◽

Susie Keepper ◽

Michèle Saunders

Keyword(s):

Older Adults ◽

Oral Health ◽

Cognitive Function ◽

Cognitive Decline ◽

Ethnic Groups ◽

Dental Care ◽

National Surveys ◽

New Findings ◽

The Impact ◽

Racial Ethnic

Abstract Poor oral health, diabetes mellitus (DM), and cognitive impairment are common problems in older adults. Using national surveys, this symposium aims to present new findings regarding the impact of the co-occurrence of DM and poor oral health on cognitive function, cognitive decline, and mortality. This symposium will also cover the topic of dental care use among adult populations in the U.S. Using data from the Health and Retirement Study (HRS) (2006- 2018), the first study shows that adults with both DM and edentulism had the worst cognitive function, followed by those with edentulism alone, and those with DM alone. Using the same HRS data, the second study found that co-occurrence of DM and edentulism had a higher risk of more rapid cognitive decline with advancing age than the presence of each condition alone. The third study used data from the 2006-2016 HRS linked with mortality files, and revealed that the risk of diabetes and edentulism on mortality may vary across racial/ethnic groups. Using the Behavioral Risk Factor Surveillance System survey (2002-2018), the fourth study examined disparities of dental service utilization among racial/ethnic groups (Whites, Hispanics, Blacks, Asians, American Indians or Alaska Natives, and Native Hawaiian or other Pacific Islanders). Age differences in dental services were also compared between older adults and other younger and middle-aged populations. This symposium highlights the role of oral health in improving cognitive health. Policies and programs are needed to increase dental care access, a critical way to help maintain good oral health.

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Healthcare Stereotype Threat and Health Outcomes Among LGB Individuals

Annals of Behavioral Medicine ◽

10.1093/abm/kaab060 ◽

2021 ◽

Author(s):

Adam W Fingerhut ◽

Alexander J Martos ◽

Soon Kyu Choi ◽

Cleopatra M Abdou

Keyword(s):

Life Satisfaction ◽

Physical Health ◽

Stereotype Threat ◽

Healthcare Providers ◽

Age Cohorts ◽

The Past ◽

Cohort Differences ◽

The Face ◽

Group Variation ◽

Mental And Physical Health

Abstract Background/Purpose Health disparities between sexual minorities and heterosexuals are well documented and have been explained by differential access to healthcare as well as exposure to discrimination. The current research examines the role that healthcare stereotype threat, or the fear of being judged by healthcare providers based on negative group stereotypes, plays in the health of LGB individuals. Methods LGB individuals (N = 1507) in three age cohorts were recruited via random digit dialing to participate in a larger study on sexual minority health. Participants completed measures assessing healthcare stereotype threat, lifetime health diagnoses, life satisfaction, and number of bad physical health days and personal distress in the past 30 days. Results Healthcare stereotype threat was associated with higher psychological distress and number of reported bad physical health days. Additionally, the Younger and Middle cohorts reported more stereotype threat than the Older cohort, but reported significantly higher levels of life satisfaction in the face of this threat than those in the Older cohort. Conclusions Healthcare stereotype threat was related to poorer mental and physical health among LGB individuals; this was true when these outcomes were assessed over the past 30 days but not when they were assessed in general. Cohort differences in healthcare stereotype threat suggest potential important within group variation that needs further investigating. The research broadens the contexts to which stereotype threat is relevant and establishes a stressor related to LGB health.

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