Need For Dental Care Research Articles

Ohio's Medicaid Expansion and Unmet Health Needs Among Low-Income Women of Reproductive Age.

Objective To examine changes in the prevalence and odds of unmet healthcare needs and healthcare utilization among low-income women of reproductive age (WRA) after Ohio's 2014, ACA-associated Medicaid expansion, which extended coverage to non-senior adults with a family income ≤ 138% of the federal poverty level. Methods We analyzed publically available data from the 2012 and 2015 Ohio Medicaid Assessment Survey (OMAS), a cross-sectional telephone survey of Ohio's non-institutionalized adult population. The study included 489 low-income women in 2012 and 1273 in 2015 aged 19-44years who were newly eligible for Medicaid after expansion in January 2014. Four unmet healthcare need and three healthcare utilization measures were examined. We fit survey-weighted logistic regression models adjusted for race/ethnicity, working status, and educational attainment to determine whether the odds of each measure differed between 2012 and 2015. Results In 2015, low-income WRA had a significantly lower odds of reporting an unmet dental care need (ORadj = 0.72, 95% CI 0.54, 0.95), unmet vision care need (ORadj = 0.68, 95% CI 0.50, 0.93), unmet mental health need (ORadj = 0.57, 95% CI 0.39, 0.83), and unmet prescription need (ORadj = 0.39, 95% CI 0.45, 0.80) compared to 2012. There were no significant differences in the odds of seeing a doctor or dentist in the past year or of having a usual source of care for low-income WRA in 2012 and 2015. Conclusions for Practice After Ohio's 2014 Medicaid expansion the odds of low-income WRA having unmet healthcare needs was reduced. Future research should examine outcomes after a longer period of follow-up and include additional measures, such as self-rated health status.

The Effect of Xerostomic Medication on Oral Health in Persons With Dementia

ObjectivesMedication-induced hyposalivation can increase the risk for oral complications, including dental caries and tooth loss. This problem is particularly important in people with dementia because of their declining ability to maintain oral care. The objective of this study was to describe the association between the number of xerostomic medications used and tooth loss and restorative and dental preventive treatment in a population of persons with dementia. DesignA longitudinal population-based register study with a 3-year follow-up was conducted. Data were extracted from the Swedish Dementia Registry (SveDem), the Swedish Prescribed Drug Register (SPDR), the Swedish National Patient Register (SNPR), and the Dental Health Register (DHR). Setting and participantsParticipants were persons with dementia who were registered in the SveDem at the time of their dementia diagnosis. MeasuresThe exposure was continuous use of xerostomic medications over the 3 years prior to dementia diagnosis (baseline). The outcomes were the incidence of tooth extractions, tooth restorations, and dental preventive procedures. Poisson regression models were used to estimate incidence rate ratios (IRRs) for the association between the exposure and outcomes, adjusting for relevant confounders. ResultsA total of 34,037 persons were included in the analysis. A dose-response relationship between the exposure and tooth extractions was observed. Compared with nonusers of xerostomic medication, the rate of tooth extractions increased with increasing number of xerostomic medications used (IRR = 1.03, 1.11, and 1.40 for persons using an average >0-1, >1-3, and >3 xerostomic medications, respectively). However, the risk for having new dental restorations and receiving preventive procedures did not differ between groups. ConclusionContinuous use of xerostomic medications can increase the risk for tooth extraction in people with dementia. This study highlights the importance of careful consideration when prescribing xerostomic medications to people with dementia, and the need for regular and ongoing dental care.

Clinical Oral Health Recommended Care and Oral Health Self-Report, NHANES, 2013-2014.

Purpose.The purpose of this study was to determine the concordance of self-reported responses to oral health questions versus clinically evaluated recommended need for oral healthcare by calibrated dentists to determine usefulness of the questions for epidemiological studies. We additionally examined other factors associated with concordant self-reports versus clinical evaluations.Materials and Methods.We used a cross-sectional study design with 4,205 participants, ages 30 years and above, who had complete oral health self-perception data and dental referral data in the NHANES 2013-14. Calibrated dentists completed clinical oral healthcare assessments. The assessments were dichotomized to (1) recommendation for immediate care and (2) routine oral health care. Self-reported oral health needs were measured with 6 items (an overall oral health self-perception question, oral pain within the previous year, impact on job/school, suspected periodontal disease, tooth appearance, and tooth mobility). The key item of interest was the overall oral health self-perception question.Results.Concordance with clinically evaluated recommended need for oral healthcare varied from 52.0% (oral pain) to 65.4% (overall oral health self-perception). Many subgroup differences were observed.Conclusions.The overall self-perception of oral health and the clinical evaluation of oral healthcare need were substantially concordant; other self-reported measures were moderately concordant. This is useful information and points to the need for a minimum set of measures that can provide actionable information and capture the need for clinical dental care.

Oral health inequalities: Determinants of access to prevention and care in France

Oral diseases are unequally distributed according to a social gradient, which now constitutes a major public health problem. Acting against oral health inequalities requires a better understanding of the underlying mechanisms in order to identify the appropriate solutions to improve access to oral health promotion and dental care for deprived populations. A patient-centered model of health care access, describing the ideal interactions between individuals and the health care system was applied to the field of oral health in the French context. This model defines access to health care as the result of interactions between individuals and the health care system, in which health needs are perceived, health care is sought, health care structures are accessed and effectively used. Analysis is based on quantitative and qualitative bibliographic data acquired through an explanatory sociological approach. Socially deprived populations face many barriers preventing their access to dental care: the need for dental care is not necessarily perceived, and, when perceived, dental care is not immediately sought, accessibility to dental care structures is difficult and dental attendance is erratic. This review provides information to decision-makers in order to support regional health policies and to help implement public health strategies according to the principle of proportionate universalism. Two axes for action were identified, namely to integrate oral health promotion interventions within health promotion programmes and to gradually reorganize the dental care system to make it more accessible to everyone.

Household Income and Children's Unmet Dental Care Need; Blacks' Diminished Return.

Background: Minorities’ Diminished Return theory is defined as the relative disadvantage of minority populations compared to Whites regarding health gains that follow socioeconomic status (SES). To test whether Minorities’ Diminished Return theory holds for unmet dental care needs (DCN), we investigated Black-White differences in the effects of family income on unmet DCN among children. Methods: Data from the National Survey of Children’s Health were used. Participants were either White or Black children age 1 to 18. Family income-to-needs ratio was the independent variable. Unmet DCN was the dependent variable. Covariates included age, gender, and parental educational attainment. Race was the focal moderator. We ran logistic regression for data analysis. Results: Higher income-to-needs ratio was associated with lower risk of unmet DCN in the pooled sample. We found an interaction between race and family income-to-needs ratio on unmet DCN, suggesting a stronger protective effect for Whites than Blacks. Conclusion: Minorities’ Diminished Return also holds for the effects of family income-to-needs ratio on unmet DCN. The relative disadvantage of Blacks compared to Whites in gaining oral health from their SES may reflect structural racism that systemically hinders Black families. There is a need for additional research on specific societal barriers that bound Blacks’ oral health gain from their SES resources such as income. Policies and programs should also help Black families to leverage their SES resources.

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

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.

DENTAL AND SALIVARY STATUSES OF MEN WITH ALCOHOL USE DISORDER DEPENDING ON AGE

Introduction. High level of alcohol consumption in Russia and significant need of dental care especially among patients with alcohol use disorder (AUD) dictate necessity of investigation of dental pathology features among this group of patients. The aim of the study is to research dental and salivary statuses of men with ADS depending on the age. Methods. Examination of indices of dental and salivary statuses was carried out among two age groups of patients with second stage of AUD aged 25-44 years - «younger» and 45-64 years - «older». Methods of statistical analysis were Pearson's chi-squared test, Mann-Whitney U test and logistic regression. Results. In studied group median of DMFT with Q1 and Q3 is 14,0 (11,0-20,0) in younger group and 23,0 (18,0-29,0) in older group with significant prevalence of missing teeth in older group (p

Assessment of orthodontic treatment need among tribal children of Indore division, Central India.

IntroductionIndia is home to many tribes which have an interesting and varied history of origins, customs and social practices. Oral health care in tribal areas is limited due to shortage of dental manpower, financial constraints and the lack of perceived need for dental care among tribal masses.ObjectiveTo assess orthodontic treatment need among tribal children of Indore division, Central India.MethodsA cross-sectional house to house survey was carried out among 800 tribal children aged 5 to 15 years old in two major tribal districts of Indore division. Permissions and consent were obtained from local administrative authorities, ethical committee and parents respectively. A structured proforma was used to record demographic data. Examination for dentofacial anomalies was conducted according to WHO 1997 survey methods. Descriptive tables and analytical tests like ANOVA, post-hoc and chi-square test were employed.ResultsThe mean age was 9.75(±2.43) years. The mean DAI score among 12 to 15 years old children was 23.19±5.22. Female exhibited higher (24.51±5.34) mean DAI score compared to males (22.12±4.87) (p<0.05). The Patelia tribes (24.38±5.13) reported higher mean DAI score than Bhilala (23.02±5.69) and Bhil tribe (22.73±4.79) (p<0.005).ConclusionThe tribal children had minor malocclusion with no or slight treatment need. Categorization of orthodontic treatment need according to malocclusion severity is particularly important for the planning of corresponding public policies. The isolation of the villages, lack of transportation options imposes limitations on the availability of health professionals to provide dental services.

Relationship between unmet dental needs and the general and oral health status of adults

Objectives The purpose of this study was to investigate the reasons for unmet dental needs in Korea and to find ways to improve dental care accessibility by using data from the 6th National Health and Nutrition Survey. Methods This study was performed using data collected from the 6th National Health and Nutrition Examination Survey (KNHANES). A total of 2,251 subjects were selected for the study. Statistical analysis was performed using SPSS 21.0 on data files obtained according to complex sampling design, and a significance level of 0.05 was used. General characteristics of the subjects, oral health status, and unmet dental needs were examined for a complex sampling frequency analysis, and the differences in distribution were analyzed using chi-square analysis. Relevant factors were determined using logistic regression analysis. Results According to the logistic regression analysis, in Model 1, gender, household income, employment status, and subjective health status were found to be significantly related to unmet dental needs (P<0.05). In Model 2, subjective health status, subjective oral health status, and chewing difficulty were significantly related to unmet dental needs (P<0.001). Model 3 showed a significant relationship between subjective health status, subjective oral health status, chewing difficulty, periodontal disease, and unmet dental needs (P<0.001). Conclusions We conclude that the reasons for the unmet dental needs in Korea are socioeconomic status, general health status, and oral health status. In the future, economic barriers to obtaining dental care need to be overcome through improvements in health insurance policies and systems and diversification of private insurance. Oral health should be improved through oral health education, which can create awareness and provide motivation for maintaining oral health.

Oral health status and parental perception of dental anxiety of attention deficit hyperactivity disorder and nonattention deficit hyperactivity disorder children in Bengaluru city: A cross-sectional study

Context: Attention deficit hyperactivity disorder (ADHD) is a complex, multifactorial disorder which is characterized by the symptoms of inattention and/or impulsivity and hyperactivity. In children with ADHD, cognitive and executive functions may be impaired leading to significant behavioral problems that may affect oral health. There is an extreme paucity of the studies related to oral health and dental anxiety among children with ADHD. Aim: The aim of this study is to assess and compare oral health status and parental perception of dental anxiety among ADHD and non-ADHD children. Materials and Methods: A cross-sectional comparative study was conducted among 100 ADHD and 100 non-ADHD children aged 6–17 years in Bengaluru city. A structured validated pro forma was used to collect demographic details, Decayed, Missing, and Filled Teeth (DMFT)/dmft, and gingival index (GI). The Dental Subscale of Children's Fear Survey Schedule was used to assess parental perception of dental anxiety. Data were analyzed using Chi-square test, Mann–Whitney U-test, and Pearson's correlation test (P < 0.05). Results: DMFT was significantly higher in ADHD (1.60 ± 1.6) than in non-ADHD group (1.15 ± 1.32) (P = 0.04). There was no significant difference between the groups for GI (P = 0.3). ADHD children exhibited significantly higher dental anxiety when compared to non-ADHD children (P < 0.001). Dental anxiety was significantly related to the caries experience among ADHD group (P < 0.001). Conclusion: Children with ADHD exhibited a poorer oral health status and higher dental anxiety than non-ADHD children. Hence, there is a need for diligent preventive dental care.

Trends in domiciliary dental care including the need for oral appliances and dental technicians in Japan.

The need for domiciliary dental care (DDC) for people requiring long-term nursing care is increasing as the super-aged society of Japan grows still older. Dysphagia diagnosis and rehabilitation are becoming more important in DDC; thus, the need for prostheses used for dysphasia rehabilitation is presumed to be increasing. To identify DDC trends in Japan, as well as the need for prostheses and dental technicians for DDC, we sent a self-administered questionnaire to dentists providing DDC and analyzed responses from 138 dentists (valid response rate, 39.8%). The results showed that 37.7% of respondents reported treating ≥50 patients per month. The most frequently performed procedures were removable prosthetic treatment and oral care, followed by dysphagia rehabilitation. Use of palatal augmentation prostheses was experienced by 54.3% of respondents, and most indicated that the prostheses were effective for improvement of oropharyngeal function. The rates of cooperation with primary care doctors and nursing care professionals were 76.8% and 85.5%, respectively. Only 6.5% of respondents reported accompanying dental technicians to DDC. The present analysis of trends in DDC indicates that oral care and dysphagia rehabilitation have become more frequent and that cooperation with healthcare professionals other than dental technicians has increased in recent DDC.

Dental Treatment Need Among First-Visit Patients Of Dental Outpatient Clinic At IIUM Kuantan For The Year 2016

Introduction: This cross-sectional study aimed to determine association of age and gender with dental treatment need among first-visit patients at Dental Outpatient Clinic, IIUM Kuantan in 2016. Materials and Methods: Ethical approval (IREC 762) was obtained from IIUM Human Ethics Committee. List of first-visit patients who attended clinic from 1st January to 31st December 2016 was retrieved to assess patient's age and gender. Dental treatment need was determined according to the normative need which was professionally defined by dental-officer-in-charge. All first-visit patients were included, except those attended Orthodontic department or with old Malaysian identification card or foreign passport. Included patients were classified into six age groups (≤14, 15-19, 20-34, 35-44, 45-64 and ≥ 65). Pearson's chi square test was used for statistical analysis using SPSS Version 20 software. Results: From a total number of 2,713 patients (age range of 2 to 87), 1,210 (44.6%) were males and 1,503 (55.4%) were females. Age (p&lt;0.001) and gender (p&lt;0.001) were significantly associated with dental treatment need. Paediatric patients (≤14) majorly received paedodontic care (97.5%). Young-age patients (15-19, 20-34 and 35-44) mostly required conservative care (39.5%, 31.2% &amp; 30.6%, respectively) while elder-age patients (45-64 and ≥ 65) have major need for prosthodontics (30.0% &amp; 40.2%, respectively). Females outnumbered males in all age groups, except for the age group of ≥ 65 whereby the situation was the opposite. Females also outnumbered males in all types of treatment need, except for periodontics which was predominated by males. Conclusion(s): Age and gender have significant associations with treatment need for dental care.

The Effect of Medicaid on Dental Care of Poor Adults: Evidence from the Oregon Health Insurance Experiment.

To evaluate the effect of Medicaid coverage on dental care outcomes, a major health concern for low-income populations. Primary and secondary data on health care use and outcomes for participants in Oregon's 2008 Medicaid lottery. We used the lottery's random selection to gauge the causal effects of Medicaid on dental care needs, medication, and emergency department visits for dental care. Data were collected for lottery participants over 2years, including mail surveys (N=23,777) and in-person questionnaires (N=12,229). Emergency department (ED) records were matched to lottery participants in Portland (N=24,646). Medicaid coverage significantly reduced the share of respondents who reported needing dental care (-9.8 percentage points, p<.001) or having unmet dental care needs (-13.5 percentage points, p<0.001). Medicaid doubled the share visiting the ED for dental care (+2.6 percentage points, p=.003) and the use of anti-infective medications often prescribed for dental care, but it had no detectable effect on uncovered dental care or out-of-pocket spending. Expansion of Medicaid covering emergency dental care substantially reduced unmet need for dental care, increasing ED dental visits and medication use, while not changing patient use of uncovered dental services.

Projecting the Demand for Dental Care in 2040.

The purpose of this study was to provide a forward-thinking assessment of the underlying factors likely to impact trends in dental care demand and the need for dental providers in 2020, 2025, and beyond. Dental workforce trends and their likely impact on the need for dentists are a function of predicted dental care demand, which will in turn be determined by the size and characteristics of our population size, economic outlook, the state of public and private dental care insurance, trends in dental care delivery, professionally determined dental care need, and population health beliefs. Projecting rates of dental care utilization far into the future is difficult because projections must be made using historical data, and established trends may not persist if there is structural change in the future. Nonetheless, when structural change occurs, it does not typically affect all aspects of the economy, so there is value in describing the likely future impact of current trends. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Dental care necessity at productive age in Cilayung Village, Jatinangor Districts, Sumedang Regency

Introduction: The need of dental care is defined as a collection of dental and oral treatment in which according to dental personnel should be obtained by a certain period in order to achieve good dental health status. According to WHO, the productive age is the age group between 35-44 and is considered as the standard age for checking the adult oral health condition. The objective of this research was to obtain the necessity of oral health data at productive age in Cilayung village. Method: The research method was descriptive with cluster sampling technique. Samples of 80 respondents were obtained by pathfinder surveys technique. The necessity of dental care was assessed using WHO oral health surveys and the dental condition of respondents were checked using mouth glass. Result: The results shows that the highest number of caries prevention is as many as 80 people (100%) and the need for one surface treatment as many as 75 people (93.75%). Conclusion: The research concluded that the people in Cilayung village is in high need of caries and surface treatment.

Acceptability of Chairside Screening for Racial/Ethnic Minority Older Adults: A Qualitative Study.

An aging and more racially and ethnically diverse population, coupled with changes in the health care policy environment, is demanding that the dental profession both redirect and expand its focus. Challenges include providing comprehensive care for patients with complicated medical needs while improving access to care for underserved groups. The purpose of this study is to examine the acceptability of screening for hypertension and diabetes in the dental setting for African American, Puerto Rican, and Dominican older adults who attend senior centers in northern Manhattan, New York City. Focus groups were conducted with 194 racial/ethnic minority men and women aged 50 y and older living in northern Manhattan who participated in 1 of 24 focus group sessions about improving oral health for older adults. All groups were digitally audio-recorded and transcribed for analysis. Groups that were conducted in Spanish were transcribed first in Spanish and then translated into English. Analysis of the transcripts was conducted using thematic content analysis. Five themes were manifest in the data regarding the willingness of racial/ethnic minority older adults to receive hypertension and diabetes screening as part of routine dental visits: 1) chairside screening is acceptable, 2) screening is routine for older adults, 3) the interrelationship between oral and general health is appreciated, 4) chairside screening has perceived benefits, and 5) chairside screening may reduce dental anxiety. Reservations centered on 4 major themes: 1) dental fear may limit the acceptability of chairside screening, 2) there is a perceived lack of need for dental care and chairside screening, 3) screening is available elsewhere, and 4) mistrust of dental providers as primary care providers. This study provides novel evidence of the acceptability of screening for hypertension and diabetes in the dental setting among urban racial/ethnic minority senior center attendees. Knowledge Transfer Statement: The results of this study may be used by oral health providers when deciding whether to conduct chairside screening for medical conditions such as hypertension and diabetes that could affect, or be affected by, the oral health of their patients. Patient experiences of care-along with clinical outcomes, avoidable hospital admissions, equity of services, and costs-are important outcomes to consider in meeting the needs of an aging and racially and ethnically diverse US population.

The cost-effectiveness of three interventions for providing preventive services to low-income children.

We evaluated the impact of loan repayment programmes, revising Medicaid fee-for-service rates, and changing dental hygienist supervision requirements on access to preventive dental care for children in Georgia. We estimated cost savings from the three interventions of preventive care for young children after netting out the intervention cost. We used a regression model to evaluate the impact of changing the Medicaid reimbursement rates. The impact of supervision was evaluated by comparing general and direct supervision in school-based dental sealant programmes. Federal loan repayments to dentists and school-based sealant programmes (SBSPs) had lower intervention costs (with higher potential cost savings) than raising the Medicaid reimbursement rate. General supervision had costs 56% lower than direct supervision of dental hygienists for implementing a SBSP. Raising the Medicaid reimbursement rate by 10 percentage points would improve utilization by <1% and cost over $38 million. Given one parameter set, SBSPs could serve over 27 000 children with an intervention cost between $500 000 and $1.3 million with a potential cost saving of $1.1 million. Loan repayment could serve almost 13 000 children for a cost of $400 000 and a potential cost saving of $176 000. The three interventions all improved met need for preventive dental care. Raising the reimbursement rate alone would marginally affect utilization of Medicaid services but would not substantially increase acceptance of Medicaid by providers. Both loan repayment programmes and amending supervision requirements are potentially cost-saving interventions. Loan repayment programmes provide complete care to targeted areas, while amending supervision requirements of dental hygienists could provide preventive care across the state.

Availability of dentures and the need for orthopedic dental care for residents of the Southern Federal District of the Russian Federation

The dental examination of 3329 (1760 men and 1569 women) adults aged from 18 up to 102 years living in the cities and rural areas of the Southern Federal District of the Russian Federation was carried out. Taking into account age (young, average, elderly, senile, long-livers), a floor and the place of residence indicators of security and needs in the dentoprosthetic help are studied, and also the frequency of occurrence of functional pathology of the chewing apparatus is determined. It is established that with age needs in a denture it isn’t dependent on a floor and the place of residence it is enlarged. Among living in rural areas larger needs in the orthopedic dental help during all age periods became perceptible that it is bound to remoteness of the treatment and prevention facilities giving dentoprosthetic help from places accommodation of residents of the village. Security with dentures was higher at residents of the cities. Duration of use of dentures at residents and the village made from 6 months to 15 years. At the same time, at residents of the cities of full-fledged dentures whom they use, more, than at residents of the village. Inferiority of the replacing dental designs was bound to their functional and esthetic inferiority, and also the increased wear or their defects. Dentures on artificial legs were taped only residents in 2,1–6,5% of cases that demands organizational measures for approach of modern methods of after treatment of the chewing apparatus to inhabitants of rural areas. In all age groups, it isn’t dependent on the place of residence, there was a high frequency of functional pathology of the chewing device.

Transportation Barriers and Use of Dental Services among Medicaid-Insured Adults.

This study explores how travel distance and other transportation barriers are associated with dental utilization in a Medicaid expansion population. We analyzed data from the Iowa Dental Wellness Plan (DWP), which provides comprehensive dental benefits for low-income adults aged 19 to 64 y as part of Iowa's Medicaid expansion. Transportation and geographical characteristics were evaluated as enabling factors within the framework of Andersen's behavioral model of health services use. In March 2015, a random sample of DWP members ( n = 4,800) was surveyed; adjusted survey response rate was 30% ( n = 1,258).The questionnaire was based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey and assessed need for dental care, use of dental services and transportation to visits, and self-perceived oral health status. Respondent and dentist addresses were geocoded and used to calculate distance to the nearest DWP general dentist. A logistic regression model predicting utilization of dental care was developed using variables representing each domain of the behavioral model. Most respondents (57%) reported a dental visit since enrolling. Overall, 11% of respondents reported unmet dental need due to transportation problems. Median distance to the nearest general dentist was 1.5 miles. In the adjusted model, travel distance was not significantly associated with the likelihood of dental utilization. However, other transportation-related issues were significantly associated with utilization, including concern about cost of transportation and driver/passenger status. As concern about transportation cost increased, likelihood of having a dental visit decreased. Targeted approaches to assisting low-income populations with transportation barriers should be considered in designing policies and interventions to improve access to dental care. Knowledge Transfer Statement: The results of this study can be used by policy makers and public health planners when designing programs and interventions to improve access to dental care. Consideration of transportation availability and costs could improve utilization of routine dental care, especially among low-income populations.

Original Research. The Evaluation of Caries Severity Index and Dental Hypoplasia in Children with Acute Lymphoblastic Leukemia. Results from a Romanian Medical Center

Abstract Acute lymphoblastic leukemia (ALL) is a type of cancer that most frequently affects children, and its treatment involves intensive chemotherapy, which might interfere with the normal development of dental tissues. The aim of our study was to measure the incidence of dental caries and enamel hypoplasia in children diagnosed with ALL treated according to the Berlin-Frankfurt-Munster-95 (ALL-BFM-95) protocol during the complete remission phase. Two groups of children between 8-12 years of age were investigated: Group 1 consisted of 36 children with ALL, and Group 2 of 58 control age-matched children. The decay-missing-filling index for the deciduous teeth (DMFT) and the presence of hypoplasia in the first permanent molars (MH) or in both incisors and molars (MIH) were recorded. The results were statistically analyzed and showed that there were no differences between the groups regarding the DMFT values (p &gt;0.05), but there was a statistically significant difference in the incidence of MH and MIH between groups (p &lt;0.05). According to our results, chemotherapy was not responsible for the decay process, as there were no differences in DMFT indices between the groups, but the high incidence of MH and MIH in the ALL group indicates the need of a good dental care for these children in order to prevent future dental complications.