Dental Care Visits Research Articles

Examining the association between cancer history in early life and dental care utilization.

This study aims to examine associations between cancer history in early life (diagnosed at 20years of age or younger) and utilization of dental care. We analysed data of 10,185 participants, aged ≥20years, from the National Health and Nutrition Examination Survey cycles 2015-2018. The main predictor was self-reported past history of any type of cancer diagnosed at 20years of age or younger (yes/no). The outcome variables were having a dental visit within the past year, treatment or preventative visit, urgent need for care, and unmet dental need. Covariates included gender, age, race, marital status, education, and income. Bivariate and multiple logistic regression were conducted, accounting for the complex sampling design. There was no difference between early life cancer survivors in regards to dental visit within the past year (OR: 0.7; 95% CI: 0.3-1.6), visit for dental treatment (OR: 0.6; 95% CI: 0.3-1.6), urgent need for care (OR: 0.8; 95% CI: 0.3-2.0), or unmet dental need (OR: 0.6; 95% CI: 0.2-1.6) compared to cancer-free participants. Cancer history in early life doesn't impact dental care visits, type of last dental visit, dental care recommendation, or unmet dental need. Future cohort studies are needed to confirm this association.

The Impact of Alzheimer’s Disease and Related Dementias on Dental Care Utilization and Costs in Older Adults

There is limited information on the impact of cognition function on dental care utilization and costs. This study used the Medicare current beneficiaries survey in 2016 and included 4,268 participants 65+. Dental care utilization and costs were measured by self-report and included preventive and treatment events. Negative binomial regression and generalized linear regression were used to examine the impact of Alzheimer’s disease (AD) and related dementia (RD) on dental care utilization and costs. We found that AD was not associated with dental care utilization, but RD was associated with a lower number of total treatment dental care visits (IRR: 0.60; 95% CI: 0.37~0.98). RD was not associated with dental care costs, but AD was associated with higher total dental care costs (estimate: 1.08; 95% CI: 0.14~2.01) and higher out-of-pocket costs (estimate: 1.25; 95% CI: 0.17~2.32). AD and RD had different impacts on different types of dental care utilization and costs. Part of a symposium sponsored by the Oral Health Interest Group.

The health care utilization model: Application to dental care use for Black and Hispanic children.

To explore the pathway associated with dental service use among Hispanic and non-Hispanic Black children, applying Andersen's model of health care service utilization. Samples of Hispanic (n=5,055) and non-Hispanic (NH) Black (n=2,695) children aged 2-17 years from the 2016 National Survey of Children's Health (NSCH) were included in this study. We used structural equation modeling (SEM) to examine the path of the relationship between dental care visits and the three groups of characteristics in Andersen's behavioral model. In the models for Hispanic and non-Hispanic Black children, parents' educational attainment directly and positively affected income and having insurance. Also, insurance (Hispanic children: β=0.17, P ≤ 0.01; NH Black children: β=0.25, P ≤ 0.01) and age of the child (Hispanic children: β=0.14, P ≤ 0.01; NH Black: β=0.21, P ≤ 0.01) directly and positively affected dental care use. However, there was no direct effect of the need factor on dental care use in either model. Children may receive dental services that eliminate acute dental problems, probably as a result of the ACA and CHIP coverage. The patterns of findings suggest the need for policy changes to improve pediatric dental coverage and promote professional recommendations for effective dental hygiene.

Patient Perceptions about Professional Dental Services during the COVID-19 Pandemic.

Background:Dental professionals are at high risk of being infected by and transmitting COVID-19 to patients. Patients’ perceived risk for infection and attitudes about receiving dental care during the pandemic are important to understand as patients consider returning to routine dental care as the pandemic progresses.Objective:The purpose of this study was to explore dental patients’ perceptions of susceptibility to contracting COVID-19, their related attitudes and beliefs regarding dental care visits, and their considerations for returning to routine care during and after the pandemic.Method:Data for this cross-sectional study came from an electronic survey of 464 US adults. Survey variables include demographics, dental hygiene behaviors, perceived susceptibility to COVID-19, attitudes and beliefs regarding risk for attending dental appointments, and the necessary conditions and events for them to feel comfortable returning to regular dental appointments.Results:Over half of study participants had a 4-y degree, an annual income of at least $50,000, and good oral hygiene practices of frequent brushing and routine dental visits. Older age and agreement with positive attitudinal statements and beliefs about professional dental care were positively related to perceived susceptibility for contracting COVID-19 in a dental setting. Perceptions of susceptibility, a higher valuation of dentistry, and agreement that COVID-19 is a serious infection were each positively related to attitudinal statements and beliefs reflecting caution in attending dental visits. Last, assurance from public health officials confirming the safety to return for routine dental care was the largest reported factor necessary for a return to routine dental visits.Conclusion:This study provides early data about patient perceptions of susceptibility and attitudes toward COVID-19 in a professional dental setting and necessary conditions for returning to regular visits. This information can help formulate messaging related to returning to professional dental care, specifically targeting fears among the most susceptible populations.Knowledge Transfer Statement:Government and public health agencies can play an important role in alleviating concerns and instilling confidence that dental settings are safe. With this information from the public, dental professionals and public health agencies can work together to share messaging that will consistently inform the public regarding the safety of returning to professional dental care as it relates to the reopening of states and cities.

The relationship of aging, complete tooth loss, and having a dental visit in the last 12 months

ObjectivesTo evaluate the extent to which dental health care visits in the past year differed among older adults with and without edentulism.Material and MethodsWe conducted a cross‐sectional study using the 2017 Medical Expenditure Panel Survey among participants aged ≥50 years (n = 10,480, weighted = 112,116,641). Two self‐reported outcome variables were used: loss of all teeth from upper and lower jaws (yes/no) and dental visit in the last 12 months (yes/no). Logistic models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI).ResultsOverall, 11.4% of the non‐institutionalized U.S. population aged ≥50 years were edentulous; the prevalence was higher in those with advanced age. Adherence to annual oral health visits was 16% among those with edentulism, 52% among those without. The prevalence of dental care visits in the past year was higher among those with advanced age without edentulism, but for those with edentulism, the odds of visiting a dental care provider was lower in all age groups compared to those 50–59 years ((60–69 years): aOR: 0.58, CI:0.36–0.95; (70–79 years): aOR: 0.51, CI: 0.30–0.88; (≥ 80 years): aOR: 0.45, CI: 0.26–0.80)).ConclusionAlthough the prevalence of edentulism was higher in those with advanced age, oral health visits during the last 12 months were less frequent in older adults with edentulism. Interventions to improve adherence to dental care recommendations in the growing aging population are warranted.

What sensitivities matter in dental anxiety? Investigating sensitivity to anxiety, pain, and disgust

ABSTRACT Dental anxiety affects many people worldwide and interferes with oral health. Beyond emotional distress, avoidance of dental care visits can lead to serious dental and health consequences. Although emerging research implicates anxiety, pain, and disgust sensitivities in the etiology and maintenance of dental anxiety, no studies to date have concurrently investigated the unique contribution of these vulnerabilities in dental anxiety. As a step toward elucidating salient mechanisms of dental anxiety, the present study investigated the aggregate contribution of anxiety, pain, and disgust sensitivities in dental anxiety, after controlling for relevant covariates. In this study, participants (N = 717; 71.3% female) included an unselected sample of undergraduate students who completed a battery of online questionnaires. Consistent with community rates, 12% of this sample reported high levels of dental anxiety. The hierarchical regression model revealed anxiety and disgust sensitivities were positively associated with dental anxiety symptoms when adjusting for other model variables. Results highlight the roles of anxiety and disgust sensitivities in dental anxiety and indicate the potential benefit of targeting these emotional sensitivities through routine screenings and treatments for dentally anxious patients.

Factors related to the passive attitude of caregivers on dental care visit when elementary and junior high school children are diagnosed with dental caries

Objectives Early diagnosis and treatment are particularly important for children who have dental caries. It has been reported that some children are not taken to a dental clinic even though they are diagnosed with dental caries at school dental check-ups. The purpose of this study is to investigate factors related to the passive attitude of caregivers regarding dental care visits when elementary and junior high school children are diagnosed with dental caries.Methods A cross-sectional study was conducted utilizing data from the 2016 Adachi Child Health Impact of Living Difficulty (A-CHILD) study. A questionnaire was administered to 1,994 parents of 4th and 6th grade students in elementary school, and 8th grade students in junior high school. Out of the 1,994 parents, 1,652 (83%) responded. Caregivers were asked whether they take their child to the dental clinic immediately if their child is diagnosed with dental caries. Those who answered "cannot take immediately" were defined as caregivers with a passive attitude towards dental care visits. Their reasoning was further probed by the questionnaire. The validity of the answer (i.e., taking their child to the dental clinic) was assessed with the child's untreated dental caries obtained from the results from the school dental health checkup. The number of children excluded in the analysis due to a lack of information on dental caries and/or the attitude of the parents was 1,613. A logistic regression analysis was performed to investigate the association between passive attitude on dental care visit and demographic factors (e.g., child's sex, grade, number of siblings, and household members), lifestyle (e.g., time home for caregiver, grandparent co-residence, skipping breakfast, snacking habits, sugar-sweetened beverage intake, frequency of teeth brushing, and parent-child relationship), and socioeconomic status (e.g., annual household income, educational attainment of caregiver, employment status of caregiver).Results In total, 269 (16.7%) caregivers reported a passive attitude for the dental care visit of their child. The most frequent reason was "I don't have time to take my child to the dental clinic" (172 people, 55.8%). The passive attitude by the caregivers was associated with untreated decay for the child (P<0.001). The passive attitude of the caregiver on the dental care visit was associated with lower maternal educational attainment, skipping breakfast for the child, and lower frequency of brushing teeth. In elementary school children, the passive attitude of the caregiver on the dental care visit was also significantly associated with maternal employment, later time of getting home by the mother and a lack of interaction with children by the caregiver.Conclusion The passive attitude of the caregiver as pertaining to the dental care visit of the child was associated with maternal socioeconomic background. Health promotion activities considering maternal socioeconomic background is needed.

The Role of the National Health Service Corps Clinicians in Enhancing Staffing and Patient Care Capacity in Community Health Centers.

The National Health Service Corps (NHSC) is a federal program to increase the supply of health professionals in underserved communities, but its role in enhancing the capacity of community health centers (CHCs) has not been investigated. This study examined the role of NHSC clinicians in improving staffing and patient care capacity in primary, dental, and mental health care in CHCs. Using 2013-2016 administrative data from CHCs and the NHSC, we used a generalized estimating equation approach to examine whether NHSC clinicians [staff full-time equivalents (FTEs)] complement non-NHSC clinicians in CHCs and whether their productivity (patient visits per staff FTE) was greater than that of non-NHSC clinicians in primary, dental, and mental health care. Each additional NHSC clinician FTE was associated with a significant gain of 0.72 non-NHSC clinician FTEs in mental health care in CHCs and an increase of 0.04 non-NHSC FTEs in primary care in CHCs with more severe staffing shortages. On average, every additional NHSC clinician was associated with an increase of 2216 primary care visits, 2802 dental care visits, and 1296 mental health care visits per center-year. The adjusted visits per additional staff for NHSC clinicians were significantly greater in dental (difference=992) and mental health (difference=423) care, compared with non-NHSC clinicians. The NHSC clinicians complement non-NHSC clinicians in primary care and mental health care. They help enhance the provision of patient care in CHCs, particularly in dental and mental health services, the 2 major areas of service gaps.

Impact of Medical Home on Health Care of Children With and Without Special Health Care Needs: Update from the 2016 National Survey of Children's Health.

Objective The medical home has been promoted as an optimal model of health care delivery for children. The purpose of this study was to examine the association between having access to a medical home and the health care experiences of children with and without special health care needs (SHCN) in the United States. Methods We analyzed data from the 2016 National Survey of Children's Health. We modeled logistic regressions to assess associations of having access to a medical home with health care experiences for 11,392 CSHCN and 38,820 non-CSHCN. Results We found that not having access to a medical home was negatively associated with preventive medical and dental care visits, greater unmet medical and dental needs, and hospital emergency room visits. Additionally, not having access to a medical home was negatively associated with the physical and oral health among CSHCN and oral health among non-CSHCN. However, we found no significant association between improved physical health status and having access to a medical home among non-CSHCN. Conclusions Results from our analysis suggest that having access to a medical home remains key determinant of improved health care experiences by CSHCN and non-CSHCN in the United States. Our findings underscore the need to develop policies and implement a more concerted program to increase access to health care delivered under the medical home model for CSHCN and non-CSHCN. Policymakers, health care administrators and physician groups can use these findings to inform future policy decisions and service delivery reforms.

PRS41 CO-OCCURRING ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS ASSOCIATED WITH POOR ORAL HEALTH AMONG ADULTS IN THE UNITED STATES

Individuals with asthma and Chronic obstructive pulmonary disease (COPD) may be at higher risk for tooth loss compared to those with neither asthma nor COPD due to medications for these conditions and other aspects of the diseases that may be a barrier to routine dental care visits. The objective of this study was to determine the association of asthma and/or COPD and tooth loss among US adults. A cross-sectional design was employed using 2016 Behavioral Risk Factor Surveillance System (N=387,217). We categorized number of missing permanent teeth into 4 groups: asthma only (N=38,817); COPD only (N = 19,819); asthma and COPD (N=13,494); and no asthma, no COPD (N=315,087). Our primary outcome was number of missing teeth categories (none, 1-6, 6-not all, and all teeth missing). We employed multinomial logistic regressions to study the association between asthma and COPD and tooth loss categories. One in 20 adults reported all missing teeth. Adults with asthma and COPD had higher odds of poor oral health (missing>=6 teeth, all) compared to no asthma, no COPD (AOR=2.04; 95%CI=1.85-2.26). Dental visits mediated the relationship between asthma and COPD and oral health. Adults with asthma and COPD had poor oral health compared to those with neither asthma nor COPD. Adults with asthma and COPD may need to maintain routine dental visits to reduce risk of tooth loss. Findings from our study can be useful for planning and developing health promotion and disease prevention programs for oral health.

Dental care utilization: examining the associations between health services deficits and not having a dental visit in past 12\u2009months

BackgroundA growing literature supports the contention that closing the divide between dental and medical care can improve access to and coordination of patient care. Health service deficits (HSDs) entail: no routine medical exam, no personal healthcare provider (HCP), no health insurance, and/or delaying medical care because of cost all within the last 12 months. Examining the associations between HSDs and dental care utilization could inform strategies and interventions aimed at narrowing the gap between the medical and dental professions. This study explored whether HSDs are associated with not having a dental care visit within the last 12 months. In addition, the study sought to provide an updated analysis of the characteristics and factors associated with dental care utilization.MethodsTwo thousand sixteen Behavioral Risk Factor Surveillance System survey data were analyzed using bivariate and multivariable techniques. The outcome variable for this study was: last dental visit was longer than 12 months ago.ResultsUS adults without healthcare insurance, without a personal HCP, who had delayed medical care because of cost, and who had their last routine medical visit longer than 12 months ago had greater odds of not having a dental visit within the last 12 months. Further, this study identified disparities in dental care utilization among males, rural residents, those earning less than $50,000 per year, Non-Hispanic Blacks and Non-Hispanic other races. Individuals with six or more and/or all of their permanent teeth removed and current smokers also had greater odds of not having had a dental care visit in the past 12 months.ConclusionsFindings suggest that a stronger integration of medical and dental care might increase dental care utilization. In addition, persistent disparities in dental care utilization remain for several demographic groups. Targeted interventions offer the promise of helping achieve HP 2020 goals for improved oral health.

The oral health status, behaviours and knowledge of patients with cardiovascular disease in Sydney Australia: a cross-sectional survey

BackgroundPeriodontal disease is a risk factor for atherosclerotic cardiovascular disease and it is recommended internationally that patients with cardiovascular disease should engage in preventative oral health practices and attend regular dental care visits. This study aimed to explore the oral health status, behaviours and knowledge of patients with cardiovascular disease.MethodsA cross-sectional questionnaire containing 31 items was administered to patients with cardiovascular disease from cardiac rehabilitation and outpatient clinics in Sydney Australia in 2016–2017.ResultsOf the 318 patients surveyed, 81.1% reported having at least one oral health problem. Over a third (41.2%) of participants had not seen a dentist in the preceding 12 months and 10.7% had received any oral healthcare information in the cardiac setting. Those with valvular conditions were more likely to have received information compared to those with other cardiovascular conditions (40.6% versus 7.4%, p < 0.001). Only half of the participants had adequate oral health knowledge.ConclusionsDespite a high incidence of reported oral health problems, many patients lacked knowledge about oral health, were not receiving oral health information from cardiac care providers and had difficulty accessing dental services. Further research is needed to develop oral health strategies in this area.

Factors Associated with Dental Care Utilization among Pregnant Women at Klapanunggal Health Centre, Bogor, Indonesia

Background: Oral health care during pregnancy is important for the health of the mother and child.During pregnancy, many changes occur in oral cavity that can be linked to periodontal di­sea­se, including gingivitis and periodontitis. Oral health condition of pregnant women may adversely bring impacts such as preterm low birth weight (PLBW) and premature birth. Pregnant women need to regularly check oral health to a dentist. However, the number of utilization of dental service which is indicated by pregnant women’s dental visit data in Indonesia is still very low.This study aimed to determine factors associated with dental care visit among pregnant women. Subjects and Method: This was a cross-sectional study conducted at Klapanunggal health cen­ter, Bogor, Indonesia. A sample of 60 pregnant women was selected by consecutive sampling. The de­pendent variable was dental care utilization. The independent variables were oral health problem and knowledge. The data were collected by questionnaires and analyzed by a multiple logistic re­gres­sion. Results: Most of pregnant women claimed that their oral health was good (35%) or average (35%). On the contrary, most of them admitted of having had at least one oral health problem (55%), in­clu­ding bleeding gum (35%), dental cavity (33.3%), and painfull teeth (10%). However, only 23.3% of pregnant women visited dentist during the current pregnancy. Factors associated with dental visit were existence of oral health problem (OR=6.41; p=0.019) and oral health knowledge during preg­nancy (OR= 4.03; p=0.050) after controlling education, employment, income, and health in­su­rance. Conclussion: utilization of oral health care service among pregnant women was low. Pregnant wo­men who reported dental visit were more likely to be those who had oral health problem and who had good oral health knowledge during pregnancy. Keywords: oral health, pregnancy, antenatal care, dental visit Correspondence: Itsna Widita, Masters Program in Quality of Health Services, Faculty of Public Health, Universitas Indonesia. Email: itsnawidita@gmail.com Journal of Health Promotion and Behavior (2019), 4(2): 145-152 https://doi.org/10.26911/thejhpb.2019.04.02.07

Manejo del paciente autista en el consultorio odontológico

Management of the autistic patient during a dental care visit

The role of care coordination and out‐of‐home placement in youth dental and vision care visits

Care coordination has been proposed as an approach to promote access to services for youth with complex health and mental health needs. Youth with behavioral health needs are at increased risk of out‐of‐home placement, an experience which may also impact service utilization. Using a sample of administrative and public health insurance record data for youth with mental health needs, we assessed the relationships between care coordination and out‐of‐home placement on service utilization of dental and vision care. Findings suggest that placement is significantly associated with increased likelihood of accessing dental and vision care. The onset of care coordination is associated with a small but significant increase in vision care use. Regulatory and policy directives for out‐of‐home care providers in the USA may be facilitating access to dental and vision care services for youth in placement.Key Practitioner Message: • Youth in placement were more likely to have dental and vision care visits; • Onset of care coordination was not associated with increased dental and vision care.

Screening for Behavioral Risk Factors Is Not Enough to Improve Preventive Services Delivery

ObjectiveUnhealthy behaviors are a major cause of chronic disease. Preappointment screening has been suggested as one way to improve preventive care delivery related to these behaviors by specifying risks to be addressed. We aimed to determine whether screening for health-related behaviors before the clinical encounter will lead to higher counseling rate and service delivery by clinicians. MethodsWe used a pre/post design in one practice with a control practice to evaluate the effects of preappointment screening for 3 behavioral risk factors (tobacco smoke exposure, no recent dental care visit, and consumption of sugar-sweetened beverages). After their clinic visit, we asked English-speaking parents whose child had one or more risk factor whether they had received counseling or services from their pediatrician to address them. ResultsWe recruited 264 parents in the pre phase and 242 in the post phase. Among 215 parents whose child had one or more risk factors, parents in the post phase were as likely to report receiving counseling than parents in the pre phase for each of the risk factors: smoking odds ratio 6.75 (95% confidence interval, 0.51, 88.88), dental health odds ratio 1.44 (95% confidence interval, 0.47, 4.41), and sugar-sweetened beverage consumption odds ratio 0.34 (95% confidence interval, 0.23, 5.18). Service delivery and reported behavior change were also similar in both phases. ConclusionsCounseling rates for tobacco, dental health, or sugar-sweetened beverage consumption were low in pediatric primary care, and preappointment screening did not significantly affect clinician counseling. Future efforts will require a more robust approach to effect change in counseling, provision of service, and family behavior.

Factors associated with the use of dental care by elderly residents of the state of São Paulo, Brazil

Abstract Objective: To investigate factors associated with the use of dental care services. Methods: A cross-sectional study with a representative sample of elderly individuals aged 65 years or older residing in the state of São Paulo in 2015 was performed. Hierarchical multivariate logistic regression analysis was used based on the theoretical model of access determination proposed by Andersen (1995) to predict dental care visits. Results: The prevalence of public service use by the elderly was 1.981 (37.8%), while 3.253 (62.2%) used the private service/ health plan/ other type of service. Hierarchical multiple analysis (p≤0.05) identified that less schooling or never having studied, non-white, lower income and motivated by pain/extraction were associated with the use of public dental services. The study showed a reduced use of public dental care among elderly persons who required some type of upper dentures (except complete dentures), need for some type of lower dentures (including complete dentures) and demonstrated a positive self-perception of oral health condition. Conclusions: A higher prevalence of the use of private dental care/health plan/other type of service was identified. Less schooling or never having studied, non-white skin color, lower income and seeking the dentist with pain or to extract teeth were factors associated with the use of public dental services by the elderly.

Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits

Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.

Dental health status and oral health behavior among university students from five ASEAN countries.

ABSTRACTThe aim of this study was to investigate dental health status and oral health behavior and associated factors among university students in five ASEAN countries (Indonesia, Malaysia, Myanmar, Thailand and Vietnam). Using anonymous questionnaires, data were collected from 3,344 undergraduate university students (mean age 20.5, SD=1.6; 58.3% female) from five ASEAN countries. Results indicate that 27.7% of students reported to have sometimes, most of the time or always having tooth ache in the past 12 months, 39.4% reported to have one or more cavities, 20.3% did not brush their teeth twice or more times a day, and 30.9% had never been to a dentist (or did not know it). In multivariate logistic regression analysis, older age, living in a lower middle income country, consumption of chocolate or candy, having made a dental care visit, and poor mental health was associated with tooth ache in the past 12 months. Being male, being 20 to 21 years old, coming from a wealthier family background, living in a lower middle income country, frequent consumption of soft drinks, not having consulted with a dentist in the past 12 months and weak beliefs in the benefits of tooth brushing were associated with inadequate tooth brushing frequency (<twice a day). Further, being male, being 20 to 21 years old, inadequate tooth brushing frequency, infrequent consumption of chocolate or candy, frequent consumption of soft drinks and low physical activity was associated with inadequate or never dental care visit. Poor dental health status and oral health behaviors were found and various risk factors identified that can be utilized to guide interventions to improve oral health programs among university students.

Using the Beers criteria to identify potentially inappropriate medication use by older adult dental patients

BackgroundAn aging population indicates that increasing numbers of older adults will seek oral health care and have multiple chronic conditions treated with a number of medications. The authors examined the Medicare Current Beneficiary Survey administrative data set to characterize potentially inappropriate medication (PIM) use by older adults visiting the dentist and related adverse experiences that may affect oral health care. MethodsThe authors used the 2015 Beers criteria to identify PIMs for older adults. The authors examined the Medicare Current Beneficiary Survey administrative data set for community-dwelling older adults with dental care visits and reported national prevalence estimates of Beers criteria medication prescribing. The authors used logistic regression to identify sociodemographic and health-related characteristics associated with potentially inappropriate prescribing. The authors described medication-related adverse experiences affecting dental care. ResultsAmong older adults with dental care visits, 56.9% received a prescription for at least 1 Beers criteria medication, and 28.3% received a prescription for 2 or more Beers criteria medications. Beers criteria medication use was associated most strongly with the number of comorbid diseases as represented by higher Charlson Index scores (odds ratios, > 1.0). ConclusionsA substantial proportion of community-dwelling older adults visiting dentists had received prescriptions for 1 or more potentially age-inappropriate Beers criteria medications. Many of these medications have adverse effects that could affect patient safety and oral health care. Practical ImplicationsThese results support the need for clinicians to be aware of PIM use by older adults, recognize associated medication-related adverse events, and avoid prescribing age-inappropriate medications to this vulnerable patient population.