Dental Home Research Articles

Oral Health Assessment for Older Residents in Long-Term Care Facilities Using Video Recording by a Mobile Electronic Device.

Many older adults who require long-term care need oral health management. However, access to dental care is limited, and connecting older patients with dental professionals is a future challenge. Therefore, the development of a remote oral health assessment system is required. This study aimed to investigate the usefulness of video-based oral health assessments in older adults residing in facilities. This study comprised 60 older adults residing in facilities who consented to dental home visit treatment by the Department of Oral Function Management at Showa University Dental Hospital between July 2021 and December 2022. The Oral Health Assessment Tool (OHAT) was used to evaluate the oral health status at the facilities by one dentist. The concordance of the oral health assessments conducted by this dentist at the facilities (OHAT-B) was compared with those conducted by the same dentist (OHAT-V1) and two other dentists (OHAT-V2 and V3) using approximately 1 min video recordings of the oral cavity taken with a mobile electronic device. On the OHAT total score, the intraclass correlation coefficient (ICC [1.1]) for OHAT-B and V1 was 0.931; the ICC (2.1) was 0.889 when compared with V2 and 0.788 when compared with V3. Moreover, the comparison between V2 and V3 showed high agreement, with an ICC (2.1) of 0.750. This study revealed that the oral health assessment of older adults residing in facilities using video recordings of the oral cavity taken with a mobile electronic device may be possible, suggesting the possibility of remote oral health assessment.

Asynchronous teledentistry program in two long-term care facilities: Iowa's virtual dental home pilot project.

Older adults living in long-term care facilities (LTCFs) often have poor oral health and difficulty accessing dental services. The aim was to implement a virtual dental home (VDH) program for residents in two LTCFs utilizing asynchronous teledentistry techniques and mobile dental equipment. This pilot project was a 6-month longitudinal cohort study in two LTCFs. Dental hygienists and dentists from a local community health care center utilized asynchronous teledentistry to provide diagnostic and preventive dental services onsite and to establish a dental home for additional comprehensive care services. Data were collected, including resident's demographics, oral health status, and dental services received. Descriptive data analyses, Wilcoxon signed rank, and McNemar tests were conducted. Thirty-four residents completed in-person baseline oral exams and 16 residents completed the recall exams. Ninety-two percent (n=23) of dentate residents (n=25) had untreated caries and 64% (n=16) of dentate residents had at least one sextant of severe gingival inflammation. The median number of teeth with active untreated caries (p=.01) significantly decreased and arrested caries (p=.02) significantly increased from baseline. Iowa's VDH pilot project was successful in establishing a dental home using asynchronous teledentistry for residents in two LTCFs and providing resident access to preventive and disease control dental services.

School Nurse-Led Health Assessment for Students Experiencing Homelessness: A Quality Improvement Project.

Childhood homelessness is increasing and is associated with negative health and academic outcomes. The goal of this quality improvement project was to improve access to healthcare and health outcomes for students experiencing homelessness through a school nurse-led comprehensive health assessment. The multilevel intervention included identifying students experiencing homelessness, conducting a standardized health assessment, and making referrals to care. This 8-month project was conducted in an urban school district. Feasibility and acceptability data were collected to guide sustainability. Student health and referral data were analyzed using descriptive statistics. At the project start, 688 students were identified as experiencing homelessness. More than half (67%) had a partial or fully completed health assessment during the project. Of the students assessed, most had a primary care provider, some had a health condition, and half had a dental home. Students experiencing homelessness would benefit from systematic school-based health assessments to identify unmet health needs.

"Evaluation of Silver Diamine Fluoride Modified Atraumatic Restorative Treatment (SMART) on hypomineralized first permanent molar"- a randomized controlled clinical study.

Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up. Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient. There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P = .049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P < .001) and a statistically significant difference in surface area changes between the 4 subgroups. Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year. The study protocol was retrospectively registered on Clinical Trials (NCT05931822-05/ 07/2023).

Oral health in home care: Perspectives and experiences of dentists in a Brazilian region.

Home care provided by dentists is crucial for ensuring adequate oral care. However, oral health professionals face challenges in delivering treatment at patients' residences due to a lack of resources. Our objective was to explore dentists' perspectives and experiences of dental home care and potential challenges for its implementation. The study took a qualitative approach. Guided by a semi-structured interview schedule, data were gathered using recorded interviews with 22 dental professionals. After transcription, data were analysed thematically using the Discourse of the Collective Subject (DCS) method, using Qualiquantisoft. The majority of participants were female (n = 20), aged between 30 and 40 years old, and predominantly specialising in primary care (n = 6) or endodontics (n = 6). All participants provided home care, performing general dental procedures, normally responding to requests from the work team (n = 13) or family (n = 7). Six main categories on to the topic emerged: importance and access to home care, procedures performed during home visits, discussions about post-home care, professional competence and patient-centred care, positive aspects of home care, and negative aspects and challenges faced in this type of care. This study highlights the fundamental, yet complex, role of home care in dentistry. Continuity of treatment through adaptability and a patient-centred approach are important.

Effectiveness of interventions on improving early-life dental care utilization: a systematic review and meta-analysis.

Although early-life dental care is crucial for preventing early childhood caries and has numerous benefits, the utilization rate of such care remains remarkably low worldwide, especially in families of low socioeconomic status. The aim of this study was to systematically review the scientific evidence relating to the effectiveness of interventions on improving early-life dental care utilization of very young children. We reviewed scientific evidence relating to these positive changes, with 7 randomized controlled trials after qualitative evaluation. Interventions assessed included prenatal oral health promotion, motivational interviewing, intraoral camera use alongside social work consultations to aid in decreasing barriers to care, monetary incentives for tooth brushing, fluoride varnish applications, and probiotic usage. The intervention was significantly effective in reducing the incidence of dental caries among children, especially in caries risk. Caries reduction was significant when oral health information was provided at frequent intervals prenatally. Caries increment was also reduced when probiotics were introduced when administered daily. Interventions that attempted to increase parental involvement in oral health care by increasing motivation and decreasing barriers had inconclusive results within the study groups. Considering high rates ECC, early establishment and preservation of a dental home should be a focus in public health measures. Continuous monitoring and parental involvement are key components to maintaining healthy oral conditions. Future studies could explore and test various innovative strategies that utilize technological platforms to engage with parents and promote early-life dental care utilization among the underserved population.

Oral Health Care for Children and Youth With Developmental Disabilities: Clinical Report.

Oral health is an essential component of overall health for all individuals. The oral health of children and youth with developmental disabilities (CYDD) involves unique characteristics and needs of which pediatricians and pediatric clinicians can be aware. Risk for oral disease in CYDD is multifactorial and includes underlying medical conditions, medications, and ability to participate in preventive oral health care and treatment, and lack of access to providers is common for this population despite being eligible for Medicaid. Pediatric clinicians are uniquely positioned to support the oral health needs of CYDD and their families through the medical home. This clinical report aims to inform pediatric clinicians about the unique oral health needs of CYDD. It provides guidance on assessing caries risk and periodontal status using structured screening instruments; understanding dental trauma, the role of diet and caries risk, trauma prevention, and malocclusion; and providing anticipatory guidance on oral hygiene that includes tooth brushing, use of fluoridated toothpaste, assessing community water fluoridation, advocating for a dental home by 1 year of age, and transition to adult dental care as part of adolescent health care. It also highlights special considerations for dental treatment rendered under sedation or general anesthesia that CYDD may need. Pediatric clinicians can help reduce risk of CYDD developing dental disease by understanding the unique needs of their patients and their barriers to accessing oral health care in their community, communicating with the child's dental home, and advocating for safe and accessible dental procedures.

Dental anxiety and oral health in American Indian and Alaska natives.

American Indian and Alaska native (AI/AN) individuals report distrust of the healthcare system. This study explored associations between having either high levels of dental distrust or high levels of dental care-related fear and anxiety ("dental anxiety") and oral health outcomes in AI/AN adults. The 2022 State of Oral Health Equity in America survey included the Modified Dental Anxiety Scale and asked to what extent respondents agreed with the statement, "At my last oral health visit, I trusted the oral health provider I saw", and asked about self-rated oral health and presence of a dental home. AI/AN individuals (N = 564) who reported low dental trust (n = 110) or with high dental anxiety (MDAS≥19; n = 113) reported significantly worse overall and oral health and were significantly less likely to have a dental home (p < 0.05 used for each analysis). Dental distrust and dental anxiety can significantly impact oral health and dental utilization in AI/AN communities and are important intervention targets to improve AI/AN oral health.

Comparison of traditional regression modeling vs. AI modeling for the prediction of dental caries: a secondary data analysis

IntroductionThere are substantial gaps in our understanding of dental caries in primary and permanent dentition and various predictors using newer modeling methods such as Machine Learning (ML) algorithms and Artificial Intelligence (AI). The objective of this study is to compare the accuracy, precision, and differences between the caries predictive capability of AI vs. traditional multivariable regression techniques.MethodsThe study was conducted using secondary data stored in the Temple University Kornberg School of Dentistry electronic health records system (axiUm) of pediatric patients aged 6–16 years who were patients on record at the Pediatric Dentistry Clinic. The outcome variables considered in the study were the decayed–missing–filled teeth (DMFT) and the decayed–extracted–filled teeth (deft) scores. The predictors included age, sex, insurance, fluoride exposure, having a dental home, consumption of sugary meals, family caries experience, having special needs, visible plaque, medications reducing salivary flow, and overall assessment questions.ResultsThe average DMFT score was 0.85 ± 2.15, while the average deft scores were 0.81 ± 2.15. For childhood dental caries, XGBoost was the best performing ML algorithm with accuracy, sensitivity. and Kappa as 81%, 84%, and 61%, respectively, followed by Support Vector Machine and Lasso Regression algorithms, both with 84% specificity. The most important variables for prediction found were age and visible plaque.ConclusionsThe machine learning model outperformed the traditional statistical model in the prediction of childhood dental caries. Data from a more diverse population will help improve the quality of caries prediction for permanent dentition where the traditional statistical method outperformed the machine learning model.

Awareness and Incorporation of the Dental Home Concept Among General Dentists and Dental Therapists in Malaysia.

Background The dental home concept (DHC) refers to an approach in oral healthcare that emphasizes establishing a long-term, comprehensive, and family-centered relationship between a patient and their primary dental care. This study determined the awareness and incorporation of the DHC among general dentists and dental therapists in Malaysia. Methodology A total of 154 general dentists and 137 dental therapists providing oral healthcare services at the Ministry of Health (MOH) primary care facilities throughout Malaysia participated in this cross-sectional study. A self-administered questionnaire was used to measure the respondents' awareness of the DHC and incorporation of the DHC characteristics into their practice. Results Most dentists and dental therapists (61.7% and 67.2%, respectively) had not heard of the term DHC and were unaware of the concept. The respondents' awareness was not associated with their age, sex, years of service, facility location, and percentage of treatment given to children aged five years and below. However, most dentists and dental therapists responded positively about incorporating most DHC characteristics into their current practice. Conclusions Most dentists and dental therapists serving the MOH primary oral healthcare facilities were unaware of the DHC, although most DHC characteristics have already been incorporated into their practice. This study provides evidence of the incorporation of the DHC into the MOH primary oral healthcare services and suggests an effort to increase the awareness of the workforce regarding the concept and its implementation.

Long-term effects of motivational interviewing vs. traditional counseling on dog owners' adherence to veterinary dental home care: a three-year follow-up study.

Periodontal disease is one of the most common health issues in dogs. However, disease is largely preventable by eliminating dental plaque, best achieved by daily tooth brushing. Unfortunately, owner adherence is low to the recommendation of daily tooth brushing in dogs. This study aimed to evaluate the impact of various communication strategies, traditional advice (TA) versus motivational interviewing (MI), and compare them to a control group receiving no additional communication (CG), on dog owners' performance of dental home care and the oral health of their dogs. The study was conducted as a longitudinal clinical intervention study spanning 3 years, and involved 75 dog owners with young dogs who were randomly assigned to one of three groups: TA, MI, or CG. Intervention groups received annual telephone consultations based on their assigned methodology. A questionnaire was administered twice to all groups, and the dental health of the dogs was assessed at the study's conclusion. Tooth brushing frequency demonstrated a significant increase in the MI group compared to the CG group (p < 0.01), albeit with a relatively low occurrence of daily brushing among owners. Dental health assessment revealed a significantly lower plaque index in the MI group compared to the CG group (p < 0.05), and a lower calculus index in the TA group compared to the CG group (p < 0.01). No statistically significant differences were observed between the MI and TA groups in terms of dental health. Regular veterinary communication appears to have a positive influence on dog owner adherence to veterinary recommendations concerning dental care in dogs. Communication with veterinarians (MI and traditional advice) improved owner knowledge, attitude, and decreased frequency of not brushing. Although dental health parameters improved, the effect size was small, suggesting the complexity of adherence. Personalized calls to dog owners offer potential for dental health improvement, warranting further comparison of MI with traditional advice.

Adherence to dental home care in dogs with periodontitis: a post-treatment survey

BackgroundPeriodontitis is a common disease in dogs, and daily dental home care in the form of tooth brushing is essential for prevention and treatment. Despite this, many studies reveal low adherence to tooth brushing advice. This study aimed to assess compliance with dental home care among dogs with periodontitis and understand the factors influencing brushing routines. A questionnaire survey was emailed to 63 dog owners whose dogs had been diagnosed with periodontitis, received dental cleaning at the University Animal Hospital, Swedish University of Agricultural Sciences and were given tooth brushing instructions. The survey was supplemented by telephone interviews, resulting in a 57% response rate.ResultsThe study presents dog owners' routines, experiences, attitudes, and motivation regarding tooth brushing. Approximately 42% brushed their dogs' teeth daily while others did so less frequently or not at all. Reported challenges, such as uncooperative dogs and difficulty establishing a routine, may explain infrequent brushing.ConclusionsWhile the study suggests that owners of dogs with periodontitis tend to follow dental care recommendations better than the general dog owner population, it also reveals that preventive care is inadequate for more than half of the dogs. Given the high prevalence of periodontitis, there's a need for resources to address infrequent tooth brushing. Understanding dog owners' needs can help establish daily brushing as a routine, improving canine oral health and overall well-being.

Oral Health Care Strategies in Rural Communities: A Case Study.

Dental caries affect 97% of the world's population during their lifetime. Early childhood caries are the number one chronic disease affecting young children, and it disproportionately affects children of low-income families. American Academy of Pediatrics recommends fluoridated toothpaste to all children starting at tooth eruption, regardless of caries risk. In addition, fluoride varnish is recommended in all children every 3 to 6 months from tooth emergence until they have an established dental home. The health disparities that are most apparent in the rural communities are inadequate prenatal care, low birth weight, cancer, chronic respiratory disease, heart disease, unintentional injury, and stroke. When it comes to oral health, water fluoridation is one of the most cost-effective strategies in preventing dental caries. The need for oral health education in physician assistant/associate (PA) programs is well documented. Implementation has largely been performed using interprofessional education. This article describes an interprofessional education program that teaches PA students to apply fluoride varnish so that they are practice-ready when they graduate and practice medicine.

Knowledge and Role of Paediatricians/Paediatric Residents in Infant Oral Healthcare and Dental Home across Saudi Arabia: A Cross-Sectional Study.

The prevention of oral diseases in children is highly achievable through providing early exposure to oral healthcare habits, which would make children more receptive towards dental services. A cross-sectional study used a structured, self-explanatory questionnaire to evaluate the knowledge and role of 190 paediatricians and paediatric residents towards infant oral healthcare and the dental home across Saudi Arabia. The authors sent a link to the questionnaire, comprising 36 questions, by email, as a Google e-form. The response rate obtained was 87.36%. A major proportion (95.8%) of the respondents considered that paediatricians play an important role in promoting oral health. Around 45.8% of the practitioners recommended tooth brushing after the eruption of the first tooth. About 38% of the practitioners were unaware of the children's first dental visit. The majority (95.2%) agreed that there should be an increased awareness regarding home dental habits. Most of them (78.3%) examined the oral cavity for dental problems as a part of routine childcare, and the majority (75.3%) admitted that they did not evaluate fluoride needs. A statistically significant higher mean knowledge score was observed for practitioners with more than 30 years of experience (9.35 ± 2.29), and there was a significant positive correlation (r = 0.486) between the knowledge score and mean score for the role of paediatric practitioners. Overall, the study concluded that the knowledge of paediatricians and paediatric residents in SA towards infant oral healthcare and the dental home was inadequate, and their role in maintaining oral health was found to be moderately satisfactory.

Occurrences of Dental Diseases in Dogs in a Teaching Animal Hospital, Morogoro, Tanzania

Dental diseases are common in dogs with a prevalence of more than 80% in some breeds of dogs. They cause damage to oral health and may act as a source of bacteria causing other diseases such as endocarditis, pneumonia and arthritis. A cross section study was conducted to determine the current status on the occurrence of dental diseases in dogs attended at Sokoine University of Agriculture (SUA) Teaching Animal Hospital in Morogoro, Tanzania. A total of 87 dogs were examined macroscopically for the presence of dental diseases. Dogs examined in this study ranged from medium (93.1%) to large (6.9%) sized, and up to 73.6% were mixed-breed. The minimum and maximum ages of the dogs were 6 and 72 months, respectively, with majority being females (60.9%). The proportions of intact, spayed and castrated were 92%, 5.8% and 2.3%, respectively. Of the 87 dogs examined, 62.1% had different kinds of dental diseases. The frequently observed dental diseases were; dental deposits (43.7%), missing teeth (24.1%), periodontal disease (20.7%), dental attrition (16.1%), and dental abrasion (10.3%). Further, it was noted that none of the dogs had been previous underwent routine dental check-up or anaesthetised for dental cleaning. This study indicates that dental diseases are frequent in dogs attended at SUA Teaching Animal Hospital. Therefore, it is recommended that routine dental examination should be performed in dogs presented at the Teaching Animal Hospital. Further, there is a need for educating dog breeders and owners on the importance of dental home care.

Oral hygiene practice and home-care challenges in children with autism spectrum disorder in San Francisco: Cross-sectional study.

Autism spectrum disorder (ASD) is characterized by challenges in social interaction, communication, and stereotypical patterns of behavior. They are more likely to have tooth brushing issues and need help with routine dental care. Children with ASD could face difficulty in accessing dental care as the parents have a challenging task in finding a dentist that would treat the child with special needs. As a result, dental care is often neglected. The aims of this study are to evaluate oral hygiene practices and challenges in children with ASD and compare it with typically developing peers (TDP). The sample size of the study was 60. Parents of children aged 3-10 were recruited and divided in 2 groups with 30 in each group. Age and gender of children were matched. ASD group included children with medical diagnosis of ASD only and no other co-morbidities. Children in TDP group had no diagnosis of ASD, and reported no disability, or any other diagnosis. Parents were asked to complete the questionnaire which asked about their demographic information, child's oral care regimens, and their knowledge about dental care. Chi-squared tests and t-test were used for statistical analysis. A p-value of .05 was used for determining statistical significance. Many children with ASD (47%) had to travel more than 20 miles for their dental home compared to 13% with TDP (p<.05). Only 60% of children with ASD brushed twice a day with 70% of parents reporting that it is difficult to brush their child's teeth compared to TDP with 93% of children brush twice daily (p<.05). Significantly a smaller number of children with ASD (47%) allowed their parent to brush their teeth as compared to 93% of TSD children (p<.001). Parents of children with autism spectrum disorder travel longer distance to find a dental home and face more difficulty in maintaining their child's daily oral hygiene.

Using teledentistry as a tool for management of dental services: A systematic review

Abstract Introduction: Unlike telemedicine, which is relatively well established in the literature and practice, implementation of teledentistry and its limitations are underexplored, and more well-designed research is needed to investigate them. Aims: The aim of the present study was to evaluate and identify the scopes, challenges, and opportunities for the use of teledentistry based on high-quality literature. Materials and Methods: As a qualitative systematic review with thematic analysis, the present study included English cross-sectional, prospective, and retrospective studies about the use of teledentistry for the prevention and treatment of dental patients. A quality appraisal methodology was used to evaluate the included studies which were found from online databases, namely, Medline through PubMed, Scopus, Web of Knowledge, and Cochrane databases, from 2017 to 2022. Results and Discussion: Five studies were included and presented with fair-to-good quality of evidence. Furthermore, there was overall agreement about the effectiveness of the use of teledentistry and the great opportunities it provides for the improvement of dental services. Several scopes were identified, including education, consultation, and examination. However, challenges such as technical difficulties and accuracy of examination of certain conditions were also identified and was advised to integrate the topic of teledentistry in dental school and health-care management courses. Conclusion: Teledentistry was found not to be a substitute for the establishment of a dental home but a complementary aspect of dental service management. In addition, better-quality, well-designed comparative studies, especially those related to scopes, economic aspects, telecommunication means, legislation, licensing, and official dental reporting are needed.

Diabetic patient awareness and knowledge about the relationship between blood sugar level and oral health in the Qassim region: Survey based study

Abstract Introduction: People with uncontrolled diabetes are at significant risk of developing several oral health-related problems. Prevention and treatment of oral diseases in diabetic patients require persistent daily self-care at home and regular dental visits. Aim: The aim of this was to assess the level of knowledge and attitude of diabetic patients toward oral health in the Qassim region of Saudi Arabia. Materials and Methods: This cross-sectional, survey, and facility-based study was conducted at the Endocrine and Diabetic Center in Buraydah, Saudi Arabia. A simple random sampling technique was used and included male and female patients and excluding those with gestational diabetes. Each patient received a questionnaire containing four domains: sociodemographic data, oral health knowledge, general health knowledge, and oral health attitude. Results and Discussion: Statistical Package for the Social Sciences (SPSS) ran a detailed descriptive analysis. A sample size of 173 Saudi diabetic patients participated in this study (68 [39.3%] male and 105 [60.7%] female). Surprisingly, 75.7% did not know their diabetic type, 73.4% brush their teeth at least once daily, and 87.3% have never used interdental flossing. Just 38.2% knew diabetic patients were at a higher risk of developing oral disease. Furthermore, 19.7% have had their dentists educate them about the effect of diabetes on their oral health, and only 13.3% stated that their physicians had educated them about the relationship between diabetic status and oral health. It is paramount to ensure the role of dentists and physicians in educating patients, as most of the sample was unaware of the relationship between diabetes and oral health. Furthermore, interdental flossing is essential for dental home care and periodontium health. Most diabetic patients in this sample do not floss and must be educated about its importance. Conclusion: Integrated dental visits for diabetic patients, in coordination with their physician, may avoid further oral and general health complications.

The Patient-Centered Dental Home: A Framework for Quality Measurement, Improvement, and Integration.

This study completed the development of a standardized patient-centered dental home (PCDH) framework to align and integrate with the patient-centered medical home. This study identified measure concepts and specific measures and standards to complete the 4-level measurement framework to implement and evaluate a PCDH. This study built on prior model development, which identified the PCDH definition and characteristics and the components nested within those characteristics. An environmental scan identified existing oral health care quality measure concepts, measures, and standards for rating by the project's National Advisory Committee (NAC). A modified Delphi process, adapted from the RAND appropriateness method, was used to obtain structured feedback from the NAC. NAC members rated measure concepts on importance and, subsequently, specific measures and standards on feasibility, validity, and actionability using a 1 to 9 rating scale. Criteria for model inclusion were based on median ratings and rating dispersion. Open-ended comments were elicited to inform model inclusion as well as identify additional concepts. We identified more than 500 existing oral health care measures and standards. A structured process was used to identify a subset that best aligned with a PCDH for rating by the NAC. Four Delphi rounds were completed, with 2 rounds to rate measure concepts and 2 rounds to rate measures and standards. NAC quantitative ratings and qualitative comments resulted in a total of 61 measure concepts and 47 measures and standards retained for inclusion in the framework. The NAC ratings of measure concepts, and specific measures and standards nested within those concepts, completed the 4-level PCDH measurement framework. The resulting framework allows for the development and implementation of core measure sets to identify and evaluate a PCDH, facilitating quality improvement and dental-medical integration. Clinicians, payers, health care systems, and policy makers can use the results of this study to guide and assess implementation of the various components of a patient-centered dental home and to support dental-medical integration.

Dentists' Utilization of Caries Risk Assessment and Individualized Caries Prevention Methods in Pediatric Patients in Saudi Arabia.

The first step in any complete oral health care plan for a child is a thorough caries risk assessment (CRA). This study aimed to investigate whether the practice dentists in Saudi Arabia's Western province do CRA methods and offer Individualized Caries Prevention (ICP) to their pediatric patients. Dentists in active clinical practice in the Western province of Saudi Arabia were the participants of this cross-sectional survey. The participants in this study were chosen using a simple random sampling technique. A self-administered, structured questionnaire was used to gather participants' responses. A majority (88.2%) of the dentists agreed that it is very important to practice CRA on a regular basis among their pediatric patients. About 67% of dentists employed Individualized Caries Prevention methods. No statistically significant correlation was observed between ICP and CRA factors, indicating that interventions primarily focused on patients' financial affordability. Dentists should encourage parents/caregivers to establish a dental home concept at the earliest, which includes CRA, education, and anticipatory guidance on the prevention of oral diseases.