Routine Dental Visits Research Articles

A feasibility and acceptability study of using an intra-oral camera and an asynchronous tele-mentoring protocol to detect and identify oral lesions.

Background:To examine the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions at the dental clinics of a Federally Qualified Health Center network.Design and Methods:General Practice Residency faculty and residents completed research ethics courses and trained dentists to use intra-oral cameras at chairside to photograph oral lesions of patients at routine dental visits. These images were then uploaded into the patient electronic health records (EHRs) with attendant descriptions and an oral surgeon was notified, who reviewed the charts, placed his observations in the EHR, and communicated his findings via secure e-mail to the involved residents, who in turn contacted their patients regarding follow-up actions. Feasibility was assessed via checklists completed by provider participants and semi-structured interviews. Acceptability was assessed via brief exit interviews completed by patient participants.Results:All 12 of the dentist participants reported that they had successfully provided the tele-mentoring intervention, and that the process (from EHR data entry to interaction with the oral surgeon over findings to patient referral) was clear and straightforward. Of 39 patient participants, most strongly agreed or agreed that the use of an intra-oral camera by their dentists helped them to better understand oral cancer screening (94.9%) and that dentists answered their questions about oral cancer and were able to provide them with resources (94.8%).Conclusions:Findings support further implementation research into adapting tele-mentoring using intra-oral cameras for training dental residents to detect and identify oral lesions and educating patients about oral cancer across settings.

Professional Baseball Players’ Knowledge and Attitudes about the Dental Screening Component of Spring Training Physicals

Objectives: Professional athletes have a high prevalence of dental pathology, a low rate of routine dental visits, and a poor understanding of how these factors can affect athletic performance. The purpose of this study is to assess perceptions and behaviors of professional baseball players, specifically minor league professional baseball players (MLPB), in taking care of their oral health. Methods: Spring Training physicals were performed for MLPB players; a dental screening examination component was included. Following the dental screening, each MLPB player was asked to complete a 9-question survey anonymously and voluntarily. These questions included: (1) demographics, (2) attitude/history regarding dental exams and cleanings, and (3) the player’s perception of the dental screening program. An oral health prevention component was also incorporated, in which MLPB players were given plaque disclosing tablets, educated verbally and provided a written explanation on their purpose and usage. Data were analyzed using descriptive statistics and Chi-square tests. Results: A total of 80 MLPB players received dental screening examinations and 42 completed the survey. Players completing the survey were equally represented between Hispanic and non-Hispanic. A significant relationship existed between whether the spring training physical was the main dentist visit and the length of time since last dental exam. Whether the spring training physical was the main dentist visit was also significantly associated with the length of time since last dental cleaning. A significant relationship existed between Hispanic players and Non-Hispanic players as to a belief that preventive education was a beneficial part of the pre-participation dental screening examination. Additionally, a significant relationship was found between Hispanic players and Non-Hispanic players as to having received dental disclosing tablets for take home use (a preventive measure) following a pre-participation dental screening examination. Conclusion: The results of this study suggest that oral health professionals and professional baseball organizations should consider implementing practices whereby they can modify perceptions and activities that contribute to good oral health, especially among Hispanic minor league professional baseball players. One sentence summary: Oral disease prevention education is important for professional athletes, especially among Hispanic minor league professional baseball players.

Chairside Screening for Undiagnosed Diabetes and Prediabetes in Patients with Periodontitis.

Introduction Globally, it is estimated that half of all people with diabetes are undiagnosed. Because of the well-documented bidirectional link between diabetes and periodontitis, dentists and dental hygienists may have the possibility to screen a targeted population for diabetes during routine dental visits. The aim of the present study is to investigate the effectiveness of one device for diagnosis of diabetes/prediabetes used in one private dental practice and investigate the correlation between the levels of HbA1c and periodontal parameters. Methods Periodontal patients that were never diagnosed with diabetes were asked to fill a risk assessment questionnaire for type 2 diabetes mellitus. PD, CAL, FMBS%, FMPS%, and HbA1c through a prick-finger test were measured before and after periodontal therapy or only once in patients following supportive periodontal therapy. Results A total of 98 subjects were screened, and among them, one had diabetes and 30 had prediabetes. The mean value of HbA1c was 5.62% for patients with untreated periodontitis and 5.42% for periodontally treated patients. The diagnosis of diabetes resulted to be correlated to FMBS% and FMPS%, while HbA1c levels were correlated to FMBS%, FMPS%, and periodontitis grade. Conclusion The present chairside diabetes-screening protocol allowed a consistent proportion of patients to become aware of their pathological or prepathological condition and to seek proper and timely medical care. Thus, dentists and dental hygienists could provide health promotion services and preventive measures.

Opioid Prescribing by Dentists in the Veterans Health Administration

Nonopioid analgesics are more effective for most oral pain, but data suggest that dental prescribing of opioids is excessive. This study evaluates the extent to which opioids exceed recommendations and the characteristics associated with opioid overprescribing by Veterans Health Administration dentists. This was a national cross-sectional study of Veterans' dental visits from 2015 to 2018. Overprescribing was defined per national guidelines as >120 morphine milligram equivalents (primary outcome). The association of dental visit and patient demographic and medical characteristics was modeled with overprescribing (defined as >120 morphine milligram equivalents) using Poisson regression with clustering by facility and patient. A secondary analysis assessed opioid prescriptions >3 days' supply. The dates of analysis were January 2020‒May 2021. Of the 196,595 visits, 28.7% exceeded 120 morphine milligram equivalents. Friday visits and people with chronic oral pain or substance misuse were associated with a higher prevalence of overprescribing. Women, older Veterans, and Black and Latinx Veterans were less likely to be overprescribed than men, younger Veterans, and White Veterans, respectively. Routine dental visits had a higher prevalence of opioid overprescribing than invasive visits. Opioid overprescribing decreased over time. White Veterans were more likely to receive oxycodone and hydrocodone, whereas people of Black race and Latinx ethnicity were more likely to receive codeine and tramadol. In the secondary analysis, 68.5% of opioid prescriptions exceeded a 3-day supply. Nearly 1 in 3 opioids prescribed by Veterans Health Administration dentists exceed guidelines. Prescribing higher potency and quantities of opioids, especially on Fridays and to certain demographic groups, should be addressed as part of dental opioid stewardship programs.

Generalized Anxiety Disorder and Its Relationship with Dental Anxiety among Pregnant Women in Dammam, Saudi Arabia.

Objective To assess the relationship between generalized anxiety disorder (GAD), dental anxiety (DA), and other factors among pregnant women. Methods The Generalized Anxiety Disorder (GAD-7) scale and the Modified Dental Anxiety Scale (MDAS) were used to evaluate GAD and DA, respectively. Hard copies of self-administered questionnaires were distributed among 780 pregnant women attending hospitals/health centers in Dammam, Saudi Arabia. Results About 31.7% of the participants demonstrated minimal anxiety, 37.9% mild anxiety, 19.7% moderate anxiety, and 10.6% severe anxiety. The mean GAD score of the sample was 7.53 ± 5.16 which differed significantly among women in the first (7.74 ± 5.47), second (6.82 ± 4.64), and third trimesters (8.13 ± 5.37) (P=0.029). Pregnant women who performed routine dental visits demonstrated lower GAD (6.98 ± 5.23) than those who visited dentists for consultation, pain, or treatment (7.58 ± 5.07). The mean GAD score was significantly higher among participants with dental pain or discomfort during the last 12 months (8.12 ± 5.05) than among those without pain or discomfort (7.02 ± 5.2) (P 0.003). Similarly, the participants with DA showed a significantly higher mean GAD score (7.69 ± 5.17) than those without DA (5.93 ± 4.71) (P 0.006). Multivariate linear regression showed that GAD significantly correlated with DA (B = 0.225, P < 0.001). Conclusion In the present study, GAD was common among pregnant women which significantly correlated with DA. Pregnant women with DA and dental pain demonstrated high GAD. Preventive and therapeutic measures should be taken to reduce GAD and DA during pregnancy.

Statistical Significance was observed for the Responses between the Participants about Knowledge, Attitude and Practice toward the Effect of Diabetes on Oral Health among adults living with diabetes in Makkah City

Abstract: Background: Diabetes mellitus is one of the most common metabolic diseases. In addition to its several effects on general health, it also has a specific effect on oral health. Methods: This comparative cross-sectional study design was conducted at governmental primary health care centers in Makkah, Kingdom of Saudi Arabia. The sample size was 222 of adults living with diabetes. The data was collected by a structured survey that included close-ended questions. The data was entered and analyzed by using multiple software programs. Results: A total of 222 Diabetic patients 112 males (50.5%) of them and 110 females (49.5%), consisting of 176 (79.3%) Type 2 Diabetes and 30 (13.3%) Type 1 while there are 14(6.3%) patients did not know their diagnosis of type of diabetes. A response rate of 100% was observed, 79.7% reported that have knowledge about the effect of DM on general health while only 43.2% reported that have Knowledge about the effect of DM on oral health. 88.7% of total diabetic patients regularly Brush their teeth, on the other hand, only 33.3% reported that they do regular flossing. 84.2% of participants know the importance of routine dental visits. However, 14.9% of them go for a regular checkup while 82.2% visiting their dentist only when having dental problems. Conclusions: Diabetic patients need properly designed oral health education and screening programs to increase their knowledge and attitude toward oral health and prevent diabetic complications on oral health.

Oral Health and Patterns of Dental Visits Among Diabetic Patients in the Eastern Province of Saudi Arabia.

PurposeDiabetes is a big public health threat in Saudi Arabia. However, there is limited evidence about dental problems, oral hygiene practices, and dental visits among diabetic patients. The study aimed to evaluate self-perceived oral health status and patterns of dental attendance among diabetic patients in the Eastern province of Saudi Arabia.MethodologyThis cross-sectional study included 486 diabetic patients (mean age 50.14±13.59 years) registered with the Saudi Diabetes Society, Saudi Arabia (October–November 2020). The World Health Organization’s oral health questionnaire for adults was administered to collect information about oral health status, oral hygiene practices, and dental attendance, in addition to sociodemographic data. Descriptive and analytical statistics were performed.ResultsMost participants (66.3%) reported having dental pain or discomfort during the last year. Bad breath (60.50%), tooth cavities (55.10%), difficulty in biting hard food (55.10%), tooth sensitivity (53.30%), and bleeding gums (52.90%) were common oral problems among participants. More than half the sample (55.1%) reported visiting the dental office during the last year. However, pain or trouble with teeth, gums or mouth was the most common (40.5%) reason for the last dental visit. Only 7.8% of participants visited the dentist for a routine dental check-up. Multiple logistic regression analysis showed that Saudi nationality (AOR 2.68, P 0.008), family history of diabetes (AOR 1.88, P 0.022), and having pain during the last year (AOR 4.01, P <0.001) were the significant factors associated with the last dental visit due to pain.ConclusionThis sample of participants demonstrated a high prevalence of dental problems. Few participants performed routine dental visits and most visits were due to pain. Saudis and patients with family history of diabetes and dental pain were more likely to perform pain related dental visits. Multidisciplinary efforts are needed to develop and implement preventive educational and clinical care models for positive oral and general health outcomes.

Oral Health Status, Oral Hygiene Practices, and Factors Affecting Dental Treatment Utilization among Pregnant Women in Dubai

Objective: Oral health is an integral part of preventive healthcare for pregnant women. This study aimed to determine the oral health problems and oral hygiene practices and identify the factors affecting dental treatment utilization among a representative population of pregnant women in Dubai. Methods: A cross-sectional study was conducted using data from anonymous structured questionnaires filled by 1,450 pregnant women attending primary health centers across different geographical locations in Dubai. Results: Of the 1,450 women, 97.8% brushed at least once a day. At least one dental problem during pregnancy was reported by 49.9%, but dental attendance during pregnancy was only 17.4%. Factors associated with dental visits were nationality, previous pregnancy, oral health problems, brushing habits, routine dental visits, and professional advice on oral care. The odds of dental attendance increase for UAE national women by 1.48, women who had other children before the current pregnancy by 1.35, those having oral health problems by 1.85, those who brush more than once a day by 1.51, those who visited the dentist routinely at least once a year by 1.92, and those who received oral health education by 2.82. The most cited reasons for not going to the dentist were no perceived dental problem (51.8%) and concerns regarding the safety of dental treatment during pregnancy (33.9%). Discussion/Conclusion: In spite of acceptable oral hygiene practices, a significant number of pregnant women (49.9%) experience dental problems. However, only a few women (17.4%) visit the dentist during their pregnancy. It is critical to design and implements strategic oral health programs for pregnant women in Dubai.

A deep learning approach to automatic gingivitis screening based on classification and localization in RGB photos

Routine dental visit is the most common approach to detect the gingivitis. However, such diagnosis can sometimes be unavailable due to the limited medical resources in certain areas and costly for low-income populations. This study proposes to screen the existence of gingivitis and its irritants, i.e., dental calculus and soft deposits, from oral photos with a novel Multi-Task Learning convolutional neural network (CNN) model. The study can be meaningful for promoting the public dental health, since it sheds light on a cost-effective and ubiquitous solution for the early detection of dental issues. With 625 patients included in this study, the classification Area Under the Curve (AUC) for detecting gingivitis, dental calculus and soft deposits were 87.11%, 80.11%, and 78.57%, respectively; Meanwhile, according to our experiments, the model can also localize the three types of findings on oral photos with moderate accuracy, which enables the model to explain the screen results. By comparing to general-purpose CNNs, we showed our model significantly outperformed on both classification and localization tasks, which indicates the effectiveness of Multi-Task Learning on dental disease detection. In all, the study shows the potential of deep learning for enabling the screening of dental diseases among large populations.

Oral Health Behaviours, Knowledge and Attitudes Among Dental College Students in Sulaimani City, Iraq

Objectives: The present study aimed to investigate the oral health behavior, knowledge, and attitudes of dental college students. &#x0D; Methods: A self-assessment questionnaire was used in this study. Participants were divided into two groups according to their level of study (pre-clinical and clinical). &#x0D; Results: A total of 140 students participated in the study, with 79(56%) pre-clinical and 61(44%) were at the clinical levels. The majority of students reported brushing their teeth (90.7%) with no association between toothbrushing behavior and gender or level of study (P&gt;0.05). The most common tooth brushing frequency was twice daily with no gender association (P&gt;0.05), and a higher percentage of students at clinical levels of the study reported brushing their teeth more than twice daily (P&lt;0.05). The majority of students reported using fluoridated toothpaste (60.7%). In total, about half of the students reported using dental floss with a significant association with the level of study (P&lt;0.01). Tongue cleaning was reported by 69.3% of the students, and about half of the students reported using mouthwashes, and one-fourth of the students reported using Miswak. In total, about half of the students reported their oral health status as “Good”. Routine dental visits and the level of the study were significantly associated (P&lt;0.01). &#x0D; Conclusions: Noticeable differences in oral health behaviors could not be concluded on a statistical basis. Nevertheless, there were areas of oral health behaviors where increased knowledge showed an improvement in health behavior. It is recommended that preventive programs, including self-care regimes, be started from the first year of dental education.

The Impact of Connecticut's Paid Sick Leave Law on the Use of Preventive Services

Paid sick leave laws have received more attention in recent years as a way to improve public health. This study estimates the impact of paid sick leave laws on the use of preventive services using a quasi-experimental design created by the implementation of Connecticut's paid sick leave law in 2012, the first statewide mandate in the U.S. Data were obtained from the 2007-2018 Behavioral Risk Factor Surveillance System. The analyses were conducted from spring 2018 to fall 2019. This study applied a difference-in-differences model to examine preventive service use (routine checkups, influenza vaccinations, dental visits, Pap tests, mammograms, and clinical breast examinations) in Connecticut and other New England states before and after the implementation of Connecticut's paid sick leave law in 2012. The use of preventive services increased in Connecticut compared with other New England states after implementation of Connecticut's paid sick leave law. Specifically, the rate of routine checkups (2.7 percentage points, p<0.001), influenza vaccinations (2.1 percentage points, p<0.01), dental visits (2.3 percentage points, p<0.01), and Pap tests (2.6 percentage points, p<0.01) increased compared with other New England states. This study found that adult workers' use of preventive services increased in Connecticut after implementation of its paid sick leave law. State-paid sick leave laws can improve public health by supporting the use of preventive care services among workers.

Influence of COVID-19 pandemic on paediatric dental attendance

ObjectivesThis retrospective study aimed to evaluate the effect of COVID-19 pandemic on dental attendance and emergency/non-emergency visits of children during the outbreak, compared to the same period of 2019.Materials and methodsPatients who visited the paediatric department clinic during the observed period were included in this study. The patient’s demographic data, purpose of visit, and treatment type were evaluated retrospectively from patient examination records. The Pearson chi-square and t-tests were used for comprehensive statistical analysis.ResultsA total of 1454 patient files (1184/270 cases from non-pandemic/pandemic period) were assessed. A significant reduction was found in aggregated emergency/non-emergency visits during the pandemic period (p < 0.01). During the pandemic, average daily visits for emergency dental care were observed to have a decrease to half of the non-pandemic period. Non-emergency routine dental visits have also exhibited a drastic decline. Severe dental pain due to pulpal inflammation and abscess/swelling were the most frequently reported urgent dental complaints that patients applied to the paediatric dental clinic during the pandemic period.ConclusionCOVID-19 pandemic has a significant influence on patients’ attendance to paediatric dental clinic. Therefore, concerning a potential post-pandemic increase in treatment demand, meticulous future planning and proper regulation of dental care should be provided for better oral health and children’s quality of life.Clinical relevanceThis study’s importance is the observation of dramatically reduced number of patient visits during the pandemic period which may yield increased number of oral health-related complications in the long run.

Dental Visits and Predictors of Regular Attendance Among Female Schoolchildren in Dammam, Saudi Arabia.

PurposeRegular dental visits are important for the maintenance of optimal oral health and improved quality of life. The purpose of the study was to evaluate patterns of dental visits and factors associated with routine dental attendance among female schoolchildren in Dammam, Saudi Arabia.Patients and MethodsThis cross-sectional study was performed on 449 female primary schoolchildren (6–11 years old) in Dammam, Saudi Arabia. The study included clinical examination for decay in the first permanent molars in children and questionnaire administration among their parents. The World Health Organization’s oral health questionnaire was used to collect data about children’s dental visits, oral hygiene behaviors, dental problems, and dietary practices. Bivariate and multivariate analyses were performed to evaluate factors associated with routine dental visits.ResultsMost children (64.1%) visited the dentist during the past one year, 22.1% performed no dental visit during the past one year, and 8.3% never visited the dentist. Among children who visited the dentist, the pain was the most common reason for dental visits (39.10%, N=170), followed by routine dental check-ups (18.60%, N=81). In bivariate analysis, education of parents, family income, daily tooth brushing, no decay in the first permanent molar, no toothache, no consumption of soft drinks, biscuits, cakes, and cream were significantly associated with routine dental attendance (P <0.05). However, the final logistic regression model showed that university education of mothers (OR 2.52, P = 0.005), not having toothache or discomfort (OR 2.88, P = 0.001), tooth brushing once or twice daily (OR 2.43, P= 0.034), and not consuming soft drinks (OR 1.96, P= 0.027) were significant predictors of routine dental visits.ConclusionThe study found that higher education of mothers, daily tooth brushing, not having dental pain, and not consuming soft drinks were significantly associated with routine dental visits in this sample of female schoolchildren. Routine dental attendance may be used to improve oral hygiene and reduce dental pain and consumption of soft drinks in children.

Oral health practice and health-related quality of life of a group of children during the early stage of the COVID-19 pandemic in Istanbul.

BACKGROUND:During the pandemic period of coronavirus disease, appropriate oral health management and disease prevention of children are very important for children's oral and general health. The aim of this study was to survey to better understand in children's dental health and dietary habits and to learn about parents' attitudes toward dental treatment and clinical factors associated with their QoL using the Turkish version of KIDSCREEN-10 during the initial stage of the COVID-19 pandemic in the general public.MATERIALS AND METHODS:A two-part questionnaire, namely Part 1 addressed topics regarding changes in general and dental health, dietary habits of children under quarantine, and sociodemographic characteristics of the family and Part 2 impact of QoL was assessed by the KIDSCREEN-10 scale with 10 questions. The questionnaire was sent online using WhatsApp to a convenience sample of mothers with children between the age group of 8 and 18 years, who lived in Istanbul. Variables were statistically analyzed using the Student's t-test for independent samples and Univariate F-test, ANOVA according to the characteristics of variables which were analyzed.RESULTS:This study included 328 from 557 mothers with 58% respondent rate. The consumption of fast food, packaged food, and carbonated beverages decreased during the COVID-19 outbreak. Half of the mothers of children reported that they were anxious or fearful about their children visiting dentists during the pandemic and 64.2% of the children missed routine dental visits. The KIDSCREEN-10 scores for 13 years old or older children were influenced more by the COVID-19 pandemic than those for the 8–12 years old, who had a better QoL (P = 0.008).CONCLUSIONS:The results of this study emphasize the importance of oral health and QoL of children during the initial phase of the COVID-19 outbreak. The general perception of QoL in this group of Turkish children seemed to be substantially affected by COVID-19 outbreak.

Psychological impact and patient perception of occlusion and orthodontic treatment in periodontitis patients

Background: This study analyzed, in patients with periodontitis, the impact of the degree of self-perceived malocclusion, the experienced negative psychosocial impact of periodontitis, and the history and timing of orthodontic treatment. Methods: For the study were enrolled 54 patients undergoing a routine dental health visit. They answered the Negative Impact of Dental Aesthetics Scale (NIDAS), the Perception of Occlusion Scale (POS). Moreover, undergoes to the Approximal Plaque Index (API), the Gingival Bleeding Index (GBI), and the number of decayed teeth (DT) and missing teeth (MT). All data were analyzed using different statistical procedures. Results: The subjects ranging within the upper POS quartile scored higher on the GBI (contrast: P= 0.037) and DT (P= 0.028) than did those in the lower POS quartiles. Different to the patients who had minor negative impacts in the NIDAS, those with strong impacts had higher scores on the API (P<005). Compared to patients without previous orthodontic treatment, those with a history of orthodontic treatment lasting 24 months had a lower API (P <0.05), GBI and DT (each P = 0.008) scores. Conclusion: The present results suggest that self-perceived dental irregularity and the negative impact of periodontitis might affect oral health, whereas previous extensive orthodontic treatment may have favourable effects by improving dental health compliance.

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.

Association Between Self-Reported Dental Hygiene Practices and Dental Procedure-Related Recurrent Angioedema Attacks in HAE Subjects: A Multicenter Survey

Hereditary angioedema (HAE) symptomsmay be triggered by dental procedures, therebycomplicatingdental care in individuals affected by thecondition. This study investigated the self-perceived dental care needs, perceived susceptibility to acute angioedema (AE) attacks after dental procedures, and dental care behavior of patients with HAE. A self-administered semistructured web-based questionnaire was distributed to 250 adult patients with HAE (type 1 or 2; 88% type 1) and 256 matched non-HAE controls. Data were analyzed using stratified χ2 tests, logistic regression, and classification trees. A total of 46.4% of HAE versus 55.5% of control patients had dental visits within 6 months (P= .04). Dental insurance was a barrier to seeking routine dental visits among both groups. However, significantly fewer patients with HAE had routine dental visits within 6 months despite having dental insurance compared with control patients (48% vs 60%, P=.01). Within the HAE group, a significantly greater number of patients with dental visits at intervals greater than 6 months had a history of recurrent postprocedural AE attacks (odds ratio [OR]: 3.9 [1.7, 8.8], P= .0005) and used antibacterial toothpaste more frequently than those without recurrent AE attacks (OR: 4.7 [1.5, 15.4], P= .005). These data support the hypothesis that patients with HAE who are predisposed to having AE episodes in response to medical or physical trauma visit the dentist less and engage in specific oral hygiene practices more frequently than matched control patients and patients with HAE who reported that they were less likely to swell after a dental procedure.

Feasibility and acceptability of an oral pathology asynchronous tele-mentoring intervention: A protocol.

Introduction: Oral cancer remains prevalent, despite being largely preventable. The widespread use of technology at chairside, combined with advances in electronic health record (EHR) capabilities, present opportunities to improve oral cancer screening by dentists, especially for disadvantaged patients with severe health needs.Design and methods: Using a mixed-methods approach, we will evaluate the feasibility and acceptability of integrating a telementoring component into the identification of oral lesions using the following 3 methods: 1) administering provider surveys that consist of a checklist of 10 key components of the intervention based on process, and asking the dental provider subjects if each one was covered; 2) conducting semi-structured interviews informed by the Consolidated Framework for Implementation Research and the Implementation Outcomes Framework with dental resident subjects to assess specific barriers to sustaining the intervention and strategies for addressing these barriers to facilitate integration of the intervention into the routine workflow of the dental clinics; and 3) administering brief exit interviews with patient subjects regarding the acceptability of the intervention to assess satisfaction with the use of intra-oral cameras at chairside to screen for and refer patients with oral lesions and identification of these oral lesions via EHR and secure e-mail tele-mentoring with an oral pathology expert.Expected impact of the study for public health: If successful, then later clinical trials will maximize the external validity of the intervention and facilitate the widespread implementation and dissemination of the model for the teaching of dentists and residents, with the ultimate goal of improving patient care.Significance for public healthThis protocol demonstrates how to utilize implementation science methods to conduct a feasibility and acceptability study designed to integrate a tele-mentoring component into the identification of oral lesions at the 6 dental clinics of a Federally Qualified Health Center in Brooklyn, NY. It provides a model for embedded implementation research in a low-resource setting that may be adapted for diverse community health centers throughout the United States and the Caribbean. The study will evaluate whether or not the use of intra-oral cameras and a tele-mentoring component that facilitates consultation with an oral pathology expert aids in the detection and identification of oral lesions during routine dental visits.

Prevalence of and Changes in Tooth Loss Among Adults Aged ≥50 Years with Selected Chronic Conditions - United States, 1999-2004 and 2011-2016.

Extensive tooth loss can lead to poor diet resulting in weight loss or obesity (1). It can also detract from physical appearance and impede speech, factors that can restrict social contact, inhibit intimacy, and lower self-esteem (1). Chronic medical conditions and oral conditions share common risk factors (2). Persons with chronic conditions are more likely to have untreated dental disease, which can result in tooth loss. Three measures of tooth loss during 1999-2004 and 2011-2016 were estimated by comparing data from the National Health and Nutrition Examination Survey (NHANES) for each period among adults aged ≥50 years with selected chronic conditions.* The three measures were 1) edentulism (having no teeth); 2) severe tooth loss (having eight or fewer teeth) (3); and 3) lacking functional dentition (having <20 teeth out of 28, which is considered a full set for the purpose of NHANES assessments) (4). During 2011-2016, prevalences of edentulism and severe tooth loss were ≥50% higher among adults with fair or poor general health, rheumatoid arthritis, asthma, diabetes, emphysema, heart disease, liver condition, or stroke than among those with those adults without the chronic condition. Lack of functional dentition was also more prevalent among adults with chronic conditions than among persons without these conditions. Tooth loss is preventable with self-care and routine dental visits (1). To encourage these behaviors, public health professionals can educate the public about the association between having a chronic condition and tooth loss, and primary care providers can educate their patients about the importance of healthy behaviors and screen and refer them for needed dental care.

Regular dental attendance and periodontal health knowledge: A cross-sectional survey.

To explore dental clinics' performance on periodontal education by comparing knowledge about periodontal health of regular and inconsistent dental attenders. A population-based study with a cross-sectional design was performed in Galicia (Northwestern Spain). Participants were randomly selected from 16 different areas and a questionnaire applied face-to-face. The survey included items on socio-demographic features, habits and routines, periodontal status and periodontal health knowledge. Participants were grouped according to the median of overall knowledge, and a logistic regression analysis was performed to explore the relationship between good periodontal knowledge and frequency of dental visits. A total of 8,206 individuals were invited to enter the study, and 3,553 of them accepted the invitation (43.3%). Most participants (59.3%; n=1,945) fit within the regular dental attenders' group. Younger women holding a university degree and visiting their dentist regularly elicited higher knowledge about periodontal health. Regular use of dental services increased the chances of being in the higher knowledge group (OR: 1.67; 95% CI: 1.40-2.00). Reported regular dental attendance is related to periodontal health knowledge. Specific interventions for promoting tailored patient education on periodontal topics during routine dental visits may have a positive effect on laypersons' knowledge about periodontal health.