Trends in preventive care: caries risk assessment and indications for sealants.
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BACKGROUND: In the 21st century, risk assessment models will continue to be developed. By understanding patients' susceptibility to disease, better treatment and preventive regimens can be offered. As the causative agent of dental caries is bacterial, the interaction between the susceptible host, the causative agent and the environment determine whether caries occurs--regardless of the patient's age. CLINICAL IMPLICATIONS: This article reviews risk assessment for dental caries and the implication for developing preventive strategies. It also describes the indications and uses of sealants in the prevention of dental caries. (+info)
Disease activity and need for dental care in a capitation plan based on risk assessment.
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This article describes a capitation model of care which would stimulate both dentists and patients to apply existing preventive knowledge. (+info)
A "health commons" approach to oral health for low-income populations in a rural state.
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Oral health needs are urgent in rural states. Creative, broad-based, and collaborative solutions can alleviate these needs. "Health commons" sites are enhanced, community-based, primary care safety net practices that include medical, behavioral, social, public, and oral health services. Successful intervention requires a comprehensive approach, including attention to enhancing dental service capacity, broadening the scope of the dental skills of locally available providers, expanding the pool of dental providers, creating new interdisciplinary teams in enhanced community-based sites, and developing more comprehensive oral health policy. By incorporating oral health services into the health commons primary care model, access for uninsured and underserved populations is increased. A coalition of motivated stakeholders includes community leaders, safety net providers, legislators, insurers, and medical, dental, and public health providers. (+info)
Impact of targeted, school-based dental sealant programs in reducing racial and economic disparities in sealant prevalence among schoolchildren--Ohio, 1998-1999.
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Despite the availability of highly effective measures for primary prevention, dental caries (tooth decay) remains one of the most common childhood chronic diseases. When properly placed, dental sealants are almost 100% effective in preventing caries on the chewing surfaces of first and second permanent molarteeth. However, sealants remain underused, particularly among children from low-income families and from racial/ethnic minority groups. Schools traditionally have been a setting for both dental disease prevention programs and for oral health status assessment. To determine the prevalence of dental sealant use among third grade students from schools with and without sealant programs, during the 1998-99 school year, the Ohio Department of Health conducted an oral health survey among schoolchildren. This report summarizes the results of this survey, which indicate that targeted, school-based dental sealant programs can substantially increase prevalence of dental sealants. Providing sealant programs in all eligible, high-risk schools could reduce or eliminate racial and economic disparities in the prevalence of dental sealants. (+info)
Impact evaluation of an oral health intervention amongst primary school children in Ireland.
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A pilot oral health programme was developed which aimed to improve dental health knowledge and behaviour amongst Irish school children aged 7-12 years. The programme comprised two integral components: a television campaign, run over a 6-week period, was incorporated into the children's programme 'Den TV' on national television, with video clips of a member of the music band Boyzone promoting key oral health messages; and a Smile of the Year contest. Concurrently, a dental nurse delivered an interactive talk with pupils, showed a video of the Den TV oral health programme and distributed posters and leaflets. The aim of this study was to assess the impact of the overall intervention on school pupils' dental health knowledge and reported behaviour. Thirty-two primary schools in two health board regions in the Republic of Ireland participated in the study. At baseline and after 6 weeks, 1534 school children completed specially developed questionnaires. There was a positive net effect of the dental nurse intervention in all but one question. The percentage of children who reported using the recommended amount of toothpaste and brushing for 3 min appeared to have been further increased having observed the television campaign. These results are in line with the argument that mass media campaigns work to supplement the one-to-one activities of health professionals in order to effect knowledge and behavioural change. (+info)
Sociocultural influences upon preventive health behavior and attitudes towards dentistry.
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One hundred eighty adults who presented for general dental care at an urban dental school clinic were interviewed and given epidemiological screening examinations. The findings presented include a profile of a clinic population with respect to ethnic identity, family income, education, nuclear family structure, and residence. The two major racial groups (black and white) are found to have highly significant differences in their perception of dental services and their experiences with dental disease and treatment. An assessment of dental health status indicates that whites were more likely to have filled teeth, and blacks, decayed or unfilled teeth. This relates to different patterns in seeking recent preventive dental services and a marked disparity in utilization early in life. Fear and anxiety about dental care, degree of orientation towards prevention and differences in exposure to preventive information varied with race. Consumerist orientation is examined in terms of willingness to criticize services, be cared for by auxiliary health workers and accept professional fees. The identification of diversity in perception and values with respect to dental health care is characterized as an element in developing understanding between providers and consumers. (+info)
Genetics in dental practice: social and ethical issues surrounding genetic testing.
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It is evident that human genetic variation is associated with many if not all human diseases including the more prevalent chronic diseases. As a result, genetics is becoming integrated into health care in all medical specialties, including oral medicine and its specialties. At the level of public health, genetic information will become increasingly important in research, policy, and program development. As application of genome technologies moves from the research laboratory to the clinical setting, a complex array of challenges will face dental clinicians in their efforts to use genetic information to improve health care and prevent disease on an individual, family, and community level. The broader social, ethical, and legal implications raised by the clinical use of genomic information have not received the same attention as did recent gene identification aspects of the Human Genome Project. The goal of this review is to foster attention and dialogue within the dental community of the ethical and social issues emerging from the availability of genetic information. Specific areas addressed include genetic testing, confidentiality, discrimination, informed consent, risk communication, and professional education. (+info)
Kids get care: integrating preventive dental and medical care using a public health case management model.
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Kids Get Care is a public health-based program in the Seattle area designed to ensure that low-income children, regardless of insurance status, receive early integrated preventive medical, dental, and developmental health services through attachment to medical and dental homes (the usual sources of medical or dental care). The oral health component of the program focuses on cross-training medical and dental providers, providing partner medical clinics with a case manager, and educating staff in nearby community-based organizations about how to identify incipient dental disease and possible early childhood developmental delays. The program identifies a local, well-respected dentist to champion the delivery of oral health screening within a medical clinic and to provide oral health training to medical clinic staff. The program works with community agencies to educate families on the importance of healthy baby teeth, routine dental care beginning at age one, and general prevention. In its first year, the program trained 355 community staff and 184 primary care providers on how to conduct an oral health assessment. These staff and providers screened more than 5,500 children for oral health problems. One medical clinic more than doubled the number of fluoride varnishes it provided, increasing from 80 to 167 during a nine-month pilot phase. Other outcome studies are in progress. (+info)