Ana Karina Mascarenhas

The association between Viadent use and oral leukoplakia.

Recently, leukoplakia of the maxillary vestibule was described in patients with no traditional risk factors but who had used Viadent® products. We designed a case-control study to evaluate the hypothesis that Viadent® users were more likely to have lesions. One hundred and forty-eight cases and controls were identified through the Section of Oral and Maxillofacial Pathology. Cases and controls were administered a questionnaire about Viadent® use and other known risks. Results of crude, stratified, and logistic regression analyses showed that use of Viadent® products was a risk indicator for leukoplakia (adjusted OR = 9.7, 95% CI = 4.7–21.6), with a strong dose-response relation.

Low positive predictive value of the oral brush biopsy in detecting dysplastic oral lesions

The authors evaluated the effectiveness of the oral brush biopsy technique as a diagnostic tool in detecting dysplastic oral lesions.

Factors associated with utilization of care for oral lesions in HIV disease

OBJECTIVES The purpose of this study was to examine factors associated with utilization of care for oral lesions in people with HIV disease. STUDY DESIGN The data were derived from 1424 adults who participated in a series of up to 4 interviews as part of the AIDS Cost and Service Utilization Survey. Treatment for thrush, oral sores, and other conditions was evaluated through use of logistic regression, with generalized estimating equations being applied. RESULTS In all, 9.1% of those in the study sample reported being treated. After adjusting for CD4 cell count and other variables, regression analyses indicated that blacks (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.32-0.91) and Hispanics (OR, 0.59; 95% CI, 0.36-0.98) had significantly lower odds of reporting being treated. Respondents with more than a high school education (OR, 1.64; 95% CI, 1.08-2.51), clinical trial participants (OR, 1.92; 95% CI, 1.27-2.90), and those receiving counseling (OR, 2.22; 95% CI, 1.60-3.09) were more likely to report being treated. CONCLUSIONS Utilization of care for oral lesions is very low. Educational and racial differences exist among those respondents who received care for HIV-associated oral lesions.

Effectiveness of Fissure Sealant Retention and Caries Prevention with and without Primer and Bond

Objective: This study evaluated the effectiveness of sealant retention and caries prevention with and without primer and bond below the fissure sealant among Kuwaiti schoolchildren. Subjects and Methods: This clinical trial used fissure sealant that was applied to four sound first permanent molars on 78 children. All the teeth were cleaned with pumice and rubber cups, isolated with rubber dams, and etched for 20 s. In a split-mouth study design, for the test teeth (n = 156), primer and bond (3M Scotchbond Multi-Purpose Plus System primer and bond) were applied below the sealant, and for the control teeth (n = 156), only sealant (Delton Plus) was applied. The number of tooth surfaces included was 480. Due to loss to follow-up, only 60 children were evaluated at 5 years for sealant retention and caries. The evaluation criteria were: completely retained sealant, complete or partial sealant retention, and caries. Results: In teeth sealed with primer and bond, 47 (19.6%) tooth surfaces had completely retained sealant, 60 (9.2%) teeth had partially retained sealant, while in 51 (21.3%) caries was prevented and 120 (50%) tooth surfaces were carious or filled. In teeth sealed without primer and bond, 25% (60 tooth surfaces) had completely retained sealant, 6% (14 teeth surfaces) had partially retained sealant, 26% (54 teeth surfaces) showed caries prevention, and 49.6% (119 tooth surfaces) were carious or filled. There was no difference between teeth sealed with primer and bond (120 teeth) and teeth sealed without primer and bond (120 teeth) in completely retained sealant (p = 0.15), complete or partial sealant retention (p = 0.6), caries prevented (p = 0.37), and caries (p = 0.93). Conclusion: Caries prevention was not enhanced in teeth sealed with primer and bond sealant compared with those sealed with sealant alone.

High Fluoride Concentration in Drinking Water May Increase the Prevalence and Severity of Dental Fluorosis, and Decrease Occurrence of Caries

Article Title and Bibliographic Information Dental Fluorosis and Dental Caries among 12-Year-Old Children from High- and Low-Fluoride Areas in Lithuania Narbutaite J, Vehkalahti MM, Milciuviene S. Eur J Oral Sci 2007;115:137-42 Level of Evidence Strength of Recommendation not needed. Purpose/Question To investigate the prevalence and severity of dental fluorosis, and the occurrence of dental caries, among 12-year-old children from high- and low-fluoride areas in Lithuania. Source of Funding Information not available. Type of Study/Design Retrospective Cohort Study

Developing a flexible core Dental Public Health curriculum for predoctoral dental and dental hygiene schools.

OBJECTIVE The curriculum for graduating dental and dental hygiene students must prepare them to contribute to the improvement or maintenance of health for individual patients and the publics health. The objective is to describe the background for and the process used to develop a core Dental Public Health Curriculum for such students. METHODS The process used was to solicit and review existing dental public health curriculum in dental and dental hygiene schools; review curriculum for other health professionals; identify the themes needed to frame the curriculum; select usable materials and identify gaps in existing curricular materials; and develop appropriate curriculum materials that would embody the competencies developed for undergraduate dental and dental hygiene education. RESULTS Twenty-three topics were identified as embodying the eight competencies. Based on these topics, six courses, Principles of Dental Public Health, Evidence-Based Dentistry, Ethics and Dental Public Health, Dental Public Health Policy and Advocacy, Oral Health Promotion and Disease Prevention, and Oral Health Literacy and Dental Public Health, were prepared. Each course includes syllabus, PowerPoint presentations, student assignments and activities, instructor guide, and classroom discussion points. Depending on the hours available in the existing curriculum at the dental or hygiene school, lecture presentations and take home assignments/discussions may be used independently or in combination with presentations from other courses. In addition, individual discussions and activities may be used to integrate dental public health materials into other courses. CONCLUSION A flexible curriculum is available at the AAPHD website to enable the incorporation of DPH topics into the curriculum.

Children's Utilization of the U.S. Military Dental Insurance

OBJECTIVES The objectives of this study were to determine the dental utilization of children enrolled in a military dental insurance program and to assess if utilization differs by socioeconomic status. METHODS Claims data for children enrolled in the Department of Defense TRICARE Dental Program for the period of February 1, 2010 through January 31, 2011 were used to identify children who had a dental visit during that benefit year. RESULTS Of the 376,681 continuously enrolled children, 266,862 (71%) had at least one dental visit during the benefit year. 82.7% of children of officers had a dental visit, as compared to 66.4% of children from enlisted families. There was a difference in dental utilization based on the military rank of the sponsors (χ(2) = 8,939.39, df = 1, p < 0.0001). Children of officers were 2.5 times (95% confidence intervals = 2.44-2.61), and children of warrant officers were 1.6 times (95% confidence intervals = 1.51-1.74) more likely to have a dental visit than children from enlisted families. The results also show utilization trends within the enlisted and officer categories with higher utilization among more senior personnel. CONCLUSIONS Socioeconomic status does play a role in dental care-seeking behavior of military families. Even when families voluntarily enroll in a program and there are no cost shares for services such as preventive services, there may be other barriers to accessing care that need to be addressed so that all groups can maximize their oral health.

Association of Caries and Tobacco Risk with Dental Fitness Classification

ABSTRACT Objective: Dental emergencies negatively affect the Army during combat. Dental readiness continues to be a primary mission of the Army Dental Care System and is an important part of mobilization. Dental Fitness Classification (DFC) is used to evaluate the oral health status and current treatment needs of soldiers. Caries and tobacco risk assessments were recently added to the annual examination of Army soldiers. The aim of this project was to determine whether any association existed between the DFC and caries and tobacco risk assessments of Army soldiers. Methods: The study population consisted of 66,484 U.S. Army active duty soldiers. The data were obtained from an Army electronic database that maintains all patient visits. The following information was obtained for each soldier; rank, DFC, caries risk, and tobacco risk assessment. Summary statistics were computed and DFC was compared with caries risk, tobacco risk, and rank using the χ2 analysis and logistic regression model. Results: High-car...OBJECTIVE Dental emergencies negatively affect the Army during combat. Dental readiness continues to be a primary mission of the Army Dental Care System and is an important part of mobilization. Dental Fitness Classification (DFC) is used to evaluate the oral health status and current treatment needs of soldiers. Caries and tobacco risk assessments were recently added to the annual examination of Army soldiers. The aim of this project was to determine whether any association existed between the DFC and caries and tobacco risk assessments of Army soldiers. METHODS The study population consisted of 66,484 U.S. Army active duty soldiers. The data were obtained from an Army electronic database that maintains all patient visits. The following information was obtained for each soldier; rank, DFC, caries risk, and tobacco risk assessment. Summary statistics were computed and DFC was compared with caries risk, tobacco risk, and rank using the chi2 analysis and logistic regression model. RESULTS High-caries risk soldiers were 15.6 times more likely to be a DFC 3 or 4 as compared to DFC 1 and 2 soldiers. DFC 3 or 4 soldiers were 1.43 times more likely to be tobacco users than DFC 1 or 2 soldiers. Logistic regression models showed that high-caries risk soldiers were at 13 times the odds of being a DFC 3 or DFC 4 as compared to DFC 1 or DFC 2. Soldiers who used tobacco products were also more likely to be in higher DFC classification compared to those that did not use any tobacco products. CONCLUSIONS This study has shown clear associations between DFC categories and caries and tobacco risk wherein DFC 3 and 4 soldiers are at higher risk for future caries and of being tobacco users. This relationship warrants the inclusion of caries and tobacco risk in the overall dental assessment of soldiers.

The association between Medicaid status and broken orthodontic appointments is not clearly established.

Article Title and Bibliographic Information Appointment keeping behavior of Medicaid vs non-Medicaid orthodontic patients. Horsley BP, Lindauer SJ, Shroff B, Tufekci E, Abubaker AO, Fowler CE, Maxfield BJ. Am J Orthod Dentofacial Orthop 2007;132: 49-53. Level of Evidence Level 3 (Other evidence) Strength of Recommendation Grade Not applicable Purpose/Question To determine if differences exist in the rates of broken appointments between Medicaid and non-Medicaid orthodontic patients. Source Of Funding Medical College of Virginia Orthodontic Education and Research Foundation. Type Of Study/Design Cross-sectional study

Does Exposure to Fluoridated Water During the Crown Completion and Maturation Phases of Permanent First Molars Decrease Pit and Fissure Caries

Article Title and Bibliographic Information Effects of Water Fluoride Exposure at Crown Completion and Maturation of Caries of Permanent First Molars Singh KA, Spencer AJ, Brennan DS. Caries Res 2004;41:34-42 Level of Evidence 2 Purpose/Question To evaluate the relative effects of exposure to fluoridated water during the pre-eruptive stages of the crown completion and maturation on caries prevention in the permanent first molars of 6- to 15-year-old Australian children. Source of Funding Government: Public Health Research and Development Grants from the National Health and Medical Research Council. Type of Study/Design Cross-Sectional Study