Eugenio D. Beltrán-Aguilar

Overview and Quality Assurance for the Oral Health Component of the National Health and Nutrition Examination Survey (NHANES), 2003-04

The 2003-04 National Health and Nutrition Examination Survey (NHANES) was a collaborative effort involving 28 federal funding partners with the National Center for Health Statistics. The collaborators for the 2003-04 NHANES oral health component included the National Institute of Dental and Craniofacial Research and the National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health. Oral health data are available on 8272 persons aged 2 years or older. This report provides an overview of the 2003-04 oral health component including content descriptions and procedures for oral health assessments conducted for the first time in a national survey in the United States. These assessments include posterior functional contacts, tooth wear, and oral health-related quality of life. This report also provides evaluations of data quality in terms of examiner reliability statistics (percent agreements, kappas, and correlation coefficients) for various NHANES 2003-04 oral health examination components and analytical recommendations for producing 6-year estimates using the previous two NHANES data collection components (1999-2000 and 2001-02).

No Visible Dental Staining in Children Treated with Doxycycline for Suspected Rocky Mountain Spotted Fever

OBJECTIVE To evaluate whether cosmetically relevant dental effects occurred among children who had received doxycycline for treatment of suspected Rocky Mountain spotted fever (RMSF). STUDY DESIGN Children who lived on an American Indian reservation with high incidence of RMSF were classified as exposed or unexposed to doxycycline, based on medical and pharmacy record abstraction. Licensed, trained dentists examined each childs teeth and evaluated visible staining patterns and enamel hypoplasia. Objective tooth color was evaluated with a spectrophotometer. RESULTS Fifty-eight children who received an average of 1.8 courses of doxycycline before 8 years of age and who now had exposed permanent teeth erupted were compared with 213 children who had never received doxycycline. No tetracycline-like staining was observed in any of the exposed childrens teeth (0/58, 95% CI 0%-5%), and no significant difference in tooth shade (P=.20) or hypoplasia (P=1.0) was found between the 2 groups. CONCLUSIONS This study failed to demonstrate dental staining, enamel hypoplasia, or tooth color differences among children who received short-term courses of doxycycline at <8 years of age. Healthcare provider confidence in use of doxycycline for suspected RMSF in children may be improved by modifying the drugs label.

The American Dental Association Caries Classification System for Clinical Practice: A report of the American Dental Association Council on Scientific Affairs

BACKGROUND The caries lesion, the most commonly observed sign of dental caries disease, is the cumulative result of an imbalance in the dynamic demineralization and remineralization process that causes a net mineral loss over time. A classification system to categorize the location, site of origin, extent, and when possible, activity level of caries lesions consistently over time is necessary to determine which clinical treatments and therapeutic interventions are appropriate to control and treat these lesions. METHODS In 2008, the American Dental Association (ADA) convened a group of experts to develop an easy-to-implement caries classification system. The ADA Council on Scientific Affairs subsequently compiled information from these discussions to create the ADA Caries Classification System (CCS) presented in this article. CONCLUSIONS The ADA CCS offers clinicians the capability to capture the spectrum of caries disease presentations ranging from clinically unaffected (sound) tooth structure to noncavitated initial lesions to extensively cavitated advanced lesions. The ADA CCS supports a broad range of clinical management options necessary to treat both noncavitated and cavitated caries lesions. PRACTICAL IMPLICATIONS The ADA CCS is available for implementation in clinical practice to evaluate its usability, reliability, and validity. Feedback from clinical practitioners and researchers will allow system improvement. Use of the ADA CCS will offer standardized data that can be used to improve the scientific rationale for the treatment of all stages of caries disease.

Dental caries and periodontal disease among U.S. pregnant women and nonpregnant women of reproductive age, National Health and Nutrition Examination Survey, 1999–2004

OBJECTIVES This study assessed and compared the prevalence and severity of dental caries and the prevalence of periodontal disease among pregnant and nonpregnant women of reproductive age (15-44 years) using data from the National Health and Nutrition Examination Survey, NHANES (1999-2004). METHODS Estimates were derived from a sample of 897 pregnant women and 3,971 nonpregnant women. Chi-square and two-sample t-tests were used to assess differences between groups stratified by age, race/ethnicity, education, and poverty. Bonferroni method was applied to adjust for multiple comparisons. RESULTS In general, there were no statistically significant differences in the prevalence estimates of dental caries and periodontal disease between pregnant women and nonpregnant women. However, results showed significant differences when stratified by sociodemographic characteristics. For example, the prevalence of untreated dental caries among women aged 15-24 years was significantly higher in pregnant women than in nonpregnant women (41 percent versus 24 percent, P = 0.001). Regardless of their pregnancy status, racial/ethnic minorities or women with less education or lower family income had higher prevalence of untreated dental caries, severity of dental caries, and periodontal disease compared to the respective reference groups of non-Hispanic whites or women with more education or higher family income. CONCLUSION Results of this study show few clinical differences in dental caries and periodontal disease between pregnant and nonpregnant women but persistent disparities by sociodemographic characteristics. In order to reduce oral health disparities in the United States, it is important to improve access to oral health care particularly among vulnerable groups. Integrating oral health into the overall health care could benefit and improve womens oral health outcomes.

Use of Dietary Fluoride Supplements by Children Living in Berlin, Germany, may have a Dose-response Preventive Effect Against Dental Caries, Regardless of their Use of Fluoridated Salt

Article Title and Bibliographic Information Effects of fluoride tablets on caries and fluorosis occurrence among 6- to 9-year olds using fluoridated salt. Meyer-Lueckel H, Grundmann E, Stang A. Community Dent Oral Epidemiol 2010;38(4):315-23. Reviewer Name Eugenio D. Beltran-Aguilar, DMD, MPH, MS, DrPH Purpose/Question To assess benefits (caries prevention) and risks (dental fluorosis) of using dietary fluoride supplements (referred as “fluoride tablets” in the article) among children consuming fluoridated salt in a district of Berlin, Germany. Source of Funding Information not available. The authors acknowledged the cooperation of the Public Dental Services of the Steglitz-Zehlendorf district in Berlin Type of Study/Design Retrospective cohort study Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Not applicable