Lauren Harrell

Feasibility of recruiting peer educators for an online social networking-based health intervention

Objective: This study aims to determine the feasibility of recruiting peer leaders to deliver a community-based health intervention using social media. Method: We recruited 16 African American and Latino men who have sex with men (MSM) as peer leaders for either an human immunodeficiency virus (HIV) prevention or general health intervention using social media. Inclusion criteria required that peer leaders were African American or Latino MSM health communication experts experienced using social media. To receive certification, peer leaders attended three training sessions on using social media for public health. Questionnaires asking about health knowledge and comfort using social media to discuss health-related topics were provided at baseline and post-training to ensure that peer leaders were qualified post-training. Repeated measures analysis of variance (ANOVA) models and χ2 tests tested for differences in peer leader knowledge and comfort using social media pre- and post-training. Results: After training, peer leaders were significantly more comfortable using social media to discuss sexual positions. There were no significant differences pre- and post-training on other comfort or knowledge measures as, at baseline, almost all peer leaders were already comfortable using social media. Conclusion: Results suggest that peer leaders can be recruited who are qualified to conduct health interventions without needing additional training. The discussed training plan can further ensure that any unqualified peer leaders will be prepared after training. To our knowledge, this is the first study to suggest that peer leaders can be recruited as peer health educators to communicate using social media.

Dental disease patterns in methamphetamine users: Findings in a large urban sample

BACKGROUND The authors used a large community sample of methamphetamine (MA) users to verify the patterns and severity of dental disease and establish a hierarchy of caries susceptibility by tooth type and tooth surface. METHODS Using a stratified sampling approach, 571 MA users received comprehensive oral examinations and psychosocial assessments. Three calibrated dentists characterized dental and periodontal disease by using National Health and Nutrition Examination Survey protocols. The authors also collected data on substance use history and other attributes linked to dental disease. RESULTS On all dental outcome measures, MA users evidenced high dental and periodontal disease, with older (≥ 30 years) and moderate or heavy MA users disproportionately affected. Women had higher rates of tooth loss and caries, as well as a greater prevalence of anterior caries. Current cigarette smokers were more likely to manifest 5 or more anterior surfaces with untreated caries and 3 or more teeth with root caries. Nearly 3% were edentulous, and a significant percentage (40%) indicated embarrassment with their dental appearance. CONCLUSIONS MA users have high rates of dental and periodontal disease and manifest a dose-response relationship, with greater levels of MA use associated with higher rates of dental disease. Women and current cigarette smokers are affected disproportionately. The intraoral patterns and hierarchy of caries susceptibility in MA users are distinctive. PRACTICAL IMPLICATIONS The prevalence and patterns of dental and periodontal disease could be used to alert dentists to possible covert MA use and to plan treatment. Concerns about dental appearance have potential as triggers for behavioral interventions.

Original ContributionsCover StoryDental disease patterns in methamphetamine users: Findings in a large urban sample

BACKGROUND The authors used a large community sample of methamphetamine (MA) users to verify the patterns and severity of dental disease and establish a hierarchy of caries susceptibility by tooth type and tooth surface. METHODS Using a stratified sampling approach, 571 MA users received comprehensive oral examinations and psychosocial assessments. Three calibrated dentists characterized dental and periodontal disease by using National Health and Nutrition Examination Survey protocols. The authors also collected data on substance use history and other attributes linked to dental disease. RESULTS On all dental outcome measures, MA users evidenced high dental and periodontal disease, with older (≥ 30 years) and moderate or heavy MA users disproportionately affected. Women had higher rates of tooth loss and caries, as well as a greater prevalence of anterior caries. Current cigarette smokers were more likely to manifest 5 or more anterior surfaces with untreated caries and 3 or more teeth with root caries. Nearly 3% were edentulous, and a significant percentage (40%) indicated embarrassment with their dental appearance. CONCLUSIONS MA users have high rates of dental and periodontal disease and manifest a dose-response relationship, with greater levels of MA use associated with higher rates of dental disease. Women and current cigarette smokers are affected disproportionately. The intraoral patterns and hierarchy of caries susceptibility in MA users are distinctive. PRACTICAL IMPLICATIONS The prevalence and patterns of dental and periodontal disease could be used to alert dentists to possible covert MA use and to plan treatment. Concerns about dental appearance have potential as triggers for behavioral interventions.

Methamphetamine Users Have Increased Dental Disease: A Propensity Score Analysis

Methamphetamine (MA) users are assumed to have a high burden of tooth decay. Less clear is how the distribution and severity of dental caries in MA users differ from the general population. Using a covariate-balancing propensity score strategy, we investigated the differential effects of MA use on dental caries by comparing the patterns of decayed, missing, and filled teeth in a community sample of 571 MA users with a subset of 2,755 demographically similar control individuals selected from a National Health and Nutrition Examination Survey (NHANES) cohort. Recruited over a 2-y period with a stratified sampling protocol, the MA users underwent comprehensive dental examinations by 3 trained and calibrated dentists using NHANES protocols. Propensity scores were estimated with logistic regression based on background characteristics, and a subset of closely matched subjects was stratified into quintiles for comparisons. MA users were twice as likely to have untreated caries (odds ratio [OR] = 2.08; 95% confidence interval [95% CI]: 1.55 to 2.78) and 4 times more likely to have caries experience (OR = 4.06; 95% CI: 2.24 to 7.34) than the control group of NHANES participants. Additionally, MA users were twice as likely to have 2 more decayed, missing, or filled teeth (OR = 2.08; 95% CI: 1.29 to 2.79) than the NHANES participants. The differential involvement of the teeth surfaces in MA users was quite distinctive, with carious surface involvement being highest for the maxillary central incisors, followed by maxillary posterior premolars and molars. Users injecting MA had significantly higher rates of tooth decay compared with noninjectors (P = 0.04). Although MA users experienced decayed and missing dental surfaces more frequently than NHANES participants, NHANES participants had more restored surfaces, especially on molars. The high rates and distinctive patterns of dental caries observed could be used 1) to alert dentists to covert MA use in their patients and 2) as the basis for comprehensive management strategies.

A Comparison of Methamphetamine Users to a Matched NHANES Cohort: Propensity Score Analyses for Oral Health Care and Dental Service Need

Dental problems are among the most frequently reported health issues of drug users. This study describes, among the largest population of methamphetamine (MA) users to date (N = 459, including both HIV-negative and HIV-positive participants) oral hygiene practice, dental care access, and dental quality of life. A matched control group from the Third National Health and Nutrition Examination Survey was utilized. Findings conclusively establish that MA users have severe oral health deficits compared to the general population: they are 3.5 times more likely to experience painful toothaches, 6.6 times to experience difficulty eating, and 8.6 times to be self-conscious due to dental appearance. HIV-positive users were more likely to have regular dental visits than HIV-negative users. Severity of use (both high-frequency use as well as injection as the method) was associated with poorer oral health care. Despite the magnitude of the need, few MA users receive the needed care.

Saliva sampling method affects performance of a salivary α-amylase biosensor

Prompted by the discordance between a standardized salivary alpha‐amylase (sAA) biosensor applied in clinical settings and a reference laboratory analyzer, we examined the impact of the saliva sampling method on the analytic performance of the biosensor.

Developing a propensity score protocol for evaluating the oral health consequences of methamphetamine use

ABSTRACT Conventional propensity-score matching strategies do not always produce covariate balance across treatment groups comparing a hard-to-reach population subclass to a representative sample from the general population. We describe techniques for combining propensity-score matching with stratification into propensity-score-based subclasses to produce samples with balanced distributions of characteristics from a cross-sectional cohort of methamphetamine users and nonusers from the 1999–2004 National Health and Nutrition Examination Survey. Resulting outcome estimates are weighted between subclasses for interpretable comparisons. We consider features of an approach facilitating between-group comparisons, including the matching ratio, number of subclasses, analysis strategy, and conceptual underpinnings of weight selection.

Extended Antibiotic Therapy may Reduce Risk of Infection Following Orthognathic Surgery

Article Title and Bibliographic Information Effectiveness of postoperative antibiotics in orthognathic surgery: a meta-analysis. Danda AK, Ravi P. J Oral Maxillofac Surg 2011;69:2650-6. Reviewers Lauren Harrell, MS, Vivek Shetty, DDS, Dr MedDent Purpose/Question To determine whether extending antibiotic coverage, beyond the perioperative period, is more effective in reducing the incidence of infection following orthognathic surgery Source of Funding Information not available Type of Study/Design Systematic review with meta-analysis of data Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Grade B: Inconsistent or limited-quality patient-oriented evidence