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BACKGROUND: Traditional 3D dental segmentation methods usually utilize predefined spatial geometric features, such as curvature and normal vectors, as the reference information for tooth segmentation. OBJECTIVE: To propose an algorithm for complex 3D dental segmentation and deeply explore the correlation between segmentation results and application scenarios. METHODS: A 3D dental segmentation algorithm based on dual stream extraction of structural features and spatial features was established, and the modular design of split flow was used to avoid feature confusion. Among them, the attention mechanism on the structural feature flow was used to capture the finegrained semantic information required for tooth segmentation, and the Tran Net based on the spatial feature flow was used to ensure the robustness of the model to complex tooth and jaw segmentation. This algorithm verified its effectiveness and reliability based on clinical datasets including healthy dental jaws and complex dental jaws such as missing teeth, malocclusion and dentition crowding. The segmentation performance of the model was measured in terms of overall accuracy, mean intersection over union, and directional cut discrepancy. RESULTS AND CONCLUSION: The overall segmentation accuracy of this algorithm in the clinical data set is 97.08%, and the segmentation effect is superior to that of other competitive methods from the qualitative and quantitative perspectives. It is verified that the structural feature flow designed in this paper can extract more precise local details of tooth shape from coordinate and normal information by constructing an attention aggregation mechanism, and the spatial feature flow designed in this paper can ensure the robustness of the model to complex teeth such as missing teeth, dislocated teeth, and crowded dentition by constructing a transformation network (Tran Net). Therefore, this tooth segmentation algorithm is highly reliable for clinicians' practical reference. [ABSTRACT FROM AUTHOR]

Disparities exist in access to early oral health care, disproportionately impacting minority ethnic groups and populations with low socioeconomic status. Medical dental integration provides an opportunity to create a new dental access point for early prevention and intervention as well as care coordination. The Wisconsin Medical Dental Integration (WI-MDI) model expanded early access to preventive oral health services by integrating dental hygienists (DHs) into pediatric primary care and prenatal care teams to address oral health inequities with the goal of reducing dental disease. This case study will describe how DHs were incorporated into the medical care teams in Wisconsin and how legislation expanding scope of practice made this possible. Since 2019, five federally qualified health systems, one non-profit clinic, and two large health systems have enrolled in the WI-MDI project. Thirteen DHs have worked across nine clinics in the WI-MDI project and over 15,000 patient visits to a medical provider included oral health services provided by DHs from 2019 to 2023. Dental hygienists working in alternative practice models such as those demonstrated in the innovative WI-MDI approach are positioned to reduce oral health disparities through the provision of early and frequent dental prevention, intervention, and care coordination. [ABSTRACT FROM AUTHOR]

In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide an overview of current professional guidelines regarding oral health care through pregnancy and infancy stages, and to include risks associated with treatment, as well as health care providers' beliefs and attitudes surrounding treatment of these specific populations. Although dental treatment during the second trimester is ideal, there is no indication that preventive or restorative dental treatment during any trimester of pregnancy can cause harm to the mother or developing fetus. Despite these recommendations, routine dental care is often voluntarily avoided or postponed for the duration of pregnancy. Post-delivery, preventive oral care is typically postponed for a child until 3 years of age, years after the first tooth has erupted. While most health care professionals agree on the importance of good oral health in every stage of life, it is not being addressed. Whether it is based on misconceptions or lack of knowledge, health care providers are performing inadequate oral care for these patients. Recommendations to increase health care during pregnancy and infancy should include improved advocacy of the established oral health care guidelines within each professional organization. In addition, curriculum revision should occur at the university level, to ensure future health care professionals will have a strong oral health foundation. Lastly, a collaborative effort needs to occur between all health care providers to better treat the patient's overall health, not only the specifics of one professional discipline. As health care professionals we are all responsible for the complete well-being of our patients, and an interdisciplinary approach will better ensure we accomplish this task. [ABSTRACT FROM AUTHOR]

Objectives This study sought to advance understanding of the influence of psychosocial factors on oral health by examining how parental self-efficacy (with regard to acting on their child's oral health needs) and oral health knowledge relate to parental and child oral health behaviors and self-rated oral health. Methods Parents of children in grades 0/1 and 5/6 ( n = 804) and children in grades 5/6 ( n = 377, mean age 11.5 ± 1.0, 53.9% female) were recruited from a stratified random sample of 11 primary (elementary) schools. Participants completed surveys capturing psychosocial factors, oral health-related knowledge, and parental attitudes about oral health. Parents also rated their own oral health status and the oral health of their child. Correlations and logistic regression analysis (adjusted for socioeconomic status, child age, and gender) examined associations between psychosocial factors and the outcomes of interest (parent and child behaviors and self-rated oral health status). Results Higher parental self-efficacy was associated with more frequent toothbrushing (by parent and child), and more frequent visits to a dental professional. These associations were particularly strong with regard to dental visits for children, with parents with the highest tertile for self-efficacy 4.3 times more likely to report that their child attended a dentist for a checkup at least once a year (95% CI 2.52-7.43); and 3 times more likely to report their child brushing their teeth at least twice a day ( Adjusted Odds Ratio 3.04, 95% CI 1.64-5.64) compared with those parents in the lowest tertile for self-efficacy. No associations with oral health knowledge were found when examined by tertile of increasing knowledge. Conclusions Oral health self-efficacy and knowledge are potentially modifiable risk factors of oral health outcomes, and these findings suggest that intervening on these factors could help foster positive dental health habits in families. [ABSTRACT FROM AUTHOR]

The role of public health program planners is to determine the effectiveness of public health programs, what recommendations should be made, what future initiatives should be taken, and what policies should be developed. At a basic level, to choose between competing alternatives, two characteristics of an intervention must be considered; these are its outcome and its cost. Based on cost and outcome, planners must select the option that offers the most advantages. Economic evaluation is commonly adopted by decision makers in the health sector to investigate the effectiveness of public health programs and to help plan future initiatives. Economic evaluation assists decision makers who must weigh the information it provides in the context of many and often competing options. In this way, an economic evaluation is an aid to decision making rather than the decision itself. Economic evaluation is becoming essential for informed decision making, with potential implications for public health policy and practice and for clinical practice too. While economic evaluations are commonly used in decision-making processes about health programs, few examples exist in the oral health literature. In the case of preventive oral health programs, economic analysis is often difficult, largely because it makes demands on epidemiological and demographic data that are hard to meet. This study will address the concepts and tools required to conduct economic evaluations of prevention programs. The emphasis will be on oral health and preventive dental programs, although the concepts presented could be useful for other public health programs by practitioners and managers with the aim of producing effective and efficient oral health programs. [ABSTRACT FROM AUTHOR]

Petersen PE, Lennon MA. Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach. Community Dent Oral Epidemiol 2004; 32: 319–21. © Blackwell Munksgaard, 2004 Despite great improvements in the oral health of populations across the world, problems still persist particularly among poor and disadvantaged groups in both developed and developing countries. According to the World Oral Health Report 2003, dental caries remains a major public health problem in most industrialized countries, affecting 60–90% of schoolchildren and the vast majority of adults. Although it appears that dental caries is less common and less severe in developing countries of Africa, it is anticipated that the incidence of caries will increase in several countries of that continent, due to changing living conditions and dietary habits, and inadequate exposure to fluorides. Research on the oral health effects of fluoride started around 100 years ago; the focus has been on the link between water and fluorides and dental caries and fluorosis, topical fluoride applications, fluoride toothpastes, and salt and milk fluoridation. Most recently, efforts have been made to summarize the extensive database through systematic reviews. Such reviews concluded that water fluoridation and use of fluoride toothpastes and mouthrinses significantly reduce the prevalence of dental caries. WHO recommends for public health that every effort must be made to develop affordable fluoridated toothpastes for use in developing countries. Water fluoridation, where technically feasible and culturally acceptable, has substantial advantages in public health; alternatively, fluoridation of salt and milk fluoridation schemes may be considered for prevention of dental caries. [ABSTRACT FROM AUTHOR]