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Objective: American Indian and Alaska native (AI/AN) individuals report distrust of the healthcare system. This study explored associations between having either high levels of dental distrust or high levels of dental care-related fear and anxiety ("dental anxiety") and oral health outcomes in AI/AN adults., Methods: The 2022 State of Oral Health Equity in America survey included the Modified Dental Anxiety Scale and asked to what extent respondents agreed with the statement, "At my last oral health visit, I trusted the oral health provider I saw", and asked about self-rated oral health and presence of a dental home., Results: AI/AN individuals (N = 564) who reported low dental trust (n = 110) or with high dental anxiety (MDAS≥19; n = 113) reported significantly worse overall and oral health and were significantly less likely to have a dental home (p < 0.05 used for each analysis)., Conclusion: Dental distrust and dental anxiety can significantly impact oral health and dental utilization in AI/AN communities and are important intervention targets to improve AI/AN oral health., (© 2024 American Association of Public Health Dentistry.)

Objectives: Teledentistry helped dentistry adapt to pandemic-era challenges; little is known about dental professionals' teledentistry experiences during this time. This analysis sought to understand professionals' pandemic teledentistry experiences and expectations for the modality's future., Methods: We conducted virtual individual interviews (n = 21) via Zoom to understand how federally qualified health centers (FQHCs) delivered oral care during the first year of the pandemic, including but not limited to the use of teledentistry. We independently coded each transcript, then identified themes and sub-themes., Results: We identified three major themes: (1) Logistical and equity considerations shaped teledentistry's adoption; (2) Team-based factors influenced implementation; and (3) Teledentistry's future is as-yet undetermined., Conclusions: Experiences with teledentistry during the first year of COVID-19 varied substantially. Future directions should be more deliberate to counter the urgency of pandemic-style implementation and must address appropriate use, reimbursement guidance, patient and provider challenges, and customizability to each clinic's context., (© 2022 American Association of Public Health Dentistry.)

Objective: To compare the use of Medicaid and commercial claims data with self-reported survey data in estimating the prevalence of oral disease burden., Methods: We analyzed 2018 Medicaid claims from the IBM Watson Medicaid Marketscan database, commercial claims from the IBM Dental Database, and Medical Expenditure Panel Survey (MEPS) data. The estimate of oral disease burden was based on standard metrics using periodontal and caries-related Current Dental Terminology (CDT) procedure codes. A direct comparison between the data sets was also done., Results: Unweighted Medicaid and commercial enrollees were 11.6 and 10.5 million, respectively. The weighted proportion from MEPS for Medicaid and commercial plans ranged from 80 to 208 million people. Estimates of caries-related treatments were calculated from IBM Watson and MEPS data for Medicaid enrollees (13% vs. 12%, respectively) and commercial claims (25% vs. 17%, respectively). Prevalence of periodontal related treatments for those with a dental visit was estimated for IBM Watson and MEPS enrollees for Medicaid (0.7% vs. 0.5%, respectively) and commercial claims (7% vs. 1.6%, respectively). Dental disease estimates were higher in individuals with at least one dental visit across cohorts. Prevalence of disease for those with a dental visit based on specific procedures were higher in commercial plans than in Medicaid., Conclusions: Claims data has the potential to serve as a proxy measure for the estimate of dental disease burden in a population., (© 2022 American Association of Public Health Dentistry.)

Objective: To ascertain the financial impact associated with the underutilization of preventive dental care for adults enrolled in Medicaid., Methods: We used adult claims data for patients aged 21-64 in the IBM Watson Marketscan Medicaid database. Enrollees were included if they had at least one dental claim in 2019 and were continuously enrolled between 2014 and 2019. We then evaluated the costs of their dental care in 2019, based on the number of years of preventive dental care they received between 2014 and 2018. We also assessed Emergency Department (ED) utilization for dental conditions, oral surgeries, and dental-related opioid prescriptions., Results: The average Medicaid enrollee with five continuous years of preventive care prior to 2019 experienced 43% lower costs than an individual who received no preventive dental care at all. Most of the savings were a result of fewer oral surgeries. A Medicaid enrollee with no preventive dental visits was eight times more likely to have an ED visit for a nontraumatic dental condition (NTDC), seven times more likely to have oral surgery and six times more likely to receive a dental-related opioid prescription compared to those who had a dental prevention visit every year in the 5-year lookback period., Conclusions: Regular preventive dental care in the lookback period was associated with significant savings in overall dental care costs when compared to dental care costs for those individuals who received no or few preventive visits. Prior preventive dental care was also associated with lower rates of ED-NTDC utilization, oral surgery, and dental-related opioid prescriptions., (© 2022 The Authors. Journal of Public Health Dentistry published by Wiley Periodicals LLC on behalf of American Association of Public Health Dentistry.)