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Objectives: This study examined how Mexican and Central American immigrants' social support was associated with three selected dental outcomes among recent immigrants, prior to the 2020 COVID‐19 pandemic. Methods: Using baseline wave data from the 2017–2022 VidaSana study about the health and social networks of Mexican and Central American immigrants living in Indiana, this study utilized logistic and ordinal logistic regression to predict lifetime fluoride use, lifetime dental restoration and flossing frequency, across levels of social support and differences between Mexican and Central American immigrants. Results: Data from 547 respondents were included in the present analysis (68% women; mean age 34.4 years [SD 11.2]; Central American 42%; Mexican 58%). Results show a high level of social support was associated with increased probability of fluoride use, dental restoration and higher flossing frequency for Mexican immigrants. However, social support for Central American immigrants was associated with a decreased likelihood of fluoride use, more infrequent flossing, and had no significant association with dental restorations experience. What would be a negative association between Central American immigrants and dental restoration was accounted for by education level and never having been to a dentist. Conclusions: While higher social support was linked to beneficial outcomes for oral health in Mexican immigrants, the opposite was found in Central Americans. These findings highlighted the complexities of social relationships among new immigrants, and potential heterogeneity within the Hispanic population, particularly regarding social and behavioural measures as they pertain to oral health. Further research is needed to identify the underlying mechanisms producing both differences in social support and oral health outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adverse effects can occur during orthodontic treatment. OBJECTIVE: To evaluate the relationship between prevalence and severity of enamel demineralization using a laser- fluorescence device, with length of orthodontic treatment time. METHOD: A cross-sectional study was conducted in 60 patients in a university orthodontic clinic. A clinical examination to establish demineralization at four sites on each tooth (premolar to premolar) was performed using the DIAGNOdent pen. The dependent variable was enamel demineralization, from which the prevalence (at least one affected site), extension (percentage of affected teeth) and adjusted average (average of the mean DIAGNOdent values per tooth) were calculated. The length of time for orthodontic treatment was determined in months. Various sociodemographic and clinical covariates were included. RESULTS: Average number of months under orthodontic treatment was 26.37 ± 24.81 months. Prevalence of enamel demineralization was 80.0%, its extension was 21.9% ± 17.2 and adjusted average of DIAGNOdent values was 6.09 ± 1.75. By quadrant, the teeth most affected were 14 (34.4%), 24 (25.0%), 31 (30.2%) and 44 (33.3%). No significant relationship (p > 0.05) was observed between enamel demineralization and length of time under orthodontic treatment. CONCLUSIONS: A high prevalence of dental demineralization was observed. In this sample, no relationship was observed between months under treatment and dental demineralization, or with other variables included in the study. [ABSTRACT FROM AUTHOR]

The article discusses the study on the parental factors related to the low use of routine dental visits in Indianapolis, Indiana. The study reportedly involved an analysis of the 2012 Marion County Health Department survey. The results revealed that children whose parents do not smoke and have higher educational level and families who ate fast food lesss were more likely to visit a dentist once a year.

The objectives of this study were to explore self-reported Internet and electronic platforms used to search for and store medical and dental information among people of Mexican origin. A sample of adults self-identified as European American (250) and as Mexican American (255), residing in Central Indiana, answered a one-time survey that included technology use questions and measured acculturation via the Psychological-Behavioral Acculturation Scale. Overall use of information technologies was estimated through an Information and Communication Technology score. Overall, participants with higher scores searched online for general and oral health information at higher rates than those with lower scores. Younger Mexican Americans and those with higher use scores were more likely to search online for general health information, as were those more psychologically and behaviorally acculturated. Interestingly, Mexican Americans were more likely than European Americans to search online for dental health information. All participants demonstrated high interest in accessing and storing their own health information especially on paper format; storage in other places, such as personal computers, smartphones, or USB flash drives, was less endorsed. Most participants would allow spouses access to their health records; however, there were significant differences between both population groups regarding access given to physicians, dentists and other family members, with Mexican Americans reporting more restrictions. Our findings provide initial information on differential use pattern of electronic health resources among Mexican Americans and suggest that new information technologies reach population groups traditionally underserved; such features may help address disparities in general and dental health. [ABSTRACT FROM AUTHOR]

Objective: This study examined the predictive validity of a simple subjective method promoted to dentists for assessing their patients' caries risk.Methods: Data from two large group practices that have used guideline-assisted caries risk assessment (CRA) for several years were analyzed retrospectively to determine the receipt of caries-related treatment following a CRA. Patient age and receipt of caries preventive treatment subsequent to the CRA were control variables in logistic regressions to determine the likelihood of caries-related treatment for low, moderate, and high risk groups.Results: Among 45,693 individuals in the two plans, those categorized as being at high caries risk were approximately four times as likely to receive any caries-related treatment as those categorized as being at low caries risk. Those categorized as at moderate risk were approximately twice as likely to receive any treatment. In addition, for those at elevated risk who required any treatment, the number of teeth requiring treatment was larger.Conclusion: The results of this study provide the first large-scale, generalizable evidence for the validity of dentists' subjective assessment of caries risk. [ABSTRACT FROM AUTHOR]

Dentists are involved in diagnosing disease in every aspect of their clinical practice. A range of tests, systems, guides and equipment--which can be generally referred to as diagnostic procedures--are available to aid in diagnostic decision making. In this era of evidence-based dentistry, and given the increasing demand for diagnostic accuracy and properly targeted health care, it is important to assess the value of such diagnostic procedures. Doing so allows dentists to weight appropriately the information these procedures supply, to purchase new equipment if it proves more reliable than existing equipment or even to discard a commonly used procedure if it is shown to be unreliable. This article, the first in a 6-part series, defines several concepts used to express the usefulness of diagnostic procedures, including reliability and validity, and describes some of their operating characteristics (statistical measures of performance), in particular, specificity and sensitivity. Subsequent articles in the series will discuss the value of diagnostic procedures used in daily dental practice and will compare today's most innovative procedures with established methods. [ABSTRACT FROM AUTHOR]

Objectives: To examine the relationship between rates of clinical service use and self-reported perception of and satisfaction with oral health status.Methods: Dental services provision rates were calculated using health maintenance organization electronic data for members 55 years of age and older with at least four years of eligibility between 1990 and 2000. A mail survey yielded 986 responses (response rate = 65.7%). Poisson regression was used to examine the relationship between service utilization rates and self-reported perception of and satisfaction with oral health status, controlling for age, education, sex, and marital status.Results: Perceptions of oral health status and levels of satisfaction with oral health status generally were closely associated. Greater dissatisfaction with oral health status and perception of poorer oral health status were associated with higher usage of nonpreventive dental services. Less satisfaction with oral health status was associated with higher restorative services usage and lower preventive services usage and slightly associated with periodontal service usage. Perception of a less favorable oral health status was strongly associated with higher restorative and periodontal services usage, but had only a weak association with preventive services usage.Conclusions: Dental plan members' service use is associated with their perception of their oral health status and their level of satisfaction with it. Future work should seek to clarify whether opinions on oral health status and satisfaction are a result of clinical experiences over time or whether the behavior and the values associated with seeking and obtaining care instead shape opinions on status and satisfaction. [ABSTRACT FROM AUTHOR]

Objective: To assist stakeholders (policy makers, dentists and patients) implementing the Patient Protection and Affordable Care Act of 2010 in the United States by providing information on conundrums arising from previous polices of the UK Labour government and emergent policies of the recently elected Coalition Government. Methods: The authors provide a background to the development of National Health Service dental services contrasted with US provision. Considerations are given from the different perspectives of stakeholders involved (policy makers, dentists, and patients). Conclusions: Policy makers must work under pressure for services to remain within boundaries of finite economic resources and what people are willing to pay for. The importance is stressed that they respond to public demands and workforce capability by clearly determining what the priorities should be, what services will be delivered, and defining responsibilities. [ABSTRACT FROM AUTHOR]

Background: It is uncertain whether the range and frequency of Diagnostic Thinking Processes (DTP) and pieces of information (concepts) involved in dental restorative treatment planning are different between students and expert clinicians. Methods: We video-recorded dental visits with one standardized patient. Clinicians were subsequently interviewed and their cognitive strategies explored using guide questions; interviews were also recorded. Both visit and interview were content-analyzed, following the Gale and Marsden model for clinical decision-making. Limited tests used to contrast data were t, ?2, and Fisher's. Scott's p was used to determine inter-coder reliability. Results: Fifteen dentists and 17 senior dental students participated in visits lasting 32.0 minutes (± 12.9) among experts, and 29.9 ± 7.1 among students; contact time with patient was 26.4 ± 13.9 minutes (experts), and 22.2 ± 7.5 (students). The time elapsed between the first and the last instances of the clinician looking in the mouth was similar between experts and students. Ninety eight types of pieces of information were used in combinations with 12 DTPs. The main differences found in DTP utilization had dentists conducting diagnostic interpretations of findings with sufficient certainty to be considered definitive twice as often as students. Students resorted more often to more general or clarifying enquiry in their search for information than dentists. Conclusions: Differences in diagnostic strategies and concepts existed within clearly delimited types of cognitive processes; such processes were largely compatible with the analytic and (in particular) non-analytic approaches to clinical decision-making identified in the medical field. Because we were focused on a clinical presentation primarily made up of non-emergency treatment needs, use of other DTPs and concepts might occur when clinicians evaluate emergency treatment needs, complex rehabilitative cases, and/or medically compromised patients. [ABSTRACT FROM AUTHOR]

To compare dental treatment experiences and costs in members of a health maintenance organization (HMO) in areas with and without community water fluoridation. HMO members with continuous dental eligibility (January 1, 1990 to December 31, 1995) who resided in Oregon and Washington were identified using administrative databases. Fluoridation status was determined by geocoding subscriber address. Measures were utilization of dental procedures, fluoride dispensings, and associated costs. Costs were based on nonmember fees, adjusted to 1995 dollar values. Data were analyzed using analysis of covariance, controlling for age and interactions. About 85 percent of eligible members ( n = 51,683) were classified as residing either in a fluoridated ( n = 12,194) or nonfluoridated ( n = 39,489) area. Mean age was 40.0 years; 52.3 percent were women. More than 92 percent of members had one or more dental visits. Community water fluoridation was associated with reduced total and restorative costs among members with one or more visits, but the magnitude and direction of the effect varied with locale and age and the effects were generally small. In two locales, the cost of restorations was higher in nonfluoridated areas in young people ( age 58). In younger adults, the opposite effect was observed. The impact of fluoridation may be attenuated by higher use of preventive procedures, in particular supplemental fluorides, in the nonfluoridated areas. These results are particularly relevant to insured populations with established access to dental care. Differences in treatment costs (savings) associated with water fluoridation should be estimated and included in future cost-effectiveness analyses of community water fluoridation. [ABSTRACT FROM AUTHOR]

Objectives: To determine the level of dental health care coverage in people aged ≥18 years across the country, and to identify the factors associated with coverage. Material and methods: Using the instruments and sampling strategies developed by the World Health Organization for the World Health Survey, a cross-sectional national survey was carried out at the household and individual (adult) levels. Dental data were collected in 20 of Mexico's 32 states. The relationship between coverage and environmental and individual characteristics was examined through logistic regression models. Results: Only 6098 of 24 159 individual respondents reported having oral problems during the preceding 12 months (accounting for 14 284 621 inhabitants of the country if weighted). Only 48% of respondents reporting problems were covered, although details of the appropriateness, timeliness and effectiveness of the intervention(s) were not assessed. The multivariate regression model showed that higher level of education, better socioeconomic status, having at least one chronic disease and having medical insurance were positively associated with better dental care coverage. Age and sex were also associated. Conclusions: Overall dental health care coverage could be improved, assuming that ideal coverage is 100%. Some equality of access issues are apparent because there are differences in coverage across populations in terms of wealth and social status. Identifying the factors associated with sparse coverage is a step in the right direction allowing policymakers to establish strategies aimed at increasing this coverage, focusing on more vulnerable groups and on individuals in greater need of preventive and rehabilitative interventions. [ABSTRACT FROM AUTHOR]

Objective: To examine retrospectively the caries-related restorative experience of at-risk individuals who received fluoride-based preventive interventions to determine if the intervention resulted in fewer caries-related procedures. Methods: Administrative data from two dental health plans were used to determine the relationship between caries risk assessment (CRA) scores, preventive treatment and caries-related treatment procedures. We identified 45 693 adults who were consecutively enrolled for at least 1 year before and 2.5 years after the CRA. Variables representing the number of teeth with any caries-related treatment procedure and receipt of preventive treatment were created. Results: The outcome variable of interest was having at least one tooth with a caries-related procedure in the 2-year follow-up period. In plan A, the recommendation for home-use fluoride was not significantly related to caries-related treatment procedures in the follow-up period for individuals at low, moderate or high risk ( P > 0.300). In plan B, application of in-office fluoride was associated with having at least one tooth with a caries-related treatment procedure in the follow-up period ( P < 0.001). Conclusions: We found incomplete compliance with guidelines for recommendation or administration of preventive treatment for patients at elevated risk for caries. We were also unable to identify any significant reductions in caries-related procedures for individuals receiving a fluoride intervention, compared with those who did not, when stratified by risk level. [ABSTRACT FROM AUTHOR]

Borges-Yáñez SA, Maupomé G, Jiménez-García G: Validity and reliability of partial examination to assess severe periodontitis. J Clin Periodontol 2004; 31: 112–118. © Blackwell Munksgaard, 2004. To compare the extent and severity index (ESI) with a gold standard represented by actual readings of loss of attachment on six sites around all teeth present (excluding third molars). Five standardized dentists ( κ=0.6) examined 712 subjects ⩾20 years of age at a dental school (1993–1995). Sensitivity, specificity, positive and negative predictive values, and true and apparent prevalence were established. True severe periodontitis prevalence was 95.8%. ESI underestimated the severity (0.1 mm), extent (4%), and prevalence (16%) of periodontitis. The severity, as established by ESI, coincided 23.4% with the gold standard. ESI failed to identify 16.7% of subjects with severe periodontal disease, but specificity and positive predictive value were very high. The underestimation of severe periodontitis through ESI may lead to inadequate recommendations for further treatment. Accurately identifying subjects with severe periodontitis requires a full-mouth examination. Because the ESI relies on measurements taken on only 28 periodontal sites to estimate the periodontitis status of the entire mouth, the validity and reliability of ESI may be modified by the prevalence of severe periodontal disease and the distribution of disease according to age and operational definitions. [ABSTRACT FROM AUTHOR]

Scientific information on diagnosis, prevention, and management of dental caries and associated indicators of risk continues to increase rapidly. Patients vary in clinically important ways, however, and uncertainty affects our understanding of risk; diagnostic and prognostic information; efficacy and effectiveness of many preventive, diagnostic, and treatment alternatives; and outcomes associated with clinical strategies. Consequently, challenges abound for clinicians to identify, evaluate, and incorporate new information, patient preferences, and uncertainties into clinical practice. Clinical decision-making—an analytical approach that makes explicit use of information to quantify probabilities and outcomes to analyze decisions under conditions of uncertainty—can provide a framework to analyze the impact of uncertainty of clinical information. Diagnostic, effectiveness, and outcome information is quantified and combined in an explicit way to serve as a tool for clinicians, not as a replacement for clinical judgment or experience. Such an approach has the potential to improve clinical practice and help dentists do their jobs better by structuring the decision problem and assessing probabilities and utilities. Clinical decision-making also helps dentists communicate with each other by identifying clinical controversies, thereby characterizing how and why disagreements may arise and what additional data may be needed to address a clinical question. [ABSTRACT FROM AUTHOR]

Oral health/illness and surrounding socio-demographic and behavioral phenomena are poorly documented in the Mexican elderly. To establish the rationales explaining oral health/illness and tailor a Health Promotion intervention (1995-1997) accordingly, an interview nested in a questionnaire was done at baseline, with the recording of 228 interviews transcribed verbatim. Every transcript was subsequently assessed by content-analysis. Results showed that lack of oral hygiene, inadequate calcium intake and old age were the most common explanations of tooth-loss. Only a few factors were felt to be under control: the same state of relative adaptation that characterized people affected by gum problems. The themes that explained them were lack of oral hygiene, and (non-specific) infections. When interviewees evaluated the impact of good oral health on their lives, many made evaluations pertaining to quality of life, adequate function, and an attractive appearance generally. [ABSTRACT FROM AUTHOR]

The article focuses on a dental research conducted by American researcher Gerardo Maupome on dietary patterns and dental decay in children in a deprived urban population of Northern Mexico. It was seen that even short intervals of malnutrition earlier in life increase the suspectibility to dental caries in later years. Heavily decayed teeth play a role in decreased somatic growth and reduced anthropometric measurements. It was concluded that dietary patterns promote their dental decay.

Background: Mexican immigrants in the United States suffer from poor oral health. The objective of the current study was to explore the utility of applying theory-based factors associated with seeking preventive dental care in a sample of Mexican American adults. Methods: Data were collected from a cross-sectional survey of a sample of 157 people of Mexican origin (64% female; age 34 ± 11 years) recruited primarily from church congregations and lay community organizations in Central Indiana. Using the Integrative Model of Behavioral Prediction as the guiding framework, structural equation modeling was used to test factors associated with intention to seek preventive dental care. Results: Attitude towards seeking preventive dental care (estimate = 0.37; p <.0001) and self-efficacy for seeking preventive dental care (estimate = 0.68; p <.0001) were associated with intention to seek preventive dental care. The association between dental beliefs and intention to seek preventive dental care was mediated by attitude and self-efficacy (indirect effect = 0.26, p =.002), and the association between past behavior and intention to seek preventive dental care was mediated by self-efficacy (indirect effect = 0.26, p =.003). Conclusions: These findings suggest that interventions to increase preventive dental care seeking behavior among Mexican Americans should focus on changing attitudes toward seeking preventive dental care and on increasing self-efficacy to seek preventive dental care. Findings also support the use of interventions to influence dental beliefs. [ABSTRACT FROM AUTHOR]