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Objectives: Perceived Social Status (PSS) is a measure of cumulative socioeconomic circumstances that takes perceived self‐control into account. It is hypothesized to better capture social class compared to socioeconomic status (SES) measures (i.e., education, occupation, and income). This study examined the association between PSS and dental utilization, comparing the strength of associations between dental utilization and PSS and SES measures among a low‐income adult Medicaid population. Methods: A cross‐sectional survey was administered to a random sample of low‐income adults in Iowa, United States with Medicaid dental insurance (N = 18,000) in the spring of 2018. Respondents were asked about PSS, dental utilization, and demographics. A set of multivariable logistic regression models examined the relative effects of PSS and SES measures on dental utilization, controlling for age, sex, health literacy, whether the respondent was aware they had dental insurance, transportation, and perceived need of dental care. Results: The adjusted response rate was 25%, with a final sample size of 2252. Mean PSS (range 1–10) was 5.3 (SD 1.9). PSS was significantly associated with dental utilization (OR = 1.11; CI = 1.05, 1.18) when adjusting for control variables, whereas other SES measures—education, employment, and income—were not. Conclusions: PSS demonstrated a small positive association with dental utilization. Results support the relative importance of PSS, in addition to SES measures, as PSS may capture aspects of social class that SES measures do not. Results suggest the need for future research to consider the effects of PSS on oral health outcomes and behaviors. [ABSTRACT FROM AUTHOR]

Background: Nursing home (NH) residents seek care at dental offices, yet many of them are at the end of life. The uncertain life expectancy further complicates the care of NH residents. This study aimed to develop and validate a Nursing Home Mortality Index (NHMI) to identify NH residents in the last year of life. Methods: Logistic modeling was used to develop predictive models for death within 1 year after initial appointment by utilizing the new patient examination data and mortality data of 903 Minnesota NH residents. The final model was selected based on areas under the curve (AUC) and then validated using data from 586 Iowa NH residents. Based on the final model, the NHMI was developed with the estimated 1‐year mortality for the low, medium and high risk group. Results: One‐year mortalities were 21% and 26% in the development and validation cohorts, respectively. Predictors included age, gender, communication capacity, physical mobility, congestive heart failure, peripheral vascular disease, cancer, cerebrovascular disease, chronic renal disease and liver disease. AUCs for the development and validation models were 0.73 and 0.68, respectively. For the validation cohort, the sensitivity and specificity were 0.79 and 0.53, respectively. The estimated 1‐year mortality risks for three risk groups were 0%–10%, 11%–19%, and ≥20%, respectively Conclusion: The high mortality rate of NH residents following a dental exam highlighted a need to incorporate patients' prognoses in treatment planning along with normative needs and patients' preferences. The NHMI provides a practical way to guide treatment decisions for end‐of‐life NH residents. [ABSTRACT FROM AUTHOR]

Poor dietary habits and inadequate nutrient intakes are of concern in the elderly. The nutritional characteristics of those who survive to become the oldest are not well defined. Our goal was to describe dietary habits, nutrient intakes and nutritional risk of community-dwelling, rural Iowans, 79 y of age and older. Subjects were interviewed (n = 420) using a standardized format on one occasion in their homes and instructed to complete 3-d diet records (n = 261) after the in-home interview. Standardized interviews assessed demographic information, cognitive function and dietary habits (Nutrition Screening Initiative Checklist). Adequate nutrient intake was defined as consumption of the nutrient's estimated average requirement, 67% adequate intake or 67% recommended dietary allowance. Mean age was 85.2 y, 57% lived alone and 58% were widowed. Subjects completing 3-d diet records were younger, more cognitively intact and less likely to be at nutritional risk than subjects not completing diet records. The percentage of subjects with inadequate intakes of selected nutrients was 75% for folate, 83% for vitamin D and 63% for calcium. Eighty percent of subjects reported inadequate intakes of four or more nutrients. Diet variety was positively associated with the number of nutrients consumed at adequate intakes (r = 0.498), total energy (r = 0.522) and dietary fiber (r = 0.421). Our results suggest that rural, community-dwelling old have inadequate intakes of several nutrients. Recommendations to increase diet variety and consume a nutrient supplement may be necessary for elderly people to achieve adequate nutrient intakes. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the predictors of survival of non-occlusal non-incisal glass-ionomer restorations as a surrogate for root surface restorations among older adults., Methods: In a retrospective cohort analysis using the University of Iowa College of Dentistry electronic dental records, we included 721 patients aged 65+ who received 2+ surface non-occlusal non-incisal glass ionomer restorations placed from January 2005 - December 2011. Restorations were followed until September 2017 or until they were deemed to have failed., Results: At baseline, participants' mean age was 77.6 ± 8.2 years, and 45.8% were females. Most patients were self-pay (65.2%). Most restorations were placed by residents and dental students (82.7%) and included only two surfaces (95.6%). About half (49.1%) failed during follow-up, with a median survival time of 3.7 years. The time ratio for lower incisors compared to other teeth was 0.6 (p = .006), for three-and-four-surface restorations compared to two was 0.7 (p = .007), for faculty as providers compared to residents and students was 1.4 (p = .039), and for the Geriatric & Special Needs Clinic compared to others was 0.8 (p = .013). Time ratios less than one indicate association with shorter durations for restorations, and time ratios greater than one indicate association with longer durations for restorations., Conclusion: Tooth type, number of restored surfaces, provider type, and clinic were all significant factors associated with survival of these restorations., (© 2024 The Authors. Special Care in Dentistry published by Special Care Dentistry Association and Wiley Periodicals LLC.)

Objectives: Some non-cavitated caries lesions (D 1 ), the initial stage of caries, progress to cavitation. This article reports participant-level and surface-level D 1 prevalence and changes in status of D 1 lesions through different periods from age 9 to 23., Methods: The Iowa Fluoride Study (IFS) participants were followed longitudinally; all permanent tooth surfaces were examined clinically for caries at ages 9, 13, 17, and 23 using standardized criteria for sound (S), questionable (D 0 ), non-cavitated (D 1 ), cavitated (D 2+ ), filled (F), or missing due to decay (M). D 1 lesions at the beginning of each interval were reassessed at each follow-up age to determine transitions (to the 5 categories or no transition)., Results: The sample had relatively high socioeconomic status (SES), with about 52%-55% high SES, 32-35% middle SES, and 12-13% low SES. Person-level prevalences of D 1 lesions were 23%, 38%, 60%, and 45% at ages 9, 13, 17, and 23, respectively. Surface-level prevalences were less than 1% at ages 9 and 13, 3% at 17, and 2% at 23. Thirteen percent of D 1 s at age 9 progressed at 13, 18% progressed from 13 to 17, and 11% progressed from 17 to 23. The percentages regressing (to sound or D 0 ) were 72%, 54%, and 72%, respectively., Conclusion: Non-cavitated lesions were more prevalent at age 17 than at ages 9, 13, and 23. The high rates of regression compared to progression or no change suggest that many non-cavitated lesions do not progress to cavitated lesions and could be reversed; therefore, surgical intervention should not be the treatment of choice for incipient lesions., (© 2022 The Authors. Journal of Public Health Dentistry published by Wiley Periodicals LLC on behalf of American Association of Public Health Dentistry.)