Thesis--Southern Connecticut State University, 2000. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.S.)--Virginia Polytechnic Institute and State University, 1993. / Vita. Abstract. Includes bibliographical references (leaves 64-68). Also available via the Internet.

This cross-sectional, non-experimental study evaluates associations between cohort membership, type of dental coverage, and utilization of dental services in all patients age 47 and over who received dental care at Virginia Commonwealth University’s (VCU) School of Dentistry in 2011. Structural Lag Theory poses that society’s institutions lag behind the actuality of a healthy and capable older adult population. The two dynamisms of the Structural Lag Theory were used for this study. The Dynamism of Changing Lives is represented by Cohort differences. Cohort differences include cohort size, people living longer and retaining more of their natural teeth along with different attitudes toward dental care. This dynamism impacts the Dynamism of Structural Change, represented by the institutions of dental coverage and utilization of dental services. Cohort membership is an independent variable. The dependent variable, utilization, is defined as Financial-Total amount spent and Procedural-Routine adult dental prophylaxis. Dental coverage, a dichotomous variable, is used as an independent and dependent variable. Descriptive statistics revealed employer provided dental coverage is the most prevalent type of dental coverage. However, when considered a payment source, out of pocket funding is the primary source of payment for dental services. Using Chi-square and logistic regression, examination of Cohorts (1-Greatest Generation, 2-Silent Generation, 3-Baby Boomer Generation) revealed that Cohort 2 had more dental coverage than Cohort 1, and Cohort 3 had more dental coverage than Cohort 2. Using logistic regression, Cohort 2 showed the highest level of Procedural utilization. Evaluating Financial utilization, multiple regression models showed Cohort 1 utilized more than Cohort 2 and Cohort 2 utilized more than Cohort 3. Those with dental coverage spend more on dental services, fees for routine adult dental prophylaxis make up the majority of the total amount spent, and those with dental coverage utilize more dental services when defined as total amount spent. Because they have experienced different social, political, economic, and technological changes at different times in their life course, the receipt of dental services by new cohorts of older people differs from previous ones. Findings from this study confirm that there is a structural lag in Medicare policy and its coverage of dental services.

Thesis (M.S.P.H.)--University of Michigan, 1942.

Thesis (M.S.P.H.)--University of Michigan, 1942.

OBJECTIVE: To understand dental service utilization by frail older adults residing in a long-term care (LTC) setting in the last two years of their life. To understand the types of dental services utilized by this demographic, the frequency of utilization and determine the characteristics that may be predictors of ‘higher dental service utilization’. METHODS: A retrospective cohort study was conducted by an electronic chart review of all LTC patients at two sites who died between 11/1/2014 - 12/30/2016 and had a dental visit in the two-year period prior to death, resulting in a sample of 369 patients. Based on the number of dental appointments attended prior to death, the patients were categorized into five groups: 0,1-2,3-5,6-9 and10 or more appointments. A multivariate logistic regression model was created to identify the factors associated with higher dental service utilization. RESULT: The study found that 84% of patients who died in the study period, utilized on-site dental services in the last two years of their life. Approximately 66% had 3 or more dental appointments. Diagnostic and preventive procedures were most commonly utilized (utilized by 81% and 73% of patients respectively). Multivariate analysis suggested that dentate patients and patients wearing removable dental prosthesis were about 7 and 12 times more likely respectively to have a higher utilization of dental services (OR=6.5 and OR=11.7). Medicaid beneficiaries were more likely (OR=1.9) to have a higher utilization of dental services than the others. CONCLUSIONS: This study showed that a large percentage of frail older adults utilized dental services even in the last years of their lives when given access to these services. As people are living longer and retaining their teeth longer, there is a rising need and subsequent demand for end-of-life dental services. Certain administrative and policy implementation strategies need to be developed to provide dental services to LTC patients in the last years of their lives.

Magister Chirurgiae Dentium (MChD) / The aim of this study is to analyse and compare the delivery of oral health care services based on the prevailing curative paradigm and WHO-treatment norms for the school-going community of Mitchells Palin district in relation to selected alternative methods of dental care delivery. The optimal use of auxiliary personnel, purchasing care from private dental practitioners and intriducing water fluoridation was examined. / South Africa

Even though the oral health of Americans has improved greatly in the last 50 years, some specific groups of the population have been left behind. Latinos, children and adults, bear a disproportionate burden of oral diseases. Latino children, the fastest growing minority group of children in the US, are affected disproportionately by oral diseases like dental caries compared to other groups. Understanding the difficulties and barriers that these children have to utilize dental care will help us in the future to develop effective programs to reduce health disparities in this segment of the population. The purpose of this study is to identify the factors that determine dental services access and utilization by children in the state of Iowa. Emphasis will be given to differences in utilization of dental services among different racial/ethnic groups. Additionally, the study will describe and compare difficulties in utilization of care among Latino children whose parents answered the survey in English (LE) and those who answered it in Spanish (LS). In order to address these objectives existing data from the Iowa Child and Family Household Health Survey 2005 (HHS) were analyzed. The dependent variable for the study was utilization of dental services. This outcome variable was dichotomized as whether or not the child had a dental visit in the last year. Characteristics of study subjects were first analyzed through descriptive statistics. Bivariate analyses were conducted to assess associations between the dependent variable and independent variables. Multiple logistic regression was used to identify factors associated with utilization of dental services in Iowa's children, and for each different racial and ethnic group. Seven factors were related to the time of the last dental visit for Iowa children: Having a regular source of dental care, dental insurance status, having a dental need in the past 12 months, brushing habits, the age of the children, and family income. The same seven factors were correlated to having a dental visit for white children. For African-American children, having a regular source of dental care, dental insurance status, and having a dental need in the last 12 months were the factors that were found associated to the time of the last dental check-up. For the Latino Spanish children, having a regular source of dental care and the age of the children were factors associated to dental utilization. Finally, for the Latino English children, the only factor associated with having a dental visit was having a regular source of dental care. Information from this research gives policy makers, public health workers, and clinicians an overview of oral health disparities affecting children in the state. For those agencies in Iowa interested in the improvement of access and utilization of dental services for minority children, this project gives important inside about the factors related to the use of services for different racial/ethnic groups in the state.

OBJECTIVE: The purpose of this dissertation is to examine the oral health, caregivers’ perception of oral health, and dental services utilization among children with learning disabilities (LD). METHODS: We used the National Health And Nutrition Examination Survey 1999-2004 data to investigate the oral health and caregivers’ perception of oral health among children with LD alone, ADHD alone, and LD with ADHD. We used the National Survey of Children’s Health 2011-2012 data to examine dental services utilization and unmet dental needs among children with LD alone, non-LD CSHCN, and LD CSHCN. RESULTS: Children with LD alone have greater likelihood of having dental caries in permanent dentition compared to non-LD, non-ADHD children (OR: 1.6, 95% CI: 1.1-2.2), while the likelihood of dental caries in permanent dentition among children with combined LD and ADHD is much greater (OR: 1.9, 95%CI: 1.3-2.7). Caregivers of children with LD, ADHD, and LD with ADHD perceived their oral health to be poorer when compared to non-LD, non-ADHD (OR: 1.8, 95% CI: 1.2-2.8, OR: 1.9, 95% CI: 1.1-3.0, OR: 2.0, 95% CI: 1.3-3.1, respectively). The accuracy of caregivers’ assessments of their children’s oral health was lower among those with LD, ADHD, and LD with ADHD children. Children with ADHD alone had the least accurate caregivers’ perception (OR: 0.5, 95% CI: 0.3-0.8). Children with LD alone were less likely to have a dental visit within the past year, whether for preventive visit (OR: 0.6, 95% CI: 0.5- 0.9) or any other dental visits (OR: 0.7, 95% CI: 0.5- 0.9). While LD severity did not impact dental visit receipt, children with moderate to severe LD have higher unmet dental needs than non-LD and mild-LD (OR: 1.8, 95% CI: 1.3- 2.5). CONCLUSION: Children with learning disabilities have significant oral health needs and are at a greater risk for dental disease. Despite that, children with LD are less likely to utilize preventive and other dental services. Future interventions need to target this vulnerable population to improve their oral health and reduce these disparities.

This study presents findings on the dental health status of a portion of the children participating in the dental component of the Child Health Investment Partnership (CHIP). The children in the CHIP group were compared on six variables to a comparison group of children seen at one participating CHIP dental office. Analyses of the data collected from the examination of 67 CHIP children and 178 children in the comparison group ages 2-13 revealed that upon initial visit to the dental office, the mean DMF score was .83 and 2.00, respectively. Dental visits at six months, revealed mean DMF values of 1.23 for the CHIP group and 2.65 for the comparison group. At one year dental visits, the CHIP group mean DMF score was 2.00 and the comparison group mean DMF score was 2.40. At six month and one year dental visits the CHIP group, when compared to the comparison group, receives no significantly different level of treatment (F/DMF) or experiences a Significantly different level of morbidity (D/DMF). The percentage of failed appointments was not found to be significantly different at 21% (comparison group) and 20% (CHIP). A survey containing nine questions was constructed by the researcher and administered to five dentists participating in the CHIP program. Missed appointments and low reimbursement were the only areas noted for improvement. Results revealed successful progress of the dental care received by CHIP children. This research will aid CHIP staff in determining the effectiveness of the dental health component of CHIP and will provide a baseline study from which future evaluation of the program may expand. / Master of Science