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OBJECTIVE: To establish baseline data of dental utilization and determine the predictors of receipt of dental procedures by Medicaid-enrolled senior adults who reside in Iowa nursing facilities. METHODS: This was a longitudinal retrospective analysis of Iowa Medicaid claims data for SFY 2007-2014 of senior adults who were 68 years or older upon entry to a nursing facility and continuously enrolled (eligible 58 out of 60 months) in Medicaid for three years prior to and at least two years after admission. RESULTS: Controlling for the subject and nursing facility level variables, the strongest predictor of dental utilization after entry was the receipt of a dental procedure before entry (p< 0.001). Subjects residing in a facility located in an urban area (p< 0.002) or in two regions of Iowa (p=0.035, p=0.019, respectively) also had increased odds of receiving a dental procedure. CONCLUSION: Our results show that approximately 50% of the subjects never received a dental procedure in the 5-year study period. The strongest predictor of receipt of dental procedures in the 2 years after entry was the receipt of dental procedures in the 3 years before entry. It is important for Medicaid-enrolled senior adults to establish a dental home while community-dwelling.

Associations Between Dietary Factors and Malocclusion. Blackwelder AC*, Warren JJ, Levy SM, Marshall TA, Bishara SE (University of Iowa, Iowa City, IA) Purpose: Malocclusions, including crowding, have a multifactorial etiology, but it has been suggested that dietary factors may be a risk factor for malocclusion. Thus, the objective was to assess associations between dietary factors and dental crowding in a sample of Iowa Fluoride Study participants. Methods: As participants in the Iowa Fluoride Study, subjects were followed up from birth to 102 months using questionnaires and diet diaries periodically to gather information on dietary intake. Subjects were also examined clinically around age 5 (n=168) and 9 (n=125) with dental casts made to gather information on malocclusion such as Tooth Size Arch Length Discrepancy (TSALD) and Canine Arch Width (CAW), as well as body mass index (BMI). Relationships between dietary factors and malocclusion were assessed. Results: The maxillary and mandibular TSALD values for the age 5 and age 9 exams were correlated with the dietary data. The age 5 maxillary TSALD (1.74 mm) was statistically significant when correlated with kilocalories (P=.031) before and after adjusting for BMI. Further examination of the extreme TSALD values with dietary data was completed using Student's t-test. The age 9 mandibular extreme TSALD value and kilocalories was also statistically significant (P=.028). The age 5 CAW was correlated with the dietary data and kilocalories was also statistically significant (P=.012). Other dietary factors were found to approach statistical significance but were not significant at the alpha=0.05 level. Conclusions: The findings from this study suggest that dietary factors may be associated with crowding of the dentition as measured by TSALD and CAW; however, further research is needed.

Oral health disparities in children is an important public health issue in the United States. A growing body of evidence exists supporting the social determinants of oral health, moving beyond individual predictors of disease to family- and community-level influences. The goal of this study is to examine one such social determinant, social capital, at the family and neighborhood levels and their relationships with oral health in Iowa children. A statewide representative data source, the 2010 Iowa Child and Family Household Health Survey, was analyzed cross-sectionally for child oral health status as the outcome, a four-item index of neighborhood social capital and four separate indicators for family social capital as the main predictors, and seven covariates. Soda consumption was checked as a potential mediator between the social capital variables and oral health status. A significant association was found between oral health status and the neighborhood social capital index (p=0.005) and family frequency of eating meals together (p=0.02) after adjusting for covariates. Neighborhood social capital and family function, a component of family social capital, may independently influence child oral health outcomes.

Objective: To identify the significant predictors associated with Army Dental Corps Junior Officers' intent to leave the military. Methods: A secondary data analysis was conducted utilizing the responses from the 2009 Army Dental Officer Retention Survey. The 92 item questionnaire consisted of questions addressing retention issues. Although the survey was distributed to all Army dental officers, only results from junior officers were considered for this study. Results: Forty-six percent of junior officers completed the survey (N=577; n=267).Fifty-eight percent of respondents reported an intent to leave the military prior to retirement. In the final regression model, six variables were significantly (p < .05) associated with an officer's intent to leave: unit of assignment (p<.009, Beta=.144); specialty training status or area of concentration (AOC) (p< .047, Beta=.098) ; age (p<.002, Beta= -.133); military lifestyle (p<.001, Beta=.236); benefits (p<.000, Beta= -.408) and professional development (p<.023, Beta=.194). The model accounted for 45.7% of the total variance. Conclusion: Variables other than pay, bonuses, deployments, frequent moves and student debt were significantly associated with intent to leave. Future studies should be conducted to more fully understand how the identified significant predictor variables impact intent to leave so that policies can be developed to help reduce turn-over among junior dental officers.

There are many factors that affect the hours worked by various professions. The literature discusses some of these factors in professions such as management and various fields of medicine. However, no information has been gathered on factors that affect the practice of dentists. A survey was disseminated to all Iowa dentists inquiring about various factors that may affect the number of hours they spend at work. The survey inquired about demographics, educational indebtedness, caregiving responsibilities of both children and dependent adults, contribution to household income, relationship status, domestic responsibilities, busyness and type of practice. The data was collected and analyzed. It was hypothesized that there was no difference in the number of hours worked between male and female Iowa dentists and there was no difference in the number of hours worked between female Iowa dentists with minor children (18 years old or younger) and female dentists without minor children. When hypotheses were statistically analyzed, the data showed there was no difference between male and female dentists' working hours in the bivariate analysis. In the multiple logistic regression model, while controlling for various factors such as age and busyness, gender was statistically significant in the number of hours worked. When evaluating the hours worked between female dentists with and without minors, there was a statistically significant difference in the number of hours worked between women with minor children and women without minors. However, in the multiple logistic regression model, presence of minors was not statistically significant. This lack of statistical significance is likely attributed to the small sample size of women dentists. As such, there was not enough power to have more than 2 variables and minor children was not included. The data suggests that young male dentists, who are responsible for 61% or more of their household income and are solo practitioners are the most likely to work full-time (32+ hours/week).

The purpose of this study is to examine the relationship between dental and mental health. To dive deeper into seeing this connection, patients with sleep apnea will be asked to share their experiences with the treatments for sleep apnea and how it had affected their mental or dental health.

Dental hygiene students may struggle in dental hygiene curriculum in regards to hand function. Currently, this is not an aspect dental hygiene programs screen for or have protocol in place to help students. The research in the study examined if hand function could improve with hand function exercises and if exercises improved instrumentation scores. During a 6-week pilot study, an occupational therapist tested the hand function of a cohort of dental hygiene students. The results were recorded and the students began a 6-week hand function exercise regimen. After 6 weeks the same evaluations were preformed and the pre- and posttest data were compared. Statistical tests showed a significant improvement in hand function. After the hand function testing was complete, the scores of the cohort on the periodontal probe and 11/12 explorer were compared to students in the previous 5 cohorts. No significant improvement was made on the instrumentation scores.

Excerpt: According to the United States Centers for Disease Control and Prevention (CDC), approximately 20 million Americans are currently infected with human papillomavirus (HPV), and another 6 million will become newly infected each year.

Objective: To investigate and determine periodontal treatment needs by the use of the Community Periodontal Index of Treatment Needs (CPITN) of a Medicaid expansion population in the state of Iowa (DWP) in comparison with patients insured by the traditional Medicaid State Plan, patients with private dental insurance, and self-pay patients, while evaluating for systemic health conditions and socio-behavioral factors. Methods: A secondary data analysis of electronic health records (EHR) from the University of Iowa College of Dentistry was completed and analyzed. Univariate and bivariate analyses were conducted. Logistic regression models were used to analyze relationships between predictors and periodontal treatment need. Results: Out of the study population, 54% were indicated for scaling and root planing (SRP). Predictors of indicating the need for SRP treatment were found to be: Age (p< .0001), gender (p< .0001), medical diagnosis of diabetes (p=.031), smoking status (p< .0001), and not receiving regular dental check-ups (p< .0001). Discussion: Our findings are consistent with common periodontal disease predictors found in the literature. Interestingly, insurance status was not a significantly associated predictor of periodontal treatment needs. However, approximately 50% patients with all insurance types were indicated for SRP. Implications: DWP patients must earn benefits by maintaining dental appointments. This earned benefits approach delays periodontal treatment as patients must earn this procedure, potentially leading to deteriorating periodontal health. Further assessment of periodontal burden in the DWP population should be conducted and potential program structure evaluated.