The body of knowledge that exists regarding cracked teeth is limited. The purpose of this study was to determine the prevalence of cracks among extracted teeth. This retrospective longitudinal cohort study included patients of the Virginia Commonwealth University School of Dentistry that underwent extraction procedures over a 6 year period. The sample consisted of 20,408 patients and 40,870 teeth. Statistical analysis software was used to identify diagnoses of a crack, fracture, or split tooth prior to extraction of the tooth by analyzing the Electronic Health Record (EHR) (axiUm™, Version 6.03.03.1035, Exan Corporation, Vancouver, BC, Canada). There were 3,228 teeth identified as cracked in the 40,870 extracted teeth—an overall prevalence of 7.90%. The percentage of cracked teeth were compared using a chi-square test of homogeneity. The prevalence of cracked teeth varied according to tooth type (chi-square = 95.5, df = 7, p < .0001). Tukey’s multiple-comparison procedure identified the groups of tooth types with a significantly different cracked prevalence. The mandibular 2nd molar had the highest prevalence (9.72%). Age and gender were also significantly correlated with cracked teeth.

Abstract THE EFFECTIVENESS OF A PREVENTIVE RECALL STRATEGY IN CHILDREN FOLLOWING DENTAL REHABILITATION UNDER GENERAL ANESTHESIA By Amanda Kerns, DDS A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2016 Thesis Advisor: Elizabeth Berry, DDS, MPH, MSD Vice Chair, Assistant Professor, Department of Pediatric Dentistry Purpose: This was a prospective randomized controlled trial assessing the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) in children with early childhood dental caries. Methods: 130 patients completed FMDR and were included in the analysis. Caries risk assessment (CRA), dental exam, and a caregiver oral health knowledge (OHK) questionnaire was completed for each patient. Patients were randomized into two groups; intervention returned at 3 and 6 months and control returned at only 6 months post-surgery. At each recall, CRA and dental exam information was recorded, and at the six month recall, all caregivers completed the OHK questionnaire. Results: Actual recall data showed a statistically significant difference in CRA at six months, with 71.8% of patients in the control and 44.8% of patients in the intervention assessed as high caries risk. Conclusions: The actual recall data suggests this recall strategy is effective in reducing CRA level following FMDR.

Objective: To determine the demographic, economic, geographic, and health infrastructure factors related to the percentage of students by school who comply with state-mandated dental screenings in Iowa. Methods: An exploratory, cross-sectional study was conducted, utilizing secondary data sources from the Iowa Department of Public Health, the Iowa Department of Education, and the U.S. Department of Agriculture, to examine factors related to dental screening compliance rates for public school kindergarteners in Iowa (AY year 2014-15). Both school-level and county-level factors were considered. A ninety percent student compliance rate was established as the criteria for a school to satisfy the threshold for being compliant with screening requirement. Multivariable logistic regression analyses were conducted to evaluate the relationship of the independent variables on whether the schools satisfactorily met the criteria for compliance. Results: Fifty-six percent of the 504 schools included in the study satisfactorily met the established criteria. Schools located in dental health professional shortage areas or in urban adjacent areas were more likely to have a greater percentage of kindergarten students exceed the 90% compliance threshold (p<0.05). Schools where a greater percentage of students were screened by a dentist or where larger populations of children were eligible for free or reduced price lunch (FRPL) (≥40%) were less likely to meet the compliance threshold. Conclusions: Schools with more lower income students, those in metro areas, and those with a higher reliance on dentists performing the oral health screenings could benefit from targeted efforts to improve compliance with mandated dental screenings.

No description available.

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.

Health is determined by the past as well as the present; the health status of indigenous peoples has been strongly influnced by the experience of colonisation and their subsequent efforts to participate as minorities in contemporary society while retaining their own ethnic and cultural identities. Colonial journays may have led to innovation and adaptation for Maori, but they have also created pain and suffering from which full recovery has yet to be felt (Durie, 2001). The oral health area can be described as having considerable and unacceptable disparities between Maori and non-Maori (Broughton 1995; Thomson, Ayers and Broughton 2003). Few reports have been conducted concerning Maori and patterns of oral health service utilisation, however a lower service utilisation among Maori than non-Maori has been noted (TPK 1996; Broughton and Koopu 1996). Overall, Maori oral health is largely unknown due to a paucity of appropriate research. This research aims to provide new information by describing Maori oral health outcomes over the life course, within a Kaupapa Maori Research (KMR) methodology. In general, the basic tenets presented for KMR are: (1) to prioritise Maori - from the margin to the centre; (2) to be Maori controlled - by Maori, for Maori; (3) to reject �victim-blame� theories; and (4) to be a step towards action and change in order to improve Maori oral health outcomes. The aims of this research are to: 1. Describe the occurrence of caris at ages 5, 15, 18 and 26 and periodontal disease at age 26 years for Maori. 2. Describe self-reported oral health, self-reported dental aesthetics and oral health service utilisation among Maori at ages 5, 15, 18 and 26. 3. Compare the above oral health characteristics between Maori and non-Maori . 4. Investigate the determinants of any differences in oral health outcomes between Māori and non-Maori using a KMR methodology. The investigation involves a secondary analysis of data from the Dunedin multidisciplinary Health and Development study (DMHDS). The existing data-set was statistically analysed using SPSS (SPSS Inc, Chicago, USA). Descriptive statistics were generated. The levels of statistical significance were set at P< 0.05. Chi-square tests were used to compare proportions and independent sample t-tests or ANOVA were used for comparing means. A summary of the Maori/non-Maori analysis shows that, for a cohort of New Zealanders followed over their life-course, the oral health features of caries prevalence, caries severity, and periodonal disease prevalence are higher among Maori compared to non-Maori. In particular, it appears that while Maori females did not always have the highest prevalence of dental caries, this group most often had a higher dmfs/DMFS for dental caries, compared to non-Maori. As adolescents and adults, self-reported results of oral health and dental appearance indicate that Maori males were more likely to report below average oral health and below average dental appearance, when compared to non-Maori. However, at age 26, non-Maori males made up the highest proportion of episodic users of oral health services. This study has a number of health implications: these relate specifically to the management of dental caries, the access to oral health services, and Maori oral health and the elimination of disparities. These are multi-levelled and have implications for health services across the continuum of care from child to adult services; they also have public health implications that involve preventive measures and the broader determinants of health; and involve KMR principles than can be applied to oral health interventions and dental health research in general. Dental diseases and oral health outcomes, such as dental anxiety and episodic use of services, are a common problem in a cohort of New Zealanders with results demonstrating ethnic disparities between Maori and on-Maori. As an area of dentistry that has had very little research in New Zealand, the findings of this study provide important information with which to help plan for population needs. The KMR approach prioritises Maori and specifically seeks to address Maori oral health needs and the elimination of disparities in oral health outcomes. While the issues that are raised may be seen as the more difficult to address, they are also more likely to achieve oral health gains for Maori and contribute to the elimination of disparities.

This study aims to provide a human resource planning example to inform government bodies in Saudi Arabia to reallocate community resources towards better dental health. This was achieved by: conducting an inventory on government human and structural oral health care resources in Jeddah and Bahrah; assessing the oral health status and treatment needs for Saudi citizens following the WHO criteria for oral health surveys; exploring the potential differences between oral health supply and treatment needs; and providing 16 models of the number and mix of dentists and hygienists to balance requirements and supply. We conducted a population-based sample survey to collect data on dental status and service requirements through self-administered questionnaires and clinical examinations. We also conducted a census of dentists and assessed their total service output by means of self-administered questionnaires. The population’s treatment needs time was estimated using the clinically assessed treatment needs multiplied by time units contained in the 2001 ODA fee-guide. Dentists’ available time was calculated from dentists’ questionnaires and the activity assessment forms. The times for treatment needs and supply of services were compared to identify differences in treatment hours. Of the 2000 participants aged 6, 12, 16, 24-29 and 35-44, 76.8% rated their oral health as excellent and 29.2% reported visiting the dentist at least once a year. The prevalence of periodontal conditions as described by the CPITN was 86.1%. The caries prevalence for the permanent and deciduous dentitions was 71.3% (mean DMFT=4.92) and 85.5% (mean dmft=5.45) respectively. One hundred seventy-five government and university dentists (56.6% response rate) completed the total service output instruments. When the projected total FTE-dentists needed to treat the incidence of oral diseases/ conditions (11,214) is contrasted with the total available supply in Jeddah and Bahrah (289 dentists) the remaining FTEs needed to meet the needs becomes 10,925 FTE-dentists. Health promotion strategies and increased productive hours could reduce this to 2,729 dentists and 1,595 hygienists. The General Directory of Health Affairs of Jeddah will need to develop different approaches to oral health promotion and/or care provision to meet the population needs.