Purpose: The purpose of this study was to use data obtained from the 1999 Virginia Statewide Oral Health Survey to provide a descriptive account of the oral health status for Virginia schoolchildren and examine the relationship between a child's insurance status and indicators of oral health status.Methods: The Division of Dental Health (DDH), in the Virginia Department of Health (VDH), completed the 1999 Virginia Oral Health Needs Assessment (VSOHNA) in cooperation with the Virginia Department of Education. The survey used a probability proportional to size (PPS) sample design in selecting school children from public schools in the Commonwealth of Virginia. Descriptive and multi-variable regression analyses were completed to examine the relationship between insurance status and oral health status indicators. Results: In the primary dentition, schoolchildren with medical and dental insurance had the highest level of caries-free teeth at 46%, compared to the schoolchildren with no insurance at 34%, and those with medical insurance only at 31%. In the primary dentition, schoolchildren with no insurance had the highest prevalence of untreated decay at 65%, when compared to schoolchildren with medical insurance only at 42%, and those with both medical and dental insurance at 25%. There were no significant relationships between insurance status and caries experience or untreated decay in the permanent dentition.Conclusion: In the primary dentition, children with no insurance or medical insurance only were more likely to have untreated decay than those with both medical and dental insurance. Insurance status does not appear to be associated with caries experience or with untreated disease in the permanent dentition.

Purpose: The purpose of this study is to assess the impact of preventive dental services (screening, oral health education, and fluoride varnish) given by pediatric medical providers with an assessment of caregivers interviewed at baseline and at 6-months follow-up.Methods: Using a prospective cohort study design, an oral health knowledge and socio-demographic questionnaire was delivered to a cross-section of caregivers of preschool-aged children seen at VCU Children's Pavilion. Baseline data was used to conduct a cross-sectional analysis of caregivers prior to their children receiving preventive dental services (screening, oral health education, and fluoride varnish). Subsequently, six months into the program, caregivers of children receiving preventive dental services were retested on their oral health knowledge. The 23-item questionnaire included knowledge, behavior and opinion items on risk factors for dental diseases, care of child's teeth, and socio-demographic characteristics of the family. Data collection occurred in the clinic waiting rooms and the examination rooms. Results: A sample of 120 caregivers completed the baseline questionnaire. Caregivers at baseline reported 89% of the children have never been to a dentist. Sixty-four percent of caregivers have never been told by a doctor or nurse when their child should go to the dentist. After receiving preventive dental care in a primary care setting, there was a significant increase in the use of fluoridated toothpaste and less trouble brushing the child's teeth. Caregivers reported a significant increase in information given to them by medical residents about how to brush the child's teeth.Conclusion: The delivery of preventive dental services in a primary care setting is effective in improving certain aspects of caregiver oral health knowledge, though persistence is needed to further caregiver education in an effort to improve the oral health of children.

The purpose of this study was to assess the baseline oral health quality of life of high-risk children and examine differences in oral health quality of life according to the child's treatment needs at an oral screening exam. We hypothesized that a child's oral health related Quality of Life (QOL) would be correlated with dental treatment needs. This study was a cross-sectional design with subjects who were 8-14 year old patients of Virginia Commonwealth University and/or members of the Boys and Girls Club of Metro Richmond. The oral health quality of life was measured using the Child Perception Questionnaire (CPQ). It is a multidimensional scale that includes items concerning functional aspects including oral pain and discomfort, but also includes psychological and social aspects. The four domains tested are: oral symptoms, functional limitations, emotional well-being and social well-being. The children were asked to report on these domains as they related to their oral health in the past 3 months. The dental treatment needs of the children were categorized as (0) no future needs, or (1) restorative or orthodontic needs. Those with no future needs were scheduled for a 6 months periodic exam and prophylaxis (cleaning). The children in need of restorative treatment were scheduled for such (restorations, stainless steel crowns, extractions), and those in need of orthodontics were referred for consult to an orthodontist. The final sample population consisted of 107 children, predominately African American (84%). The intra-oral screenings revealed 75% of children required future dental treatment, specifically 84% restorative and 12% orthodontic work and 25% in need of preventative recall (cleaning and exam at 6 months). Overall, children reported high levels of oral health quality of life. When asked about the overall health of their teeth, lips, jaws and mouth, 39 % (n=42) reported excellent or very good, 50% (n=53) reported good, and 9% (n=10) reported fair or poor. When asked how "overall life" was affected by oral health, 72% (n=77) reported very little or not at all, 13% (n=14) reported some, and 15% (n=16) reported a lot or very much. There were no significant correlations between the oral health quality of life domains and the children's dental treatment needs.

The purpose of this study was to examine the use of dental services for young children following a preventive oral health intervention in a pediatric medical clinic. Over a 3 year period (2005-2008), children 0-36 months of age, enrolled in Medicaid, were provided preventive oral health services in a medical setting. Descriptive statistics and multivariate logistic regression were used to determine the effect receiving the preventive oral health services in a medical setting with the outcomes of dental utilization. 15% were determined to have dental caries at the intervention and 42% found to have a dental visit post-intervention. Children determined to have decay at the intervention were significantly more likely to have one or more restorative or adjunctive service post-intervention. After receiving preventive oral health care in a medical clinic, the resulting utilization of dental services was higher than what is commonly reported for dental utilization in infant populations of low-income children.

Purpose: To assess a caregiver’s oral health attitudes, habits, and behaviors pre and post intervention, and to determine whether a particular delivery-style (verbal-only or with visual supplementation) of a motivational interviewing session is more effective in improving oral health behaviors as well as improving success of a chosen preventive goal. Methods: N=140 caregivers of pediatric dental patients were given questionnaires to assess readiness to change and current preventive oral health behaviors. Oral health education was communicated in a MI style (verbal-only or with visual supplementation). One preventive oral health goal was selected to focus on. The home preventive behavior survey was re-administered at follow-up. Results: Preventive home behaviors improved, with no significant difference between interventions. There was significance in the amount of change in items specified as a goal. Conclusions: Behaviors improved significantly after a MI educational intervention. Goal setting and providing oral health education in a MI style can improve home preventive behaviors.

Purpose: The purpose of this study is to examine infant oral health knowledge and readiness of expectant mothers to incorporate preventive oral health behaviors for their infants. Methods: The study used a prospective cohort design to examine the effect of prenatal education and motivational counseling with expectant mothers about infant oral health care readiness. Participants were all enrolled in a prenatal care program called Centering Pregnancy offered by VCU’s Department of Obstetrics and Gynecology. They all completed a pre-survey questionnaire, followed by a motivational counseling intervention, and then completed a post-survey questionnaire. Results: A sample of 30 pregnant women completed the pre- and post-survey. The participants were predominantly white (60%) who had finished college (67%) with an average age of 28.8 years. Based on the analysis of the readiness (RAPIDD scale) responses, the participants showed an improvement in their value for dental health with a p-value illustrating a significant overall change between the pre and post surveys (p < .02). The results for the knowledge portion of the survey demonstrated an increase in their infant oral health education, showing a significant change across time (p < .0001). The results to the last portion of the pre and post survey illustrated that the participants learned at what age to establish a dental home for their infant. Conclusion: This study has shown that with the proper educational tools parents are able to accept and improve their knowledge related to infant oral health and the prevention of early childhood caries.

Purpose: This study examined differences in oral health status and dental treatment needs by HMO regions in Virginia. Methods: The Division of Dental Health (DDH), Virginia Department of Health (VDH), completed the 1999 Virginia Oral Health Needs Assessment (VSOHNA) with the cooperation of the Virginia Department of Education. The survey used a probability proportional to size (PPS) sample design in selecting school children from public schools in the Commonwealth of Virginia. Surface (DMFS/dfs) and tooth-level (DMFT/dft) data were collected as indicators of dental disease on all children. Child-level data was also recorded for each student consisting of age, race, gender, enrollment in a free and reduced lunch program, medical insurance status, dental insurance status, and history of dental visits. A descriptive and regression analysis was completed to examine the relationship between HMO regions and oral health status indicators. Results: The survey included more than 5,000 children in 200 schools and 52 school districts. The mean DMFT/dft levels were 1.47 (.33) and 1.7 (.03), respectively. The mean level of untreated decay (dt) for all schoolchildren was 0.66 (0.01). First graders had the highest levels of untreated disease at 0.71, while third graders had a mean of 0.66. The Central region of the state appeared to have the highest level of untreated decay. Conclusion: There were no significant differences in the percentage of "caries-free" children between the HMO regions. Untreated dental disease of Virginia schoolchildren varied according to the region in which they lived.

THE EFFECTS OF MOTIVATIONAL INTERVIEWING IN PREGNANCY ON KNOWLEDGE AND RETENTION OF INFANT ORAL HEALTH INFORMATION By Andrew D. Zima, Jr., B.S., M.S., D.D.S. A thesis submitted in partial fulfillment of the requirements for the degree of Masters of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2010 Major Director: Tegwyn H. Brickhouse, D.D.S., Ph.D Associate Professor, Department of Pediatric Dentistry Purpose: The purpose was to examine the effect of motivational counseling in pregnancy with readiness and acceptance of infant oral health information. Methods: The study used a prospective cohort design to examine the effect of prenatal education and motivational counseling with expectant mothers about infant oral health care readiness. Participants were all enrolled in a prenatal care program called Centering Pregnancy offered by VCU’s Department of Obstetrics and Gynecology. They all completed a pre-survey questionnaire, followed by a motivational counseling intervention, and then completed a post-survey questionnaire. A third survey was sent out 1 year post-partum. The participants were evaluated for their willingness to accept v vi information, their knowledge about infant oral health, and the retention and implementation of infant oral health information. Results: A sample of 87 pregnant women completed the pre- and post-survey and 11 of these participants completed and mailed back the 1 year post-partum survey. Based on the analysis of the readiness (RAPIDD scale) responses, the participants showed statistically significant overall improvements in their pre versus post survey openness to health information (p < .0039) and value for dental health (p < .001). The results for the knowledge portion of the survey demonstrated an increase in their infant oral health education, showing a significant change across time (p < .0001) from the pre survey to both the post and 1 year post partum surveys. The results to the last portion of the pre, post, and 1 year survey illustrated that the participants learned at what age to establish a dental home for their infant. Conclusion: This study has shown that with the proper educational tools parents are able to accept and improve their knowledge related to infant oral health and the prevention of early childhood caries. Data suggests that parents are implementing routine home infant oral health measures, but fewer have established a dental home by age 1.

Porphyromonas gingivalis, a gram-negative anaerobic bacterium, is a major etiological agent in the initiation and progression of severe forms of periodontal disease. Oral bacteria like P. gingivalis are subject to continually changing conditions as a consequence of host eating, oral hygiene patterns and subgingival temperatures. As such survival requires an adaptive response to environmental cues, but little is known about the mechanism by which P. gingivalis controls co- and post-transcriptional regulation of RNA levels and potentially protein expression. RNA-binding proteins (RBPs) are evolutionarily conserved across species and are involved in such regulatory mechanisms. However, P. gingivalis currently has no identified RBP. Recently, PG0627 has become an ideal candidate for a putative RBP due to its sequence homology to RBPs across various species. By characterizing PG0627, we can gain better insight into the function of this hypothetical protein and determine if it indeed behaves like an RNA-binding protein. A host of studies were done on a PG0627-deficient P. gingivalis mutant, V3139, in order to determine the biological role of the protein encoded by the gene. Our bioinformatics analysis indicated that PG0627 had sequence homology to several RNA recognition motifs or RBPs. Furthermore, our PG0627-deficient mutant, when compared to W83, exhibited decreased cell-associated iron content, decreased total interactions and invasions with eukaryotic cells, and decreased protease activity. Conversely, our PG0627-deficient mutant displayed slightly increased growth in the presence of nitrosative stress, and in hemin-depleted conditions. In conclusion, our results support that PG0627 is a valid candidate for an RNA-binding protein in P. gingivalis.

Syfte: Studiens syfte var att utforska tv och internets påverkan avseende synen på, intresset för samt val kring oral hälsa hos unga vuxna vid Jönköping University. Metod: En pappersenkät delades ut till 100 unga vuxna vid Jönköping University i åldrarna 20-30 år. Av dessa var 66 kvinnor, 33 män och 1 med annan könsidentitet. Enkäten bestod av 10 frågor rörande tidskonsumering av tv och internet samt i vilken grad dessa medier påverkar synen på och intresset för oral hälsa. Frågorna berörde även vilken information kring oral hälsa som intresserar mest, samt i vilken grad tv och internet upplevs som trovärdig och påverkar individens orala hälsoval. Resultat: Resultatet av studien visade att Hela och rena tänder var den orala hälsoinformation som intresserade respondenterna mest. En viss påverkan kunde ses avseende syn på, intresse för samt val kring oral hälsa. Ingen skillnad kunde ses mellan tv och internet avseende påverkan, inte heller någon signifikant skillnad mellan män och kvinnor. Ingen koppling kunde ses avseende respondenternas syn på oral hälsa och konsumtionsgrad av tv och internet. Slutsats: Tv och internet hade en viss påverkan på respondenterna avseende syn på, intresse för samt val kring oral hälsa. / Aim: The aim was to explore the influence of television and internet regarding the view of, interest in and oral health choices among young adults at Jönköping University. Method: A questionnaire were distributed to 100 young adults at Jönköping University in the ages of 20-30 years. Of these, 66 were women, 33 men and 1 with different gender identity. The questionnaire concerned time consuming of television and internet and the extent to which these media influence the view of and interest in oral health. The questions also addressed what oral health information respondents found most interesting, and the extent to which television and internet are perceived as credible and affect the individual's oral health choices. Result: The study indicated that whole and clean teeth were the most interesting oral health information. Some impact could be seen regarding view of, interest in, and choices regarding oral health. There was no difference between television and internet concerning the impact, without significant difference between men and women. No connection was found regarding respondents’ views of oral health and consumption of these media. Conclusion: Television and internet had some impact on the respondents regarding their views of, interest in and choices regarding oral health.