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1.
Yvonne S. Lin Marilynn L. Rothen Peter Milgrom 《Journal of the American Dental Association (1939)》2019,150(3):186-192
Background
Silver diamine fluoride (SDF) is used topically to prevent or arrest caries. The authors' aim was to characterize the kinetics of silver and fluoride after topical application of SDF.Methods
Sixteen adults participated in a pharmacokinetics study after the application of 38% SDF to 5 teeth (approximately 50 microliters, estimated 4-11 milligrams per participant). Serum and urine samples were collected over 24 hours after application and were analyzed for silver and fluoride.Results
Silver serum peak was 0.67 (standard deviation [SD], 0.49) nanograms per milliliter; median time to peak was 3 hours. The estimated elimination half-life of silver was 46 (SD, 26) hours. No silver was recovered in urine. Baseline fluoride serum levels ranged from less than 10 through 50 ng/mL (< 0.01-0.05 parts per million) and fluctuated around baseline after SDF. The 24-hour urinary fluoride was 1.29 (SD, 0.81) mg.Conclusions
SDF was well tolerated in this study, and no adverse events related to SDF were reported.Practical Implications
This clinical study confirmed that topical application of 38% SDF, in growing use in the United States, is safe and well tolerated in healthy adults. 相似文献2.
Yasmi O. Crystal Malvin N. Janal Dylan S. Hamilton Richard Niederman 《Journal of the American Dental Association (1939)》2017,148(7):510-518.e4
Background
The caries arrest that can be achieved by using silver diamine fluoride (SDF) offers a minimally invasive and inexpensive alternative to traditional restorative caries treatment. The authors evaluated how the dentinal staining that is associated with SDF influences the acceptance of this treatment among parents of young children in the New York City metropolitan area.Methods
The authors invited the parents of children who had experienced dental caries and who had appointments at the New York University Pediatric Dentistry Clinic and at several private clinics in New Jersey to participate in a Web-based survey designed to assess parents’ demographics, perceptions of photographs of SDF-treated carious teeth, and acceptability of treatment in different behavior management scenarios.Results
Ninety-eight mothers and 22 fathers from diverse backgrounds participated. Most parents (67.5%) judged SDF staining on the posterior teeth to be esthetically tolerable, but only 29.7% of parents made this same judgment about anterior teeth (P < .001). In the absence of their child having behavioral barriers to conventional restorations, 53.6% of parents reported that they were likely to choose SDF to treat their child’s posterior teeth, but only 26.9% of parents were likely to choose SDF to treat their child’s anterior teeth. As the number of children’s behavioral barriers increased, so did the parents’ level of acceptance. In extreme cases, in which parents had to decide whether their children should undergo general anesthesia during treatment, parents’ acceptance rate of SDF as a treatment method increased to 68.5% on posterior teeth and to 60.3% on anterior teeth. Parents’ acceptance of the treatment also varied according to their socioeconomic status.Conclusions
Staining on posterior teeth was more acceptable than staining on anterior teeth. Although staining on anterior teeth was undesirable, most parents preferred this option to advanced behavioral techniques such as sedation or general anesthesia.Practical Implications
Clinicians need to understand parental sensitivities regarding the staining effect of SDF to plan adequately for the use of SDF as a method of caries management in pediatric patients. 相似文献3.
Branca Heloisa Oliveira Joana Cunha-Cruz Anjana Rajendra Richard Niederman 《Journal of the American Dental Association (1939)》2018,149(8):671-679.e1
Background
In this systematic review, the authors aim to assess the effect of silver diamine fluoride (SDF) in preventing and arresting caries in exposed root surfaces of adults.Types of Studies Reviewed
Two reviewers independently searched for controlled clinical trials with at least 12 months of follow-up, without language or date of publication restraints, in 8 electronic databases, 5 registries of ongoing trials, and reference lists of narrative reviews.Results
The authors found 2,356 unique records and included 3 trials in which the investigators randomly assigned 895 older adults. Investigators in all studies compared SDF with placebo; investigators in 1 also compared 38% SDF with chlorhexidine and sodium fluoride varnishes. The primary effect measures were the weighted mean differences (WMDs) in decayed or filled root surfaces (DFRS) and the mean differences in arrested carious lesions between SDF and control groups. The studies had low risk of bias in most domains. SDF applications had a significantly better preventive effect in comparison with placebo (WMD DFRS: 24 months, ?0.56; 95% confidence interval, ?0.77 to ?0.36; 30 months or more, ?0.80; 95% confidence interval, ?1.19 to ?0.42), and they were as effective as either chlorhexidine or sodium fluoride varnish in preventing new root carious lesions. SDF also provided a significantly higher caries arrest effect than did placebo (pooled results not calculated). Complaints about black staining of the carious lesions by SDF were rare among older adults.Conclusions and Practical Implications
Yearly 38% SDF applications to exposed root surfaces of older adults are a simple, inexpensive, and effective way of preventing caries initiation and progression. 相似文献4.
Ollie Yiru Yu May Lei Mei Irene Shuping Zhao Quan-Li Li Edward Chi-Man Lo Chun-Hung Chu 《Dental materials》2018,34(12):e344-e352
Objective
To evaluate the remineralising effect of the adjunctive application of 38% silver diamine fluoride (SDF) solution and 5% sodium fluoride (NaF) varnish on artificial enamel caries lesions.Methods
Forty-eight demineralised enamel specimens were allocated into four groups. Group 1 received 38% SDF and 5% NaF; Group 2 received 38% SDF; Group 3 received 5% NaF; and Group 4 received deionized water. After pH cycling, the surface morphology and fluoride content of the specimens were studied via scanning electron microscopy (SEM)/energy dispersive spectroscopy (EDS). The lesion depth and crystal characteristics were assessed using micro-computed tomography and X-ray diffraction (XRD) respectively. The crystallization reaction was performed by incubating hydroxyapatite powder with NaF or SDF for 48 h. The precipitates were studied via transmission electron microscopy (TEM) and X-ray photoelectron spectroscopy (XPS).Results
SEM demonstrated the destruction of the enamel surface in Group 4. EDS revealed that the mean fluoride weight percentage of Groups 1–4 were 1.28 ± 0.15, 1.33 ± 0.19, 1.03 ± 0.09 and 0.87 ± 0.04 respectively. The mean lesion depths of Groups 1–4 were 129 ± 14 μm, 131 ± 16 μm, 153 ± 10 μm and 181 ± 21 μm respectively. The addition of NaF to SDF did not reduce the lesion depths (p = 0.779). XRD revealed that silver chloride formed as a main product in Groups 1 and 2. Meanwhile, TEM analysis indicated that silver nanoparticles were incorporated into hydroxyapatite crystal in SDF-treated hydroxyapatite. XPS spectra suggested that the chemical state of the silver was metallic.Significance
The adjunctive application of SDF and NaF varnish had a similar remineralising effect to that of SDF on enamel caries. 相似文献5.
6.
Rebecca L. Slayton Olivia Urquhart Marcelo W.B. Araujo Margherita Fontana Sandra Guzmán-Armstrong Marcelle M. Nascimento Brian B. Nový Norman Tinanoff Robert J. Weyant Mark S. Wolff Douglas A. Young Domenick T. Zero Malavika P. Tampi Lauren Pilcher Laura Banfield Alonso Carrasco-Labra 《Journal of the American Dental Association (1939)》2018,149(10):837-849.e19
Background
An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated evidence-based clinical recommendations for the arrest or reversal of noncavitated and cavitated dental caries using nonrestorative treatments in children and adults.Types of Studies Reviewed
The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid, Cochrane CENTRAL, and Cochrane database of systematic reviews to identify randomized controlled trials reporting on nonrestorative treatments for noncavitated and cavitated carious lesions. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and move from the evidence to the decisions.Results
The expert panel formulated 11 clinical recommendations, each specific to lesion type, tooth surface, and dentition. Of the most effective interventions, the panel provided recommendations for the use of 38% silver diamine fluoride, sealants, 5% sodium fluoride varnish, 1.23% acidulated phosphate fluoride gel, and 5,000 parts per million fluoride (1.1% sodium fluoride) toothpaste or gel, among others. The panel also provided a recommendation against the use of 10% casein phosphopeptide–amorphous calcium phosphate.Conclusions and Practical Implications
Although the recommended interventions are often used for caries prevention, or in conjunction with restorative treatment options, these approaches have shown to be effective in arresting or reversing carious lesions. Clinicians are encouraged to prioritize use of these interventions based on effectiveness, safety, and feasibility. 相似文献7.
Objectives
This ex vivo study compared the physico-chemical structural differences between primary carious teeth biannually treated with silver diamine fluoride (SDF) and carious teeth without such treatment.Method
Twelve carious primary upper-central incisors were collected from 6-year-old children. Six teeth had arrested caries after 24-month biannual SDF applications and 6 had active caries when there was no topical fluoride treatment. The mineral density, elemental contents, surface morphology, and crystal characteristics were assessed by micro-computed tomography (micro-CT), energy-dispersive X-ray spectrometry (EDX), scanning electron microscopy (SEM), and transmission electron microscopy (TEM).Results
Micro-CT examination revealed a superficial opaque band approximately 150 μm on the arrested cavitated dentinal lesion. This band was limited in the active carious lesion. EDX examination detected a higher intensity of calcium and phosphate of 150 μm in the surface zone than in the inner zone, but this zone was restricted in the active cavitated dentinal lesion. SEM examination indicated that the collagens were protected from being exposed in the arrested cavitated dentinal lesion, but were exposed in the active cavitated dentinal lesion. TEM examination suggested that remineralised hydroxyapatites were well aligned in the arrested cavitated dentinal lesion, while those in the active cavitated dentinal lesion indicated a random apatite arrangement.Conclusions
A highly remineralised zone rich in calcium and phosphate was found on the arrested cavitated dentinal lesion of primary teeth with an SDF application. The collagens were protected from being exposed in the arrested cavitated dentinal lesion.Clinical significance
Clinical SDF application positively influences dentine remineralisation. 相似文献8.
Silver diammine fluoride (SDF) is used as an anticaries agent; however, its mode of action is uncertain, whether chemical, physical, mechanical or antibacterial. As a preliminary study, the effect of SDF on hydroxyapatite (HAp) and gelatin (as a chemically-representative protein) was examined.
Methods
2.5 mg HAp powder specimens and 0.5 mL 10% gelatin (Riedel-de Haën) (initially as a sol at ∼37 °C), were mixed with 0.5 mL of 38% SDF (J. Morita), 4% NaF (Sigma) or 40% AgNO3 (Sigma) and tumbled in 1.5 mL polypropylene tubes (Sarstedt) for 48 h at ∼23 °C, in two series: exposed to laboratory lighting, and kept dark at all times. The HAp specimens were separated by centrifugation and decanting, then these and one set of gelatin specimens were dried at 60 °C in situ; a second parallel set of gelatin specimens were dried at ∼23 °C. Each was washed with 1 mL deionized water for 1 min, 3 times. Treated materials were observed, before and after washing, with scanning and transmission electron microscopy (SEM, TEM); energy-dispersive X-ray analysis (EDX), and electron diffraction (ED).Results
SDF appeared to produce globular particles of CaF2 on the surface of the HAp, but these disappeared on washing, whilst with AgNO3 yellow cubic crystals of Ag3PO4 formed which were not dissolved on washing, but which darkened, converting gradually to metallic silver, on exposure to light. NaF had no effect on gelatin, whilst with SDF and AgNO3, particles of silver were produced which were resistant to washing.Conclusions
Both principal components of tooth tissue react with SDF; the solubility of the putative CaF2 formed weakens the case for it exerting a caries-protective effect. The importance of the persistent silver needs further study. 相似文献9.
Objective
To investigate the inhibitory effects of 38% silver diamine fluoride (SDF) on demineralised dentine.Methods
Human dentine blocks were demineralised and allocated to four groups: SF, F, S and W. The blocks in group SF received a topical application of 38% SDF solution (253,900 ppm Ag, 44,800 ppm F), group F received a 10% sodium fluoride solution (44,800 ppm F), group S received a 42% silver nitrate solution (253,900 ppm Ag) and group W received deionised water (control). They were subjected to pH cycling using demineralisation solution (pH 5) and remineralisation solution (pH 7) for 8 days. The surface morphology, crystal characteristics, lesion depth and collagen matrix degradation of the specimens were investigated by scanning electron microscopy (SEM), X-ray diffraction (XRD), micro-CT testing and spectrophotometry with a hydroxyproline assay.Results
The surface morphology under SEM showed evident demineralisation with exposed collagen in groups S and W, but not in group SF. Clusters of granular spherical grains were observed in the cross-sections of specimens in groups SF and F. XRD revealed precipitates of silver chloride in groups SF and S. The mean lesion depths (±SD) of groups SF, F, S and W were 182 ± 32 μm, 204 ± 26 μm, 259 ± 42 μm and 265 ± 40 μm, respectively (SDF, F < S, W; p < 0.01). Groups SF and S had significantly less hydroxyproline liberated from the dentine matrix than groups F and W (p < 0.01).Conclusion
The use of 38% SDF inhibited demineralisation and preserved collagen from degradation in demineralised dentine.Clinical significance
SDF application positively influences dentine remineralization. 相似文献10.
Lydie A. Lebrun-Harris María Teresa Canto Pamella Vodicka 《Journal of the American Dental Association (1939)》2019,150(4):246-258
Background
Research has identified significant gaps in preventive oral health care among certain subpopulations of US children. The authors of this study sought to estimate children’s preventive oral health care use and oral health and investigate associations with child, family, and health care characteristics.Methods
Data for this observational, cross-sectional study came from the 2016 National Survey of Children’s Health. Children aged 2 through 17 years were included (n = 46,100). Caregiver-reported measures were preventive dental visits, prophylaxis, toothbrushing or oral health care instructions, fluoride, sealants, fair or poor condition of the teeth, and problems with carious teeth or caries. Univariate, bivariate, and multivariable logistic regression analyses were conducted.Results
As reported by parents or caregivers, 8 in 10 children had a preventive dental visit in the past year but lower rates of specific services: 75% prophylaxis, 46% fluoride, 44% instructions, and 21% sealants. In addition, 12% had carious teeth or caries and 6% had fair or poor condition of the teeth. In adjusted analyses, young children (aged 2-5 years), children with no health insurance, and those from lower-income and lower-educated households had decreased likelihood of a preventive dental visit as well as specific preventive services. Children with preventive health care visits and a personal physician or nurse had increased likelihood of receiving preventive oral health care.Conclusions
Preventive oral health services are lagging among young children and children from lower socioeconomic backgrounds. Further studies are needed to identify interventions that encourage use of specific preventive services.Practical Implications
Dentists should work with caregivers and primary care providers to promote preventive oral health care, especially among young children and those from lower socioeconomic backgrounds. 相似文献11.
D. Brad Rindal Gregg Gilbert Claudia Carcelén Ellen Funkhouser Emily Durand David A. Uppgaard Jeff Fellows Jana Ikeda Alexander Ross Kerr Branden Brar Valeria V. Gordan Sudhir Agarwal Peter Barnett Robert K. Pickard Maura Gillison 《Journal of the American Dental Association (1939)》2019,150(2):130-139.e4
Background
Oral human papillomavirus (HPV) infection is the principal underlying cause of a dramatic increase in oropharyngeal cancer. Dentistry can play an important role in developing clinical algorithms for secondary prevention.Methods
The authors conducted this cross-sectional pilot study with practices of The National Dental Practice-Based Research Network. The authors evaluated the feasibility and acceptability of screening and testing procedures as judged by practitioners and patients. The authors used tablet devices for patient screening, obtaining consent, and administering a confidential oral HPV risk factor survey.Results
Most patients (85%) were comfortable being asked about their cigarette use and their sexual behavior (69%) and were interested in participating again (79%). More than 90% of practitioners were comfortable with study procedures except the extra time required for patient participation (75% comfortable). There were no problems with oral rinse collection as reported by patients or practitioners.Conclusions
It is feasible in community dental offices to collect oral rinses for HPV detection and to ask patients explicit questions about sexual history when using a tablet device for confidentiality.Practical Implications
Discussing high-risk types of HPV and appropriately assessing that risk are a challenge for oral health care professionals. These results are positive from a research perspective but do not address the advisability of routine HPV screening in dentistry. 相似文献12.
目的：评价氟化氨银溶液（silver diammine fluoride,SDF）对人工龋牙本质和玻璃离子粘固剂（glass ionomer cement,GIC）之间的微拉伸粘接强度的影响。方法：将12颗人离体磨牙制备成脱矿牙本质和未脱矿牙本质2组标本,均分为对照组、氟化氨银组及氟化氨银与光固化联合处理组（n ＝20）,将处理完成的牙本质与 GIC 富士 IX 粘接,24 h 后对标本进行切割及微拉伸强度试验,最后用扫描电镜观察牙本质与 GIC 之间的超微结构,并进行数据统计分析。结果：脱矿后牙本质的粘接强度显著高于未脱矿的牙本质（P ＜0．01）。经过光固化 SDF 处理的人工龋牙本质的粘接强度数值显著高于只经 SDF 处理的人工龋牙本质的粘接强度（P ＜0．01）。结论：SDF 处理的人工脱矿牙本质与 GIC 之间的微拉伸粘接强度得到显著提高。 相似文献
13.
Claire Hall Farzana Sufi Jeffery L. Milleman Kimberly R. Milleman 《Journal of the American Dental Association (1939)》2019,150(3):204-212
Background
Mouthrinses containing potassium salts have been shown to be effective for the relief of dentinal hypersensitivity (DH) when used adjunctively to toothbrushing with a nonsensitivity toothpaste.Methods
The authors conducted a randomized, 8-week, single-center, examiner-blinded, parallel-group clinical trial with 191 participants with DH. Participants were randomized to twice-daily use of either 3% potassium nitrate (KNO3) mouthrinse plus fluoride toothpaste or the same fluoride toothpaste alone. The primary outcome was change from baseline in response to an evaporative (air) stimulus at 8 weeks, measured using the Schiff sensitivity scale. Secondary outcomes were response to an evaporative (air) stimulus with the Schiff sensitivity scale (4 weeks) and a visual rating scale (4 and 8 weeks) and response to a tactile stimulus (4 and 8 weeks).Results
Both groups showed statistically significant improvements in evaporative (air) sensitivity from baseline after 4 and 8 weeks (P < .0001). At weeks 4 and 8, the authors observed significant improvements from baseline in tactile sensitivity only in the KNO3 mouthrinse group (P < .0001). Between-treatment comparisons for all sensitivity measures at both time points showed statistically significantly greater DH reductions in the KNO3 mouthrinse group compared with the toothpaste-alone group (P = .0004 for the visual rating scale at week 4; P < .0001 for all other measures and time points). Treatments were generally well tolerated.Conclusions
Twice-daily use of a 3% KNO3 mouthrinse, adjunctive to toothbrushing with fluoride toothpaste, provided significant improvements in DH compared with fluoride toothpaste alone.Practical Implications
Addition of 3% KNO3 mouthrinse to a typical oral hygiene regimen of toothbrushing with fluoride toothpaste provides an alternative strategy for the management of DH.ClinicalTrials.gov: NCT02226562. 相似文献14.
Lisa A. Lang Sarah E. Hansen Norma Olvera Sorin Teich 《The Journal of prosthetic dentistry》2019,121(4):611-617
Statement of problem
Identifying factors that affect the clinical outcomes of implant therapy is important.Purpose
The purpose of this retrospective study was to determine whether implant location was a factor affecting the complication and failure rates of single-tooth implant-supported restorations in a predoctoral setting.Material and methods
The charts of 431 patients treated with a surgically placed dental implant and restored with a single crown in the predoctoral clinic were analyzed. Data on implant location, type of complication (surgical or prosthetic), and type of failure were collected and analyzed according to implant location using the Fisher Exact Test and Mantel-Haenszel Exact Chi Square Test analysis (α=.05).Results
The charts revealed 158 complications (68 surgical and 90 prosthetic) in 110 patients, and 3.9% of the implants failed. No statistically significant difference was found between the number of surgical complications or prosthetic complications in the maxilla and the mandible (P=.469).Conclusions
Jaw location (maxilla compared with mandible) of the implant had no statistically significant impact on the incidence of surgically or prosthetically related complications. No statistically significant difference was found in overall implant failures, surgical failures, and prosthetic failures between maxillary and mandibular implants. 相似文献15.
Daniel R. Reissmann Mike T. John Chris J. Enstad Patricia A. Lenton Ira Sierwald 《Journal of the American Dental Association (1939)》2019,150(4):278-286
Background
This study aimed to determine the psychometric properties of the English-language version of the Orofacial Esthetic Scale (OES-E) in a population of dental patients.Methods
In this cross-sectional study, 1,784 English-speaking, adult dental patients (mean age, 56.7 [standard deviation, 15.8] years; 60.0% women) were included. The 8-item OES-E was used to assess orofacial appearance. Dimensionality of the OES was investigated through an analysis of the items’ correlation matrix, a parallel analysis, and an exploratory factor analysis. Convergent validity was determined by means of several correlations between the OES and items of the Oral Health Impact Profile measuring orofacial appearance. Reliability of the OES was assessed as the instrument’s internal consistency by means of computing Cronbach α and average interitem correlation.Results
All analyses for dimensionality revealed that the OES is sufficiently represented by a single factor. Convergent validity was supported by means of the correlations of the OES summary score with the other measures of the construct with Pearson product moment and Spearman rank correlation coefficients of the expected size and direction. Cronbach α (lower boundary of 95% confidence interval, 0.94) and average interitem correlation (0.70) revealed that the scale’s internal consistency was excellent.Conclusion
This study found that the OES-E has sufficient psychometric properties to characterize dental patient’s global assessment of orofacial appearance.Practical Implications
The brevity and the easy application make the OES a pragmatic tool to clinically appraise the important construct of orofacial appearance in dental patients. 相似文献16.
Seyed Aliakbar Vahdati Mahmoud Torabinejad Robert Handysides Jamie Lozada 《Journal of endodontics》2019,45(2):99-103
Introduction
Currently, no study has compared the outcome of nonsurgical root canal treatment (NSRCT) and single-tooth implants (STIs) provided to the same patient. The purpose of this study was to determine if the survival outcome of the 2 treatment modalities is different.Methods
The medical/dental records of 3671 patients with at least 1 STI and 1 NSRCT were reviewed. One hundred seventy patients with at least a 5-year follow-up were included. The survival outcome of NSRCT and STI and related factors were evaluated.Results
Both treatments had a 95% survival rate with a mean 7.5-year follow-up. Most preoperative and postoperative factors involved in both procedures had no significant effect on the treatment outcomes. The number of adjunct and additional treatments, the number of appointments, the elapsed time before the final restoration, the number of prescribed medications, and the cost of the treatment were significantly higher for STI in comparison with NSRCT.Conclusions
Both NSRCT and STI are highly successful treatments. Compromised teeth that could otherwise be saved by NSRCTs and deemed restorable should not routinely be treatment planned for STI. 相似文献17.
Aim
The expression of cysteine cathepsins in human carious dentine suggests that this enzyme contributes to the collagen degradation in caries progress. This study investigated whether silver diamine fluoride (SDF) inhibited the activity of cysteine cathepsins.Methods
Three commercial SDF solutions with concentrations at 38%, 30% and 12% were studied. Two fluoride solutions with the same fluoride ion (F-) concentrations as the 38% and 12% SDF solutions, and 2 silver solutions with the same silver ion (Ag+) concentrations as the 38% and 12% SDF solutions were prepared. Five samples of each experimental solution were used to study their inhibitory effect on two cathepsins (B and K) using cathepsin assay kits. Positive control contained assay buffer and cathepsins dilution was used to calculate the percentage inhibition (difference between the mean readings of the test solution and control solution divided by that of the control group).Results
The percentage inhibition of 38%, 30% and 12% SDF on cathepsin B were 92.0%, 91.5% and 90.3%, respectively (p < 0.001); on cathepsin K were 80.6%, 78.5% and 77.9%, respectively (p < 0.001). Ag+ exhibited the inhibitory effect against both cathepsin B and K with or without the presence of F- (p < 0.01). The solutions containing Ag+ have significantly higher inhibitory effect than the solutions containing F- only (p < 0.01).Conclusion
According to this study, SDF solution at all 3 tested concentrations significantly inhibited the activity of cathepsin B and K. 相似文献18.
Background
Only some states provide coverage of nonemergency dental services for adult Medicaid enrollees. This study examined the association between coverage of Medicaid adult nonemergency dental services and dental services use and expenditures.Methods
The authors analyzed data from the 2000 through 2015 Medical Expenditure Panel Survey Household Component for adults 21 years or older enrolled in Medicaid. The authors examined a range of outcomes such as dental visits, preventive and 5 other types of dental services, and total and out-of-pocket dental expenditures. Multivariate regression models were used to estimate the differences in outcomes for Medicaid enrollees between states that provided coverage of nonemergency dental services and states that did not, controlling for potentially confounding factors.Results
Compared with Medicaid enrollees in states that did not provide coverage, enrollees in states that provided coverage of nonemergency dental services were approximately 9 percentage points more likely to have a dental visit, approximately 7 percentage points more likely to have any preventive dental service, and more likely to have all other types of dental services except oral surgery services. Among enrollees with any visit, out-of-pocket share of dental expenditures was approximately 19 percentage points lower among those in covered states than those in uncovered states.Conclusions
Medicaid adult nonemergency dental benefits were associated with higher use of preventive and other types of dental services and lower out-of-pocket share of dental costs.Practical Implications
Our results may help inform policy makers as they consider ways of improving dental health of adults through Medicaid. 相似文献19.
Laura Fernández-Ferrer María Vicente-Ruíz Verónica García-Sanz José María Montiel-Company Vanessa Paredes-Gallardo José Manuel Almerich-Silla Carlos Bellot-Arcís 《Journal of the American Dental Association (1939)》2018,149(9):778-786.e2