Community-based Sealant Programs in the United States: Results of a Survey

The appropriate use of pit and fissure sealants could reduce substantially the majority of occlusal caries among US school-aged children. The 1986–87 national oral health survey conducted by the NIDR showed that less than 8 percent of the children 5–17 years of age had sealants on their teeth. The purpose of this national study was to document the current status of community-based sealant programs and to identify general program characteristics. Data were gathered through a mail survey to all state dental directors and site visits to four selected comprehensive community-based programs. Twentynine states were currently conducting sealant programs. The vast majority of these programs had formal quality assurance systems and companion health education components. Eight states indicated that sealant programs had been terminated within the last two years. Medicaid reimbursement for sealants was available in 42 states, with a mean reimbursement rate of $10.71 per sealant. Reimbursement rates ranged from $3.00- $20.00 per sealant. State practice acts almost uniformly permitted the placement of sealants by dental hygienists (n = 48), but less frequently by dental assistants (n = 15). Approximately 43 percent of state practice acts did not require a dentist to be present physically when auxiliaries place sealants in public/community sealant programs. All respondents indicated that there was a need for additional programs in their state. No structural factors—for example, level of Medicaid reimbursement for sealants or state practice act requirements for auxiliary supervision—were found to be associated with the presence of community-based sealant programs. Nationally, only a small percentage of children appeared to be receiving sealants in community programs.     

Evolving trends in size and structure of group dental practices in the United States

In this study, the authors examined recent trends in the growth of dental establishments and dental firms, including geographic location. In this article, they also present information about the demographic characteristics of dentists who work in a dental practice that is part of a larger company that delivers dental care in multiple locations. The number of dental establishments (single locations) and the average size of these establishments grew from 1992 to 2007. Large multi-unit dental firms grew in terms of number of establishments and the percentage of total receipts. Large multi-unit dental firms represent a small but growing segment of the dental market. Dentists less than thirty-five years old were most likely to work in a practice that was part of a larger company, and females were more likely than males to work in such a setting. The percentage of dentists working in these settings was also found to vary by region and state. The authors present a typology of dental group practice and suggest that future research should take into account the differences so that appropriate conclusions can be drawn and generalizations across categories are not made.     

Changing trends in oral cancer in the United States, 1935 to 1985: a Connecticut study

An extensive epidemiologic study was undertaken in an attempt to analyze patterns of oral cancer distribution and demography in Connecticut between 1935 and 1985. Sources of data for the investigation included both the Connecticut Tumor Registry (CTR) and the University of Connecticut Oral Pathology Biopsy Service. During the 51-year study period, 9,708 cases of primary oral cancer were reported to the CTR. Male age-adjusted incidence rates for overall oral cancer remained stable between 1935 and 1964 (14.5 to 14.8 per 100,000), with a gradual decline to 10.9 per 100,000 in the early 1980s. In contrast, age-adjusted rates for females advanced approximately threefold, from 1.4 per 100,000 in the 1930s to 4.1 per 100,000 in the early 1980s. There was a decrease in age-specific rates of oral cancer in males aged 70 and older; in contrast, age-specific incidence rates in females increased steadily over the same period. It was also found that female birth cohorts born in 1900 and later exhibited higher oral cancer incidence rates than those of previous cohorts. Between the 1960s and the present, male patients 30 to 39 years of age exhibited a nearly fourfold increase in oral cancer incidence; this was not observed among similarly aged females. Connecticut counties with highest oral cancer incidence rates in both sexes were the more densely populated Hartford and New Haven counties. In general, the picture of oral cancer, as revealed through analysis of cases accessioned by the University biopsy service between 1975 and 1986, exhibited similar trends to those disclosed by analysis of CTR data.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cultural adaptability of dental hygiene students in the United States: a pilot study.

PURPOSE: Dental hygiene students should prepare to competently provide services to culturally diverse patients; therefore, this study was conducted as a baseline to determine the cross-cultural adaptability of dental hygiene students. METHODS: The sample consisted of 188 dental hygiene students attending four culturally diverse dental hygiene programs (N = 108) and four non-culturally diverse dental hygiene programs (N = 80). The culturally diverse programs randomly selected were located in the southwest, southeast and mid-Atlantic regions of the U.S., and the non-diverse programs were located in the northwest, northcentral, central, and southern regions of the U.S. Any dental hygiene program with students representing four of the five ethnic categories (Caucasian, African American, Hispanic/Latino, American Indian/Alaska Native, and Asian/Pacific Islander) with a culturally diverse student enrollment of 40% or greater, was considered a culturally diverse program; any dental hygiene program enrolling students from only one ethnic category was considered a non-culturally diverse program. Participating students completed the Cross-Cultural Adaptability Inventory (CCAI), a 50 item instrument that measures and individual's cultural adaptability and its four research dimensions; emotional resilience, flexibility/openness, perpetual acuity, and personal autonomy. The instrument does not target one particular cultural, rather it is culture general, meaning the inventory is proficient in assessing all cultures. RESULTS: The unpaired t-test revealed a statistically significant difference, at the 0.05 level, in the overall, emotional resilience, flexibility/openness, and perceptual acuity between the two dental hygiene groups. Data analyses revealed the overall score of the dental hygiene students was lower than the CCAI norm group, which consisted of individuals with cross-cultural experience. The culturally diverse group scored higher than the non-diverse group in emotional resilience but scored lower than the non-diverse group in flexibility/openness and perpetual acuity. There was no statistically significant difference between the culturally diverse and non-culturally diverse groups in the dimension of personal autonomy. CONCLUSION: Results of the study led to the conclusion that dental hygiene students attending culturally diverse and non-culturally diverse programs possess some qualities such as personal autonomy and self-identity needed for cultural adaptability. The overall CCAI scores were lower than the CCAI norm group suggesting students need cross-cultural education and training. For this reason, it is important that dental hygiene curricula incorporate cross-cultural educational strategies and peer and patient cross-cultural encounters to enable students to develop competency in providing cross-cultural health care.     

A comparative study of mandibular fractures in the United States and Turkey

This study compared the data on mandibular fractures that occurred in a city in the United States and one in Turkey between 1991 and 2000. The 210 Turkish patients had 252 mandibular fractures, whereas the 665 US patients had 1042 mandibular fractures. Males accounted for 84% (560 patients) and females for 16% (105 patients) of the cases in the US. The male:female ratio was 5.5:1. In Turkey, males accounted for 76% (160 patients) and females for 24% (50 patients) of cases. The male:female ratio was 3.2:1. Assault (53.7%) was the most common cause of fracture in the US, whereas in Turkey the most common cause was a motor vehicle accident (36.2%). The most common site of mandibular fracture in the US was the angle (27.57%); in Turkey the most common site was the body (28.97%). Many of these variations may be related to socioeconomic, cultural and environmental differences between the two countries.     

Prosthodontic education in the United States

Prosthodontic education in the United States is well established and closely supervised by the American Dental Association, prosthodontic specialty organizations, and dental educators. Since the social and economic environment is rapidly changing in relation to medical care, it is incumbent that the prosthodontic community be willing to adapt new scientific and technical information to be able to continue to provide high-quality dental care.