Nishimura et al conducted a two-year longitudinal study to show the predictive abilities of a caries activity test, and to include the predicted screening indexes that were based on previous caries activity test results and lifestyle factors that influence caries activity. Results show that caries activity test score at 18 months of age not only reflected caries incidence but also predicted caries incidence and screening results in 2- and 3 ½-year-old children. They conclude that a caries activity test could predict 3 ½-year-old children’s caries risk based on 18-month and 2-year-old test results and early weaning, less sucrose intake and toothbrushing by parents were effective in reducing a child’s caries risk.

This was an Australian case-control study. CASE-CONTROL SELECTION: Cases were recruited from children referred for dental treatment under general anaesthesia at free public hospitals in eight health service districts in the state of Queensland, Australia [early childhood caries (ECC) public cases], and three private specialist paediatric dental clinics (ECC private cases). Controls were selected from a full list of all childcare facilities in the area using a selection ratio of one in seven children. As dental health status of the children was unknown prior to recruitment, a subgroup of 62 children with ECC was recruited in the control cohort (ECC childcare) and formed the third source of ECC cases. ASCERTAINMENT: The teeth of children in dental clinics or childcare facilities were examined using lighting from an examiner’s head-lamp, with the child placed on the laps of the mother and examiner. A child was considered to have ECC if at least one cavity was present. Caries was charted using the World Health Organization oral health survey basic methods criteria(1) and enamel hypoplasia using the modified Developmental Defects of Enamel index. Presence of Streptococcus mutans was also assessed. Mothers were interviewed and screened to determine their social, medical and dental histories; dental caries experience; absence or presence of plaque and gingival inflammation; and presence of S. mutans. Validated questionnaires were used to obtain social, medical, dental, dietary and toothbrushing histories of the mothers. DATA ANALYSIS: Group comparisons of continuous variables (such as age and birthweight) were compared for statistical significance using analysis of variance. Categorical variables were compared for statistical difference across groups using contingency chi2 tests together with multinomial logistic regression modelling. RESULTS: A large proportion of children tested positive for S. mutans if their mothers also tested positive. A common risk indicator found in ECC children from childcare facilities and public hospitals was visible plaque [odds ratio (OR), 4.1; 95% confidence interval (CI), 1.0-15.9; and OR, 8.7; 95% CI, 2.3-32.9, respectively). Compared with ECC-free controls, the risk indicators specific to childcare cases were enamel hypoplasia (OR, 4.2; 95% CI, 1.0-18.3), difficulty in cleaning the child’s teeth (OR 6.6; 95% CI, 2.2-19.8), presence of S. mutans (OR, 4.8; 95% CI, 0.7-32.6), sweetened drinks (OR, 4.0; 95% CI, 1.2-13.6) and maternal anxiety (OR, 5.1; 95% CI, 1.1-25.0). Risk indicators specific to public hospital cases were presence of S. mutans in the child (OR, 7.7; 95% CI, 1.3-44.6) or mother (OR, 8.1; 95% CI, 0.9-72.4), ethnicity (OR, 5.6; 95% CI, 1.4-22.1), and access of mother to pension or healthcare card (OR, 20.5; 95% CI, 3.5-119.9). By contrast, a history of chronic ear infections was found to be protective for ECC in childcare children (OR, 0.28; 95% CI, 0.09-0.82). CONCLUSIONS: This case-control study showed that children of different socioeconomic backgrounds who have ECC share the common risk indicators of visible plaque, consumption of sugary snacks and presence of S. mutans. Additional risk indicators in children from childcare facilities were enamel hypoplasia, difficulty in cleaning the child’s teeth, sweetened drinks and maternal anxiety, whereas ethnicity and mothers’ access to pension or healthcare cards were specific

Yoshioka et al report two cases of paresthesia in the mental region. No lesions were readily apparent on the patients’ panoramic radiographs. To exclude the presence of disease in the mandible that could have been responsible for the NCS, computed tomographic (CT) images should be obtained. The images identified metastases to the mandible from primary malignant tumors elsewhere in the body. To prevent misdiagnosis of numb chin syndrome (NCS), dentists need to be aware of the clinical manifestations of NCS, the need for CT imaging, the shortcommings of panoramic radiographs and the value of obtaining detailed and accurate medical and dental histories from patients.

Declining student interest and scholastic abilities in the sciences are concerns for the health professions. Additionally, the National Institutes of Health is committed to promoting more research on health behaviors among US youth, where one of the most striking contemporary issues is obesity. This paper reports findings on the impact of a partnership between Oregon Health and Science University (OHSU) and the Oregon Museum of Science and Industry linked to a 17-week exhibition of BodyWorlds3 and designed to inform rural underserved youth about science and health research. Self-administered survey measures included health knowledge, attitudes, intended health behaviors, and interest in the health professions. Four hundred four surveys (88% of participants) were included in analyses. Ninety percent or more found both the BodyWorlds (n = 404) and OHSU (n = 239) exhibits interesting. Dental care habits showed the highest level of intended behavior change (Dental = 45%, Exercise = 34%, Eating = 30%). Overall, females and middle school students were more likely than male and high school students, respectively, to state an intention to change exercise, eating and dental care habits. Females and high school students were more likely to have considered a career in health or science prior to their exhibit visit and, following the exhibit, were more likely to report that this intention had been reinforced. About 6% of those who had not previously considered a career in health or science (n = 225) reported being more likely to do so after viewing the exhibits. In conclusion, high quality experiential learning best created by community-academic partnerships appears to have the ability to stimulate interest and influence intentions to change health behaviors among middle and high school students.

This study explored oral health disparities associated with food insecurity in working poor Canadians.

We used a cross-sectional stratified study design and telephone survey methodology to obtain data from 1049 working poor persons aged between 18 and 64 years. The survey instrument contained sociodemographic items, self-reported oral health measures, access to dental care indicators (dental visiting behaviour and insurance coverage) and questions about competing financial demands. Food-insecure persons gave ‘often’ or ‘sometimes’ responses to any of the three food insecurity indicators used in the Canadian Community Health Survey (2003) assessing ‘worry’ about not having enough food, not eating enough food and not having the desired quality of food because of insufficient finances in the previous 12 months .

Food-insecure working poor persons had poor oral health compared with food-secure working poor persons indicated by a higher percentage of denture wearers ( P < 0.001) and a higher prevalence of toothache, pain and functional impacts related to chewing, speaking, sleeping and work difficulties ( P < 0.001). Fewer food-insecure persons rated their oral health as good or very good ( P < 0.001). Logistic regression analyses showed that oral health disparities between food-insecure and food-secure persons related to denture wearing, having a toothache, reporting poor/very poor self-rated oral health or experiencing an oral health impact persisted after adjusting for sociodemographic factors and access to dental care factors ( P < 0.05). Food-insecure working poor persons reported relinquishing goods or services in order to pay for necessary dental care.

This study identified oral health disparities within an already marginalized group not alleviated by access to professional dental care. Working poor persons regarded professional dental care as a competing financial demand.

Tianviwat S, Chongsuvivatwong V, Birch S. Optimizing the mix of basic dental services for Southern Thai schoolchildren based on resource consumption, service needs and parental preference. Community Dent Oral Epidemiol 2009; 37: 372-380. © 2009 John Wiley & Sons A/S

To identify the optimal levels and mix of basic dental services (sealants and fillings for permanent teeth and extraction of primary teeth) under two different dental settings: hospital-based and mobile dental clinics under specified resource constraints.

A linear programming model is used based on explicit identification of system objectives and resource constraints. The objective was to maximize benefits as measured by parental willingness to pay (WTP) for basic dental services provided to schoolchildren subject to constraints on total resources, service need and parental preferences among different dental care settings.

Optimization was identified to require 270, 180, 552, 828, 228 and 532 cases of hospital sealant, mobile sealant, hospital filling, mobile filling, hospital extraction and mobile extraction, respectively. The corresponding current service levels were 48, 281, 191, 170, 479, and 677 respectively. The optimal service configuration produced a total WTP of 485 860 baht which exceeded the WTP for the current service configuration by more than 75.4%.

Mobile clinic fillings were the highest priority among basic dental services. The current service configurations fail to reflect the setting preferences and provide greater emphasis to extractions than the optimal configuration with less emphasis given to preventive and restorative services.

The objective of this study was to examine the characteristics and treatment-seeking behaviors of patients diagnosed with oral and pharyngeal cancer (OPC) and to determine whether seeing an oral healthcare provider in the preceding year was associated with an earlier stage of diagnosis.

Trained interviewers administered a pretested survey instrument to a sample of 131 patients newly diagnosed with OPC at two cancer centers in Florida. Analyses were conducted to compare characteristics of patients by cancer summary stage (early or advanced) on receipt of OPC examination, patterns of dental care, and number of initial signs and symptoms. In addition, analyses were also conducted for characteristics of patients’ dental care utilization (regular primary care dentist, time of most recent dental visit, and regular dental care) by receipt of OPC examination.

Overall, 25.3% of participants reported receiving an OPC examination at their last dental visit and participants who received an OPC examination were significantly more likely (79%) to be diagnosed at early stages than those who did not receive an oral cancer examination (48%). Patients with a regular primary care dentist were more likely to be diagnosed at early stages (65%) than those without a regular primary care dentist (41%). Factors significantly associated with receiving an OPC examination included having a regular primary care dentist ( P < 0.001), having a dental visit in the preceding 12 months ( P < 0.001), and receiving regular care ( P < 0.001). The number of signs or symptoms reported by the patient was significantly associated with the stage at diagnosis ( P = 0.002) and the most common initial symptom reported by patients was soreness in the mouth.

Emergency department visits for dental care of nontraumatic origin. Community Dent Oral Epidemiol 2009; 37: 366-371. © 2009 Wiley & Sons A/S

To explore the nature of emergency department (ED) visits for dental problems of nontraumatic origin in Canada’s largest province, Ontario.

The Canadian Institute for Health Information’s National Ambulatory Care Reporting System was used, which contains demographic, diagnostic, procedural and administrative information from hospital-based ambulatory care settings across Ontario. Data of fiscal years 2003/04 to 2005/06 were included for emergency visits that had a main problem coded with an International Classification of Diseases – 10th edition code in the range K00-K14, representing diseases of the oral cavity, salivary glands and jaws. Volumes are presented by a number of different factors in order to describe patient and visit characteristics.

During this period, there were a total of 141 365 ED visits for dental problems of nontraumatic origin in Ontario, representing an estimated 116 357 persons. Approximately half of all visits (54%) were made by those 20 to 44 years old, and associated with periapical abscesses and toothaches (56%). The great majority (78%) were triaged as nonurgent, and most (93%) were discharged home.

ED visits for dental problems of nontraumatic origin are not insignificant. Over the study period, these visits were greater than for diabetes and hypertensive diseases. Policy efforts are needed to provide alternative options for seeking emergency dental care in Ontario.

Scenarios involving dental services investigate whether Asian cultures are similar enough to allow standardization of service offerings. The authors control and manipulate levels of service quality and performance to yield a 2 x 2 experimental design, with Japanese, Chinese, and Korean subjects (N = 637) selected to test the invariance of the measures. The findings yield significant cultural differences with the Chinese respondents perceiving significantly higher service quality and expressing greater customer satisfaction when performance is high and expressing less customer satisfaction when performance is low than do the Japanese and Korean respondents. Thus, even though all three countries are considered high-context cultures, having their roots in Confucianism, differences in national culture lead to the conclusion that “one size does not fit all” in terms of service offerings

ODS is hosting a rally in Pioneer Courthouse Square from noon to 12:30 p.m. on Tuesday, June 23, to celebrate the success of the ODS Personal Best Charity Challenge. This five-week campaign encouraged ODS employees to take more steps each day and become more involved in their local communities. In the end, 145,503,320 steps were taken. “This is so cool,” said Rod Hart, ODS Manager, Healthcare Services. “ODS employees walked around the earth almost three times!” The ODS Charity Challenge was a joint effort by ODS Personal Best, ODS’ internal wellness program and the ODS volunteer program (see also ODS Companies).

During the Charity Challenge, ODS employees formed teams of six and tracked their daily steps using pedometers supplied by ODS Personal Best. Teams also got extra steps for participating in health challenges or four community events: March for Babies, Comcast Hands on Greater Portland Cares Day, Making Strides Against Breast Cancer Walk or the Heart and Stroke Walk. In addition to earning extra steps for participation in the events, each team earned extra steps for every dollar raised for these events. As a prize, the top three teams will have money donated in their team name to the Charity Challenge nonprofit of their choice.

“This campaign just exploded,” said Hart. “Our employees really responded to the joint effort of improving their health while improving their communities. This rally will be a way to thank them for all their hard work.”

ODS invites you to join them at the Square on Tuesday, June 23, for the ODS Charity Challenge rally to celebrate ODS employees, their commitment to their health and their communities. Events include revealing the total number of steps taken and dollars raised, a prize for best team name and the top three teams will present their team check to their benefiting nonprofit. About ODS ODS is a multifaceted organization that provides medical, dental and professional liability insurance products, along with a variety of business services including benefits administration. ODS serves more than one million members. Founded in 1955, ODS is Oregon’s leading dental plan and one of the state’s leading medical plans. ODS is a founding member of the Delta Dental Plans Association, the nation’s largest and most experienced dental benefits provider. ODS is headquartered in Portland and has offices in Medford, Ore., Milwaukie, Ore., Bend Ore., and La Grande, Ore., as well as Bothell, Wash., and Anchorage, Alaska. For more information, visit www.odscompanies.com.

Keywords: ODS Companies, Philanthropy, Professional Services, Insurance, Fund Raising, InsuranceBreast Cancer, Breast Carcinoma, Oncology, Wellness, Women’s Health.