Objectives Refugees encounter several health disparities including oral health problems.This study evaluated the self-reported oral health status, practices, and access to care of adult refugees living in San Antonio, Texas, United States. Materials and Methods Adult refugees (n = 207) who accessed services from two centers in San Antonio, completed this survey. Multivariate logistic regression was used to examine the relationship of the refugees’ demographics with oral health status, practices, and access to care. Results Oral pain in the previous 12 months was common among refugees having been reported by almost 58.9% of the survey participants; 43% reported pain as the reason for their last dental visit. Approximately half of the participants reported both the condition to their teeth and gums as being good: 42.5 and 54.6%, respectively. Most participants (84%) reported brushing their teeth one or two times a day, and around 78% reported they never smoked. Fifty-two percent reported needing dental care in the past 12 months, but not being able to receive it; while 45.9% reported not having dental insurance, 41.5% reported not having money to pay a dentist. Fifteen percent reported never visiting a dentist. Arabic speakers, moving to the United States more recently, and lower level of education were associated with a poor oral health status and practices (p < 0.05). Conclusion Refugees in this study encountered limited access to dental care. Their inability to seek dental care could affect their oral and general health, weaken efforts of preventing oral health diseases, and restrict their full inclusion into the community.

An Integrated National Board Dental Examination (INBDE) combining basic, behavioral, and clinical sciences will be implemented in 2020 to replace the current two-part National Board Dental Examination required for all candidates who seek to practice dentistry in the U.S. The aims of this study were to determine how U.S. dental schools are preparing for implementation of the INBDE and to assess their top administrators' attitudes about the new exam. A total of 150 deans, academic deans, and other administrators at all 64 U.S. dental schools with graduating classes in 2016 were emailed a 19-question electronic survey. The survey questions addressed the respondents' level of support, perceived benefits and challenges, and planned preparation strategies for the INBDE. The individual response rate was 59%, representing 57 of the 64 schools. Approximately 60% of the respondents either agreed or strongly agreed that they support the integrated exam, while roughly 25% either somewhat or strongly disagreed. While most respondents (72%) reported that their institutions would be prepared for the INBDE, 74% reported that the merged exam created additional strain for their institutions. Respondents reported viewing content integration and clinical applicability as benefits of the INBDE, while required curriculum changes and student preparedness and stress were seen as challenges. Most of the respondents reported their schools were currently employing strategies to prepare for the INBDE including meetings with faculty and students and changes to curricula and course content. The beginning of the fourth year and the end of the third year were the most frequently reported times when schools planned to require students to take the INBDE, although almost half of the respondents did not yet know what it would be required at their school. Several schools were reconsidering using the boards as a passing requirement. This study found that support for the INBDE was not universal, but strategies are under way to prepare students, faculty, and curricula for this new means of assessment.

This study was conducted to determine the content of infection control (IC) curricula, the extent of IC monitoring and compliance, and the number of bloodborne pathogen (BBP) exposures/year in U.S. dental schools. A questionnaire was emailed to persons responsible for predoctoral IC programs. The response rate was 60 percent. Most schools did not have an independent course and used classroom lectures and clinic demonstrations to teach IC. Schools with an IC committee were more likely to use online learning (p<0.05), utilize multiple teaching methods (p<0.05), issue written warnings for IC violations (p<0.0001), and use multiple disciplinary actions (p<0.005) than schools without an IC committee. Schools with an IC coordinator were less likely to issue grade reductions for IC violations than schools with no IC coordinator (p<0.05). Thirty-eight percent reported ≥16 BBP exposures/year, and 18 percent reported <5. There was signiicant correlation between BBP exposure incidents and large class size (p<0.005). Respondents were satisied with their IC curriculum and perceived that dental students had a high level of IC compliance and satisfaction, along with staff IC promotion and compliance. The indings suggest that schools without an IC committee should consider its beneits. Further investigation of schools with high numbers of BBP exposures is recommended.

Objectives: Dental-related emergency department (ED) visits are a growing public health concern. Dental insurance coverage is a strong predictor of dental service access. The objective of this study was to conduct a systematic review to assess the incidence of dental-related ED visits for Medicaid dental enrollees compared to those with other insurances. Methods: PubMed, EMBASE, and Google Scholar were searched for surveillance and observational data published in English from January 1999 to April 2020 to address the following PECOT question: Do patients with nontraumatic dental conditions (NTDC) (P1), or patients with any dental condition (P2) who have Medicaid (E) compared to other insurance status (private insurance, Medicare, no insurance) (C) have a differential incidence of single dental-related ED visits (O) in the literature search results from 1999 to April 2020 (T)? A critical appraisal was performed using a combination of the AXIS tool (for crosssectional studies with observational data and MetaQAT (for public health evidence). Results: This systematic review included 32 studies. Overall, risk of bias was low. Due to significant statistical heterogeneity, a synthesis without metaanalysis was conducted. NTDC ED visits ranged from 16.0 percent to 79.8 percent for Medicaid patients and 0.9 percent to 57.2 percent for uninsured patients. The range for any dental visit to the ED was 2.2-63.8 percent for Medicaid patients and 2.9-40.8 percent for uninsured patients. Conclusions: The results of this study support expanding insurance coverage in Medicaid programs to reduce ED use for NTDC visits in the United States.

The 2020 environment challenges health professionals and stakeholders to reconsider oral health-care design and business operations to drive meaningful change toward improving the oral health of all. The Three Domain Framework reinforces connections between social and structural determinants of health while promoting new opportunities to demonstrate value-based solutions that connect care providers, individuals, and communities.