Surveys of health professionals typically have low response rates, and these rates have been decreasing in the recent years. We report on the methods used in a successful survey of dentist members of the National Dental Practice–Based Research Network. The objectives were to quantify the (1) increase in response rate associated with successive survey methods, (2) time to completion with each successive step, (3) contribution from the final method and personal contact, and (4) differences in response rate and mode of response by practice/practitioner characteristics. Dentist members of the network were mailed an invitation describing the study. Subsequently, up to six recruitment steps were followed: initial e-mail, two e-mail reminders at 2-week intervals, a third e-mail reminder with postal mailing a paper questionnaire, a second postal mailing of paper questionnaire, and staff follow-up. Of the 1,876 invited, 160 were deemed ineligible and 1,488 (87% of 1,716 eligible) completed the survey. Completion by step: initial e-mail, 35%; second e-mail, 15%; third e-mail, 7%; fourth e-mail/first paper, 11%; second paper, 15%; and staff follow-up, 16%. Overall, 76% completed the survey online and 24% on paper. Completion rates increased in absolute numbers and proportionally with later methods of recruitment. Participation rates varied little by practice/practitioner characteristics. Completion on paper was more likely by older dentists. Multiple methods of recruitment resulted in a high participation rate: Each step and method produced incremental increases with the final step producing the largest increase.

This article presents the demographic data for 91 doctors and 347 adult AOB patients, as well as the practitioners' self-reported treatment preferences.

Introduction: Anterior openbite (AOB) continues to be a challenging malocclusion for orthodontists to treat and retain long-term. There are many orthodontic treatment modalities used to treat AOB in adult patients, but there is no consensus on which modalities are most successful. This study aims to identify the overall success rate of AOB orthodontic treatment in the adult population across the United States, as well as factors that influence treatment success. Methods: Practitioners and their adult AOB patients were recruited through the National Dental PBRN. Patient dentofacial and demographic characteristics, practitioner demographic and practice characteristics, and factors relating to orthodontic treatment were reported. Treatment success was determined from post-treatment lateral cephalometric films and intraoral frontal photos. Treatment was categorized into four main groups: aligners, fixed appliances, TADs and orthognathic surgery. Extractions were also evaluated. Univariate and multivariate models were used to evaluate how treatment success varies with treatment modality, pre-treatment dentofacial characteristics, and patient and practitioner demographic and practice characteristics. Results: End of active treatment data was collected from 84 practitioners and 254 patients. Eighty four percent of patients finished with positive vertical overlap of all incisors and 93% with positive overbite on the post-treatment lateral cephalogram. While there were no statistically significant differences in success rates between the treatment groups, patients treated with orthognathic surgery had an increased odds for success when compared to those treated with fixed appliances only. Treatment success was also associated with academic practice setting, pre-treatment IMPA £90°, no to mild pre-treatment crowding, and treatment duration < 30 months. Conclusion: The success of orthodontic treatment in adult AOB patients who participated in this study was very high. While there was a range of success for the major treatment modalities, orthognathic surgery was the only treatment modality that reached statistically significance. There were some pre-treatment dentofacial characteristics and treatment factors associated with successful closure of AOB. I would like thank the University of Washington Department of Orthodontics and the University of Washington Orthodontic Alumni Association for this wonderful opportunity and academically fulfilling experience. Thank you to my research committee members, Greg Huang, Geoffrey Greenlee, and Andrea Burke, for your mentorship and guidance. I would also like to give a special thank you to my research partner, Sam Finkleman. Finally, I would like to express my gratitude and appreciation for my family and friends for all their support.

BackgroundThe oral microbiota has been implicated in the pathogenesis of rheumatoid arthritis through activation of mucosal immunity. This study tested for associations between oral health, microbial communities and juvenile idiopathic arthritis (JIA).MethodsA cross-sectional exploratory study of subjects aged 10–18 years with oligoarticular, extended oligoarticular and polyarticular JIA was conducted. Control groups included pediatric dental clinic patients and healthy volunteers. The primary aim was to test for an association between dental health indices and JIA; the secondary aim was to characterize the microbial profile of supragingival plaque using 16S rRNA gene sequencing.ResultsThe study included 85 patients with JIA, 62 dental patients and 11 healthy child controls. JIA patients overall had significantly more gingival inflammation compared to dental patients, as evidenced by bleeding on probing of the gingiva, the most specific sign of active inflammation (p = 0.02). Overall, however, there was a trend towards better dental hygiene in the JIA patients compared to dental patients, based on indices for plaque, decay, and periodontitis. In the JIA patients, plaque microbiota analysis revealed bacteria belonging to genera Haemophilus or Kingella elevated, and Corynebacterium underrepresented. In poly JIA, bacteria belonging to the genus Porphyromonas was overrepresented and Prevotella was underrepresented.ConclusionIncreased gingival inflammation in JIA was independent of general oral health, and thus cannot be attributed to poor dental hygiene secondary to disability. The variation of microbial profile in JIA patients could indicate a possible link between gingivitis and synovial inflammation.

Background Cracked teeth are ubiquitous in the adult dentition. The objective of this study was to determine which patient traits/behaviors and external tooth/crack characteristics correlate with cracked teeth being symptomatic. Methods Dentists in the National Dental Practice-Based Research enrolled a convenience sample of subjects each with a single, vital posterior tooth with at least one observable external crack in this observational study; 2,975 cracked teeth, from 209 practitioners, were enrolled. Data were collected at the patient-, tooth-, and crack-level. Generalized estimating equations were used to obtain significant (p<0.05) independent odds ratios (OR) associated with teeth presenting as symptomatic. Results Characteristics positively associated with cracked tooth symptoms, after adjusting for demographics, included individuals who clenched, ground or pressed their teeth together (OR=1.30; 95%CI: 1.12–1.50), molar teeth (OR=1.58; 95%CI: 1,30–1.92), teeth with a wear facet through enamel (OR=1.22; 95%CI: 1.01–1.40), caries lesions (OR=1.31; 95%CI: 1.07–1.60), cracks that were on the distal surface of the tooth (OR=1.31; 95%CI: 1.13–1.52) and cracks that blocked transilluminated light (OR=1.31; 95%CI: 1.09–1.57). Teeth with stained cracks were negatively associated with having cracked tooth symptoms (OR=0.68; 95%CI:0.55–0.84). Conclusions and Practical Implications The greatest likelihood of a cracked tooth being symptomatic was found when patients reported clenching and/or grinding their teeth and had a molar tooth with a distal crack that blocked transilluminated light. This information can help inform dentists in the decision-making process regarding the prognosis for a cracked tooth.

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Introduction: This paper evaluates patient satisfaction of adults, who received orthodontic treatment for anterior openbite malocclusion across the United States. The factors that influence the satisfaction of these patients are also described. Methods: Practitioners were recruited from the National Dental Practice-Based Research Network. Upon joining the Network, practitioner demographics and information on their practices were acquired. Practitioners enrolled their adult patients in active treatment for anterior openbite. Patient demographics, patient dentofacial characteristics, and details regarding previous and current treatment were collected through questionnaires at enrollment (T1). Pre-treatment lateral cephalograms and intraoral frontal photographs were submitted. Treatment performed and details related to treatment outcome were recorded through questionnaires at the end of active treatment (T2). Post-treatment lateral cephalograms and intraoral frontal photographs were submitted. Patient satisfaction at the end of active treatment (T2) was assessed using a five-point, Likert-like scale and open-ended responses. Predictive univariate models were developed to evaluate the factors that influence patient satisfaction. Open-ended responses were reviewed for general trends. Results: End of active treatment (T2) data was received for 256 patients. Two hundred forty-eight of these patients completed and returned the patient satisfaction questionnaires. High levels of satisfaction were found in our sample of adult patients receiving treatment for anterior openbite malocclusion. Specifically, 96% of the sample reported being very or somewhat satisfied. Only ten patients (4%) were not satisfied with the treatment provided or an element of the final result. Successful openbite closure, treatment modality, and certain patient characteristics may influence patient satisfaction. However, there was insufficient power to demonstrate statistical significance. Open-ended responses directly associated with patient satisfaction were received from twenty-three patients (9%). They relayed positive, neutral, and negative feelings about the treatment received and final results. Additional responses regarding the orthodontic treatment in general, but not specifically linked to patient satisfaction, were received from 119 patients (48%). These comments depict an overwhelmingly positive experience. Conclusions: Adult patients who received orthodontic treatment for anterior openbite malocclusion were generally satisfied with the treatment provided, as well as the final esthetic and functional results.

Aim Our objectives were to describe the approach used in the National Dental Practice‐Based Research Network to capture patient‐reported outcomes and to compare electronic and paper modes of data capture in a specific network study. Methods This was a prospective, multicenter cohort study of 1862 patients with dentin hypersensitivity. Patient‐reported outcomes were assessed based on patients’ perception of pain using Visual Analog Scales and Labeled Magnitude scales at baseline and at 1, 4 and 8 weeks post‐baseline. Results Eighty‐five percent of study patients chose to complete follow‐up assessments via an electronic mode; 15% completed them via a paper mode. There was not a significant difference in the proportions of patients who completed the 8‐week assessment when comparing the electronic mode to the paper mode (92% vs. 90.8%, P = 0.31, Rao‐Scott clustered χ2‐test). Conclusion The electronic mode of data capture was as operational as the traditional paper mode, while also providing the advantage of eliminating data entry errors, not involving site research coordinators in measuring the patient‐reported outcomes, and not incurring cost and potential delays due to mailing study forms. Electronic data capture of patient reported outcomes could be successfully implemented in the community dental practice setting.