Objectives. We measured the impact of dental diseases on the academic performance of disadvantaged children by sociodemographic characteristics and access to care determinants Methods. We performed clinical dental examinations on 1495 disadvantaged elementary and high school students from Los Angeles County public schools. We matched data with academic achievement and attendance data provided by the school district and linked these to the child’s social determinants of oral health and the impact of oral health on the child’s school and the parents’ school or work absences. Results. Students with toothaches were almost 4 times more likely to have a low grade point average. About 11% of students with inaccessible needed dental care missed school compared with 4% of those with access. Per 100 elementary and high school–aged children, 58 and 80 school hours, respectively, are missed annually. Parents averaged 2.5 absent days from work or school per year because of their children’s dental problems. Conclusions. Oral health affects students’ academic performance. Studies are needed that unbundle the clinical, socioeconomic, and cultural challenges associated with this epidemic of dental disease in children.
Our findings suggest that the prevalence of sleep disorders in the USA is much lower than previously reported in the literature suggesting under diagnosis of sleep disorders by primary care physicians.
Using the National Health and Nutrition Examination Surveys (NHANES) 1999–2004, the authors examined age patterns in oral health indicators by race/ethnicity and socioeconomic status related to edentulism, presence of root caries, and periodontal disease. Our analysis included subjects who were non-Hispanic White, Mexican American, and African American over the age of 20, and who participated in the NHANES oral health examination. African Americans experienced more oral health problems at younger ages; as age increased, so did racial disparities in oral health problems. Lower educational attainment was strongly associated with more oral health problems at all ages.
These results may indicate a faster progression of oral health problems with age among African Americans, thus suggesting that the “earlier aging” of members of racial/ethnic minorities which has been reported in prior research may also be found in oral health.
The study identified specific clinical and behavioral factors where dental professionals can intervene to possibly improve the OHRQOL of HIV-infected or at-risk HIV-uninfected women.
Objective-To determine the impact of highly active antiretroviral therapy (HAART) on salivary gland function in HIV positive women from the Women's Interagency HIV Study (WIHS).
Design-Longitudinal cohort study.Subjects and Methods-A total of 668 HIV positive women from the WIHS cohort with an initial and at least 1 follow-up oral sub-study visit contributed 5358 visits. Salivary gland function was assessed based on a dry mouth questionnaire, whole unstimulated and stimulated salivary flow rates, salivary gland enlargement or tenderness and lack of saliva on palpation of the major salivary glands.Main Outcome Measures-Changes in unstimulated and stimulated flow rates at any given visit from that of the immediate prior visit (continuous variables). The development of self-reported dry mouth (present/absent), enlargement or tenderness of salivary glands (present/absent), and absence of secretion on palpation of the salivary glands were binary outcomes (yes/no).Results-Protease Inhibitor (PI) based HAART was a significant risk factor for developing decreased unstimulated (p=0.01) and stimulated (p=0.0004) salivary flow rates as well as salivary gland enlargement (p=0.006) as compared with non-PI based HAART.
Conclusions-PI-basedHAART therapy is a significant risk factor for developing reduced salivary flow rates and salivary gland enlargement in HIV positive patients.
Dental students' attitudes towards access to dental care for the underserved may be impacted by participation in community oral health promotion programs that target individuals in underserved communities. At the University of Southern California School of Dentistry, freshman dental students provide classroom oral health promotion and preventive dental care programs to underserved elementary school children. One hundred forty-four freshman dental students were surveyed three times during their freshman year-before, during, and after participation in these programs. The students' attitudes about societal expectations, health professionals' responsibility, access to care, and students' personal efficacy to positively impact the need for expanded oral health care services for segments of the population were measured. Students reported positive attitudes in all categories throughout the study period. The students' attitudes about societal expectations to care for the oral health of the underserved remained stable over the study period, but they became more uncertain of who should be responsible for fulfilling that obligation, who should receive that care, and their capability to provide this care while in dental school. These changes in attitude may reflect the students' greater understanding of the complexity of the determinants of oral health as a consequence of their community education experiences.
Dental and periodontal variables showed little difference between HIV sero-positive and sero-negative women. Among sero-positive women, there were significant differences in coronal and root caries by AIDS diagnostic criteria, but no periodontal indicators by either AIDS diagnostic criteria or CD4 status, were observed.
The objective of this study was to assess dental students' attitudes toward underserved populations across their four years of dental school. Students at the Herman Ostrow School of Dentistry of the University of Southern California were invited to take part in the study. Participating students completed a questionnaire on their attitudes toward the underserved at three time points: 1) during orientation week; 2) at the end of their second year after taking part in some community dental programs; and 3) at the end of their fourth year after they had completed all their mandatory and volunteer rotations in community dental programs. Students' attitudes were measured in four categories: societal expectations, dentist/student responsibility, personal eficacy, and access to care. First-year students scored 85 out of a maximum of 115 on the questionnaire. Female students scored higher than male students (P=0.006). Age, debt, and past history of volunteer work were not related to irst-year students' total attitude scores; however, students with a history of volunteer experience scored higher on the dentist/student responsibility category (P=0.04). Students' attitude scores declined across the four years of dental school (P=0.001). The same patterns were evident for all categories except societal expectations. The decline was not related to age, gender, debt, or volunteer work experience. Follow-up studies are needed to help explain the factors that may be related to this decline.
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