For many older children, caries continues to decline or remain unchanged. Nevertheless, for a subgroup of younger children, caries is increasing and this increase is impacting some traditionally low-risk groups of children.

BackgroundOral health is an integral component of general health and well-being. While edentulism has been examined in relation to socioeconomic status, rural residency, chronic disease and mental health, no study that we know of has examined edentulism and these factors together. The objective of this study was to determine whether depression and rural residency were significantly associated with partial and full edentulism in US adults after controlling for potential confounders.Methods2006 Behavioral Risk Factor Surveillance Survey (BRFSS) data were analyzed to identify factors associated with increased odds of partial or full edentulism. This year of BRFSS data was chosen for analysis because in this year the standardized and validated Personal Health Questionnaire-8 (PHQ-8) was used to measure current depression. This measure was part of the optional questions BRFSS asks, and in 2006 33 states and/or territories included them in their annual surveillance data collection. Bivariate and logistic regression analyses were performed on weighted BRFSS data.ResultsLogistic regression analysis using either full or partial edentulism as the dependent variable yielded that rural residency or living in a rural locale, low and/or middle socioeconomic status (SES), depression as measured by the PHQ-8, and African American race/ethnicity were all independent risk factors when controlling for these and a number of additional covariates.ConclusionsThis study adds to the epidemiological literature by assessing partial and full edentulism in the US utilizing data from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Examining data collected through a large national surveillance system such as BRFSS allows for an analysis that incorporates an array of covariates not available from clinically-based data alone. This study demonstrated that current depression and rural residency are important factors related to partial and full edentulism after controlling for potential confounders.

These results show present and widening workforce disparities in rural and socioeconomically depressed counties in Kentucky. Understanding the geographic distribution of dentists and the socioeconomic correlates of their practice locations may inform workforce development and reimbursement policies for the goal of improving access to oral health care in these areas.

Community-based dental education programs (CBDEPs) are an important part of the curriculum in many dental schools. This article describes the redesign of the CBDEP at the University of Kentucky College of Dentistry. As part of the formative evaluation of this CBDEP, information on clinical productivity was collected in order to educate intramural faculty members about the scope and extent of services provided in extramural sites; develop an understanding of the productivity expected; complement the intramural education by placing dental students in particular settings where they could enhance certain clinical disciplines; and serve as a decision making tool in the selection of sites that provide the richest clinical experiences. A total of 158 students participated in the CBDEP during the three years of our study . Productivity per site was calculated based on total, mean, and median number of services provided, billing (utilizing Kentucky's Medicaid fees for 2006), and Relative Value Units (RVUs). A total of 26,202 services, $972,109 in billing, and 43,053 RVUs was generated by the students, with an average of 175 services, $6,481, and 287 RVUs per student. Four categories (restorative, oral surgery, preventive, and diagnostic) accounted for 88 percent of total RVUs for all sites and all years. Productivity measured with RVU was the highest at private practices. Students spent most of their time providing restorative and oral surgery services. Measuring clinical productivity can be an effective tool to establish benchmarks, improve the site selection process, and educate those skeptical about the beneits of extramural education. Such an evaluation will enable faculty and program administrators involved in CBDEP to make continuous improvements. Dr. Arevalo is a Resident in Pediatric

Objectives To explore patterns of dental care utilization among adult Hispanic migrant farmworkers utilizing the Andersen Behavioral Model of Health Services. Methods In 2010, 278 Hispanic migrant workers participated in the oral health assessment. Hierarchical logistic regression modeling was used to assess the effects of multiple factors on having a past‐year dental visit. Predisposing variables included age, education, and knowledge toward preventing tooth decay. Enabling factors included medical insurance, place for medical care, and social support. Need measures included oral health problems and treatment. Results Only 20.5 percent of Hispanic migrant farmworkers reported a past‐year dental visit. More than one‐half (52.5 percent) needed oral health treatment and nearly two‐thirds (61.2 percent) stated that they perceived their mouth to be in poor condition. The final model indicated that those who reported preventing tooth decay by brushing and flossing, brushed their teeth once a day, and stated a good condition of their mouth were more likely to have had a past‐year dental visit. Conclusions Most Hispanic migrant farmworkers in south Florida have not had a past year dental visit. Similar to other ethnic minorities in the United States, migrant farmworkers experience poor oral health outcomes and have inadequate access to health‐care services.

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Objective: The University of Kentucky College of Dentistry (UKCD) runs a large mobile dental operation. Economic conditions dictate that as the mobile units age it will be harder to find donors willing or able to provide the financial resources for asset replacement. In order to maintain current levels of access for the underserved, consideration of replacement is paramount. A financial analysis for a new mobile unit was conducted to determine self-sustainability, return on investment (ROI), and feasibility of generating a cash reserve for its replacement in 12 years. Methods: Information on clinical income, operational and replacement costs, and capital costs was collected. A capital budgeting analysis (CBA) was conducted using the Net Present Value (NPV) methodology in four different scenarios. Depreciation funding was calculated by transferring funds from cash inflows and reinvested to offset depreciation at fixed compound interest. Results: A positive ROI was obtained for two scenarios. He depreciation fund did not generate a cash reserve sufficient to replace the mobile unit. Conclusions: Mobile dental programs can play a vital role in providing access to care to underserved populations and ensuring their mission requires long-term planning. Careful financial viability and CBA based on sound assumptions are excellent decision-making tools.