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Introduction: The objective of this study was to compare the outcomes of initial nonsurgical root canal therapy for different tooth types provided by both endodontists and other providers. Methods: By using an insurance company database, 487,476 initial nonsurgical root canal therapy procedures were followed from the time of treatment to the presence of an untoward event indicated by Current Dental Terminology codes for retreatment, apical surgery, or extraction. Population demographics were computed for provider type and tooth location. KaplanMeier survival estimates were calculated for 1, 5, and 10 years. Hazard ratios for provider type and tooth location were calculated by using the Cox proportional hazards model. Results:The survival of all teeth collectively was 98% at 1 year, 92% at 5 years, and 86% at 10 years. Significant differences in survival on the basis of provider type were noted for molars at 5 years and for all tooth types at 10 years. The greatest difference discovered was 5% higher survival rate at 10 years for molars treated by endodontists. A hazard ratio of 1.394 was found when comparing other providers' success with that of endodontists within this 10-year molar group. Conclusions: These findings show that survival rates of endodontically treated teeth are high at 10 years after treatment regardless of provider type. Molars treated by endodontists after 10 years have significantly higher survival rates than molars treated by non-endodontists.

Objective Very few studies have examined the relationship between timing of fluoride intake and development of dental fluorosis on late-erupting permanent teeth using period-specific fluoride intake information. This study examined this relationship using longitudinal fluoride intake information from the Iowa Fluoride Study. Methods Participants’ fluoride exposure and intake (birth to 10 years) from water, beverages, selected food products, dietary fluoride supplements and fluoride toothpaste was collected using questionnaires sent to parents at 3- and 4- month intervals from birth to age 48 months, and every six months thereafter. Three trained and calibrated examiners used the Fluorosis Risk Index (FRI) categories to assess 16 late-erupting teeth among 465 study participants. A tooth was defined as having definitive fluorosis if any of the zones on that tooth had an FRI score of 2 or 3. Participants with questionable fluorosis were excluded from analyses. Descriptive and logistic regression analyses were performed to assess the importance of fluoride intake during different time periods. Results Most dental fluorosis in the study population was mild, with only 4 subjects (1%) having severe fluorosis (FRI Score 3). The overall prevalence of dental fluorosis was 27.8%. Logistic regression analyses showed that fluoride intake from each of the individual years from age 2 to 8 years plays an important role in determining the risk of dental fluorosis for most late-erupting permanent teeth. The strongest association for fluorosis on the late-erupting permanent teeth was with fluoride intake during the sixth year of life. Conclusion Late-erupting teeth may be susceptible to fluorosis for an extended period from about age 2 to 8 years. Although not as visually prominent as the maxillary central incisors, some of the late-erupting teeth are esthetically important and this should be taken into consideration when making recommendations about dosing of fluoride intake.

On the basis of the information available from insurance claims data, this study shows that the long-term survival rates of initial endodontic therapy are adversely affected by the delayed placement of the final restoration and full coverage crown.

Introduction: Ability to access needed dental care may vary among population subgroups. We assessed 1) the differences in the proportions of adults who reported unmet dental care needs in the past 12 months and the associated barriers (structural, financial, and cognitive) in 2015 to 2016 versus 2003 to 2004 by race/ethnicity and 2) the subgroups that are more likely to report unmet dental care needs. Methods: Data of 10,029 respondents aged ≥19 y from the 2003–2004 and 2015–2016 National Health and Nutrition Examination Surveys were used. Chi-square tests assessed the differences in the proportions of adults who reported not getting the needed dental care between the periods. A multiple logistic regression model was run to identify characteristics that were significantly associated with unmet need after adjusting for other factors. Results: Overall, 19.4% of the adults reported an unmet dental care need in 2015 to 2016, as compared with 21% in 2003 to 2004. The overall unmet dental care need decreased only in the Hispanic groups (34% to 28%, P = 0.045) between 2003–2004 and 2015–2016. Between the periods, unmet need decreased among Hispanics aged 19 to 64 y (35% to 28%, P = 0.02), Hispanics with some college education or above (33.5% to 21.0%, P = 0.008), and nonpoor Hispanic adults (29.8% to 20.4%, P = 0.048). No significant differences were observed in the proportions of adults reporting structural ( P = 0.09), financial ( P = 0.86), or cognitive ( P = 0.07) barriers between the periods. When compared with their counterparts, nonelderly adults, women, Hispanics, adults with a high school education, those with less than a high school education, and poor adults were significantly more likely to report unmet dental care needs. Conclusions: Racial and ethnic disparities in accessing and receiving the needed dental care still exist. Financial barriers to dental care are the most commonly cited reasons for not getting the needed dental care. Knowledge Transfer Statement: The results of the study will inform policy makers, public health planners, and dental professionals about subgroups that still face difficulty in receiving the dental care they need. Policy makers should develop new policies to mitigate the financial barriers that are still prevalent. Dental professionals can mitigate the public’s cognitive and financial barriers by educating the community through outreach programs and by providing services to low-income populations at reduced charges or through alternative payment plans.