Validity of Two Methods for Assessing Oral Health Status of Populations

Beltrán, Eugenio D.; Malvitz, Dolores M.; Eklund, Stephen A.

doi:10.1111/j.1752-7325.1997.tb02977.x

Cited by 31 publications

(30 citation statements)

References 35 publications

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“…13 Encouragingly, 3 studies found that after 2 to 5 hours of training, physicians, nurses, and physician assistants could perform oral screenings approaching the accuracy of dentists and suitable for the purposes of referral for a complete evaluation by a dentist. [14][15][16] The systematic review by Bader et al 13 identified only 1 study on the effectiveness of primary care clinicians in making a dental referral. That study of workers in the Special Supplemental Nutrition Program for Women, Infants, and Children suggested that they might be only partially effective in getting children into dental care.…”

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confidence: 99%

Dental Screening and Referral of Young Children by Pediatric Primary Care Providers

2004

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ABSTRACT. Objective. Several health care organizations recommend that physicians provide preventive dentistry services, including dental screening and referral. This study is the first to investigate characteristics of medical providers that influence their referral to a dentist of children who are at risk for dental disease.Methods. A cross-sectional survey was undertaken of primary care clinicians in 69 pediatric practices and 49 family medicine practices who were enrolled in a study to evaluate a pediatric preventive dentistry program targeted toward Medicaid-eligible children in North Carolina. A 100-item, self-administered questionnaire with 23 items on some aspect of dental referral elicited providers' knowledge and opinions toward oral health, their provision of dental services, and their confidence in providing these services. We hypothesized that providers' dental knowledge, opinions about the importance of oral health, and confidence in providing oral health services would be associated with their propensity to refer children who are younger than 3 years and are suspected of having risk factors for future dental disease or a few teeth in the beginning stages of decay. We also hypothesized that providers' perceived referral difficulty would affect their referral activities. Patient characteristics (tooth decay status, insurance status, immigrant status, English speaking), practice characteristics (setting, number of providers, patient volume, busyness), practice environment (perceived and actual availability of dentists), and other provider characteristics (gender, type, practice experience, board certification, training in oral health during or after professional education, hours worked, teaching of residents, preventive behaviors) were assessed and used as control variables. Preliminary bivariate analysis (analysis of variance, 2 ) identified characteristics associated with referral activity. Multivariable logistic regression analysis using backward stepwise logistic regression tested the posed hypotheses, with provider, practice, and patient characteristics included as potential control variables.Results. Nearly 78% of 169 primary care clinicians who participated in the survey reported that they were likely to refer children who had signs of early decay or high risk for future disease. Approximately half (54%) call a dental office sometimes or more frequently to make an appointment for a child whom they refer, but the most common method is to give the caregiver the name of a dentist without additional assistance (96%). Bivariate analysis revealed that providers who had high confidence in their ability to perform screenings and reported low overall referral difficulty were more likely to refer children. Bivariate analyses also found that providers who were not in group practices, were board certified, graduated 20 years ago or more, saw 80 or more patients per week, had >60% of their total patients who were infants and toddlers, and saw >3.5 patients per hour were significantly less likely to refer at...

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confidence: 99%

Dental Screening and Referral of Young Children by Pediatric Primary Care Providers

2004

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“…Other, useful but less rigorously validated instruments are also available, such as the Index of Activities of Daily Oral Hygiene and the Mucosal Plaque Score. Visual inspection has also been used successfully to determine the oral health status in children, showing good reproducibility, with sensitivity, specificity, and predictive values above 90% for the evaluation of the prevalence of caries when compared with visual-tactile (15). Although the benefits and drawbacks of applying exclusively visual criteria rather than other more complex and costly diagnostic techniques have still not been fully evaluated, the use of visual examination has become widespread and is frequently employed to monitor the clinical course of oral disease and to provide information to those responsible for health policy (16).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of an oral health scale of infectious potential using a telematic survey of visual diagnosis

Relvas¹,

Limeres²,

Tomás³

et al. 2013

Med Oral

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Objective: To compare the results of a subjective estimation of oral health through review of a set of intraoral photographs with those of an objective oral health scale of infectious potential. Method: The pool of patients was made up of 100 adults. Using an infectious-potential scale based on dental and periodontal variables, we assigned 1 of the 4 grades of the scale (range, 0 to 3; 0 corresponds to an excellent oral health status and 3 to the poorest oral health status) to each subject. A total of 20 representative subjects were selected from the pool of patients, 5 subjects for each one of the grades of the scale, and a standardized photographic record was made. One thousand dentists practicing in Spain were sent the survey by e-mail and 174 completed forms were received. We then calculated the concordance of the oral health status indicated by the respondents after visualising the photographs on comparison with the results of the oral health scale of infectious potential; concordance was termed correct grade allocation (CGA). Results: The majority of respondents (69.1%) achieved a CGA in 8 to 12 cases and none achieved more than 15 CGAs. The poorest CGA rates were found with grades 1 and 2, with a mean of 1.74 ± 1.09 and 1.87 ± 1.18, respectively, out of a maximum of 5. The concordance in terms of CGA was high for grade 0 (70.5%), very low for grade 1 (10.8%), low for grade 2 (37.3%), and moderate for grade 3 (42.6%). Conclusion: In comparison with visual examination of the oral cavity, the use of objective scale that establishes a reliable diagnosis of oral health in terms of infectious potential was found to be advantageous. Key words:Diagnosis, intraoral photographies, oral health scale, objective estimation, visual examination.

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“…When tested against findings of a comprehensive visual-tactile examination as a reference standard, validity of the screening protocol was high for detection of both untreated decay and restorations with more than 90% for sensitivity, specificity, and predictive values in a population with 30% to 40% prevalence of caries (treated and untreated). 10 Sensitivity was lower for presence of sealants (59%)Vreflecting the lack of tactile reference for sealants that were not tinted. Modified methods to estimate severity have been examined.…”

Section: Basic Screening Surveymentioning

confidence: 99%

“…5 In contrast to established protocols for detailed and resource-intensive visual-tactile clinical examinations with multiple data fields, monitoring in public health requires less costly and simpler methods that can routinely document the extent and severity of disease and risks. 10 These methods should present findings in formats that are understood by nondental decision makers and provide data for inclusion in publicly available Web-based information systems. Such systems would include the National Oral Health Surveillance System 11 and the Behavioral Risk Factor Surveillance System.…”

Section: Monitoring Oral Healthmentioning

confidence: 99%

The Role of Evidence in Formulating Public Health Programs to Prevent Oral Disease and Promote Oral Health in the United States

Gooch

Griffin

Malvitz

2006

Journal of Evidence Based Dental Practice

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Validity of Two Methods for Assessing Oral Health Status of Populations

Cited by 31 publications

References 35 publications

Dental Screening and Referral of Young Children by Pediatric Primary Care Providers

Dental Screening and Referral of Young Children by Pediatric Primary Care Providers

Evaluation of an oral health scale of infectious potential using a telematic survey of visual diagnosis

The Role of Evidence in Formulating Public Health Programs to Prevent Oral Disease and Promote Oral Health in the United States

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