Community dentistry and oral epidemiology最新文献

{"title":"Financial Burden in Dental Care: Global Determinants, Policy Interventions and Access Inequities-A Scoping Review.","authors":"Karthik Madhavan, Sheryl Ann Sajan","doi":"10.1111/cdoe.70104","DOIUrl":"https://doi.org/10.1111/cdoe.70104","url":null,"abstract":"<p><strong>Objective: </strong>Access to dental care is often limited by financial, structural and social factors, contributing to persistent oral health inequalities globally. This scoping review systematically maps and synthesizes how financial pressures influence access, service utilization and oral health outcomes, particularly among underserved and vulnerable populations.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, 73 peer-reviewed studies published between 2004 and 2024 were included. The included studies spanned high-income countries (the USA, Canada, Japan, South Korea and Australia) and low- and middle-income countries (Iran, Tanzania, Uganda, Lesotho and Pakistan). Key outcomes were out-of-pocket expenditures, catastrophic health expenditure, delayed or foregone care, unmet needs, insurance gaps and utilization patterns.</p><p><strong>Results: </strong>Study populations included adults, children, older adults and vulnerable groups such as racial and ethnic minorities and individuals with special needs. Between 17% and 63% of participants reported delaying or foregoing dental care due to cost, reflecting variation across populations and study contexts. Structural barriers, such as transportation limitations, provider shortages and clinic accessibility, further restrict care in low-resource areas. Social and cultural factors, such as discrimination, language barriers and mistrust, also reduced care-seeking among marginalized groups. These findings indicate the need for policies that address both financial and non-financial barriers to dental care.</p><p><strong>Conclusions: </strong>Reducing financial barriers requires more than expanding coverage alone. Policies should aim to provide comprehensive benefits, affordable essential services, adequate provider availability and strategies that address structural and social barriers to promote equitable oral health outcomes.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can a Low-Threshold Check-Up Motivate Older Adults to Schedule a Dental Visit? A Randomized Controlled Trial.","authors":"Aster De Vleeschauwer, Roos Colman, Peter Pype, Louise Poppe, Barbara Janssens","doi":"10.1111/cdoe.70105","DOIUrl":"https://doi.org/10.1111/cdoe.70105","url":null,"abstract":"<p><strong>Objectives: </strong>Oral disorders are an important disability driver in adults aged 70 and older, who often experience greater tooth loss and higher levels of untreated oral disease than younger persons. Despite the importance of regular dental visits, older adults attend dental services less frequently, facing several barriers. This study aimed to evaluate whether a low-threshold dental screening could increase the likelihood that older adults (≥ 65 years) contact a dental professional.</p><p><strong>Methods: </strong>A total of 194 community-dwelling adults aged ≥ 65 years without a dental check-up in the past 12 months were randomized (1:1) in a two-arm, single-blinded, controlled superiority trial. The intervention group received an oral screening, personalized oral health information, referral letters for a dentist and general practitioner, and a list of nearby dentists. The control group received only general oral hygiene flyers and a list of nearby dentists. The primary outcome was whether participants contacted a dental professional within 4 months following the intervention. Oral hygiene practices (i.e., tooth brushing frequency and use of brushing materials) were evaluated as secondary outcomes.</p><p><strong>Results: </strong>No evidence for an effect of the intervention on contact with a dental professional was found (risk difference = -0.01 (95% CI: -0.12; 0.10)). Within 4 months, 14% of control group participants and 12% of those in the intervention group reported contacting a dental professional, mostly due to urgent issues (e.g., pain or broken teeth), rather than the intervention itself. Among those who did not seek care (n = 133), 79% cited a lack of perceived need. Furthermore, no intervention effect was found regarding oral hygiene practices.</p><p><strong>Conclusion: </strong>Motivating older adults to attend preventive professional dental care remains challenging. Greater integration of oral health into primary care, along with early-life promotion of positive oral health behaviours, is essential.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventable Dental Related Emergency Department Visits and Hospital Admissions: A Systematic Review of Economic Burden and Healthcare System Costs","authors":"U. M. G. Sanketha Francis,&nbsp;Jing Jie Lai,&nbsp;Ruvini M. Hettiarachchi,&nbsp;Leah Hobbs,&nbsp;Anura Ariyawardana,&nbsp;J. L. P. Chaminda,&nbsp;Haitham Tuffaha","doi":"10.1111/cdoe.70084","DOIUrl":"10.1111/cdoe.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To systematically evaluate the economic burden of preventable dental-related emergency department visits (PDEDV) and preventable dental-related hospital admissions (PDHA), identify reasons for these presentations, and synthesise recommendations to reduce avoidable utilisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review followed the PRISMA 2020 guidelines. A comprehensive multiple database search was conducted in PubMed, Embase, Cochrane Library, EBSCOHOST, and Web of Science for studies reporting direct and/or indirect costs of PDEDV and PDHA in any age group, published in English from 2000 to March 2026. Three calibrated reviewers screened and critically appraised the identified studies. Data including patient characteristics, estimated charges/costs, reasons for PDEDV and PDHA, and recommendations to minimise the avoidable burden were extracted. Charges/costs were inflation-adjusted and standardised to 2024 US dollars.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 2600 total studies identified, 25 met the inclusion criteria. The majority were conducted in the United States and focused on direct medical costs. Uninsured individuals, public health insurance enrolees and residents of low-income areas were more likely to experience PDEDV. Mean charges per any PDEDV ranged from $409.73 to $2740.76. Mean charges per any PDHA ranged from $5234.46 to $62 298.25, while mean hospital costs ranged from $350.42 to $22 375.53. Dental caries was the commonest cause for PDEDV. Odontogenic infections were the costliest to manage, with mean charges of $2740.76 per PDEDV and $62 298.25 per PDHA. PDEDV and PDHA were primarily driven by financial barriers, socio-demographic disparities, limited access to routine dental care, and health workforce constraints. Proposed strategies focused on improving affordability and access to preventive dental care, enhancing oral health literacy, strengthening integration between medical and dental services, and expanding the dental workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PDEDV and PDHA, particularly those due to dental caries and odontogenic infections, impose a significant economic burden on healthcare systems, highlighting the need to reduce financial and access barriers to routine dental care for high-risk groups and priority conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"392-406"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Obesity Associated With Dental Caries in Primary Dentition? Findings From a Birth Cohort in Southern Brazil","authors":"Yorrana Martins Corrêa,&nbsp;Cinthia Fonseca Araujo,&nbsp;Mariana Silveira Echeverria,&nbsp;Andréa Dâmaso Bertoldi,&nbsp;Geert J. M. G. van der Heijden,&nbsp;Flávio Fernando Demarco,&nbsp;Helena Silveira Schuch","doi":"10.1111/cdoe.70056","DOIUrl":"10.1111/cdoe.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Nutritional disorders and dental caries share common risk factors, including diet and socioeconomic position, but the association between these two conditions remains unclear. The aim of this study was to investigate the potential association between overweight/obesity and the occurrence of dental caries in primary dentition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This longitudinal study, conducted using data from the 2015 Pelotas Birth Cohort, utilised information collected at birth, 24 months and 4 years of age. The exposure variable was the obesity collected by BMI (body mass index), at 24 months, using anthropometric measures (weight and height) and classified according to WHO guidelines. Covariates included sex, child's and maternal age, socioeconomic factors (family income and maternal education) and sugar consumption data. The outcome was dental caries at the age of four, assessed using several variables: early childhood caries (ECC), encompassing all activity including white spots and restorations; severe early childhood caries (S-ECC), which refers exclusively to cavitated lesions; and the dmft (Decayed, Missing and Filled Teeth) index. Descriptive analysis was carried out and regression models were tested.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From the 4275 eligible participants, 3374 children (50.5% boys and 49.5% girls) composed the analytical sample. At 24 months, 2474 (73.3%) children were healthy weight (95% CI 71.8; 74.8) and 900 (26.7%) presented overweight/obesity (18.8% overweight and 7.9% obese). Concerning dental caries at the age of four, 37.6% had ECC (including white spots and restorations) and 21.4% had S-ECC. Among children classified as healthy weight at 24 months, 38.6% presented ECC at 4 years of age. Among obese children, the prevalence of ECC was 34.8%. A similar pattern was observed for S-ECC: the prevalence was 22.0% among healthy weight children, 19.9% among overweight and 19.1% among obese children. The Poisson regression analysis adjusting for confounding factors showed no difference between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, this cohort study in Brazilian children at the age of four did not observe meaningful associations between overweight/obesity and dental caries in primary dentition. The findings suggest that obesity in childhood should not be considered a risk factor for caries development in children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"427-435"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathways Linking Socioeconomic Circumstances to Childhood Dental Caries: The Mediating Role of Parenting and Oral Health Behaviours Before and After Childsmile Implementation","authors":"Kyle Cousins,&nbsp;Mariél de Aquino Goulart,&nbsp;Paul Bradshaw,&nbsp;David I Conway,&nbsp;Andrea Sherriff","doi":"10.1111/cdoe.70062","DOIUrl":"10.1111/cdoe.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the extent that parenting styles and oral health behaviours mediate the relationship between socioeconomic circumstances (SEC) and childhood dental caries experience: pre−/post-national roll-out in 2011 of Childsmile, the child oral health improvement programme for Scotland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A longitudinal design linked 2798 participants from Birth Cohort-1 (following from age 10 months in 2005/06 to age 5 years in 2009/10) and 3015 from Birth Cohort-2 (following from age 10 months in 2011 to age 5 years in 2015) of the Growing Up in Scotland study with caries experience at age five from the National Dental Inspection Programme. Two Structural Equation Models (Birth Cohort-1 and 2) tested an a priori framework to explain the social gradient (SEC: Income Poverty, Area-based Deprivation, Household Education, Household Employment) in caries experience, considering proximal behaviours (toothbrushing, cariogenic diet, regular dental attendance) before introducing validated parenting styles (Parental Responsiveness/Demandingness).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Models for both the pre−/post-Childsmile cohorts illustrated similar pathways. Dental attendance and parenting had no direct effect on caries experience. Responsiveness partially mediated the SEC-toothbrushing relationship, while demandingness partially mediated the SEC-diet relationship. Cariogenic diet directly increased caries experience prevalence (<i>β</i> = 0.33/0.24), while increased toothbrushing persistently decreased caries (<i>β</i> = −0.18/−0.13). Total mediated effect of SEC decreased from 58.8% to 39.1%, with the largest relative decrease being directly via toothbrushing (9.5%/4.0%). The effect mediated through parenting pathways remained minimal (4.8%/3.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pathways between SEC and childhood caries were unchanged after Childsmile roll-out, with minimal effects from parenting styles. The diminishing SEC effects via toothbrushing may be positively attributed to Childsmile interventions. The persistent unexplained effect of SEC on caries experience highlights the need for equity-focused structural approaches that address broader socioeconomic inequalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"462-470"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De-Implementing Low-Value Care in Dentistry: The Case for Choosing Wisely Campaigns","authors":"Fabio Arriola-Pacheco,&nbsp;Rafael Aiello Bomfim,&nbsp;Karen Born,&nbsp;Herenia P. Lawrence","doi":"10.1111/cdoe.70071","DOIUrl":"10.1111/cdoe.70071","url":null,"abstract":"<p>De-implementation refers to the practice within implementation science that targets reducing low-value care; that is practices that have been proven to be outdated, unnecessary, potentially harmful and in some cases not cost-efficient. Reducing and removing habitual practices, as well as introducing new care, is not easy, as there are multiple provider, patient and system related factors that can hinder these efforts. The Choosing Wisely campaigns have been one of the ways that de-implementation of low-value care has been targeted. Choosing Wisely campaigns consist of recommendations that are implemented through specialty-specific guidance that can be used by providers, patients and the healthcare systems. While Choosing Wisely campaigns have gained widespread traction in medicine, the spread to oral health has been comparatively limited. This commentary explores some of the existing Choosing Wisely campaign recommendations within dentistry and takes a close look at how overprescription, overtreatment, overtesting, and the inclusion and prioritization of care are addressed through these campaigns. Current Choosing Wisely recommendations provide a useful basis that can be utilized to foster a broader movement towards the de-implementation of low-value care in dentistry, thereby facilitating substantive changes in oral health practice, policy, and service delivery.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"381-391"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Psychometric Properties of the Ultra-Short Version of the Oral Health Impact Profile in Australia","authors":"Brandan Khor,&nbsp;Gustavo Hermes Soares,&nbsp;Dandara Gabriela Haag,&nbsp;Gloria Mejia,&nbsp;Liana Luzzi,&nbsp;Lisa Jamieson,&nbsp;Pedro Henrique Ribeiro Santiago","doi":"10.1111/cdoe.70072","DOIUrl":"10.1111/cdoe.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The Oral Health Impact Profile (OHIP) is the most widely used instrument to measure the subjective impact of oral conditions. This study reports the shortening and psychometric evaluation of an ultra-short version (OHIP-7A) from the OHIP-14 in a large national Australian population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional data included 2734 participants from Australia's National Study of Adult Oral Health (NSAOH) 2017–2018. The sample was divided into training (<i>n</i> = 1367) and test sample (<i>n</i> = 1367). Exploratory statistical procedures (redundancy analysis, Ant Colony Optimisation, dimensionality analysis) used in the establishment of ultra-short versions were employed in the training sample. Confirmatory procedures involving the examination of model fit, criterion validity and reliability were employed in the test sample. The establishment of ultra-short versions from an expert opinion (‘Expert-derived OHIP-7’) and exploratory (‘Exploratory-derived OHIP-7’) perspectives were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both Expert-derived and Exploratory-derived ultra-short versions displayed a unidimensional structure with good item performance based on network loadings. Both models displayed excellent model fit in terms of Comparative Fit Index (CFI ≥ 0.950) and Root Mean Square Error of Approximation (RMSEA ≤ 0.050), good criterion validity with variables such as self-rated dental health and good reliability (ω <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <mo>&gt;</mo>\u0000 </mrow>\u0000 </semantics></math> 0.70). However, based on individual items' ability to capture ‘impact’ according to item content and distribution of responses across item categories, the Exploratory-derived OHIP-7 (OHIP-7A) was considered superior.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The good psychometric properties of the OHIP-7A in terms of validity and reliability allow aspects of oral health that are meaningful to patients to be captured with a small number of items. This is the first and largest study to comprehensively validate an ultra-short version of the OHIP in an Australian population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"493-505"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated Use of Emergency Departments for Nontraumatic Dental Conditions: Factors Associated With Being a Superutilizer","authors":"Morgan Santoro,&nbsp;Lisa J. Heaton,&nbsp;Adrianna C. Sonnek,&nbsp;Rebecca A. Preston,&nbsp;John J. O'Malley,&nbsp;Eric P. Tranby","doi":"10.1111/cdoe.70060","DOIUrl":"10.1111/cdoe.70060","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Due to inadequate access to regular, affordable dental care, many patients turn to emergency departments (EDs) for the treatment of nontraumatic dental conditions (NTDCs). NTDC ED visits are a large burden on the U.S. healthcare system, with over 1.3 million visits each year and over $1 billion in associated charges. This study examines the characteristics of ED visitors and superutilizers (4+ ED visits in a calendar year) for non-dental (general) and dental reasons; investigates the cost of care for ED visitors and superutilizers; and estimates associations between patient characteristics and the likelihood of superutilization.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Data obtained from the State Emergency Department Databases was used to summarise trends in visits by general and dental ED visitors and superutilizers, including visit rates and costs, across 14 states and 5 years. Logistic regression models were developed to estimate the likelihood of being dental superutilizers and superutilizers (for dental and non-dental visits) based on the characteristics of their first ED visit (age, gender, race/ethnicity, income quartile, insurance type, presence of comorbidities and state in which ED visit occurred).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of the total number of ED visitors (&lt;i&gt;N&lt;/i&gt; = 25 905 031), the majority (92.4%) were general (non-dental) visitors; 6.4% were general superutilizers; 1.2% were dental visitors; and less than 1% (&lt;i&gt;n&lt;/i&gt; = 2617) were dental superutilizers; dental superutilizers made up 0.2% of all superutilizers. Individuals who sought ED care for dental or non-dental reasons four or more times in a year were more likely to be white, be in the second or third quartile in terms of income, and have insurance coverage through Medicaid, other dental insurance, or to be uninsured. Finally, mean and median treatment costs for general and dental superutilizers were considerably higher than for both general and dental visitors to the ED.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Individuals seeking ED care for NTDCs four or more times in a year are more likely to be white, have insurance coverage through Medicaid, Medicare or to be uninsured, and have one or more medical comorbidities. Cost of care for superutilizers is also considerably higher than for other ED visitors. Expansion of dental services for adults, particularly those on Medicaid, is needed to ensure they can access timely preventative and restorative services and avoid the burden of dental crisis requiring ","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"436-446"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Association Between Brazilian Primary Oral Health Care Models and Preventive Dental Visits and Risk Behaviours: A 5-Year Cohort Study Among Young Adults","authors":"Jocelaine Vieira Vione,&nbsp;Letícia Donato Comim,&nbsp;Nathália Costa de Castro,&nbsp;Julio Eduardo do Amaral Zenkner,&nbsp;Orlando Luiz do Amaral Júnior,&nbsp;Luana Severo Alves","doi":"10.1111/cdoe.70075","DOIUrl":"10.1111/cdoe.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the prospective association between the absence and different models of primary oral health care in Brazil (traditional units and Family Health Strategy [FHS] teams) and preventive dental visits and risk behaviours (smoking initiation and increase in alcohol consumption) among young individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This 5-year prospective cohort study derived from a population-based cross-sectional survey conducted in 2018 that evaluated the oral health conditions of 1197 15- to 19-year-old adolescents from southern Brazil. In 2022–2024, follow-up assessments were conducted (mean time interval 5 ± 0.5 years). Socio-demographic characteristics, the use of dental services (including the reason for the last dental visit), behavioural habits (smoking and alcohol consumption) and participants' address were collected at baseline and follow-up. The outcomes were last dental visit for prevention, smoking initiation and increase in alcohol consumption. The main predictor variable was public dental services coverage in the neighbourhood (absent, primary health care or FHS including a dental team) obtained from official data. Unadjusted and adjusted multilevel Poisson regression models were performed to estimate relative risk (RR) and 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hundred and seventy individuals were re-evaluated (47.6% retention). After adjusting for individual-level variables, participants residing in neighbourhoods with FHS including a dental team were more likely to visit a dentist for preventive purposes (RR: 1.59; 95% CI: 1.29–1.97), and had a lower risk for smoking initiation (RR: 0.45; 95% CI: 0.21–0.97), and an increase in alcohol consumption (RR: 0.80; 95% CI: 0.67–0.97) compared to areas without coverage. Coverage by traditional primary health care showed no significant association with the study outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Brazil's FHS model with integrated oral health teams outperforms traditional dental services in promoting preventive care and reducing risk behaviours among young adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"506-514"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Health Care Services, Barriers and Enablers to Maintaining Good Oral Health in Motor Neurone Disease: A Scoping Review","authors":"Mariam A. Khokhar,&nbsp;Lucy A. O'Malley,&nbsp;Anne-Marie Glenny,&nbsp;Xiaohui Chen","doi":"10.1111/cdoe.70061","DOIUrl":"10.1111/cdoe.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this scoping review was to map existing literature on oral health and related care in individuals with Motor Neurone Disease (MND). Specifically, the review aimed to identify barriers and facilitators to maintaining oral hygiene, summarise available clinical guidelines and patient-facing resources, and examine how oral health care is integrated within multidisciplinary management of MND.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The review focused on oral health practices without restrictions on language, publication date or study type, excluding studies unrelated to MND or oral health. Data sources included MEDLINE, Embase, CINAHL, and grey literature such as clinical guidelines and patient resources. Screening and data extraction were performed independently by two reviewers to ensure rigor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 847 studies screened, eleven primary studies met the inclusion criteria, comprising case reports, case series, self-reports, cross-sectional studies and letters. The grey literature search identified three clinical guidelines and eight patient information leaflets/resources. The included studies spanned diverse populations, including Amyotrophic Lateral Sclerosis (ALS) patients with varying disease subtypes and care needs, and explored oral hygiene difficulties, care barriers and unique insights from the case studies. Identified gaps highlighted the lack of integration of dental professionals into multidisciplinary care teams. Barriers such as physical limitations, caregiver dependency and limited-service accessibility were prevalent. However, caregiver involvement, multidisciplinary collaboration and innovative solutions like antimicrobial photodynamic therapy and adaptive oral aids emerged as enablers. Poor oral health was strongly associated with increased pain, aspiration pneumonia and diminished well-being, emphasising the need for targeted interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Embedding oral health management within multidisciplinary care frameworks for MND patients, enhancing caregiver training, improving access to dental services and adopting innovative strategies will improve patient outcomes and inform future research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"447-461"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}