Community dentistry and oral epidemiology最新文献

{"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}

{"title":"Translating Observational Data Into Public Health Action: Reducing Early Childhood Caries Burden Related to Socioeconomic Disparities","authors":"An T. M. Dao,&nbsp;Loc G. Do,&nbsp;Helena S. Schuch,&nbsp;Huy V. Nguyen,&nbsp;Diep H. Ha","doi":"10.1111/cdoe.70064","DOIUrl":"10.1111/cdoe.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The “valley of death” between research and practice remains a major challenge. The five-stage Translational Research framework (TR1-TR5) provides a pathway, moving evidence into real-world impact. Traditionally, Randomised Controlled Trials (RCTs) dominate TR stages, yet they are often impractical in public health. Longitudinal observational studies (LOSs), combined with advanced causal statistics, can emulate RCTs. Using the relationship between socioeconomic status (SES) and early childhood caries (ECC) as a case study, where SES is a complex, upstream determinant lacking trial evidence, this study illustrates how LOSs paired with causal statistics, within the TR framework, can generate policy-relevant action, highlighting a promising yet underused strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper first reviewed causal inference gaps identified in a published scoping review of 85 LOSs (TR1), focusing on a subset of 20 studies presented in this paper that examined the relationship between SES and dental caries. The review analysed SES construction, gaps in SES-oral health behaviour-caries pathways, and the use of advanced causal statistics. Findings from TR2 (published) were then summarised to highlight key modifiable mediators linking SES and ECC, followed by TR3-4 (published), which examined interventions targeting these mediators across populations. Finally, this paper presented TR5 for the first time, extending the analysis to estimate population-level impact metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TR1 highlighted that most LOSs remained focused on associations rather than causal inference. SES construction was inconsistent and the mechanisms linking SES to dental caries have not been comprehensively examined. TR2 identified free sugar intake (FSI) as a key modifiable mediator. TR3-4 emphasised on reducing FSI to &lt; 10% lowered ECC risk in the general population and suggested &lt; 5% for the high-risk groups. TR5 highlighted that stricter FSI thresholds produced substantial population-level gains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The TR framework supported by advanced causal statistics enables translating LOSs into effective public health evidence in the absence of RCTs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"471-479"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503257","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":"Impact of a Culturally Adapted Intervention on Early Childhood Caries Among Immigrants—A Cluster-Randomised Trial","authors":"Mariam Reda,&nbsp;Knut Helge M. Jensen,&nbsp;Abhijit Sen,&nbsp;Anne N. Åstrøm,&nbsp;Manal Mustafa","doi":"10.1111/cdoe.70065","DOIUrl":"10.1111/cdoe.70065","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Early Childhood Caries (ECC) is reported to be more common among immigrant children than their native counterparts. There are no community-based studies that assess the effectiveness of an intervention in reducing the risk of ECC among immigrant children in Norway. This study aimed to assess the effect of a culturally adapted intervention on ECC, plaque, feeding and oral hygiene habits in immigrant children, as well as on their parents' oral health behaviours.&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;Seven primary health centres in Bergen, Norway, were randomly assigned to either an intervention or a control group. Immigrant parents of newborns participated in the baseline study (&lt;i&gt;n&lt;/i&gt; = 345). Self-reported data were collected via questionnaires at baseline (infants aged 0–6 months) and at follow-up (18–24 months following baseline). The intervention group received a culturally adapted intervention, which consisted of two one-to-one motivational interviews, MI-informed counselling (MI), toothbrushing demonstrations and pamphlets in the participants' native languages at baseline and after 6 months. The control group received only the routine dental information provided at the primary health centres. Clinical oral examinations were performed to assess the presence or absence of ECC and plaque in the children at follow-up. Differences in outcomes were assessed and compared between intervention and control groups using generalised linear mixed models. Odds ratios with corresponding 95% confidence intervals were reported.&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;A lower prevalence of carious lesions was observed in the intervention group (7.7%) than in the control group (10.6%), while plaque accumulation was higher in the intervention group (19.2%) than in the control group (17.3%). The intervention group exhibited lower odds of night-time feeding, not brushing day and night, or not using fluoride. Conversely, the intervention group showed higher odds of sugar intake in feeding bottles. Parents in the intervention group had higher odds of irregular flossing, mouthwash use and frequent sweet intake. However, none of the findings were statistically significant, indicating no true effect of the intervention.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The present study suggests that the intervention had no impact on ECC, plaque, feeding or oral hygiene habits of the immigrant children or on the parents' dietary and oral hygiene habits. These findings underscore the necessity for community-based, co","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"480-492"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572724","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":"Longitudinal Analysis of Fluoride Levels in Irish Water Supplies: A 52-Year Review","authors":"Vinay Sharma,&nbsp;Brian O'Connell,&nbsp;Eithne O'Flaherty,&nbsp;Jan Rigby,&nbsp;Jacinta McLoughlin,&nbsp;Michael Cronin,&nbsp;Michael O'Sullivan,&nbsp;Lewis Winning,&nbsp;Oscar Cassetti,&nbsp;Michael Crowe","doi":"10.1111/cdoe.70055","DOIUrl":"https://doi.org/10.1111/cdoe.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aim</h3>\u0000 \u0000 <p>The Health (Fluoridation of Water Supplies) Act of 1960 in Ireland mandates monthly fluoride sampling in Public Water Supplies (PWS). In 2007, authorities adjusted the mandated fluoride concentration from 0.8–1.0 to 0.6–0.8 mg/L. Approximately 71% of the Irish population has access to fluoridated drinking water. This study aimed to analyse fluoride measurements in Irish water supplies for five decades (1964–2016) to assess compliance and effectiveness of the fluoridation programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were sourced from government records and Environmental Protection Agency (EPA) reports. Analysis focused on fluoride concentration measurements, compliance rates, and data completeness across public, private, and group water supplies. Descriptive statistics were used to evaluate trends and patterns in fluoride levels over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>By 2000, over 90% (<i>n</i> = 307) of PWS, each serving more than 1000 persons, were fluoridated. In the early monitoring period (1964–69), missing data were substantial at 66%, with <i>satisfactory</i> fluoride results (0.8–1.00 mg/L) at only 17% and <i>marginal</i> results (0.70–0.80 and &gt; 1.00–1.10 mg/L) at 15%. Compliance improved steadily, reaching peak performance in 1994–99 with 57% <i>satisfactory</i> results. Following the 2007 adjustment in target concentrations, missing data decreased significantly to 18%, with <i>satisfactory</i> results (0.60–0.80 mg/L) increasing from 40% to 49% and <i>marginal</i> results (0.50–0.60 mg/L and &gt; 0.80–0.90 mg/L) stabilising at 7%–13%. Analysis of private and group supplies revealed evolving trends: from 2000 to 2006, 21% of fluoride testing results were <i>satisfactory</i> and 75% <i>marginal</i>, while the 2007–2016 period showed 39% <i>satisfactory</i> and 48% <i>unsatisfactory</i> results, though only 1% exceeded 0.9 mg/L.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The fluoride control in PWS has been largely effective, with consistent improvements in monitoring practices and compliance with target levels over the study period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"418-426"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647826","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":"Model-Based Cost-Effectiveness of Direct Restorations: Amalgam Dominates","authors":"O. Bailey,&nbsp;S. J. Stone,&nbsp;G. Taylor,&nbsp;L. Ternent,&nbsp;C. R. Vernazza","doi":"10.1111/cdoe.70050","DOIUrl":"10.1111/cdoe.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>A phase-down of dental amalgam use has been mandated and the feasibility of its phase-out in England by 2030 is being explored. Amalgam use in English National Health Service (NHS) care still predominates for posterior restorations, though access to this care is increasingly limited. The objective of this study was to quantify the relative long-term costs and consequences of amalgam versus composite direct posterior restorations in adult permanent teeth in the English NHS setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A microsimulation model of restoration failure and reintervention was constructed and parameterised in TreeAge Pro, based on a review of the literature. It extrapolated costs and outcomes of directly restoring cariously-cavitated lower premolar teeth in 10 000 18-year-old English NHS patients with amalgam and composite restorations over a lifetime-horizon. Discounting of 3.5% was applied to costs and outcomes. An extended medical-sector perspective with societal considerations was taken. Deterministic and probabilistic sensitivity analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Amalgam robustly dominated conventional and bulk-fill composite restorations, being less costly over a lifetime from patient (£70) and funder perspectives (£34), with the restoration and tooth surviving significantly longer (4-years; 12-years non-discounted). Amalgam also incurred reduced numbers of visits (1), treatment time (43-min), and laboratory costs (£8) for fixed and removable prosthodontics over a lifetime. Time until a direct restoration was no longer possible was significantly higher for amalgam than composite (6-years; 17-years non-discounted).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The model showed good internal and external validity, accurately predicting tooth survival following restoration in relation to long-term NHS claims data. Without considerable educational change to upskill clinicians and health service change, an amalgam phase-out in England will likely have significant lifelong impacts on restoration and tooth survival and costs for all stakeholders, whilst reducing societal productivity and exacerbating already existing issues of limited access to care and socio-economic inequalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"54 4","pages":"407-417"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803401","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":"Sociodemographic and Structural Factors Associated With Dentist Availability in Indigenous Localities of Peru: An Ecological Cross-Sectional Study.","authors":"Alisson Salazar Villavicencio, Roxana Patricia López-Ramos, Evelyn Alvarez Vidigal","doi":"10.1111/cdoe.70099","DOIUrl":"https://doi.org/10.1111/cdoe.70099","url":null,"abstract":"<p><strong>Objectives: </strong>To identify sociodemographic and structural factors associated with dentist availability in Indigenous localities of Peru in 2024.</p><p><strong>Methods: </strong>An observational, analytical, ecological cross-sectional study was conducted using secondary data from the National Health Establishment Registry (HISMINSA) and the Indigenous or Native Peoples Database (BDPI) for 2024. The sample included 1277 officially recognized Indigenous localities in the Andean and Amazonian regions. Dentist availability, defined as the presence of at least one registered dentist in the local health facility, was the dependent variable. Independent variables included demographic factors (population size and proportion of Indigenous language speakers), geographic characteristics (Andean or Amazonian region and department) and structural indicators (household access to water, sewerage and electricity). Logistic regression models, adjusted using a directed acyclic graph (DAG), were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Of 1277 Indigenous localities, 32.0% had at least one dentist and 68.0% had none. In adjusted models, Amazonian localities had significantly lower odds of dentist availability compared with Andean localities (aOR = 0.585; 95% CI: 0.41-0.83). Larger numbers of households and the presence of sewerage were modestly associated with higher availability, while substantial geographical disparities persisted.</p><p><strong>Conclusions: </strong>Geographic and structural factors were associated with dentist availability in Indigenous localities of Peru, with persistent disadvantages observed in Amazonian regions. These findings highlight territorial inequalities in the distribution of oral health services and support the need for policies aimed at improving access to dental care in underserved Indigenous communities.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548053","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":"Using Role Substitution to Improve Oral Health of Dependent Older People Residing in Care Homes and Assisted Living Settings in the United Kingdom.","authors":"Paul R Brocklehurst, Gerry McKenna, Zoe Hoare, Alison Jenkins, Rachel Evans, Saif Sayeed Syed, Michelle Harvey, Ivor G Chestnutt, Sarah R Baker, Craig J Smith, Ciaran O'Neill, Annie Hendry, Anup Karki, Kirstie Moons, Fiona Sandom, Michael Donaldson, Caroline Lappin, Karen Shepherd, Lorraine Morgan, Georgios Tsakos","doi":"10.1111/cdoe.70089","DOIUrl":"https://doi.org/10.1111/cdoe.70089","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To determine whether Dental Therapists and Dental Nurses could reduce plaque levels of dependent older adults residing in care homes and assisted living settings, when compared to 'treatment as usual'.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A two-arm pragmatic cluster randomised controlled trial over a 6-month period was undertaken based on an a priori assumption of superiority. Forty-eight dependent settings across Wales, North-West England, London and Northern Ireland were recruited. Dependent settings were excluded if they solely focused on end-of-life or palliative care or were already participating in an oral health prevention programme. Residents were excluded if they were below 65 years of age or if they were receiving end-of-life or palliative care. Dependent settings were randomised using an adaptive algorithm, which generated the randomisation sequence. After allocation, the Chief Investigator, Principal Investigators and the trial statistician were blinded until the trial was completed and the analysis was complete. Due to the nature of the intervention, outcome assessors, those delivering the intervention and the residents were not blinded. Dental Therapists provided routine dental care according to their Scope of Practice. Dental Nurses administered fluoride varnish, oversaw the use of high-strength fluoride toothpaste, and sought to improve the level of day-to-day prevention offered by the formal carers. Current practice formed the control arm. In the United Kingdom, this is often ad hoc and relies on dentists, if available, visiting residents presenting with clinical symptoms. The intervention period lasted for 6 months. The primary outcome measure was the proportion of residents that demonstrated a 50% reduction in the Silness and Löe plaque index. Secondary outcome measures were the number of new carious lesions (coronal and root caries), bleeding on probing, Oral Impacts on Daily Performances, EuroQol five dimensions questionnaire (quality of life measure), oral symptoms, episodes of pain, and episodes of unscheduled care, and the number of onward referrals to dentists.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-four dependent settings were allocated to receive the intervention and 24 continued with 'treatment as usual'. 41.7% of the settings were in London, 33.3% were in Wales or the Northwest of England, and 25.0% of the settings were in Northern Ireland. One hundred and twenty-two residents were allocated to the control arm and 142 residents in the intervention arm. The mean age was 85 years and 67.2% were female. Levels of cognitive impairment were high in both arms (mean score 13.7 on the Six Item Cognitive Impairment Test). No statistically significant differences were found in the primary or secondary outcome measures at 6-months. No differences were apparent in the number of adverse events related to the trial by group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A 6-month intervention using Dental Therapist","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548066","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":"Integrating Oral Health Into Pandemic Preparedness and Response: Missed Opportunities and Strategic Imperatives for Global Health System Resilience and Security.","authors":"Moréniké Oluwátóyìn Foláyan, Ayodeji Arobo, Emmanuel Oyeyemi, Ahmed Bhayat, Maha El Tantawi","doi":"10.1111/cdoe.70092","DOIUrl":"https://doi.org/10.1111/cdoe.70092","url":null,"abstract":"<p><strong>Background: </strong>Despite evidence linking oral health to severe COVID-19 outcomes and its potential role in surveillance and service delivery, integration remained absent. This study enquired about: (1) representation of oral health in national COVID-19 taskforces and funding; (2) policy-level barriers to inclusion; (3) lessons from maintaining essential services; and (4) strategies for mobilizing oral health professionals in future emergencies.</p><p><strong>Methods: </strong>We conducted a scoping review guided by the PRISMA-ScR framework. Systematic searches were performed in PubMed/MEDLINE and Scopus (2000-2025) using tailored search strings combining key terms: oral health, pandemic preparedness, COVID-19, dentistry, health systems and related MeSH terms. Eligible evidence included peer-reviewed studies, reviews, policy documents and commentaries in English. Non-human studies were excluded. Data were charted using the WHO Health System Building Blocks framework.</p><p><strong>Results: </strong>After dual-reviewer screening, 2569-3860 records were screened, yielding 5-8 eligible studies per question (26 studies total). The evidence revealed a consistent narrative of systemic exclusion yet operational resilience. For representation, oral health professionals were almost universally absent from national COVID-19 task forces, with dedicated financial support entirely lacking. Regarding barriers, policy integration was hindered by the framing of oral care as non-essential, its omission from global health security architectures like the International Health Regulations, and limited professional advocacy. In contrast, lessons from service adaptation demonstrated that essential care was maintained through the rapid adoption of triage, teledentistry, robust infection control and effective communication. On workforce mobilization, while consensus existed on the potential for OHPs to expand into roles such as vaccination and surveillance, implementation was obstructed by a lack of pre-emergency training, formal deployment mechanisms and regulatory frameworks with minimal linkage to international instruments.</p><p><strong>Conclusion: </strong>The review reflects systemic neglect of oral health, with the literature dominated by descriptions of clinical and operational adaptations rather than formal policy integration. We identify missed opportunities in leveraging OHPs for pandemic response and propose embedding oral health within One Health governance, financing, surveillance and emergency response structures to build more resilient health systems.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469272","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":"From Control to Elimination: Making the End of Dental Caries Thinkable.","authors":"Habib Benzian, Manu Raj Mathur, Eugenio Beltrán-Aguilar","doi":"10.1111/cdoe.70087","DOIUrl":"https://doi.org/10.1111/cdoe.70087","url":null,"abstract":"<p><strong>Background: </strong>Dental caries remains one of the most prevalent noncommunicable diseases worldwide despite decades of clinical and behavioural interventions. Persistently high prevalence suggests that current approaches are better organised for ongoing disease management than for preventing new disease occurrence. This commentary examines whether an elimination framework could provide a more coherent and outcome-oriented direction for oral health policy and practice.</p><p><strong>Methodology: </strong>We apply the Dahlem Framework to assess whether dental caries meets established criteria for disease eradication. We then position caries within the classical continuum of control, elimination, and eradication, drawing on current evidence on caries aetiology, fluoride exposure, dietary environments, primary care integration, surveillance, and the social and commercial determinants of oral health.</p><p><strong>Results: </strong>Dental caries does not meet the criteria for eradication. It has no single causal agent, no interruptible transmission cycle, no immunising intervention, and no global surveillance architecture capable of detecting incidence. Eradication is therefore conceptually impossible. Elimination, however, defined as the stable disappearance of dental caries as a public health problem within a defined population, is biologically plausible and operationally achievable. An elimination frame shifts expectations from managing recurrence to preventing occurrence and reframes caries as a system outcome rather than solely an individual behavioural or clinical problem.</p><p><strong>Conclusion: </strong>Caries elimination is not the promise of biological absence, but a realistic and measurable population health objective. Adopting an elimination framework could strengthen policy coherence, surveillance, implementation research, professional education, and accountability, while reorienting oral health systems toward prevention, equity, and sustained population-level impact.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435454","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":"Socioeconomic Factors, Dental Service Use and Clusters of Oral Health Conditions in Brazilian Five-Year-Old Children.","authors":"Pedro Henrique Duarte França de Castro, Maria Augusta Bessa Rebelo, Mario Vianna Vettore","doi":"10.1111/cdoe.70093","DOIUrl":"https://doi.org/10.1111/cdoe.70093","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association of sociodemographic characteristics and dental service utilisation with clusters of oral health conditions among Brazilian five-year-old children.</p><p><strong>Methods: </strong>Secondary data on five-year-old children (N = 4354) from the Brazilian National Oral Health Survey (SB Brasil 2023) were analysed. Sociodemographic variables included sex, skin colour, family income, conditional cash transfer programme, household crowding, number of durable goods, and maternal education. Oral health measures included dental caries (measured using dmft), clinical consequences of untreated dental caries (measured using pufa index), malocclusion, and perceived oral health. Dental service utilisation was assessed based on dental service seeking, reason for the last dental visit, and satisfaction with dental care. Latent Profile Analysis was performed to identify clusters of oral health conditions. Associations between the study variables were evaluated through multinomial regression analysis.</p><p><strong>Results: </strong>Four distinct clusters emerged. Two clusters with greater levels of dental caries and worst perceived oral health (24.9% and 9.9%) were associated with poor family income, conditional cash transfer programme, higher household crowding, and lower maternal education. Children in clusters with greater oral health needs were more likely to have never visited a dentist, to seek care due to pain, and to report poorer experiences with dental services. Preventive dental care was more common among clinically healthy children, whereas toothache and elective dental treatment were associated with clusters comprising children with higher levels of caries and more restored teeth.</p><p><strong>Conclusions: </strong>Clusters of oral health conditions in early childhood were socially patterned. Poor dental service utilisation was linked to worst clusters of oral health conditions.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429923","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}