JDR Clinical & Translational Research最新文献

{"title":"Childhood Socioeconomic Status Affects Dental Pain in Later Life.","authors":"T Yamamoto, U Cooray, T Kusama, S Kiuchi, H Abbas, K Osaka, K Kondo, J Aida","doi":"10.1177/23800844241271740","DOIUrl":"10.1177/23800844241271740","url":null,"abstract":"<p><strong>Objectives: </strong>Lower socioeconomic status (SES) is associated with increased dental pain among children. Lower SES in childhood may also contribute to the experience of dental pain among older adults, regardless of the SES in later life. However, this association is still unclear.</p><p><strong>Methods: </strong>We used cross-sectional data from the 2019 Japan Gerontological Evaluation Study using self-administrated questionnaires to investigate the causal mediating pathways between childhood SES and dental pain in later life using several SES variables collected at older age as potential mediators. A total of 21,212 physically and cognitively independent participants aged 65 y or older were included in the analysis. The dependent variable was experiencing dental pain during the past 6 mo. The independent variable was the SES at the age of 15 y (low/middle/high). Ten covariates were selected covering demographics and other domains. Education, subjective current income, objective current income, objective current property ownership, and the number of remaining teeth were used as mediators. Prevalence ratios (PRs) and 95% confidence intervals (95% CIs) for dental pain by childhood SES were calculated using a modified Poisson regression model.</p><p><strong>Results: </strong>The mean age of the study participants was 74.5 ± 6.2 y, and 47.5% were men. Of these, 6,222 participants (29.3%) experienced dental pain during the past 6 mo, and 8,537 participants (40.2%) were of low childhood SES. Adjusted for covariates and mediators, the participants with middle and high childhood SES had a lower PR of dental pain (PR = 0.93 [95%, CI 0.89-0.98], PR = 0.79 [95% CI, 0.73-0.85], respectively). Almost 40% of the association between childhood SES and dental pain at older age was mediated via SES in later life and the number of teeth.</p><p><strong>Conclusions: </strong>This study reemphasizes the importance of support for early-life SES to maintain favorable oral health outcomes at an older age.Knowledge Transfer Statement:The results of this study can be used by policymakers to promote policies based on a life-course approach that supports children living in communities with low SES and helps them maintain favorable oral health outcomes into their older age.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"135-145"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Severe Early Childhood Caries over Time in Low-Income Preschoolers.","authors":"Y C Chou, F S Cheng, S H Weng, H Y Hu","doi":"10.1177/23800844241279266","DOIUrl":"10.1177/23800844241279266","url":null,"abstract":"<p><strong>Introduction: </strong>Early childhood caries (ECC), and the progression to severe ECC (S-ECC), is a serious oral health issue, leading to acute pain, sepsis, tooth loss, and compromised quality of life. Although the association between sociodemographic factors and ECC has been widely discussed, it remains unclear whether the same association exists between inequality and S-ECC.</p><p><strong>Objectives: </strong>To investigate the impact of low income on the oral health of preschool children and explore any additional risk factors for developing ECC and S-ECC during follow-up.</p><p><strong>Methods: </strong>The study used Taipei Child Development Screening Program data from 2014 to 2019. It included children aged 3 to 5 y who had more than 2 oral exams and completed baseline oral health questionnaires. Low-income children were matched 1:4 with controls by age and gender. Evaluation of ECC and S-ECC used the dmft index during follow-up exams. Generalized estimating equations (GEEs) assessed the impact of household income on ECC and S-ECC risk over time.</p><p><strong>Results: </strong>Of the 895 participants, 179 were from low-income households. We revealed a significantly higher risk of developing S-ECC (adjusted odds ratio [aOR] 1.99; 95% confidence interval [CI] 1.25-3.17) in children from low-income households, with no significantly increased of risk of developing ECC. Children who consumed sugary beverages >4 times per week showed elevated risks of developing both ECC (aOR 1.77; 95% CI 1.07-2.94) and S-ECC (aOR 1.89; 95% CI 1.13-3.17). Protective factors included children with mothers with a college education (S-ECC: aOR 0.50; 95% CI 0.32-0.79).</p><p><strong>Conclusion: </strong>Children from low-income households have a significant risk of developing S-ECC compared with children from non-low-income households during follow-up. Factors contributing to this risk include lower maternal education, poor maternal oral health, and increased consumption of sugar-sweetened beverages. Policymakers should develop health measures to reduce the prevalence of ECC and S-ECC in children from low-income households whose mothers have lower educational levels and poor oral health.Knowledge Transfer Statement:The results of this study highlight the significant S-ECC risk among preschool children from low-income households in Taipei, with other risk factors including higher consumption of sugar-sweetened beverages, lower maternal education, and poor maternal oral health. Policymakers can use our findings to develop targeted policy and behavioral interventions to reduce S-ECC in vulnerable populations.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"146-156"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study of Naturally Living Parents and Child Oral Health: Omissions and Commissions.","authors":"C McLean, L Slack-Smith, I Matic Girard, P R Ward","doi":"10.1177/23800844241266498","DOIUrl":"10.1177/23800844241266498","url":null,"abstract":"<p><strong>Background: </strong>Oral health continues to be one of the most common and costly diseases in early childhood, and there is a need for further, innovative research.</p><p><strong>Purpose: </strong>We explored the ways naturally living parents (those who embody the \"natural\" within their parenting ideology and behavior) navigated and perceived their children's oral health.</p><p><strong>Methods: </strong>Twelve participants who identified as being \"naturally living parents\" participated in semistructured interviews. Data were thematically analyzed, and findings were aligned to an omissions and commissions framework to exhibit the complexity of parent decision-making.</p><p><strong>Results: </strong>Parents performed distinct omissions, including omitting fluoride, sugar, and \"toxins\" to maintain their children's oral health. Parents talked about having a commitment to knowledge building to protect their children's oral health (e.g., ingredient label reading and increasing knowledge of \"safe\" ingredients). Findings also provide insight into how parents consider and trust health information and health care providers and ways they gather information relating to oral health.</p><p><strong>Conclusions: </strong>Analysis indicated that although parents navigated both omissions and commissions, omissions were more overtly present. Compared to previous health research using this framework, omissions and commissions were not as clearly demarcated in relation to oral health. The results show that oral health is a complex interplay of omissions and commissions, and parents must navigate not only discrete elements that affect the oral health of their children but also how these are influenced by considerations including social well-being.Knowledge Transfer Statement:The study highlights the need for dentists and early childhood health professionals to consider the complex way some parents perceive, inform, and rationalize decisions regarding their children's oral health. There is a need for nuance when considering children's oral health and naturally living parenting, especially in relation to effectively communicating health information that fosters trust and is considerate of broader lifestyle and health factors.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"112-123"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parents' Views on Access to Dental Care and the Interim Canada Dental Benefit.","authors":"A Menon, V Cruz de Jesus, J I Virtanen, R J Schroth","doi":"10.1177/23800844251323169","DOIUrl":"https://doi.org/10.1177/23800844251323169","url":null,"abstract":"<p><strong>Introduction: </strong>Canada's national health insurance historically excluded dental care until the introduction of the Interim Canada Dental Benefit (CBD) in October 2022. This represented a paradigm shift toward enhancing dental care accessibility for children younger than 12 y from lower-income families. This study investigated parents' perspectives on access to oral health care and the Interim CDB.</p><p><strong>Methods: </strong>The Strategic Counsel for Health Canada collected data from participants across Canada using an online survey administered in March 2023. Data were administered to parents of children younger than 12 y with a household income less than $90,000. The survey included 45 questions covering demographics, barriers to accessing dental care, and awareness of the Interim CBD. Paired/overlap <i>t</i> test for means and paired/overlap <i>z</i> test for percentages were performed, with statistical significance set at <i>P</i> ≤ 0.05.</p><p><strong>Results: </strong>A total of 2,203 participants completed the survey, with a response rate of 65%. Most participants expressed concerns about the costs (90.9%) and accessibility (80.9%) of dental care, indicated that regular dental visits for children are important (97.2%), and would take their children more frequently to dental appointments if they had extra money (79.9%). Some of the barriers preventing regular dental visits for children included the costs of service and transportation and lack of insurance. Most parents supported the Interim CDB (87%), with the greatest support coming from the provinces of Manitoba and Saskatchewan (90.4%).</p><p><strong>Conclusion: </strong>This research underscores the imperative for ongoing evaluation and policy refinement to ensure the Canadian Dental Care Plan (CDCP) effectively addresses the nuanced needs of Canadian families, fostering a more inclusive and accessible dental care system. Parents' concerns regarding dental care and their support for the Interim CDB signal a clear mandate for improving program outreach and accessibility through the CDCP.Knowledge Transfer Statement:This study showed the significant concerns reported by survey participants about dental care affordability in Canada and the highly positive perception of the Interim Canada Dental Benefit (CDB). This supports the necessity of programs such as the CDB and Canadian Dental Care Plan, which are crucial for the success of a policy intervention. Concern about accessing dental services, despite the availability of insurance, indicates ongoing barriers to dental care, suggesting areas for future policy refinements.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251323169"},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situational Analysis of European and International Oral Health Policy Making for Quality Improvement.","authors":"S Akter, V Fehrer, M Lorenz, P Jeurissen, S Listl","doi":"10.1177/23800844251325540","DOIUrl":"https://doi.org/10.1177/23800844251325540","url":null,"abstract":"<p><strong>Introduction: </strong>Despite increasing dental expenditures, the burden of oral diseases has not decreased. The room for improving the quality of oral health care (OH) remains large. The purpose of this study was to explore the current understanding, needs, efforts, and actions in European and global policy making for oral health quality improvement.</p><p><strong>Methods: </strong>Drawing from qualitative methodology comprising desk research and semi-structured interviews, a situational analysis was carried out. Interviews with experts in international oral health policy were recorded, transcribed, and analyzed inductively and iteratively.</p><p><strong>Results: </strong>The interviews with 13 participants representing 11 organizations provided diverse insights into policy making for improving the quality of OH. Thematic analyses identified 4 main themes: (1) perception and understanding of quality improvement (QI) in OH policy making, (2) prioritization of QI, (3) efforts and actions for QI, and (4) stakeholder engagement. Three maps were also generated: situational map, social world map, and positional map. Participants acknowledged several facilitators and barriers and provided QI ideas but also expressed concerns. They said that QI was underserved and not properly prioritized. Competing goals and financial limitations were considered major barriers for QI. Some organizations described that they are involved in OH QI and took various initiatives to improve quality, whereas others acknowledged that QI efforts could be expanded. Participants also expressed a necessity for better coordination among stakeholders and joint action on QI to enhance the overall OH of the population in Europe and globally.</p><p><strong>Conclusions: </strong>The findings of this study suggest that there is substantial room for improvement in European and global policy making concerning the QI of OH. While stakeholders seem to recognize the relevance of OH QI, competing priorities and limited resources seem to be perceived as barriers to scaling up QI efforts. The potential of international synergies in QI for OH is emphasized.Knowledge Transfer Statement:The findings of this study provide valuable insights for decision makers and stakeholders who aim to improve oral health care policy making to optimize oral health care in Europe and beyond by offering a deeper understanding of the current situation of international quality improvement efforts for oral health care.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251325540"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necessity of Collaborative Health Care for Patients with Stage III and IV Periodontitis: Qualitative Study.","authors":"J R H Tay, Y R I Lim, W Z Lee, G G Nascimento, E Ng","doi":"10.1177/23800844251325552","DOIUrl":"https://doi.org/10.1177/23800844251325552","url":null,"abstract":"<p><strong>Aim: </strong>To understand the barriers and facilitators faced by clinicians in the treatment of periodontitis and to explore the barriers and facilitators to periodontal care encountered by patients when navigating the health care system.</p><p><strong>Materials and methods: </strong>Semistructured in-depth interviews were conducted with clinicians (<u>n</u> = 22) and patients (<u>n</u> = 18) selected through purposive sampling. Audio recordings were transcribed, coded, and analyzed thematically to identify key issues.</p><p><strong>Results: </strong>Four main themes were identified by clinicians: 1) psychological barriers and dissatisfaction caused by uncertain treatment outcomes when managing periodontitis; 2) professional barriers caused by referral processes and decisions about shared care; 3) barriers caused by patients' undervaluing specialist care; and 4) participatory care, standardized referral processes, and aligning treatment expectations in primary and tertiary care-facilitated management. Three main themes were identified for patients: 1) first contact with general dentists facilitated patients' perceptions about good dental care; 2) recognizing the emotional and social impact of periodontitis promoted health seeking and engagement in dental care; and 3) problems with navigating and understanding the health care system negatively affected patients' journeys. Both groups highlighted the importance of primary care services in playing a key role in managing periodontitis and raising public awareness of periodontitis.</p><p><strong>Conclusion: </strong>Close collaboration between primary and tertiary levels of health care is required to ensure an efficient referral process and continuity of care. Prioritizing empathetic approaches and raising awareness of periodontitis at clinical and policy levels is needed to address the structural and interpersonal barriers in care delivery.Knowledge Transfer Statement:Primary care services play a key role in treating patients with periodontitis. Closer collaboration is required to ensure a seamless transition of care between specialists and general dental practitioners. Patients need to be engaged and play a participatory role when planning for care integration at a health care system level. Greater public health education is needed to improve awareness of the etiology and treatment of periodontitis.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251325552"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Opioid and Antibiotic Prescribing at US Academic Dental Institutions: 2011 to 2020.","authors":"S Tungare, A-I Yansane, S Gantela, K K Kookal, S McCurdy, T M Krause, S Sharma, M Walji","doi":"10.1177/23800844251320335","DOIUrl":"https://doi.org/10.1177/23800844251320335","url":null,"abstract":"<p><strong>Introduction: </strong>In the United States, dentists are one of the leading prescribers of opioids and antibiotics. Because dental schools are the training grounds for future dentists, it is crucial to understand how prescribing has changed and why these medications are being prescribed in academic settings.</p><p><strong>Objectives: </strong>The objective of this research was to describe the prescribing trends and factors associated with opioid and antibiotic medication prescribing at US academic dental institutions between 2011 and 2020.</p><p><strong>Methods: </strong>Data from electronic dental records collected through the BigMouth data repository from 9 anonymized dental institutions between 2011 and 2020 were used. Prescribing rates were defined as the percentage of patients who received an opioid/antibiotic prescription. The primary outcome was whether at least 1 opioid or antibiotic medication was prescribed at the encounter. Monotonicity and statistical significance of prescribing trends by year were assessed using the Mann-Kendall test, and a statistical analysis using an adjusted multilevel mixed-effects logistic regression model was performed to identify significant patient-, visit-, and dental provider-level factors associated with prescribing of these medications.</p><p><strong>Results: </strong>In total, 5,720,166 patient encounters from 905,426 patients had aggregate opioid and antibiotic prescribing rates of 2.0% and 2.7%, respectively, between 2011 and 2020. For both medications, a downward prescribing trend was observed from 2013, which increased in 2020. Opioid prescribing was most likely for young adults aged 15 to 24 y (odds ratio [OR] = 5.26;95% confidence interval [CI]: 4.99-5.55) and by oral surgeons (OR = 10.03; 95% CI: 8.02-12.55). Antibiotic prescribing had a higher odds for patients aged >65 y (OR = 5.04; 95% CI: 4.62-5.49) and by periodontists/implant specialists (OR = 6.21; 95% CI: 4.96-7.78). Multiple treatments at the same dental visit and pain-associated dental procedures were associated with statistically significantly higher odds of being prescribed both medications.</p><p><strong>Conclusion: </strong>There are significant differences in opioid and antibiotic prescribing by dentist specialty, patient age, whether the dental visit had multiple treatment procedures, and whether 1 or more postoperative dental pain-associated procedures were performed.Knowledge Transfer Statement:This study provides an understanding of patient-, dentist-, and visit-level factors associated with opioid and antibiotic medication prescriptions issued by clinicians at academic dental institutions in the United States. The results can contribute further to predict clinical scenarios related to the prescribing of these medications and the development of specific interventions to reduce inappropriate and excessive opioid and antibiotic medication prescribing.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251320335"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Teledentistry versus In-Person Examinations to Detect Dental Caries: A Systematic Review and Meta-analysis.","authors":"K Casas, L DiPede, S Toema, C Ogwo","doi":"10.1177/23800844251320974","DOIUrl":"https://doi.org/10.1177/23800844251320974","url":null,"abstract":"<p><strong>Introduction: </strong>There is no recent consensus on the effectiveness of teledentistry versus in-person examination in the diagnosis of dental caries, especially after the COVID-19 pandemic.</p><p><strong>Objective: </strong>To assess the diagnostic accuracy of teledentistry versus in-person examination for dental caries diagnosis (PROSPERO #CRD42023410962).</p><p><strong>Methods: </strong>This systematic review and meta-analysis compared the effectiveness of teledentistry versus in-person examination for dental caries diagnosis. The eligibility criteria were peer-reviewed studies published in English between January 2013 and December 2021 that reported diagnostic parameters (specificity and sensitivity) for caries detection in primary and permanent dentition. Articles were extracted using search strategies from PubMed and CINAHL databases and screened using PRISMA-DTA guidelines, following a review for quality assessment and risk of bias using the QUADAS-2 and JBI Critical Appraisal Checklists. Meta-analysis was conducted in R using the MADA package. A descriptive analysis of the sensitivity, specificity, diagnostic odds ratio, and confidence intervals was performed with respective forest plots. Heterogeneity was assessed using Cochrane <u>Q</u> and Higgins's <u>I</u>² tests. Univariate measures of diagnostic accuracy were performed based on the DerSimonian-Laird random effect and reported summary diagnostic odds ratios.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria and were reviewed and included in the meta-analysis. The diagnostic parameters ranged from 45.6% to 88.3% for sensitivity, 55.2% to 98.3% for specificity, 79% to 92% for positive predictive value, 48% to 97% for negative predictive value, and 70% to 96% for accuracy. The κ scores ranged from 0.46 to 0.89 for teledentistry modalities. Tests for equality of sensitivities and specificities were significant (<u>P</u> < 0.001). The studies were not heterogeneous with Cochran's <u>Q</u>: 14.502 (<u>P</u> = 0.206) and Higgins's <u>I</u>² of 24%. The multivariable analysis showed a diagnostic odds ratio based on the DerSimonian-Laird random effect of 35.14, which indicates that the odds of caries detection via teledentistry is 35 times more true positive (i.e., correctly identifying a positive condition) than false positive.</p><p><strong>Conclusions: </strong>Diagnosis of caries via teledentistry is effective and comparable to in-person diagnosis. Remote assessments are consistent in diagnostic accuracy for caries.Knowledge Transfer Statement:This systematic review and meta-analysis added to the evidence about using teledentistry assessment as a diagnostically accurate tool to detect dental caries. Using teledentistry dental practices could promote greater access to dental and oral health care in the absence of in-person assessment.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251320974"},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bisphenol A Biomonitoring after Sealant Placement: A Prospective Cohort Study in Schoolchildren.","authors":"V Supornsilchai, L Sutthirat, I Kaewkamnerdpong, C Jantarat, N Sakorn, W Nosoongnoen, T Chaiboonyarak, L Samaranayake, S Wacharasindhu, T Porntaveetus","doi":"10.1177/23800844251320009","DOIUrl":"https://doi.org/10.1177/23800844251320009","url":null,"abstract":"<p><strong>Introduction: </strong>Bisphenol A (BPA), known for its endocrine-disrupting properties, is a concern when leaching from dental sealants. This study investigates the systemic BPA exposure following the placement of Bis-GMA-based dental sealants in Thai primary school students.</p><p><strong>Objectives: </strong>The main objective was to evaluate the changes in urinary BPA concentrations after the application of Bis-GMA dental sealants in a cohort of Thai students.</p><p><strong>Methods: </strong>In a prospective cohort of Thai primary school students participating in a voluntary sealant placement program, urinary BPA concentrations were measured at 4 time points: immediately before and on days 1, 7, and 14 after sealant application. BPA levels were measured using high-performance liquid chromatography. Repeated-measures analysis using generalized estimating equations was performed to determine the correlation between BPA concentration and time. Beta coefficient was used to estimate the mean change in BPA concentration following sealant placement. The associated cofactors were evaluated by calculating the incidence rate ratio.</p><p><strong>Results: </strong>Sixty-seven children (50.7% boys) with a mean age of 9.9 ± 1.3 years and a body mass index of 17.7 ± 4.4 kg/m² participated. On average, students had 2.9 ± 1.9 (range, 1-11) teeth with filled sealants. The median adjusted BPA levels before sealant placement and on days 1, 7, and 14 were 0.01, 0.03, 0.19, and 0.23 µg/g creatinine, respectively. The analysis showed a significant association between the number of sealed teeth and increased BPA levels at all visits.</p><p><strong>Conclusion: </strong>The application of Bis-GMA-based dental sealants in children results in low-level systemic BPA exposure due to chemical leaching. Despite such a low level of BPA exposure, approved by international health authorities, it could be considered a silent, chronic, and persistent systemic event, the long-term implications of which are yet to be deciphered.Knowledge Transfer Statement:This research shows that Bis-GMA dental sealants cause minimal bisphenol A (BPA) exposure in children, within safe international limits. However, the long-term effects are unknown. This information should inform dental care practices and guide policymakers in assessing the chronic impacts of BPA exposure from dental materials.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251320009"},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Artificial Intelligence Can Revolutionize Evidence-Based Health Care: A Critical Commentary.","authors":"F Tamimi, K Jasim","doi":"10.1177/23800844251321839","DOIUrl":"https://doi.org/10.1177/23800844251321839","url":null,"abstract":"<p><p>Evidence-based medicine (EBM) enhances clinical decision-making but faces implementation challenges, particularly in dentistry, where patient-specific complexities limit its effectiveness. This article examines EBM through the lens of Aristotelian logic, exploring its use of deductive and inductive reasoning and its limitations in addressing real-world variability. We then discuss how artificial intelligence (AI) can enhance EBM by synthesizing data, automating evidence appraisal, and generating personalized treatment insights. While AI offers a promising solution, it also presents challenges related to ethics, transparency, and reliability. Integrating AI into EBM requires careful consideration to ensure precise, adaptive, and patient-centered decision-making.Knowledge Transfer Statement:This commentary provides a critical discourse on the challenges of evidence-based medicine and how artificial intelligence could help address these shortcomings.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251321839"},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}