JDR Clinical & Translational Research最新文献

{"title":"Dental Caries: The Way Forward.","authors":"D T Kopycka-Kedzierawski, M Fontana, M L Marazita, S W McLaren, E Morou-Bermúdez, T G O'Connor, E Van Wijngaarden, J Xiao, R J Billings","doi":"10.1177/23800844241271647","DOIUrl":"10.1177/23800844241271647","url":null,"abstract":"<p><strong>Knowledge transfer statement: </strong>It is evident that some progress in reducing ECC prevalence in children has been made, but these improvements are not equally distributed. Systemic inequities in oral health among the youngest, most vulnerable children must be reduced.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"4-6"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287708","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":"High Anticholinergic Burden and Dental Caries: Findings from Northern Finland Birth Cohort 1966.","authors":"A Tiisanoja, V Anttonen, A-M Syrjälä, P Ylöstalo","doi":"10.1177/23800844241253250","DOIUrl":"10.1177/23800844241253250","url":null,"abstract":"<p><strong>Introduction: </strong>Anticholinergic drugs propose a threat for oral health by causing dry mouth. The aim of this cross-sectional study was to investigate whether a high anticholinergic burden was associated with the presence of initial caries lesions, manifested caries lesions, dental fillings, or tooth loss among 46-y-old people.</p><p><strong>Methods: </strong>The study population consisted of 1,906 participants from the Northern Finland Birth Cohort 1966 who underwent an oral health examination in 2012-2013. Socioeconomic and medical data were collected from questionnaires, medical records, and national registers. Nine previously published anticholinergic scales were combined and used to measure the high anticholinergic burden from the participants' medication data. Cariological status was determined according to the International Caries Detection and Assessment System, and the number of missing teeth (excluding third molars) was used as an indicator for tooth loss. The decayed, missing, and filled surfaces index was used to depict caries experience. Negative binominal regression models were used to estimate prevalence rate ratios (PRRs) and confidence intervals (CIs).</p><p><strong>Results: </strong>Fourteen percent of the participants (<u>n</u> = 276) used at least 1 anticholinergic drug and about 3% had a high anticholinergic burden (<u>n</u> = 61). After adjusting for confounding factors, participants with a high anticholinergic burden had a higher likelihood of having manifested carious lesions needing restorative treatment (PRR, 1.60; CI, 1.11-2.29) and more missing teeth (PRR, 1.59; CI, 1.13-2.24) when compared to participants without any or with a lower anticholinergic burden.</p><p><strong>Conclusions: </strong>High anticholinergic burden was associated with a present caries experience and with tooth loss among the general middle-aged population.</p><p><strong>Knowledge transfer statement: </strong>The findings of this study suggest that middle-aged patients with a high anticholinergic burden may have a heightened risk of dental caries. These patients may benefit from targeted caries preventive regimes.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"74-83"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317338","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":"Predicting Dental General Anesthesia Use among Children with Behavioral Health Conditions.","authors":"J Peng, T J Gorham, B D Meyer","doi":"10.1177/23800844241252817","DOIUrl":"10.1177/23800844241252817","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate how different data sources affect the performance of machine learning algorithms that predict dental general anesthesia use among children with behavioral health conditions.</p><p><strong>Study design: </strong>Observational study using claims data.</p><p><strong>Methods: </strong>Using Medicaid claims from Partners For Kids (2013-2019), electronic medical record data, and the Ohio Child Opportunity Index, we conducted a retrospective cohort study of 12,410 children with behavioral health diagnoses. Four lasso-regularized logistic regression models were developed to predict dental general anesthesia use, each incorporating different data sources. Lift scores, or the ratio of positive predictive value to base case prevalence, were used to compare models, and a lift score of 2.5 was considered minimally acceptable for risk prediction.</p><p><strong>Results: </strong>Dental general anesthesia use ranged from 3.2% to 3.9% across models, which made it difficult for the machine learning models to achieve high positive predictive value. Model performance was best when either the electronic medical record (lift = 2.59) or Ohio Child Opportunity Index (lift = 2.56), but not both (lift = 2.34) or neither (lift = 1.87), was used.</p><p><strong>Conclusions: </strong>Incorporating additional data sources improved machine learning model performance, and 2 models achieved satisfactory performance. The model using electronic medical record data could be applied in hospital-based settings, and the model using the Ohio Child Opportunity Index could be more valuable in community-based settings.</p><p><strong>Knowledge transfer statement: </strong>Machine learning was applied to satisfactorily predict which children with behavioral health diagnoses would require dental treatment under general anesthesia. Incorporating electronic medical record data or area-level social determinants of health data, but not both, improved the performance of the machine learning predictions. The 2 highest performing models could be applied by hospitals using medical record data or by organizations using area-level social determinants of health data to risk stratify the pediatric behavioral health population.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"7-15"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320887","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":"Triple Jeopardy in Oral Health: Additive Effects of Immigrant Status, Education, and Neighborhood.","authors":"G H Soares, D Haag, J L Bastos, G Mejia, L Jamieson","doi":"10.1177/23800844241253518","DOIUrl":"10.1177/23800844241253518","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the additive effects of parent's nativity status/language spoken at country of birth, education, and area-level socioeconomic status (SES) on untreated dental caries among children aged 5 to 9 y in Australia.</p><p><strong>Methods: </strong>Cross-sectional population-based data were obtained from the 2014 National Child Oral Health Study (N = 12,140). Indicators of social position used to explore additive effects on dental caries included nativity status, language, university degree, and neighborhood socioeconomic level. Multiple-way interactions were examined, and departure from additivity resulting from 2- and 3-way interactions were estimated as relative excess risk due to interaction (RERI).</p><p><strong>Results: </strong>Children marginalized across multiple layers of disadvantage had substantially higher frequencies of dental caries compared with children in the most advantaged category. RERI for the 3-way interaction between immigrant status, education, and neighborhood SES was negative (RERI₃: -0.14; 95% confidence interval [CI]: -1.68, 1.40). When operationalizing language, education, and neighborhood SES, the joint effect of the 3 marginalized positions was additive (RERI₃: 0.43; 95% CI: -2.08, 2.95).</p><p><strong>Conclusion: </strong>Children marginalized across multiple intersecting axes of disadvantage bear the greatest burden of dental caries, with frequencies surpassing the cumulative effect of each social position alone. Findings emphasize the need to account for intersecting inequities and their oral health effects among children with immigrant backgrounds.</p><p><strong>Knowledge transfer statement: </strong>Our analysis underscores the necessity for policies and public health strategies targeting dental caries-related inequities to comprehensively account for various indicators of social disadvantage, particularly encompassing language proficiency, educational attainment, and neighborhood socioeconomic status. Within the intricate interplay of these factors, we identify a vulnerable subgroup comprising children with the highest prevalence of dental decay. Therefore, prioritizing this specific demographic should be the focal point of policies and public health initiatives aimed at fostering equitable oral health outcomes.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"54-63"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320888","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":"The Evaluation of a 5-miRNA Panel in Patients with Periodontitis Disease.","authors":"O Baru, L Pop, L Raduly, C Bica, N Mehterov, R Pirlog, S Buduru, C Braicu, I Berindan-Neagoe, M Badea","doi":"10.1177/23800844241252395","DOIUrl":"10.1177/23800844241252395","url":null,"abstract":"<p><strong>Introduction: </strong>Side by side with tooth decay, periodontitis remains one of the most common oral diseases and is increasingly recognized as a serious public health concern worldwide.</p><p><strong>Objectives: </strong>The present study aims at comparing the levels of 5 specific miRNAs (miR-29b-3p, miR-34a-5p, miR-155-5p, miR-181a-5p, and miR-192-5p) in patients with periodontal disease and healthy controls.</p><p><strong>Methods: </strong>The pathogenic mechanism is related to the activation of immune response and significant alteration of coding and noncoding genes, including miRNA. The study includes 50 subjects (17 with periodontal disease and 33 healthy controls) with a mean age of 45.3 y. In both periodontitis patients and healthy controls, a panel of 5 miRNAs (miR-29b-3p, miR-34a-5p, miR-155-5p, miR-181a-5p, and miR-192-5p) is examined by determining their expression levels with quantitative reverse transcription polymerase chain reaction.</p><p><strong>Results: </strong>The periodontitis patients express high levels of all the investigated miRNAs. Receiver operating characteristic curve analysis shows an area under the curve (AUC) of 0.69 to 0.74 for individual transcripts with the highest AUC value observed for miR-192, followed by miR-181a.</p><p><strong>Conclusions: </strong>The study indicates that the 5-miRNA panel can be used as biomarker for periodontitis. In this way, all implantology procedures and treatment options for patients diagnosed with periodontitis can be improved for better long-term results, predictability, and follow-up frequency.</p><p><strong>Knowledge transfer statement: </strong>The discovery of a miRNA panel as a potential biomarker for periodontitis offers major opportunities for practical application. Our study can improve diagnostic accuracy; researchers can develop new theories on molecular mechanisms and biomarker discovery.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"34-43"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179407","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":"Depression Symptoms Linked to Multiple Oral Health Outcomes in US Adults.","authors":"F Bafageeh, T Loux","doi":"10.1177/23800844241246225","DOIUrl":"10.1177/23800844241246225","url":null,"abstract":"<p><strong>Background: </strong>Individuals with mental illness have poor oral health compared to those without mental health conditions. However, the literature is still lacking regarding the specifics of this relationship.</p><p><strong>Objective: </strong>This study aims at examining the relationship between depression and oral health problems such as oral conditions, access to dental care, and oral hygiene measures.</p><p><strong>Methods: </strong>A cross-sectional study using a secondary data analysis of 9,693 participants from the 2017 to March 2020 prepandemic National Health and Nutrition Examination Survey (NHANES). The independent variable was severity of depressive symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9). Proportional odds and binary logistic regression were used to calculate crude and adjusted odds ratios (AORs) between depression and 8 oral health outcomes and oral hygiene-related behaviors.</p><p><strong>Results: </strong>After adjusting for sociodemographics, health conditions, and behaviors, individuals with depression were significantly more likely to have dental aches in the past year (AOR = 1.70; 95% confidence interval [CI], 1.13-2.56), difficulty getting dental care when needed (AOR = 1.93; 95% CI, 1.45-2.58), and difficulty at their jobs due to a problem in their mouth (AOR = 1.63; 95% CI, 1.07-2.49) compared to individuals without depression.</p><p><strong>Conclusion: </strong>Individuals with depressive symptoms often neglect oral hygiene and self-care practices and are less likely to seek medical care for oral health problems, making them at increased risk of poor oral health outcomes. These findings can be applied by dentists, psychologists, and therapists to increase awareness of links between depression and oral health and to encourage patients with depression to seek oral hygiene preventative care.</p><p><strong>Knowledge transfer statement: </strong>Health care professionals can be on the frontline in creating awareness in the general public about the links between depression and oral health and hygiene. Applying the findings from this study can help communicate about the relationship between depression and poor oral health and relieve some burden on the American health care sector, which often struggles to provide medical care to patients with depression and oral health issues.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"64-73"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908596","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":"Tooth Discoloration from 2 Silver Fluorides Used in Adults with Special Needs: A Randomized Trial.","authors":"L See, S Zafar, D Fu, D H Ha, L J Walsh, C Lopez Silva","doi":"10.1177/23800844241246199","DOIUrl":"10.1177/23800844241246199","url":null,"abstract":"<p><strong>Background: </strong>Discoloration of carious lesions after application of silver diamine fluoride lowers patient acceptance and limits its wider use for caries arrest.</p><p><strong>Objective: </strong>To assess lesion and tooth color changes from 2 novel silver fluoride (AgF) products and its relationship to caries activity (clinical visuo-tactile scores) and bacterial load (using laser fluorescence with the DIAGNOdent).</p><p><strong>Methods: </strong>A split-mouth design was followed, with matched smooth surface carious lesions in the same arch in adults with special needs randomized for 1-min treatments with AgF/potassium iodide (KI) (Riva Star Aqua, SDI) and AgF/stannous fluoride (SnF₂) (Caries Status Disclosing Solution; Whiteley). Standardized images taken at baseline, immediately postoperatively, and at 3-mo review were subjected to digital image analysis to calculate delta-E and to track changes in luminosity of carious lesions.</p><p><strong>Results: </strong>Twelve participants were recruited in the study. A total of 56 teeth (28 pairs) were included. Significantly greater changes were seen in treated lesions than in the adjacent noncarious natural tooth structure, both immediately after treatment and at the 3-mo review (<i>P</i> < 0.0001). Color change and caries activity were not affected by tooth type, tooth location, plaque status, salivary status, or special needs condition. AgF/SnF₂ caused transitory darkening immediately on application, while AgF/KI caused the immediate formation of yellow deposits (silver iodide). Both products caused significant darkening of treated lesions at 3 mo (<i>P</i> = 0.0009; <i>P</i> = 0.0361), with no differences between them (<i>P</i> = 0.506). Responding lesions showed larger and more perceptible color changes immediately after either AgF application (<i>P</i> = 0.002; <i>P</i> = 0.024).</p><p><strong>Conclusions: </strong>Both AgF products were highly effective for caries arrest in this patient population. Despite minor differences in the appearance of treated lesions at the time of application, both products lead to similar darkening of treated sites at 3 mo.</p><p><strong>Knowledge transfer statement: </strong>This study shows the usefulness of silver fluoride used in conjunction with potassium iodide or stannous fluoride for achieving caries arrest in smooth surface lesions in adults with special needs. Patients need to be informed that long-term staining of the lesion occurs with both, similar to silver diamine fluoride.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"24-33"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957333","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":"State-Level Structural Racism and Children's Dental Care Access and Oral Health.","authors":"A M Kranz, L A Evans, C Gadwah-Meaden, Kimberley H Geissler","doi":"10.1177/23800844241308149","DOIUrl":"https://doi.org/10.1177/23800844241308149","url":null,"abstract":"<p><strong>Introduction: </strong>Black children in the United States have lower rates of dental visits and higher rates of poor oral health. However, few studies have examined the role of structural racism as a contributor to racial gaps in children's oral health. This study assessed associations between state-level structural racism and oral health outcomes of children and the related Black-White disparities.</p><p><strong>Methods: </strong>This repeated cross-sectional observational study examined children aged 1 to 17 y in the 2016 to 2021 National Survey of Children's Health (NSCH). Three outcomes were examined: utilization (dentist visit in past 12 mo), any oral health problem (difficulty in past 12 mo with bleeding gums, cavities, or toothaches), and oral health (teeth in excellent or very good condition). A state-level index was constructed to measure Black-White structural racism composed of 5 dimensions (judicial, educational, economic, political, and neighborhood segregation) and linked to the NSCH. Estimated population-weighted logit regression models were used to assess associations between the outcomes and race and structural racism, adjusting for demographics and socioeconomic status.</p><p><strong>Results: </strong>The dataset consisted of 98,423 Black (11%) or White (88%) children. Black children had relatively worse outcomes than White children did, with the largest difference observed for the children having teeth in excellent or very good condition (73% vs. 83%). State-level structural racism was not statistically significantly associated with a child receiving dental care, having any oral health problem, or having teeth in excellent or very good condition. US Black-White disparities in these outcomes were unchanged after adjustment for state-level structural racism.</p><p><strong>Conclusions: </strong>Expanded efforts are needed to address US Black-White disparities in child oral health outcomes. State-level structural racism was not associated with these outcomes. Future research should explore whether findings change when examining these associations at a different geographic level and whether indices of structural racism should explicitly include items specific to health care access and child-specific institutional domains.</p><p><strong>Knowledge transfer statement: </strong>Black children in this US study had relatively worse oral health and were less likely to have a dental visit than White children were. Structural racism did not explain these disparities, which suggests the need for further research to study mechanisms driving these disparities and how to address them. Policy makers should consider policies that expand where care is delivered, who delivers care, and increase dentists' Medicaid participation, strategies identified previously for reducing disparities.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241308149"},"PeriodicalIF":2.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872137","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":"Blockchain for Trustworthy Artificial Intelligence in Dentistry.","authors":"D Cerda Mardini, M Sharma, S Madathil","doi":"10.1177/23800844241303483","DOIUrl":"https://doi.org/10.1177/23800844241303483","url":null,"abstract":"<p><strong>Knowledge transfer statement: </strong>The topic discussed in this commentary could serve as an initial inquiry point that deeply probes into the trustworthiness of an AI solution that a user might consider applying in the field of dentistry.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241303483"},"PeriodicalIF":2.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872136","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":"Inequities in Unmet Oral Care Needs after a Swedish Subsidization Reform: An Intersectional Analysis.","authors":"C Anticona, A L Suominen, J L Bastos, P Lif Holgerson, P E Gustafsson","doi":"10.1177/23800844241305109","DOIUrl":"https://doi.org/10.1177/23800844241305109","url":null,"abstract":"<p><strong>Introduction: </strong>The main strategy to achieve equal provision of oral care in Sweden has been to offer partial subsidies for the adult population. However, their effects on unmet oral care needs (UOCNs) have not been extensively assessed.</p><p><strong>Objective: </strong>This study used an intersectionality framework to examine 1) the overall frequency of UOCNs, 2) single-indicator inequities, and 3) intersectional inequities in total UOCNs and financial-related UOCNs (FUOCNs) in Sweden before and after implementation of a partial subsidization reform in 2008.</p><p><strong>Methods: </strong>Data from 12 national surveys conducted over 2004 to 2018 were divided into 3 periods: prereform (2004 to 2007), early postreform (2008 to 2011), and late postreform (2012 to 2018). The analytic sample consisted of 98,177 respondents aged 24 to 84 y. Changes in the prevalence of UOCNs were estimated by inferential statistics. Single-indicator and intersectional inequities were examined by intersectional analysis of individual heterogeneity and discriminatory accuracy, across 48 strata defined by gender, age, educational level, income, and immigrant status.</p><p><strong>Results: </strong>The prevalence of total UOCNs and FUOCNs decreased significantly early after the reform, followed by a slight rebound. Relative inequities increased by education, income, and immigrant status after the reform and decreased for age. The discriminatory accuracy for both types of UOCNs was moderate and improved marginally but significantly with the inclusion of the intersectional strata. Most intersectional strata showed greater FUOCN inequities after the reform.</p><p><strong>Conclusions: </strong>Contrary to expected, larger inequities in FUOCNs were identified in most intersectional strata after the reform. The moderate discriminatory accuracy suggested that Sweden could benefit from future strategies to foster equity that are universal but proportionately more intense among the intersectional strata with greater inequities (proportionate universalism).</p><p><strong>Knowledge transference statement: </strong>This analysis highlighted the benefit of adopting the principle of proportionate universalism as a strategy to reduce unmet oral care needs in Sweden. This would mean implementing universal strategies and specific support measures for the most vulnerable social groups as a future oral care policy change in Sweden.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241305109"},"PeriodicalIF":2.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854291","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}