Journal of public health dentistry最新文献

{"title":"From Policy Endorsement to Programmatic Delivery: The Persistent Implementation Gap of Silver Diamine Fluoride in the Global South","authors":"Bugude Shiva Shankar","doi":"10.1111/jphd.70059","DOIUrl":"10.1111/jphd.70059","url":null,"abstract":"","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"271-273"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silver Diamine Fluoride in Oral Health Policy: A Strategic Pathway to Improve Access and Equity","authors":"Aisan Nouri,&nbsp;Lisa Jamieson,&nbsp;Seyed Kian Haji Seyed Javadi","doi":"10.1111/jphd.70066","DOIUrl":"10.1111/jphd.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the potential role of silver diamine fluoride (SDF) as a public health intervention and propose a practical policy framework for its equitable integration into oral healthcare systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A policy-oriented narrative synthesis of current evidence was undertaken, drawing on systematic reviews, clinical trials, economic evaluations, professional guidance, and implementation literature. Evidence was considered across clinical, workforce, economic, regulatory, and equity domains to identify barriers to SDF uptake and the policy actions required for effective implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SDF is an effective, minimally invasive, and comparatively low-cost intervention for arresting active carious lesions. Its simple application, limited equipment requirements, and suitability for community-based delivery make it particularly relevant for children, older adults, people with special healthcare needs, and populations facing financial, geographic, or physical barriers to conventional dental care. However, broader implementation remains constrained by regulatory ambiguity, limited reimbursement and procurement pathways, workforce training gaps, aesthetic concerns, inconsistent consent and follow-up processes, and fragmented governance. A six-pillar framework is proposed, encompassing financing and procurement; regulatory clarity and professional scope; workforce training; patient communication, consent, and program monitoring; research and evaluation; and governance and intersectoral collaboration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The principal challenge to wider SDF integration is no longer the absence of supporting evidence but persistent policy and health-system barriers. Incorporating SDF into oral health policy, alongside appropriate clinical protocols, referral pathways, financing, workforce preparation, and monitoring, could expand access to minimally invasive care and support more equitable, accessible, and sustainable oral health systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"336-342"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental-Legal Partnerships: Extending the Medical-Legal Partnership Model to Dentistry","authors":"Alexander Testa,&nbsp;Rahma Mungia,&nbsp;Jack Tsai","doi":"10.1111/jphd.70070","DOIUrl":"10.1111/jphd.70070","url":null,"abstract":"&lt;p&gt;Oral health is a fundamental component of overall health [&lt;span&gt;1-3&lt;/span&gt;] and is shaped not only by clinical care but also by social determinants of health (i.e., the conditions in which individuals live, work, and play) [&lt;span&gt;4-6&lt;/span&gt;]. A growing body of research indicates that hardships such as food insecurity [&lt;span&gt;6-8&lt;/span&gt;], housing instability [&lt;span&gt;6, 9&lt;/span&gt;], lack of insurance coverage [&lt;span&gt;10&lt;/span&gt;], and employment instability [&lt;span&gt;11, 12&lt;/span&gt;] influence oral health and access to dental care. Although many of these issues are economic in nature, they are often intertwined with underlying civil legal issues, such as unsafe housing conditions, wrongful denial of public benefits, and employment disputes [&lt;span&gt;13&lt;/span&gt;]. Civil legal issues that negatively affect domains of health—including oral health—are referred to as health-related legal needs [&lt;span&gt;14, 15&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;To address health-related legal needs, medical-legal partnerships (MLPs) have emerged as a model that integrates legal services into health care settings by connecting patients with pro bono legal aid to resolve civil legal issues that undermine health and well-being [&lt;span&gt;13, 16&lt;/span&gt;]. By the end of 2025, nearly 500 MLP programs nationwide were operating in hospitals, community health centers, and clinics [&lt;span&gt;15, 17&lt;/span&gt;]. MLPs have also been established to reach various populations, such as veterans [&lt;span&gt;18&lt;/span&gt;], individuals experiencing homelessness [&lt;span&gt;19&lt;/span&gt;], and victims of violence [&lt;span&gt;20&lt;/span&gt;]. Dental settings (i.e., dental programs operated within federally qualified health centers [FQHCs], hospitals, dental schools, community clinics, and private dental practices), however, remain largely absent from the MLP model. Indeed, despite the growth of MLPs in numerous medical settings [&lt;span&gt;15&lt;/span&gt;] and a brief reference to their potential relevance for dentistry in the National Institute of Dental and Craniofacial Research's &lt;i&gt;Oral Health in America&lt;/i&gt; report [&lt;span&gt;3&lt;/span&gt;], the authors' search of the literature identified no published descriptions of MLPs in dental settings and only a single description of a pilot program in rural Minnesota [&lt;span&gt;21&lt;/span&gt;]. The premise of this commentary is to inform the dental community about the potential value of extending the MLP model to dental care, including integrating dental programs into existing MLPs (e.g., within FQHCs) or by forming new partnerships between dental organizations and civil legal aid providers. We also highlight the need for formal research to address questions about the feasibility and effectiveness of incorporating dental care into MLP models.&lt;/p&gt;&lt;p&gt;The MLP model began in the late 1990s and has since expanded nationally, with a presence in nearly every state supported by organizations such as the National Center for Medical-Legal Partnership [&lt;span&gt;15, 17&lt;/span&gt;]. The premise of the MLP model is that civil legal issues, such as denial of public benef","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"274-279"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Care Access for Young Children With Medicaid: Groundtruthing Online Data and Actual Access in the Chicago Metro Area","authors":"Natalie Crnosija,&nbsp;Hailey Steele,&nbsp;Amy Mitchell,&nbsp;Jose Penaloza,&nbsp;Ayleen Mokbel,&nbsp;Anna Sandoval,&nbsp;Joshua Tootoo,&nbsp;Briana Soriano,&nbsp;Aaron Lilienfeld,&nbsp;Melissa Fiffer,&nbsp;Marie Lynn Miranda,&nbsp;Molly Martin","doi":"10.1111/jphd.70064","DOIUrl":"10.1111/jphd.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many dental clinics reportedly accept Medicaid for young children per online sources, but parents' experiences suggest that this differs from actual access. Recognizing potential differences between reported and realized access, we studied realized dental care access and neighborhood-level barriers to care in the Chicago metro area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We created a list of Medicaid-accepting dental clinics using the Centers for Medicare and Medicaid Services Insurekidsnow.gov “Find a Dentist” search engine tool. Limited to Coordinated Oral Health Promotion Chicago Cohort Study participants' ZIP Codes (<i>N</i> = 51), research staff called each clinic posing as parents trying to schedule their Medicaid-insured children for appointments. Dental clinic and participant addresses were geocoded; using American Community Survey data, we estimated the population's actual access to Medicaid-accepting clinics and neighborhood-level barriers. We used an Enhanced Two-Step Floating Catchment Area analysis to determine realized access and identify disparities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 379 dental clinics identified online as taking Medicaid insurance for children, only 240 (63.32%) confirmed accepting Medicaid. The catchment area overall met the Health Professional Shortage Area threshold (1 dentist: 5000 population), indicating adequate access for the Medicaid-insured population. Yet, some southern Chicago/southwestern suburbs had exceptionally poor access (&lt; 1 dental clinic: 10,000 population).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Online data showed many dental clinics accepted Medicaid for children, but our study revealed that realized dental care access varied dramatically, with the fewest clinics in areas with the highest portion of children on Medicaid and the largest socioeconomic barriers. Multilevel change is needed to ensure access to critical dental health services for all.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"319-327"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Custodial Dental Care in Federal Courts: A Systematic Review of Appellate Decisions and Implications for Public Health","authors":"Jay D. Shulman","doi":"10.1111/jphd.70060","DOIUrl":"10.1111/jphd.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine how federal appellate courts evaluate constitutional claims concerning custodial dental care and to characterize the clinical and procedural features of these cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Decisions of the U.S. courts of appeals issued between 1980 and 2025 were identified through structured database searches. Cases substantively evaluating dental care were coded for severe pain, infection, abscess (coded separately), functional impairment, delay, custody type, representation status, defendant level, and appellate outcome. Descriptive statistics summarized case characteristics, and logistic regression evaluated associations between selected variables and appellate outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 182 appellate decisions met inclusion criteria, of which 174 evaluated adequacy of care. Severe pain was described in 86% of coded cases and functional impairment in 62%. Infection was documented in 41% of cases, with an abscess specifically identified in 16%. Delay was alleged in 73% of cases. Overall, 35% of decisions resulted in reversal or remand. Among cases with documented delay duration, the median delay was substantially longer in plaintiff-favorable cases, and delays exceeding 90 days were associated with higher odds of reversal or remand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Appellate review emphasizes documented awareness and response rather than equivalence to community standards. This legal threshold does not ensure timely clinical resolution. Public health evaluation of custodial dental systems should consider disease progression and access to definitive treatment in addition to legal compliance. Improvements are likely to depend on system-level monitoring of access and timeliness of care rather than litigation alone, reflecting the distinction between legal sufficiency and clinical adequacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"280-283"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Associations Between Medicaid Policy and Silver Diamine Fluoride Utilization","authors":"Beau Meyer,&nbsp;Carson Richardson,&nbsp;Mikhail Jones,&nbsp;Juan Peng,&nbsp;Madison Vinson,&nbsp;Eric Tranby","doi":"10.1111/jphd.70067","DOIUrl":"10.1111/jphd.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This retrospective cohort study determined associations between Medicaid reimbursement policies for silver diamine fluoride treatment (SDF) and utilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data included publicly available Medicaid provider manuals and fee schedules as well as aggregated claims from CareQuest Institute for Oral Health. The main outcome was SDF utilization rate calculated as a percentage of claims per enrollees. Summary statistics and linear mixed models with random intercepts were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen states were included in the analysis. The median SDF utilization rate across states increased from 1.80% (IQR: 1.37%, 2.59%) in 2018 to 3.35% (IQR: 1.94%, 5.54%) in 2022. Of seven potential policy dimensions, only reimbursement amount was significantly associated with SDF utilization rate, and only when accounting for time (<i>β</i> = 0.15; 95% CI: 0.12, 0.18).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Policy factors, particularly reimbursement amount, likely play a role in SDF utilization; however, additional research is needed to understand how dentists adopt SDF in ways that translate into improved outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"353-357"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incarceration History, Dental Care Utilization, and Oral Health Difficulties Among U.S. Military Veterans","authors":"Alexander Testa,&nbsp;Luis Mijares,&nbsp;Jack Tsai","doi":"10.1111/jphd.70062","DOIUrl":"10.1111/jphd.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine whether a history of incarceration is associated with self-reported dental care utilization and oral health difficulties among low-income U.S. military veterans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were from Wave 5 of the National Veteran Homeless and Other Poverty Experiences study (<i>N</i> = 1384). Weighted logistic and multinomial logistic regression models were estimated to examine the association between a history of incarceration and (a) dental care utilization, and (b) oral health difficulties, adjusting for demographic, socioeconomic, military, and health insurance characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In covariate-adjusted models, veterans with a history of incarceration had significantly higher odds of not having a dental visit in the past year compared to those without prior incarceration (adjusted odds ratio [aOR] = 2.393, 95% confidence interval [CI] = 1.357, 4.219, <i>p</i> = 0.003), and reporting a higher relative risk of occasional oral health difficulties in the past 3 months (RRR = 1.856, 95% CI = 1.027, 3.353, <i>p</i> = 0.034) compared to never/hardly ever experiencing difficulties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A history of incarceration may represent an important social driver of dental care utilization and oral health difficulties among veterans. Potential programmatic responses through the U.S. Department of Veterans Affairs and the criminal justice system are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"301-308"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Evidence to Engagement: Understanding Online Resistance to Community Water Fluoridation for Public Health Communication—A Qualitative Study","authors":"Nilesh Torwane,&nbsp;Diep Ha,&nbsp;Ratilal Lalloo,&nbsp;Kristiana Ludlow,&nbsp;Nithin Manchery,&nbsp;Loc Do","doi":"10.1111/jphd.70061","DOIUrl":"10.1111/jphd.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study explored how individuals in an online anti-CWF community construct and sustain opposition narratives to inform evidence-based communication and policy engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative study was undertaken with adults who self-identified as not supportive of CWF. Fourteen participants from the United Kingdom, Australia, and the United States of America were recruited via the Fluoride Action Network Facebook page, a prominent global hub for anti-fluoridation discourse. Semi-structured interviews were conducted via Zoom between January and July 2025. Data were analyzed using inductive qualitative content analysis. Codes were organized into main, generic, and sub-categories and quantified by endorsement frequency. Reporting followed SRQR and COREQ guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five main categories were identified: (1) Knowledge, Attitudes, Perceptions, and Policy Views; (2) Information Sources and Trust; (3) Reasons for Opposition; (4) Grassroots and Community Actions; and (5) Alternatives and Conditions for Acceptability. Opposition to CWF was shaped by ethical, health, and institutional concerns rather than by scientific disagreement alone. Eight generic categories captured key reasons for opposition, including perceptions of mass medication without consent, health and social harms, institutional distrust, concerns about industrial waste, ethical objections, skepticism about benefits, preference for individualized alternatives, and experiences of professional dismissal. Anti-fluoride networks and social media were the most trusted sources of information (86%), while trust in mainstream science and health authorities was very low (&lt; 15%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Opposition to CWF is sustained through network-mediated information ecosystems and reinforced by behavioral economic mechanisms, including loss aversion, autonomy bias, and default framing effects. Effective public health responses must therefore move beyond evidence dissemination to incorporate network-aware communication and behavioral insights-informed strategies that prioritize transparency, public participation, and equitable framing of CWF within broader oral health policy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"284-300"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Artificial Intelligence Substitute Dental Public Health Expertise? A Competency-Based Analysis Across Core DPH Domains","authors":"Shaikha AlDukhail","doi":"10.1111/jphd.70065","DOIUrl":"10.1111/jphd.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial intelligence (AI) is increasingly integrated into public health and dentistry, with a range of applications. While these developments raise questions about efficiency and scalability, uncertainty remains regarding whether AI can substitute for Dental Public Health (DPH) expertise. This paper aims to distinguish between AI-amenable and fundamentally human DPH competencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An analytical framework was applied to the 10 dental public health (DPH) specialty competencies. Current AI applications reported in the health literature were mapped across competencies including program management, systems evaluation, ethical decision-making, surveillance system design, communication, collaboration and leadership, policy advocacy, evidence appraisal, research, and integration of social determinants of health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AI demonstrated strong technical capacity across data-intensive and analytical competencies, including program management, systems evaluation, surveillance design, evidence appraisal, research, and integration of social determinants of health. These domains were classified as augmentable, as AI enhanced data integration, pattern recognition, and operational efficiency when accompanied by appropriate human oversight. In contrast, competencies grounded in ethical decision-making, communication, leadership and collaboration, and policy advocacy were identified as irreplaceable, as they require moral judgment, contextual interpretation, professional accountability, and relational engagement beyond current AI capabilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings support the use of AI as a complementary tool in DPH while affirming that the specialists remain indispensable for governance, equity, public accountability, and strategic decision-making in population oral health policy and practice. Competency frameworks, accreditation standards, and workforce development efforts should explicitly define the appropriate role of AI while reinforcing the primacy of human judgment and ethical leadership in population oral health practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"328-335"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic Effects of Social Determinants of Health and Periodontitis on Premature Cardiovascular Mortality: A Nationally Representative Cohort Study","authors":"Dianjin Qi,&nbsp;Yipeng Ouyang","doi":"10.1111/jphd.70063","DOIUrl":"10.1111/jphd.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Periodontitis, a prevalent chronic inflammatory disorder, is linked to an increased risk of cardiovascular disease (CVD). However, the impact of social determinants of health (SDoH) on premature CVD mortality in individuals with periodontitis remains poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 8277 US adults aged 30–74 years, collected from NHANES 2009–2014 with mortality follow-up through 2019, were analyzed. Periodontitis was defined according to CDC/AAP criteria, and premature CVD mortality was defined as death from CVD before age 75. A cumulative SDoH score was constructed based on eight indicators. Kaplan–Meier survival curves and log-rank tests compared survival probabilities across groups. Sensitivity analyses utilized Fine and Gray competing risk models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Periodontitis was independently associated with an elevated risk of premature CVD mortality (HR = 2.21; 95% CI = 1.01–4.86), particularly among those with multiple adverse SDoH. A significant dose–response relationship was observed between cumulative SDoH burden and premature CVD mortality in the periodontitis cohort (<i>P</i> for trend = 0.03), but not in those without periodontitis. Food insecurity emerged as the sole individual SDoH independently linked to increased mortality risk. Kaplan–Meier curves revealed significantly lower cumulative survival among adults with periodontitis burdened with high SDoH (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Periodontitis was associated with an increased risk of premature CVD mortality, especially in the presence of cumulative adverse SDoH, suggesting the need for integrated medical-dental care and broader strategies to address social inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"86 3","pages":"309-318"},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}