Jennifer Archibald, Yara Halasa-Rappel, Steven D Ureles, Paulina Miller, Man Wai Ng, Rosalyn M Sulyanto
{"title":"The association of sealed primary molars with caries and restorative treatments.","authors":"Jennifer Archibald, Yara Halasa-Rappel, Steven D Ureles, Paulina Miller, Man Wai Ng, Rosalyn M Sulyanto","doi":"10.1016/j.adaj.2025.08.017","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.08.017","url":null,"abstract":"<p><strong>Background: </strong>The authors investigated the association of resin-based sealants with the onset of pit and fissure caries (PFC) and smooth surface caries (SSC) on primary molars.</p><p><strong>Methods: </strong>Primary molars with sealant placement or nonplacement in a hospital clinic and operating room (OR) were tracked in this 5-year retrospective study of children younger than 6 years with a high risk of developing caries (n = 383 children, n = 1,845 teeth). Onset of PFC and SSC and subsequent restorative and surgical retreatment were recorded. A Cox proportional hazards model and a flexible parametric model were used to estimate the association of sealant placement with caries incidence and time to caries onset, respectively.</p><p><strong>Results: </strong>The adjusted hazard ratio of developing PFC on sealed molars was 0.19 (95% CI, 0.11 to 0.32; P < .001) in all settings, 0.35 (95% CI, 0.18 to 0.66; P < .001) in a clinic, and 0.05 (95% CI, 0.02 to 0.14; P < .001) in the OR. The reduction of adjusted hazard ratio for SSC in sealed molars was not significant in all settings, clinic, and OR. Time to PFC onset in sealed molars was 4.76 years (all settings), 4.65 years (clinic), and 4.75 years (OR) vs 4.02 years (all settings), 4.15 years (clinic) and 3.55 years (OR) in unsealed molars. Unsealed primary molars required significantly greater restorative or surgical retreatment.</p><p><strong>Conclusions: </strong>Sealed primary molars are associated with a reduction of, and delay in, onset time of PFC but not SSC. Sealant placement is associated with less invasive restorative and surgical retreatment in primary molars that developed caries and decreased retreatment in the OR.</p><p><strong>Practical implications: </strong>Dental sealants on primary molars should be considered for children at high risk of developing caries.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Habib Benzian, Eugenio Beltrán-Aguilar, Richard Niederman
{"title":"Oral health, dentistry, and the new World Health Organization Pandemic Agreement: Aligning for resilience.","authors":"Habib Benzian, Eugenio Beltrán-Aguilar, Richard Niederman","doi":"10.1016/j.adaj.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.09.004","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparing the performance of ChatGPT, DeepSeek, and Gemini in systematic and umbrella review tasks over time.","authors":"Maryam Emami, Mohammadjavad Shirani","doi":"10.1016/j.adaj.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.08.011","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the performance of ChatGPT-4o (OpenAI), DeepSeek-V3 (High-Flyer), and Gemini 1.5 Pro (Google) during 3 consecutive weeks in performing full-text screening, data extraction, and risk of bias assessment tasks in systematic and umbrella reviews.</p><p><strong>Methods: </strong>This study evaluated the correctness of large language model (LLM) responses in performing review study tasks by prompting 3 independent accounts. This process was repeated during 3 consecutive weeks for 40 primary studies. The correctness of responses was scored, and data were analyzed by Kendall W, generalized estimating equations followed by pairwise comparisons with Bonferroni correction, and Mann-Whitney U tests (α = .05).</p><p><strong>Results: </strong>DeepSeek achieved the highest data extraction accuracy (> 90%), followed by ChatGPT (> 88%). Moreover, DeepSeek outperformed significantly in data extraction compared with Gemini in most pairwise comparisons (P < .0167). Gemini showed an improvement in data extraction performance over time, with significantly higher accuracy in the third week than in the first week (P < .0167). ChatGPT generally performed better in systematic reviews than in umbrella reviews (P < .05).</p><p><strong>Conclusions: </strong>The studied LLMs showed potential for accurate data extraction, particularly DeepSeek, but consistently had unreliable performance in critical tasks like full-text screening and risk of bias assessment. LLM applications in review studies require cautious expert supervision.</p><p><strong>Practical implications: </strong>Researchers planning to use LLMs for review study tasks should be aware that LLM responses to full-text screening and risk of bias assessment are unreliable. DeepSeek is the preferred LLM for data extraction in both systematic and umbrella reviews, whereas ChatGPT is recommended for systematic reviews.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abraham Ancselovics, Mea A Weinberg, Stuart L Segelnick
{"title":"Erythematous morbilliform rash after endodontic therapy.","authors":"Abraham Ancselovics, Mea A Weinberg, Stuart L Segelnick","doi":"10.1016/j.adaj.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.09.002","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Children's oral health care use and oral health in the United States after the COVID-19 pandemic.","authors":"Wei Lyu, George L Wehby","doi":"10.1016/j.adaj.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.09.001","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic adversely affected children's access to and use of oral health care services and their oral health status. The authors compared these outcomes after the pandemic through 2023 with prepandemic levels.</p><p><strong>Methods: </strong>Data from the annual National Survey of Children's Health from 2019 through 2023 were analyzed. The authors used a multivariable regression model to compare children's unmet oral health care needs, oral health care use (ie, any visits, any preventive visits, and specific preventive dental services), and parent or caregiver ratings of the child's oral health each year from 2020 through 2023 with 2019. Additional analyses were stratified according to sociodemographic characteristics and state-level dentist supply.</p><p><strong>Results: </strong>In the total sample, all outcomes had rebounded to prepandemic levels by 2023, or earlier in some cases, except for poor oral health ratings, which were still higher in 2023 than the prepandemic level by 0.3 percentage points (pp) (95% CI, 0.06 to 0.5 pp). Moreover, states with low dentist supply had lower dental examination and sealant rates in 2023 than 2019 by 2.5 pp (95% CI, -4.7 to -0.3 pp) and 1.9 pp (95% CI, -3.5 to -0.3 pp), respectively. Hispanic and publicly insured children also had lagging sealant rates in 2023 compared with prepandemic levels.</p><p><strong>Conclusions: </strong>Oral health care access and usage rebounded to prepandemic levels by 2023 for most children. However, poor oral health rates were still higher in 2023. In addition, dental examination and sealant rates remained lower in states with low dentist supply.</p><p><strong>Practical implications: </strong>More efforts are needed to address persistent oral health issues for children most vulnerable to poor oral health and those related to low dentist supply.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of inferior alveolar and lingual nerve block anesthesia on acoustic voice quality and speech effort: A within-subject study.","authors":"Cansu Sahin, Ferit Bayram, Göksu Yılmaz, Gülçin Bilgin Göçmen, Ahmet Konrot","doi":"10.1016/j.adaj.2025.08.021","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.08.021","url":null,"abstract":"<p><strong>Background: </strong>Patients frequently report difficulty in speaking after inferior alveolar nerve block anesthesia (IANBA), primarily because of numbness in the tongue and lips. However, the objective impact of IANBA on speech and voice quality (VQ) remains unclear. The aim of this study was to evaluate the effects of IANBA on acoustic voice quality and speech articulation using objective measurements and subjective self-assessments.</p><p><strong>Methods: </strong>Thirty-four adult patients undergoing IANBA were enrolled in a prospective study. Voice recordings were obtained before and after anesthesia. Objective assessments included acoustic voice parameters, speech articulation metrics, and formant analysis. Subjective speech effort was measured with the Borg Category-Ratio 10 scale.</p><p><strong>Results: </strong>No statistically significant changes were found in acoustic VQ indexes, formant values, or speech articulation parameters after IANBA. However, participants reported a significant increase in perceived speech effort after anesthesia (P < .001), as measured by the Borg scale.</p><p><strong>Conclusions: </strong>Whereas IANBA does not appear to have an impact on objective measures of speech or VQ, it increases the perceived effort required to speak. These findings highlight the need for clinicians to address patient concerns about speech changes after local anesthesia, even when objective alterations are minimal.</p><p><strong>Practical implications: </strong>Although objective measures of voice and speech remain unaffected after IANBA, patients may perceive increased difficulty in articulation. Dentists and oral surgeons should acknowledge these perceptual effects, particularly when managing the care of people with speech-critical occupations or those prone to prolonged sensory disturbances such as paresthesia. The study was registered on ClinicalTrials.gov before enrolling the first participant (NCT05710484).</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jesse Woon, Marcella H Boynton, Ujunwa F Onyeama, Nadja A Vielot, Adam D Lietzan
{"title":"The role of dentists in promoting human papillomavirus vaccination for oropharyngeal cancer prevention: A cross-sectional survey of dentists in North Carolina.","authors":"Jesse Woon, Marcella H Boynton, Ujunwa F Onyeama, Nadja A Vielot, Adam D Lietzan","doi":"10.1016/j.adaj.2025.08.018","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.08.018","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) causes cancers of the oropharynx, and HPV vaccination prevents these cancers. Given the prominent role of HPV vaccines in promoting oral health, this study aimed to understand the knowledge, perceptions, and perceived barriers associated with HPV and HPV vaccination among dentists in North Carolina, a state that does not currently permit vaccine administration by dentists.</p><p><strong>Methods: </strong>A cross-sectional study using a questionnaire was electronically distributed to North Carolina dentists. Eligibility criteria included reporting an active dental license and practicing dentistry. Descriptive statistics and linear regression models were used to evaluate associations.</p><p><strong>Results: </strong>Of the respondents (N = 174), most identified as female (56.3%), reported their area of dentistry as general or restorative (74.1%), and worked in a private practice setting (80.5%). More than 85% of respondents recognized diseases associated with HPV, such as warts and oropharyngeal cancers; however, only a minority routinely addressed virus-related risk (10.91% often; 3.03% almost always) or HPV vaccination (7.27% often; 1.82% almost always) when discussing preventive strategies against head and neck cancers. Many dentists perceived their role in HPV prevention as important but were reluctant to discuss HPV vaccination status with a patient. The most cited barriers to promoting or administering HPV vaccines in a dental setting were lack of education, training, or information (76.44%), liability reasons (60.34%), and procedure reimbursement (60.34%).</p><p><strong>Conclusions: </strong>Dentists recognize the importance of identifying and preventing HPV-related oral sequelae, but many are hesitant to discuss or to promote in-office HPV vaccine administration because of multiple perceived barriers.</p><p><strong>Practical implications: </strong>Continued educational endeavors may mitigate liability concerns and promote efforts to guide dentists to become HPV vaccinators.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yilei Liu, Kawtar Zouaidi, Colin C Hubbard, Muhammad F Walji, Matthew R Cooke, Donald B Rindal, Kristin N Ray, Elsbeth Kalenderian, Katie J Suda
{"title":"High-risk medications in pediatric dentistry: Patterns, outcomes, and clinical implications.","authors":"Yilei Liu, Kawtar Zouaidi, Colin C Hubbard, Muhammad F Walji, Matthew R Cooke, Donald B Rindal, Kristin N Ray, Elsbeth Kalenderian, Katie J Suda","doi":"10.1016/j.adaj.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.08.007","url":null,"abstract":"<p><strong>Background: </strong>High-risk medications such as opioids and benzodiazepines are frequently prescribed in pediatric dental care, yet their prescribing patterns and associated adverse outcomes remain poorly understood. The aim of this study was to determine the extent of such prescribing to pediatric patients and factors associated with adverse outcomes.</p><p><strong>Methods: </strong>MarketScan data for patients younger than 18 years with a dental visit from 2014 through 2019 were analyzed. High-risk medications included benzodiazepines, barbiturates, and opioids. Composite outcomes included hospitalization, emergency department visit, or urgent care visit within 7 days after the dental visit. Opioid-attributable outcomes included opioid-related overdose within 7 days or persistent opioid use 4 through 365 days after the visit. Generalized estimating equations assessed the association between outcomes and patient and visit characteristics.</p><p><strong>Results: </strong>Among pediatric dental visits, 0.72% (n = 269,991) involved high-risk medications, with 4.3% experiencing a composite outcome. Higher odds were observed in ages 9 through 11 years (odds ratio [OR], 1.56), male patients (OR, 1.05), patients with complex chronic conditions (OR, 2.22), and care delivered in hospital or ambulatory surgery settings (OR, 2.20). Among dental visits with opioids, 10.1% had an opioid-attributable outcome, with the highest odds in patients 4 through 5 years (OR, 1.48), female patients (OR, 1.08), patients with complex chronic conditions (OR, 1.22), and care delivered in outpatient clinics (OR, 1.43).</p><p><strong>Conclusions: </strong>One in 10 pediatric dental visits involving opioids was associated with opioid-related overdose or persistent use, with the highest odds in young children. These results highlight the need for caution in opioid prescribing and providing guideline-based nonopioid analgesia to children.</p><p><strong>Practical implications: </strong>Promote safer, equitable pediatric dental prescribing through guideline adherence, nonopioid pain management, and provider training.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suzanne E Tomasi, Ruth Lipman, Felicia Bloom, Randall J Nett, Jean M Cox-Ganser, Ethan D Fechter-Leggett
{"title":"Suicide deaths among dentists in the United States.","authors":"Suzanne E Tomasi, Ruth Lipman, Felicia Bloom, Randall J Nett, Jean M Cox-Ganser, Ethan D Fechter-Leggett","doi":"10.1016/j.adaj.2025.08.016","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.08.016","url":null,"abstract":"<p><strong>Background: </strong>Dentists experience myriad occupational stressors and are known to have an elevated risk of suicide. Previous US studies focused on suicide among White male dentists, and all studies were published before 2000. This study aimed to assess suicide mortality among male and female US dentists, to evaluate methods of suicide, and to examine trends over time.</p><p><strong>Methods: </strong>Data on US dentists who died from 1979 through 2018 were provided by the American Dental Association and matched to the National Death Index. Decedents who died by intentional self-harm were identified, and proportionate mortality ratios (PMRs) indirectly standardized for age, sex, race, and 5-year calendar period with 95% CIs were calculated using the Life Table Analysis System (National Institute for Occupational Safety and Health). Suicide methods and trends over time were also analyzed.</p><p><strong>Results: </strong>Of 21,928 eligible decedent records, 475 (2.2%) deaths were caused by suicide, with PMRs of 2.01 (95% CI, 1.83 to 2.21; P < .001) for male dentists and 2.15 (95% CI, 1.23 to 3.49; P = .009) for female dentists. Firearms were the predominant suicide method for male dentists (61.4%), but female dentists were split between firearms (31.3%) and hangings (31.3%). PMRs for suicide increased steadily for male and female dentists since 1995.</p><p><strong>Conclusions: </strong>From 1979 through 2018, US male and female dentists exhibited higher suicide mortality than the general population, with a steady increase since 1995.</p><p><strong>Practical implications: </strong>Dentist suicide prevention resources may be beneficial, particularly addressing occupational stressors. Reducing stigma and enhancing access to mental health services could lessen the risk of suicide for dental care professionals.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ajay Kumar Verma, Anjali Narwal, Mala Kamboj, Anju Devi, Gopikrishnan Vijayakumar, Sivakumar N
{"title":"An extensive cystic radiolucency in the right maxilla.","authors":"Ajay Kumar Verma, Anjali Narwal, Mala Kamboj, Anju Devi, Gopikrishnan Vijayakumar, Sivakumar N","doi":"10.1016/j.adaj.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.08.019","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}