Journal of the American Dental Association最新文献

{"title":"A national analysis of factors associated with the prevalence and practice of expanded function dental assistants in the United States.","authors":"Hanna Aronovich, Victoria Nguyen, Sophie Wilkinson","doi":"10.1016/j.adaj.2026.06.009","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.06.009","url":null,"abstract":"<p><strong>Background: </strong>The scope and regulation of expanded function dental assistants (EFDAs) vary according to state. The authors explored predictors of EFDA workforce participation rates and quantified EFDA regulation, delegation patterns, and perception nationally.</p><p><strong>Methods: </strong>The authors applied a cross-sectional design using secondary data collection and 2 online surveys to dentists (n = 558) and dental assistants (n = 1,016). Licensed dentists and dental assistants working in a dental practice in the United States were eligible to participate.</p><p><strong>Results: </strong>In states with registered EFDAs, nearly one-half (46.9%) had low EFDA rates. More established EFDA levels were associated with higher EFDA rates. Dentists delegated preventive functions to dental assistants frequently, but only 32.9% delegated direct restorations. Delegation depended on both environmental and personal factors. Dentists were approximately twice as likely to delegate direct restorations if they felt it saved them time, nearly 12 times more likely to delegate in states with function-specific certificates (compared with states without EFDA registration), and more than 4 times more likely to delegate in public health settings than in dental support organizations. Overall, both regulations and workplace environment strongly influenced how much responsibility dentists gave to dental assistants.</p><p><strong>Conclusions: </strong>EFDAs represent a valuable, yet underdeveloped, component of the dental workforce. There are opportunities to increase EFDA rates and delegation. Although this study has limitations, the authors point to key considerations and opportunities for future workforce development and research.</p><p><strong>Practical implications: </strong>States aiming to introduce or expand EFDA roles should collaborate with associations and schools to provide EFDA training, guidance on how to fully use EFDAs, and information on the associated productivity benefits.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897394","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":"Buprenorphine","authors":"Katelyn Bye PharmD, RPh,&nbsp;Sanny Juresic PharmD, RPh,&nbsp;Nathan Smith PharmD, RPh, BCPS,&nbsp;Leslie R. Siegel PharmD, RPh","doi":"10.1016/j.adaj.2025.11.014","DOIUrl":"10.1016/j.adaj.2025.11.014","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 950-952"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105988","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":"Nomogram predicting suboptimal nonsurgical therapy response in stage III or IV periodontitis using hematologic and periodontal indexes","authors":"Tongxuan Mu MM,&nbsp;Yaru Yang MM,&nbsp;Zhe Li MM,&nbsp;Weijia Zhang MM,&nbsp;Zihan Wang BM,&nbsp;Zirui Wang BM,&nbsp;Hong Wu PhD,&nbsp;Li Lin PhD,&nbsp;Xiaolin Tang PhD,&nbsp;Yaping Pan PhD,&nbsp;Chen Li PhD","doi":"10.1016/j.adaj.2026.02.016","DOIUrl":"10.1016/j.adaj.2026.02.016","url":null,"abstract":"<div><h3>Background</h3><div>The authors aimed to identify risk factors for suboptimal response to nonsurgical periodontal therapy in patients with stage III or IV periodontitis and develop a predictive model to guide personalized treatment strategies.</div></div><div><h3>Methods</h3><div>A total of 146 patients with stage III or IV periodontitis who underwent nonsurgical periodontal treatment were retrospectively examined. Clinical and blood test data were collected. The data set was categorized into optimal (n = 92) and suboptimal (n = 54) response groups. Suboptimal responders were those with 30% or more of sites with initial probing depth of 5 mm or greater that failed to achieve a 2-mm or greater reduction or clinical health at the 6-week follow-up, and others were considered optimal. Results of logistic regression analyses identified independent risk factors, and a nomogram prediction model was constructed. Model discrimination was assessed using the area under the receiver operating characteristic curve and calibration was evaluated through the Hosmer-Lemeshow test and calibration curves. Clinical decision curve analysis was used to assess net benefit.</div></div><div><h3>Results</h3><div>Thick gingival phenotype, grade C periodontitis, elevated platelet to lymphocyte ratio, and mean corpuscular hemoglobin were significant risk factors for suboptimal response. The predictive model had strong discrimination (area under the receiver operating characteristic curve = 0.782) and good calibration (Hosmer-Lemeshow test, <em>P</em> = .532). Clinical decision analysis confirmed the usefulness of the predictive model within specific probability thresholds.</div></div><div><h3>Conclusions</h3><div>Gingival phenotype, periodontitis grade, platelet to lymphocyte ratio, and mean corpuscular hemoglobin are significant predictors of nonsurgical treatment outcomes in stage III and stage IV periodontitis. The proposed nomogram enables early identification of suboptimal responders.</div></div><div><h3>Practical Implications</h3><div>This nomogram supports personalized intervention strategies to optimize clinical outcomes and resource usage. This study was registered at the Chinese Clinical Trial Registry. The registration number is ChiCTR2400080731.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 1029-1040.e4"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941871","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":"Oral Human Papillomavirus Detection","authors":"Michael Glick DMD","doi":"10.1016/j.adaj.2026.05.028","DOIUrl":"10.1016/j.adaj.2026.05.028","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 953-954"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604423","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":"Pediatric dental surgeries","authors":"Joanna Buscemi PhD,&nbsp;David Avenetti DDS, MSD, MPH,&nbsp;Helen Lee MD, MPH","doi":"10.1016/j.adaj.2026.05.014","DOIUrl":"10.1016/j.adaj.2026.05.014","url":null,"abstract":"<div><span><figure><span><img><ol><li><span><span>Download: <span>Download high-res image (173KB)</span></span></span></li><li><span><span>Download: <span>Download full-size image</span></span></span></li></ol></span></figure></span></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 1059-1061"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and environmental contributions to dental fluorosis in the primary dentition","authors":"Raymi Rodrigo Leitão de Souza DDS,&nbsp;Letícia Caminha Aguiar Lopes DDS, MS,&nbsp;Francisca Aline da Silva Matias-Santos DDS, MS,&nbsp;Maria Eduarda Matos Sousa DDS, MS,&nbsp;Viviane Oliveira do Nascimento DDS, MS,&nbsp;Marina de Deus Moura de Lima DDS, MS, PhD,&nbsp;Cacilda Castelo Branco Lima DDS, MS, PhD,&nbsp;Lúcia de Fátima Almeida de Deus Moura DDS, MS, PhD,&nbsp;Marcoeli Silva de Moura DDS, MS, PhD","doi":"10.1016/j.adaj.2026.02.012","DOIUrl":"10.1016/j.adaj.2026.02.012","url":null,"abstract":"<div><h3>Background</h3><div>Although environmental exposure is the main determinant of dental fluorosis (DF), the contribution of genetic factors remains unclear. Twin studies offer an effective approach to distinguish genetic from environmental influences on this condition.</div></div><div><h3>Methods</h3><div>This was a cross-sectional census-based study involving twin preschoolers aged 3 through 5 years in Teresina, Brazil. Children with complete primary dentition were included, and children who did not cooperate were excluded. The children’s guardians answered questionnaires regarding socioeconomic-, health-, and zygosity-related aspects. DF was diagnosed using the Thylstrup-Fejerskov index (scale from 0 [no DF]-9 [severe DF]). Coincidence was analyzed using Spearman correlation coefficient (<em>r</em>) and multinomial logistic regression. Heritability (<em>H</em>²) was estimated using the Holzinger formula. Multilevel logistic regression identified associated factors (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>A total of 219 pairs of twins were included (87 monozygotic [MZ], 132 dizygotic [DZ]). The prevalence of DF was 23%. Coincidence regarding the presence of DF was considered very strong among MZ twins (<em>r</em>MZ = .92) and strong among DZ twins (<em>r</em>DZ = .76) (<em>P</em> &lt; .001). Observed <em>H</em>² was moderate (<em>H</em>² = 66.5%). Attending a private school (odds ratio [OR], 5.17; <em>P</em> &lt; .001), exclusive breastfeeding for less than 6 months (OR, 2.51; <em>P</em> = .015), and early-life toothbrushing with fluoridated toothpaste (OR, 1.97; <em>P</em> = .019) were predictors of the condition.</div></div><div><h3>Conclusions</h3><div>Moderate <em>H</em>² and higher diagnostic coincidence among MZ twins suggest a genetic influence on the development of DF in primary dentition.</div></div><div><h3>Practical Implications</h3><div>Understanding the genetic and environmental factors associated with DF offers valuable insights for the early identification of children at risk of developing DF. This knowledge can guide clinicians and policy makers in developing targeted preventive strategies, improving fluoride management, and implementing evidence-based interventions to minimize DF and enhance pediatric oral health outcomes.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 1005-1017"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775198","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":"Authors’ Response","authors":"Chamindie Punyadeera MPhil, PhD,&nbsp;Xiaomin Huang PhD,&nbsp;Jaikrishna Balakittnen PhD,&nbsp;Chameera Ekanayake Weeramange PhD,&nbsp;Sarju Vasani MB BChir, MA (Med),&nbsp;Akila Wijesekera MD,&nbsp;Lizbeth Kenny MBBS,&nbsp;Rahul Ladwa MPhil, MedOnc,&nbsp;Brett G.M. Hughes MBBS (Hons)","doi":"10.1016/j.adaj.2026.06.017","DOIUrl":"10.1016/j.adaj.2026.06.017","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 954-956"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604443","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":"United in purpose","authors":"Richard J. Rosato DMD","doi":"10.1016/j.adaj.2026.07.017","DOIUrl":"10.1016/j.adaj.2026.07.017","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 945-947"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADA 2026 Scientific Session concurrent meetings","authors":"","doi":"10.1016/j.adaj.2026.07.006","DOIUrl":"10.1016/j.adaj.2026.07.006","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Page 1071"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living evidence-informed guideline on the early detection of oral squamous cell carcinoma and potentially malignant disorders","authors":"Ankita Shashikant Bhosale BDS, MPH,&nbsp;Carolina Martins-Pfeifer DDS, MSc, PhD,&nbsp;Francisca Verdugo-Paiva DDS, MSc,&nbsp;Olivia Urquhart MPH,&nbsp;Alonso Carrasco-Labra DDS, MSc, PhD,&nbsp;Julia Pimentel DDS,&nbsp;A. Ross Kerr DDS, MSD,&nbsp;Marco Magalhaes DDS, MSc, PhD,&nbsp;Carol Anne Murdoch-Kinch DDS, PhD,&nbsp;JoAnn Gurenlian RDH, MS, PhD,&nbsp;Nishant Agrawal MD,&nbsp;Anil K. Chaturvedi PhD,&nbsp;Eva Grayzel BA,&nbsp;Alexander T. Pearson MD, PhD,&nbsp;James C. Melville DDS,&nbsp;Anita S.H. Patel DMD,&nbsp;Alessandro Villa DDS, PhD, MPH,&nbsp;Michael Glick DMD,&nbsp;Mark W. Lingen DDS, PhD","doi":"10.1016/j.adaj.2026.04.010","DOIUrl":"10.1016/j.adaj.2026.04.010","url":null,"abstract":"<div><h3>Background</h3><div>Identifying oral potentially malignant disorders and oral cavity cancer early can lead to better patient outcomes. The guideline panel evaluated the usefulness of light-based adjuncts for screening adults without mucosal abnormalities and for determining the need for biopsy among adults with mucosal abnormalities in the oral cavity or on the lip.</div></div><div><h3>Types of Studies Reviewed</h3><div>The authors conducted a living systematic review to evaluate evidence on the benefits and harms of light-based adjuncts and a scoping review to assess people and clinician values and preferences regarding the use of light-based adjuncts and biopsy of mucosal abnormalities. The guideline panel used this evidence to formulate recommendations according to the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework. The framework also guided the panel’s consideration of required resources, equity, acceptability, and feasibility in shaping the final recommendations.</div></div><div><h3>Results</h3><div>The guideline panel formulated 2 recommendations and 2 good practice statements. For adults with and without mucosal abnormalities, they formulated conditional recommendations against the use of light-based adjuncts on the basis of very low certainty evidence. The good practice statements urge clinicians to perform a clinical oral examination in all adult patients.</div></div><div><h3>Conclusions and Practical Implications</h3><div>Biopsy remains the reference standard for establishing a definitive diagnosis of an oral potentially malignant disorder and oral squamous cell carcinoma. All adults should undergo a clinical oral examination in primary care settings. When implementing or adapting these recommendations, local contexts should be considered to promote equitable access to early detection.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 9","pages":"Pages 968-979"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}