Journal of the American Dental Association最新文献

{"title":"Authors' Response.","authors":"Zahra Bagheri, Hyongsup Kimm","doi":"10.1016/j.adaj.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.09.006","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111512","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":"Examining the multidimensional implications of oral health in chronic kidney disease: A systematic review.","authors":"Sandra Moreira Rua Ventura, Pedro Manuel Vasconcelos Mesquita","doi":"10.1016/j.adaj.2026.06.004","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.06.004","url":null,"abstract":"<p><strong>Background: </strong>The authors of this systematic review aimed to synthesize the evidence on the multidimensional oral health outcomes associated with chronic kidney disease (CKD), including oral health status, oral manifestations, oral health-related quality of life, underlying biological mechanisms, and access to oral health care.</p><p><strong>Types of studies reviewed: </strong>A total of 46 English-language studies published over the past decade were included, comprising randomized controlled trials, nonrandomized interventional studies, and observational designs (eg, cohort, case-control, and cross-sectional studies). Studies were selected according to predefined population, exposure, comparator, and outcomes criteria. Risk of bias and methodological quality were assessed independently, and findings were synthesized qualitatively due to heterogeneity. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.</p><p><strong>Results: </strong>Patients with CKD exhibited poorer oral health outcomes than healthy controls across multiple domains. These included reduced oral health-related quality of life (standardized mean difference, 0.45), high prevalence of oral mucosal lesions (81.8%), higher salivary pH (standardized mean difference, 1.74), and substantial tooth loss (mean, 15 teeth). Proposed mechanisms include systemic inflammation, altered mineral metabolism, kidney osteodystrophy, salivary changes, and oral microbiome dysbiosis.</p><p><strong>Conclusions and practical implications: </strong>Routine use of the 14-item Oral Health Impact Profile can help clinicians identify oral health-related quality of life issues in patients with CKD, guide early detection and prevention of oral complications, and support integration of oral health care with overall medical management, including monitoring kidney function tests to identify patients at higher risk. In the future, researchers should focus on underrepresented groups, particularly patients with mild to moderate CKD, and use robust study designs to clarify longitudinal outcomes and the complex interactions between CKD and oral health. The protocol used in this systematic review was registered in the International Prospective Register of Systematic Reviews database (registration CRD42024618866).</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990590","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":"Fluoridation and the risk of multiple amalgam or composite resin restorations for privately insured Massachusetts children: A retrospective cohort study.","authors":"Sam A Merabi, Pam Factor-Litvak, Eric P Tranby, Ivy Mushamiri","doi":"10.1016/j.adaj.2026.05.027","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.05.027","url":null,"abstract":"<p><strong>Background: </strong>Community water fluoridation (CWF) is widely associated with reduced childhood caries. The authors examined whether CWF reduces amalgam or composite resin restoration risk among privately insured children in Massachusetts.</p><p><strong>Methods: </strong>In this retrospective cohort study, the authors analyzed dental insurance claims (2016-2019) linked to municipal fluoridation and Internal Revenue Service data among 35,610 privately insured children aged 1 through 16 years. Linear regression estimated adjusted mean differences in amalgam or composite resin restorations to examinations ratios and Poisson regression with log-link estimated adjusted risk ratios for multiple amalgam or composite resin restorations. Age stratification included teenagers entering the study (n = 9,215). Models adjusted for age, sex, income, topical fluoride, and sealants.</p><p><strong>Results: </strong>In adjusted models, the CWF cohort had a lower amalgam or composite resin restorations to examinations ratio (-0.034; 95% CI, -0.057 to -0.011; P = .004). A lower ratio was observed among adolescents 13 years and older at study entry (-0.092; 95% CI, -0.155 to -0.030; P = .004). Results of secondary threshold analyses showed generally larger relative risk reductions with higher treatment thresholds reaching an overall 19.0% reduced risk for more than 8 amalgam or composite resin restorations (estimate, -0.211; 95% CI, -0.360 to -0.062; P = .005). Similarly, a 26.9% reduced risk was observed for more than 7 amalgam or composite resin restorations among adolescents 13 years and older at study entry (estimate, -0.312; 95% CI, -0.511 to -0.115; P = .002).</p><p><strong>Conclusions: </strong>The results of this study showed that privately insured children exposed to CWF had a lower risk of undergoing restorative dental treatment, with greater protection generally observed at higher treatment counts. These findings support the extension of CWF's preventive public health benefits to privately insured children.</p><p><strong>Practical implications: </strong>Results showed CWF remains relevant for reducing dental treatment needs and may inform municipal fluoridation decisions.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148969439","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":"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":"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":"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}