Journal of public health dentistry最新文献

{"title":"Parental Nutrition Literacy and Its Association With Early Childhood Caries Among Children Aged 3-6 Years: A Cross-Sectional Study.","authors":"Devadharani Kumaresan, Protyusha Guha Biswas, Jeyaseelan Ramasamy, Sarah Jane Monica, Karunanidhi Kannappan, Kaushik Prakash","doi":"10.1111/jphd.70081","DOIUrl":"https://doi.org/10.1111/jphd.70081","url":null,"abstract":"<p><strong>Background: </strong>Dietary practices, oral hygiene, and parental behavior have an impact on early childhood caries (ECC), a common chronic illness in preschoolers. Children's oral health outcomes are significantly influenced by the nutrition literacy and oral health knowledge of their parents.</p><p><strong>Aim and objectives: </strong>To assess parental nutrition literacy, including knowledge, attitudes, and practices, and its association with early childhood caries (ECC) among children aged 3-6 years.</p><p><strong>Methods: </strong>Three hundred fifty parent-child pairs were included in a cross-sectional study. A standardized questionnaire was used to gather information on sociodemographic, nutritional, and oral health practices, attitudes, and knowledge. Chi-squared tests were used to examine group differences; p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Compared with parents of children with ECC, parents of caries-free children showed significantly greater knowledge, preventive attitudes, and protective behaviors. The control group had significantly better maternal nutrition awareness (p = 0.001), accurate comprehension of the sugar caries link (p < 0.001), breastfeeding practices (p < 0.001), and twice daily brushing encouragement (p < 0.001). The ECC group continued to exhibit poor feeding practices, nocturnal sugar exposure, delayed initiation of oral hygiene, and irregular fluoride use, despite widespread awareness of the risks associated with sugar. Cultural norms, maternal education, and sociodemographic characteristics all influenced parental behavior.</p><p><strong>Conclusion: </strong>Oral hygiene habits and parental nutrition literacy are significant, modifiable predictors of ECC. To lower the prevalence of ECC and encourage the best possible oral health in preschoolers, targeted, culturally sensitive interventions, early behavioral guidance, and organized parental involvement are crucial.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149551","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":"Health Insurance and Untreated Dental Caries Among Children in the United States: The Mediating Role of Dental Care Utilization.","authors":"Deesha R Bhaumik, Sung Kyun Park, Morgan C Byrd, Margherita Fontana, David W Hutton, Betsy Foxman","doi":"10.1111/jphd.70084","DOIUrl":"https://doi.org/10.1111/jphd.70084","url":null,"abstract":"<p><strong>Objective: </strong>We evaluate the extent to which dental care utilization mediates the relationship between health insurance type and untreated dental caries among children in the United States.</p><p><strong>Methods: </strong>Our study population included children ages 2-18 in the 2017-March 2020 National Health and Nutrition Examination Survey (NHANES) cycle. The exposure was health insurance (private insurance, Medicaid, no insurance), the outcome was untreated dental caries, and the mediator was dental care utilization (dental visit ≤ 1 year). We conducted causal mediation analyses and adjusted for age, race/ethnicity, and family income to poverty ratio. Results are presented on a risk difference scale with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Untreated dental caries prevalence from 2017 to 2020 was 12.8% (95% CI: (9.46%, 16.15%)) among children aged 2-6 and 11.7% (95% CI: (9.86%, 13.48%)) among children ages 7-18. Children covered by Medicaid/CHIP had a 7.7% (95% CI: (7.5%, 8.0%)) excess risk of dental caries compared to privately insured children. Dental care utilization statistically significantly mediated this relationship by 8.3%. By contrast, risk of dental caries among children covered by Medicaid/CHIP was 5.1% (95% CI: (-5.6%, -4.6%)) less than that of uninsured children. Dental care utilization statistically significantly mediated this relationship by 50.9%.</p><p><strong>Conclusion: </strong>Dental care utilization remains an important mechanism in reducing untreated dental caries across insurance types, accounting for a substantially larger share of the difference between children covered by Medicaid/CHIP and uninsured children than between those covered by Medicaid/CHIP and private insurance. Additional mechanisms beyond utilization likely contribute to differences in untreated dental caries between children covered by Medicaid/CHIP and private insurance.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140020","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":"Dietary Quality and the Association Between Tooth Loss and Cognitive Performance in Older Adults: A Causal Mediation Analysis of NHANES 2011-2014.","authors":"Kuan-Yu Chu","doi":"10.1111/jphd.70087","DOIUrl":"https://doi.org/10.1111/jphd.70087","url":null,"abstract":"<p><strong>Objectives: </strong>To quantify how much of the association between tooth loss and cognitive performance is statistically attributable to dietary quality.</p><p><strong>Methods: </strong>Cross-sectional causal mediation analysis of 2600 adults aged 60-80 years (NHANES 2011-2014). Functional tooth loss (< 20 natural teeth) was the exposure, dietary quality (Healthy Eating Index 2020; HEI-2020) the mediator, and a composite cognitive z-score (processing speed, episodic memory, semantic fluency) the outcome. Survey-weighted models estimated the total effect; mediation quantities were estimated from unweighted models with 1000 bootstrap replicates.</p><p><strong>Results: </strong>Severe tooth loss was associated with lower cognitive z-scores (survey-weighted β = -0.167 SD; 95% CI: -0.226, -0.107) and lower dietary quality (-2.8 HEI-2020 points; 95% CI: -3.7, -2.0). Dietary quality accounted for 8.9% of the association (95% CI: 3.8%-16.9%). The mediated effect was small in absolute terms (-0.012 SD, ≈0.2 Digit Symbol points) and fragile: it would be nullified by unmeasured mediator-outcome confounding only 1.5 times that implied by race/ethnicity, and was of borderline significance after periodontal adjustment in the dentate subsample (7.7%; 95% CI: 0.1%-32.6%; p = 0.047).</p><p><strong>Conclusions: </strong>Dietary quality accounted for a small share of the cross-sectional tooth loss-cognition association. Because exposure, mediator, and outcome were measured contemporaneously and the estimate was sensitive to plausible confounding, these findings are consistent with-but do not establish-a dietary mediating pathway. The robust association between tooth loss and poorer diet nonetheless supports nutritional screening in dental care of older adults.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121006","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":"The Association Between General Health Literacy and Oral Health Among Korean Adults.","authors":"In Cheol Hwang, Hong Yup Ahn","doi":"10.1111/jphd.70088","DOIUrl":"https://doi.org/10.1111/jphd.70088","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the association between general health literacy (HL) and multiple oral health indicators among Korean adults.</p><p><strong>Methods: </strong>We analyzed data from 5338 adults (≥ 19 years) who participated in the 2023 Korea National Health and Nutrition Examination Survey. HL was assessed using the Health Literacy Index for the Community (HLIC), with scores < 28 indicating inadequate HL. Three oral health status outcomes (chewing difficulty, self-rated oral health, and voice discomfort) and one preventive dental care utilization outcome (oral health screening) were examined. Multivariable logistic regression analyses were conducted, adjusting for sociodemographic, health-related, and behavioral factors.</p><p><strong>Results: </strong>After full adjustment, inadequate HL was associated with chewing difficulty, voice discomfort, and poor self-rated oral health. Additionally, individuals with inadequate HL were less likely to have undergone preventive oral screening in the past year.</p><p><strong>Conclusions: </strong>Our findings suggest that inadequate HL is independently associated with poorer oral health outcomes and reduced dental care utilization, particularly in Asian contexts where oral health literacy interventions remain limited.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120988","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":"Integration of Oral Health Into Primary Care and Public Health Systems: A Systematic Review of Strategies, Outcomes, and Sustainability Determinants.","authors":"Abhi Thakkar, Bharani Kumar Bhattu, Chintan Desai, Deepkumar Patel, Abhishek Gupta, Harender Singh","doi":"10.1111/jphd.70086","DOIUrl":"https://doi.org/10.1111/jphd.70086","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effectiveness and implementation of integrated oral health services within primary care and other health system settings.</p><p><strong>Methods: </strong>A systematic review of electronic databases was conducted. Studies evaluating the integration of oral health services into primary care or related settings were eligible, including comparative and implementation studies of preventive interventions, screening, counseling, fluoride varnish delivery, referral pathways, and integrated care models. Risk of bias and methodological quality were assessed using design-appropriate tools. Where outcomes were sufficiently comparable, random-effects meta-analysis was performed, with pooled estimates reported as risk ratios (RR), hazard ratios (HR), or standardized mean differences (SMD) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Twenty-seven studies met the inclusion criteria, including randomized trials, cohort studies, implementation evaluations, qualitative studies, and economic analyses. Integrated preventive oral health interventions were associated with reduced caries incidence (pooled RR/HR 0.19, 95% CI 0.09-0.43; two studies) and lower caries burden in children (pooled SMD -0.45, 95% CI -0.54 to -0.36; two studies). Several studies also reported improved delivery of preventive oral health services in primary care. Heterogeneity in study designs and outcome reporting limited quantitative synthesis.</p><p><strong>Conclusions: </strong>Integration of preventive oral health services into primary care appears feasible and may improve oral health outcomes and service delivery. However, heterogeneity and the small number of studies contributing to pooled estimates limit confidence in the findings. Further well-designed controlled studies using standardized outcome measures are needed.</p><p><strong>Trial registration: </strong>PROSPERO: CRD420251239041.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120948","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":"Unmet Dental Treatment Needs and Service Utilization in Myanmar: Evidence From the First National Oral Health Survey.","authors":"Kaung Myat Thwin, Prathip Phantumvanit, Hideo Miyazaki, Hiroshi Ogawa","doi":"10.1111/jphd.70085","DOIUrl":"https://doi.org/10.1111/jphd.70085","url":null,"abstract":"<p><strong>Objectives: </strong>Unmet dental treatment need is a key indicator for oral health system planning, yet population-level data are lacking in Myanmar. This study assessed the prevalence, distribution, and factors associated with unmet dental treatment need among Myanmar adults.</p><p><strong>Methods: </strong>This was a secondary analysis of cross-sectional data from Myanmar national oral health survey 2016-2017, using stratified two-stage cluster sampling. A total of 2520 participants from two WHO index age groups (35-44: adults and 60-74: older adults) were included. Clinical oral examinations and self-administered questionnaires were conducted. Unmet treatment need, based on WHO intervention urgency, was dichotomized as no need or any need. Modified Poisson regression with robust variance was used.</p><p><strong>Results: </strong>The prevalence of unmet dental treatment need was 66.0% among adults and 77.2% among older adults. Preventive or routine care was the most common need, followed by prompt treatment. Only 11.0% of adults and 9.2% of older adults visited a dentist within the past 2 years. Higher DMFT scores and the presence of periodontal pockets were strongly associated with unmet need in both age groups. Chewing tobacco use was associated with lower prevalence of unmet need in adults (95% CI: 0.75-0.91), while toothbrushing frequency of ≤ once a day was associated with higher prevalence in older adults (95% CI: 1.03-1.16).</p><p><strong>Conclusions: </strong>Unmet dental treatment need is highly prevalent in Myanmar, with very low dental service utilization. Clinical disease severity is strongly associated with unmet need. Strengthening access to care and expanding preventive services are essential to address this burden.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121002","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":"Nontraumatic Dental Emergency Department Visits and Follow Up Dental Care Among Wisconsin Medicaid Beneficiaries.","authors":"Qishi Zhan, Tao Cui, Naveen Bansal, Maharaj Singh, Wenhui Sheng, Shengtong Han, Pradeep Bhagavatula","doi":"10.1111/jphd.70082","DOIUrl":"https://doi.org/10.1111/jphd.70082","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency department (ED) visits for nontraumatic dental conditions (NTDCs) are a persistent concern for Medicaid beneficiaries. This study examined factors associated with NTDC-related ED utilization and dental follow up among Wisconsin Medicaid beneficiaries.</p><p><strong>Methods: </strong>We conducted a retrospective claims-based cohort study using Wisconsin Medicaid claims from January 1, 2014, through December 31, 2019. The ED cohort (n = 553,669) outcome was at least one NTDC-related ED visit. The follow up cohort (n = 21,386 with an index NTDC-related ED visit) outcome was at least one nonemergency dental visit within 6 months. Multivariable logistic regression estimated adjusted associations. Supplementary analyses used a logistic prediction model and LightGBM under a balanced modeling framework.</p><p><strong>Results: </strong>Adults had the highest NTDC-related ED visit rate (6.0%), exceeding children (1.5%) and older adults (1.5%). Rates were higher among White (4.4%) and Black (4.1%) beneficiaries than among Hispanic beneficiaries (2.7%). Only 8.8% of beneficiaries with an NTDC-related ED visit received dental follow up within 6 months. After adjustment, HMO enrollment, adult age group, and residence in non-Milwaukee urban or rural areas were associated with higher odds of NTDC-related ED visits. For follow up, the highest area level income quartile had greater odds of subsequent nonemergency dental care.</p><p><strong>Conclusions: </strong>NTDC-related ED utilization and post ED dental follow up were associated with demographic, socioeconomic, geographic, and insurance related factors. The low follow up rate suggests a substantial gap between emergency care and subsequent nonemergency dental care, supporting care coordination, Medicaid dental access, and regional strategies for connecting ED patients to dental providers.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083469","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":"Examining Adverse Childhood Experiences as a Risk Factor for Preventive Dental Care and Tooth Decay: National Survey of Children's Health 2022-2023.","authors":"Elizabeth Crouch, Nina Frattaroli, Zachary Brian, Cassie Odahowski, Amy Martin, Joni Nelson","doi":"10.1111/jphd.70083","DOIUrl":"https://doi.org/10.1111/jphd.70083","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between cumulative adverse childhood experiences (ACEs) and oral health outcomes among US children and adolescents in the post-COVID-19 period, specifically examining preventive dental care receipt and caregiver-reported tooth decay.</p><p><strong>Methods: </strong>We analyzed nationally representative data from the 2022-2023 National Survey of Children's Health (NSCH), using a cross-sectional study design. The analytic sample included 44,489 children aged 6-17 years with complete geographic data. Multivariable logistic regression models estimated associations between cumulative ACE exposure and two outcomes: receipt of a preventive dental visit in the past year and parent-reported tooth decay. Models adjusted for sociodemographic, household, and health-related factors, including language, income, insurance type, special healthcare needs, and rural residence.</p><p><strong>Results: </strong>Children exposed to four or more ACEs had significantly higher odds of experiencing tooth decay (aOR 1.60; 95% CI 1.33-1.94) compared with those with less than four ACEs. After adjustment, cumulative ACE exposure was not associated with reduced receipt of preventive dental care. Other predictors of tooth decay included low household income, public insurance, special healthcare needs, speaking a non-English language at home, and rural residence. Children with high ACE exposure continued to exhibit disproportionate oral health burdens.</p><p><strong>Conclusions: </strong>These findings suggest that childhood adversity is associated with poorer oral health status, while preventive dental care utilization may be influenced by broader socioeconomic and contextual factors. Given the cross-sectional design and reliance on caregiver-reported measures, longitudinal studies are needed to clarify temporal relationships and better understand the pathways linking childhood adversity and oral health outcomes.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077115","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":"Dental Care Utilization Among Patients Receiving Primary Care Within a Massachusetts Accountable Care Organization.","authors":"John Ahern, Ariela Braverman Bronstein, Caleb Tam, Benjamin Le Cook","doi":"10.1111/jphd.70072","DOIUrl":"https://doi.org/10.1111/jphd.70072","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize demographic factors associated with dental care utilization in the past year among patients receiving primary care at a Massachusetts Accountable Care Organization -participating health system.</p><p><strong>Methods: </strong>Electronic medical record data were obtained for unique primary care patients who completed oral health screening at a single Massachusetts ACO-participating health system between July 1, 2023, and March 1, 2024. Dental care utilization was assessed using patients' self-reported receipt of dental care in the previous 12 months. Bivariate and multivariable logistic regression models assessed associations between patient demographics and non-utilization of dental care.</p><p><strong>Results: </strong>Overall, 38% of patients had not utilized dental care in the past year. Compared with reference groups in their respective categories, higher odds of non-utilization were observed among males (OR 1.21; 95% CI: 1.16-1.26), children aged 0-5 (OR 3.97; 95% CI: 3.51-4.48), adults aged ≥ 60 (OR 4.03; 95% CI: 3.61-4.49), Haitian Creole speakers (OR 1.78; 95% CI: 1.59-2.00), Asian patients (OR 1.27; 95% CI: 1.16-1.38) and publicly insured patients (OR 2.34; 95% CI: 2.19-2.49).</p><p><strong>Conclusions: </strong>Disparities in self-reported dental care utilization were observed across sex, age, language, race, and insurance status within a single Massachusetts Accountable Care Organization -participating health system.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077083","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":"The Relationship Between Untreated Molar Caries and Dental Sealants Among US Adolescents.","authors":"Shillpa Naavaal, Christina Scherrer, Kathleen Tatro, Susan O Griffin","doi":"10.1111/jphd.70079","DOIUrl":"https://doi.org/10.1111/jphd.70079","url":null,"abstract":"<p><strong>Objective: </strong>Despite the availability of effective preventive dental services, caries prevalence remains high. In this study, we examined the relationship between untreated molar caries (UMC) on the permanent molars of adolescents and the presence of dental sealants.</p><p><strong>Methods: </strong>Our study population included all adolescents aged 12-19 years and those from low-income households. We used National Health and Nutrition Examination Survey data (2011-2016). Our outcome was UMC, and the primary exposure was the presence of at least one sealant on second molars (2M), first molars (1M), or both. We examined the association between UMC and sealant status using bivariate analyses and multivariable logistic regression models controlling for socioeconomic and other covariates. All analyses were weighted and accounted for complex survey data; p < 0.05 was considered significant.</p><p><strong>Results: </strong>Among adolescents (n = 3601), 15.3% had UMC, and 55.7% experienced caries in permanent molars. Molar sealant prevalence was 30.8%, while 12.8% and 3.8% had only 1M and 2M sealants, respectively. Adolescents without sealants had a higher prevalence of UMC than those with 1M, 2M, or both sealants (22.3% vs. 10.6%, 8.0%, and 6.2%, respectively). Adjusted models indicated that adolescents with both 1M and 2M sealants had 72% lower odds of UMC than those without sealants (OR = 0.28, 95% CI: 0.18, 0.44). Findings were similar but more pronounced for adolescents in low-income households.</p><p><strong>Conclusions: </strong>The prevalence of UMC is significantly higher among adolescents without sealants. Oral health programs should promote and prioritize sealants, especially for 2M, to improve adolescent oral health and reduce the burden of dental caries.</p>","PeriodicalId":94108,"journal":{"name":"Journal of public health dentistry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066979","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}