2008 NOHC - JPHDSupplement
2008 NOHC - JPHDSupplement
2008 NOHC - JPHDSupplement
68, Supplement 1
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JOURNAL OF
PUBLIC HEALTH
DENTISTRY
Volume 68, Number 5
Supplement 1 - 2008
pp S1 - S58
Supplement 1 - 2008
Official Journal
of the American Association
of Public Health Dentistry
JOURNAL OF
PUBLIC HEALTH
DENTISTRY
SUPPLEMENT 1
VOLUME 68
C O N T E N T S
2008 NATIONAL ORAL HEALTH CONFERENCE
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Highlights
S10 AAPHD Presidents Remarks at the Opening Session Evans
S11 ASTDD Presidents Welcome and Address Steed
2008 AAPHD Awards
S12 Public Service Award: Rasmuson Foundation
S13 Special Merit Award: Sutherland
S13 Remarks on receiving the Special Merit Award in Dentistry
S14 Distinguished Service Award: Gift
S15 Remarks on receiving the Distinguished Service Award
S21 Leverett Graduate Student Merit Award for Outstanding Achievement in
Dental Public Health
S21 Predoctoral Dental Student Merit Awards for Outstanding Achievement in
Dental Public Health
S19 Herschel S. Horowitz Award: Rowe
2008 ASTDD Awards
S24 Presidents Award: Doherty
S23 Distinguished Service Awards: Sherman, Louis
S22 Outstanding Achievement Award - Morgan
ASTDD/ADA/CDC Community Water Fluoridation Awards
S25 Community Water Fluoridation Awards
American Association of Community Dental Programs
S27 The 2008 Myron Allukian Jr. Lifetime Achievement Award in Community
Dental Programs
Meeting Minutes
S28 AAPHD Annual Business Meeting Minutes
S30 ASTDD Annual Business Meeting Minutes
S33 ABDPH Diplomates Meeting Minutes
Abstracts
S35 NOHC Abstracts
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20062007 AAPHD
OFFICERS AND EXECUTIVE COUNCIL
President
Caswell Evans Jr., DDS, MPH
Univ. of Illinois Chicago
College of Dentistry
Chicago, IL
Phone: 312-413-7365; Fax: 312-413-9050
casevans@uic.edu
President-Elect
Mark H. K. Greer, DMD, MPH
Hawaii State Dept Human Services
Honolulu, HI
Phone: 808-832-5700; Fax: 808-832-5722
mhkgreer@mail.health.state.hi.us
Vice-President
Scott L. Tomar DMD, DrPH
Univ. of Florida College of Dentistry
Gainesville, FL
Phone: 352-273-5968; Fax: 352-273-5985
stomar@dental.ufl.edu
Secretary-Treasurer
Mary E. Foley, RDH, MPH
Childrens Dental health Project
Washington, DC
Phone: 202-833-8288 Ext. 5
mfoley@cdhp.org
Immediate Past President
Kathryn Atchison, DDS, MPH
UCLA School of Dentistry
Los Angeles, CA
Phone: 310-825-6544; Fax: 310-764-7734
katchison@resadmin.ucla
Executive Council
William D. Bailey, DDS, MPH
wdb9@cdc.gov
Eugenio Beltran, DMD, MS, DrPH
edb4@cdc.gov
Raul Garcia, DMD, MMSC
rig@bu.edu
Judith Jones, DDS, MPH, DScD
judjones@bu.edu
Jayanth V. Kumar, DDS, MPH
jvk01@health.state.ny.us
Ana Karina Mascarenhas, BDS, MPH
karinan@bu.edu
Jane Steffensen, RDH, MPH, CHES
steffensen@uthscsa.edu
Newsletter Editor, Communiqu
Becky DeSpain Eden, RDH, MEd
Baylor College of Dentistry
Dallas, TX
Phone: 214-828-8402; Fax: 214-828-8449
bdespaineden@bcd.tamhsc.edu
Foundation Chair
Linda Niessen, DMD
Dallas, TX
Phone: 717-849-4465; Fax: 717-849-4471
lniessen@dentsply.com
Historian
E. Joseph Alderman, DDS, MPH
Atlanta, GA
Phone: 404-876-3530
ejalderman@comcast.net
Executive Director
Pamela J. Tolson, CAE
AAPHD National Office
3085 Stevenson Drive, #200,
Springfield, IL 62703
Phone: 217-529-6941; Fax: 217-529-9120
natoff@aaphd.org
Website: www.aaphd.org
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S5
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2008 Program
Planning Committee
Mark H.K. Greer (Co-chair)
Scott Tomar (Co-chair)
Sheila Semler (Co-chair)
Emanuel Finn (Co-chair)
Joseph Alderman
Robert L. Birdwell
Patrick Blahut
Christopher P. Callahan
Amos Deinard
Paul Eke
Caswell A. Evans
Chris Farrell
Timothy Iafolla
Beverly Isman
Lewis Lampiris
Tim Lynch
Paul OConnor
Maureen Oostdik
Dean Perkins
Steven Steed
Pamela J. Tolson
Pamella Vodicka
S7
Networking Opportunities
A number of networking opportunities
made it possible for attendees to catch up
with old friends and make new. Special
invitation-only events includes the ABBPH
Diplomates Dinner, the Oral Health Action
Partnership Dinner, An ADHA hosted
breakfast for ASTDD and AAPHD
member dental hygienists, a breakfast in the
exhibit area, and a roundtable luncheon.
The spotlight shown brightly on the
ASTDDs 60th Anniversary Celebration
with a reception sponsored by Aseptico.
ASTDD highlighted is roots beginning in
1945 and celebrated its accomplishments
along the way, culminating in the Diamond
Jubilee party. Everyone enjoyed great food
and dancing to music at the 1940s
themed party. See photos on page 8 and 9
of the Supplement.
On Wednesday, many registrants took part
in the NOHC Fun Run/Walk before
heading to the plenary session and
concurrent sessions before saying goodbye
to their colleagues for one more year.
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Student Awards
S20
AMERICAN ASSOCIATION OF
PUBLIC HEALTH DENTISTRY FOUNDATION
Herschel S. Horowitz Scholarship: The AAPHD Foundation has awarded three Herschel S. Horowitz Scholarships and
will be announcing the fourth recipient during the 2008 National Oral Health Conference. The 2004 and first recipient,
Dr. Lisa Chung, received her MPH at UC Berkeley in Spring of 2005 and began the one-year dental public health
residency program at UCSF in the Fall of 2005. The 2005 recipient, Dr. Tara Esmeili, started the MPH program in the
summer of 2005 at the University of California Berkeley. No scholarship was awarded in 2006. The 2007 recipient,
Alana Kvichak, started the MPH program at UC Berkley in the fall of 2007. The 2008 recipient will be announced
during the 2008 AAPHD Awards Luncheon. Through an agreement with the Horowitz Family, combined with contributions
to the Foundations Horowitz Scholarship Fund, ten $25,000 scholarships will be awarded through 2013. Applications
and scholarship criteria may be found at www.aaphd.org.
Donald W. Johnson
Linda Kaste
Kathy Atchison
Rebecca King
Robert Bagramian
Dushanka V. Kleinman
Elizabeth Bernhard
Raymond Kuthy
Ron Billings
Steven Levy
Irene Bober-Moken
Gene P. Lewis
Brian A. Burt
William R. Maas
Robert SkipCollins
John D. Mahilo
Dolores M. Malvitz
H. Berton McCauley
Terri Dolan
Chester Douglass
Hermine McLeran
Robert Dumbaugh
Robert Mecklenburg
Caswell A. Evans
Nicholas Mosca
Denise Fedele
Linda C. Niessen
Janie Fuller
Sharon J. Perlman
Steve Geiermann
Scott M. Presson
Barbara F. Gooch
Gary Rozier
Harry Goodman
Mary Tavares
Ralph Green
George Taylor
Veronica Greene
Scott Tomar
Kathy Hayes
Jeanine Tucker
Lawrence Hill
Jane Weintraub
Irene Hilton
Robert Weyant
Alex White
Elvine Y. Jin
Robert M. Johnson
FY 2007-2008 Contributors
E. Joseph Alderman and
Howard Lee Yarborough
Myron Allukian, Jr.
ASTDD
Kathryn A. Atchison
Victor M. Badner
William Bailey
Laurie Barker
William F. Bird
Irene G. Bober-Moken
Brian Burt
Roosevelt Bush
E.M. Campbell
Aida Chohayeb
Durward Collier
Robert Collins
Georgia dela Cruz
Charles Czerepak
Amos Deinard
Neal A. Demby
Joseph Doherty
Mark Doherty
Michael W. Easley
Caswell A. Evans Jr.
John D. Featherstone
Jay Friedman
Stuart Gansky
Michael Garrett
Barbara Gooch
Carolyn F. Gray
Veronica A. Greene
Han Gyeon-Soon
Suzanne W. Hayes
Michael J. Helgeson
Irene Hilton
Alice M. Horowitz
Dick Ito
Donald W. Johnson
David B Jones
Choi Jun-Seon
Linda Kaste
Manuel Kau
Dietmar Kennel
Byung-ock Kim
Dong-Kie Kim
Jin-Bom Kim
Rebecca King
Dushanka Kleinman
Steven Krauss
Marsha Larrabee
Byong Jin Lee
Arlene M. Lester
Yihong Li
Thomas Louden
Jack Luomanen
William Maas
Charlotte Connick Mabry
Dolores Malvitz
Irwin Mandel
Donald Marianos
H. Berton McCauley
Kimberly McFarland
Vinod/Kalpana Miriyala
Nicholas G. Mosca
Linda Niessen
Dai IL Paik
Scott M. Presson
Shihoko Sakuma
Robert H. Selwitz
Jonathon Shenkin
Buddhi Shrestha
Chin-Shunchang
Kristen Simmons
Keun Bae Song
C.J. Spratt
Angela M. Stout
Han Su-Jin
John Suomi
Susan Tengan
Toms of Maine
Ray Wagner
Chang Kee Wan
Jane Weintraub
Robert Weyent
Alex White
Minoru Yagi
John Yamamoto
Ralph Young
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Second Place
Oitip Chankanka
College of Dentistry
The University of Iowa
Title: The Associations Between Dietary
Intake from 36 to 60 Months of Age and
Non-cavitated Caries in the Primary
Dentition
Sponsor: Steven M. Levy, DDS, MPH
Third Place
Moshtagh Farokhi
Department of Community Dentistry
University of Texas at San Antonio
Title: The Influence of Acculturation on
Measures of Oral Health Practices for
Mexican-American Mothers Attending
the CHRISTUS Santa Rosa
ChildrensHospital WIC Clinic in San
Antonio, TX
Second Place
Christian Yee
Department of Preventive and Restorative
Dental Sciences
University of California at San Francisco
Title: Healthy San Francisco: SFDPH
Personnels Views of Dental Care
Importance
Sponsor: Jane A. Weintraub, DDS, MPH
Third Place
Demetress L. Davis
School of Dentistry, Dental Public Health
Meharry Medical College
Title: Factors that Influence Mutans
Streptococci Among Low Income
Pregnant Women
Sponsor: Angel Rivera Torres, DDS,
MPH, MSPH, PhD
Honorable Mentions
Mark CasaFrancisco
College of Dentistry
University of Kentucky
Title: A Survey of Kentuckys Pediatricians
Regarding their Role In Childrens Oral
Health
Sponsor: David Nash, DMD, MS, EdD
Ritu Bansal
Texas A&M Health and Science Center
Baylor College of Dentistry
Title: Knowledge, Attitudes, and Use of
Fluorides Among Dentists in Texas
Sponsor: Kenneth Bolin, DDS, MPH
Kecia Leary
College of Dentistry
The University of Iowa
Title: School Nurses and their Role in the
Oral Health of School-Aged Children
Karin Weber-Gasparoni, DDS, MS, PhD
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S25
Minnesota
Ortonville
Silver Bay
Edgerton
Bird Island
Bayport
Mississippi
Town of Como
City of New Albany
Missouri
Bowling Green
Boonville
Sarcoxie
Montana
Laurel
New Hampshire
Hanover Water Works Company
New Jersey
Atlantic City Municipal Utility
Authority
New York
Tonawanda Town Water Department
Oneonta City
Perry Village
S26
North Carolina
Tarboro
North Dakota
Valley City
Grand Forks
Cooperstown
Rugby
Ohio
City of Orrville
Oklahoma
Durant
Sapulpa
Stillwater
Pawhuska
Pennsylvania
Lower Bucks County Joint Municipal
Authority
PA-American Water Company
Kittanning District
New Kensington Municipal Authority
North East Municipal Authority
South Carolina
Shaw Air Force Base
California
Community Fluoridation
Reaffirmation Awards
Indiana
Bedford Utilities
Louisiana
Walker
Alabama
North Baldwin Utilities
Florida
Daytona Beach
Maine
Bangor
Massachusetts
Long Meadow
North Attleboro
South Carolina
Dillon
State Fluoridation Quality Award
Massachusetts
Nebraska
Nevada
Tennessee
Decherd
Greeneville Water & Light
Sparta
Maryville Department of Water
Texas
Lackland Air Force Base
Lackland Air Force Base Annex
Terrell
Utah
Hill Air Force Base
Virginia
City of Staunton
City of Bedford
Washington
Kelso
West Virginia
City of Wellsburg
Grantsville Municipal
Glenville Utilities
Chester Water Department
Ohio
Vandalia & Tipp City
Texas
Elgin
Virginia
Town of Brookneal
County of Cumberland
West Virginia
Clay Municipal Water Works
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Absent
Brad Whistler
Absent
Ranee Tuscano
Lynn Mouden
Rosanna Jackson
Absent
Absent
Greg McClure
Emanuel Finn
Absent
Elizabeth Lense
Absent
Absent
Absent
Julie Janssen
Absent
Absent
Katherine Weno
Absent
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
N. Mariana Islands
Guests: Dr. Lew Lamipris (ADA), Ms. Linda Koskela, Dr. Julie
Tang, Dr. Jean Spratt, Ms. Julia Wacloff, Ms. Lori Cofano, Ms.
Beverly Isman, Ms. Jane Steffanson, Ms. Kathy Guerink, Dr. Don
Marianos, Dr. Kathy Phipps, Dr. Bill Maas, Dr. William Bailey, Ms.
Mary Ellen Yankosky, Ms. Dawn McGlasson, Dr. Stephanie Miner,
Dr. Michael Morgan, Dr. Joe Doherty, Ms. Kathy Mangskau, Dr.
Don Altman, and Dr. Jim Crall.
After the roll call, Chris started the meeting by introducing
the associate members who were present and two former presidents
of ASTDD Mike Morgan and Joe Doherty.
Dr. Perkins reviewed the organizations fiscal budget. Dean
asked if there were any questions about the budget. He noted that
we are in fiscal compliance and have achieved the A133 circular
compliance that is required by the federal auditors. Dean noted
that he would provide a more detailed budget report on request.
Dr. Mouden presented the names of nominees for officers as
selected by the nomination committee. The nominees are Margaret
Snow for President-Elect, Emmanuel Finn for Director, and Nick
Mosca for Secretary. There were no other nominations made from
the floor.
Bev distributed the 2007 ASTDD annual report and noted
that she is working on a year-end and a five-year cumulative report
for the CDC CA. A new CDC RFP was released and Bev asked for
input for activities for this proposal. Bev asked members whether
the tip sheets for the National Association of Chronic Disease
Directors Healthy Aging grant and HRSA oral health workforce
grant were useful and she requested feedback for future tip sheets.
She noted that there were opportunities for members to attend the
American Evaluation Association meetings. Bev introduced the
Dionne Richardson
Judith Feinstein
Absent
Absent
Absent
Sheila Semler
Absent
Janet Olstad
Nick Mosca
Absent
Margaret Virag
Absent
Chris Wood
Margaret Snow
Absent
Rudy F. Blea
Absent
Rebecca King
Kimberlie Yineman
Absent
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Absent
Susan Potter
Gordon Empey
Absent
Absent
Absent
Absent
Absent
Julie Ellingson
Absent
Absent
Absent
Absent
Absent
Absent
Absent
David Walker
Warren LeMay
Absent
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During the past two years our expenses have exceed our income
by 11.3%. Two significant changes took place over the past
two years:
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XII.
New Business:
XIII.
Adjournment:
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grasp of the concepts and objectives of Head Start
and how it differs from traditional day-care.
Conclusions: Through understanding the importance
of the role of Head Start in communities, and in the lives
of the children and families, dentists are more willing to
become a provider of dental services for the enrollees
and their families.
Abstract #: 4
SETTING THE DIRECTION FOR THE FUTURE: ONE STATES
COMMITMENT TOWARD THE VISION OF OPTIMUM ORAL
HEALTH FOR CHILDREN
Author(s): Marcia Manter, MA, Oral Health Kansas;
Lawrence W. Walker, DDS, MPH, OHS, Region VII, Kansas
City
Objective: To use collaboration as a strategy to
prevent Early Childhood Caries
Methods: Kansas Head Start Association, in
partnership with Office of Oral Health, Oral Health Kansas
and other organizations, has implemented a statewide
oral health initiative toward the vision of optimun oral
health for Kansas children, birth to five. The association
uses proven strategies including demonstration
programs, oral health parent education materials, staff
development,and techinical assistance.
Results: Head Start programs have incorporated
improved oral health protocols into their system of
health care including lift the lip screening, brushing
daily with fluoride toothpaste, eating habits, parent and
staff education, and fluoride varnish. More than half of
Head Start grantees contract with dental hygienists for
services.
Conclusions: This long-term and continuing initiative
illustrates the benefits of high-level leadership of shared
planning, education, and dedication to obliterate the
barriers to optimum oral health. Kansas Head Start and
community early childhood children are benefiting from
these efforts.
Abstract #: 5
EVALUATION OF MINNESOTAS COMMUNITY
COLLABORATIVE PRACTICE HEAD START MODEL
Author(s): Deborah Jacobi, RDH, MA, Apple Tree
Dental; Michael Helgeson, DDS, Apple Tree Dental;
Gayle Kelly, MS, Minnesota Head Start Association; Clare
Larkin, RDH, MEd, CDHC, RF, Normandale Community
College; Metropolitan State University; Midge Pfeffer,
RDH, BS, Consultant
Objective: To present evaluation findings on the
impact of Community Collaborative Practice as an oral
healthcare system for Minnesota Head Start children.
Methods: In December 2006, the Region V Office of
Head Start affirmed that Minnesotas Community
Collaborative Practice and adaptation of the ASTDDs
Basic Screening Survey would fulfill federal Head Start
dental performance standards. Head Start enrollees are
now able to receive a standardized assessment, triage,
and referral along with preventive care and education
onsite in Head Start centers. Children with early or urgent
treatment needs are linked to partnering dentists in
private offices, community clinics, and educational
S37
University, Arizona School of Dentistry & Oral Health
(ASDOH) as the sole provider of dental services under
this program creating a unique public/private
partnership. The goals of the program include service,
training of dental students and workforce development.
Results: In the first 12 months of the program
approximately 1700 patients were referred to the
program, over 600 of who were treated. More than
6500 dental procedures were performed in ASDOHs
state of the art facility. Patients had access to
advanced technologies and treatment modalities such
as cone beam tomography, implants and laser dentistry.
The inaugural graduating class of 2007 all fulfilled the
CODA standard on special care dentistry. The class of
2008 will have nearly 50 hours of clinical experience in
treating special care patients and the class of 2009 will
have over 75 hours. Students are also treating special
care patients in their external rotations (largely in
community health centers).
Conclusions: The Arizona State Dental Service Pilot
Program is a successful public/private partnership
between the Division of Developmental Disabilities and
ASDOH that is meeting the established goals of service,
training and workforce development.
Abstract #: 9
CLINICAL COMPETENCIES OF AEGD FELLOWS CARING
FOR PEOPLE LIVING WITH HIV/AIDS
Author(s): Victor Badner (DMD, MPH/ North Bronx
Healthcare Network), Kavita P Ahluwalia (DDS, MPH/
Columbia University College of Dental Medicine
(CUCDM)), Marita K. Marrman (EdD, MS/ Columbia
University Mailman School of Public Health), Carol Kunzel
(Ph.D./ CUCDM)
Objective: To identify and operationalize a subset
of clinical competencies advanced by the American
Dental Education Association (ADEA) for use in the
training of Advanced Education in General Dentistry
(AEGD) Fellows when caring for people living with HIV/
AIDS (PLWHA).
Methods: An interdisciplinary team comprised of a
clinical dentist specialized in HIV/AIDS care, a public
health dentist, a sociologist, and a specialist in
professional health sciences educational methods
analyzed the 82 competency statements developed
by ADEA in 1997 for their relevance to caring for PLWHA.
An iterative process, focusing on non-direct dental
procedure aspects of oral health care for PLWHA, was
used to select a set of 18 competencies. The initial
number was reduced to 4 main competencies,
subdivided into specific, measurable subcompetencies. Learning objectives were then
delineated for each sub-competency and assessment
instruments were developed to measure cognitive,
affective and behavioral changes in Fellows when
providing care for PLWHA.
Results: A comprehensive set of measurable clinical
competencies of specific relevance to the care of
PLWHA were developed for targeted training and
assessment of AEGD Fellows performance. These
competencies can be used as the basis both for
performance and for formalized reflection exercises that
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elicit trainee consideration of the psychological, social
and environmental aspects of caring for PLWHA.
Conclusions: A specific set of competencies for
training and evaluation of AEGD Fellows in the care of
PLWHA were identified and operationalized. ADEAs
competencies can be successfully modified for trainees
engaged in treating special populations.
Abstract #: 10
CHC Multidisciplinary Model Aimed at Preventing
Early Childhood Caries: THE COLORADO EXPERIENCE
Author(s): Francisco Ramos-Gomez, DDS, MPH; Mary
Foley, RDH, MPH; Valerie Orlando, RDH, BS
Objective: Participants will learn how to engage
multidisciplinary health care professionals and their staff
to provide oral health assessment, treatment and
referral during perinatal and early childhood primary
care and perinatal visits. They will be introduced to the
Institute for Health Improvements (IHI) Change Model
and will learn how to use the model to implement
change in their respective healthcare environments.
Methods: The HRSA, BPHC funded the Oral Health
Disparities Collaborative Project which convened
expert faculty as well as representatives from
community health centers, (CHC) Head Start programs,
philanthropic organizations, regional, state and local
dental offices. The IHI facilitated the training sessions.
Training session participants included faculty with
expertise in pediatric and perinatal oral health care,
CHC dental practice management and Head Start. Key
CHC personnel included physicians, dentists, nurse
practitioners, physician assistants, and office and
technological support staff. A data collection and
management tool was introduced to support the effort.
Results: Four CHCs serving over 20,000 clients have
integrated oral health into perinatal and early childhood
primary care, well-child visits. All children enrolled in
these CHCs have an established dental home by age
one. All pregnant women receive immediate referral
and dental appointments upon diagnosis of pregnancy.
Conclusions: The Oral Health Disparities
Collaborative is a model that is easily replicated and
may be used by the hundreds of community health
centers across the country that wish to incorporate oral
health into primary health care services.
Abstract #: 11
METHAMPHETAMINE INFORMATION: KENTUCKY
DENTISTS NEEDS ASSESSMENT
Author(s): Ershal Harrison, DMD, RPH, Assistant
Professor, Department of Oral Health, University of
Kentucky College of Dentistry; Karen O. Skaff, RDH, PhD,
Chair, Department of Clinical Sciences, University of
Kentucky College of Health Sciences; Richard J. Crout,
Objective: Methamphetamine is a highly addictive
central nervous system stimulant once prescribed for
the treatment of narcolepsy, attention deficit disorder
and obesity. Illegal methamphetamine use is on the rise
in the U.S. Dentists need to know about its use and
effects on the mouth. The purpose of this study was to
assess the knowledge of KY dentists concerning use and
dental consequences, treatment and referral patterns.
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Michigan, Brian A. Burt, MPH, PhD, University of Michigan,
Anita M. Sandretto, PhD, University of Michigan, Justine
L. Kolker, MS, PhD, DDS, University of Iowa, Teresa A
Marshall, PhD, RD, University of Iowa, Amid I. Ismail, BDS,
MPH, MBA, DrPH, University of Michigan
Objective: To test the hypothesis that high
consumption of soft drinks, relative to milk and 100
percent fruit juice, is a risk factor for dental caries in
low-income African-American children in Detroit.
Methods: A representative sample of 369 children,
aged three to five years, was examined in 2002-03 and
after two years. Dietary information was collected using
the Block Kids Food Frequency Questionnaire. Caries
was assessed using the International Caries Detection
and Assessment System.
Results: Soft drinks, 100 percent fruit juice, and milk
represented the total sugared beverages consumed
by the cohort. Cluster analysis of the relative proportion
of each drink at baseline and follow-up identified four
consumption patterns. Zero-inflated negative binomial
models found that children who changed from being
low consumers of soft drinks at baseline to high
consumers after two years had a 1.8 times higher mean
number of new decayed, missing and filled tooth
surfaces, compared with low consumers of soft drinks at
both time points.
Conclusions: Children who consumed more soft
drinks as they grew older, relative to milk and 100
percent fruit juice, had a greater risk of developing
dental caries.
Abstract #: 15
TREATMENT OF DENTAL CARIES OVER TWO YEAR
PERIOD AMONG MEDICAID ENROLLED AFRICAN
AMERICAN CHILDREN IN DETROIT
Author(s): Woosung Sohn, DDS, PhD, DrPH, Sungwoo
Lim, MA, MS, Amid I. Ismail, BDS, MPH, MBA, DrPH, Dept.
of CRS & E, School of Dentistry, University of Michigan,
Ann Arbor MI
Objective: To evaluate the quality of the dental
treatments that were rendered to Medicaid enrolled
African American children.
Methods: Longitudinal data on caries status
collected from 700 low-income African American in
Detroit between 2002-03 (Wave I) and 2004-05 (Wave
II) were matched with their Medicaid dental records for
the same period. Caries examination was conducted
using the ICDAS criteria. The status of each tooth surface
examined in Wave I was compared with that of Wave II
grouped by Medicaid utilization and the type of the
dental visit (no visit, preventive-only visit, preventive
and restorative visit).
Results: Of the 700 children, 351 (46%, weighted) had
at least one dental visit during the two-year period. Of
these 351 children, 217 received only preventive
procedures and the remaining 134 children received
treatments as well as preventive services. Among the
children who had one or more dental visits, 56% of
cavitated lesions identified at Wave I were left
untreated at Wave II. Among the children who received
only preventive procedures during dental visits, 93% of
cavitated lesions identified at Wave I examination were
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left untreated at Wave II. There was no significant
difference in number of newly developed cavitated
lesions between children with preventive-only visits and
those without dental visits.
Conclusions: The results indicate that significant
proportion of Medicaid enrolled children who seek
dental care do not receive appropriate comprehensive
care.
Abstract #: 16
EARLY CHILDHOOD CARIES PREVENTION: UNDERSTANDING REASONS FOR PARENTAL TREATMENT
PREFERENCES
Author(s): Susan Hyde, DDS, MPH, PhD; Sally H. Adams,
RN, PhD; Judith C. Barker, PhD. University of California,
San Francisco, Center to Address Disparities in Childrens
Oral Health
Objective: Determine underlying reasons for
parental preferences (TP) among early childhood caries
preventive treatment options.
Methods: An acceptability and preferences
interview of 5 treatments, 3 for children (tooth brushing
with fluoride toothpaste, fluoride varnish, xylitol in food),
and 2 for mothers (xylitol gum, chlorhexidine rinse),
included: illustrated cards describing the treatment with
a verbal explanation, photo/video clip, and product
samples. Hispanic Head Start parents (N=201) chose their
TP in each of 10 possible pairs, and provided open-ended
explanations for their choices.
Results: Four major reasons (themes) emerged from
the TP explanations accounting for 93.8% of TP choices:
treatment recipient/beneficiary (27.5%), convenience
(27.2%), treatment promotes healthy/avoids unhealthy
habits (21.2%), and effectiveness (17.9%). Earlier research
showed that across the 10 pairs, varnish was the most
preferred, closely followed by brushing. Effectiveness
(41.5%), targeting the child (26.5%), and convenience
(25.5%) were the top reasons cited for choosing varnish;
while developing good brushing habits (59.9%),
targeting the child (18.6%), and convenience (7.2%)
were the top reasons for brushing.
Conclusions: Parents cited healthy habit promotion,
effectiveness, targeting the child, and convenience as
the major reasons for choosing varnish and brushing.
These results may be useful in planning prevention
programs for young children in Hispanic communities.
Support: Funded by US DHHS NIH: NIDCR and NCMHD
U54 DE14251.
Abstract #: 17
FACTORS AFFECTING THE ORAL HEALTH OF EARLY
HEAD START CHILDREN: A QUALITATIVE STUDY OF STAFF,
PARENTS AND PREGNANT WOMEN
Author(s): Mahyar Mofidi, DMD, PhD, Health
Resources and Services Administration; Leslie P. Zeldin,
MSUP, MPH, University of North Carolina, Chapel Hill; R.
Gary Rozier, DDS, MPH, University of North Carolina,
Chapel Hill
Objective: To gain insights into the oral health of
Early Head Start (EHS) children, this study explored EHS
staff, parents and pregnant womens oral health
knowledge, attitudes, and activities as well as their
Poster Presentations
Abstract#: 19
HEALTHY TEETH: DETERMINING OBSTACLES TO
ACCESSING DENTAL CARE
Author(s): Alexandria Saulsberry, MD, Medical
College of Wisconsin, Sima Patel, MD, Medical College
of Wisconsin, Tifany Frazer, MPH, Medical College of
Wisconsin, Matt Crespin, RDH, BS, CDHC, Childrens Health
Alliance of Wisconsin, Karen Ordinans, Childrens Health
Alliance of Wisconsin
Objective: To determine barriers to oral health care
access as perceived by parents and youths in City of
Milwaukee.
Methods: Three one-hour focus groups were
conducted to identify parent and youth beliefs about
access to dental care; both fund of knowledge on oral
health topics and barriers to oral health services. Parents
were recruited from a local Head Start and charter
school and youths (ages 12-15) were recruited from a
public school. Sessions were audiotaped and
transcribed.
Results: Thirteen parents participated in two focus
groups and eight students in a youth focus group. The
following was observed: (1) gaps in knowledge exist
about basic dental care, (2) access to dental care is
difficult and (3) concerns about quality of care and
safety exist, especially when alternative models for oral
health services are considered. Head Start parents had
minimal oral health knowledge. Parents of children who
have school-based oral health programming were more
aware of oral health issues. Youths had better
knowledge with insight into the pathophysiology of
dental disease and the need for good oral hygiene. All
agreed that getting an appointment was difficult and
availability of appointments are not convenient with
parents work or youths school schedules.
Conclusions: Focus group findings on oral health
care access suggest that City of Milwaukee youths had
better exposure to dental information than parents and
there are benefits to expanding dental education for
school-age children. Obstacles exist to the accessibility
of dental office hours, the process of getting an
appointment and finding dentists willing to accept
Medicaid coverage. More assessment is indicated to
understand parents caution when considering
alternative models to oral health care services.
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Abstract #: 20
ONE COMMUNITY HEALTH CENTERS EXPERIENCE IN
PROMOTING THE COMMUNITY HEALTH CENTER MODEL AS
A SOLUTION TO WISCONSINS ORAL HEALTH CRISIS
Author(s): Greg Nycz, Director, Family Health Center
of Marshfield, Inc.
Objective: Solve the dental access problem and
eliminate oral health disparities in northern Wisconsin
and throughout the State.
Methods: Phase I Establish a large community health
center dental clinic in Rusk County (population 15,627).
Phase II Utilize patient origin data to target
communities in surrounding counties. Engage with those
communities to create additional dental clinics,
provide care closer-to-home, and free up resources to
focus service capacity on Rusk County. Address health
literacy issues by: fully integrating dental, clinical and
administrative information into the electronic medical
record; creating decision support to identify patients
without a dental home to primary care physicians who
will provide guidance and referral; and providing a
feedback loop to those same physicians on patient
compliance with referral recommendations. Phase III
Explore the potential of creating a new dental school
to provide for the workforce needs of safety net
providers. Phase IV Replicate dental clinics throughout
the State.
Results: Phase I was completed with the
establishment of a 5-dentist practice in Rusk County
(2002). Phase II is in process with a 2-dentist practice in
Clark County (2005), a 10-dentist practice in Chippewa
County (2007), and a 4-dentist practice in Price County
(2008). Phase III is in the feasibility stage. Progress on
Phase IV has been empowered by the doubling of
Wisconsins health center grant program to $6,000,000
per year, effective in 2008.
Conclusions: Providing real value to taxpayers by
greatly expanding access to oral health services under
a comprehensive health center model can be
successful in engaging local communities, key
constituents, state legislators and state administrators
in supporting progress toward a comprehensive solution.
Abstract #: 21
CAPITAL BUDGETING ANALYSIS AND MOBILE DENTAL
OPERATIONS: THE UNIVERSITY OF KENTUCKY COLLEGE OF
DENTISTRYS EXPERIENCE
Author(s): Oscar Arevalo DDS, ScD, MBA, MS
University of Kentucky College of Dentistry; Amit
Chattopadhyay PhD, MPH, MDS, BDS University of
Kentucky Colleges of Dentistry and Public Health; Harold
Lester DMD University of Kentucky College of Dentistry
Objective: The University of Kentucky College of
Dentistry (UKCD) operates a mobile dental program
composed of four fully self-contained units. Current
economic conditions dictate that as the mobile units
age it will be harder to find donors willing or able to
provide the resources required to finance asset
replacement. However, in order to maintain current
levels of access for the underserved, current activity
and consideration of replacement is paramount. A
Capital Budgeting Analysis (CBA) was conducted to
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determine if a new mobile unit would yield a positive
Return on Investment (ROI) and generate a cash-reserve
for the replacement cost at the end of its useful lifetime.
Methods: An estimate for a new mobile unit was
obtained. Data from FY 2006 2007 including clinical
productivity, billing, collections and operational costs
for one of the mobile units were collected. A CBA was
conducted using the Net Present Value (NPV) decision
model in four different scenarios: worst, current, good
and best. Depreciation funding was calculated by
transferring funds from cash inflows (clinical income plus
state support) and reinvested to offset depreciation at
a fixed compound interest.
Results: A positive ROI was obtained only for the best
scenario (Kentucky Medicaid fees adjusted at UCR levels
plus state appropriations minus cash outflows).
However, the depreciation fund did not generate a
cash-reserve sufficient to replace the mobile unit at
the end of its useful lifetime. (12 years)
Conclusions: Although capital budgeting is a useful
tool when making managerial decisions, the numbers
seldom tell the whole story. As a safety net provider,
the UKCDs mobile operation has a positive social
impact ensuring access to dental care for the
underserved children in Kentucky and improving their
quality of life.
Abstract #: 22
MOBILE CLINIC PROGRAMS IN U.S. DENTAL SCHOOLS
A NATIONAL SURVEY
Author(s): Niel Nathason, MA, MPH, University of
Southern California School of Dentistry
Objective: The aim of this descriptive study was to
compile and tabulate data regarding mobile dental
programs operated by academic training institutions
across the United States, in order to disseminate this
information within dental schools and public health
audiences and to encourage replication of similar
programs by organizations to increase care delivered
to underserved communities.
Methods: A survey of all U.S. schools of dentistry was
conducted via an internet based survey system
(SurveyMonkey.com) during the fall of 2007. The
questionnaire was developed using questions from
faculty and staff at the University of Southern California
School of Dentistry, which has had an extensive mobile
dental program for several decades, as well as
questions previously used in a similar survey from the
University of California, San Francisco.
Results: Responses were received from all dental
schools. Thirteen (13) dental schools indicated having
mobile dental programs and completed the survey. The
questionnaire included 81 questions and 8 sections
covering: university sponsorhip; vehicle and clinic
details; technological systems; personnel and student
rotations; patient demographics and service provision;
mobile outreach and community information; financial
issues and sources; and evaluation methods.
Conclusions: Mobile dental clinic programs are
effective in increasing access to care for underserved
populations, exposing students to rural and innercity
communities, improving clinical proficiency of dental
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Results: Since the inception of the new procedures
in 2005, 45 school-based dental providers have been
approved by the department. The length of the
approval process varies depending on factors such as
the: complexity of program, familiarity of program with
guidelines and protocols, and/or experience as an
established dental clinic. The average approval
turnaround period for approval is 3 months. Compliance
with program guidelines and protocols are verified by
the NYSDOH via an in person site visit. In addition,
programs provide quarterly and annual reports.
Conclusions: The process for approval of schoolbased programs in New York State provides a
mechanism to assure quality and appropriateness of
services. However, technical assistance must be
available to program planners at the local level for
expediting the approval process.
Abstract #: 28
STUDENTS POST-EVALUATION OF THE SEAL KY
PROGRAM
Author(s): Iniva R. Ngaka, BS, MS, DMD student; Judith
Skelton, PhD; M. Raynor Mullins, DMD, MPH
Objective: The purpose of this study was to evaluate
the dental students perception of the Seal KY program
as they progress from 1st to 4th year in their curriculum.
Methods: The Seal Kentucky Program was created
to provide a community-based dental sealant program
for elementary aged school children onsite at selected
high risk schools in rural Kentucky. The program was
designed to engage students in service learning in their
first year curriculum at UKCD. Student dentist preparation
for this experience is delivered in 2 companion courses
in the first 2 months of the first year. Content for the
clinical portion of the course is designed to teach dental
students basic preventive techniques that can be used
in community settings to address the epidemic of dental
caries in underserved populations and to introduce
students to patient care in a clinical setting. For two
days groups of 10-12 students screened children, placed
sealants, assisted classmates and instructed children. A
survey was sent to 223 student dentists as a postevaluation method.
Results: 62% of the students enrolled at the University
of Kentucky College of Dentistry participated (UKCD) in
the survey. 76% of the students reported the experience
as valuable as an introduction to patient care. The
students (81%) also reported having gained a greater
understanding of the needs of underserved children in
rural Kentucky.
Conclusions: The student responses were
overwhelmingly positive in support of the program as
well as in support of the possibility of an additional
program providing more comprehensive dental care.
Abstract #: 29
EVALUATION OF THE SMILES ACROSS GREATER
MISSOURI 2006-07: DENTAL SEALANTS
Author(s): Moncy Mathew , DDS, MPH*; Michael
McCunniff , DDS, MS*; Barry Daneman, MA*; Jasmine H.
Ratliff, MHA**; Matthew Kuhlenbeck, MHA**; Cynthia P
Hayes MHR, MHA**; Alyse Sabina, MPH**; Charles Gasper
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MS(R)**. * UMKC School of Dentistry; ** Missouri
Foundation
Objective: To create an evaluation structure for
grantees implementing dental sealant programs as part
of the Smiles across Greater Missouri program, funded
by the Missouri Foundation for Health (MFH).
Methods: The program targeted underserved
children in 3rd and 6th grade, providing dental
screenings, education, referrals if needed, and sealants.
The evaluation structure utilized qualitative instruments
(open-ended questionnaires, interviews of key
stakeholders) and quantitative instruments (minimum
data sets, interim reports). Data were collected
periodically over the course of the program year.
Results: There were a total of 6 grantees, comprising
of 2 county health departments, 3 Community Health
Centers, and 1 Health Agency, operating school-based
programs. A total of 1098 eligible children received
sealants, and 583 participants were referred for further
dental care. Obtaining participation from eligible
populations was challenging, with the overall program
participation rate of 29% of eligible populations.
Obtaining dental care for referrals was a significant
challenge for applicants without an in-house dental
clinic.
Conclusions: Efforts towards marketing sealants
need to increase in order to gain visibility over other
dental screenings and/or fluoride varnish programs.
Case-management may be required to track outcomes
of referrals. Evaluation should be broad-based and
include stakeholder input to obtain information to
improve cost-effectiveness of sealant programs
Abstract #: 30
USING PATIENT SATISFACTION SURVEYS FOR QUALITY
ASSURANCE
Author(s): Anuradha Deshmukh, BDS, MSD, CAGS,
Boston University Goldman School of Dental Medicine,
Department of General Dentistry/Office of Clinical
Services, Stephen DuLong, DMD, CAGS, Boston
University Goldman School of Dental Medicine, Office
of Clinical Service.
Objective: The main objective was to assess the
satisfaction of patients with the care they received at
Boston University School of Dental Medicine by using
patient satisfaction surveys, an indicator used for Quality
Assurance.
Methods: The study population consisted of a random
sample of patients who had completed their treatment
by May 31, 2007. The clinics surveyed included all nine
clinics at BUGSDM. The data were collected using a
questionnaire that was modified for each of the clinic
directors need for data collection by the members of
QA committee. The surveys were mailed out in June 2007.
Data was entered and cleaned using Microsoft Excel
2003 and PC SAS was used for analysis. Bivariate analysis,
multivariate logistic and multiple regression analyses
were performed.
Results: The total study population was 323 with a
response rate of 17% (323/1900). The respondents
included 63% females and 37% males. The mean age of
the study population was 51.8 16.4 years. Majority of
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Abstract #: 34
ORAL HEALTH EDUCATIONAL PROGRAM FOR HIV(+)
MOTHERS
Author(s): Mara Elena Guerra* Pediatric Dentist,
Vilma Tovar Oral Patologist; Ana Rodriguez General
Dentist:Centro de Atencin a Pacientes con
Enfermedades Infectocontagiosas Facultad de
Odontologa Universidad Central de Venezuela
Objective: To describe an training program for HIV(+)
mothers to self detect opportunistic infections and
prevent dental caries in mother and child.
Methods: By Venezuelan law, all pregnant women
should be tested for HIV 3 times during pregnancy. From
2003, 2007 HIV(+) pregnant women were recruited at
the Hospital Universitario de Caracas. At the first visit
each mother was interviewed and examined by a
dentist. Then, mothers receive an interactive
educational program on the clinical manifestations of
HIV-related opportunistic infections and dental caries.
The training focuses on early identification of lesions,
seeking appropriate care once lesions are detected
and in-home preventive practices. The program is
provided at the first visit and refreshers at each pre and
post-partum visit, every 3 months
Results: 123 mothers have regular participation in
the program (missed <4 visits). In addition, 43 had
emergency visits due to pain, 34 mothers missed >4
visits. After training mothers were capable of detecting
early signs of disease (HIV infection and dental caries).
Conclusions: The capacity to detect and monitor
the intraoral manifestations of HIV provides a feeling of
empowerment, and lesions are detected and treated
early. In addition, preliminary data shows a secular trend
towards less prevalence of dental caries in their
children. A follow-up of missing mothers indicate that
the most common barrier is transportation to the
hospital.
Abstract #: 35
CHALLENGES, SUCCESSES, AND ACCIDENTAL QUIRKS
IN ESTABLISHING HIV ORAL HEALTH PROGRAMS
Author(s): Helene Bednarsh, RDH, MPH, Boston Public
Health Commission; Jane Fox, MPH, Boston University
School of Public Health; Timothy Martinez, DDS, SPNS
Evaluation and Support Center.
Objective: In September 2006 HRSA funded 15
demonstration sites (urban and rural) to develop and
implement oral health programs for persons living with
HIV. HRSA funded one evaluation and support center
to provide training/technical assistance and multi-site
evaluation.
Methods: Barriers to oral health care are well
defined. Models of care to increase access also
experience barriers and these may apply to other
programs for underserved populations. The challenges
in developing these programs will be described as well
as the successes achieved in the first 18 months of the
programs. Unanticipated events, negative or positive,
are of use in evaluating design and recommending
models of care.
Results: Program start-up barriers fall into three major
categories: 1. Staffing and training; 2. Developing
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linkages and clinic set-up; and 3. Unanticipated events.
The challenges experienced by these programs and the
interventions to abate them would be of assistance to
others developing models of care. Projects have also
encountered a variety of successes especially in relation
to patient recruitment.
Conclusions: Barriers facing underserved
populations are similar. PLHIV face additional barriers
such as stigma, confidentiality, and concern over
disclosure. These innovations in care can be applied
across the population and not be limited to programs
increasing access to oral health care for PLHIV.
Abstract #: 36
THE ORAL HEALTH-RELATED ACCESS TO CARE, QUALITY
OF LIFE AND ATTITUDES OF THE HOMELESS POPULATION
Author(s): Niel Nathason MPH MA, Hazem Seirawan
DDS MPH MS, Roseann Mulligan DDS MS
Objective: The aim of this study is to measure the
homeless access to dental care, oral health-related
behaviors, quality of life (OHRQOL) and attitudes
towards oral health.
Methods: A convenience sample of homeless
subjects was recruited from the Union Rescue Mission
(URM) of Los Angeles County before their dental
treatment at the USC + URM Dental Clinic located inside
the mission. The study outcomes were measured using
instruments that were previously cited in the literature.
Access to care was measured using the ASTDD
instrument, and OHRQOL was measured using OHIP-14
questionnaire (Slade et al.). Bilingual personnel (English/
Spanish) were trained to interview each subject
individually.
Results: The study recruited 152 adult homeless with
an average age of 46 years, 79% were males; 52% were
African-American and 23% were Hispanic. About half of
the sample (52%) reported having a toothache in the
last six months, 51% reported a need for dental care in
the last year but they were not able to see a dentist. The
subjects OHRQOL averaged 54 points and only 8% had
an optimum (highest level) of OHRQOL. Nearly all
subjects reported that they brushed their teeth with 32%
reported brushing once-a-day. The majority of the
subjects 77% strongly agreed that the appearance of
their teeth is important, 59% that sweet products are
generally poor for teeth and 70% that tobacco is poor
for teeth (61% were current smokers). About two thirds
of the subjects (67%) strongly agreed that brushing
prevents tooth decay and 65% that it results in healthier
gums. The results were not significantly different by
gender or ethnicity.
Conclusions: Homeless do not have adequate
access to dental care despite their higher needs, suffer
poor OHRQOL, and a large segment of them have poor
knowledge/attitudes toward oral health.
Abstract #: 37
ORAL HEALTH NEEDS AND RESOURCES IN THE
AFTERMATH OF HURRICANE KATRINA
Author(s): Robin Knowles, RDH, MPH, Asst. Prof. of
Dental Hygiene,Tunxis Community College; Julie Nocera,
RDH, MS, Asst. Prof of Dental Hygiene, Tunxis Community
College
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families living in rural Mendota, CA as part of a larger,
cross-sectional, population-based study. This analysis
included families with at least one 8-17 year-old child at
home. 133 caregivers were interviewed about their
childrens oral health. 232 children completed a 0-4
Likert scale (4 most favorable), 5-domain, 34-item selfadministered OHRQoL questionnaire, the Child Oral
Health Impact Profile (COHIP). Pairs of domains were
compared.
Results: The childs mean age was 12 years (SD=3.2);
46% were male; 97% were Latino; and 67% U.S. born. Fair
or poor oral health was reported for 29% of the children;
57% visited a dentist during the past year; 15% had a
toothache at their last visit; and 10% had never seen a
dentist. The overall median COHIP score was 3.1. The
median scores for functional (3.5), social-emotional (3.3),
and school environment (3.8) domains were more
favorable than self-image (2.3) and oral health (2.8)
domains. Wilcoxon signed rank tests showed significant
differences (p<0.001) in mean scores between these two
groups.
Conclusions: The childrens OHRQoL was significantly
lower in the self-image and oral health domains
compared to the other domains indicating lack of selfconfidence and attractiveness as related to their teeth,
mouth and face.
Abstract #: 41
ORAL HEALTH KNOWLEDGE ATTITUDES AND BEHAVIORS
OF MIGRANT AND SEASONAL FARMWORKER
PRESCHOOLER PARENTS SERVED BY THREE MIGRANT
DENTAL CLINICS
Author(s): Sherri M. Lukes, RDH, MS, Associate
Professor, SIUC
Objective: The objective of the project was to
establish baseline data about oral health knowledge,
attitudes and behaviors of migrant and seasonal
farmworker preschooler parents utilizing services at
three dental clinics operated by the same agency.
Methods: An oral health knowledge attitudes and
behaviors survey was developed and pilot tested in
2006. The resulting 34 item survey was administered by
trained promotores de salud (community health workers)
to 45 (15 per site) parents of preschoolers served by
three dental clinics.
Results: Parents reported 77.8% (35) of the children
had their teeth cleaned daily, primarily by the mother.
Approximately 58% (26) had a dental in the last 12 months
and no pain/problem was the most commonly sited
reason for no visit; however, of those who had sought
care, an exam was the most common reason for the
visit. Sixty percent (27) stopped bottle feeding at 1-1 1/
2 years of age while 88% (40) reported believing a child
should stop taking the bottle at 1-1 years.
Approximately 18% (8) reported the child currently takes
a bottle to bed and cows milk was most commonly in
the bottle. Fruit juice and cows milk and fresh fruit and
cookies were the most common drinks and snacks
consumed between meals. Parents reporting their own
oral health to be good was 46.7% (21) but 77.8% (35)
rated that of their child as good.
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Conclusions: More work is needed in educating and
serving this difficult to reach population and the impact
promotores de salud may have in the process.
Abstract #: 42
HEALTH VALUES AND HEALTH LITERACY IN A DENTAL
SCHOOL CLINIC
Author(s): Kathryn A. Atchison, DDS, MPH, UCLA
School of Dentistry, Claudia Der-Martirosian, PhD, UCLA
School of Dentistry, Melanie W. Gironda, MSW, PhD,
UCLA School of Dentistry
Objective: Low health literacy, ones limited
capacity to obtain, comprehend and act on health
information, is described as the silent health epidemic
(Joint Commission, 2007). Culture is linked to health
literacy by the values that shape the perception and
processing of health information. This study examines
the association between health values and oral health
literacy among a dental clinic population.
Methods: Participants included 200 adult patients
seeking treatment from the UCLA School of Dentistry
Oral Diagnosis Clinic who were at least 18 years old,
without cognitive, vision or hearing impairment, and
English speaking. Raw scores of an 84-word REALM-D and
48-item Health Values survey were computed using
SPSS-14. Nine health values that significantly
discriminated between people with high and low dental
health literacy (p < .004) were entered into a logistic
regression analysis, controlling for socio-demographic
characteristics.
Results: Patients ranged in age from 19 to 89, 42%
were non-white, 28% did not complete high school, and
20% did not use English as their main language. Logistic
regression showed three significant predictors: the
dentist as appropriate to give health advice, ill health
results from carelessness, and the importance of health.
None of the socio-demographic characteristics were
significant in predicting dental health literacy.
Conclusions: The results highlight that health values,
rather than sociodemographic characteristics were
associated with dental health literacy. This suggests the
importance of assuring that adequate communication
takes place so that the health provider understands the
patients health values and their understanding of their
treatment needs and treatment plan.
This study was supported by NIDCR R03-PAR-04-117
Abstract #: 43
CONCEPTUALIZATION OF DENTAL PROBLEMS AND
CARE SEEKING AMONG LATINO IMMIGRANT CAREGIVERS
OF YOUNG CHILDREN
Author(s): Kristin S. Hoeft, MPH, University of
California- San Francisco, Erin E. Masterson, BS, University
of California- San Francisco, Judith C. Barker, PhD,
University of California- San Francisco.
Objective: This study examined Latino immigrant
caregivers perceptions of and behaviors surrounding
early childhood caries in their children aged 1-5 years.
Methods: In urban San Jose, CA, a convenience
sample of 50 Latino caregivers of young children
provided in-depth qualitative interviews in Spanish
about their beliefs and experiences surrounding their
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catchment areas using a geographic information
system to map school boundaries. Public health dental
hygienists verified school catchment areas in the field.
Through an iterative process of applying specific census
indicators of education, employment and income to
school catchment populations, and then validating
these with the Fluoride Mouthrinse Review Committee,
three 2001 census indicators were selected to create a
composite index. Schools were assigned to quintiles for
each of the three social indicators, a value was assigned
for each indicator, and the total value for the set of
indicators was used to create a ranked list of all
elementary schools in the province.
Results: Elementary schools were ranked from -6 to
+6. Eligibility for the fluoride mouthrinse program was
determined as any negative ranking. Nearly 40 percent
of all elementary schools were determined eligible by
the new index.
Conclusions: The Fluoride Mouthrinse School Eligibility
Index (FMSEI) is a useful surrogate measure of risk and a
new method for targeting the FMP. Further validation
and refinement of the index is in progress and will
contribute to its acceptance.
Abstract #: 47
SCHOOL-BASED ORAL HEALTH SERVICES AS
PREDICTORS OF SCHOOL PARTICIPATION IN THE 2006-2007
MASSACHUSETTS ORAL HEALTH SURVEY
Author(s): Corinna S. Culler RDH MPH, Onolee L. Bock
BS, Thalida Dong DMD 2010, Michelle M. Henshaw DDS
MPH, Boston University School of Dental Medicine
Objective: Oral health surveillance often involves
data collection within public school systems. Our aim
was to determine if oral health programs offered in
schools affected the schools participation in the 20062007 Massachusetts Oral Health Survey.
Methods: 158 schools were randomly selected to
participate, 106 agreed. School nurses were asked to
report the school-based oral health services available
to their students. Services were categorized by type;
no services offered (30% of schools), education only
(38%), preventive (18%), and treatment services (15%).
Risk ratios were calculated for schools in each category
compared to all others.
Results: School participation significantly differed by
the type of dental services normally provided at the
school (p=.002). Schools offering comprehensive
treatment programs were the least likely to participate,
but had similar rates to those having no oral health
services. Schools offering preventive services were
more likely to participate. However, schools offering only
OH education were the most likely to participate.
Conclusions: The direction of effect of existing OH
programs on survey participation was not consistent
across service categories. Oral health education alone
or sealant programs increased the likelihood of
participation, while having treatment programs
decreased the likelihood. Given these findings, surveys
may overestimate sealant prevalence and untreated
decay in states with large numbers of school-based
programs.
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Abstract #: 48
SECOND YEAR RESULTS OF THE DENTAL EXAMINATION
MANDATE OF SCHOOL-AGE CHILDREN IN KINDERGARTEN,
2ND AND 6TH GRADES IN ILLINOIS FOR 2006-07 SCHOOL
YEAR
Author(s): Sangeeta Wadhawan, BDS, MPH, Illinois
Department of Public Health, UIC, Julie Janssen, RDH,
MA, Illinois Department of Public Health
Objective: To collect and analyze school dental
examination data among Kindergarten, 2nd and 6th
grade children in Illinois.
Methods: As mandated by Section 27-8.1 of the
school code, all children in kindergarten, second and
sixth grades are required to have an oral health
examination by May 15th of each year in compliance
with the rules adopted by the Department of Public
health. In addition, school code requires all school
districts submit completed paper based surveys which
is now replaced by an online survey to the Illinois State
Board of Education summarizing dental compliance by
June 30th each year.
Results: In the 2006-07 school year, the dental
compliance level of all students in all reported schools
was 80.4%. The compliance level of public schools was
78.8% and of non-public schools was 91.5%. A statewide
total of 78,524 reported students (19.6%) of the total
reported students (400,443) were in noncompliance with
the dental examination mandate. The compliance level
of all reported students in Kindergarten was 86.1%, 2nd
grade 81.5% and 6th grade 73.8% respectively. Among
all examined public and nonpublic school students in K,
2nd and 6th grades, 28.5% had dental sealants, 27.9%
were with caries experience, 19.2% had untreated caries
and 2.0% needed urgent treatment. Compliance levels
as well as dental health indices obtained for nonpublic
schools were much higher than those for public schools
by overall measure as well as by grade levels.
Conclusions: Collecting mandatory school dental
examination data statewide is a viable method for
assessing disease burden and access issues around oral
health among children and strengthens the oral health
surveillance system by providing an ongoing system of
data collection and provides trends over time.
Abstract #: 49
CARIES PREVALENCE AMONG LOW-INCOME
CHILDREN AGED 0-3 YEARS
Author(s): Homa Amini, DDS, MPH, MS, Nationwide
Childrens Hospital, Paul S. Casamassimo, Nationwide
Childrens Hospital, Beth Noel, RDH, Nationwide
Childrens Hospital
Objective: To assess the dental caries prevalence
rate among children aged 0-3 years in an Infant Clinic in
Columbus, Ohio.
Methods: Data were collected from a retrospective
chart review of the dental records of 119 children aged
0-3 years who had a new patient visit at Nationwide
Childrens Hospital between August 2004 and December
2007. Oral health findings and demographic information
for each child in the study were recorded. Demographic
information included age, gender, race/ethnicity, and
type of dental insurance. Oral health information
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race, a statistically significant association was found
between the presence of decay and source of dental
care among African American women (p=.0018).
Conclusions: The link between good oral health and
good nutrition has long been established. With the
appropriate questions, WIC certification may provide
an opportunity in states to identify oral health care needs
and risks for low-income populations. Improving the oral
health of pregnant women in Mississippi may reduce the
bacteria that can be transmitted to the child and
improve the decay rate among children in Mississippi as
well.
Abstract #: 53
UNMET DENTAL NEEDS IN A RURAL, NON-FLUORIDATED,
UNDERSERVED FLORIDA COUNTY
Author(s): Evan B. Rosen, MPH; Scott L. Tomar, DMD,
DrPH; University of Florida College of Dentistry
Objective: To assess self-rated oral health status, use
of dental services, and perceived unmet need for
dental care among adult residents of Union County, FL,
a rural county with high levels of poverty, no community
water fluoridation, and few dentists.
Methods: A 22-item survey instrument was
developed by using items from previous reliable surveys.
Questionnaires were distributedby dental students from
U Florida to persons aged 18 years and older near the
only supermarket in Union County . Questionnaires were
self-completed or, in cases of illiteracy or impaired vision,
administered by a student.
Results: Surveys were completed by 513 adults (230
male, 283 female) age 18-88 years (median=46 years).
48.8% rated the condition of their teeth as fair or poor,
36.3% experienced a toothache within the past 6
months, and 41% of dentate adults had their teeth
cleaned within the past year. 48.3% reported unmet
need for dental care within the past 12 months due to
cost and 66.5% perceived a current need to dental
treatment.
Conclusions: Relative to the state and the nation,
disease experience and unmet need for dental care is
very prevalent among adults in this non-fluoridated
underserved county in north central Florida. Increased
access to preventive and restorative services would
improve their quality of life.
Abstract #: 54
DENTAL VISITS AND INCREASED BODY MASS INDEX IN
CHILDREN AND ADULT
Author(s): Karin Herzog, Columbia College New York,
NY
Objective: Studies do not consistently show an
association between weight and dental caries. The
purpose of this study was to examine the relationships
among the number of dental visits, fillings and body mass
indexes in adults and children, while controlling for age,
race, gender, region, poverty status, education, marital
status, insurance, employment and health status.
Methods: Using the 2005 consolidated household
file and the 2005 dental visits file found in the Medical
Expenditure Panel Survey, regression analysis was
conducted on a sample of 17,808 adults . Analysis was
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also conducted on a sample of 8,487 children using the
2004 consolidated household file and the 2004 dental
visits file in MEPS.
Results: For children below 100% of the federal
poverty line, child body mass index is not a risk factor for
having a filling (p-value 0.992); however, a higher BMI is
positively correlated with the number of dental visits
(p-value 0.067). For adults below 100% of the federal
poverty line, a higher body mass index is also not a risk
factor for having filling (p-value 0.706); however, it is
positively correlated with the number of dental visits
(p-value 0.06).
Conclusions: Body mass index is not a risk factor for
having a filling for adults and children below 100% of
the federal poverty line. A higher body mass index for
both children and adults is correlated with increased
dental visits. More prospective studies are needed to
understand the association between oral health and
obesity.
Abstract #: 55
THE EFFECTS OF MULTIPLE SCLEROSIS ON THE ORAL
HEALTH STATUS
Author(s): Aida A. Chohayeb, DDS, MSD, Researcher
Womens Network Collective; Rafi K. Saatcyian, DDS,
Private Practice, New York City; Jacquelynn M. Wozniak,
Program Analyst; Sharon M. Cadis, Ed.D, Womens
Network Clinical Consultation, New York City
Objective: Multiple Sclerosis is a chronic
neurological inflammatory disorder of the Central
Nervous System with unknown etiology. This research
project was conducted to provide knowledge about
the oral health status of MS patients.
Methods: Those attending a Network Collective
meeting were recruited and consented to participate
in this study. Thirty three women ( 24 Caucasians [C] , 7
African Americans (AA), and 2 Hispanics (H) ) and seven
men (5 C and 2 AA) were examined in a private practice
in New York City. The PI ( C) recorded the education ,
income level, frequency of dental visits , oral hygiene
habits, and smoking history. The years since they were
diagnosed with MS were recorded. Data were divided
into 3 groups Group A, 1-5 years; Group B, 6-10 years;
Group C, 11 years or more. Oral examination
recorded decayed, missing and restored teeth as well
as the periodontal health status.
The data were analyzed by means of SPSS and Excel.
Results: (1) Group A experienced the MS effects on
oral health more frequently, had a higher incidence of
caries and bleeding gums, and had the only individual
with periodontal pockets. (2) Groups B and C reported
better oral hygiene, but had more calculus deposits,
grinding of teeth, and burning mouth syndrome. (3) All
men together with Groups A and B of women had near
equal numbers of missing teeth, but Group C women
had three times the number of missing teeth.
Conclusions: (1) The socio-economic status of the
MS patients had no effects on the results of this pilot
study. (2) Proper oral health care should be stressed
for patients suffering from MS to include annual dental
visits as well as smoking cessation. (3) Further research
is needed on a larger population of MS patients.
S53
Arevalo, DDS, ScD, MBA, MS/ University of Kentucky
College of Dentistry
Objective: Health disparities involving American
Indians and Alaskan Natives (AIANs) are substantial, as
they have poorer health status facing severe difficulties
in accessing healthcare and obtaining appropriate
treatment in a timely fashion. We assessed year to year
variations in oral cancer (OC) incidence and mortality
rate disparities in AIAN group compared to others.
Methods: We used public use SEER data from 1995
to 2004 including age-adjusted oral cancer incidence
and mortality rates and assessed annual percentage
changes (APC) during the study period. All adjustments
used the 2000 US population as the reference standard.
We compared OC age adjusted incidence, and
mortality rates across racial categories using SEER-stat
program (v6.2.4 Built August 9, 2006). We calculated
annual percentage change from the previous years
data designating 1995 annual percentage change as
zero.
Results: There are substantial differences in the
annual changes of OC incidence and mortality rates in
AIANs (overall & for women and men). These annual
fluctuations were distinctly different compared to all
other races where the curves were smoother
indicating less annual changes. For example, comparing
AIANs vs. Whites, overall APC Incidence for OC: 19951996: -40.9% vs. 0.35%; Mortality: -24.9% vs. -3.15%;
Incidence 2002-2003: -6.6% vs. 160.9%; Mortality: -2.2%
vs. -2.2%.
Conclusions: OC annual percentage changes for
AIAN are substantially greater compared to other race/
ethnic groups for which several possible reasons exist.
Abstract #: 60
EVALUATION OF ORAL HEALTH IN NORTHWESTERN
MADAGASCAR
Author(s): Samia Omar (MPH, Stony Brook University)
Objective: To assess the oral health status, behavior,
and risks of patients during the 2007 Madagascar Ankizy
Fund (MAF) dental clinic in select villages in Madagascar.
Methods: A survey was administered to all 423
patients who attended the clinic, assessing oral hygiene,
behavior, diet, and illness experience. Patients were
then examined to assess treatment needs. Statistical
analyses for categorical variables were carried out using
the chi-square test, the ANOVA test for grouped
variables, and multiple regression analyses to confirm
observed correlations by controlling for gender, age
and location ( = 0.05).
Results: An average of 4.35 4.17 teeth were
extracted per patient and 1.78 2.46 restored.
Treatment was predicted by location, while the number
of extractions was predicted by gender, location, seeing
a dentist in the past year, frequency of cleaning teeth
(P = 0.040, R = 0.1356), and toothpaste use (P = 0.029, R =
0.1398). Age was the best predictor for both extractions
and restorative procedures. Although high consumption
of both sugar and starch was related to treatment
needed, the relationship was not statistically significant.
Conclusions: Despite the progress made in reducing
dental problems in the area through the MAF Dental
Mission, the population remains at great risk of
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developing dental caries, especially children and
adolescents; thus demanding more efforts in prevention.
The findings were useful in providing recommendations
for a school-based oral health education program in
the region.
Abstract #: 61
DELIVERING EFFECTIVE ORAL HEALTH CARE THROUGH
COLLABORATIVE PARTNERSHIPS IN HEAD START
Author(s): Bea Hicks, RDH, MA; Michelle Landrum,
RDH, BS
Objective: To develop collaborative partnerships
that deliver an effective oral health care program to
Head Start children, parents, and staff in the areas of
prevention, education, and access to care.
Methods: The Office of Head Start awarded an Oral
Health Initiative Grant to Parent Child Inc. (PCI), the local
Head Start delegate agency in San Antonio, Texas. As a
result, collaborative partnerships were formed with the
San Antonio Metropolitan Health District and The
University of Texas Health Science Center at San
Antonios Department of Dental Hygiene. The goal of
the grant is to deliver effective oral health care in the
areas of prevention, education, and access to care for
Head Start children and their families. Utilizing the Basic
Screening Survey, initial data was collected at 89 PCI
centers on 4,815 children, ages six months to five years.
Follow-up phone interviews were conducted with
parents to assess treatment barriers. In addition, a pretest questionnaire was administered to parents and PCI
staff to determine their dental knowledge.
Results: Based on assessment outcomes, strategies
were implemented to develop a dental referral
network, reduce barriers to establishing a dental home,
and provide effective preventive and fluoride varnish
services. Implementation of educational resources for
children, parents, and staff was conducted in a culturally
sensitive manner.
Conclusions: Through collaborative partnerships, a
model oral health program in PCI has been established.
This program is creating awareness of the importance
of oral health in the PCI community, linking PCI families
to dental homes, and providing valuable preventive
services to this at-risk population.
Abstract #: 62
COLLABORATION CAN IMPROVE ORAL HEALTH FOR
HEAD START/EARLYHS CHILDREN & FAMILIES
Author(s): E. Joseph Alderman, DDS, MPH, Region IV
Head Start Oral Health Consultant, Atlanta, GA; Lilli J.
Copp, Director, Floridas Head Start State Collaboration
Office, Tallahassee, FL
Objective: To learn about the Office of Head Starts
(OHS) contract that seeks to improve the Oral Health
(OH) of HS/EHS children (i.e. Inter-Agency Agreement
(IAA), MCHB/OHS, with Regional Head Start Oral Health
Consultants (RHSOHC), and how FL has addressed HS/
EHS access to oral health services.
Methods: Collaboration between OHS Region IV,
State Collaboration and State OH Offices, the dental
community and HS/EHS staff/families/caregivers have
resulted in plans to address oral health issues. The FL HS
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African American children after controlling for
socioeconomic differences within the sampled
population.
Conclusions: Dental sealants are widely accepted
as an effective decay preventive treatment. African
American children, regardless of income, had a
statistically significant lower rate of dental sealants. The
authors offer six possible explanations for this finding and
steps to address sealant disparities for the state.
Abstract #: 66
ORAL
HEALTH
EDUCATION
CURRICULUM
DEVELOPMENT - PUBLIC HEALTH, DENTAL AND DENTAL
HYGIENE EDUCATION COLLABORATION
Author(s): Julie Ann Janssen, RDH, MA, Sangeeta
Wadhawan, BDS, MPH, Kathleen Thacker, RDH, BS, llinois
Department of Public Health
Objective: To develop oral health education lessons
that enhance existing K 12 curriculum while building
relationships with dental and dental hygiene schools and
providing public health teachable moments for dental
and dental hygiene students.
Methods: Based on surveys of teachers piloting a
curriculum; lesson plans for older grades were
inadequate. The Illinois Department of Public Health
(IDPH) engaged the Illinois Public Health Association to
develop a project with dental and dental hygiene
students to create new lesson plans for middle and high
school students. A scholarship program was created.
Schools must provide time with the students for IDPH to
explain the project. The description stresses issues of
health literacy, society and culture, as well as age
appropriateness and motivating teens and pre-teens
to make positive choices and maintain healthy
behaviors. The students are encouraged to develop
lessons that link oral health to other subjects such as
sociology or science. The criteria for a good lesson
includes measures to determine if teens are learning
and changing behaviors and not merely entertained by
a clever classroom presentation.
Results: Response rates have increased each of the
four years of the scholarship. In 2007, a total of 109 entries
were received from 13 dental hygiene and 2 dental
schools. The winning entry was copied on CD Rom and
provided to all IDPH community school programs. The
project was recognized and awarded a grant from the
Illinois State Dental Society.
Conclusions: Working closely with the dental and
dental hygiene students enhances and strengthens
relationships between public health and schools. It also
provides an opportunity to expose students to public
health and oral health education as something more
than puppet shows and health fairs.
Abstract #: 67
IMPROVING ORAL HEALTH AND HEALTHCARE IN
HOMECARE RECIPIENTS IN NYC
Author(s): Kavita P. Ahluwalia, DDS, MPH, Columbia
University, Mildred Ramirez, PhD, Hebrew Home for the
Aged, Tracey Sokoloff, RN, MPH, Isabella Homecare,
Fanteema Barnes, MPH, Columbia University
Objective: To determine the relationship between
oral health, oral care needs, functional status and
S56
systemic health in older adults receiving homecare
services.
Methods: 160 older adults receiving homecare
services in NYC consented to participate in this study.
Oral health measures, cognitive function (MMSE),
functional deficits (ADLs), medical conditions and
assistance with daily care needs were determined by a
combination of examination, observation, chart review
and face-to-face survey. Descriptive analyses and
regression analyses were conducted.
Results: This Medicaid-eligible sample had poor oral
health (44% were edentulous, mean DMFT was 23.5), and
reported difficult access to dental care (average time
since last dental visit was 3.5 years and only 50% were
aware of dental benefits through Medicaid). A majority
of subjects needed assistance with ambulation, bathing,
and eating. The top five medical diagnoses were
hypertension, asthma, arthritis, diabetes, and depression.
Preliminary analyses suggest that access to and
utilization of dental services, and daily care assistance
needs impact oral health outcomes to a greater extent
than functional and systemic status.
Conclusions: While improving homecare providers
oral health-related training, daily care requirements and
oversight may improve oral health outcomes in this
population, barriers to accessing and utilizing dental
services must be examined if gains in oral health are to
be sustained through the lifespan.
Abstract #: 68
ORAL HEALTH PREVENTION IN PRACTICE (PIP) REPORT:
A COMMUNITY DISSEMINATION TOOL
Author(s): Constance M. Bayles, Ph.D.Center for
Healthy Aging (CHA), University of Pittsburgh; Margaret
Kuder Hamilton, MHPE, CHES, School of Dental Medicine,
University of Pittsburgh; Howard Tolchinsky, DMD, Public
Health Dentist. Pennsylvania Department of Health
Objective: Assess oral health behavior, knowledge
in older adults; complete data analysis to determine
needs, information gaps, use; design an intervention.
Methods: Thirty-five adults (65+) in the CHA 10 Keys
to Healthy Aging Community Ambassador Course
participated in oral health project. Included were 12
questions developed by the National Association of
Chronic Disease Directors. Investigators introduced
survey, explained consent process, and collected data.
Educational intervention was developed.
Results: Mean age 72.7; 80% female; 63% graduated
high school with 34% college graduate or higher; 70%
percent reported brushing twice a day, while 24%
brushed once a day; 76% had seen a dentist in past
year. Majority reported having a dentist or dental clinic
(86%) and 55% reported having insurance. Curriculum
developed included oral hygiene information, local
sources of reduced cost dental care, and the
importance of oral health. Fluoridated toothpaste and
toothbrushes were distributed. A newspaper article was
published and information was posted on CHA website.
An Oral PIP Report was developed to distribute to Family
and Friends.
Conclusions: Oral health is an important part of the
Course. Adults can be oral health ambassadors to
improve oral health knowledge and access to care in
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Student Abstract #1
KNOWLEDGE, ATTITUDE AND USE OF FLUORIDES
AMONG DENTISTS IN TEXAS
Author(s): Ritu Bansal, BDS, MPH, Dept. of Public
Health Sciences, Baylor College of Dentistry
Objectives: The Centers for Disease Control and
Prevention recommendations on fluoride use were
published in 2001. This study examines how information
from the recommendations has diffused to practicing
dentists and the level of fluoride knowledge and use
among Texas dentists.
Methods: A questionnaire was sent out to dentists
who self-identified as being in pediatric (343), dental
public health (72) and general practices (980); a 12%
sample of registered dentists in Texas
Results: Response rate was 42.9%. About 90% of
surveyed dentists reported using fluorides routinely. Only
18.8% reported fluoride varnish as the professionally
applied topical fluoride most often used. About 2.4% of
the respondents did not know whether patients had
access to fluoridated tap water and 57% incorrectly
identified the primary effect of fluoride. Makes enamel
stronger while tooth is developing prior to eruption was
the most commonly cited wrong answer by 44%. Only
5% identified that post-eruptive effect exceeds any preeruptive effect, and 70% could accurately identify
approximate concentrations of fluoride in commonly
used fluoride products.
Conclusions: Despite the evidence for fluoride
varnish preventing and controlling dental caries being
Grade 1, low fluoride varnish use is not surprising since it
took sealants 20 years to be commonly used. Dentists
are expected to be knowledgeable about products
they use, but this study reflects lack of understanding
about fluorides predominant mode of action. More
accurate understanding enables dentists to make
informed and appropriate judgment on treatment
options and leads to effective use of fluoride based on
risk assessment of dental caries.
Student Abstract #2
A SURVEY OF KENTUCKYS PEDIATRICIANS REGARDING
THEIR ROLE IN CHILDRENS ORAL HEALTH
Author(s): Mark Casafrancisco, DMD, MPH, Division
of Pediatric Dentistry, University of Kentucky, David Nash,
DMD, MS, EdD, Division of Pediatric Dentistry, University
of Kentucky
Objectives: To determine the differences between
the oral health-related knowledge, attitudes, and
professional experiences of pediatricians in Kentucky
and a U.S. sample as reported in 2000.
Methods: A census of 526 general pediatricians
providing primary and well-child care in Kentucky was
conducted using a questionnaire of 47 items to measure
provider and practice demographics, oral healthrelated knowledge, attitudes, and professional
experiences.
Results: Of 468 eligible participants, 83(18%)
responded. Kentuckys pediatricians were similar to, but
differed significantly from pediatricians of 2000 study in
that: 1) a greater proportion were located in rural areas;
2) they exhibited a greater level of oral health
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knowledge including the role of milk- or sugary
beverage-containing bottle use, bacteria in the dental
caries process; 3) they were less likely to assess a childs
fluoride intake; 4) a greater proportion agreed with
referring a patient to the dentist by 12 months of age; 5)
a greater proportion observed clinically visible dental
caries in school-aged children at least once per week;
6) there was greater familiarity with fluoride varnish as a
dental preventive technology; and, 7) a greater
proportion of Kentuckys pediatricians received no oral
health instruction if medical school training was in versus
outside of Kentucky. Response rate, and recall and
response biases are limitations.
Conclusions: Kentuckys pediatricians are different
from their national counterparts in oral health-related
knowledge, attitudes and professional experiences. They
have a potential role and are willing, but educational,
practice-based, and health care workforce barriers stem
greater participation. Studies to increase involvement
are warranted.
Student Abstract #3
THE ASSOCIATIONS BETWEEN DIETARY INTAKE FROM
36 TO 60 MONTHS OF AGE AND NON-CAVITATED CARIES
IN THE PRIMARY DENTITION
Author(s): Oitip Chankanka, DDS, MSc, PhD
candidate, Department of Preventive and Community
Dentistry, University of Iowa, Steven M. Levy, DDS, MPH,
Preventive and Community Dentistry, University of Iowa,
Teresa A. Marshall, Preventive and Community Dentistry,
University of Iowa
Objectives: To examine the role of age 36 to 60
months dietary intake on primary tooth non-cavitated
caries, after adjustment for cavitated caries experience.
Methods: With the Iowa Fluoride Study cohort,
dietary data at 36, 48 and 60 months old were collected
using abstracted 3-day dietary diaries, with dental exams
conducted at age 5. Univariable and multivariable
logistic regression analyses were conducted.
Results: In univariable logistic regression, cavitated
caries experience, greater regular soda pop intake, and
greater unprocessed starches intake at snacks were risk
factors, while higher SES, greater daily tooth brushing
frequency and greater all sugars and starches intake at
meals were protective factors for non-cavitated caries.
In multivariable logistic regression using dietary
frequency (occasions) data, greater juice drink intake
at snacks was a significant risk factor, after adjustment
for cavitated caries experience, SES and tooth brushing
frequency. In multivariable logistic regression using
dietary quantity (ounces) data, greater juice drink intake
at snacks was a significant risk factor and greater milk
intake at meals was a significant protective factor, after
adjusted for cavitated caries experience, SES and daily
tooth brushing frequency. Juice drink intake at snacks
was not a significant risk factor for cavitated caries.
Conclusions: Non-cavitated caries could have
different risk factors from those for cavitated caries.
Future research studies that investigate risk factors for
both non-cavitated caries and cavitated caries are
needed.
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Student Abstract #7
A PILOT STUDY TO PROMOTE MATERNAL AND INFANT
ORAL HEALTH
Author(s): Demetress L. Davis, BS., RDH - Third Year
Dental Student Meharry Medical College
Objectives: Mutans streptococci are the principal
bacteria associated with early childhood caries. Little
is known about prenatal factors associated with Mutans
streptococci and their transmission to infants. The
purpose of this study is to investigate social, medical
and dental factors associated with Mutans streptococci
in low-income pregnant women.
Methods: Pregnant women with high Mutans
streptococci were recruited form a Community Health
Center to participate in a study to reduce Mutans
streptococci. Women were screened using Dentocult
SMO kit and those having <10,000 CFU were excluded.
Colonies (CFUs) were counted and those with too
numerous to count were >300 CEFUs. Participants
completed a baseline questionnaire and demographics
and oral health behaviors. Charts were abstracted to
collect data on medical conditions. ANOVA and
multiple regression analyses assessed the effects of
demographics, oral health behaviors and medical
conditions on Mutans streptococci.
Results: Of 109 women screened, 67 (61%) met the
inclusion criterion and 63 had data for this analysis. The
average age was 25.3 years, 73.7% were Hispanic, 40.4%
spoke only Spanish and 38.8% had <high school
education. 80% brushed twice and 52.6% flossed once
a day; 36.8% had a dental visit in the past 6 months.
Participants were an average of 14 (SD=52) weeks
pregnant, 19.7% used an asthma inhaler 52.5% reported
hyperemesis. 37.7% had 300 or more CFUs with a mean
of 197.2 (SD=93.5). Multivariable analysis showed that
those with higher education, fewer weeks pregnant,
spoke Spanish and did not use an inhaler had lower CFUs
(p<0.02).
Conclusions: Mutans streptococci are high among
low-income pregnant women. Those with low education
and who have become acculturated seem to be at
greatest risk.
Student Abstract #8
Epidemiology of Dental Caries of Adults in a Rural
Area in India
Author(s): Ami M. Maru, Junior Dental Student,
School of Dental Medicine, Case Western Reserve
University, Cleveland, OH
Objectives: Data on oral health status from rural
parts of the Indian subcontinent appears to be sparse.
The purpose of the study was to assess the oral health
status and dental treatment needs of a rural Indian
population.
Methods: The study population consisted of 189
volunteer subjects from the village of Kachchh, with a
mean age of 34.9+14.2 years and 54% males. Dental
caries experience was assessed by decayed, missing
due to caries and filed teeth (DMFT) and tooth surfaces
(DMFS). Structured interviews collected information
about the participants perception of health including
oral health, too brushing and snacking habits.
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Results: While only 38.1% perceived themselves to
be in good or very good dental health, nearly 85% felt
the same about general health. Although, more than
80% reported brushing their teeth at least once a day,
very small proportion used dental floss (0.5%) or mouth
rinse (1.56%). The most common sugar exposure was
through sweetened tea, with 75% of respondents
consuming the beverage at least once a day. More
than 80% of the study participants had untreated caries
and the mean DMFT and DMFS scores were 5.1+3.9 and
13.8+17.8, which did not show any gender differences.
The dental treatment needs ranged from 16.9% twosurface fillings to 60.8% one-surface fillings; 23.8% crowns
or bridges and 37.6% extractions. The proportion of D/
DMFT in the study sample was 56.4%. Those who
perceived themselves to be in better oral health had
significantly lower DMFT (4.0+3.2 vs. 5.9+4.1) and DMFS
(8.4+11.7 vs 17.1+20.0) scores (p<0.05). A similar trend
was observed between perception of general health
and DMFT (4.8+3.4 vs 7.0+5.6) as well as DMFS (11.9+13.7
vs. 24.1+30.7) scores.
Conclusions: Results indicate high levels of dental
caries as well as dental treatment needs among a rural
East Indian population.
Student Abstract #9
The Influence of Acculturation on Measures of Oral
Health Practices for Mexican-American Mothers
Attending the CHRISTUS Santa Rosa Children Hospital, WIC
Clinic in San Antonio, TX
Author(s): Moshtagh R. Farokhi, DDS, MPH, FAGD,
Department of Community Dentistry, University of Texas
Health Science Center, San Antonio, TX
Purpose: The purpose of this project was to examine
associates between maternal oral health practices and
their acculturation levels and to identify risk factors for
Early CHildhood Caries (ECC) for Mexican-Americans
attending a Women Infant and CHild Clinic (WIC) in San
Antonio, TX.
Objectives: To determin if acculturatio nwould be a
predictor of oral health practices of Mexican-American
mothers and their children living in San Antonio and to
establish any associations between maternal
acculturation and practices of oral health in a sample
of predominantly Mexican-American women, attending
the WIC at the CHRISTUS Santa Rosa Children Hospital
(CSRCH).
Methods: A sample of 204 Mexican-American
mothers and their children were enrolled in the study.
After the approval of the study and consent forms by
University of Texas Health Science Center at San Antonio
(UTHSCSA) and CSRCHs Institutional Review Boards
(IRB), a validated questionnaire based on Knowledge,
Attitudes, Beliefs and Behaviors (KABS 2) and a selfreporting acculturation questionnaire titled
Acculturation Rating Scale for Mexican Americans II
(ARSMA II) were administered in English or Spanish to
qualified mothers. Children underwent an oral screening
by one dentist using the lift the lip technique and in
the knee-to-knee position.
Results: Mothers from the slightly to strongly Anglo
oriented levels were more likely to be high school
educated in the United States, visited the dentist for
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