Predicting Flossing through the Application of the Multi-Theory Model (MTM) of Health Behavior Change among Minority Adolescents in the United States.

Adolescents from minority groups are particularly susceptible to poor oral hygiene behaviors, including lack of daily flossing. This cross-sectional study aimed to conduct an exploratory behavioral research to identify evidence-based (theory-based) approaches to promote flossing behavior among African American/Black and Latinx/Hispanic (minority) adolescents. A 39-item psychometrically valid web-based questionnaire was used to collect responses from a nationwide sample of minority adolescents aged 10-17 years residing in the United States. The data were analyzed using bivariate and multivariate statistical methods. Of 520 minority adolescents (260 African American/Black and 260 Latinx/Hispanic adolescents), the proportion of flossing was nearly equally split in the sample. A significantly higher proportion of minority adolescents who were flossing had access to floss as opposed to those who were not flossing (86.8% vs. 69.8%, p < 0.001). A significantly higher proportion of minority adolescents who were not flossing did not visit the dentist over the past year as opposed to those who floss (25.2% vs. 14.7%, p < 0.001). Among the participants who were not flossing, gender, grade level, instruction in school regarding flossing, and multi-theory model (MTM) of health behavior change constructs were the significant predictors (p < 0.001) of initiating and sustaining flossing. The findings of this study will serve as baseline data for developing and evaluating effective evidence-based interventions using the MTM.

The association between dental, general, and mental health status among underserved and vulnerable populations served at health centers in the US.

OBJECTIVES: Vulnerable populations in underserved communities are disproportionately at high risk for multiple medical, dental, and behavioral health conditions. This study aims to: a) examine the occurrence of acute dental needs and b) investigate the association of acute dental needs and self-rated general and mental health status among the adult dentate health center population. METHODS: This cross-sectional study analyzed data on adult patients (n = 5,035) from the 2014 Health Center Patient Survey, a nationally representative survey of health center patients. Multivariate logistic regression was used to assess the association of acute dental needs and a) self-rated general health status and b) mental health status. RESULTS: Approximately, two thirds of adult dentate heath center patients reported having an acute dental need. After adjusting for confounding factors, not having or having had health insurance that pays for dental care, general health status of fair or poor, and ever having a mental illness were associated with higher odds of having an acute dental need. CONCLUSIONS: The results highlight the role of health centers in addressing oral health disparities among vulnerable populations and the importance of a team-based multidisciplinary approach to ensuring the integration and coordination of oral health services within a comprehensive primary care delivery system.

Co-relationships between glandular salivary flow rates and dental caries.

OBJECTIVE: This study was designed to evaluate the relationship of age, gender, ethnicity and salivary flow rates on dental caries in an adult population using data collected from the Oral Health San Antonio Longitudinal Study of Aging (OH: SALSA). BACKGROUND: Saliva is essential to maintain a healthy oral environment and diminished output can result in dental caries. Although gender and age play a role in the quantity of saliva, little is known about the interaction of age, gender and ethnicity on dental caries and salivary flow rates. MATERIALS AND METHODS: Data from the 1147 participants in the OH: SALSA were analysed. The dependent variables were the number of teeth with untreated coronal caries, number of teeth with root caries and the number of coronal and root surfaces with untreated caries. The independent variables were stimulated and unstimulated glandular salivary flow rates along with the age, sex and ethnicity (e.g. European or Mexican ancestry) of the participants. RESULTS: Coronal caries experience was greater in younger participants while root surface caries experience was greater in the older participants. Coronal caries was lower in the older age groups while the root caries experience increased. Men had a statistically significant (p < 0.02) higher experience of root caries than women. Values for unstimulated and stimulated parotid salivary flow rates showed no age difference and remained constant with age, whereas the age differences in the unstimulated and stimulated submandibular/sublingual salivary flow rates were significant. The mean number of teeth with coronal and root caries was higher in Mexican-Americans than in European-Americans. CONCLUSIONS: Over one-fourth of the adults between the ages of 60 and 79 have untreated root caries over one-third having untreated coronal caries. Lower salivary flow rates play a significant role in both the number of teeth and the number of surfaces developing caries in these adults. Women and individuals of European-American ancestry experience less caries.

Preparing the dental workforce for oral disease prevention in an aging population.

The growing proportion of older adults in the U.S. population, as well as escalating dental expenditures, is leading to major changes in the demands on oral health care delivery. Researchers over the years have clearly demonstrated the shortcomings of traditional restorative treatment and the cycle of repeat interventional care. Oral health care professionals are constantly seeking advances in technology, protocols, methodologies, and materials to meet the needs of the growing, diverse older population. Early stages of oral diseases such as caries and periodontal disease are vigorous, preventable, and reversible. Assessment of social, systemic, and oral risk factors that emphasize patient counseling to facilitate risk reduction, along with individualized evidence-based disease prevention planning, is more cost-effective than traditional restorative treatment and will improve overall outcome. The purposes of this article are to briefly describe current issues and challenges related to oral health promotion for older adults and to examine strategies for disease prevention and health promotion in health and dental care settings.