Dental Public Health and Education Commons^™

Understanding The Relationship Between Children's Oral Health Utilization And Parent's Use Of Healthcare Services, Shillpa Naavaal, Rashmi Lamsal

Dental Public Health and Policy Publications

Introduction: Parents play an influential role in their children's lives, but little is known about how their healthcare experiences connect. This study examined the relationship between parent's healthcare use and their child's overall and preventive dental care use.

Methods: We pooled three years (2017–2019) of Medical Expenditure Panel Survey (MEPS) data and merged child (0–17 years) and parent data. Our outcomes included any dental visit, preventive visit, and receipt of sealant or fluoride. The primary exposure variable was the parents’ medical and dental care use, grouped into four categories. Descriptive and bivariate analyses were conducted, and multivariable logistic regression analyses …

Investigating The Association Between Parental Paid Sick Leave Benefit And Children's Dental Care Utilization, Rashmi Lamsal, Shillpa Naavaal

Dental Public Health and Policy Publications

Objective: The purpose of this research is to examine the association between paid sick leave (PSL) benefit for employed parents and their child's dental care utilization, including preventive, diagnostic, and treatment services.

Methods: Using pooled data from the 2017–2019 Medical Expenditure Panel Survey, we created a dyadic observational unit linking children aged 0–17 years with their parents (n = 7652) specifically focusing on the younger children of employed parents. Descriptive statistics and a multivariate logistic regression model were employed to examine the association between parental PSL benefit and child dental care utilization, accounting for various child and …

Oral Health Impact And Cost-Effectiveness Of Resealing First Permanent Molars, Christina Scherrer, Pritam Deb, Jayden Ayash, Shillpa Naavaal

Dental Public Health and Policy Publications

Introduction: This study examined the cost-effectiveness and health impact of various dental sealant resealing scenarios for first permanent molars from the payer perspective.

Methods: The authors used a discrete event simulation model for 4,000 recently sealed first molars in a hypothetical cohort of 1,000 children aged 7 years over a 10-year time horizon. Scenarios included a base case of no resealing, resealing at first dental visit, and resealing at the age of 12 years.

Results: Without resealing, only 34.88% of teeth retained sealants after 10 years, whereas resealing at the age of 12 years increased this to …

Role Of Oral Health Providers In Supporting Hpv-Related Cancer Prevention In The Dental Setting, Megan Cloidt, Sarah Vivo, Aubree Thelen, Shillpa Naavaal

Dental Public Health and Policy Publications

Background: Human papillomavirus (HPV) vaccination can prevent HPV-related illness and associated cancers, including oropharyngeal. The safety and efficacy of HPV vaccination has been well-established, but national HPV vaccination rates remain unacceptably low with persistent disparities for certain populations. While vaccination has been one of the biggest public health accomplishments of the last century, vaccine hesitancy continues to grow in the United States, and remains a challenging element of low HPV vaccine uptake.

Description: Oral health providers have been traditionally siloed and largely uninvolved in vaccination counseling and administration, but the COVID-19 pandemic brought oral health providers, pharmacists and …

Effectiveness Of School Fluoride Delivery Programs: A Community Guide Systematic Review, Susan O. Griffin, Mei Lin, Christina Scherrer, Shillpa Naavaal, David P. Hopkins, Anita A. Jones, Tammy Alexander, Virginia A. Black, Elizabeth Clark, Lori K. Cofano, Raúl Isidro García, Anna Goddard, Jane Grover, Susan M. Kansagra, Thomas E. Kottke, Elizabeth C. Lense, Tooka Zokaie, The Community Preventive Services Task Force

Dental Public Health and Policy Publications

Introduction: Although preventable, dental caries remains highly prevalent. Many children do not receive preventive dental services routinely in clinical settings. This review examined the effectiveness of school (preschool through high school) fluoride varnish delivery programs in preventing caries.

Methods: Community Guide systematic review methods were followed. In 2024, databases were searched for studies published through December 2023 on school flouride varnish delivery program effectiveness in increasing fluoride varnish receipt and decreasing caries. Included studies had to be written in English, published in peer-reviewed journals, and conducted in upper-middle– or high-income countries. Data synthesis conducted in 2024 used median …

Improving Dental Hygiene Students' Knowledge, Attitudes, And Confidence Toward Prenatal Oral Health Through Experiential Learning, Denise C. Mckinney, Sinjini Sikdar, Shillpa Naavaal

Dental Public Health and Policy Publications

Purpose Maintaining optimal oral health is essential for maternal health as well as the health of their child. The purpose of this pilot study was to examine dental hygiene (DH) students' knowledge of prenatal oral health before and after receiving an asynchronous prenatal oral health care training (POHCT), and their attitudes and self-perceived confidence before and after receiving an experiential learning opportunity with a pregnant and/or post-partum client at a Women's Infants and Children nutrition program (WIC) clinic.

Methods A one-group pre/post-test design was used. This IRB-approved study (#2027439-4) utilized a convenience sample of DH student participants (n=37) in their …

Subgingival Microbiomes Of Healthy And Periodontitis Subjects, Tareq Abdulrasoul

Theses and Dissertations

Background: Periodontitis is a common chronic inflammatory disease triggered by the dysbiosis of the subgingival microbiome. 16s rRNA sequencing has been used to profile the subgingival plaque samples in healthy and periodontitis subjects. Here, we have collected subgingival plaque samples from subjects and analyzed the microbiome profile from 16s rRNA sequencing. We hypothesized that periodontitis patients will have a different subgingival microbiome profile than that of healthy subjects.

Methods: Subgingival plaque samples were collected from periodontitis and healthy subjects who were indicated for periodontal surgeries (osseous resective and regenerative surgery for periodontitis patients or crown lengthening for healthy …

Perceptions Of A State-Level Hpv Vaccine Mandate And Exemption Option In Rural Virginia: A Qualitative Study, E. Marshall Brooks, Kendall Fugate-Laus, Ben Webel, Shillpa Naavaal

Dental Public Health and Policy Publications

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; yet, despite the availability of safe and effective HPV vaccines, only half of eligible adolescents have completed the vaccine series. School-entry requirements are one proven strategy to increase vaccination rates among children and youth and reduce the burden of HPV-related cancer. This study investigated community perceptions of an HPV vaccine school-entry mandate in Virginia and the consequences of a low threshold exemption option included in the legislation. We conducted 40 interviews with community members including 15 interviews with parents, 19 with healthcare providers, and 6 with …

Describing Trends In Virginia's Dentist And Dental Hygienist Workforce: Challenges And Opportunities, Shillpa Naavaal, Yetty Shobo, Barbara Hodgdon

Dental Public Health and Policy Publications

Purpose: Regular assessment of the dental workforce is essential to improve the population's oral health. This analysis aimed to understand the trends in the distribution of dentists and dental hygienists (DHs) in Virginia.

Methods: Annual survey data (2013-2022) of dentists and DHs from the Virginia Department of Health Professions Healthcare Workforce Data Center was used to examine the trends in provider distribution by age, gender, race/ethnicity, and geography across Virginia.

Results: In 2022, there were 5,720 dentists and 5,290 DH licensees in Virginia. In the dentist workforce, there was a high representation of those aged ≥60 years …

Health, Beliefs, And Faith: Hpv Vaccine Uptake Intent Among Catholic, Evangelical, And Mainline Protestant Parents, Jeanine P.D. Guidry, Shillpa Naavaal, Linnea I. Laestadius, Carrie A. Miller, Gina Zurlo, Candace W. Burton, Kellie E. Carlyle, Julie Russo, Paul B. Perrin

Dental Public Health and Policy Publications

The HPV vaccine has the potential to prevent nearly 92% of HPV-related cancer cases, yet its uptake remains suboptimal. While well-documented barriers to HPV vaccine uptake include inadequate knowledge and lack of provider recommendation, religious preferences have emerged as another crucial factor influencing vaccination decisions. This study examined the interrelatedness of religion, beliefs, and HPV vaccination uptake among children among Catholic, Evangelical, and Mainline Protestant parents. A nationally representative survey was conducted among 1,068 U.S. parents from one of three major Christian denominations: Catholic, Evangelical, or Mainline Protestant. We examined the extent to which demographic factors, constructs from the Health …

Implementation Of A Cancer Education Program In Rural Counties With The Lowest Hpv Vaccination Rates And Health Rankings, Sarah Arezo, Shillpa Naavaal, Charlotte Garrett, Marcie S. Wright, Vanessa B. Sheppard, Michael A. Preston

Dental Public Health and Policy Publications

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection (STI). To address STIs, one rural county public school district developed a series of Family Life Programs to educate pre-teens about pertinent health information. The Schooling Cancer Program (SCP) was developed in partnership with the local Cancer Research and Resource Center to raise awareness about cancer risk factors including HPV-related cancers and HPV prevention methods. Methods: We collected a post-evaluation survey from students who attended a SCP session at one of the targeted middle schools. The SCP educated students about topics focusing on healthy lifestyles. The survey asked students’ …

Intersectionality, Racial Discrimination And Oral Healthcare Utilization Among Black Adults In Baltimore City, Maryland, Briona M. Phillips

Theses and Dissertations

INTRODUCTION: Oral health is essential for overall well-being, yet disparities persist, particularly among marginalized populations including Black adults. Limited access to and underutilization of oral healthcare services exacerbate these disparities. Discrimination, both individual and systemic, acts as a significant barrier to accessing care, contributing to disparities in oral health outcomes. Individuals facing discrimination experience mistrust and fear within oral healthcare settings, leading to delayed or avoided care. Therefore, investigating and addressing discrimination among Black adults is essential for promoting equitable access to oral healthcare, improving overall oral health outcomes, and lessening existing disparities.

PURPOSE: The purpose of this dissertation was …

The Value Of Educating Teachers, Coaches, And Athletic Trainers On The Management Of Dental Trauma., Darlene W. Jean

Theses and Dissertations

Purpose: To investigate the benefit of educating teachers, coaches, and athletic trainers about dental trauma to prevent incidents and improve the management of students/athletes with dental trauma.

Methods: Teachers, coaches, and athletic trainers throughout the greater Richmond metro area were recruited via email. Participants answered a pre-seminar survey to evaluate their baseline knowledge and determine whether they have experienced dental trauma with their students/athletes previously. The participants were given the option to attend an in-person or virtual seminar educating them on the basic management of traumatic dental injuries and how to guide affected students/athletes and their families to obtain optimal …

Clinical Outcomes Of Primary Anterior Esthetic Crowns In Pediatric Dentistry, Jenan Alahmad

Theses and Dissertations

Clinical Outcomes of Primary Anterior Esthetic Crowns in Pediatric Dentistry - A Prospective Cohort Study

By: Jenan Alahmad, BDS

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.

Virginia Commonwealth University, 2024

Thesis Advisor: Parthasarathy Madurantakam, DDS, MDS, PhD

Department of Pediatric Dentistry

BODY

Purpose: This prospective cohort study aimed to compare the effectiveness of restoring maxillary anterior teeth in children (aged 3-6 years) with three different materials: Zirconia Crowns (ZC), Resin Composite Crowns (RC), and Pre-veneered Stainless-Steel Crowns (PVSSC). The study aims to assess the Oral …

Transforming Children's Oral Health: The Impact Of Oral Healthcare Policies On Virginia Medicaid Dental Health Outcomes., Anita M. Kumar

Theses and Dissertations

Abstract: Transforming Children's Oral Health: The Impact of Oral Healthcare Policies on Virginia Medicaid Dental Health Outcomes.

Objectives: This dissertation uses Department of Medical Assistance Services (DMAS) administrative files at the individual and provider level from fiscal years (FY) 2011 to 2021 to systematically study the effect of recently implemented oral health policies (EBD guidelines on sealants, CMS updated quality measures, expansion of Medicaid oral healthcare for qualifying pregnant women) on oral health outcomes of Virginia Medicaid-enrolled children.

Methods: The studies employ a difference in differences regression methods (negative binomial, Poisson, and logistic) to examine the effects of oral health …

Perceptions About Human Papillomavirus Vaccine And Oropharyngeal Cancers, And The Role Of Dental Care Providers In Human Papillomavirus Prevention Among Us Adults, Shillpa Naavaal, Christina A. Demopoulos, Abigail Kelly, Eric Tranby, Julie Frantsve-Hawley

Dental Public Health and Policy Publications

Background: The authors examined adults' perceptions about the importance of the human papillomavirus (HPV) vaccine in preventing oropharyngeal cancers and dental care providers' role in HPV prevention and identified associated factors.

Methods: Adults (≥ 18 years) completed a national survey of consumer and patient attitudes, experiences, and behaviors on oral health. Descriptive and multivariable logistic regression models determined associations between perceptions regarding HPV and attitudes toward dental care providers' role and HPV knowledge, HPV vaccine recommendation, and sociodemographic characteristics.

Results: One in 3 adults (32.8%; n = 5,320) said the HPV vaccine was very important, 1 in 2 said it …

Treatment Access And Outcomes For Craniofacial Care: Patient And Parent Perspectives, Benjamin F. Lowe Iii

Theses and Dissertations

Objective: The purpose was to evaluate whether craniofacial patients and their parents have adequate access to care, perceive this care as high quality, and believe that the incorporation of telehealth visits would benefit their current system of craniofacial care. Methods: An original survey was developed and sent to families in treatment with the Virginia Commonwealth University craniofacial team. The tool was used to gather demographic information and assess opinions toward access to, outcomes of, and telehealth services for craniofacial care. Patients 18 years and older took the survey for themselves, while patients under 18 years old had a parent/guardian take …

Provider Racial Concordance And Medical Mistrust In Pediatric Dentistry, Chinelo Eke

Theses and Dissertations

Purpose: Studies have drawn varying conclusions on the importance of a racially concordant patient provider relationship. Medical mistrust has continued to garner attention as healthcare enterprises thread equity, diversity and inclusion throughout their organizational policies, practices and systems.

Methods: Parents/caregivers of pediatric patients at VCU Pediatric Dentistry were invited to participate. Surveys included questions about demographics, racial concordance, language preference, and the validated Group-Based Medical Mistrust Scale.

Results: A total of 246 guardians completed the survey. For guardians, 40% reported Black or African American, 31% Hispanic, and 19% Caucasian. Seventy-one percent of guardians reported speaking English, 18% Spanish, and 11% …

Food Deserts And Pediatric Oral Health Status In An Under-Resourced Urban Community, Jessica T. Mcauliffe

Theses and Dissertations

Purpose: The aim of this analysis of survey data was to assess the influence of living within a food desert as a predictor of oral health problems among children of East Henrico County, Virginia.

Methods: Survey participants were recruited and questionnaires applied online. Residing in a food desert, using access to affordable produce as a proxy value, was the independent variable, while self- reported assessment of the child’s oral health status was the primary outcome variable. Analyses controlled for other indirect factors of pediatric oral health. Logistic regression was used to model the association between the self-reported access to healthy …

Hydroxyapatite Toothpaste On Caries Prevention In Children, Samantha Richardson, Kelly Vaughan

Dental Hygiene Student Scholarship

Are Hydroxyapatite Toothpastes The Answer To Fluoride Free Patients?

Richardson, Samantha 1 and Vaughan, Kelly 2

Dental Hygiene Program, Virginia Commonwealth University

Abstract:

Objectives/Aims: With the rising trend to become more clean with our ingredient lists, we are facing more patients refusing fluoride treatments and fluoridated toothpastes. This trend has been prevalent in our younger generations due to parents only wanting the purest natural ingredients for their children and now declining fluoride application. The goal of this literature is to find a safe alternative toothpaste that will be just as effective as fluoride.

Methods: This review of literature has been …

Covid-19 Pandemic Impact On Us Childhood Caries And Potential Mitigation, Christina Scherrer, Shillpa Naavaal, Susan O. Griffin, Mei Lin

Dental Public Health and Policy Publications

Non-Hispanic Black (NHB) and Hispanic and low-income US children have a higher prevalence of untreated caries than their higher-income and non-Hispanic White (NHW) counterparts. Due to the COVID-19 pandemic, many dental offices and school sealant programs closed beginning March 2020. We examine the effect of reduced access to restorative care and sealants on the oral health of children from low-income households overall and by race/ethnicity and how increased sealant delivery in September 2022 could mitigate these effects. We used Markov chain Monte Carlo simulation to model COVID-19’s impact on first permanent molar (1M) caries incidence and loss in quality of …

Comprehensive Pregnancy Dental Benefits Improved Dental Coverage And Increased Dental Care Utilization Among Medicaid-Enrolled Pregnant Women In Virginia, Shillpa Naavaal, David W. Harless

Dental Public Health and Policy Publications

Objectives: To evaluate the changes in dental insurance and utilization among pregnant women before and after the pregnancy Medicaid dental benefit policy implementation in 2015 in Virginia.

Methods: We used pooled cross-sectional data from six cycles of the Virginia Pregnancy Risk Assessment Monitoring System on women aged ≥21 years. Using logistic regression models and a difference-in-difference design, we compared the effects of policy implementation on dental insurance and utilization between pre-policy (2013-2014) and post-policy period (2016-2019) among women enrolled in Medicaid (treatment, N = 1,105) vs. those with private insurance (control, N = 2,575). A p-value of 0.05 was …

Association Between Periodontal Disease And Oral Cancer Screening Among Us Adults: Nhanes 2011-2014, Shillpa Naavaal, Dina T. Garcia, Xiaoyan Deng, Dipankar Bandyopadhya

Dental Public Health and Policy Publications

Objectives:

To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD.

Materials and Methods:

We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥ 30 years. PD status was classified as no PD, mild/moderate PD, and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral …

Trends In Dental Workforce In Virginia, Reem Hashmi, Shillpa Naavaal Bds, Ms, Mph

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

The Effects Of Covid-19-Related Stressors On Bruxism And Temporomandibular Disorders, Hagir A. Saleh, Samantha Smith

Dental Hygiene Student Scholarship

Problem: COVID-19 has proven to be a major public health emergency, with an array of physical and emotional complications. While COVID-19 has its own effects on the human body, anxiety induced by the pandemic has shown to take a toll on the human oral cavity by means of causing individuals to grind and clench their teeth due to anxiety/stress, potentially leading to temporomandibular disorders and orofacial pain.

Methods: A thorough review of literature was conducted by consulting credible studies published on online databases such as PubMed, Dentistry & Oral Sciences Source, Google Scholar, and Academic Search Complete. The studies examined …

The Contribution Of Different Permanent Tooth Types To Untreated Caries: Implications For Public Health Surveillance And Prevention, Susan O. Griffin, Liang Wei, Shillpa Naavaal, Eleanor Fleming

Dental Public Health and Policy Publications

Background: Untreated caries (UC), although highly prevalent, is largely preventable. Information on the contribution of different teeth to UC prevalence and severity could be helpful in evaluating UC surveillance protocols and the relative benefits of caries prevention interventions.

Methods: The authors combined data from 3 cycles (2011-2016) of the National Health and Nutrition Examination Survey for participants aged 6 through 11 years, 12 through 19 years, 20 through 34 years, 35 through 49 years, 50 through 64 years, 65 through 74 years, and 75 years and older. For each age group the authors calculated the contribution of successive permanent tooth …

For Medicaid Beneficiaries, The Ability To Find A Dentist Is A Key Component Of Access To Care, Julie C. Reynolds, Shillpa Naavaal

Dental Public Health and Policy Publications

No abstract provided.

Opioid And Nonopioid Analgesic Prescriptions For Dental Visits In The Emergency Department, 2015-2017 National Hospital Ambulatory Medical Care Survey, Shillpa Naavaal, Uma Kelekar, Shital Shah

Dental Public Health and Policy Publications

Introduction: Prescription and nonprescription opioid misuse and the rising number of dental visits in emergency departments (EDs) are growing public health concerns in the US. Our study objective was to examine the relationship between prescription analgesics (opioids and nonopioids) and the type of ED visits (dental and nondental) at the national level.

Methods: We used data from the 2015-2017 National Hospital Ambulatory Medical Care Survey to examine the association between opioid, nonopioid, and combination of opioid and nonopioid analgesic prescriptions and dental and nondental visits in the ED. Covariates included socioeconomic variables, time of visit, provider type, triage level, hospital …

A Scoping Review Of The Roles, Training, And Impact Of Community Health Workers In Oral Health Supplemental Tables, Dina T. Garcia, Jaime Lawson, Erica R. Brody, Susan C. Mckernan, Sarah E. Raskin, Nixon Arauz, Maghboeba Mosavel, Tegwyn Brickhouse

Health Policy Publications

Objective: To synthesize English or Spanish-language literature on community health workers’ (CHWs’) roles, training, and impact in oral health. Basic research design: A scoping review conducted in accordance with the Arksey and O’Malley (2005) methodological framework. Method: Electronic literature searches were conducted in Medline (Ovid), Embase (Ovid), DOSS, CINAHL, Web of Science, and Global Health CAB from inception of the databases to April 2020. Three reviewers independently conducted the title and abstract and full-text reviews. This was followed by data charting by three reviewers and data summarizing by two reviewers. Results: Out of the 36 articles that met the inclusion …

Utilization Of Dental Services Among Medicaid Enrolled Pregnant Women In Virginia, Shillpa Naavaal, Tegwyn Brickhouse, Jonathan W. Yu, Joann Wells

Philips Institute for Oral Health Research Publications

The study evaluated the impact of the Virginia Medicaid dental benefit on dental services utilization among pregnant women enrolled in Medicaid. Data from a total of 10,395 women who had at least one dental claim during the 2015-2017 period were included in the study. The number of dental visits and dental services utilized per person grew from an average of 2.2 visits and 7 services in 2015 to 3.1 visits and 10.5 services in 2017, respectively. In 2017, of all dental services used, 6% were for preventive services and 59% were for treatment services. Continued efforts and targeted interventions are …