Dental Public Health and Education Commons^™

Improving Fluoride Varnish Application Rates In A Pediatric Primary Care Microsystem, Roman G. Roxas

Master's Projects and Capstones

Problem

Childhood caries is a preventable public health issue disproportionately affecting the underserved. National guidelines recommend fluoride varnish (FV) application during well‑child visits. In California, fewer than 15% of children under age six received FV. In a pediatric primary care clinic, baseline performance was 11% in 2025.

Context

A six‑month quality improvement project was implemented. Key barriers included reduced team cohesion, workflow variability, unclear roles, and underutilized electronic health record (EHR) prompts.

Interventions

The change package standardized medical assistant–led workflows, activated EHR prompts, and provided targeted education. Leadership reinforcement through regular huddles supported adoption, consistency, and team engagement.

Measures

Outcome …

Facilitators And Barriers That Exist For Patients Receiving Dental Care In Rural Communities, Monse Sandoval Brumbaugh

University Honors Theses

Rising healthcare costs and limited access to care have exacerbated the shortage of healthcare providers. Although multiple factors contribute to a clinician’s preference for practicing in rural areas, the imbalance created leads to rural communities with significantly reduced access to essential services, particularly dental care. The disparity between urban and rural healthcare is a well-documented global problem, but it remains a pressing issue in the United States, particularly in Oregon. The Full Time Equivalents (FTE) count of full-time practicing dentists in rural regions is significantly lower than in urban areas. Statewide, there are about 0.48 dentists per 1,000 residents. However, …

Examining The Rural Workforce: Comparing Admissions Strategies And Training Pathways In U.S. Medical And Dental Education, Charolyn A. Harris

Honors Theses

Access to healthcare in rural and underserved communities remains a significant challenge in the United States, particularly in dental care, where workforce shortages are more pronounced. This study examines how medical and dental education programs develop rural healthcare providers, focusing on admissions strategies and training pathways. Using a structured scoping review and secondary data analysis, this research compares how each field incorporates known predictors of rural practice, such as rural background and training experiences, into workforce pipeline development. Findings indicate that while both medical and dental education recognize rural background as a strong predictor of rural practice, medical education more …

Reducing Childhood Dental Decay: Fluoride Education Campaign With The Monterey County Health Department, Shelby L. Minter

Capstone Projects and Master's Theses

Dental decay is a significant problem for youth across Salinas, contributing to preventable oral health disparities. The Monterey County Health Department Oral Health Program provides oral health education and prevention services across Monterey County. This project focused on improving parental knowledge and confidence about fluoride usage in areas where pediatric dental caries rates are high. Its purpose was to support the prevention of dental decay through the promotion of fluoride benefits. Two educational campaigns were conducted at elementary schools in Salinas; Monte Bella Elementary School and Alisal Community School. The expected outcomes were increased knowledge, confidence, and positive attitudes towards …

The Quantification Of Fluoride Water Quality And Its Significance On Oral Health, Harleen Kaur Maroak

Electronic Theses, Projects, and Dissertations

Fluoride is a naturally occurring mineral and studies have shown that when added to community water supplies, it effectively reduces dental caries. According to the U.S. Public Health Services (PHS), 0.7mg/L is the optimal fluoride level in drinking water to prevent tooth decay. This study focuses on examining the fluoride levels in water in San Bernardino County (SBC) and Riverside County (RC). Data is collected from recently published articles, databases along with assessing the laboratory water sample (n=45) analysis to determine if the fluoride levels are meeting the optimal standards. In SBC, there are total of 154 water systems with …

Garlic Breath And Beads Of Sweat: The Effects Of Garlic And Chili Peppers On The Growth And Ph Of Streptococcus Mutans., Lena Pitzer

Honors Projects

The purpose of this project is to provide a quantifiable and repeatable measurement of how the presence of garlic and chili pepper during the growth of a carious dentine strain of Streptococcus mutans affects the growth of the strain and surrounding pH level.This research project examines two possible alternative agents, garlic and chili peppers, due to the known antimicrobial effects of their active components, allicin and capsaicin. Prepared garlic and chili extracts were used during disk diffusion to assess and measure the zones of inhibition. The anticipated results are that there will be inhibition present with both the garlic and …

Global Public Health Feasibility: Digital Dentistry In Geriatric Population, Merna Amr Saleh

Theses and Dissertations

Oral health is a critical yet often overlooked determinant of well-being among older adults in Egypt, where mobility limitations, geographic barriers, and low awareness of preventive practices exacerbate dental disparities. DentalPal, a teledentistry-based mobile application, was developed to provide older adults with remote dental consultations, oral hygiene advice, and triage guidance. The platform enables users to submit oral photographs or radiographs for assessment, seek second opinions, and initiate follow-up chats directly with the healthcare provider. This flexible design allows users to access dental consultations on demand while ensuring continuity of care The question that guided this study was how older …

Evaluation Of Finger-Tightening Torque Applied To Implant Healing Abutments By Dental Providers With Varying Experience And Physical Characteristics: An In-Vitro Study., Bayan Abuhalimeh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Evaluation of Finger-Tightening Torque Applied to Implant Healing Abutments by Dental Providers with Varying Experience and Physical Characteristics: An In-vitro Study

Bayan Abuhalimeh, D.D.S

Aim: The primary objective of this project is to measure the actual torque applied by dental providers when finger-tightening a healing abutment and assess the variability among individuals. A secondary objective is to analyze the correlation between applied torque and: provider experience level (residents, general dentist, specialist); gender; age; and, physical attributes (e.g., grip strength, hand size, and dominant hand used for tightening). The null hypothesis is that there is no difference in the mean finger-tightening …

An Analysis Of Employment Patterns And Career Decisions Among Dental Hygienists: In A Transforming Healthcare Landscape, Shirley Calderon Jamarck

Dental Hygiene ETDs

The purpose of this study was to identify the factors contributing to dental hygienists’ consideration of changing careers, retiring early, or feeling burned out. A 26-question survey was emailed to members of the American Dental Hygienists’ Association, with 742 responses meeting inclusion criteria. Participants evaluated aspects of their careers, including job satisfaction, wages and benefits, personal growth, work-related stress, burnout, work-life balance, and retirement plans. Results revealed that one-third of respondents planned to leave the profession, citing burnout, physical strain, and limited career growth as reasons. High correlations were found between job satisfaction and feeling valued, professional accomplishment, and growth …

Development Of Preventive Dental Guidelines In The Primary Healthcare Setting In Egypt: A Delphi Method, Basant Mehriz

Theses and Dissertations

This study addresses the critical need for standardized preventive dental care guidelines within Egypt's primary healthcare system amid the rising burden of oral diseases. Through a systematic two-phase methodology combining a comprehensive literature review and a Delphi consensus-building process engaging 35 dental professionals, the research established priorities for contextually appropriate preventive measures. The consensus framework revealed strong support for clinical interventions (mean of 83% agreement), particularly fluoride-based prevention; community initiatives (mean of 83%), especially school-based programs; policy measures (mean of 77%) such as workforce and educational development, though with variable support for taxation and social determinants approaches. Statistical analysis demonstrated …

A Comparative Study Investigating Patient Experience At Corporate And Private Dental Practices., Abigail R. Logeman

Theses/Capstones/Creative Projects

Oral healthcare is an essential aspect of an individual’s systemic health. However, many oral conditions are left untreated due to the inaccessibility to dental care. Many disparities limit access to dental care like low income and lack of insurance coverage. Untreated oral conditions are linked to systemic health problems like cardiovascular disease, stroke, and pancreatic cancer. Patient experience is a driving factor in the continued involvement in dental care that would limit some of the diseases with oral health manifestations. I aim to compare patient experiences in private and corporate dental practices to provide a scope of the dental care …

Dental Access And Public Health Policy Gaps, Hafsa Tasneem

Theses/Capstones/Creative Projects

Oral health is a key component of overall well-being, yet it is often overlooked in public health policy and planning. While regular dental care can prevent long-term complications, many individuals delay or forget treatment due to barriers such as cost, lack of insurance, scheduling difficulties, and limited awareness of available resources. I did this study as I came across health disparities in underserved communities and wanted to see if the results would be similar in a university population that is insured and has access to more resources. To investigate challenges that individuals within a university community face in accessing dental …

Assessing Correlation Of Dental Health And Appalachian Culture, Samantha G. Cheek

Honors Theses

Proper dental health is crucial for overall well-being, yet access to dental care remains a significant challenge in rural Appalachia. This study examines the relationship between Appalachian cultural identity, fatalistic beliefs, and dental health. Using survey data from 20 participants at dental offices in Chattanooga, Tennessee, the study assessed correlations between Appalachian identity, fatalism, and self-reported dental health. Results indicate a high prevalence of dental health issues (95% reported significant problems), with 70% lacking dental insurance. However, correlations between Appalachian identity, fatalism, and dental health were not statistically significant. Findings suggest that while cultural factors play a role in healthcare …

New Bayesian Methods For Longitudinal Data Analysis With Complex Dependence Structures., Anish Mukherjee

Electronic Theses and Dissertations

Longitudinal data in real-world settings are frequently found to be heterogeneous and exhibit intricate spatio-temporal dependence structures. Analyzing such complex data to obtain reliable estimation while quantifying uncertainty necessitates using sophisticated Bayesian methodology. In this work, we present novel Bayesian methods developed to address these challenges. We often observe heterogeneity in longitudinal data, where the mean and variance for certain profiles meaningfully differs from the rest. Some profiles may also exhibit outliers at a limited number of measurements. Using a standard mixed effects model, which assumes homogeneity, can lead to overestimating the residual variance and inefficient estimation. In this work, …

Effect Of Characteristics Of Titanium Dental Implant And Patient Related Factors On Implant Stability: 2-Year Retrospective Follow-Up Study, Kyaw Zin Thein

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Dental implants offer improvements in oral function and aesthetics for edentulous patients. Thai dental implants have emerged as a cost-effective alternative product. Objective: This study aimed to evaluate factors that influence the success of PRK dental implants over a two-year follow-up period. Methods: This retrospective study included patient records of at least one unit of PRK implant-supported prosthesis with a minimum of two-year of follow-up between 2020 and 2025 at the Dental Innovation Foundation under Royal Patronage, Thailand. Data was extracted on demographics, oral habits, medical history, and periodontal parameters (plaque index, pocket depth, keratinized gingiva width, and gingival …

Assessing Dental Hygienist’S Use Of Anxiety Reducing Practices Toward Patients With Dental Anxiety, Sara C. Steiger

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to assess dental hygienists' practices regarding anxiety-reducing techniques, their attitudes towards managing patients with dental anxiety, and the extent of their training on the topic. To collect data, an adaptation of the existing survey from the UNC Department of Dental Ecology Survey, was distributed to licensed dental hygienists. The findings of the research questions were analyzed using descriptive statistics in the form of frequencies and percentages. The results of this study indicate a substantial need for enhanced educational resources to better equip dental hygienists in managing patients with dental anxiety. Most participants do not …

Racial Diversity Matters: Experiences Of Dental Hygienists Of Color In Education And Practice, Sonika Masih

All Graduate Theses, Dissertations, and Other Capstone Projects

Oral health is important to overall health. Poor oral health can affect a person’s ability to smile and chew, and can negatively affect their self-esteem. Poor oral health can lead to systemic diseases and even death. Therefore, access to dental care is vital for maintaining a quality of life, but people of color often lack access to this essential care. Negative stereotyping, color blind attitudes, and providers' biases are barriers for people of color to access dental care. Dental hygienists play a crucial role in removing barriers to oral healthcare for underserved populations. However, the dental hygiene profession does not …

From Tricare To Medicaid: Dental Insurance Disparities Among U.S. Veterans And Active Duty Service Members, Madeline K. Mcnutt Ms

Honors Undergraduate Theses

Oral health plays a critical role in systemic well-being, yet dental care access in the United States remains deeply unequal, particularly among low-income and historically marginalized populations. Among those significantly affected are military veterans, who frequently experience barriers to oral healthcare due to eligibility restrictions within the Department of Veterans Affairs (VA) system. This study offers a comparative analysis of dental insurance satisfaction between recipients of Medicaid and the TRICARE Active Duty Dental Program (ADDP), two federally funded programs that reflect the divide between civilian and military healthcare access. While TRICARE ADDP provides comprehensive and uniform coverage for Active Duty …

Evaluating The Implementation Of Social Determinants Of Health Screening In An Interdisciplinary Clinic, Taylor M. Adams

DNP Projects

Background: Social Determinants of Health (SDOH), including food, housing, interpersonal violence, and transportation are non-medical problems that can influence health outcomes (World Health Organization, 2020). Low-income minorities and public-payer groups are at considerable higher risk for social needs. Collaboration within the community can improve health outcomes (Sulley et al., 2021). A literature review revealed limited evidence of screening in dental clinic settings. Failure to identify and address SDOH needs in this population can lead to poorer health outcomes.

Purpose: The purpose of this quality improvement project was to implement and evaluate social determinants of health screening and evaluate the …

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 …

Dental Therapy In Washington State: Exploring Dental Hygienists’ Perceptions And Attitudes Towards An Emerging Workforce Model, Soy Mouy Gearheart

Dental Hygiene ETDs

Purpose: This study examines dental hygienists' perceptions of dental therapy in Washington State. Methods: A cross-sectional survey utilizing a Likert-scale questionnaire was conducted among dental hygienists recruited from Washington State Dental Jobs Facebook groups. Descriptive statistics and cross-tabulation analysis examined key variables. Results:Of the 46 participants (n=46), 72% reported that they believed dental therapy could improve access to care in underserved areas. Concerns about current educational standards for safe practice were noted. 11% expressed interest in pursuing a dental therapy degree within the next five years, motivated by interest and career opportunities. Notably, 67% of all male respondents indicated …

A Quantitative Examination Of Tobacco And Marijuana Use On Oral Health Outcomes Among Young Adults In Texas, Meenakshi Dasagi

Dissertations and Theses (Open Access)

This dissertation aimed to quantify the relationship between methods of tobacco and marijuana use and their impact on oral health. Tobacco use was defined as smoking combustible tobacco (cigarettes, cigars, and hookah) or electronic aerosolized vaping nicotine with an e-cigarette.5,9 Similarly, marijuana use was defined as smoking combustible marijuana (joints, blunts, and spliffs) or vaping marijuana with an e-cigarette.8 Despite the prevalence of nicotine vaping and marijuana use among young adults1,3-4,7,14-15, there is limited evidence of their association with oral health in Texas. To address this issue, this dissertation comprising three studies analyzed longitudinal data from the Texas Adolescent Tobacco …

A Comparison Of Temporary Threshold Shifts In Dentists, Hygienists, And Dental Assistants, Sabina E. Ciaccio

Dissertations, Theses, and Capstone Projects

Objective: The purpose of this study is to compare the temporary threshold shifts (TTS) in dentists, hygienists, and dental assistants. The specific aim of this study is to compare the differences in temporary shifts caused by the different dental equipment and the proximity to the equipment. The current literature does not compare the change in hearing thresholds of dental personnel.

Methods: Dentists, dental assistants, and hygienists from Hermann Dental Associates will be given a case history form to determine inclusion status for this study. Exclusion criteria will include known hearing loss and significant noise exposure the day prior. …

Increasing Oral Health In A Midwest Elementary School: Quality Improvement Project, Dee Young

Doctor of Nursing Practice Projects

Marginalized communities experience barriers to accessing oral healthcare in the United States (US). Due to this, many children are left to use the emergency department (ED) for dental care. The purpose of this Doctor of Nursing Practice (DNP) project was to improve oral health services access in children at one suburban Midwest elementary school. The objectives of this project were: a) to improve the efficiency of students registering in Fall 2023 to access available oral health exam services, b) to increase the number of students who receive an oral health exam compared to the number in the previous school year. …

Establishing An Objective, Quantifiable Method For Detecting Erosive Tooth Wear, Camille Kita

Biological Sciences Undergraduate Honors Theses

This study aims to monitor and evaluate erosive tooth wear (ETW) by measurement of enamel surface thickness and texture in a clinical setting. The objective approach is fundamentally different from the standard subjective visual assessment that professionals in the dental field using the Basic Erosive Wear Evaluation (BEWE) method.

Twenty-nine hyposalivation and three control subjects were used in this longitudinal study, for a total of 597 samples (only 577 teeth were eligible for surface texture analysis) evaluated in a longitudinal study including both baseline and 12 month follow up surfaces. Each participant’s buccal surface of the tooth was first analyzed …

The Effect Of Dental Insurance Coverage And Economic Fluctuations On Oral Health Outcomes In The United States, Laura Singletary

Senior Theses

Proper oral health is imperative to overall health, but obstacles often persist in

receiving proper oral health care. Lack of dental insurance coverage and economic recessions are two main factors contributing to oral health outcomes. Extended time without cleanings or addressing current oral health concerns exacerbates oral health problems into more costly procedures for the patient that are conveniently not covered by many insurance plans. This thesis investigates the oral health outcomes associated with periods following economic downturns, specifically citing the time of the Great Recession from 2007-2009.

Risk Factors Of Dental Anxiety And Exploration Of Interventions, Katelin Hancock

University Honors Theses

Within this literature review, the root causes of dental anxiety, current intervention methods, and possible preventative interventions are discussed. Dental anxiety affects millions of individuals across diverse backgrounds and can be detrimental to oral health. This issue can arise from various sources, however, different socioeconomic and sociodemographic factors can contribute to an individual's risk of developing dental anxiety. Understanding what predisposes certain populations to become more likely to develop dental anxiety is imperative to holistically address the concern. Investigating the relationship between lack of access, oral health, and anxiety levels allows for an understanding of the root causes of anxiety. …

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 …

Dental Outreach In Academic Dental Settings, Tisha Clayborn

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Creating an effective outreach program in a dental academic setting involves a strategic approach combining educational objectives and community service. This Dental Outreach Program Guide aligns with organizational objectives, contributes to community well-being, and serves as a model for future outreach initiatives in academic dental settings. This program utilizes the PRECEDE-PROCEED planning model to design and evaluate an oral health strategy. This program aims to outline a strategic plan incorporating evidence-based decision-making, data-driven metrics, and a comprehensive roadmap for successful implementation.

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …