2012 Ph.D. APPLIED EXAM Department of Biostatistics University of Washington
|
|
- Ashlie Wilkinson
- 5 years ago
- Views:
Transcription
1 2012 Ph.D. APPLIED EXAM Department of Biostatistics University of Washington Background Dental caries is an infectious, transmissible bacterial disease that is a common childhood condition in the United States. In 2000, a Surgeon General s report on oral health (US Department of Health and Human Services, 2000) stated, dental caries (tooth decay) is the single most common chronic childhood disease - 5 times more common than asthma and 7 times more common than hay fever. It reported that the majority (52%) of children aged 5 to 9 years had at least one carious lesion or filling. Furthermore, there are striking disparities in dental disease. Nationally representative surveys have found that children in families living below the poverty level experience more dental decay than those who are economically better off. Furthermore, caries seen in poor children is more likely to be untreated (as opposed to treated with a dental restoration) than caries in those living above the poverty level. More than 19% of poor children aged 6 to 19 have one or more untreated decayed permanent teeth compared to 8% of non-poor children. Billions of dollars are spent in the United States each year to provide treatment and to deal with the consequences of this highly prevalent but preventable disease. The larger part of these expenditures is by the Federal and State governments through Medicaid. Early preventive interventions have the potential to greatly reduce later downstream costs to the Medicaid program. An NIH Consensus Conference (NIH, 2001) on the Diagnosis and Management of Dental Caries throughout Life evaluated preventive practices and identified those with substantive benefit. Key among these recommended practices are parental oral health education, promotion of tooth brushing with fluoridated toothpaste, topical fluorides, and dental sealants. However, these practices have achieved limited impact on caries reduction particularly among low income children and ethnic minorities because recommended practices often do not reach the populations at greatest risk. In fact, national data shows a recent rise in tooth decay among children. The NIH Consensus Conference also identified sugarless and xylitol containing products as potentially beneficial. Xylitol products have received little study or application in the United States. Xylitol is a naturally occurring 5-carbon sugar polyol (also called a sugar alcohol ) currently approved for use in foods, pharmaceuticals and oral health products in more than 35 countries (Burt, 2006). It is found naturally in various trees, fruits and vegetables and is an intermediate product of the glucose metabolic pathway in man and animals. Although structurally dissimilar, it has approximately the same sweetness as sucrose or table sugar and an FDA-approved caloric content of 2.4 kcal/g compared with 4.0 kcal/g for sucrose. Due to the above properties, xylitol has been FDA approved as a dietary food additive and has been used in dietary food for diabetic patients. It has been shown that post-prandial blood glucose level and insulin requirement were significantly less after equivalent dose of xylitol versus sucrose were added to a breakfast meal. Currently, xylitol can be found in the ingredients list of general market products such as gums, mints, candies, lozenges, soft drinks, toothpastes, and dietary food. To date, after nearly 30 years of xylitol product usage, there is no known reported case of major detrimental side effects related 1
2 to the use of xylitol in food, gum, or syrup. Children can tolerate a daily dose of 45g without developing side effects while the effective dosing range is thought to be several fold lower. Side effects include laxative effects and are self limiting. There are reasons to believe that xylitol products could have beneficial effects on prevention of caries (van Loveren, 2004; Burt, 2006). Chewing gum or other types of chewy candy or sucking on hard candies or lozenges can by itself prevent cavities by stimulating salivary flow. However, gums or other products containing some sweeteners such as sucrose and fructose feed oral bacteria that create acid and cause tooth decay. The harmful effects of the sugar more than offsets the benefits of increased salivary flow. On the other hand, xylitol and other types of sweeteners that are used as sugar replacements have been shown to lack such cariogenic effects. Thus, consuming sugar-free products that contain sweeteners such as xylitol are considered to be a useful anti-caries measure. Beyond their effects on saliva, products containing xylitol may have additional anti-caries activity due to specific effects of xylitol on oral bacteria that cause tooth decay. Specifically, xylitol has been shown to interfere with the metabolism and adherence to tooth surfaces of cariogenic bacteria. For example, it has been shown that when S. mutans are exposed to xylitol, both in long-term and short-term consumption, they develop xylitol-resistant strains which may be less virulent in the oral environment. These xylitol resistant bacteria adhere less well to tooth surfaces and produce less acid than do xylitol sensitive bacteria. Xylitol resistant mutant S. mutans can persist in both saliva and plaque for many years after xylitol is removed from the diet. Evidence from controlled clinical studies of xylitol indicates that there is selective decrease in levels of cariogenic bacteria in plaque and saliva, possible decrease in plaque quantity, and increased remineralization of enamel with xylitol use (Maguire and Rugg-Gunn 2003). This research suggests that xylitol could have benefits on caries prevention that persist after the exposure to xylitol ends. There is preliminary evidence from clinical studies that xylitol is effective in reducing caries rates. These studies have involved children of various ages as well as a variety of modes of delivery of xylitol, including candies, lozenges, chewing gum, etc. Studies of xylitol products have often also included the use of fluoridated toothpaste and/or behavior modification as adjuncts, in line with suggestions by the NIH Consensus Statement of using combined intervention to reduce dental caries (NIH, 2001). However, previous research on anti-caries effects of xylitol has suffered from methodological limitations that have prevented clear conclusions. There does not exist clear evidence that xylitol products have specific anti-caries effects beyond those that might be due to increased salivary flow. Several reviews of the previous research have been published (e.g., van Loveren, 2004; Burt, 2006; Mickenautsch et al., 2007; Antonio et al., 2011). The Study A group-randomized trial was performed to determine the effect of xylitol on prevention of caries in young children. Xylitol was delivered by providing the children with chewy candies ( gummy bears ). The trial participants were all children who were enrolled at the beginning of a given school year in kindergarten classes in 15 schools within an urban community located in the 2
3 United States. The community was chosen as the site for the trial because the children in the community experience very high dental caries rate and have poor access to or utilization of local private dental care. The community has a high level of poverty as indicated by more than 90% of children qualifying for a federal free and reduced lunch program. The trial was performed as a group-randomized trial in which groups of children (all children enrolled within a given classroom) are randomized together to a given treatment condition. This type of randomization is preferable to individual randomization of children because of the high likelihood that children within the same classroom would share gummy bears with each other. Of the 15 schools, 3 schools had 4 classrooms each and 12 had 2 classrooms each. Randomization was performed just before the beginning of the kindergarten school year using the list of classrooms available at that time. Within each school, classrooms were randomized to one of the two treatment arms in such a way that there were equal numbers of classrooms on each treatment arm. However, by the end of the trial there were only 32 classrooms remaining in the trial. The reason for this is that after the start of the school year, some classrooms were merged due to enrollment levels being lower than anticipated. The merging of classrooms occurred prior to any study treatment being given. As a result data are available from 32 classrooms (2 schools with 1 participating classroom each, 10 schools with 2 classrooms, 2 schools with 3 classrooms, and 1 school with 4 classrooms). All school teachers, study observers (hygienists, dentists, outreach workers), and parents were blinded to the assigned treatments for the classrooms. Xylitol was delivered by providing the children with chewy candies ( gummy bears ) that contained 1.3 mg of xylitol per candy. The control condition was gummy bears that were identical to the xylitol candies except that they contained an alternate sweetener to match for sweet taste. The alternate sweetener is known to have no effects on tooth decay, i.e., it has neither caries preventive or caries promoting activity. Children were given 3 candies 3 times per day (9 candies total) for the duration of the school year (9 months). In the xylitol group the total amount of xylitol contained in the candies was 11.7g per day. A log was maintained to record on each school day which children were present and had been observed by the teacher to consume at least one gummy bear. The children were instructed to finish eating their gummy bears in the classroom and not to take them outside at recess or lunch time, to help reduce the amount of sharing of gummy bears between children in different classrooms in the same school. The number of school days in the year was approximately 200 and varied little across schools or classrooms. The children were not given any gummy bears by the researchers after the end of the kindergarten school year. During the kindergarten year, approximately 2% of the children switched from one classroom (or school) to another within the 15 schools participating in the trial, in which case they started receiving the type of gummy bear assigned to the new classroom when they started attending that classroom. Information about such transfers of children is not available on an individual child level. At the start of the school year, before study treatments started, a dental exam was performed on each child. Caries was recorded using the International Caries Detection and Assessment System (ICDAS), which is a clinical visual system developed by researchers from the United Kingdom, the United States, and Europe to evaluate early stages of dental caries ( The ICDAS criteria record the severity of the lesions on all surfaces for each tooth present in the mouth. The tooth surfaces are called occlusal (biting), buccal (adjacent to cheek), lingual 3
4 (adjacent to tongue), and distal and mesial surfaces (between the teeth towards the back or the front of the mouth). At most 20 primary teeth and a maximum of 100 surfaces were scored (most children have 20 primary teeth after all have erupted typically by the time of kindergarten). Each surface was scored on a scale ranging from 0 to 6, in which 0 represents a sound (disease-free) surface, 1 represents initial visual changes in tooth enamel, and levels 2-6 represent increasingly severe lesions. Additional codings exist to record tooth surfaces found to have a dental filling and for teeth that were missing due to caries (when there was evidence that a tooth previously erupted had to be extracted due to caries). The data available are based on classification of each tooth surface as either (1) diseased, if the ICDAS score was 3 or higher or if there was a filling present or if the tooth was recorded as missing due to caries, or (2) disease free, otherwise. The data are available as the total counts of diseased surfaces for each child. Information on gender and race/ethnicity of the children was also collected. Race/ethnicity was provided for 424 enrolled children, of whom 406 were African-American. (Data on race/ethnicity is not included in the data provided for this exam.) Dental exams were also performed at two follow-up times: 1) at the end of the kindergarten school year (in June), and 2) at the end of the following school year (first grade). These exams were performed in a similar way as for the exam at the start of the kindergarten year. However, the information recorded at each of these exams was the number of surfaces with new disease that had not been observed at baseline. Therefore, tooth surfaces that had been scored as diseased at baseline would not be counted as diseased at a follow-up exam. The definition of disease used was the same as for the baseline exam, namely ICDAS score of 3 or higher, dental filling, or evidence of tooth extraction due to caries. Note that both follow-up exams were compared with baseline results for purposes of scoring; therefore, disease at the final follow-up is disease that is new relative to baseline (not new relative to the previous follow-up exam). For each of the follow-up exams, some children were not examined either because they had transferred out of the school district, moved away, or were absent from school on all of the dental examination days. Only children who were listed as being enrolled at the start of the kindergarten year were included in the dental exams (i.e., children who enrolled in the school part way through the kindergarten year or in the following year were not examined). Note that there could be some undercounting in the decay counts. In all children, primary teeth are lost naturally (exfoliate) when the permanent teeth begin to erupt which typically begins during first grade. Although the trained dental examiners were dentists trained to be able to distinguish teeth that had exfoliated naturally from those that had to be extracted due to caries, some misclassification inevitably occurs. For example, a tooth surface that is scored as being diseased at the first follow-up and then is subsequently extracted due to disease, could be mistakenly recorded as naturally exfoliated at the second follow-up. Another type of misclassification occurs when a tooth with a cavity that has been restored with tooth colored material might be scored as sound simply because the filling is not obviously visible. For all these reasons, the number of tooth surfaces scored as being diseased could decrease from one follow-up exam to the next. The Data 4
5 The data is available in a comma delimited file. There are 526 records and the following variables: 1. id (1 526) 2. school (1-15) 3. classroom (numbered within school from 1 to number of classrooms within the school) 4. treatment (1=Control, 2=Xylitol) 5. gender (-9=NA, 1=female, 2=male) 6. days (total number of days of gummy bear consumption) 7. dmfs0 (number of decayed, missing, or filled primary surfaces at the start of the kindergarten year) 8. dmfs1 (number of new decayed, missing, or filled surfaces at the end of the kindergarten year, where new is relative to start of kindergarten year) 9. dmfs2 (number of new decayed, missing, or filled surfaces at the first grade exam, where new is relative to start of kindergarten year) Scientific Questions. 1. Describe the evidence from this trial for a preventive effect of xylitol on prevention of caries in primary teeth in children. 2. Is there evidence that the effect of xylitol varies according to the child s prior caries history as assessed at the beginning of kindergarten? 3. Is there evidence for a dose-response relationship between the amount of xylitol consumed and the incidence of caries on primary teeth? References A.G. Antonio, V.S. da Silva Pierro, L.C. Maia (2011). Caries preventive effects of xylitol-based candies and lozenges: a systematic review. Journal of Public Health Dentistry 71(2): Burt B.A. The use of sorbitol- and xylitol-sweetened chewing gum in caries control. Journal of the American Dental Association 137(2): Maguire, A., A.J. Rugg-Gunn (2003). Xylitol and caries prevention is it a magic bullet? British Dental Journal 194(8): S. Mickenautsch, S.C. Leal,V. Yengopal et al. (2007). Sugar-free chewing gum and dental caries a systematic review. Journal of Applied Oral Science 15(2):
6 NIH (2001). "NIH Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life. Bethesda, MD, March 26-28, Conference Papers." J Dent Educ 65(10): USDHHS (2000). "Oral health in America: a report of the Surgeon General." Rockville, MD. U.S Department of Health and Human Services. National Institute of Dental and Craniofacial Research, National Institute of Health. van Loveren C. (2004). Sugar alcohols: what is the evidence for caries-preventive and cariestherapeutic effects? Caries Research 38(3):
ORAL HEALTH OF GEORGIA S CHILDREN Results from the 2006 Georgia Head Start Oral Health Survey
ORAL HEALTH OF GEORGIA S CHILDREN Results from the 26 Georgia Head Start Oral Health Survey Introduction Oral health is an essential component of health throughout life. Poor oral health and untreated
More informationجامعة تكريت كلية طب االسنان مادة طب الفم الوقائي املرحلة اخلامسة م. ازهار عماش حسني
جامعة تكريت كلية طب االسنان مادة طب الفم الوقائي املرحلة اخلامسة م. ازهار عماش حسني 6102-6102 1 Lec-3- Non- sugars sweeteners Much research has been carried out in order to fined sugar substitutes. The
More informationXylitol and Dental Caries: An Overview for Clinicians
MARCH 2003 JOURNAL OF THE CALIFORNIA DENTAL ASSOCIATION Xylitol Xylitol and Dental Caries: An Overview for Clinicians Heather Lynch, MD, and Peter Milgrom, DDS Heather Lynch, MD, is a postdoctoral fellow
More informationDEPOSITS. Dentalelle Tutoring 1
DEPOSITS Dentalelle Tutoring WWW.DENTALELLE.COM 1 PH SCALE WWW.DENTALELLE.COM 2 DENTAL CARIES Dental caries is a dynamic process that involves a susceptible tooth, cariogenic bacteria in dental plaque
More informationLinking Research to Clinical Practice
Linking Research to Clinical Practice Non Fluoride Caries Preventive Agents Denise M. Bowen, RDH, MS The purpose of Linking Research to Clinical Practice is to present evidence based information to clinical
More informationAlabama Medicaid Agency. 1st Look Program
Alabama Medicaid Agency 1st Look Program Overview 1 st Look Program goals Qualified Physicians Who qualifies for the program? Billing/Eligible Services Documentation Requirements Referrals Program Contacts
More informationFood, Nutrition & Dental Health Summary
By Liz Pearson, RD www.lizpearson.com Food, Nutrition & Dental Health Summary Canadian Health Measures Survey (2007 to 2009) 57% of 6 11 year olds have or have had a cavity 59% of 12 19 year olds have
More informationDental Health. This document includes 12 tips that can be used as part of a monthly year-long dental health campaign or as individual messages.
Dental Health This document includes 12 tips that can be used as part of a monthly year-long dental health campaign or as individual messages. What is gingivitis? Gingivitis is the beginning stage of gum
More informationObjectives. Describe how to utilize caries risk assessment for management of early childhood caries
Objectives Define Early Childhood Caries Describe how to utilize caries risk assessment for management of early childhood caries Explain how to implement early childhood caries management within a dental
More informationPERINATAL CARE AND ORAL HEALTH
PERINATAL CARE AND ORAL HEALTH Lakshmi Mallavarapu, DDS Terry Reilly Health Services Boise, Idaho CE objectives Recognize the necessity of Oral Care during Perinatal Period Examine and assess teeth and
More informationOral Health Care: The window to overall health. Head 2 Toe Conference May 9, 2013 Christy Cogil, RN, CFNP and Dr. Melissa Ravago, DMD
Oral Health Care: The window to overall health Head 2 Toe Conference May 9, 2013 Christy Cogil, RN, CFNP and Dr. Melissa Ravago, DMD Oral Health in America Oral health is essential to the general health
More informationWhat Are Polyols? Polyols are:
What Are Polyols? Polyols are: Sugar-free, low-digestible carbohydrate sweeteners Also known as sugar replacers, a more consumer-friendly name that better describes how and why they are used Referred to
More informationSOFT DRINKS & DENTAL HEALTH.
SOFT DRINKS & DENTAL HEALTH www.giveuplovingpop.org.uk @gulpnow SOFT DRINKS & DENTAL HEALTH All text tables, copyright Health Equalities Group 2017 Primary authors: Alexandra Holt, MSc. Health Equalities
More informationKey Dietary Messages
Key Dietary Messages Developed by Dr. Teresa Marshall, Ph.D Department of Preventive and Community Dentistry College of Dentistry, University of Iowa Dietary Behavior Number of meals/s Meal patterns Between-meal/
More informationDental Care and Health An Update. Dr. Ranjini Pillai, DDS, MPH, FAGD, FICOI
Dental Care and Health An Update Dr. Ranjini Pillai, DDS, MPH, FAGD, FICOI WHO s Definition of Health? Health is a state of complete physical, mental, and social wellbeing and not merely the absence of
More informationDental caries prevention. Preventive programs for children 5DM
Dental caries prevention Preventive programs for children 5DM Definition of Terms Preventive dentistry: usage of all the means to achieve and maintain the optimal oral health prevention of dental caries,
More informationProtecting All Children s Teeth Caries
Protecting All Children s Teeth Caries 1 http://www.aap.org/oralhealth/pact Introduction used with permission from Ian Van Dinther Caries is an infectious transmissible disease resulting from tooth adherent
More informationLearning Objectives. Nutrition and Oral Health for Children
Learning Objectives Nutrition and Oral Health for Children Beth Ogata, MS, RD Nutrition 527 April 4, 2006 Describe oral health problems for children List nutrition-related risk factors for oral health
More informationChapter 14 Outline. Chapter 14: Hygiene-Related Oral Disorders. Dental Caries. Dental Caries. Prevention. Hygiene-Related Oral Disorders
Chapter 14 Outline Chapter 14: Hygiene-Related Oral Disorders Hygiene-Related Oral Disorders Dental caries Prevention Gingivitis Prevention Tooth hypersensitivity Pathophysiology Treatment 2 Hygiene-Related
More informationORAL HEALTH MECHANISM OF ACTION INFLUENTIAL FACTORS 5/8/2017
ORAL HEALTH Oral health is a state of being free from chronic mouth & facial pain, oral & throat cancer, oral sores, birth defects such as cleft lip & palate, periodontal (gum) disease, tooth decay & tooth
More informationCourse #:
Welcome to Lesson 7: Indicators of Problems of the Dental Health for Individuals with Disabilities webcast series. Please adjust your computer volume so that it is at a comfortable listening level for
More informationTitle. Citation 北海道歯学雑誌, 38(Special issue): Issue Date Doc URL. Type. File Information.
Title The ICDAS (International Caries Detection & Assessme Author(s)Kanehira, Takashi; Takehara, Junji; Nakamura, Kimiya Citation 北海道歯学雑誌, 38(Special issue): 180-183 Issue Date 2017-09 Doc URL http://hdl.handle.net/2115/67359
More informationARE YOU MOUTHWISE? AN ORAL HEALTH OVERVIEW FOR PRIMARY CARE
ARE YOU MOUTHWISE? AN ORAL HEALTH OVERVIEW FOR PRIMARY CARE Funding providing by: Developed by: Terry L. Buckenheimer, DMD Karen Pesce Buckenheimer, R.N., BSN Executive Director, MORE HEALTH, Inc. Why
More informationOral Health Care for Pregnant Women
Oral Health Care for Pregnant Women Renee Samelson MD, MPH, FACOG Associate Clinical Professor Maternal Fetal Medicine Albany Medical College Committee on Oral Health Access to Care Institute of Medicine
More informationThinking About Another Sweet Gulp? Think Again
Thinking About Another Sweet Gulp? Think Again John Tran University of Illinois at Chicago College of Dentistry ttran50@uic.edu According to a recent Center for Disease Control (CDC) report, more than
More informationDental Insights. Equipping Parents with Important Information About Children s Oral Health pril 2014
Equipping Parents with Important Information About Children s Oral Health pril 2014 Introduction Despite tremendous advancements in dental care and treatment over the past 50 years, dental caries (tooth
More informationCaries Prevention and Management: A Medical Approach. Peter Milgrom, DDS
Caries Prevention and Management: A Medical Approach Peter Milgrom, DDS Minimally Invasive Treatments Infection control Tissue preservation Hand instruments Adhesive materials such as GI Allow for pulpal
More informationSmile Survey 2010: The Oral Health of Children in Pierce County
Smile Survey : The Oral Health of Children in Pierce County Prepared by the Office of Community Assessment April 11 1 Table of Contents Executive Summary... 3 Background... 5 Methods... 6 Elementary School
More informationCAries Management By Risk Assessment"(CAMBRA) - a must in preventive dentistry
CAries Management By Risk Assessment"(CAMBRA) - a must in preventive dentistry Nanda Kishor KM* *MDS, Reader, Department of Conservative and Endodontics Pacific Dental College, Udaipur, Rajasthan, India
More informationAgePage. Taking Care of Your Teeth and Mouth. Tooth Decay (Cavities) Gum Diseases
National Institute on Aging AgePage Taking Care of Your Teeth and Mouth No matter what your age, you need to take care of your teeth and mouth. When your mouth is healthy, you can easily eat the foods
More informationCavities are Preventable
Cavities are Preventable Childhood cavities can be prevented. They are caused by germs in the mouth interacting with sugars in food and drinks. You can t avoid germs or sugars, but you can limit exposure
More informationU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. National Institutes of Health. National Institute of Dental and Craniofacial Research
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental and Craniofacial Research What's wrong with sugary snacks, anyway? Sugary snacks taste so good but
More informationPOSITION STATEMENT ON HEALTH CARE REFORM NADP PRINCIPLES FOR EXPANDING ACCESS TO DENTAL HEALTH BENEFITS
POSITION STATEMENT ON HEALTH CARE REFORM THE NATIONAL ASSOCIATION OF DENTAL PLANS (NADP) is the nation s largest association of companies providing dental benefits. NADP members cover 136 million Americans
More informationPromoting Oral Health
Promoting Oral Health Hope Saltmarsh, RDH, M.Ed. Doug Johnson, DMD October 2009 11/3/2009 12:14:04 PM 5864_ER_RED 1 Learning Objectives Identify Bright Futures recommendations for oral health. Describe
More informationU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health What do I need to know about dry mouth? Dry mouth is the feeling that there is not enough saliva in the mouth. Everyone has a
More informationEarly Childhood Caries (ECC) KEVIN ZIMMERMAN DMD
Early Childhood Caries (ECC) KEVIN ZIMMERMAN DMD What Is Early Childhood Caries? Early Childhood Caries (ECC) is a transmissible infectious process that affects children younger than age 6 and results
More informationOral Health Advice. Recovery Focussed Pharmaceutical Care for Patients Prescribed Substitute Opiate Therapy. Fluoride toothpaste approx 1450ppmF
Recovery Focussed Pharmaceutical Care for Patients Prescribed Substitute Opiate Therapy Oral Health Advice Fluoride toothpaste approx 1450ppmF Choosing the right toothbrush Brief Intervention Oral Health
More informationOral Health in Colorado
Oral Health in Colorado Progress and Opportunities Sara Schmitt Director of Community Health Policy Prepared for the Delta Dental of Colorado Foundation September 2017 About Us: Inform State and National
More informationHEALTH SURVEILLANCE INDICATORS: YOUTH ORAL HEALTH. Public Health Relevance. Highlights
HEALTH SURVEILLANCE INDICATORS: YOUTH ORAL HEALTH Public Health Relevance Good dental and oral health contribute to physical, mental and social well-being. Tooth decay, especially untreated dental caries,
More informationA guide to dental health for your baby and the family
Patient information A guide to dental health for your baby and the family Contents Good dental care from the beginning 2 Registration with a dentist 3 Fluoride toothpaste 4 Brushing your child s teeth
More informationA Few SoundBites on Diet, Nutrition and Oral Health
A Few SoundBites on Diet, Nutrition and Oral Health Carole A. Palmer EdD, RD Tufts University: School of fdental lmedicine i Friedman School of Nutrition Science and Policy Conflict of Interest Disclosure
More informationOral Health Matters The forgotten part of overall health
Oral Health Matters The forgotten part of overall health In 2000, the Surgeon General issued a report Oral Health in America. In the Report, the Surgeon General focused on why oral health is important.
More informationDental care and treatment for patients with head and neck cancer. Department of Restorative Dentistry Information for patients
Dental care and treatment for patients with head and neck cancer Department of Restorative Dentistry Information for patients i Why have I been referred to the Restorative Dentistry Team? Treatment of
More informationNew Parents Oral Health Handbook
New Parents Oral Health Handbook Casper Children s Dental Clinic New Parents Did you know almost half of Wyoming s children will get at least one cavity by the time they reach kindergarten? Often times,
More informationEUROPEAN COMMISSION HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL
EUROPEAN COMMISSION HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL Directorate C - Scientific Opinions C2 - Management of scientific committees; scientific co-operation and networks Doc.SANCO/SCMPMD/2002/0005
More informationOral Health in Early Childhood Programs. Implementing 606 CMR 7.11(11)(d)
Oral Health in Early Childhood Programs Implementing 606 CMR 7.11(11)(d) Sponsored by: The Boston Public Health Commission s Office of Oral Health in partnership with childcare agencies. 2 Implementing
More informationTeeth to Treasure. Grades: 4 to 6
Teeth to Treasure Grades: 4 to 6 What is oral health? It s keeping your teeth, gums and mouth healthy! Why do you suppose this is important? Well, let s take a look at how we use and need our teeth. Appearance
More informationThe Detroit Dental Health Project. On behalf of community organizations, investigators, and staff
The Detroit Dental Health Project On behalf of community organizations, investigators, and staff 1 Question Why do some African-American children (
More informationU.S. Army Center for Health Promotion & Preventive Medicine
A Healthy Mouth for Your Baby U.S. Army Center for Health Promotion & Preventive Medicine Directorate of Health Promotion and Wellness Oral Fitness Program Aberdeen Proving Ground Maryland, 21010-5403
More informationPrimary Teeth are Important
Primary Teeth are Important Making the Connection Between Oral Health and School Success Presented by: Children Parents Early Childhood Educators Dental/Medical 1 Training Overview 2 Dental Decay in Infants
More informationDeveloped by: The Inter Tribal Council of Arizona, Inc. Dental Clinical and Prevention Support Center
Inter Tribal Council of Arizona, Inc. Dental Clinical and Prevention Support Center 2214 North Central Avenue, Suite 100 Phoenix, Arizona 85004 602-258-4822 602-258-4825 fax www.itcaonline.com Developed
More informationHealthy Smile Happy Child. Daniella DeMaré Healthy Smile Happy Child Project Coordinator (204)
Healthy Smile Happy Child Daniella DeMaré Healthy Smile Happy Child Project Coordinator ddemare@chrim.ca (204) 789-3500 What s on the Agenda? Early Childhood Caries (ECC) and Risk Factors: what every health
More informationOral Health: A component of the Patient Centered Medical home
Oral Health: A component of the Patient Centered Medical home Mark Deutchman MD University of Colorado Schools of Medicine, Dental Medicine and Public Health 1 Oral Health is a Fit for PCMH Patient centered
More informationMODULE 15: ORAL HEALTH ACROSS THE LIFESPAN
MODULE 15: ORAL HEALTH ACROSS THE LIFESPAN Oral Health Across the Lifespan MODULE 15: ORAL HEALTH ACROSS THE LIFESPAN Part 3: Oral Health in Childhood Erin Hartnett DNP, APRN-BC, CPNP Learning Objectives
More informationInfant and Toddler Oral Health
Infant and Toddler Oral Health Photo CD Decompressor are needed to use this picture Greater New York Dental Meeting December 1, 2002 Steven Chussid D.D.S. Timing of First Visit Guidelines of the American
More informationOral health education for caries prevention
Oral health education for caries prevention Objective Understand the fundamentals that inform oral health education programmes. Understand how to segment oral health information for preventive purposes
More informationBacterial Plaque and Its Relation to Dental Diseases. As a hygienist it is important to stress the importance of good oral hygiene and
Melissa Rudzinski Preventive Dentistry Shaunda Clark November 2013 Bacterial Plaque and Its Relation to Dental Diseases As a hygienist it is important to stress the importance of good oral hygiene and
More informationDental Health E-presentation.
Dental Health E-presentation www.healthycornwall.org.uk Learning Outcomes This short E-presentation has been developed to give you a basic understanding of the importance of good dental health and dental
More informationHealthy Smile Happy Child s New Lift the Lip Video
Healthy Smile Happy Child s New Lift the Lip Video Daniella DeMaré Project Coordinator Healthy Smile Happy Child Initiative Sandy Kostyniuk Program Consultant, Manitoba and Saskatchewan Region The Public
More informationThe Oral Health Status of Nebraska s Children Compared to the General U.S. Population
Nebraska Nebraska Department Oral of Health Survey & Human of Young Services Children Data Brief June 2017 The Oral Health Status of Nebraska s Children Compared to the General U.S. Population Head Start
More information1. The prevalence of tooth decay among Toronto children decreased each year from 2012 to 2014 and levelled off in 2015.
HEALTH SURVEILLANCE INDICATORS: CHILD ORAL HEALTH Public Health Relevance Good dental and oral health can contribute to a child's healthy physiological, psychological, and social development. Tooth decay,
More informationEarly Childhood Oral Health for MCH Professionals. Julia Richman, DDS, MSD, MPH
Early Childhood Oral Health for MCH Professionals Julia Richman, DDS, MSD, MPH Who are we? A. Medical care providers (ie MD, RN) B. Dental care providers C. Social services providers D. Other public health
More information2015 Pierce County Smile Survey. May An Oral Health Assessment of Children in Pierce County. Office of Assessment, Planning and Improvement
2015 Pierce County Smile Survey An Oral Health Assessment of Children in Pierce County May 2017 Office of Assessment, Planning and Improvement Table of Contents Tables... iii Figures... iv Executive Summary...
More informationEarly Childhood Caries The Newest Infectious Disease Epidemic in Native American Children. Steve Holve, MD IHS Consultant in Pediatrics
Early Childhood Caries The Newest Infectious Disease Epidemic in Native American Children Steve Holve, MD IHS Consultant in Pediatrics Bacterial Meningitis is a serious, preventable, infectious disease
More informationA Healthy Mouth for Your Baby
A Healthy Mouth for Your Baby U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health A Healthy Mouth for Your Baby Healthy teeth are important even baby teeth. Children need healthy
More informationPolyols: Sweet Oral Benefits
J. Int Oral Health 2011 Case Report All right reserved Polyols: Sweet Oral Benefits Joan Patton* Lyn O Brien Nabors *B.S, Manager, Nutrition Communications of the Calorie Control Council, B.S, President
More informationTaking Care of Your Teeth and Mouth
National Institute on Aging Taking Care of Your Teeth and Mouth Max is shocked. His dentist told him that he has a tooth that needs to come out. The 63-year-old had been sure he would keep his teeth forever.
More informationOral Care during Pregnancy
Published on: 22 Mar 2012 Oral Care during Pregnancy Introduction Pregnancy influences nearly every aspect of a woman's life, including the oral health. Diet and hormonal changes during pregnancy may increase
More informationOral Health Improvement. Prevention in Practice Vicky Brand
Oral Health Improvement Prevention in Practice Vicky Brand Quiz Question A B C The % of 5 yr olds in 05/06 in Greater Manchester who experienced tooth decay was just over Which of the following is more
More informationGood oral hygiene today
Dental essentials Good oral hygiene today Healthy teeth and gums for life You know, there s nothing like the fresh, clean feeling in your mouth after you ve brushed and flossed your teeth to make you feel
More informationLinking Research to Clinical Practice
Prevention of Root Caries Denise M. Bowen, RDH, MS Linking Research to Clinical Practice The purpose of Linking Research to Clinical Practice is to present evidence based information to clinical dental
More informationCARIES RISK ASSESSMENT FORM FOR AGE 0 TO 5 YEARS Instructions on reverse Patient Name: I.D. # Age Date Initial/baseline exam date Recall/POE date
CARIES RISK ASSESSMENT FORM FOR AGE 0 TO 5 YEARS Instructions on reverse Patient Name: I.D. # Age Date Initial/baseline exam date Recall/POE date Respond to each question in sections 1, 2, and 3 with a
More informationBest Practices in Oral Health for Older Adults -How to Keep My Bite in My Life!
Best Practices in Oral Health for Older Adults -How to Keep My Bite in My Life! Mr. has most of his natural teeth. Mr. JB Age 78. In for rehab from stroke; will return home. Non-dominant hand/arm paralyzed.
More informationJournal of American Science 2017;13(9) Xylitol in Chewing Gums. Hani Nassar
Xylitol in Chewing Gums Hani Nassar Department of Restorative Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia hnassar@kau.edu.sa Abstract: Xylitol is a naturally
More informationRestorative treatment The history of dental caries management consisted of many restorations placed as well as many teeth removed and prosthetic
Restorative treatment The history of dental caries management consisted of many restorations placed as well as many teeth removed and prosthetic replacements provided. Paradigm shift towards a medical
More informationDental Health in Child Care
Healthy Practices: Nutrition and Fitness 1 Child care providers can help promote young children's dental health by teaching good dental habits. Here are some general tips for child care providers to help
More informationSeniors Oral Care
For information about oral health care, please contact the Ontario Dental Association at 416-922-3900 or visit www.youroralhealth.ca The Ontario Dental Association gratefully acknowledges UBC ELDERS Education,
More informationDiet and dental caries
Prevention-- 5 th class Lect 1 1 Diet and dental caries The role diet and nutrition in the etiology and pathogenesis of caries may be viewed as systemic (nutrition) and local effect (diet) In general,
More informationA Healthy Mouth for Your Baby
A Healthy Mouth for Your Baby U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health A Healthy Mouth for Your Baby Healthy teeth are important even baby teeth. Children need healthy
More informationBuilding a Community Dental Health Network 75% Cavity Free 5 Year Olds by 2020 UCSF DPH 175-February 28,2017
Building a Community Dental Health Network 75% Cavity Free 5 Year Olds by 2020 UCSF DPH 175-February 28,2017 Kim Caldewey, PA, MPH Dental Health Program Manger Dental Health: A Public Health Approach California
More informationOverview: The health care provider explores the health behaviors and preventive measures that enhance children s oral health.
Lesson 5: Prevention Overview: The health care provider explores the health behaviors and preventive measures that enhance children s oral health. Goals: The health care provider will be able to describe:
More informationContemporary Policy Implications to Control and Prevent Dental Caries. Policies are formed to achieve outcomes? Are outcomes being achieved?
Contemporary Policy Implications to Control and Prevent Dental Caries Policies are formed to achieve outcomes? Are outcomes being achieved? 2 3 4 Temple University School of Dentistry s Mission is the
More informationIntegrating Oral Health into Primary Care Francis E Rushton, MD, FAAP Medical Director SC QTIP
Integrating Oral Health into Primary Care Francis E Rushton, MD, FAAP Medical Director SC QTIP Introduction and Acknowledgements This oral health integration training was developed for MORE Care. It was
More informationPENNSYLVANIA ORAL HEALTH COLLECTIVE IMPACT INITIATIVE
PENNSYLVANIA ORAL HEALTH COLLECTIVE IMPACT INITIATIVE PA Chapter American Academy of Pediatrics An Initiative supported by the Pennsylvania Head Start Association Your Hosts Lisa Schildhorn, MS Executive
More informationA Healthy Mouth for Your Baby
A Healthy Mouth for Your Baby U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental and Craniofacial Research Before your baby is born What you eat when
More informationMargherita Fontana, DDS, PhD. University of Michigan School of Dentistry Department of Cariology, Restorative Sciences and Endodontics
Margherita Fontana, DDS, PhD University of Michigan School of Dentistry Department of Cariology, Restorative Sciences and Endodontics Personalized Caries Management If evidence is limited, what can be
More informationFrequently Asked Questions. About Community Water Fluoridation. Overview. 1-What is fluoride?
Frequently Asked Questions About Community Water Fluoridation Overview 1-What is fluoride? Fluoride is a naturally occurring mineral that protects teeth from tooth decay. 2-Why is fluoride added to water
More informationLoloz With Cavibloc Scientific Literature Review October 2016
Loloz With Cavibloc Scientific Literature Review October 2016 Loloz brand of lollipops and lozenges is the result of 7 years of research by a team of microbiologists at the UCLA School of Dentistry. The
More informationA Lifetime of Healthy Happy Teeth! Grades: 2 & 3
A Lifetime of Healthy Happy Teeth! Grades: 2 & 3 Why do we need our teeth? Eating! To chew our food. That s an easy one! Can you imagine trying to eat an apple, carrot or a hamburger without teeth? It
More informationUtilizing Fluoride Varnish through Women, Infants, and Children (WIC) program
Utilizing Fluoride Varnish through Women, Infants, and Children (WIC) program Oral Health Florida Conference Palm Beach Gardens, FL August 4 th, 2009 Champions For Early Intervention Healthy People 2010
More informationRisk Assessment. Full Summary. Description and Use:
Risk Assessment Full Summary Description and Use: Risk assessment is a strategy for improving the efficiency and effectiveness of prevention procedures and programs. Risk assessment protocols that are
More informationMassachusetts Head Start Oral Health Initiative and 2004 Head Start Oral Health Survey
Massachusetts Head Start Oral Health Initiative and 2004 Head Start Oral Health Survey Preface Oral health is an integral component to overall health and well being, Surgeon General David Satcher in the
More informationSF HIP ~ San Francisco Children s Oral Health. Strategic Plan
SF HIP ~ San Francisco Children s Oral Health Strategic Plan 2014-2017 Tooth decay affects overall health and development Speech and communication Eating and dietary nutrition Sleeping Learning Playing
More informationGood Oral Health: The Path to Good Overall Health
Good Oral Health: The Path to Good Overall Health Leading Age Spring Conference May 2, 2018 Carole Ferch, RDH Carol Van Aernam, RDH, BA Copyright 2018 IOWA CAREGIVERS All Rights Reserved Multi-stakeholder
More informationHELPING YOUR CLIENTS MAKE HEALTHY CHOICES: SUGAR
HELPING YOUR CLIENTS MAKE HEALTHY CHOICES: SUGAR Thursday, April 13, 2017 Presented by: Pam McFarlane (MDA) and Amanda Nash, RD (HSF) Outline About the Heart and Stroke and MDA Oral Health and Dental Care
More informationNutrition and Oral Health
Nutrition and Oral Health Ellen Karlin Disclosure Statement Ellen Karlin MMSc, RD, LDN, FADA Nutrition Consultant Comprehensive Asthma and Allergy Center Neither I nor my immediate family has any financial
More informationOral Health Education Resources
Page 1 of 14 Education Prevention Access to Care Oral Health Assessment Dental Public Health Residency Program Dental Health Careers Oral Health Education Resources Please Read: The following oral health
More informationOral Health. Early years
Oral Health in Barnsley Early years Barnsley Oral Health Promotion Team - Oral Health Improvement Practitioner, Barnsley Community Dental Promotion Service, Rotherham NHS Foundation Trust Aim and Objectives
More informationIt s all about dental health
It s all about dental health 01 June 2006 1. What do we mean by dental health? Dental health refers to all aspects of the health and functioning of our mouth especially the teeth and gums. Apart from working
More informationKnowledge, Attitude and Practice about Oral Health among General Population of Peshawar
SHORT COMMUNICATION Knowledge, Attitude and Practice about Oral Health among General Population of Peshawar Farzeen Khan, Aisha Ayub 3 and Zeeshan Kibria 1 ABSTRACT To determine the level of knowledge
More information