National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (6)
- Adverse Drug Events (ADE) (1)
- Adverse Events (3)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Children/Adolescents (8)
- Community-Based Practice (1)
- Comparative Effectiveness (1)
- (-) Dental and Oral Health (24)
- Disparities (2)
- Elderly (4)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
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- Healthcare Utilization (2)
- Health Insurance (4)
- Health Literacy (1)
- Health Services Research (HSR) (1)
- Long-Term Care (2)
- Low-Income (1)
- Medicaid (6)
- Medical Errors (2)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medication (4)
- Medication: Safety (1)
- Neurological Disorders (1)
- Nursing Homes (3)
- Obesity (1)
- Opioids (3)
- Outcomes (1)
- Patient Adherence/Compliance (1)
- Patient Safety (4)
- Pneumonia (1)
- Policy (1)
- Practice Patterns (3)
- Prevention (4)
- Provider (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Screening (1)
- Sleep Problems (1)
- Surveys on Patient Safety Culture (1)
- Trauma (1)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 24 of 24 Research Studies DisplayedChou R, Pappas M, Dana T
Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this evidence review was to update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF. Findings showed no direct evidence on benefits and harms of primary care oral health screening or referral to dentist, while dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.
AHRQ-funded; 290201500009I.
Citation: Chou R, Pappas M, Dana T .
Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Dec 7;326(21):2179-92. doi: 10.1001/jama.2021.15658..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Dental and Oral Health, Screening, Evidence-Based Practice, Guidelines, Prevention
Tokede O, Walji M, Ramoni R
Quantifying dental office-originating adverse events: the dental practice study methods.
Investigators initiated the Dental Practice Study (DPS) with the goal of determining the frequency and types of adverse events (AEs) that occur in dentistry on the basis of retrospective chart audit. In this article, they discussed the 6-month pilot phase of the DPS during which they explored the feasibility and efficiency of their multi-staged review process to detect AEs.
Citation: Tokede O, Walji M, Ramoni R .
Quantifying dental office-originating adverse events: the dental practice study methods.
J Patient Saf 2021 Dec 1;17(8):e1080-e87. doi: 10.1097/pts.0000000000000444..
Keywords: Dental and Oral Health, Adverse Events, Patient Safety, Medical Errors
Lipton BJ, Finlayson TL
AHRQ Author: Decker SL
The association between Medicaid adult dental coverage and children's oral health.
This study examined the association of Medicaid adult dental coverage and children’s oral health as Medicaid-eligible children are more likely to experience tooth decay than children in higher-income families. Data from the 1996-2016 National Health and Nutrition Examination Survey and the 2003, 2007, and 2011-12 waves of the National Survey of Children’s Health was used. Adult dental coverage was associated with a 5-percentage-point reduction in the prevalence of untreated caries among children after Medicaid-enrolled adults had access to dental coverage for at least one year. Children under twelve years of age were the most affected.
AHRQ-authored.
Citation: Lipton BJ, Finlayson TL .
The association between Medicaid adult dental coverage and children's oral health.
Health Aff 2021 Nov;40(11):1731-39. doi: 10.1377/hlthaff.2021.01135..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Access to Care
Wang ML, Minyé HM, Egan KA
Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.
The purpose of this study was to assess the efficacy of a community-based childhood obesity prevention intervention targeting sugar-sweetened beverage (SSB) consumption on self-rated oral health among children and their parents/caregivers. The investigators found that short-term improvements in oral health among children and their parents/caregivers were observed among those participating in a SSB behavioural intervention.
AHRQ-funded; HS022242.
Citation: Wang ML, Minyé HM, Egan KA .
Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.
Community Dent Oral Epidemiol 2021 Aug;49(4):362-68. doi: 10.1111/cdoe.12610..
Keywords: Children/Adolescents, Obesity, Dental and Oral Health, Prevention
Xu L, Xie D, Griffin KS
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
Although mandibular advancement device (MAD) treatment of adults with obstructive sleep apnea (OSA) is generally less efficacious than positive airway pressure (PAP), the two treatments are associated, with similar clinical outcomes. As a sub-analysis of a randomized trial comparing the effect of MAD versus PAP on blood pressure, this study compared objectively measured adherence to MAD versus PAP treatment in adults with OSA.
AHRQ-funded; HS019738.
Citation: Xu L, Xie D, Griffin KS .
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
J Sleep Res 2021 Aug;30(4):e13240. doi: 10.1111/jsr.13240..
Keywords: Sleep Problems, Patient Adherence/Compliance, Treatments, Dental and Oral Health, Respiratory Conditions
Teoh L, Thompson W, Hubbard CC
Comparison of dental benzodiazepine prescriptions from the U.S., England, and Australia from 2013 to 2018.
Benzodiazepines contribute to substance use disorder and are often part of polydrug abuse, most frequently with opioids. Although dental opioid prescribing differs significantly between countries, little is known about the patterns of dental benzodiazepine prescribing. The aim of this study was to compare dental prescribing of benzodiazepines among the U.S., England, and Australia in 2013-2018.
AHRQ-funded; HS025177.
Citation: Teoh L, Thompson W, Hubbard CC .
Comparison of dental benzodiazepine prescriptions from the U.S., England, and Australia from 2013 to 2018.
Am J Prev Med 2021 Jul;61(1):73-79. doi: 10.1016/j.amepre.2021.01.025..
Keywords: Opioids, Medication, Practice Patterns, Dental and Oral Health
Azadani EN, Townsend J, Peng J
The association between traumatic dental and brain injuries in American children.
This study examined the association between dento-alveolar trauma (DAT) and traumatic brain injuries (TBIs) among children ages 0-18 years. The Nationwide Emergency Department Sample (NEDS), an HCUP dataset, was analyzed using ICD-9-CM codes for the 2010-2014 NEDS data. Out of 6,281,658 emergency department (ED) visits, DAT was recorded in 93,408 (1.5%) visits and TBI was recorded in 996,334 (15.9%) visits. Of the DAT-positive encounters, 7.5% had codes associated with TBI. Patients with DAT had 0.20 odds of having TBI compared with patients who did not DAT when all confounding variables were kept constant. Multiple injuries, being involved in motor vehicle crashes, and injuries due to assault were associated with higher odds of concomitant TBI in patients who sustained DAT.
AHRQ-funded; HS24263.
Citation: Azadani EN, Townsend J, Peng J .
The association between traumatic dental and brain injuries in American children.
Dent Traumatol 2021 Feb;37(1):114-22. doi: 10.1111/edt.12611..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Trauma, Neurological Disorders, Dental and Oral Health
Gross AE, Suda KJ, Zhou J
Serious antibiotic-related adverse effects following unnecessary dental prophylaxis in the United States.
The majority of antibiotics prescribed before a dental visit are considered unnecessary (80.9%). This study characterized adverse effects related to unnecessary dental prophylaxis. This retrospective cohort study used data from dental visits between 2011 and 2015 from the IBM Watson Health Marketscan Commercial Claims/Encounters, Medicare Supplemental, Coordination of Benefits Research databases. Antibiotics prescribed included amoxicillin (67.9%), clindamycin (15.5%), cephalexin (8.6%), azithromycin (2.8%), and penicillin (1.5). Antibiotic adverse effects (AAEs) were found in 1.4% of unnecessary prescriptions. The most common AAEs were emergency department (ED) visits, allergic reactions, 14 cases of C. difficile infection, and 5 anaphylactic reactions. AAEs were more common with clindamycin than amoxicillin.
AHRQ-funded; HS025177.
Citation: Gross AE, Suda KJ, Zhou J .
Serious antibiotic-related adverse effects following unnecessary dental prophylaxis in the United States.
Infect Control Hosp Epidemiol 2021 Jan;42(1):110-12. doi: 10.1017/ice.2020.1261..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Dental and Oral Health, Adverse Drug Events (ADE), Adverse Events
Yansane A, Lee JH, Hebballi N
Assessing the patient safety culture in dentistry.
Medical errors are among the leading causes of death within the United States. Studies have shown that patients can be harmed while receiving care, sometimes resulting in permanent injury or, in extreme cases, death. To reduce the risk of patient safety incidents, it is imperative that a robust culture of safety be established. The primary objective of this study was to evaluate the patient safety culture among providers at 4 US dental institutions, comparing the results with their medical counterparts in 2016.
AHRQ-funded; HS024406.
Citation: Yansane A, Lee JH, Hebballi N .
Assessing the patient safety culture in dentistry.
JDR Clin Trans Res 2020 Oct;5(4):399-408. doi: 10.1177/2380084419897614..
Keywords: Surveys on Patient Safety Culture, Patient Safety, Dental and Oral Health, Provider, Medical Errors, Adverse Events
Khouja T, Burgette JM, Donohue JM
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Researchers examined whether low-income children's use of preventive dental services is linked to variation in state Medicaid policies that affect parents' access to dental care in Medicaid. Using MEPS data along with Area Health Resources File and Medicaid adult dental coverage policies, they found no change in children's receipt of preventive dental care associated with Medicaid expansions in states that covered vs did not cover preventive dental services for adults. They concluded that factors other than parental access to dental benefits through Medicaid may be more salient determinants of preventive dental care use among low-income children.
AHRQ-funded; HS026727.
Citation: Khouja T, Burgette JM, Donohue JM .
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Health Serv Res 2020 Oct;55(5):642-50. doi: 10.1111/1475-6773.13324..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Low-Income, Access to Care, Policy
Bevans KB, Moon J, Becker BD
Development of patient-reported outcome measures of children's oral health aesthetics.
The authors sought to develop and evaluate the psychometric properties of child- and parent-proxy measures of oral health aesthetics. Items that describe children's perceptions of their oral attractiveness and its impact on social, emotional, and behavioral functioning were developed based on a systematic review of existing measures, clinician feedback, and child semi-structured interviews. The authors found that the oral health aesthetic item banks and short forms provided precise and valid assessments of children's satisfaction with their oral appearance and may be useful for targeting and evaluating pediatric dental and orthodontic care in clinical practice and research settings.
AHRQ-funded; HS020508.
Citation: Bevans KB, Moon J, Becker BD .
Development of patient-reported outcome measures of children's oral health aesthetics.
Community Dent Oral Epidemiol 2020 Oct;48(5):423-32. doi: 10.1111/cdoe.12555..
Keywords: Children/Adolescents, Dental and Oral Health, Quality of Life
Zhou J, Calip GS, Rowan S
Potentially inappropriate medication combination with opioids among older dental patients: a retrospective review of insurance claims data.
Opioid prescribing by dentists for older patients receiving medications with potential contraindications and the subsequent impact on acute care outcomes is not well described. The objective of this paper was to evaluate the use of potentially inappropriate medication combinations (PIMCs) involving opioids prescribed by dentists according to the Beers Criteria and risks of 30-day emergency department (ED) visits and all-cause hospitalization among commercially insured dental patients ages 65 years and older.
AHRQ-funded; HS025177.
Citation: Zhou J, Calip GS, Rowan S .
Potentially inappropriate medication combination with opioids among older dental patients: a retrospective review of insurance claims data.
Pharmacotherapy 2020 Oct;40(10):992-1001. doi: 10.1002/phar.2452..
Keywords: Elderly, Opioids, Dental and Oral Health, Medication: Safety, Medication, Practice Patterns
Wretman CJ, Zimmerman S, Ward K
Measuring self-efficacy and attitudes for providing mouth care in nursing homes.
Mouth care is increasingly recognized as an important component of care in nursing homes (NHs) yet is known to be deficient. To promote quality improvement and inform research efforts, it is necessary to have valid measures of staff self-efficacy and attitudes to provide mouth care. The purpose of this study was to measure self-efficacy and attitudes for providing mouth care in nursing homes.
AHRQ-funded; HS022298.
Citation: Wretman CJ, Zimmerman S, Ward K .
Measuring self-efficacy and attitudes for providing mouth care in nursing homes.
J Am Med Dir Assoc 2020 Sep;21(9):1316-21. doi: 10.1016/j.jamda.2020.02.007..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dental and Oral Health
Zimmerman S, Sloane PD, Ward K
Effectiveness of a mouth care program provided by nursing home staff vs standard care on reducing pneumonia incidence: a cluster randomized trial.
Pneumonia affects more than 250 000 nursing home (NH) residents annually. A strategy to reduce pneumonia is to provide daily mouth care, especially to residents with dementia. The objective of this study was to evaluate the effectiveness of Mouth Care Without a Battle, a program that increases staff knowledge and attitudes regarding oral hygiene, changes mouth care, and improves oral hygiene, in reducing the incidence of pneumonia among NH residents.
AHRQ-funded; HS022298.
Citation: Zimmerman S, Sloane PD, Ward K .
Effectiveness of a mouth care program provided by nursing home staff vs standard care on reducing pneumonia incidence: a cluster randomized trial.
JAMA Netw Open 2020 Jun;3(6):e204321. doi: 10.1001/jamanetworkopen.2020.4321..
Keywords: Pneumonia, Nursing Homes, Long-Term Care, Dental and Oral Health, Prevention, Patient Safety
Suda KJ, Zhou J, Rowan SA
Overprescribing of opioids to adults by dentists in the U.S., 2011-2015.
Dentists prescribe 1 in 10 opioid prescriptions in the U.S. When opioids are necessary, national guidelines recommend the prescription of low-dose opioids for a short duration. This study assessed the appropriate prescribing of opioids by dentists before guideline implementation. The investigators concluded that between 1 in 4 and 1 in 2 opioids prescribed to adult dental patients are overprescribed.
AHRQ-funded; HS025177.
Citation: Suda KJ, Zhou J, Rowan SA .
Overprescribing of opioids to adults by dentists in the U.S., 2011-2015.
Am J Prev Med 2020 Apr;58(4):473-86. doi: 10.1016/j.amepre.2019.11.006..
Keywords: Opioids, Dental and Oral Health, Provider, Practice Patterns, Medication
Decker SL, Lipton BJ
AHRQ Author: Decker SL
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Its findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
J Health Econ 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009.
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Keywords: Access to Care, Dental and Oral Health, Health Insurance, Healthcare Utilization, Medicaid, Outcomes
Fingar KR, Smith MW, Davies S
AHRQ Author: Stocks C
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
This study examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine States in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. It found that county-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for.
AHRQ-authored; AHRQ-funded; 290201200003I; HS021700.
Citation: Fingar KR, Smith MW, Davies S .
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
Health Aff 2015 Aug;34(8):1349-57. doi: 10.1377/hlthaff.2015.0223..
Keywords: Dental and Oral Health, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Medicaid
Malecki K, Wisk LE, Walsh M
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
The authors explored individual-, psychosocial-, and community-level predictors of oral health status in the Survey of the Health of Wisconsin Oral Health Screening project. Their results suggested that costs were a primary predictor of access to care and poor oral health status, underscoring the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers and promoting preventive health behaviors.
AHRQ-funded; HS000063.
Citation: Malecki K, Wisk LE, Walsh M .
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
Am J Public Health 2015 Jul;105 Suppl 3:S466-74. doi: 10.2105/ajph.2014.302338.
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Keywords: Access to Care, Dental and Oral Health, Disparities, Healthcare Costs, Health Services Research (HSR)
Horner-Johnson W, Dobbertin K, Beilstein-Wedel E
Disparities in dental care associated with disability and race and ethnicity.
The purpose of this study was to determine how the combination of disability and race and ethnicity is associated with dental examinations, delays in receiving needed care, and inability to obtain needed care among noninstitutionalized working-age adults in the United States. It found that, compared with non-Hispanic whites, other racial and ethnic groups were less likely to receive annual dental examinations.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K, Beilstein-Wedel E .
Disparities in dental care associated with disability and race and ethnicity.
J Am Dent Assoc 2015 Jun;146(6):366-74. doi: 10.1016/j.adaj.2015.01.024..
Keywords: Racial and Ethnic Minorities, Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Disparities
Dumas SA, Polk D
Pediatric dental clinic location and utilization in a high-resource setting.
This study examined dental utilization by Medicaid-insured children living in a high-resource area and characterized distance and travel-related variables to accessing care. It concluded that closer proximity may contribute to the higher utilization of services observed compared with national rates.
AHRQ-funded; HS019486.
Citation: Dumas SA, Polk D .
Pediatric dental clinic location and utilization in a high-resource setting.
J Public Health Dent 2015 Summer;75(3):183-90. doi: 10.1111/jphd.12086.
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Keywords: Children/Adolescents, Healthcare Utilization, Dental and Oral Health, Access to Care, Medicaid
Mody L
Preventing aspiration pneumonia in high-risk nursing home residents: role of chlorhexidine-based oral care questioned again.
This commentary discusses a study by Juthani-Mehta et al in this issue of Clinical Infectious Diseases that adds more steam to the ongoing controversy of the value of chlorhexidine-based oral care by challenging an earlier study. That study found that the odds of dying from pneumonia in those who did not receive oral care was >3 times that of the group receiving oral care. By contrast, the Juthani-Mehta et al study finds no benefit to chlorhexidine use.
AHRQ-funded; HS019979.
Citation: Mody L .
Preventing aspiration pneumonia in high-risk nursing home residents: role of chlorhexidine-based oral care questioned again.
Clin Infect Dis 2015 Mar 15;60(6):858-9. doi: 10.1093/cid/ciu941..
Keywords: Nursing Homes, Dental and Oral Health, Elderly, Patient Safety
Manski RJ, Moeller JF, Chen H
AHRQ Author: Manski RJ
Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.
The purpose of this paper is to empirically determine if insurance alone would close the current gaps in dental use and expenditures between insured and uninsured older Americans. Comparing simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured, the authors found that it would close previous gaps in use and expense.
AHRQ-authored.
Citation: Manski RJ, Moeller JF, Chen H .
Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.
Health Serv Res. 2015 Feb;50(1):117-35. doi: 10.1111/1475-6773.12205..
Keywords: Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Health Insurance, Elderly, Healthcare Costs
Smith W, Brach C, Horowitz AM
AHRQ Author: Brach C
Poor oral health literacy: why nobody understands you.
The authors examined the mistaken interpretation of the word “individuals” to be limited almost exclusively to citizens and patients. They identified gaps in knowledge, understanding, and practices regarding caries prevention among the public and all provider groups.
AHRQ-authored.
Citation: Smith W, Brach C, Horowitz AM .
Poor oral health literacy: why nobody understands you.
J Dent Hyg 2015 Feb;89 Suppl 1:36-8.
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Keywords: Dental and Oral Health, Health Literacy, Prevention
Kranz AM, Rozier RG, Preisser JS
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
To understand continuity of oral health services for Medicaid-enrolled children utilizing the North Carolina (NC) Into the Mouths of Babes (IMB) preventive oral health program, the researchers examined the time to a dentist visit after a child’s third birthday. They found that children with only IMB visits compared to only dentist visits before age 3 had lower rates of dentist visits after their third birthday.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
Matern Child Health J 2015 Jan;19(1):196-203. doi: 10.1007/s10995-014-1510-3..
Keywords: Access to Care, Children/Adolescents, Community-Based Practice, Dental and Oral Health, Medicaid