National Healthcare Quality and Disparities Report
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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
26 to 50 of 66 Research Studies DisplayedBevans 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
Shenkman E, Tomar S, Manning D
Feasibility and usability of measuring receipt of sealants in 2 states.
In this study, the authors examined the reliability and validity of the Dental Quality Alliance childhood sealant measure under actual use conditions in Texas and Florida. The 2 states provide care for almost 20% of children in Medicaid nationally. They proposed eliminating the caries risk assessment requirement and incorporating a 3-year look-back period to identify already sealed, missing, or restored molars.
AHRQ-funded; U18 HS025298.
Citation: Shenkman E, Tomar S, Manning D .
Feasibility and usability of measuring receipt of sealants in 2 states.
J Am Dent Assoc 2019 Oct;150(10):839-45. doi: 10.1016/j.adaj.2019.05.022..
Keywords: Dental and Oral Health, Children/Adolescents, Quality Measures, Quality of Care
Meyerhoefer CD, Zuvekas SH, Farkhad BF
AHRQ Author: Zuvekas SH
The demand for preventive and restorative dental services among older adults.
This study examined the use of preventive and restorative dental services among older adults. Traditional Medicare does not have dental benefits, and older adults must either be employed, have post-retirement dental benefits or spousal coverage, or enroll in a Medicare Advantage program that includes dental coverage. The authors used 2007-2015 Medical Expenditure Panel Survey and supplemental data on dental care prices to estimate the demand for dental care. Dental service was not sensitive to out-of-pocket prices. Older adults with private dental insurance increased preventive service by 25%, and dental coverage through Medicaid increased basic and major service use by 23% and 36%. Women used dental insurance more than men.
AHRQ-authored.
Citation: Meyerhoefer CD, Zuvekas SH, Farkhad BF .
The demand for preventive and restorative dental services among older adults.
Health Econ 2019 Sep;28(9):1151-58. doi: 10.1002/hec.3921..
Keywords: Medical Expenditure Panel Survey (MEPS), Elderly, Dental and Oral Health, Medicare, Health Insurance, Access to Care
Suda KJ, Calip GS, Zhou J
Assessment of the appropriateness of antibiotic prescriptions for infection prophylaxis before dental procedures, 2011 to 2015.
This retrospective cohort study examined the use of antibiotic prophylaxis prescribed before dental procedures with patients who have commercial dental insurance. Data from the Truven insurance network was used for claims from 2009 to 2015. Patients in the study were given an antibiotic prescription 7 days before a dental visit. These patients have an appropriate cardiac diagnosis and the median age was 63 and majority female. The majority of dental visits were classified as diagnostic (70.2%) or and/or preventive (58.8%). There were prevalent comorbidities in some patients including prosthetic joint devices (42.5%) and cardiac conditions at higher risk of adverse outcome from infections (20.9%). It was found that 80.9% of antibiotic prescriptions were deemed to be unnecessary based on guidelines.
AHRQ-funded; HS025177.
Citation: Suda KJ, Calip GS, Zhou J .
Assessment of the appropriateness of antibiotic prescriptions for infection prophylaxis before dental procedures, 2011 to 2015.
JAMA Netw Open 2019 May 3;2(5):e193909. doi: 10.1001/jamanetworkopen.2019.3909..
Keywords: Decision Making, Dental and Oral Health, Medication, Practice Patterns, Prevention
Suda KJ, Durkin MJ, Calip GS
Comparison of opioid prescribing by dentists in the United States and England.
The goal of this cross-sectional study was to compare opioid prescribing rates by dentists in the US and England, using data on prescriptions dispensed from outpatient pharmacies and health care settings in 2016 by dentists in both countries. Findings show that the proportion of prescriptions for opioids written by US dentists was 37 times greater than the proportion written by English dentists. US dentists also had a higher number of opioid prescriptions per 1000 population and number of prescriptions per dentist. Dihydrocodeine was the only opioid prescribed by English dentists, while US dentists prescribed a range of opioids containing hydrocodone, codeine, oxycodone, and tramadol, as well as long-acting opioids. The researchers conclude that US dentists adopt measures similar to those used in England to reduce dental opioid prescribing in the United States.
AHRQ-funded; HS025177.
Citation: Suda KJ, Durkin MJ, Calip GS .
Comparison of opioid prescribing by dentists in the United States and England.
JAMA Netw Open 2019 May 3;2(5):e194303. doi: 10.1001/jamanetworkopen.2019.4303..
Keywords: Dental and Oral Health, Medication, Opioids, Pain, Practice Patterns, Provider
Gross AE, Hanna D, Rowan SA
Successful implementation of an antibiotic stewardship program in an academic dental practice.
Researchers created a comprehensive antibiotic stewardship program (ASP) for dental practices. A baseline needs assessment and literature evaluation was conducted by a team of dentists, pharmacists, and physician leaders. An academic dental center in Illinois that is the state’s largest oral health provider for Medicaid recipients was used. After intervention with the ASP, there was a 72.9% decrease in antibiotic prescribing for urgent care visits.
AHRQ-funded; HS025177.
Citation: Gross AE, Hanna D, Rowan SA .
Successful implementation of an antibiotic stewardship program in an academic dental practice.
Open Forum Infect Dis 2019 Mar;6(3):ofz067. doi: 10.1093/ofid/ofz067..
Keywords: Antibiotics, Antimicrobial Stewardship, Dental and Oral Health, Medication, Patient Safety
Abdus S, Decker SL
AHRQ Author: Abdus S, Decker SL
Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures.
AHRQ researchers compared nonemergency dental services use in states with and without Medicaid adult nonemergency dental benefits. Dental use increased in states with the Medicaid dental benefit. Out-of-pocket expenses decreased approximately 19 percent in covered states.
AHRQ-authored.
Citation: Abdus S, Decker SL .
Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures.
J Am Dent Assoc 2019 Jan;150(1):24-33. doi: 10.1016/j.adaj.2018.08.010..
Keywords: Dental and Oral Health, Healthcare Costs, Healthcare Utilization, Medicaid, Medical Expenditure Panel Survey (MEPS)
Burgette JM, Preisser JS, Rozier RG
Access to preventive services after the integration of oral health care into early childhood education and medical care.
The authors compared children enrolled in North Carolina Early Head Start (EHS) programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Rozier RG .
Access to preventive services after the integration of oral health care into early childhood education and medical care.
J Am Dent Assoc 2018 Dec;149(12):1024-31.e2. doi: 10.1016/j.adaj.2018.07.019..
Keywords: Access to Care, Children/Adolescents, Dental and Oral Health, Health Services Research (HSR), Medicaid, Patient-Centered Healthcare, Prevention
Weintraub JA, Zimmerman S, Ward K
Improving nursing home residents' oral hygiene: results of a cluster randomized intervention trial.
This paper describes a 2-year cluster randomized trial of Mouth Care Without a Battle (MCWB) that was conducted in nursing homes (NHs) to determine if recommended mouth care practices provided by NH staff could improve residents' oral hygiene and denture outcomes. The investigators found that training NH staff to attend to residents' oral hygiene and denture care had a sustained, favorable impact on residents' oral and denture hygiene after 24 months compared with usual care.
AHRQ-funded; HS022298.
Citation: Weintraub JA, Zimmerman S, Ward K .
Improving nursing home residents' oral hygiene: results of a cluster randomized intervention trial.
J Am Med Dir Assoc 2018 Dec;19(12):1086-91. doi: 10.1016/j.jamda.2018.09.036.
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Keywords: Dental and Oral Health, Elderly, Nursing Homes
Yoon S, Odlum M, Lee Y
Applying deep learning to understand predictors of tooth mobility among urban Latinos.
In this study, the investigators applied deep learning algorithms to build correlate models that predicted tooth mobility in a convenience sample of urban Latinos. The authors suggest that their application was useful for gaining insights into the most important modifiable and non-modifiable factors predicting tooth mobility, and maybe useful for guiding targeted interventions in urban Latinos.
AHRQ-funded; HS019853.
Citation: Yoon S, Odlum M, Lee Y .
Applying deep learning to understand predictors of tooth mobility among urban Latinos.
Stud Health Technol Inform 2018;251:241-44..
Keywords: Dental and Oral Health, Elderly, Racial and Ethnic Minorities, Urban Health
Yoon S, Choi T, Odlum M
Machine learning to identify behavioral determinants of oral health in inner city older Hispanic adults.
In this study, the investigators applied machine learning techniques to a community-based behavioral dataset to build prediction models to gain insights about minority dental health and population aging as the foundation for future interventions for urban Hispanics. Their application of machine learning techniques identified emotional and systemic factors such as chronic stress and health literacy as the strongest predictors of self-reported dental health among hundreds of possible variables.
AHRQ-funded; HS019853.
Citation: Yoon S, Choi T, Odlum M .
Machine learning to identify behavioral determinants of oral health in inner city older Hispanic adults.
Stud Health Technol Inform 2018;251:253-56..
Keywords: Dental and Oral Health, Elderly, Racial and Ethnic Minorities, Urban Health
Burgette JM, Preisser JS, Weinberger M
Absence of a moderating effect of parent health literacy on Early Head Start enrollment and dental use.
The purpose of the study was to examine the moderating effect of parents' health literacy (HL) on the effectiveness of North Carolina Early Head Start (EHS) in improving children's dental use. The investigators found that parents in EHS had a higher prevalence of low HL compared to non-EHS parents. Parents' HL did not moderate the relationship between EHS and child dental use, suggesting that EHS results in similar improvements in dental use regardless of parent's HL levels.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Weinberger M .
Absence of a moderating effect of parent health literacy on Early Head Start enrollment and dental use.
J Public Health Dent 2018 Jun;78(3):257-65. doi: 10.1111/jphd.12269..
Keywords: Caregiving, Children/Adolescents, Dental and Oral Health, Health Literacy
Burgette JM, Preisser JS, Weinberger M
Early head start, pediatric dental use, and oral health-related quality of life.
The objective of the study was to examine the mediating effect of child dental use on the effectiveness of North Carolina Early Head Start (EHS) in improving oral health-related quality of life (OHRQoL). It concluded that EHS increases child dental use, which worsens family OHRQoL. However, EHS is associated with improved OHRQoL overall.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Weinberger M .
Early head start, pediatric dental use, and oral health-related quality of life.
JDR Clin Trans Res 2017 Oct;2(4):353-62. doi: 10.1177/2380084417709758.
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Keywords: Children/Adolescents, Dental and Oral Health, Quality of Life, Children/Adolescents
Burgette JM, Preisser JS, Weinberger M
Enrollment in early head start and oral health-related quality of life.
Researchers examined the effect of enrollment in North Carolina Early Head Start (EHS) - a federally funded early education program for children under three years of age and their families - on oral health-related quality of life (OHRQoL). Their study is the first to demonstrate that families of young children enrolled in EHS report improved OHRQoL compared to their non-enrolled peers.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Weinberger M .
Enrollment in early head start and oral health-related quality of life.
Qual Life Res 2017 Oct;26(10):2607-18. doi: 10.1007/s11136-017-1584-7.
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Keywords: Children/Adolescents, Dental and Oral Health, Quality of Life
Burgette JM, Preisser JS, Jr., Weinberger M
Impact of early head start in North Carolina on dental care use among children younger than 3 years.
The researchers examined the effects of North Carolina Early Head Start (EHS), an early education program for low-income children younger than 3 years and their families, on dental care use among children. They concluded that EHS participation increases dental care use among disadvantaged young children.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Jr., Weinberger M .
Impact of early head start in North Carolina on dental care use among children younger than 3 years.
Am J Public Health 2017 Apr;107(4):614-20. doi: 10.2105/ajph.2016.303621.
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Keywords: Children/Adolescents, Dental and Oral Health, Access to Care, Health Promotion, Low-Income
Lipton BJ, Wherry LR, Miller S
AHRQ Author: Lipton BJ, Decker S
Previous Medicaid expansion may have had lasting positive effects on oral health of non-Hispanic black children.
The researchers estimated the relationship between adult oral health and the extent of state public health insurance eligibility for pregnant women, infants, and children throughout childhood separately for non-Hispanic whites, non-Hispanic blacks, and Hispanics. They found that expanded Medicaid coverage geared toward pregnant women and children during their first year of life was linked to better oral health in adulthood among non-Hispanic blacks.
AHRQ-authored.
Citation: Lipton BJ, Wherry LR, Miller S .
Previous Medicaid expansion may have had lasting positive effects on oral health of non-Hispanic black children.
Health Aff 2016 Dec;35(12):2249-58. doi: 10.1377/hlthaff.2016.0865.
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Keywords: Medicaid, Dental and Oral Health, Children/Adolescents, Disparities, Racial and Ethnic Minorities
Horner-Johnson W, Dobbertin K
Dental insurance and dental care among working-age adults: differences by type and complexity of disability.
The purpose of this study was to examine differences in dental insurance, receipt of dental checkups, and delayed and unmet needs for dental care by type and complexity of disability. It found that all disability types except hearing had significantly higher adjusted odds of being without dental insurance, as did people with complex activity limitations. Further, disparities in care were apparent even when controlling for presence of dental insurance.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K .
Dental insurance and dental care among working-age adults: differences by type and complexity of disability.
J Public Health Dent 2016 Sep;76(4):330-39. doi: 10.1111/jphd.12160.
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Keywords: Access to Care, Dental and Oral Health, Disabilities, Health Insurance, Medical Expenditure Panel Survey (MEPS)
Berdahl T, Hudson J, Simpson L
AHRQ Author: Berdahl T, Hudson J
Annual report on children's health care: dental and orthodontic utilization and expenditures for children, 2010-2012.
The researchers examined general dental and orthodontic utilization and expenditures by health insurance status, public health insurance eligibility, and sociodemographic characteristics among children aged 0 to 17 years using data from 2010-2012. Overall, 41.9 percent of US children reported an annual dental office-based visit for general (nonorthodontic) dental care.
AHRQ-authored.
Citation: Berdahl T, Hudson J, Simpson L .
Annual report on children's health care: dental and orthodontic utilization and expenditures for children, 2010-2012.
Acad Pediatr 2016 May-Jun;16(4):314-26. doi: 10.1016/j.acap.2016.02.013.
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Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental and Oral Health, Healthcare Costs, Health Insurance
Figueiredo R, Dempster L, Quinonez C
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
The researchers evaluated emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada). They found that over 80% of the ED visits by homeless people were for odontogenic infections, and 46% of homeless people had more than one such visit. They concluded that access to dental care is inadequate and that ED settings are ineffective for treatment of dental problems.
AHRQ-funded; HS014129.
Citation: Figueiredo R, Dempster L, Quinonez C .
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
J Health Care Poor Underserved 2016;27(2):860-8. doi: 10.1353/hpu.2016.0081.
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Keywords: Access to Care, Dental and Oral Health, Emergency Department, Vulnerable Populations
Weintraub JA, Burgette JM, Chadwick DG
Educating North Carolina's oral health workforce in an evolving environment.
In 2014, North Carolina had 4,681 actively practicing dentists and ranked 47th among US states in dentist-to-population ratio. The need for dentists is increasing as the population grows, and underserved areas persist. This commentary discusses the impact of the state's 2 dental schools and external factors on dental workforce trends.
AHRQ-funded; HS000032.
Citation: Weintraub JA, Burgette JM, Chadwick DG .
Educating North Carolina's oral health workforce in an evolving environment.
N C Med J 2016 Mar-Apr;77(2):107-11. doi: 10.18043/ncm.77.2.107..
Keywords: Dental and Oral Health, Education, Access to Care, Rural Health, Vulnerable Populations
Burgette JM, Lee JY, Baker AD
Is dental utilization associated with oral health literacy?
The objectives of this study were to examine the pattern of association between dental utilization and oral health literacy (OHL). After adjusting for age, education, race, marital status, self-efficacy, and dental knowledge, multiple linear regression showed that dental utilization was not a significant predictor of OHL.
AHRQ-funded; HS000032.
Citation: Burgette JM, Lee JY, Baker AD .
Is dental utilization associated with oral health literacy?
J Dent Res 2016 Feb;95(2):160-6. doi: 10.1177/0022034515617457..
Keywords: Dental and Oral Health, Healthcare Utilization, Health Literacy