OBJECTIVE:To assess dental utilization of resettled adult refugees in Washington (WA) state and the demographic factors associated with dental utilization. METHODS:Data were collected between January 1, 2015, and December 31, 2015 for newly arrived adult refugees (>21 years) enrolled in Washington State dental Medicaid program. Three state agencies provided enrollment and claims data that included demographic information as well as number and types of dental claims, and time to first dental claim for the newly resettled adult refugee population. RESULTS:A total of 1294 adult refugees resettled in WA State in 2015. Approximately, 67% were aged 21-39 years and 32.4% White race and 93.9% without any disability. Over half (57%) of adult refugees had at least one dental claim within 12 months, and the median time to first dental utilization was 4.1 months [IQR:2.4-6.8]. Black refugees had a 74% greater chance of a first dental claim within 12 months of resettlement compared to White refugees (p < .001), and people from countries with high volume of refugees also had a 31% greater chance than those from countries with low volume of refugees (p = .005). CONCLUSIONS:Over half of all the adult refugees resettled in WA utilized dental services within 12 months of arrival. Understanding the mosaic of demographic backgrounds of newly resettled refugees in any given state will improve early utilization of dental care needs and therefore improve their oral health.

Purpose: To assess factors associated with the dental utilization of refugee children in Washington state who received oral health care. Methods: This study used Medicaid data of newly arrived children who resettled in 2015. Demographics, refugee population density groups, special care needs, dates of dental encounters, and dental claim variables were analyzed using descriptive statistics, analysis of variance (ANOVA), regression analysis, and the Cox proportional-hazard ratios (P<0.05). Results: Among 1,125 children, 78 percent had at least one dental claim. The majority were under six years (37 percent), male (55 percent), and without disabilities (98 percent). On average children started using dental care within 6.0 months (±4.0 standard deviation) of resettlement (median equals 4.4; interquartile range [IQR] equals 2.6 to 10.3). White children had the greatest mean number of dental claims, whereas Black children had the least (P<0.001). Children from the low-volume refugee population density group were significantly less likely to have a dental claim than children from the medium-volume refugee population density group (P<0.001). Compared to 13- to 21-year-olds, children aged zero to seven years and seven to 13 years had a 46.7 percent (95 percent confidence interval [95% CI] equals 24.9 to 72.3 percent) and 54.8 percent (95% CI equals 30.3 to 83.9 percent) significantly increased likelihood of having their first dental claim (P<0.001). Conclusions: A large percentage (78 percent) of children newly resettled in the state of Washington utilized at least one dental service. Age, race, and refugee population density group were significantly associated with utilization within the initial 12 months after resettlement.

OBJECTIVE:To describe current Dental Public Health diplomates and list the competency domains that diplomates considered either essential or optional elements of their practice.METHODS:The American Board of Dental Public Health administered an electronic survey to active and life member diplomates during September 2021. The survey included 101 items in three sections: (1) Education and Work Experience; (2) Dental Public Health Tasks; and (3) Demographics. The Dental Public Health Tasks section asked individuals how essential work-related tasks were to their current practice. Descriptive analyses were conducted using SAS.RESULTS:The overall response rate was 82.6% (157 eligible of 190 returned). Most respondents were women, 35 to 54 years of age, and either non-Hispanic white or non-Hispanic Asian. Twice as many had DDS or DMD degrees than BDS degrees. The vast majority completed a Dental Public Health residency and received masters level training from an accredited program. About three-fourths worked in the United States and held a U.S. license. More than 37% reported a second doctoral degree and 70% worked in academia. Responses to questions about tasks closely aligned with working in academia and less so with positions related to advocacy, regulation, and program evaluation.CONCLUSIONS:Current diplomates are concentrated in academia. If this trend continues, it may be necessary to restructure the competencies, so training and skills acquisition remain timely and relevant. The specialty may also need to encourage future generations to consider non-academic positions so Dental Public Health remains an impactful component of the public health care system.

OBJECTIVE The study examined changes in acculturation level, socio-economic status, and their association with preventive dental service use, receipt of restorative, or surgical care, and unmet dental needs. METHODS Data from the Medical Expenditure Panel Survey (MEPS) for children aged 1 to 17 years from 2007 to 2015 were analysed. Firstly, a cross-sectional structural equation model (SEM) that included both a measurement model and a structural model was fitted simultaneously to obtain predicted latent variables for acculturation, socio-economic status (SES), dental service utilization, and unmet dental needs. Secondly, the change in acculturation, SES, dental service utilization, and unmet dental needs were calculated over two consecutive years within the same child. Finally, the structural model in these changes was fitted, and the indirect and direct pathways between acculturation and SES were tested with dental insurance as a mediator. RESULTS Data for 33 507 children in both panel years were analysed. An increase in family acculturation resulted in lower utilization of preventive dental service and more unmet dental need, with socio-economic status and dental insurance kept constant between the panel years, and after adjusting for race/ethnicity, gender, and age. In addition, increased acculturation was associated with higher SES, and a higher probability of having obtained dental insurance, both of which resulted in increased preventive dental service utilization and less unmet dental need. The positive direct effect and negative indirect effect of acculturation on unmet dental need cancelled each other out and resulted to almost zero total effect between acculturation and unmet dental need. Similarly, the negative direct effect and positive indirect effect of acculturation on preventive dental service cancelled each other out leading to a small increase in preventive dental service utilization. CONCLUSION Children of immigrant families are at risk of inadequate access to dental care as their families becomes more acculturated, without increase in SES and access to dental insurance. This study supports policies that promote immigrant family's adequate access to dental insurance and employment to improve their socio-economic status.

Background: By midcentury, the US population will be remarkably more racially and ethnically diverse, with a dramatic increase in the proportion of older adults. This report addresses ongoing oral health disparities and inequitable access to care related to these changes, with emphasis on implications for the workforce, taking note of effects of the COVID-19 pandemic. Relevant Considerations: Considering that social determinants shape health behaviors, reflection on the most effective type of dental workforce should take into account population characteristics and the relationship of oral health with overall health and general well-being. The dental workforce composition will need to mirror changing demographics, and effective dental health teams will be characterized by cultural competence, humility, readiness, and capacity to adapt to changes. In addition, the influence of social histories and the pandemic on health and dental care utilization is important. Equally important are the inclusion of oral health literacy in treatment planning and disease prevention, as well as oral health–related quality of life in considering outcomes of care. Providing patient-centered care for a diverse population requires tailored treatment modalities, as well as intra- and interprofessional approaches. In this way, the whole person can be cared for, including those with special health care needs, whether related to chronic disease, mental health conditions, or behavioral, physical, and social differences. Conclusions: Changing demographics will affect the delivery of oral health care, including who can best provide care and how, what the needs are, and in what ways prevention and treatment can most effectively be accomplished. The education of dentists must address unmet population needs, including for those with special health care concerns and older adults. These population groups are influenced by a variety of social determinants, and provision of services may need to occur in alternative care delivery settings. Identifying and addressing the needs of every patient within this broad array of new requirements will challenge dental professionals to redefine what it means to be a health care practitioner. Knowledge Transfer Statement: This article describes how sociodemographic changes in the United States will challenge the dental workforce in new ways and points to research and practice needs to address these challenges. Oral health disparities and the changing oral health care needs of patients from diverse and underserved groups are discussed, with a focus on the implications for delivery of care and policies that are needed to improve oral health outcomes for all.

Objective To compare the use of Medicaid and commercial claims data with self-reported survey data in estimating the prevalence of oral disease burden. Methods We analyzed 2018 Medicaid claims from the IBM Watson Medicaid Marketscan database, commercial claims from the IBM Dental Database, and Medical Expenditure Panel Survey (MEPS) data. The estimate of oral disease burden was based on standard metrics using periodontal and caries-related Current Dental Terminology (CDT) procedure codes. A direct comparison between the data sets was also done. Results Unweighted Medicaid and commercial enrollees were 11.6 and 10.5 million, respectively. The weighted proportion from MEPS for Medicaid and commercial plans ranged from 80 to 208 million people. Estimates of caries-related treatments were calculated from IBM Watson and MEPS data for Medicaid enrollees (13% vs. 12%, respectively) and commercial claims (25% vs. 17%, respectively). Prevalence of periodontal related treatments for those with a dental visit was estimated for IBM Watson and MEPS enrollees for Medicaid (0.7% vs. 0.5%, respectively) and commercial claims (7% vs. 1.6%, respectively). Dental disease estimates were higher in individuals with at least one dental visit across cohorts. Prevalence of disease for those with a dental visit based on specific procedures were higher in commercial plans than in Medicaid. Conclusions Claims data has the potential to serve as a proxy measure for the estimate of dental disease burden in a population.

Purpose: The purpose of this study was to examine trends and characteristics of pediatric nontraumatic dental condition (NTDC) visits to emergency departments (EDs) in the United States from 2010 to 2017. Methods: The 2010 to 2017 Nationwide Emergency Department Sample (NEDS) was analyzed for NTDC visits to EDs for children (zero to 20 years old). NTDC visits were identified based on ICD-9 and ICD-10 codes. Patient characteristics analyzed included age, sex, primary payor, county population, day of discharge, and household income. Descriptive statistics and a logistic regression analysis for 2016 and 2017 were completed. Results: Pediatric NTDC visits to EDs decreased from 103.1 to 89.3 per 10,000 ED visits between 2010 and 2017. Pediatric NTDC ED visits by Medicaid enrollees increased from 51 percent to 65.3 percent from 2010 to 2017. This was followed by a corresponding decrease among uninsured pediatric patients with NTDC visits to EDs. The odds of NTDC visits to EDs were higher among Medicaid enrollees, 15- to 20-year-olds, and the uninsured but were lower among those in wealthier zip codes. Conclusions: Emergency department visits for nontraumatic dental condition visits by pediatric patients decreased over time following the implementation of the Affordable Care Act. Despite this decrease, low socioeconomic status children continue to utilize emergency departments for dental conditions at higher rates than their peers.

Objectives To test the feasibility and preliminary effectiveness of the NIATx model for organizational change to reduce appointment no-shows in dental care settings. Methods The NIATx Dental Pilot Study used a clustered prepost interventional design and a mixed-methods approach. Five independent dental clinics serving Medicaid enrollees were recruited. Quantitative data on the impact of the NIATx model were complemented by qualitative assessment information collected from dental staff. The NIATx model was applied through a multisite learning collaborative that engaged participating organizations in adopting targeted no-show best practices. The primary outcome measure was no-show data collected at the preintervention phase (5 months), intervention phase (7 months), and postintervention phase (3 months). Results Female patients were in the majority (median 54.5 percent). Mean age ranged from 8 to 50 (median 35.2) years. The median percentage for Hispanics was 11.0 percent, and the proportion of uninsured patients was 25 percent. Preintervention no-show rates ranged from 14 percent (clinic B) to 38 percent (clinic E). All clinics had lower no-show rates during the postintervention period, with decreases ranging from 1 percent (clinic B) to 13 percent (clinic E). Overall, the no-show rates decreased in the study. Conclusions The study demonstrated the feasibility of applying the NIATx model to reduce no-show rates, with some difficulty observed with sustainability across dental practices during the postintervention period.

Purpose: To assess pediatric dentists' knowledge, attitudes, and factors associated with the use of the Hall technique (HT) in the United States. Methods: An electronic questionnaire with a cover letter and consent form was sent to 6,277 active members of the American Academy of Pediatric Dentistry (AAPD) between April 15 and June 1, 2019. Descriptive and multivariate analyses were calculated. Results: The response rate was 9.4 percent; 52 percent were males, 76 percent were white non-Hispanic, and 83 percent were in private practice. Ninety-seven percent were familiar with HT, and 39 percent had used it. Factors significantly associated with the use of HT were female dentists (P=0.01), patients with Medicaid insurance (P<0.001), rural locations (P=0.02), academic and community/public health clinics (P=0.004). Compared with AAPD members in the Western region, pediatric dentists in the North-Central region were more likely to use HT (odds ratio [OR] =2.50, 1.22 to 5.13, P=0.01) but pediatric dental residents in the North-Central region were less likely to use it (OR= 0.39,0.18 to 0.84, P=0.02). Conclusion: Use of HT was considered a viable alternative in the management of dental caries. Despite the limitations of the technique, pediatric dentists' practice location and place of residency were significantly associated with its use.

OBJECTIVES:Individuals with disabilities experience greater barriers accessing health care services and have poorer oral health outcomes than those without disabilities. The aims of this study were to examine dental access, utilization, expenditures, and sources of payment between adults with intellectual disabilities (ID), other types of disabilities, and without disabilities.METHODS:Secondary analyses of data from the 2017 Medical Expenditure Panel Survey (MEPS) allowed examination of dental access (being able to get dental care and receiving necessary dental care without delay), dental utilization (having a dental visit in the past year), total dental expenditures, and associated sources of payment between three groups of adults based on disability status using descriptive, bivariate, and multivariable statistics.RESULTS:Adults with ID have 2.70 (95% CI: 2.03, 3.61) times the odds of being unable to get dental care and 2.88 (95% CI: 2.11, 3.94) times the odds of having to delay necessary dental care compared with adults without disabilities. No significant differences were observed in dental utilization or mean total dental expenditure between the three groups after adjusting for demographic and socioeconomic variables. Among adults who incurred a dental expenditure, adults with ID had a greater share of dental care paid for by Medicaid, and adults without disabilities had a greater share of dental care paid for by private insurance.CONCLUSIONS:Despite similar mean total dental expenditures, reduced dental access reported by adults with ID suggests that this population experiences significantly greater challenges obtaining dental care. Adults with ID rely more heavily on Medicaid to finance dental care.

OBJECTIVES:To assess the association between dental sealant placement and subsequent restorative treatment of permanent first molars over time.METHODS:We analysed Wisconsin Medicaid claims data from 2001 to 2009 for children aged 6-16 years. Children entered the study cohort at age 6 and were censored if Medicaid eligibility was lost for >31 days. A fixed effects analysis via a Cox proportional hazards model, stratified by individual, was used to estimate the time-averaged and time-dependent effects of sealant placement on dental treatment defined as any restorative, endodontic or surgical procedure.RESULTS:A total of 185,262 children with permanent first molars who turned 6 years enrolled in Medicaid were examined. Sealant placement was higher for teeth #16 and 26 (5.42 and 5.46 per 100 person-years (100PY), versus 5.29 and 5.31/100PY for #36 and 46, respectively. The average rate for restorative treatments had the opposite pattern, with lower rate for teeth #16 and 26 (1.78 and 1.72/100PY) versus teeth #36 and 46 (2.14 and 2.12/100PY), respectively. In the fixed effects regression model, the hazard of dental treatment was substantially lower after sealant placement on a tooth, with time-averaged hazard ratio HR = 0.23 (95% CI 0.21-0.25, P < .001) versus before sealant. The largest effect was in the first year after sealant placement (HR = 0.13, 95% CI: 0.11-0.14), which decreased over time (HR = 0.50, 0.59 and 0.74 in years 2, 3 and 4, respectively), and was not statistically significant in later years.CONCLUSIONS:This study demonstrates that permanent first molar sealant placement delayed subsequent dental treatments in children enrolled in Medicaid.

Objective To investigate geographical variations and their relationship to race/ethnicity in dental sealant utilization for first molars among Wisconsin Medicaid enrollees from 2010 to 2013. Methods Wisconsin Medicaid dental claims for sealants in children aged 6-16 years were analyzed. County-level population density, urban influence code, presence of dental health professional shortage areas, and population-per-dentist ratio were considered as geographic predictors. Descriptive statistics and mixed effects Poisson regression models were used to examine the effect of county level covariates on the number of dental sealants received per person-year (PY) of eligibility adjusting for patient-level characteristics. Over-dispersion was modeled by a random residual effect, and all models adjusted for single-year age and gender interaction and race/ethnicity main effect. Results Medicaid claims for sealants on first permanent molars for 2010-2013 totaled 288,019 over 1,130,000 PY. The age- and gender-standardized rate of first molar sealant applications per 100 PY were 27.9, 25.7, and 16.6 for White, Hispanic, and Black children, respectively. County-specific rates ranged from a low of 8.9 per 100 PY to a high of 62.6 per 100 PY. In the multivariate analysis after adjusting for geography, compared to Whites, Hispanics had highest rates (rate ratio (RR) = 1.33, 95% CI = 1.30-1.37) of dental sealant utilization followed by Blacks (RR = 1.25, 95% CI = 1.21-1.29). Population density was the only significant geographic predictor (RR = 0.56 per 10-fold increase, 95% CI = 0.45-0.69). Conclusions Substantial geographic variability in the utilization of sealants for first molars was identified. Lower population density was the main geographical predictor of high sealant utilization.

Objective: Mission of Mercy (MoM) events are scheduled to provide care to populations suffering from urgent needs and inadequate access to dental care in the United States. This study examined individual and county-level characteristics of MoM attendees and the factors associated with changes in the rate of attendance. Methods: Deidentified archival data for MoM events available from the America's Dentists Care Foundation (2013-2016) were analyzed. Summary statistics were calculated separately for each year. Chi-square test was performed to identify changes in attendance distribution over time. Poisson regression analyses were conducted to test changes in the rate of attendance with and without adjustment for county-level characteristics and history of prior MoM events. Results: Total numbers of attendees at Wisconsin MoM events were 1,560, 1,635, 1,187, and 951 in 2013, 2014, 2015, and 2016, respectively. Attendees were mostly female (>50%) and White (58%-81%), and mean age ranged between 36.5 and 39.2 y. The average travel distance ranged between 27 and 80 miles. Residents of counties where MoM events were held in previous years were more likely to attend another MoM event after adjusting for county distance to current location. After adjusting for dentists-to-population ratio, event history, and county distance to event location, we found that there was no statistically significant change in the rate of attendance from 2013 to 2016. Conclusions: Previous attendees with experience of attending a MoM event in their counties of residence were more likely to attend another MoM event. Higher rates of attendance were associated with shorter travel distances to MoM events. Knowledge Transfer Statement: The Mission of Mercy (MoM) events are promoted by local dental organizations to highlight the issue of access to dental care and bring greater awareness to the problem by providing urgent dental care to populations in need. Through the data-sharing practices and analyses, policy makers, dental health advocates, and program organizers will have a better understanding of the impact and reach of the program. Findings from this study will help to expand program practices, promote efficiency, and aid in the identification of appropriate event locations, innovative strategies, and public policies relevant to addressing access to dental care.

Objective: To examine trends and variations in billed and paid amounts for preventive dental procedures by race/ethnicity, age, and sex in Wisconsin dental Medicaid. Methods: We analyzed data from the 2001 to 2013 Wisconsin Medicaid claims database for preventive dental procedures for children and adults. Billed and paid amounts for preventive dental procedures were aggregated over a visit and adjusted for inflation based on the Medical Care Consumer Price Index produced by the Bureau of Labor Statistics for 2013. Quantile regression was used to examine the trends over time and the effect of patient demographics. Result: At the 50th and 75th percentiles, the overall billed amounts for preventive dental procedures were $84.97 and $105.53, and the paid amounts were $35.80 and $41.66, respectively. At the 75th percentile, there was a $2.24 increase per year in the billed amount and a $26.88 overall increase from 2001 to 2013. In the paid amount, there was a $1.34 decrease per year for an overall $16.07 decrease from 2001 to 2013. Billed and paid claims for racial/ethnic minority enrollees were $1 to $3 higher per visit at the 75th percentile when compared with those of Whites. Regarding the billed:paid ratio, White, African American, and Hispanic enrollees had values of 50% to 52%, whereas American Indians had the lowest value at 47.7%. At the 75th percentile, children aged 10 to 19 y had significantly higher billed ($26.73) and paid ($9.92) amounts than did adults aged 20 to 69 y. Conclusion: The billed amount increased over time, and the paid amount decreased after adjustment for inflation. In addition, there was a wide gap between billed and paid amounts over time. Knowledge Transfer Statement: This study highlights clear differences between paid and billed amounts in Wisconsin dental Medicaid. The financial health of dental practices is dependent on appropriate reimbursement for dental services provided; thus, information of this nature could serve as a proxy performance measure for access to preventive dental care. Findings from this study could be used by policy makers and dental Medicaid program managers to develop outcome metrics to improve access to preventive dental services.

Christopher Okunseri Stephanie Zbin Cheng Zheng Frederick Eichmiller Elaye Okunseri Aniko Szabo 1School of Dentistry, Department of Clinical Services, Marquette University, Milwaukee, WI, USA; 2Joseph. J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; 3Delta Dental of Wisconsin, Stevens Point, WI, USA; 4Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA Objective: This study compared attendees at Wisconsin Mission of Mercy (MoM) events with and without prior emergency department (ED) visits for dental care in terms of demographic characteristics and dental procedures received. Methods: De-identified archival data available from the America’s Dentists Care Foundation (2013–2016) were analyzed. Summary statistics were calculated based on prior ED visit status for county-level characteristics and type of dental procedures received. Generalized estimating equation models with logistic links were fitted to examine associations between the predictor and independent variables. Results: Most attendees were White, adult females (mean age 37 years). Current dental pain was reported by 61% vs 33% of attendees with and without prior ED visit. Cleaning (57%) was the most common procedure received by attendees with no prior ED visits, while extractions (47%) were the most common for those with prior ED visits. Among MoM attendees, males had higher odds of prior ED visits compared to females. Compared to White, Black had higher odds and Hispanic had lower odds of having prior ED visits. In the multivariable analysis, dental pain (OR: 3.32; 95% CI: 2.75, 4.02) had the strongest association with prior ED visits. Attendees with prior ED visit history had higher odds of receiving extractions and restorative care, compared to cleaning after adjustment for person and county-level characteristics. Conclusion: Among MoM attendees, prior ED visits were associated with not being Hispanic, being male, and having dental pain. Compared to attendees with no prior ED visit, those with prior ED visits had higher odds of receiving restorative care and extractions.

Kar Yan Li 1 Christopher E Okunseri Colman McGrath May CM Wong 3 1Faculty of Dentistry, The University of Hong Kong, Hong Kong, People’s Republic of China; 2Department of Clinical Services, School of Dentistry, Marquette University, Milwaukee, WI, USA; 3Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, People’s Republic of China Objective: To assess self-reported general health (SRGH) and self-reported oral health (SROH), and to identify factors associated with these self-health reports among adults in the United States. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) for 1999 to 2014 were analyzed. Survey-weighted descriptive statistics were computed and Pearson correlations between the two self-reported health status measures were tested. Separate multivariable logistic regressions in SROH and SRGH were performed. Measures of inequalityabsolute inequality (AI) and relative inequality (RI) in SRGH and SROH were investigated. Results: The sample consisted of 37,904 adults. Survey-weighted proportions of “excellent or very good” general health decreased from 54% in 1999–2000 to 45% in 2013–2014 and that of oral health increased from 27% in 1999–2000 to 38% in 2013–2014. Whites, participants with college degrees and those ≥400% of family poverty income ratio (PIR) had a higher probability of reporting “excellent or very good” general and oral health. Young people had a higher probability of reporting “excellent or very good” general health and the probability of reporting “excellent or very good” oral health fluctuated among the different age groups. There was a slight increase in both AI and RI by sociodemographic factors for SRGH (except for gender). For SROH, AI increased slightly, and RI decreased slightly (except for education) over the same period. Conclusion: Self-reported general health had higher ratings than self-reported oral health. Survey period, age, race/ethnicity, education and family PIR were significantly associated with SRGH and SROH, but gender was only significant in the SROH model. SRGH was significantly associated with SROH after adjusting for other sociodemographic factors.

Objective: To assess self-reported general health (SRGH) and self-reported oral health (SROH), and to identify factors associated with these self-health reports among adults in the United States. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) for 1999 to 2014 were analyzed. Survey-weighted descriptive statistics were computed and Pearson correlations between the two self-reported health status measures were tested. Separate multi-variable logistic regressions in SROH and SRGH were performed. Measures of inequality-absolute inequality (AI) and relative inequality (RI) in SRGH and SROH were investigated. Results: The sample consisted of 37,904 adults. Survey-weighted proportions of "excellent or very good" general health decreased from 54% in 1999-2000 to 45% in 2013-2014 and that of oral health increased from 27% in 1999-2000 to 38% in 2013-2014. Whites, participants with college degrees and those >= 400% of family poverty income ratio (PIR) had a higher probability of reporting "excellent or very good" general and oral health. Young people had a higher probability of reporting "excellent or very good" general health and the probability of reporting "excellent or very good" oral health fluctuated among the different age groups. There was a slight increase in both AI and RI by sociodemographic factors for SRGH (except for gender). For SROH, AI increased slightly, and RI decreased slightly (except for education) over the same period. Conclusion: Self-reported general health had higher ratings than self-reported oral health. Survey period, age, race/ethnicity, education and family PIR were significantly associated with SRGH and SROH, but gender was only significant in the SROH model. SRGH was significantly associated with SROH after adjusting for other sociodemographic factors.

Purpose: This pilot study investigated the prevalence of Molar-Incisor Hypomineralization (MIH) in third-grade school children in Milwaukee Wisconsin, USA. Methods: A convenience sample of third-grade school children in the Milwaukee Public School System (MPS) participated in the study. Calibrated examiners trained on the European Academy of Paediatric Dentistry (EAPD) MIH recommendations examined the children between December 1, 2014 and June 30, 2015. Children were examined at their schools using a flashlight and mirror after receiving consent from parents/caregivers and assent from each child. Findings were recorded onto a standardized form by one of five trained examiners. Summary statistics were calculated, and bivariate analysis were done to identify factors associated with MIH. Results: A total of 375 children (average age = 8.66 years, range 7-12) were examined, 60% females and 41% Hispanics. Overall, 36 (9.6%) of the children demonstrated findings consistent with the diagnosis of MIH. Among the teeth with MIH defects, severe defects were higher in lower molars. There were no statistically significant differences between those with and without MIH by sex, race/ethnicity, and socioeconomic status in this study. Conclusion: The study revealed that 9.6% of the children examined were affected by MIH. Future studies should focus on statewide and/or nationwide surveys in the United States to ascertain the extent and severity of the condition.