ABSTRACTBackground Dental public health (DPH) is a specialty of dentistry that serves the community as a patient rather than the individual. It requires broad knowledge and skills in preventing and controlling oral diseases, planning and administering programs, applied research, surveillance and evaluation, financing, and providing dental care. This article aims to outline DPH practice, emphasizing its role in improving the oral health of communities, and highlight professional training pathways in this field.Methods We used the Ten Essential Public Health Services framework to illustrate DPH practice. The Association of State and Territorial Dental Directors (ASTDD) provides guidance to state and local health programs for promoting oral health policies and programs at the population or community level. In addition, we presented the education and training pathways for becoming a DPH specialist and identified opportunities for all dental practitioners.Results This paper outlines real-world examples how DPH practitioners have contributed to improving the oral health of Californians. The opportunities to practice both in the public health and private sectors and the collaboration with academia are highlighted. Examples throughout the paper such as the collaborative effort in San Francisco to address high tooth decay rates in children and its contribution to the statewide policy illustrate the opportunity for practicing dentists to improve community oral health and overall health with a DPH mind-set.Conclusions Improving the oral health of Californians requires competent dental public health and clinical practitioners. It is essential to have robust education and training programs with a community focus that offers multiple pathways.

Introduction Tooth decay remains the most prevalent chronic disease in children and adults, even though it is largely preventable. Studies show that mothers’ oral and overall health is linked to children’s oral health and pregnancy outcomes. This paper examines achievements during the last 20 years, assesses current challenges, and discusses future priorities. Oral health status Data show a modest improvement in children’s oral health during the last 20 years; however, tooth decay still affects more than half of adolescents. According to national survey data, about 26% of working-age adults had untreated tooth decay. Overall, significant oral health disparities by race/ethnicity and income persist. Dental service utilization The annual dental visit rate for children in the 2015 Medical Expenditure Panel Survey was 48%. Among children enrolled in Medicaid, dental visit rates increased from 18% in 1993 to nearly 50% in 2018. About 46% of women are estimated to receive teeth cleaning during pregnancy. Over the years, race or ethnicity and income-level differences in dental visits observed in the early 2000s have narrowed substantially in children but not among pregnant women. Discussion Many effective interventions are available at the community and individual levels but are underutilized. Lack of integration of oral health into the overall health care system and programs, community conditions, poverty, and limited health literacy make it difficult for families to engage in healthy habits, use preventive interventions, and access treatment promptly. Conclusion To further improve oral health, policy and system reforms are needed to address the factors mentioned above. Therefore, we urge the federal Maternal and Child Health Bureau to take steps to convene a workshop to develop a framework for future actions.

Objectives: Previous meta-analyses have mainly focused on studies conducted in endemic fluorosis areas with relatively high fluoride concentrations. These are impoverished rural communities in China, India, and Iran, and the findings cannot be generalised to developed countries. Therefore, we investigated the association between fluoride concentrations relevant to community water fluoridation and children's cognition measured with IQ scores by synthesising effect sizes reported in observational studies. Methods: A previous meta-analysis and the National Toxicology Program database that included a search of multiple databases and the authors' search of PubMed, Google Scholar, and Mendeley provided the data. Cross-sectional and cohort studies examining the association between fluoride and children's cognition and intelligence scores were selected. Two reviewers abstracted data using standard procedures. We performed three meta-analyses to synthesise the effects using the random effects models.Results: Eight studies of standardized mean difference in IQ scores from non-endemic fluorosis areas found no statistically significant difference between recommended and lower levels of fluoride (standardized mean difference = 0.07; 95% confidence interval: -0.02, 0.17; I2 = 0%), and no significant fluctuation in IQ scores across the differences in fluoride concentrations by non-linear modeling with restricted cubic spline (P = 0.21). Meta-analyses of children's and maternal spot urinary fluoride associated pooled regression coefficients (Betachildren = 0.16; 95% confidence interval: -0.40, 0.73; P = 0.57; I2 = 0%, Betamaternal = -0.92; 95% CI: -3.29, 1.46; P = 0.45; I2 = 72%) were not statistically significant. Further regression analysis by standardizing absolute mean IQ scores from lower fluoride areas did not show a relationship between F concentration and IQ scores (Model Likelihood-ratio test: P-value = 0.34.)Conclusions: These meta-analyses show that fluoride exposure relevant to community water fluoridation is not associated with lower IQ scores in children. However, the reported association observed at higher fluoride levels in endemic areas requires further investigation. (c) 2023 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4. 0/).

Introduction Osteoporosis is a disease that is characterised by low bone mineral density (BMD), and loss of structural and biomechanical properties that are essential in maintaining bone homeostasis. Osteoporosis is diagnosed by clinical measurement of BMD and is the best predictor of osteoporosis. The study was conducted with the aim of assessing the effectiveness of orthopantomogram (OPG) as a screening tool for osteoporosis in postmenopausal women and chronic drug users. Objectives The primary objective of the current study was to assess the mandibular cortical width and antegonial index in postmenopausal women and chronic drug users, the secondary objective was to compare the mandibular cortical width and antegonial index of postmenopausal women and chronic drug users with that of the control group (healthy individual). Methods Three groups were taken in this study with a sample size of 300 with 100 OPG in each group. The groups categorised in the study were postmenopausal women, patients under drugs (glucocorticoids, proton pump inhibitor, anti-epileptic drugs, selective serotonin reuptake inhibitor) and the control group and the parameters assessed were antegonial index and mandibular cortical width. Results Results were tabulated and analysed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 26.0, Armonk, NY). The normality tests Kolmogorov-Smirnov and Shapiro-Wilks test results reveal that the variables (both indices) follow the normal distribution. The mandibular cortical width was 3.44, 2.66 and 2.96 in the normal, postmenopausal women and women on drugs respectively. The antegonial index was 163.5, 157.2 and 158.8 in the normal, postmenopausal women and women on drugs respectively. Conclusion From the above results, it is evident that there is a statistically significant reduction in antegonial index and mandibular cortical width in postmenopausal women compared to normal individuals. Alterations of this value are suggestive that early pre-clinical changes of osteoporosis can be detected in the high-risk group using OPG.

The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to dental health care personnel (DHCP). Because a large proportion of COVID-19 cases are asymptomatic and many dental procedures generate aerosols, additional precautions are needed to protect DHCP and their patients. Dental practices must comply with several state and federal requirements, including the California Department of Public Health Officer orders and California Division of Occupational Safety and Health (Cal/OSHA) standards. The California Dental Association has developed resources to assist dental professionals in complying with these requirements. In addition, the Medi-Cal Dental Program and local oral health programs have used various materials to educate the public about COVID-19 and oral health, including information for parents about visiting the dental office.

Traditional lectures are the most common teaching method employed by many dental institutions. It is the method where the teacher stands in front of the students and delivers a speech about a particular topic to make the students understand the topic. This method of teaching is very popular among teachers and is still being used by many. Unfortunately, this traditional teaching method has significant drawbacks often resulting in a poor understanding of the concepts taught to the students. This has led to the advent of the Multiple Interactive Learning Algorithm which is abbreviated as MILA. MILA teaching involves fragmentation of the entire duration of the class into multiple small sessions. Here, the word facilitator is preferred over the lecturer, as the teacher facilitates the students in learning a particular concept rather than lecturing it. MILA uses many innovative techniques that are interactive to make the learning process more efficient. MILA has improved the understanding and retaining of a concept in memory and has also made the students engage actively in the learning process. MILA is employed in teaching various topics in Oral Medicine and Radiology such as TMJ disorders, IOPA, radiation physics, etc. The paper aims to discuss the new and innovative teaching method MILA in Oral Medicine and Radiology.

ABSTRACTABSTRACTThis report presents findings from a survey of third grade children conducted during the 2018 and 2019 school years. The prevalence of tooth decay, untreated tooth decay and dental sealants was 61%, 22% and 37%, respectively. Overall achievements among third graders included a noticeable reduction in tooth decay experience (61% down from 71%) and untreated decay (22% down from 29%) and an increase in dental sealant prevalence (37% up from 28%) compared to the 2004-05 school year when this was last assessed. However, tooth decay remains a significant public health problem, especially among certain racial/ethnic and socioeconomically disadvantaged groups. Additional informationNotes on contributorsBrendan DarsieBrendan Darsie, MPH, is a research scientist II for the Office of Oral Health and the Center for Healthy Communities in the California Department of Public Health. Conflict of Interest Disclosure: None reported.Shannon ConroyShannon Conroy, PhD, MPH, is a research scientist supervisor I and the chief of the Surveillance and Evaluation Unit for the Office of Oral Health and the Center for Healthy Communities in the California Department of Public Health. Conflict of Interest Disclosure: None reported.Jayanth KumarJayanth Kumar, DDS, MPH, is the state dental director, Office of Oral Health and the Center for Healthy Communities, California Department of Public Health. Conflict of Interest Disclosure: None reported.

Studies demonstrate that dental providers value effective provider-patient communication but use few recommended communication techniques. This study explored perspectives of California dental providers and oral health literacy experts in the United States on use of communication techniques. We conducted a qualitative key informant interview study with 50 participants between November 2019 and March 2020, including 44 dental providers (dentists, hygienists, and assistants) in public or private practice in California and 6 oral health literacy (OHL) experts. We undertook thematic analysis of interview transcripts and descriptive statistics about interviewees from pre-surveys. Dental providers reported frequently speaking slowly, and using simple language and models/radiographs to communicate with patients, while infrequently using interpretation/translation, illustrations, teach-back, or motivational interviewing. Providers reported using only 6 of the 18 American Medical Association's (AMA) recommended communication techniques and only 3 of the 7 AMA's basic communication techniques. A majority of providers indicated using one of five oral health assessment and educational strategies. Key barriers to effective communication included limited time, financial incentives promoting treatment over prevention, lack of OHL training, limited plain-language patient education materials, and patients with low OHL knowledge. Dental organizations should prioritize supporting dental providers in effective patient communication practices. Standardizing OHL continuing education, creating an evidence-based OHL toolkit for dental teams, ensuring accessible interpretation/translation services, and incentivizing dental providers to deliver education could improve oral health literacy and outcomes.

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsJayanth KumarJayanth Kumar, DDS, MPH, is the state dental director, Office of Oral Health and the Center for Healthy Communities, California Department of Public Health. Conflict of Interest Disclosure: None reported.Jared FineJared Fine, DDS, MPH, became dental health administrator for the Alameda County Department of Public Health in 1975, a position he held until his retirement in 2014. Conflict of Interest Disclosure: None reported.

Prevalence of dental caries in children with cleft lip and palate was shown to be high compared to any other oral complications. The prevalence of associated systemic disease and those are defected postnatally is 25% among children with cleft. The number of factors such as literacy level of their parents, socioeconomic status and occupation of parents also contributes to the poor oral hygiene status of those children. To determine the dental caries status in children with and without cleft lip and palate. The purpose of the study to analyse the dental caries status in children with and without cleft lip and palate. A study was carried out by collecting data by reviewing patients data and analysing the data of 86000 patients between June 2019 and March 2020 at the private dental institute. The sample size that was taken included 5 children with cleft lip and palate (case group) and 5 children without cleft lip and palate (control group), who came to the private dental institute for consultation. The dental caries status were evaluated using DMFT/dmft score and was compared between the groups. Data was statistically analysed using SPSS 2.0, Mann-Whitney U Test was conducted. Result was recorded. The results showed that children with cleft lip and palate showed a lesser DMFT score compared to children without cleft lip and palate, statistically significant (Mann-Whitney U-test; p=0.034). Therefore it was concluded that within the limitation of the current study, children with cleft lip and palate showed lesser incidences of dental caries when compared to children without cleft lip and palate.

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsLinda NeuhauserLinda Neuhauser, DrPH, MPH, is a clinical professor of community health sciences at the University of California, Berkeley, School of Public Health and co-principal investigator of Health Research for Action.Conflict of Interest Disclosure for all authors: None reported.Anthony EleftherionAnthony Eleftherion, is the director of communications at Health Research for Action.Conflict of Interest Disclosure for all authors: None reported.Rebecca FreedRebecca Freed is the associate director, health literacy communications at Health Research for Action.Conflict of Interest Disclosure for all authors: None reported.Karen Sokal-GutierrezKaren Sokal-Gutierrez, MD, MPH, is a clinical professor at the University of California, Berkeley, School of Public Health.Conflict of Interest Disclosure for all authors: None reported.Rosanna JacksonRosanna Jackson is an oral health program manager at the Office of Oral Health in the California Department of Public Health.Conflict of Interest Disclosure for all authors: None reported.Jessica LiuJessica Liu, MPH, is the research project coordinator at Health Research for Action.Conflict of Interest Disclosure for all authors: None reported.Susan L. IveySusan L. Ivey, MD, MHSA, is a professor adjunct at the University of California, Berkeley, School of Public Health and the director of research at Health Research for Action.Conflict of Interest Disclosure for all authors: None reported.Kristin HoeftKristin Hoeft, PhD, MPH, is an assistant professor in the department of preventive and restorative dental sciences at the University of California, San Francisco, School of Dentistry.Conflict of Interest Disclosure for all authors: None reported.Alice M. HorowitzAlice M. Horowitz, RDH, MA, PhD, is an associate research professor in the department of behavioral health and community health at the University of Maryland School of Public Health.Conflict of Interest Disclosure for all authors: None reported.Jayanth KumarJayanth Kumar, DDS, MPH, is the state dental director for the California Department of Public Health.Conflict of Interest Disclosure for all authors: None reported.

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsJayanth KumarJayanth Kumar, DDS, MPH, is the state dental director for the California Department of Public Health. Conflict of Interest Disclosure: None reported.

Cleft lip and palate were classified as followed by Veau in 1931. The major four groups are clefts of softpalate, clefts of hard palate, unilateral clefts of the lip, alveolus and palate, bilateral clefts of the lip, alveolusand palate. Gingival health in children is one of the important factors to be taken into a serious problem as itmay progress to jeopardize the periodontium of the adult. It affects the periodontal disease in the inceptionof earlier in life. In dentistry, it is important for a dentist to recognize early and diagnose gingival diseasesto optimize treatment outcome. To determine the gingival health status in children with and without cleftlip and palate. The purpose of the study was to analyse the gingival status in children with and without cleftlip and palate (a case control study). A study was carried out by collecting data by reviewing patients dataand analysing the data of 86000 patients between June 2019 and March 2020 at the private dental institute.The sample size that was taken included 6 children with cleft lip and palate (case group) and 6 childrenwithout cleft lip and palate (control group), who came to the private dental institute for consultation. Thegingival health status was evaluated using OHIS score and was compared between the groups. Data wasstatistically analysed using SPSS 2.0, Mann-Whitney U Test was conducted. Result was recorded. Thechildren with cleft lip and palate showed similar OHI-S scores compared to children without cleft lip andpalate. Therefore, it was concluded that within the limitations in current study, there was no difference inoral health status between children with cleft lip and palate and children without cleft lip and palate.

The editorial expression of concern regarding survey data analyzed by Neurath et al. (2019) cited the subsequent report by the Centers for Disease Control and Prevention (CDC) that noted data quality issues, misdiagnosis, and the biological implausibility of the 2011 to 2014 prevalence estimates. However, Neurath et al. believe that they have plausible explanations supporting increased prevalence in 2011 to 2012. We think not. Data from the CDC for 1992 and 2002 (CDC 2016), relevant for assessing exposure for the NHANES 1999 to 2004 and 2011 to 12 cohorts (National Health and Nutrition Examination Survey), respectively, indicate that the percentage of Americans living in fluoridated communities increased slightly from about 56% to 59%. It is implausible that this 5% increase explains the reported 8-fold increase in moderate and severe dental fluorosis. The authors erroneously state that the intake “equals or exceeds 0.6 mg/kg/d” when in fact Erdal and Buchanan (2005) estimate average intake levels of 0.05 and 0.06 mg/kg/d for <1and 3to 5-yold groups. Confirmation bias led them to overlook a more authoritative recent report (Environmental Protection Agency 2010) where estimated total fluoride intake for high-water-intake individuals of similar age is only 0.1 mg/kg/d. Moreover, Fejerskov’s dose-response calculation (1990) is based only on water, not total fluoride intake as claimed. Estimates from the 2015 to 2016 NHANES cycle indicate that a majority of US youth have very mild dental fluorosis, while the prevalence of moderate and severe dental fluorosis is only 1.4%. Contrary to Neurath and colleagues’ Knowledge Transfer Statement, the evidence does not indicate that objectionable dental fluorosis has increased in the United States.

Alveoloplasty has been defined as the surgical removal of a portion of the alveolar process. It has stated that some form of alveoloplasty is indicated in nearly every instance of multiple extractions and frequently even in single extraction. The aim of this study was to evaluate the prevalence of suture techniques in single tooth alveoloplasty wounds. The purpose of this study was to analyse the sutures used for single tooth alveoloplasty. A study was carried out by collecting data by reviewing patients data and analysing the data of 86000 patients between June 2019 and March 2020 at the private dental institute. A total number of 26 case sheets were reviewed from intra oral photographs and additional supports. Photographs were assessed to determine the technique of suturing for patients undergoing single tooth alveoloplasty. The study was evaluated and approved by the ethical committee of the private dental institute Data was statistically analysed using SPSS 2.0, Chi Square Test was conducted. The results were recorded. The results showed majority of the dental students provided simple interrupted sutures post single tooth alveoloplasty wounds. Statistically, the difference was not significantly associated between tooth number and type of suture in single tooth alveoloplasty wounds as the p value was 0.404, (Chi Square test, p>0.05). Within the limitation of present study, the majority of the dental students provided simple interrupted sutures post single tooth alveoloplasty wounds especially in relation to tooth number 37.

Oral lichen planus(OLP) is a common chronic mucocutaneous disorder with an immune mediatedpathogenesis. Etiology of OLP is unknown, but it is thought to be the result of an autoimmune process withan unknown predisposing factor. The clinical presentation of OLP ranges from mild painless white keratoticlesions to painful erosions and ulcerations. It has various oral manifestations with the reticular type beingthe most common. The erosive and atrophic variants are less common but most likely to cause symptoms.Topical corticosteroids constitute the mainstay for symptomatic lesions of OLP. The aim of this study is toinvestigate the prevalence of reticular variant of oral lichen planus.Materials and Methods: In the presentstudy a total of 68 patients were included. The demographic, clinical and treatment details were recorded. Allthe collected data was analyzed by SPSS IBM software Results: Among 63 patients with OLP 60.3% werefemales showing a bilateral involvement in the buccal mucosa (92.1%) with P<0.05. The reticular variantconstituted (37.1 %) of all the total cases and erosive variant was the most common (57.1%).Corticosteroidswere the most common drug. Conclusion:Within the limitations of the study it is evident that OLP has morefemale prevalence, erosive form was more frequent followed by the reticular form of Lichen planus. Buccalmucosa was the most commonly affected site and majority of the patients were treated using Corticosteroids.