Risk of Tooth Loss After Cigarette Smoking Cessation

INTRODUCTION. Little is known about the effect of cigarette smoking cessation on risk of tooth loss. We examined how risk of tooth loss changed with longer periods of smoking abstinence in a prospective study of oral health in men. METHODS. Research subjects were 789 men who participated in the Veterans Administration Dental Longitudinal Study from 1968 to 2004. Tooth status and smoking status were determined at examinations performed every 3 years, for a maximum follow-up time of 35 years. Risk of tooth loss subsequent to smoking cessation was assessed sequentially at 1-year intervals with multivariate proportional hazards regression models. Men who never smoked cigarettes, cigars, or pipes formed the reference group. Hazard ratios were adjusted for age, education, total pack-years of cigarette exposure, frequency of brushing, and use of floss. RESULTS. The hazard ratio for tooth loss was 2.1 (95% confidence interval [CI], 1.5-3.1) among men who smoked cigarettes during all or part of follow-up. Risk of tooth loss among men who quit smoking declined as time after smoking cessation increased, from 2.0 (95% CI, 1.4-2.9) after 1 year of abstinence to 1.0 (95% CI, 0.5-2.2) after 15 years of abstinence. The risk remained significantly elevated for the first 9 years of abstinence but eventually dropped to the level of men who never smoked after 13 or more years. CONCLUSION. These results indicate that smoking cessation is beneficial for tooth retention, but long-term abstinence is required to reduce the risk to the level of people who have never smoked.U.S. Department of Veterans Affairs Epidemiology (Merit Review grant); Massachusetts Veterans Epidemiology Research and Information Center; National Institutes of Health (R01 DA10073, R03 DE016357, R15 DE12644, K24 DE00419

Dental Service Utilization and Neighborhood Characteristics in Young Adults in The United States: A Multilevel Approach

Objective: To investigate the association between neighborhood level factors and dental visits in young adults in the United States after adjusting for individual level factors. Methods: The National Longitudinal Study of Adolescent Health Wave 1 (1994-1995) to Wave III (2001-2002) was analyzed. The primary outcome of having had at least one dental visit in the previous 12 months was analyzed via a multilevel random-effects logistic model accounting for geographic clustering in Wave III and survey design clustering from Wave I. Neighborhood level covariates were defined at the census tract level. Results: Overall rate of dental visits was 57 percent, highest among 18-20 year olds (65 percent) and lowest in 23-26 year olds (52 percent). Increased proportion of African-Americans (≤5 percent to ≥20 percent) and Hispanics (≤5 percent to ≥20 percent) in a neighborhood corresponded with a decrease in dental visits (60 percent versus 52 percent) and (58 percent versus 51 percent), respectively. Neighborhoods with a high proportion of college-educated residents had a higher percentage of dental visits. Similar differences were found when comparing the lowest and highest tertiles defined by poverty level and unemployment with dental visits. Neighborhood education was significantly associated with dental service utilization after adjustment for individual level factors and dental utilization in adolescence (Waves I and II) in the random effects model. Conclusions: This study demonstrates that the education level of residents within a neighborhood was associated with dental service utilization in young adults in the United States

Predictors of Dental Care Use: Findings From the National Longitudinal Study of Adolescent Health

Purpose To examine longitudinal trends and associated factors in dental service utilization by adolescents progressing to early adulthood in the United States. Methods The data source was the National Longitudinal Study of Adolescent Health from Waves I (1994–1995), II (1996), III (2001–2002), and IV (2007–2008). This was a retrospective, observational study of adolescents\u27 transition to early adulthood. We obtained descriptive statistics and performed logistic regression analyses to identify the effects of baseline and concurrent covariates on dental service utilization from adolescence to early adulthood over time. Results Dental service utilization within the prior 12 months peaked at age 16 (72%), gradually decreased until age 21 (57%), and remained flat thereafter. Whites and Asians had a 10–20 percentage points higher proportion of dental service utilization at most ages compared with Blacks and Hispanics. Dental service utilization at later follow-up visits was strongly associated with baseline utilization, with odds ratio = 10.7, 2.4, and 1.5 at the 1-, 7-, and 13-year follow-ups, respectively. These effects decreased when they were adjusted for current income, insurance, and education. Compared with Whites, Blacks were consistently less likely to report a dental examination. Conclusions Dental service utilization was highest in adolescence. Gender, education, health insurance, and income in young adulthood were significant predictors in reporting a dental examination. Blacks had lower odds of reporting a dental examination, either as adolescents or as young adults

Provision of Fluoride Varnish Treatment by Medical and Dental Care Providers: Variation by Race/Ethnicity and Levels of Urban Influence

Objective: In 2004, Wisconsin Medicaid policy changed to allow medical care providers to be reimbursed for fluoride varnish treatment (FVT) to children\u27s teeth to improve access and utilization. To date, no study has been published on whether geographic and racial/ethnic variation in the provision of FVT in response to this policy change exists. This study\u27s objective is to examine the association of rates of FVT for children enrolled in Wisconsin Medicaid with race/ethnicity, urban influence codes (UIC), and dental health professional shortage area (DHPSA) designation based on county of residence. Methods: A retrospective, pre–post design was used based on FVT claims for children in the Wisconsin Medicaid program from 2002 to 2006. Poisson regression models were used to evaluate the association of rates of FVT claims with race/ethnicity, UIC, and DHPSA designation. Results: The rate of FVT claims varied by resident county-type according to UIC and DHPSA designation, age, and race/ethnicity. Post-policy, the largest increases were observed for Native Americans residing in non-DHPSA counties, enrollees living in rural counties, and for Hispanics living in partial and entire DHPSA counties. African-Americans residing in partial DHPSA and metropolitan counties displayed the lowest rates of FVT claims. Conclusions: Overall access and utilization of FVT increased, but substantial racial/ethnic and geographic variation in the provision of FVT for children enrolled in Wisconsin Medicaid was observed. Future policies should incorporate measures that will specifically address the racial and geographic variations identified in this study

A deterministic detector for vector vortex states

Encoding information in high-dimensional degrees of freedom of photons has led to new avenues in various quantum protocols such as communication and information processing. Yet to fully benefit from the increase in dimension requires a deterministic detection system, e.g., to reduce dimension dependent photon loss in quantum key distribution. Recently, there has been a growing interest in using vector vortex modes, spatial modes of light with entangled degrees of freedom, as a basis for encoding information. However, there is at present no method to detect these non-separable states in a deterministic manner, negating the benefit of the larger state space. Here we present a method to deterministically detect single photon states in a four dimensional space spanned by vector vortex modes with entangled polarisation and orbital angular momentum degrees of freedom. We demonstrate our detection system with vector vortex modes from the |[Formula: see text]| = 1 and |[Formula: see text]| = 10 subspaces using classical and weak coherent states and find excellent detection fidelities for both pure and superposition vector states. This work opens the possibility to increase the dimensionality of the state-space used for encoding information while maintaining deterministic detection and will be invaluable for long distance classical and quantum communication

Impact of Wisconsin Medicaid Policy Change on Dental Sealant Utilization

Background In September 2006, Wisconsin Medicaid changed its policy to allow nondentists to become certified Medicaid providers and to bill for sealants in public health settings. Objective This study examined changes in patterns of dental sealant utilization in first molars of Wisconsin Medicaid enrollees associated with a policy change. Data Source The Electronic Data Systems of Medicaid Evaluation and Decision Support for Wisconsin from 2001 to 2009. Study Design Retrospective claims data analysis of Wisconsin Dental Medicaid for children aged 6-16 years. Principal Findings A total of 479,847 children followed up for 1,441,300 person-years with 64,546 visits were analyzed. The rate of visits for sealants by dentists increased significantly from 3 percent per year prepolicy to 11 percent per year postpolicy, and that of nondentists increased from 18 percent per year to 20 percent after the policy change, but this was not significant. Non-Hispanic blacks had the lowest visit rates for sealant application by dentists and nondentists pre- and postpolicy periods. Conclusions The Wisconsin Medicaid policy change was associated with increased rates of visits for dental sealant placement by dentists. The rate of visits with sealant placements by nondentists increased at the same rate pre- and postpolicy change