Nutrition Education in Clark County, Nevada

Over 51 million school hours are missed annually by school-aged children due to a dental problem or visit, with 117 hours missed per 100 children (NIDCR, 2002). Approximately half a million of California\u27s 7.2 million school-age children missed at least one day of school in 2007 because of dental issues such as toothaches (Pourat, & Nicholson, 2009). Independent research regarding various educational and intervention programs have been conducted in elementary schools across the country that focus on nutrition and/or physical activity, some of which have found that the programs positively impacted students’ dietary behaviors (Edwards, Mauch, & Winkelman, 2011; Muth, Chatterjee, Williams, Cross, & Flower, 2008; Tuuri et al., 2009). However, there does not appear to be literature regarding the standardization of nutrition and oral health education curricula for elementary school children. Nevertheless, there are school districts that have well structured health education curricula that cover nutrition and oral health education (California Department of Education, 2009; Central Michigan University, 2005). All of these reports are in agreement with Dietz, et al (2008) which reported that nutrition and oral hygiene education should be an integral part of keeping growing children healthy and forming good nutrition habits that will carry into adulthood

A Study to Determine if University Athletic Teams in Desert Environments Experience Risky Diet-related Behaviours

Training and competing in desert environments may exacerbate concerns related to disordered eating, supplement use, and hydration in some student athlete populations. A survey administered equitably to both genders solicited self-reported responses from members of 18 different teams over four years from a southwestern United States university athletic program. More than 1,700 athletes responded to 42 items on the questionnaire. Teams, not individual student athletes, were the units of measure for statistical analyses. Initial analysis of results indicated that there were no overt concerns regarding dietary behaviors due to training and competing in the desert environment. Further analysis subjected the team responses to principle component factor analysis and determined the construct validity using Varimax rotation with Kaiser normalization. Six factors were identified which accounted for 93% of total variance associated with reported risky dietary related behaviors among athletic teams. Specifically, the factors contributing to dietary related behavior total variance were; 1) weight loss and exercise issues and practices -47.15%, 2) self-image - 26.00%, 3) hydration - 10.92%, 4) supplement use - 3.85%, 5) disordered eating - 3.70%, and 6) hormonal issues - 1.71%. University athletic programs should use routine assessment of dietary related behaviours, including hydration, to help identify team members practicing risky dietary related behaviours

Interprofessional Faculty Development: Integration of Oral Health into the Geriatric Diabetes Curriculum, from Theory to Practice.

Georgia Dounis,1 Marcia Ditmyer,2 Susan VanBeuge,3 Sue Schuerman,4 Mildred McClain,1 Kiki Dounis,1,5 Connie Mobley21Department of Clinical Sciences, 2Department of Biomedical Sciences, 3Department of Physiological Nursing, 4Department of Physical Therapy, University of Nevada Las Vegas School of Dental Medicine, Las Vegas, NV, USA; 5Department of Family Medicine, University of Nevada School of Medicine, Reno, NV, USABackground: Health care workforce shortages and an increase demand for health care services by an older demographic challenged by oral–systemic conditions are being recognized across health care systems. Demands are placed on health care professionals to render coordinated delivery of services. Management of oral–systemic conditions requires a trained health care workforce to render interprofessional patient-centered and coordinated delivery of health care services. The purpose of this investigation was to evaluate the effectiveness of an interprofessional health care faculty training program.Methods: A statewide comprehensive type 2 diabetes training program was developed and offered to multidisciplinary health care faculty using innovative educational methods. Video-recorded clinically simulated patient encounters concentrated on the oral–systemic interactions between type 2 diabetes and comorbidities. Post-encounter instructors facilitated debriefing focused on preconceptions, self-assessment, and peer discussions, to develop a joint interprofessional care plan. Furthermore, the health care faculty explored nonhierarchical opportunities to bridge common health care themes and concepts, as well as opportunities to translate information into classroom instruction and patient care.Results: Thirty-six health care faculty from six disciplines completed the pre-research and post-research assessment survey to evaluate attitudes, knowledge, and perceptions following the interprofessional health care faculty training program. Post-training interprofessional team building knowledge improved significantly. The health care faculty post-training attitude scores improved significantly, with heightened awareness of the unique oral–systemic care needs of older adults with type 2 diabetes, supporting an interprofessional team approach to care management. In addition, the health care faculty viewed communication across disciplines as being essential and interprofessional training as being vital to the core curriculum of each discipline. Significant improvement occurred in the perception survey items for team accountability and use of uniform terminology to bridge communication gaps.Conclusion: Attitude, knowledge, and perceptions of health care faculty regarding interprofessional team building and the team approach to management of the oral–systemic manifestations of chronic disease in older adults was improved. Uniform language to promote communication across health professionals, care settings, and caregivers/patients, was noted. Interprofessional team building/care planning should be integrated in core curricula.Keywords: team building, patient-centered care, oral–systemic, older adult

Obesity Reduction Within a Generation: The Dual Roles of Prevention and Treatment

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93699/1/oby.2011.199.pd

A case-control study of determinants for high and low dental caries prevalence in Nevada youth

<p>Abstract</p> <p>Background</p> <p>The main purpose of this study was to compare the 30% of Nevada Youth who presented with the highest Decayed Missing and Filled Teeth (DMFT) index to a cohort who were caries free and to national NHANES data. Secondly, to explore the factors associated with higher caries prevalence in those with the highest DMFT scores compared to the caries-free group.</p> <p>Methods</p> <p>Over 4000 adolescents between ages 12 and 19 (Case Group: N = 2124; Control Group: N = 2045) received oral health screenings conducted in public/private middle and high schools in Nevada in 2008/2009 academic year. Caries prevalence was computed (Untreated decay scores [D-Score] and DMFT scores) for the 30% of Nevada Youth who presented with the highest DMFT score (case group) and compared to the control group (caries-free) and to national averages. Bivariate and multivariate logistic regression was used to analyze the relationship between selected variables and caries prevalence.</p> <p>Results</p> <p>A majority of the sample was non-Hispanic (62%), non-smokers (80%), and had dental insurance (70%). With the exception of gender, significant differences in mean D-scores were found in seven of the eight variables. All variables produced significant differences between the case and control groups in mean DMFT Scores. With the exception of smoking status, there were significant differences in seven of the eight variables in the bivariate logistic regression. All of the independent variables remained in the multivariate logistic regression model contributing significantly to over 40% of the variation in the increased DMFT status. The strongest predictors for the high DMFT status were racial background, age, fluoridated community, and applied sealants respectively. Gender, second hand smoke, insurance status, and tobacco use were significant, but to a lesser extent.</p> <p>Conclusions</p> <p>Findings from this study will aid in creating educational programs and other primary and secondary interventions to help promote oral health for Nevada youth, especially focusing on the subgroup that presents with the highest mean DMFT scores.</p

Validation of a multifactorial risk factor model used for predicting future caries risk with nevada adolescents

<p>Abstract</p> <p>Background</p> <p>The objective of this study was to measure the validity and reliability of a multifactorial Risk Factor Model developed for use in predicting future caries risk in Nevada adolescents in a public health setting.</p> <p>Methods</p> <p>This study examined retrospective data from an oral health surveillance initiative that screened over 51,000 students 13-18 years of age, attending public/private schools in Nevada across six academic years (2002/2003-2007/2008). The Risk Factor Model included ten demographic variables: exposure to fluoridation in the municipal water supply, environmental smoke exposure, race, age, locale (metropolitan vs. rural), tobacco use, Body Mass Index, insurance status, sex, and sealant application. Multiple regression was used in a previous study to establish which significantly contributed to caries risk. Follow-up logistic regression ascertained the weight of contribution and odds ratios of the ten variables. Researchers in this study computed sensitivity, specificity, positive predictive value (PVP), negative predictive value (PVN), and prevalence across all six years of screening to assess the validity of the Risk Factor Model.</p> <p>Results</p> <p>Subjects' overall mean caries prevalence across all six years was 66%. Average sensitivity across all six years was 79%; average specificity was 81%; average PVP was 89% and average PVN was 67%.</p> <p>Conclusions</p> <p>Overall, the Risk Factor Model provided a relatively constant, valid measure of caries that could be used in conjunction with a comprehensive risk assessment in population-based screenings by school nurses/nurse practitioners, health educators, and physicians to guide them in assessing potential future caries risk for use in prevention and referral practices.</p

Risk assessment – can we achieve consensus?

Objective The object of this conference paper was to review and discuss caries risk assessment in general practice from the questions i) ‘Why’, ii) ‘When’, and iii) ‘How’. Method Narrative review. Results i) Patient caries risk assessment is the basic component in the decision‐making process for adequate prevention and management of dental caries and for determination of individual recall intervals . ii) Caries risk assessment should always be performed at a child's first dental visit and then regularly throughout life, and especially when social or medical life events are occurring. iii) There are several risk assessment methods and models available for but the evidence for their validity is limited. Although there is no clearly superior method for predicting future caries, the use of structured protocols combining socioeconomy, behavior, general health, diet, oral hygiene routines, clinical data, and salivary tests or computer‐based systems are considered best clinical practice. The accuracy ranges between 60% and 90%, depending on age. Caries risk assessment is more effective in the selection of patients at low risk than those with high caries risk. Conclusion As evidence suggests that past caries experience is far from ideal but the most important single risk component for more caries at all ages, any clinical sign of likely active demineralization on smooth, occlusal, and proximal tooth surfaces should be taken as a signal for the implementation of individually designed preventive and disease management measures.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96394/1/cdoe12026.pd

2015 American College of Rheumatology Workforce Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144285/1/art40432_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144285/2/art40432.pd

Does Secondhand Smoke Affect the Development of Dental Caries in Children? A Systematic Review

This review evaluated evidence of the relationship between secondhand smoke (SHS) and dental caries in children in epidemiological studies. Relevant literature was searched and screened, and the methodological quality was assessed. The search yielded 42 citations. High-quality studies including one cohort format and 14 case-control format studies were selected. Early childhood caries was examined in 11 studies. The independent association of SHS was significant in 10 studies, and the strength was mostly weak to moderate. One study did not select SHS as a significant variable. Three studies reported decreases in the risk of previous exposure, and the association was not significant. Dose-response relationships were evident in five studies. Permanent teeth were examined in seven studies. Five studies reported significant associations, which were mostly weak. The risk of previous exposure remained similar to that of current exposure, and a dose-response relationship was not evident in one study. The overall evidence for the causal association in early childhood caries is possible regarding epidemiological studies, and the evidence of permanent teeth and the effect of maternal smoking during pregnancy were insufficient. The results warrant further studies of deciduous teeth using a cohort format and basic studies regarding the underlying mechanism