Objectives: This study assessed the interest of California water professionals regarding continuing education on water fluoridation, examining how this interest correlates with their roles, opinions on fluoridation's oral health benefits, and the fluoridation status of their systems.

Methods: In 2024, a comprehensive survey was distributed by email with two follow up messages to initial non-respondents. The survey was sent to 10,350 water professionals who have responsibility for compliance reporting to their regulatory/permitting agency which is the California State Water Resources Control Board. Data were collected using Qualtrics on their opinions and interest in further training related to water fluoridation. Descriptive statistics, chi-square tests and logistic regression models were employed to analyze the data.

Results: We received 334 (3.2%) responses to the survey. Overall, these responses revealed a substantial interest in continuing education on fluoridation, although this interest was not strongly associated with personal beliefs about the benefits of fluoridation for oral health. Instead, interest was more significantly associated with the fluoridation status of their systems and their general valuation of continuing education. Awareness of the CDC’s Fluoridation Learning Online was low, with 12% of respondents aware of this resource.

Conclusions: The findings suggest a need for continuing education in water fluoridation to bridge the knowledge gaps among water professionals. Enhancing the promotion of existing online resources and developing tailored educational initiatives could support effective fluoridation practices. Policy efforts should also consider the diverse perspectives and educational needs of water professionals to foster broader support and effective implementation of fluoridation programs.

Public health dentistry is essential for preventing oral disease and reducing disparities. School-based dental sealant programs (SBDSPs) promote pediatric oral health equity, particularly for underserved students. SEAL!ND, North Dakota’s state-led SBDSP, has provided preventive dental services since 2012, prioritizing schools where ≥45% of students qualify for free or reduced-fee lunch. This study analyzes ten years of SEAL!ND data (2014–2024) to assess trends in program reach, racial disparities, and public health impact.

In 2023–24, SEAL!ND served 70 schools, screening 3,070 students and applying 8,531 sealants. Program reach expanded from 18 qualifying schools in 2014–15 to 54 in 2023–24, despite a pandemic-related drop to 21 in 2021–22. However, early care gaps persist—kindergarten students without prior dental visits increased from 36% (2022–23) to 46% (2023–24). Additionally, 40% of students required urgent or early dental referrals, down from 47% in 2021–22, reflecting gradual post-pandemic improvement. American Indian students, 21% of participants, had higher rates of untreated decay (58% vs. 36%) and urgent care needs (7% vs. 4%), reinforcing the need for equitable oral health interventions. SEAL!ND continues targeted outreach to address these disparities. Beyond qualifying schools, volunteer dental teams extended services to 16 non-qualifying schools in 2023–24, further broadening SEAL!ND’s impact.

SEAL!ND’s steady growth and expanded outreach highlight its sustained public health impact. To further advance oral health equity, key priorities include expanding school partnerships, increasing provider participation in Medicaid, and integrating culturally responsive care into program delivery to improve long-term access and outcomes.

Background: Emerging evidence suggests that the oral microbiome may influence cognitive health through mechanisms involving neuroinflammation and systemic inflammation. This study investigates the relationship between oral microbiome diversity, taxonomic composition, and cognitive performance in older adults using NHANES 2011-12 data.

Methods: We analyzed data from adults aged 60-69 years who had both oral microbiome sequencing and cognitive assessments. Alpha diversity (within-sample diversity) and beta diversity (between-sample diversity) were assessed using standardized metrics. Taxonomic composition was analyzed at multiple levels to identify bacterial genera associated with cognitive function. Cognitive performance was evaluated using the CERAD Word Learning Test, Digit Symbol Substitution Test (DSST), and Animal Fluency Test, along with self-reported memory concerns. Multivariable regression models were used to examine associations while adjusting for key confounders: Sociodemographic & Psychosocial Factors, Oral & Systemic Health, Lifestyle & Behavioral Factors, Medication & Environmental Exposures

Results: Preliminary findings suggest that lower oral microbiome diversity is associated with poorer cognitive performance. Additionally, specific bacterial taxa were differentially abundant between individuals with high and low cognitive scores, indicating potential microbial biomarkers of cognitive health.

Conclusion: These findings highlight the oral microbiome as a possible modifiable factor in cognitive decline. Further research is needed to explore causal relationships and potential interventions targeting the oral microbiome to support cognitive health

Background: The US has made significant improvements in oral health in children over the past two decades. However, progress among adults has been limited, with persistent disparities and inequities. Research on dental care utilization disparities among US adults with diabetes remains scarce. This study aims to fill this gap.

Methods: The 2022 Behavioral Risk Factor Surveillance System (BRFSS) data was utilized to examine the primary outcome — having a dental visit within the past year — among US adults 18 years or older with diabetes. The primary independent variable was rural residence. Other covariates were selected based on theoretical relevance. The weighted Chi-square tests and multivariable logistic regression were used to assess the association between rural residence and dental visits.

Results: Among 61,158 adults with diabetes, 57.6% had a dental visit within the past year. However, a small proportion of rural residents accessed dental care compared to urban residents (50.1% vs. 58.3%; p<0.001). After adjusting for confounders, rural residents had 16% lower odds of having a dental visit in the past year (aOR=0.84, 95%CI: 0.71 – 0.99). Factors associated with a higher likelihood of dental visits included being female, being married, having higher education and income, retirement, having insurance and personal care provider, being a never-smoker, having no depression, and having routine doctor’s visits in the past 12 months.

Conclusion: US adults with diabetes in rural areas have lower access to oral health care, affirming the need for policy and practice interventions to increase dental care accessibility for remote communities.

Background: Oral health among cancer patients is of high importance, but information on dental services usage among cancer patients remains understudied. This study examined dental care utilization and expenditures among U.S. adults aged 45 years and older with cancer and compared them to those without.

Methods: A pooled analysis using the 2017–2019 Medical Expenditure Panel Survey was conducted. Primary outcomes included a preventive dental visit, and dental expenditures. The primary exposure was self-reported cancer diagnosis. Survey-weighted chi-square tests and logistic regression models assessed associations between cancer diagnosis and dental care use. Mean healthcare and dental expenditures were compared across groups.

Results: The study population included adults aged ≥45 years (n=37,568), with 17.5% having a cancer diagnosis (n=6,556). Among cancer patients, 57.3% had any type of dental visit and 26.3% had a preventive dental visit. Among cancer group, higher odds of preventive dental care utilization were associated with age 65–74 (aOR=1.19, 95%CI:1.07–1.33), females (aOR=1.26, 95%CI:1.17–1.35), having dental insurance (aOR=1.3, 95%CI:1.22-1.45). Private health insurance, income >400%FPL, education beyond college, and non-Hispanic White race were associated with higher odds of preventive dental visits among cancer patients. Individuals with a cancer diagnosis had higher average dental expenditure ($574 v/s 442; p-value:<.0001), but those who had a preventive dental visit had a lower average dental care expenditure ($359.9 v/s $374.35; p-value<.0001) compared to those without cancer.

Conclusion: Adults with cancer face significant socioeconomic disparities in dental utilization. Promoting preventive dental care among cancer patients can improve their oral health and reduce dental care costs.

Introduction: For dentists who are also parents, the demands of their careers often put them in challenging positions related to their families and work-life balance. While numerous studies have examined the effects of pregnancy and parenthood on the longevity and satisfaction of physician careers, research specific to dentistry is lacking.

Methods and analysis: This cross-sectional survey aims to understand the collective experiences of pregnancy, breastfeeding, childbearing, infertility, and parenthood across various practice models (academic, private practice, corporate, public health, residency) and specialties of dentistry. The survey asks questions focused on the personal encounters, occupational factors and systemic barriers (including policies or lack thereof) that impact a respondent's experiences. Demographic information collected will include, in addition to sex and gender, age, race, ethnicity, income, family status, childbearing status, nursing experience, and years of employment. It will be open to both male and female practicing dentists and dental residents. Potential survey respondents will be contacted via alumni newsletters and social media accounts; current dental residents will be invited to participate via their residency emails, and the survey will be administered electronically via REDCAP. Descriptive statistics used to summarize survey responses will be analyzed in R; open-ended questions will be addressed in Dedoose software using qualitative methodology according to the tenets of grounded theory.

Conclusions: Study results will inform institutional protocols and implementation research to more effectively support dentists facing parenting challenges and promote their well-being and career progression opportunities.

Background: Dental decay remains the most common chronic disease among children. Language isolation impacts access to dental care. The Cambridge Healthy Smiles Program screens about 90% of PK, 1st, 3rd, 6th, and 9th grade public school students in Cambridge, MA, a linguistically diverse population.

Objective: Determine oral health disparities related to home language among Cambridge Public School students.

Methods: We compared the distribution of treatment recommendations (continuing standard care, cleaning or sealants, dental exam for possible decay, urgent care referral) between English and non-English home language groups for all in-school screenings from fall 2019 to spring 2025 using a Chi-square test of independence. We compared the percentage of students with a treatment recommendation indicating decay by home language, with the top 7 most spoken languages included.

Results: There was a significant difference in the distribution of treatment recommendations by language group (p<0.001). 49% of students who spoke English at home received a treatment recommendation beyond standard care, compared to 60% of students who spoke other languages. Overall, 18% of students had possible decay. Students who speak Amharic (31%), Arabic (29%), and Haitian Creole (29%) had the highest rates of decay, followed by those who spoke Bengali (26%) and Chinese (24%). Students who spoke Spanish (18%) or English (15%) had the lowest rates of decay.

Conclusion: There are disparities in dental outcomes based on home language, highlighting the need for targeted programming within Cambridge, MA. Further research is needed to address these disparities on a state and national level.

Background: Bullying is an ongoing issue that impacts the mental and physical health of adolescents, particularly in school settings. The National Center for Educational Statistics reported that one out of every five students reported being bullied, and 41.3% of students who reported being bullied at school indicated that bullying would happen again (National Center for Education Statistics, 2022). Adolescents who are not satisfied with their body appearances, such as dissatisfaction with oral health and body image, are more likely to be victims of bullying (Siqueira et al., 2019). Bullying related to facial appearances is an important yet often overlooked public health issue. Adolescents who have visible oro-facial differences (e.g., malocclusion, missing teeth, or discoloration) often experience social stigma, leading to mental health outcomes, low self-esteem, and avoidance of dental care (Kaur et al., 2017). This study aims to understand and address the experiences of minority urban adolescents in urban communities with bullying and its effects.

Methods: A focus group research design with adolescents aged 13 to 17 was used to explore bullying experiences among at-risk minority adolescents living in an urban community. Each focus group had four to five adolescents per group. A semi-structured interview guide was used to facilitate discussion about their experiences with bullying and bullying behavior.

Results: Data collection is currently ongoing.

Conclusions: From the focus group, we hope to learn about adolescents' experiences and develop intervention programs aimed at mitigating their exposure, preventing bullying, and addressing related issues with oral health.

One of the most common infectious diseases in the world is dental caries. Dental caries, also known as tooth decay or cavities, is caused by certain types of tooth-adherent cariogenic bacteria in the mouth (primarily Streptococcus mutans) which metabolize sugars in food and drinks to produce acid. The acid causes enamel and dentin demineralization of tooth structure and eventual cavitation over time. This study was done to test the erosive effects on extracted teeth submerged in different solutions of varying levels of acids and sugar that are found in commonly consumed drinks such as sodas, coffee, tea, and juices over a period of time. In my study, 80 extracted teeth were divided into 16 groups, tested against 3 different levels of pH and sugar over the exposure period of 8 weeks. The teeth were photographed, radiographed and weighed to analyze for any erosive damage to the coronal and root structures. Over 8 weeks, decalcification of the enamel and root thinning were evident in the groups of teeth with lowering pH levels. Without bacterial presence, when different levels of sugar were introduced to the solutions, no statistical changes were noted in demineralization. In conclusion, this study shows the harmful effects of acid to dental tooth structures over the duration of 8 weeks. This study helps us to further understand the disease process of dental caries which is crucial for advancing knowledge & technologies, identifying risk factors, developing better treatments, and improving oral health outcomes for individuals and communities across the world.

Background: Poor oral health is predictive of poor health across the lifespan. Dental caries is the most common childhood chronic disease, yet largely preventable. Despite the availability of effective interventions, specifically dental sealants, untreated dental caries persist among children and adolescents. The purpose of this study is to examine the prevalence of untreated dental decay among adolescents with and without dental sealants.

Methods: Data on US adolescents (12-19 years) from 2011-2016 was pooled from NHANES (n=3,807). The outcome was untreated decay on permanent molars and the exposure was the presence of any molar dental sealants. Descriptive and bivariate analyses were conducted to examine sociodemographic characteristics of the study population and associations with the outcome using chi-square tests. Multivariable logistic regression models examined the relationship between untreated caries and dental sealants, controlling for pertinent variables. All analyses were weighted and conducted using SAS survey procedures.

Results: Approximately 15.0% of adolescents had at least one untreated molar dental caries. Almost half of adolescents had at least one dental sealant on any permanent molar (47.2%)Adolescents with at least one dental sealant had 3 times lower odds (OR =2.92, 95% CI:2.08,4.09) of having untreated dental caries compared to adolescents without any dental sealant

Conclusions: Dental sealants are associated with significant reductions in untreated molar caries among adolescents. Programs and policies should be promoted to increase access to dental sealants amongst adolescents.

Keywords: oral health, adolescents, dental sealants