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

Oral diseases have been associated with an increased risk of cerebrovascular disease incidence, but evidence regarding their impact on cerebrovascular disease mortality remains limited.

Objective

This study aimed to examine the associations between periodontitis, missing teeth, dental caries, and stomatitis and both the incidence and mortality of cerebrovascular disease in a large Korean population.

Methods

This retrospective cohort study utilized data from the National Health Insurance Service (NHIS) Health Screening Cohort. A total of 113,506 adults aged ≥40 years who underwent health and oral examinations in 2005–2006 were followed for up to 14 years. Oral diseases were assessed as independent variables, and cerebrovascular disease incidence and mortality were defined based on the World Health Organization’s International Classification of Diseases, 10th Revision (ICD-10; codes I60–I69). Kaplan–Meier survival analysis, log-rank tests, and Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95% confidence intervals (CI).

Results

During follow-up, 21.38% of participants developed cerebrovascular disease, and 0.26% died. Periodontitis (HR = 1.05, 95% CI: 1.02–1.09), dental caries (HR = 1.05, 95% CI: 1.01–1.09), and having ≥15 missing teeth (HR = 2.26, 95% CI: 2.02–2.50) were significantly associated with increased risk of cerebrovascular disease. Additionally, having ≥15 missing teeth was significantly associated with increased cerebrovascular disease-related mortality (HR = 1.65, 95% CI: 1.35–2.80).

Conclusion

Periodontitis, dental caries, and severe tooth loss are associated with increased risks of both incidence and mortality of cerebrovascular disease. These findings highlight the importance of oral health management in preventing cerebrovascular disease and improving survival.

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.

Objective:

This study investigates the relationship between Oral Health-Related Quality of Life (OHRQoL) domains and depression severity among adults.

Methods:
This observational study analyzed data from the 2021–23 National Health and Nutrition Examination Survey. Participants aged 20 years and older were included. Five outcome variables, representing four OHIP domains, were re-categorized into three categories for analysis: very often/often; occasionally; hardly ever/never. Multinomial logistic regression models were used, adjusting for depression severity, demographic, and socio-economic factors.

Results:
Among the 4,534 participants in the study, 12.58% experienced moderate to severe depression, while 20% reported mild depressive symptoms. Notable, 20.85% of individuals with moderate to severe depression reported often feeling self-conscious about their appearance, and 18% frequently avoided certain foods due to problems with their teeth, mouth, or dentures. The odds of often feeling uncomfortable eating food rather than hardly ever being uncomfortable was 7.3 times greater for people with severe depressive symptoms than those who did not have depression. Compared to adults without depression, those with severe depression had 11.39 times higher odds of often having difficulty doing their usual job or attending school due to problems in their teeth, mouth, or dentures rather than those who hardly ever experienced such problems.

Conclusion:
This study underscores the challenges faced by individuals experiencing varying levels of depression, which adversely affect their quality of life and psychosocial functioning. Incorporating depression screening into dental practice and fostering care coordination could improve dental service utilization, leading to better oral health outcomes and enhanced OHRQoL.

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.