Search PubMed⌕ Search

Biomedical subjects

Amid I Ismail

Publications and source records attributed to Amid I Ismail.

16 recordsLinked to original sources
PubMed2007

Dental caries.

Dental caries, otherwise known as tooth decay, is one of the most prevalent chronic diseases of people worldwide; individuals are susceptible to this disease throughout their lifetime. Dental caries forms through a complex interaction over time between acid-producing bacteria and fermentable carbohydrate, and many host factors including teeth and saliva. The disease develops in both the crowns and roots of teeth, and it can arise in early childhood as an aggressive tooth decay that affects the primary teeth of infants and toddlers. Risk for caries includes physical, biological, environmental, behavioural, and lifestyle-related factors such as high numbers of cariogenic bacteria, inadequate salivary flow, insufficient fluoride exposure, poor oral hygiene, inappropriate methods of feeding infants, and poverty. The approach to primary prevention should be based on common risk factors. Secondary prevention and treatment should focus on management of the caries process over time for individual patients, with a minimally invasive, tissue-preserving approach.

Biofilms↗
PubMed2006

Assessment of the relationship between neighborhood characteristics and dental caries severity among low-income African-Americans: a multilevel approach.

OBJECTIVES: To assess the relationship between neighborhood effects and the severity of dental caries among low-income African-Americans. METHODS: A multistage probability sample of African-American families living in the poorest 39 census tracts in Detroit was drawn. During 2002-03, cross-sectional data of a cohort that includes 1021 caregivers were collected in the first of three waves of interviews and examinations. Multilevel analyses focused on 27 neighborhood clusters and involved a combination of individual (Level-1) and neighborhood (Level-2) data including census and geocoded (address matching to census geographic areas) information. RESULTS: There is significant variation in the severity of caries between low-income neighborhood clusters. Caries severity decreases with a higher number of churches, while it increases with a higher number of grocery stores in the clusters after accounting for individual characteristics. Only 14% of the inter-individual variability in caries was explained by classical individual risk factors for this condition. CONCLUSION: Neighborhoods contribute something unique to caregivers' oral health, beyond socioeconomic position and individual risk factors. Multilevel interventions are necessary to reduce disparities among African-Americans and churches may offer a promising venue from which to conduct them.

Adolescent↗
PubMed2006

Dietary patterns related to caries in a low-income adult population.

The aim of this study was to examine the relationship between dietary patterns and caries experience in a representative group of low-income African-American adults. Participants were residents of Detroit, Michigan, with household incomes below 250% of the federally-established poverty level (n = 1,021). Dietary histories were obtained by trained interviewers in face-to-face interviews with the adult participants, using the Block 98.2 food frequency questionnaire. Caries was measured by the ICDAS criteria (International Caries Detection and Assessment System). There were 200 dietary records whose data were judged to be invalid; these participants were omitted from the dietary analyses to leave n = 821. Factor analysis identified patterns of liquid and solid food consumption, and the resulting factor scores were used as covariates in multivariable linear regression. Caries was extensive, with 82.3% of the 1,021 participants (n = 839) having at least one cavitated lesion. Nearly three quarters of the adult participants were overweight or obese. This population had severe caries, poor oral hygiene, and diets that are high in sugars and fats and low in fruits and vegetables. Apart from tap water, the most frequently consumed food item by adults of all ages was soft drinks; 19% of all energy from sugar came from soft drinks alone. In both the bivariate analyses and in the regression model, frequency of soft drink consumption and the presence of gingival plaque deposits were significantly associated with caries. Interventions to promote oral health are unlikely to be successful without improvements in the social and physical environment.

Adolescent↗
PubMed2005

Cigarette smoking among low-income African Americans: a serious public health problem.

BACKGROUND: This study examines the current prevalence of cigarette smoking and the number of cigarettes smoked in a community-based sample of 1021 low-income African-American men and women. METHODS: Participants were selected using a two-stage, area probability sample design. Data were collected in 2002-2003 in face-to-face interviews and analyzed in 2005. All data and analyses were weighted to account for the complex sampling design. RESULTS: Fifty-nine percent of men and 41% of women were current smokers, with younger individuals apparently initiating smoking at an earlier age than older individuals. CONCLUSIONS: The high prevalence of cigarette use provides further evidence that the excess burden of tobacco-related disease among low-income African-American families may be on the rise. This is of great concern, and if confirmed by further research, indicates an urgent need for preventive intervention.

Adolescent↗
PubMed2005

Knowledge of oral cancer and screening practices of primary care providers at Federally Qualified Health Centers.

OBJECTIVES: Primary care providers (PCPs) who worked in Federally-Qualified Health Centers (FQHC) in Michigan were surveyed to assess their knowledge level and practices related to screening and preventing oral cancer. METHODS: A questionnaire was developed with the assistance of dental and medical experts, and revised through focus groups. The questionnaire included one case scenario describing a suspicious oral lesion in a 55-year old female patient, followed by questions assessing PCPs' knowledge level, attitude, opinion, and screening practices for oral cancer. This mail survey was conducted in 2003. RESULTS: Survey response rate was 56.4%. Over 70% of the respondents reported that they screen patients for oral cancer during a routine physical examination. Forty-four percent of PCPs had high knowledge level, based on the scenario questions. Those who had high knowledge level were more likely to be physicians, males, and more likely to perform screening for oral cancer than those with low knowledge level. There was no difference in age and race/ethnicity between high and low knowledge groups. Perceived barriers included (1) lack of education; (2) lack of specialists to refer patients; and (3) lack of reimbursement. CONCLUSIONS: The majority of PCPs in this survey had positive attitudes about performing screening for oral cancer. To involve PCPs in screening for oral cancer, oral health programs should focus on providing up-to-date education, setting up a referral system, and providing proper reimbursement.

Adult↗
PubMed2005

Regular dental visits and dental anxiety in an adult dentate population.

BACKGROUND: The objective of this study was to investigate factors associated with regular dental visits in an adult population. METHODS: A representative sample of non-institutionalized dentate adults (aged 18 through 69 years) from the Detroit tricounty area (Wayne, Macomb and Oakland counties) was randomly selected using list-assisted random digit dialing. The authors collected the data through a self-administered questionnaire that asked for information about regular dental visits, private dental insurance, perceived oral health status and dental treatment experience. The authors used Corah's Dental Anxiety Scale to measure respondents' dental anxiety level. They also conducted a descriptive analysis and a logistic regression analysis. RESULTS: A final sample of 630 adults who resided in 368 households participated in this study. Seventy-two percent of respondents had dental insurance (excluding Medicaid). About 63 percent reported that they visited a dentist regularly. About 12 percent of adults had high dental anxiety (a score of 13 or higher on the Corah scale). A logistic regression model found that dental anxiety, dental insurance status and perceived oral health status were significantly associated with regular dental visits after accounting for sociodemographic factors such as sex, age and income. Among those who had dental insurance, dentally anxious adults were significantly less likely to visit dentists regularly. However, this association was not significant among respondents without dental insurance. CONCLUSION: Dental insurance, perceived oral health status and dental anxiety were associated with regular dental visits. Dental anxiety was an influencing factor in regular dental visit behavior, especially among adults who had private dental insurance. CLINICAL IMPLICATIONS: Practitioners need to be educated about the causes of dental anxiety and receive training in how to treat the problem.

Adolescent↗
PubMed2004

Utilities of dentin regeneration among insured and uninsured adults.

OBJECTIVES: This population-based study measured utilities (preferences measured under conditions of uncertainty) of dentin regeneration (DR), a potential new therapy, root canal therapy (RCT), and extraction (EXT). METHODS: A representative sample of dentate adults (aged 18-69 years) was randomly selected from the Detroit area. A computer program was used to administer the standard gamble (SG) method and record utility score (US) for treatment options of a tooth with reversible pulpitis using the SG method. For the SG method, two anchor states were used: filled tooth with full oral health and filled tooth with severe and continuous pain leading to EXT. Additional data were obtained using a self-administered questionnaire. RESULTS: Out of the 807 adults who resided in 446 screened and selected households, a final sample of 630 adults who resided in 368 households were interviewed. The mean US for DR with 75 and 95% success rates were 72.5 and 86.2 (on a 0-100 scale), respectively. The US for RCT and immediate EXT were 75.6 and 31.3, respectively. Eleven per cent of the adults valued DR with 95% success probability higher than a simple filling with full oral health for life. There were no statistically significant differences in the average US of DR between insured and uninsured adults. Factors such as gender, race, education, income and insurance status, experiences with EXTs or root canal treatment, regularity of dental visits, quality of life, and quality of oral health were not significantly associated with the scores of DR. There was, however, a small but significant interaction between race and dental insurance, and race and gender. CONCLUSION: This population-based study found that DR was highly preferred to other standard treatment options.

Adolescent↗
PubMed2004

Willingness to pay for dentin regeneration in a sample of dentate adults.

OBJECTIVES: Measurement of individuals' valuation of dental treatments is important in the evaluation of new technologies. In this paper the value of dentin regeneration, a new treatment for teeth with reversible pulpitis, is measured based on what individuals say they would be willing to pay to receive the treatment. METHODS: A total of 611 randomly selected dentate adults answered willingness to pay (WTP) and dental insurance questions. Detailed descriptions of the process and expected outcomes for dentin regeneration were presented to subjects as part of a larger study measuring preferences for different treatments. WTP was determined for two different levels of success for dentin regeneration. RESULTS: At a success rate of 95%, the mean WTP for dentin regeneration was $262.70 (noninsured) and $11.00 per month (insured subjects). For success rate of 75%, the corresponding values were $210.90 and $9.20 per month. Multivariate analyses were used to identify any significant relationships between WTP and a range of variables covering socio-demographic, socio-economic, dental experience and oral health status variables. The findings indicate that individuals' valuations of treatments involve substantial unexplained variation. About half of the noninsured subjects would pay for dentin regeneration if it cost $200 per tooth. CONCLUSIONS: The data on the WTP for dentin regeneration indicate that a substantial percentage of adults will pay for this new technology. This study provides for the first time an estimate of WTP for dentin regeneration among the population.

Adult↗
PubMed2004

Efficacy of educational interventions targeting primary care providers' practice behaviors: an overview of published systematic reviews.

OBJECTIVES: Primary care providers (e.g., family physicians, pediatricians, registered nurses, physician assistants, and nurse practitioners) could play a pivotal role in the provision of preventive services, especially for very young children (younger than 3 years old) and population groups with limited access to dental care. Given the current problems with access to dental care among low-income Americans, we contend there is a need to involve nondental primary health care providers in screening for and preventing oral health problems. The objective of this overview is to present findings from systematic reviews on the efficacy of continuing medical education, printed educational material, academic outreach, reminders, and local opinion leaders on the adoption of new knowledge and practices by primary care providers. METHODS: A search was conducted using the Cochrane Library and MEDLINE. The search aimed to locate systematic reviews published between January 1988 and March 2003. Two researchers independently extracted data and assessed study quality using a modified version of the QUOROM statement. RESULTS: Eleven systematic reviews were included in this overview. The evidence from the included systematic reviews showed that formal continuing medical education (CME) and distributing educational materials did not effectively change primary care providers' behaviors. There are effective interventions available to increase knowledge and change behaviors of primary care providers, such as small group discussion, interactive workshops, educational outreach visits, and reminders. CONCLUSION: There is a limited knowledge base on the efficacy of the selected interventions on oral health screening by primary care providers. Considering the potential role of primary care providers in improving oral health of underserved populations, this research area should receive more attention.

Attitude of Health Personnel↗
PubMed2004

Evidence-based dentistry in clinical practice.

BACKGROUND: Evidence-based dentistry, or EBD, is not a new concept for the dental profession in the United States. The American Dental Association has long relied on credible scientific evidence in setting policy and communicating with dentists and the general public. EBD provides an approach to oral health care that follows a process of systematically collecting and analyzing scientific evidence to answer a specific clinical question. OVERVIEW: The authors discuss applications of systematic review findings to everyday clinical practice and explore the implications of EBD for dental education, clinical research and the provision of care to patients. CONCLUSIONS AND PRACTICE IMPLICATIONS: In developing appropriate treatment plans, dentists should combine the patient's treatment needs and preferences with the best available scientific evidence, in conjunction with the dentist's clinical expertise. To keep pace with other health professions in building a strong evidence-based foundation, dentistry will require significant investments in clinical research and education to evaluate the best currently available evidence in dentistry and to identify new information needed to help dentists provide optimal care to patients.

Cariostatic Agents↗
PubMed2002

Internal consistency and reliability of a questionnaire assessing organizational innovation in two schools of dentistry.

The objective of this study was to test the internal consistency and test-retest reliability of a questionnaire designed to assess the status of and factors associated with organizational innovation in schools of dentistry. The questionnaire included thirty-three questions that assessed the following six domains: innovation/environment, innovation/leadership, innovation/personal, feedback/environment, feedback/personal, and feedback/interpersonal. A seventh domain, evidence-based learning, assessed the reaction of dental faculty to a scenario where the scientific evidence found a current treatment to be ineffective in improving the health status of patients. The questionnaire was mailed three times to a systematic sample of fifty-six dental faculty working at a research-intensive dental school (RES) and all thirty-nine dental faculty working at a dental school where the emphasis is on clinical education (CL). The two U.S. dental schools had similar numbers of students; however, they differed significantly in their research portfolios. The response rate was 70.5 percent. The seven domains had alpha coefficients ranging between 0.60 and 0.89. The test-retest reliability for the seven domains ranged between 0.65 and 0.92. Dental faculty of the RES school had significantly higher average scores than faculty of the CL school on innovation/leadership, innovation/environment, feedback/environment, and feedback/personal domains. Regression analyses found no differences between the two schools in innovation/environment scores. The innovation/environment scores were significantly associated with innovation/leadership, feedback/environment, feedback/interpersonal, and age. The evidence-based learning domain was negatively associated with the innovation/environment domain, indicating that faculty who were willing to abandon teaching of a treatment found to be ineffective felt that their school environment was not highly innovative. In conclusion, this preliminary study found that the questionnaire reliably assessed six domains representing innovation and feedback. This preliminary study also found that an innovative environment in two schools of dentistry is associated with presence of leaders who promote change and innovation, an environment that encourages feedback, and faculty members who value interpersonal feedback.

Age Factors↗
PubMedDate not supplied

Determinants of health in children and the problem of early childhood caries.

Early childhood caries (ECC) is a significant dental problem for many low-income and minority children in the United States. The diagnosis, prevention, and management of ECC have been based upon both experiential knowledge and scientific evidence. In the prevention and management of ECC, the focus has been on modifying the dental, infectious, and behavioral determinants of the disease. The purpose of this concept paper is to expand the paradigm used to understand the etiology of ECC and design programs to prevent and manage this condition.

Cariostatic Agents↗
PubMedDate not supplied

Children's first dental visit: attitudes and practices of US pediatricans and family physicians.

PURPOSE: The aim of the present study was to survey the recommendations and practices regarding the first dental visit by young children, as reported by family physicians and pediatricians in the United States. METHODS: A representative sample of family physicians and pediatricians was surveyed in the year 2000. The initial survey was mailed out to 1,500 family physicians and 1,000 pediatricians who were selected from the AMA Masterfile. After the first mailing, 3 follow-up questionnaires and a postcard reminder were mailed to the nonresponders within a period of 3 months. The questionnaire described case scenarios of 2, 12-month-old children, one with low caries-risk and the other at high risk with noticeable cavitation of the maxillary front teeth. RESULTS: The response rate to the survey was 43% (622 out of 1,439) for family physicians and 52% (493 out of 957) for pediatricians. When the case scenario of a child with high caries risk was presented, more than 90% of the respondents recommended that the child see a dentist as soon as possible. For the child with low caries-risk, the proportion of respondents recommending early dental visit was significantly lower: only about 19% of family physicians and 14% of pediatricians. For a child at low risk for dental caries, about 40% of family physicians and 63% of pediatricians recommended the first dental visit around the third birthday. The majority of the respondents (pediatricians=91% and family physicians=77%) reported frequent screening for gross tooth decay. However, only a minority of them (pediatricians=33% and family physicians=19%) frequently checked for early signs of tooth decay as part of their regular practice. CONCLUSIONS: US physicians can decide on referral patterns based on the risk status of a child. However, the majority of respondents do not regularly screen for early signs of early childhood caries.

Age Factors↗
PubMedDate not supplied

Reliability and validity of brief measures of oral health-related knowledge, fatalism, and self-efficacy in mothers of African American children.

PURPOSE: Low-income African American children experience high rates of dental caries compared to the general population. Knowledgeable and efficacious caregivers can play an important role in caries prevention. The purpose of this study was to develop and evaluate 4 brief measures reflecting mothers' potentially modifiable cognitions associated with African American children's oral health: (1) knowledge about appropriate bottle use (KBU); (2) knowledge about children's oral hygiene (KCOH); (3) oral health-related fatalism (OHF); and (4) oral health-related self-efficacy (OHSE). METHODS: Questions were selected based on reviews of the health promotion and oral health literature, with input from low-income African American caregivers of young children. Reliability and validity were evaluated using survey and dental examination data from 719 low-income African American mothers and their 1- to 5-year-old children. RESULTS: Alpha reliabilities ranged from 0.76 to 0.91. KCOH was significantly associated with mothers' oral health perceptions and children's caries status. OHSE was significantly positively correlated with children's brushing frequency and with mothers' subjective perceptions of children's oral health, which was, in turn, significantly associated with children's caries status. CONCLUSIONS: Results support the reliability and validity of the new measures. If confirmed by further research, these measures can be used to develop tailored educational and cognitive-behavioral interventions to reduce oral health disparities.

Black or African American↗