Skip to main content
eScholarship
Open Access Publications from the University of California

Scholarly Works (64 results)

  • Article
  • Peer Reviewed
UC San Francisco Previously Published Works (2016)
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2020)

    Objectives

    This paper reviews the precision public health literature pertaining to oral health, identifies possible threats that could inadvertently increase health inequities, and proposes potential opportunities that precision public health could utilize to reduce oral health inequities.

    Methods

    The health sciences literature was reviewed and supplemented with new data to identify important issues relating to precision medicine, precision oral health, precision public health, and health equity.

    Results

    Examples from general health and oral health were provided to illustrate salient concepts.

    Conclusions

    Future precision public health should utilize multifactorial, multi-level conceptual frameworks and conceptual causal models with upstream social determinants and downstream health effects, as well as a proportionate universalism perspective; and proper analytic methods, including sufficient sample sizes, appropriate statistical competitors, health disparity indices, causal modeling, and internal and external validation.
      Cover page: At the crossroads of oral health inequities and precision public health
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2007)
      The Health Insurance Portability and Accountability Act of 1996 requires Notices of Privacy Practices (NPP) in plain (clear, concise, and easily understood) language. The objectives of this study were to test the readability of U.S. dental school NPPs; examine factors relating to readability; and develop a plain language NPP supplement. Readability statistics were Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL). Social capital measures of potential resources available to people in a civil society (e.g., perceived trust, perceived reciprocity, and per capita voluntary organization membership) along with lawyers per capita for each state were examined for potential relationships with readability levels. One-sample t-tests assessed plain language (FRE=60, FKGL=8), and analyses of variance compared groups. Spearman rank correlations (r(s)) compared social capital to readability. A plain language NPP supplement was developed. All fifty-six U.S. dental school NPPs were obtained (100 percent response). Forty-eight of fifty-six schools (86 percent) had website NPPs. FRE and FKGL were significantly more complex than plain language, overall (both p<0.0001, 95% CIs: FRE=37.6, 40.5; FKGL=11.2, 11.8) and by region (all p<0.014). Readability did not differ by region. Social capital measures moderately related to readability (0.18 < or = |r(s)| < or =0.39) with reciprocity being most related (FRE r(s)=0.36, FKGL r(s)=-0.39). U.S. dental school NPPs are more complex than "plain language."
        Creative Commons 'BY-SA' version 4.0 license
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2012)

        Purpose

        Although changes in blood perfusion have been described as being associated with temporomandibular disorder (TMD) myofascial pain, very little is known about blood flow levels in the deep and superficial masseter muscle. This study investigated blood flow in deep and superficial sites of six healthy female participants at baseline and during intermittent and continuous biting exercises and recovery.

        Materials and methods

        Blood flow was monitored unilaterally using a single-fiber probe laser Doppler flowmeter. The blood flow was continuously monitored at baseline and during two biting exercises: (a) intermittent at 25%, 50%, and 100% maximum voluntary bite force for 30 seconds each followed by 90 seconds rest between each biting level and (b) continuous biting at similar maximum voluntary bite force levels followed by 90 seconds rest.

        Results

        There was significantly higher blood flow in the deep sites compared to the superficial sites (p < 0.001) and a significant increase in blood flow during biting compared to baseline (p < 0.001). There were no significant changes in blood flow among the three levels of biting, between the intermittent and continuous exercises, or from baseline blood flow compared to recovery.

        Conclusions

        This study showed regional differences in masseter muscle blood flow, perhaps related to differences in muscle fiber type and pattern of muscle fiber recruitment.
          Cover page: Deep and superficial masseter muscle blood flow in women.
          • Thesis
          • Peer Reviewed
          UC San Francisco Electronic Theses and Dissertations (2014)

          Purpose: The purpose is to measure childhood caries experience and explore possibly associated geographic, demographic, socioeconomic, and sociocultural factors at community health centers (CHCs) in Hawai'i. Methods: The study comprises children ages 0-12 attending a CHC on Hawai'i and O'ahu between August 2007 and August 2012. Data extracted from existing paper charts include demographic, clinical, and utilization variables. Results: In 329 patients, 1666 encounters were recorded. Caries was found to be present in 63% of the children. 19.3% of dental appointments were broken, and treatment plans were not completed 35.1% of the time. On Hawai'i and O'ahu, overall visit type was significantly related to broken appointments (p=0.0002 and p=0.0038 respectively). Children were 3.0 times and 2.5 times more likely to miss their treatment appointments than examination appointments on Hawai'i and O'ahu (p<0.0001 and p=0.0009 respectively). Residence within the clinic/van ZIP code (p<0.0001) was significantly related to broken appointments and treatment plan incompletion on Hawai'i. Those residing outside the clinic/van ZIP code were 3.1 times more likely to not complete the treatment plan (p=0.004). The overall race effect (3 df, p=0.0369) was significant for broken appointments on Hawai'i. Pacific Islanders were more likely to break appointments compared to Asians (p=0.0142), Hawaiians (p=0.0385), and all other races (p=0.0082). All races other than Asian, Hawaiian, and Pacific Islander were also 3.2 times more likely to complete treatment plans (p=0.033) on Hawai'i. Discussion: The study provides an updated oral health profile of the low-income and minority pediatric population in Hawai'i and can serve as a database for CHCs to re-evaluate how to improve their clinical operations and for policymakers to make decisions on future strategies to effectively and culturally-appropriately promote dental health and enhance health status and access to care in Hawai'i. Despite CHCs accepting Medicaid and having schedule availability, large percentages of broken appointments and untreated caries still remain. This holds great relevance for the Affordable Care Act (ACA) and provide important insights of what to expect. Data from Hawai'i indicate that ACA-mandated enrollment may remain insufficient to meet pediatric dental treatment needs, especially where geographic barriers may reduce access to care.

            Cover page: Geosocioeconomics &amp; Childhood Caries at CHCs in Hawai'i: ACA Implications
            • Article
            • Peer Reviewed
            UC San Francisco Previously Published Works (2021)
            In March 2020, the World Health Organization declared COVID-19 as the first coronavirus-initiated pandemic. COVID-19's fast-paced global spread with a broad range of clinical manifestations compelled health regulatory organizations, public health professionals, and researchers to update their information about the disease and provide individual- and community-based guidelines, solutions, and regulations to break the disease cycle, mitigate person-to-person transmission, and reduce cross-contamination in healthcare settings. In this review, the authors provide known facts and updated information about SARS-CoV-2 virology and its new variants, transmission routes, reported clinical symptoms, epidemiology, and infection control and prevention guidelines with a focus on a hierarchy of controls in dental settings.
              Cover page: Coronavirus Disease Update on Epidemiology, Virology, and Prevention.
              • Article
              • Peer Reviewed
              UC San Francisco Previously Published Works (2012)
              This is a longitudinal study of a large US biracial community cohort of 732 young women - 50% African-American and 50% Caucasian - specifically investigating incidence, remission, and progression of, as well as factors associated with common chronic pains (back, head, face, chest and abdomen). The results show back, head and abdominal pains were the most common, severe and persistent pains. Facial pain, although less common and severe, was the only pain presenting significant racial differences with Caucasians having higher prevalence, incidence and persistence; incidence per 1000 person-years was 58 for Caucasians and 18 for African-Americans while remission per 1000 person-years was 107 for Caucasians and 247 for African-Americans (p<0.05). Risk factors associated with incidence (I) differed from those associated with persistence(P), perhaps due to the young age and shorter pain duration in this population. Face pain incidence, but not persistence for example, was associated with student status, fatigue, perceived stress and general health. Depression does not seem to be associated with any of these pains. However, increased number of existing pain sites was related to subsequent increase chance of developing new pain (I) or maintaining the existing pain (P).
                Creative Commons 'BY-SA' version 4.0 license
                • Article
                • Peer Reviewed
                UC San Francisco Previously Published Works (2014)

                Background

                Agricultural worker families encounter multiple barriers to accessing all needed dental care. This study investigated predisposing, enabling, and need factors associated with children's past year dental utilization among Hispanic agricultural worker families in central California.

                Methods

                Oral health survey and clinical data were collected from families participating in a larger, population-based study in 2006-7. Generalized estimating equation logit regression assessed effects on a dental visit among children aged 0-17 (n=405). Analyses adjusted for clustering of children in the same household. Predisposing (sociodemographics), enabling (child's dental insurance, usual source of dental care, caregiver past year dental visit, acculturation level, income and education), and need (caregiver's oral health rating, perception of cavities, and clinically-determined treatment urgency) factors were examined.

                Results

                Half (51%) the children had a past year dental visit, while 23% had never been to a dentist. In the final model, children were less likely to have a past year dental visit if they were foreign-born, male, had caregivers that thought they had cavities or were unsure, and if the dentist recommended treatment 'at earliest convenience'. Children aged 6-12, with a regular dental care source, and whose caregivers had a recent dentist visit were more likely to have a past year dental visit.

                Conclusions

                Children were more likely to have a past year dental visit if they had a usual source of dental care (OR =4.78, CI=2.51-9.08), and if the caregiver had a past year dental visit (OR=1.88, CI=1.04-3.38). Emphasis should be placed on these two modifiable factors to increase children's dental utilization.
                  • Article
                  • Peer Reviewed
                  UC San Francisco Previously Published Works (2013)
                  The University of California, San Francisco School of Dentistry established the Dental Postbaccalaureate Program in 1998 to provide reapplication assistance to students from economically and/or educationally disadvantaged backgrounds who were previously denied admission to dental school. The goals were to increase diversity in the dental school student population and improve access to dental services for underserved populations. This article assesses the programs short-, mid-, and long-term outcomes and is the first to examine long-term practice patterns after a dental postbaccalaureate program. Data collected on all participant (n=94) demographics, pre/post-program DAT scores, and post-program dental school admission results were used to assess short- and mid-term outcomes. Long-term outcomes and practice patterns were assessed using results of a census survey administered between 2009 and 2011 to the participants who had completed dental school and been in practice for at least two years (n=57). The survey had a response rate of 93 percent (n=53). Descriptive statistical techniques were used to examine the responses and to compare them to U.S. Census Bureau data and nationally available practice data for new dental graduates. Program participants DAT scores improved by an average of two points, and 98 percent were accepted to dental school. All survey respondents were practicing dentistry, and 81 percent reported serving underserved populations. These participants treat more Medicaid recipients than do most dentists, and their patient population is more diverse than the general population. The outcomes demonstrate that the programs graduates are increasing diversity in the dental student population and that their practices are providing access to care for underserved populations.
                    Cover page: Long-term outcomes of a dental postbaccalaureate program: increasing dental student diversity and oral health care access.
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2017)

                    Objectives

                    Beliefs that flavored smokeless tobacco (ST) is more pleasant, less potent, or otherwise easier to use could contribute to youth initiation. We evaluated associations between perceived ease-of-use of flavored ST (moist snuff and chewing tobacco) and ST initiation susceptibility in a representative sample of US youth.

                    Methods

                    Among 7,718 tobacco never-users in the Population Assessment of Tobacco and Health study (age: 12-17; collected: 2013-2014), we compared 4 ST susceptibility items (curiosity, expectation, willingness to try, and a composite) according to whether participants reported flavored ST to be "easier to use" than unflavored ST. We calculated marginal prevalences of ST susceptibility and odds ratios adjusted for socio-demographic characteristics, tobacco advertisement receptivity, warning label exposure, and sensation seeking.

                    Results

                    ST susceptibility was greatest among tobacco never-users who perceived flavored ST as easier to use. Adjusted odds of potential ST susceptibility (≥1 item) were 1.5-fold higher (95% confidence interval: 1.2, 1.8) among adolescents who perceived flavored ST as easier to use than unflavored ST.

                    Conclusions

                    ST flavors could contribute to perceptions that facilitate youth initiation. Alternatively, youth susceptible to ST use may perceive flavored varieties differently. Prospective studies are warranted to strengthen causal evidence and measure ST initiation according to perceived ease-of-use.
                      Cover page: Perceived Flavored Smokeless Tobacco Ease-of-use and Youth Susceptibility
                      Top