RESUMEN
BACKGROUND: Obtaining thorough documentation of a patient's medical history is important for dental care professionals, as oral health is connected intricately to systemic health. The purpose of this study was to assess the accuracy of parent-reported health history for pediatric patients in a dental setting. METHODS: A retrospective chart review was conducted on 863 patients 17 years and younger. Parent-reported health history was compared with subsequent physician-to-dentist consultations. The most common diagnoses were grouped on the basis of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, categories. RESULTS: The sensitivity of parent report of health conditions was highest for reporting mental and behavioral disorders (75.1%; 95% CI, 69.6% to 80.0%), followed by nervous system diseases (63.0%; 95% CI, 47.5% to 76.8%), respiratory conditions (47.9%; 95% CI, 37.6% to 58.4%), congenital conditions (46.3%; 95% CI, 30.7% to 62.6%), and cardiovascular conditions (25.0%; 95% CI, 11.4% to 43.4%) and was lowest for hematologic conditions (12.2%; 95% CI, 4.1% to 26.2%). Parents of children 6 years and older and those with private insurance had higher sensitivity for reporting mental and behavioral conditions than those with children younger than 6 years or having Medicaid (P < .0001). The specificity of parent-reported health conditions ranged from 96.0% for mental and behavioral disorders to 99.8% for hematologic conditions. CONCLUSIONS: Sensitivity varied widely, showing that parents may be unreliable in their report of children's health histories and that dentists cannot rely solely on parents when obtaining health history. PRACTICAL IMPLICATIONS: In advocating for patient safety, especially for those with special needs and complex medical conditions, this study supports the use of medical evaluation before dental treatment and for the integration of dental and electronic health records.
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Medicaid , Salud Bucal , Estados Unidos , Niño , Humanos , Estudios Retrospectivos , Derivación y Consulta , Registros Electrónicos de SaludRESUMEN
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: A large national cohort study of the association between bisphosphonates and osteonecrosis of the jaw in patients with osteoporosis: A nested case-control study. Kwon JW, Park EJ, Jung SY, Sohn HS, Ryu H, Suh HS. JDR Clin Res Suppl 2015;94(9) Suppl 2:213S-9S. SOURCE OF FUNDING: 2014 Pusan National University Research Grant TYPE OF STUDY/DESIGN: Nested matched case-control study.
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Conservadores de la Densidad Ósea , Difosfonatos , Estudios de Casos y Controles , Estudios de Cohortes , Humanos , Osteonecrosis , OsteoporosisRESUMEN
The population of the United States is aging rapidly, and the prevalence of chronic diseases will increase as the population grows and ages. The management of chronic illnesses will become an increasing burden for primary care providers. This article suggests that dentists may need to monitor chronic disease and control the risk factors (ie, provide primary care) for their own dental patients.
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Enfermedad Crónica/epidemiología , Costo de Enfermedad , Odontología/tendencias , Dinámica Poblacional/tendencias , Atención Primaria de Salud/tendencias , Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus/epidemiología , Necesidades y Demandas de Servicios de Salud , Humanos , Neoplasias/epidemiología , Obesidad/epidemiología , Dinámica Poblacional/estadística & datos numéricos , Prevalencia , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: The aim of this cohort study was to quantify the effect of alcohol on the risk of oral cancer in different strata of folate intake, controlling for known confounders. METHODS: A cohort of 87,621 women in the Nurses' Health Study was followed up from 1980 to 2006, and 147 incident oral cancer cases were reported and confirmed. Data on alcohol intake and diet were obtained through self-reported food frequency questionnaires every 4 years. Cox proportional regression analysis was conducted to estimate the adjusted risk ratios (RR) and 95% confidence intervals (95% CI). RESULTS: When compared with nondrinkers, the adjusted RRs (95% CIs) for alcohol intake were 0.59 (0.39-0.87) for 0.1-14.9 g/d, 1.15 (0.67-1.97) for 15-29.9 g/d, and 1.92 (1.08-3.40) for ≥30 g/d. We observed a significant interaction between alcohol and folate intakes (P = 0.02). The cancer risk for subjects with high alcohol (≥30 g/d) and low folate (<350 µg/d) intakes was significantly elevated (RR, 3.36; 95% CI, 1.57-7.20) as compared with nondrinkers with low folate intake. The risk associated with high alcohol intake (≥30 g/d) was reduced to 0.98 (0.35-2.70) in the high-folate (≥350 µg/d) group as compared with nondrinkers with high folate intake. CONCLUSIONS: High alcohol intake is associated with significantly increased oral cancer risk, especially in women with low folate intake. IMPACT: A significant interaction between alcohol and folate intakes seems to affect oral cancer risk in women, a finding with potential public health utility.