Research Publications

Background. American Indian/Alaska Native (AI/AN), Black (B), and Hispanic/Latino (H/L) people are underrepresented in dentistry, yet disproportionately constitute the safety-net dental workforce. We examined the relationship between serving as safety-net providers (SNPs) and self-reported income…

Access to dental care for millions of Californians is tied to coverage by California’s Medicaid (Medi-Cal) Dental insurance program. While child dental coverage is federally mandated, adult dental coverage is optional. In 2009, adult dental coverage was mostly eliminated but was partially…

Dental therapists (DTs) are primary dental care practitioners that have been deployed in many countries around the world. There is increasingly strong evidence supporting the safety and effectiveness of DTs, including their ability to promote community-based services and enhance oral health equity…

Objectives: This work describes the process by which the quality of electronic health care data for a public health study was determined. The objectives were to adapt, develop, and implement data quality assessments (DQAs) based on the National Institutes of Health Pragmatic Trials Collaboratory (…

Objective: Despite the many advancements made in patient safety over the past decade, combating diagnostic errors (DEs) remains a crucial, yet understudied initiative toward improvement. This study sought to understand the perception of dental patients who have experienced a dental diagnostic…

IMPORTANCE: Process-based quality measures are generally intended to promote evidence-based practices that have been proven to improve outcomes. However, due to lack of standardized implementation of diagnostic codes in dentistry, assessing the association between process and oral health outcomes…

This study assessed flavored tobacco use among adolescent e-cigarette, cigarette, cigar, hookah, and smokeless tobacco users; specific e-cigarette flavor preferences; risk profiles of youth that use various flavors; and the impact of survey question wording on prevalence. Cross-sectional data from…

The COVID-19 pandemic had a profound impact on all aspects of the oral health care system. The temporary suspension of oral health services impacted patients seeking preventive and restorative dental services with enduring consequences. Dental providers faced threats to job security as well as to…

Formative assessment of the rollout process of the California Oral Health Literacy (OHL) toolkit uses a mixed-methods approach. The OHL toolkit is an educational resource for dental professionals to improve communication with patients. This study was intended to obtain user feedback and suggestions…

This report reviews the use of teledentistry following the COVID-19 pandemic in 4 states—California, Maine, Pennsylvania, and Wisconsin—and the supports needed to enhance dental care in a post-COVID-19 world. States were selected for case studies based on the following parameters: existence of…

Objective This study examines the individual, educational, and policy factors that predict dentists pursuing postgraduate dental (PGD) training. Methods Individual dentist records from the 2017 American Dental Association Masterfile were linked with pre-doctoral training attributes and state-level…

Objective Postgraduate dental (PGD) primary care training has grown significantly. This study examines the individual, educational, community, and policy factors that predict practice patterns of PGD-trained dentists. Study design Individual dentist records from the 2017 American Dental Association…

There is a lack of diversity in the dental workforce. Efforts to enhance underrepresented minority (URM) recruitment and retention within dental school exist, but little effort has been made to track URM providers through education and practice. This study assesses the status of workforce diversity…

In her 2020 book Caste: The Origin of Our Discontents, Isabel Wilkerson argues that a caste system not only exists in the US, but also operates as a hidden force affecting social inequality. In this paper, Healthforce Center’s Associate Director for Research Dr. Elizabeth Mertz and colleagues…

Adding new types of clinicians is often a policy strategy to address clinician shortages and enhance access to health care. In oral health, several states have sought to expand the dental workforce to include dental therapists, which are primary dental care providers who can evaluate and treat…

Little is known about the scope and role of discriminatory experiences in dentistry. The purpose of this study is to document the experiences that American Indian/Alaska Native (AI/AN), Black, and Hispanic dentists have had with discrimination. SEE PUBLICATION

In 2016, the California Department of Health Care Services launched the Dental Transformation Initiative (DTI) to address statewide underperformance in providing dental services to Medicaid-eligible children and youth. The DTI allowed selected counties and other qualified organizations to create…

Studies estimate that approximately one-third of all opioid prescriptions (Rxs) from dentists are associated with nonsurgical dental procedures, which suggests unwarranted opioid use. The authors conducted a retrospective longitudinal cohort study of adult Medicaid beneficiaries…

Pre-dental post-baccalaureate programs can help address oral health disparities by improving the diversity of the dental workforce pipeline. While long-term outcomes have had a positive impact on underserved areas and communities, dentists of underrepresented minority or socioeconomically…

The purpose of this study is to describe Mexican-American parents' experiences navigating the dental care system for their children. The study used qualitative interviews to collect data.

Dental therapists (DTs) are primary care dental providers, used globally, and were introduced in the United States (US) in 2005. DTs have now been adopted in 13 states and several Tribal nations. This study aimed to qualitatively examine the drivers and outcomes of the US dental therapy movement…

The goal of this study was to explore challenges and opportunities that dental public health (DPH) residents and recent graduates experienced during and after their residency training programs in the US. In this qualitative study, to recruit participants, study invitations were distributed to…

Although many factors contribute to the high prevalence of oral health problems and widening disparities in the U.S., limited oral health literacy has emerged as a major contributor. Oral health literacy (OHL) refers to people’s abilities to access, understand and use oral health information to…

Oral health care faces ongoing workforce challenges that affect patient access and outcomes. While the Medicare program provides an estimated $14.6 billion annually in graduate medical education (GME) payments to teaching hospitals, including explicit support for dental and podiatry programs,…

Poor oral health, and biological impact of oral disease, affects a person's general health and well-being. Using electronic dental health record data to identify high-risk dental caries patients coupled with a new oral health team member, the dental care advocate (DCA) facilitated the dental…

Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following…

Community health workers (CHWs) are an increasingly important member of the healthcare and public health professions who help build primary care capacity. Yet, in spite of the exponential growth of CHW interventions, CHW training programs, and CHW certification and credentialing by state agencies,…

Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following…

Access to oral healthcare remains a significant problem in the United States. One solution that has gained momentum over the past decade is the expansion of the oral health workforce through the addition of a new member: the dental therapist (DT). This article describes the progress and development…

Learning health‐care systems are foundational for measuring and achieving value in oral health care. This article describes the components of a preventive dental care program and the quality of care in a large dental accountable care organization. A retrospective study design describes and…