Browsing by Author "Scully, Allison C."

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    Amalgam or composite in pediatric dentistry: Analysis of private insurance claims data
    (Elsevier, 2023-08) Dentino, Francis C.; Yepes, Juan F.; Jones, James E.; Scully, Allison C.; Eckert, George J.; Downey, Tim; Maupome, Gerardo; Pediatric Dentistry, School of Dentistry
    Background Advancements in dental materials and changing parental preferences are modifying the frequency of use of restorative materials. This insurance claims analysis examined the trends in the use of amalgam and resin composite in the United States. Methods Commercial dental insurance claims were analyzed to compare 505,994 restorations, corresponding with procedure codes for 1-, 2-, and 3-surface amalgam or resin restorations. Paid claims collected nationwide from January 2010 through March 2020 were analyzed. Data for children aged 3 through 12 years were used, resulting in 219,632 unique patient identification numbers. Generalized estimating equation models applied to logistic regression were used. All tests were conducted using a 2-sided 5% significance level. Results In general, girls were less likely to receive amalgam than boys. A $20,000 increase in median household income was associated with a 16% decrease in the odds of amalgam being placed. Pediatric dentists (performing 15.1% of all restorations) were not as likely as general dentists (18.4%) to use amalgam. Having more surfaces in a restoration was associated with higher probability of amalgam placement. The percentage of amalgam restorations was higher for 2010 (26.9%) than for 2011 through 2020, and this pattern recurred in several of the years analyzed. Generally, patient age at time of amalgam restoration increased over time. Conclusion The use of amalgam is trending down; the sharpest decline was noted in 2014. Pediatric dentists were less likely to use amalgam than general dentists. Girls and patients with higher socioeconomic status were less likely to have amalgam.
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    Effect of titanium dioxide on Streptococcus mutans biofilm
    (Sage, 2023) Sanders, Molly K.; Duarte, Simone; Ayoub, Hadeel M.; Scully, Allison C.; Vinson, LaQuia A.; Gregory, Richard L.; Pediatric Dentistry, School of Dentistry
    Background: Streptococcus mutans (S. mutans) participates in the dental caries process. Titanium dioxide (TiO2) nanoparticles produce reactive oxygen species capable of disrupting bacterial DNA synthesis by creating pores in cell walls and membranes. Objective: The objective of this study was to determine the effect of TiO2 on the disruption of S. mutans biofilm. Methods: This study was conducted in four phases involving a TiO2-containing toothbrush and TiO2 nanoparticles. Each phase was completed using 24 h established S. mutans biofilm growth. Phase one data was collected through a bacterial plating study, assessing biofilm viability. Biofilm mass was evaluated in phase two of the study by measuring S. mutans biofilm grown on microtiter plates following crystal violet staining. The third phase of the study involved a generalized oxygen radical assay to determine the relative amount of oxygen radicals released intracellularly. Phase four of the study included the measurement of insoluble glucan/extracellular polysaccharide (EPS) synthesis using a phenol-sulfuric acid assay. Results: Both exposure time and time intervals had a significant effect on bacterial viability counts (p = 0.0323 and p = 0.0014, respectively). Bacterial counts after 6 min of exposure were significantly lower than after 2 min (p = 0.034), compared to the no treatment control (p = 0.0056). As exposure time increased, the amount of remaining biofilm mass was statistically lower than the no treatment control. Exposure time had a significant effect on oxygen radical production. Both the 30 and 100 nm TiO2 nanoparticles had a significant effect on bacterial mass. The silver nanoparticles and the 30 and 100 nm TiO2 nanoparticles significantly inhibited EPS production. Conclusion: The TiO2-containing toothbrush kills, disrupts, and produces oxygen radicals that disrupt established S. mutans biofilm. TiO2 and silver nanoparticles inhibit EPS production and reduce biofilm mass. The addition of TiO2 to dental products may be effective in reducing cariogenic dental biofilm.
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    Financial Impact of COVID-19 on Dental Care for Pediatric Patients: a Dental Claims Review
    (American Academy of Pediatric Dentistry, 2023-02) Rector, Julia M.; Scully, Allison C.; Yepes, Juan F.; Jones, James E.; Eckert, George; Downey, Timothy; Maupome, Gerardo; Pediatric Dentistry, School of Dentistry
    Purpose: The purpose of this study was to quantify the impact of the COVID-19 pandemic on private dental insurance claims for pediatric dental care. Methods: Commercial dental insurance claims for patients in the United States ages 18 and younger were obtained and analyzed. The claims dates ranged from January 1, 2019, to August 31, 2020. Total claims paid, average paid amount per visit, and the number of visits were compared between provider specialties and patient age groups from 2019 to 2020. Results: Total paid claims and total number of visits per week were significantly lower in 2020 compared to 2019 from mid-March to mid-May (P<0.001). There were generally no differences from mid-May through August (P>0.15), except for significantly lower total paid claims and visits per week for "other" specialists in 2020 (P<0.005). The average paid amount per visit was significantly higher during the COVID shutdown period for 0-5 year-olds (P<0.001) but significantly lower for all other ages. Conclusions: Dental care was greatly reduced during the COVID shutdown period and was slower to recover for "other" specialties. Younger patients ages zero to five years had more expensive dental visits during the shutdown period.
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    Silver Diamine Fluoride and Progression of Incipient Approximal Caries in Permanent Teeth: A Retrospective Study
    (American Academy of Pediatric Dentistry, 2021) Polacek, Jenna; Malhi, Nimrat; Yang, Yu-Ju; Scully, Allison C.; Soki, Fabiana N.; Boynton, James R.; Pediatric Dentistry, School of Dentistry
    Purpose: The purpose of this study was to evaluate the progression of incipient approximal caries lesions in permanent teeth of children and adolescents with and without silver diamine fluoride (SDF) application. Methods: A retrospective analysis of dental records and radiographs was performed. Baseline and follow-up bitewing radiographs were evaluated and scored using International Caries Classification and Management System (ICCMS) criteria to assess lesion progression. Results: A total of 131 lesions from 68 subjects (mean age equals 9.6 years) were evaluated radiographically and followed for up to 41 months (mean time equals 13.61±6.8 months); 23.6 percent of lesions in the SDF group progressed compared to 38.1 percent in the control group (P<0.001). On average, lesions in the control group increased more per month compared to the study group (P<0.001). The odds of lesion progression in the control group were 2.76 times the odds of progression in the study group. There was a statistically significant difference in lesion progression based on application method; lesions where SDF was applied with Superfloss progressed more per month, on average, versus microbrush application. Conclusions: Silver diamine fluoride may be an effective therapy to slow caries progression of incipient approximal lesions in permanent teeth in high caries-risk populations. Future studies are needed to detect differences in application methods.
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    Trends in dental insurance claims in the United States before and during the SARS-CoV-2 pandemic in 2020
    (Wiley, 2022) Maupome, Gerardo; Scully, Allison C.; Yepes, Juan F.; Eckert, George J.; Downey, Timothy; Global Health, School of Public Health
    Objectives: The SARS-CoV-2 pandemic disrupted health care services. Previous reports estimated reductions in demand and supply of dental care services, but actual changes have not been reported. The present report depicts a perspective of trends in claims from private dental practice in the United States during 2019 and 2020. Methods: Private dental insurance paid claims data from a data warehouse (encompassing 66+ carriers in the United States) were obtained for children and adults (treatments identified by their American Dental Association Code of Dental Procedures and Nomenclature [CDT]), encompassing a 5% random sample of all records between January 2019 and December 2020. A market-based treatment classification placed CDT codes into one of four categories based on the likelihood of being associated with urgent/emergency care. Results: Claims for 3.8 million patients constituted the 5% random sample for analyses. Substantial drops in the provision of treatment items were quantified for a large segment of private dental insurance plans at a national level, showing differential impacts in dental care categories. Conclusions: Week-by-week, detailed descriptions of demand/availability changes in dental care throughout the first year of the 2020 SARS-CoV-2 pandemic were obtained through contrasting perspectives in 2019. Provision of dental care and associated impacts fluctuated over time subject to treatment urgency, but also modified as the weeks/months of dental office lockdowns ebbed in and out of the dental market.
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    Willingness and Ability of Dental Healthcare Workers to Work During the COVID-19 Pandemic
    (Elsevier, 2021) Scully, Allison C.; Joshi, Ajay P.; Rector, Julia M.; Eckert, George J.; Pediatric Dentistry, School of Dentistry
    Background The 2019 novel coronavirus pandemic continues to disrupt dental practice in the United States. Dental health care workers (DHCWs) play an integral role in societal health, yet little is known about their willingness and ability to work during a pandemic.background Methods DHCWs completed a survey distributed on dental specific Facebook groups for an eight-week period (May 2020-June 2020) about their willingness and ability to work during the COVID-19 pandemic, barriers to working, and willingness to take a COVID-19 vaccine. Results 459 surveys were returned. Only 53% of dentists, 33% of hygienists, 29% of assistants and 48% of non-clinical staff would be able to work a normal shift during the pandemic, while even fewer (50%, 18%, 17%, 38% respectively) would be willing to work a normal shift. Barriers included caring for family, a second job and personal obligations and were faced by assistants and hygienists. Dentists were more likely than hygienists (p<0.001), assistants (p<0.001) and non-clinical staff (p=0.014) to take a COVID-19 vaccine.results Conclusions DHCWs have a decreased ability and willingness to report to work during a pandemic, with dentists being significantly more able and willing to work than hygienists and assistants. Dentists are more likely than staff to take a COVID-19 vaccine.