Findings of the University of Texas Health Science Center at San Antonio's Dental School pilot mobile van program in Laredo, Texas

Lack of access to oral health care frequently affects those of lower socio-economic level; individuals in this group experience more dental decay, and the caries experience is more likely to be untreated. Inadequate dental care access may be attributed to exclusion that is due to income, geography, age, race or ethnicity. Objective: The present study aims were to: (1) determine how oral disease prevalence and access to dental services in four US-Mexico Border unincorporated low socioeconomic settlements identified as colonias compare to each other and Laredo, Texas, and (2) determine if insurance status affects dental care access and/or disease prevalence. Methods: A secondary analysis of data from a retrospective chart review of 672 patients attending a Mobile Dental Van Program in the Webb County colonias. Demographic information, (ethnicity, age, gender, insurance coverage and colonia site), dental visits within past year, insurance status, presence of dental sealants, prevalence of untreated dental decay (caries), and presence of gum disease (gingivitis and periodontitis) were extracted. Pearson's chi-square tests (χ2) were computed to compare the prevalence of these outcomes between colonias and Laredo and their potential association with insurance status. Results: For 6 - 11 year olds, dental visits in the past year were lower for colonias (39%), than Laredo (58.5%) (p<0.002). Caries prevalence was higher for colonias (56.6%), than Laredo (37.1%) (p<0.001). Gum disease prevalence was higher in colonias (73%), than in Laredo (21.4%) (p<0.001). No significant differences were noted for caries (χ2=1.73; p<0.188) and gum disease (χ2=0.0098; p<0.921) by patient's insurance status. For adults 36 - 64 years of age, dental visits in the past year were lower in colonias (22.4%), than Laredo (36.3%) (p<0.001). Caries prevalence was higher for colonias (78.3%), than Laredo (54.0%) (p<0.001). Gum disease prevalence was also higher among colonias (91.3%) than Laredo (61.3%) (p<0.001). No significant differences were noted for caries (χ2=0.0010; p<0.975) and gum disease (χ2=0.0607; p<0.805) by patient's insurance status. Conclusion: Colonia residents seeking dental care at a Mobile Dental Van Program in Webb County have significantly higher prevalence of oral disease regardless of insurance status.^

Homeless access to dental health care: Creation of a dental service model

This project involved developing a model for planning a dental emergency treatment center that could function as an embedded component of a shelter for the homeless population. The dental services provided by such a clinic should include treatment for tooth pain, dental caries or cavities, chipped or broken teeth, broken partials, abscessed teeth, emergency cleanings, periodontal disease or gum disease and fillings. These are the dental services that are most often sought by homeless people in hospital emergency rooms.^ The underlying assumption for this project was that the oral health needs of the homeless community can most effectively be addressed by implementing small dental clinics in existing facilities that provide shelter and other services for this population. The model described in this project identifies oral health care services that would be provided by the clinic, facility (physical plant) requirements and associated infrastructure to operate an embedded dental clinic, methods for obtaining funding, strategies of recruiting dental professionals to staff the facility, and methods to assess the outcomes of the embedded clinic strategy. As an example, this project describes a strategy for developing such an embedded clinic at San Antonio Metropolitan Ministries SAMM shelter based on recommendations from community health care leaders, managers of homeless shelters, members of the homeless community and dental professionals^

The cost of publicly financed dental care in relation to community water fluoridation in Texas

Dental caries lead to children being less ready to learn and results in diminished productivity in the classroom. Tooth decay causes pain and infection, leading to impaired chewing, speech, and facial expression, in addition to a loss in self-esteem. There have been many studies supporting the safety and efficacy of community water fluoridation in reducing dental caries. Water fluoridation has been identified by the Centers for Disease Control and Prevention as one of 10 great public health achievements of the 20th century. The decline in the prevalence and severity of tooth decay in the United States during the past 60 years has been attributed largely to the increased use of fluoride; in particular, the widespread utilization of community water fluoridation. However, in the decades since fluoridation was first introduced, reductions in dental caries have declined, most likely due to the presence of other sources of fluoride. Questions have been raised regarding the need to continue to fluoridate community water supplies in the face of possible excessive exposure to fluoride. Nevertheless, dental caries continue to be a significant public health burden throughout the world, including the United States, especially among low-income and disadvantaged populations. Although many poor children receive their dental care through Medicaid, the percentage of Texas children with untreated dental caries continues to exceed the U.S. average and is well above Healthy People 2010 goals, even as state Medicaid expenditures continue to rise. The objective of this study is to determine the relationship between Medicaid dental expenditures and community water fluoridation levels in Texas counties. By examining this relationship, the cost-effectiveness of community water fluoridation in the Texas pediatric Medicaid beneficiary population, as measured by publicly financed dental care expenditures, may be ascertained.^

Revisión de los baremos odontológicos de aplicación en la justicia civil y formulación de nuevo baremo

Se realizó un estudio de expedientes judiciales para verificar la presencia de lesiones dentarias en litigios judiciales y corroborar si los baremos aplicados fueron pertinentes. Siendo muy importante el porcentaje de casos donde no existió pérdida dentaria pero sí lesión y no existiendo un baremo que contemple estos casos, surge entonces la necesidad de formular un nuevo baremo o modificar los existentes para que se incluya no sólo la pérdida total del elemento dentario sino también los traumatismos que no producen pérdida del elemento dentario pero si lesión, porque representan una importante incapacidad masticatoria, fonética y estética. Se propone agregar a los baremos en uso o redactar un nuevo baremo que incluya la siguiente valoración: - En caso de fracturas dentarias con compromiso pulpar y traumatismos que producen pérdida de vitalidad pulpar, adjudicar un porcentaje de incapacidad del 50% de los valores otorgados por los baremos existentes (Bertini, Briñon, etc.) para la pérdida total de dicho elemento. En los casos de fracturas dentarias sin pérdida de vitalidad, otorgar un 25% de los valores de los baremos existentes.

Villefranche MedSeA mesocosm experiment 2013: perturbation studies and field studies

A joint mesocosm experiment took place in February/March 2013 in the bay of Villefranche in France as part of the european MedSeA project. Nine mesocosms (52 m**3) were deployed over a 2 weeks period and 6 different levels of pCO2 and 3 control mesocosms (about 450 µatm), were used, in order to cover the range of pCO2 anticipated for the end of the present century. During this experiment, the potential effects of these perturbations on chemistry, planktonic community composition and dynamics including: eucaryotic and prokaryotic species composition, primary production, nutrient and carbon utilization, calcification, diazotrophic nitrogen fixation, organic matter exudation and composition, micro-layer composition and biogas production were studied by a group of about 25 scientists from 8 institutes and 6 countries. This is one of the first mesocosm experiments conducted in oligotrophic waters. A blog dedicated to this experiment can be viewed at: http://medseavillefranche2013.obs-vlfr.fr.

Seawater carbonate chemistry and particulate organic particles during an incubation experiments with natural phytoplankton community, 2002

Incubation experiments with natural phytoplankton revealed a relationship between CO2 concentration and the production of transparent exopolymer particles (TEP), with TEP production being linearly related to theoretical CO2 uptake rates. The effect of different CO2 concentrations on TEP production was examined during incubation experiments with natural phytoplankton sampled at two different locations in the central Baltic Sea in summer 1999.

Combined effects of CO2 and temperature on carbon uptake and partitioning by the marine diatoms Thalassiosira weissflogii and Dactyliosolen fragilissimus

Carbon uptake and partitioning of two globally abundant diatom species, Thalassiosira weissflogii and Dactyliosolen fragilissimus, was investigated in batch culture experiments under four conditions: ambient (15°C, 400 µatm), high CO2 (15°C, 1000 µatm), high temperature (20°C, 400 µatm), and combined (20°C, 1000 µatm). The experiments were run from exponential growth into the stationary phase (six days after nitrogen depletion), allowing us to track biogeochemical dynamics analogous to bloom situations in the ocean. Elevated CO2 had a fertilizing effect and enhanced uptake of dissolved inorganic carbon (DIC) by about 8% for T. weissflogii and by up to 39% for D. fragilissimus. This was also reflected in higher cell numbers, build-up of particulate and dissolved organic matter, and transparent exopolymer particles. The CO2 effects were most prominent in the stationary phase when nitrogen was depleted and CO2(aq) concentrations were low. This indicates that diatoms in the high CO2 treatments could take up more DIC until CO2 concentrations in seawater became so low that carbon limitation occurs. These results suggest that, contrary to common assumptions, diatoms could be highly sensitive to ongoing changes in oceanic carbonate chemistry, particularly under nutrient limitation. Warming from 15 to 20 °C had a stimulating effect on one species but acted as a stressor on the other species, highlighting the importance of species-specific physiological optima and temperature ranges in the response to ocean warming. Overall, these sensitivities to CO2 and temperature could have profound impacts on diatoms blooms and the biological pump.

PeECE III - Pelagic Ecosystem CO2 Enrichment Study, Raunefjord, Bergen, Norway, 2005

The effects of CO2-induced seawater acidification on plankton communities were also addressed in a series of 3 mesocosm experiments, called the Pelagic Ecosystem CO2 Enrichment (PeECE I-III) studies, which were conducted in the Large-Scale Mesocosm Facilities of the University of Bergen, Norway in 2001, 2003 and 2005, respectively. Each experiment consisted of 9 mesocosms, in which CO2 was manipulated to initial concentrations of 190, 350 and 750 µatm in 2001 and 2003, and 350, 700 and 1050 µatm in 2005. The present dataset concerns PeECE III.