Research Questions & Gaps in Knowledge

Related to Dental Public Health Strategies

As the ASTDD Best Practices Project continues to promote best practices based on effective dental public health strategies, the Project seeks collaborative opportunities to stimulate research for dental public health strategies, build scientific evidence, accelerate transfer of science into practice, and strengthen linkages between researchers and state/community oral health programs. The following list of research questions illustrates information needed by oral health programs to perform public health functions and deliver essential dental public health services.

The sources of the questions listed below include the following:

[1] Questions identified by the Task Force on Community Preventive Services (Truman BI and others. Reviews of evidence on interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries. Am J Prev Med 2002;23(suppl 1): 21-54.)

[2] Input from CDC’s Division of Oral Health provided adding questions and components of questions to the list.

[3] Input from the ASTDD Best Practices Committee provided additional questions.

Dental Public Health Strategies / Research Questions / Questions on Gaps in Knowledge
1. State Oral Health Surveillance System / a. What is the accuracy and precision of alternative measures of caries and periodontal diseases? [1]
b. Can current or proposed surveillance measures (e.g., findings from the basic screening survey) be used for program evaluation? [1]
c. How do simple surveillance systems (with few measures) compare to complex surveillance system (with many measures) in their impact and effectiveness to perform public health functions? [3]
d. Should the National Oral Health Surveillance System be expanded? Are there other oral health behaviors, conditions, or interventions for which we need data? What are appropriate measures? [2]
e. What is the impact of the National Oral Health Surveillance System to perform public health functions? (Evaluate the effectiveness of NOHSS to build evidence for oral health surveillance system.) [3]
2. State Oral Health Coalitions / a. How can state oral health coalitions maximize their impact on improving community health status and system changes? (Documented research evidence for positive coalition or partnership outcomes is weak and limited empirical evidence exists on their effectiveness in improving community-level outcomes.) [3]
b. What can stimulate an oral health coalition to maintain/revive its momentum and increase capacity? What are key contributing factors that can demonstrate coalition sustainability and effectiveness in obtaining strategic objectives? [3]
c. Do state oral health coalitions increase efficiency in delivering community preventive services? Can state oral health coalitions demonstrate measurable outcomes and success in contributing to the delivery of evidence based community preventive services? [2,3]
3. State Oral Health Plans / a. What factors contribute to an effective and cost-effective collaborative planning process? [3]
b. What is a good written format for a state oral health plan that will be more effective in disseminating information to state and local stakeholders? [3]
4. Statutory Mandate for a State Oral Health Program / a. What language included in a mandate is most effective in sustaining a state oral health program and enhancing its impact? [3]
b. How do brief mandates compare to detailed mandates in sustaining or building capacity for state oral health program? [3]
5. Community Water Fluoridation / a. What is the effectiveness of laws, policies, and incentives to encourage communities to start or continue water fluoridation? [1]
b. How effective is community water fluoridation in reducing dental caries among adults (18 years of age and older)? [1, 2]
c. How effective is community water fluoridation in preventing root caries? [1]
d. What are effective strategies in campaigning for fluoridation legislation? OR What factors influence the outcomes of fluoridation campaigns?
[2, 3]
e. What legislative language is most effective in supporting community water fluoridation? [3]
6. Fluoride Mouthrinse and Supplement Programs / a. What are the appropriate program evaluation measures to show effectiveness? [3]
7. School-based Sealant Programs / a. How do state dental practice laws and regulations affect use of and costs of sealants in school- or community-based programs? [1, 2]
b. How do school district oral health policies and curricula affect use of sealants? [1]
c. How do school-based sealant programs compare with community-based sealant programs in cost-efficiency? [2]
d. Can we develop a standardized method for calculating sealant program costs? [2]
e. Do sealant costs per child decrease as the number of children sealed increases? (Are there economies of scale?) [2]
f. What is the effect of public education on awareness, community mobilization (through coalitions), and resource allocation for sealant promotion? [1]
g. What is the effect of professional education, combined with provider reminders and other system-oriented strategies, on knowledge, skills and appropriate use of sealants? [1]
h. What is the effect of insurance coverage and managed care plans on access to and use of sealants? [1]
i. How effective and cost-effective are models of sealant delivery other than school-based (e.g., school-linked, community-based)? [1, 2]
j. How long are sealants delivered in school and community settings effective? What are the retention rates in the first year and over time? [3]
k. How do dental providers accept sealants in school based and community setting? What are the key factors of non-acceptance and how does the literature address these concerns? [3]
8. Workforce Development / a. How do dental practice laws impact workforce needs in the public health setting? [3]
b. What workforce development strategies demonstrate long-term, sustainable benefits? [3]
c. What are alternative workforce strategies to increase access for the uninsured and underserved population? [3]
d. What are effective recruiting methods for the (1) dental public health workforce and (2) the workforce to delivery clinical services in a public health setting? [3]
e. How many dental public health professionals are needed (e.g., with public health training or board certified in dental public health)? [3]
9. Oral Health Surveys / a. Should state oral health programs that have conducted epidemiological oral health surveys (e.g., DMF/def scores) continue to periodically conduct epidemiological surveys? [3]
b. How can self-reporting be improved to provide more valid and reliable oral health data? [3]
10. Fluoride Varnish Programs / a. What are effective and efficient implementation approaches for a community-based fluoride varnish programs? [3]
b. What factors increase recall visits for subsequent fluoride varnish applications to assure compliance to a program protocol? [3]

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