RECENT MASTER'S THESES AND DOCTORAL DISSERTATIONS
 

Chang, C-L: Managed care and the receipt of dental services for children on Medicaid
Doctoral dissertation (Ph.D. ), University of the Sciences in Philadelphia; 2007
Abstract: Tooth decay is the most common pediatric health problem. The epidemic of tooth decay disproportionately occurs in indigent children. The Medicaid program, started in 1965, has become the major public force to provide health coverage for indigent children. Dental care is included in the mandatory benefits through the Early Periodically Screening Diagnosis and Treatment (EPSDT) program. However, the underuse of dental services in Medicaid has been a long-standing problem. As state governments have gradually transformed their Medicaid programs from fee-for-service to managed care models, it has become necessary to update the understanding of pediatric dental utilization in Medicaid. In addition, dental utilization and care delivery in an urban Medicaid environment may be different from those in rural areas, and is rarely studied. Therefore, this research used Philadelphia children aged 3–20 in a Medicaid managed care organization (MMCO) as a study case (1) to update data on dental services utilization; (2) to examine if geographic mismatch between dentists and children exists in an urban setting; (3) to explore possible factors such as patient relevant characteristics affecting the use of dental care; (4) to assess the regular use of preventive dental services. The descriptive analysis with dental claims found that, over the four-year study period, 72% of the study children received preventive dental services. However, only 37% received preventive dental services annually. For those children with four-year continuous enrollment, regular use of preventive services was even less common. About six percent of the children with four-year continuous enrollment received preventive dental services annually. From the perspective of a Medicaid managed care provider, geographic information showed that there is little evidence to support a severe geographic mismatch between major dental providers and the majority of the study children. However, the geographic mismatch still affects the likelihood of dental care use in a small proportion of the study children, who had no available major dental providers in their residential areas. Analysis with logistic regression showed that several patient relevant characteristics, such as available "major" dental providers, poverty in residential areas, co-morbidity/frequent medical attention, and race/ethnicity, were related to the use of dental care. Possible explanations were provided for the relationship between patient relevant characteristics and the likelihood of dental care use. To improve the use of dental care, especially preventive care, those identified characteristics can be used to devise strategies targeting those who underuse dental care, and promote the importance of oral hygiene and dental check-up. Also, efforts to provide medical care and dental care in partnership may also help in increasing dental care use.

Cooper, RW: Crises in dental education: An instrumental case study examination
Doctoral dissertation (Ph.D.), The University of Arizona, 2007.
Abstract: This study illuminates the perceptions of dental school administrators and faculty of a new, non-traditional dental school and the extent to which these perceptions influence the processes of dental education within their school as well as their perceptions of crises in dental education.
Using an instrumental case study approach, an intrinsic case study examines perceptions that developed a non-traditional dental school. The case study is then instrumental in examination of the influences of the new economy and networks within the theory of academic capitalism that influence the formation and operation of this new school as well as influences on perceptions of crises in dental education as defined by organized dentistry.
All characteristics of the new economy (globalization, knowledge as raw material, non-Fordist manufacturing, educated/tech savvy workers) are perceived as profoundly influencing the processes of dental education at the new school. Of four networks within the theory of academic capitalism (new circuits of knowledge, interstitial organization emergence, intermediating networks, extended managerial capacity) only new circuits of knowledge are perceived to have profound influence on the formation and operation of the school.
The perceptions of characteristics of the new economy and networks of the theory of academic capitalism have established a dental school decidedly distinctive in the approach to dental education with the crises in dental education perceived as real and influencing this distinct approach taken by this school in providing dental education.
Salient characteristics of the new economy and networks within the theory of academic capitalism, when operationally defined, serve as powerful tools as explanatory vehicles to define the extent of their influence on the foundations and operations of this dental education institution and the extent to which these foundations and operations may influence the crises in dental education.

Hanks, MA. Family dental care : Perspectives from women recovering from methamphetamine addiction.
Dissertation: Thesis (M.A.)--Oregon State University, 2007.
Abstract: This research focuses on the economic and social impacts to women's and children's dental health after methamphetamine abuse. Family oral health status, access to professional services, health literacy and home hygienic practices are evaluated in the frameworks of critical medical anthropology, applied anthropological praxis and matrix and bio-psycho-social addiction models from the standpoint that family oral health status is affected by a mother's changing perceptions of oral health care after an active addiction to methamphetamine. Utilizing a mixed methods approach (quantitative survey and grounded theory methods) the study finds that family oral health is situated in a framework of social inequity and power struggle, infrastructural insecurities in the OHP Medicaid system, and participants' personal experiences. Children's access to dental services and proper home care is dependant upon their mothers'/caretakers' personal experiences, health literacy and access to care.

Muhney, KA: The prevalence of academic dishonesty in Texas dental hygiene programs
Master Thesis (M.S.): The Texas A&M University System Health Science Center, 2007.
Abstract: The media has given much attention to the academic cheating crisis in America. Ongoing research studies regarding the morals and attitudes of college students show the majority believe that, in today's global world, it is necessary to cheat in order to get ahead. The prevalence and attitudes concerning academic dishonesty of health profession students, including medical, dental, and nursing has been extensively researched. No such studies exist in the discipline of dental hygiene. The purpose of this study was to investigate the prevalence of cheating in Texas dental hygiene programs. Four hundred surveys were mailed to 20 Texas dental hygiene schools for graduating students to complete. Usable survey returns were 289 for a response rate of 72.25%. Data were analyzed using SPSS with frequencies and chi-square tests. Findings from this study reveal that 86.5% of graduating Texas dental hygiene students have cheated a minimum of one time during matriculation. Overload with demands at school was the most frequent reason cited to justify a student's cheating behavior.

Nelms, AK: What victims of domestic violence need from the dental profession
Master Thesis (M.S.): The Texas A&M University System Health Science Center, 2007
Abstract: This study was conducted to determine whether victims of domestic violence (1) present in dental offices with signs of abuse; (2) are asked about their injuries by the oral health care provider; (3) are given referrals and/or assistance; and (4) would like to have the abuse recognized and discussed by the dental professional. A survey consisting of 14 questions was developed and mailed to 15 domestic violence shelters in the North Texas area. Eleven (73.3%) shelters participated, with a total of 112 out of 165 (67.8%) surveys returned. Descriptive statistics were analyzed and an ANOVA Test was conducted to determine statistical significance between likelihood of abuse and ethnicity. The majority (76%) of respondents had suffered from a head, neck, or mouth injury as a result of abuse. Over half (52.9%) of the participants had seen a dentist when signs of abuse was present, yet 88.6% were not asked about their injuries. In addition, 69.2% responded that they would have liked to have been asked about their injuries. It appears that the dental profession needs to take a more active role in the recognition of domestic violence in their patient populations.

Sowole AA. Patient satisfaction with care provided by a district dental clinic.
Thesis, M.Sc.(Dent.), Faculty of Dentistry, University of the Western Cape, 2007; 74 pp.
Patient satisfaction is critical for the growth of oral health service and practice. The present study was a descriptive study on patient satisfaction with oral health care provided by a district dental clinic. The aim of the study was to determine whether patients attending the dental clinic of the Lagos State University hospital were satisfied with the care they received.