ACCESS TO ORAL CARE

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。鉴于卫生局局长关于美国口腔健康的报告得出的结论，并非所有公民都有平等的机会获得牙科服务，美国牙科贸易协会(ADTA)/圣达菲倡议支持研究项目，调查这种不平等的可能原因，这是最受欢迎的。虽然他们的研究可能会发现许多原因，但最普遍的原因之一可能是公众对口腔健康的重要性和定期口腔健康检查的必要性缺乏了解。然而，阿尔法诺和霍洛维茨最近的一项研究表明，当提供有关口腔癌患病率的信息时，公众会去看牙医。这一发现，再加上一种用于检测口腔癌的新产品——一种名为OralCDx的刷状活检，提出了一个检验假设的机会，即一项旨在提高公众对口腔癌威胁生命的统计数据的认识的教育活动，以及在当地牙科诊所可以进行口腔癌筛查的信息，将导致那些不经常寻求牙科服务的公众去看牙医。这一假设的一个必然结果是，一定数量寻求免费检查的人，在被告知需要对软硬口腔组织提供额外服务时，将继续这种做法，以获得这些服务。在这项建议中，我们描述了一项可行性研究，该研究从一项教育运动开始，告知公众口腔癌的发病率，并提供口腔癌筛查。目的是吸引新的患者接受口腔癌筛查。在测试现场，OralCDx测试将用于筛查在检查中发现的口腔病变。此外，作为研究的一部分，每位患者将接受口腔软硬组织的全面检查，并在适当的时候，将被告知是否需要额外的牙科服务。该项目将：1)跟踪响应该活动寻求口腔癌检测的新患者数量；2)跟踪口腔病变患者数量；3)跟踪OralCDx刷活检结果；4)跟踪返回寻求额外服务的患者数量。5)对于刷活检结果异常的患者，后续进行了手术刀活检，对比刷活检和手术刀活检结果。在3-6个月的研究期结束时，将汇编和报告口头筛选检查后返回的人数。这一数字的增加将支持这样一种假设，即将口腔健康与口腔癌等可能危及生命的疾病联系起来可以增加对口腔卫生服务的利用。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Given the conclusion of the Surgeon General's Report on Oral Health In America that all our citizens do not have equal access to dental services, the American Dental Trade Association (ADTA)/Santa Fe initiative to support research programs to investigate possible causes for this inequity is most welcome. While the research from their initiative is likely to identify numerous causes, one of the most prevalent maybe the lack of information on the part of the public concerning the importance of oral health and of the necessity of regular oral health examinations. However, a recent study by Alfano and Horowitz suggests that when presented with information about the prevalence of oral cancer, the public will visit a dentist. This finding, taken together with the availability of a new product for the testing of oral cancer, a brush biopsy called OralCDx, suggests an opportunity to test the hypothesis \i that an educational campaign designed to raise public awareness of the life threatening statistics on oral cancer together with the message that oral cancer screening is available at a local dental clinic will result in visits to dentists by those members of the public who do not regularly seek access to dental services. A corollary to this hypothesis is that a given number of those that seek the free screenings, when informed of the need for additional services to soft and hard oral tissues, will remain with the practice to obtain these services. In this proposal we describe a feasibility study, which begins with an educational campaign to inform the public of the incidence of oral cancer and to offer a screening for oral cancer. The aim will be to entice new patients to obtain oral cancer screening. At the testing site, the OralCDx test will be used for screening of oral lesions identified during the examination. In addition, as part of the study, each patient will receive a full mouth examination of hard and soft tissues and, when appropriate, will be advised of the need for additional dental services. The project will: 1) track the number of new patients that seek the oral cancer test in response to the campaign, 2) track the number of patients with an oral lesion 3) track the results of the OralCDx brush biopsy 4) track the number of patients that return for additional services. 5) For those patients with an abnormal brush biopsy result who have a scalpel biopsy subsequently, compare the results of the brush biopsy and scalpel biopsy. At the conclusion of the 3-6 month study period, the number of returnees as a result of the oral screening examination will be compiled and reported. An increase in this number will support the hypothesis that connecting oral health to a potentially life-threatening disease such as oral cancer can increase utilization of oral health services.