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Translational Research

COHRA (Center for Oral Health Research in Appalachia)

What?

Defining the Causes of Oral Disparity in Appalachia, USA

Oral Disparity

How ?

Concept

Factors Contributing to Oral Disparity may include:

  • Community
  • Family and
  • Individual

these could be studied by linking

  1. Community Characteristics
  2. Family Interactions
  3. Behavior
  4. Microbes and
  5. Genes

Concept Design

How?

Specifics

Specifics

Each Individual Enrolled

Family History Oral Health Screening Samples

A. In-depth Interview

  • Medical
  • Demographic
  • Pregnancy
  • Oral-Health Behavior

B. 15 Point Self Reporting Assessment ( PC Tablet or laptop )

  • Physio-social
  • Health Behavior
  • Family Relationship

( >7,000 Variables )
( 2.5 Hours/Patient )

  • Soft Tissue Exam
  • Caries
  • Perio
  • Malocclusion
  • Salivary flow
  • Papillary Bleed Score

( 2 Hours/Patient )

  • DNA
     
  • Plaque
  • Throat Culture
  • Tongue Culture
  • Denticult
  • BANA
     
  • Household Water

( 9 Samples/Patient )

Why?

US Oral Health

Appalachia

Oral Health

  • West Virginia has the highest adult edentulism rates among all states; 47.7% of adults older than 65 are completely edentulous.
  • One third of adults under age 35 have lost at least six permanent teeth.
  • West virginia adults rank lowest in the nation on dental attendance (47%), compared to the national average (67%).
  • By age 8, 66% of children have dental decay; 37.5% have untreated decay.
  • Dental caries are the most common infectious disease of West Virginia children. By the time of high school graduation, 84% of WV youth have had dental caries. 33% of WV children suffer from untreated decay.

General Health

  • West Virginia ranked 2nd highest in prevalence of persons reporting their general health as either "fair" or "poor" (25.3%)
  • "Fair" and "Poor" health was most common among adults without a high school diploma/GED (51%) and those with annual income less than $15,000 (49.2%).
  • Nearly 1/4 (23.5%) of adults aged 18 to 64 had no healthcare coverage.
  • Eighteen percent (17.*%) of adults needed medical care within the past 12 months but could not afford it.
  • West Virginia adults use smokeless tobacco three times the rate of the US average.
  • Past-month smokeless tobacco use was 31% among WV youth in grades 9-12, compared to the national average of 9.3% (CDC, 1987)