Disparities in Oral Health among School-Aged Children in Kansas

Background: The effects of age, rural-urban geographic location, and percentage of Free and Reduced Price Meal Program (FRPMP) participation on children’s oral health outcome measures (untreated decay, treated decay, and sealants) have not been fully explored in Kansas. Methods: The current study utilized a surveillance sample of 140,217 children (grades K through 12) attending 200 schools in Kansas, which requested screening assistance from the Kansas Department of Health and Environment (KDHE) from 2012 to 2013. Multilevel logistic regression analysis was conducted to identify significant factors associated with oral health outcome measures. Results: Older children were associated with decreased odds of having untreated decay, and increased odds of having treated decay and sealants. Children attending very rural schools had increased odds of untreated and treated decay and decreased odds of presence of sealants. For every 5% increase in the school-level %FRPMP, the odds of having untreated and treated decay increased by 5% and 3%, respectively. However, %FRPMP was not statistically associated with the presence of sealants. Conclusions: Children attending schools in very rural and rural areas appear to have worse oral health outcomes, as measured by higher proportions of untreated and treated decay, and a smaller proportion of presence of sealants.

The effect of weight loss on fasting blood sugars and hemoglobin A1c in overweight and obese diabetics and non-diabetics

BACKGROUND: Diet and exercise are recommended first line treatment for overweight, obese, and diabetic patients with the goal of decreasing weight and improving glycemic control. The goal of this study was to determine the effect that a low calorie diet and behavioral modification program, as implemented by a medically supervised weight loss program, would have on the fasting blood sugar and hemoglobin A1c in overweight or obese diabetic and over-weight or obese non-diabetic participants. METHODS: Charts from 2009 to 2010 were reviewed for 310 diabetic and non-diabetic patients enrolled in the Via Christi Weight Management (VCWM) program in Wichita, Kansas. Data were collected before and after patients underwent a program of meal replacements and weekly physical activity lasting 12 weeks. Variables included pre and post treatment fasting blood sugars, hemoglobin A1c, body mass index, percent body weight lost, and diabetes status. RESULTS: Diabetic participants lost an average of 11.7% of their initial body weight (IBW), and non-diabetic patients lost 12.5% of their IBW over the treatment course. Post-treatment average fasting blood glucose (FBG) decreased in both diabetics and non-diabetics by 15.53 mg/dL and 8.46 mg/dL, respectively (p = 0.08). Diabetic patients experienced a significant decrease of 0.83% from pre to post-treatment in hemoglobin A1c. For diabetic and non-diabetic groups, the changes in FBG were correlated with the change in weight. CONCLUSIONS: Diet and exercise, as prescribed by the VCWM program, is effective in reducing hemoglobin A1c in diabetics and reducing fasting blood sugars in both diabetic and non-diabetic patients.