Rocio Quinonez

Rocio Quinonez
University of North Carolina at Chapel Hill | UNC · Pediatric Dentistry and Pediatrics

DMD, MS, MPH

About

106
Publications
11,411
Reads
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2,153
Citations
Citations since 2017
44 Research Items
1458 Citations
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2017201820192020202120222023050100150200250
2017201820192020202120222023050100150200250

Publications

Publications (106)
Article
Full-text available
Background Pregnancy presents an opportune time for oral health promotion and intervention; however, implementation of the prenatal oral health guidelines remains a challenge among prenatal and oral health providers. The purpose of this study was twofold: To employ a theory-based approach to identify high-priority Consolidated Framework for Impleme...
Article
Objectives: To explore pre-doctoral faculty perceptions toward implementation of value-based care (VBC) in didactic and clinical teaching. Methods: This project was a collaborative effort between CareQuest and the University of North Carolina at Chapel Hill, Adams School of Dentistry introducing VBC to pre-doctoral dental faculty as part of a ne...
Article
Full-text available
Oral health is essential to human health. Conditions associated with poor oral health involve all organ systems and many major disease categories including infectious disease, cardiovascular disease, chronic pain, cancer, and mental health. Outcomes are also associated with health equity. Medical education organizations including the Association of...
Article
Objectives: Oral health is a critical component of children's overall health, but past research has found that pediatricians report barriers to implementing oral health into practice. Recently, policies have further delineated the importance of oral health in primary medical care. We sought to determine how pediatricians' practices and perceived b...
Article
Following the adoption of competency‐based education in dentistry in the 1990s, entrustable professional activities (EPAs) were introduced in the field of medicine in the mid‐2000s to help educators better determine the competence of trainees. More recently, the field of dental education has begun exploring EPAs as a framework for assessing compete...
Article
Full-text available
Objective To assess the frequency and timing of dental treatment completion among pregnant and post-partum women served through the University of North Carolina at Chapel Hill (UNC-CH) Prenatal Oral Health Program (pOHP) dental clinic in the context of North Carolina (NC) dental Medicaid policies. Methods We completed a retrospective chart review...
Article
Purpose: Diet is a well-established, modifiable factor influencing dental caries risk. However, evidence regarding its association with distinct clinical patterns of dental caries is lacking. The purpose of this study was to identify the association of child nutrition patterns with two distinct clinical presentations (subtypes) of childhood dental...
Article
Purpose To define faculty needs and services requested for the implementation of a faculty‐centered curriculum support system (i.e., Academic Support Center [ASC]) to assist curriculum redesign. Methods Faculty and students were invited to participate in 60‐min, one‐on‐one interviews to describe pain points in teaching and identify possible suppor...
Article
Purpose: To evaluate the association between temperament and caries. Methods: A total of 408 primary caregiver-child pairs were followed for 36 months; they completed the Early Childhood Behavior Questionnaire Very Short-Form (ECBQ-VSF) at age four years. Demographic, behavioral, and clinical data were obtained at ages one, two-and-a-half, and fou...
Article
Background: A virtual oral health care help line was established to provide consultation and triage for people with dental questions and concerns. Its goal during a pandemic was to keep patients from seeking unnecessary in-person care from emergency departments and urgent care clinics, especially when dental practices were closed or limited to pro...
Article
Purpose The need to innovate predoctoral dental education is well established; however, there are few recent reports to guide substantial curriculum transformation. The purpose of this study was to describe faculty perspectives on their vision of future graduates, curriculum needs, and potential barriers to a successful redesign. This information w...
Article
Purpose There is minimal research characterizing admission prerequisites courses across schools of dentistry. The purpose of this study was to typify didactic and laboratory course requirements and compare requirements based on institution demographics. Methods In July 2019, the researchers evaluated websites from 76 North American dental schools...
Article
Curriculum transformations represent opportunities to innovate; however, there are few examples to inform this process. In 2018, the University of North Carolina at Chapel Hill (UNC) Adams School of Dentistry began to transform the predoctoral curriculum to improve content integration, enhance team-based experiences, and develop leaders. Part of th...
Article
Purpose The entrustable professional activity (EPA) framework is an assessment approach used to define the educational outcomes of a program by outlining discrete work tasks learners are expected to perform independently upon graduation. This study outlines the development and evaluation of an EPA framework for predoctoral dental education at the U...
Article
Odontogenic pain affects up to 54.9% of pregnant women (1, 2, 3). This pain is often associated with pulpal and/or periapical infections which pose risks to women and their fetus. The American Dental Association in collaboration with the American College of Obstetricians and Gynecologists developed a consensus statement to affirm the importance of...
Article
Purpose The Association of American Medical Colleges and American Dental Education Association have identified oral health knowledge, skills, and attitudes shared by both medical and dental professionals. Although oral health was deemed an essential competency for medical practitioners, our state struggled to ensure learners received proper trainin...
Article
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Introduction: Knowledge gaps exist among providers and pregnant women about the importance and safety of oral health care around pregnancy. This article describes the current state of perinatal oral health and healthcare among underserved women in North Carolina (NC) and provides policy recommendations to improve their access to and utilization of...
Article
Purpose: Inadequate prenatal oral health education in dental hygiene (DH) curricula can negatively impact patient care by graduating clinicians lacking competence in the provision of care for this population. The purpose of this study was to assess the knowledge, opinions, and willingness of DH students to provide oral care services to pregnant pat...
Article
Purpose: Currently, caries risk assessment tools consider all children with special health care needs in tandem. The purpose of this study was to test this assumption by examining caries risk among and within five distinct groups of children, most with special health care needs (CSHCN): (1) autism (ASD); (2) congenital heart disease (CHD); (3) cere...
Article
Changes in U.S. health care delivery systems and Commission on Dental Accreditation standards provide impetus for interprofessional education (IPE) and collaborative practice, but roadmaps for engaging dental and dental hygiene faculty to incorporate IPE in a systematic manner are limited. The purpose of this report is to describe the process for c...
Article
Background: Optimal oral health education is limited in nursing curricula and may therefore, not translate as a priority for nurses in clinical practice. Objectives: To evaluate the influence of an educational intervention on knowledge, confidence, practice behaviors, and perceived barriers of nursing students regarding preventive oral health se...
Article
The University of North Carolina at Chapel Hill Adams School of Dentistry is developing a transformative curriculum that prepares students to enter contemporary practice. The Advocate, Clinician, and Thinker (ACT) framework will provide the basis for developing a resilient workforce capable of meeting emerging health care needs over the next 40 yea...
Article
Poor maternal oral health during pregnancy is associated with adverse maternal and child outcomes, including preterm birth and early childhood caries. Subsequently, professional associations have developed prenatal oral health guidelines, but significant gaps exist in implementing guidelines into clinical practice. The purpose of this study was to...
Chapter
The examination of the 3-year-old child for some dentists represents a first dental experience, although earlier examinations are advocated by a number of organizations for diagnostic, preventive, and treatment purposes. For a child who has not had a dental examination previously, the new environment, new people, and manipulation of tissues can be...
Article
Full-text available
Background: Pregnant women are vulnerable to a wide range of oral health conditions that could be harmful to their own health and future child. Despite the usefulness of regular dental service utilization in prevention and early detection of oral diseases, it is notably low among pregnant women. In this qualitative study, we aimed to explore barri...
Article
Schools of medicine and dentistry on the same geographical campus have an opportunity to promote oral health by training physicians to become more skilled in screening for oral disease in addition to counseling and referring patients to dental health professionals.
Article
OBJECTIVES: The American Academy of Pediatrics (AAP) recommends an oral health risk assessment and referral to a dental home by a child’s first birthday. We evaluated the adherence of primary care providers (PCPs) to AAP dental referral guidelines for children age <4 years and barriers to implementation of these guidelines. METHODS: A cross-section...
Article
Purpose: Fluoridated toothpaste ingestion is associated with increased dental fluorosis prevalence. Current guidelines recommend a smear of fluoridated toothpaste for children younger than three years old and a pea-sized amount for children age three years or older. The purpose of this study was to evaluate two educational approaches to improve car...
Article
Objectives: To evaluate characteristics of pregnant women served through the University of North Carolina's (UNC) prenatal oral health program (pOHP) dental clinic and community healthcare pathways to inform efforts in promoting prenatal oral health policies. Methods: The pOHP provides medical and dental students and practitioners with interprof...
Article
Orofacial growth and development is a complex process spanning the life course. This article provides an oral health overview in the context of overall growth, physical and social development from infancy through adolescence. It reviews oral health–specific developmental milestones during childhood (0–12 years) and adolescence (≥13 years). It exami...
Article
Purpose: Assess how pediatric dentists (PD) and general practitioners (GP) manage after-hours pediatric dental emergencies according to perceived urgency. Methods: A survey was e-mailed to PD and GP in North Carolina. Participants responded to management of 18 cases (primary and permanent dentition) according to perceived urgency. Repeated-measures...
Article
Objectives To examine the Baby Oral Health Program's (bOHP) influence on dental visits for children 0 to 3 years and overall dental visits in four federally qualified health center (FQHC) clinics. Methods Using an interrupted time series study design, administrative data were obtained for the year prior and following the intervention. The interven...
Article
Full-text available
Objectives Limited information exists on the extent oral health is addressed in the context of prenatal care. This study sought to investigate characteristics of primary care physicians (PCP) who provide oral health counseling to pregnant women. Methods The study relied upon data from the 2013 Survey of PCP on Oral Health. Provision of oral health...
Article
Background: Two common methods of treating pediatric dental patients with severe early childhood caries (S-ECC) are general anesthesia (GA) and conscious sedation (CS). We sought to first evaluate the cost-effectiveness of treating S-ECC with GA versus CS and then compare the cost-effectiveness at 2 time points: 2011 and 2015. Methods: We used a...
Article
Full-text available
Objectives To determine acceptability and feasibility of a quality improvement (QI) collaborative in safety net dental practices, and evaluate its effects on financial stability, access, efficiency, and care for pregnant women and young children. Methods Five safety net dental practices participated in a 15-month learning collaborative utilizing bu...
Article
The aim of this study was to examine the influence of the Prenatal Oral Health Program (pOHP) at the University of North Carolina at Chapel Hill on medical students' oral health-related knowledge, confidence, attitudes, and dental referral practices. Specifically, the study sought to determine these students' ability to screen, counsel, and refer t...
Article
Objectives: To assess the use of quality improvement (QI) methods to implement an early childhood oral health program (Baby Oral Health Program-bOHP) in four federally qualified health center (FQHC) dental clinics. Study design: Using a mixed-methods study design, survey responses, administrative data, QI project templates, and focus group measu...
Article
Objectives: Oral diseases are very prevalent across the lifespan and impact overall health, yet are largely preventable. The Smiles for Life (SFL) curriculum was created to educate healthcare providers about oral disease and support integration of oral health and primary care. This study examines SFL's influence on clinical practice and education....
Article
Purpose: The purpose of this study was to assess after-hours practice characteristics of pediatric dentists (PDs) and general dentists (GDs) and determine how patients-of-record obtain after-hours emergency dental care. Methods: A 29-item survey was electronically distributed to PDs and GDs in North Carolina in September 2014. Demographics and a...
Article
Background: National Health and Nutrition Examination Survey 2011-2012 data indicated that, in the United States, nearly onefourth of children and over one-half of adolescents experienced dental caries in their permanent teeth. The purpose of this review was to summarize the available clinical evidence regarding the effect of dental sealants for t...
Article
Background: This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry con...
Article
Background and objectives: Despite the emphasis on delivery of preventive oral health services in non-dental settings, limited information exists about state Medicaid policies and strategies to educate practicing physicians in the delivery of these services. This study aims to determine: (1) training requirements and policies for reimbursement of...
Article
Full-text available
Introduction Prenatal oral health interventions can positively impact maternal and child oral health, yet limited information exists concerning how to best educate pregnant women about infant oral health. Our objective was to examine the influence of having given birth on pregnant women’s infant oral health knowledge and beliefs. Methods We conduct...
Article
Objectives: To examine professional guidelines and/or requirements of state and national dental organizations regarding the responsibility of dentists for after-hours emergency care. Methods: Guidelines of national dental professional organizations, specialties, and all 50 state dental boards were examined for language pertaining to after-hours...
Article
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Prenatal oral health extends beyond the oral cavity, impacting the general well-being of the pregnant patient and her fetus. This case report follows a 19-year-old pregnant female presenting with acute liver failure secondary to acetaminophen overdose for management of dental pain following extensive dental procedures. Through the course of her ill...
Article
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Introduction: Establishing dental homes for children at an early age is an important step toward instilling good oral health practices and changing trajectories of oral health. The purpose of this study was to determine how accredited dental and dental hygiene programs in Canada prepare students in the areas of infant, toddler and prenatal oral he...
Article
The purpose of this report was to describe the management of an eight-year-old Bulgarian male with Down syndrome presenting with periodontitis as a manifestation of systemic disease in the early mixed dentition. Treatment involved full-mouth mechanical debridement and extraction of hopeless teeth under general anesthesia followed by systemic antibi...
Article
This chapter discusses the concepts of care coordination, interprofessional education (IPE), and collaboration, and examines policy and community/ practice level modifications for improving children's oral health care. Oral health is an essential component of overall health, and the changing epidemiology in pediatric oral health is a clear indicati...
Chapter
This chapter describes the conceptual basis and uses of caries risk assessment (CRA) and provides an overview of important considerations for assessing children's risk for dental disease. The chapter also reviews current caries-risk assessment tools (CATs) and highlights implementation and policy issues regarding various uses of CRA. It provides an...
Article
We examined the extent to which three predictors of children's recall, selected on the basis of their theoretical significance, contributed to the prediction of children's recall for the details of dental operative procedures in a diverse sample of 28 children (54–140 months of age). Parents provided information regarding their children's dental hi...
Article
Interprofessional collaboration has become a critical component of accreditation standards in dentistry and medicine. This article reports on implementation in an academic setting of a prenatal oral health program (pOHP) that addresses coordinated care, accreditation standards, and new clinical practice guidelines. The pOHP is an educational interv...
Article
Oral health is an integral part of the overall health of children. Dental caries is a common and chronic disease process with significant short- and long-term consequences. The prevalence of dental caries for the youngest of children has not decreased over the past decade, despite improvements for older children. As health care professionals respon...
Conference Paper
Background: Poor maternal oral health is a significant public health issue due to its prevalence and connections with adverse pregnancy/birth outcomes and chronic diseases across the lifecourse. Although both medical and dental professional organizations have recently endorsed practice guidelines for prenatal oral health, the extent to which interv...
Article
Professional guidelines and state Medicaid policies encourage pediatricians to provide oral health screening, anticipatory guidance, and fluoride varnish application to young patients. Because oral health activities are becoming more common in medical offices, the objective of this study was to assess pediatricians' attitudes and practices related...
Article
Full-text available
Purpose: The purposes of this study were to: describe practice patterns, knowledge, and attitudes of pediatric dentists in North Carolina (N.C.) in delivering dietary recommendations to the parents/caregivers of infants and toddlers; and identify barriers that limit the implementation of related recommendations. Methods: Our survey instrument in...
Article
Purpose: The purposes of this study were to: (1) assess knowledge, attitudes, and behaviors of North Carolina general dentists (GDs) regarding American Academy of Pediatrics (AAP) dental referral guidelines; and (2) determine factors that influence pediatricians' ability to comply with AAP guidelines. Methods: One thousand GDs were surveyed to d...
Article
Purpose: Many communities lack dental professionals with the knowledge and behavioral skills needed to deliver care to young children (<3 years). This study aimed to examine the impact of an intervention (the Baby Oral Health Program (bHOP)) on dental providers' knowledge, values, confidence and practice behaviors regarding preventive oral health...
Article
Article title and bibliographic information Can child temperament be related to ECC? Aminabadi NA, Ghoreishizadeh A, Ghoreishizadeh M, Oskouei SG, Ghojazadeh M. Caries Res 2014;48:3-12. Purpose/Question To investigate the relationship of ECC and different traits of child temperament, directly and indirectly through nutritional and oral hygiene hab...
Article
This report outlines a series of recommendations derived from an advocacy and policy workshop at the 2013 American Academy of Pediatric Dentistry (AAPD) Behavior Guidance Symposium. The committee charge was to address two questions: (1) what should be done to change public and media perception of behavior guidance, if anything, and: (2) what should...
Article
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Care coordination between physicians and dentists remains a challenge. This study of dentists providing pediatric dental care examined their opinions about physicians' role in oral health and identified factors associated with these opinions. North Carolina general and pediatric dentists were surveyed on their opinions of how physicians should proc...
Article
The purpose of this study was to evaluate the knowledge, comfort, practice behaviors, and perceived barriers of dental hygienists in North Carolina regarding their delivery of oral health preventive services to infants and toddlers. A questionnaire was mailed to 2,000 dental hygienists randomly selected from the North Carolina Board of Dental Exami...
Article
Objectives Stage of readiness can contribute to providers’ clinical behavioral patterns, but little is understood about its impact in dentistry. The purpose of this investigation is to (1) describe the stage of readiness of general dentists in North Carolina (NC) to deliver preventive oral health services to infants and toddlers and (2) assess fact...
Article
Objectives: We determined the number of state Medicaid programs adopting initiatives to support preventive dental services provision by nondental health care professionals, their perceived attributes, and implementation barriers. Methods: We used Qualtrics to conduct a cross-sectional survey in 2008 of Medicaid dental program managers to determi...
Article
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Children with developmental disabilities often have unmet complex health care needs as well as significant physical and cognitive limitations. Children with more severe conditions and from low-income families are particularly at risk with high dental needs and poor access to care. In addition, children with developmental disabilities are living lon...
Article
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Objective . (1) To describe an innovative program training US pediatricians to be Chapter Oral Health Advocates (COHAs). (2) To provide insight into COHAs’ experiences disseminating oral health knowledge to fellow pediatricians. Patients and Methods . Interviews with 40 COHAs who responded to an email request, from a total of 64 (62% response). Tra...
Article
Abstract This resource on pregnancy and oral health covers topics for health care providers who take care of prenatal patients. The module covers a range of topics, including oral diseases of pregnancy, complications of these diseases on the pregnancy, safety of dental interventions in pregnancy, and how to promote oral health for pregnant women an...
Article
Full-text available
Objective: To estimate the cost-effectiveness of a medical office-based preventive oral health program in North Carolina called Into the Mouths of Babes (IMB). Design: Observational study using Medicaid claims data (2000-2006). Setting: Medical staff delivered IMB services in medical offices, and dentists provided dental services in offices or...
Article
Abstract This resource on acute dental emergencies covers topics for health care providers who take care of ambulatory or hospitalized patients. The module covers a range of topics, including oral pain and infections such as abscesses and cellulitis. In addition, students learn about common trauma to primary and secondary dentition, including the b...
Article
Abstract This resource on geriatric oral health covers topics for health care providers who take care of older adult patients. The module covers a range of topics including oral health assessment; common oral diseases such as caries, periodontitis, and oral cancer; oral-systemic links (diabetes, arthritis, and dementia, to name a few); nursing home...
Article
Abstract Smiles for Life Module 6, Fluoride Varnish, covers topics for health care providers who take care of children and adolescents. The module is more than simply a “how-to” for varnish teeth; the module covers a range of topics including the cause of early childhood caries (ECC), how to assess risks for ECC, how to perform a proper oral exam o...
Article
Abstract This resource on oral examination addresses how to perform consistent and thorough oral examinations of children and adults. Clinicians learn to differentiate between normal and abnormal findings and develop an awareness of the needs of special populations such as the elderly or medically compromised individuals. This resource is designed...
Article
Abstract This resource is a learning module that addresses the nature, prevalence, and consequences of oral disease throughout the life cycle, with a focus on correlations between oral and systemic health. Clinicians learn their role in preventing oral disease, addressing frequently encountered oral problems, and promoting oral health among their p...
Article
Abstract This resource addresses how adult oral health is impacted by factors such as disease, aging, medication, and substance use. Clinicians review risk factors and etiologies of oral conditions, as well as appropriate treatment and referral procedures. Additionally, this module addresses how to effectively promote oral disease prevention, coord...
Article
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Risk-based prioritization of dental referrals during well-child visits might improve dental access for infants and toddlers. This study identifies pediatrician-assessed risk factors for early childhood caries (ECC) and their association with the need for a dentist's evaluation. A priority oral health risk assessment and referral tool (PORRT) for ch...
Article
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This study aimed to describe children <6 years requiring general anesthesia for dental treatment and factors associated with a change in medical management prior to surgery. This case series reviewed the past medical history and preoperative assessment of patients referred for dental preoperative evaluations at a single institution (2005-2008). A "...
Article
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To review the early history of the promotion of oral health for infants and toddlers, the impact of the AAPD guideline on infant oral health care and ways to maximize health outcomes. Review of the literature. Concepts on primary prevention and early intervention were reported as early as the 19th century. Progress to positively impact the oral hea...
Article
Full-text available
To estimate the effectiveness of a medical office-based preventive dental program (Into the Mouths of Babes [IMB]), which included fluoride varnish application, in reducing treatments related to dental caries. We used longitudinal claims and enrollment data for all children aged 72 months or younger enrolled in North Carolina Medicaid from 2000 thr...
Article
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Dental caries (tooth decay), the most common chronic disease affecting young children, is exacerbated by limited access to preventive dental services for low-income children. To address this problem, North Carolina implemented a program to reimburse physicians for up to six preventive oral health visits for Medicaid-enrolled children younger than a...