About

Michelle Henshaw is the Associate Dean for Global & Population Health and a Professor of Health Policy and Health Services Research at the Henry M. Goldman School of Dental Medicine. Her role involves leading efforts to develop and showcase GSDM’s position as a world leader in global health and interprofessional care initiatives. Dr. Henshaw's major research interests are in health services research and oral epidemiology, with recent focus on how oral conditions affect health-related quality of life, understanding oral health disparities, and access to care for underserved populations. She serves as Co-Director of the Center for Research to Evaluate and Eliminate Dental Disparities (CREEDD) and is the Principal Investigator of Project 2: Oral Health Advocates in Public Housing. Her professional activities include active participation in community and professional organizations, such as serving on the Planning Board for the Oral Health Foundation, being a member of the Massachusetts Coalition for Oral Health, and having served as Chair of the Community and Preventive Dentistry Section of the American Dental Education Association.

Research topics

• Medicine
• Nursing
• Gerontology
• Family medicine
• Psychology
• Environmental health
• Computer Science
• Medical education
• Dentistry
• Pedagogy
• Political Science
• Demography
• Developmental psychology
• Pathology
• Psychiatry
• Mathematics education

Selected publications

• Parent-Targeted Oral Health Text Messaging for Underserved Children Attending Pediatric Clinics

  JAMA Network Open · 2025-01-02 · 5 citations

  articleOpen accessSenior author

  Importance: Caries is the most common chronic childhood disease, with substantial health disparities. Objective: To test whether parent-targeted oral health text (OHT) messages outperform child wellness text (CWT) messages on pediatric caries increment and oral health behaviors among underserved children attending pediatric well-child visits. Design, Setting, and Participants: The parallel randomized clinical trial, Interactive Parent-Targeted Text Messaging in Pediatric Clinics to Reduce Caries Among Urban Children (iSmile), included participants who were recruited during pediatric medical clinic visits at 4 sites in Boston, Massachusetts, that serve low-income and racially and ethnically diverse (herein, underserved) populations. English-speaking or Spanish-speaking caregivers of children younger than 7 years with at least 1 tooth were eligible. The study, which had a dose-matched design, was conducted from March 9, 2018, to February 28, 2022, with a 24-month follow-up. Text messages were sent for 4 months, plus a 1-month booster at 12 months. Intervention: Text messages were bilingual, automated, interactive, customized, and gamified. OHT messages focused on child toothbrushing and preventive dental visits. CWT messages focused on reading and child safety. Both included a choice of other content topics pertinent to their randomized arm. Main Outcomes and Measures: The primary outcome was 24-month caries increment assessed by calibrated examiners. Secondary outcomes were oral health behaviors known to predict pediatric caries (eg, toothbrushing, sugar-sweetened beverages, diet, fluoride toothpaste use, and preventive dental visits), which were assessed by self-report, and participant satisfaction with the text message program. Caries examinations occurred at baseline and 12 and 24 months later. Self-report surveys occurred at these time points and at the end of the text message program (4 months). Results: Among 1388 caregivers who were approached for eligibility, 969 were eligible. Of these, 754 caregivers (mean [SD] age, 32.9 [7.2] years; 713 female [94.6%]) and 754 children (mean [SD] age, 2.9 [1.7] years; 377 female [50.0%]) were randomized (77.8%); 449 of 657 participants (68.3%) were below the poverty line. Responses to text messages were high (OHT group: 67.9%; CWT group: 69.6%). There were no significant group differences in caries increment (OHT group: 43.0% vs CWT group: 42.7%; adjusted odds ratio, 0.99 [95% CI, 0.63-1.56]). Children in the OHT messaging group were significantly more likely to meet toothbrushing guidelines (odds ratio [OR], 1.77 [95% CI, 1.13-2.78]), have preventive dental visits (pooled OR, 1.51 [95% CI, 1.18-1.94]), and use fluoride toothpaste (pooled OR, 1.46 [95% CI, 1.06-2.01]) compared with those in the CWT messaging group over 24 months. OHT messages had a significant effect on caregivers' own toothbrushing (pooled mean difference, 0.48 [95% CI, 0.03-0.92]). Conclusion and Relevance: The findings of this randomized clinical trial including underserved children and their caregivers suggest that OHT messages had significant and sustained effects on preventive dental behaviors known to reduce caries among both caregivers and children, but had no effect on caries increment in children. Highly appealing and low-burden text messages coupled with evidence of change in oral health behaviors may be important in reducing oral health disparities. Trial Registration: ClinicalTrials.gov Identifier: NCT03294590.

  PublisherOA PDFDOI

• Determining the Feasibility of a Mail-In Saliva Sample Protocol for Persons Living with HIV in Two Urban Northeast United States Clinics

  HIV/AIDS - Research and Palliative Care · 2025-10-01

  articleOpen accessSenior author

  Background: Mail-in saliva samples are a participant-centered means of monitoring patients' oral and overall health that may help to reduce unnecessary medical trips and more efficiently use provider time. The use and acceptability of mail-in saliva samples have been studied in high-risk populations; however, it has not been studied in cohorts of people living with HIV (PLWH). Objective: To investigate the feasibility of PLWHs' willingness to provide mail-in saliva samples, 900 saliva collection kits were mailed to a randomized sample of PLWH across two urban and diverse clinics in the Northeast United States in 2019-2020. Results: 73/900 (8%) packages were returned to study personnel, with 100% (73/73) containing saliva deemed usable for analysis. 55/900 (6%) of packages were returned to the study team undeliverable. Further information may be gained from investigating the influence of personalized test results, health literacy, the requirement of the oral health survey, and study compensation that may affect an individual's motivation to participate in the study. Conclusion: While findings suggest limited feasibility of mail-in saliva collection without personalized test results in a cohort of PLWH in terms of response rate, all returned saliva samples were usable for analysis suggesting that addressing potential barriers may improve response rates and the feasibility of using mail-in salivary diagnostics to monitor disease progression in PLWH in future studies.

  PublisherOA PDFDOI

• Estimation of Oral Disease Burden among Older Adults in LTC: A Scoping Review

  International Journal of Environmental Research and Public Health · 2024 · 10 citations

  Senior authorCorresponding
  • Medicine
  • Gerontology
  • Dentistry

  Oral health is an essential part of healthy aging and very little data exists around the disease burden for older adults in a long-term care setting. The aim of this scoping review was to estimate the disease burden of dental caries, periodontal disease, and tooth loss among older adults in Long-Term Care (LTC). This scoping review was conducted in accordance with the Joanna Briggs Institute methodology. A detailed strategy was used to conduct a comprehensive search of electronic databases: PubMed, Embase, and Dentistry and Oral Sciences Source (DOSS). The Rayyan AI platform was used to screen abstracts for assessment by one of five co-investigators. Results indicate that only one in three might have a functional dentition upon entry into LTC, and among those who are dentate, most might expect to develop at least one new coronal and one new root caries lesion each year. There is a need to better document the disease experiences of this group to tailor approaches to care that might reduce the avoidable suffering as a result of dental caries and periodontal disease.

  PublisherOA PDFDOI

• The Longitudinal Reciprocal Relationships of Tooth Brushing Behaviors Between Underserved Children and Their Caregivers

  Annals of Behavioral Medicine · 2024-02-17 · 3 citations

  articleOpen access

  BACKGROUND: Tooth brushing is effective in preventing early childhood caries. However, it is unclear how children's and caregiver's tooth brushing are reciprocally related. PURPOSE: The current study investigated whether the longitudinal relationships between children and caregiver tooth brushing are moderated by a caregiver-targeted child oral health intervention and caregiver depression. METHODS: Secondary analysis of a randomized clinical trial that tested whether caregiver-targeted oral health text messages (OHT) outperformed child wellness text messages (CWT) on pediatric dental caries and oral health behaviors (n = 754, mean child age = 2.9 years, 56.2% Black, 68.3% <poverty level). Tooth brushing behaviors were self-reported by caregivers using a timeline follow-back method at baseline and 4, 12, and 24 months later. Caregiver depressive symptoms were self-reported at baseline. A multigroup random intercept cross-lagged panel model examined relationships between caregiver and child tooth brushing for four post hoc groupings of condition: OHT versus CWT, and caregiver depressive symptoms: high versus low. RESULTS: Within-participants analyses revealed that caregiver tooth brushing at Months 4 and 12 positively predicted their child's tooth brushing at Months 12 and 24 for caregivers in the OHT condition with low depressive symptoms (i.e., moderation by depressive symptoms and condition). Similarly, children's tooth brushing at Month 4 positively predicted caregiver tooth brushing at Month 12 for caregivers in the OHT condition with low depressive symptoms. There were no significant associations among participants in the CWT condition, regardless of depressive symptoms. CONCLUSIONS: Child and caregiver tooth brushing have reciprocal influences, but only for those in the OHT condition with low depressive symptoms.

  PublisherOA PDFDOI

• A service‐learning framework to address accreditation standards: Self‐Assessment, communication skills, health literacy, and cultural competence

  Journal of Dental Education · 2024 · 3 citations

  Senior authorCorresponding
  • Medical education
  • Psychology
  • Pedagogy

  OBJECTIVES: Pre-doctoral dental programs must provide opportunities for students to become proficient in self-assessment, communication skills, health literacy, and cultural competence, essential for independent unsupervised practice. This study aimed to assess how student learning through a classroom education service-learning program addresses the Commission on Dental Accreditation (CODA) standards 2-11 and 2-17; specifically through the examination of self-assessment, communication skills, health literacy, and cultural competence. METHODS: This 2022 retrospective mixed methods cohort study examined unstructured faculty comments on drafted lesson plans and structured evaluations of classroom education service-learning rehearsal sessions. A random sample of faculty comments from three academic years, 2018, 2019, and 2020, were deidentified and analyzed by five researchers for emerging themes using NVivo. Quantitative data from rehearsal presentations were analyzed with descriptive statistics to assess the concordance of self and faculty feedback on specific evaluation criteria. RESULTS: Six major themes from faculty lesson plan feedback emerged: knowledge, professionalism, communication, presentation skills, cultural competence, and program logistics. Concordance between faculty feedback and student self-assessment ranged from 83% to 92.4% across all evaluation criteria over the 3 years: spoke clearly and confidently at the right pace, provided accurate dental terminology and facts, used grade-appropriate language, provided clear instructions to follow, appeared enthusiastic throughout the rehearsal presentation, and designed a well thought out lesson plan that will engage children for the entire presentation. CONCLUSION: Findings support the classroom education service-learning program as a framework to provide opportunities for student self-assessment and feedback on communication skills, health literacy, and cultural competence aligned with CODA standards 2-11 and 2-17.

  PublisherOA PDFDOI

• System Dynamics Modeling of Caries Severity States in Long-Term Care

  Journal of Dental Research · 2024-11-21 · 1 citations

  articleOpen accessSenior author

  Dental caries among long-term care (LTC) residents is a persistent and complex problem driven by social and structural factors. Systems thinking may be useful in considering novel approaches to reducing disease. This study aimed to develop a system dynamics model to simulate the progression of dentate older adults in LTC through caries severity states and estimate the effects of 3 intervention scenarios on the progression of caries: preventive topical fluoride (TF), arrest of caries with silver diamine fluoride (SDF), and a combination of TF and SDF. Dentate older adults in LTC were categorized into 4 caries severity states by their number of untreated carious lesions. The model assumed that changes in severity states were consistent with incidence rates reported in the literature and available billing data for dental care and that individuals move in and out of the system by entering and exiting the facility or experiencing edentulism. For all scenarios, the proportion of dentate older adults in LTC with 1 or more untreated lesions stays stable, the distribution of disease shifts from a high severity state, and the system approaches equilibrium after 4 y. The TF intervention predicts minimal impacts on decreasing the proportion of dentate older adults with 1 or more untreated lesions (2.5% decrease), while the SDF intervention and the combination interventions were most disruptive. There was a 29.6% and 33.6% decrease, respectively. Given the specific population dynamics in LTC, these findings suggest that long-term (greater than 4 y) interventions should be designed to address both the management of existing lesions and their incidence. This system dynamics model allows researchers to render institution-specific data points from LTCs to estimate the effects of proposed interventions at the respective site.

  PublisherOA PDFDOI

• Cost-effectiveness analysis design for interventions to prevent children's oral disease

  Frontiers in Oral Health · 2024-07-18

  articleOpen access

  Introduction: In 2015, the National Institute of Dental and Craniofacial Research (NIDCR) launched the Multidisciplinary Collaborative Research Consortium to Reduce Oral Health Disparities in Children, supporting four randomized trials testing strategies to improve preventive care. A Coordinating Center provides scientific expertise, data acquisition and quality assurance services, safety monitoring, and final analysis-ready datasets. This paper describes the trials' economic analysis strategies, placing these strategies within the broader context of contemporary economic analysis methods. Methods: The Coordinating Center established a Cost Collaborative Working Group to share information from the four trials about the components of their economic analyses. Study teams indicated data sources for their economic analysis using a set of structured tables. The Group meets regularly to share progress, discuss challenges, and coordinate analytic approaches. Results: All four trials will calculate incremental cost-effectiveness ratios; two will also conduct cost-utility analyses using proxy diseases to estimate health state utilities. Each trial will consider at least two perspectives. Key process measures include dental services provided to child participants. The non-preference-weighted Early Childhood Oral Health Impact Scale (ECOHIS) will measure oral health-related quality of life. All trials are measuring training, implementation, personnel and supervision, service, supplies, and equipment costs. Conclusions: Consistent with best practices, all four trials have integrated economic analysis during their planning stages. This effort is critical since poor quality or absence of essential data can limit retrospective analysis. Integrating economic analysis into oral health preventive intervention research can provide guidance to clinicians and practices, payers, and policymakers.

  PublisherOA PDFDOI

• Geriatric Dental Medicine

  Clinics in Geriatric Medicine · 2023-04-10

  articleSenior author
  PublisherDOI

• Commentary on: Tooth Loss, Periodontal Disease, and Mild Cognitive Impairment Among Hispanic/Latino Immigrants: The Moderating Effect of Age at Immigration

  The Journals of Gerontology Series A · 2023-06-01

  letterOpen access
  PublisherOA PDFDOI

• Theoretical and methodological approaches in designing, developing, and delivering interventions for oral health behaviour change

  Community Dentistry And Oral Epidemiology · 2023 · 22 citations

  • Medicine
  • Dentistry
  • Nursing

  Oral health behaviour change interventions are gaining momentum on a global scale. After lagging behind other disciplines, oral health behaviour change is becoming an area of fast and important development. Theories used in medicine and healthcare more generally are now being applied to oral health behaviour change with varying results. Despite the importance of using theories when designing and developing interventions, the variety and variation of theories available to choose from create a series of dilemmas and potential hazards. Some theories, like the COM-B (Capability, Opportunity, Motivation-Behaviour) model, and frameworks, like the Behaviour Change Wheel might represent areas of opportunity for oral health behaviour change interventions with careful consideration vital. Different methodological approaches to intervention development are actively utilized in oral health with a wide host of potential opportunities. The issue of co-designing and co-developing interventions with intended users and stakeholders from the start is an important component for successful and effective interventions, one that oral health behaviour change interventions need to consistently implement. Oral health behaviour change interventions are utilizing technology-based approaches as a major vehicle for intervention delivery and, innovative solutions are implemented across a wide host of oral health behaviour change interventions. With multiple options for designing, developing, and delivering interventions, careful selection of appropriate, user-inclusive, and adaptable approaches is essential. With a lot of available information and evidence from other disciplines, oral health behaviour change interventions need to reflect on lessons learned in other fields whilst also maximizing the potential of the wide variety of theories, frameworks, methodologies, and techniques available at present.

  PublisherOA PDFDOI

Recent grants

• NIH Grant K23DE000454

  NIH · $614k · 2006

• NIH Grant U54DE019275

  NIH · $32.3M · 2017

Frequent coauthors

• Raul I. García

  Boston University

  18 shared

• Belinda Borrelli

  Boston University

  13 shared

• Nancy R. Kressin

  Boston University

  12 shared

• Paul L. Geltman

  Massachusetts Department of Public Health

  12 shared

• Joseph M. Calabrese

  Boston University

  11 shared

• Martha E. Nunn

  Biostatistical Consulting (United States)

  11 shared

• Terrence S. Batliner

  10 shared

• Judith Albino

  Colorado School of Public Health

  10 shared

Labs

• Center for Research to Evaluate and Eliminate Dental Disparities (CREEDD)PI

Education

• B.A.

  Columbia University

• B.S.

  University of California, San Francisco

• Other

  University of California, San Francisco

• Other

  Boston University