encouragement and willingness to work with my schedule to help me complete this program while attending classes part time. I would like to thank Dr. Raymond Kuthy, my thesis chair, for his tireless repetition of concepts that were initially foreign to me. His mentorship over the past three years has been invaluable and greatly appreciated. I want to thank my committee, Drs. Teresa Marshall, Michelle McQuistan and Fang Qian for their dedication and guidance as I worked to complete this project. I would like to thank all of the other professors in the Department of Preventive and Community Dentistry who offered kind words of encouragement along the way. Most importantly, I want to thank my family, without whom I could have never done this. To my father and mother, I want to thank you for encouraging and supporting me through my early years of education, so that I could embark upon this degree program. To my wonderful husband, Rick, without your help, I could not have started or finished this program. To my amazing children, David and Lauren, thank you for being patient with me as I spent endless hours at the computer trying to finish this academic endeavor in the limited time that I had available to me. I must acknowledge the Department of Preventive and Community Dentistry and Delta Dental of Iowa Foundation for their financial support of this research.