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Association of childhood socioeconomic status with edentulism among Chinese in mid-late adulthood. BMC Oral Health 2019; 19:292. [PMID: 31884947 PMCID: PMC6935473 DOI: 10.1186/s12903-019-0968-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/22/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the association between childhood socioeconomic status (SES) and edentulism. METHODS The edentulous status of Chinese in mid-late adulthood was determined using self-reported lost all of teeth from the Health and Retirement Longitudinal Study (CHARLS). Childhood SES was determined based on the following parameters: the education, occupation and working status of the parents; financial situation of the family; relationship with the parents; care, love and affection from the mother; quarrels and fights between parents; primary residence; neighbors' willingness to help and with close-knit relationships. Adulthood SES was assessed by educational achievements. This study used principal component analysis (PCA) to select variables and binary logistic regression models to determine the association between childhood SES and edentulism. RESULTS Data were available from a total of 17,713 respondents, 984 of whom were edentulous (2.9%). The prevalence of edentulism in mid- to late-age Chinese individuals was higher in those with poor childhood SES. In final regression model, edentulism was significantly associated with willingness of neighbors to help with close-knit relationships (OR = 0.89, 95% CI = 0.79-0.99), parents with high school education or above (OR = 1.18, 95% CI = 1.01-1.39) and drinking and smoking habits of the father (OR = 1.10, 95% CI = 0.97-1.24). CONCLUSION Childhood SES was significantly associated with the prevalence of edentulism in mid- to late-age Chinese individuals. In particular, parents with high school education or above, unwillingness of neighbor to help with close-knit relationships, drinking and smoking habits of the father independent of adulthood SES were significantly associated with edentulism. Accordingly, the development of optimal recommendations and more effective intervention strategies requires considering the experiences in early life associated with poor SES contributes to poor oral health.
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Wade A, Hobbs M, Green MA. Investigating the relationship between multimorbidity and dental attendance: a cross-sectional study of UK adults. Br Dent J 2019; 226:138-143. [PMID: 30679858 DOI: 10.1038/sj.bdj.2019.47] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2018] [Indexed: 11/09/2022]
Abstract
Introduction Regular dental attendance is related to better oral health. However, long-standing health conditions (LSHCs) may be related to dental attendance and this relationship may vary by socioeconomic status. Method Data were collected from wave two (2013–2015) of the Yorkshire Health Study (n= 7,654). Data included dental attendance, LSHC, age, gender, education-level, smoking, body mass index, and area-level deprivation. Logistic regression (attend or not) was used to analyse associations with LSHC and multimorbidity. Results Overall, 63.1% (n = 4,826) of individuals attended the dentist. Of these, 37.8% (n =2894) had no LSHC, 26.0% (n = 1987) had one LSHC and 36.4% (n = 2784) had two or more LSHC. The presence of a singular LSHC was not associated with dental attendance(OR = 0.91 [0.81, 1.04]), however, those with two or more LSHCs were more likely to attend the dentist (OR = 0.81 [95% CI 0.72, 0.92]). Interactions between individual-level education, as a marker of socioeconomic status, and LSHC revealed few associations with dental attendance. Conclusion Multimorbidity was associated with dental attendance such that those with multimorbidity were more likely to attend. These important findings highlight the increasing challenge of multimorbidity for global healthcare systems.
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Affiliation(s)
- A Wade
- Leeds General Infirmary, Leeds, LS1 3EX
| | - M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, Christchurch, New Zealand
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
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Willingness of general dental practices in South East London to engage with research. Prim Health Care Res Dev 2019; 20:e118. [PMID: 32799989 PMCID: PMC6691998 DOI: 10.1017/s1463423618000944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This study assessed the willingness of general dental practices (GDPs) to
participate in research. All 263 GDPs in South East London that provide dental
care under National Health Service (NHS) contracts were invited. The survey
instrument was adapted from previous studies and piloted before administration.
Geographical factors and practice characteristics associated with willingness to
participate in research were explored in logistic regression models. A total of
77 responses were received (response rate: 29%). Of them, 40 (53%)
expressed interest in being involved in primary care research. They saw their
main role as collecting data and facilitating access to patients. Time,
bureaucracy and lack of energy were the main reasons behind a decision not to
engage with research. Those spending more time in NHS services were more likely
to be willing to participate in research. Other possible indicators were
single-handed GDPs, participation in the dental foundation training programme
and location in more affluent areas.
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Hakeem FF, Sabbah W. Is there socioeconomic inequality in periodontal disease among adults with optimal behaviours. Acta Odontol Scand 2019; 77:400-407. [PMID: 30919709 DOI: 10.1080/00016357.2019.1582795] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To examine if socioeconomic inequalities exist in periodontal disease among adult with optimal oral health behaviours. MATERIALS AND METHODS Data were from the Adult Dental Health Survey 2009, a national survey of England, Wales and Northern Ireland. Overall, 4738 participants aged 35 years and older were included in the analysis. Periodontal disease indicated by pocket depth or loss of attachment ≥4 mm, and gingival bleeding were used as periodontal outcomes. Education and deprivation indicated socioeconomic position. Behavioural factors were dental visits, toothbrushing and smoking. The subset of adults with and without optimal health related behaviours included 2916 and 1822 participants, respectively. The associations between periodontal disease and socioeconomic position were tested adjusting for demographic and behavioural factors. Additional models stratifying the sample to those with and without optimal behaviour subgroup were constructed. RESULTS Education and deprivation were significantly associated with periodontal disease in the partially adjusted models. In the analysis of those with optimal behaviours, only deprivation and highest level of education showed significant association with periodontitis (PD), but not with gingival bleeding. Among those without optimal behaviours, all socioeconomic factors were associated with all outcomes except deprivation and PD. CONCLUSIONS Oral health behaviours marginally contributed to inequalities in gingival bleeding and periodontal disease. Socioeconomic inequalities were attenuated among those with optimal behaviours and persisted among those without optimal behaviours. Behaviours appeared to be an effect modifier for the relationship between periodontal outcomes and socioeconomic factors.
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Affiliation(s)
- Faisal F. Hakeem
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University Dental College and Hospital, Madinah, Saudi Arabia
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
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Hach M, Christensen LB, Lange T, Hvidtfeldt UA, Danielsen B, Diderichsen F, Osler M, Prescott E, Andersen I. Social inequality in tooth loss, the mediating role of smoking and alcohol consumption. Community Dent Oral Epidemiol 2019; 47:416-423. [DOI: 10.1111/cdoe.12468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/18/2019] [Accepted: 04/25/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Maria Hach
- Department of Odontology and School of Oral Health Care, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Lisa B. Christensen
- Department of Odontology, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Theis Lange
- Section of Biostatistics, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Statistical Science Peking University Peking China
| | - Ulla A. Hvidtfeldt
- Diet, Genes and Environment Danish Cancer Society Research Center Copenhagen Denmark
| | - Bo Danielsen
- Faculty of Health and Medical Sciences, School of Oral Health Care University of Copenhagen Copenhagen Denmark
| | - Finn Diderichsen
- Department of Public Health University of Copenhagen Copenhagen Denmark
- Oswaldo Cruz Foundation Rio de Janeiro Brazil
| | - Merete Osler
- Center for Clinical Research and Prevention Frederiksberg/Bispebjerg Hospitals Frederiksberg Denmark
- Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Eva Prescott
- Department of Cardiology, Bispebjerg/Frederiksberg Hospitals University of Copenhagen Copenhagen Denmark
| | - Ingelise Andersen
- Department of Public Health, Section of Social Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
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Primary teeth microhardness and lead (Pb) levels. Heliyon 2019; 5:e01551. [PMID: 31049448 PMCID: PMC6484203 DOI: 10.1016/j.heliyon.2019.e01551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 11/22/2022] Open
Abstract
Objectives Lead (Pb) exposure is associated with dental caries. Whether Pb affects tooth microhardness, is unclear. Our objective was to assess whether Pb concentration is associated with microhardness. Methods Exfoliated primary teeth were collected from 46 volunteers. Teeth were sectioned, one half of each tooth was tested for enamel Knoop microhardness. The remaining half was digested and Pb measured using an inductively coupled plasma-mass spectrometer. Results The correlations between Pb levels and microhardness were very low, and were not statistically significant at p < 0.05. Conclusions Previous exposure to high levels of Pb was not associated with decreased tooth microhardness. Clinical significance This study assessed whether Pb in deciduous teeth is associated with tooth microhardness. As this was not the case, further studies are needed to identify the mechanisms behind the association between lead exposure and tooth decay.
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Wellappuli N, Ekanayake L. Role of oral health‐related behaviors in education inequalities in chronic periodontitis among Sri Lankan men. ACTA ACUST UNITED AC 2019; 10:e12416. [DOI: 10.1111/jicd.12416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/05/2018] [Accepted: 02/21/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Nimali Wellappuli
- Office of the Provincial Director of Health ServicesColombo Sri Lanka
| | - Lilani Ekanayake
- Department of Community Dental Health Faculty of Dental Sciences University of Peradeniya Peradeniya Sri Lanka
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Bof de Andrade F, Drumond Andrade FC. Socioeconomic Inequalities in Oral Health-Related Quality of Life among Brazilians: A Cross-Sectional Study. Dent J (Basel) 2019; 7:dj7020039. [PMID: 30986921 PMCID: PMC6631570 DOI: 10.3390/dj7020039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 01/07/2023] Open
Abstract
Objective: Assess the magnitude of the socioeconomic inequalities related to the impact of oral health on quality of life among adults and elderly individuals. Methods: This was a cross-sectional study with data from the most recent oral health survey from the state of Minas Gerais, Brazil. The sample included data on 2288 individuals—1159 adults in the 35–44 age group and 1129 adults in the 65–74 age group. Socioeconomic inequalities in Oral Impacts on Daily Performance ratings were measured using two inequality measures: the slope index of inequality (SII) and the relative index of inequality (RII). Results: The prevalence of negative impact of oral health on quality of life was 42.2% for the total sample, 44.9% among adults and 37.5% among elderly individuals. Significant absolute and relative income inequalities were found for the total sample (SII −27.8; RII 0.52) and both age groups (adults: SII −32.4; RII 0.49; elderly: SII −18.3; RI 0.63), meaning that individuals in the lowest income level had the highest prevalence of negative impacts. Regarding schooling, no significant differences were observed among the elderly. Conclusion: There were significant socioeconomic inequalities related to the negative impact of oral health-related quality of life in Brazil among both age groups.
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Affiliation(s)
- Fabíola Bof de Andrade
- Oswaldo Cruz Foundation (FIOCRUZ), Rene Rachou Research Institute, Belo Horizonte 30190-009, Brazil.
| | - Flavia Cristina Drumond Andrade
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health and School of Social Work, Urbana, IL 61801, USA.
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Matsuyama Y, Tsakos G, Listl S, Aida J, Watt R. Impact of Dental Diseases on Quality-Adjusted Life Expectancy in US Adults. J Dent Res 2019; 98:510-516. [DOI: 10.1177/0022034519833353] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Comparing the burden of dental conditions to other health outcomes provides useful insight for public policy. We aimed to estimate quality-adjusted life expectancy (QALE) loss due to dental conditions in the US adult population. Social inequalities in QALE loss by dental conditions were also examined. Data from 3 cross-sectional waves of the National Health and Nutrition Examination Survey (NHANES waves 2001 to 2002, 2003 to 2004, and 2011 to 2012) were pooled and analyzed. The average age of study participants ( n = 9,445) was 48.4 y. Disutility scores were derived from self-rated health and the numbers of physically unhealthy days, mentally unhealthy days, and days with activity limitation, employing a previously published algorithm. The associations between the disutility scores and the numbers of decayed teeth, missing teeth, and periodontitis were examined by multiple linear regression stratified by age groups (20–39, 40–59, and ≥60 y), adjusted for other covariates (age, sex, wave fixed effect, educational attainment, smoking, and diabetes). The QALE loss due to dental conditions at the age of 20 was estimated using life tables. Decayed and missing teeth, but not periodontitis, were associated with a larger disutility score. The coefficient for decayed teeth was larger among the older population, whereas that of missing teeth was smaller among them. The estimated QALE loss was 0.43 y (95% confidence interval [CI], 0.28–0.59), which reached 5.3% of QALE loss (8.15 y; 95% CI, 8.03–8.27) due to overall morbidity. There were clear social gradients in QALE loss by dental conditions across the life course, and people with high school or less education had 0.32 y larger QALE loss in total compared with people with college or more education. This study suggests that improvements in people’s dental health may yield substantial gains in population health and well-being. The necessity of more comprehensive public health strategies is highlighted.
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Affiliation(s)
- Y. Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Japan
- Department of Epidemiology and Public Health, University College London, London, UK
| | - G. Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - S. Listl
- Department of Dentistry-Chair for Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Conservative Dentistry–Section for Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| | - J. Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - R.G. Watt
- Department of Epidemiology and Public Health, University College London, London, UK
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Cornejo Ulloa P, van der Veen MH, Krom BP. Review: modulation of the oral microbiome by the host to promote ecological balance. Odontology 2019; 107:437-448. [PMID: 30719639 PMCID: PMC6732124 DOI: 10.1007/s10266-019-00413-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/23/2019] [Indexed: 01/05/2023]
Abstract
The indivisible relationship between the human host and its oral microbiome has been shaped throughout the millennia, by facing various changes that have forced the adaptation of oral microorganisms to new environmental conditions. In this constant crosstalk between the human host and its microbiome, a bidirectional relationship has been established. The microorganisms provide the host with functions it cannot perform on its own and at the same time the host provides its microbes with a suitable environment for their growth and development. These host factors can positively affect the microbiome, promoting diversity and balance between different species, resulting in a state of symbiosis and absence of pathology. In contrast, other host factors can negatively influence the composition of the oral microbiome and drive the interaction towards a dysbiotic state, where the balance tilts towards a harmful relationship between the host and its microbiome. The aim of this review is to describe the role host factors play in cultivating and maintaining a healthy oral ecology and discuss mechanisms that can prevent its drift towards dysbiosis.
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Affiliation(s)
- Pilar Cornejo Ulloa
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Monique H van der Veen
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Bastiaan P Krom
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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Novrinda H, Han DH, Jung-Choi K, Ryu JI. Neo-Marxian social class inequalities in oral health among the South Korean population. Community Dent Oral Epidemiol 2018; 47:162-170. [PMID: 30548668 DOI: 10.1111/cdoe.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/27/2022]
Abstract
AIM The aims of this study were to examine inequalities in periodontitis and tooth loss among South Korean adults using the Wright's Neo-Marxian social class (NMSC) indicator and to assess the impact of material, psychosocial, health behavioural and workplace environmental factors in the association of social class with oral health. METHODS This study used the data from the 4th Korea National Health and Nutrition Examination Survey with 6710 participants aged 19-54 years old. Participants were classified into 12 social class positions based on the Wright's social class map. Healthy gum and absence of tooth loss were the health outcomes. Mediating factors were material (M), psychosocial (PS), health behavioural (HB) and workplace environmental (WPE) factors. A series of logistic regressions were performed to analyse the data. Odds ratio (OR) and 95% confidence interval (CI) were used to report the results. RESULTS For the absence of periodontal pockets status, expert supervisors were the healthiest periodontal group among the social classes (OR = 2.15 95% CI 1.59-2.90) in the age and gender adjusted model. For the absence of tooth loss, skilled workers had the highest OR for absence of tooth loss (OR = 1.64 95% CI 1.31-2.05) in the age- and gender-adjusted model. For absence of periodontal pockets, the explanatory power of the M factor was the highest in all social class positions except for nonskilled supervisors followed by the HB factor. Additionally, the absence of tooth loss had a fairly similar pattern. The explanatory power of the M factor was the highest in all social class positions except for the petty bourgeoisie (highest: HB) and nonskilled supervisors (highest: WPE) followed by the HB and WPE factors. CONCLUSION There were nongradient oral health inequalities among the South Korean population according to the NMSC. Oral health promotion programmes that focus on changing the socioeconomic environment and health behaviours should be implemented.
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Affiliation(s)
- Herry Novrinda
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Department of Dental Public Health and Preventive Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jae-In Ryu
- Department of Preventive and Social Dentistry, Kyung Hee University, Seoul, Korea
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Socio-economic factors associated with periodontal conditions among Brazilian elderly people - Multilevel analysis of the SBSP-15 study. PLoS One 2018; 13:e0206730. [PMID: 30403725 PMCID: PMC6221335 DOI: 10.1371/journal.pone.0206730] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 10/18/2018] [Indexed: 12/29/2022] Open
Abstract
The objective of the present study was to analyze individual, contextual and social support factors associated with periodontal condition among 2332 dentate elderly Brazilian participants from the São Paulo State Oral Health Survey 2015 (SBSP-15). METHODS This study used the database compiled by the SBSP-15, conducted from January to December in 2015. The associations were made by relative risk (RR), with Multilevel Poisson Regressions, among individual, contextual and social support variables, and had periodontal diseases as outcomes. RESULTS The mean age of elders was 70.13 years (SD 5.67). The risk factors for all outcomes of periodontal diseases were male gender and self-perceived color of non-white skin. Regarding social support, feeling unhappy was a risk factor for the presence of shallow periodontal pockets (3-5mm) RR 1.43(CI 95% 1.10-1.86). The coverage of the Family Health Strategy (FHS) was a protective factor for gingival bleeding RR = 0.7(CI 95% 0.44-0.99) and calculus RR = 0.75(CI 95% 0.60-0.95), and a risk factor for the number of lost sextants (sextants with only one tooth or without any teeth) RR = 1.12(CI 95% 1.00-1.28). Living in municipalities with more than 90% fluoridation coverage was a protective factor for the number of lost sextants RR = 0.89(CI 95% 0.78-0.99). CONCLUSIONS The study showed evidence that individual (gender and self-perceived skin color), contextual (coverage of the family health strategy and water fluoridation) and social support factors (feeling unhappy) are associated with the clinical outcomes of periodontal diseases in Brazilian elders. This reinforces the need for transdisciplinary actions in the FHS, stimulating work together and intersectoral collaboration between FHS and NASF (Family Health Support Center).
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63
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Shin HS. Social gradients in oral health status in Korea population. Arch Oral Biol 2018; 95:89-94. [DOI: 10.1016/j.archoralbio.2018.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 06/27/2018] [Accepted: 07/30/2018] [Indexed: 12/26/2022]
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Mejia GC, Elani HW, Harper S, Murray Thomson W, Ju X, Kawachi I, Kaufman JS, Jamieson LM. Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. BMC Oral Health 2018; 18:176. [PMID: 30367654 PMCID: PMC6204046 DOI: 10.1186/s12903-018-0630-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/04/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities are associated with oral health status, either subjectively (self-rated oral health) or objectively (clinically-diagnosed dental diseases). The aim of this study is to compare the magnitude of socioeconomic inequality in oral health and dental disease among adults in Australia, Canada, New Zealand and the United States (US). METHODS Nationally-representative survey examination data were used to calculate adjusted absolute differences (AD) in prevalence of untreated decay and fair/poor self-rated oral health (SROH) in income and education. We pooled age- and gender-adjusted inequality estimates using random effects meta-analysis. RESULTS New Zealand demonstrated the highest adjusted estimate for untreated decay; the US showed the highest adjusted prevalence of fair/poor SROH. The meta-analysis showed little heterogeneity across countries for the prevalence of decayed teeth; the pooled ADs were 19.7 (95% CI = 16.7-22.7) and 12.0 (95% CI = 8.4-15.7) between highest and lowest education and income groups, respectively. There was heterogeneity in the mean number of decayed teeth and in fair/poor SROH. New Zealand had the widest inequality in decay (education AD = 0.8; 95% CI = 0.4-1.2; income AD = 1.0; 95% CI = 0.5-1.5) and the US the widest inequality in fair/poor SROH (education AD = 40.4; 95% CI = 35.2-45.5; income AD = 20.5; 95% CI = 13.0-27.9). CONCLUSIONS The differences in estimates, and variation in the magnitude of inequality, suggest the need for further examining socio-cultural and contextual determinants of oral health and dental disease in both the included and other countries.
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Affiliation(s)
- Gloria C. Mejia
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Hawazin W. Elani
- Harvard School of Dental Medicine, Harvard University, Boston, MA USA
| | - Sam Harper
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec H3A 1A2 Canada
| | - W. Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Ichiro Kawachi
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec H3A 1A2 Canada
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA 5005 Australia
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Venturelli Garay RE, Watt RG. Review and analysis of Chilean dental undergraduate education: curriculum composition and profiles of first year dental students. HUMAN RESOURCES FOR HEALTH 2018; 16:48. [PMID: 30223851 PMCID: PMC6142632 DOI: 10.1186/s12960-018-0314-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND In Chile, dentistry has become a very popular career choice for students, which has resulted in a substantial increase in both, the number of dental graduates and dental schools. Nonetheless, there is a need for change in the way dental schools select and educate their students to keep pace with the rapidly changing nature of societal needs and to tackle the marked health inequalities that exist in the country. The aim of this study was to review and critique dental undergraduate education in Chile, with a particular focus on the curriculum composition and profiles of students admitted to dental schools from 2010 to 2014. METHODS A descriptive and retrospective design was utilised. Two different methods were undertaken: primary data collection regarding curriculum and secondary data analysis in relation to students' profiles. Descriptive statistics were used to assess the relative proportions of subject modules within the undergraduate dental curriculum and in particular the public health components. The analysis of the student profiles described specific background factors, namely, gender, age, secondary school type, location, rural-urban status and student's year of admission. Also, trends of dental students' intake between 2010 and 2014 were investigated. Logistic regression analysis was undertaken to assess potential associations between the aforementioned background factors and students' choice of dental school. RESULTS Regarding the curriculum review, a 67% response rate was obtained. The most dominant component of Chilean dental curriculum was the clinical subjects (33%), followed by the basic and biological sciences (16%) and then medical and dental sciences (13%). In relation to the admission of students, the majority attended private schools (72%); most were females (62%); aged 19 years or less (74%); had an urban origin (99%); and came from subsidised private secondary schools (48%). Significant differences were found between students admitted to traditional and private dental schools. CONCLUSIONS Clinical sciences are the most dominant subjects in the Chilean dental curriculum. Overall, traditional and private institutions had a broadly similar composition in their curriculum with the exception of the public health component. Students from disadvantaged backgrounds were the minority in dental schools across Chile.
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Affiliation(s)
- Renato E Venturelli Garay
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom.
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom
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Henderson E, Dalawari P, Fitzgerald J, Hinyard L. Association of Oral Health Literacy and Dental Visitation in an Inner-City Emergency Department Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1748. [PMID: 30111688 PMCID: PMC6121363 DOI: 10.3390/ijerph15081748] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 12/01/2022]
Abstract
To examine the association between oral health literacy (OHL) with sociodemographic variables and dental visitation in adults presenting to an urban emergency department (ED). Methods: This was a cross-sectional study of a convenience sample of 556 adults aged 18⁻90. Interview data from the study were used to collect self-reported sociodemographic characteristics and dental visitation history. The OHL of the study participants was measured using the Health Literacy in Dentistry scale (HeLD-14), and the score was dichotomized into low and high OHL. Bivariate associations between sociodemographic variables and OHL were conducted using chi-square tests, and logistic regression was used to examine the association between OHL and dental visitation within the past year. Results: Sixty percent of participants reported having visited a dentist within the past year. Over two-thirds of the sample was classified as having low OHL. Low OHL was more common in non-White races, less-educated, single, unemployed, and lower-income individuals, and those without a primary care physician or dental insurance (p < 0.05). Patients with low oral health literacy were 39% less likely to have visited the dentist in the past year (OR = 0.61; 95% CI 0.38, 0.96). Conclusions: This study highlights significant disparities in OHL. Interventions targeted toward the unique needs of underserved populations should be developed to improve health outcomes.
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Affiliation(s)
- Emmett Henderson
- Center for Health Outcomes Research, Saint Louis University, Saint Louis, MO 63104, USA.
| | - Preeti Dalawari
- Department of Surgery, Division of Emergency Medicine, Saint Louis University, Saint Louis, MO 63110, USA.
| | - Jennifer Fitzgerald
- Department of Surgery, Division of Emergency Medicine, Saint Louis University, Saint Louis, MO 63110, USA.
| | - Leslie Hinyard
- Center for Health Outcomes Research, Saint Louis University, Saint Louis, MO 63104, USA.
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Schulte AG, Tsakos G. The Joint ORCA-EADPH Symposium on Sugar: The Oral Health Perspective - A Commentary. Caries Res 2018; 53:145-148. [PMID: 30086549 PMCID: PMC6425819 DOI: 10.1159/000490951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 06/08/2018] [Accepted: 06/08/2018] [Indexed: 12/22/2022] Open
Abstract
Caries is the most prevalent chronic condition worldwide and the association between high-level intake of sugars and dental decay is strong and well established. Interestingly, to combat caries, dental practitioners and public health dentists in many countries have focused mainly on the application of different kinds of fluorides and fissure sealants but not on the reduction of sugar intake. Furthermore, for many years, sugars have not been the focus of dental research activities presented at the annual conferences of the European Organisation for Caries Research (ORCA) and the European Association of Dental Public Health (EADPH). In 2015, following the publication of the new WHO guidelines on the intake of sugars, the boards of ORCA and EADPH agreed to organize a common symposium entitled "Joint ORCA-ADPH Symposium on Sugar: The Oral Health Perspective". This symposium was organized by a scientific committee and took place on July 6, 2016, in association with the 63rd ORCA Congress in Athens, Greece. It included 9 lectures highlighting different aspects of sugar consumption, contribution of sugar to dental caries, measuring sugar consumption, and fighting against sugar on a patient and public health basis. The purpose of this commentary is to give background information about the rationale of the above-mentioned symposium.
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Affiliation(s)
- Andreas G Schulte
- Department of Special Care Dentistry, Dental School, Witten/Herdecke University, Witten,
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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68
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Shin HS. Association between the number of teeth and hypertension in a study based on 13,561 participants. J Periodontol 2018. [DOI: 10.1002/jper.17-0413] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Hye-Sun Shin
- Department of Dental Hygiene; Eulji University College of Health Science; Seongnam Korea
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69
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Dalazen CE, Carli ADD, Bomfim RA. Fatores associados às necessidades de tratamento odontológico em idosos brasileiros: uma análise multinível. CIENCIA & SAUDE COLETIVA 2018; 23:1119-1130. [DOI: 10.1590/1413-81232018234.27462015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 06/22/2016] [Indexed: 11/21/2022] Open
Abstract
Resumo Este estudo teve como objetivos estimar a prevalência da necessidade de prótese e tratamento dental em idosos brasileiros, e verificar a associação entre essas necessidades e fatores contextuais e individuais. Realizou-se estudo com dados (n = 7.619) da Pesquisa Nacional de Saúde Bucal – SB Brasil 2010. Modelos de regressão logística multinível foram utilizados para estimar odds ratio e intervalos de 95% de confiança entre as necessidades de tratamento e as variáveis contextuais (Índice de Desenvolvimento Humano Municipal, Coeficiente de Gini e cobertura de saúde bucal na Estratégia de Saúde da Família) e individuais (sexo, renda, escolaridade e cor da pele). Para a necessidade de tratamento dental, ser homem, apresentar menor escolaridade, menor renda, cor da pele autorrelatada como não branca e residir em municípios com menor IDH -M foram fatores que aumentaram as chances de os indivíduos necessitarem de tratamento; para a necessidade de prótese, a cor da pele autorreferida como não branca, menor renda e menor escolaridade também aumentaram as chances dos idosos necessitarem de prótese. Os resultados indicaram associação entre as necessidades de tratamento e determinantes individuais e contextuais.
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Sato Y, Tsuboya T, Watt RG, Aida J, Osaka K. Temporary employment and tooth loss: a cross-sectional study from the J-SHINE study. BMC Oral Health 2018; 18:26. [PMID: 29466974 PMCID: PMC5822609 DOI: 10.1186/s12903-018-0488-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 02/14/2018] [Indexed: 12/17/2022] Open
Abstract
Background Temporary employment leads to psychological distress and higher mortality, but data on its associations with oral health is limited. We examined whether having the experience of temporary employment was associated with tooth loss among working adults in Japan. Methods We conducted a cross-sectional study from the 2010–2011 Japanese Study on Stratification, Health, Income, and Neighborhood study that analyzed 2652 participants aged 25–50 years (men = 1394; women = 1258). Independent variable was changes in employment status (continuous regular employment and the experience of temporary employment). Dependent variable was self-reported tooth loss (none, 1 tooth, 2 teeth, 3 teeth, 4 teeth, and more than 4 teeth). Covariates were sex, age, years of education, self-rated household economic status in early life at 5 years old, marital status, number of family members in the household, history of diabetes, and body mass index. We conducted a negative binomial regression analysis to estimate prevalence rate ratios (PRRs) and 95% confidence intervals (95%CIs) for tooth loss. We also confirmed the interaction term between changes in employment status and sex. Results The median age of the participants was 37 years. The percentages of men and women who experienced temporary employment were 14.5% and 61.3%, respectively. Compared with continuous regular employment, the experience of temporary employment was significantly associated with tooth loss in both sexes after adjusting for the covariates (men: PRR = 1.50 [95%CI = 1.13, 2.00]; women: PRR = 1.42 [95%CI = 1.14, 1.76]). The interaction term between employment status and sex was not significant (p = 0.71). Conclusions Temporary employment is adversely associated with oral health.
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Affiliation(s)
- Yukihiro Sato
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Toru Tsuboya
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
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MacEntee MI, Donnelly LR. Oral health and the frailty syndrome. Periodontol 2000 2018; 72:135-41. [PMID: 27501496 DOI: 10.1111/prd.12134] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 12/27/2022]
Abstract
The frailty syndrome is an ever-growing area of study among older adults because of its association with an increased risk of falls, hospitalization, institutionalization, dependency and mortality. Frailty is neither a disease nor a disability but is better understood as a medical syndrome of multisystem dysregulation that results in a diminished ability to overcome everyday stressors. The prevalence of frailty in any given population can vary widely, in part because of the way in which it is defined and measured, but in general it is higher among women and in those with advanced age and declining health. Whilst it is largely understood that older adults will differ biologically, psychologically and socially, and that each of these domains can impact oral health, we are only beginning to investigate how the mouth is affected in frailty. Given that both hard and soft structures contribute to oral health and disease status among older adults with varying degrees of impairment and disability, frailty adds yet another dimension to be considered. This paper will discuss how frailty can influence and be influenced by oral disorders, as well as the potential relationship to oral neglect and the resultant consequences among this vulnerable population.
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Shen J, Listl S. Investigating social inequalities in older adults' dentition and the role of dental service use in 14 European countries. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2018; 19:45-57. [PMID: 28064379 PMCID: PMC5773639 DOI: 10.1007/s10198-016-0866-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/13/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Oral disease, despite being largely preventable, remains the most common chronic disease worldwide and has a significant negative impact on quality of life, particularly among older adults. OBJECTIVE This study is the first to comprehensively and at a large scale (14 European countries) measure the social inequalities in the number of natural teeth (an informative oral health marker) in the over 50-year-old population and to investigate the extent to which such inequalities are attributable to dental service use. METHODS Using Wave 5 of the Survey of Health, Ageing and Retirement in Europe, which included internationally harmonized information on over 50,000 individuals across 14 European countries, we calculated Gini and Concentration indices (CI) as well as the decompositions of CIs by socioeconomic factors. RESULTS Sweden consistently performed the best with the lowest inequalities as measured by Gini (0.1078), CI by income (0.0392), CI by education (0.0407), and CI by wealth (0.0296). No country performed the worst in all inequality measures. However, unexpectedly, some wealthier countries (e.g., the Netherlands and Denmark) had higher degrees of inequalities than less-wealthy countries (e.g., Estonia and Slovenia). Decomposition analysis showed that income, education, and wealth contributed substantially to the inequalities, and dental service use was an important contributor even after controlling for income and wealth. CONCLUSIONS The study highlighted the importance of comprehensively investigating oral health inequalities. The results are informative to policymakers to derive country-specific health policy recommendations to reduce oral health inequalities in the older population and also have implications for oral health improvement of the future generations.
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Affiliation(s)
- Jing Shen
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
| | - Stefan Listl
- Quality and Safety of Oral Care, Radboud University, Nijmegen, The Netherlands
- Translational Health Economics, Heidelberg University, Heidelberg, Germany
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Murakami K, Ohkubo T, Nakamura M, Ninomiya T, Ojima T, Shirai K, Nagahata T, Kadota A, Okuda N, Nishi N, Okamura T, Ueshima H, Okayama A, Miura K. Socioeconomic Inequalities in Oral Health among Middle-Aged and Elderly Japanese: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S59-S65. [PMID: 29503388 PMCID: PMC5825696 DOI: 10.2188/jea.je20170247] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Most studies on socioeconomic inequalities in oral health have not considered the effects of behavioral and biological factors and age differences. Furthermore, the nationwide status of inequalities remains unclear in Japan. METHODS We analyzed data from 2,089 residents aged ≥40 years throughout Japan. The lowest quartile of the number of remaining teeth for each 10-year age category was defined as poor oral health. Behavioral and biological factors included smoking status, obesity, diabetes mellitus, high-sensitivity C-reactive protein, and the use of dental devices. Multiple logistic regression analyses were conducted to examine the associations of educational attainment and equivalent household expenditure (EHE) with oral health, and stratified analyses by age category were also conducted (40-64 years and ≥65 years). RESULTS Lower education and lower EHE were significantly associated with an increased risk of poor oral health after adjusting for age, sex, employment status, marital and living statuses, and EHE/education; the odds ratio for junior high school education compared with ≥college education was 1.84 (95% confidence interval [CI], 1.36-2.49), and the odds ratio of the lowest compared with the highest EHE quartile was 1.91 (95% CI, 1.43-2.56). Further adjustments for behavioral and biological factors attenuated but did not eliminate these associations. EHE was significantly associated with oral health among elderly adults only, with a significant interaction by age category. CONCLUSIONS Those with a lower education and those with lower EHE had a significantly higher risk of poor oral health, even after adjustments for behavioral and biological factors.
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Affiliation(s)
- Keiko Murakami
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Kayoko Shirai
- Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan
| | - Tomomi Nagahata
- Department of Nutrition, School of Health and Nutrition, Tokaigakuen University, Aichi, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
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Association between individual and neighbourhood socioeconomic factors and masticatory efficiency: a cross-sectional analysis of the Paris Prospective Study 3. J Epidemiol Community Health 2017; 72:132-139. [DOI: 10.1136/jech-2017-209593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/13/2017] [Accepted: 11/21/2017] [Indexed: 01/21/2023]
Abstract
BackgroundThere is a lack of evidence on the impact of socioeconomic factors on masticatory efficiency. The present study investigates the relationship between individual and neighbourhood socioeconomic factors (main exposure) and the number of masticatory units (MUs) used as surrogate of the masticatory efficiency (main outcome).MethodsIn this cross-sectional study nested in the Paris Prospective Study 3, 4270 adults aged 50–75 and recruited from 13 June 2008 to 31 May 2012 underwent a full-mouth examination. Number of MUs defined as pairs of opposing teeth or dental prostheses allowing mastication, number of missing teeth and gingival inflammation were documented. The individual component of the socioeconomic status was evaluated with an individual multidimensional deprivation score and education level. The neighbourhood component of the socioeconomic status was evaluated with the FDep99 deprivation index. Associations were quantified using marginal models.ResultsIn multivariate analyses, having less than 5 MUs was associated with (1) the most deprived neighbourhoods (OR=2.27 (95% CI 1.63 to 3.17)), (2) less than 12 years of educational attainment (OR=2.20 (95% CI 1.66 to 2.92)) and (3) the highest individual score of deprivation (OR=3.23 (95% CI 2.24 to 4.65)). Associations with education and individual score of deprivation were consistent across the level of neighbourhood deprivation. Comparable associations were observed with the number of missing teeth. Associations with gingival inflammation were of lower magnitude; the relationship was present for deprivation markers but not for education.ConclusionPoor masticatory efficiency is associated with low educational attainment and high deprivation scores.
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Oscarson N, Espelid I, Jönsson B. Is caries equally distributed in adults? A population-based cross-sectional study in Norway - the TOHNN-study. Acta Odontol Scand 2017; 75:557-563. [PMID: 28754061 DOI: 10.1080/00016357.2017.1357080] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of the study was to examine the prevalence and distribution of dental caries in an adult population and identify factors associated with being caries free. MATERIAL AND METHODS Data were collected from a randomized population sample in Northern Norway (N = 1932; 988 women; mean age 47.0 years, SD 15.3). The study included a structured questionnaire and a clinical examination. The sum of enamel and dentine caries, DS1-5, formed the main outcome measures for caries prevalence. RESULTS Mean DMFT was 15.1 (95% CI 14.8, 15.4), mean DFT was 12.0 (CI 11.7, 12.2), and mean DT was 1.1 (CI 1.0, 1.2). The mean value for dentine caries (DS3-5) was 0.8 (CI 0.7, 0.9), and mean DS1-5 was 3.8 (CI 3.6, 4.1). Mean DS1-5 was highest in the youngest age group (mean 6.9, 95% CI 6.3, 7.6) and in rural areas (mean 5.0, CI 4.4, 5.6). The most caries-prone 20% in the youngest age group had 52% of the total number of carious lesions compared with 80% in the two oldest age groups. Tooth brushing twice daily (p = .005), drinking sugar containing soft drink (p =.029), and attending dental services every year (p < .001), were associated with being caries free. CONCLUSION Dental caries is still a common condition, particularly in the youngest age group. Living in a rural area, low socioeconomic status, less frequent tooth cleaning and sugar containing soft drinks were associated with a higher prevalence of dental caries. The different caries distribution among adults calls for different preventive strategies at both population and individual levels.
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Affiliation(s)
- Nils Oscarson
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
| | - Ivar Espelid
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
- School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden
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Hummel R, Bruers J, van der Galiën O, van der Sanden W, van der Heijden G. Outcome measures for oral health based on clinical assessments and claims data: feasibility evaluation in practice. BMC Oral Health 2017; 17:125. [PMID: 28982347 PMCID: PMC5629757 DOI: 10.1186/s12903-017-0410-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 08/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is well known that treatment variation exists in oral healthcare, but the consequences for oral health are unknown as the development of outcome measures is still in its infancy. The aim of this study was to identify and develop outcome measures for oral health and explore their performance using health insurance claims records and clinical data from general dental practices. METHODS The Dutch healthcare insurance company Achmea collaborated with researchers, oral health experts, and general dental practitioners (GDPs) in a proof of practice study to test the feasibility of measures in general dental practices. A literature search identified previously described outcome measures for oral healthcare. Using a structured approach, identified measures were (i) prioritized, adjusted and added to after discussion and then (ii) tested for feasibility of data collection, their face validity and discriminative validity. Data sources were claims records from Achmea, clinical records from dental practices, and prospective, pre-determined clinical assessment data obtained during routine consultations. RESULTS In total eight measures (four on dental caries, one on tooth wear, two on periodontal health, one on retreatment) were identified, prioritized and tested. The retreatment measure and three measures for dental caries were found promising as data collection was feasible, they had face validity and discriminative validity. Deployment of these measures demonstrated variation in clinical practices of GDPs. Feedback of this data to GDPs led to vivid discussions on best practices and quality of care. The measure 'tooth wear' was not considered sufficiently responsive; 'changes in periodontal health score' was considered a controversial measure. The available data for the measures 'percentage of 18-year-olds with no tooth decay' and 'improvement in gingival bleeding index at reassessment' was too limited to provide accurate estimates per dental practice. CONCLUSIONS The evaluated measures 'time to first restoration', 'distribution of risk categories for dental caries', 'filled-and-missing score' and 'retreatment after restoration', were considered valid and relevant measures and a proxy for oral health status. As such, they improve the transparency of oral health services delivery that can be related to oral health outcomes, and with time may serve to improve these oral health outcomes.
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Affiliation(s)
- Riët Hummel
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, the Netherlands.
- Zilveren Kruis Achmea, Leusden, the Netherlands.
| | - Josef Bruers
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, the Netherlands
- KNMT, Royal Dutch Dental Association, Nieuwegein, the Netherlands
| | | | - Wil van der Sanden
- Department of Quality and Safety of Oral Health Care, College of Oral Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert van der Heijden
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, the Netherlands
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Wang L, Cheng L, Yuan B, Hong X, Hu T. Association between socio-economic status and dental caries in elderly people in Sichuan Province, China: a cross-sectional study. BMJ Open 2017; 7:e016557. [PMID: 28947446 PMCID: PMC5623543 DOI: 10.1136/bmjopen-2017-016557] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/14/2017] [Accepted: 08/22/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES As a vulnerable group, the elders' oral health gained less attention, particularly the relationship between socioeconomic status (SES) and dental caries. This study aimed to assess the associations and to explore the effects of confounders on the associations in elderly people. DESIGN Cross-sectional study. SETTINGS 3 neighbourhood committees and 3 village committees in Sichuan Province, China. PARTICIPANTS 744 people (362 men and 382 women) aged 65-74 years were included. OUTCOME MEASURES Oral health outcomes included the decayed, missing and filled teeth (DMFT) index and its components. SES was assigned by educational level, household income and type of household. The bivariate association between the participants' characteristics and DMFT was analysed using non-parametric tests. Four logistic regression models were used to analyse the associations between SES and dental caries by regulating confounders. RESULTS Poor oral health was observed in these participants. Bivariate analysis showed a significant association between SES and DMFT (p﹤0.05). Only adjusting gender, high educational level (adjusted (AOR)=0.34, 95% CI 0.17 to 0.66), high household income (AOR=0.47, 95% CI 0.41 to 0.77) were protective factors against dental caries, and living in agricultural families (AOR=1.86, 95% CI 1.32 to 2.63) was risk factor (p﹤0.05). After adjusting other confounders, SES was partly related to the dental caries. Moreover, an interaction existed among SES indicators. CONCLUSIONS SES is associated with dental caries, and older people with low SES have poor oral health. The associations were explained partly by diet, behaviour and awareness. Our results provide effective evidence in targeted policy-making and intervention measures and implicate that pertinence measures, economic assistance and medical insurance funds should be provided to older people of low SES. Furthermore, a follow-up design should attempt to confirm the causal relationship between SES and dental caries and evaluate the effect of intervention.
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Affiliation(s)
- Linyan Wang
- Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Li Cheng
- Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Bo Yuan
- Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiao Hong
- Department of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Tao Hu
- Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Listl S, Broadbent JM, Thomson WM, Stock C, Shen J, Steele J, Wildman J, Heilmann A, Watt RG, Tsakos G, Peres MA, van der Heijden G, Jürges H. Childhood socioeconomic conditions and teeth in older adulthood: Evidence from SHARE wave 5. Community Dent Oral Epidemiol 2017; 46:78-87. [PMID: 28925509 DOI: 10.1111/cdoe.12332] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 08/02/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Dental diseases are the most common chronic diseases worldwide. Healthy teeth are vital for quality of life, particularly diet and nutrition. However, little information exists to inform health policymakers about potentially long-lasting influences of early-life conditions. The purpose of this study was to investigate the relation between early-life socioeconomic conditions and number of natural teeth at age 50 and above. METHODS Analyses were conducted on cross-sectional data from the Survey of Health, Ageing and Retirement in Europe (SHARE wave 5), which includes information on 41 560 respondents aged 50 years or older from 14 European countries and Israel. Using SHARE life history information, a series of regression models (OLS, Tobit) were estimated to analyse the relationship between socioeconomic conditions in earlier life and the number of teeth at age 50+. RESULTS Childhood socioeconomic background was associated with the number of natural teeth at age 50 and above, even after controlling for current determinants of oral health. Respondents who had had more than 25 books in their childhood household had a mean 1.4 (95% CI: 1.2-1.5) more teeth than respondents with fewer books. Respondents who reported poor financial conditions during childhood had a mean 0.6 (95% CI: 0.3-0.9) fewer teeth than respondents who reported better financial conditions in childhood. CONCLUSION These findings substantiate the association between socioeconomic conditions in the early years of life and tooth retention to older adulthood and highlight the long-lasting relation between childhood living conditions and oral health through the lifecourse.
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Affiliation(s)
- Stefan Listl
- Department of Quality and Safety of Oral Health Care, Radboud University Nijmegen, Nijmegen, The Netherlands.,Department of Conservative Dentistry, Translational Health Economics Group (THE Group), Heidelberg University, Heidelberg, Germany
| | - Jonathan M Broadbent
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - W Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Christian Stock
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Jing Shen
- Newcastle upon Tyne, Newcastle University, Newcastle, UK
| | - Jimmy Steele
- Newcastle upon Tyne, Newcastle University, Newcastle, UK
| | - John Wildman
- Newcastle upon Tyne, Newcastle University, Newcastle, UK
| | - Anja Heilmann
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Marco A Peres
- Australian Research Centre for Population Oral Health (ARCPOH), University of Adelaide, Adelaide, SA, Australia
| | - Geert van der Heijden
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, Netherlands
| | - Hendrik Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
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79
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Hakeberg M, Wide Boman U. Self-reported oral and general health in relation to socioeconomic position. BMC Public Health 2017; 18:63. [PMID: 28747180 PMCID: PMC5530538 DOI: 10.1186/s12889-017-4609-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 07/19/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND During the past two decades, several scientific publications from different countries have shown how oral health in the population varies with social determinants. The aim of the present study was to explore the relationship between self-reported oral and general health in relation to different measures of socioeconomic position. METHODS Data were collected from a randomly selected sample of the adult population in Sweden (n = 3500, mean age 53.4 years, 53.1% women). The response rate was 49.7%. Subjects were interviewed by telephone, using a questionnaire including items on self-reported oral and general health, socioeconomic position and lifestyle. RESULTS A significant gradient was found for both oral and general health: the lower the socioeconomic position, the poorer the health. Socioeconomic position and, above all, economic measures were strongly associated with general health (OR 3.95) and with oral health (OR 1.76) if having an income below SEK 200,000 per year. Similar results were found in multivariate analyses controlling for age, gender and lifestyle variables. CONCLUSIONS For adults, there are clear socioeconomic gradients in self-reported oral and general health, irrespective of different socioeconomic measures. Action is needed to ensure greater equity of oral and general health.
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Affiliation(s)
- Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, 40530 Gothenburg, SE Sweden
| | - Ulla Wide Boman
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, 40530 Gothenburg, SE Sweden
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80
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Hakeberg M, Wide Boman U. Dental care attendance and refrainment from dental care among adults. Acta Odontol Scand 2017; 75:366-371. [PMID: 28420315 DOI: 10.1080/00016357.2017.1317105] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to analyse dental care utilization, refrainment from self-perceived needed dental care and the association with socioeconomic indicators among adult individuals. MATERIALS AND METHODS This cross-sectional survey included 3500 randomly selected adult individuals. Telephone interviews were conducted and the participants answered a battery of questions regarding dental visiting habits, health, socioeconomic position (SEP), behavioural factors and lifestyle indicators. RESULTS The outcome 'dental visits' was significantly correlated with SEP, especially with monetary dimensions, such as income and economic resources for unforeseen expenditures. However, educational level was not a significant predictor in the tested statistical models. Furthermore, other covariates that contributed significantly to the models were ethnicity, dental anxiety and lifestyle factors, albeit with a different pattern of impact on the two outcome dimensions. Important features of the SEP variables were the stepwise gradient relative to the outcomes, implicating that the lower the SEP status, the greater the risk of reporting irregular dental visiting habits and refraining from dental care due to financial problems. CONCLUSIONS Dental care utilization and refraining from dental care for financial reasons clearly reveal associations with socioeconomic positions among adult individuals.
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Affiliation(s)
- Magnus Hakeberg
- Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulla Wide Boman
- Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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81
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Murr A, Pink C, Hammer E, Michalik S, Dhople VM, Holtfreter B, Völker U, Kocher T, Gesell Salazar M. Cross-Sectional Association of Salivary Proteins with Age, Sex, Body Mass Index, Smoking, and Education. J Proteome Res 2017; 16:2273-2281. [DOI: 10.1021/acs.jproteome.7b00133] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Annette Murr
- Department
of Functional Genomics, Interfaculty Institute for Genetics and Functional
Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Str. 15a, 17475 Greifswald, Germany
| | - Christiane Pink
- Unit
of Periodontology, Department of Restorative Dentistry, Periodontology,
Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Rotgerberstr. 8, 17475 Greifswald, Germany
| | - Elke Hammer
- Department
of Functional Genomics, Interfaculty Institute for Genetics and Functional
Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Str. 15a, 17475 Greifswald, Germany
| | - Stephan Michalik
- Department
of Functional Genomics, Interfaculty Institute for Genetics and Functional
Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Str. 15a, 17475 Greifswald, Germany
| | - Vishnu M. Dhople
- Department
of Functional Genomics, Interfaculty Institute for Genetics and Functional
Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Str. 15a, 17475 Greifswald, Germany
| | - Birte Holtfreter
- Unit
of Periodontology, Department of Restorative Dentistry, Periodontology,
Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Rotgerberstr. 8, 17475 Greifswald, Germany
| | - Uwe Völker
- Department
of Functional Genomics, Interfaculty Institute for Genetics and Functional
Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Str. 15a, 17475 Greifswald, Germany
| | - Thomas Kocher
- Unit
of Periodontology, Department of Restorative Dentistry, Periodontology,
Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Rotgerberstr. 8, 17475 Greifswald, Germany
| | - Manuela Gesell Salazar
- Department
of Functional Genomics, Interfaculty Institute for Genetics and Functional
Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Str. 15a, 17475 Greifswald, Germany
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82
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van der Tas JT, Kragt L, Elfrink MEC, Bertens LCM, Jaddoe VWV, Moll HA, Ongkosuwito EM, Wolvius EB. Social inequalities and dental caries in six-year-old children from the Netherlands. J Dent 2017; 62:18-24. [PMID: 28450065 DOI: 10.1016/j.jdent.2017.04.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/20/2017] [Accepted: 04/22/2017] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The purpose of our study was to investigate the association of different socioeconomic and sociodemographic factors with dental caries in six-year-old children. Furthermore, we applied a district based approach to explore the distribution of dental caries among districts of low and high socioeconomic position (SEP). METHODS In our cross-sectional study 5189 six-year-olds were included. This study was embedded in a prospective population-based birth cohort study in Rotterdam, the Netherlands, the Generation R Study. Parental education level, parental employment status, net household income, single parenting, and teenage pregnancy were considered as indicators for SEP. Dental caries was scored on intraoral photographs by using the decayed, missing, and filled teeth (dmft) index. We compared children without caries (dmft=0) to children with mild caries (dmft=1-3) or severe caries (dmft >3). Multinomial logistic regression analyses and binary logistic regression analyses were performed to study the association between SEP and caries, and between district and caries, respectively. RESULTS Only maternal education level remained significantly associated with mild caries after adjusting for all other SEP-indicators. Paternal educational level, parental employment status, and household income additionally served as independent indicators of SEP in children with severe caries. Furthermore, living in more disadvantaged districts was significantly associated with higher odds of dental caries. CONCLUSION Dental caries is more prevalent among six-year-old children with a low SEP, which is also visible at the district level. Maternal educational level is the most important indicator of SEP in the association with caries. CLINICAL SIGNIFICANCE Our results should raise concerns about the existing social inequalities in dental caries and should encourage development of dental caries prevention strategies. New knowledge about the distribution of oral health inequalities between districts should be used to target the right audience for these strategies.
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Affiliation(s)
- Justin T van der Tas
- The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands.
| | - Lea Kragt
- The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands.
| | - Marlies E C Elfrink
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands.
| | - Loes C M Bertens
- Department of Obstetrics and Gynaecology, ErasmusMC University Medical Center Rotterdam, The Netherlands.
| | - Vincent W V Jaddoe
- The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Epidemiology, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Paediatrics, ErasmusMC University Medical Center Rotterdam, The Netherlands.
| | - Henriëtte A Moll
- The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Paediatrics, ErasmusMC University Medical Center Rotterdam, The Netherlands.
| | - Edwin M Ongkosuwito
- The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands.
| | - Eppo B Wolvius
- The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands.
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83
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Bernabé E, Humphris G, Freeman R. The social gradient in oral health: Is there a role for dental anxiety? Community Dent Oral Epidemiol 2017; 45:348-355. [DOI: 10.1111/cdoe.12297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 02/23/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Eduardo Bernabé
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St. Thomas’ Hospitals; London UK
| | - Gerry Humphris
- Health Psychology; School of Medicine; University of St Andrews; St Andrews UK
| | - Ruth Freeman
- Dental Health Services Research Unit; School of Dentistry; University of Dundee; Dundee UK
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84
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Elani HW, Harper S, Thomson WM, Espinoza IL, Mejia GC, Ju X, Jamieson LM, Kawachi I, Kaufman JS. Social inequalities in tooth loss: A multinational comparison. Community Dent Oral Epidemiol 2017; 45:266-274. [PMID: 28185272 DOI: 10.1111/cdoe.12285] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 12/19/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To conduct cross-national comparison of education-based inequalities in tooth loss across Australia, Canada, Chile, New Zealand and the United States. METHODS We used nationally representative data from Australia's National Survey of Adult Oral Health; Canadian Health Measures Survey; Chile's First National Health Survey Ministry of Health; US National Health and Nutrition Examination Survey; and the New Zealand Oral Health Survey. We examined the prevalence of edentulism, the proportion of individuals having <21 teeth and the mean number of teeth present. We used education as a measure of socioeconomic position and measured absolute and relative inequalities. We used random-effects meta-analysis to summarize inequality estimates. RESULTS The USA showed the widest absolute and relative inequality in edentulism prevalence, whereas Chile demonstrated the largest absolute and relative social inequality gradient for the mean number of teeth present. Australia had the narrowest absolute and relative inequality gap for proportion of individuals having <21 teeth. Pooled estimates showed substantial heterogeneity for both absolute and relative inequality measures. CONCLUSIONS There is a considerable variation in the magnitude of inequalities in tooth loss across the countries included in this analysis.
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Affiliation(s)
- Hawazin W Elani
- Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Sam Harper
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - William Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Iris L Espinoza
- Oral Pathology Department, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Gloria C Mejia
- School of Dental Medicine, East Carolina University, Greenville, NC, USA
| | - Xiangqun Ju
- Department of Health Science, The University of Adelaide, Adelaide, SA, Australia
| | - Lisa M Jamieson
- Faculty of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Ichiro Kawachi
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
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85
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Östberg AL, Kjellström AN, Petzold M. The influence of social deprivation on dental caries in Swedish children and adolescents, as measured by an index for primary health care: The Care Need Index. Community Dent Oral Epidemiol 2017; 45:233-241. [DOI: 10.1111/cdoe.12281] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/11/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Anna-Lena Östberg
- Public Dental Service; Region Västra Götaland; Göteborg Sweden
- Department of Behavioral and Community Dentistry; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
| | | | - Max Petzold
- Health Metrics Unit; The Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
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86
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Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need? PLoS One 2017; 12:e0169004. [PMID: 28118361 PMCID: PMC5261606 DOI: 10.1371/journal.pone.0169004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 12/09/2016] [Indexed: 11/19/2022] Open
Abstract
Objective This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Methods Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008–2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients’ individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Results Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (<18 years) and older adults (≥65 years) received preventive care in the form of ‘instruction and advice’, compared with 46% of working age adults (18–64 years); p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001): ‘partial dentures’ (7%); ‘scale and polish’ (3.7%); ‘tooth extraction’ (3%; p = 0.001), and ‘instruction and advice’ (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive ‘instruction and advice’ than non-smokers (OR 4.124; 95% CI: 3.088–5.508; p = 0.01). A further new finding from the multilevel models was a significant difference in treatment related to area of residence; adults from the most deprived quintile were more likely to receive ‘tooth extraction’ when compared with least deprived, and less likely to receive preventive ‘instruction and advice’ (p = 0.01). Conclusion This is the first study to model patient management data from a state-funded dental service and show that individual and contextual factors predict common treatments received. Implications of this research include the importance of making provision for our aging population and ensuring that preventative care is available to all. Further research is required to explain the interaction of organisational and system policies, practitioner and patient perspectives on care and, thus, inform effective commissioning and provision of dental services.
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87
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Östberg AL, Skeie MS, Skaare AB, Espelid I. Caries increment in young children in Skaraborg, Sweden: associations with parental sociodemography, health habits, and attitudes. Int J Paediatr Dent 2017; 27:47-55. [PMID: 26826705 DOI: 10.1111/ipd.12225] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To explore parental sociodemography, oral health habits, and attitudes in relation to dental caries increment in their children. DESIGN A longitudinal questionnaire and clinical study. The children were followed annually from age 3 years (n = 271) to 6 years (n = 243). Carious lesions of different depth were registered (initial and manifest) by four calibrated dentists. The parents filled out a questionnaire. Statistics included factor analyses, Cronbach's alpha together with bivariate and multivariate logistic regression analyses. RESULTS Most of the parents exhibited positive health behaviour and attitudes. 'Late start of toothbrushing of child' was, however, common (≥1 year; 29%) and 'external locus of control' showed a high mean value (10,1; possible range 3-15). In a multivariate model, 'parent born abroad' (OR 3.26, 95% CI 1.85-5.76) and 'parental indulgence' (OR 3.20, 95% CI 1.37-7.51) were the most important for the development of carious lesions in the children. CONCLUSIONS This study identified 'parent born abroad' and 'parental indulgence' as significant risk factors for caries in the age period 3 to 6 years. Identifying parents with the greatest need should be emphasized, in order to target promotion and prevention activities.
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Affiliation(s)
- Anna-Lena Östberg
- Public Dental Service, Region Västra Götaland, Skövde, Sweden.,R&D Centre, Skaraborg Primary Care, Skövde, Sweden.,Department of Behavioural and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Marit S Skeie
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Anne B Skaare
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ivar Espelid
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, University of Oslo, Oslo, Norway
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88
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Oral-health-related background factors and dental service utilisation among Sudanese children with and without a congenital heart defects. BMC Oral Health 2016; 16:123. [PMID: 27846833 PMCID: PMC5111257 DOI: 10.1186/s12903-016-0318-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/07/2016] [Indexed: 12/11/2022] Open
Abstract
Background Sudanese children with congenital heart defects (CHDs) were found to have poorer oral health than those without CHDs. The aims of this study were to: describe the patterns of oral-health-related background factors in children with and without CHD and explore any differences, and to evaluate the effects of background factors on caries and gingivitis prevalence and dental services utilisation. Methods In this analytical cross-sectional study, caregivers of children aged 3–12 years with (CHD cases n = 111) and without CHDs (Controls n = 182), underwent face-to-face interviews using a structured questionnaire. The questionnaire items covered several oral health background factors (independent variables) including: child’s health status, oral hygiene practices, dental services utilization, mother’s level of education, and caregiver’s perception and awareness of their child’s oral health. The relationship between these factors and occurrence of ‘caries’ and ‘gingivitis’ as well as ‘child’s dental services utilisation’ (dependent variables) were explored using multiple adjusted and hierarchal logistic regression analyses. Results Compared with controls, CHD cases had lower frequencies of brushing and use of fluoridated toothpaste, and their caregivers were less knowledgeable about caries. Among CHD cases, the variables (brushing and fluoridated toothpaste use) had significant impacts on caries prevalence (odd ratio (OR) =5.6, 95% confidence interval (CI): 1.4–22.8 and OR = 0.3, 95% CI: 0.1–0.8 for infrequent compared to frequent ones, respectively) as well as the mother’s level of education (OR = 2.6, 95% CI: 1.0–6.4). When differences in background factors were controlled for, the adjusted ORs for caries and gingivitis prevalence in CHD cases compared with controls were 1.8, (95% CI: 1.1–3.2) and 5.3 (95% CI: 2.9–9.4), respectively. Among CHD cases, the child’s age (8–12 years: OR = 11.9, 95% CI: 1.9–71.6), and the mother’s level of education (lower education: OR = 0.2, 95% CI: 0.03–0.9) were significantly associated with the child’s dental services utilisation. Conclusions Lower frequencies of brushing and use of fluoride tooth paste were reported among CHD cases, and brushing had the predominant significant impact on caries prevalence. The child’s age and the mother’s level of education were the main factors affecting the child’s (CHD cases) dental services utilisation. Electronic supplementary material The online version of this article (doi:10.1186/s12903-016-0318-5) contains supplementary material, which is available to authorized users.
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89
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Bachkati KH, Mortensen EL, Brønnum-Hansen H, Holm-Pedersen P. Midlife Cognitive Ability, Education, and Tooth Loss in Older Danes. J Am Geriatr Soc 2016; 65:194-199. [PMID: 28111753 DOI: 10.1111/jgs.14513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the possible influence of cognitive ability and education at age 50 or 60 on number of teeth at age 70. SETTING Community-dwelling population in Copenhagen, Denmark. PARTICIPANTS Men and women born in 1914 (N = 302). MEASUREMENTS Cognitive ability was assessed using the Wechsler Adult Intelligence Scale at age 50 or 60. A global cognitive ability measure was used as a continuous measure and according to tertile. Information on education was gathered using a questionnaire at age 50 or 60. A clinical oral examination took place at age 70, and oral health was measured according to number of teeth (<6 vs ≥6). Baseline covariates were smoking, alcohol, sex, and income. RESULTS Logistic regression analyses revealed that greater cognitive ability and educational attainment had a protective effect against risk of tooth loss. The associations were significant and persisted after adjusting for confounders and a two-way interaction between cognitive ability and education. CONCLUSION Higher education level and cognitive ability measured at age 50 or 60 were associated with having more teeth at age 70. Whether these findings are due to the interaction of these factors with oral health, related socioeconomic factors, or other factors remains to be studied.
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Affiliation(s)
- Kristine Harrsen Bachkati
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Erik Lykke Mortensen
- Danish Aging Research Center, University of Southern Denmark, Odense, Denmark.,Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Brønnum-Hansen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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90
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Lee JH, Lee JS, Choi JK, Kweon HI, Kim YT, Choi SH. National dental policies and socio-demographic factors affecting changes in the incidence of periodontal treatments in Korean: A nationwide population-based retrospective cohort study from 2002-2013. BMC Oral Health 2016; 16:118. [PMID: 27814698 PMCID: PMC5097391 DOI: 10.1186/s12903-016-0310-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 10/25/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Dental insurance coverage has recently expanded in Korea. The number of patients diagnosed with periodontal disease (PD), and the actual number of periodontally compromised patients has increased. However, few studies have investigated the relationships between the prevalence of periodontal disease and the incidence of PD treatment, dental insurance policies, and socio-demographic factors. To determine the incidence of periodontal treatments required, the comprehensive longitudinal data of the National Health Insurance Service were used. This study evaluated changes in the incidence of periodontal treatments, using data from the Korean National Health Insurance Cohort Database. METHODS A random stratified sample of 1,025,340 Korean patients was selected from National Health Insurance database, using 1,476 multistage samplings (of sex, age, and income level) for 12 years from 2002 to 2013. Chi-square analysis, and univariate, and multivariate logistic regression were used to evaluate the association of socio-demographic factors with the prevalence of PD and the incidence of periodontal treatment. RESULTS The incidence of periodontal treatment steadily and significantly increased, in both male and female participants, from 2002 to 2013. The increase was associated with socio-demographic factors and changes in national dental insurance policies. The incidence of periodontal treatment evaluated by age is influenced by the changes in national dental policies. These results suggest that the increase in patients diagnosed with PD reflects changes in dental policies and insurance benefits. CONCLUSIONS This study confirms that national dental policies and socio-demographic factors are related to the incidence of periodontal treatments. The incidence of periodontal treatment is significantly related to the expansion of insurance coverage in South Korea.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, 35233, South Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jung-Kyu Choi
- Department of Health Insurance Research, Ilsan Hospital, National Health Insurance Service, Goyang, 10444, South Korea
| | - Hye-In Kweon
- Department of Periodontology, Ilsan Hospital, National Health Insurance Service, 100 Ilsan-ro Ilsan-donggu, Goyang, 10444, South Korea
| | - Young-Taek Kim
- Department of Periodontology, Ilsan Hospital, National Health Insurance Service, 100 Ilsan-ro Ilsan-donggu, Goyang, 10444, South Korea.
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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91
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Antunes J, de Andrade FB, Peres MA. How functional disability relates to dentition in community-dwelling older adults in Brazil. Oral Dis 2016; 23:97-101. [PMID: 27608422 DOI: 10.1111/odi.12580] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the association between dentition status and functional disabilities among community-dwelling older individuals. SUBJECTS AND METHODS A total of 5012 individuals aged 65-74 were interviewed in 2013 during a nationwide community-based survey. This cross-sectional study used a questionnaire including information on dentition, locomotion impairment, difficulties in basic and instrumental activities of daily life, socio-demographic characteristics, behaviour and general health status. Poisson regression models assessed prevalence ratios (PR) and 95% confidence intervals (95% CI). RESULTS About 31.3% of older people in Brazil reported having ≥21 preserved teeth, the condition for a functional dentition without prosthetic appliances. This proportion was significantly lower among individuals with locomotion impairment and difficulties in basic and instrumental activities of daily life. After adjusting for relevant covariates, functional dentition remained statistically associated with severe (PR = 0.69, 95% CI = 0.15-0.63) and total (PR = 0.69, 95% CI = 0.26-0.44) locomotion impairments, and difficulties in basic activities of daily life (PR = 0.70, 95% CI = 0.53-0.93). CONCLUSION Having a functional dentition was significantly less prevalent among those affected by functional disabilities, and this association is unlikely to be due to insufficient control for relevant covariates. The association between dentition and functional disability is bidirectional and involves a complex interplay of one upon the other, and of factors that influence both outcomes.
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Affiliation(s)
- Jlf Antunes
- School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | - F B de Andrade
- Center for Studies in Public Health and Aging, Rene Rachou Research Institute, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - M A Peres
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
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92
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Mariño R, Ramos-Gómez F, Manton DJ, Onetto JE, Hugo F, Feldens CA, Bedi R, Uribe S, Zillmann G. The future of pediatric dentistry education and curricula: a Chilean perspective. BMC Oral Health 2016; 17:20. [PMID: 27431994 PMCID: PMC4950627 DOI: 10.1186/s12903-016-0251-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 07/13/2016] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND A meeting was organised to consolidate a network of researchers and academics from Australia, Brazil, Chile, the UK and the USA, relating to Early Childhood Caries (ECC) and Dental Trauma (DT). As part of this meeting, a dedicated session was held on the future of paediatric dental education and curricula. Twenty-four paediatric dentistry (PD) academics, representing eight Chilean dental schools, and three international specialists (from Brazil and Latvia) participated in group discussions facilitated by five members of the ECC/DT International Collaborative Network. Data were collected from group discussions which followed themes developed as guides to identify key issues associated with paediatric dentistry education, training and research. DISCUSSION Participants discussed current PD dental curricula in Chile, experiences in educating new cohorts of oral health care providers, and the outcomes of existing efforts in education and research in PD. They also, identified challenges, opportunities and areas in need of further development. This paper provides an introspective analysis of the education and training of PD in Chile; describes the input provided by participants into pediatric dentistry education and curricula; and sets out some key priorities for action with suggested directions to best prepare the future dental workforce to maximise oral health outcomes for children. Immediate priorities for action in paediatric dentistry in Chile were proposed.
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Affiliation(s)
- Rodrigo Mariño
- Melbourne Dental School, University of Melbourne, Melbourne, Australia. .,Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, Australia.
| | | | - David John Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | | | - Fernando Hugo
- School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Raman Bedi
- Dental Institute, Kings College London, London, UK
| | - Sergio Uribe
- Dental School, Universidad Austral de Chile, Valdivia, Chile
| | - Gisela Zillmann
- Facultad de Odontología, Universidad de Chile, Santiago, Chile
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93
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Arora G, Mackay DF, Conway DI, Pell JP. Ethnic differences in oral health and use of dental services: cross-sectional study using the 2009 Adult Dental Health Survey. BMC Oral Health 2016; 17:1. [PMID: 27412290 PMCID: PMC4942933 DOI: 10.1186/s12903-016-0228-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 05/30/2016] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND Oral health impacts on general health and quality of life, and oral diseases are the most common non-communicable diseases worldwide. Non-White ethnic groups account for an increasing proportion of the UK population. This study explores whether there are ethnic differences in oral health and whether these are explained by differences in sociodemographic or lifestyle factors, or use of dental services. METHODS We used the Adult Dental Health Survey 2009 to conduct a cross-sectional study of the adult general population in England, Wales and Northern Ireland. Ethnic groups were compared in terms of oral health, lifestyle and use of dental services. Logistic regression analyses were used to determine whether ethnic differences in fillings, extractions and missing teeth persisted after adjustment for potential sociodemographic confounders and whether they were explained by lifestyle or dental service mediators. RESULTS The study comprised 10,435 (94.6 %) White, 272 (2.5 %) Indian, 165 (1.5 %) Pakistani/Bangladeshi and 187 (1.7 %) Black participants. After adjusting for confounders, South Asian participants were significantly less likely, than White, to have fillings (Indian adjusted OR 0.25, 95 % CI 0.17-0.37; Pakistani/Bangladeshi adjusted OR 0.43, 95 % CI 0.26-0.69), dental extractions (Indian adjusted OR 0.33, 95 % CI 0.23-0.47; Pakistani/Bangladeshi adjusted OR 0.41, 95 % CI 0.26-0.63), and <20 teeth (Indian adjusted OR 0.31, 95 % CI 0.16-0.59; Pakistani/Bangladeshi adjusted OR 0.22, 95 % CI 0.08-0.57). They attended the dentist less frequently and were more likely to add sugar to hot drinks, but were significantly less likely to consume sweets and cakes. Adjustment for these attenuated the differences but they remained significant. Black participants had reduced risk of all outcomes but after adjustment for lifestyle the difference in fillings was attenuated, and extractions and tooth loss became non-significant. CONCLUSIONS Contrary to most health inequalities, oral health was better among non-White groups, in spite of lower use of dental services. The differences could be partially explained by reported differences in dietary sugar.
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Affiliation(s)
- Garima Arora
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
| | - Daniel F Mackay
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
| | - David I Conway
- Dental School, University of Glasgow, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
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94
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Dalazen CE, De Carli AD, Bomfim RA, dos Santos MLM. Contextual and Individual Factors Influencing Periodontal Treatment Needs by Elderly Brazilians: A Multilevel Analysis. PLoS One 2016; 11:e0156231. [PMID: 27249677 PMCID: PMC4889082 DOI: 10.1371/journal.pone.0156231] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 05/11/2016] [Indexed: 01/08/2023] Open
Abstract
Objective To assess the relationship between periodontal treatment needs by elderly Brazilians and contextual as well as individual variables. Methods A cross-sectional study was carried out to assess the need for clinical periodontal treatment, based on National Oral Health Survey (SB Brasil 2010) data on the presence of dental calculus, shallow (3–5 mm) and deep (≥ 6 mm) periodontal pockets, and gingival bleeding in elderly people (n = 7,619). The contextual variables included the Municipal Human Development Index (MHDI), income inequality (Gini Index) and coverage of the municipal population by the Family Health Strategy (FHS) program oral health teams.<0} The individual variables were sex, income, education level and self-reported skin color. Multilevel logistic regression models were used to calculate the odds ratio (OR) and 95% confidence intervals (CI95%) between periodontal treatment needs and the contextual as well as individual variables. Results Gingival bleeding was found in 20.7% of the elderly analyzed (n = 1,577), dental calculus in 34% (n = 2,590), shallow periodontal pockets in 15.6% (n = 1,189), and deep periodontal pockets in 4.2% (n = 320). Individual factors were correlated with all the outcomes assessed. Sex was a protective factor in regard to gingival bleeding (OR = 0.87; CI95% 0.76–1.00), dental calculus (OR = 0.86; CI95% 0.75–0.99), shallow periodontal pockets (OR = 0.69; CI95% 0.60–0.80) and deep periodontal pockets (OR = 0.58; CI95% 0.45–0.74). It was found that fewer women needed treatment. Elderly people who self-reported having nonwhite skin had higher chances of needing periodontal treatment. Skin color was a risk factor for gingival bleeding (OR = 1.32; CI95% 1.14–1.53), dental calculus (OR = 1.32; CI95%1.14–1.54) and shallow periodontal pockets (OR = 1.27; CI95% 1.09–1.49). Education level was associated with the presence of dental calculus (OR = 0.77; CI95% 0.66–0.89), shallow periodontal pockets (OR = 0.86; CI95% 0.73–1.00) and deep periodontal pockets (OR = 0.74; CI95% 0.57–0.97), thus acting as a risk factor for undereducated elderly people. There was a correlation between population coverage by the Family Health Strategy (FHS) program oral health teams and the presence of gingival bleeding (OR = 0.67; CI95% 0.52–0.88), shallow periodontal pockets (OR = 0.76; CI95% 0.58–0.98) and deep periodontal pockets (OR = 0.62; CI95% 0.44–0.89), making these teams act as a protective factor. Conclusions This study showed evidence of the sociocontextual as well as individual sociodemographic characteristics influencing periodontal treatment needed by elderly Brazilians, based on the clinical features of periodontal disease. The results suggest the existence of inequality related to periodontal treatment needs among elderly Brazilians, especially in regard to sex and ethnicity, in addition to a potentially positive impact from the expansion of the Family Health Strategy (FHS) program oral health teams.
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Affiliation(s)
- Chaiane Emilia Dalazen
- Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
- * E-mail:
| | - Alessandro Diogo De Carli
- Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Rafael Aiello Bomfim
- Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Mara Lisiane Moraes dos Santos
- Departamento de Tecnologia de Alimentos e Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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95
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Di Bernardi ER, Tsakos G, Sheiham A, Peres KG, Peres MA. Association of changes in income with self-rated oral health and chewing difficulties in adults in Southern Brazil. Community Dent Oral Epidemiol 2016; 44:450-7. [DOI: 10.1111/cdoe.12234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 03/29/2016] [Indexed: 12/01/2022]
Affiliation(s)
| | - Georgios Tsakos
- Department of Epidemiology and Public Health; University College London; London UK
| | - Aubrey Sheiham
- Department of Epidemiology and Public Health; University College London; London UK
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health; School of Dentistry; University of Adelaide; Adelaide SA Australia
| | - Marco Aurélio Peres
- Australian Research Centre for Population Oral Health; School of Dentistry; University of Adelaide; Adelaide SA Australia
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96
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Åstrøm AN, Lie SA, Mbawalla H. Do self-efficacy and depression predict oral impacts on daily performances across time? A 2-yr follow-up of students in Tanzania. Eur J Oral Sci 2016; 124:358-67. [DOI: 10.1111/eos.12274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Anne N. Åstrøm
- Department of Clinical Dentistry; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
| | - Stein A. Lie
- Department of Clinical Dentistry; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
| | - Hawa Mbawalla
- Muhimbili University of Health and Allied Sciences; Dar Es Salaam Tanzania
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97
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Holde GE, Oscarson N, Tillberg A, Marstrander P, Jönsson B. Methods and background characteristics of the TOHNN study: a population-based study of oral health conditions in northern Norway. Int J Circumpolar Health 2016; 75:30169. [PMID: 26900910 PMCID: PMC4762226 DOI: 10.3402/ijch.v75.30169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/28/2016] [Accepted: 01/28/2016] [Indexed: 12/19/2022] Open
Abstract
Objectives The aim of the Tromstannen – Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. Study design Cross-sectional population-based study including a questionnaire and clinical dental examination. Methods A randomly selected sample of 2,909 individuals (20–79 years old) drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20–34, 35–49, 50–64 and 65–79) and ethnicity (Norwegian, Sámi, other European and other world). Results From the original sample of 2,909 individuals, 1,986 (68.3%) people participated, of whom 1,019 (51.3%) were women. The highest attendance rate was among women 20–34 years old (80.3%) and the lowest in the oldest age group of women (55.4%). There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p < 0.001) and education level (p < 0.001). The majority of Sámi resided in smaller municipalities. In larger cities, most participants used private dental health care services, whereas, in rural areas, most participants used the public dental health care service. Conclusion The TOHNN study has the potential to generate new knowledge on a wide range of oral health conditions beneficial to the population in Troms County. Due to the high participation rate, generalization both nationally and to the circumpolar area ought to be possible.
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Affiliation(s)
- Gro Eirin Holde
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.,Department of Clinical Dentistry, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway;
| | - Nils Oscarson
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
| | - Anders Tillberg
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.,Department of Clinical Dentistry, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Peter Marstrander
- Public Dental Health Care Service, Tromsø County Council, Tromsø, Norway
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
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98
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Elias-Boneta AR, Toro MJ, Rivas-Tumanyan S, Murillo M, Orraca L, Encarnacion A, Cernigliaro D, Toro-Vizcarrondo C, Psoter WJ. Persistent oral health disparity in 12-year-old Hispanics: a cross-sectional study. BMC Oral Health 2016; 16:10. [PMID: 26830842 PMCID: PMC4736133 DOI: 10.1186/s12903-016-0162-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 01/14/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dental caries is the most prevalent chronic illness worldwide. In the US dental caries has been described as a "silent epidemic", affecting 58.2 % of 12-15 year-olds, particularly in minority and immigrant groups. Caries is associated with complex yet preventable biological and behavioral factors such as dental plaque and diet, as well as social determinants of health. In developed nations, a higher risk caries has been associated with populations of low socio-economic status (SES), especially in areas with greater income disparity. An island-wide study conducted in Puerto Rico in 1997 revealed a high prevalence of dental caries in 12-year-olds and a significant health disparity between children attending private and public schools. The purpose of the present study was twofold: 1) to estimate caries levels of 12-year-old school Puerto Ricans in 2011; and 2) compare results to data obtained in 1997 to explore any possible change in caries outcomes after a government health insurance (GHI) reform was implemented. METHODS In this cross-sectional study, a probability sample of 133 out of 1,843 schools was selected proportional to enrollment size, and stratified by 1997 GHI regions, school type, and gender. Calibrated examiners conducted oral soft tissue and caries examinations. Dental caries prevalence was estimated. Mean Decayed Missing Filled Tooth/Surface (DMFT/S) indices and mean Significant Caries Index (SiC) were calculated and compared retrospectively to data obtained in 1997. RESULTS The final sample included 1,587 school-enrolled children. About 53 % of participants were female and 77 % attended public schools. Between 1997 and 2011, reductions were observed in caries prevalence (81 to 69 %), mean DMFT scores (3.8 to 2.5), mean DMFS scores (6.5 to 3.9), and mean SiC index (7.3 to 5.6) in both private and public schools, with a more prominent decrease in private schools. Between 1997 and 2011, overall the filled component increased (50 to 67 %), while decayed and missing component decreased (42 to 30 %) and (8 to 3 %), respectively. CONCLUSIONS Among 12-year-old schoolchildren in Puerto Rico between 1997 and 2011, caries prevalence, extent, and severity decreased as well as the DMFT missing component, while the filled component increased. Dental caries prevalence was high and the health disparity persists between children enrolled in public and private schools after more than a decade of the GHI implementation. The relationship between GHI implementation and other potentially relevant co-factors for caries warrants further research, as does the seemingly entrenched disparity across groups.
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Affiliation(s)
- Augusto R Elias-Boneta
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
| | - Milagros J Toro
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
| | - Sona Rivas-Tumanyan
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
| | - Margarita Murillo
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
| | - Luis Orraca
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
| | - Angeliz Encarnacion
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
| | - Dana Cernigliaro
- Department of Dental Medicine, NYU-Lutheran Medical Center, Brooklyn, New York, USA.
| | - Carlos Toro-Vizcarrondo
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
| | - Walter J Psoter
- Department of Dental Medicine, NYU-Lutheran Medical Center, Brooklyn, New York, USA.
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99
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Ramsay SE, Whincup PH, Watt RG, Tsakos G, Papacosta AO, Lennon LT, Wannamethee SG. Burden of poor oral health in older age: findings from a population-based study of older British men. BMJ Open 2015; 5:e009476. [PMID: 26715480 PMCID: PMC4710823 DOI: 10.1136/bmjopen-2015-009476] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Evidence of the extent of poor oral health in the older UK adult population is limited. We describe the prevalence of oral health conditions, using objective clinical and subjective measures, in a population-based study of older men. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A representative sample of men aged 71-92 years in 2010-2012 from the British Regional Heart Study, initially recruited in 1978-1980 from general practices across Britain. Physical examination among 1660 men included the number of teeth, and periodontal disease in index teeth in each sextant (loss of attachment, periodontal pocket, gingival bleeding). Postal questionnaires (completed by 2147 men including all participants who were clinically examined) included self-rated oral health, oral impacts on daily life and current perception of dry mouth experience. RESULTS Among 1660 men clinically examined, 338 (20%) were edentulous and a further 728 (43%) had <21 teeth. For periodontal disease, 233 (19%) had loss of attachment (>5.5 mm) affecting 1-20% of sites while 303 (24%) had >20% sites affected. The prevalence of gingival bleeding was 16%. Among 2147 men who returned postal questionnaires, 35% reported fair/poor oral health; 11% reported difficulty eating due to oral health problems. 31% reported 1-2 symptoms of dry mouth and 20% reported 3-5 symptoms of dry mouth. The prevalence of edentulism, loss of attachment, or fair/poor self-rated oral health was greater in those from manual social class. CONCLUSIONS These findings highlight the high burden of poor oral health in older British men. This was reflected in both the objective clinical and subjective measures of oral health conditions. The determinants of these oral health problems in older populations merit further research to reduce the burden and consequences of poor oral health in older people.
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Affiliation(s)
- S E Ramsay
- Department of Primary Care & Population Health, UCL, London, UK
| | - P H Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - R G Watt
- Department of Epidemiology & Public Health, UCL, London, UK
| | - G Tsakos
- Department of Epidemiology & Public Health, UCL, London, UK
| | - A O Papacosta
- Department of Primary Care & Population Health, UCL, London, UK
| | - L T Lennon
- Department of Primary Care & Population Health, UCL, London, UK
| | - S G Wannamethee
- Department of Primary Care & Population Health, UCL, London, UK
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100
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Mizutani S, Ekuni D, Tomofuji T, Irie K, Azuma T, Iwasaki Y, Morita M. Self-efficacy and progression of periodontal disease: a prospective cohort study. J Clin Periodontol 2015; 42:1083-9. [PMID: 26498854 DOI: 10.1111/jcpe.12476] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Shinsuke Mizutani
- Departments of Preventive Dentistry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 2-5-1 Shikata-cho, Kita-ku Okayama 700-8558 Japan
| | - Daisuke Ekuni
- Departments of Preventive Dentistry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 2-5-1 Shikata-cho, Kita-ku Okayama 700-8558 Japan
| | - Takaaki Tomofuji
- Departments of Preventive Dentistry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 2-5-1 Shikata-cho, Kita-ku Okayama 700-8558 Japan
- Advanced Research Center for Oral and Craniofacial Sciences; Okayama University Dental School; 2-5-1 Shikata-cho, Kita-ku Okayama 700-8558 Japan
| | - Koichiro Irie
- Departments of Preventive Dentistry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 2-5-1 Shikata-cho, Kita-ku Okayama 700-8558 Japan
- Department of Preventive Dentistry and Dental Public Health; School of Dentistry; Aichi Gakuin University; 1-100 Kusumoto-cho, Chikusa-ku, Nagoya Aichi 464-8650 Japan
| | - Tetsuji Azuma
- Departments of Preventive Dentistry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 2-5-1 Shikata-cho, Kita-ku Okayama 700-8558 Japan
| | - Yoshiaki Iwasaki
- Health Service Center; Okayama University; 2-1-1 Tsushima-naka, Kita-ku Okayama 700-8530 Japan
| | - Manabu Morita
- Departments of Preventive Dentistry; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 2-5-1 Shikata-cho, Kita-ku Okayama 700-8558 Japan
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