51
|
Fang C, Aldossri M, Farmer J, Gomaa N, Quiñonez C, Ravaghi V. Changes in income-related inequalities in oral health status in Ontario, Canada. Community Dent Oral Epidemiol 2020; 49:110-118. [PMID: 33044034 DOI: 10.1111/cdoe.12582] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/28/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Oral health inequalities impose a substantial burden on society and the healthcare system across Canadian provinces. Monitoring these inequalities is crucial for informing public health policy and action towards reducing inequalities; however, trends within Canada have not been explored. The objectives of this study are as follows: (a) to assess trends in income-related inequalities in oral health in Ontario, Canada's most populous province, from 2003 to 2014, and (b) to determine whether the magnitude of such inequalities differ by age and sex. METHODS Data representative of the Ontario population aged 12 years and older were sourced from the Canadian Community Health Survey (CCHS) cycles 2003 (n = 36,182), 2007/08 (n = 36,430) and 2013/14 (n = 41,258). Income-related inequalities in poor self-reported oral health (SROH) were measured using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) and compared across surveys. All analyses were sample-weighted and performed with STATA 15. RESULTS The prevalence of poor SROH was stable across the CCHS cycles, ranging from 14.1% (2003 cycle) to 14.8% (2013/14 cycle). SII estimates did not change (18.7-19.0), while variation in RII estimates was observed over time (2003 = 3.85; 2007/08 = 4.47; 2013/14 = 4.02); differences were not statistically significant. SII and RII were lowest among 12- to 19-year-olds and gradually higher among 20- to 64-year-olds. RII was slightly higher among females in all survey years. CONCLUSION Absolute and relative income-related inequalities in SROH have persisted in Ontario over time and are more severe among middle-aged adults. Therefore, oral health inequalities in Ontario require attention from key stakeholders, including governments, regulators and health professionals.
Collapse
Affiliation(s)
- Cheng Fang
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Musfer Aldossri
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Julie Farmer
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Noha Gomaa
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Carlos Quiñonez
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Vahid Ravaghi
- School of Dentistry, University of Birmingham, Birmingham, UK
| |
Collapse
|
52
|
Baldo Moraes R, Knorst JK, Brondani B, Baldo Marques B, de Sousa Reis M, Henriqson D, Ardenghi TM. Relationship between gingival bleeding and associated factors with reports of verbal bullying in adolescents. J Periodontol 2020; 92:225-233. [PMID: 32716571 DOI: 10.1002/jper.19-0745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/29/2020] [Accepted: 06/06/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Dentofacial features are related to increased bullying episodes in young people. The aim of this study was to assess the association between gingival bleeding and reports of verbal bullying among adolescents. METHODS This is a cross-sectional study conducted with a representative sample of 608 12-year-old adolescents from southern Brazil. The occurrence of verbal bullying was verified through adolescents' self-report. Oral health measurements included the presence of gingival bleeding, dental fracture, dental fluorosis, and dental caries experience. Gingival bleeding was assessed through adolescent self-perception by the following question: "Did you notice any bleeding in your gums?" Demographic, socioeconomic, and psychosocial variables were also evaluated. Poisson regression models with robust variance were used to evaluate the influence of gingival bleeding on the occurrence of verbal bullying. Results are presented as prevalence ratio (PR) and 95% confidence interval (95% CI). RESULTS Out of 608 adolescents evaluated, 577 answered bullying questions. The prevalence of self-reported verbal bullying was 12.8%. Adolescents who presented gingival bleeding had an 80% higher prevalence of verbal bullying than their counterparts (PR 1.80; 95% CI 1.01 -3.19). Dental shame, speech difficulties and influence of dental condition on studies also impacted the higher prevalence of bullying. CONCLUSION Our results suggest that the presence of gingival bleeding negatively impacts the social life of adolescents, causing more episodes of verbal bullying. These findings encourage public health policies aimed at reducing oral health inequities, thus reflecting on the well-being and quality of life of this target population.
Collapse
Affiliation(s)
- Renita Baldo Moraes
- Department of Nursing and Dentistry, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Bruna Brondani
- Department of Pediatric Dentistry and Orthodontics, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Beatriz Baldo Marques
- Department of Nursing and Dentistry, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Magda de Sousa Reis
- Department of Nursing and Dentistry, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | | | - Thiago Machado Ardenghi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| |
Collapse
|
53
|
Tan CXW, Brand HS, Iqbal S, De Boer NKH, Forouzanfar T, de Visscher JGAM. A self-reported survey on oral health problems in patients with inflammatory bowel disease with a stoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:e80-e86. [PMID: 32601008 DOI: 10.1016/j.oooo.2020.04.816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/06/2020] [Accepted: 04/27/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Patients with inflammatory bowel disease have an increased risk of developing oral health problems. The aim of this study was to investigate whether oral diseases in these patients are related to inflammation of the intestine and if there is a correlation between inflammatory bowel disease-specific health-related quality of life (IBD-HR-QOL) and oral health problems. STUDY DESIGN The study was a cross-sectional survey and analysis of self-reported oral health of individuals with a stoma for Crohn's disease (CD), ulcerative colitis (UC), and treated colon cancer (CC). Validated international questionnaires were sent to members of the Stoma Federation of The Netherlands. Because there was an unequal distribution of male and female patients with CD and CC, data of 169 age-matched female patients with CD, UC, and CC with a stoma were analyzed. RESULTS Patients with CD had significantly more oral health problems compared with those with UC or CC. Patients with CD and UC both had significantly more gingival-related problems compared with patients with CC. There was a significant negative correlation between IBD-HR-QOL and oral health problems. CONCLUSIONS In the 3 distinguishable groups of patients with a stoma, patients with CD had an increased risk for oral health problems, independently from surgical removal of (a part of) the inflamed intestine, suggesting a general increased susceptibility of patients with CD for oral health problems.
Collapse
Affiliation(s)
- Christopher X W Tan
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Sumaira Iqbal
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Nanne K H De Boer
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, VU University, AG&M Research Institute, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jan G A M de Visscher
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| |
Collapse
|
54
|
Yin Z, Yang J, Huang C, Sun H, Wu Y. Eating and communication difficulties as mediators of the relationship between tooth loss and functional disability in middle-aged and older adults. J Dent 2020; 96:103331. [DOI: 10.1016/j.jdent.2020.103331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/20/2020] [Accepted: 03/26/2020] [Indexed: 10/24/2022] Open
|
55
|
Hoshi M, Aida J, Kusama T, Yamamoto T, Kiuchi S, Yamamoto T, Ojima T, Kondo K, Osaka K. Is the Association between Green Tea Consumption and the Number of Remaining Teeth Affected by Social Networks?: A Cross-Sectional Study from the Japan Gerontological Evaluation Study Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062052. [PMID: 32244856 PMCID: PMC7142926 DOI: 10.3390/ijerph17062052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 01/06/2023]
Abstract
Consumption of green tea without sugar, as well as social networks, are associated with a lower risk of tooth loss. There is a possibility of confounding both factors because tea is often drunk with friends. Therefore, the present study aimed to examine whether green tea consumption is beneficially associated with the number of remaining teeth, while considering social networks. This cross-sectional study was based on the Japan Gerontological Evaluation Study (JAGES) in 2016. Self-administered questionnaires containing questions about green tea consumption were mailed to 34,567 community-dwelling residents aged ≥ 65 years. We used the number of remaining teeth as a dependent variable, and green tea consumption and the number of friends met over the past month (social network size) as independent variables. Linear regression models with multiple imputation were used. A total of 24,147 people responded (response rate = 69.9%), and 22,278 valid data were included into our analysis. Participants’ mean age was 74.2 years (standard deviation = 6.3), and 45.9% were men. Among the participants, 52.2% had ≥ 20 teeth, 34.2% drank 2–3 cups of green tea per day, and 32.6% met ≥ 10 people over the past month. After adjusting for all potential confounders, both higher green tea consumption and a larger social network size were associated with more remaining teeth (both p for trend < 0.001). The association of green tea was greater among those with smaller social networks (p for interaction < 0.05). The protective association of green tea was remarkable among people with smaller social networks.
Collapse
Affiliation(s)
- Manami Hoshi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
- Correspondence: ; Tel.: +81-22-717-7639
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| | - Tatsuo Yamamoto
- Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan;
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan;
| | - Katsunori Kondo
- Center of Preventive Medical Sciences, Chiba University, Chiba 260-0856, Japan;
- National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| |
Collapse
|
56
|
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.
Collapse
|
57
|
Tonomura S, Naka S, Tabata K, Hara T, Mori K, Tanaka S, Sumida Y, Kanemasa K, Nomura R, Matsumoto-Nakano M, Ihara M, Takahashi N, Nakano K. Relationship between Streptococcus mutans expressing Cnm in the oral cavity and non-alcoholic steatohepatitis: a pilot study. BMJ Open Gastroenterol 2019; 6:e000329. [PMID: 31645988 PMCID: PMC6781959 DOI: 10.1136/bmjgast-2019-000329] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/03/2019] [Accepted: 09/14/2019] [Indexed: 12/26/2022] Open
Abstract
Background Non-alcoholic steatohepatitis (NASH) is a severe state of non-alcoholic fatty liver disease (NAFLD), which is pathologically characterised by steatosis, hepatocyte ballooning, and lobular inflammation. Host–microbial interaction has gained attention as one of the risk factors for NASH. Recently, cnm-gene positive Streptococcus mutans expressing cell surface collagen-binding protein, Cnm (cnm-positive S. mutans), was shown to aggravate NASH in model mice. Here, we assessed the detection rate of cnm-positive S. mutans in oral samples from patients with NASH among NAFLD. Methods This single hospital cohort study included 41 patients with NAFLD. NASH was diagnosed histologically or by clinical score. The prevalence of cnm-positive S. mutans, oral hygiene and blood tests, including liver enzymes, adipocytokines and inflammatory and fibrosis markers, were assessed in biopsy-proven or clinically suspected NASH among NAFLD. Results Prevalence of cnm-positive S. mutans was significantly higher in patients with NASH than patients without NASH (OR 3.8; 95% CI 1.02 to 15.5). The cnm-positive S. mutans was related to decreased numbers of naturally remaining teeth and increased type IV collagen 7S level (median (IQR) 10.0 (5.0–17.5) vs 20.0 (5.0–25.0), p=0.06; 5.1 (4.0–7.9) vs 4.4 (3.7–5.3), p=0.13, respectively). Conclusions Prevalence of cnm-positive S. mutans in the oral cavity could be related to fibrosis of NASH among NAFLD.
Collapse
Affiliation(s)
| | - Shuhei Naka
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Keiko Tabata
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tasuku Hara
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kojiro Mori
- Department of Gastroenterology and Hepatology, Nara City Hospital, Nara, Japan
| | - Saiyu Tanaka
- Department of Gastroenterology and Hepatology, Nara City Hospital, Nara, Japan
| | - Yoshio Sumida
- Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Aichi-gun, Japan
| | - Kazuyuki Kanemasa
- Department of Gastroenterology and Hepatology, Nara City Hospital, Nara, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University School of Dentistry Graduate School of Dentistry, Suita, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center Hospital, Suita, Japan
| | | | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Division of Oral Infection and Disease Control, Osaka University School of Dentistry Graduate School of Dentistry, Suita, Japan
| |
Collapse
|
58
|
Manabe K, Tanji F, Tomata Y, Zhang S, Tsuji I. Preventive Effect of Oral Self-Care on Pneumonia Death among the Elderly with Tooth Loss: The Ohsaki Cohort 2006 Study. TOHOKU J EXP MED 2019; 247:251-257. [PMID: 30996210 DOI: 10.1620/tjem.247.251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Tooth loss is a risk factor for pneumonia mortality, but it is unclear whether oral care negates excess mortality due to pneumonia among community-dwelling elderly with tooth loss. The purpose of this study was to examine the influence of oral care on the association between the number of remaining teeth and the risk of pneumonia death. We analyzed for 18,098 individuals (aged ≥ 65 years) participating in a prospective cohort study. In a 2006 baseline survey, the following data were collected: the number of remaining teeth, oral care, history of disease, smoking, alcohol drinking, education level and so forth. We also obtained data on dates and causes of death between 2006 and 2014. The primary outcome was mortality due to pneumonia. Compared with those having ≥ 20 teeth, the risk of pneumonia mortality was increased among participants having 10-19 or 0-9 teeth; the multivariate hazard ratios (HRs) (95% confidence intervals [CI]) were 1.45 (1.03-2.04) and 1.38 (1.01-1.87), respectively. Among those having 0-9 teeth, a significantly increased risk of mortality due to pneumonia was disappeared for those who brushed their teeth ≥ 2 times per day, for those with visiting a dentist, and for those with use of denture, whereas the risk persisted among those who brushed their teeth ≤ 2 times per day, for those without visiting a dentist, and for those without use of denture. Tooth-brushing, visiting a dentist or use of denture may negate the increased risk of pneumonia death among the elderly with tooth loss.
Collapse
Affiliation(s)
- Kaoru Manabe
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Fumiya Tanji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Yasutake Tomata
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Shu Zhang
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| |
Collapse
|
59
|
Medina-Solís CE, Ávila-Burgos L, Márquez-Corona MDL, Medina-Solís JJ, Lucas-Rincón SE, Borges-Yañez SA, Fernández-Barrera MÁ, Pontigo-Loyola AP, Maupomé G. Out-Of-Pocket Expenditures on Dental Care for Schoolchildren Aged 6 to 12 Years: A Cross-Sectional Estimate in a Less-Developed Country Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111997. [PMID: 31195612 PMCID: PMC6603907 DOI: 10.3390/ijerph16111997] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 12/20/2022]
Abstract
Aim: The objective of this study was to estimate the Out-Of-Pocket Expenditures (OOPEs) incurred by households on dental care, as well as to analyze the sociodemographic, economic, and oral health factors associated with such expenditures. Method: A cross-sectional study was conducted among 763 schoolchildren in Mexico. A questionnaire was distributed to parents to determine the variables related to OOPEs on dental care. The amounts were updated in 2017 in Mexican pesos and later converted to 2017 international dollars (purchasing power parities-PPP US $). Multivariate models were created: a linear regression model (which modeled the amount of OOPEs), and a logistic regression model (which modeled the likelihood of incurring OOPEs). Results: The OOPEs on dental care for the 763 schoolchildren were PPP US $53,578, averaging a PPP of US $70.2 ± 123.7 per child. Disbursements for treatment were the principal item within the OOPEs. The factors associated with OOPEs were the child's age, number of dental visits, previous dental pain, main reason for dental visit, educational level of mother, type of health insurance, household car ownership, and socioeconomic position. Conclusions: The average cost of dental care was PPP US $70.2 ± 123.7. Our study shows that households with higher school-aged children exhibiting the highest report of dental morbidity-as well as those without insurance-face the highest OOPEs. An array of variables were associated with higher expenditures. In general, higher-income households spent more on dental care. However, the present study did not estimate unmet needs across the socioeconomic gradient, and thus, future research is needed to fully ascertain disease burden.
Collapse
Affiliation(s)
- Carlo Eduardo Medina-Solís
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
- The Center for Advanced Studies and Research in Dentistry "Keisaburo Miyata", Faculty of Dentistry, the Autonomous University of the State of Mexico, Toluca 50000, Mexico.
| | - Leticia Ávila-Burgos
- The Center for Health Systems Research, the National Institute of Public Health, Cuernavaca 62100, Mexico.
| | - María de Lourdes Márquez-Corona
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
| | - June Janette Medina-Solís
- Ministry of Education of Campeche, Sub-secretary of Educational Coordination, Direction of Coordination and Budgetary Management, Campeche 24095, Mexico.
| | - Salvador Eduardo Lucas-Rincón
- The Center for Advanced Studies and Research in Dentistry "Keisaburo Miyata", Faculty of Dentistry, the Autonomous University of the State of Mexico, Toluca 50000, Mexico.
- School of Dentistry, the Ixtlahuaca University Centre, Ixtlahuaca 50080, Mexico.
| | | | - Miguel Ángel Fernández-Barrera
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
| | - América Patricia Pontigo-Loyola
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University in Indianapolis, Indianapolis, IN 46202, USA.
- The Indiana University Network Science Institute, Bloomington, IN 47408, USA.
| |
Collapse
|
60
|
Margozzini P, Berríos R, Cantarutti C, Veliz C, Ortuno D. Validity of the self-reported number of teeth in Chilean adults. BMC Oral Health 2019; 19:99. [PMID: 31164110 PMCID: PMC6549282 DOI: 10.1186/s12903-019-0794-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/22/2019] [Indexed: 11/30/2022] Open
Abstract
Background Clinical dental evaluations are considered complex and costly measurements that epidemiological surveillance studies of multiple simultaneous chronic diseases currently require, for example National Health Surveys (ENS). Accordingly, simpler and more affordable methods need to be validated. The aim of this study was to assess the validity of the self-report on the total number of teeth in the general Chilean adult population. Methods A substudy was conducted on ENS 2016–2017 participants. A stratified random sample of 101 of them was subjected to a telephone questionnaire. This information was then compared with the results obtained from the oral examination performed by a trained nurse during a home visit. Spearman correlations, intraclass correlation coefficients and the Bland-Altman method were used to analyse the data. Results In men, the average number of teeth recorded during the oral examination coincided with the number of teeth in the self-report (22 teeth). In women, the total teeth average was 18 and 19 teeth according to the examination and self-report, respectively. For the total number of participants, a strong and significant Spearman correlation was obtained (ρ = 0.93); in men and women, the Spearman correlation observed was also strong and significant (ρ = 0.90 and ρ = 0.96 respectively). The value of the intraclass correlation coefficient indicated a significant concordance (CCI = 0.96) in both men and women (CCI = 0.93 and 0.98 respectively). A tendency to greater correlation was observed as the number of teeth decreased. Conclusions The number of teeth self-reported by the subjects in this study correlated with the number of teeth recorded in the clinical examination. Self-report is a valid method to determine the number of teeth in national health surveys.
Collapse
Affiliation(s)
- Paula Margozzini
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Berríos
- Escuela de Odontología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cynthia Cantarutti
- Escuela de Odontología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Veliz
- Escuela de Odontología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Duniel Ortuno
- Escuela de Odontología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
| |
Collapse
|
61
|
Barboza-Solís C, Porras-Chaverri M, Fantin R. Is tooth loss important when evaluating perceived general health? Findings from a nationally representative study of Costa Rican adults. Community Dent Oral Epidemiol 2019; 47:358-365. [PMID: 31074536 DOI: 10.1111/cdoe.12466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/11/2019] [Accepted: 04/19/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Although previous studies have shown that oral diseases can impact certain systemic conditions, dental care has been historically separated from medical healthcare organizations in middle-income countries. There is a lack of research approaches which test the independent relationship between oral health and multidimensional measures of general health. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relatively to certain morbidity conditions, tooth loss is a health condition associated with SRH. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relative to certain morbidity conditions, tooth loss is a health condition associated with SRH. METHODS Data were obtained from the Costa Rican Longevity and Healthy Aging Study 1945-1955 Retirement Cohort, a national representative longitudinal survey including residents born between 1945 and 1955. The association between severe tooth loss and SRH was analysed cross-sectionally using the first wave of the study conducted in 2010. A multivariable logistic regression, adjusted for potential confounders, was performed on 2797 participants. A counterfactual analysis was additionally performed to illustrate the theoretical change on SRH prevalence-if all the participants were not to have had severe tooth loss. RESULTS Severe tooth loss was associated with poor SRH, after adjustment for smoking, morbidity, biomarkers and performance-based physical measures. The counterfactual analysis showed that severe tooth loss was the fifth most important morbidity condition in determining poor SRH. Declaring a poor SRH would have been decreased by 2.0 percentage points if those participants having severe tooth loss had shared the same risk pattern of those who had not lost the majority of their teeth. CONCLUSION Individuals consider their oral health status to a similar extent as other morbidity conditions when evaluating their general health. A stronger focus on oral health, and its impact on general health, could lead to better planning of national resources, thereby improving accessibility to health care and modifying prevailing conceptions of health care in low- and middle-income countries.
Collapse
Affiliation(s)
| | - Mariela Porras-Chaverri
- Centro de Investigación en Ciencias Atómicas, Nucleares y Moleculares, Universidad de Costa Rica, San José, Costa Rica
| | - Romain Fantin
- Facultad de Medicina, Escuela de Salud Pública, Universidad de Costa Rica, San José, Costa Rica.,Facultad de Medicina, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| |
Collapse
|
62
|
Duijster D, Oude Groeniger J, van der Heijden GJMG, van Lenthe FJ. Material, behavioural, cultural and psychosocial factors in the explanation of socioeconomic inequalities in oral health. Eur J Public Health 2019; 28:590-597. [PMID: 29272383 PMCID: PMC6051465 DOI: 10.1093/eurpub/ckx209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background This study aimed to assess the contribution of material, behavioural, cultural and psychosocial factors in the explanation of socioeconomic inequalities (education and income) in oral health of Dutch adults. Methods Cross-sectional data from participants (25-75 years of age) of the fifth wave of the GLOBE cohort were used (n = 2812). Questionnaires were used to obtain data on material factors (e.g. financial difficulties), behavioural factors (e.g. smoking), cultural factors (e.g. cultural activities) and psychosocial factors (e.g. psychological distress). Oral health outcomes were self-reported number of teeth and self-rated oral health (SROH). Mediation analysis, using multivariable negative binomial regression and logistic regression, was performed. Results Education level and income showed a graded positive relationship with both oral health outcomes. Adding material, behavioural, cultural and psychosocial factors substantially reduced the rate ratio for the number of teeth of the lowest education group from 0.79 (95% confidence interval (CI): 0.75-0.83) to 0.92 (95% CI: 0.87-0.97) and of the lowest income group from 0.80 (95% CI: 0.73-0.88) to 1.04 (95% CI: 0.96-1.14). Inclusion of all factors also substantially reduced the odds ratio for poor SROH of the lowest education group from 1.61 (95% CI: 1.28-2.03) to 1.12 (95% CI: 0.85-1.48) and of the lowest income groups from 3.18 (95% CI: 2.13-4.74) to 1.48 (95% CI: 0.90-2.45). Conclusion In general, behavioural factors contributed most to the explanation of socioeconomic inequalities in adult oral health, followed by material factors. The contribution of cultural and psychosocial factors was relatively moderate.
Collapse
Affiliation(s)
- Denise Duijster
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Geert J M G van der Heijden
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| |
Collapse
|
63
|
Sekundo C, Stock C, Jürges H, Listl S. Patients' self‐reported measures of oral health—A validation study on basis of oral health questions used in a large multi‐country survey for populations aged 50+. Gerodontology 2019; 36:171-179. [DOI: 10.1111/ger.12398] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 02/04/2019] [Accepted: 02/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Caroline Sekundo
- Department of Conservative Dentistry, Translational Health Economics Group (THE Group) Heidelberg University Heidelberg Germany
| | - Christian Stock
- Division of Clinical Epidemiology and Aging Research German Cancer Research Center (DKFZ) Heidelberg Germany
- Institute of Medical Biometry and Informatics (IMBI) Heidelberg University Hospital Heidelberg Germany
| | - Hendrik Jürges
- Schumpeter School of Business and Economics University of Wuppertal Wuppertal Germany
| | - Stefan Listl
- Department of Conservative Dentistry, Translational Health Economics Group (THE Group) Heidelberg University Heidelberg Germany
- Department of Quality and Safety of Oral Health Care Radboud University Nijmegen Nijmegen The Netherlands
| |
Collapse
|
64
|
Matsuyama Y, Jürges H, Listl S. The Causal Effect of Education on Tooth Loss: Evidence From United Kingdom Schooling Reforms. Am J Epidemiol 2019; 188:87-95. [PMID: 30203091 DOI: 10.1093/aje/kwy205] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 09/05/2018] [Indexed: 12/11/2022] Open
Abstract
Associations between education and oral health have frequently been reported, but until now there has been no causal evidence. Exploiting exogenous variation in the duration of schooling due to 1947 and 1972 reforms in mandatory schooling in the United Kingdom, we examined the causal relationship between education and tooth loss in older age. We conducted a cross-sectional study using data from waves 3 (2006-2007), 5 (2010-2011), and 7 (2014-2015) of the English Longitudinal Study of Ageing. We used a 2-stage least squares instrumental variable approach and included 5,667 respondents (average age = 67.8 years; 44.4% were men) in the analyses, of whom 819 (14.5%) had no teeth. The schooling reforms increased the duration of education by an average of 0.624 years (95% confidence interval: 0.412, 0.835). For respondents born within ±6 years of the pivotal cohorts, a 1-year increment of education causally reduced the probability of edentulism by 9.1 (95% confidence interval: 1.5, 16.8) percentage points. The effects were stronger for the 1947 reform than for the 1972 reform. Results were robust to broadening of the cohort bandwidth and functional form of the cohort trend. The findings suggest that investment in education produces improved oral health later in life.
Collapse
Affiliation(s)
- Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyō-ku, Tokyo, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
- Department of Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hendrik Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - Stefan Listl
- Department of Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
- Section for Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
65
|
Similä T, Nieminen P, Virtanen JI. Validity of self-reported number of teeth in middle-aged Finnish adults: the Northern Finland Birth Cohort Study 1966. BMC Oral Health 2018; 18:210. [PMID: 30538003 PMCID: PMC6290517 DOI: 10.1186/s12903-018-0666-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/16/2018] [Indexed: 11/22/2022] Open
Abstract
Background We examined the validity of self-reported number of teeth in middle-aged adults by using representative cohort data to compare corresponding self-reported and clinical values. Methods This validity study is part of the representative 46-year-old follow-up of the Northern Finland Birth Cohort 1966 (NFBC1966) Study. Mailed questionnaires (n = 5950) requested information on self-reported number of teeth and background variables (education, tooth brushing and smoking), while clinical oral health examinations (n = 1891) assessed the number of teeth (the ‘gold standard’). The main analyses compared the self-reported and clinical values for the number of teeth in 1669 participants. Scatterplot and Bland-Altman plot served for visual analyses, and alternative correlation coefficients (Pearson, Spearman, intraclass) for numerical comparisons separately for men and women, with stratification according to background variables. Results The clinical assessment revealed that the mean value for the number of teeth was 27.46 (SD = 2.38), while the corresponding value based on self-reported information was 27.48 (SD = 2.78). According to the Bland-Altman plot, the mean difference between the clinical and self-reported values was − 0.02 (95% limits of agreement, LoA: − 3.37 to 3.32). The observed ranges of intraclass correlation coefficients (ICC) among men and women were 0.72 to 0.95 and 0.72 to 0.85, respectively, depending on the background variables. Conclusions Self-reported number of teeth in middle-aged Finnish adults agreed closely with the corresponding clinical measure.
Collapse
Affiliation(s)
- Toni Similä
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital, P.O. Box 5000, 90029, Oulu, Finland.
| | - Pentti Nieminen
- Medical Informatics and Data Analysis Research Group, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Jorma I Virtanen
- Medical Research Center Oulu, Oulu University Hospital, P.O. Box 5000, 90029, Oulu, Finland.,Institute of Dentistry, University of Turku, 20014, Turku, Finland
| |
Collapse
|
66
|
Mehr K, Olszanecka‐Glinianowicz M, Chudek J, Szybalska A, Mossakowska M, Zejda J, Wieczorowska‐Tobis K, Grodzicki T, Piotrowski P. Dental status in the Polish senior population and its correlates—Results of the national survey PolSenior. Gerodontology 2018; 35:398-406. [PMID: 30051927 DOI: 10.1111/ger.12364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 06/21/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Katarzyna Mehr
- Department of Oral RehabilitationPoznan University of Medical Sciences Poznan Poland
| | - Magdalena Olszanecka‐Glinianowicz
- Health Promotion and Obesity Management UnitDepartment of PathophysiologyMedical Faculty in KatowiceMedical University of Silesia in Katowice Katowice Poland
| | - Jerzy Chudek
- Department of Internal Medicine and Oncological ChemotherapyMedical Faculty in KatowiceMedical University of Silesia in Katowice Katowice Poland
| | | | | | - Jan Zejda
- Department of EpidemiologyMedical Faculty in KatowiceMedical University of Silesia in Katowice Katowice Poland
| | | | - Tomasz Grodzicki
- Department of Internal Medicine and GerontologyJagiellonian University Medical College Krakow Poland
| | - Paweł Piotrowski
- Department of Oral RehabilitationPoznan University of Medical Sciences Poznan Poland
| |
Collapse
|
67
|
Tooth loss is associated with accelerated cognitive decline and volumetric brain differences: a population-based study. Neurobiol Aging 2018; 67:23-30. [PMID: 29609079 DOI: 10.1016/j.neurobiolaging.2018.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 01/07/2023]
Abstract
Tooth loss has been related to cognitive impairment; however, its relation to structural brain differences in humans is unknown. Dementia-free participants (n = 2715) of age ≥60 years were followed up for up to 9 years. A subsample (n = 394) underwent magnetic resonance imaging at baseline. Information on tooth loss was collected at baseline, and cognitive function was assessed using the Mini-Mental State Examination at baseline and at follow-ups. Data were analyzed using linear mixed effects models and linear regression models. At baseline, 404 (14.9%) participants had partial tooth loss, and 206 (7.6%) had complete tooth loss. Tooth loss was significantly associated with a steeper cognitive decline (β: -0.18, 95% confidence interval [CI]: -0.24 to -0.11) and remained significant after adjusting for or stratifying by potential confounders. In cross-sectional analyses, persons with complete or partial tooth loss had significantly lower total brain volume (β: -28.89, 95% CI: -49.33 to -8.45) and gray matter volume (β: -22.60, 95% CI: -38.26 to -6.94). Thus, tooth loss may be a risk factor for accelerated cognitive aging.
Collapse
|
68
|
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.
Collapse
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
| |
Collapse
|
69
|
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.
Collapse
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
| |
Collapse
|
70
|
Åstrøm AN, Ekbäck G, Ordell S, Lie SA, Gulcan F. Dental hygienist attendance and its covariates in an ageing Swedish cohort. Eur J Oral Sci 2017; 125:487-494. [PMID: 29083073 DOI: 10.1111/eos.12385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Delegation of tasks between professional groups is important to make health-care services accessible and effective for ageing people. Focussing on a Swedish 1942 birth cohort and guided by Andersen's Behavioral Model, this study assessed dental hygienist attendance from age 50 to age 70 and identified covariates at the population-averaged and person-specific levels. In 1992, a census of 50-yr-old subjects was invited to participate in a questionnaire survey. Of the 6,346 respondents, 3,585 completed follow-ups in 1997, 2002, 2007, and 2012. Multiple logistic regression analysis was conducted using a marginal model and a random intercept model. Cochran's Q test revealed that significantly more respondents confirmed dental hygienist attendance in 2012 than in 1992 (57.2% in 2012 vs. 26.0% in 1992). Population-averaged ORs for dental hygienist attendance across time were 3.5 at age 70 yr compared with age 50 yr (baseline); 2.0 if being a regular rather than an irregular dental attendee; and 0.7 if being of non-native origin compared with native origin. The corresponding person-specific ORs were 8.9, 3.2, and 0.5. Consistent with Andersen's Behavioral Model, predisposing, enabling, and need-related factors were associated with dental hygienist attendance at population-averaged and person-specific levels. This has implications for promoting dental hygienist attendance among ageing people.
Collapse
Affiliation(s)
- Anne N Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Gunnar Ekbäck
- Örebro County Council, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Sven Ordell
- Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden
| | - Stein A Lie
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Ferda Gulcan
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| |
Collapse
|
71
|
Fantin R, Delpierre C, Kelly-Irving M, Barboza Solís C. Early socioeconomic conditions and severe tooth loss in middle-aged Costa Ricans. Community Dent Oral Epidemiol 2017; 46:178-184. [PMID: 29168897 DOI: 10.1111/cdoe.12351] [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] [Received: 08/29/2017] [Accepted: 10/19/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE A wide literature shows a strong social gradient in tooth loss according to income, education and occupation, in both developed and developing countries. It has been shown associations between tooth loss and parental education and occupation, independently of adult conditions. To explore the role of early socioeconomic circumstances on tooth loss, we used a lifecourse model. We analysed the direct and indirect links between early socioeconomic conditions and severe adult tooth loss. METHODS We used the Costa Rican Longevity and Healthy Aging Study 1945-1955 Retirement Cohort, a nationally representative longitudinal survey of Costa Rican residents born between 1945 and 1955. We used imputed data on 2796 individuals. Principal component analyses were run to integrate measures approaching the material circumstances during childhood and adulthood. We additionally examined the role of adult health behaviours and education level as potential mediators in the multivariable regression. RESULTS Early socioeconomic conditions were found strongly associated with severe tooth loss; 72.4% of the people who experienced the most deprived socioeconomic conditions during childhood (quartile 1) had severe tooth loss at the time of the interview; vs 43.3% in quartile 4 (most advantaged). This link diminished after adjustment for adult mediators. However, it remained a significant determinant of severe tooth loss in the final model. CONCLUSION The lifecourse model allowed to highlight that early socioeconomic conditions could have long-term consequences on severe tooth loss in middle ages via both direct and indirect mechanisms.
Collapse
Affiliation(s)
- Romain Fantin
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
| | - Cyrille Delpierre
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
| | | | | |
Collapse
|
72
|
Bando S, Tomata Y, Aida J, Sugiyama K, Sugawara Y, Tsuji I. Impact of oral self-care on incident functional disability in elderly Japanese: the Ohsaki Cohort 2006 study. BMJ Open 2017; 7:e017946. [PMID: 28928197 PMCID: PMC5623473 DOI: 10.1136/bmjopen-2017-017946] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To assess whether oral self-care (tooth brushing, regular dental visits and use of dentures) affects incident functional disability in elderly individuals with tooth loss. DESIGN A 5.7-year prospective cohort study. SETTING Ohsaki City, Japan. PARTICIPANTS 12 370 community-dwelling individuals aged 65 years and older. PRIMARY OUTCOME MEASURES Incident functional disability (new long-term care insurance certification). RESULTS The 5.7-year incidence rate of disability was 18.8%. In comparison with participants who had ≥20 teeth, the HRs (95% CIs) for incident functional disability among participants who had 10-19 and 0-9 teeth were 1.15 (1.01-1.30) and 1.20 (1.07-1.34), respectively (p trend<0.05). However, the corresponding values for those who brushed their teeth ≥2 times per day were not significantly higher in the '10-19 teeth' and '0-9 teeth' groups (HRs (95% CI) 1.05 (0.91-1.21) for participants with 10-19 teeth, and 1.09 (0.96-1.23) for participants with 0-9 teeth), although HRs for those who brushed their teeth <2 times per day were significantly higher (HRs (95% CI) 1.32 (1.12-1.55) for participants with 10-19 teeth, and 1.33 (1.17-1.51) for participants with 0-9 teeth). Such a negating association was not observed for other forms of oral self-care. CONCLUSIONS Tooth brushing may partially negate the increased risk of incident functional disability associated with having fewer remaining teeth.
Collapse
Affiliation(s)
- Shino Bando
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yasutake Tomata
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Kemmyo Sugiyama
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan
| |
Collapse
|
73
|
Cheema S, Maisonneuve P, Al-Thani MH, Al-Thani AAM, Abraham A, Al-Mannai GA, Al-Emadi AA, Al-Chetachi WF, Almalki BA, Hassan Khalifa SEA, Haj Bakri AO, Lowenfels A, Mamtani R. Oral health behavior and factors associated with poor oral status in Qatar: results from a national health survey. J Public Health Dent 2017; 77:308-316. [PMID: 28369902 DOI: 10.1111/jphd.12209] [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] [Received: 09/02/2016] [Accepted: 01/13/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Oral health is a crucial determinant of quality of life. We aimed to determine oral health condition and factors associated with poor oral status in the adult national population of Qatar. METHODS We used data from the World Health Organization supported STEPS (STEPwise approach to Surveillance) Survey conducted by the Supreme Council of Health, Qatar in 2012. A total of 2,496 Qataris (1,053 men, 1,443 women) answered the national survey. The Rao-Scott Chi-Square test was used to analyze oral health characteristics and multinomial logistic regression to assess risk factors. RESULTS The self-perceived oral status of approximately 40 percent of respondents was either "average" or "poor" rather than "good." Poor oral status was more often reported by women (OR = 1.93; 95%CI = 1.30-2.80), by older (OR = 3.38; 95%CI = 1.59-7.19) and less educated respondents (OR = 3.58; 95%CI = 2.15-5.96). Other risk groups included people with diabetes (OR = 1.87; 95%CI = 1.24-2.81), smokeless tobacco users (OR = 3.90; 95%CI = 1.75-8.68), or ever tobacco users (OR = 1.66; 95%CI = 1.03-2.67). Oral health status appeared to be independent of diet, BMI status, and history of hypertension. Difficulties and behaviors related to oral health were more frequently reported by women than by men. These included pain (P < 0.001), difficulty chewing (P < 0.001), and discomfort over appearance of teeth (P < 0.001). Participants used toothbrushes, toothpicks, dental floss, and miswak to maintain oral hygiene. CONCLUSION Our results provide evidence that oral health remains a public health concern in Qatar.
Collapse
Affiliation(s)
- Sohaila Cheema
- Department of Global and Public Health, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | | | | | - Amit Abraham
- Department of Global and Public Health, Weill Cornell Medicine - Qatar, Doha, Qatar
| | | | | | | | | | | | | | - Albert Lowenfels
- Department of Surgery, New York Medical College, Valhalla, NY, USA
| | - Ravinder Mamtani
- Department of Global and Public Health, Weill Cornell Medicine - Qatar, Doha, Qatar
| |
Collapse
|