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Su S, Lipsky MS, Licari FW, Hung M. Comparing Oral Health Behaviours of Men and Women in the United States. J Dent 2022; 122:104157. [DOI: 10.1016/j.jdent.2022.104157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 10/18/2022] Open
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Shaghaghian S, Saranjam E, Homayooni M. Oral health-related quality of life in patients infected with HIV, Iran: a cross-sectional study. BMC Oral Health 2021; 21:308. [PMID: 34134683 PMCID: PMC8207799 DOI: 10.1186/s12903-021-01660-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
Background The life expectancy of patients with Human Immunodeficiency Virus (HIV) has increased, but its oral manifestations can affect the Oral Health-Related Quality of Life (OHRQoL) of these patients. This study aimed to evaluate OHRQoL in HIV-infected patients and determine its related factors. Methods In this cross-sectional study, 250 HIV-infected patients were randomly selected from Shiraz Voluntary Counseling and Testing center in 2019. OHRQoL was measured using the revised Geriatric Oral Health Assessment Index for HIV patients. The associations between patients’ OHRQoL and demographic characteristics were examined. Results The mean score of the patients' OHRQoL was 24.55 ± 6.27. The lowest and highest scores belonged to the psychosocial and pain categories, respectively. In the univariate analysis, the OHRQoL was significantly associated with patients' age (p = 0.012), duration of the disease (p = 0.009), job (p = 0.006), edentulous status (p = 0.003), and wearing denture (p < 0.001). However, in the multiple linear regression analysis, a significant difference was found only between denture wearing and non-denture wearing patients (p ≤ 0.001). Conclusions The OHRQoL of HIV-infected patients was not optimal since most of the patients were worried about their oral and dental health problems. The OHRQoL was significantly better in denture-wearing patients. This finding highlights the impact of unmet dental needs on OHRQoL in HIV-infected patients. Therefore, dental services coverage for patients with HIV is essential, so that they can have timely access to oral health care. Furthermore, dentures should be considered as an unmet healthcare need among HIV patients in public health policies.
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Affiliation(s)
- S Shaghaghian
- Communicable Diseases Unit, Shohadae-Enghelab Health Center, Shiraz University of Medical Sciences, P. O. Box: 7164788363, Shiraz, Iran. .,Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - E Saranjam
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Homayooni
- Voluntary Counseling and Testing Center, Shiraz University of Medical Science, Shiraz, Iran
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Rocha Trindade RTVM, Marques JROF, Veiga MAGD, Marques DNDS, Mata ADSPD. HIV-1 impact on oral health-related quality of life: a cross-sectional study. AIDS Care 2020; 33:1321-1328. [PMID: 32715739 DOI: 10.1080/09540121.2020.1798866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This cross-sectional study compared the Oral-Health-Related Quality of Life (OHRQoL) in HIV negative patients (Group 1, n=129, mean age: 39.9 ± 15.6, 75 females) and HIV+ patients (Group 2, n=670, mean age: 43.2 ± 9.8, 246 females) from the same socio-economic environment using the OHIP-49 questionnaire. OHIP total score were determined by simple summing. A multiple linear regression model was carried out to predict OHIP scores in which HIV+ patients experienced a significantly (p<0.001) worst OHRQoL for total and every dimension. A general linear model was used for estimating the means in the two groups adjusted for covariates included in the previous model. Adjusted means for subscale and total OHIP scores were significantly higher for Group 2 (61.6 ± 6.26 vs. 119.8 ± 3.31) with a large effect size (0.94). HIV+ infection, decayed teeth, prosthodontic and surgical needs, care index, drug use, employment and age presented an independent effect on questionnaire scores. This study shows that HIV+ infection has an independent and negative impact on the OHRQoL while care index presents a positive impact. Additional factors like high decayed teeth, prosthodontic treatment needs and drug use are independently associated with total OHIP scores, presenting a negative effect on OHRQoL.
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Saadeh R, Bober-Moken I, Challa S. Relationship between General Health Behaviors and Oral Health Behaviors in 2015-2016 NHANES Adult Population. Eur J Dent 2019; 13:405-412. [PMID: 31618787 PMCID: PMC6890499 DOI: 10.1055/s-0039-1698364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to examine the relationship between general health behaviors and oral health behaviors in adults who participated in the interview component of the National Health and Nutrition Examination Survey (NHANES) of 2015 to 2016. MATERIALS AND METHODS This was a cross-sectional study design of a national data set that included 5,992 adults who represented a sample of civilian, noninstitutionalized US population. STATISTICAL ANALYSIS Chi-squared test of independence was used to describe the relationship of demographic information with oral health behaviors of participants. Multivariate logistic regression was used to determine the association between general and oral health behaviors. RESULTS More than half (53.6%) of the participants had seen a dentist in the past 12 months and the main reason for that visit was for a regular checkup, cleaning, or examination. More than one-quarter (28.7%) reported visiting a dentist because something was hurting or bothering them. Most respondents (63.4%) reported being hardly ever or never having been embarrassed by their mouth condition. Age at one's first sexual encounter, having a new sexual partner, mental health counseling, moderate- intensity sports, and computer use were significantly associated with positive oral health behaviors. CONCLUSIONS For maximum effectiveness, health promotion efforts should target risk behaviors common to both oral and general health.
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Affiliation(s)
- Rami Saadeh
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas, United States
| | - Irene Bober-Moken
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas, United States
| | - Suman Challa
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas, United States
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Chatzopoulos GS, Cisneros A, Sanchez M, Wolff LF. Systemic medical conditions and periodontal status in older individuals. SPECIAL CARE IN DENTISTRY 2018; 38:373-381. [DOI: 10.1111/scd.12319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Georgios S. Chatzopoulos
- Division of Periodontology; Department of Developmental and Surgical Sciences; School of Dentistry; University of Minnesota; Minneapolis MN USA
| | - Alejandro Cisneros
- Division of Periodontology; Department of Developmental and Surgical Sciences; School of Dentistry; University of Minnesota; Minneapolis MN USA
| | - Miguel Sanchez
- Division of Periodontology; Department of Developmental and Surgical Sciences; School of Dentistry; University of Minnesota; Minneapolis MN USA
| | - Larry F. Wolff
- Division of Periodontology; Department of Developmental and Surgical Sciences; School of Dentistry; University of Minnesota; Minneapolis MN USA
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Mohamed N, Saddki N, Yusoff A, Mat Jelani A. Association among oral symptoms, oral health-related quality of life, and health-related quality of life in a sample of adults living with HIV/AIDS in Malaysia. BMC Oral Health 2017; 17:119. [PMID: 28830386 PMCID: PMC5568203 DOI: 10.1186/s12903-017-0409-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 08/08/2017] [Indexed: 12/22/2022] Open
Abstract
Background Health-related quality of life (HRQOL) is a multidimensional construct that refers to an individual’s self-perceived well-being. This study used the revised Wilson and Cleary HRQOL model to investigate the associations among oral symptoms, oral health-related quality of life (OHRQOL), and HRQOL of people living with HIV/AIDS (PLWHA) in Malaysia. Methods A total of 121 PLWHA receiving medical care in Kota Bharu (Kelantan, Malaysia) participated in this cross-sectional study. The Malay version of the short Oral Health Impact Profile (S-OHIP(M)) and the Malay version of the 36-item Medical Outcome Study Short Form (SF-36) were used to assess OHRQOL and HRQOL, respectively. A higher S-OHIP(M) score indicates greater oral impact and worse OHRQOL; a higher SF-36 score indicates better HRQOL. An additional structured self-administered questionnaire was used to obtain other variables of interest from the participants. Results Most participants had at least one oral symptom (69.4%), and the most common oral symptom was a cavitated tooth (55.4%). The prevalence of oral impacts was 33.9%, and the mean S-OHIP(M) score was 8.8 (SD = 7.92). The mean S-OHIP(M) score was significantly higher in participants who had toothaches, cavitated teeth, gum abscesses, and bad breath. In addition, participants with lower S-OHIP(M) scores had significantly higher scores in all SF-36 domains. Conclusions Our study provides evidence for an association among oral symptoms, OHRQOL, and HRQOL in PLWHA from Malaysia. In particular, the presence of oral symptoms was significantly associated with more severe oral impacts and poorer OHRQOL. The presence of less severe oral impacts was associated with a better HRQOL. Electronic supplementary material The online version of this article (doi:10.1186/s12903-017-0409-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nurulasmak Mohamed
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Norkhafizah Saddki
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Azizah Yusoff
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Anilawati Mat Jelani
- Department of Medicine, Hospital Raja Perempuan Zainab II, 15586, Kota Bharu, Kelantan, Malaysia
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Rahmati-Najarkolaei F, Rahnama P, Gholami Fesharaki M, Behnood V. Predictors of Oral Health Behaviors in Female Students: An Application of the Health Belief Model. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017; 18:e24747. [PMID: 28191334 PMCID: PMC5292392 DOI: 10.5812/ircmj.24747] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 08/19/2015] [Accepted: 09/07/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Oral and dental health diseases can affect the general health of students. OBJECTIVES The aim of this study was to identify the predictors of oral and dental health behavior using the health belief model (HBM) in female students in Teheran, Iran. PATIENTS AND METHODS This was a cross-sectional study framed by the HBM, including 400 female students living in district 5 of Tehran, Iran. The sampling technique used in this study was multi-stage stratified random sampling. The data on the HBM constructs (perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy) and demographic characteristics were collected using a self-administered questionnaire. Descriptive statistics, bivariate correlations, and linear regression were performed to analyze the data, using the SPSS software, version 18. RESULTS The results showed that there were relationships between the knowledge, perceived barriers, cues to action, and mother's education with oral health behaviors. A multivariate hierarchical regression analysis was conducted with the barrier entered at step one, knowledge at step two, and cues to action at step three. Finally, the three variables accounted for 17% of the total variance in the oral and dental health behavior. CONCLUSIONS The current study provided evidence for the utility of the belief-based model in the prediction of oral health behaviors. It could be suggested that oral health behavior can be promoted by reducing the perceived barriers and enhancing the students' knowledge of oral and dental hygiene.
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Affiliation(s)
| | - Parvin Rahnama
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahed University, Tehran, IR Iran
| | | | - Vahid Behnood
- Young Researchers and Elite Club, Karaj Branch, Islamic Azad University, Karaj, IR Iran
- Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Vahid Behnood, Baqiyatallah University of Medical Sciences, P. O. Box: 193955487, Tehran, IR Iran. Tel: +98-2182482469, Fax: +98-2188600062, E-mail:
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Abstract
This paper, by means of a quality framework, reviews health services research in relation to people with HIV infection. The relevance of oral health care services to people’s needs is considered in terms of the goal of health services to reduce the burden of disease on the everyday life of the population. Dental services may therefore have a role in primary prevention in the HIV epidemic, passing on information about HIV and promoting health through the early diagnosis and treatment of oral disease. Effectiveness research of oral health care in HIV assesses the usefulness of oral diagnosis, whether care is safe, and whether treatment is clinically effective. Few data are available on the efficiency of services. People with HIV still have problems accessing dental care, due to the volume of care available in relation to their need and acceptability of care. Access problems in the US are compounded by social inequality. Health services research data are particularly sparse in resource-poor countries, and there is a need to translate the available information into treatment guidelines appropriate to these settings. The research community and funding agencies should place greater emphasis on the quality of oral health services for people with HIV.
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Affiliation(s)
- P G Robinson
- Dept. of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, UK.
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Hodgson TA, Naidoo S, Chidzonga M, Ramos-Gomez F, Shiboski C. (A1) Identification of Oral Health Care Needs in Children and Adults, Management of Oral Diseases. Adv Dent Res 2016; 19:106-17. [PMID: 16672560 DOI: 10.1177/154407370601900121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The workshop considered five questions reviewing the identification of international oral health care needs of children and adults, and the management of oral diseases in resource-poor countries: (1) What is the role of the dental profession in the management of the HIV-infected individual? (2) Identifying health care needs-What are the epidemiology and disparities of HIV-associated oral lesions in children from different continents? (3) How effective is HIV treatment in controlling oral diseases? (4) Could we develop basic inexpensive oral and dental care protocols for economically deprived HIV-infected patients? and (5) What is the best method of arranging resources to meet the oral health care needs of people with HIV disease? The consensus of the workshop participants was that there is a need to re-target research efforts to non-established market economy countries and prioritize research in these regions to children with HIV disease. It will be important to assess commonalities and variations in oral health needs across geographical and cultural boundaries, and research efforts should be centralized in resource-poor countries to support multi-center longitudinal standardized studies. It is essential that oral health research be integrated into other health care research programs, to make these research priorities and public health initiatives feasible.
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Affiliation(s)
- T A Hodgson
- Oral Medicine, Division of Maxillofacial Diagnostic, Medical and Surgical Sciences, UCL Eastman Dental Institute and UCLHT Eastman Dental Hospital, London, UK.
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Hodgson TA, Greenspan D, Greenspan JS. Oral Lesions of HIV Disease and HAART in Industrialized Countries. Adv Dent Res 2016; 19:57-62. [PMID: 16672551 DOI: 10.1177/154407370601900112] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The epidemiology of HIV-related oral disease in industrialized nations has evolved following the initial manifestations described in 1982. Studies from both the Americas and Europe report a decreased frequency of HIV-related oral manifestations of 10–50% following the introduction of HAART (highly active antiretroviral therapy). Evidence suggests that HAART plays an important role in controlling the occurrence of oral candidosis. The effect of HAART on reducing the incidence of oral lesions, other than oral candidosis, does not appear as significant, possibly as a result of low lesion prevalence in industrialized countries. In contrast to other oral manifestations of HIV, an increased prevalence of oral warts in patients on HAART has been reported from the USA and the UK. HIV-related salivary gland disease may show a trend of rising prevalence in the USA and Europe. The re-emergence of HIV-related oral disease may be indicative of failing therapy. A range of orofacial iatrogenic consequences of HAART has been reported, and it is often difficult to distinguish between true HIV-related oral disease manifestations and the adverse effects of HAART. A possible association between an increased risk of oral squamous cell carcinoma and HIV infection has been suggested by at least three epidemiological studies, with reference to the lip and tongue. These substantial and intensive research efforts directed toward enhancing knowledge regarding the orofacial consequences of HIV infection in the industrialized nations require dissemination in the wider health care environment.
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Affiliation(s)
- T A Hodgson
- Unit of Oral Medicine, UCL Eastman Dental Institute and UCLHT Eastman Dental Hospital, 256 Gray's Inn Road, London, WC1X 8LD, UK.
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Yang AJ, Gromoske AN, Olson MA, Chaffin JG. Single and Cumulative Relations of Social Risk Factors with Children’s Dental Health and Care-Utilization Within Regions of the United States. Matern Child Health J 2015; 20:495-506. [DOI: 10.1007/s10995-015-1847-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kumar V, Patil K, Munoli K. Knowledge and attitude toward human immunodeficiency virus/acquired immuno deficiency syndrome among dental and medical undergraduate students. J Pharm Bioallied Sci 2015; 7:S666-71. [PMID: 26538940 PMCID: PMC4606682 DOI: 10.4103/0975-7406.163598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background and Objectives: Human immunodeficiency virus (HIV) is a major public health challenge. Unjustified calls for the isolation of patients with HIV infection might further constrain the potential for expansion of clinical services to deal with a greater number of such patients. This infectious illness can evoke irrational emotions and fears in health care providers. Keeping this in view, a study was conducted to assess the knowledge and attitudes related to HIV/acquired immune deficiency syndrome (AIDS) among dental and medical students. Methodology: Descriptive cross-sectional survey of the entire dental and medical undergraduate students from two colleges was carried out using a pretested, self-administered questionnaire. Descriptive statistics such as percentage was used to present the data. Results: Ninety-eight percentage medical and dental undergraduate graduate students knew about HIV transmission in the hospital. Journals and internet were the leading source of information among both medical and dental undergraduates. The majority of respondents discussed HIV-related issues with their classmates. Surprisingly, 38% medical and 52% dental undergraduates think that HIV patient should be quarantined (isolation) to prevent the spread of infection. 68% medical and 60% dental undergraduates are willing to rendering dental/medical care to HIV-infected patients. Relatively large proportion (98%) of participants was willing to participate for HIV prevention program. Conclusion: The knowledge of medical and dental students is adequate, but the attitude needs improvement. Dental and medical students constitute a useful public health education resource. Comprehensive training, continuing education, and motivation will improve their knowledge and attitude, which enable them to provide better care to HIV patients.
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Affiliation(s)
- Vinod Kumar
- Department of Pedodontics, Navodaya Dental College and Hospital, Raichur, Karnataka, India
| | - Kavitha Patil
- Department of Ophthalmology, Raichur Institute of Medical Sciences, Raichur, Karnataka, India
| | - Karishma Munoli
- Department of Ophthalmology, Raichur Institute of Medical Sciences, Raichur, Karnataka, India
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Parish C, Siegel K, Pereyra M, Liguori T, Metsch L. Barriers and facilitators to dental care among HIV-Infected adults. SPECIAL CARE IN DENTISTRY 2015; 35:294-302. [PMID: 26336866 DOI: 10.1111/scd.12132] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Oral health problems can significantly compromise HIV-infected individuals' general health and well-being, yet many of them experience an unmet need for oral care. The barriers and facilitators of obtaining dental care in a sample of HIV-infected adults, all of whom were eligible for Ryan White Part A funding for their treatment, were investigated through qualitative interviews with HIV-positive individuals who had not received dental services in the prior 12 months (n = 44). Identified barriers were as follows: (1) dental anxiety and fear, (2) cumbersome administrative procedures, (3) long waits at the dental office, (4) problem focused care-seeking behavior, (5) transportation difficulties, (6) dentists' reluctance to treat people like them, and (7) psychological issues. Identified facilitating factors were as follows: (1) coverage for dental care, (2) being treated with respect and acceptance, and (3) having an assigned case manager or social worker. Many of the barriers uncovered in this qualitative study can be addressed and overcome by case management services, but other approaches are needed to address the additional psychological and stigma-related factors that are impeding access to oral healthcare in this population.
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Affiliation(s)
- Carrigan Parish
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Karolynn Siegel
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Margaret Pereyra
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.,Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Coral Gables, Miami
| | - Terri Liguori
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.,Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Coral Gables, Miami
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.,Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Coral Gables, Miami
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Saltnes SS, Storhaug K, Borge CR, Enmarker I, Willumsen T. Oral health-related quality-of-life and mental health in individuals with chronic obstructive pulmonary disease (COPD). Acta Odontol Scand 2015; 73:14-20. [PMID: 25373517 DOI: 10.3109/00016357.2014.935952] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate the association between oral health, oral health-related quality-of-life (OHRQoL) and mental health-related quality-of-life (QoL) in persons with chronic obstructive pulmonary disease (COPD) with respect to demographic, social and clinical oral health variables. MATERIALS AND METHODS One hundred participants were included in a cross-sectional study at a hospital in Norway. Data were collected via the Oral Health Impact Profile (OHIP-14), the SF-36v2 Health Survey Mental Component (MCS), other self-reported factors, an interview and a clinical examination. Multiple regression analyses were performed. The Regional Committee for Medical and Health Research Ethics approved the study. RESULTS. Higher education (p < 0.01), being a smoker (p < 0.05) and experience of oral health problems (p < 0.001) were significantly associated with oral health-related quality-of-life (OHRQoL). Furthermore, those with feelings of dry mouth (p < 0.05) and impaired OHRQoL (p < 0.001) experienced more mental health problems. CONCLUSIONS This study demonstrated that oral health and personal factors are related to mental health-related QoL and OHRQoL in individuals with COPD. This finding shows the need to focus on oral care.
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Functional and psychosocial impact of oral disorders and quality of life of people living with HIV/AIDS. Qual Life Res 2014; 24:503-11. [PMID: 25120016 DOI: 10.1007/s11136-014-0778-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 01/03/2023]
Abstract
PURPOSE This study compared the Quality of Life (QOL) according to the presence of functional and psychosocial impact of oral disorders and evaluated the convergent validity between the dimensions of the WHOQOL and the OHIP-14 scores among people living with HIV. METHODS This was a cross-sectional study with patients enrolled in reference centres of a midsize Brazilian city. Interviews were conducted when the participants arrived at the centres seeking services for medical appointments and collecting medicines. The OHIP-14 was used to evaluate the functional and psychosocial impact of oral disorders. QOL was assessed using the general issues and six domains of the WHOQOL-HIV BREF. The Chi square test, Mann-Whitney test, and Spearman correlation analysis were used for analysis. RESULTS The sample comprised 422 people living with HIV/AIDS (response rate: 81.2%). The prevalence of functional and psychosocial impact of oral disorders was 34.0%. The prevalence of very poor/poor QOL and those who were very dissatisfied/dissatisfied with their health was higher among those with functional and psychosocial impact of oral disorders. There was a negative correlation between the scores on the domains of QOL and the severity of the impact of the oral disorders (r-value ranged from -0.107 to -0.30). CONCLUSION Individuals with functional and psychosocial impact of oral disorders were found to more frequently rate their QOL as poor/very poor, and were more often dissatisfied with health. The correlation between the scores of QOL and functional and psychosocial impact of oral disorders scores was weak, indicating that they represent different constructs. The measures of functional and psychosocial impact of oral disorders should be complemented by general measures of QOL.
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Lemay CA, Cashman SB, McDonald A, Graves JR. A new approach to ensuring oral health care for people living with HIV/AIDS: the dental case manager. Prev Chronic Dis 2013; 9:E158. [PMID: 23098645 PMCID: PMC3499982 DOI: 10.5888/pcd9.110297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction The American Dental Association has identified several barriers to adequate dental care for vulnerable populations, including appropriate case management. The objective of this study was to examine the perceptions, attitudes, and beliefs of dental patients living with HIV/AIDS on the role and value of the dental case manager (DCM) and the effect of DCM services on their oral or overall health. Methods We used a qualitative descriptive study design and focus groups. Twenty-five people who had received DCM services on Cape Cod, Massachusetts, attended 1 of 5 focus groups in 2009 and 2010. Digital recordings of the groups were transcribed verbatim. Textual data were categorized using directed qualitative content analysis techniques. We identified major themes and representative quotes. Results The following themes emerged from discussions on the DCM’s role: being available, knowledgeable about clients and insurance, and empathetic; increasing access; and providing comfort. Most participants credited their oral and overall health improvements to the DCM. All participants believed that the DCM was a valuable addition to the clinic and noted that other at-risk populations, including the elderly and developmentally disabled, likely would benefit from working with a DCM. Conclusion The addition of a DCM facilitated access to dental care among this sample of people living with HIV/AIDS, providing them with an advocate and resulting in self-reported improvements to oral and overall health.
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Chi DL, Tucker-Seeley R. Gender-stratified models to examine the relationship between financial hardship and self-reported oral health for older US men and women. Am J Public Health 2013; 103:1507-15. [PMID: 23327271 DOI: 10.2105/ajph.2012.301145] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES We evaluated the relationship between financial hardship and self-reported oral health for older men and women. METHODS We focused on adults in the 2008 Health and Retirement Study (n = 1,359). The predictor variables were 4 financial hardship indicators. We used Poisson regression models to estimate the prevalence ratio of poor self-reported oral health. RESULTS In the non-gender-stratified model, number of financial hardships was not significantly associated with self-reported oral health. Food insecurity was associated with a 12% greater prevalence of poor self-reported oral health (95% confidence interval [CI] = 1.04, 1.21). In the gender-stratified models, women with 3 or more financial hardships had a 24% greater prevalence of poor self-reported oral health than women with zero (95% CI = 1.09, 1.40). Number of hardships was not associated with self-reported oral health for men. For men, skipping medications was associated with 50% lower prevalence of poor self-reported oral health (95% CI = 0.32, 0.76). CONCLUSIONS Number of financial hardships was differentially associated with self-reported oral health for older men and women. Most financial hardship indicators affected both genders similarly. Future interventions to improve vulnerable older adults' oral health should account for gender-based heterogeneity in financial hardship experiences.
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Affiliation(s)
- Donald L Chi
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, WA 98195-7475, USA.
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Rajabiun S, Fox JE, McCluskey A, Guevara E, Verdecias N, Jeanty Y, DeMayo M, Mofidi M. Patient perspectives on improving oral health-care practices among people living with HIV/AIDS. Public Health Rep 2012; 127 Suppl 2:73-81. [PMID: 22547879 DOI: 10.1177/00333549121270s210] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This qualitative study explored the impact on oral health-care knowledge, attitudes, and practices among 39 people living with HIV/AIDS (PLWHA) participating in a national initiative aimed at increasing access to oral health care. Personal values and childhood dental experiences, beliefs about the importance of oral health in relation to HIV health, and concerns for appearance and self-esteem were found to be determinants of oral health knowledge and practice. Program participation resulted in better hygiene practices, improved self-esteem and appearance, relief of pain, and better physical and emotional health. In-depth exploration of the causes for these changes revealed a desire to continue with dental care due to the dental staff and environmental setting, and a desire to maintain overall HIV health, including oral health. Our findings emphasize the importance of addressing both personal values and contextual factors in providing oral health-care services to PLWHA.
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Affiliation(s)
- Serena Rajabiun
- Boston University School of Public Health, Health & Disability Working Group, 715 Albany St., Boston, MA 02118, USA.
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Maida CA, Marcus M, Spolsky VW, Wang Y, Liu H. Socio-behavioral predictors of self-reported oral health-related quality of life. Qual Life Res 2012; 22:559-66. [DOI: 10.1007/s11136-012-0173-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2012] [Indexed: 10/28/2022]
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Rungsiyanont S, Vacharotayangul P, Lam-Ubol A, Ananworanich J, Phanuphak P, Phanuphak N. Perceived dental needs and attitudes toward dental treatments in HIV-infected Thais. AIDS Care 2012; 24:1584-90. [PMID: 22428899 DOI: 10.1080/09540121.2012.663884] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Despite the advancement in highly active antiretroviral therapy and improved health status of HIV-infected individuals, dental problems are still affecting their life and well-beings. We aimed to establish the prevalence of oral and dental complaints among HIV-infected patients, the prevalence of delayed access to dental service, and factors related with delayed access to dental service. A cross-sectional study using self-report questionnaire completed by the HIV-positive subjects was conducted at the largest HIV research clinic in Thailand during 2009-2010. Of all 299 subjects (28.6% males, 71% females, and 0.4% sex change from male to female: ages ranged from 22 to 59 years [mean 36.7±5.53)]), 84.3% reported of having past or present illnesses or problems related to the dental or oral conditions. The most reported problems were dental hypersensitivity (93.3%), bleeding from the gum (92.1%), and having dental caries (65.9%). Two-hundred and forty-two subjects (80.9%) would not disclose their HIV status when seeing a dentist. The most cited reasons of such behavior were their personal right whether to reveal or not, and being afraid of not receiving dental treatment from the dentists or staffs (51.7 and 40.9%, respectively). It is important to note that HIV-subjects admitted to having fear of being discriminated by the dental staffs even if they trusted their dentists as having high morality. In conclusion, our HIV-subjects had good basic knowledge of oral health with regard to HIV infection, experienced common dental problems, and wished to have accesses to HIV-dental specialist services, if possible.
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Affiliation(s)
- Sorasun Rungsiyanont
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Wattana, Bangkok, Thailand.
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Nabbanja J, Gitta S, Peterson S, Rwenyonyi CM. Orofacial manifestations in HIV positive children attending Mildmay Clinic in Uganda. Odontology 2012; 101:116-20. [DOI: 10.1007/s10266-012-0060-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 01/30/2012] [Indexed: 10/28/2022]
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Pakpour AH, Yekaninejad MS, Zarei F, Hashemi F, Steele MM, Varni JW. The PedsQL™ Oral Health Scale in Iranian children: reliability and validity. Int J Paediatr Dent 2011; 21:342-52. [PMID: 21489002 DOI: 10.1111/j.1365-263x.2011.01130.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The primary objective of the study was to translate and evaluate the psychometric properties of the Pediatric Quality of Life Inventory™ (PedsQL™) Oral Health Scale in over 1000 Iranian children. METHODS A standard forward and backward translation procedure was used to convert the US English dialect version of the PedsQL™ Oral Health Scale into the Iranian language (Persian). The Iranian version of the PedsQL™ Oral Health Scale, in combination with the PedsQL™ 4.0 Generic Core Scales, was then subsequently administered to 1053 Iranian children and 1026 parents. The reliability of the PedsQL™ Oral Health Scale was evaluated using internal consistency and test-retest methods. Known-groups discriminant validity, exploratory factor analysis (EFA) of the Oral Health and the four Generic Core Scales combined, and confirmatory factor analysis (CFA) of the Oral Health Scale alone were conducted. The Benjamini-Hochberg procedure was used to correct P-values for multiple comparisons. RESULTS Good to excellent internal consistency and test-retest reliabilities were demonstrated. The PedsQL™ Oral Health Scale demonstrated discriminant validity for subgroups of children across different decayed, missing and filled teeth (DMFT) index categories and gender. The EFA supported the a priori factor model of the combined five scales. The CFA analysis confirmed the unidimensional factor structure of the Oral Health Scale. CONCLUSIONS The PedsQL™ Oral Health Scale demonstrated excellent psychometric properties in combination with the PedsQL™ 4.0 Generic Core Scales. These five scales combined can be utilized to assess the multidimensional oral-health-related quality of life of Iranian children.
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Affiliation(s)
- Amir H Pakpour
- Department of Public Health, Qazvin University of Medical Sciences, Iran
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Tomar SL, Pereyra M, Metsch LR. Oral health-related quality of life among low-income adults living with HIV. J Public Health Dent 2011. [DOI: 10.1111/j.1752-7325.2011.00260.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Umadevi KR, Blignaut E, Glick M, Nasir E, Yengopal V, Younai F, Robinson PG. Social aspects of HIV and their relationship to craniofacial problems: workshop 4C. Adv Dent Res 2011; 23:117-21. [PMID: 21441492 DOI: 10.1177/0022034511400223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The oral research community needs an understanding of the social causes, consequences, and costs of disease in relation to oral health. This workshop concluded that HIV infection constitutes a special dental need requiring specific arrangements to facilitate oral care for infected persons. Oral manifestations of HIV infection affect everyday life, but more evidence is needed on the effects of interventions to alleviate these impacts. Other oral health habits add to the burden of HIV/AIDS-associated oral diseases and compete with them for resources. These problems are most acute where the prevalence of HIV is high and resources are scarce. Effective health promotion is therefore important in these areas. Without data on the utility of oral health care in developing countries, practical approaches are guided by societal and multidisciplinary principles. There are also important ethical considerations.
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Affiliation(s)
- K R Umadevi
- Oral Pathology, Ragas Dental College, Chennai, India
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Harada E, Moriya S, Murata A, Muramatsu M, Kashiwazaki H, Kobayashi K, Notani K, Inoue N. Relationship between subjective assessment of oral health and medical expenses in community-dwelling elderly persons. Gerodontology 2011; 29:e246-52. [PMID: 21306431 PMCID: PMC3427878 DOI: 10.1111/j.1741-2358.2011.00459.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives The increasing medical expenses of elderly persons in Japan’s rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. Materials and Methods Participants were 259 elderly subjects (range: 65–84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses (‘Good’, ‘Not good’ and ‘Not at all good’) on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman’s rank method, the Mann–Whitney U-test and the Kruskal–Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. Results A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. Conclusion The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors.
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Affiliation(s)
- Eriko Harada
- Division of Oral Health Science, Department of Geriatric Dentistry, Graduate School of Dental Medicine, Hokkaido University, Kita-ku, Sapporo, Japan.
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Campos JADB, Loffredo LDCM. [Reproducibility of a scale for oral health among children and adolescents HIV+/AIDS]. CIENCIA & SAUDE COLETIVA 2010; 15:2181-7. [PMID: 20694340 DOI: 10.1590/s1413-81232010000400032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2007] [Accepted: 10/30/2008] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate the intraobserver reproducibility of a Portuguese version scale used to evaluate aspects of oral health among children and adolescents HIV+. The scale was proposed by Balbo and a questionnaire was applied in two occasions, within a one week period, to 27 children and adolescents. The reproducibility was estimated by kappa statistics by point (k). With relation to the mother, it was reached a maximum of agreement for items related to the importance of maintaining the oral health, diary tooth brushing and the individual utilization of dental brush; breath and esthetics presented a good agreement. Regarding the children, a regular agreement was observed on the dental floss use. In contrast, the respondents had difficulties in reporting the name and address of the professionals that gave guidance in prevention activities to them. The k-values for perception, care and promotion were 0.48, 0.21 and 0.64 respectively, pointing to reproducibility levels classified as regular, fair and good. Given the different levels of reproducibility offered by the dental scale for HIV+ oral health, we suggest that it could be modified, especially in the domain of care.
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Affiliation(s)
- Juliana Alvares Duarte Bonini Campos
- Departamento de Odontologia Social, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista Júlio de Mesquita Filho, Araraquara, SP, 14801-385, Brazil.
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Nittayananta W, Talungchit S, Jaruratanasirikul S, Silpapojakul K, Chayakul P, Nilmanat A, Pruphetkaew N. Effects of long-term use of HAART on oral health status of HIV-infected subjects. J Oral Pathol Med 2010; 39:397-406. [PMID: 20202089 DOI: 10.1111/j.1600-0714.2009.00875.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of this study was to determine the effects of long-term use of highly active antiretroviral therapy (HAART) on oral health status of HIV-infected subjects. METHODS Oral examination and measurement of saliva flow rate of both unstimulated and wax-stimulated whole saliva were performed in HIV-infected subjects with and without HAART, and in non-HIV individuals. The following data were recorded; duration and risk of HIV infection, type and duration of HAART, CD4 cell count, viral load, presence of orofacial pain, oral dryness, oral burning sensation, oral lesions, cervical caries, and periodontal pocket. Multiple logistic regression analysis was performed to determine the effects of long-term use of HAART on oral health status of HIV-infected subjects. RESULTS One hundred and fifty-seven HIV-infected subjects - 99 on HAART (age range 23-57 years, mean 39 years) and 58 not on HAART (age range 20-59 years, mean 34 years) - and 50 non-HIV controls (age range 19-59 years, mean 36 years) were enrolled. The most common HAART regimen was 2 NRTI + 2 NNRTI. HIV-infected subjects without HAART showed greater risks of having orofacial pain, oral dryness, oral lesions, and periodontal pockets than those with short-term HAART (P < 0.01). The subjects with long-term HAART were found to have a greater risk of having oral lesions than those with short-term HAART (P < 0.05). The unstimulated and stimulated salivary flow rates of the subjects with HAART were significantly lower than in those without HAART (P < 0.05). CONCLUSION We conclude that long-term HAART has adverse effects on oral health status of HIV-infected subjects.
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Affiliation(s)
- Wipawee Nittayananta
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
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Steele MM, Steele RG, Varni JW. Reliability and Validity of the PedsQL™ Oral Health Scale: Measuring the Relationship Between Child Oral Health and Health-Related Quality of Life. CHILDRENS HEALTH CARE 2009. [DOI: 10.1080/02739610903038818] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Leao JC, Ribeiro CMB, Carvalho AAT, Frezzini C, Porter S. Oral complications of HIV disease. Clinics (Sao Paulo) 2009; 64:459-70. [PMID: 19488613 PMCID: PMC2694251 DOI: 10.1590/s1807-59322009000500014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 02/18/2009] [Indexed: 12/13/2022] Open
Abstract
Oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). A better understanding of the oral manifestations of AIDS in both adults and children has implications for all health care professionals. The knowledge of such alterations would allow for early recognition of HIV-infected patients. The present paper reviews epidemiology, relevant aspects of HIV infection related to the mouth in both adults and children, as well as current trends in antiretroviral therapy and its connection with orofacial manifestations related to AIDS.
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Affiliation(s)
- Jair C Leao
- Departamento de Clinica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, PE, Brazil.
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Mulligan R, Seirawan H, Alves ME, Navazesh M, Phelan JA, Greenspan D, Greenspan JS, Mack WJ. Oral health-related quality of life among HIV-infected and at-risk women. Community Dent Oral Epidemiol 2008; 36:549-57. [PMID: 18782330 DOI: 10.1111/j.1600-0528.2008.00443.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Objective measures of dental diseases reflect only their clinical end-point. There is a need to use multidimensional measures of diseases that consider their psychosocial aspects and functional impact. The aim of this study is to compare the oral health-related quality of life (OHRQOL) between a group of HIV-infected women and a similar group of at-risk HIV-uninfected women, and to investigate the role of potential confounding clinical oral health and behavioral factors. METHODS Our sample included HIV-infected women (87%) and women at risk for HIV infection (13%) followed up for 5.5 years. OHRQOL was measured using the short version of the Oral Health Impact Profile (OHIP-14), which is a validated and reliable instrument. RESULTS HIV-infected women averaged 10% poorer OHRQOL than HIV-uninfected women; this difference was not apparent after adjusting for the number of study visits attended and significant behavioral and clinical oral health factors. The OHRQOL was inversely related to dental and periodontal diseases and to smoking and freebase cocaine use; these relationships were not confounded by HIV status. CONCLUSIONS The study identified specific clinical and behavioral factors where dental professionals can intervene to possibly improve the OHRQOL of HIV-infected or at-risk HIV-uninfected women.
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Affiliation(s)
- R Mulligan
- School of Dentistry, University of Southern California, Los Angeles, CA, USA.
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Hegarty AM, Chaudhry SI, Hodgson TA. Oral healthcare for HIV-infected patients: an international perspective. Expert Opin Pharmacother 2008; 9:387-404. [DOI: 10.1517/14656566.9.3.387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Tirwomwe JF, Rwenyonyi CM, Muwazi LM, Besigye B, Mboli F. Oral manifestations of HIV/AIDS in clients attending TASO clinics in Uganda. Clin Oral Investig 2007; 11:289-92. [PMID: 17476537 DOI: 10.1007/s00784-007-0118-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Accepted: 04/18/2007] [Indexed: 10/23/2022]
Abstract
The objective of the study is to establish the prevalence of oral manifestations and their influence on oral functions. A total of 514 subjects aged 18 to 58 years (mean 42 years) were randomly recruited from five The AIDS Support Organization (TASO) clinics in Uganda. They were clinically examined for oral lesions under field conditions by four trained dentists based on World Health Organization criteria. Women constituted 74.5% of the study population. Oral manifestations were recorded in 72% of the subjects, out of which 70% had candidiasis of pseudomembranous, erythematous, and angular cheilitis variants. Non-Hodgkin's lymphoma, atypical ulcers, necrotizing periodontitis, and hairy leucoplakia were least frequently observed in the subjects. Of those who had oral lesions (n = 370), 68.4% had some form of discomfort in the mouth. Tooth brushing, chewing, and swallowing were frequently associated with discomfort. Reported forms of discomfort were dry mouth, increased salivation, and burning sensation especially on taking salty and spicy foods or acidic drinks. Only 8.5% (n = 44) of the subjects were taking medications specifically for oral lesions, which included antifungal, antiviral, and antibacterial agents. None of the subjects were on antiretroviral therapy. Oral lesions associated with human immunodeficiency virus/acquired immunodeficiency syndrome in TASO clients is a major public health problem requiring education in recognition and appropriate management.
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Affiliation(s)
- J F Tirwomwe
- Department of Dentistry, School of Health Sciences, Kampala International University, Kampala, Uganda
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Lorenz KA, Cunningham WE, Spritzer KL, Hays RD. Changes in symptoms and health-related quality of life in a nationally representative sample of adults in treatment for HIV. Qual Life Res 2006; 15:951-8. [PMID: 16900276 DOI: 10.1007/s11136-005-6010-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2005] [Indexed: 12/20/2022]
Abstract
Patient-centered measures of functioning and well-being are needed to monitor and improve health for HIV-infected persons. We estimated the associations between HRQOL and symptoms over time in HIV-infected persons, adjusting for demographic and clinical characteristics using a longitudinal study of a nationally representative cohort of 2267 patients in care for HIV infection surveyed in 1996 and again in 1998. We used two global measures of HRQOL (overall health and overall quality of life) scored to have a mean of 50 and standard deviation of 10 in the sample. The total number of symptoms decreased (-1.29, p<0.001 for the difference), and overall health (1.09, p<0.001 for the difference) and overall quality of life (1.31, p<0.001 for the difference) improved over the period. Controlling for baseline symptoms and HRQOL, each additional symptom at follow-up (B=-1.14, p<0.001) was associated with worsened overall health and worsened overall quality of life (B=-0.95, p<0.001). The association of two additional symptoms with lower global HRQOL was similar in magnitude to the effect of having significant depressive symptoms or the diagnosis of AIDS. In conclusion, among HIV-infected patients, symptoms are significantly related to HRQOL over time. The functioning and well-being of patients with HIV is inextricably linked to the symptoms they experience.
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Affiliation(s)
- Karl A Lorenz
- Veterans Integrated Palliative Program, Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, Geffen School of Medicine at UCLA, Los Angeles, CA 90073, USA.
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Abstract
The interactions between oral and systemic health are bi-directional and complex, involving many pathways. Regarding health as not merely the absence of disease, but as a state of total well-being, these interactions profoundly influence the progress of many diseases, and the quality of life and economic performance of HIV-infected individuals and populations. The evidence base for specific interactions is currently weak, partly because few good-quality studies have been published, partly because of the naïveté of the instruments currently available for recording these interactions and their inherent complexity. Recording quality of life should be a fundamental aspect of all future studies. The most significant conclusion of this Workshop is the need for all involved in oral health research and oral health care to be seen as, and to act as, essential partners in comprehensive care for whole patients and communities.
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Affiliation(s)
- N W Johnson
- School of Dentistry and Oral Health, Griffith University, Queensland, Australia.
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Freed JR, Marcus M, Freed BA, Der-Martirosian C, Maida CA, Younai FS, Yamamoto JM, Coulter ID, Shapiro MF. Oral health findings for HIV-infected adult medical patients from the HIV Cost and Services Utilization Study. J Am Dent Assoc 2005; 136:1396-405. [PMID: 16255464 DOI: 10.14219/jada.archive.2005.0053] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The HIV Cost and Services Utilization Study (HCSUS) was conducted by a consortium of private and government institutions centered at the RAND Corp. to provide national estimates of adult medical patients who are HIV-positive. This article presents descriptive oral health findings from that study. METHODS The National Opinion Research Center (NORC) conducted four interviews of a nationally representative sample of adults with HIV who made a medical visit for regular care in early 1996. This article uses data from the second interview conducted between December 1996 and July 1997. The authors constructed analytical weights for each respondent so the 2,466 interviewees represented a population of 219,700. RESULTS Most adult medical patients with HIV rated their oral health as at least "good," but 12 percent (representing a population of 25,300) rated it as "poor." Xerostomia was the most commonly reported symptom (37 percent) to arise in the time since the previous interview. Twenty-nine percent had a dental benefit under Medicaid and 23 percent had private insurance. Eighteen percent had not revealed their HIV status to the dentist they usually saw. CONCLUSIONS National data on adult medical patients with HIV provide a context for local or convenience sample studies and can help give direction to public health and public policy programs directed to the oral health needs of this population. CLINICAL IMPLICATIONS The attitudes and beliefs of adult HIV patients should be taken into account in the creation of community health education programs and continuing education for dentists. Medicaid programs should include adult dental benefits.
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Affiliation(s)
- James R Freed
- Division of Public Health and Community Dentistry, University of California, Los Angeles School of Dentistry, 90095-1668, USA.
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Marcus M, Yamamoto JM, Der-Martirosian C, Freed BA, Maida CA, Younai F, Shapiro M. National estimates of out-of-pocket dental costs for HIV-infected users of medical care. J Am Dent Assoc 2005; 136:1406-14. [PMID: 16255465 DOI: 10.14219/jada.archive.2005.0054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Out-of-pocket costs for U.S. dental care in 1996 were dollar 157 per person at the poverty level and dollar 229 for people with higher incomes. This article examines out-of-pocket expenditures for dental care in HIV-infected patients who took part in the HIV Cost and Services Utilization Study (HCSUS), conducted by a consortium of private and government institutions centered at the RAND Corp. METHODS The HCSUS used a probability sampling design. The authors used a weighted sample of 2,466 HCSUS respondents to estimate the national population of HIV-infected users of medical care. The patients were asked to report how much they had spent on their dental care in the preceding 12 months, including payments made by them, their family or their friends--but not by insurance companies--for their dental care. RESULTS In 1996, 135,000 HIV-infected subjects spent dollar 20.5 million on dental care, averaging dollar 152 per user. Whites spent dollar 220, African-Americans dollar 55 and Hispanics dollar 101. People receiving dental care from private dentists spent dollar 232 compared with dollar 7 spent by those who received care in AIDS clinics. CONCLUSIONS More than one-half of the HIV-infected users of medical care identified private dentists as their source of dental care and spent the vast majority of the dollar 20.5 million. The remaining subjects identified public dental programs as their source of care and had low expenditures. The explanation for these low expenditures is the subsidization of public programs and the likelihood that fewer and less costly services are provided by such programs. PRACTICE IMPLICATIONS Dentists should be aware of out-of-pocket funds spent by the HIV-infected population in private practices and public programs. Any policy change reducing public funding may result in higher out-of-pocket costs for disadvantaged groups or in increasing disparities in access to dental services.
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Affiliation(s)
- Marvin Marcus
- Division of Public Health and Community Dentistry, University of California, Los Angeles, School of Dentistry, 90095-1668, USA.
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Sugisaki M, Kino K, Yoshida N, Ishikawa T, Amagasa T, Haketa T. Development of a new questionnaire to assess pain-related limitations of daily functions in Japanese patients with temporomandibular disorders. Community Dent Oral Epidemiol 2005; 33:384-95. [PMID: 16128799 DOI: 10.1111/j.1600-0528.2005.00238.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Various measures/scales have been used to assess oral health-related quality of life in patients with temporomandibular disorders (TMDs). However, there have been few reports on the validity of questionnaires, and even fewer assessments of their use in Japanese sociocultural conditions. OBJECTIVES The objectives of the study were: (i) to develop and refine the number of questions concerning pain-related limitations of daily function in the TMD questionnaire (LDF-TMDQ, 13 items) in Japanese patients with TMD, (ii) to assess factor validity, and (iii) to determine convergent and discriminant validity of the LDF-TMDQ with the observed items within a multidimensional questionnaire. METHODS Four hundred and fifty-six (85.9%) outpatients with TMD were enrolled. The subjects were allocated into two roughly equal groups--E-group (233) for exploratory factor analysis and C-group (223) for confirmatory factor analysis [structural equation modeling (SEM)]. RESULTS The exploratory factor analysis extracted 10 items and three factors. SEM showed the revised model to accurately describe the relationships between the measured items. As to convergent validity, the factor 'limitation in executing a certain task' and 'limitation of mouth opening' showed significant correlations with the observed items within the multi-dimensional questionnaire. However, the factor 'limitation of sleeping', show no correlation with any item. As to discriminant validity, all three factors had correlation coefficients below 0.4 with the psychological scale, the personality scale, and the visual analog scale for pain intensity. CONCLUSION The LDF-TMDQ was reduced from 13 items to 10. The factor validity of the LDF-TMDQ, and the construct validity of 'limitation in executing a certain task' and 'limitation of mouth opening' were confirmed, while that of 'limitation of sleeping' remains to be determined.
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Affiliation(s)
- Masashi Sugisaki
- Department of Dentistry, Jikei University School of Medicine, Nishi-shimbashi, Minato-ku, Tokyo, Japan.
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Dobalian A, Andersen RM, Stein JA, Hays RD, Cunningham WE, Marcus M. The impact of HIV on oral health and subsequent use of dental services. J Public Health Dent 2003; 63:78-85. [PMID: 12816137 DOI: 10.1111/j.1752-7325.2003.tb03479.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study examined differences in health and access to dental services among a nationally representative sample of patients with HIV using Andersen's Behavioral Model of Health Services Use. METHODS This investigation is a longitudinal study that used structural equation modeling to analyze data from the HIV Cost and Services Utilization Study, a probability sample of 2,864 adults under treatment for HIV infection. Key predisposing variables included sex, drug use, race/ethnicity, education, and age. Enabling factors included income, insurance, and regular source of care. Need factors included mental, physical, and oral health. Dependent variables included whether a respondent utilized dental services and number of visits. RESULTS More education, dental insurance, usual source of dental care, and poor oral health predicted a higher probability of having a dental visit. African Americans, Hispanics, those exposed to HIV through drug use or heterosexual contact, and those in poor physical health were less likely to have a dental visit. Of those who visited dental professionals, older persons, those with dental insurance, and those in worse oral health had more visits. African Americans and persons in poor mental health had fewer visits. CONCLUSIONS Persons with more HIV-related symptoms and a diagnosis of AIDS have a greater need for dental care than those with fewer symptoms and without AIDS, but more pressing needs for physical and mental health services limit their access to dental services. Providers should better attend to the oral health needs of persons with HIV who are in poor physical and mental health.
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Affiliation(s)
- Aram Dobalian
- Department of Health Services Administration, University of Florida, PO Box 100195, Gainesville, FL 32610-0195, USA.
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