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Wright FAC, Shu ECC, Cumming RG, Naganathan V, Blyth FM, Hirani V, Le Couteur DG, Handelsman DJ, Seibel MJ, Waite LM, Stanaway FF. Oral health-related quality of life of older Australian men. Community Dent Oral Epidemiol 2023; 51:767-777. [PMID: 35561045 DOI: 10.1111/cdoe.12754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 02/16/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aims of this study were to assess oral health-related quality of life (OHRQoL) in a cohort of older Australian men and explore the association between their general health conditions, socio-demographic factors and OHRQoL. METHODS The Concord Health and Ageing in Men Project (CHAMP) is a cohort study of the health of a representative sample of Australian men, initiated in 2005-2006 with an initial sample of 1705 men 70 years or over. Participants completed a self-administered health and socio-demographic questionnaire and attended an interview and clinical assessment at baseline and each of three follow-up assessments. Information on oral health and responses to the Oral Health Impact Profile (OHIP-14) were collected in the 4th follow-up in which 778 men completed the OHIP-14 questionnaire and 614 men had a dental assessment. The prevalence of oral health impact was defined as a response of fairly often or very often to one or more of the OHIP-14 questions. Mean OHIP-14 scores were calculated for the 14 questions and used as the dependent variable in the regression analyses. Zero-inflated Poisson regression was used to estimate prevalence rate ratios (PRR). RESULTS Only 10% of men presented oral health impacts. In multivariate regression modelling, being born in Italy/Greece (PRR: 2.16, 95% CI: 1.93-2.42) or in other countries (PRR: 2.12, 95% CI: 1.89-2.38), having poor self-rated general health (PRR: 1.38, 95% CI: 1.24-1.53), having poor mental wellbeing (PRR: 1.14, 95% CI: 1.04-1.24), having ≥6 depressive symptoms (PRR: 1.18, 95% CI: 1.05-1.32), being a current smoker (PRR: 1.34, 95% CI: 1.06-1.70) and having more decayed tooth surfaces (PRR:1.01, 95% CI: 1.00-1.02) were associated with higher impact scores. CONCLUSIONS Overall, older Australian men exhibit good oral health-related quality of life. The inter-relationship between perceptions of general health and well-being, health and oral health variables and social background supports policy objectives of closer integration of general health and oral health services for older Australian men.
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Affiliation(s)
- Fredrick Alan Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Ellie C-C Shu
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Robert G Cumming
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Repatriation General Hospital, University of Sydney, Concord, New South Wales, Australia
| | - Markus J Seibel
- Concord Clinical School, University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Fiona F Stanaway
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
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van Meijeren-van Lunteren A, You Y, Raat H, Wolvius E, Kragt L. Caries Preventive Interventions and Oral Health Inequalities: A Scoping Review. JDR Clin Trans Res 2023; 8:311-325. [PMID: 35912710 PMCID: PMC10504820 DOI: 10.1177/23800844221109116] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Dental caries remains one of the most prevalent but preventable diseases among children worldwide and especially affects children with a lower socioeconomic status or ethnic minority background. It is important that all groups of children are reached by preventive interventions to reduce oral health inequalities. So far, it is unknown whether children from different social and ethnic groups benefit equally from potentially effective oral health interventions. OBJECTIVES This scoping review aimed to identify European public health interventions that report their effect on dental caries across different social groups. METHODS Four databases were searched for studies evaluating the effect of oral health interventions on dental caries among children from 0 to 12 y, and studies were included when results were presented by children of different social groups separately. RESULTS A total of 14 studies were included, representing 4 different countries: 3 randomized and 11 nonrandomized studies. Most studies were performed at schools. Six studies showed results indicative of a reduction in oral health inequalities, 4 studies showed results that potentially widen oral health inequalities, and 5 studies showed results that were indicative of no impact on oral health inequalities. Interventions that contain early approaches, with a high frequency, approaching multiple levels of influence, and including at least the broader organizational or public policy level, may have the potential to reduce oral health inequalities among children from birth to young adolescence. CONCLUSION We recommend researchers to perform high-quality intervention studies and to evaluate the effectiveness of oral health intervention always in different socioeconomic or ethnic groups separately, to better understand their contribution toward oral health (in)equalities. KNOWLEDGE TRANSFER STATEMENT This review offers insight in the differential effects that oral health interventions might have across different social groups. Its results can be used to develop interventions that might reduce oral health inequalities among children. Also, we recommend future researchers to always evaluate the effects of any preventive oral health measure in different social groups separately.
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Affiliation(s)
- A.W. van Meijeren-van Lunteren
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
| | - Y. You
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Public Health, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
| | - H. Raat
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Public Health, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
| | - E.B. Wolvius
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
| | - L. Kragt
- The Generation R Study Group, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, CA Rotterdam, the Netherlands
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3
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Watt RG. Oral health inequalities-Developments in research, policy and practice over the last 50 years. Community Dent Oral Epidemiol 2023. [PMID: 37243417 DOI: 10.1111/cdoe.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/09/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
At times of major geopolitical conflict, macroeconomic crisis and the 'aftershocks' of the COVID-19 syndemic still having a global impact, it is the most vulnerable and disadvantaged in society who undoubtedly suffer the most. During these turbulent and uncertain times, it is essential that sufficient policy attention is given to tackling the persistent and stark health inequalities that exist both between and within countries. This commentary aims to critically reflect on developments in oral health inequalities research, policy and practice over the last 50 years. Despite often challenging political contexts, progress has undoubtedly been made in our understanding of the nature and underlying social, economic and political causes of oral health inequalities. A developing body of global research has highlighted patterns of inequalities in oral health that exist across the lifecourse, but less progress has been made in implementing and evaluating policy interventions to tackle these unfair and unjust inequalities in oral health. At a global level through WHO leadership, oral health is at a 'tipping point' with a unique window of opportunity for policy change and development. Transformative policy and system reforms co-produced with community and other key stakeholders are now urgently needed to tackle oral health inequalities.
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Affiliation(s)
- Richard G Watt
- WHO Collaborating Centre in Oral Health Inequalities and Public Health, Department of Epidemiology and Public Health, UCL, London, UK
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Fernando C, Ha DH, Do LG, Tadakamadla SK. Socioeconomic Status and Toothbrushing in Indigenous and Non-Indigenous Australian Children. JDR Clin Trans Res 2023; 8:139-147. [PMID: 35360957 DOI: 10.1177/23800844221086205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Dental caries in children is a multifactorial and complex condition. Toothbrushing helps maintain good oral hygiene and delivers fluoride. However, determinants of toothbrushing could vary based on Indigenous status. OBJECTIVE This study aimed to assess the association between socioeconomic status and adequate toothbrushing practice (brushing twice or more a day) in Indigenous and non-Indigenous Australian children. METHODS Data were acquired from the National Child Oral Health Survey (NCOHS) 2012 to 2014. NCOHS administered questionnaires to parents of a representative sample of 24,215 Australian children aged 5 to 14 y recruited using a complex sampling method. Data on the frequency of toothbrushing and socioeconomic status were collected through the questionnaires. Statistical analysis was conducted progressively from bivariate to multivariable regression modeling, stratified by Indigenous status. RESULTS Just over half of Indigenous children and over two-thirds of non-Indigenous children reported adequate toothbrushing. The prevalence of adequate brushing (twice or more a day) was 42% (95% confidence interval [CI], 1.10-1.84) higher among children with an overseas-born parent than those with Australian-born parents. Among non-Indigenous children, sex and age, parents' country of birth, number of children in the family, and other family socioeconomic indicators (education, income, private health insurance) were associated with adequate toothbrushing. The prevalence of adequate brushing was 1.09 (95% CI, 1.03-1.15) and 1.15 (95% CI, 1.10-1.21) times higher when their parent possessed vocational training and tertiary education, respectively, compared to those children whose parents had school-level education. CONCLUSIONS There were differences in patterns of socioeconomic disparities for toothbrushing practices between Indigenous and non-Indigenous Australian children. KNOWLEDGE TRANSFER STATEMENT To promote positive toothbrushing practices in children, dental clinicians and public health professionals must be aware of the determinants of toothbrushing practices. Socioeconomic disparities in toothbrushing frequency were more apparent in non-Indigenous children. These results will help develop population-specific interventions that tackle the determinants to help improve oral hygiene behavior in Indigenous and non-Indigenous children.
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Affiliation(s)
- C Fernando
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - D H Ha
- School of Dentistry, The University of Queensland, Brisbane, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - L G Do
- School of Dentistry, The University of Queensland, Brisbane, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - S K Tadakamadla
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Almutairi M, McKenna G, O’Neill C. A comparative examination of the role of need in the relationship between dental service use and socio-economic status across respondents with distinct needs using data from the Scottish Health Survey. BMC Public Health 2023; 23:159. [PMID: 36694144 PMCID: PMC9872289 DOI: 10.1186/s12889-023-15078-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Disparities in oral health and distinct patterns in service use related to socio-economic status have been shown to exist in the United Kingdom. A number of studies have used the Andersen behavioural model to better understand the factors that influence utilization and thereby inform policies aimed at improving service uptake. As the nature of need may differ across distinct types of patients, however, so too may the distribution of enabling and pre-disposing factors and observed relationships between need, other factors and service use. In this study we compare samples with distinct self-assessed needs in terms of their characteristics and patterns of service use to compare application of the Andersen model to dental services among respondents to a population based survey. MATERIALS AND METHODS Data were taken from the Scottish Health Survey, for 2019. Data on service use, oral hygiene habits, perceived treatment need, and socio-demographic characteristics were extracted. Data were analysed using descriptive statistics, t-tests and ordered logistic regression analyses. RESULTS Two thousand one hundred forty-eight usable responses were obtained from the survey, 74.95% of the sample had visited the dentist less than a year ago, 11.82% between 1 year and up to 2 years ago, 7.12% between 2 and 5 years ago and 6.10% more than 5 years. Descriptive statistics, t-tests and ordered logistic regression analyses revealed distinct patterns of service use when the sample was partitioned based on perceived treatment need. Specifically those with self-assessed treatment need were older, more likely to smoke, be male and be less likely to have a degree than those who did not. While service use was positively related to age (predisposing) among those who did not have self-assessed treatment need, it was negatively related for those with perceived treatment need. Distinct patterns were also evident with respect to sugar exposure (need) and ease with which time off work could be organised (enabling). DISCUSSION The study shows common and distinct patterns of service use related to enabling and predisposing factors across groups differentiated by self-perceived treatment need. If inequalities in health and healthcare use are to be addressed, it is important to understand their origins. Conflation of distinct types of need that may correlate with predisposing and enabling factors complicates this. CONCLUSION In applying the Andersen model, it is important to take account of potential differences in the types of need expressed where possible to understand the role of other variables in service use.
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Affiliation(s)
- Majed Almutairi
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. .,Public Health Department, School of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia.
| | - Gerry McKenna
- grid.4777.30000 0004 0374 7521Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Ciaran O’Neill
- grid.4777.30000 0004 0374 7521Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
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Lawal FB, Omara M. APPLICABILITY of DENTAL PATIENT REPORTED OUTCOMES in LOW RESOURCE SETTINGS -A CALL to BRIDGE the GAP in CLINICAL and COMMUNITY DENTISTRY. J Evid Based Dent Pract 2023; 23:101789. [PMID: 36707169 DOI: 10.1016/j.jebdp.2022.101789] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/21/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
Low resource settings (LRSs) are typically regions where inadequate healthcare resources exist and the healthcare system does not meet the acceptable global standards. The problems encountered in LRS in oral and dental medicine could be related to lack of human personnel, e.g., insufficient numbers of dentists and other dental professionals, poor infrastructure, limited or remote treatment/care facilities, lack of dental materials and supplies as well as inadequate monitoring and evaluation of public health programs. Despite the limited human resources in LRS, such settings are currently experiencing a brain drain, a situation where there is massive emigration of highly trained and qualified healthcare professionals including dentists to other countries for better living conditions. To allocate health resources judiciously, exploration of alternatives to traditional oral health assessments, which are cheap, easily available, and patient-oriented, becomes pertinent. Thus, there is a need to consider the applicability of oral assessment tools such as dental patient-reported outcomes (dPROs) in general, and oral health-related quality of life (OHRQoL) in particular. Therefore, the aim of this narrative review was to describe opportunities for the applicability of dPROs in LRSs with a focus on Nigeria, based on empirical data. The applicability of dPROs and OHRQoL in LRS includes prevention, screening, diagnosis, assessment of oral health impact, application of the first step of targeted treatment, treatment evaluation, planning, and monitoring of public health programs, as well as research needs. dPROs could be very useful in LRS because their practical advantages may be utilized to improve patient and population health.
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Affiliation(s)
- Folake B Lawal
- Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria; Consortium for Advanced Research Training in Africa (CARTA), APHRC, Nairobi, Kenya.
| | - Maisa Omara
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
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7
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Periodontitis and Preeclampsia in Pregnancy: A Systematic Review and Meta-Analysis. Matern Child Health J 2022; 26:2419-2443. [PMID: 36209308 PMCID: PMC9747857 DOI: 10.1007/s10995-022-03556-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. METHODS Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. RESULTS Thirty studies including six cohort- and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 - 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 - 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 - 17.19, p < 0.0001). CONCLUSIONS Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted.
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Adherence to the food-based Japanese dietary guidelines and prevalence of poor oral health-related quality of life among older Japanese adults in the Kyoto-Kameoka study. Br J Nutr 2022; 128:467-476. [PMID: 34446118 PMCID: PMC9340853 DOI: 10.1017/s0007114521003329] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Although better diet quality is inversely related to the risk of geriatric disorders, the association of adherence to dietary guidelines with oral health-related quality of life (OHRQoL) is unclear. We aimed to investigate this association in older Japanese adults. This cross-sectional study included 7984 Japanese participants aged ≥ 65 years from the population-based Kyoto-Kameoka study. Dietary intake was estimated using a validated self-administered FFQ. The scores for adherence to the Japanese Food Guide Spinning Top (range: 0 (worst) to 80 (best)) were calculated. These scores were stratified into quartiles (Qs). Poor OHRQoL was defined as a score ≤ 50 using a 12-item Geriatric Oral Health Assessment Index. The OR and 95 % CI were calculated using multivariable logistic regression and the spline model. Higher adherence score was associated with a lower prevalence of poor OHRQoL (Q1-Q4:36·0 %, 32·1 %, 27·9 % and 25·1 %, respectively). An inverse association was found between the score for adherence to the food-based Japanese dietary guidelines and the OR of poor OHRQoL among all the participants (Q1: reference; Q2: OR, 0·87 (95 % CI: 0·75, 1·00); Q3: OR, 0·77 (95 % CI: 0·66, 0·90); Q4: OR, 0·72 (95 % CI: 0·62, 0·85); Pfor trend < 0·001). These relationships were similar to the results in the spline model. Higher adherence to the food-based Japanese dietary guidelines is inversely associated with the prevalence of poor OHRQoL in older adults. Our results may provide useful insights to improve and maintain oral health.
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Mackenbach JD, Ibouanga EL, van der Veen MH, Ziesemer KA, Pinho MGM. Relation between the food environment and oral health-systematic review. Eur J Public Health 2022; 32:606-616. [PMID: 35849329 PMCID: PMC9341680 DOI: 10.1093/eurpub/ckac086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background There is increasing evidence that the food environment, i.e. the availability, accessibility, price and promotion of foods and beverages, has a significant influence on oral health through food consumption. With this systematic literature review, we systematically summarize the available evidence on relations between the food environment and oral health outcomes in children and adults. Methods English-language studies were identified through a systematic literature search, executed by a medical information specialist, on OVID/Medline, Embase, Web of Science and CINAHL. Title and abstract screening, full-text screening and quality assessment [using the Quality Assessment with Diverse Studies (QuADS) tool] were done independently by two authors. Results Twenty-three studies were included, of which 1 studied the consumer food environment (food labeling), 3 the community food environment (e.g. number of food stores in the community), 5 the organizational food environment (availability of healthy foods and beverages in schools), 2 the information environment (television advertisements) and 13 government and industry policies related to the food environment (e.g. implementation of a sugar-sweetened beverage tax). Almost all studies found that unhealthy food and beverage environments had adverse effects on oral health, and that policies improving the healthiness of food and beverage environments improved—or would improve in case of a modeling study—oral health. Conclusions This systematic literature review provides evidence, although of low to moderate quality and available in a low quantity only, that several aspects of the food environment, especially policies affecting the food environment, are associated with oral health outcomes.
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Affiliation(s)
- Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.,Upstream Team, Amsterdam UMC, Amsterdam, The Netherlands
| | - Elodie L Ibouanga
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Monique H van der Veen
- Departments of Preventive Dentistry and Pediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.,Department of Oral hygiene, University for Applied Sciences Inholland, Amsterdam, The Netherlands
| | | | - Maria G M Pinho
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.,Upstream Team, Amsterdam UMC, Amsterdam, The Netherlands
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Patel R, Witton R. Strategic planning in oral health improvement. Perspect Public Health 2022; 142:142-144. [PMID: 35470741 DOI: 10.1177/17579139211056363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- R Patel
- Public Health England South West, Follaton House, Plymouth Road, Totnes TQ9 5NE, UK
| | - R Witton
- Peninsula Dental School, University of Plymouth, Plymouth, UK
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11
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Bhatti A, Wray F, Eskytė I, Gray-Burrows KA, Owen J, Giles E, Zoltie T, Smith V, Pavitt S, West R, McEachan RR, Marshman Z, Day PF. HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing): a qualitative exploration of the acceptability of a complex oral health intervention. BMC PRIMARY CARE 2022; 23:55. [PMID: 35346054 PMCID: PMC8962587 DOI: 10.1186/s12875-022-01659-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND To explore the acceptability of the oral health intervention, HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing) to parents with young children aged 9-12 months and health visitors. METHODS Following the delivery of the universal oral health intervention called HABIT, qualitative semi-structured interviews with parents and focus groups with health visitors were undertaken. Interviews were audio-recorded and transcribed. Health visitors completed self-reported diaries after delivering the HABIT intervention with parents. The qualitative data was analysed using framework analysis (guided by a theoretical framework of acceptability). RESULTS Seventeen parents were interviewed, and five health visitors and three nursery nurses participated in two focus groups. Parents reported health visitors to be 'trusted' and valued the reassurance provided during the HABIT visit. Health visitors found the HABIT training and resources useful and valued the consistency and increased confidence in undertaking oral health conversations. There were, however, challenges in changing behaviour where families faced competing demands on time and resources. Both health visitors and parents described the importance of the intervention's timing and suggested that multiple visits may be needed to support optimal oral health habits. CONCLUSION The HABIT intervention was acceptable to parents and health visitors. Health visitors would welcome a further refinement to enhance intervention delivery that specifically achieves a balance between using a guided script and retaining the flexibility to adapt the conversation to suit the needs of individual families. This, in turn, will maximise impact and enable parents of young children to adopt and maintain optimal home-based oral health behaviours for their child.
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Affiliation(s)
- Amrit Bhatti
- University of Leeds, Leeds, United Kingdom, England.
| | - Faye Wray
- Bradford Institute for Health Research, Bradford, United Kingdom, England
| | - Ieva Eskytė
- University of Leeds, Leeds, United Kingdom, England
| | | | - Jenny Owen
- University of Leeds, Leeds, United Kingdom, England
| | - Erin Giles
- University of Leeds, Leeds, United Kingdom, England
| | | | - Victoria Smith
- Bradford Institute for Health Research, Bradford, United Kingdom, England
| | - Sue Pavitt
- University of Leeds, Leeds, United Kingdom, England
| | - Robert West
- University of Leeds, Leeds, United Kingdom, England
| | | | - Zoe Marshman
- University of Sheffield, Sheffield, United Kingdom, England
| | - Peter F Day
- University of Leeds, Leeds, United Kingdom, England
- Bradford Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, United Kingdom, England
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Bastos JL, Constante HM, Schuch HS, Haag DG, Jamieson LM. How do state-level racism, sexism, and income inequality shape edentulism-related racial inequities in contemporary United States? A structural intersectionality approach to population oral health. J Public Health Dent 2022; 82 Suppl 1:16-27. [PMID: 35726462 DOI: 10.1111/jphd.12507] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/27/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Research on racial oral health inequities has relied on individual-level data with the premise being that the unequal distribution of dental diseases is an intractable problem. We address these insufficiencies by examining the relationships between structural racism, structural sexism, state-level income inequality, and edentulism-related racial inequities according to a structural intersectionality approach. METHODS Data were from two sources, the 2010 survey of the U.S. Behavioral Risk Factor Surveillance System, and Patricia Homan et al.'s (2021) study on the health impacts from interlocking systems of oppression. While the first contains information on edentulism from a large probabilistic sample of older (65+) respondents, the second provides estimates of racism, sexism, and income inequality across the US states. Taking into account a range of individual characteristics and contextual factors in multilevel models, we determine the extent to which structural forms of marginalization underlie racial inequities in edentulism. RESULTS Our analysis reveals that structural racism, structural sexism, and state-level income inequality are associated with the overall frequency of edentulism and the magnitude of edentulism-related racial inequities, both individually and intersectionally. Coupled with living in states with both high racism and sexism (but not income inequality), the odds of edentulism were 60% higher among non-Hispanic Blacks, relative to Whites residing where these structural oppressions were at their lowest. CONCLUSIONS These findings provide evidence that racial oral health inequities cannot be disentangled from social forces that differentially allocate power and resources among population groups. Mitigating race-based inequities in oral health entails dismantling the multifaceted systems of oppression in the contemporary U.S. society.
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Affiliation(s)
- João L Bastos
- Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Helena M Constante
- Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Helena S Schuch
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Dandara G Haag
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, Australia
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13
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Aqeeli A, Alsharif AT, Kruger E, Tennant M, Bakeer H. Caries prevalence and severity in association with sociodemographic characteristics of 9-to-12-year-old school children in Al-Madinah, Saudi Arabia. Saudi Dent J 2021; 33:897-903. [PMID: 34938031 PMCID: PMC8665159 DOI: 10.1016/j.sdentj.2021.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/28/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022] Open
Abstract
Aim This study was conducted to estimate the prevalence and severity of dental caries in 9-to-12-year-old schoolchildren in Al-Madinah, Saudi Arabia (SA); to compare its expression by mean of decayed, missing and filled teeth (dmft/DMFT) and the Significant Caries Index (SiC Index); to examine the association between caries experience and sociodemographic factors; and to determine whether schoolchildren in Al-Madinah are at greater risk for high levels of dental caries. Materials and methods Data of 1,000 schoolchildren aged 9–12 years old from a cross-sectional oral health survey in Al-Madinah, SA was obtained and analysed. Dental caries was measured using dmft/DMFT and the SiC Index which was computed into two groups: highest 30% DMFT scores (SiC30) and highest 10% DMFT scores (SiC10). Sociodemographic variables included age, gender, nationality, school type (public or private) and family income. Descriptive and inferential were calculated to estimate caries prevalence and severity and its association with sociodemographic factors. Results Caries prevalence in primary or permanent teeth was 85.1%, with untreated caries of 76.1%. The mean dmft was 2.66 ± 2.63 while the mean DMFT was 1.43 ± 1.73. Caries severity was significantly higher among males, Saudis, those from low-income families and those from public schools (p < 0.05). The mean values of SiC30 (3.52 ± 1.57) and SiC10 (4.98 ± 1.77) were considerably higher than the overall average DMFT value. Conclusion Dental caries persists as a public health challenge among schoolchildren in Al-Madinah, SA, with a very high prevalence and severity among schoolchildren. The use of the SiC Index highlighted the subgroups with more severe caries experience.
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Affiliation(s)
- Amal Aqeeli
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Preventive Dental Sciences, Taibah University Dental College and Hospital, Madinah, Saudi Arabia
| | - Alla T Alsharif
- Preventive Dental Sciences, Taibah University Dental College and Hospital, Madinah, Saudi Arabia
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Hala Bakeer
- Preventive Dental Sciences, Taibah University Dental College and Hospital, Madinah, Saudi Arabia
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14
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Sousa KGD, Gavião MBD, Castelo PM, Huamani JRS, Freitas CND, Mialhe FL, Barbosa TDS. Effect of educational strategy combined with ART on oral health-related quality of life: a controlled clinical trial. Braz Oral Res 2021; 35:e136. [PMID: 34932665 DOI: 10.1590/1807-3107bor-2021.vol35.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/05/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess whether complementing atraumatic restorative treatment (ART) with oral health educational strategies (OHES) improves the perception of oral health-related quality of life (OHRQoL) and clinical oral outcomes. A controlled clinical trial included 93 six- to eight-year-old students from five public schools of Piracicaba, Saltinho, and Charqueada municipalities (State of São Paulo, Brazil) divided into 3 groups (31 children each) which received: OHES (caries-free), ART (dental caries), and ART plus OHES (dental caries). OHRQoL (CPQ8-10-ISF:16), dental caries, biofilm control, and gingivitis were assessed before and 1 month after interventions by one calibrated examiner. OHES consisted of an educational interactive activity performed once a week for four weeks. Data were analyzed using mixed model ANOVA, Chi-square, and Sign tests. After 1 month of follow-up, improvement in gingivitis status, OHRQoL total score, and Functional Limitations, Emotional Well-Being and Social Well-Being domains scores were found in all groups (p < 0.05). The improvement in biofilm control was observed only in the OHES group (p < 0.001; power = 0.98), while a decrease in Oral Symptoms scores was observed only in ART+OHES group (p <0.001; power = 0.99) and a significant change in the perception of oral health was observed in the two groups that received ART (p < 0.05). In conclusion, improvement in overall OHRQoL and oral status was observed in all children, although the effect of including health educational strategies in the treatment plan was determinant for the perception of an improved oral health after restorative treatment.
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Affiliation(s)
- Karina Guedes de Sousa
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Health Sciences and Pediatric Dentistry, Piracicaba, SP, Brazil
| | - Maria Beatriz Duarte Gavião
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Health Sciences and Pediatric Dentistry, Piracicaba, SP, Brazil
| | - Paula Midori Castelo
- Universidade Federal de São Paulo - Unifesp, Department of Pharmaceutical Sciences, Diadema, SP, Brazil
| | - Juana Rosmeri Salas Huamani
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Health Sciences and Pediatric Dentistry, Piracicaba, SP, Brazil
| | - Camila Nobre de Freitas
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Health Sciences and Pediatric Dentistry, Piracicaba, SP, Brazil
| | - Fábio Luiz Mialhe
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Health Sciences and Pediatric Dentistry, Piracicaba, SP, Brazil
| | - Taís de Souza Barbosa
- Universidade Federal de Juiz de Fora - UFJF, Department of Dentistry, Governador Valadares, MG, Brazil
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15
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Marcus K, Balasubramanian M, Short S, Sohn W. Culturally and linguistically diverse (CALD): terminology and standards in reducing healthcare inequalities. Aust N Z J Public Health 2021; 46:7-9. [PMID: 34902191 DOI: 10.1111/1753-6405.13190] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Kanchan Marcus
- Population Oral Health, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Madhan Balasubramanian
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Stephanie Short
- Discipline of Behavioural & Social Sciences in Health, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Woosung Sohn
- Population Oral Health, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, New South Wales
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16
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Hagman J, Wide U, Werner H, Hakeberg M. A psychological intervention for caries active young adults, a randomized controlled trial. Clin Exp Dent Res 2021; 8:239-247. [PMID: 34792290 PMCID: PMC8874066 DOI: 10.1002/cre2.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of the present study was to evaluate the effect of a brief version of the behavioral intervention Acceptance and Commitment Therapy (ACT) on reducing gingivitis and plaque levels after 18 weeks. Materials and methods One hundred thirty‐five caries‐active young adults (18–25 years of age), recruited from two public dental clinics, participated in this parallel group randomized control trial (RCT). Participants in the intervention (n = 67) received two ACT sessions in combination with standard information on oral health, and participants allocated to the control group (n = 68) received standard information only. Gingivitis and plaque levels were recorded at baseline and at the 9‐ and 18‐week follow‐ups. The effect of the intervention versus standard information alone was analyzed by intention‐to‐treat and per protocol, applying the General Linear Model (GLM). Exploratory analyses for the intervention and control groups were conducted to evaluate the effect of gender and smoking habits on the gingivitis and plaque outcome. The CONSORT guidelines for RCT were followed. Results A significant decrease in gingivitis and plaque levels was observed over time, irrespective of treatment allocation. However, the ACT intervention was not significantly more effective at reducing gingivitis and plaque scores than standard information alone, even though the intervention participants had maintained their improvement to a greater extent. The exploratory analysis revealed that females improved their gingivitis and plaque levels significantly more than the males in the intervention group (p = 0.025 for gingivitis and p = 0.013 for plaque). Conclusion A brief ACT intervention was not proven to be more effective than standard information alone at improving oral health in a sample of young adults with poor oral health. However, ACT seems to have a positive effect on oral health among females. (TRN ISRCTN15009620).
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Affiliation(s)
- Jennie Hagman
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulla Wide
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helene Werner
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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17
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Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach. BMC Oral Health 2021; 21:564. [PMID: 34749711 PMCID: PMC8573976 DOI: 10.1186/s12903-021-01935-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 10/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background The aim of the current study was to (a) measure the socioeconomic inequalities in oral health and examine whether the inequalities are greater in disease experience or in its treatment and to (b) decompose the factors that influence oral health inequalities among the adults of Guangdong Province. Methods A cross-sectional study was conducted among 35- to 44-year-old and 65- to 74-year-old adults in Guangdong Province. All participants underwent oral health examinations and answered questionnaires about their oral health. We measured the concentration indices of the DMFT and its separate components, namely, decayed teeth (DT), missing teeth (MT), and filled teeth (FT), to explore the inequalities in oral health status; then, we analysed its decomposition to interpret the factors that influence the inequalities. Results The results showed that significant inequality was concentrated on FT (CI = 0.24, 95% CI = 0.14/0.33, SE = 0.05). The concentration indices for the DMFT (CI = 0.02, 95% CI = 0.02/0.06, SE = 0.02) and MT (CI = 0.02, 95% CI 0.03/0.08, SE = 0.03) were small and close to zero, while the concentration for DT (CI = − 0.04, 95% CI = − 0.01/0.02, SE = 0.03) was not statistically significant. The results from the decomposition analysis suggested that a substantial proportion of the inequality was explained by household income, high education level, regular oral examination and type of insurance (5.1%, 12.4%, 43.2%, − 39.6% (Urban Employee Basic Medical Insurance System) and 34.5% (New-Type Rural Medical Collaboration System), respectively). Conclusions The results indicated greater inequalities in dental caries than in caries experience. Among the included factors, household income, high education level, and regular oral health examinations had the greatest impact on the inequalities in the number of FT. In addition, the current medical insurance systems, including the Urban Employee Basic Medical Insurance System, Urban Resident Basic Medical Insurance System, and the New-Type Rural Medical Collaboration System, have not been effectively used in oral treatment. Policy-making and the implementation of interventions for tackling socioeconomic oral health inequalities should focus on reducing the burden of treatment and providing greater access to dental care for low-income groups. Welfare policies are skewed towards rural areas and low-income people.
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18
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Abstract
Special care dentistry (SCD), one of 13 dental specialties, is the most recent addition to the GDC Speciality List, in 2008. Yet, SCD is often an area which dentists and dental care professionals only encounter via referral or directly within a secondary care or community dental setting. At undergraduate level, though a listed aspect of the GDC's curriculum, experiences within special care departments are often limited. Additionally, with other specialties such as restorative dentistry taking precedence, there is a risk of SCD being viewed as an adjunct to the main curriculum. Despite this, lessons learned from SCD are key to understanding the holistic patient-centred experience. It is an opportunity to combine advanced clinical knowledge with patient management, which all dental professionals should possess in order to fulfil our duty of care for all. The aim of this article is to explore the lack of exposure to SCD in undergraduates, and highlight the reasons behind the management of patients with additional needs being an essential part of the undergraduate curriculum and beyond. The article also explores the importance of SCD in treating patients in an increasingly diverse society, particularly for those with complications related to the recent COVID-19 pandemic. Identifies what special care is as a recently added speciality, which patients it cares for and how it is accessed. Discusses the impact that special care dentistry has on the dental applicant, undergraduate student and qualified professional. Discusses the limited interactions undergraduates and qualified professionals have with special care departments and patients, and the impact of this. Explores the application of special care dentistry techniques in general practice and considers patients who require referral, for all dental care professionals.
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19
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Broomhead T, Ballas D, Baker SR. Neighbourhoods and oral health: Agent-based modelling of tooth decay. Health Place 2021; 71:102657. [PMID: 34543838 DOI: 10.1016/j.healthplace.2021.102657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/12/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022]
Abstract
This research used proof of concept agent-based models to test various theoretical mechanisms by which neighbourhoods may influence tooth decay in adults. Theoretical pathways were constructed using existing literature and tested in two study areas in Sheffield, UK. The models found a pathway between shops and sugar consumption had the most influence on adult tooth decay scores, revealing that similar mechanisms influence this outcome in different populations. This highlighted the importance of the interactions between neighbourhood features and individual level variables in influencing outcomes in tooth decay. Further work is required to improve the accuracy and reliability of the models.
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Affiliation(s)
- T Broomhead
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, S10 2TA, United Kingdom.
| | - D Ballas
- Department of Economic Geography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD, Groningen, the Netherlands
| | - S R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, S10 2TA, United Kingdom
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20
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Nath S, Poirier BF, Ju X, Kapellas K, Haag DG, Ribeiro Santiago PH, Jamieson LM. Dental Health Inequalities among Indigenous Populations: A Systematic Review and Meta-Analysis. Caries Res 2021; 55:268-287. [PMID: 34107490 PMCID: PMC8491513 DOI: 10.1159/000516137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/21/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by measuring dental caries prevalence and severity. An electronic database (MEDLINE) was initially searched using relevant keywords. This was followed by use of the search string in the following electronic databases: Scopus, EBSCOhost, Cochrane, and Open Grey. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction, which was facilitated using JBI SUMARI software. The primary outcome was the decayed missing filled teeth (DMFT) score and dental caries prevalence. Subgroup analysis was done by country of publication to identify causes of heterogeneity. Forest plots were used with the standardized mean difference (SMD) and publication bias was assessed using the Egger test with funnel plot construction. For the final review, 43 articles were selected and 34 were meta-analyzed. The pooled mean DMFT for both the permanent dentition (SMD = 0.26; 95% CI 0.13-0.39) and deciduous dentition (SMD = 0.67; 95% CI 0.47-0.87) was higher for the Indigenous population than for the general population. Indigenous populations experienced more decayed teeth (SMD = 0.44; 95% CI 0.25-0.62), a slightly higher number of missing teeth (SMD = 0.11< 95% CI -0.05 to 0.26), and lesser filled teeth (SMD = -0.04; 95% CI -0.20 to 0.13) than their nonindigenous counterparts. The prevalence of dental caries (SMD = 0.27; 95% CI 0.13-0.41) was higher among indigenous people. Globally, indigenous populations have a higher caries prevalence and severity than nonindigenous populations. The factors which have led to such inequities need to be examined.
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Affiliation(s)
- Sonia Nath
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
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21
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Marcus K, Balasubramanian M, Short S, Sohn W. Barriers and facilitators to oral health care utilization in culturally and linguistically diverse mothers: a mixed methods systematic review protocol. JBI Evid Synth 2021; 19:669-674. [PMID: 33141803 DOI: 10.11124/jbies-20-00037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The objective of the review is to synthesize existing literature examining the barriers and facilitators to preventive oral health care utilization experienced by culturally and linguistically diverse mothers. INTRODUCTION Preventive oral health care in the absence of pain is underutilized in culturally and linguistically diverse groups. Culturally and linguistically diverse mothers experience oral health care utilization barriers compared to their host country counterparts. Much of the current evidence is focused on oral health care knowledge, attitudes, and beliefs of culturally and linguistically diverse groups. To date, it remains unclear as to which barriers or facilitators impact preventive oral health care utilization in culturally and linguistically diverse mothers. INCLUSION CRITERIA This review will consider studies that explore oral health care utilization in culturally and linguistically diverse mothers (with children younger than 18 years) who are either born in a different country or who have one parent born in a country that differs culturally and/or linguistically to the host population. Papers that explore barriers and facilitators to oral health care utilization will be included. Quantitative and qualitative studies will be included. METHODS A three-step search strategy will be conducted within the following databases: MEDLINE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, ProQuest Central, and Scopus. The search will be supplemented with gray literature and reference searching from collected articles. No date limitation will be applied. Two reviewers will assess papers against the inclusion criteria. A convergent integrated approach using the JBI mixed methods methodology will be followed for critical appraisal, data extraction, and data synthesis and integration.
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Affiliation(s)
- Kanchan Marcus
- Population Oral Health, Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Madhan Balasubramanian
- Population Oral Health, Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Stephanie Short
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Woosung Sohn
- Population Oral Health, Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
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22
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Bellu CB, Dragan IF, Serban S. Romanian insight. Br Dent J 2021; 230:386. [PMID: 33837312 DOI: 10.1038/s41415-021-2904-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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Shah S, Wordley V. An overview of adult dental fee exemptions in NHS primary dental care in England. Br Dent J 2021:10.1038/s41415-021-2790-9. [PMID: 33762696 PMCID: PMC7989690 DOI: 10.1038/s41415-021-2790-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/13/2020] [Indexed: 11/09/2022]
Abstract
Aims To explore the current landscape of NHS primary dental care services for fee-exempt adult patients and observe attendance, band claiming and geographical patterns.Materials and methods Data were analysed from FP17 claims submitted to NHS Business Services Authority from 2006-2019.Results Fee-exempt adult patients in 2018-2019 account for 23.7% of all adult claims in NHS primary dental care. This percentage has decreased year-on-year since 2011-2012 from 31.5%. In 2018-2019, there were significantly fewer band 1 claims for fee-exempt adult patients (36.0%) compared to their fee-paying counterparts (58.3%). Treatment needs appear to be higher for fee-exempt adult patients since more band 2 and 3 treatment claims were completed (49.0%) compared to fee-payers (30.8%). Band 3 claims were three times higher for fee-exempt adult patients.Discussion Adults with fee exemptions must be able to access timely oral health services since they appear to have higher treatment needs than fee-payers. The areas with the highest proportion of fee-exempt adult patients reflect relative levels of deprivation across regions in England. Barriers to access must be reduced to fully engage all groups of patients and improve oral health.Conclusion Oral health inequalities appear to exist between fee-paying and fee-exempt adult patients. The post-pandemic world will offer a unique opportunity to reassess NHS dental services.
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Affiliation(s)
- Sagar Shah
- Clinical Fellow at NHS Business Services Authority, NHS Dental Services, 1 St Annes Road, Eastbourne, East Sussex, BN21 3UN, UK.
| | - Valerie Wordley
- Clinical Fellow at NHS England and NHS Improvement, Skipton House, 80 London Road, London, SE1 6LH, UK
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24
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van Meijeren-van Lunteren AW, Voortman T, Elfrink MEC, Wolvius EB, Kragt L. Breastfeeding and Childhood Dental Caries: Results from a Socially Diverse Birth Cohort Study. Caries Res 2021; 55:153-161. [PMID: 33706311 DOI: 10.1159/000514502] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/13/2020] [Indexed: 12/29/2022] Open
Abstract
Previous studies showed that prolonged breastfeeding increases the risk of caries. However, the observed associations were mainly based on non-European populations, and important confounding and mediating factors like socioeconomic position (SEP) and diet were often neglected. The aim of this study was to investigate the role of breastfeeding and bottle-feeding practices on dental caries during childhood while accounting for SEP, ethnic background, and sugar intake. This study was part of the Generation R Study, a prospective multiethnic cohort study conducted in Rotterdam, The Netherlands. In total, 4,146 children were included in the analyses. Information about feeding practices was derived from delivery reports and questionnaires during infancy. Caries was measured via intraoral photographs at the age of 6 years and defined as decayed, missing, and filled teeth (dmft). Negative binomial hurdle regression analyses were used to study the associations between several infant feeding practices and childhood caries. The prevalence of dental caries at the age of 6 years was 27.9% (n = 1,158). Prolonged breastfeeding (for >12 months) was associated with dental caries (OR 1.35, 95% CI 1.04-1.74) and the number of teeth affected by dental caries (RR 1.27, 95% CI 1.03-1.56). Furthermore, nocturnal bottle-feeding was associated with dental caries (OR 1.52, 95% CI 1.20-1.93). All associations were independent of family SEP, ethnic background, and sugar intake. Results from this Dutch cohort study confirmed the previously observed associations between prolonged breastfeeding and nocturnal bottle-feeding and the increased risk of childhood dental caries, even after proper adjustments for indicators of SEP, ethnic background, and sugar intake. Future studies are encouraged to elaborate further on possible explanations for the observed relationships. Healthcare professionals should be aware and advise caregivers about the potential risk of prolonged breastfeeding on caries development by applying the current recommendations on breastfeeding, oral hygiene, and feeding frequency.
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Affiliation(s)
- Agatha W van Meijeren-van Lunteren
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands, .,Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands,
| | - Trudy Voortman
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Marlies E C Elfrink
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Mondzorgcentrum Nijverdal, Nijverdal, The Netherlands
| | - Eppo B Wolvius
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Lea Kragt
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
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25
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Naz S, Bernabe E, Marcenes W, Delgado-Angulo EK. Ethnic differences in treatment preferences among adults in East London. Br Dent J 2021:10.1038/s41415-020-2597-0. [PMID: 33574579 DOI: 10.1038/s41415-020-2597-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/02/2020] [Indexed: 11/09/2022]
Abstract
Aim To explore ethnic differences in treatment preferences among adults.Methods A sample of 1,764 adults from ten ethnic groups were recruited from the adult population in Outer North East London using stratified multistage random sampling. Treatment preferences for a front tooth, a back tooth and an aching back tooth were collected via questionnaires. Ethnic differences in treatment preferences were assessed in regression models adjusting for demographic characteristics, socioeconomic indicators, dental visiting behaviour and clinical dental status.Results Ethnic differences in treatment preferences were observed, albeit only for back not front teeth. Compared to White British, Black African (odds ratio: 0.85; 95% confidence interval [CI]: 0.74-0.97), Caribbean (0.71; 95% CI: 0.51-0.98) and Other (0.73; 95% CI: 0.61-0.87) were less likely to preserve a back tooth. If the back tooth was aching, Black Others were still less likely (0.82; 95% CI: 0.71-0.93) to opt for restorative than surgical treatment. On the contrary, Bangladeshi were more likely (1.14; 95% CI: 1.06-1.22) to preserve a painful back tooth than White British.Conclusion Differences in treatment preferences were found among ethnic groups, suggesting that cultural background might influence the choices made and the value placed on dental extractions versus restorative treatment.
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Affiliation(s)
- Sanober Naz
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, London, UK; Kent Community Health NHS Foundation Trust, Kent, UK
| | - Eduardo Bernabe
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, London, UK
| | | | - Elsa Karina Delgado-Angulo
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, London, UK; Facultad de Odontología, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Bogale B, Engida F, Hanlon C, Prince MJ, Gallagher JE. Dental caries experience and associated factors in adults: a cross-sectional community survey within Ethiopia. BMC Public Health 2021; 21:180. [PMID: 33478460 PMCID: PMC7819221 DOI: 10.1186/s12889-021-10199-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 01/10/2021] [Indexed: 02/04/2023] Open
Abstract
Background Ethiopia is a developing sub-Saharan African country with increasing prevalence of non-communicable diseases (NCDs), including oral conditions. Oral health and dental care have been given little consideration, and there is limited information relating to population oral health and use of dental services in the country. The aim of this study was to examine the burden and associated factors of dental caries experience and investigate access to dental care amongst adults within Ethiopia. Methods This community-based oral health survey is a baseline study for the ASSET - Health System Strengthening in sub-Saharan Africa project undertaken in the Butajira area, south-central Ethiopia. A stratified random sample of households and individuals participated in the study. The survey instruments were mainly based on the WHO Oral Health Survey Methods manual (5th ed.). Face-to-face interviews and clinical dental examinations were conducted. The data were analysed for descriptive statistics; and Poisson regression models were built to assess the association of dental caries and predictor variables in adults (≥18 years). Results Most of the study population (n = 626) were female (63.9%), married (71.4%) and Muslim (76.0%). Just over half (53.2%) lived in rural areas and many (44.4%) had no formal education. A majority (74.0%) reported never utilising dental care services, and the main reason was never experiencing any dental problem (71.3%). Sixty percent (n = 377) of the adults had experienced dental caries, 88.0% (n = 332) of whom had untreated carious teeth. Pain or discomfort was reported by 16.5, and 7.2% had one or more PUFA component. Most (59.9%) adults with dental caries experience reported tooth pain or discomfort during the last year. In the fully adjusted Poisson regression model, increasing age, dental care utilisation and Khat chewing had positive significant associations with dental caries experience, whilst education status was negatively associated (p < 0.05). Conclusion This study demonstrated a high burden of dental caries and considerable consequences resulting from untreated disease in this population of adults. There was evidence of social inequity, limited utilisation of dental care and oral health awareness. This highlights the need for oral health system strengthening focusing on health promotion and expanding overall access to care. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10199-9.
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Affiliation(s)
- Birke Bogale
- Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, London, UK. .,Department of Dental and Maxillofacial Surgery, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - Fasikawit Engida
- Department of Dentistry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK.,College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, Ethiopia.,Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Martin J Prince
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK
| | - Jennifer E Gallagher
- Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, London, UK
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Tan YR, Tan EH, Jawahir S, Mohd Hanafiah AN, Mohd Yunos MH. Demographic and socioeconomic inequalities in oral healthcare utilisation in Malaysia: evidence from a national survey. BMC Oral Health 2021; 21:34. [PMID: 33468125 PMCID: PMC7816410 DOI: 10.1186/s12903-020-01388-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/28/2020] [Indexed: 11/15/2022] Open
Abstract
Background Throughout the years, oral healthcare utilisation in Malaysia has been low despite various efforts by the Ministry of Health Malaysia for improvement. This study aimed to determine the prevalence of oral healthcare utilisation and identify factors associated with oral healthcare utilisation among adults in Malaysia. Methods Secondary data analysis of adults aged 18 years and over from the National Health and Morbidity Survey 2019 was conducted in this study. Characteristics of respondents and those who utilised oral healthcare were described using complex sample descriptive statistics. Logistic regression analysis was performed to examine the association between the dependent and independent variables. Dependent variable was oral healthcare utilisation in the last 12 months. Independent variables were demographic and socioeconomic factors (predisposing, enabling and need characteristics) based on Andersen’s Behavioural Model. Results A total of 11,308 respondents, estimated to represent 21.7 million adults aged 18 years and over in Malaysia were included in the analysis. Prevalence of oral healthcare utilisation in the last 12 months was 13.2%. Demographic factors of sex, age, marital status, and socioeconomic factors of education level and occupation as well as health belief such as medical check-up were significantly related to oral healthcare utilisation. Enabling factor of household income quintile had significant association with oral healthcare utilisation. Inequalities were observed; females (OR = 1.57, 95% CI = 1.25, 1.96), younger adults (OR = 1.64, 95% CI = 1.15, 2.33), those who were married (OR = 1.65, 95% CI = 1.23, 2.22), those with higher education (OR = 2.21, 95% CI = 1.23, 3.99), those who had medical check-up in the last 12 months (OR = 1.86, 95% CI = 1.53, 2.25) and those with higher income (OR = 1.43, 95% CI = 1.04, 1.96) were more likely to utilise oral healthcare. Conclusion Understanding factors associated with utilisation of oral healthcare could help in formulating effective interventions to improve oral healthcare utilisation. Demographic and socioeconomic factors are strong determinants of oral healthcare utilisation in Malaysia. Appropriate interventions to strengthen the existing programmes aimed to promote regular and timely oral health check-ups are needed to improve oral healthcare utilisation.
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Affiliation(s)
- Yeung R'ong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Ee Hong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Suhana Jawahir
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Ainul Nadziha Mohd Hanafiah
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Muhammad Hafiz Mohd Yunos
- Tengkawang Dental Clinic, Terengganu Health Department, Ministry of Health Malaysia, 21700 Hulu Terengganu, Terengganu, Malaysia
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Musrati A, Huew R. Dietary consumption and its association with dental caries in schoolchildren in Benghazi, Libya. DENTISTRY AND MEDICAL RESEARCH 2021. [DOI: 10.4103/dmr.dmr_43_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lee AK, Aigner A, Schmid T, Kurth T. Spatio-temporal trends in caries: A study on children in Berlin-Mitte. Clin Exp Dent Res 2020; 7:196-204. [PMID: 33200569 PMCID: PMC8019772 DOI: 10.1002/cre2.354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 02/01/2023] Open
Abstract
Background Significant inequalities in caries distribution among children in Germany have been reported, but small‐scale areas remain understudied. Aim To examine spatio‐temporal trends in children's dental caries at the small‐area level in Berlin‐Mitte. Design Routinely collected data from Berlin's annual Health Examination Surveys were used, which also include information on age, sex, country of origin, and residential area. The study population consists of 14,866 children aged 5 to 7 between 2006 and 2014 in the district of Berlin‐Mitte. Outcome variables are the dmft (decayed, missing, and filled teeth), the presence of any caries experience, untreated caries, and caries risk. The outcomes are summarized descriptively and graphically presented for 10 quarters and 41 communities within Berlin‐Mitte. Results Relevant gaps in children's dental caries were discovered between the quarters of Mitte. Three quarters in the northeast part of Mitte have consistently indicated the lowest oral health status in all four outcomes, and children having high caries risk have been increasingly concentrating in this area over time. Despite the continuous improvements in the southern part, the averages in total of Mitte for all outcomes have risen. Conclusion Our findings confirm the spatiotemporally mounting disparities in children's oral health between the quarters in Berlin‐Mitte and that particular quarters need urgent attention. The small‐area approach made it easier and more effective to reveal the spatial distribution of children's dental caries at the local level. The small‐area analysis should be strongly encouraged in future caries research to narrow the inequalities in children's oral health.
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Affiliation(s)
- Ae Kyung Lee
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Annette Aigner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Timo Schmid
- Institute of Statistics and Econometrics, Freie Universität Berlin, Berlin, Germany
| | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Najafi F, Rezaei S, Hajizadeh M, Soofi M, Salimi Y, Kazemi Karyani A, Soltani S, Ahmadi S, Homaie Rad E, Karami Matin B, Pasdar Y, Hamzeh B, Nazar MM, Mohammadi A, Poustchi H, Motamed-Gorji N, Moslem A, Khaleghi AA, Fatthi MR, Aghazadeh-Attari J, Ahmadi A, Pourfarzi F, Somi MH, Sohrab M, Ansari-Moghadam A, Edjtehadi F, Esmaeili A, Joukar F, Lotfi MH, Aghamolaei T, Eslami S, Tabatabaee SHR, Saki N, Haghdost AA. Decomposing socioeconomic inequality in dental caries in Iran: cross-sectional results from the PERSIAN cohort study. ACTA ACUST UNITED AC 2020; 78:75. [PMID: 32832079 PMCID: PMC7436972 DOI: 10.1186/s13690-020-00457-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/10/2020] [Indexed: 12/24/2022]
Abstract
Background The current study aimed to measure and decompose socioeconomic-related inequalities in DMFT (decayed, missing, and filled teeth) index among adults in Iran. Methods The study data were extracted from the adult component of Prospective Epidemiological Research Studies in IrAN (PERSIAN) from 17 centers in 14 different provinces of Iran. DMFT score was used as a measure of dental caries among adults in Iran. The concentration curve and relative concentration index (RC) was used to quantify and decompose socioeconomic-related inequalities in DMFT. Results A total of 128,813 adults aged 35 and older were included in the study. The mean (Standard Deviation [SD]) score of D, M, F and DMFT of the adults was 3.3 (4.6), 12.6 (10.5), 2.1 (3.4) and 18.0 (9.5), respectively. The findings suggested that DMFT was mainly concentrated among the socioeconomically disadvantaged adults (RC = - 0.064; 95% confidence interval [CI), - 0.066 to - 0.063). Socioeconomic status, being male, older age and being a widow or divorced were identified as the main factors contributing to the concentration of DMFT among the worse-off adults. Conclusions It is recommended to focus on the dental caries status of socioeconomically disadvantaged groups in order to reduce socioeconomic-related inequality in oral health among Iranian adults. Reducing socioeconomic-related inequalities in dental caries should be accompanied by appropriate health promotion policies that focus actions on the fundamental socioeconomic causes of dental disease.
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Affiliation(s)
- Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Moslem Soofi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sina Ahmadi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Enayatollah Homaie Rad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradi Nazar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Mohammadi
- Department of Health Information Technology, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazgol Motamed-Gorji
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Moslem
- Department of Anesthesiology, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ali Asghar Khaleghi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Reza Fatthi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Aghazadeh-Attari
- Social determinants of Health Research Center, Urmia Jundishapur University of Medical Sciences, Urmia, Iran
| | - Ali Ahmadi
- Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrnoush Sohrab
- Diabetes Research cente, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Ansari-Moghadam
- Health Promotion Research Center, Zahedan Jundishapur University of Medical Sciences, Zahedan, Iran
| | - Farhad Edjtehadi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Esmaeili
- Department of Cardiology, Medical school, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Teamur Aghamolaei
- Department of Public Health, School of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Saied Eslami
- Pharmaceutical Research Center, Pharmaceutical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Nader Saki
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Akbar Haghdost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Seerig LM, Nascimento GG, Peres MA, Horta BL, Demarco FF. [Accumulated risk from poverty and tooth loss at 31 years of age: the 1982 live birth cohort in Pelotas, Rio Grande do Sul State, Brazil]. CAD SAUDE PUBLICA 2020; 36:e00167619. [PMID: 32813794 DOI: 10.1590/0102-311x00167619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/20/2019] [Indexed: 12/13/2022] Open
Abstract
The objective was to estimate the effect of accumulated risk from poverty and tooth loss at 31 years, using longitudinal data from the 1982 live birth cohort in Pelotas, Rio Grande do Sul State, Brazil. The income trajectory variables were built with four time points: birth and 15, 24, and 30 years of age. Potential confounding factors were sex, maternal schooling, maternal skin color, and smoking at 24 years. Potential mediators used the history of dentistry services use and caries based on the Significant Index Caries (SIC). The trajectory variable in the accumulated risk model was created with group-based trajectory modeling. The target outcome was the number of missing teeth at 31 years. Mean number of missing teeth at 31 years was 1.25. In the accumulated risk model after adjusting for confounders and mediators, individuals that were poor at one or two time points showed risk ratio - RR = 1.92 (95%CI: 1.40-2.63), and those with three or four episodes of poverty showed RR = 1.97 (95%CI: 1.24-3.13) for tooth loss. The results highlight the effect of lifetime poverty on tooth loss. The effect was expanded in individuals that were exposed to poverty longer. Public policies aimed at improving income conditions also help reduce tooth loss.
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Affiliation(s)
| | | | - Marco Aurelio Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
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Piotrowska DE, Jankowska D, Huzarska D, Szpak AS, Pędziński B. Socioeconomic inequalities in use and non-use of dental services in Poland. Int J Public Health 2020; 65:637-647. [PMID: 32388573 PMCID: PMC7360667 DOI: 10.1007/s00038-020-01379-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives To assess the impact of classical socioeconomic factors on the use and non-use of dental services on a representative sample of Polish population. Methods The study was based on face-to-face surveys conducted by GUS (Statistics Poland) on 13,376 respondents in 2010 and 12,532 individuals in 2013. Results The percentage of people using dental services in the highest income group was approximately twice as high as that in the lowest one (Q1: 7.0% vs. Q5: 16.4%), with the same being true for education (the lowest education group: 8.3% vs. the highest education group: 18.0%), and place of residence (inhabitants of rural areas: 9.2% vs. inhabitants of largest cities: 15.9%) in 2013. The analysis has shown the disparities in not using dental services when in need to be less clear-cut. Conclusions The conducted research, based on two independent periods, a representative population sample, univariate analysis and the multivariate regression model has revealed pronounced social inequalities in dental care use. It is a challenge to determine the factors which contribute most to health inequalities and the interventions which are most effective in reducing them.
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Affiliation(s)
- Dorota Elżbieta Piotrowska
- Department of Public Health, Medical University of Bialystok, ul. Szpitalna 37, 15-295, Białystok, Poland.
| | - Dorota Jankowska
- Department of Statistics and Medical Informatics, Medical University of Bialystok, ul.Szpitalna 37, Białystok, 15-295, Poland
| | - Dorota Huzarska
- Department of Public Health, Medical University of Bialystok, ul. Szpitalna 37, 15-295, Białystok, Poland
| | - Andrzej Stanisław Szpak
- Department of Public Health, Medical University of Bialystok, ul. Szpitalna 37, 15-295, Białystok, Poland.,Institute of Rural Health, ul.Jaczewskiego 2, Lublin, 20-090, Poland
| | - Bartosz Pędziński
- Department of Public Health, Medical University of Bialystok, ul. Szpitalna 37, 15-295, Białystok, Poland.,Lomza Medical Center Ltd., ul.Ks.Kardynała Wyszyńskiego 9, Lomza, 18-400, Poland
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Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study. BMC Oral Health 2020; 20:63. [PMID: 32111212 PMCID: PMC7048098 DOI: 10.1186/s12903-020-1036-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/04/2020] [Indexed: 01/26/2023] Open
Abstract
Background Socioeconomic-related inequality in oral hygiene behaviors in Iran is poorly understood. This study aims to measure and decompose socioeconomic-related inequalities in oral hygiene behaviors among middle-aged and elderly adults in Iran. Methods A cross-sectional analysis was performed using data from the Prospective Epidemiological Research Studies in IrAN (PERSIAN), a large national cohort study. A total of 130,016 individuals aged 35 years and above from 17 cohort centers in Iran were included in the study. The normalized concentration index (Cn) was used to measure the magnitude of inequality in oral hygiene behaviors, i.e. brushing at least twice and flossing once daily, among middle-aged and elderly Iranian adults included in the cohort centers. Decomposition analysis was performed to quantify the contribution of each determinant to the observed inequality in oral hygiene behaviors. Results Totally, 65.5% of middle-aged and elderly adults brushed their teeth twice a day or more, 7.6% flossed at least once a day and 3.48% had both habits. The estimated Cn of the two habits combined, i.e. tooth brushing and dental flossing, for all provinces taken part in the PERSIAN cohort study was 0.399 (95% confidence interval [CI]: 0.383 to 0.417), indicating that the prevalence of the two habits combined is more concentrated among individuals with higher socioeconomic status. Inequality in oral hygiene behaviors was pro-rich in all cohort centers. The decomposition results suggested socioeconomic status as the main factor contributing to the overall inequality, followed by the level of education, and the province of residence. Conclusion A low prevalence of oral hygiene behaviors among middle-aged and elderly Iranian adults was observed. There was also a pro-rich inequality in oral hygiene behaviors among middle-aged and elderly adults in all cohort centers. These results suggest an urgent need for targeted policy interventions to increase the prevalence of preventive oral hygiene behaviors among the poor and less-educated middle-aged and elderly adults in Iran.
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Pinni J, Avula JS, Bandi S. Association of dental caries with socio-demographic and nutritional factors among school children in Guntur district of Andhra Pradesh, India. PEDIATRIC DENTAL JOURNAL 2019. [DOI: 10.1016/j.pdj.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ramsay SE, Papachristou E, Watt RG, Lennon LT, Papacosta AO, Whincup PH, Wannamethee SG. Socioeconomic disadvantage across the life-course and oral health in older age: findings from a longitudinal study of older British men. J Public Health (Oxf) 2019; 40:e423-e430. [PMID: 29684223 DOI: 10.1093/pubmed/fdy068] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/04/2018] [Indexed: 12/16/2022] Open
Abstract
Background The influence of life-course socioeconomic disadvantage on oral health at older ages is not well-established. We examined the influence of socioeconomic factors in childhood, middle-age and older age on oral health at older ages, and tested conceptual life-course models (sensitive period, accumulation of risk, social mobility) to determine which best described observed associations. Methods A representative cohort of British men aged 71-92 in 2010-12 included socioeconomic factors in childhood, middle-age and older age. Oral health assessment at 71-92 years (n = 1622) included tooth count, periodontal disease and self-rated oral health (excellent/good, fair/poor) (n = 2147). Life-course models (adjusted for age and town of residence) were compared with a saturated model using Likelihood-ratio tests. Results Socioeconomic disadvantage in childhood, middle-age and older age was associated with complete tooth loss at 71-92 years-age and town adjusted odds ratios (95% CI) were 1.39 (1.02-1.90), 2.26 (1.70-3.01), 1.83 (1.35-2.49), respectively. Socioeconomic disadvantage in childhood and middle-age was associated with poor self-rated oral health; adjusted odds ratios (95% CI) were 1.48 (1.19-1.85) and 1.45 (1.18-1.78), respectively. A sensitive period for socioeconomic disadvantage in middle-age provided the best model fit for tooth loss, while accumulation of risk model was the strongest for poor self-rated oral health. None of the life-course models were significant for periodontal disease measures. Conclusion Socioeconomic disadvantage in middle-age has a particularly strong influence on tooth loss in older age. Poor self-rated oral health in older age is influenced by socioeconomic disadvantage across the life-course. Addressing socioeconomic factors in middle and older ages are likely to be important for better oral health in later life.
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Affiliation(s)
- Sheena E Ramsay
- Institute of Health & Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK.,Institute of Epidemiology and Health Care, UCL, London, UK
| | | | - Richard G Watt
- Department of Epidemiology & Public Health UCL, London, UK
| | - Lucy T Lennon
- Institute of Epidemiology and Health Care, UCL, London, UK
| | | | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
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Socioeconomic and ethnic status of two- and three-year-olds undergoing dental extractions under general anaesthesia in Wolverhampton, 2011-2016. Br Dent J 2019; 226:349-353. [PMID: 30850792 DOI: 10.1038/s41415-019-0029-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction Socioeconomic and ethnic status have in the past been implicated as possible causes of dental caries. Aims To assess the role that relative social depravation and ethnicity has on dental caries in two- and three-year-olds undergoing DGA in Wolverhampton. Design and methods Retrospective analysis of hospital records of 213 patients over a six-year period (2011-2016). A three-way analysis of variance (ANOVA) and chi-square tests were used to test statistical significance. Results The most significant factor between ethnicity, year and sex, was ethnicity (P = 0.026), with the greatest difference between mean number of teeth extracted per treatment visit for Other Whites (mean = 6.3) compared with White British (mean = 4.0) (difference P = 0.012). The association between the difference in extracted quadrant and year of treatment was significant (P = 0.011), with the greatest frequency of extractions involving three and four quadrants in the later years of 2015 and 2016. Seventy percent of children treated were living in the 20% most deprived areas (deciles one and two) compared with children living in more affluent areas (deciles three to ten) (P <0.001). Conclusion An important public health issue is highlighted which needs to be addressed, both at a national level and locally, through early oral health education for mothers from relatively deprived areas; particularly those of Other White ethnicity.
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Chinzorig T, Aida J, Cooray U, Nyamdorj T, Mashbaljir S, Osaka K, Garidkhuu A. Inequalities in Caries Experience Among Mongolian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3892. [PMID: 31615100 PMCID: PMC6843787 DOI: 10.3390/ijerph16203892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 01/03/2023]
Abstract
Although inequalities in dental caries have been well-reported, there is only one Mongolian study on the association between socioeconomic status (SES) and caries experience, which was published ten years ago. This study aimed to determine the dental health status of Mongolian children living in urban and suburban areas of Ulaanbaatar city and examine its association with income and parental educational attainment. An oral examination was conducted by dentists and caries were measured as deft/DMFT indices. A questionnaire including demographic characteristics and socioeconomic status was completed by their parents or caregiver. Parental educational attainment and household income were used as the measures of SES. The relative index of inequality (RII) and slope index of inequality (SII) were employed to examine the association between SES on deft and DMFT after adjusting for covariates. Dental caries prevalence (those with deft/DMFT > 0) was 89.3% among the total number of participants. The mean deft/DMFT values for age groups 1-6, 7-12, and 13-18 were 5.83 (SD = 4.37, deft), 5.77 (SD = 3.31, deft/DMFT), and 3.59 (SD = 2.69, DMFT), respectively. Rather than residence area and parental educational attainment, significant caries experience inequality was observed in relation to income (RII 0.65 95%, CI 0.52 to 0.82, SII -2.30, 95% CI -4.16 to -0.45). A prevention strategy for lower socioeconomic groups and building integrated oral health surveillance to monitor epidemiological trends for further evaluation of its progress is necessary.
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Affiliation(s)
- Tselmuun Chinzorig
- Department of International and Community Oral Health, School of Dentistry, Tohoku University, Miyagi 980-0872, Japan.
- Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.
| | - Jun Aida
- Department of International and Community Oral Health, School of Dentistry, Tohoku University, Miyagi 980-0872, Japan.
| | - Upul Cooray
- Department of International and Community Oral Health, School of Dentistry, Tohoku University, Miyagi 980-0872, Japan.
| | - Tsengelsaikhan Nyamdorj
- Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.
| | - Soyolmaa Mashbaljir
- Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.
| | - Ken Osaka
- Department of International and Community Oral Health, School of Dentistry, Tohoku University, Miyagi 980-0872, Japan.
| | - Ariuntuul Garidkhuu
- Department of International and Community Oral Health, School of Dentistry, Tohoku University, Miyagi 980-0872, Japan.
- Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.
- School of Medicine, Department of Public Health, International University of Health and Welfare, Tochigi 286-8686, Japan.
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Hakeem FF, Sabbah W. Is there socioeconomic inequality in periodontal disease among adults with optimal behaviours. Acta Odontol Scand 2019; 77:400-407. [PMID: 30919709 DOI: 10.1080/00016357.2019.1582795] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To examine if socioeconomic inequalities exist in periodontal disease among adult with optimal oral health behaviours. MATERIALS AND METHODS Data were from the Adult Dental Health Survey 2009, a national survey of England, Wales and Northern Ireland. Overall, 4738 participants aged 35 years and older were included in the analysis. Periodontal disease indicated by pocket depth or loss of attachment ≥4 mm, and gingival bleeding were used as periodontal outcomes. Education and deprivation indicated socioeconomic position. Behavioural factors were dental visits, toothbrushing and smoking. The subset of adults with and without optimal health related behaviours included 2916 and 1822 participants, respectively. The associations between periodontal disease and socioeconomic position were tested adjusting for demographic and behavioural factors. Additional models stratifying the sample to those with and without optimal behaviour subgroup were constructed. RESULTS Education and deprivation were significantly associated with periodontal disease in the partially adjusted models. In the analysis of those with optimal behaviours, only deprivation and highest level of education showed significant association with periodontitis (PD), but not with gingival bleeding. Among those without optimal behaviours, all socioeconomic factors were associated with all outcomes except deprivation and PD. CONCLUSIONS Oral health behaviours marginally contributed to inequalities in gingival bleeding and periodontal disease. Socioeconomic inequalities were attenuated among those with optimal behaviours and persisted among those without optimal behaviours. Behaviours appeared to be an effect modifier for the relationship between periodontal outcomes and socioeconomic factors.
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Affiliation(s)
- Faisal F. Hakeem
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University Dental College and Hospital, Madinah, Saudi Arabia
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
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Knight ET, Murray Thomson W. A public health perspective on personalized periodontics. Periodontol 2000 2019; 78:195-200. [PMID: 30198135 DOI: 10.1111/prd.12228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In this paper, we consider personalized periodontics from a public health perspective. Periodontitis is an under-acknowledged and important public health problem, and there has long been interest in identifying and treating those who are at high risk of developing this disease. Although susceptibility/risk-assessment tools in periodontology are currently in their early stages of development, personalized periodontics is increasingly becoming a realistic approach. At the population level, however, personalized periodontics is not an effective way of improving periodontal health because it would target only those who seek help or are able to access care. The occurrence of periodontitis in populations is socially patterned, with those of lower socio-economic position having poorer periodontal health and being far less likely to seek care. There is the potential for social inequalities actually to worsen as a result of personalized periodontics. In most health systems, personalized periodontics is likely to be accessible only to the social strata for whom it is affordable, and those with the greatest need for such an intervention will remain the least likely to be able to get it. Thus, personalized periodontics is likely to be a niche service for a small proportion of the adult population. This is at odds with the public health approach.
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Affiliation(s)
- Ellie T Knight
- Sir John Walsh Research Institute, Department of Oral Sciences, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - W Murray Thomson
- Sir John Walsh Research Institute, Department of Oral Sciences, School of Dentistry, The University of Otago, Dunedin, New Zealand
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Caries prevalence, clinical consequences and self-reported pain experienced by children living in the West Bank. Eur Arch Paediatr Dent 2019; 20:333-338. [DOI: 10.1007/s40368-018-00412-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
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Kavaliauskienė A, Šidlauskas A, Zaborskis A. Modification and psychometric evaluation of the child perceptions questionnaire (CPQ 11-14) in assessing oral health related quality of life among Lithuanian children. BMC Oral Health 2019; 19:1. [PMID: 30611272 PMCID: PMC6320629 DOI: 10.1186/s12903-018-0701-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022] Open
Abstract
Background Oral health related quality of life (OHRQoL) research among children and adolescents in Lithuania is just starting and no measures have been validated to date. Therefore, this study aimed to validate a Lithuanian version of the full (37 items) Child Perceptions Questionnaire (CPQ11–14) within a random sample of children aged 11 to 14. Methods A cross-sectional survey among a randomly selected sample of schoolchildren (N = 307) aged 11 to14 was conducted. An anonymous questionnaire included the full CPQ11–14 and items on global life satisfaction, oral health and oral life quality self-rating. The questionnaire was translated into Lithuanian using translation guidelines. In addition, an item on the oral pain was modified identifying the pain location. Standard tests (Cronbach’s α, construct validity and discriminant validity), supplemented with both exploratory and confirmatory factor analyses, were employed for psychometric evaluation of the instrument. The questionnaire was also tested by comparison students’ and their parents’ (N = 255) responses about oral symptoms and functional limitations. Results The modified Lithuanian version of CPQ11–14 revealed good internal consistency reliability (Cronbach’s alpha for the total scale was 0.88). The measure showed significant associations with perceived oral health status and oral well-being, as well as with global life satisfaction (p < 0.01). Discriminant validity of the instrument was approved by comparison of children’s groups defined by self-reported caries experience and malocclusion. Factor analysis revealed a complex structure with two or three factors in each of four domains of the CPQ11–14. Excellent or acceptable levels of indices of model fitting with the given data were obtained for oral symptoms, functional limitations and emotional well-being domains, but not for the social well-being domain. A significant association between child and parental responses was found (intraclass correlation coefficient was 0.56 and 0.43, correspondingly in domains of oral symptoms and functional limitations). Conclusion The Lithuanian version of the CPQ11–14 (with a modified item that identifies location of oral pain) appears to be a valid instrument to be used in further studies for measuring OHRQoL among 11 to 14 year old children in Lithuania. Electronic supplementary material The online version of this article (10.1186/s12903-018-0701-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aistė Kavaliauskienė
- Faculty of Odontology, Clinic of Orthodontics, Lithuanian University of Health Sciences, Medical Academy, J.Luksos-Daumanto street, 6, LT-50106, Kaunas, Lithuania.
| | - Antanas Šidlauskas
- Faculty of Odontology, Clinic of Orthodontics, Lithuanian University of Health Sciences, Medical Academy, J.Luksos-Daumanto street, 6, LT-50106, Kaunas, Lithuania
| | - Apolinaras Zaborskis
- Faculty of Public Health, Health Research Institute and Department of Public Health, Lithuanian University of Health Sciences, Medical Academy, Tilzes street, 18, LT-47181, Kaunas, Lithuania
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Fonsêca GS, Pires FS, Junqueira SR, Souza CRD, Botazzo C. Redesenhando caminhos na direção da clínica ampliada de saúde bucal. SAUDE E SOCIEDADE 2018. [DOI: 10.1590/s0104-12902018180117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo O trabalho analisa a experiência da clínica ampliada de saúde bucal em uma Unidade Básica de Saúde (UBS) do município de São Paulo. O estudo é de abordagem qualitativa, do tipo pesquisa-ação, em que cirurgiãs-dentistas e estagiários de odontologia experienciaram a clínica ampliada de saúde bucal, realizando registros sobre suas práticas em diários de pesquisa e construindo, em conjunto com os usuários, projetos terapêuticos singularizados. Foram analisados três diários de pesquisa e 52 casos clínicos e seus respectivos projetos terapêuticos singularizados, elaborados entre os anos de 2014 e 2015. O material foi tratado por análise de conteúdo temática, com as seguintes categorias: procedimentos odontológicos realizados na atenção primária à saúde; referência e contrarreferência; divisão do trabalho; anamnese e satisfação do usuário. A análise indicou que novos processos de trabalho estimulam os usuários a expor suas demandas de saúde e que projetos terapêuticos singularizados são fundamentais para a produção do cuidado, o que gera satisfação e resolubilidade. As principais limitações encontradas foram: pouco apoio da rede especializada, escassez de pessoal auxiliar, não acesso ao prontuário único e dificuldade em ressignificar as narrativas para além dos achados bucais. Torna-se essencial o desenvolvimento de estudos relacionados a novos fazeres em saúde bucal em outras realidades.
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Watt RG, Mathur MR, Aida J, Bönecker M, Venturelli R, Gansky SA. Oral Health Disparities in Children: A Canary in the Coalmine? Pediatr Clin North Am 2018; 65:965-979. [PMID: 30213357 DOI: 10.1016/j.pcl.2018.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite being largely preventable, oral diseases are still a major public health problem in child populations in many parts of the world. Increasingly, however, oral diseases disproportionately affect socially disadvantaged groups in society. It is unjust and unfair that children and families from disadvantaged backgrounds experience high levels of oral diseases. This article analyzes oral diseases through a health disparities lens. Action to combat oral health disparities requires a radical multifaceted strategy that addresses the shared underlying root causes of oral diseases, the social determinants of health inequality.
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Affiliation(s)
- Richard G Watt
- Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Manu Raj Mathur
- Department of Dental Public Health, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area Gurgaon, Gurgaon, Haryana 122002, India
| | - Jun Aida
- Department of International Health, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Marcelo Bönecker
- Dental Faculty, Av. Prof Lineu Prestes 2227 - University of Sao Paulo, Sao Paulo 05508-900, Brazil
| | - Renato Venturelli
- Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Stuart A Gansky
- Division of Oral Epidemiology and Dental Public Health, Center to Address Disparities in Children's Oral Health (Known As CAN DO), Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, Box #1361, San Francisco, CA 94143, USA
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Venturelli Garay RE, Watt RG. Review and analysis of Chilean dental undergraduate education: curriculum composition and profiles of first year dental students. HUMAN RESOURCES FOR HEALTH 2018; 16:48. [PMID: 30223851 PMCID: PMC6142632 DOI: 10.1186/s12960-018-0314-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND In Chile, dentistry has become a very popular career choice for students, which has resulted in a substantial increase in both, the number of dental graduates and dental schools. Nonetheless, there is a need for change in the way dental schools select and educate their students to keep pace with the rapidly changing nature of societal needs and to tackle the marked health inequalities that exist in the country. The aim of this study was to review and critique dental undergraduate education in Chile, with a particular focus on the curriculum composition and profiles of students admitted to dental schools from 2010 to 2014. METHODS A descriptive and retrospective design was utilised. Two different methods were undertaken: primary data collection regarding curriculum and secondary data analysis in relation to students' profiles. Descriptive statistics were used to assess the relative proportions of subject modules within the undergraduate dental curriculum and in particular the public health components. The analysis of the student profiles described specific background factors, namely, gender, age, secondary school type, location, rural-urban status and student's year of admission. Also, trends of dental students' intake between 2010 and 2014 were investigated. Logistic regression analysis was undertaken to assess potential associations between the aforementioned background factors and students' choice of dental school. RESULTS Regarding the curriculum review, a 67% response rate was obtained. The most dominant component of Chilean dental curriculum was the clinical subjects (33%), followed by the basic and biological sciences (16%) and then medical and dental sciences (13%). In relation to the admission of students, the majority attended private schools (72%); most were females (62%); aged 19 years or less (74%); had an urban origin (99%); and came from subsidised private secondary schools (48%). Significant differences were found between students admitted to traditional and private dental schools. CONCLUSIONS Clinical sciences are the most dominant subjects in the Chilean dental curriculum. Overall, traditional and private institutions had a broadly similar composition in their curriculum with the exception of the public health component. Students from disadvantaged backgrounds were the minority in dental schools across Chile.
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Affiliation(s)
- Renato E Venturelli Garay
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom.
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom
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Association of Self-Perceived Oral Health and Function with Clinically Determined Oral Health Status among Adults Aged 35⁻54 Years: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081681. [PMID: 30087297 PMCID: PMC6121354 DOI: 10.3390/ijerph15081681] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/02/2018] [Accepted: 08/07/2018] [Indexed: 11/27/2022]
Abstract
This study aimed to analyse the association of self-perceived oral health status (OHS) and functions with clinical OHS in Korean adults aged 35–54 years. The study was designed as a cross-sectional study using data from the Fourth Korea National Health and Nutrition Examination Survey (2007–2009). A total of 6605 subjects aged 35–54 years who completed the oral examination and questionnaires were included. An association of self-perceived OHS and functions with clinically determined OHS was confirmed by a complex-samples general linear model. Data on socioeconomic variables, i.e., household income and education level, self-perceived OHS and functions, such as chewing and speaking, were collected by trained interviewers. The clinical OHS was determined by trained dentists and included the number of untreated decayed teeth (DT); decayed, missing, and filled teeth (DMFT); prosthetic and periodontal status. The combined score was estimated as the sum of self-perceived OHS and functions. Based on the estimation coefficient, the clinical variables that were most strongly associated with self-perceived OHS and functions were, in order, periodontal status, prosthetic status, DT, and DMFT. In addition, the combined score for self-perceived OHS and functions was associated with household income, education, and clinically determined OHS.
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Assari S. Socioeconomic Status and Self-Rated Oral Health; Diminished Return among Hispanic Whites. Dent J (Basel) 2018; 6:E11. [PMID: 29695074 PMCID: PMC6023433 DOI: 10.3390/dj6020011] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 04/20/2018] [Accepted: 04/20/2018] [Indexed: 12/12/2022] Open
Abstract
Background. An extensive body of knowledge has documented weaker health effects of socio-economic status (SES) for Blacks compared to Whites, a phenomenon also known as Blacks’ diminished return. It is, however, unknown whether the same diminished return also holds for other ethnic minorities such as Hispanics or not. Aim. Using a nationally representative sample, the current study aimed to compare Non-Hispanic and Hispanic Whites for the effects of SES on self-rated oral health. Methods. For the current cross-sectional study, we used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001⁻2003. With a nationally representative sampling, CPES included 11,207 adults who were either non-Hispanic Whites (n = 7587) or Hispanic Whites (n = 3620. The dependent variable was self-rated oral health, treated as dichotomous measure. Independent variables were education, income, employment, and marital status. Ethnicity was the focal moderator. Age and gender were covariates. Logistic regressions were used for data analysis. Results. Education, income, employment, and marital status were associated with oral health in the pooled sample. Although education, income, employment, and marital status were associated with oral health in non-Hispanic Whites, none of these associations were found for Hispanic Whites. Conclusion. In a similar pattern to Blacks’ diminished return, differential gain of SES indicators exists between Hispanic and non-Hispanic Whites, with a disadvantage for Hispanic Whites. Diminished return of SES should be regarded as a systemically neglected contributing mechanism behind ethnic oral health disparities in the United States. Replication of Blacks’ diminished return for Hispanics suggests that these processes are not specific to ethnic minority groups, and non-White groups gain less because they are not enjoying the privilege and advantage of Whites.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor 48109-2700, MI, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor 48109-2700, MI, USA 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
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Lucas PJ, Patsios D, Walls K, Neville P, Harwood P, Williams JG, Sandy J. Neighbourhood incidence rate of paediatric dental extractions under general anaesthetic in South West England. Br Dent J 2018; 224:169-176. [DOI: 10.1038/sj.bdj.2018.77] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2017] [Indexed: 11/09/2022]
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Shi C, Faris P, McNeil DA, Patterson S, Potestio ML, Thawer S, McLaren L. Ethnic disparities in children's oral health: findings from a population-based survey of grade 1 and 2 schoolchildren in Alberta, Canada. BMC Oral Health 2018; 18:1. [PMID: 29301577 PMCID: PMC5753483 DOI: 10.1186/s12903-017-0444-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/07/2017] [Indexed: 12/04/2022] Open
Abstract
Background Although oral health has improved remarkably in recent decades, not all populations have benefited equally. Ethnic identity, and in particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada. Methods A dental survey (administered during 2013-14) included a mouth examination and parent questionnaire. Oral health outcomes included: 1) percentage of children with dental caries; 2) number of decayed, extracted/missing (due to caries) and filled teeth; 3) percentage of children with two or more teeth with untreated caries; and 4) percentage of children with parental-ratings of fair or poor oral health. We used multivariable regression analysis to examine ethnic disparities in oral health, adjusting for demographic, socioeconomic and caries-related behavioral variables. Results We observed significant ethnic disparities in children’s oral health. Most visible minority groups, particularly Filipino and Arab, as well as Indigenous children, were more likely to have worse oral health than White populations. In particular, Filipino children had an almost 5-fold higher odds of having severe untreated dental problems (2 or more teeth with untreated caries) than White children. Adjustment for demographic, socioeconomic, and caries-related behavior variables attenuated but did not eliminate ethnic disparities in oral health, with the exception of Latin American children whose outcomes did not differ significantly from White populations after adjustment. Conclusions Significant ethnic disparities in oral health exist in Alberta, Canada, even when adjusting for demographic, socioeconomic and caries-related behavioral factors, with Filipino, Arab, and Indigenous children being the most affected. Electronic supplementary material The online version of this article (10.1186/s12903-017-0444-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Congshi Shi
- Department of Community Health Sciences, University of Calgary, TRW3, 3280 Hospital Dr. NW, Calgary, AB, T2N 4Z6, Canada
| | - Peter Faris
- Alberta Health Services, Calgary, AB, Canada
| | - Deborah A McNeil
- Department of Community Health Sciences, University of Calgary, TRW3, 3280 Hospital Dr. NW, Calgary, AB, T2N 4Z6, Canada.,Alberta Health Services, Calgary, AB, Canada.,Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Steven Patterson
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Melissa L Potestio
- Department of Community Health Sciences, University of Calgary, TRW3, 3280 Hospital Dr. NW, Calgary, AB, T2N 4Z6, Canada.,Alberta Health Services, Calgary, AB, Canada
| | - Salima Thawer
- Department of Community Health Sciences, University of Calgary, TRW3, 3280 Hospital Dr. NW, Calgary, AB, T2N 4Z6, Canada.,School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Lindsay McLaren
- Department of Community Health Sciences, University of Calgary, TRW3, 3280 Hospital Dr. NW, Calgary, AB, T2N 4Z6, Canada.
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André Kramer AC, Petzold M, Hakeberg M, Östberg AL. Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents. Caries Res 2017; 52:42-50. [DOI: 10.1159/000481411] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 09/08/2017] [Indexed: 01/26/2023] Open
Abstract
The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.
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Tikare S, AlQahtani NA, Eroje AB, AlQahtani KM, Assiri JA, AlAmri MH. Effectiveness of School Oral Health Screening and Factors Affecting Dental Attendance Among Female Primary School Children in Saudi Arabia. JOURNAL OF ADVANCED ORAL RESEARCH 2017. [DOI: 10.1177/2229411217729103] [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
Objectives: School dental screening and referral is a dental public health measure that helps children with oral health problems to come in contact with dental services. Recent studies have failed to demonstrate the effectiveness of school screening programs in stimulating dental attendance. The objective of the present study is to assess the effectiveness of school oral health screening in stimulating dental attendance and factors affecting dental attendance among female primary school children in Saudi Arabia. Methodology: A multistage cluster random sampling method was used in which the unit of randomization was the school. All children were given comprehensive oral health education followed by oral screening. Oral health referrals to visit dental clinic were given to children needing any dental treatment. The parents were contacted by telephone two months after oral health referral and information on child’s dental attendance and reasons for failing to attend dental clinics was collected according to predetermined set of questions and the data was subjected to statistical analysis. Results: A total of 1,035 female school children aged 6 to 12 years received oral health education at school followed by dental screening. Only 211 (23.8%) children attended dental clinics after receiving oral health referrals. The most important reason for not attending the dental clinic was difficulty for working parents to take time off (41.2%) followed by logistic problems (20.4%) and some parents thought dental treatment was not important since there was no pain (9.7%). The least perceived barriers were cost of dental treatment (3.6%), difficulty in taking leave from school (3%), and school exams (3%). Conclusions: School oral health screening and referrals have been found to be ineffective at stimulating dental attendance. Parental factors like ‘lack of time’ and ‘logistic problems’ for taking their child to the dentist were found to be major factors affecting dental attendance. Methods to improve parent’s awareness regarding oral health of children and alternative choices to ensure adequate dental care to vulnerable children needs to be explored.
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Affiliation(s)
- Shreyas Tikare
- Assistant Professor, Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Saudi Arabia
| | - Nabeeh A. AlQahtani
- Assistant Professor, Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Saudi Arabia
| | - Alezi Braimoh Eroje
- Assistant Professor, Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Saudi Arabia
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