Gender differences in tooth loss among Chilean adolescents: socio-economic and behavioral correlates

Association between parity and tooth loss among northern Nigerian Hausa women

BACKGROUND

Female reproduction is associated with physiological, metabolic, and nutritional demands that can negatively affect health and are possibly cumulative when parity is high. While it is probable that maternal oral health is similarly affected, available evidence is based on fairly low parity populations and likely confounders affecting oral health status were not considered.

AIM

To determine the relationship between parity and tooth loss in a population with many high parity women. Contributions of age, reproductive and socioeconomic parameters, and oral health practices were considered.

MATERIALS AND METHODS

This was a cross-sectional study involving 612 Hausa women of all parity levels aged 13-65 years. Women with ≥5 children were considered high parity. Sociodemographic status and oral health practices were collected using a structured interviewer-administered questionnaire. All teeth present, (excluding third molars) and missing teeth were noted, with inquiries regarding tooth loss etiology. Associations with tooth loss were evaluated through correlations, ANOVA, post hoc analyses and Student's t tests. Effect sizes were used to interpret the magnitude of differences. Multiple regression (negative binomial model) was used to investigate predictors of tooth loss.

RESULTS

Hausa women had a low prevalence of tooth loss, despite poor oral hygiene, and limited dental care. Older, middle SES, and higher parity women experienced significantly more tooth loss. Additionally, increased duration of reproductively active years was significantly related to fewer remaining teeth.

CONCLUSION

Higher parity was related to greater tooth loss in Hausa women. Women with ≥5 children experienced more loss than lower parity age mates.

Sex differences in the association between obesity and gingivitis among 12-year-old South Brazilian schoolchildren

OBJECTIVE

To assess the association between weight status and gingivitis in a representative sample of 12-year-old schoolchildren from South Brazil.

BACKGROUND

An association between obesity and gingivitis in children and adolescents has been observed; however, the present evidence has major limitations.

METHODS

A cross-sectional study was conducted in Porto Alegre, South Brazil, from September 2009 to December 2010 and included a representative sample of 1528 12-year-old schoolchildren attending public and private schools. Data collection included the application of a questionnaire, recording of anthropometric measures (weight and height), and clinical examination (gingival bleeding index, recorded in four sites per tooth). The outcome of the study was the prevalence of gingivitis, defined as the proportion of schoolchildren presenting ≥52% of bleeding sites (based on the median). Weight status was categorized according to body mass index into normal, overweight, or obese. The association between predictor variables and gingivitis prevalence was assessed using Poisson regression models. Unadjusted and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI) were estimated.

RESULTS

Gingivitis prevalence was 48.7% (95% IC = 33.8-63.6) and, on average, schoolchildren presented 51.8% (95% IC = 46.2-57.5) of bleeding sites. Obese individuals had 13% higher prevalence for presenting gingivitis than did normal-weight ones (PR = 1.13, 95% CI = 1.09-1.18, P < .001). The stratified analysis showed that this association was sex-specific: Obese girls presented a greater chance of having gingivitis (adjusted PR = 1.21, 95% CI = 1.09-1.34, P < .001), but such association was not observed among boys (PR = 1.07, 95% CI = 0.95-1.20, P = .29).

CONCLUSION

This study showed sex differences in the association between obesity and gingivitis among 12-year-old South Brazilian schoolchildren.

Prevalence of dental caries and its association with body mass index among school-age children in Shenzhen, China

Background

Dental caries and overweight/obesity are health problems with shared risk factors, but the relationships between caries and BMI need to be further explored. The objective was to evaluate the current status of dental caries and the association between dental caries and Body Mass Index (BMI) among primary and secondary school students in Shenzhen, China, during the 2016–2017 academic year.

Methods

A population-based, cross-sectional study that enrolled a total of 1,196,004 students was conducted in Shenzhen. Physical and dental examinations were given to all primary and secondary school students by certified physicians and dentists following the national specification for student health examinations, and dental caries was diagnosed using WHO criteria. Descriptive analysis was applied to assess current oral health status and a multifactorial, logistic regression model was employed to evaluate the relationship between dental caries and obesity.

Results

A total of 1,196,004 students participated in the census. Mean age of the participants was 10.3 years, ranging from 6 to 20 years. The prevalence of dental caries was 41.15% in the present study, which was higher among girls (42.88%) than that in boys (39.77%) with a p-value of < 0.001. Students in public schools showed a significantly lower (p < 0.001) caries prevalence (37.36%) compared with those in private schools (47.96%). The caries restoration rate of students in Shenzhen was only 10.30%, which means only one out of ten students with caries received restorations. The mean dmft and DMFT scores were 0.97 and 0.33, respectively. More girls (10.96%) had their teeth filled than boys (9.78%). The restoration rate was higher (p < 0.001) in public schools (11.73%) than in private ones (8.35%). Children who were overweight or obese had a lower risk of experiencing caries compared to those who were within a normal weight (OR = 0.74/0.64). Caries was inversely associated with BMI among primary and secondary school students in Shenzhen.

Conclusions

The prevalence of dental caries among primary and secondary school children was found to be related to sex, type of schools, region, and BMI. Further studies and more government support are required to confirm the findings of this study and to address current oral health problems.

Making sense of medieval mouths: Investigating sex differences of dental pathological lesions in a late medieval Italian community

OBJECTIVES

Bioarchaeological investigations of sex-based differences in the prevalence of dental pathological lesions, particularly caries, have drawn considerable attention, and out of this work, two dominant models have emerged. Traditionally, the first model interprets sex-related patterns in caries as a product of gendered differences in diet. A more recent model interprets a generally higher propensity for caries prevalence in females in light of reproductive ecology. To test the hypothesis that females have higher risk of caries in accordance with reproductive ecology, we examined and analyzed caries prevalence and other potentially synergistic oral pathological lesions in a late medieval (A.D. 1300-1500) Italian archaeological sample.

MATERIALS AND METHODS

We examined sex- and age-related prevalence in caries and other oral pathological lesions in a late medieval Italian skeletal assemblage excavated from Villamagna consisting of 38 females and 37 males (n = 1,534 teeth). We examined age- and sex-related patterns in six dental traits: antemortem tooth loss, caries, calculus, periapical inflammation, tooth wear, and periodontitis.

RESULTS

Significant age-related increases in antemortem tooth loss, caries, calculus, and tooth wear were observed in both males and females. However, there was a lack of expected sex differences in oral pathological lesions, with instead older males exhibiting significantly more antemortem tooth loss and corrected caries than females.

DISCUSSION

Results are discussed in relation to the ethnohistoric context of medieval rural dietary practices as well as biomedical salivary literature, which suggest that dietary changes throughout the life course may have facilitated trade-offs that buffered females from higher rates of dental pathological lesions.

Association between age at asthma diagnosis and tooth loss

OBJECTIVES

This study aimed to investigate the association between age at asthma diagnosis and tooth loss due to caries using data obtained from the Korean National Health and Nutrition Examination Survey.

MATERIALS AND METHODS

A complex sample multivariable linear regression was used, and the results were analysed. Age at diagnosis and the number of teeth lost were set as independent and dependent variables, respectively. Among the total 65,973 subjects, 10,056 aged <12 years and 11,714 with missing values in dependent and independent variables were excluded. Asthmatic subjects were divided into the following age groups based on the age at diagnosis: 0-6 years, 7-12 years, 13-18 years, 19-28 years, and 29-64 years. In each analysis, the calibration was performed by adding covariates to each model.

RESULTS

Compared with the no asthma group (β = 0), the values of β in asthmatic subjects belonging to the age groups 0-6 years (β = 0.794, 0.521, 0.560) and 7-12 years (β = 0.527, 0.407, 0.437) were high in all models.

CONCLUSIONS

Our findings revealed significant increase in tooth loss due to caries after early asthma diagnosis at 0-6 years (β = 0.560, p < .001) and 7-12 years (β = 0.437, p < .001). Clinicians need to shift their perception of dental risks in young asthmatic patients and provide active oral health care to them.

Cognitive Ability as a Determinant of Socioeconomic and Oral Health Status among Adolescent College Students of Bengaluru, India

INTRODUCTION

Levels of oral health and economic status are unequally distributed throughout the population. Inequality has multiple causes and that the effect of Socio Economic Status (SES) and demographic factors, on oral health is mediated through several factors. Association between cognitive ability and oral health had been demonstrated in older age groups but adolescents and younger adults have received relatively little attention in this field.

AIM

To establish the role of cognitive ability as a determinant of SES and oral health status among adolescent college students of Benagluru, Karnataka, India.

MATERIALS AND METHODS

A cross-sectional study was conducted among 1000 adolescents aged 17-19 years. Six government and six private first grade colleges were selected by multi-stage random sampling. Cognitive ability was assessed using digit symbol substitution test and digit span test. Dental caries and periodontal status were recorded by extent of bleeding, presence of calculus, periodontal pockets, loss of attachments using Community Periodontal Index, decayed, missing and filled teeth surfaces using Decayed, Missing, Filled Teeth and Surfaces Index. SES status was assessed using Kuppuswamy scale. Chi-square test was used to check the association of cognitive ability with oral health indicators and SES status. Regression analysis was performed to assess the effect of cognitive ability on oral health indicators after adjusting for SES and effect of SES status on oral health indicators after adjusting for indicators of cognitive ability.

RESULTS

Significant association and negative correlation between cognitive ability and indicators for oral health was seen in the regression models. Cognitive ability attributed for nearly 30% changes in the indicators for oral health after adjusting for SES and SES attributed for nearly 25% variance in indicators for oral health after adjusting for cognitive ability.

CONCLUSION

There is a potential role of cognitive ability in SES and oral health.

Tooth loss prevalence and risk indicators among 12-year-old schoolchildren from South Brazil

This population-based cross-sectional study aimed to assess the prevalence and risk indicators for tooth loss due to dental caries among 12-year-old schoolchildren from South Brazil. 1,528 out of 1,837 (participation rate = 83.17%) schoolchildren were included. Tooth loss prevalence was 5.81% (95% CI = 3.71-8.98) and 0.08 (95% CI = 0.04-0.12) teeth were missing. Schoolchildren with low socioeconomic status (OR = 2.28, 95% CI = 1.23-4.21), who repeated years in school (OR = 1.56, 95% CI = 1.01-2.42), and with gingivitis (OR = 1.81, 95% CI = 1.33-2.45) were more likely to have missing teeth. Schoolchildren brushing 2 times/day (OR = 0.78, 95% CI = 0.64-0.96) or more (OR = 0.49, 95% CI = 0.33-0.74), and those with dental insurance or private dentists (OR = 0.60, 95% CI = 0.39-0.93) were less likely to present missing teeth. © 2014 S. Karger AG, Basel.

[How does gender influence oral health?]

Most oral diseases show gender-specific differences in prevalence. This is true for common diseases such as caries and periodontitis, which are considered the main causes of tooth loss, affecting women more often than men. Furthermore, other diseases, e.g. temporomandibular joint dysfunction, malignant oral tumours, and several diseases of the oral mucosa show differing incidences between men and women. This is confirmed by empirical evidence from studies in Germany and other European countries, the USA, and emerging nations in Amercia and Southeast Asia. The present article aims to summarize gender-specific knowledge on oral health and present perspectives for future research. The main focus is on tooth loss and edentulism, a key measure of oral health, and their main causes, i.e. caries and periodontitis.

Permanent first molar extraction in adolescents and young adults and its effect on the development of third molar

OBJECTIVES

The aim of the present study was to determine the prevalence of permanent first molar (P1M) extraction among Turkish adolescents and young adult subpopulation, and to investigate the effects of P1M extraction on development of the third molars (3Ms) in the same quadrant.

MATERIALS AND METHODS

A retrospective study including 2,925 panoramic radiographs (PRs) taken from patients (aged 13-20 years) who were examined to identify cases of had at least one maxillary or mandibular P1Ms extracted was performed. Additionally, 294 PRs with the maxillary or mandibular unilateral loss of a P1M were used to assess the developmental grades of the 3Ms. Statistical analyses were performed by means of parametric tests after performing a Shapiro-Wilks normality test to the data.

RESULT

A total of 945 patients (32.3 %) presented with at least one P1M extraction with no gender difference (P = 0.297). There were more cases of mandibular P1Ms extracted (784 patients, 1,066 teeth) than maxillary P1Ms extracted (441 patients, 549 teeth) (P < 0.001). The development of the 3Ms on the extraction side, in the both maxilla and mandible, was significantly accelerated when compared with the contralateral teeth (P = 0.000, P = 0.000, respectively). No statistically significant differences were found in the differences in the developmental of the 3Ms between the maxilla and mandible (P = 0.718).

CONCLUSIONS

High prevalence of P1Ms extraction among Turkish adolescents and young adults shows a need for targeted dental actions, including prevention and treatment. The development of the 3Ms on the extraction side, in the both maxilla and mandible, was significantly accelerated.

CLINICAL RELEVANCE

To date, no information about prevalence of P1Ms extraction among Turkish adolescents and young adults is documented. In addition, the present study has a larger population and complementary information about 3Ms development than previous studies.

The neolithic demographic transition and oral health: The Southeast Asian experience

The purpose of this article is to present new oral health data from Neolithic An Son, southern Vietnam, in the context of (1) a reassessment of published data on other Neolithic, Bronze, and Iron Age Southeast Asian dental series, and (2) predictions of the Neolithic Demographic Transition (NDT). To this end, frequencies for three oral conditions (caries, antemortem tooth loss, and alveolar lesions) were investigated for seven Southeast Asian adult dental series from Thailand and Vietnam with respect to time period, age-at-death and sex. A clear pattern of elevated rates for oral disease in the Neolithic followed by a marked improvement in oral health during the Bronze and Iron Ages was observed. Moreover, rates of caries and antemortem tooth loss for females were almost without exception higher than that for males in all samples. The consensus view among Southeast Asian bioarchaeologists that oral health did not decline with the adoption/intensification of agriculture in Southeast Asia, can no longer be supported. In light of evidence for (1) the low cariogenicity of rice; (2) the physiological predisposition of females (particularly when pregnant) to poorer oral health; and (3) health predictions of the NDT model with respect to elevated levels of fertility, the most plausible chief explanation for the observed patterns in oral health in Southeast Asia is increased levels of fertility during the Neolithic, followed by a decline in fertility during the subsequent Bronze and Iron Ages.

Predictors of oral health after spinal cord injury

STUDY DESIGN

Cross-sectional study.

OBJECTIVES

To examine predictors of oral health in people with spinal cord injury (SCI).

METHODS

Ninety-two people with SCI (> or =6 months, 44% cervical level) completed questionnaires and underwent oral examination. Socio-economic, injury-related and oral habits variables were used for predicting oral health score (OHS); Decayed, missing and filled teeth (DMFT) score; and periodontal screen and recording index (PSR).

RESULTS

Most people with SCI were able to bring at least one hand to the mouth (82%) and brush teeth independently (65%). Regarding daily oral habits, 84% reported brushing teeth, 48% rinsing mouth, 14% flossing, 33% tobacco use and 13% mouthstick use. Only 32% had teeth cleaned within the past year. Oral examination revealed three decayed and eight missing teeth on average, with prominent periodontal disease (64%). Employment before SCI and more risky oral habits were significant predictors of worse OHS (P=0.005 and P=0.014, respectively) and PSR score (P=0.010 and P=0.035, respectively). Older age was the only predictor of worse DMFT score (P<0.001).

CONCLUSION

Oral health appears compromised in people with SCI. Identification of modifiable risk factors warrants examination whether intervention with focus on behavioral changes may improve oral health in this population.

Tooth loss prevalence and risk indicators in an isolated population of Brazil

OBJECTIVE

The aim of this study was to assess the prevalence, extent, and risk indicators of tooth loss in an isolated population of Brazil.

MATERIAL AND METHODS

Two-hundred-and-forty-two subjects, ranging in age from 14 to 82 years (mean 36.2 years), were identified by census in an isolated population of Brazil. All consenting subjects received a full-mouth clinical (DFT index and information about missing teeth) and periodontal examination of 6 sites per tooth. Furthermore, they were interviewed using a structured written questionnaire in order to gather information about demographic, environmental, and biological variables.

RESULTS

Of the 200 subjects (80% response rate), 19 (9.5%) were edentulous, 90% had lost at least one tooth, and 39% had lost more than 8 teeth. The mean number of teeth lost was 9.5 (95% CI = 8.2-10.8). First mandibular molars were the most commonly missing teeth. In a multiple logistic regression analysis based on a theoretical hierarchical model of tooth loss, having more than 8 teeth lost was strongly associated with adult age (OR = 18.3-17.3, 95% CIs = 4.8-69.7 and 4.0-75.1) and female gender (OR = 5.9, 95% CI = 1.9-18.2) in the final model.

CONCLUSIONS

Tooth loss was highly prevalent and extensive in this isolated population. Demographic and behavioral factors played an important role in tooth loss prevalence in this population.

Gender differences in oral health in South Asia: metadata imply multifactorial biological and cultural causes

OBJECTS

This study was designed to examine the magnitude and etiology of gender differences in oral health. South Asia was selected for study because sex differences in caries rates exist in prehistory here, great cultural diversity provides context, and clinical reports document caries by gender.

METHODS

A literature survey yielded extensive data on caries rates in India, Nepal, Bangladesh, and Sri Lanka. The percentage of individuals with caries (prevalence) and the mean number of decayed, missing, and filled teeth (experience) comprise the data. Statistical tests for gender differences come from published sources or were independently computed.

RESULTS

Higher caries rates were found more often among females than males. The data show that: (a) in male children caries rates are greater than, or equal to, female rates, (b) the gender bias reverses (F > M caries rates) from adolescence through the reproductive years, (c) mature adults typically exhibit significant differences, with higher caries rates in females, (d) a male gender bias in adults is rare, and (e) though some studies find no significant gender difference in caries, a female bias dominates. Tooth loss is also greater in women than men and often results from caries (vs. periodontal disease).

CONCLUSIONS

The gender gap in oral health exists in South Asia and results from genetic, hormonal, and cultural influences. Three cultural factors contribute to this gender gap South Asia: (a) the relative value of sons and daughters, (b) frequent fasting among Hindu women, and (c) the belief that dietary restrictions result in easier childbirth.

Influence of gender and social factors on oral health, treatment degree and choice of dental restorative materials in patients from a dental school

OBJECTIVE

The attitude towards oral health is influenced by gender, the level of education and the social background of the patients The aim of the present study was to determine a possible relationship of gender, the educational level and the oral health as well as the choice of dental restorations.

METHODOLOGY

A total of 2374 outpatients (age: 18-80 years) from a University dental school were assessed. Inclusion criteria were 15 remaining teeth and good general health. In addition to anamnesis data, information concerning educational level and present occupation was collected. The dental assessment included number of teeth, endodontic treatment, type of restorations (root canal fillings, restoration materials) as well as dental panoramic radiographs (OPG).

RESULTS

The female patients demonstrated a statistically significant higher percentage of restoration, more teeth with crowns and more tooth coloured fillings compared to men (P < 0.01). Patients with a higher level of education preferred more expensive restorations, whereas patients with a low level of education exhibited more inexpensive restorations. However, patients with private health insurance showed lower levels of carious lesions.

CONCLUSION

The examined patients showed no significant correlation between educational level and type of dental restorations but female patients had a lower number of teeth and more restoration.

Sex differences in dental caries experience: clinical evidence, complex etiology

A sex difference in oral health has been widely documented through time and across cultures. Women's oral health declines more rapidly than men's with the onset of agriculture and the associated rise in fertility. The magnitude of this disparity in oral health by sex increases during ontogeny: from childhood, to adolescence, and through the reproductive years. Representative studies of sex differences in caries, tooth loss, and periodontal disease are critically reviewed. Surveys conducted in Hungary, India, and in an isolated traditional Brazilian sample provide additional support for a significant sex bias in dental caries, especially in mature adults. Compounding hormonal and reproductive factors, the sex difference in oral health in India appears to involve social and religious causes such as son preference, ritual fasting, and dietary restrictions during pregnancy. Like the sex difference in caries, tooth loss in women is greater than in men and has been linked to caries and parity. Results of genome wide association studies have found caries susceptible and caries protective loci that influence variation in taste, saliva, and enamel proteins, affecting the oral environment and the micro-structure of enamel. Genetic variation, some of which is X-linked, may partly explain how sex differences in oral health originate. A primary, but neglected, factor in explaining the sex differential in oral health is the complex and synergistic changes associated with female sex hormones, pregnancy, and women's reproductive life history. Caries etiology is complex and impacts understanding of the sex difference in oral health. Both biological (genetics, hormones, and reproductive history) and anthropological (behavioral) factors such culture-based division of labor and gender-based dietary preferences play a role.

Tooth loss and associated factors in adolescents: a Brazilian population-based oral health survey

OBJECTIVE

To estimate tooth loss among adolescents and its factors associated.

METHODS

Data from 16,833 participants of the Brazilian Oral Health Survey 2002-2003 were analyzed. The outcome studied was tooth loss of at least one tooth. Independent variables included geographical localization, gender, skin color, per capita income, education gap, dental service utilization and fluoridated water supply at the local level. Crude and adjusted prevalence ratios were estimated using Poisson regression for each Brazilian macroregion and nationwide.

RESULTS

The prevalence of at least one tooth loss was 38.9% (95% CI 38.2%;39.7%). Adolescents living in localities with non-fluoridated water supply were 40% more likely to have tooth loss compared with those living in areas with fluoridated water supply. There was seen a strong association (p<0.01) between non-fluoridated water supply and tooth loss prevalence in the Northeast. In other Brazilian regions this association was confounded for distal variables, mainly socioeconomic variables, reinforcing regional inequalities.

CONCLUSIONS

High prevalence of tooth loss among Brazilian adolescents shows a need for targeted dental actions including prevention at earlier ages, treatment of affected teeth and universal access to fluoridated water.

Oral Health Impact of Periodontal Diseases in Adolescents

The need for treatment of destructive periodontal diseases is based on observations made by oral health professionals, who, prompted by clinical findings, recommend treatment. We hypothesized that clinical signs of periodontal destruction have an impact on the oral-health-related quality of life of adolescents. We conducted a cross-sectional study among 9203 Chilean high school students sampled by a multistage random cluster procedure. We recorded clinical attachment levels and the presence of necrotizing ulcerative gingivitis. The students answered the Spanish version of the Oral Health Impact Profile and provided information on several socio-economic indicators. The results of multivariable logistic regression analyses (adjusted for age, gender, and tooth loss) showed that both attachment loss [OR = 2.0] and necrotizing ulcerative gingivitis [OR = 1.6] were significantly associated with higher impact on the Oral Health Related Quality of Life of adolescents. Individuals in lower socioeconomic positions systematically reported a higher impact on their oral-health-related quality of life.

Factors associated with dental attendance among adolescents in Santiago, Chile

Background

Dental treatment needs are commonly unmet among adolescents. It is therefore important to clarify the determinants of poor utilization of dental services among adolescents.

Methods

A total of 9,203 Chilean students aged 12–21 years provided information on dental visits, oral health related behavior, perceived oral health status, and socio-demographic determinants. School headmasters provided information on monthly tuition and annual fees. Based on the answers provided, three outcome variables were generated to reflect whether the respondent had visited the dentist during the past year or not; whether the last dental visit was due to symptoms; and whether the responded had ever been to a dentist. Aged adjusted multivariable logistic regression models were used to assess the influence of the covariates gender; oral health related behaviors (self-reported tooth brushing frequency & smoking habits); and measures of social position (annual education expenses; paternal income; and achieved parental education) on each outcome.

Results

Analyses showed that students who had not attended a dentist within the past year were more likely to be male (OR = 1.3); to report infrequent tooth brushing (OR = 1.3); to have a father without income (OR = 1.8); a mother with only primary school education (OR = 1.5); and were also more likely to report a poor oral health status (OR = 2.0), just as they were more likely to attend schools with lower tuition and fees (OR = 1.4). Students who consulted a dentist because of symptoms were more likely to have a father without income (OR = 1.4); to attend schools with low economic entry barriers (OR = 1.4); and they were more likely to report a poor oral health status (OR = 2.9). Students who had never visited a dentist were more likely to report infrequent tooth brushing (OR = 1.9) and to have lower socioeconomic positions independently of the indicator used.

Conclusion

The results demonstrate that socioeconomic and behavioral factors are independently associated with the frequency of and reasons for dental visits in this adolescent population and that self-perceived poor oral health status is strongly associated with infrequent dental visits and symptoms.

Spanish version of the Oral Health Impact Profile (OHIP-Sp)

Background

The need for appraisal of oral health-related quality of life has been increasingly recognized over the last decades. The aims of this study were to develop a Spanish version (OHIP-Sp) of the Oral Health Impact Profile and to evaluate its convergent and discriminative validity, and its internal consistency.

Methods

The original 49-items OHIP was translated to Spanish, revised for understanding and semantics by two independent dentists, and then translated back to English by an independent bilingual dentist. The data originated in a cross sectional study conducted among high school students from the Province of Santiago, Chile. The study group was sampled using a multistage random cluster procedure yielding 9,203 students aged 12–21 years. All selected students were invited to participate and all filled a questionnaire with information on socio-demographic factors; oral health related behaviors; and self-reported oral health status (good, fair or poor). From this group, 9,163 students also accepted to fill a detailed questionnaire on socio-economic indicators and to receive a clinical examination comprising direct recordings of clinical attachment levels (CAL) in molars and incisors, tooth loss, and the presence of necrotizing ulcerative gingival lesions.

Results

The participation rate and the questionnaire completeness were high with OHIP-Sp total scores being computed for 9,133 subjects. Self-perceived oral health status was associated with the total OHIP-Sp score and all its domains (Spearman rank correlation). The OHIP-Sp total score was also directly associated with the 4 dental outcomes investigated (Mann-Whitney test) and the largest impact was found for the outcomes, 'tooth loss' with a mean OHIP-Sp score = 13.5 and 'CAL >= 3 mm' with a mean OHIP-Sp score = 13.0.

Conclusion

The OHIP-Sp revealed suitable convergent and discriminative validity and appropriate internal consistency (Cronbach's α). Further studies on OHIP-Sp warrant the inclusion of populations with a higher disease burden; and the use of test-retest reliability exercises to evaluate the stability of the test.