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Chaudhary FA, Ahmad B, Arjumand B, Alharkan HM. The Association Between Economic Status and Religious Identity With Oral Health Disparities and Inequalities Around the World. Cureus 2024; 16:e51917. [PMID: 38333499 PMCID: PMC10850934 DOI: 10.7759/cureus.51917] [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: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION The inequalities in oral health remain one of the current issues in the global public health agenda. The number of studies investigating health disparity by religious identity is limited and there is currently no such report relating to oral health. Similarly, there is compelling evidence for oral health disparities between socioeconomic statuses, education levels, and ethnic groups. This ecological study aimed to explore the disparity in oral health-related outcomes between Muslim and non-Muslim countries and country income status. METHODS Publicly available data related to oral health measures, country income status, and membership in the Organization of Islamic countries were used. Five oral health-related measures were examined: caries experience (decayed, missing, and filled teeth (DMFT)), percentage of the population with no periodontal disease, and disability-adjusted life years (DALY) attributed to oral conditions, and mouth and oropharynx cancer. One-way analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare the oral health parameters by country income status and simple linear regression was used to compare the parameters between the non-member countries (n-MC) and member countries (MC). For the significant parameters, adjusted coefficients were obtained using multiple linear regression. RESULTS From 170 countries included, 53 (31%) were MC and 117 (69%) were n-MC. Analysis showed that the mean DMFT in adults aged 35-44 years was significantly higher in the n-MC compared to MC after adjusting for country income status (p<0.05) but the latter was the stronger explanatory predictor of the outcome. The strength of the effect of country membership classification (standardized coefficient β: DMFT35-44-year-old = -0.16) was smaller than country income status (β = -0.60) in the multiple regression. CONCLUSION There is significant but weak evidence from the available data to support the claim that economic status and religion contribute to oral health disparity.
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Affiliation(s)
- Farooq Ahmad Chaudhary
- Department of Community Dentistry, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, PAK
| | - Basaruddin Ahmad
- Department of Dental Public Health, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, MYS
| | - Bilal Arjumand
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, SAU
| | - Hamad Mohammad Alharkan
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, SAU
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Ugolini A, Porro F, Carli F, Agostino P, Silvestrini-Biavati A, Riccomagno E. Probabilistic graphical modelling of early childhood caries development. PLoS One 2023; 18:e0293221. [PMID: 37903153 PMCID: PMC10615302 DOI: 10.1371/journal.pone.0293221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/23/2023] [Indexed: 11/01/2023] Open
Abstract
In order to develop a statistical model for complex interactions among factors affecting early childhood caries development (ECC), 234 children from the "XXXX oral growth longitudinal study" were analysed at ages 3, 4 and 5. A questionnaire for children's parents (clinical history, nutritional and oral hygiene habits) and clinical oral examinations were recorded each year. The probabilistic dependence structure on the most significant factors was modelled with an Undirected Graphical Model (UGM or Markov random fields) which provides a probabilistic reasoning approach for the establishment of multi-way associations. The best fitting UGM was estimated through the maximum likelihood principle and two-way factor associations were verified through Fisher's exact statistical hypothesis tests for count data. The effect of sugar intake on caries incidence is mediated by oral hygiene; for caries incidence, oral hygiene quality is more relevant than toothbrushing time; the effect of pacifier on caries incidence is statistically significant only when considered in combination with breastfeeding time. Among behavioural ECC risk factors, the quality of oral hygiene, and not the toothbrushing frequency, is a primary factor that modulates the sugar intake in his primary role of the ECC developer. School-based oral health programs for ECC prevention should be improved with supervised toothbrushing program. UGM analysis could improve the school-based oral health programs with more effective and efficient prevention strategies based on the hierarchical interactions among the ECC risk factors. Oral hygiene plays a pivotal role in early childhood caries and can modulate positively or negatively their development. Supervised toothbrushing is a crucial intervention to be included in the daily educational and clinical practice and in the school-based oral health promotion programs. Trial registration: Clinical trial registration number: NCT02798809.
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Affiliation(s)
- Alessandro Ugolini
- Department of Surgical and Integrated Diagnostic Sciences, University of Genova, Genoa, Italy
| | - Francesco Porro
- Department of Mathematics, University of Genova, Genoa, Italy
| | - Federico Carli
- Department of Mathematics, University of Genova, Genoa, Italy
| | - Paola Agostino
- Department of Surgical and Integrated Diagnostic Sciences, University of Genova, Genoa, Italy
| | | | - Eva Riccomagno
- Department of Mathematics, University of Genova, Genoa, Italy
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3
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Lopez DJ, Hegde S, Whelan M, Dashper S, Tsakos G, Singh A. Trends in social inequalities in early childhood caries using population‐based clinical data. Community Dent Oral Epidemiol 2022. [PMID: 36424707 DOI: 10.1111/cdoe.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the longitudinal trends in social inequalities in early childhood caries (ECC) using collected population-based data. METHODS Clinical data on children were routinely collected from 2008 to 2019 in Victoria, Australia. ECC prevalence and severity (dmft) were quantified according to Indigenous status, culturally and linguistically diverse (CALD) status, concession cardholder status, geographic remoteness and area deprivation. The inverse probability weighting was used to quantify social inequalities in ECC. The weighted prevalence differences, and the ratio between the weighted prevalence of ECC and mean dmft and their 95% confidence interval, were then plotted. RESULTS Absolute inequalities in ECC prevalence increased for children by 7% for CALD status and cardholder status between 2008 and 2019. Likewise, absolute inequalities in ECC severity in this time period increased by 0.6 for CALD status and by 0.4 for cardholder status. Relative inequalities in ECC increased by CALD (ratio: 1.3 to 2.0), cardholder status (1.3 to 2.0) and area deprivation (1.1 to 1.3). Relative inequalities in severity increased by CALD (1.5 to 2.8), cardholder (1.4 to 2.5) or area deprivation (1.3 to 1.5). Although children with Indigenous status experienced inequalities in ECC prevalence and severity, these did not increase on the absolute (ECC: 0.1-0.1 Severity: 1.0-0.1) or relative scale (ECC ratio: 1.3-1.3 Severity ratio: 1.6-1.1). CONCLUSIONS Trends in inequalities in ECC were different according to sociodemographic measures. Oral health policies and interventions must be evaluated on the basis of reducing the prevalence of oral diseases and oral health inequalities between population sub-groups.
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Affiliation(s)
- Diego J. Lopez
- Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, University of Melbourne Melbourne Victoria Australia
| | - Shalika Hegde
- Dental Health Services Victoria Melbourne Victoria Australia
| | - Martin Whelan
- Dental Health Services Victoria Melbourne Victoria Australia
| | - Stuart Dashper
- Melbourne Dental School University of Melbourne Melbourne Victoria Australia
| | - Georgios Tsakos
- Department of Epidemiology and Public Health University College London London UK
| | - Ankur Singh
- Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, University of Melbourne Melbourne Victoria Australia
- Melbourne Dental School University of Melbourne Melbourne Victoria Australia
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Al-Mutairi R, Liversidge H, Gillam DG. Prevalence of Moderate to Severe Periodontitis in an 18–19th Century Sample—St. Bride’s Lower Churchyard (London, UK). Dent J (Basel) 2022; 10:dj10040056. [PMID: 35448049 PMCID: PMC9024818 DOI: 10.3390/dj10040056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
The aim of the study was to determine the prevalence of moderate to severe periodontitis in 18–19th century skulls in the St Bride’s Lower Churchyard in London, UK. Materials and methods: A total of 105 adult skulls (66 M: F 39) from the Museum of London collection were examined for evidence of dental disease. The primary method was to measure the presence of moderate to severe periodontitis. Other dental pathologies were recorded such as tooth wear, calculus, and caries. Results: Overall, the prevalence of moderate to severe periodontitis in the sample was 21–24%. Males were observed to be more susceptible to periodontal disease than females. The severity of bone loss in the skull collection also increased with age. There was no significant difference in the amount of calculus deposition when comparing either age or sex. A total of 14% of the individuals in the sample showed signs of smoking. Conclusion: The results of the study indicated that the prevalence of moderate to severe periodontitis in an 18–19th century skull sample was 21–24%, which was higher than in previous studies. This may be due to the lack of basic personal mouth care and professional dental treatment as well as known risk factors such as smoking, stress, low socioeconomic status, and malnutrition.
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Affiliation(s)
- Ruqayah Al-Mutairi
- Al Jahra Speciality Dental Center, Ministry of Health, Al Qasser, Block 2, Street 619, Al Jahra 00004, Kuwait;
| | - Helen Liversidge
- Oral Bioengineering, Institute of Dentistry, Barts and the London School of Medicine and Dentistry QMUL, London E1 2AD, UK;
| | - David Geoffrey Gillam
- Oral Bioengineering, Institute of Dentistry, Barts and the London School of Medicine and Dentistry QMUL, London E1 2AD, UK;
- Correspondence:
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Almutairi S, Scambler S, Bernabé E. Family functioning and dental caries among preschool children. J Public Health Dent 2021; 82:406-414. [PMID: 34545569 DOI: 10.1111/jphd.12475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/31/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the relationship of family functioning with dental caries among 3-4-year-olds and the role of family functioning in explaining the relationship of family socioeconomic status (SES) with childhood dental caries. METHODS Data from 761 parent-child dyads who took part in the East London Oral Health Inequalities study were analyzed. Family functioning was assessed using the 60-item family assessment device that yielded scores on general functioning and six domains (roles, communication, problem-solving, affective involvement, affective responsiveness, and behavior control). Children were clinically examined at home for dental caries. The association of family functioning and family SES (education and socioeconomic classification) with dental caries (dmft and dt scores) was tested using negative binominal regression while adjusting for child and parental demographic factors. RESULTS Children from families with unhealthy general functioning had 1.49 (95% CI: 1.01-2.20) and 1.84 (95% CI: 1.20-2.82) times greater dmft and dt, respectively, than those from families with healthy functioning after adjustment for confounders. The estimates for the associations of parental education and socioeconomic classification with dmft and dt were attenuated by around 12%-18% after adjusting for family functioning. Of the six family functioning domains assessed, only unhealthy behavior control in the family was associated with greater numbers of decayed teeth after adjustments. CONCLUSIONS This study showed that unhealthy family functioning was associated with dental caries among young children. Family functioning partly explained the relationship between family SES and childhood dental caries.
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Affiliation(s)
- Sarah Almutairi
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Department of Dental Public Health, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Sasha Scambler
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Mota KR, da Silva JVF, Borges CD, Leite de Marcelos PGC, Alvares PR, Santos Júnior VED. Effectiveness of the use of xylitol chewing gum in prevention of dental caries: A systematic review. J Indian Soc Pedod Prev Dent 2021; 39:113-119. [PMID: 34341229 DOI: 10.4103/jisppd.jisppd_330_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This systematic review of the literature assessed the effectiveness of using chewing gum containing only xylitol compared to prevention strategies or placebo in reducing the incidence of carious lesions in children using data obtained from randomized controlled trials. Electronic search was carried out in PubMed MEDLINE, Latin American and Caribbean Literature on the Health Science, Web of Science, Scopus, Science Direct, and Scientific Electronic Library Online through the period between 2000 and 2020. Included clinical studies were done in children when the xylitol was dispensed in gum and the preventive effect of xylitol on tooth decay was compared to other preventive strategies or control groups. The studies were evaluated for their quality to obtain the level of evidence. The preventive fraction of each study was extracted. Two hundred studies were found. After analyzing the inclusion and removal of duplicates, only five studies were analyzed for the quality of evidence. With the analysis through the Grading of Recommendations Assessment, Development, and Evaluation system, it was possible to verify the very low level of scientific evidence on the effectiveness of gums containing only xylitol for the prevention of caries in children. The preventive fraction obtained varied between - 0.31 and 0.57 depending on the compared prevention strategy. The conflicting results, limitations, and inconsistencies of the studies allow us to establish that there is insufficient evidence to support the use of gums containing only xylitol for the prevention of caries in children. Other properly designed clinical trials need to be carried out.
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Affiliation(s)
- Kelly Rodrigues Mota
- Department of Paediatric Dentistry, Federal University of Alagoas, Maceió, Brazil
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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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Badr F, Sabbah W. Inequalities in Untreated Root Caries and Affordability of Dental Services among Older American Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228523. [PMID: 33212971 PMCID: PMC7698597 DOI: 10.3390/ijerph17228523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/13/2020] [Indexed: 12/25/2022]
Abstract
The growing geriatric population is facing numerous economic challenges and oral health changes. This study explores the relationship between affordability of dental care and untreated root caries among older American adults, and whether that relationship is independent of ethnicity and socioeconomic factors. Data from 1776 adults (65 years or older) who participated in the National Health and Nutrition Examination Survey (NHANES) were analyzed. The association between affordability of dental care and untreated root caries was assessed using logistic regression models. Findings indicated that untreated root caries occurred in 42.5% of those who could not afford dental care, and 14% of those who could afford dental care. Inability to afford dental care remained a statistically significant predictor of untreated root caries in the fully adjusted regression model (odds ratio 2.79, 95% confidence interval: 1.78, 4.39). Other statistically significant predictors were gender (male), infrequent dental visits, and current smoking. The study concludes that the inability to afford dental care was the strongest predictor of untreated root caries among older Americans. The findings highlight the problems with access to and use of much needed dental services by older adults. Policy reform should facilitate access to oral healthcare by providing an alternative coverage for dental care, or by alleviating the financial barrier imposed on older adults.
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Affiliation(s)
- Fatma Badr
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia;
- Faculty of Dentistry, Oral & Craniofacial Sciences, Dental Public Health, King’s College London, Denmark Hill Campus, 2nd Floor Dental Extension, Bessemer Road, Denmark Hill, London SE5 9RS, UK
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, Dental Public Health, King’s College London, Denmark Hill Campus, 2nd Floor Dental Extension, Bessemer Road, Denmark Hill, London SE5 9RS, UK
- Correspondence:
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Amanat MA, John J, Pin TM, Danaee M, Malhotra V, Abbas SA, Kamaruzzaman SB. Dentition status among an ethnically diverse older urban Malaysian population. J Public Health (Oxf) 2020; 42:304-311. [PMID: 30796789 DOI: 10.1093/pubmed/fdz014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 12/31/2018] [Accepted: 01/24/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Poor oral health affects not only dietary choices but overall well-being. This study explores the influence of lifestyle, socio-demographics and utilization of dental services on the dentition status of an older urban Malaysian population. METHODS A total of 1210 participants 60 years and above, representing the three main ethnic groups were recruited from a larger cohort study. Weighted factors valued for comparison included socio demographics and health status. Knowledge of and attitude and behaviour towards personal oral health were also assessed. Dentition status, adapted from WHO oral health guidelines, was the dependent variable investigated. Data were analysed using descriptive chi square test and multivariate binary logistic regression. RESULTS Overall, 1187 respondents completed the study. The dentition status and oral health related knowledge, attitude and behaviour varied between the three ethnic groups. The Chinese were significantly less likely to have ≥13 missing teeth (OR = 0.698, 95% CI: 0.521-0.937) and ≥1 decayed teeth (0.653; 0.519-0.932) compared to the Malays, while the Indians were significantly less likely than the Malays to have ≥1 decayed teeth (0.695; 0.519-0.932) and ≥2 filled teeth (0.781; 0.540-1.128). CONCLUSION Ethnic differences in dentition outcome are related to oral health utilization highlighting the influence of cultural differences and the need for culturally sensitivity interventions.
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Affiliation(s)
- Muhammad Abbas Amanat
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya. Kuala Lumpur, Malaysia
| | - Jacob John
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya. Kuala Lumpur, Malaysia.,Ageing and Age-Associated Disorders Research Group, Wellness Research Cluster, University of Malaya, Kuala Lumpur, Malaysia
| | - Tan Maw Pin
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Ageing and Age-Associated Disorders Research Group, Wellness Research Cluster, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vaishali Malhotra
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya. Kuala Lumpur, Malaysia
| | - Syed Amjad Abbas
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya. Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Ageing and Age-Associated Disorders Research Group, Wellness Research Cluster, University of Malaya, Kuala Lumpur, Malaysia
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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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Smith JS. Archaeological oral health: a comparison of post-medieval and modern-day dental caries exposure of adults in East London. Br Dent J 2019; 227:721-725. [PMID: 31654010 DOI: 10.1038/s41415-019-0737-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Modern levels of dental decay worldwide are on the rise. This study aimed to calculate historical rates of decay and compare them with recent figures. To compare the rate of dental decay in East Londoners from a post-medieval burial ground and a published modern sample, a database of human remains held at the Museum of London Archaeology (MOLA) was interrogated. The resulting numbers of decayed and missing teeth were analysed and compared to the East London Oral Health Inequality study initially undertaken in 2010. A lower decayed/missing/filled teeth (DMFT) score was seen in the post-medieval burials.
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Affiliation(s)
- Joseph S Smith
- Queen Mary University of London, Oral and Maxillofacial Department, Turner Street, Whitechapel, London, UK.
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12
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Delgado-Angulo EK, Mangal M, Bernabé E. Socioeconomic inequalities in adult oral health across different ethnic groups in England. Health Qual Life Outcomes 2019; 17:85. [PMID: 31101052 PMCID: PMC6525386 DOI: 10.1186/s12955-019-1156-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ethnic inequalities in oral health among British adults remain largely unexplored. This study explored the role of socioeconomic position (SEP) in explaining ethnic inequalities in oral health; and the consistency of socioeconomic inequalities in oral health across ethnic groups. METHODS Data from 45,599 adults, aged 16 years and over, who participated in the Health Survey for England were pooled across 5 years. The seven ethnic groups included were White British, Irish, Black Caribbean, Indian, Pakistani, Bangladeshi and Chinese. Edentulousness and toothache were the outcome measures. A composite measure of SEP was developed based on education, social class, income and economic activity using confirmatory factor analysis. Ethnic inequalities in oral health were assessed in logistic regression adjusting for sex, age, survey year and SEP. RESULTS Indian (OR: 0.55, 95%CI: 0.40-0.76), Pakistani (0.56, 0.38-0.83), Bangladeshi (0.35, 0.23-0.52) and Chinese (0.41, 0.25-0.66) were less likely to be edentulous than White British after controlling for SEP. Irish (1.22, 1.06-1.39) and Caribbean (1.37, 1.19-1.58) were more likely and Bangladeshi (0.83, 0.69-0.99) were less likely to have toothache than White British after controlling for SEP. Socioeconomic inequalities in edentulousness were consistently found across almost all ethnic groups while socioeconomic inequalities in toothache were found among White British and Irish only. CONCLUSION This study shows that the role of SEP in explaining ethnic inequalities in oral health depended on the outcome being investigated. Socioeconomic inequalities in oral health among minority ethnic groups did not consistently reflect the patterns found in White British.
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Affiliation(s)
- Elsa K Delgado-Angulo
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK.,Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Munisha Mangal
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK.
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13
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Delgado-Angulo EK, Marcenes W, Harding S, Bernabé E. Ethnicity, migration status and dental caries experience among adults in East London. Community Dent Oral Epidemiol 2018; 46:392-399. [DOI: 10.1111/cdoe.12381] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Elsa K. Delgado-Angulo
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St. Thomas’ Hospitals; London UK
- Departamento Académico de Odontología Social; Universidad Peruana Cayetano Heredia; Lima Perú
| | - Wagner Marcenes
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St. Thomas’ Hospitals; London UK
| | - Seeromanie Harding
- Schools of Life Course Sciences & Population Health and Environmental Sciences; Faculty of Life Sciences & Medicine; King's College London; London UK
| | - Eduardo Bernabé
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St. Thomas’ Hospitals; London UK
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14
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Factors associated with use of general anaesthesia for dental procedures among British children. Br Dent J 2017; 223:339-345. [DOI: 10.1038/sj.bdj.2017.763] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2017] [Indexed: 11/08/2022]
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Gaewkhiew P, Bernabé E, Gallagher JE, Klass C, Delgado-Angulo EK. Oral impacts on quality of life and problem-oriented attendance among South East London adults. Health Qual Life Outcomes 2017; 15:82. [PMID: 28446237 PMCID: PMC5405499 DOI: 10.1186/s12955-017-0663-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 04/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental care seeking behaviour is often driven by symptoms. The value of oral health related quality of life (OHRQoL) measures to predict utilisation of dental services is unknown. This study aims to explore the association between OHRQoL and problem-oriented dental attendance among adults. METHODS We analysed cross-sectional data for 705 adults, aged 16 years and above, living in three boroughs of Inner South East London. Data were collected during structured interviews at home. The short form of the Oral Health Impact Profile (OHIP-14) was used to assess the frequency of oral impacts on daily life in the last year. Problem-oriented attendance was defined based on time elapsed since last visit (last 6 months) and reason for that visit (trouble with teeth). The association between OHIP-14 (total and domain) scores and problem-oriented attendance was tested in logistic regression models adjusting for participants' sociodemographic characteristics. RESULTS Problem-oriented attenders had a higher OHIP-14 total score than regular attenders (6.73 and 3.73, respectively). In regression models, there was a positive association between OHIP-14 total score and problem-oriented attendance. The odds of visiting the dentist for trouble with teeth were 1.07 greater (95% Confidence Interval: 1.04-1.10) per unit increase in the OHIP-14 total score, after adjustment for participants' sociodemographic characteristics. In subsequent analysis by OHIP-14 domains, greater scores in all domains but handicap were significantly associated with problem-oriented attendance. CONCLUSION This study shows that oral impacts on quality of life are associated with recent problem-oriented dental attendance among London adults. Six of the seven domains in the OHIP-14 questionnaire were also associated with dental visits for trouble with teeth.
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Affiliation(s)
- Piyada Gaewkhiew
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK
- Department of Community Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Eduardo Bernabé
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK.
| | - Jennifer E Gallagher
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK
| | - Charlotte Klass
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK
- Public Health England - London Region, London, UK
| | - Elsa K Delgado-Angulo
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK
- Departamento Académico de Odontología Social, Universidad Peruana Cayetano Heredia, Lima, Peru
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Delgado-Angulo EK, Bernabé E, Marcenes W. Ethnic inequalities in periodontal disease among British adults. J Clin Periodontol 2016; 43:926-933. [DOI: 10.1111/jcpe.12605] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Elsa K. Delgado-Angulo
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St. Thomas’ Hospitals; London UK
- Departamento Académico de Odontología Social; Universidad Peruana Cayetano Heredia; Lima Perú
| | - Eduardo Bernabé
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St. Thomas’ Hospitals; London UK
| | - Wagner Marcenes
- Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
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van der Tas JT, Kragt L, Veerkamp JJS, Jaddoe VWV, Moll HA, Ongkosuwito EM, Elfrink MEC, Wolvius EB. Ethnic Disparities in Dental Caries among Six-Year-Old Children in the Netherlands. Caries Res 2016; 50:489-497. [PMID: 27595263 DOI: 10.1159/000448663] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/20/2016] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to investigate potential differences in caries prevalence of children from ethnic minority groups compared to native Dutch children and the influence of socio-economic status (SES) and parent-reported oral health behaviour on this association. The study had a cross-sectional design, embedded in a population-based prospective multi-ethnic cohort study. 4,306 children with information on caries experience, belonging to 7 different ethnic groups, participated in this study. The decayed, missing, and filled teeth (dmft) index was assessed at the age of 6 and categorized in two ways for analysis: children without caries (dmft = 0) versus any caries experience (dmft >0) and children without caries (dmft = 0) versus children with mild caries (dmft = 1-3) or severe caries (dmft >3). Compared to native Dutch children, children with a Surinamese-Hindustani, Surinamese-Creole, Turkish, Moroccan, and Cape Verdean background had significantly higher odds for dental caries. Especially the Surinamese-Hindustani, Turkish, and Moroccan group had significantly higher odds for severe dental caries. Household income and educational level of the mother explained up to 43% of the association between ethnicity and dental caries, whereas parent-reported oral health behaviour did not mediate the association. Alarming disparities in caries prevalence between different ethnic (minority) groups exist, which cannot be fully explained by social inequalities. Public health strategies can apply this new knowledge and specifically focus on the reduction of ethnic disparities in oral health. More research is needed to explain the high caries prevalence among different ethnic minority groups.
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Affiliation(s)
- Justin T van der Tas
- Department of The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
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