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Broomhead T, Baker SR, Martin N, McKenna G, El-Dhuwaib B, Alavi A, Gibson B. Exploring experiences of living with removable dentures-A scoping review of qualitative literature. Gerodontology 2024; 41:314-327. [PMID: 38247018 DOI: 10.1111/ger.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Examine the literature on the experiences of living with removable dentures (complete or partial) to identify any gaps and provide a map for future research. BACKGROUND Increasing proportions of society are living partially dentate with some form of restoration, including removable dentures. Previous studies have reported on the location, materials and usage of these prostheses, along with effects on oral-health-related quality of life (OHRQoL). However, less is known about experiences with removable dentures from a patient-centred perspective. METHODS A scoping review of the qualitative literature was undertaken using the framework of Arksey and O'Malley, updated by Levac et al. Literature searches were carried out using Medline and Web of Science. Papers were screened by title and abstract using inclusion and exclusion criteria. Remaining papers were read in full and excluded if they did not meet the required criteria. Nine papers were included in the final review. FINDINGS Key themes from these papers were: impact of tooth loss and living without teeth, and its impacts in relation to social position, appearance, confidence and function (chewing and speaking); social norms and tooth loss, including attitudes to tooth retention and treatment costs, and changes in intergenerational norms towards dentures; expectations of treatment, including patients being more involved in decision making, viewing the denture as a "gift" and dentures helping to achieve "an ideal"; living with a removable denture (complete or partial), including patient preparedness for a denture, adaptation and impacts on activities and participation; and the dentist-patient relationship, including issues with information and communication, and differing priorities between patients and dentists. CONCLUSION Little qualitative research exists on experiences of living with a removable denture. Existing literature demonstrates the importance of dispersed activities in differing social, spatial and temporal contexts when wearing removable dentures. Focusing on processes of positive adaptation to dentures and OHRQoL, rather than deficits, is also required to fully understand patients' experiences. Additionally, more complex technological advances may not always be in the best interest of every patient.
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Affiliation(s)
- T Broomhead
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - S R Baker
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - N Martin
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - G McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - B El-Dhuwaib
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - A Alavi
- Haleon (formerly GSK Consumer Healthcare), Weybridge, UK
| | - B Gibson
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Cecchin-Albertoni C, Deny O, Planat-Bénard V, Guissard C, Paupert J, Vaysse F, Marty M, Casteilla L, Monsarrat P, Kémoun P. The oral organ: A new vision of the mouth as a whole for a gerophysiological approach to healthy aging. Ageing Res Rev 2024; 99:102360. [PMID: 38821417 DOI: 10.1016/j.arr.2024.102360] [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: 01/25/2024] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
This article brings a new perspective on oral physiology by presenting the oral organ as an integrated entity within the entire organism and its surrounding environment. Rather than considering the mouth solely as a collection of discrete functions, this novel approach emphasizes its role as a dynamic interphase, supporting interactions between the body and external factors. As a resilient ecosystem, the equilibrium of mouth ecological niches is the result of a large number of interconnected factors including the heterogeneity of different oral structures, diversity of resources, external and internal pressures and biological actors. The manuscript seeks to deepen the understanding of age-related changes within the oral cavity and throughout the organism, aligning with the evolving field of gerophysiology. The strategic position and fundamental function of the mouth make it an invaluable target for early prevention, diagnosis, treatment, and even reversal of aging effects throughout the entire organism. Recognizing the oral cavity capacity for sensory perception, element capture and information processing underscores its vital role in continuous health monitoring. Overall, this integrated understanding of the oral physiology aims at advancing comprehensive approaches to the oral healthcare and promoting broader awareness of its implications on the overall well-being.
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Affiliation(s)
- Chiara Cecchin-Albertoni
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Olivier Deny
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Valérie Planat-Bénard
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Christophe Guissard
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Jenny Paupert
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Frédéric Vaysse
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France
| | - Mathieu Marty
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; LIRDEF, Faculty of Educational Sciences, Paul Valery University, Montpellier CEDEX 5 34199, France
| | - Louis Casteilla
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Paul Monsarrat
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France; Artificial and Natural Intelligence Toulouse Institute ANITI, Toulouse, France
| | - Philippe Kémoun
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France.
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Geddis-Regan A, Abley C, Exley C, Wassall R. Dentists' Approaches to Treatment Decision-Making for People with Dementia: A Qualitative Study. JDR Clin Trans Res 2024; 9:221-230. [PMID: 37775967 PMCID: PMC11318378 DOI: 10.1177/23800844231199385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION Globally, the number of people living with dementia (PLwD) is projected to increase substantially. Dentists will encounter an increasing number of PLwD retaining natural teeth who need dental care. Dental treatment planning can be complex for PLwD as both oral diseases and dental treatment can be detrimental to patients' oral and social function and comfort. In addition, patients may lack the capacity to make decisions about their treatment, posing further challenges for dentists. OBJECTIVE This study aimed to explore dentists' approach to treatment decision-making with or for PLwD. METHODS Semistructured one-to-one interviews were completed with 22 dentists between April 2020 and March 2021. Data generation and analysis followed the principles of constructivist grounded theory with data being collected and analyzed simultaneously using a maximum variation sample. Interviews were recorded, transcribed verbatim, and then analyzed, leading to a theoretical understanding of how dentists approach treatment decisions for PLwD. RESULTS Four data categories describe dentists' approaches to treatment decision-making for PLwD. Dentists sought to provide individualized care for PLwD. However, they described planning care based on risk-benefit analyses that primarily considered biomedical factors and generic assumptions. There was an underemphasis on the psychological or social implications of dental care or its delivery. Furthermore, while some dentists attempted to involve patients in treatment decisions, they reported fewer attempts to identify the views and preferences of PLwD identified as lacking decisional capacity. In this scenario, dentists reported leading the decision-making process with little regard for patients' known or identified preferences and minimal involvement of PLwD's family. CONCLUSIONS Dentists acknowledge the complexity in treatment decision-making for PLwD yet focused heavily on biomedical considerations, with an underemphasis on individuals' preferences and autonomy. Considering psychosocial aspects of care alongside biomedical factors is essential to support holistic person-centered care for this growing patient cohort. KNOWLEDGE TRANSFER STATEMENT This study highlighted that dentists may only be considering biomedical aspects of care when considering what treatment is appropriate for people living with dementia. When making or supporting treatment decisions, dentists should explore patients' preferences and actively consider relevant psychosocial factors. These can be actively identified through considered discussions with patients as well as their family members. Gathering this information should support more person-centered and value-concordant decision-making for people living with dementia.
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Affiliation(s)
- A. Geddis-Regan
- University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | - C. Abley
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - C. Exley
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - R. Wassall
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Dental Hospital, Newcastle upon Tyne, UK
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Nono D, Bagenda G, Okullo I, Rwenyonyi CM. Exploring lived experiences on the usage of removable complete dentures among edentulous patients attending Makerere University Dental Hospital, Kampala, Uganda. BMC Oral Health 2024; 24:709. [PMID: 38898433 PMCID: PMC11186153 DOI: 10.1186/s12903-024-04484-3] [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: 03/27/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Edentulism remains a major disability worldwide, especially among the elderly population, although the prevalence of complete edentulism has declined over the last decades. In Uganda, the prevalence of edentulism in people aged 20 years and above is 1.8%. The therapy for edentulous patients can be realized through the use of conventional removable complete dentures, implant-supported prostheses, and computer-aided design and computer-aided manufacturing (CADCAM), however, the provision of removable complete dentures continues to be the predominant rehabilitation for edentulous patients. However, no published study has explored the lived experiences with removable complete dentures among the Ugandan population. The aim of the present study was to explore patients' lived experiences on the usage of removable complete dentures among Ugandan edentulous patients attending Makerere University Dental Hospital. METHODS This was a qualitative study approach using purposive sampling. Fifteen (15) respondents were selected across social demographics. Interviews were recorded and transcribed and themes were generated to draw a deeper meaning to the usage of removable complete dentures. A qualitative statistical package, Atlas Ti software was used to generate themes from the interviews followed by an interpretation of the generated data and the results were presented as text and in a table. RESULTS The reported key positive experiences due to removable complete denture rehabilitation were the improvement in speech, eating ability, regaining good facial appearance, better oral hygiene management, self-esteem and confidence to smile in public, and a feeling of completeness. However, respondents complained of pain and discomfort due to the looseness of dentures, inability to eat certain foods, and regular cleaning of dentures. The respondents did not go through proper informed consent processes before getting removable complete dentures. CONCLUSION The study found that patients were satisfied with their removable complete dentures rehabilitation due to the positive experiences registered, such as the ability to eat and talk well, and restoration of self-esteem, all of which improved their quality of life. However, they experience pain and discomfort due to the looseness of dentures.
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Affiliation(s)
- David Nono
- School of Clinical Research, Central University of Nicaragua (UCN-Central Campus), Managua, Nicaragua.
- School of Clinical Research, Texila American University, Georgetown, Guyana.
- School of Dentistry, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Godfrey Bagenda
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Isaac Okullo
- School of Dentistry, College of Health Sciences, Makerere University, Kampala, Uganda
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Geddis-Regan A, Wassall RR, Abley C, Exley C. Exploring dental treatment decision-making experiences of people living with dementia and family carers. Gerodontology 2024; 41:83-93. [PMID: 37036039 DOI: 10.1111/ger.12687] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 04/11/2023]
Abstract
INTRODUCTION People living with dementia can have complex dental care needs. Dentists and patients should make treatment decisions together, yet some people living with dementia may be unable to make their own decisions about their dental care. Dental treatment decision-making and patients' experiences of this process have not been comprehensively researched. OBJECTIVE This study aimed to explore the dental treatment decision-making perspectives and experiences of people living with dementia and their family members. METHODS Semi-structured interviews were undertaken with 8 people living with dementia and 17 family caregivers. A constructivist grounded theory approach was adopted, using a maximum variation sample. Qualitative data collection and analysis occurred concurrently. Data underwent initial open coding followed by more focused coding, supported by reflexive memo writing, which supported data categorisation. RESULTS People living with dementia reported wanting to be understood as unique individuals with specific needs. All participants described wanting to be actively involved in dental treatment decisions. However, many felt that they were insufficiently involved in treatment decision-making. This perceived underinvolvement meant that some people living with dementia and family members felt the treatment outcomes they sought were neither discussed nor considered. CONCLUSION People living with dementia and carers had specific expectations of dental care yet felt passive in decision-making despite their desire to be involved in this process. Dentists should seek to actively establish patients' preferences, regardless of mental capacity and consider these in discussions and decisions about dental treatment.
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Affiliation(s)
- Andrew Geddis-Regan
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK
- North Cumbria Integrated Care NHS Foundation Trust, Carlisle Dental Centre, Carlisle, UK
| | - Rebecca R Wassall
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Dental Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Clare Abley
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Catherine Exley
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
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6
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Tung HJ, Ford R. Incident edentulism and number of comorbidities among middle-aged and older Americans. Gerodontology 2023; 40:484-490. [PMID: 36708102 DOI: 10.1111/ger.12675] [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: 07/31/2022] [Revised: 12/28/2022] [Accepted: 01/06/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUNDS Certain chronic non-communicable diseases have been associated with the loss of all natural permanent teeth, referred to as edentulism. It has been suggested that edentulism, a chronic dental state, involving the loss of all teeth and poorer masticatory efficiency, could be associated with multiple chronic conditions as people age. In this study, we describe the association between the number of comorbidities and incident edentulism in a representative sample of older Americans. METHODS We took data from the Health and Retirement Study (HRS). Dentate participants aged 50 or older at the baseline of 2006 (N = 13 221) and 2012 (N = 13 938) were linked to their dentate and survival status at the follow-up interviews in 2012 and 2018, respectively. The association between the number of comorbidities and incident edentulism was investigated by using multinomial logistic regression models. RESULTS Over the two observation periods, the number of selected chronic conditions was predictive of edentulism 6 years later. A 10% higher chance of becoming edentulous by 2012 (OR = 1.10, 95% CI = 1.01, 1.20) was found for every additional comorbid condition to those who remained dentate in 2012. A similar association was identified for the 2012-2018 period. CONCLUSION Among older adults, the number of comorbidities was predictive of incident edentulism, and the same association pattern was found across two longitudinal study periods. Older adults with an increase in the number of comorbidities may experience a higher chance of tooth loss later in time.
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Affiliation(s)
- Ho-Jui Tung
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Randall Ford
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
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Zhang X, Dai S, Jiang X, Huang W, Zhou Q, Wang S. The pathways from disadvantaged socioeconomic status in childhood to edentulism in mid-to-late adulthood over the life-course. Int J Equity Health 2023; 22:150. [PMID: 37553562 PMCID: PMC10408210 DOI: 10.1186/s12939-023-01865-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 03/04/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND This study aimed to examine the direct and indirect pathways from childhood socioeconomic status (SES) to the prevalence of edentulism in mid-to-late age Chinese individuals using structural equation modeling (SEM). METHODS This study analyzed data from 17,032 mid- to-late age Chinese individuals in the 2014 and 2015 China Health and Retirement Longitudinal Study (CHARLS). Childhood SES was determined based on the parents' education and occupation, financial situation of the family, primary residence, food availability, and medical convenience. Adulthood SES was established according to educational achievements of the individuals. Edentulism is defined as the loss of all natural teeth. SEM was used to examine the statistical significance of the association between childhood SES and edentulism, mediated by childhood health, adulthood SES, and adult health. RESULTS Childhood SES had significant indirect (β = -0.026, p < 0.01), and total (β = -0.040, p < 0.01) effects on edentulism. It was determined that 65% of the total effect of childhood SES on edentulism was indirect, and mainly mediated by adult SES. Also, the goodness-of-fit indices of the best-fitting model were acceptable. CONCLUSION This study revealed that childhood health, adult health and adult SES are mediators that explain the relationship between childhood SES and edentulism. The global attention to alleviate the inequality in edentulism should focus on exploring recommendations and intervention strategies from childhood to adulthood, by considering adult SES, childhood and adult health.
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Affiliation(s)
- Xiaoning Zhang
- School of Nursing, Hangzhou Normal University, Hangzhou, 311121, China.
- Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, China.
| | - Shuping Dai
- School of Marxism, Handong Women's University, Jinan, China
| | - Xue Jiang
- School of Stomatology, Xuzhou Medical University, Xuzhou, 221004, China
| | - Wenhao Huang
- School of Management, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, 221004, China
| | - Qiong Zhou
- Department of Nursing, Jiangsu Lianyungang College of Traditional Chinese Medicine, Lianyungang, 222007, China
| | - Sheng Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, 311121, China.
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Rakhra D, Grīnfelde M. Prevention of Disease and the Absent Body: A Phenomenological Approach to Periodontitis. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2023; 48:299-311. [PMID: 37189304 DOI: 10.1093/jmp/jhad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
A large part of the contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of health care. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of this disease prevention, focusing on how we-as embodied beings-engage with health-promoting behaviours. It specifically considers how we engage with oral hygiene regimens to prevent periodontitis and why we are not good at it. The article suggests that poor adherence to health-promoting behaviours can be explained with reference to the concept of the absent body, because prevention of disease is generally concerned with pre-symptomatic illness experience. The final section contains a discussion of some strategies for the improvement of disease prevention based on this viewpoint.
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Affiliation(s)
- Dylan Rakhra
- Department of Philosophy, The University of Bristol, Bristol, UK
| | - Māra Grīnfelde
- University of Latvia Institute of Philosophy and Sociology, Riga, LatviaRīga Stradiņš University, Riga, Latvia
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Macdonald ME. The Necessity of qualitative research for advancing oral health. Community Dent Oral Epidemiol 2023; 51:67-70. [PMID: 36749669 DOI: 10.1111/cdoe.12787] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 02/08/2023]
Abstract
Researchers are engaged with producing knowledge. Through this knowledge production, they make claims about the world. For applied health researchers, our knowledge production is both a scientific as well as a moral activity. Increasingly, oral health researchers are turning to qualitative research, a research approach that takes science and morality seriously. Qualitative research pushes researchers to think about the different worlds in which people live and work, and endeavours to generate data that reflect those worlds. This paper argues that humans are complex, and that qualitative approaches are necessary for understanding how we are all deeply embedded in historical, social, cultural and political contexts, and why this matters when thinking about oral health. This paper also dispels myths about the limitations of qualitative research and proposes future directions to improve the sophistication of qualitative oral health sciences.
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Affiliation(s)
- Mary Ellen Macdonald
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montréal, Québec, Canada.,Institute of Health Sciences Education, McGill University, Montréal, Québec, Canada
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Schiller S, Rustemeier E, Kraus D, Stark H, Müller F, Utz KH. Misfit of Complete Maxillary Dentures' Posterior Palatal Seal following Polymerisation with Four Different Autopolymerising Resins: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5285. [PMID: 35955220 PMCID: PMC9369520 DOI: 10.3390/ma15155285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The majority of complete dentures are still conventionally manufactured using a flask-and-pack technique. However, the polymerization process may introduce a distortion of the denture body. The aim of this study was to evaluate the three-dimensional fit of the posterior palatal seal of maxillary complete dentures with the original impression, and to give recommendations for scraping. METHODS Four autopolymerising resins were used to manufacture 40 palatal plates each for high, medium and flat palates (total n = 120). The misfit was captured by taking a reline impression with a highly fluid silicone, the dimensions of which were measured with a flat-bed scanner. RESULTS The shape of the palate had a significant impact (median p = 0.0435), but not the resin type (median p = 0.2575). It was largest for the flat palate and smallest for the high palate. The largest misfit was observed in the palatal midline area (flat-palate average median: 685 µm; high and medium palates: 620 µm) decreasing towards the lateral and anterior regions. CONCLUSIONS The results suggest compensating for the palatal misfit that occurs with autopolymerising resins by scraping a postdam of an approximately 0.7 mm depth to the master cast, decreasing towards the anterior and lateral areas. In high and medium palates, the scraping could be less pronounced.
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Affiliation(s)
- Simone Schiller
- Independent Researcher, Kastanienstraße 10, 53340 Meckenheim, Germany;
| | - Elke Rustemeier
- Global Precipitation Climatology Centre, Deutscher Wetterdienst, Frankfurter Straße 135, 63067 Offenbach am Main, Germany;
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; (D.K.); (H.S.)
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; (D.K.); (H.S.)
| | - Frauke Müller
- Division de Gérodontologie et Prothèse Adjointe, Clinique Universitaire de Médecine Dentaire (CUMD), 1 rue Michel-Servet, 1211 Geneva, Switzerland;
| | - Karl-Heinz Utz
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; (D.K.); (H.S.)
- Independent Researcher, Käferweg 1, 53639 Königswinter, Germany
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Goh V, Hassan FW, Baharin B, Rosli TI. Impact of psychological states on periodontitis severity and oral health-related quality of life. J Oral Sci 2021; 64:1-5. [PMID: 34690248 DOI: 10.2334/josnusd.21-0267] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE This cross-sectional study aimed to identify impacts of depression, anxiety and stress on periodontitis severity and oral health-related quality of life (OHRQoL). METHODS A total of 141 periodontitis patients were recruited. Psychological states were assessed using the Malay short-form Depression, Anxiety and Stress Scales (MDASS-21). Subjects were grouped as positive for depression, anxiety or stress (DAS) (positive-DAS), without DAS (non-DAS), stress-only and anxiety-only. OHRQoL was evaluated using the Malay short-form Oral Health Impact Profile (S-OHIP[M]). RESULTS OHRQoL was associated with MDASS-21, probing pocket depths, recession, clinical attachment levels, number of teeth present and number of teeth with mobility. S-OHIP(M) of positive-DAS subjects was associated with clinical attachment levels, number of teeth present and presence of anxiety. Anxiety-only subjects reported higher S-OHIP(M) scores compared to the non-DAS group. CONCLUSION OHRQoL of all subjects was negatively impacted by periodontitis severity and tooth loss. Combinations of depression, anxiety or stress led to worse periodontal status and OHRQoL. Subjects with anxiety-only experienced poorer OHRQoL compared to those without depression, anxiety and stress regardless of periodontitis severity. Possible impacts of psychological states on periodontitis and OHRQoL highlights the importance of assessing and improving psychological factors as part of periodontal therapy and to enhance OHRQoL.
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Affiliation(s)
- Victor Goh
- Periodontology, Department of Restorative Dentistry, Faculty of Dentistry, The National University of Malaysia
| | | | - Badiah Baharin
- Periodontology, Department of Restorative Dentistry, Faculty of Dentistry, The National University of Malaysia
| | - Tanti I Rosli
- Dental Public Health, Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia
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Macdonald ME. It's time to make dental education 'grief literate'. J Dent Educ 2021; 85:1718-1720. [PMID: 34309847 DOI: 10.1002/jdd.12753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/03/2021] [Accepted: 07/15/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Mary Ellen Macdonald
- Faculty of Dentistry, Institute for Health Sciences Education, McGill University, Montreal, Canada
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Jayachandran S, Hill K, Walmsley AD. A critical review of qualitative research publications in dental implants from 2006 to 2020. Clin Oral Implants Res 2021; 32:659-671. [PMID: 33715249 DOI: 10.1111/clr.13743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/01/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This critical review is aimed to investigate the current status of qualitative research in dental implant research and to explore the quality of available information. MATERIAL AND METHODS A systematic search was done on the journal databases to identify dental implant research articles that used qualitative methodology during 2006 and 2020. The resulting articles were appraised against the checklist offered by the Critical Appraisal Skills programme (CASP) tool. Also, the theories evolved from the research were reviewed to understand the value of this methodology in dental implant research. RESULTS Twenty-five (25) articles out of the 8,421 original results were identified as using qualitative methodology. The researchers have sought to identify the views of patients about tooth loss, dental implants, and the information they receive from dental professionals, and views of the dentists about dental implant practice. The review found that there were few inconsistencies in the quality of such research especially the qualitative data analysis. CONCLUSIONS The quantity of qualitative research in dental implants remains low; however, the quality has improved in the past two decades. Despite these improvements, there is still a lack of research in understanding both patients' and dentists' views on dental implant procedures and management.
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Affiliation(s)
| | - Kirsty Hill
- The School of Dentistry, University of Birmingham, Birmingham, United Kingdom
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van der Zande MM, Exley C, Wilson SA, Harris RV. Disentangling a web of causation: An ethnographic study of interlinked patient barriers to planned dental visiting, and strategies to overcome them. Community Dent Oral Epidemiol 2020; 49:144-157. [PMID: 33104275 DOI: 10.1111/cdoe.12586] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/07/2020] [Accepted: 10/04/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To explore barriers to planned dental visiting, investigating how barriers interlink, how they accumulate and change, and how individuals envisage overcoming their combination of barriers through personal strategies. METHODS An ethnographic study was conducted of adult urgent dental care attenders who did not have a dentist, including 155 hours of nonparticipant observations, 97 interviews and 19 follow-up interviews in six urgent dental care settings. Data were analysed using constant comparison, first identifying barriers and personal strategies to overcome them, and subsequently analysing interlinks between barriers and personal strategies. RESULTS Accounts of barriers to planned dental visiting encompassed multiple barriers, which related to socioeconomic circumstances as well as experiences of oral health care. Barriers were multi-layered and more difficult to overcome when occurring together. Personal strategies to overcome diverse barriers often hinged on increasing importance of oral health to individuals, yet this was not always sufficient. The combination of barriers participants experience was dynamic, changing due to personal, family, or employment circumstances, and with increasing severity of barriers over time. Over time, this could lead to higher cost, and additional barriers, particularly embarrassment. CONCLUSION Barriers to planned dental visiting are complex, multi-layered and change over time, constituting a 'web of causation'. This adds a novel perspective to the literature on barriers to dental visiting, and requires that researchers, dental practitioners and policy makers remain open to barriers' interlinked effects, changes in primacy among individual patients' barriers, and their accumulation over time to better support uptake of planned dental visiting.
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Affiliation(s)
- Marieke M van der Zande
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Catherine Exley
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Samantha A Wilson
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Rebecca V Harris
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
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The patient experience of dental implant surgery: a literature review of pertinent qualitative studies. Ir J Med Sci 2020; 190:835-842. [PMID: 32720197 DOI: 10.1007/s11845-020-02327-y] [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: 06/05/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
This review aims to identify and summarise the findings of published qualitative studies relating to patients' experiences of dental implant surgery, by means of textual narrative synthesis. A comprehensive two-stage electronic and manual search of the literature identified relevant qualitative studies up to January 2020. Included primary studies (n = 15) used qualitative research methods including interviews and focus groups to investigate patients' experiences of dental implant treatment. They looked at the experience of tooth loss, the decision making process, the pre-implant experience, motivating factors and barriers for treatment and the post-implant experience with the prosthesis. There is a deficiency in the exploration of the patients' intraoperative dental surgical experience and the adjunctive effects of conscious sedation. The included studies give considerable insight into patients' experiences of the dental implant journey, which in the main, had overall positive consensus. The limited information available regarding patients' experience of the intra operative dental implant surgery with or without conscious sedation warrants further investigation. This information is a fundamental step to understanding the patients' preferences, needs and values and ultimately enhancing the quality of patient care.
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Al‐Sahan MM, MacEntee MI, Bryant SR. A metatheory explaining how patients manage tooth loss. Gerodontology 2020; 37:258-270. [DOI: 10.1111/ger.12457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/15/2019] [Accepted: 11/28/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Maha M. Al‐Sahan
- Department of Oral Health Sciences Faculty of Dentistry University of British Columbia Vancouver BC Canada
- Department of Prosthetic Dental Sciences College of Dentistry King Saud University Riyadh Saudi Arabia
| | - Michael I. MacEntee
- Department of Oral Health Sciences Faculty of Dentistry University of British Columbia Vancouver BC Canada
| | - S. Ross Bryant
- Department of Oral Health Sciences Faculty of Dentistry University of British Columbia Vancouver BC Canada
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Individual- and City-Level Socioeconomic Factors and Tooth Loss among Elderly People: A Cross-Level Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072345. [PMID: 32235684 PMCID: PMC7177366 DOI: 10.3390/ijerph17072345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 01/20/2023]
Abstract
This study aimed to test the association of contextual and individual socioeconomic status with tooth loss among Brazilian elderly people aged 65–74 years. Data from 5435 elderly participants from the Brazilian National Oral Health Survey (2010) were linked to city-level data for 27 state capitals and the Federal District. Tooth loss was clinically assessed according to the number of missing natural teeth. Contextual social variables included Human Development Index income (HDI-income) and HDI-education. Individual socioeconomic measures were monthly family income and years of schooling. Covariates included sex, skin colour, number of residents per room and number of goods. Multilevel Negative Binomial regression models were used to estimate rate ratios (RR) and 95% confidence intervals between contextual and individual variables and tooth loss. Contextual and individual income and education measures were consistently associated with tooth loss. Elderly people living in cities with low HDI-income and low HDI-education were respectively 21% and 33% more likely to present tooth loss. Cross-level interaction suggested that the relationship of lower income and lower schooling with tooth loss is different across levels of city-level income and city-level education inequality, respectively. Public policies aiming to reduce the income and education gaps and preventive dental interventions are imperative to tackle tooth loss among elderly people.
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Association of childhood socioeconomic status with edentulism among Chinese in mid-late adulthood. BMC Oral Health 2019; 19:292. [PMID: 31884947 PMCID: PMC6935473 DOI: 10.1186/s12903-019-0968-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/22/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the association between childhood socioeconomic status (SES) and edentulism. METHODS The edentulous status of Chinese in mid-late adulthood was determined using self-reported lost all of teeth from the Health and Retirement Longitudinal Study (CHARLS). Childhood SES was determined based on the following parameters: the education, occupation and working status of the parents; financial situation of the family; relationship with the parents; care, love and affection from the mother; quarrels and fights between parents; primary residence; neighbors' willingness to help and with close-knit relationships. Adulthood SES was assessed by educational achievements. This study used principal component analysis (PCA) to select variables and binary logistic regression models to determine the association between childhood SES and edentulism. RESULTS Data were available from a total of 17,713 respondents, 984 of whom were edentulous (2.9%). The prevalence of edentulism in mid- to late-age Chinese individuals was higher in those with poor childhood SES. In final regression model, edentulism was significantly associated with willingness of neighbors to help with close-knit relationships (OR = 0.89, 95% CI = 0.79-0.99), parents with high school education or above (OR = 1.18, 95% CI = 1.01-1.39) and drinking and smoking habits of the father (OR = 1.10, 95% CI = 0.97-1.24). CONCLUSION Childhood SES was significantly associated with the prevalence of edentulism in mid- to late-age Chinese individuals. In particular, parents with high school education or above, unwillingness of neighbor to help with close-knit relationships, drinking and smoking habits of the father independent of adulthood SES were significantly associated with edentulism. Accordingly, the development of optimal recommendations and more effective intervention strategies requires considering the experiences in early life associated with poor SES contributes to poor oral health.
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Lima de Paula LML, Sampaio AA, Costa JG, Gomes VE, Ferreira EFE, Ferreira RC. The course from tooth loss to successful rehabilitation with denture: Feelings influenced by socioeconomic status. SAGE Open Med 2019; 7:2050312119874232. [PMID: 31588360 PMCID: PMC6740051 DOI: 10.1177/2050312119874232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 07/30/2019] [Indexed: 01/02/2023] Open
Abstract
Objective: This study evaluated the perception of users of complete dentures (successful cases) provided by the public health service throughout the course from tooth loss to rehabilitation. Methods: A total of 11 individuals who received their complete dentures through the public health service were interviewed according to a qualitative approach based on three pre-established topics: (1) tooth loss, (2) living without teeth, and (3) living with dentures. The obtained material was submitted to content analysis. Results: Individuals associated the socioeconomic status with lifelong oral health experiences and difficulty to access oral treatment. Tooth loss was the solution to pain and sometimes perceived as a natural event of life. Living without teeth was a negative surprise that resulted in physical and psychological impairments. The period of adaptation to dentures represented suffering and required psychological efforts to be successful. Conclusion: The dentures represented a reward for the suffering and recovered normal function, appearance, and socialization.
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Affiliation(s)
- Lara Melina Leite Lima de Paula
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Aline Araujo Sampaio
- Department of Oral Surgery, Pathology and Clinical Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Josué Gomes Costa
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Viviane Elisângela Gomes
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Efigênia Ferreira E Ferreira
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Barboza-Solís C, Porras-Chaverri M, Fantin R. Is tooth loss important when evaluating perceived general health? Findings from a nationally representative study of Costa Rican adults. Community Dent Oral Epidemiol 2019; 47:358-365. [PMID: 31074536 DOI: 10.1111/cdoe.12466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/11/2019] [Accepted: 04/19/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Although previous studies have shown that oral diseases can impact certain systemic conditions, dental care has been historically separated from medical healthcare organizations in middle-income countries. There is a lack of research approaches which test the independent relationship between oral health and multidimensional measures of general health. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relatively to certain morbidity conditions, tooth loss is a health condition associated with SRH. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relative to certain morbidity conditions, tooth loss is a health condition associated with SRH. METHODS Data were obtained from the Costa Rican Longevity and Healthy Aging Study 1945-1955 Retirement Cohort, a national representative longitudinal survey including residents born between 1945 and 1955. The association between severe tooth loss and SRH was analysed cross-sectionally using the first wave of the study conducted in 2010. A multivariable logistic regression, adjusted for potential confounders, was performed on 2797 participants. A counterfactual analysis was additionally performed to illustrate the theoretical change on SRH prevalence-if all the participants were not to have had severe tooth loss. RESULTS Severe tooth loss was associated with poor SRH, after adjustment for smoking, morbidity, biomarkers and performance-based physical measures. The counterfactual analysis showed that severe tooth loss was the fifth most important morbidity condition in determining poor SRH. Declaring a poor SRH would have been decreased by 2.0 percentage points if those participants having severe tooth loss had shared the same risk pattern of those who had not lost the majority of their teeth. CONCLUSION Individuals consider their oral health status to a similar extent as other morbidity conditions when evaluating their general health. A stronger focus on oral health, and its impact on general health, could lead to better planning of national resources, thereby improving accessibility to health care and modifying prevailing conceptions of health care in low- and middle-income countries.
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Affiliation(s)
| | - Mariela Porras-Chaverri
- Centro de Investigación en Ciencias Atómicas, Nucleares y Moleculares, Universidad de Costa Rica, San José, Costa Rica
| | - Romain Fantin
- Facultad de Medicina, Escuela de Salud Pública, Universidad de Costa Rica, San José, Costa Rica.,Facultad de Medicina, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
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Emily Kettle J, Warren L, Glenn Robinson P, Walls A, Gibson BJ. 'I didn't want to pass that on to my child, being afraid to go to the dentist': making sense of oral health through narratives of connectedness over the life course. SOCIOLOGY OF HEALTH & ILLNESS 2019; 41:658-672. [PMID: 30582176 DOI: 10.1111/1467-9566.12845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
While previous sociological research on oral health has identified the relevance of personal relationships, there is more scope to analyse the mouth through a lens of connectedness. Recent qualitative interviews with 43 older people (65+) in England and Scotland found that participants constructed relational narratives to make sense of their oral health practices. By drawing on ideas of family practices, family display and personal life, we illustrate how the mouth can be understood relationally. Participants presented their own embodied experiences as connected to the actions of their parents. Narratives also reflected how, as parents and grandparents themselves, participants tried to shape the experiences of others. In this way, oral health practices were conceptualised as being about family. This can be seen in self-narratives that demonstrated how participants located themselves as embedded in webs of ongoing relationships. We highlight the importance of narrated practices of thinking and feeling, whereby participants imagined doing oral health, and indeed family, in different ways. We thereby demonstrate how oral health practices are constituted through family connectedness and at the same time how these practices contribute to the constitution of family. Policy should therefore pay attention to family relations when promoting improvements in oral health practices.
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Affiliation(s)
| | - Lorna Warren
- Sociological Studies, University of Sheffield, Sheffield, United Kingdom
| | | | - Angus Walls
- Edinburgh Dental Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Barry John Gibson
- Oral Health and Development, University of Sheffield, Sheffield, United Kingdom
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22
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Engman A. Embodiment and the foundation of biographical disruption. Soc Sci Med 2019; 225:120-127. [DOI: 10.1016/j.socscimed.2019.02.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/23/2019] [Accepted: 02/11/2019] [Indexed: 12/01/2022]
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Bitencourt FV, Corrêa HW, Toassi RFC. Tooth loss experiences in adult and elderly users of Primary Health Care. CIENCIA & SAUDE COLETIVA 2019; 24:169-180. [PMID: 30698251 DOI: 10.1590/1413-81232018241.09252017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 06/04/2017] [Indexed: 11/22/2022] Open
Abstract
From the theoretical perspective of phenomenology, this article seeks to understand the experiences of tooth loss in adult and elderly users of Primary Health Care in Porto Alegre, Rio Grande do Sul. Tooth loss was identified by the analysis of dental records of users that attended the oral health service at the Health Unit under study. Following this identification, individual household interviews were carried out. The sample was intentional. Data were interpreted by content analysis using the software ATLAS.ti (Visual Qualitative Data Analysis). The study had ethical approval. Losing teeth was an experience that expresses subjectivities, showing plural narratives and highlighting the social function of the mouth. Besides the number of missing teeth, the understanding of how people perceived themselves without their teeth determined how much tooth loss affected their lives. Wearing prostheses adds significance to individuals' perceptions of their body, restoring the balance between their body and the world. Qualitative approach studies in health services should be considered in order to plan interventions which prioritize people's individual needs in their own territories, thus reducing stigmas and social inequalities.
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Affiliation(s)
- Fernando Valentim Bitencourt
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santana. 90035-003 Porto Alegre RS Brasil.
| | - Helena Weschenfelder Corrêa
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santana. 90035-003 Porto Alegre RS Brasil.
| | - Ramona Fernanda Ceriotti Toassi
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santana. 90035-003 Porto Alegre RS Brasil.
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‘I've got lots of gaps, but I want to hang on to the ones that I have’: the ageing body, oral health and stories of the mouth. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18001605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe mouth may be presented and understood in different ways, be subject to judgement by others and, as we age, may intrude on everyday life due to problems that affect oral health. However, research that considers older people's experiences concerning their mouths and teeth is limited. This paper reports on qualitative research with 43 people in England and Scotland, aged 65–91, exploring the significance of the mouth over the lifecourse. It uses the concept of ‘mouth talk’ to explore narratives of maintaining, losing and replacing teeth. Participants engaged in ‘mouth talk’ to downplay the impact of the mouth, demonstrate socially appropriate ageing, and distance themselves from ‘real’ old age by retaining a moral identity and sense of self. They also found means to challenge dominant discourses of ageing in how they spoke about missing teeth. Referring to Leder's notion of ‘dys-appearance’ and Gilleard and Higgs’ work on the social imaginary of the fourth age, the study illustrates the ways in which ‘mouth talk’ can contribute to sustaining a sense of self in later life, presenting the ageing mouth, with and without teeth, as an absent presence. It also argues for the importance of listening to stories of the mouth in order to expand understanding of people's approaches to oral health in older age.
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Mejia GC, Elani HW, Harper S, Murray Thomson W, Ju X, Kawachi I, Kaufman JS, Jamieson LM. Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. BMC Oral Health 2018; 18:176. [PMID: 30367654 PMCID: PMC6204046 DOI: 10.1186/s12903-018-0630-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/04/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities are associated with oral health status, either subjectively (self-rated oral health) or objectively (clinically-diagnosed dental diseases). The aim of this study is to compare the magnitude of socioeconomic inequality in oral health and dental disease among adults in Australia, Canada, New Zealand and the United States (US). METHODS Nationally-representative survey examination data were used to calculate adjusted absolute differences (AD) in prevalence of untreated decay and fair/poor self-rated oral health (SROH) in income and education. We pooled age- and gender-adjusted inequality estimates using random effects meta-analysis. RESULTS New Zealand demonstrated the highest adjusted estimate for untreated decay; the US showed the highest adjusted prevalence of fair/poor SROH. The meta-analysis showed little heterogeneity across countries for the prevalence of decayed teeth; the pooled ADs were 19.7 (95% CI = 16.7-22.7) and 12.0 (95% CI = 8.4-15.7) between highest and lowest education and income groups, respectively. There was heterogeneity in the mean number of decayed teeth and in fair/poor SROH. New Zealand had the widest inequality in decay (education AD = 0.8; 95% CI = 0.4-1.2; income AD = 1.0; 95% CI = 0.5-1.5) and the US the widest inequality in fair/poor SROH (education AD = 40.4; 95% CI = 35.2-45.5; income AD = 20.5; 95% CI = 13.0-27.9). CONCLUSIONS The differences in estimates, and variation in the magnitude of inequality, suggest the need for further examining socio-cultural and contextual determinants of oral health and dental disease in both the included and other countries.
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Affiliation(s)
- Gloria C. Mejia
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Hawazin W. Elani
- Harvard School of Dental Medicine, Harvard University, Boston, MA USA
| | - Sam Harper
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec H3A 1A2 Canada
| | - W. Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Ichiro Kawachi
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec H3A 1A2 Canada
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA 5005 Australia
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Malcolm D, Pullen E. 'Everything I enjoy doing I just couldn't do': Biographical disruption for sport-related injury. Health (London) 2018; 24:366-383. [PMID: 30253661 DOI: 10.1177/1363459318800142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article draws on interview data with a population of non-elite sport/exercise participants (n = 20) to illustrate the interrelationship between biographical disruption and sport-related injury. It argues that contrary to the significance implied by their lack of prominence on current public health agendas, sport-related injuries can have a devastating personal impact, comparable to the more extreme variants of biographical disruption depicted in the literature on chronic illness. It seeks to explain the apparent incongruence between biophysical severity and subjective assessment of impact, by invoking notions of community normalisation and imagined futures, and identifying the unavailability of what subjects evaluate as effective medical support. These factors combine to problematise the attainment of biographical repair. It further highlights how biographical contingencies such as youthfulness, distinction through exhibiting responsible citizenship and the sense of failure to exert bodily self-management through exercise, perpetuate and escalate both biographical disruption and chronic illness. The paper thus illustrates the aetiological interdependence of biographical disruption and chronic illness as exercisers exacerbate relatively minor ailments due to their reluctance to modify habitual routines.
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Gibson BJ, Kettle JE, Robinson PG, Walls A, Warren L. Oral care as a life course project: A qualitative grounded theory study. Gerodontology 2018; 36:8-17. [DOI: 10.1111/ger.12372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/31/2018] [Accepted: 08/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Barry J. Gibson
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry University of Sheffield Sheffield UK
| | - Jennifer E. Kettle
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry University of Sheffield Sheffield UK
| | | | | | - Lorna Warren
- Department of Sociological Studies University of Sheffield Sheffield UK
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Maia FBM, de Sousa ET, de Sousa JP, Scudine KGO, Freitas CHSDM, Sampaio FC, Forte FDS. Influence of the dental prosthetic status on self-perceptions of health and treatment needs: A cross-sectional study of middle-aged adults with chronic disease. J Clin Exp Dent 2018; 10:e567-e573. [PMID: 29930775 PMCID: PMC6005088 DOI: 10.4317/jced.54783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/11/2018] [Indexed: 11/05/2022] Open
Abstract
Background Subjective aspects of dental prosthesis need in middle-aged adults are poorly explored, especially when the population presents chronic diseases. Objectives: To investigate if the use and necessity of dental prosthesis influence the self-perceptions of health and dental treatment need in middle-aged adults with chronic diseases. Material and Methods A cross-sectional study was performed in 210 middle-aged adults. Socio-demographic aspects, dental services use, oral and general perceptions of health, dental treatment need and OIDP were assessed using a standardized questionnaire. One trained dentist evaluated the use and necessity of dental prosthesis. Data were analyzed using Chi-square and multivariate logistic regression (p<0.05). Results The use of dental prosthesis showed a proportion of 2.2:1 for upper to lower arch. Dental prosthesis need was largely prevalent (90 and 95% in upper and lower arch, respectively). The self-perceptions of dental treatment need and oral health were associated with the use and necessity of dental prosthesis (p<0.05), which could not be observed in relation to the general self-perception. The adjusted model demonstrated that the subjective necessity of dental treatment was 16.04 (1.92-133.7) fold higher in individuals with necessity of rehabilitation in the lower arch. Besides, a positive self-perception of oral health (satisfied) was 2.59 (1.38-4.85) more expressive in individuals that used a dental prosthesis in upper arch. Conclusions The self-perception of oral health was influenced by the use of maxillary dental prosthesis in individuals with chronic disease. Moreover, individuals were more likely able to perceive treatment need when the lower jaw was affected by tooth loss. Key words:Tooth loss, epidemiology, personal satisfaction, aged, chronic disease.
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Affiliation(s)
| | - Emerson-Tavares de Sousa
- Department of Pediatric Dentistry, Piracicaba Dental School, Campinas University, Piracicaba -SP/Brazil
| | - Jossaria-Pereira de Sousa
- Department of Pediatric Dentistry, Piracicaba Dental School, Campinas University, Piracicaba -SP/Brazil
| | | | | | - Fabio-Correia Sampaio
- Department of Clinical and Social Odontology, Dental School, Federal University of Paraiba, Brazil
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Mago A, MacEntee MI, Brondani M, Frankish J. Anxiety and anger of homeless people coping with dental care. Community Dent Oral Epidemiol 2018; 46:225-230. [PMID: 29446849 DOI: 10.1111/cdoe.12363] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 01/04/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To reveal and describe from open-ended interviews how homeless people in Vancouver interpret, appraise and cope with dental care. METHODS Audio-recorded interviews with 25 homeless people (18 men and 7 women; age range: 25-64 years), purposefully selected for a range of experiences, were transcribed and analysed inductively. The process of interpretive description drawing from the Behavioral Model for Vulnerable Populations and Lazarus's Theory of Emotions identified how participants appraised and coped with dental care. RESULTS Four dominant themes emerged: barriers to care; service use; opinions on dental health; and improving dental services. Participants were anxious about the cost of dentistry and fearful of dentists. They got emergency dental care with difficulty, usually in hospital emergency departments although mostly they preferred self-treatment. They acknowledged the importance of dental health but felt stigmatized by their homelessness and visibly unhealthy mouths. They wanted accessible dental services with financial assistance from government, more widespread information about community dental clinics, and, notably among the Indigenous participants, less humiliating discrimination from dentists. CONCLUSIONS Homeless people have difficulty coping with dental care. They believe that dentistry is frightening, humiliating and expensive, and governments are neither sympathetic to their disability nor willing to provide helpful information about community dental clinics or sufficient dental benefits for their needs.
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Affiliation(s)
- Anjali Mago
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Michael I MacEntee
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Mario Brondani
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - James Frankish
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Tan CD. “I'm a normal autistic person, not an abnormal neurotypical”: Autism Spectrum Disorder diagnosis as biographical illumination. Soc Sci Med 2018; 197:161-167. [DOI: 10.1016/j.socscimed.2017.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
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Fantin R, Delpierre C, Kelly-Irving M, Barboza Solís C. Early socioeconomic conditions and severe tooth loss in middle-aged Costa Ricans. Community Dent Oral Epidemiol 2017; 46:178-184. [PMID: 29168897 DOI: 10.1111/cdoe.12351] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/19/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE A wide literature shows a strong social gradient in tooth loss according to income, education and occupation, in both developed and developing countries. It has been shown associations between tooth loss and parental education and occupation, independently of adult conditions. To explore the role of early socioeconomic circumstances on tooth loss, we used a lifecourse model. We analysed the direct and indirect links between early socioeconomic conditions and severe adult tooth loss. METHODS We used the Costa Rican Longevity and Healthy Aging Study 1945-1955 Retirement Cohort, a nationally representative longitudinal survey of Costa Rican residents born between 1945 and 1955. We used imputed data on 2796 individuals. Principal component analyses were run to integrate measures approaching the material circumstances during childhood and adulthood. We additionally examined the role of adult health behaviours and education level as potential mediators in the multivariable regression. RESULTS Early socioeconomic conditions were found strongly associated with severe tooth loss; 72.4% of the people who experienced the most deprived socioeconomic conditions during childhood (quartile 1) had severe tooth loss at the time of the interview; vs 43.3% in quartile 4 (most advantaged). This link diminished after adjustment for adult mediators. However, it remained a significant determinant of severe tooth loss in the final model. CONCLUSION The lifecourse model allowed to highlight that early socioeconomic conditions could have long-term consequences on severe tooth loss in middle ages via both direct and indirect mechanisms.
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Affiliation(s)
- Romain Fantin
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
| | - Cyrille Delpierre
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
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Gibson BJ, Sussex PV, Fitzgerald RP, Thomson WM. Complete tooth loss as status passage. SOCIOLOGY OF HEALTH & ILLNESS 2017; 39:412-427. [PMID: 27726151 DOI: 10.1111/1467-9566.12492] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of this article is to add to the literature on the sociology of oral health and dentistry by presenting the relevance of status passage to the study of complete tooth loss. The article reports on an analysis of data taken from participants residing in the Nelson region of New Zealand. In total the data include interviews from 20 participants, all of whom had their remaining natural teeth removed before 1960. In total, 12 women and eight men were interviewed. All were from a European background with an age range of 71 to 101 years. Following a narrative approach, participants were interviewed on the nature of the social factors that resulted in complete tooth loss by starting with their family history and then focusing on the factors and events leading up to their total tooth loss. Data were analysed using the methods and techniques of grounded theory. This article provides an outline of the importance of scheduling, prescribing, social factors, 'compound awareness contexts' and reversibility to the status passage into complete tooth loss. We conclude by arguing that the theory of status passage may enable a detailed analysis of the 'time-space extensionality' of trajectories into complete tooth loss.
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Affiliation(s)
- Barry John Gibson
- Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, UK
| | - Philip V Sussex
- Department of Oral Health, Nelson Hospital, Nelson, New Zealand
| | - Ruth P Fitzgerald
- Department of Anthropology, University of Otago, Dunedin, New Zealand
| | - William Murray Thomson
- Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
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Sale JEM, Amin M, Carrasco-Labra A, Brignardello-Petersen R, Glick M, Guyatt GH, Azarpazhooh A. A practical approach to evidence-based dentistry: VIII: How to appraise an article based on a qualitative study. J Am Dent Assoc 2017; 146:623-630. [PMID: 26227647 DOI: 10.1016/j.adaj.2015.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 06/10/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OVERVIEW Because of qualitative researchers' abilities to explore social problems and to understand the perspective of patients, qualitative research studies are useful to provide insight about patients' fears, worries, goals, and expectations related to dental care. To benefit fully from such studies, clinicians should be aware of some relevant principles of critical appraisal. In this article, the authors present one approach to critically appraise the evidence from a qualitative research study. PRACTICAL IMPLICATIONS Critical appraisal involves assessing whether the results are credible (the selection of participants, research ethics, data collection, data analysis), what are these results, and how they can be applied in clinical practice. The authors also examined how the results could be applied to patient care in terms of offering theory, understanding the context of clinical practice, and helping clinicians understand social interactions in clinical care. By applying these principles, clinicians can consider qualitative studies when trying to achieve the best possible results for their own practices.
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Can we measure patients’ perception during dental impressions? The Burdens in Dental Impression-Making Questionnaire – BiDIM-Q. J Prosthodont Res 2017; 61:34-42. [DOI: 10.1016/j.jpor.2016.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/24/2016] [Accepted: 03/13/2016] [Indexed: 11/18/2022]
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Patient perceived burden of implant placement compared to surgical tooth removal and apicectomy. J Dent 2015; 43:1456-61. [DOI: 10.1016/j.jdent.2015.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 09/29/2015] [Accepted: 10/15/2015] [Indexed: 11/23/2022] Open
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Fonseca LLV, Nehmy RMQ, Mota JAC. [The social value of teeth and access to dental health services]. CIENCIA & SAUDE COLETIVA 2015; 20:3129-38. [PMID: 26465855 DOI: 10.1590/1413-812320152010.00172015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 05/06/2015] [Indexed: 11/22/2022] Open
Abstract
Oral healthcare provided by the Unified Health System (SUS) faces the challenge of attending the epidemiological profile of Brazil's adult population. Qualitative research using semi-structured interviews was conducted to understand the experiences, expectations and perception of SUS users to services in Diamantina, State of Minas Gerais, and content analysis was used to assess the data. Discussion of the results was based on dialogue between the symbolic interactionism of Goffman and Bourdieu's concept of habitus. The results show that the users did not give importance to dental care during childhood and adolescence because care was unknown to them. There was no offer of treatment besides dental extraction. Today, they value teeth and suffer the embarrassment caused by rotten teeth. However, access to dental restoration via SUS is not possible. For their children, they perceive better access to information and care, but for specialized procedures there are barriers. They express resignation both in relation to the poor state of the teeth and the difficulties of access to dental care, which can be understood by the constant exclusion experienced by them in the past, shaping their actions in the present. It was concluded that oral health in SUS should incorporate the social value and the aesthetic dimension of teeth as a social right.
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Affiliation(s)
- Luciara Leão Viana Fonseca
- Departamento de Odontologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil,
| | - Rosa Maria Quadros Nehmy
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brasil
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Coles E, Freeman R. Exploring the oral health experiences of homeless people: a deconstruction-reconstruction formulation. Community Dent Oral Epidemiol 2015. [PMID: 26202302 DOI: 10.1111/cdoe.12190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore qualitatively, using a grounded theory approach, homeless people's awareness of their oral health needs and how they access dental services using a deconstruction-reconstruction formulation, and provide recommendations for service designers and dental professionals who work with people experiencing homelessness. METHODS A qualitative study using grounded theory methodology was conducted. A purposive sample of homeless people was recruited from health facilities and organizations serving homeless populations in four Scottish cities and towns. Participants were interviewed about their oral health within the wider context of their experiences of homelessness. Initial research questions were open and focused on social processes such as oral health practices and interaction with dental services. Data collection and analysis were carried out simultaneously and iteratively, with emerging findings informing subsequent cycles. Data analysis was guided by Glaser and Strauss's grounded theory methodology and involved constant comparison, coding of transcripts and detailed memo-writing. RESULTS Thirty-four homeless people took part. Participant experiences were conceptualized as a journey into and through the stages of homelessness, towards 'reclaiming life'. Oral health experiences were mapped as a parallel 3-stage journey from the deconstruction of self-care, to the construction and maintenance of the neglected dentine, and finally to the reclamation of oral health resulting in a reconstructed functioning dentition. CONCLUSIONS This qualitative exploration using a deconstruction-reconstruction formulation has added to the understanding of homeless people's oral health awareness and dental treatment access while permitting an examination of the wider socioeconomic and psychosocial issues that disrupt their intentions to attend for treatment. These findings provide service designers and dental professionals with recommendations for the provision of responsive, acceptable and appropriate dental health services for those experiencing homelessness.
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Affiliation(s)
- Emma Coles
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Ruth Freeman
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
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Kashbour W, Rousseau N, Ellis J, Thomason J. Patients’ experiences of dental implant treatment: A literature review of key qualitative studies. J Dent 2015; 43:789-97. [DOI: 10.1016/j.jdent.2015.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 04/15/2015] [Accepted: 04/17/2015] [Indexed: 10/23/2022] Open
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Baker SR, Gibson BG. Social oral epidemi(olog)(2) y where next: one small step or one giant leap? Community Dent Oral Epidemiol 2014; 42:481-94. [PMID: 25039714 PMCID: PMC4288991 DOI: 10.1111/cdoe.12118] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 06/06/2014] [Indexed: 01/22/2023]
Abstract
Since the early 1990s, there has been heated debate critically reflecting on social epidemiology. Yet, very little of this debate has reached oral epidemiology. This is no more noticeable than in the field of oral health inequalities. One of the significant achievements of social oral epidemiology has been the persistent documentation of social patterning of oral disease. Nevertheless, where social oral epidemiology has fallen down is going beyond description to explaining these patterns. Thinking how and in what way things happen, not just in relation to oral health inequalities but also more broadly, requires a more creative approach which links to scholarship outside of dentistry, including the work from critical epidemiologists to that within the social sciences. The aim of this review study is to provide a critical commentary on key aspects of more general epidemiological debates in order to inform and develop social oral epidemiology theory and methodology. In the first section, 'Where are we now?', six key debates are reflected upon: (i) analysis of variance versus analysis of causes, (ii) the fallacy of independent effects, (iii) black box thinking, (iv) theory and the understanding of mechanisms, (v) individualization of risk and (vi) the meaning of 'social'. In the second section, 'Where to next?' we draw on a number of fundamental issues from within the social science literature in order to highlight possible channels of future inquiry. Our overriding goal throughout is to facilitate a critical engagement in order to improve understanding and generate knowledge in relation to population oral health.
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Affiliation(s)
- Sarah R Baker
- Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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