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Drumond VZ, de Arruda JAA, de Andrade BAB, Silva TA, Mesquita RA, Abreu LG. Tooth loss from the perspective of studies employing a life course approach: a systematic review. Health Promot Int 2024; 39:daae112. [PMID: 39322426 DOI: 10.1093/heapro/daae112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2024] Open
Abstract
The life course approach scrutinizes factors that shape the development of diseases over time. Tooth loss, which is influenced by social, behavioral and biological factors, can occur at various stages of life and tends to become more prevalent in later years. This systematic review examined the influence of socioeconomic, psychosocial, biological and behavioral adversities in life on the likelihood of tooth loss. Searches were conducted in the Embase, PubMed, Web of Science, Ovid, PsycINFO, Scopus and LILACS databases. Reference management was performed using EndNote online. The risk of bias was appraised using the Newcastle-Ottawa Scale (NOS). The electronic searches yielded 1366 records, 17 of which (13 cohort and four cross-sectional studies) met the inclusion criteria. According to the NOS, all studies had a low risk of bias. Two studies found a link between a lower education and higher incidence of tooth loss and socioeconomic status exerted a significant influence in 47% of the studies. Disadvantaged socioeconomic trajectories and health-related factors, such as smoking, general health perception and oral health behaviors, increased the likelihood of tooth loss. Factors such as dental visits, a history of toothache and exposure to fluoridated water influenced the likelihood of tooth loss. Individuals who experienced adversities in socioeconomic, behavioral and biological aspects throughout their life course were more prone to tooth loss.
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Affiliation(s)
- Victor Zanetti Drumond
- Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Professor Rodolho Paulo Rocco 325, Cidade Universitária, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruno Augusto Benevenuto de Andrade
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Professor Rodolho Paulo Rocco 325, Cidade Universitária, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil
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Hach M, Hvidtfeldt UA, Christensen LB, Lange T, Danielsen B, Osler M, Diderichsen F, Andersen I. Underlying pathways of social inequality in tooth loss: The mediating role of sugary beverages and diabetes. Scand J Public Health 2024; 52:624-631. [PMID: 37184274 DOI: 10.1177/14034948231173744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Previous studies show social inequality in tooth loss, but the underlying pathways are not well understood. The aim was to investigate the mediated proportion of sugary beverages (SBs) and diabetes and the association between educational level and tooth loss, and to investigate whether the indirect effect of SBs and diabetes varied between educational groups in relation to tooth loss. METHODS Data from 47,109 Danish men and women aged 50 years or older included in the Danish Diet, Cancer and Health Study was combined with data from Danish registers. Using natural effect models, SBs and diabetes were considered as mediators, and tooth loss was defined as having <15 teeth present. RESULTS In total, 10,648 participants had tooth loss. The analyses showed that 3% (95% confidence interval 2-4%) of the social inequality in tooth loss was mediated through SBs and diabetes. The mediated proportion was mainly due to differential exposure to SBs and diabetes among lower educational groups. CONCLUSIONS The findings show that SBs and diabetes to a minor degree contribute to tooth-loss inequalities. The explanation indicates that individuals in lower educational groups have higher consumption of SBs and more often suffer from diabetes than higher educational groups.
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Affiliation(s)
- Maria Hach
- School of Oral Health Care, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ulla A Hvidtfeldt
- Diet, Genes and Environment, Danish Cancer Society Research Center, Denmark
| | - Lisa B Christensen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Theis Lange
- Section of Biostatistics, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Bo Danielsen
- School of Oral Health Care, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Frederiksberg/Bispebjerg Hospitals and Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Finn Diderichsen
- Department of Public Health, University of Copenhagen, Denmark and Oswaldo Cruz Foundation, Brazil
| | - Ingelise Andersen
- Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Irie K, Tsuneishi M, Saijo M, Suzuki C, Yamamoto T. Occupational Difference in Oral Health Status and Behaviors in Japanese Workers: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138081. [PMID: 35805739 PMCID: PMC9265852 DOI: 10.3390/ijerph19138081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023]
Abstract
The occupational environment is an important factor for oral health because people spend a long time in the workplace throughout their lives and are affected by work-related stress and occupational health policies. This study aimed to review evidence for the association between occupation and oral health status and behaviors. A literature search of PubMed was conducted from February to May 2022, as well as a manual search analyzing the article origins. Articles were screened and considered eligible if they met the following criteria: (1) published in English; (2) epidemiological studies on humans; and (3) examined the association between occupation and oral health status and behaviors. All 23 articles identified met the eligibility criteria. After full-text assessments, ten articles from Japan were included in this review: four on the association between occupation and dental caries, three on occupation and periodontal disease, two on occupation and tooth loss, and one on occupation and oral health behaviors. An association was apparent between occupation, oral health status and behaviors among Japanese workers. In particular, skilled workers, salespersons, and drivers who work longer hours and often on nightshifts, tended to have poor oral health.
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Affiliation(s)
- Koichiro Irie
- Department of Oral Health and Preventive Dentistry, School of Dentistry, Meikai University, Sakado 350-0283, Japan; (M.S.); (C.S.)
- Correspondence:
| | - Midori Tsuneishi
- Japan Dental Association Research Institute, Chiyoda-ku 102-0073, Japan;
| | - Mitsumasa Saijo
- Department of Oral Health and Preventive Dentistry, School of Dentistry, Meikai University, Sakado 350-0283, Japan; (M.S.); (C.S.)
| | - Chiaki Suzuki
- Department of Oral Health and Preventive Dentistry, School of Dentistry, Meikai University, Sakado 350-0283, Japan; (M.S.); (C.S.)
| | - Tatsuo Yamamoto
- Department of Dental Sociology, Kanagawa Dental University, Yokosuka 238-8580, Japan;
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Kim SY, Lee CH, Yoo DM, Kwon MJ, Kim JH, Kim JH, Byun SH, Park B, Lee HJ, Choi HG. Is the Number of Missing Teeth Associated With Mortality? A Longitudinal Study Using a National Health Screening Cohort. Front Med (Lausanne) 2022; 9:837743. [PMID: 35801211 PMCID: PMC9253612 DOI: 10.3389/fmed.2022.837743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to estimate the risk of mortality related to the number of missing teeth in a South Korean population. The ≥ 40-year-old population of the Korean National Health Insurance Service-Health Screening Cohort 2002–2003 was analyzed. Participants were selected from a total of 220,189 participants and included in groups of 0 teeth lost, 1–2 teeth lost, and ≥ 3 teeth lost. Among the total population, 17,211 participants were included in no missing teeth, 1–2 missing teeth, and ≥ 3 missing teeth and were randomly matched 1:1:1 for age and sex. Mortality from specific causes and all-cause mortality were compared among the groups. The hazard ratio (HR) of the number of missing teeth for all-cause mortality or each cause of mortality was analyzed using Cox proportional hazard models. According to the cause of death, the HRs for metabolic disease, digestive disease, and trauma were greater in the group with ≥ 3 missing teeth than in the no missing teeth group. The group with ≥ 3 missing teeth indicated a 1.19-fold higher HR for all-cause mortality than the no missing teeth group [95% confidence intervals (95% CIs) = 1.12–1.27, P < 0.001]. The group with 1- 2 missing teeth did not show a higher HR for all-cause mortality. In the group with 1–2 missing teeth, the HRs for mortality from mental disease and digestive disease were higher than those in the no missing teeth group. The group with 1–2 missing teeth did not show a higher HR for all-cause mortality. The number of missing teeth was linked with a higher risk of mortality. For specific causes of mortality, mortality from metabolic disease, digestive disease, and trauma was higher in the participants with the number of missing teeth.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Chang Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea
| | - Mi Jung Kwon
- Department of Pathology, Hallym University College of Medicine, Anyang, South Korea
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University College of Medicine, Anyang, South Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Dentistry, Hallym University College of Medicine, Anyang, South Korea
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon, South Korea
| | - Bumjung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
| | - Hyo-Jeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
- *Correspondence: Hyo Geun Choi
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Yang H, Han R, Wang Z. Socioeconomics, health-related factors, and tooth loss among the population aged over 80 years in China. BMC Public Health 2022; 22:444. [PMID: 35247999 PMCID: PMC8898425 DOI: 10.1186/s12889-022-12861-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background The prevalence of tooth loss varies across the globe among oldest-old individuals. The presence of fewer than 20 teeth in old age was associated with a decrease in people’s health and quality of life. This paper explored the association between socioeconomics, health-related factors, and tooth loss among the population over the age of 80 in China. Methods The tooth loss status of older Chinese adults was collected with a structured questionnaire from the 8th wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 6716 individuals aged 80 years and above were included. Logistic regression was used to assess the association between socioeconomic statuses, dietary intake at approximately 60 years old, health-related factors, and tooth loss. Results Of the 6716 individuals aged 80 years and above, the composition of the group with fewer teeth for both men and women was statistically significant in many ways. Multivariate logistic regression analyses show that for men, being older than 90 years and being ADL disabled (adjusted OR: 1.71, 95% CI: 1.01–2.89) are factors that are significantly and consistently associated with a higher risk of having fewer than 20 teeth, while having a higher household income per capita (adjusted OR: 0.56, 95% CI: 0.32–0.99) decreases the risk. For women, an age of above 95 years, brushing teeth less than once per day (adjusted OR: 1.96, 95% CI: 1.26–3.03), consuming sugar some of the time as opposed to less than once per month at approximately 60 years old (adjusted OR = 1.74, 95% CI: 1.15–2.62), and being ADL disabled (adjusted OR: 1.70, 95% CI: 1.04–2.77) are factors that are significantly associated with the risk of having fewer than 20 teeth. Conclusion The analysis suggests that socioeconomic status, dietary intake in early old age, and ADL capacity are associated with the risk of having fewer teeth for the population aged 80 years and above, and the risk factors vary between sexes.
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Oral Health, Health Service Utilization, and Age at Arrival to the U.S. among Safety Net Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031477. [PMID: 35162501 PMCID: PMC8835091 DOI: 10.3390/ijerph19031477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/16/2022]
Abstract
Background: Immigrants’ oral health disparities have not been adequately investigated using a lifecourse approach, which investigates the cumulative effects of risk and protective exposures among other considerations. Methods: We examined self-reported oral health outcomes and health care appointment outcomes among a sample of patients enrolled at a federally qualified health center in Richmond Virginia (N = 327) who were categorized into three groups by approximate age at arrival to the U.S. Results: Study participants who arrived to the U.S. prior to age 18 had better retention of natural dentition, better oral health related quality of life, and a lower proportion of dental appointments to address pain than those who arrived after age 18 or were born in the U.S. Conclusions: Im/migrants’ differentiated oral health outcomes by age at arrival to the U.S. suggest the relevance of lifecourse factors, for example the cumulative effects of risk and protective exposures, and confirm the merits of lifecourse studies of im/migrants’ oral health.
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Shin HS, Im AJ, Lim HJ. Socioeconomic status, food security, and chewing discomfort of Korean elders: results from the Korea National Health and Nutrition Examination Survey. Nutr Res Pract 2022; 16:94-105. [PMID: 35116130 PMCID: PMC8784262 DOI: 10.4162/nrp.2022.16.1.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 03/10/2021] [Accepted: 07/05/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hye-Sun Shin
- Department of Dental Hygiene, Eulji University College of Health Science, Seongnam 13135, Korea
| | - Ae-Jung Im
- Department of Dental Hygiene, Eulji University College of Health Science, Seongnam 13135, Korea
| | - Hee-Jung Lim
- Department of Dental Hygiene, Eulji University College of Health Science, Seongnam 13135, Korea
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A cross-sectional analysis of oral health care spending over the life span in commercial- and Medicaid-insured populations. J Am Dent Assoc 2021; 153:101-109.e11. [PMID: 34772476 DOI: 10.1016/j.adaj.2021.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Life course theory creates a better framework to understand how oral health care needs and challenges align with specific phases of the life span, care models, social programs, and changes in policy. METHODS The authors obtained data from the 2018 IBM Watson Multi-State Medicaid MarketScan Database (31 million claims) and the 2018 IBM Watson Dental Commercial and Medicare Supplemental Claims Database (45 million claims). The authors conducted analysis comparing per enrollee spending on fee-for-service dental claims and medical spending on oral health care for patients from ages 0 through 89 years. RESULTS Oral health care use rate and spending are lower during the first 4 years of life and in young adulthood than in other periods of life. Stark differences in the timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations. CONCLUSIONS This life span analysis of the US multipayer oral health care system shows the complexities of the current dental service environment and a lack of equitable access to oral health care. PRACTICAL IMPLICATIONS Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the life span.
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Celeste RK, Darin-Mattsson A, Lennartsson C, Listl S, Peres MA, Fritzell J. Social Mobility and Tooth Loss: A Systematic Review and Meta-analysis. J Dent Res 2021; 101:143-150. [PMID: 34448425 DOI: 10.1177/00220345211029277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study systematically reviews the evidence of the association between life course social mobility and tooth loss among middle-aged and older people. PubMed, Scopus, Embase, and Web of Science were systematically searched in addition to gray literature and contact with the authors. Data on tooth loss were collated for a 4-category social mobility variable (persistently high, upward or downward mobility, and persistently low) for studies with data on socioeconomic status (SES) before age 12 y and after age 30 y. Several study characteristics were extracted to investigate heterogeneity in a random effect meta-analysis. A total of 1,384 studies were identified and assessed for eligibility by reading titles and abstracts; 21 original articles were included, of which 18 provided sufficient data for a meta-analysis with 40 analytical data sets from 26 countries. In comparison with individuals with persistently high social mobility, the pooled odds ratios (ORs) for the other categories were as follows: upwardly mobile, OR = 1.73 (95% CI, 1.53 to 1.95); downwardly mobile, OR = 2.52 (95% CI, 2.19 to 2.90); and persistently low, OR = 3.96 (95% CI, 3.13 to 5.03). A high degree of heterogeneity was found(I2 > 78%), and subgroup analysis was performed with 17 study-level characteristics; however, none could explain heterogeneity consistently in these 3 social mobility categories. SES in childhood and adulthood is associated with tooth loss, but the high degree of heterogeneity prevented us from forming a robust conclusion on whether upwardly or downwardly mobile SES may be more detrimental. The large variability in effect size among the studies suggests that contextual factors may play an important role in explaining the difference in the effects of low SES in different life stages (PROSPERO CRD42018092427).
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Affiliation(s)
- R K Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - A Darin-Mattsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - C Lennartsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - S Listl
- Department of Dentistry-Quality and Safety of Oral Health Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - M A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - J Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
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Stona P, Kramer PF, Vargas-Ferreira F, Amorim LMD, Coelho EMDRB, Feldens CA. Socioeconomic and intraoral polarization of untreated caries and tooth loss among male adolescents. Braz Oral Res 2021; 35:e031. [PMID: 33729276 DOI: 10.1590/1807-3107bor-2021.vol35.0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/22/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate the intraoral distribution of untreated caries and tooth loss and estimate the impact of different socioeconomic factors on the occurrence of these outcomes. A cross-sectional study was conducted with 652 18-year-old male adolescents from the city of Sapucaia do Sul, Brazil, who conscripted for military service. The participants answered a questionnaire addressing sociodemographic variables. Two trained and calibrated examiners performed the clinical examinations for the diagnosis of dental caries using the criteria of the World Health Organization. Tooth group and adolescent were the units of analysis for the primary outcomes of the study. Poisson regression analysis with robust variance was performed, with the calculation of crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). The prevalence of caries experience and untreated caries was 70.2% and 39.3%, respectively, and 9.4% of the adolescents had missing teeth. Sixty-seven percent of the untreated caries and 98.8% of missing teeth were in first molars. The probability of dental caries and tooth loss was significantly higher among adolescents with less schooling (PR = 2.56; 95%CI: 1.97-3.32 and PR = 3.28; 95%CI: 1.61-6.65, respectively) and those whose mothers had less schooling (PR = 1.31; 95%CI: 1.03-1.67 and PR = 2.30; 95%CI: 1.18-4.50, respectively). In conclusion, the occurrence of untreated dental caries and tooth loss was concentrated in the first molars of adolescents. Moreover, the prevalence of both conditions was higher among adolescents with low schooling and whose mothers had low schooling, reflecting the strong intraoral and socioeconomic polarization of these outcomes.
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Affiliation(s)
- Priscila Stona
- Faculdade da Serra Gaúcha - FSG, School of Dentistry, Department of Pediatric Dentistry. Caxias do Sul, RS, Brazil
| | - Paulo Floriani Kramer
- Universidade Luterana do Brasil - Ulbra, School of Dentistry, Department of Pediatric Dentistry. Porto Alegre, RS, Brazil
| | - Fabiana Vargas-Ferreira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry. Belo Horizonte, MG, Brazil
| | - Lívia Mund de Amorim
- Universidade Luterana do Brasil - Ulbra, School of Dentistry, Department of Pediatric Dentistry. Porto Alegre, RS, Brazil
| | | | - Carlos Alberto Feldens
- Universidade Luterana do Brasil - Ulbra, School of Dentistry, Department of Pediatric Dentistry. Porto Alegre, RS, Brazil
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Celeste RK, Eyjólfsdóttir HS, Lennartsson C, Fritzell J. Socioeconomic Life Course Models and Oral Health: A Longitudinal Analysis. J Dent Res 2020; 99:257-263. [PMID: 32077794 DOI: 10.1177/0022034520901709] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We compared socioeconomic life course models to decompose the direct and mediated effects of socioeconomic status (SES) in different periods of life on late-life oral health. We used data from 2 longitudinal Swedish studies: the Level of Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old. Two birth cohorts (older, 1925 to 1934; younger, 1944 to 1953) were followed between 1968 and 2011 with 6 waves. SES was measured with 4 indicators of SES and modeled as a latent variable. Self-reported oral health was based on a tooth conditions question. Variables in the younger and older cohorts were grouped into 4 periods: childhood, young/mid-adulthood, mid /late adulthood, late adulthood/life. We used structural equation modeling to fit the following into lagged-effects life course models: 1) chain of risk, 2) sensitive period with late-life effect, 3) sensitive period with early- and late-life effects, 4) accumulation of risks with cross-sectional effects, and 5) accumulation of risks. Chain of risk was incorporated into all models and combined with accumulation, with cross-sectional effects yielding the best fit (older cohort: comparative fit index = 0.98, Tucker-Lewis index = 0.98, root mean square error of approximation = 0.04, weighted root mean square residual = 1.51). For the older cohort, the chain of SES from childhood → mid-adulthood → late adulthood → late life showed the following respective standardized coefficients: 053, 0.92, and 0.97. The total effect of childhood SES on late-life tooth loss (standardized coefficient: -0.23 for older cohort, -0.17 for younger cohort) was mediated by previous tooth loss and SES. Cross-sectional effects of SES on tooth loss were observed throughout the life course, but the strongest coefficients were at young/mid-adulthood (standardized coefficient: -0.41 for older cohort, -0.45 for younger cohort). SES affects oral health cumulatively over the life course and through a chain of risks. Actions to improve socioeconomic conditions in early life might have long-lasting effects on health if they help prevent people from becoming trapped in a chain of risks.
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Affiliation(s)
- R K Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - H S Eyjólfsdóttir
- Aging Research Center, Karolinska Institutet / Stockholm University, Stockholm, Sweden
| | - C Lennartsson
- Aging Research Center, Karolinska Institutet / Stockholm University, Stockholm, Sweden
| | - J Fritzell
- Aging Research Center, Karolinska Institutet / Stockholm University, Stockholm, Sweden
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Ferreira RC, Senna MIB, Rodrigues LG, Campos FL, Martins AEBL, Kawachi I. Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference? BMC Oral Health 2020; 20:246. [PMID: 32887590 PMCID: PMC7650222 DOI: 10.1186/s12903-020-01238-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 08/30/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. METHODS Data from the 2010 National Oral Health Survey of 9633 adults living in 157 Brazilian municipalities were used. The individual socioeconomic indicators were education and household income. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:< 0.699 versus high: > 0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. RESULTS At the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95% CI: 7.93-11.13) and 6.95 (95% CI: 6.43-7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI. CONCLUSIONS There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.
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Affiliation(s)
- Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
| | - Maria Inês Barreiros Senna
- Department of Dental Clinic, Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Lorrany Gabriela Rodrigues
- School of Dentistry, Federal University of Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Fernanda Lamounier Campos
- School of Dentistry, Federal University of Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Andrea Eleuterio Barros Lima Martins
- University of Montes Claros, Campus Universitário Professor Darcy Ribeiro, Avenida Rui Braga, S/N, Vila Mauricéia, Montes Claros, Minas Gerais, 39401-089, Brazil
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, USA
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Delgado-Angulo EK, Alshehri R, Scambler S, Bernabé E. Is grandparents' social class associated with adult grandchildren's oral health? Analysis of two British cohorts. Community Dent Oral Epidemiol 2020; 48:402-408. [PMID: 32463137 DOI: 10.1111/cdoe.12545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES No studies have taken a multigenerational approach to the study of oral health inequalities. This study investigated whether grandparents' social class was associated with adult grandchildren's oral health. METHODS Data from the 1958 National Child and Development Study (NCDS) and the 1970 British Cohort Study (BCS) were analysed. Cohort members' occupational social class and persistent trouble with mouth, teeth or gums in the past 12 months were reported at ages 33 years in the NCDS and 26 years in the BCS. Information on grandparents' and parents' social class was reported by the cohort members' mothers during childhood. The association between grandparents' social class and cohort members' report of persistent trouble with mouth, teeth or gums was tested in marginal structural models (MSMs). RESULTS Data from 9853 NCDS and 6487 BCS participants were analysed. Grandparents' social class was not associated with cohort members' report of persistent trouble with teeth, gums or mouth in the NCDS sample (odds ratios of 1.25 [95% Confidence Interval: 0.95-1.65] for social class IV/V and 1.12 [95% CI: 0.76-1.64] for social class IIINM-M relative to social class I/II) or the BCS sample (odds ratios of 0.98 [95% CI: 0.68-1.43] for social class IV/V and 0.88 [95% CI: 0.67-1.16] for social class IIINM-M relative to social class I/II). CONCLUSION This study provided no support for an independent association between grandparents' social class and adult grandchildren's oral health.
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Affiliation(s)
- Elsa K Delgado-Angulo
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Facultad de Estomatología Roberto Beltrán Neira, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Reem Alshehri
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - 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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14
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Novrinda H, Han DH, Jung-Choi K, Ryu JI. Neo-Marxian social class inequalities in oral health among the South Korean population. Community Dent Oral Epidemiol 2018; 47:162-170. [PMID: 30548668 DOI: 10.1111/cdoe.12439] [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: 07/02/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/27/2022]
Abstract
AIM The aims of this study were to examine inequalities in periodontitis and tooth loss among South Korean adults using the Wright's Neo-Marxian social class (NMSC) indicator and to assess the impact of material, psychosocial, health behavioural and workplace environmental factors in the association of social class with oral health. METHODS This study used the data from the 4th Korea National Health and Nutrition Examination Survey with 6710 participants aged 19-54 years old. Participants were classified into 12 social class positions based on the Wright's social class map. Healthy gum and absence of tooth loss were the health outcomes. Mediating factors were material (M), psychosocial (PS), health behavioural (HB) and workplace environmental (WPE) factors. A series of logistic regressions were performed to analyse the data. Odds ratio (OR) and 95% confidence interval (CI) were used to report the results. RESULTS For the absence of periodontal pockets status, expert supervisors were the healthiest periodontal group among the social classes (OR = 2.15 95% CI 1.59-2.90) in the age and gender adjusted model. For the absence of tooth loss, skilled workers had the highest OR for absence of tooth loss (OR = 1.64 95% CI 1.31-2.05) in the age- and gender-adjusted model. For absence of periodontal pockets, the explanatory power of the M factor was the highest in all social class positions except for nonskilled supervisors followed by the HB factor. Additionally, the absence of tooth loss had a fairly similar pattern. The explanatory power of the M factor was the highest in all social class positions except for the petty bourgeoisie (highest: HB) and nonskilled supervisors (highest: WPE) followed by the HB and WPE factors. CONCLUSION There were nongradient oral health inequalities among the South Korean population according to the NMSC. Oral health promotion programmes that focus on changing the socioeconomic environment and health behaviours should be implemented.
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Affiliation(s)
- Herry Novrinda
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Department of Dental Public Health and Preventive Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jae-In Ryu
- Department of Preventive and Social Dentistry, Kyung Hee University, Seoul, Korea
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15
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MacEntee MI, Wong ST, Chi I, Lo ECM, Minichiello V, Soheilipour S, Mariño R. Developmental regulation of lifelong dental experiences and beliefs in Guangzhou and Hong Kong. Gerodontology 2018; 36:18-29. [PMID: 30549089 DOI: 10.1111/ger.12383] [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] [Received: 04/05/2018] [Revised: 08/13/2018] [Accepted: 11/05/2018] [Indexed: 11/27/2022]
Abstract
AIMS The aim of this study was to explain through the life-course and life-span perspectives of developmental regulation theory the controls on dental experiences and beliefs throughout the lives of older people in Guangzhou and Hong Kong. BACKGROUND Dental diseases and disabilities among older people are serious public health concerns in China. METHODS A facilitator conducted eight focus groups, three in Hong Kong and five in Guangzhou, involving a total of 51 participants. She encouraged discussions about lifetime events to explain dental experiences and beliefs. Transcripts were coded and analysed using a constant comparative approach to identify themes that explained the regulators of dental experiences throughout the participants' lives. RESULTS Participants explained the influence of culture and history through critical events, and how external and internal factors regulated their current oral health status and beliefs. They emphasised the role of Traditional Chinese Medicine and family, and the stress of social upheaval compounded by a scarcity of dental services. They revealed also how current choice of dental services and health promotional programs, helped by personal food choice, self-reliance, and scepticism, helped them to adjust and cope with dental diseases and disabilities and the commercialisation of dental services. CONCLUSIONS Dental experiences and beliefs of older people living in Guangzhou and Hong Kong were regulated strongly during personal development by culture and history during critical events, and by various controlling factors, such as health promotion and choice of services supplemented by food choice, nutritional balance, self-reliance, scepticism and social adjustments.
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Affiliation(s)
- Michael I MacEntee
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sabrina T Wong
- School of Nursing, and Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Edward C M Lo
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Victor Minichiello
- School of Health, Faculty of the Professions, University of New England, Armidale, New South Wales, Australia
| | - Shimae Soheilipour
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Oral Public Health, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rodrigo Mariño
- Cooperative Research Centre for Oral Health Science Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
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16
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Shin HS. Number of existing permanent teeth is associated with chronic kidney disease in the elderly Korean population. Korean J Intern Med 2018; 33:1150-1159. [PMID: 28407463 PMCID: PMC6234409 DOI: 10.3904/kjim.2016.386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/01/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND/AIMS The aim of this study was to assess the association between the number of existing permanent teeth and chronic kidney disease (CKD) in a representative sample of the elderly Korean population. METHODS A total of 2,519 subjects who participated in the Korean National Health and Nutrition Examination Survey were cross-sectionally examined. The number of existing permanent teeth was evaluated by clinical oral examination. CKD was defined based on definition and classification by Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines. Multivariable logistic regression analyses were performed controlling for age, gender, income, education, tooth-brushing frequency, periodontitis, state of dentition, smoking, alcohol consumption, hypertension, obesity, diabetes mellitus, and hypercholesterolemia. Subgroup analyses by age and gender were also performed. RESULTS The number of teeth was significantly associated with CKD after controlling for all potential confounders (adjusted odds ratio [AOR], 1.67; 95% confidence interval [CI], 1.04 to 2.70 for lower number of teeth; AOR, 1.59; 95% CI, 1.14 to 2.23 for moderate number of teeth). In the subgroup analyses, the association was highlighted in females aged 75 years over (AOR, 2.55; 95% CI, 1.05 to 6.20 for lower number of teeth; AOR, 1.95; 95% CI, 1.01 to 3.80 for moderate number of teeth). CONCLUSION Our findings suggest that the number of existing permanent teeth may be associated with CKD among Korean elderly.
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Affiliation(s)
- Hye-Sun Shin
- Correspondence to Hye-Sun Shin, Ph.D. Department of Dental Hygiene, Eulji University College of Health Science, 553 Sanseong-daero, Sujeong-gu, Seongnam 13135, Korea Tel: +82-31-740-7247 Fax: +82-31-740-7352 E-mail:
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17
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Andrade FBD, Antunes JLF, Souza Junior PRBD, Lima-Costa MF, Oliveira CD. Life course socioeconomic inequalities and oral health status in later life: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:7s. [PMID: 30379285 PMCID: PMC6255023 DOI: 10.11606/s1518-8787.2018052000628] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/30/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.
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Affiliation(s)
- Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | | | | | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Cesar de Oliveira
- University College London, Department of Epidemiology & Public Health. London, UK
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Vendrame É, Goulart MDA, Hilgert JB, Hugo FN, Celeste RK. Decomposing early and adult life social position effects on oral health and chronic diseases in a cross-sectional study of Southern Brazil. Community Dent Oral Epidemiol 2018; 46:601-607. [DOI: 10.1111/cdoe.12410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 07/05/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Édina Vendrame
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Mariél de Aquino Goulart
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Juliana B. Hilgert
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Graduate Program in Epidemiology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Fernando N. Hugo
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Research Center in Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Roger Keller Celeste
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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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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20
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Shim SH, Han DH. Association between height and periodontitis in Korean adults: Results from KNHANES IV and V. J Periodontal Res 2017; 53:345-352. [PMID: 29159808 DOI: 10.1111/jre.12519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Evidence shows that a short stature in adulthood is associated with chronic diseases. However, few studies have investigated the association between height and periodontitis. The purpose of this study was to examine the relationship between adult height and periodontitis and to assess the roles of covariates in different birth cohorts of Korea. MATERIAL AND METHODS This was a cross-sectional study using the data from the 4th and 5th Korea National Health and Nutritional Examination Survey. The subjects were grouped into 2 birth cohorts based on their historical and social context: born from 1946 to 1962 and from 1963 to 1978. The dependent variables were periodontitis and severe periodontitis, while the independent variable was the height quartile. Demographic factors (age and gender), socioeconomic position (own education, region and income), health behaviors (frequency of daily tooth brushing and smoking) and medical status (diabetes) were included. Logistic regression analyses estimated the association of adult height with periodontitis after sequential adjustments. RESULTS The sample size of the final analysis was 18 010. The shortest quartile was associated with severe periodontitis (OR = 1.55, 95% CI 1.11-2.16) in the 1963-1978 birth cohort. The association remained after full adjustment in the 1963-1978 birth cohort (OR = 1.41, 95% CI 1.01-1.97). CONCLUSION Our study shows that there is an inverse association between height and severe periodontitis only in the younger Korean birth cohort. Our results support the impact of height, as an early childhood environmental indicator, on severe periodontitis in adulthood.
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Affiliation(s)
- S-H Shim
- Department of Dental Hygiene, Kyungbok University, Namyangju, Korea
| | - D-H Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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Ibiyemi O, Idiga E. Tooth loss among the elders in an inner city area of Ibadan, Nigeria. Gerodontology 2017; 34:264-271. [PMID: 28211095 DOI: 10.1111/ger.12263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the prevalence and factors associated with tooth loss among elders in an inner city area of Ibadan, Nigeria. BACKGROUND Tooth loss is an indication of the oral health of a population, and the possible effects of oral health on general health of the elders has been reported. MATERIAL AND METHODS A cross-sectional study was undertaken among 392 consenting elders in Idikan, Ibadan, Nigeria. Information on socio-demographic characteristics, causes and effects of tooth loss was obtained using a pretested semistructured questionnaire. After the interview, the elders were examined for the presence of tooth loss by a trained examiner. RESULT Mean (SD) age of the elders was 73.0 (9.2) years. One hundred and eighty-seven (47.7%) participants had ≥1 missing tooth, and 20 (5.1%) participants had complete edentulousness. The mean SD number of missing teeth was 5.9 (4.7) teeth. Age, level of education, monthly income and physical impairment were associated with mean (SD) number of missing teeth (P˂.05). Speech difficulty, appearance problems, chewing difficulty, feeling bereaved, mobility of adjacent teeth, halitosis and premature ageing were reported more by participants who had ˃16 missing teeth compared to those who had ≤16 teeth (P˂.05). CONCLUSION The mouth prevalence of tooth loss was 47.7%, and mean (SD) number of missing teeth was 5.9 (4.7) teeth. Age, level of education, monthly income and physical impairment were associated with number of missing teeth (P˂.05). Speech difficulty, appearance problem, chewing difficulty, feeling of bereavement, mobility of adjacent teeth, halitosis and premature ageing were associated with increasing number of missing teeth (P˂.05).
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Affiliation(s)
- Olushola Ibiyemi
- Department of Periodontology and Community Dentistry, Faculty of Dentistry, University of Ibadan, Ibadan, Nigeria
| | - Ejiro Idiga
- Department of Preventive Dentistry, University College Hospital, Ibadan, Nigeria
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