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Prevalence of Caries According to the ICDAS II in Children from 6 and 12 Years of Age from Southern Ecuadorian Regions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127266. [PMID: 35742515 PMCID: PMC9223782 DOI: 10.3390/ijerph19127266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/04/2022]
Abstract
In Ecuador, national data on dental caries are scarce and the detection of incipient enamel lesions has been omitted. The objective of this study was to determine the prevalence of caries in school children aged 6 and 12 years of both sexes, belonging to urban and rural areas of three provinces of the country, using the International Caries Detection and Assessment System (ICDAS II). The sample consisted of 665 children from public schools, examined according to ICDASII. Caries prevalence and caries index were established using ICDAS II 2-6/C-G and ICDAS II 4-6/E-G criteria for comparison with WHO indicators. The Mann−Whitney U statistical test was used for comparison of two groups, the effect size was measured with the correlation coefficient. and the Kruskal−Wallis H test (p < 0.05) for multiple comparisons. Caries prevalence exceeded 87% for primary and permanent dentition. There were no significant differences according to province (p ≤ 0.05). The caries index at 6 years was 6.57 and at 12 years 9.21. The SIC was high at 12 years in rural areas. The prevalence of caries in the population studied was high despite the preventive measures established by health agencies.
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Pichemin C, Boyer E, Jarno P, Bertaud V, Meuric V, Couatarmanach A. Oral Care Needs Amongst Disadvantaged Migrants in France. Int Dent J 2022; 72:559-564. [PMID: 35279328 PMCID: PMC9381369 DOI: 10.1016/j.identj.2021.12.002] [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: 06/10/2021] [Revised: 11/28/2021] [Accepted: 12/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Disadvantaged migrant populations face risk factors that can affect their oral health amongst other health issues. The purpose of this study was to explore the oral care needs of these populations and to identify the obstacles they might encounter in accessing dental care. Methods A cross-sectional study using secondary data was carried out in the Centre Médical Louis Guilloux in Rennes, France, a health centre offering dental consults to migrants. The data were obtained by clinical oral examination and analysed according to various criteria: reason for consultation, diagnosis, treatment plan, drug prescriptions, and referrals to other practitioners. Results A high prevalence of decay was observed amongst the patients (72.3%). Fifty-nine patients were identified as needing major oral health care amongst the 130 files that were analysed. The lack of proficiency in the host country's language was associated with a major need for oral care (P < .02). Conclusions This study highlights that disadvantaged migrants face important oral care needs in France. It suggests alternative actions that should be carried out to improve their access to dental care, including access to interpreting.
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Diamanti I, Berdouses ED, Kavvadia K, Arapostathis KN, Polychronopoulou A, Oulis CJ. Dental Caries Prevalence and Experience (ICDAS II Criteria) of 5-, 12- and 15-Year-Old Children and Adolescents with an Immigrant Background in Greece, Compared with the Host Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:14. [PMID: 35010274 PMCID: PMC8751141 DOI: 10.3390/ijerph19010014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
Evidence regarding disparities in oral health among native and immigrant child and adolescent populations in Europe is scarce. The present study aimed to determine the caries status of 5-, 12-, and 15-year-olds with an immigrant background in Greece in relation to their sociodemographic characteristics and compare their caries levels with those of their native Greek peers. A sample of 707 immigrants underwent clinical examination for caries (ICDAS II criteria), followed by a calculation of caries prevalence and experience estimates (2013-2014). Multivariable regression models assessed the effect of ethnic background on the caries experience (d3-6mfs/D3-6MFS) of the total (707 immigrants and 3702 Greeks) population, and the association between parental education level and the immigrants' d3-6mfs/D3-6MFS. Among the 5- and 12-year-olds, those with an immigrant background demonstrated higher caries rates and had unfulfilled treatment needs at higher proportions. Among 15-year-old adolescents, no considerable differences in caries status were observed according to ethnic background (native Greek or immigrant). The strength of the association between immigrant background and caries experience levels attenuated gradually with increasing age (IRR = 1.61, 1.27 and 1.10, and p = 0.001, p = 0.006 and p = 0.331 for 5-, 12- and 15-year-olds, respectively). Among the immigrants, adolescents with less educated mothers exhibited elevated caries levels. Public health strategies should prioritize immigrant children and early adolescents in order to reduce the existing ethnic disparities in oral health.
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Affiliation(s)
- Iliana Diamanti
- Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | - Katerina Kavvadia
- Department of Dentistry, European University Cyprus, 6 Diogenous Str., 2404 Nicosia, Cyprus;
| | - Konstantinos N. Arapostathis
- Department of Paediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Argy Polychronopoulou
- Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Constantine J. Oulis
- Department of Paediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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Lauritano D, Moreo G, Carinci F, Campanella V, Della Vella F, Petruzzi M. Oral Health Status among Migrants from Middle- and Low-Income Countries to Europe: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212203. [PMID: 34831957 PMCID: PMC8624247 DOI: 10.3390/ijerph182212203] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/08/2021] [Accepted: 11/17/2021] [Indexed: 11/22/2022]
Abstract
Introduction. Economic inequality, political instability and globalization have contributed to the constant growth of the migration phenomenon in recent years. In particular, a total of 4.2 million people migrated to Europe during 2019 and most of them settled in Germany, France and Italy. Objectives. The objective of this study was to conduct a systematic review of studies analyzing the oral health condition among migrants from middle- and low-income countries to Europe and assessing the eventual association between their sociodemographic and socioeconomic characteristics and oral health status. Materials and Methods. A systematic review was conducted in PubMed, Cochrane Library, Scopus and Science Direct databases. After titles, abstracts and full-text examination, only 27 articles were selected on the basis of inclusion criteria and consequently included for quality assessments and data extraction. Results. Most of the studies reported a higher prevalence of caries experience, a poorer periodontal health and more difficulties in accessing dentalcare services among migrant groups compared with the non-migrant population. Inequalities were mostly associated with ethnic background, economic condition and social grade. Conclusion. Our review demonstrates the lack of dental health among migrants, underlining that their cultural beliefs and their social and economic living conditions could influence their oral health.
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Affiliation(s)
- Dorina Lauritano
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121 Ferrara, Italy;
- Correspondence: ; Tel.: +39-335-679-0163
| | - Giulia Moreo
- Dental and Maxillo-Facial Surgery Unit, IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy;
| | - Francesco Carinci
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121 Ferrara, Italy;
| | - Vincenzo Campanella
- Department of Clinical Science and Translational Medicine, University of Rome “Tor Vergata”, 00113 Rome, Italy;
| | - Fedora Della Vella
- Interdisciplinary Department of Medicine, University of Bari, 70121 Bari, Italy; (F.D.V.); (M.P.)
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari, 70121 Bari, Italy; (F.D.V.); (M.P.)
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Shaharyar SA, Bernabé E, Delgado-Angulo EK. The Intersections of Ethnicity, Nativity Status and Socioeconomic Position in Relation to Periodontal Status: A Cross-Sectional Study in London, England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910519. [PMID: 34639818 PMCID: PMC8508573 DOI: 10.3390/ijerph181910519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 09/29/2021] [Accepted: 10/02/2021] [Indexed: 11/16/2022]
Abstract
The role of migration as a social determinant of periodontitis has been overlooked. Intersectionality theory could help understand how immigration status interacts with other social determinants of health to engender inequalities in periodontitis. The objective of the present study was to evaluate whether ethnicity, nativity status and socioeconomic position intersect to structure social inequalities in periodontal status. Data from 1936 adults in a deprived and multi-ethnic area of London were analysed. The numbers of teeth with probing depth and clinical attachment loss were determined from clinical examinations. A matrix with 51 intersectional strata, defined according to ethnicity, nativity status and education, was created. A cross-classified multilevel analysis, with participants clustered within intersectional social strata, was performed to assess the extent to which individual differences in periodontal measures were at the intersectional strata level. A complex pattern of social inequalities in periodontal status was found, which was characterised by high heterogeneity between strata and outcome-specificity. The variance partition coefficient of the simple intersectional model, which conflated additive and interaction effects, indicated that 3-5% of the observed variation in periodontal measures was due to between-stratum differences. Moreover, the percentual change in variance from the simple intersectional to the intersectional interaction model indicated that 73-74% of the stratum-level variance in periodontal measures was attributed to the additive effects of ethnicity, nativity status and education. This study found modest evidence of intersectionality among ethnicity, nativity status and education in relation to periodontal status.
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Affiliation(s)
- Syeda Ammara Shaharyar
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (S.A.S.); (E.K.D.-A.)
| | - Eduardo Bernabé
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (S.A.S.); (E.K.D.-A.)
- Correspondence: ; Tel.: +44-(0)-20-3299-3022
| | - Elsa Karina Delgado-Angulo
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (S.A.S.); (E.K.D.-A.)
- Departamento Académico de Odontología Social, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
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Laniado N, Sanders AE, Fazzari MJ, Badner VM, Singer RH, Finlayson TL, Hua S, Isasi CR. Social support and dental caries experience: Findings from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Community Dent Oral Epidemiol 2021; 49:494-502. [PMID: 33638557 PMCID: PMC8390586 DOI: 10.1111/cdoe.12626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/04/2021] [Accepted: 01/14/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To examine the association of social support with dental caries experience in Hispanics/Latinos living in the United States (US) and to assess whether the relationship is modified by nativity status. METHODS This cross-sectional study analysed data for 4459 dentate men and women aged 18-74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. At baseline (2008-2011), dentists quantified dental caries experience as the number of decayed, missing, and filled permanent tooth surfaces (DMFS) for all teeth excluding third molars. Social support was assessed according to measures of structural support (Social Network Index) and functional support (Interpersonal Support Evaluation List). Covariate-adjusted multiple linear regression estimated the relationship between social support and dental caries experience and tested whether the association was modified by nativity status (born within the 50 US states, foreign-born <10 years in the United States, foreign-born >10 years or more in the United States). RESULTS In covariate-adjusted models, each additional role in the social network was associated with 1.39 fewer DMF tooth surfaces (95% CI: -2.21, -0.58) among foreign-born Hispanics/Latinos with fewer than 10 years lived in the US. For foreign-born Hispanics/Latinos with 10 years or more in the United States, each additional social network role was associated with 0.57 fewer DMF tooth surfaces (95% CI: -1.19, 0.04). No association was observed between functional social support and dental caries experience regardless of nativity status. CONCLUSIONS Our findings suggest that structural social support is protective against dental caries experience among recent immigrants of Hispanic/Latino background. This association may reflect the importance of social support to integration into the medical and dental infrastructure and thus receipt of dental care. Future research that examines the behavioural and cultural factors that moderate the relationship between social support and dental caries experience will inform development of culturally sensitive dental caries prevention programs for Hispanics/Latinos in the United States.
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Affiliation(s)
- Nadia Laniado
- Department of Dentistry, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx NY
| | - Anne E. Sanders
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill NC
| | - Melissa J. Fazzari
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Victor M. Badner
- Department of Dentistry, Jacobi Medical Center/North Central Bronx Hospital, Bronx NY
| | - Richard H. Singer
- Department of Orthodontics, College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, FL
| | - Tracy L. Finlayson
- Division of Health Management and Policy, School of Public Health, San Diego State University, San Diego, CA
| | - Simin Hua
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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Oral Health Status, Oral Health Behaviours and Oral Health Care Utilisation Among Migrants Residing in Europe: A Systematic Review. J Immigr Minor Health 2021; 23:373-388. [PMID: 32686073 PMCID: PMC7914188 DOI: 10.1007/s10903-020-01056-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As the reported data on oral health status among the migrants in Europe is fragmented, we systematically reviewed the published literature on the oral health status, behaviours and care utilisation among migrants residing in Europe. For this, we retrieved publications from PubMed and EMBASE, supplemented by manual citation screening and grey literature search on Google scholars. Two independent reviewers screened the studies, extracted data and critically appraised the publications. A total of 69 studies included showed higher dental caries among migrant children. But some studies on adolescents and adults reported similar or even better oral health among migrants compared to the host population, while other reported the opposite. Poor oral health behaviours were generally reported among the migrants and they frequently made use of emergency service utilisation compared to the host population. We shed light on the gaps in dental literature and make some recommendations for the future.
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Murillo-Pedrozo AM, Martínez-Herrera E, Ronda-Pérez E, Agudelo-Suárez AA. A Qualitative Study of the Health Perceptions in the Venezuelan Immigrant Population in Medellín (Colombia) and Its Conditioning Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3897. [PMID: 33917688 PMCID: PMC8068052 DOI: 10.3390/ijerph18083897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
This study explored the general and oral health perceptions in the Venezuelan immigrant population in Medellín (Colombia) and its conditioning factors. A qualitative study involving Venezuelan immigrants ≥18 years with a minimum stay of six months in Colombia was conducted. Dentists, dental students, and other health professionals also participated. Semi-structured interviews (n = 17), focus groups (n = 2), and key informants' interviews (n = 4) were utilized. The interviews and focus groups were recorded and transcribed for later narrative content analysis. A high degree of vulnerability of participants was found due to the precarious living conditions from the premigratory moment and the lack of job placement possibilities at the time of settling in Colombia, where the migratory status played a fundamental role. Among the perceived needs, the mitigation of noncommunicable diseases stood out. Poor mental health symptoms (depression and anxiety) were perceived, and oral health was not a priority. Barriers to accessing health and dental care were found. The migrant condition was found to be a determinant that affected physical, mental, and oral health and the provision of health care. This situation is of interest to the construction of public health policies that guarantee access to fundamental rights.
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Affiliation(s)
| | - Eliana Martínez-Herrera
- Research Group of Epidemiology, National School of Public Health “Héctor Abad Gómez”, University of Antioquia, Medellín 050010, Colombia;
- Research Group on Health Inequalities, Environment, Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, 08005 Barcelona, Spain
| | - Elena Ronda-Pérez
- Public Health Research Group, University of Alicante, 03690 Alicante, Spain;
- CIBERESP, 28029 Madrid, Spain
| | - Andrés A. Agudelo-Suárez
- Faculty of Dentistry, University of Antioquia, Medellín 050010, Colombia;
- Public Health Research Group, University of Alicante, 03690 Alicante, Spain;
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Naz S, Bernabe E, Marcenes W, Delgado-Angulo EK. Ethnic differences in treatment preferences among adults in East London. Br Dent J 2021:10.1038/s41415-020-2597-0. [PMID: 33574579 DOI: 10.1038/s41415-020-2597-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/02/2020] [Indexed: 11/09/2022]
Abstract
Aim To explore ethnic differences in treatment preferences among adults.Methods A sample of 1,764 adults from ten ethnic groups were recruited from the adult population in Outer North East London using stratified multistage random sampling. Treatment preferences for a front tooth, a back tooth and an aching back tooth were collected via questionnaires. Ethnic differences in treatment preferences were assessed in regression models adjusting for demographic characteristics, socioeconomic indicators, dental visiting behaviour and clinical dental status.Results Ethnic differences in treatment preferences were observed, albeit only for back not front teeth. Compared to White British, Black African (odds ratio: 0.85; 95% confidence interval [CI]: 0.74-0.97), Caribbean (0.71; 95% CI: 0.51-0.98) and Other (0.73; 95% CI: 0.61-0.87) were less likely to preserve a back tooth. If the back tooth was aching, Black Others were still less likely (0.82; 95% CI: 0.71-0.93) to opt for restorative than surgical treatment. On the contrary, Bangladeshi were more likely (1.14; 95% CI: 1.06-1.22) to preserve a painful back tooth than White British.Conclusion Differences in treatment preferences were found among ethnic groups, suggesting that cultural background might influence the choices made and the value placed on dental extractions versus restorative treatment.
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Affiliation(s)
- Sanober Naz
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, London, UK; Kent Community Health NHS Foundation Trust, Kent, UK
| | - Eduardo Bernabe
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, London, UK
| | | | - Elsa Karina Delgado-Angulo
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, London, UK; Facultad de Odontología, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Elaine Muirhead V, Milner A, Freeman R, Doughty J, Macdonald ME. What is intersectionality and why is it important in oral health research? Community Dent Oral Epidemiol 2020; 48:464-470. [PMID: 32840901 DOI: 10.1111/cdoe.12573] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/10/2020] [Accepted: 08/03/2020] [Indexed: 11/26/2022]
Abstract
This paper is the second of two reviews that seek to stimulate debate on new and neglected avenues in oral health research. The first commissioned narrative review, "Inclusion oral health: Advancing a theoretical framework for policy, research and practice", published in February 2020, explored social exclusion, othering and intersectionality. In it, we argued that people who experience social exclusion face a "triple threat": they are separated from mainstream society, stigmatized by the dental profession, and severed from wider health and social care systems because of the disconnection between oral health and general health. We proposed a definition of inclusion oral health and a theoretical framework to advance the policy, research and practice agenda. This second review delves further into the concept of intersectionality, arguing that individuals who are socially excluded experience multiple forms of discrimination, stigma and disadvantage that reflect intersecting social identities. We first provide a theoretical and historical overview of intersectionality, rooted in Black feminist ideologies in the United States. Our working definition of intersectionality, requiring the simultaneous appreciation of multiple social identities, an examination of power and inequality, and a recognition of changing social contexts, then sets the scene for examining existing applications of intersectionality in oral health research. A critique of the sparse application of intersectionality in oral health research highlights missed opportunities and shortcomings related to paradigmatic and epistemological differences, a lack of robust theoretically engaged quantitative and mixed methods research, and a failure to sufficiently consider power from an intersectionality perspective. The final section proposes a framework to guide future oral health research that embraces an intersectionality agenda consisting of descriptive research to deepen our understanding of intersectionality, and transformative research to tackle social injustice and inequities through participatory research and co-production.
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Affiliation(s)
- Vanessa Elaine Muirhead
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Adrienne Milner
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Ruth Freeman
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
| | - Janine Doughty
- Pathway Homelessness and Inclusion Oral Health Fellow, University College London Hospitals NHS Foundation Trust, London, UK
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Ito K, Cable N, Yamamoto T, Suzuki K, Kondo K, Osaka K, Tsakos G, Watt RG, Aida J. Wider Dental Care Coverage Associated with Lower Oral Health Inequalities: A Comparison Study between Japan and England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155539. [PMID: 32751843 PMCID: PMC7432332 DOI: 10.3390/ijerph17155539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 02/07/2023]
Abstract
Countries with different oral health care systems may have different levels of oral health related inequalities. We compared the socioeconomic inequalities in oral health among older adults in Japan and England. We used the data for adults aged 65 years or over from Japan (N = 79,707) and England (N = 5115) and estimated absolute inequality (the Slope Index of Inequality, SII) and relative inequality (the Relative Index of Inequality, RII) for edentulism (the condition of having no natural teeth) by educational attainment and income. All analyses were adjusted for sex and age. Overall, 14% of the Japanese subjects and 21% of the English were edentulous. In both Japan and England, lower income and educational attainment were significantly associated with a higher risk of being edentulous. Education-based SII in Japan and England were 9.9% and 26.7%, respectively, and RII were 2.5 and 4.8, respectively. Income-based SII in Japan and England were 9.2% and 14.4%, respectively, and RII were 2.1 and 1.9, respectively. Social inequalities in edentulous individuals exist in both these high-income countries, but Japan, with wider coverage for dental care, had lower levels of inequality than England.
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Affiliation(s)
- Kanade Ito
- Department of Oral Care for Systemic Health Support, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo 113-8510, Japan
- Correspondence: ; Tel.: +82-3-5803-4969
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK; (N.C.); (G.T.); (R.G.W.)
| | - Tatsuo Yamamoto
- Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan;
| | - Kayo Suzuki
- Department of Policy Studies, Aichi Gakuin University, Nisshin 470-0195, Japan;
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba 260-0856, Japan;
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University, Sendai 980-8575, Japan; (K.O.); (J.A.)
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK; (N.C.); (G.T.); (R.G.W.)
| | - Richard G. Watt
- Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK; (N.C.); (G.T.); (R.G.W.)
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University, Sendai 980-8575, Japan; (K.O.); (J.A.)
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Violence as the Most Frequent Cause of Oral and Maxillofacial Injuries among the Patients from Low- and Middle-Income Countries-A Retrospective Study at a Level I Trauma University Emergency Department in Switzerland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134906. [PMID: 32646020 PMCID: PMC7369963 DOI: 10.3390/ijerph17134906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 01/10/2023]
Abstract
Preventive strategies can be developed by gathering more information about oral and maxillofacial injuries and oral pathologies in immigrants from low- to middle-income countries (LMIC). Additional information on the quality of care can also improve the allocation of clinical resources for the management of these patients. We studied immigrants from LMIC who presented in the emergency department (ED) at Berne University Hospital with dental problems or oral or maxillofacial injuries. The patient data included age, gender, nationality, the etiology and type of trauma and infection in the oral-maxillofacial area, and overall costs. The greatest incidence of maxillofacial injuries was observed in the age group of 16-35 years (n = 128, 63.6%, p = 0.009), with males outnumbering females in all age groups. Trauma cases were most frequent in the late evening and were mostly associated with violence (n = 82, 55.4%, p = 0.001). The most common fracture was fracture of the nose (n = 31). The mean costs were approximately the same for men (mean = 2466.02 Swiss francs) and women (mean = 2117.95 Swiss francs) with maxillofacial injuries but were greater than for isolated dental problems. In conclusion, the etiology of dental and maxillofacial injuries in immigrants in Switzerland requires better support in the prevention of violence and continued promotion of oral health education.
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Delgado-Angulo EK, Zúñiga Abad F, Scambler S, Bernabé E. Is there a healthy migrant effect in relation to oral health among adults in England? Public Health 2020; 181:53-58. [PMID: 31945646 DOI: 10.1016/j.puhe.2019.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/04/2019] [Accepted: 11/23/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the study was to assess the healthy migrant effect in relation to oral health among adults in England. STUDY DESIGN This is a secondary data analysis of a nationally representative survey. METHODS Data from 13,373 adults of Irish, black Caribbean, Indian, Pakistani, Bangladeshi and Chinese ethnicity, who participated in the Health Survey for England, were analysed. The proportions of edentate and dentate adults with toothache in the last 6 months in first- and second-generation migrants within each ethnic group were compared with those in the white British (reference group) ethnic group in logistic regression models after adjusting for demographic factors and socio-economic position. Among first-generation migrants, the associations of age at arrival and length of residence with each oral health outcome were assessed in logistic regression models after adjusting for sociodemographic factors. RESULTS Compared with white British migrants, first-generation black Caribbean (odds ratio [OR]: 1.42) and second-generation Pakistani (OR: 3.16) migrants had higher odds of being edentulous, whereas first-generation Indian (OR: 0.62), Pakistani (OR: 0.62), Bangladeshi (OR: 0.41) and Chinese (OR: 0.49) migrants had lower odds. Among dentate adults, second-generation Irish (OR: 1.51) migrants, first- and second-generation black Caribbean (OR: 1.61 and 1.54, respectively) migrants, first-generation Indian (OR: 1.24) migrants and second-generation Pakistani (OR: 1.34) migrants had higher odds of having toothache in the past 6 months, whereas second-generation Bangladeshi (OR: 0.51) migrants had lower odds than white British. Age at arrival and length of residence were positively associated with being edentulous among first-generation black Caribbean, Pakistani and Bangladeshi migrants. CONCLUSION Evidence on the healthy migrant effect was mixed, with more consistent findings seen for edentulousness among Asian groups. Black Caribbean migrants were generally the ethnic group with the worst oral health when compared with white British.
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Affiliation(s)
- E K Delgado-Angulo
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK; Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - F Zúñiga Abad
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - S Scambler
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - E Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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