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An R, Jiang G, Wu Z, Liu M, Sohaib M, Chen W. Perceptions and experience of rural older people in oral health management in China: a qualitative study. BMC Oral Health 2024; 24:644. [PMID: 38822319 PMCID: PMC11143558 DOI: 10.1186/s12903-024-04401-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/23/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND To explore the perceptions and experience of oral health management among rural older people in China. METHODS Qualitative methodologies were used in this study. Face-to-face semi-structured interviews were conducted. Thirteen older adults in rural areas were purposively sampled at two metropolitan hospitals in Hunan, China. The data were transcribed and thematically analyzed, and MAXQDA software was used to assist with coding. RESULTS Three overarching major themes and ten sub‑themes capturing the perceptions and experience of oral health management among rural older people were identified. Three themes emerged from the thematic analysis: oral health cognitive bias, poor management behaviors, and limited oral health services. Oral health management as a whole is negative, oral health behaviors are poor, oral health service utilization is limited. CONCLUSIONS Based on these findings, there is great scope here for improving the current status of oral health for rural older people around awareness, behavior, and access. Oral health education, improved oral health services and primary oral health promotion are warranted.
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Affiliation(s)
- Ran An
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, No.87 Xiangya Road, Changsha, Hunan Province, China
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Guanghua Jiang
- College of Nursing, Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Zitong Wu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Meizi Liu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Muhammad Sohaib
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, No.87 Xiangya Road, Changsha, Hunan Province, China
| | - Wenfeng Chen
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, No.87 Xiangya Road, Changsha, Hunan Province, China.
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Zhang J, Huang Z, Wang W, Zhang L, Lu H. Development and validation of a nomogram for predicting depressive symptoms in dentistry patients: A cross-sectional study. Medicine (Baltimore) 2024; 103:e37635. [PMID: 38579067 PMCID: PMC10994422 DOI: 10.1097/md.0000000000037635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/26/2024] [Indexed: 04/07/2024] Open
Abstract
Depressive symptoms are frequently occur among dentistry patients, many of whom struggle with dental anxiety and poor oral conditions. Identifying the factors that influence these symptoms can enable dentists to recognize and address mental health concerns more effectively. This study aimed to investigate the factors associated with depressive symptoms in dentistry patients and develop a clinical tool, a nomogram, to assist dentists in predicting these symptoms. Methods: After exclusion of ineligible participants, a total of 1355 patients from the dentistry department were included. The patients were randomly assigned to training and validation sets at a 2:1 ratio. The LASSO regression method was initially employed to select highly influrtial features. This was followed by the application of a multi-factor logistic regression to determine independent factors and construct a nomogram. And it was evaluated by 4 methods and 2 indicators. The nomograms were formulated based on questionnaire data collected from dentistry patients. Nomogram2 incorporated factors such as medical burden, personality traits (extraversion, conscientiousness, and emotional stability), life purpose, and life satisfaction. In the training set, Nomogram2 exhibited a Concordance index (C-index) of 0.805 and an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.805 (95% CI: 0.775-0.835). In the validation set, Nomogram2 demonstrated an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.810 (0.768-0.851) and a Concordance index (C-index) of 0.810. Similarly, Nomogram1 achieved an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.816 (0.788-0.845) and a Concordance index (C-index) of 0.816 in the training set, and an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.824 (95% CI: 0.784-0.864) and a Concordance index (C-index) of 0.824 in the validation set. Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) indicated that Nomogram1, which included oral-related factors (oral health and dental anxiety), outperformed Nomogram2. We developed a nomogram to predict depressive symptoms in dentistry patients. Importantly, this nomogram can serve as a valuable psychometric tool for dentists, facilitating the assessment of their patients' mental health and enabling more tailored treatment plans.
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Affiliation(s)
- Jimin Zhang
- Department of Stomatology, No. 903 Hospital of PLA Joint Logistic Support Force (Xi Hu Affiliated Hospital of Hangzhou Medical College), Hangzhou, China
| | - Zewen Huang
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, China
| | - Wei Wang
- Department of Psychology, The Education University of Hong Kong, Tai Po, China
| | - Lejun Zhang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Heli Lu
- Department of Psychosomatic Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Xu N, Deng S, Liang Y, Chen A, Zou D, Li L, Qiu R. Impact of migration on oral health outcomes of children in multi-beneficial kindergartens in Nanning, Southern China: a cross-sectional study. BMC Oral Health 2023; 23:507. [PMID: 37480059 PMCID: PMC10362724 DOI: 10.1186/s12903-023-03212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 07/07/2023] [Indexed: 07/23/2023] Open
Abstract
OBJECTIVE To explore the effect of children's migration on their oral health outcomes in multi-beneficial kindergartens in Jiangnan District, Nanning, China, and to provide a basis for improving the oral health of migrant children. METHODS A cross-sectional study was conducted among 470 children aged 5 years in Jiangnan District, Nanning, Guangxi. A questionnaire was used to collect information on their demographic and socioeconomic background, migration experience, eating habits, oral hygiene behaviours and utilization of dental care services. Dental caries of primary teeth was examined using the decayed, missing, and filled teeth (dmft) index recommended by the World Health Organization. Dental caries experience and oral health-related behaviours were compared between migrant and resident children. The impact of children's migration attributes on their oral health outcomes was examined by univariate and multivariate analyses. RESULTS Among the examined children, 52.3% were migrant children. The prevalence of caries among the children in multi-beneficial kindergartens was 78.3%, and the mean number of dmft was 5.73 ± 5.00. The prevalence of caries was 81.7% for migrant children and 74.6% for resident children (p = 0.060). No significant difference was found in the mean numbers of DMFT between migrant children and resident children (5.96 ± 4.81 vs. 5.47 ± 5.20, p = 0.139). There were significant differences in the frequency of tooth brushing (p = 0.023) and parental help with tooth brushing (p = 0.008), typical use of fluoride (p = 0.012), regular dental check-ups (p = 0.003) and experience of dental fillings for caries (p < 0.001) between migrant and resident children. The multivariate logistic regression analysis showed that among the children with caries, the proportion of resident children who had regular dental check-ups was 1.720 times higher than that of migrant children (95% CI = 1.155 ~ 2.560), and resident children were more likely to have caries filled than migrant children (OR = 3.313, 95% CI = 1.585 ~ 6.927). CONCLUSION Oral health status and oral health behaviours were poor among children in multi-beneficial kindergartens in Nanning, China, and migration might be a significant predictive indicator for the poor utilization of dental care services by children. The government departments should make special policy to promote the children's oral health in multi-beneficial kindergartens, and invest more to cover the migrant children's utilization of oral health services.
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Affiliation(s)
- Nini Xu
- College of Stomatology, Hospital of Stomatology Guangxi Medical University , Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Clinical Research Center forCraniofacial Deformity, Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Key Laboratory of Research and Application of Stomatological Equipment, Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021 China
- Department of Stomatology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530002 Guangxi China
| | - Sicheng Deng
- College of Stomatology, Hospital of Stomatology Guangxi Medical University , Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Clinical Research Center forCraniofacial Deformity, Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Key Laboratory of Research and Application of Stomatological Equipment, Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021 China
| | - Yan Liang
- College of Stomatology, Hospital of Stomatology Guangxi Medical University , Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Clinical Research Center forCraniofacial Deformity, Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Key Laboratory of Research and Application of Stomatological Equipment, Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021 China
| | - Aihua Chen
- College of Stomatology, Hospital of Stomatology Guangxi Medical University , Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Clinical Research Center forCraniofacial Deformity, Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Key Laboratory of Research and Application of Stomatological Equipment, Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021 China
| | - Dan Zou
- College of Stomatology, Hospital of Stomatology Guangxi Medical University , Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Clinical Research Center forCraniofacial Deformity, Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Key Laboratory of Research and Application of Stomatological Equipment, Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021 China
| | - Ling Li
- College of Stomatology, Hospital of Stomatology Guangxi Medical University , Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Clinical Research Center forCraniofacial Deformity, Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Key Laboratory of Research and Application of Stomatological Equipment, Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021 China
| | - Rongmin Qiu
- College of Stomatology, Hospital of Stomatology Guangxi Medical University , Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Clinical Research Center forCraniofacial Deformity, Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Key Laboratory of Research and Application of Stomatological Equipment, Education Department of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021 China
- Department of Pediatric Dentistry, College & Hospital of Stomatology, Guangxi Medical University, Research Center for Craniofacial Deformity, Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, No.10 Shuangyong Road, Nanning, 530021 Guangxi China
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Chang Q, Cheng M, Xu M, Du S, Wang X, Feng X, Tai B, Hu D, Lin H, Wang B, Wang C, Zheng S, Liu X, Rong W, Wang W, Dong Y, Si Y. Decomposing socioeconomic inequalities in dental caries among Chinese adults: findings from the 4th national oral health survey. BMC Oral Health 2023; 23:372. [PMID: 37291567 PMCID: PMC10251606 DOI: 10.1186/s12903-023-03037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/13/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE This cross-sectional study aimed to investigate socioeconomic inequalities in dental caries among adults (35 years and older) in China and explore the contributions of various factors to these inequalities. METHODS This study included 10,983 adults (3,674 aged 35-44 years, 3,769 aged 55-64 years and 3,540 aged 65-74 years) who participated in the 4th National Oral Health Survey (2015-2016) in China. Dental caries status was evaluated by the decayed, missing and filled teeth (DMFT) index. Concentration indices (CIs) were applied to quantify the different degrees of socioeconomic-related inequality in DMFT, decayed teeth with crown or root caries (DT), missing teeth due to caries or other reasons (MT), and filled teeth without any primary or secondary caries (FT) among adults of different age groups. Decomposition analyses were conducted to identify the determinants and their associations with inequalities in DMFT. RESULTS The significant negative CI indicated that DMFT for the total sample were concentrated among socioeconomically disadvantaged adults (CI = - 0.06; 95% confidence interval [CI], - 0.073 to - 0.047). The CIs for DMFT for adults aged 55-64 and 65-74 years were - 0.038 (95% CI, - 0.057 to - 0.018) and - 0.039 (95% CI, - 0.056 to - 0.023), respectively, while the CI for DMFT for adults aged 35-44 years was not statistically significant (CI = - 0.002; 95% CI, - 0.022 to 0.018). The concentration indices of DT were negative and concentrated in disadvantaged populations, while FT showed pro-rich inequalities in all age groups. Decomposition analyses showed that age, education level, toothbrushing frequency, income and type of insurance contributed substantially to socioeconomic inequalities, accounting for 47.9%, 29.9%, 24.5%,19.1%, and 15.3%, respectively. CONCLUSION Dental caries was disproportionately concentrated among socioeconomically disadvantaged adults in China. The results of these decomposition analyses are informative for policy-makers attempting to develop targeted health policy recommendations to reduce dental caries inequalities in China.
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Affiliation(s)
- Qing Chang
- The Second Dental Center, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China
| | - Menglin Cheng
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Mengru Xu
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China
| | - Shuo Du
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China
| | - Xing Wang
- Chinese Stomatological Association, Beijing, P.R. of China
| | - Xiping Feng
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. of China
| | - Baojun Tai
- School & Hospital of Stomatology, Wuhan University, Wuhan, P.R. of China
| | - Deyu Hu
- West China School of Stomatology, Sichuan University, Chengdu, P.R. of China
| | - Huancai Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yetsen University, Guangzhou, P.R. of China
| | - Bo Wang
- Chinese Stomatological Association, Beijing, P.R. of China
| | - Chunxiao Wang
- Chinese Center for Disease Control and Prevention, Beijing, P.R. of China
| | - Shuguo Zheng
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China
| | - Xuenan Liu
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China
| | - Wensheng Rong
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China
| | - Weijian Wang
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China
| | - Yanmei Dong
- Department of Cariology and Endodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China
| | - Yan Si
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, P.R. of China.
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Xu J, Tian G, Sun J, Liu J, Chen F, Shi Q, Zhang T, Zhang H, He J, Deng F, Zhang B, Wang H, Wu Q, Kang Z. Horizontal inequity trends of health care utilization in rural China after the medicine and healthcare system reform: based on longitudinal data from 2010 to 2018. Int J Equity Health 2023; 22:90. [PMID: 37194035 DOI: 10.1186/s12939-023-01908-4] [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: 07/06/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND To assess the effectiveness of China's medicine and health care reform in promoting equity in health care utilization among rural residents, it is necessary to analyze temporal trends in equity in health care utilization among rural residents in China. This study is the first to assess horizontal inequity trends in health care utilization among rural Chinese residents from 2010 to 2018 and provides evidence for improving government health policies. METHODS Longitudinal data obtained from China Family Panel Studies from 2010 to 2018 were used to determine trends in outpatient and inpatient utilization. Concentration index, concentration curve, and horizontal inequity index were calculated to measure inequalities. Decomposition analysis was applied to measure the contribution of need and non-need factors to the unfairness. RESULTS From 2010 to 2018, outpatient utilization among rural residents increased by 35.10%, while inpatient utilization increased by 80.68%. Concentration indices for health care utilization were negative in all years. In 2012, there was an increase in the concentration index for outpatient utilization (CI = -0.0219). The concentration index for inpatient utilization decreased from -0.0478 in 2010 to -0.0888 in 2018. Except for outpatient utilization in 2012 (HI = 0.0214), horizontal inequity indices for outpatient utilization were negative in all years. The horizontal inequity index for inpatient utilization was highest in 2010 (HI = -0.0068) and lowest in 2018 (HI = -0.0303). The contribution of need factors to the inequity exceeded 50% in all years. CONCLUSIONS Between 2010 and 2018, low-income groups in rural China used more health services. This seemingly pro-poor income-related inequality was due in large part to the greater health care need among low-income groups. Government policies aimed at increasing access to health services, particularly primary health care had helped to make health care utilization in rural China more equitable. It is necessary to design better health policies for disadvantaged groups to reduce future inequities in the use of health services by rural populations.
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Affiliation(s)
- Jinpeng Xu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Guomei Tian
- Department of Nuclear Medicine, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Jiale Sun
- Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Jian Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Fangting Chen
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qi Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Ting Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hongyu Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jingran He
- School of Health Management, Harbin Medical University, Harbin, China
| | - Fangmin Deng
- School of Health Management, Harbin Medical University, Harbin, China
| | - Bokai Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Haixin Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- School of Health Management, Harbin Medical University, Harbin, China.
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Hu X, Fan X, Tian J, Zhang B, Huang R. Utilization of dental care service and associated factors among pre-school children in northwest China over the past decade. BMC Oral Health 2023; 23:54. [PMID: 36717826 PMCID: PMC9887760 DOI: 10.1186/s12903-023-02736-2] [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: 04/06/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The purpose of this study was to analyze the factors influencing the utilization of oral health care among 5 years old children. METHODS We conducted two observational cross-sectional studies. The studies were conducted in 2005 and 2015 and included 5-year-old children who underwent dental examination by trained dentists and the caregivers of the children were requested to answer the questionnaire. Multi-level stratified sampling method was used. Chi-square tests were used to analyze the utilization of dental care and other socio-economic variables. Logistic regression models were employed to explore the primary factors influencing the use of dental care among pre-school children. RESULTS In 2005, a total of 399 and in 2015, 492 child-caregiver pairs were included. The majority of the caregivers in both surveys were females, comprising 68.2% and 74.8% of the caregivers in 2005 and 2015, respectively. 75.2% and 87.0% (p < 0.05) of the respondents had an education level of lesser than 9 years. The prevalence of caries was higher in 2015 (63.2%) (p < 0.05) than in 2005 (53.4%). In 2005 and 2015, the utilization of dental care services was 20.8% and 20.0%, respectively. A statistically significant association was observed between caries and dental care use in 5-year-olds over the past decade. After adjusting for confounders, dental service usage among children in urban areas was 1.62 times higher than that of rural areas in 2005 (95% CI 0.069-0.571), and the self-assessment of caregivers regarding their child's oral health significantly improved oral health use in 2015. CONCLUSION The utilization of dental care services over the past decade is insufficient among pre-school children in northwest China. Hence, with the decreasing gap about economic and health service resources, policymakers should place greater emphasis on raising awareness among caregivers about the oral health status of their children.
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Affiliation(s)
- Xiao Hu
- grid.43169.390000 0001 0599 1243Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China ,grid.43169.390000 0001 0599 1243Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Xiaoyu Fan
- grid.43169.390000 0001 0599 1243Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Jiangang Tian
- grid.43169.390000 0001 0599 1243Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Bin Zhang
- grid.43169.390000 0001 0599 1243Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Ruizhe Huang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China. .,Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
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Qu X, Houser SH, Tian M, Zhang Q, Pan J, Zhang W. Effects of early preventive dental visits and its associations with dental caries experience: a cross-sectional study. BMC Oral Health 2022; 22:150. [PMID: 35488264 PMCID: PMC9052678 DOI: 10.1186/s12903-022-02190-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/20/2022] [Indexed: 02/08/2023] Open
Abstract
Objectives Limited information is known about preventive dental visits (PDVs) before seven years of age among children in China. This study aimed to examine the early PDV rate, identify the impact of PDV on dental caries and untreated dental caries, and explore the factors related to PDV among Chinese sampled children under seven years old. Methods A cross-sectional survey was conducted in five selected primary health care facilities in Chengdu, China, from May to August 2021. Parent–child dyads during regular systematic medical management were recruited to participate. Children's dental caries were identified through dental examinations and documented as decayed, missing and filled teeth index (dmft) by trained primary care physicians. Dental-related information was collected through a questionnaire. Zero-inflated negative binomial (ZINB) regression was used to test the effect of early PDV on the dmft value, and logistic regression was used to analyse impact factors on the early PDV. Results A total of 2028 out of 2377 parent–child dyads were qualified for analysis. Half of the children (50.4%) were male, with a mean age of 4.8 years. Among all the children, 12.1% had their first dental visit for preventive purposes, 34.4% had their first dental visit for symptomatic purposes, and more than half had never visited a dentist. The results showed that a lower dmft value (adjusted OR: 0.69, 95% CI: 0.48–0.84), a higher rate of caries-free (aOR: 6.5, 95% CI: 3.93–10.58), and a lower rate of untreated dental caries (aOR: 0.40, 95% CI: 0.21–0.76) were associated with early PDV utilization. Children who had a higher rate of PDV were positively associated with living in a family with better parental behaviours (aOR: 2.30, 95% CI: 1.71–3.08), better parental oral health perception (aOR: 1.23, 95% CI: 1.06–1.32), fathers who had no untreated caries (aOR: 0.68, 95% CI: 0.47–0.97), families with higher socioeconomic status (aOR: 1.09, 95% CI: 1.04–1.16), and dental health advice received from well-child care physicians (aOR: 1.47, 95% CI: 1.08–2.00). Conclusions Early PDV was associated with a lower rate of dental caries prevalence and untreated dental caries among sampled children younger than seven in Western China. Underutilization and social inequities existed in PDV utilization. Public health strategies should be developed to increase preventive dental visits and eliminate social disparities that prevent dental care utilization. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02190-6.
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Affiliation(s)
- Xing Qu
- Institute of Hospital Management, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, China
| | - Shannon H Houser
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Meirong Tian
- Institute of Hospital Management, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, China
| | - Qiong Zhang
- Department of Paediatric Dentistry, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases and National Clinical Research, Sichuan University, Sichuan University, Chengdu, 610041, China
| | - Jay Pan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China. .,Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China.
| | - Wei Zhang
- Institute of Hospital Management, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, China. .,West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, 610041, China. .,Med-X Center for Informatics, Sichuan University, Chengdu, 610041, China.
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