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Carbajal Rodriguez G, van Meijeren-van Lunteren AW, Wolvius EB, Kragt L. Poverty Dynamics and Caries Status in Young Adolescents. Community Dent Oral Epidemiol 2024. [PMID: 39390670 DOI: 10.1111/cdoe.13012] [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: 03/04/2024] [Revised: 09/04/2024] [Accepted: 09/25/2024] [Indexed: 10/12/2024]
Abstract
OBJECTIVES To investigate whether timing, accumulation and trajectories of poverty are associated with dental caries in young adolescents. METHODS The study was conducted within the Generation R Study, which is an ongoing population-based prospective cohort study conducted in Rotterdam, the Netherlands. This study included 2653 children. Information about household income and number of children and adults living in a household at six time points from pregnancy to 13 years old was retrieved from parental questionnaires to construct the poverty variable. Dental caries was assessed with the decayed, missing and filled teeth index through intraoral photographs at the age of 13 years. Sociodemographic and oral health-related characteristics were included as possible confounders. The association between poverty and dental caries was analysed on the basis of the three lifecourse theories, that is, critical period, cumulative risk and social mobility model. For the latter, we used latent class growth analysis (LCGA) to identify poverty trajectories over time. Next, the associations were studied with Hurdle Negative Binomial Models. RESULTS Poverty at birth and intermittent poverty up to the age of 13 were significantly associated with dental caries at 13 years of age (OR 1.41, 95% CI 1.01-1.99; OR 1.36, 95% CI 1.01-1.83 respectively) and with an increased mean number of decayed teeth by 34% (95% CI 1.02-1.76; 95% CI 1.05-1.71, respectively). LCGA showed four trajectories for the probabilities of poverty. All trajectories were significantly associated with dental caries at 13 years of age, with the 'downward mobility' trajectory showing the strongest association with dental caries (OR 1.55, 95% CI 1.05-2.29) and an increasing mean number of decayed teeth by 58% (95% CI 1.18-2.12) than the 'stable absent' trajectory. CONCLUSION Poverty at birth, intermittent poverty and downward poverty trajectory were associated with higher odds and higher mean number of decayed teeth at 13 years of age. The three lifecourse models influenced dental caries status during adolescence, hence strategies and policies targeted to improve socioeconomic conditions on deprived children should be implemented.
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Affiliation(s)
- Gisselle Carbajal Rodriguez
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Agatha W van Meijeren-van Lunteren
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Eppo B Wolvius
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lea Kragt
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Dickenson AJ, Brocklehurst P, Cope A, Wilson M. Improving children's oral health in Wales through partnership. BMJ Paediatr Open 2024; 8:e002989. [PMID: 39353712 PMCID: PMC11459329 DOI: 10.1136/bmjpo-2024-002989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 09/22/2024] [Indexed: 10/04/2024] Open
Affiliation(s)
| | | | - Anwen Cope
- Dental Public Health, University of Wales Cardiff, Cardiff, UK
| | - Mary Wilson
- Primary Care Division, Public Health Wales, Swansea, UK
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Carrouel F, du Sartz de Vigneulles B, Clément C, Lvovschi VE, Verot E, Tantardini V, Lamure M, Bourgeois D, Lan R, Dussart C. Promoting Health Literacy in the Workplace Among Civil Servants: Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e58942. [PMID: 39149854 PMCID: PMC11337139 DOI: 10.2196/58942] [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: 03/28/2024] [Accepted: 06/26/2024] [Indexed: 08/17/2024] Open
Abstract
Background In 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on noncommunicable diseases. The population needs improved OH skills and attitudes and an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people's lives, appears to be an opportunity. In France, civil servants have several socioprofessional levels and represent an excellent model with results transposable to the population. Objective This study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplaces. Methods A cross-sectional study of French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (1) a questionnaire on OH knowledge, (2) the Oral Health Literacy Instrument, French version (OHLI-F; this is composed of reading comprehension and numeracy sections) to assess the OHL level, and (3) the Short Test of Functional Health Literacy in Adults, French version (s-TOFHLA-F) to assess the HL level. The scores for OH knowledge, the OHLI-F, and the s-TOFHLA-F were reported as means (SD) and the 95% CI. These scores were classified into 3 categories: adequate (75-100), marginal (60-74) and inadequate (0-59). ANOVA and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch 2-sample t test and a paired t test (both 2-tailed). For the correlation matrix, the Pearson correlation and related tests were computed. Results A total of 1917 persons completed the 3 questionnaires, with adequate levels of OHL (n=1610, 84%), OH knowledge (n=1736, 90.6%), and HL (n=1915, 99.9%). The scores on the s-TOFHLA-F (mean 98.2, SD 2.8) were higher than the OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). The OHLI-F was highly correlated with OH knowledge (P<.001), but the OHLI-F and OH knowledge had a low correlation with s-TOFHLA-F (P=.43). The OHLI-F reading comprehension score was significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impacted the 3 scores (P<.001). The professional category was a determinant of adequate OHLI-F and OH knowledge scores. Conclusions Some French civil servants had inadequate or marginal levels of OH knowledge (n=181, 9.5%) and OHL (n=307, 16%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be nonstandardized, adapted to the literacy level of professional categories of workers, and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of noncommunicable diseases.
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Affiliation(s)
- Florence Carrouel
- Health Systemic Process Laboratory (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | | | - Céline Clément
- Health Systemic Process Laboratory (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- Interpsy Laboratory (INSERM UR4432), University of Lorraine, Nancy, France
| | - Virginie-Eve Lvovschi
- Research on Healthcare Performance Laboratory (INSERM U1290), University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- Hospices Civils of Lyon, Lyon, France
| | - Elise Verot
- Health Systemic Process Laboratory (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- PRESAGE Institute, University Jean Monnet, Saint-Etienne, France
- Centre Hospitalier Universitaire de Saint-Étienne (CIC 1408 INSERM), Saint-Étienne, France
| | - Valeria Tantardini
- Geriatric Rehabilitation and Follow-up Care Service, Centre Hospitalier Universitaire of Rouen, Oissel site, Rouen, France
| | - Michel Lamure
- Health Systemic Process Laboratory (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Denis Bourgeois
- Health Systemic Process Laboratory (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- Hospices Civils of Lyon, Lyon, France
| | - Romain Lan
- Health Systemic Process Laboratory (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- Anthropologie bio-culturelle, droit, éthique et santé Laboratory (ADES, UMR7268), Centre National de la Recherche Scientifique, Etablissement Français du Sang, Aix Marseille University, Marseille, France
| | - Claude Dussart
- Health Systemic Process Laboratory (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- Hospices Civils of Lyon, Lyon, France
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Brondani B, Knorst JK, Ardenghi TM, Mendes FM, Brondani MA. Community and individual socioeconomic inequalities and dental caries from childhood to adolescence: A 10-year cohort study. Community Dent Oral Epidemiol 2024; 52:540-549. [PMID: 38402550 DOI: 10.1111/cdoe.12950] [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: 06/16/2023] [Revised: 10/25/2023] [Accepted: 02/07/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE To evaluate the effect of individual and contextual socioeconomic inequalities in the occurrence of untreated dental caries during the transition from childhood to adolescence. METHODS This 10-year prospective cohort study followed up an initial sample of 639 1-5 years old schoolchildren from southern Brazil. After 7 and 10 years from the baseline (T1), two other reassessments were conducted (T2 and T3), respectively. Untreated dental caries was measured through the International Caries Detection and Assessment System (ICDAS- scores 3, 5 and 6) at T1 and T3. Socioeconomic status (SES) at the contextual and individual level was assessed at T1. At T2, socioeconomic, behavioural and psychosocial characteristics were evaluated as possible pathways of explanation. Structural equation modelling was used to estimate the direct and indirect effects among the variables over 10 years. RESULTS A total of 429 adolescents were reevaluated at 10-year follow-up (cohort retention rate of 67.1%). About 30.6% presented untreated dental caries at T3. Low individual SES at T1 directly impacted a higher occurrence of dental caries at T3. Non-white skin colour at T1 also indirectly impacted a higher occurrence of dental caries at T3 through low individual SES at T1 and lower household income at T2. Contextual SES did not predict, directly or indirectly, dental caries at T3. CONCLUSION There is strong evidence that socioeconomic inequalities at the individual level play an important role on the occurrence of dental caries from childhood to adolescence. On the other hand, there was no evidence that contextual SES influences the occurrence of dental caries over time.
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Affiliation(s)
- Bruna Brondani
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Jessica K Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mário A Brondani
- Department of Oral Health Sciences, School of Dentistry, University of British Columbia, Vancouver, Canada
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Fagundes MLB, Júnior OLDA, Hugo FN, Kassebaum NJ, Giordani JMDA. Distribution of Edentulism by the Macro Determinants of Health in 204 Countries and Territories: An Analysis of the Global Burden of Disease Study. J Dent 2024; 146:105008. [PMID: 38685342 DOI: 10.1016/j.jdent.2024.105008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/27/2024] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE To carry out a comprehensive description of edentulism estimates by the macro determinants of health in 2000, 2010 and 2019 worldwide. METHODS This ecological study analyzed data from the Global Burden of Disease Study (GBD) to describe the incidence rate, prevalence rate and years lived with disability (YLDs) rate due to edentulism by macro determinants of health (governance, macroeconomic policy, social policy, public policies, societal values), for 204 countries and territories. The estimates were reported as rates (cases/100,000 people), for people of both sexes aged 55 years or older. RESULTS Countries belonging to the least privileged categories of the macro determinants showed the lowest prevalence rate, incidence rate, and YLD rate due to edentulism for all exposures. Countries with low government expenditure on health showed the lowest prevalence rate of edentulism in 2000 (18,972.1; 95 %CI 15,960.0 - 21,984.3) and 2010 (16,646.8; 95 %CI: 14,218.3-19,075.4) than those with high government expenditure on health in 2000 (25,196.6; 95 %CI: 23,226.9 - 27,166.2) and 2010 (21,014.7; 95 %CI: 19,317.9 - 22,711.5). Countries with low SDI showed the lowest YLDs in 2000 (321.0, 95 %CI: 260.1- 381.9), 2010 (332.0; 95 %CI: 267.7-396.3), and 2019 (331.6; 95 %CI: 266.6-396.5). CONCLUSION The findings point to persistent inequalities in the distribution of edentulism between countries worldwide. The most privileged countries, with higher economic development, better governance, and better social and public policies, have shown higher rates of edentulism. CLINICAL SIGNIFICANCE This model must be reconsidered by advancing toward upstream and midstream strategies, beyond its conventional downstream clinical interventions.
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Affiliation(s)
| | | | - Fernando Neves Hugo
- College of Dentistry, Department of Epidemiology and Health Promotion, New York University, New York, NY, USA.
| | - Nicholas J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
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Lopez N, Shingler K, Real C, Nirkhiwale A, Quick K. Cultural competency in dental education: developing a tool for assessment and inclusion. J Dent Educ 2024; 88:587-595. [PMID: 38361495 DOI: 10.1002/jdd.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/13/2023] [Accepted: 01/06/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE/OBJECTIVES This study aimed to assess the cultural competency content in selected Doctor of Dental Surgery (DDS) courses and to explore the use of an assessment tool that may be used to standardize the integration of cultural competency in the dental school curriculum. METHODS A survey was sent to course directors to determine the inclusion of four topics related to cultural competence, the mechanisms of inclusion, and their comfort level in teaching the topics in their courses. A scan of the same courses was conducted with the use of a tool developed from an Expert Panel's recommendations for knowledge, skills, and attitudes (KSA) to be included in curricula for teaching cultural competence. RESULTS Twenty-one course directors responded. Fifteen reported they include social determinants of health and twelve include health inequities in their courses. Faculty reported an average of 8.67 comfort level in teaching these topics but there was less comfort level in teaching cultural humility and implicit bias. Course directors used assignments, case studies, lectures, quizzes, and patient care (clinical courses) to include the topics. The scan of courses showed that the use of the Competencies for General Dentists in course syllabi covered the recommended knowledge, skills, and attitudes for cultural competence. CONCLUSIONS The rubric was suitable for assessing cultural competency content. The Competencies for General Dentists in course syllabi will allow the integration of the recommended KSA in dental courses to teach cultural competence. However, dental faculty may need training in the integration of KSA items in course objectives and content.
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Affiliation(s)
- Naty Lopez
- Department of Primary Dental Care, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Kristin Shingler
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Carmen Real
- Department of Primary Dental Care, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Arpit Nirkhiwale
- Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Karin Quick
- Primary Dental Care and Division of Dental Public Health, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
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Tapager I, Westergaard CL, Øzhayat EB. Health status, care dependency and oral care utilization among older adults: a register-based study. Gerodontology 2024. [PMID: 38563253 DOI: 10.1111/ger.12748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND AND OBJECTIVES The aim of the study was to examine oral care utilisation among older Danes and to describe the extent to which oral care use is associated with the co-existence of challenges relating to general health and care dependency. MATERIALS AND METHODS The study used registry data covering the entire population of older adults (≥65 years) in seven municipalities in Denmark (N = 178 787 individuals). Oral care services utilisation was computed from administrative data on oral care contacts up to and including 2019, including both private oral care and a municipal oral care programme (MOCP). Various registry data sources were used to compute risk factors to describe oral care utilisation across indicators of general health and care dependency. RESULTS Indicators for poorer health were associated with larger proportions of individuals enrolled in the MOCPs and larger proportions of non-users of any type of oral care. Higher degrees of care dependency were associated with larger proportions of individuals enrolled in MOCPs and individuals with no use of any oral care services, with the exception of nursing home residents, who comprised a lower proportion of non-users than individuals receiving at-home care. Municipal oral care mainly enrolled older adults who were nursing home residents (60% of nursing home residents were enrolled). CONCLUSION Our findings support existing evidence on the link between oral care utilisation and general health and frailty. While the municipal care programmes assisted in covering oral care for those with the highest level of care dependency, future preventive strategies for ensuring care continuity for older adults that are increasing in frailty may want to focus on the earlier stages of frailty and of general health deterioration.
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Affiliation(s)
- Ina Tapager
- VIVE - The Danish Center for Social Science Research, Copenhagen, Denmark
| | | | - Esben Boeskov Øzhayat
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Anticona C, Suominen AL, Holgerson PL, Gustafsson PE. Impact of an oral care subsidization reform on intersectional inequities in self-rated oral health in Sweden. Int J Equity Health 2024; 23:63. [PMID: 38504240 PMCID: PMC10953229 DOI: 10.1186/s12939-024-02121-7] [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: 09/27/2023] [Accepted: 02/02/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Oral health in Sweden is good at the population level, but seemingly with persisting or increasing inequities over the last decades. In 2008, a major Swedish reform introduced universal partial subsidies to promote preventive care and reduce the treatment cost for patients with extensive care needs. This study aimed to apply an intersectional approach to assess the impact of the 2008 subsidization reform on inequities in self-rated oral health among adults in Sweden over the period 2004-2018. METHODS Data from 14 national surveys conducted over 2004-2018 were divided into three study periods: pre-reform (2004-2007), early post-reform (2008-2012) and late post-reform (2013-2018). The final study population was 118,650 individuals aged 24-84 years. Inequities in self-rated oral health were examined by intersectional analysis of individual heterogeneity and discriminatory accuracy across 48 intersectional strata defined by gender, age, educational level, income, and immigrant status. RESULTS Overall, the prevalence of poor self-rated oral health decreased gradually after the reform. Gender-, education- and income-related inequities increased after the reform, but no discernible change was seen for age- or immigration-related inequities. The majority of intersectional strata experienced patterns of persistently or delayed increased inequities following the reform. CONCLUSIONS Increased inequities in self-rated oral health were found in most intersectional strata following the reform, despite the seemingly positive oral health trends at the population level. Applying an intersectional approach might be particularly relevant for welfare states with overall good oral health outcomes but unsuccessful efforts to reduce inequities.
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Affiliation(s)
- Cynthia Anticona
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE-90187, Sweden.
- Department of Odontology, Umeå University, Umeå, SE-90187, Sweden.
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Teaching Unit, Kuopio University Hospital, Kuopio, Finland
| | - Pernilla Lif Holgerson
- Department of Odontology, Section of Pediatric Dentistry, Umeå University, Umeå, SE-90187, Sweden
| | - Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE-90187, Sweden
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Balasooriyan A, van der Veen MH, Bonifácio CC, Dedding C. Understanding parental perspectives on young children's oral health (≤ 4 years) growing up in a disadvantaged neighbourhood of Amsterdam, the Netherlands: an exploratory study. BMC Public Health 2024; 24:627. [PMID: 38413935 PMCID: PMC10900557 DOI: 10.1186/s12889-024-18073-0] [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: 09/12/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Families' understanding towards oral health problems among young children is poorly studied. More insight into parents' experiences, especially of those living in disadvantaged neighbourhoods, is needed to address persistent oral health inequalities. This qualitative study aims to explore parental perspectives on children's oral health (≤ 4 years) and the opportunities they see to improve children's oral health. METHODS Forty-seven mothers and five fathers with different migration backgrounds from a disadvantaged neighbourhood in Amsterdam, the Netherlands, participated in our study. Semi-structured interviews (n = 27), participant observations (n = 7) and one focus group discussion were conducted. A thematic data analysis was used. RESULTS Parents describe their daily life with young children as busy, hectic and unpredictable. Parents seem to be most concerned about parenting. Mothers, in particular, feel fully responsible for raising their children and managing daily complexities. While most parents value their children's oral health, they all experience challenges. Parents find it hard to limit daily candy intake and to handle unwilling children during tooth brushing. They feel limited support for these issues from their household, social network and professionals. CONCLUSION Parental struggles in children's oral health are complex and interrelated as they occur across family, societal, community and professional levels. Given the complex daily reality of families with young children, establishing and maintaining healthy oral health habits seems not at the top of parents' minds. They ask for advice in the upbringing of their children backed up by social support, increased attention to children's oral health within the community and professional assistance. Collaborating with parents as knowledgeable partners might be the first step in acting upon the endeavour to address oral health inequality among young children.
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Affiliation(s)
- Awani Balasooriyan
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands.
| | - Monique H van der Veen
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
| | - Clarissa Calil Bonifácio
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
| | - Christine Dedding
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centre (UMC), Amsterdam, The Netherlands
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10
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Albandar JM. Disparities and social determinants of periodontal diseases. Periodontol 2000 2024. [PMID: 38217495 DOI: 10.1111/prd.12547] [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: 10/19/2023] [Accepted: 12/08/2023] [Indexed: 01/15/2024]
Abstract
Periodontal diseases are highly prevalent in populations worldwide and are a major global public health problem, with major negative impacts on individuals and communities. This study investigates evidence of disparities in periodontal diseases by age groups, gender, and socioeconomic factors. There is ample evidence that these diseases disproportionally affect poorer and marginalized groups and are closely associated with certain demographics and socioeconomic status. Disparities in periodontal health are associated with social inequalities, which in turn are caused by old age, gender inequality, income and education gaps, access to health care, social class, and other factors. In health care, these factors may result in some individuals receiving better and more professional care compared to others. This study also reviews the potential causes of these disparities and the means to bridge the gap in disease prevalence. Identifying and implementing effective strategies to eliminate inequities among minorities and marginalized groups in oral health status and dental care should be prioritized in populations globally.
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Affiliation(s)
- Jasim M Albandar
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, Pennsylvania, USA
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11
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Dasson Bajaj P, Shenoy R, Davda LS, Mala K, Bajaj G, Rao A, K S A, Pai M, Jodalli P, B R A. A scoping review exploring oral health inequalities in India: a call for action to reform policy, practice and research. Int J Equity Health 2023; 22:242. [PMID: 37990194 PMCID: PMC10664303 DOI: 10.1186/s12939-023-02056-5] [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: 09/11/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION Reduction in health inequalities and providing universal access to health care have been identified as two important global milestones by the World Health Organization for countries to achieve by 2030. Therefore, recognizing the magnitude of oral health inequalities in India has become a pressing priority to improve access to dental care within the country. This scoping review was conducted with the aim of reviewing, collating and analysing the current knowledge base on oral health inequalities in India. METHODOLOGY The scoping review followed Arksey and O'Malley's approach, and reporting was performed in accordance with the PRISMA-ScR guidelines. A systematic search was conducted on Scopus, PubMed, Web of Science, and EMBASE to identify literature addressing one or more dimensions of oral health inequalities in India, published in English between January 2002 and April 2022. The data were charted, and qualitative analysis was performed to derive themes, highlighting the key concepts emerging from this review. RESULTS In accordance with the eligibility criteria, a total of 71 articles retrieved through database search and backward citation search were included in this scoping review. The major themes ranged from individual to diverse sociodemographic factors acting as barriers to and facilitators of access to dental care. Deficiencies in human resources for oral health, along with a wide diversity in dental service provision and dental education were other major themes contributing to inequality. Subsequently, this has resulted in recommendations on restructuring the dental workforce and their development and modifications in oral health care policies and practices. The qualitative synthesis demonstrates the intertwined nature of the multiple factors that influence the goal of achieving an affordable, accessible, extensive and inclusive oral healthcare system in India. CONCLUSIONS This comprehensive review provides a broad perspective on oral health inequalities in India, providing valuable insights for both researchers and policymakers in this area and guiding their efforts towards achieving universal oral health coverage in the Indian context.
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Affiliation(s)
- Parul Dasson Bajaj
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ramya Shenoy
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
| | - Latha Sanjay Davda
- Civilian Dental Surgeon, UK and Adjunct Faculty, Manipal College of Dental Sciences Mangalore, Ministry of Defense, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Kundabala Mala
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Gagan Bajaj
- Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ashwini Rao
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Aparna K S
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Mithun Pai
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Praveen Jodalli
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Avinash B R
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Zhang Y, Leveille SG, Camhi SM, Shi L. Association of oral care with periodontitis and glycemic control among US adults with diabetes. BMC Oral Health 2023; 23:903. [PMID: 37990177 PMCID: PMC10664594 DOI: 10.1186/s12903-023-03580-0] [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: 03/15/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Studies indicate that treating periodontitis may benefit glycemic control among people with diabetes. It is unclear whether oral self-care such as flossing may reduce risk for periodontitis and improve glycemic control among people with diabetes. The purpose of this study was to examine associations between oral care, specifically, flossing and preventive dental care, with periodontitis and glycemic control, among US dentate adults with diabetes. METHODS We analyzed data from the National Health and Nutrition Examination Survey 2011-2014 for 892 participants aged 30 years and older with diabetes who completed the periodontal examination and lab test for hemoglobin A1c (HbA1c). Sampling weights were applied. Multivariable logistic regression and multivariable linear modeling were performed to examine the associations of flossing and preventive dental services on periodontal health and HbA1c levels, respectively, controlling for sociodemographic characteristics, health behaviors, and other risk factors. RESULTS Among U.S. dentate adults with diabetes, 52.1% of flossers and 72.1% of non-flossers had periodontitis (p < 0.001). Flossers were 39% less likely to have periodontitis (Adj. OR 0.61, 95% CI 0.43-0.88) compared to non-flossers. Flossers had an average HbA1c reading 0.30% (95% CI 0.02%-0.58%) lower than non-flossers, adjusted for covariates (p = 0.037). Preventive dental visits were associated with reduced risk for periodontitis (Adj. OR 0.54, 95%CI, 0.38-0.75) but not glycemic control. CONCLUSION Flossing was associated with periodontal health and glycemic control among US adults with diabetes. Although further research is needed, the findings support that oral self-care may be particularly beneficial for adults with diabetes.
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Affiliation(s)
- Yuqing Zhang
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
- College of Nursing, University of Cincinnati, 3110 Vine Street, Cincinnati, OH, 45221, USA.
| | - Suzanne G Leveille
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
| | - Sarah M Camhi
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
- College of Arts and Sciences, Department of Kinesiology, University of San Francisco, Fulton Street, San Francisco, CA, 94117, USA
| | - Ling Shi
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
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Benzian H, Raj Mathur M. SDG 10: Placing inequalities in oral health at the core of the global agenda. Br Dent J 2023; 235:761. [PMID: 38001177 DOI: 10.1038/s41415-023-6554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Affiliation(s)
- Habib Benzian
- Department of Epidemiology & Health Promotion, WHO Collaborating Center Quality Improvement & Evidence-based Dentistry, New York University, NY, USA; Global Health Research Fellow, Stellenbosch Institute of Advanced Study (STIAS), Stellenbosch, South Africa.
| | - Manu Raj Mathur
- Professor and Head - Dental Public Health and Primary Care, Queen Mary University of London, UK; Head Health Policy, Public Health Foundation of India, New Delhi, India
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Kitsaras G, Gomez J, Hogan R, Ryan M. Evaluation of a digital oral health intervention (Know Your OQ™) to enhance knowledge, attitudes and practices related to oral health. BDJ Open 2023; 9:40. [PMID: 37633985 PMCID: PMC10460405 DOI: 10.1038/s41405-023-00166-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/28/2023] Open
Abstract
OBJECTIVE/AIM Optimal oral health behaviours are crucial to avoid preventable dental diseases and maintain good oral health. This research aimed to evaluate the impact of a digital oral health intervention (Know Your OQ™) in changing knowledge, attitudes and practices related to oral health. MATERIALS & METHODS Two studies were conducted with a total of 296 healthy adults. Demographic data as well as knowledge, attitudes, and practices (KAPs) related to oral health were collected before and after completion of the Know Your OQ™ intervention. The KAPs questionnaire included 19 multiple choice questions. Comprehension and feedback were also collected. RESULTS In total, 134 (45%) male and 162 (55%) female participants completed the two studies. Across both studies, 5 out of 7 knowledge questions and 2 out of 5 attitude questions showed significant changes pre/post-intervention with participants increasing their knowledge and improving their attitudes towards oral health. Only 1 practice changed in the first study, however, in the second study, 4 out of 7 practice questions showed significant changes pre/post-intervention. Comprehensibility was high across both studies with overall, positive feedback on the intervention. CONCLUSION A digital oral health intervention was successful in increasing knowledge, changing attitudes and self-reported practices with regards to oral health in a diverse sample of the US population.
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Affiliation(s)
- George Kitsaras
- Dental Health Unit, Division of Dentistry, The University of Manchester, Manchester, UK.
| | - Juliana Gomez
- Dental Health Unit, Division of Dentistry, The University of Manchester, Manchester, UK
| | - Richard Hogan
- Dental Health Unit, Division of Dentistry, The University of Manchester, Manchester, UK
| | - Maria Ryan
- Colgate-Palmolive Company, Piscataway, NJ, 08854, USA
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Haider F, Bernabé E, Delgado-Angulo EK. Education mediates the relationship of parental socioeconomic status with subjective adult oral health. Health Qual Life Outcomes 2023; 21:86. [PMID: 37563734 PMCID: PMC10416478 DOI: 10.1186/s12955-023-02169-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Evidence shows that both socioeconomic status (SES) during childhood and education are associated with adult oral health. However, whether the range of opportunities families have regarding their children's education mediate the effect of childhood disadvantage on oral health later in life remains unknown. The aim of this study was to evaluate the mediating role of education in the association between parental SES and subjective oral health status in middle adulthood. METHODS Data from 6703 members of the British Cohort Study 1970 were analyzed. Parental SES was measured using the 7-class National Statistics Socio-Economic Classification (NS-SEC) at age 10 years. Five measures of education (type of high school, highest qualification, age left full-time education, status of institution and field of study) were obtained from ages 16 and 42 years. Subjective oral health was measured with a single global item at age 46 years. Causal mediation analysis was performed, using a weighting-based approach, to evaluate how much of the effect of parental SES on subjective oral health was mediated by the measures of education separately and jointly. RESULTS Overall, 23.6% of individuals reported poor oral health. Parental SES was associated with every measure of education, and they were also associated with subjective oral health in regression models adjusted for confounders. The effect of parental SES on subjective oral health was partially mediated by each measure of education, with a proportion mediated of 53.2% for the institution status, 46.5% for the field of study, 42.8% for the school type, 38.9% for the highest qualification earned and 38.4% for the age when full-time education was discontinued. The proportion of the effect of parental SES on subjective oral health jointly mediated by all measures of education was 81.1%. CONCLUSION This study found a substantial mediating role of education in the association between parental SES and subjective oral health in middle adulthood.
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Affiliation(s)
- Faten Haider
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Eduardo Bernabé
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Queen Mary University of London, Turner street, E1 2AD, London, UK.
| | - Elsa Karina Delgado-Angulo
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Lima, Perú
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McNeil DW. Behavioural and cognitive-behavioural theories in oral health research: Current state and future directions. Community Dent Oral Epidemiol 2023; 51:6-16. [PMID: 36779644 PMCID: PMC10516240 DOI: 10.1111/cdoe.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 02/14/2023]
Abstract
OBJECTIVES Behavioural and cognitive-behavioural theories, models and frameworks have been incorporated for decades in behavioural and social oral health sciences, oral health care, and education of dentists, hygienists, and other oral healthcare professionals. METHODS While a myriad of these conceptualizations have been incorporated in this work, there are six of them that have had the greatest impact in the oral health arena: (a) Health Belief Model; (b) Theory of Reasoned Action, Theory of Planned Behavior and Integrated Behavioral Model, which are considered in unison; (c) Social Learning Theory and Social Cognitive Theory which are considered together; (d) Transtheoretical Model/Stages of Change Model; (e) Salutogenesis Model/Theory and Sense of Coherence Framework; and the (f) Behavior Change Wheel, Capability-Opportunity-Motivation-Behavior Model and Theoretical Domains Framework, which are categorized together. RESULTS An analysis of nomenclature (i.e. theories, models, frameworks and conceptualizations) is provided in the context of a description of each of these theories and models, with discussion about their aspects that particularly relate to oral health. Additionally, a quantitative, longitudinal view is provided of the frequency of use of these theories and models in the oral health arena. Given the benefits of theory-based intervention development, dissemination and implementation, it is important to consider these theories and models in a collective context. CONCLUSIONS At a basic level, these theories and models help in identifying and acting on mechanisms, both of behaviour itself and behaviour change. Future directions are discussed in terms of need for theory evolution and development.
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