1
|
Lima RB, de Freitas Miranda-Filho AE, Moura APGE, Nelson-Filho P, da Silva LAB, da Silva RAB. Territorial Disparities in Dental Care for Disabled Persons and Oral Health-Related Indicators: A Population-Level Approach in Brazil's Public Healthcare System from 2014 to 2023. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:632. [PMID: 38791846 PMCID: PMC11121442 DOI: 10.3390/ijerph21050632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/09/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024]
Abstract
This study evaluated territorial disparities in dental care for disabled persons in Brazil's public healthcare system from 2014 to 2023. The person-year incidence of outpatient dental procedures carried out by special care dentistry specialists and hospitalizations for dental procedures for disabled persons were compared across different regions and against the national estimate. In addition, productivity was correlated with oral health-related indicators. The significance level was set at 5%. The northern region exhibited the highest outpatient productivity, while the southern region showed lower productivity compared to the national estimate (both p-value < 0.05). This pattern was reversed in inpatient productivity (both p-value < 0.05), with the northeastern and central-western regions also below average (both p-value < 0.05). There were no significant correlations between the indicators and inpatient productivity, but outpatient productivity was positively correlated with the proportions of inhabitants who self-rated their general and oral health as "poor" or "very poor", who have never visited a dentist, and who visited a dentist for tooth extraction (all p-values < 0.05). Territorial disparities in dental care for disabled persons were observed within Brazil's public healthcare system, and they were correlated with unfavorable oral health-related indicators at the population level.
Collapse
Affiliation(s)
- Ricardo Barbosa Lima
- Graduate Program in Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | | | - Ana Paula Gomes e Moura
- Graduate Program in Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Léa Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Raquel Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| |
Collapse
|
2
|
Alimoradi Z, Jafari E, Roshandel Z, Potenza MN, Lin CY, Pakpour AH. Meta-analysis with systematic review to synthesize associations between oral health related quality of life and anxiety and depression. BDJ Open 2024; 10:9. [PMID: 38350985 PMCID: PMC10864408 DOI: 10.1038/s41405-024-00191-x] [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: 10/02/2023] [Revised: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The present systematic review aimed to investigate how oral health related quality of life (OHQOL) associates with anxiety and depression. The study protocol was registered prospectively in the PROSPERO database (CRD42023389372). MATERIALS AND METHODS Studies investigating associations between OHQOL and depression and/or anxiety were included. Fisher's Z scores were used to summarize associations between OHQOL and depression/anxiety. Funnel plots and Begg's Tests were used to assess publication bias. Meta-regression was conducted to examine potential moderator effects in the associations. Academic databases including the ISI Web of Knowledge, Scopus, ProQuest and PubMed were systematically searched. The quality of included studies was checked with the Newcastle Ottawa Scale (NOS). RESULTS All 15 included studies were cross-sectional (14,419 participants from nine countries; mean age=43.74 years). The pooled estimates showed weak associations between OHQOL and depression (Fisher's z-score of 0.26 [95% CI = 0.17, 0.35; I2 = 96.2%; τ2 = 0.03]) and anxiety (Fisher's z-score of 0.22 [95% CI = 0.001, 0.43; I2 = 97.9%; τ2 = 0.06]). No severe problems in methodology quality, publication biases, or moderator effects were observed. CONCLUSION Both depression and anxiety were weakly associated with individuals' OHQOL. Although the synthesized associations were not strong, they were significant, indicating that depression and anxiety are potential factors influencing individuals' OHQOL.
Collapse
Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran, 3419759811
| | - Elahe Jafari
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran, 3419759811
| | - Zahra Roshandel
- Department of Odontology and Oral Health Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT, 06511, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- University of Religions and Denominations, Qom, Iran.
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran, 3419759811.
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| |
Collapse
|
3
|
Zwick L, Schmitz N, Shojaa M. Oral health-related quality of life and depressive symptoms in adults: longitudinal associations of the English Longitudinal Study of Ageing (ELSA). BMC Oral Health 2023; 23:1029. [PMID: 38124069 PMCID: PMC10734100 DOI: 10.1186/s12903-023-03722-4] [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: 06/09/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Little is known about the relationship between oral health status and depressive symptoms in adults in England. The aim of this study was to examine the longitudinal association between oral health parameters and depressive symptoms in adults in England. METHODS Data were obtained from the English Longitudinal Study of Aging (ELSA), which included information on self-rated oral health, oral impairment in daily life (Oral Impacts on Daily Performances, OIDP), and depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) in 6790 adults aged ≥ 50 years. Wave 3 data were used as baseline, while Waves 5 and 7 were used for follow-up assessments. Logistic regression was used to determine whether depressive symptoms at baseline anticipated self-rated oral health and OIDP and whether oral health status (at baseline) was associated with the development of depressive symptoms at follow-up assessment. RESULTS Participants with poor self-rated oral health were at higher risk of developing depressive symptoms, even after adjusting for behavioral, clinical, and sociodemographic characteristics (OR = 1.69, 95% CI 1.38-2.07). Similarly, having oral impacts on daily performances were associated with the development of depressive symptoms: The OR for developing depressive symptoms at Wave 5 or 7 was 2.19 (95% CI 1.62-2.96) after adjustment for all covariates. Participants with depressive symptoms at baseline were more likely to report poor self-rated oral health (OR = 1.93, 95% CI 1.52-2.44) or one or more oral impacts (OR = 1.86, 95% CI 1.45-2.40) at follow-up than those without depressive symptoms at baseline, even after adjusting for confounders. CONCLUSIONS In the present study, a bidirectional association was found between depressive symptoms and poor oral health in older adults. Maintaining good oral health in older adults may be a protective factor against depressive symptoms. Therefore, more attention should be paid to promoting oral health awareness in older adults, including encouraging regular dental checkups, proper toothbrushing and flossing techniques, and healthy lifestyles.
Collapse
Affiliation(s)
- Luisa Zwick
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany
| | - Norbert Schmitz
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany
| | - Mahdieh Shojaa
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany.
| |
Collapse
|
4
|
Gemp S, Ziebolz D, Haak R, Mauche N, Prase M, Dogan-Sander E, Görges F, Strauß M, Schmalz G. Oral Health-Related Quality of Life in Adult Patients with Depression or Attention Deficit Hyperactivity Disorder (ADHD). J Clin Med 2023; 12:7192. [PMID: 38002804 PMCID: PMC10672471 DOI: 10.3390/jcm12227192] [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: 10/23/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of this cross-sectional study was the evaluation of the oral health-related quality of life (OHRQoL) in patients with depression or attention-deficit/hyperactivity disorder (ADHD) in comparison with a group of mentally healthy individuals. Patients from the Department of Psychiatry and Psychotherapy, University of Leipzig, Germany, were recruited. A healthy comparison group (HC) was recruited from the Department of Cariology, Endodontology and Periodontology. The OHRQoL was assessed using the Oral Health Impact Profile G14 (OHIP G14). Furthermore, a questionnaire regarding oral hygiene behaviour was applied. A total of 141 patients with depression or ADHD (depression n = 94, ADHD n = 47) and 145 HC individuals with a balanced age and gender distribution were surveyed. OHIP G14 median scores were significantly higher in the overall psychiatric patient group compared to HC (5.00 vs. 0.00, p < 0.001). This was also found for the four dimensions of OHIP G14 (p < 0.001). The OHIP G14 sum score of patients with depression and ADHD was comparable (5.00 vs. 6.50, p = 0.302). A significant association among psychiatric patients between smoking, gum bleeding, professional tooth cleaning, oral health education, interdental cleaning, and elevated OHIP scores was found (p < 0.001). In conclusion, patients with depression and adults with ADHD show a reduced OHRQoL. A contradictory association between oral hygiene/oral health behaviour and OHRQoL supports the hypothesis of a changed perception of oral conditions in patients with mental diseases. Interdisciplinary collaboration between psychiatric specialists and dentists should be fostered.
Collapse
Affiliation(s)
- Stephan Gemp
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.G.); (R.H.)
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.G.); (R.H.)
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.G.); (R.H.)
| | - Nicole Mauche
- Department of Psychiatry and Psychotherapy, University of Leipzig, 04103 Leipzig, Germany; (N.M.); (M.P.); (E.D.-S.); (F.G.); (M.S.)
| | - Madlen Prase
- Department of Psychiatry and Psychotherapy, University of Leipzig, 04103 Leipzig, Germany; (N.M.); (M.P.); (E.D.-S.); (F.G.); (M.S.)
| | - Ezgi Dogan-Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig, 04103 Leipzig, Germany; (N.M.); (M.P.); (E.D.-S.); (F.G.); (M.S.)
| | - Frauke Görges
- Department of Psychiatry and Psychotherapy, University of Leipzig, 04103 Leipzig, Germany; (N.M.); (M.P.); (E.D.-S.); (F.G.); (M.S.)
| | - Maria Strauß
- Department of Psychiatry and Psychotherapy, University of Leipzig, 04103 Leipzig, Germany; (N.M.); (M.P.); (E.D.-S.); (F.G.); (M.S.)
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (S.G.); (R.H.)
| |
Collapse
|
5
|
Park KE, Lee H, Kwon YD, Kim S. Association Between Changes in Oral Health-Related Quality of Life and Depressive Symptoms in the Korean Elderly Population. Int J Public Health 2023; 68:1605403. [PMID: 37065644 PMCID: PMC10103146 DOI: 10.3389/ijph.2023.1605403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
Objectives: The aim of this study was to examine the association between changes in oral health related quality of life (OHRQoL) and depressive symptoms in the elderly South Koreans.Methods: We used the 2018 and 2020 Korean Longitudinal Study of Ageing data. Our study population was a total of 3,604 participants aged over 65 in 2018. The independent variable of interest was the changes in the Geriatric Oral Health Assessment Index as OHRQoL between 2018 and 2022. The dependent variable was depressive symptoms in 2020. Multivariable logistic regression analyzed the associations between changes in OHRQoL and depressive symptoms.Results: Participants with improvement in OHRQoL over 2-year period were likely to have fewer depressive symptoms in 2020. Especially, changes in the oral pain and discomfort dimension score was associated with depressive symptoms. A decline in oral physical function, such as difficulty in chewing and speaking, was also associated with depressive symptoms.Conclusion: Negative change in OHRQoL is a risk factor for depression in elderly. This results suggest the importance of maintaining good oral health in later life, as a protective factor against depression.
Collapse
Affiliation(s)
- Kyoung Eun Park
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hooyeon Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- *Correspondence: Hooyeon Lee,
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sukil Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
6
|
Effect of Morbidities, Depression, Anxiety, and Stress on Oral Health-Related Quality of Life among Migrant Elderly Following Children in Weifang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084677. [PMID: 35457544 PMCID: PMC9033005 DOI: 10.3390/ijerph19084677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 02/06/2023]
Abstract
This study explored the relationship between depression, anxiety, stress, morbidity, and oral health-related quality of life (OHRQoL) in the migrant elderly following children (MEFC) in Weifang, China. A total of 613 MEFC were selected using multistage cluster random sampling. The GOHAI scale was used to evaluate oral health-related quality of life. The DASS-21 scale was used to assess levels of depression, anxiety, and stress. Univariate analysis and binary logistic regression were used to analyze the correlation between these indicators and oral health-related quality of life, of which 43.9% were classified as having poor oral health. Logistic regression analysis showed that the MEFC who were of older age (OR = 0.965, p = 0.039), with hypertension (OR = 0.567, p = 0.004), with gastroenteropathy (OR = 0.263, p = 0.007), had received an outpatient service in the past year (OR = 0.669, p = 0.048), were depressed (OR = 0.338, p = 0.012), and anxious (OR = 0.414, p = 0.026) were less likely to report good oral health status. On the other hand, the MEFC with a high school education or above (OR = 1.872, p = 0.020) were more likely to report good oral health than those with primary school education and below. In conclusion, with regard to depression, anxiety, and stress: the results indicated that the fewer morbidities, the lower the level of depression and anxiety and the better the OHRQoL of MEFC. Targeted measures for government, communities, and family members were given to improve the OHRQoL of MEFC.
Collapse
|
7
|
Yamada S, Komiyama T, Ohi T, Murakami T, Miyoshi Y, Endo K, Hiratsuka T, Hara A, Satoh M, Tatsumi Y, Inoue R, Asayama K, Kikuya M, Hozawa A, Metoki H, Imai Y, Ohkubo T, Hattori Y. Regular dental visits, periodontitis, tooth loss, and atherosclerosis: The Ohasama study. J Periodontal Res 2022; 57:615-622. [PMID: 35388479 PMCID: PMC9321748 DOI: 10.1111/jre.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/07/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
Objective We aimed to explore the association between regular dental visits and atherosclerosis and between periodontitis, number of remaining teeth, and atherosclerosis among community dwellers in Japan. Background Few studies have examined the association between regular dental visits, periodontitis, tooth loss, and atherosclerosis in community dwellers in Japan. Methods The participants of this cross‐sectional study included community dwellers aged ≥55 years and residing in Ohasama. Exposure variables were regular dental visits; periodontitis, defined as radiographic alveolar bone loss (BL); the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) classification; and number of remaining teeth. The primary outcome was atherosclerosis, defined as maximum carotid intima‐media thickness ≥1.1 mm or confirmation of atheromatous plaque. Results Of 602 participants, 117 had atherosclerosis. In the multivariate model, compared to those with regular dental visits, the odds ratio (OR) (95% confidence intervals [CIs]) of atherosclerosis among those with the absence of regular dental visits was 2.16 (1.03–4.49). Regarding BL‐max, compared with those in the first quartile, ORs (95% CIs) of those in the second, third, and fourth quartiles were 1.15 (0.65–2.30), 0.65 (0.32–1.35), and 1.57 (0.81–3.01), respectively. Regarding CDC/AAP classification, compared to those with no or mild periodontitis, ORs (95% CIs) for those with moderate and severe periodontitis were 2.48 (0.61–10.1) and 4.26 (1.01–17.5), respectively. Regarding the number of remaining teeth, compared to those with ≥20 teeth, ORs (95%CIs) for those with 10–19 and 1–9 teeth were 1.77 (1.004–3.12) and 0.96 (0.52–1.80), respectively. Conclusion The absence of regular dental visits and presence of periodontitis are associated with atherosclerosis among community dwellers in Japan.
Collapse
Affiliation(s)
- Sho Yamada
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Takahisa Murakami
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yoshitada Miyoshi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kosei Endo
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takako Hiratsuka
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Azusa Hara
- Division of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yukako Tatsumi
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Ryusuke Inoue
- Department of Medical Information Technology Center, Tohoku University Hospital, Sendai, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Masahiro Kikuya
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| |
Collapse
|