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Perpelea AC, Sfeatcu R, Tușaliu M, Tănase M, Meleșcanu Imre M, Ripszky Totan A, Funieru C, Nicolescu DN, Pițuru SM. Exploring the Threefold Viewpoint on Children's Oral Health in a Cross-Sectional Study. Healthcare (Basel) 2024; 12:883. [PMID: 38727440 PMCID: PMC11082952 DOI: 10.3390/healthcare12090883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Oral health is situated within the framework of the global health agenda, addressing facets pertaining to well-being and quality of life. The research is based on the need to address variables at the community level to improve schoolchildren's oral health and promote healthy behaviors and aims to carry out an in-depth analysis from the perspective of the factors that influence children's oral health. Step 1, designed by the World Health Organization, was utilized. An easy-to-use web interface was created for data collection. The statistical analysis consisted of using multinomial and binominal logistic regression models. The level of education of the adult has a high probability of influencing the consumption of unhealthy or healthy foods, it has a significant probability of exerting influence on social or medical problems and a correlation was found between the level of academic education and the pattern of dental visits. The development of health-promoting behaviors begins in childhood and involves parents, who have an essential role in the education of their children. Oral health promotion programs in schools need to target the child-adult-teacher-dentist relationships. Taking into consideration the aforementioned, a threefold viewpoint is necessary for the development of a national program aimed at promoting the oral health of schoolchildren in Romania.
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Affiliation(s)
- Anca-Cristina Perpelea
- Department of Organization, Professional Legislation and Management of the Dental Office, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania; (D.N.N.)
| | - Ruxandra Sfeatcu
- Department of Oral Health and Community Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-21 Calea Plevnei Street, 010221 Bucharest, Romania
| | - Mihail Tușaliu
- Department of Ophthalmology, ENT, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Mihaela Tănase
- Department of Pedodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-21 Calea Plevnei Street, 010221 Bucharest, Romania
| | - Marina Meleșcanu Imre
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Calea Plevnei, 010221 Bucharest, Romania
| | - Alexandra Ripszky Totan
- Department of Biochemistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania
| | - Cristian Funieru
- Department of Preventive Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania
| | - Dragoș Nicolae Nicolescu
- Department of Organization, Professional Legislation and Management of the Dental Office, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania; (D.N.N.)
| | - Silviu-Mirel Pițuru
- Department of Organization, Professional Legislation and Management of the Dental Office, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania; (D.N.N.)
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Brondani B, Knorst JK, Agostini BA, Ramadan YH, Mendes FM, Ardenghi TM. Does bullying due to oral conditions influence cigarette smoking in adolescents? A structural equation modeling. Braz Oral Res 2023; 37:e100. [PMID: 38055518 DOI: 10.1590/1807-3107bor-2023.vol37.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/07/2022] [Indexed: 12/08/2023] Open
Abstract
This study aimed to explore the pathways that can influence cigarette smoking among adolescents. This population-based cohort followed a random sample of 12-year-old adolescents from southern Brazil for 6 years. Regular cigarette smoking was assessed through a self-reported question, previously used in the Brazilian National Survey of Scholar Health. We also gathered data on bullying, dental caries at baseline, incidence of caries, sex, friend network, and Sense of Coherence (SOC). Socioeconomic and demographic characteristics were also collected. Structural equation modeling was used to evaluate the pathways. Of the 1,134 adolescents examined at baseline, 768 were re-evaluated (67.7% retention rate). The prevalence of smoking was 37.6%. This prevalence was directly affected by low SOC (SC: -0.14, p < 0.01), low household income (SC: -0.12, p < 0.01), and male sex (SC: 0.15, p < 0.01). Presence of dental caries at baseline indirectly influenced the occurrence of dental bullying at follow-up via the incidence of dental caries (SC: 0.01, p < 0.05). Dental bullying indirectly influenced cigarettes consumption via SOC (SC: 0.62, p < 0.05). Friend network also indirectly influenced the consumption of cigarettes via SOC (SC: 0.32, p < 0.05). Psychosocial factors influence adolescent cigarette consumption through its higher direct and indirect effects (via bullying). In addition, behavioral, sociodemographic, and clinical factors also influence the occurrence of smoking.
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Affiliation(s)
- Bruna Brondani
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, São Paulo, SP, Brazil
| | - Jessica Klöckner Knorst
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | | | - Yassmín Hêllwaht Ramadan
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Fausto Medeiros Mendes
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, São Paulo, SP, Brazil
| | - Thiago Machado Ardenghi
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
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Wright FAC, Shu ECC, Cumming RG, Naganathan V, Blyth FM, Hirani V, Le Couteur DG, Handelsman DJ, Seibel MJ, Waite LM, Stanaway FF. Oral health-related quality of life of older Australian men. Community Dent Oral Epidemiol 2023; 51:767-777. [PMID: 35561045 DOI: 10.1111/cdoe.12754] [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: 05/07/2021] [Revised: 02/16/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aims of this study were to assess oral health-related quality of life (OHRQoL) in a cohort of older Australian men and explore the association between their general health conditions, socio-demographic factors and OHRQoL. METHODS The Concord Health and Ageing in Men Project (CHAMP) is a cohort study of the health of a representative sample of Australian men, initiated in 2005-2006 with an initial sample of 1705 men 70 years or over. Participants completed a self-administered health and socio-demographic questionnaire and attended an interview and clinical assessment at baseline and each of three follow-up assessments. Information on oral health and responses to the Oral Health Impact Profile (OHIP-14) were collected in the 4th follow-up in which 778 men completed the OHIP-14 questionnaire and 614 men had a dental assessment. The prevalence of oral health impact was defined as a response of fairly often or very often to one or more of the OHIP-14 questions. Mean OHIP-14 scores were calculated for the 14 questions and used as the dependent variable in the regression analyses. Zero-inflated Poisson regression was used to estimate prevalence rate ratios (PRR). RESULTS Only 10% of men presented oral health impacts. In multivariate regression modelling, being born in Italy/Greece (PRR: 2.16, 95% CI: 1.93-2.42) or in other countries (PRR: 2.12, 95% CI: 1.89-2.38), having poor self-rated general health (PRR: 1.38, 95% CI: 1.24-1.53), having poor mental wellbeing (PRR: 1.14, 95% CI: 1.04-1.24), having ≥6 depressive symptoms (PRR: 1.18, 95% CI: 1.05-1.32), being a current smoker (PRR: 1.34, 95% CI: 1.06-1.70) and having more decayed tooth surfaces (PRR:1.01, 95% CI: 1.00-1.02) were associated with higher impact scores. CONCLUSIONS Overall, older Australian men exhibit good oral health-related quality of life. The inter-relationship between perceptions of general health and well-being, health and oral health variables and social background supports policy objectives of closer integration of general health and oral health services for older Australian men.
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Affiliation(s)
- Fredrick Alan Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Ellie C-C Shu
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Robert G Cumming
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Repatriation General Hospital, University of Sydney, Concord, New South Wales, Australia
| | - Markus J Seibel
- Concord Clinical School, University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Clinical School the University of Sydney and Sydney Local Health District, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Fiona F Stanaway
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
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Lin YC, Huang ST, Yen CW, Huang YK, Shieh TM, Chi WH, Yao WL, Ho PS. Comparing individual-, family-, and community-level effects on the oral health of preschool children: a multilevel analysis of national survey data. BMC Oral Health 2023; 23:353. [PMID: 37268948 DOI: 10.1186/s12903-023-03077-w] [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: 11/18/2022] [Accepted: 05/25/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Early childhood is a critical stage for the prevention of dental caries. The prevalence of caries in preschool children is still high in Taiwan, where National Health Insurance covers 99% of the population. The effort to improve the oral health of preschool children should be based on conceptual model that encompasses more than individual-level factors. This study input nationwide survey data in a conceptual model to evaluate the effects of comprehensive factors related to the high prevalence of caries in preschool children. METHODS This observation study examined factors related to the oral health of preschool children by employing a comprehensive multilevel model to analyse nationally representative data from the Taiwan Oral Health Survey of Preschool Children (TOHPC) 2017-2018. Individual-level, family-level and community-level contextual effects were evaluated through multilevel analysis in this study. The proportional change in variance (PCV) was used to compare the multilevel model with the null model and individual-level, family-level, and community-level context effects. RESULTS The estimated deft index for preschool children was 1.34 (1.22-1.47) at age 3, 2.20 (2.08-2.32) at age 4, and 3.05 (2.93-3.18) at age 5. The overall prevalence of caries in preschool children in Taiwan was 34.27% (30.76%, 37.78%) at age 3, 51.67% (48.99%, 54.35%) at age 4, and 62.05% (59.66%, 64.44%) at age 5. The model that included the individual-, family-, and community-context levels exhibited the highest reduction of variance (PCV = 53.98%). The PCV was further reduced to 35.61% when only the level of accessibility to dental services for individuals, families, and the community was considered. For the model in which no community-context cofactors were considered and the model considering only the individual level, the PCVs were 20.37% and 5.52%, respectively. CONCLUSIONS Our findings indicate the key components that affect oral health in preschool children and can serve as a reference for policy makers. The most notable finding of this study is that to improve the oral health of preschool children, community-level factors should be targeted. To rely solely on dentists for leading oral health education programs for children is impractical and inefficient. Training more professional oral health educators to provide additional community-based oral health promotion campaigns is critical. We suggest training more professional oral health educators to provide more community-based oral health promotion campaigns.
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Affiliation(s)
- Ying-Chun Lin
- Department of Oral Hygiene, Shu-Zen College of Medical and Management, Kaohsiung, Taiwan
| | - Shun-Te Huang
- Division of Pediatric and Special Needs Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Wei Yen
- Division of Pediatric and Special Needs Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yung-Kai Huang
- Department of Oral Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Wei-Hsueh Chi
- Department of Oral Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wu-Lin Yao
- Department of Oral Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Shan Ho
- Department of Oral Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan.
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Martin MA, Avenetti D, Lee HH, Nordgren R, Berbaum ML, Edomwande Y, Cui L, Sandoval A. Community health worker intervention to improve tooth brushing in young children: Results from a cluster randomized controlled trial. Community Dent Oral Epidemiol 2023; 51:503-511. [PMID: 35766288 PMCID: PMC9797618 DOI: 10.1111/cdoe.12768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Coordinated Oral health Promotion (CO-OP) Chicago is a cluster randomized controlled trial testing the efficacy of a community health worker (CHW) intervention to improve tooth brushing in low-income children. METHODS Four hundred twenty children under 3 years old (mean 21.5 months) were recruited from 20 sites in or near Chicago, IL. Children were identified mainly as Black race (41.9%) or Hispanic ethnicity (53.8%) and most (85.2%) had Medicaid. Intervention families were offered four CHW home visits over 1 year. Brushing frequency was self-reported. Plaque score was determined from images collected in homes using disclosing solution. Analyses used GEE logistic models with variable selection at p < .05. RESULTS At enrolment, 45.0% of families reported twice a day or more child brushing frequency, and child plaque scores were poor (mean of 1.9, SD: 0.6). Data were obtained from 87.1% of children at 6 months and 86.2% at 12 months. In the CHW intervention arm (10 sites, N = 211), 23.7% received 4 visits, 12.8% 3 visits, 21.3% 2 visits, 23.2% 1 visit and 19% no visits from CHWs. No intervention effect was seen for brushing frequency or plaque score. Child brushing frequency improvement over time was associated with a range of child and caregiver factors. The only factor associated with a change in plaque score over time was parent involvement in brushing. CONCLUSIONS Oral-health-specific CHW services were not associated with improved brushing behaviours in these young children. However, caregiver involvement with brushing supported more quality brushing. More robust interventions are needed to support families during this critical developmental period.
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Affiliation(s)
| | | | - Helen H Lee
- University of Illinois Chicago, Chicago, Illinois, USA
| | | | | | | | - Liyong Cui
- University of Illinois Chicago, Chicago, Illinois, USA
| | - Anna Sandoval
- University of Illinois Chicago, Chicago, Illinois, USA
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Baker SR, Heaton LJ, McGrath C. Evolution and development of methodologies in social and behavioural science research in relation to oral health. Community Dent Oral Epidemiol 2023; 51:46-57. [PMID: 36756884 DOI: 10.1111/cdoe.12821] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 02/10/2023]
Abstract
The aim of this introductory paper is to provide an overview of key methodological developments in social and behavioural research in oral health. In the first section, we provide a brief historical perspective on research in the field. In the second section, we outline key methodological issues and introduce the seven papers in the theme. Conceptual models can contextualize research findings and address the 'why' and 'how' instead of 'what' and 'how many'. Many models exist, albeit they need to be evaluated (and adapted) for use in oral health research and in specific settings. The increasing availability of big data can facilitate this with data linkage. Through data linkage, it is possible to explore and understand in a broader capacity the array of factors that influence oral health outcomes and how oral health can influences other factors. With advances in statistical approaches, it is feasible to consider casual inferences and to quantify these effects. There is a need for not only individual efforts to embrace causal inference research but also systematic and structural changes in the field to yield substantial results. The value of qualitative research in co-producing knowledge with and from human participants in addressing 'the how' and 'the why' factors is also key. There have been calls to employ more sophisticated qualitative methods together with mixed methods approaches as ways of helping to address the complex or Wicked Problems in population oral health. In the final section, we outline possible future methodological directions in social and behavioural oral health research including participatory approaches and the development of core outcome sets. Our overriding goal in the paper is to facilitate a critical debate in relation to methodological issues which can be used to improve understanding and generate knowledge in population oral health and that this, in turn, will help inform oral health policy and practices.
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Affiliation(s)
- Sarah R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Lisa J Heaton
- CareQuest Institute for Oral Health, Boston, Massachusetts, USA.,Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Colman McGrath
- Applied Oral Sciences & Community Dental Care, The University of Hong Kong, Hong Kong, Hong Kong
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Slack-Smith L, Arena G. Why and how we can use data linkage in oral health research: a narrative review. Community Dent Oral Epidemiol 2023; 51:75-78. [PMID: 36749677 DOI: 10.1111/cdoe.12815] [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: 11/02/2021] [Revised: 08/30/2022] [Accepted: 11/09/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Poor oral health, impacting health and wellbeing across the life-course, is a costly and wicked problem. Data (or record) linkage is the linking of different sets of data (often administrative data gathered for non-research purposes) that are matched to an individual and may include records such as medical data, housing information and sociodemographic information. It often uses population-level data or 'big data'. Data linkage provides the opportunity to analyse complex associations from different sources for total populations. The aim of the paper is to explore data linkage, how it is important for oral health research and what promise it holds for the future. METHODS This is a narrative review of an approach (data linkage) in oral health research. RESULTS Data linkage may be a powerful method for bringing together various population datasets. It has been used to explore a wide variety of topics with many varied datasets. It has substantial current and potential application in oral health research. CONCLUSIONS Use of population data linkage is increasing in oral health research where the approach has been very useful in exploring the complexity of oral health. It offers promise for exploring many new areas in the field.
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Affiliation(s)
- Linda Slack-Smith
- School of Population and Global Health M431, The University of Western Australia, Perth, Western Australia, Australia
| | - Gina Arena
- School of Population and Global Health M431, The University of Western Australia, Perth, Western Australia, Australia
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Riddle M, Rice E. Rigorous theory-based intervention research is the bold action needed to address oral health disparities and inequities. Community Dent Oral Epidemiol 2023; 51:43-45. [PMID: 36779641 DOI: 10.1111/cdoe.12814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 02/14/2023]
Abstract
The Consensus Statement about behavioral and social sciences in oral health encourages future research to draw on testable theories that specify causal pathways that reflect the complex nature of oral health. In this commentary, we amplify the importance of explicit and well-specified theory in oral health intervention research, acknowledging that problematic use of theory has limited its utility in developing effective public health interventions. Also, we affirm the need to focus on determinants of oral health-and health inequities-most likely to drive meaningful change, and to understand the causal pathways that connect drivers of change from the individual to the global level. We view theory-based, causal mechanisms research as a powerful approach to building successful public health interventions, and suggest resources to inspire such research, including exemplary studies, methodologies, and collaborative initiatives that facilitate strong theory-based public health research.
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Affiliation(s)
- Melissa Riddle
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Elise Rice
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
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Tsakos G, Watt RG, Guarnizo-Herreño CC. Reflections on oral health inequalities: Theories, pathways and next steps for research priorities. Community Dent Oral Epidemiol 2023; 51:17-27. [PMID: 36744970 DOI: 10.1111/cdoe.12830] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 02/07/2023]
Abstract
Health inequalities, including those in oral health, are a critical problem of social injustice worldwide, while the COVID-19 pandemic has magnified previously existing inequalities and created new ones. This commentary offers a summary of the main frameworks used in the literature of oral health inequalities, reviews the evidence and discusses the potential role of different pathways/mechanisms to explain inequalities. Research in this area needs now to move from documenting oral health inequalities, towards explaining them, understanding the complex mechanisms underlying their production and reproduction and looking at interventions to tackle them. In particular, the importance of interdisciplinary theory-driven research, intersectionality frameworks and the use of the best available analytical methodologies including qualitative research is discussed. Further research on understanding the role of structural determinants on creating and shaping inequalities in oral health is needed, such as a focus on political economy analysis. The co-design of interventions to reduce oral health inequalities is an area of priority and can highlight the critical role of context and inform decision-making. The evaluation of such interventions needs to consider their public health impact and employ the wider range of methodological tools available rather than focus entirely on the traditional approach, based primarily on randomized controlled trials. Civil society engagement and various advocacy strategies are also necessary to make progress in the field.
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Affiliation(s)
- Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
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Newton JT. Achieving consensus on priorities for future behavioural and social research into social inequalities-Results of polling attendees at the BEHSR/IADR Summit on Behavioral and Social Oral Health Sciences. Community Dent Oral Epidemiol 2023; 51:36-42. [PMID: 36751983 DOI: 10.1111/cdoe.12808] [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: 08/08/2022] [Revised: 10/07/2022] [Accepted: 10/21/2022] [Indexed: 02/09/2023]
Abstract
AIM To explore the priority given by researchers working in the field of behavioural, epidemiological and health services research to key aspects of research in oral health and inequalities. METHOD Survey of registrants at the Behavioural Epidemiological and Health Services Research group of the International Association for Dental Research (BEHSR/IADR) Summit October 2020. FINDINGS The highest ranking for priority was given to 'Testing interventions to reducing oral health inequalities', and within this area to the exploration of public health approaches to reducing such disparities. Lower ranking priorities included 'Describing inequalities within countries' and 'Describing the mechanisms by which inequality produces poor health'. CONCLUSIONS Registrants at the (BEHSR/IADR) Summit October 2020 gave priority to testing interventions which will seek to reduce oral health inequalities, particularly through public health approaches such as creating policy change and community level interventions. Epidemiological research describing inequalities within countries was given a lower priority.
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Affiliation(s)
- Jonathon Tim Newton
- Department of Psychology as Applied to Dentistry, King's College London, London, UK
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Goodwin M, Henshaw M, Borrelli B. Inequities and oral health: A behavioural sciences perspective. Community Dent Oral Epidemiol 2023; 51:108-115. [PMID: 36753398 DOI: 10.1111/cdoe.12826] [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: 11/19/2021] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 02/09/2023]
Abstract
OBJECTIVES The importance of tackling ongoing dental health inequities, observed both within and across countries, cannot be overstated. Alarmingly, health inequities in some areas are widening, resulting in an urgent need to act. The objective of this commentary is to explore oral health inequities through the lens of behavioral science and discuss adapting evidence based interventions for populations experiencing health inequities. METHOD/RESULTS The first section of this paper aims to describe the role of health disparities and inequities within oral health, with a specific focus on behaviours. The determinants, from upstream to downstream, and the interplay between these levels of intervention are discussed. This is followed by an overview of oral health promotion interventions, again with a focus on behaviours, which could potentially improve oral health while also taking into account oral health inequities. It is essential to translate evidence-based interventions (EBIs) to populations that have the greatest burden of disease. The second section of this paper discusses the rationale for cultural adaption of EBIs, criteria to justify EBIs and considers different cultural adaptation strategies necessary for the development and testing of effective, engaging, equitable and culturally relevant interventions. CONCLUSIONS We conclude with future directions for the development of theory-based multi-level interventions, guided by extent evidence-based interventions, and transdisciplinary approaches to science and key stakeholders such as patients, providers and payers.
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Affiliation(s)
- Michaela Goodwin
- Division of Dentistry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Michelle Henshaw
- Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Belinda Borrelli
- Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.,The University of Manchester, Manchester, UK
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Damares Lago J, Restrepo M, Girotto Bussaneli D, Patrícia Cavalheiro J, Feltrin de Souza J, Santos-Pinto L, de Cássia Loiola Cordeiro R, Jeremias F. Molar-Incisor Hypomineralization: Prevalence Comparative Study in 6 Years of Interval. ScientificWorldJournal 2022; 2022:4743252. [PMID: 36530554 PMCID: PMC9757933 DOI: 10.1155/2022/4743252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 06/28/2024] Open
Abstract
The aim of this study was to evaluate the prevalence evolution rate of MIH (molar-incisor hypomineralization) after a 6-year period in Araraquara/SP, Brazil. This population-based study evaluated MIH in 545 schoolchildren (6-12 years of age) and other associated alterations, dental caries and dental fluorosis (DF). A semistructured questionnaire was sent to the schoolchildren's parents/guardians with the purpose of identifying the socioeconomic profile. Associations between MIH and the clinical characteristics were analyzed by the Poisson analysis of regression with robust variance, estimating the RPc (crude prevalence ratio) with CI 95%. The level of significance of 5% was adopted. The MIH prevalence in Araraquara/SP in 2016 was 14.3% (n = 78), and at this time, an increase of 2% was observed, in comparison with the data of the first prevalence study conducted in 2010 (12.3%). The mild degree compromise was the most prevalent diagnosis in the affected teeth (82.0%). Among children with MIH, the mean number of affected teeth was 2.78. Of the total number of children with MIH, 32.0% presented alterations in both first permanent molars and permanent incisors. There is no significant association between MIH and dental caries experience on permanent dentition (PRc = 1.141; CI 95% 0.709-1.835) or on primary dentition (PR c = 1.132; CI 95% 0.749-1.709). Children with MIH presented significantly less prevalence of dental fluorosis (PR c = 0.505; CI 95% 0.268-0.950). There is no association between MIH and monthly Brazilian minimal wage income (PR c = 1.130; CI 95% 0.655-1.949). It was concluded that the number of MIH cases had increased, revealing a greater need for defining the etiological factors and establishing a correct diagnosis to make it possible to institute early intervention.
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Affiliation(s)
- Jéssica Damares Lago
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP-Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Manuel Restrepo
- Department of Pediatric Dentistry, School of Dentistry, Universidad CES, Medellín, Antioquia, Colombia
| | - Diego Girotto Bussaneli
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP-Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Jéssica Patrícia Cavalheiro
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP-Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Juliana Feltrin de Souza
- Department of Stomatology, School of Dentistry, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Lourdes Santos-Pinto
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP-Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Rita de Cássia Loiola Cordeiro
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP-Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Fabiano Jeremias
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP-Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
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Kanaan M, Brabant A, Eckert GJ, Hara AT, Carvalho JC. Tooth Wear and Oral-Health-Related Quality of Life in Dentate Adults. J Dent 2022; 125:104269. [PMID: 35998742 DOI: 10.1016/j.jdent.2022.104269] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/20/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study estimated the extent to which tooth wear, adjusted for (oral) health risk indicators, impacts adversely on the Oral-Health-Related Quality of Life (OHRQoL) of dentate adults. METHODS A cross-sectional study was conducted and had a convenience sample of 570 adults ≥18 years old with at least one bilateral molar occlusal contact. Participants answered a self-applied questionnaire (ICC=0.71) consisting of four domains: socio-demographics, oral care attendance, (oral) health conditions and lifestyle, complaints and oral-health-related quality of life (OHIP-14). Tooth wear was clinically assessed using the Basic Erosive Wear Examination index by two examiners, whose inter-examiner reliability were k=0.76-0.80. RESULTS The outcome was a high score on the OHRQoL (median split ≥ 7). The prevalence of tooth wear was 75.0%. Only 30.2% of adults reported impacts on at least 1 performance parameter affected 'fairly often' or 'very often'. The hierarchical logistic regression showed that participants 35-54 years old (OR=2.1), who were ever prevented from regular oral health care due to costs of care (OR=3.6), who ingested acidic beverages ≥ daily (OR=1.7), who had tooth sensitivity (OR= 2.9) and those having the impression that their teeth have changed appearance (OR= 5.9) were significantly more likely to report lower OHRQoL than their counterparts. The severity of tooth wear was not significant when considering moderate and severe cases together. CONCLUSIONS Although the prevalence of tooth wear was high, its severity and impact on OHRQoL were limited. However, distal and proximal indicators for tooth wear were mediators for impaired OHRQoL and treatment needs. CLINICAL SIGNIFICANCE Prevalence and severity of tooth wear had limited impact on OHRQoL in adults. Distal and proximal indicators for tooth wear were mediators for impaired OHRQoL. The understanding of these relationships offers an opportunity to assess in depth the treatment needs and quality of life of patients affected by tooth wear.
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Affiliation(s)
- Mireille Kanaan
- Faculty of Medicine and Dentistry, UCLouvain, Brussels, Belgium
| | - Alain Brabant
- Faculty of Medicine and Dentistry, UCLouvain, Brussels, Belgium
| | - George Joseph Eckert
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, United States of America
| | - Anderson Takeo Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, United States of America
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Fagundes MLB, Amaral Júnior OLD, Menegazzo GR, Bastos LF, Hugo FN, Abreu LG, Iser BPM, Giordani JMDA, Hilgert JB. Pathways of socioeconomic inequalities in self-perceived oral health. Braz Oral Res 2022; 36:e088. [PMID: 35703713 DOI: 10.1590/1807-3107bor-2022.vol36.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
Although there is a large body of evidence of the influence of social determinants on oral health, information on the mechanisms by which these determinants operate is poorly documented. Therefore, we aimed to investigate the pathways through which socioeconomic inequalities may influence self-perceived oral health (SPOH) in Brazilian adults. This cross-sectional study used data from the National Health Survey (NHS) of 2019, with a representative sample of adults aged 18 to 59 years (n = 65,803). The outcome was SPOH, assessed by a global self-item. Structural equation modeling was used to test direct and indirect pathways connecting a latent variable for socioeconomic position (SEP) to SPOH via psychosocial, behavioral, and biological factors. Higher SEP was directly associated with better SPOH [standardized coefficient (SC) = 0.069; p < 0.01)] fewer depressive symptoms (SC = -0.059; p < 0.01), fewer missing teeth (SC = 0.131; p < 0.01), and more healthy behaviors (SC = 0.643; p < 0.01). Fewer depressive symptoms (SC = -0.141; p < 0.01), more healthy behaviors (SC = 0.242; p < 0.01), and fewer missing teeth (SC = 0.058; p < 0.01) were directly associated with good SPOH. Among specific indirect effects of SEP on SPOH, the behavioral pathway was the one that best explained this association (SC = 0.155). Socioeconomic inequities in SPOH are mediate by psychosocial, behavioral, and biological factors. This has implications for positioning health strategies in the social context in which people live, to facilitate healthy choices and promote good oral health.
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Affiliation(s)
- Maria Laura Braccini Fagundes
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil
| | - Orlando Luiz do Amaral Júnior
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil .,Unidade Central de Educação FAI Faculdades - UCEFF , School of Dentistry , Department of Oral Health , Itapiranga , SC , Brazil
| | - Gabriele Rissotto Menegazzo
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil
| | - Lucelen Fontoura Bastos
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Child and Adolescent Oral Health , Belo Horizonte . MG , Brazil
| | - Betine Pinto Moehlecke Iser
- Universidade do Sul de Santa Catarina - Unisul, Post-Graduate Program in Health Sciences , Tubarão , SC , Brazil
| | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
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15
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Does Efficiency of Oral and Dental Health Centers Change by the Development Level of Regions? Value Health Reg Issues 2022; 31:61-66. [PMID: 35453060 DOI: 10.1016/j.vhri.2022.03.002] [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: 12/28/2021] [Revised: 02/25/2022] [Accepted: 03/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study aimed to analyze the efficiency levels of oral and dental health centers (ODHCs) affiliated to the Ministry of Health from the perspective of the development levels in the regions. METHODS Within the framework of this study, the efficiencies of 127 ODHCs are evaluated with the data envelopment analysis based on Charnes, Cooper, Rhodes (CCR); Banker, Charnes, Cooper (BCC); and scale efficiency methods. RESULTS It is found that CCR, BCC, and scale efficiencies of the 42 ODHCs located in the first region, the highest development region, are efficient by 31%, 50%, and 38% whereas 13%, 26%, and 26% of other 85 ODHCs located in other regions are efficient, respectively. Additionally, the average efficiency scores of 42 ODHCs in the first region by CCR (0.82), BCC (0.89), and score efficiency (0.93) are much higher than the average efficiency scores of 85 ODHCs in other regions by CCR (0.73), BCC (0.80), and scale efficiency (0.92). CONCLUSIONS According to the findings, it is considered that the individuals from the first region use the oral and dental healthcare more than the individuals do in other regions because the access to oral and dental healthcare is higher in the first region and the individuals living in this region have better predisposing and enabling factors. The study results are thought to present evidence-based information to health policy makers regarding the regional planning of oral and dental healthcare.
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Poirier BF, Hedges J, Smithers LG, Moskos M, Jamieson LM. Child-, Family-, and Community-Level Facilitators for Promoting Oral Health Practices among Indigenous Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1150. [PMID: 35162173 PMCID: PMC8834955 DOI: 10.3390/ijerph19031150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/29/2022]
Abstract
Despite the preventive nature of oral diseases and their significance for general wellbeing, poor oral health is highly prevalent and has unfavourable ramifications for children around the world. Indigenous children in Australia experience disproportionate rates of early childhood caries compared to their non-Indigenous counterparts. Therefore, this paper aims to collate parental experiences and generate an understanding of facilitators for Indigenous childhood oral health. This project aggregated stories from parents of Indigenous children across South Australia who were participants in an early childhood caries-prevention trial. This paper explores facilitators for establishing oral health and nutrition behaviours for Indigenous children under the age of three through reflexive thematic analysis. Fisher-Owens' conceptual model for influences on children's oral health is utilised as a framework for thematic findings. Child-level facilitators include oral hygiene routines and regular water consumption. Family-level facilitators include familial ties, importance of knowledge, and positive oral health beliefs. Community-level facilitators include generational teaching, helpful community resources, and holistic health care. Recommendations from findings include the following: exploration of Indigenous health workers and elder participation in oral health initiatives; inclusion of Indigenous community representatives in mainstream oral health discussions; and incorporation of child-level, family-level, and community-level facilitators to increase support for efficacious oral health programs.
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Affiliation(s)
- Brianna F. Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
| | - Lisa G. Smithers
- School of Public Health and the Robinson Research Institute, University of Adelaide, Adelaide 5000, Australia;
- School of Health and Society, University of Wollongong, Wollongong 2522, Australia
| | - Megan Moskos
- Future of Employment and Skills Research Centre, School of Economic and Public Policy, Faculty of the Professions, University of Adelaide, Adelaide 5000, Australia;
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
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Bonzanini LIL, Arduim ADS, Lenzi TL, Hugo FN, Hilgert JB, Casagrande L. Molar-incisor hypomineralization and dental caries: A hierarchical approach in a populational-based study. Braz Dent J 2022; 32:74-82. [PMID: 35019021 DOI: 10.1590/0103-6440202104511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/28/2021] [Indexed: 11/22/2022] Open
Abstract
The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH) studies. Hypomineralized defects can have several consequences such as hypersensitivity, increased dental plaque accumulation, and consequently higher caries risk. This cross-sectional study aimed to investigate the prevalence of MIH and its association with dental caries in schoolchildren from a city in southern Brazil. A random cluster sample of schoolchildren was selected. Clinical examinations were carried out to collect information on MIH (following the European Academy of Pediatric Dentistry criteria), dental caries (using the DMF-T index) and gingivitis. Socioeconomic, demographic and behavior variables were collected using a standardized questionnaire answered by the children's parents/caregivers. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance through a hierarchical approach (p<0.05). A total of 513 schoolchildren were included in the study. MIH and caries prevalence was 19.7% and 31.6%, respectively. The mean age was 11.6 (+1.9) years. Dental caries was more prevalent in children with MIH (PR 1.39; 95% CI 1.05 - 1.85). Older children and children whose families were enrolled in conditional cash transference programs (PR 1.97 95% CI 1.47 - 2.64), and children who did not have their mother or father as the head of the family (PR 1.56 95% CI 1.06 - 2.30) presented a higher prevalence of dental caries. Our findings suggest that children with MIH are more likely to have dental caries.
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Affiliation(s)
- Laura Izabel Lampert Bonzanini
- Post-Graduate Program in Dental Clinic/Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Andressa da Silva Arduim
- Post-Graduate Program in Dental Clinic/Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Tathiane Larissa Lenzi
- Post-Graduate Program in Dental Clinic/Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Luciano Casagrande
- Post-Graduate Program in Dental Clinic/Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
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Krishnan G, Dhananjaya G. Relationship between sense of coherence and knowledge on early childhood caries among pregnant women in Bangalore Rural and Urban District. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_39_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Silva-Junior MF, Rosário de Sousa MDL, Batista MJ. Health literacy on oral health practice and condition in an adult and elderly population. Health Promot Int 2021; 36:933-942. [PMID: 33277894 DOI: 10.1093/heapro/daaa135] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The objective of this study was to investigate the impact of health literacy (HL) on health practices and oral health outcomes in an adult and elderly population in Brazil. A cross-sectional study nested in a cohort study was followed up over a period of four years (2011 and 2015) and assessed individuals between 23 and 69 years old from Piracicaba, São Paulo, Brazil. Data were collected by means of oral examinations (coronal caries, periodontal disease and visible biofilm) and interviews (socioeconomic, demographic, oral health-related quality of life, health practices and HL). The 14-item Health Literacy Scale (HLS) was used for HL data, which was the main explanatory variable. The result of the sum of the HLS-14 questionnaire for each participant was dichotomized into the median (46 points): 'high' and 'low' HL. Binary/multinomial logistic regressions were performed on health practice and oral health outcomes, controlled by age and sex (Model 1) and age, sex and socioeconomic status (Model 2; p < 0.05). The final sample consisted of 137 subjects and 43.8% (n = 60) presented low HL (LHL). LHL was associated with health practices, such as use of public dental services in Model 1 (odds ratio [OR] = 0.34, 95% CI: 0.14-0.87) and use of dental services for emergency in Model 1 (OR = 2.69, 95% CI: 1.29-5.51) and Model 2 (OR = 2.93, 95% CI: 1.17-7.30). Based on age and sex, LHL was associated with use of public dental service and use of emergency dental visits. Based on age, sex and socioeconomic status, LHL was associated with use of emergency dental visits.
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Affiliation(s)
- Manoelito Ferreira Silva-Junior
- Department of Dentistry, State University of Ponta Grossa, Av. Gen. Carlos Cavalcanti 4748, Ponta Grossa, Paraná, 84030-900, Brazil
| | - Maria da Luz Rosário de Sousa
- Department of Community Dentistry, Piracicaba Dental School, University of Campinas, Av. Limeira 901, Piracicaba, São Paulo, 13414-018, Brazil
| | - Marília Jesus Batista
- Department of Community Dentistry, Piracicaba Dental School, University of Campinas, Av. Limeira 901, Piracicaba, São Paulo, 13414-018, Brazil.,Department of Health Sciences and Pediatric Dentistry, Faculty of Medicine Jundiaí, R. Francisco Teles 250, Jundiaí, São Paulo, 13202-550, Brazil
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20
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Feitosa MCP, Garib D, de Cássia Moura Carvalho Lauris R, Herkrath APQ, Vettore MV. The impact of orthognathic surgery on quality of life in individuals with oral clefts. Eur J Orthod 2021; 44:170-177. [PMID: 34173641 DOI: 10.1093/ejo/cjab039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES To evaluate the relationships between individual, environmental, clinical factors and oral health-related quality of life (OHRQoL) in patients with cleft lip and palate (CLP) following orthognathic surgery. MATERIALS AND METHODS A follow-up study was conducted involving 69 adults with unilateral and bilateral CLP under orthodontic treatment. Interviews and oral examinations were conducted prior to orthognathic surgery (T0) to evaluate age, gender, psychological well-being, dental caries, malocclusion, social support, social networks, family income and education and OHRQoL. All participants were reviewed after 6 months (T1) to re-assess psychological well-being, malocclusion and OHRQoL. Structural equation modeling estimated the associations between the variables. RESULTS OHRQoL total scores reduced following orthognathic surgery, from 11.7 to 6.9 (P < 0.01). Occlusal characteristics and psychological well-being improved between T0 and T1. In the structural equation modeling, reduction of malocclusion (β = 0.02) between T0 and T1 directly predicted poor OHRQoL at T1. Improvement of psychological well-being between T0 and T1 was associated with better OHRQoL at T1 (β = -0.07). Dental caries and malocclusion at T0 were indirectly linked to poor OHRQoL at T1 (β = 0.02). LIMITATIONS The short follow-up period of 6 months after orthognathic surgery. CONCLUSIONS/IMPLICATIONS This represents the first prospective study examining the interrelationships of predictors of OHRQoL in patients with CLP after orthognathic surgery. OHRQoL and psychological well-being improved after orthognathic surgery. Clinical and psychological characteristics were important determinants of OHRQoL. These findings suggest the importance of the biopsychosocial model of health and the patient-centered approach in oral health care in individuals with CLP.
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Affiliation(s)
- Mariana Chaves Petri Feitosa
- Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Daniela Garib
- Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.,Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | | | | | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
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Baxevanos K, Menexes G, Lazaridou A, Coolidge T, Topitsoglou V, Kalfas S. Dental caries and psychosocial factors: Testing a conceptual model in adolescents. Community Dent Oral Epidemiol 2021; 49:314-321. [PMID: 33932046 DOI: 10.1111/cdoe.12653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES A conceptual model was designed to examine interrelations among psychosocial factors, oral health behaviour, and dental caries in a sample of adolescents. METHODS This cross-sectional study design of 531 Greek families included an oral examination and a survey completed by adolescents, and a survey completed by mothers. The outcome measure was dental caries experience. Additionally, dental sealants were recorded. The participants provided information which comprised the Sense of Coherence (SoC) scale and 11 psychosocial and behavioural variables that formed 6 composite variables (life-course experiences, socio-economic status, perceived parental support, perceived parental punishment, preventive measures, sugar intake frequency). The composite variables of preventive measures and sugar intake formed the latent variable of oral health behaviour. The interrelations of the above factors were included in a conceptual model and tested using a Structural Equation Modelling analysis. RESULTS Data fit the proposed conceptual model (χ2 = 23.338, df = 14, P = .055, RMSEA = 0.036). Among psychosocial variables, adolescent's SoC was the best predictor of both dental caries (Standardized Regression Coefficient - Std. RC ± Standard Error (SE) = -0.178 ± 0.04) and oral health behaviour (Std. RC ± SE = -0.378 ± 0.09). All psychosocial factors were associated with SoC (Std. RCs ± SE between -0.162 ± 0.04 and 0.211 ± 0.04) and via SoC with oral health behaviour (Std. RCs ± SE between -0.080 ± 0.03 and 0.061 ± 0.02). CONCLUSIONS A conceptual model was tested that integrated SoC with the psychosocial factors theoretically shaping it and clarified all factors' predictive abilities on dental caries via oral health behaviour.
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Affiliation(s)
- Konstantinos Baxevanos
- Department of Preventive Dentistry, Periodontology, and Implant Biology, Faculty of Health Sciences, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Menexes
- Laboratory of Agronomy, School of Agriculture, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asimina Lazaridou
- Department of Anesthesiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Trilby Coolidge
- Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Vasiliki Topitsoglou
- Department of Preventive Dentistry, Periodontology, and Implant Biology, Faculty of Health Sciences, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotirios Kalfas
- Department of Preventive Dentistry, Periodontology, and Implant Biology, Faculty of Health Sciences, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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22
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Arora A, Lucas D, To M, Chimoriya R, Bhole S, Tadakamadla SK, Crall JJ. How Do Mothers Living in Socially Deprived Communities Perceive Oral Health of Young Children? A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073521. [PMID: 33805307 PMCID: PMC8038038 DOI: 10.3390/ijerph18073521] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/17/2021] [Accepted: 03/25/2021] [Indexed: 01/07/2023]
Abstract
This qualitative study aims to explore and gain an in-depth understanding of the knowledge and perceptions of mothers living in Greater Western Sydney (GWS), one of Australia’s most socio-economically disadvantaged regions, regarding the factors that influence oral health of young children. Mother–child dyads (n = 45) were purposively selected from a population-based cohort study in GWS. Semi-structured in-depth interviews were audio-recorded, transcribed verbatim, and subsequently analyzed using thematic analysis. Five main themes emerged from the interviews: (1) beliefs about child oral health and first set of teeth; (2) awareness and attitudes towards oral health services; (3) identification of caries risk and protective factors; (4) broader cultural and social class influences on childhood oral health practices; and (5) the influence of parental self-confidence, self-efficacy, and perceived control. Overall, mothers reported having limited knowledge and awareness on the importance of baby teeth, child’s first dental visit, and seeking oral health care. Oral health and preventative practices in children were reported to be influenced by past dental experiences, culture and social class, and parental factors. The empirical findings of this study bring our attention to the critical factors that influence child oral health and the opportunities for co-creating child oral health promotion by targeting mothers.
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Affiliation(s)
- Amit Arora
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia;
- Correspondence:
| | - Dimitri Lucas
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia; (D.L.); (M.T.)
| | - Michael To
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia; (D.L.); (M.T.)
| | - Ritesh Chimoriya
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia;
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia; (D.L.); (M.T.)
| | | | - James J. Crall
- Division of Public Health and Community Dentistry, School of Dentistry, University of California Los Angeles, Los Angeles, CA 90095, USA;
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Nagpal R, Gupta A, Marya CM, Mushtaq I, Tandon S. Association of sense of coherence with oral health behaviors and gingival bleeding among adolescents. J Indian Soc Periodontol 2021; 25:150-155. [PMID: 33888948 PMCID: PMC8041081 DOI: 10.4103/jisp.jisp_165_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 11/17/2022] Open
Abstract
Context: Adolescents experience many types of gingival and periodontal diseases, including gingivitis, localized or generalized aggressive periodontitis, and periodontal complications of various systemic diseases. The occurrence of periodontal diseases is not only related to biotic factors but may also be affected by nonbiotic factors such as oral health behaviors and practices. Various factors that influence an individual's health-related behaviors include a psychosocial construct named sense of coherence (SOC). Aim: The aim of this study is to investigate the association of SOC with oral health behaviors and gingival bleeding. Settings and Design: This was a cross-sectional, analytical study that was done in the school setting. Materials and Methods: A random sample of 850 adolescents was selected from nine schools of the Faridabad block of Faridabad district (Haryana) through the multistage cluster sampling technique. Methods of data collection included a combination of questionnaire administration and clinical examination. The questionnaire comprised sociodemographic variables, questions related to oral health behaviors, and Antonovsky's SOC scale. The questionnaire was interviewer administered. Statistical Analysis: Unadjusted and adjusted rate ratios of gingival units having bleeding on probing were estimated by Poisson regression multilevel analysis in Statistical Package for the Social Sciences (SPSS) software for Microsoft Office. Results: Adolescents whose mothers had studied <8 years (relative risk [RR] 1.26; 95% confidence interval [CI] 1.04–1.38), who were males (RR 1.198; 95% CI 1.01–1.29), low SOC (RR 15.93; 95% CI 13.06–19.35), and toothbrushing frequency of less than once a day (RR 1.43; 95% CI 1.21–1.67) and children with plaque index >1 (RR 2.765; 95% CI 2.12–3.25) presented with the higher number of gingival units having bleeding. Conclusion: SOC is associated with gingival bleeding through oral health behaviors.
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Affiliation(s)
- Ruchi Nagpal
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Anil Gupta
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Charu Mohan Marya
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Imran Mushtaq
- Chief Psychologist Child Development Clinic (Centre for Developmental and Behavioral Pediatrics), New Delhi, India
| | - Shourya Tandon
- Department of Public Health Dentistry, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
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Santoso CMA, Bramantoro T, Nguyen MC, Nagy A. Lifestyle and psychosocial correlates of oral hygiene practice among Indonesian adolescents. Eur J Oral Sci 2021; 129:e12755. [PMID: 33501697 DOI: 10.1111/eos.12755] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 11/04/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022]
Abstract
Poor oral hygiene leads to poor oral health, which in turn has negative impacts on overall health and quality of life. This study aimed to evaluate the prevalence and associated factors of oral hygiene practice among school-going adolescents in Indonesia. Secondary analysis of cross-sectional, nationally representative data from the 2015 Indonesia Global School-based Health Survey, covering 11,142 students aged 11-18 years, was performed. Multiple logistic regression was employed to explore associations between lifestyle, psychosocial factors, and tooth-brushing frequency. Around 10.8% of the students brushed their teeth less frequently than the recommended twice-daily regimen. Male gender, lower socio-economic status, poor dietary practice, longer sedentary time, drug use, psychological distress, less peer support, and no parental support were associated with infrequent tooth brushing. The findings support the need to integrate oral health promotion into general health actions that target families, schools, and social environments of adolescents to develop healthier habits.
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Affiliation(s)
| | - Taufan Bramantoro
- Department of Dental Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Minh Chau Nguyen
- Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Attila Nagy
- Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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Lu TY, Chen JH, Du JK, Lin YC, Ho PS, Lee CH, Hu CY, Huang HL. Dysphagia and masticatory performance as a mediator of the xerostomia to quality of life relation in the older population. BMC Geriatr 2020; 20:521. [PMID: 33267812 PMCID: PMC7709251 DOI: 10.1186/s12877-020-01901-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/12/2020] [Indexed: 02/07/2023] Open
Abstract
Background The impact of poor oral health on older adults’ quality of life is a public health problem. In this study, the mediating effects of dental status, occlusal condition, dysphagia, and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) were assessed in the older adult population. Methods Stratified cluster sampling was used to recruit 1076 community-dwelling adults aged 65 years and older from Kaohsiung, Taiwan. Community care centers were randomly selected according to their geographic classifications (urban, rural, or mountainous areas). Assessments of dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia, dysphagia and depression was collected through face-to-face interviews. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using the Geriatric Oral Health Assessment Index. Hierarchical regression models were used to assess the relationships between OHRQoL and physical function, dental status and oral function in older adults. Path analysis was used to estimate direct and indirect pathways between xerostomia and OHRQoL. Results Participants with xerostomia exhibited a 0.20 OHRQoL reduction (p < .001) compared with patients with no xerostomia, and the direct effect accounted for 83.3% of the total effect. Dysphagia and masticatory performance were found to exert significant mediating effects on the association between xerostomia and OHRQoL (βs = 0.20 and − 0.12, respectively; both p < .001; βs = 0.06 and − 0.09, respectively; both p < .05). Moreover, potential mediating effects of the number of functional teeth (βs = − 0.11 and − 0.43, respectively; both p < .001) and occlusal condition (βs = 0.09 and 0.13, respectively; both p < .05) on the relationship between xerostomia and masticatory performance were noted. Conclusions Dysphagia and masticatory performance may serve as pathways through which xerostomia affects quality of life. Early oral function intervention may be a valuable and actionable target for older adults to maintain quality of life. Our results further suggest that checkup and screening for oral dysfunction are essential to prevent or delay the onset of complications.
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Affiliation(s)
- Ting-Yu Lu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City, 807, Taiwan.,Department of Oral Hygiene, Hsin Sheng Junior College of Medical Care and Management, Taoyuan City, Taiwan
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Je-Kang Du
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Ying-Chun Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City, 807, Taiwan
| | - Pei-Shan Ho
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City, 807, Taiwan.,Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chien-Hung Lee
- Department of Public Health, College of Health Sciences and Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chih-Yang Hu
- School of Public Health, Health Sciences Center, Louisiana State University, New Orleans, LA, USA
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City, 807, Taiwan.
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26
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van der Zande MM, Exley C, Wilson SA, Harris RV. Disentangling a web of causation: An ethnographic study of interlinked patient barriers to planned dental visiting, and strategies to overcome them. Community Dent Oral Epidemiol 2020; 49:144-157. [PMID: 33104275 DOI: 10.1111/cdoe.12586] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/07/2020] [Accepted: 10/04/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To explore barriers to planned dental visiting, investigating how barriers interlink, how they accumulate and change, and how individuals envisage overcoming their combination of barriers through personal strategies. METHODS An ethnographic study was conducted of adult urgent dental care attenders who did not have a dentist, including 155 hours of nonparticipant observations, 97 interviews and 19 follow-up interviews in six urgent dental care settings. Data were analysed using constant comparison, first identifying barriers and personal strategies to overcome them, and subsequently analysing interlinks between barriers and personal strategies. RESULTS Accounts of barriers to planned dental visiting encompassed multiple barriers, which related to socioeconomic circumstances as well as experiences of oral health care. Barriers were multi-layered and more difficult to overcome when occurring together. Personal strategies to overcome diverse barriers often hinged on increasing importance of oral health to individuals, yet this was not always sufficient. The combination of barriers participants experience was dynamic, changing due to personal, family, or employment circumstances, and with increasing severity of barriers over time. Over time, this could lead to higher cost, and additional barriers, particularly embarrassment. CONCLUSION Barriers to planned dental visiting are complex, multi-layered and change over time, constituting a 'web of causation'. This adds a novel perspective to the literature on barriers to dental visiting, and requires that researchers, dental practitioners and policy makers remain open to barriers' interlinked effects, changes in primacy among individual patients' barriers, and their accumulation over time to better support uptake of planned dental visiting.
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Affiliation(s)
- Marieke M van der Zande
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Catherine Exley
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Samantha A Wilson
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Rebecca V Harris
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
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Number of Remaining Teeth and Its Association with Educational Level in Chilean Adults: Data from the National Health Survey 2016-2017. Int J Dent 2020; 2020:8848190. [PMID: 32934655 PMCID: PMC7479467 DOI: 10.1155/2020/8848190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/09/2020] [Accepted: 08/23/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Several population studies have addressed oral health inequalities. Edentulism, functional dentition, and number of remaining teeth have been associated with different socioeconomic level measurements. The aim of this study was to evaluate the association between educational level and tooth loss in the Chilean population aged 15 years and above, based on the 2016-2017 National Health Survey (ENS 2016-2017). Material and Methods. The sample for this cross-sectional study comprised 5473 subjects. The main independent variable was educational level (LEL: low, MEL: medium, and HEL: high). To measure tooth loss, we considered the variables number of remaining teeth, edentulism, and functional dentition. We used logistic regressions to assess the condition of dentition according to the subject's EL. As to the number of teeth variable, linear regressions were conducted. The analyses were carried out considering the complex sampling design in SPSS 24.0. Results When comparing LEL subjects with HEL subjects, the adjusted difference in number of remaining teeth was 3.11 for the maxilla and 1.72 for the mandible. An individual with LEL had a 7.51 [3.50-16.10] and 6.06 [2.68-13.68] times higher risk of upper edentulism and lower edentulism than a HEL individual, respectively. Regarding functional dentition, the adjusted OR in HEL subjects was 13.33 [8.02-22.15] and in MEL subjects was 2.81 [2.03-3.87], compared to LEL results. Conclusions LEL was associated with a significant tooth loss in the Chilean population. Subjects with LEL obtained a lower mean of number of remaining teeth and higher prevalence of edentulism and nonfunctional dentition.
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Lang AY, Carpenter LM, de Silva AM, Kearney SL, Hegde S. Health promotion competencies for promoting child-oral health: Victorian multidisciplinary workforce perspectives. Health Promot J Austr 2020; 32 Suppl 2:126-138. [PMID: 32926487 DOI: 10.1002/hpja.418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/04/2020] [Indexed: 11/05/2022] Open
Abstract
ISSUE ADDRESSED Population oral health (OH) improvements depend on successful, coordinated execution of oral health promotion (OHP) programs by both oral and general health professionals with key competencies (skills, abilities, knowledge and values). This study explored multidisciplinary professionals' perspectives of the competencies required for the successful implementation of a community-based OHP program called Smiles 4 Miles (S4M) in early childhood settings in Victoria, Australia. METHODS Convenience sampling was used to recruit multidisciplinary professionals working in the S4M early childhood health promotion program in Victoria. Semi-structured focus groups were conducted with program managers/coordinators (n = 26) from 21 S4M sites and the state-wide program coordination team (n = 5). Focus groups explored OHP competency needs, capacity to promote child OH and strategies for enhancing OHP competencies. The competencies identified through focus groups were then compared to the International Union for Health Promotion and Education (IUHPE) competencies framework. RESULTS Strategies to enhance individual and organisational OHP competencies included intersectoral collaborations; working in multidisciplinary teams; support networks and partnerships; sharing skills and expertise between health professionals. The OHP competencies identified by the participants were consistent with key IUHPE domains including ethical values and health promotion knowledge base underpinning, enabling change, advocacy for health, mediating through partnerships, communication, leadership, assessment, planning, implementation, evaluation and research. CONCLUSION A multidisciplinary workforce based in community settings can play key and complementary roles in OHP and widen avenues for oral disease prevention. SO WHAT?: Integrated collaborative workforce models involving multidisciplinary professionals beyond the OH sector can more effectively support efforts to address the burden of oral disease.
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Affiliation(s)
- Adina Y Lang
- Dental Health Services Victoria, Carlton, VIC, Australia
| | | | | | | | - Shalika Hegde
- Dental Health Services Victoria, Carlton, VIC, Australia
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Structural equation modelling of the complex relationship between toothache and its associated factors among Indonesian children. Sci Rep 2020; 10:13567. [PMID: 32782302 PMCID: PMC7419561 DOI: 10.1038/s41598-020-70104-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/23/2020] [Indexed: 12/22/2022] Open
Abstract
The Indonesian family life survey (IFLS) is used for formulating various government policies. Our preliminary study using data from the IFLS showed increase in the prevalence of toothache from 2007 to 2014. Hence, a need to analyse the factors associated with toothache using structural equation modelling (SEM) for identifying the direct and indirect association of factors with toothache was evident. The objective of this study is to analyse the complex relationships between toothache and its associated risk factors. This cross-sectional study was conducted on the data obtained from the IFLS in 2014. The IFLS data pertaining to toothache and its prevalence were analysed using the STATA software, and the multifaceted relationship was analysed using SEM. The prevalence of toothache among Indonesian children was 15.55% (1,959 of 12,595). SEM showed the direct association between toothache and age (p < 0.001) and parent awareness of children's health conditions (p < 0.005) and food consumption frequency (p < 0.001). Parents’ education level and residential area showed an indirect association with toothache, mediated by socio-economic status and parent awareness of children's health conditions (p < 0.001). We identified the multifaceted relationship between toothache and the social covariates. Parents’ awareness of their children’s health conditions mediated several indirect associations, highlighting its importance.
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Azevedo MBD, Pinto RDS, Abreu MHNGD, Lucas SD. Factors associated with the needs of specialised dental treatment among adults aged 35-44 years old in the state of Minas Gerais, Brazil: a multilevel cross-sectional study. CIENCIA & SAUDE COLETIVA 2020; 25:2783-2792. [PMID: 32667559 DOI: 10.1590/1413-81232020257.29852018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 12/03/2018] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the individual and contextual factors associated with the specialised dental treatment needs of a population of adults aged 35 to 44 years old in the state of Minas Gerais. The individual variables were obtained from the database of the SB Minas Gerais project - a survey of oral health status of the population of Minas Gerais, Brazil. The variables at the municipal level were derived from any available public databases related to oral health services. A multilevel analysis was performed to evaluate the association of independent individuals and contextual variables with or without dental treatment needs in the secondary care of the oral health network. Individuals with a higher income (OR 0.53; CI95% 0.31-0.93) and with greater access to oral health care (OR 0.94; CI95% 0.90-0.99) had less secondary care treatment needs. Income and access to oral health care are related to the needs of specialised dental treatment in Minas Gerais.
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Affiliation(s)
- Mônica Baltazar de Azevedo
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Rafaela da Silveira Pinto
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Mauro Henrique Nogueira Guimarães de Abreu
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Simone Dutra Lucas
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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Mohammadpour M, Bastani P, Brennan D, Ghanbarzadegan A, Bahmaei J. Oral health policymaking challenges in Iran: a qualitative approach. BMC Oral Health 2020; 20:158. [PMID: 32487152 PMCID: PMC7268740 DOI: 10.1186/s12903-020-01148-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 05/24/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND As the strategies proposed for oral health improvement in developed countries are not adapted for developing ones, this study aimed to identify the challenges of oral health policy implementation in Iran as a low-income developing country. METHODS This qualitative study was conducted in 2019 in Iran as a middle-eastern developing country. The study population consisted of experts who had experience in oral health and were willing to participate in the study. Snowball sampling was used to select 12 participants for semi-structured interviews and saturation was achieved after 16 interviews. Guba and Lincoln criteria including credibility, transferability, confirmability and dependability were used to determine reliability and transparency, and finally a five-step framework analysis method was used to analyze the data. RESULTS The analysis of the interviews resulted in identification of 7 main themes that were categorized into 5 problems of policy implementation as proposed by the Matus framework. The main themes of executive and preventive challenges to implement oral health policies were categorized as organizational problems, the main themes of educational and resource challenges were situated as material problems, and the main themes of insurance, policy making and trusteeship challenges were considered as legal, policymaking and perspective. CONCLUSION The implementation of oral health policies has faced some challenges. It seems that the national coverage of oral health and integration of these services in prevention and serious attention to the private sector can be considered as the most important strategies for achieving improved oral health in Iran.
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Affiliation(s)
- Mohammadtaghi Mohammadpour
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- grid.412571.40000 0000 8819 4698Health Human Recourses Research Center, School of Health Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - David Brennan
- grid.1010.00000 0004 1936 7304Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide, Adelaide, South Australia Australia
| | - Arash Ghanbarzadegan
- grid.1010.00000 0004 1936 7304Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide, Adelaide, South Australia Australia
| | - Jamshid Bahmaei
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Urwannachotima N, Hanvoravongchai P, Ansah JP, Prasertsom P, Koh VRY. Impact of sugar-sweetened beverage tax on dental caries: a simulation analysis. BMC Oral Health 2020; 20:76. [PMID: 32183817 PMCID: PMC7079374 DOI: 10.1186/s12903-020-1061-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 03/03/2020] [Indexed: 12/20/2022] Open
Abstract
Background The tiered sugar-sweetened beverage (SSB) tax was implemented in Thailand to encourage industries to reduce sugar content in beverages, and consequently reduce sugar consumption in the population. The aim of the study is to explore the expected impact of the new SSB tax policy in Thailand, a middle-income country in Asia, and other alternative policies on oral health outcomes as measured by the prevalence and severity of dental caries among the Thai population. Methods A qualitative system dynamics model that captures the complex interrelationships among SSB tax, sugar consumption and dental caries, was elicited through participatory stakeholder engagement. Based on the qualitative model, a quantitative system dynamics model was developed to simulate the SSB tax policy and other alternative scenarios in order to evaluate their impact on dental caries among Thai adults from 2010 to 2040. Results Under the base-case scenario, the dental caries prevalence among the Thai population 15 years and older, is projected to increase from 61.3% in 2010 to 74.9% by 2040. Implementation of SSB tax policy is expected to decrease the prevalence of dental caries by only 1% by 2040, whereas the aggressive policy is projected to decrease prevalence of dental caries by 21% by 2040. Conclusions In countries where a majority of the sugar consumed is from non-tax sugary food and beverages, especially Asian countries where street food culture is ubiquitous and contributes disproportionately to sugar intake, SSB tax alone is unlikely to have meaningful impact on oral health unless it is accompanied with a comprehensive public health policy that aims to reduce total sugar intake from non-SSB sources.
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Affiliation(s)
- Nipaporn Urwannachotima
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand. .,Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Piya Hanvoravongchai
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - John Pastor Ansah
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Piyada Prasertsom
- Bureau of Dental Health, Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Victoria Rui Ying Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Lower Kent Ridge Road, Singapore, Singapore
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Laniado N, Badner VM, Sanders AE, Singer RH, Finlayson TL, Hua S, Kaste LM, Isasi CR. Social capital and periodontal disease in Hispanic/Latino adults in the United States: Results from the Hispanic Community Health Study/Study of Latinos. J Clin Periodontol 2020; 47:542-551. [PMID: 31998991 DOI: 10.1111/jcpe.13262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/18/2019] [Accepted: 01/26/2020] [Indexed: 11/26/2022]
Abstract
AIMS To examine the association of social capital with periodontal disease severity. MATERIALS AND METHODS We analysed data obtained from 3,994 men and women aged 18-74 years in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (HCHS/SOL SCAS). From 2008 to 2011, dentists assessed periodontitis status with a full-mouth periodontal examination. Periodontitis was classified using standardized case definitions. Multivariable logistic regression estimated odds of moderate-severe periodontitis associated with two measures of social capital: structural support (Social Network Index) and functional support (Interpersonal Support Evaluation List). RESULTS For US-born participants, for each additional person in their social network, the adjusted odds of moderate-severe periodontitis was reduced 17% (OR = 0.83, 95% CI = 0.71, 0.96). However, no association was found between functional support and periodontal disease severity. CONCLUSIONS Greater structural social support was associated with a lower prevalence of moderate-severe periodontitis in US-born Hispanics/Latinos. These findings suggest that US-born Hispanics/Latinos with less social support represent a vulnerable segment of the population at high-risk group for periodontal disease.
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Affiliation(s)
- Nadia Laniado
- Department of Dentistry, Albert Einstein College of Medicine, Bronx, New York.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Victor M Badner
- Department of Dentistry, Jacobi Medical Center/North Central Bronx Hospital, Bronx, New York
| | - Anne E Sanders
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Richard H Singer
- Department of Orthodontics, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida
| | - Tracy L Finlayson
- Division of Health Management and Policy, School of Public Health, San Diego State University, San Diego, California
| | - Simin Hua
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Linda M Kaste
- College of Dentistry and School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
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Sadhu V, Anjum MDS, Divya V, Tenali V, Sravya T, Jyothi M. Do social support and social network influence dental caries in 12–14-year-old schoolchildren of Hyderabad City? – A cross-sectional study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2020. [DOI: 10.4103/jiaphd.jiaphd_11_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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System dynamics analysis of dental caries status among Thai adults and elderly. JOURNAL OF HEALTH RESEARCH 2019. [DOI: 10.1108/jhr-05-2019-0097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Purpose
The purpose of this paper is to estimate the changes of dental caries status among Thai adults and elderly under the different policy options using system dynamics modeling.
Design/methodology/approach
A multi-sector system dynamics model was developed to capture the dynamic interrelationship between dental caries status changes and oral health behavior – including self-care, dental care utilization and sugar consumption. Data used to populate the model was obtained from the Thai national oral health survey in 2000, 2006, 2012 and Thailand Official Statistics Registration. Three policy scenarios were experimented in the model: health promotion policy, dental personnel policy and affordable dental care service policy.
Findings
Dental caries experiences among Thai adults and elderly were projected to increase from now to 2040, as the elderly population increases. Among all policies experimented herein, the combined policies of health promotion, increased affordability and capacity of dental health service were found to produce the highest improvement in dental caries status with 3.7 percent reduction of population with high decayed, missing and filled teeth (DMFT) and 5.2 percent increase in population with very low DMFT.
Originality/value
This study is the first comprehensive simulation model that attempts to explore the dynamic interrelationship among dental caries experiences and behavioral factors that impact on oral health outcomes. In addition, the simulation model herein offers a framework for policy experimentation that provides policymakers with additional insights to inform health policy planning.
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Strauss FJ, Espinoza I, Stähli A, Baeza M, Cortés R, Morales A, Gamonal J. Dental caries is associated with severe periodontitis in Chilean adults: a cross-sectional study. BMC Oral Health 2019; 19:278. [PMID: 31823773 PMCID: PMC6905015 DOI: 10.1186/s12903-019-0975-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/26/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The co-occurrence of caries and periodontitis and a possible association is still a matter of debate. Thus, the aim of the study was to determine the co-occurrence of caries and periodontitis in Chilean adults. METHODS Evaluation of periodontal and dental status in 994 adults (35-44 years old) based on the First Chilean National Examination Survey 2007-2008. The prevalence of caries was defined as the percentage of participants with one or more teeth with untreated caries by using the D component of the DMFT index (DT ≠ 0). The prevalence of periodontitis was determined using standard case definitions for population-based surveillance of periodontitis described by the CDC-AAP. RESULTS Individuals with caries had an approximately 40% higher prevalence of severe (29.3% vs 20.8%, p < 0.05) and a 13% higher prevalence of total periodontitis (89.3% vs 78.4%, p < 0.05) than those without caries. Ordinal logistic regression revealed a positive association between periodontitis and the number of teeth with caries (DT ≠ 0; 3 or 4 teeth with caries: OR 1.74; CI = 1.12-2.29 p < 0.05; 5 or more teeth with caries: OR 2.47; CI = 1.66-3.67 p < 0.01). CONCLUSION Dental caries is associated with the severity and prevalence of periodontitis in Chilean adults. Individuals with 3 or more teeth with untreated caries are more likely to suffer from periodontal disease.
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Affiliation(s)
- Franz-Josef Strauss
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Olivos 943, Comuna de Independencia, Santiago, Chile. .,Department of Oral Biology, Medical University of Vienna, Vienna, Austria.
| | - Iris Espinoza
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Santiago, Chile
| | - Alexandra Stähli
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria.,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mauricio Baeza
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Olivos 943, Comuna de Independencia, Santiago, Chile.,Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Santiago, Chile
| | - Ricardo Cortés
- Department of Prosthetic Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Alicia Morales
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Olivos 943, Comuna de Independencia, Santiago, Chile.,Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Santiago, Chile
| | - Jorge Gamonal
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Olivos 943, Comuna de Independencia, Santiago, Chile. .,Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Santiago, Chile.
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Dutra LDC, de Lima LCM, Neves ÉTB, Gomes MC, de Araújo LJS, Forte FDS, Paiva SM, Ferreira FM, Granville-Garcia AF. Adolescents with worse levels of oral health literacy have more cavitated carious lesions. PLoS One 2019; 14:e0225176. [PMID: 31774850 PMCID: PMC6880994 DOI: 10.1371/journal.pone.0225176] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/30/2019] [Indexed: 11/25/2022] Open
Abstract
The aim of the present study was to investigate whether the ability to recognize and read oral health terms is associated with the number of teeth with cavitated carious lesions in adolescents. A population-based cross-sectional study was conducted involving a sample of 746 adolescents representative of students aged 15 to 19 years at the public and private school systems in a city in northeast Brazil. Two examiners who had undergone a training and calibration exercise (inter-examiner and intra-examiner Kappa coefficient: 0.87 to 0.93) performed the diagnosis of caries using the Nyvad Index and evaluated the level of OHL (BREALD-30) of the adolescents. The participants answered questions regarding their history of visits to the dentist and the parents/caregivers answered a questionnaire addressing socioeconomic characteristics. A directed acyclic graph was created to direct the selection of covariables for adjustments in the Poisson multiple regression analysis to test the association between dental caries and OHL (α = 5%). Cavitated carious lesions (codes 3 to 6 on the Nyvad index) were found in 41.6% of the adolescents. Only 29.4% had a high level of OHL (BREALD-30 scores between 23 and 30); 42.3% of the families belonged to the A-B social class and 93% of the adolescents had been to the dentist at least once in their lifetimes. In the multivariate analysis, adolescents with inadequate (PR: 1.69; 95% CI: 1.18–2.41; p = 0.004) and marginal (PR; 1.42; 95% CI: 1.01–1.99; p = 0.042) OHL and those in the lower social classes (C-D-E) (PR: 1.85; 95% CI: 1.39–2.47; p<0.001) had more teeth with cavitated carious lesions. In conclusion, adolescents aged 15 to 19 years with poorer levels of OHL had a larger number of teeth with cavitated carious lesions, independently of their socioeconomic status and history of visiting a dentist.
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Affiliation(s)
- Laio da Costa Dutra
- Graduate Program in Dentistry, State University of Paraiba (UEPB), Campina Grande, Paraiba, Brazil
| | | | | | - Monalisa Cesarino Gomes
- Graduate Program in Dentistry, State University of Paraiba (UEPB), Campina Grande, Paraiba, Brazil
| | | | | | - Saul Martins Paiva
- Graduate Program in Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Morais Ferreira
- Graduate Program in Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Amornsuradech S, Vejvithee W. Socioeconomic inequality and dental caries among Thai working age population. JOURNAL OF HEALTH RESEARCH 2019. [DOI: 10.1108/jhr-03-2019-0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The purpose of this paper is to determine the relationship between socioeconomic status (SES) and oral health among Thai adults.
Design/methodology/approach
This study is a cross-sectional analytical study using secondary data from the 7th Thailand National Oral Health Survey (2012). Age group 35–44 years old samples were used to represent the working age population. Oral health outcome was determined by untreated dental caries. SES was indicated by income, education and occupational groups. Demographic background, oral health-related behavior and access to dental service were adjusted for analysis. Binary logistic regression analysis was performed to determine the relationship between independent variables and oral health outcome.
Findings
People with lower education showed a higher odds ratio for having untreated dental caries before and after controlling for related variables. Those living in the north and northeast, using additional cleaning tools and going to the public provider for dental service also showed better oral health.
Research limitations/implications
The limitation of this study is that the cross-sectional study cannot indicate casual relationships. The national oral health survey was not designed to find relationships between factors. The access to data and measurement of SES was limited. The policy maker should emphasize on people with lower education which have a higher risk for dental caries to improve oral health in disadvantaged groups. Future research should include all related factors in the study including diet and knowledge about oral health. Moreover, oral health outcome is a long-term effect which accumulated through a lifetime. The social class might change over time and so do behaviors.
Originality/value
There is socioeconomic inequality in dental caries of Thai working age population.
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Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, Listl S, Celeste RK, Guarnizo-Herreño CC, Kearns C, Benzian H, Allison P, Watt RG. Oral diseases: a global public health challenge. Lancet 2019; 394:249-260. [PMID: 31327369 DOI: 10.1016/s0140-6736(19)31146-8] [Citation(s) in RCA: 1515] [Impact Index Per Article: 303.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/12/2019] [Accepted: 04/26/2019] [Indexed: 02/08/2023]
Abstract
Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, greatly reducing quality of life for those affected. The most prevalent and consequential oral diseases globally are dental caries (tooth decay), periodontal disease, tooth loss, and cancers of the lips and oral cavity. In this first of two papers in a Series on oral health, we describe the scope of the global oral disease epidemic, its origins in terms of social and commercial determinants, and its costs in terms of population wellbeing and societal impact. Although oral diseases are largely preventable, they persist with high prevalence, reflecting widespread social and economic inequalities and inadequate funding for prevention and treatment, particularly in low-income and middle-income countries (LMICs). As with most non-communicable diseases (NCDs), oral conditions are chronic and strongly socially patterned. Children living in poverty, socially marginalised groups, and older people are the most affected by oral diseases, and have poor access to dental care. In many LMICs, oral diseases remain largely untreated because the treatment costs exceed available resources. The personal consequences of chronic untreated oral diseases are often severe and can include unremitting pain, sepsis, reduced quality of life, lost school days, disruption to family life, and decreased work productivity. The costs of treating oral diseases impose large economic burdens to families and health-care systems. Oral diseases are undoubtedly a global public health problem, with particular concern over their rising prevalence in many LMICs linked to wider social, economic, and commercial changes. By describing the extent and consequences of oral diseases, their social and commercial determinants, and their ongoing neglect in global health policy, we aim to highlight the urgent need to address oral diseases among other NCDs as a global health priority.
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Affiliation(s)
- Marco A Peres
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
| | - Lorna M D Macpherson
- Department of Dental Public Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Robert J Weyant
- Department of Dental Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Blánaid Daly
- Division of Child and Public Dental Health, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Renato Venturelli
- WHO Collaborating Centre in Oral Health Inequalities and Public Health, Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Stefan Listl
- Quality and Safety of Oral Healthcare, Department of Dentistry, Radboud University Medical Center, Radboud University, Nijmegen, Netherlands; Section for Translational Health Economics, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Cristin Kearns
- Department of Preventive and Restorative Dental Sciences and Philip R Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Habib Benzian
- WHO Collaborating Centre for Quality-Improvement, Evidence-Based Dentistry, Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA; New York University College of Global Public Health, New York, NY, USA
| | - Paul Allison
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Richard G Watt
- WHO Collaborating Centre in Oral Health Inequalities and Public Health, Department of Epidemiology and Public Health, University College London, London, UK.
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Stormon N, Ford PJ, Lalloo R. Community-level predictors of Australian children's dental caries and injury. Aust Dent J 2019; 64:263-272. [PMID: 31264710 DOI: 10.1111/adj.12706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Social determinants of oral health are complex and have been described by conceptual frameworks. A widely embraced model of children's oral health was published by Fisher-Owens et al. (2007), identifying theoretical constructs influencing oral health. The current study aimed to investigate community-level constructs described in the conceptual model. METHODS The Longitudinal Study of Australian Children is a cross-sequential dual cohort study, with a representative sample (n = 10090) of Australian children. Generalized estimating equations were applied to model seven waves of carer-reported oral health and community measures. RESULTS In the final model, children living in Queensland had a 1.48 (CI 1.35-1.62) increased odds of dental caries over time. Children in low socio-economic status (SES) areas (OR 1.32 CI 1.20-1.44) had an increased odds of caries. The state of Queensland (OR 1.24 CI 1.05-1.46) and poor neighbourhood liveability (OR 1.17 CI 1.05-1.31) were predictors of dental injury. CONCLUSION By modelling available community measures, this study found SES and rurality were predictors of caries over childhood. Our results highlight the difficulty of applying conceptual models to oral health. The use of qualitative studies and realist reviews should be considered to complement statistical models to provide contextualized insights into funding, policy and service delivery on children's oral health.
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Affiliation(s)
- N Stormon
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - P J Ford
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - R Lalloo
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
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Qin Y, Zhang R, Yuan B, Xu T, Chen H, Yang Y, Hu T. Structural equation modelling for associated factors with dental caries among 3-5-year-old children: a cross-sectional study. BMC Oral Health 2019; 19:102. [PMID: 31170956 PMCID: PMC6554934 DOI: 10.1186/s12903-019-0787-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 05/15/2019] [Indexed: 02/05/2023] Open
Abstract
Background The aim of the current study was to explore the factors influencing dental caries among 3–5-year-old children in Sichuan Province and the interrelationship between these factors using structural equation modelling (SEM). Methods A cross-sectional study was conducted among 2746 3–5-year-old children in Sichuan Province. Examination of caries was conducted on all children and a questionnaire was answered by the children’s caregiver. SEM alternative models were constructed to interpret the intricate relationships between socio-economic status (SES), caregiver’s oral health knowledge, attitudes, children’s oral health behaviours and children’s dental caries. Result The results showed that dental caries were significantly associated with dietary behaviours (β = 0.11, SE = 0.03, P = 0.001, BC 95% CI =0.05/0.18) and SES (β = − 0.17, SE = 0.03, P<0.001, BC 95% CI = -0.23/− 0.10) directly, While the indirect effect of SES on dmft is in an opposite direction (β = 0.08, SE = 0.02, BC 95% CI = 0.04/0.12). Conclusion We found that unhealthy dietary behaviours increased the prevalence of dental caries. However, oral health knowledge and attitude failed to affect dietary behaviour in this model. This result warns that oral health education should strengthen feeding-related knowledge. Meanwhile, it also reminds that it is easier known than done. Future oral health education should focus on exploring a more effective way for the public to turn knowledge into action.
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Affiliation(s)
- Yuandong Qin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Rui Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Bo Yuan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Ting Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Hong Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Yingming Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min South Road, Chengdu, Sichuan, 610041, People's Republic of China.
| | - Tao Hu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min South Road, Chengdu, Sichuan, 610041, People's Republic of China.
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Patcas R, Daum MM, van Waes HJM, Beltrani S, Pfister LT, Landolt MA. Emotions experienced during the shedding of the first primary tooth. Int J Paediatr Dent 2019; 29:22-28. [PMID: 30218480 DOI: 10.1111/ipd.12427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/21/2018] [Accepted: 08/25/2018] [Indexed: 11/29/2022]
Abstract
AIM To examine the different emotions expressed by children exfoliating their first primary tooth, evaluate their proportional distribution, and reveal possible influences of child- and parent-related variables on the reported emotions. DESIGN A cross-sectional questionnaire was directed to parents of children who had recently shed at least one primary tooth. Primary outcome variables were the child's emotions at the time of exfoliation. Child-related determinants were sex, duration of tooth wiggle, previous accident- or caries-related visits at dentist, and having witnessed tooth exfoliation in older siblings. Parent-related determinants included socio-economic variables (education, religion, country of origin). RESULTS One thousand two hundred and seventy-four of 3617 questionnaires were returned and analysed (35.2%). 82.0% of the parents reported positive, and 22.0% negative emotions in their child. Previous caries-related visits at the dentist diminished the likelihood of positive emotions (OR = 0.65), and accident-related visits increased the odds of positive emotions (OR = 1.57), as did an extended duration of tooth wiggle (OR = 1.98). Higher education of mothers (OR = 2.89) and fathers (OR = 1.96) and an origin from non-Western countries (OR = 2.56 and OR = 1.85, respectively) were also related to positive emotions. CONCLUSIONS For most children, losing the first primary tooth is associated with positive emotions. Dental visits and parental factors influence these emotions. Parents and dentists should be aware of their impact on children's emotional development.
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Affiliation(s)
- Raphael Patcas
- Clinic for Orthodontics and Pediatric Dentistry, Centre for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Moritz M Daum
- Division of Developmental Psychology: Infancy and Childhood, Department of Psychology, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Hubertus J M van Waes
- Clinic for Orthodontics and Pediatric Dentistry, Centre for Dental Medicine, University of Zurich, Zurich, Switzerland.,Public School Dental Services of the City of Zurich, Zurich, Switzerland
| | - Selina Beltrani
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Lara T Pfister
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Markus A Landolt
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
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VanWormer JJ, Tambe SR, Acharya A. Oral Health Literacy and Outcomes in Rural Wisconsin Adults. J Rural Health 2018; 35:12-21. [DOI: 10.1111/jrh.12337] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/24/2018] [Accepted: 10/30/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Jeffrey J. VanWormer
- Center for Oral and Systemic Health; Marshfield Clinic Research Institute; Marshfield Wisconsin
| | - Sailee R. Tambe
- School of Public Health; University of Minnesota; Minneapolis Minnesota
| | - Amit Acharya
- Center for Oral and Systemic Health; Marshfield Clinic Research Institute; Marshfield Wisconsin
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Tomazoni F, Vettore MV, Mendes FM, Ardenghi TM. The Association between Sense of Coherence and Dental Caries in Low Social Status Schoolchildren. Caries Res 2018; 53:314-321. [PMID: 30359970 DOI: 10.1159/000493537] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/27/2018] [Indexed: 11/19/2022] Open
Abstract
The relationship between dental caries and sense of coherence (SOC) has not been substantiated in children and adolescents, particularly among those with a low socioeconomic status. The aim of this study was to investigate the association between SOC and dental caries in schoolchildren from a low socioeconomic background. A random sample of 356 8- to 14-year-old schoolchildren enrolled in public schools from the poorest region of Santa Maria, a southern city in Brazil, was selected. Dental examinations were performed to assess dental plaque and dental caries (DMF-S and dmf-s indexes). The children's SOC was assessed using a validated Brazilian version of the SOC-13 scale. Socioeconomic, demographic, and behavioral data were collected from parents using a questionnaire. Multilevel Poisson regression analysis was used following a hierarchical approach to investigate the association between the SOC and DMF-T + dmf-t mean. Children whose mothers had studied for 8 years or less (RR 1.30; 95% CI 1.08-1.57) and children with dental plaque (RR 1.29; 95% CI 1.06-1.58) presented with higher DMF-T scores than their counterparts (p < 0.05). A higher household income (RR 0.66; 95% CI 0.51-0.84) and greater SOC scores (RR 0.71, 95% CI 0.56-0.90) were associated with lower DMF-T in children (p < 0.05). Children's SOC seems to be a relevant protective psychosocial factor for dental caries experience in socially vulnerable children.
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Affiliation(s)
- Fernanda Tomazoni
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Mario Vianna Vettore
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom
| | - Fausto Medeiros Mendes
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Federal University of São Paulo, São Paulo, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil,
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Masood M, Mnatzaganian G, Baker SR. Inequalities in dental caries in children within the UK: Have there been changes over time? Community Dent Oral Epidemiol 2018; 47:71-77. [PMID: 30298932 DOI: 10.1111/cdoe.12426] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 08/20/2018] [Accepted: 09/09/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine any change over time in the association between deprivation and caries experience between 2003 and 2013 in a nationally representative sample of UK children. METHODS Data from UK Children's Dental Health Surveys, 2003 and 2013, were used. The target population was 5-, 8-, 12- and 15-year-olds. A total of 9604 children in 2003 and 9866 in 2013 were included in the surveys. Outcome variables were any active caries, caries experience and total number of carious teeth. Family socio-economic position (SEP) or deprivation level was measured at school level using eligibility for free school meals (FSM) to identify children from low-income families. Incidence rate ratios (IRR) and pooled standardized incidence rates ratios were calculated to measure dichotomous outcome variables by year, age group and status of deprivation. The study continuous outcome was modelled using a zero-inflated Poisson regression while the dichotomous outcomes were modelled using logistic regressions. The multivariable analyses were run by age groups accounting for year, sex and deprivation status. RESULTS The percentage of those identified as deprived was significantly higher in 2013 (35.8% in 2013 vs 26.0% in 2003, P < 0.001). Among both deprived and non-deprived children, the prevalence of any active caries significantly dropped over the years, observed in all age groups. Comparing 2013 with 2003 and accounting for sex, deprivation level, "any active caries," "any caries experience" and "total number of carious teeth" significantly dropped were observed in all age groups. Comparing the years, the association of deprivation with caries outcomes mostly remained the same or decreased. This decrease was predominantly seen in "any caries experience." Only among the 5-year-olds, did the association between deprivation and total number of carious teeth over the years significantly increase. For all age groups, the likelihood of "any active caries" and "total number of carious teeth" by deprivation remained the same comparing the two points in time: 2003 and 2013. However, irrespective of year, deprivation was significantly associated with caries observed in all age groups. CONCLUSION In the UK, the prevalence of active dental caries and caries experience has decreased in the period between 2003 and 2013. Similarly, the likelihood of having dental caries by deprivation in 2013 was predominantly lower than that observed in 2003.
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Affiliation(s)
- Mohd Masood
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.,Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland.,Division of Population & Patient Health, Dental Institute, King's College London, London, UK
| | - George Mnatzaganian
- Department of Community and Allied Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Sarah R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Finlayson TL, Lemus H, Becerra K, Kaste LM, Beaver SM, Salazar CR, Singer RH, Youngblood ME. Unfair Treatment and Periodontitis Among Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Racial Ethn Health Disparities 2018; 5:1093-1106. [PMID: 29327269 PMCID: PMC6760848 DOI: 10.1007/s40615-017-0459-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/01/2017] [Accepted: 12/28/2017] [Indexed: 10/18/2022]
Abstract
This study investigates how perceived unfair treatment, towards self and observed towards others due to ethnicity, is associated with periodontitis among diverse Hispanic/Latino adults, accounting for sociodemographic, health behavior, and acculturation factors. Baseline (2008-2011) dental and survey data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multicenter epidemiologic study, were analyzed (N = 12,750). Crude and adjusted prevalence ratios and confidence limits were estimated. Half (49%) reported never being treated unfairly, while 41% reported they were sometimes, and 10% reported it often/always. One third (32%) never saw others treated unfairly, while 42% reported it sometimes, and 26% reported it often/always. In the final fully adjusted model, the prevalence of periodontitis was higher among adults who were as follows: non-Dominican, older, male, had a past year dental visit, current and former smokers, and among those who observed unfair treatment towards others. Lower prevalence was associated with higher income, higher educational attainment, less than full-time employment, reporting experiencing unfair treatment, higher acculturation scores, and having health insurance. Perceived unfair treatment towards self was negatively associated with periodontitis prevalence, while observed unfair treatment towards others was positively associated with the outcome among diverse Hispanics/Latinos. The associations between unfair treatment and periodontitis warrant further exploration.
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Affiliation(s)
| | | | - Karen Becerra
- Gary and Mary West Senior Dental Center, San Diego, CA, USA
| | | | | | | | - Richard H Singer
- Nova Southeastern University, Ft. Lauderdale, FL, USA and Univesity of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL, USA
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Watt RG, Mathur MR, Aida J, Bönecker M, Venturelli R, Gansky SA. Oral Health Disparities in Children: A Canary in the Coalmine? Pediatr Clin North Am 2018; 65:965-979. [PMID: 30213357 DOI: 10.1016/j.pcl.2018.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite being largely preventable, oral diseases are still a major public health problem in child populations in many parts of the world. Increasingly, however, oral diseases disproportionately affect socially disadvantaged groups in society. It is unjust and unfair that children and families from disadvantaged backgrounds experience high levels of oral diseases. This article analyzes oral diseases through a health disparities lens. Action to combat oral health disparities requires a radical multifaceted strategy that addresses the shared underlying root causes of oral diseases, the social determinants of health inequality.
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Affiliation(s)
- Richard G Watt
- Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Manu Raj Mathur
- Department of Dental Public Health, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area Gurgaon, Gurgaon, Haryana 122002, India
| | - Jun Aida
- Department of International Health, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Marcelo Bönecker
- Dental Faculty, Av. Prof Lineu Prestes 2227 - University of Sao Paulo, Sao Paulo 05508-900, Brazil
| | - Renato Venturelli
- Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Stuart A Gansky
- Division of Oral Epidemiology and Dental Public Health, Center to Address Disparities in Children's Oral Health (Known As CAN DO), Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, Box #1361, San Francisco, CA 94143, USA
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Lorenzo-Erro SM, Massa F, Álvarez-Vaz R, Schuch HS, Correa MB, Peres MA. The role of contextual and individual factors on periodontal disease in Uruguayan adults. Braz Oral Res 2018; 32:e62. [PMID: 29995066 DOI: 10.1590/1807-3107bor-2018.vol32.0062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 05/23/2018] [Indexed: 11/22/2022] Open
Abstract
The present study aimed at understanding the relationship between periodontitis and socio-contextual and individual determinants of health. Data from "The First Uruguayan Oral Health Survey, 2011", which included 223 and 455 individuals with 35-44 and 65-74 years old respectively, were used. A stratified, multistage cluster sampling design was adopted (cities with ≥ 20.000 residents). Periodontitis was assessed using the modified Community Periodontal Index (CPI) and clinical attachment loss (CAL) (periodontal pocket and CAL ≥ 4 mm). Independent variables included contextual socioeconomic status (SES) measured by proportion of houses with Unsatisfied Basic Needs (UBN) and individual demographic and behavioral factors. Logistic regression multilevel models were generated. Living in contexts with a higher UBN was associated with higher odds for periodontitis in both age groups, even when adjusting for individual level variables (odds ratio [OR] = 1.51, 95%CI = 1.42-1.60 and 1.31, 95%CI = 1.21-1.42, respectively). Being male or heavy smoker increased the odds of periodontitis in this population for both age groups. Social structure impacts periodontal disease by modifying individual socioeconomic situations: in better socioeconomic context, UBN acts increasing the protector role of socioeconomic situation but in a poverty context the role is attenuated. Conclusions for this study are that periodontitis varies across contextual socio-demographic groups being higher in the population with a lower SES, challenging health authorities to integrate oral health into national non-communicable diseases programs.
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Affiliation(s)
| | - Fernando Massa
- University of the Republic of Uruguay, School of Dentistry, Epidemiology and Statistic Unit, Montevideo, Uruguay
| | - Ramón Álvarez-Vaz
- University of the Republic of Uruguay, Statistic Institute School of Economy, Montevideo, Uruguay
| | - Helena Silveira Schuch
- The University of Adelaide, Australian Research Centre for Population Oral Health, Adelaide Dental School, Australia
| | - Marcos Britto Correa
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Marco Aurélio Peres
- The University of Adelaide, Australian Research Centre for Population Oral Health, Adelaide Dental School, Australia
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