Self-reported oral health status, edentulism and all-cause mortality risk in 12 809 Australian older adults: a prospective cohort study

OBJECTIVE

To investigate the association between oral health status and all-cause mortality in older adults using prospective cohort study design.

SETTING AND PARTICIPANTS

In total, 12 809 adults aged ≥70 years (54.3% females) were participants of the ASPREE Longitudinal Study of Older Persons (ALSOP).

METHODS

Participants self-reported the presence of natural teeth and oral health status. The association of self-reported oral health, edentulism and the integrative measure of the two with all-cause mortality were explored using the Cox-regression models adjusted for age, gender, socio-economic status, health-related behaviours, weight status, aspirin and polypharmacy. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported.

RESULTS

In total, 22.2% of participants reported edentulism and 13.8% had fair/poor oral health. After adjustment for confounders, risk of all-cause mortality was higher among those with edentulism (vs. no edentulism) HR (95% CI) 1.43 (1.18, 1.73); and those with edentulism and reporting poor/fair oral health HR (95% CI) 1.69 (1.02, 2.82), or with no edentulism but reporting poor/fair oral health HR (95% CI) 1.46 (1.19-1.80) vs. no edentulism and reporting good/very good/excellent oral health. No association was observed between self-reported oral health alone and all-cause mortality.

CONCLUSIONS

The risk of all-cause mortality was 69% higher among older adults reporting both edentulism and poor/fair oral health compared with those with teeth and more favourable self-reported oral health. © 2023 Australian Dental Association.

Impact of an oral care subsidization reform on intersectional inequities in self-rated oral health in Sweden

BACKGROUND

Oral health in Sweden is good at the population level, but seemingly with persisting or increasing inequities over the last decades. In 2008, a major Swedish reform introduced universal partial subsidies to promote preventive care and reduce the treatment cost for patients with extensive care needs. This study aimed to apply an intersectional approach to assess the impact of the 2008 subsidization reform on inequities in self-rated oral health among adults in Sweden over the period 2004-2018.

METHODS

Data from 14 national surveys conducted over 2004-2018 were divided into three study periods: pre-reform (2004-2007), early post-reform (2008-2012) and late post-reform (2013-2018). The final study population was 118,650 individuals aged 24-84 years. Inequities in self-rated oral health were examined by intersectional analysis of individual heterogeneity and discriminatory accuracy across 48 intersectional strata defined by gender, age, educational level, income, and immigrant status.

RESULTS

Overall, the prevalence of poor self-rated oral health decreased gradually after the reform. Gender-, education- and income-related inequities increased after the reform, but no discernible change was seen for age- or immigration-related inequities. The majority of intersectional strata experienced patterns of persistently or delayed increased inequities following the reform.

CONCLUSIONS

Increased inequities in self-rated oral health were found in most intersectional strata following the reform, despite the seemingly positive oral health trends at the population level. Applying an intersectional approach might be particularly relevant for welfare states with overall good oral health outcomes but unsuccessful efforts to reduce inequities.

Self-assessment of dental health status, behaviours and oral health risk factors among adolescents from public schools in Maputo City-Mozambique

Self-assessment of dental health status may have an impact on the oral health behaviour of adolescents which could impact their oral health. Oral health has been linked to various medical health conditions, thus eliminating oral health diseases can improve general health. The present study aimed to assess the association between behaviours and risk factors (oral hygiene habits, sugar intake, urban/rural status) and negative self-perception of dental health status among adolescents attending public schools in Maputo City.Method An analytic cross-sectional study, conducted in three Primary public schools from urban and peri-urban areas in Maputo City selected by convenience due to their geographic location was included. The size of the sample was 236 12-year-olds. Data was collected using a self-completion questionnaire designed by the World Health Organization (WHO). Chi-square tests or Fishers' Exact tests were used for associations. A simple and multiple logistic regression was used to determine the strength of these associations using backward elimination (p < 0.05). Results: The sample consisted of 221 adolescents, with 114 (51.6%) residing in urban areas and 107 (48.4%) in peri-urban areas. More than half of the participants (111 individuals) reported having a negative perception of their dental health. In the urban location, a higher percentage of participants had a "negative" perception of dental health (57.9%, n = 66), while in the peri-urban location, more participants perceived their dental health as "positive" (57.9%, n = 62). Participants residing in an urban setting were 82% more likely to have a negative perception of dental health (AOR = 1.82 [95% C.I.: 1.05 to 3.14]). Those who had experienced dental pain tended to report a higher proportion of negative dental perception (57.2%, n = 91), with 2.7 times more likely to report a negative perception of dental health (AOR = 2.72 [95% C.I.: 1.46 to 5.08]). The majority (n = 139; 63.2%) claimed to clean their teeth twice a day.Conclusion There was a higher negative perception of dental health in urban areas. The need to strengthen oral health promotion in urban schools is high since schools play such a significant role in oral health promotion.

The association of periodontal disease and oral health with hypertension, NHANES 2009-2018

BACKGROUND

Hypertension is a worldwide public health problem. We sought to explore the interaction of oral health and smoking on hypertension, and periodontal disease and smoking on hypertension.

METHODS

We included 21,800 participants aged ≧ 30 years from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. Information of oral health and periodontal disease were self-reported. Blood pressure was taken by trained personnel and/or physicians at mobile testing center. Multiple logistic regression was used to estimate the association between oral health, periodontal disease and the prevalence of hypertension. The effects of oral health and periodontal disease on hypertension under smoking status and age were analyzed by stratified and interaction analysis.

RESULTS

A total of 21,800 participants were investigated, including 11,017 (50.54%) in hypertensive group and 10,783 (49.46%) in non-hypertensive group. Compared with the excellent/very good of oral health, the multivariable-adjusted OR of good, fair, and poor were 1.13 (95% CI, 1.02-1.27), 1.30 (95% CI, 1.15-1.47), and 1.48 (95% CI, 1.22-1.79) (p for trend < 0.001) for hypertension, respectively. Compared without periodontal disease group, the multivariable-adjusted OR of periodontal disease for hypertension was 1.21 (95% CI ,1.09-1.35) (p for trend < 0.001). Furthermore, we found the interactions between periodontal disease and smoking, oral health and smoking, periodontal disease and age, oral health and age were p < 0.001.

CONCLUSIONS

An association between oral health and periodontal disease with the prevalence of hypertension was identified. There exists interactive effect of periodontal disease and smoking, oral health and smoking, periodontal disease and age, oral health and age on hypertension in American population over 30 years of age and older.

Self-Rated Oral Health as a Valid Measure of Oral Health Status in Adults Living in Rural Australia

It is unclear how well self-rated oral health (SROH) reflects actual oral health status in the rural Australian population. Therefore, this study aimed to compare the clinically assessed oral health status and SROH of adults living in rural Australia. The data were from 574 participants who took part in the Crossroads II cross-sectional study. Three trained and calibrated dentists evaluated the oral health status of participants based on WHO criteria. SROH was assessed with the question 'Overall, how would you rate the health of your teeth and gums?', with a score ranging from excellent = 5 to poor = 1. A logistic regression analysis (LRA) was performed, allowing us to assess factors associated with SROH. The mean age of participants was 59.2 years (SD 16.3), and 55.3% were female. The key results from the LRA show poorer SROH in those with more missing teeth (OR = 1.05; 95% CI; 1.01-1.08), more decayed teeth (OR = 1.28; 95% CI: 1.11-1.46), and more significant clinical attachment loss of periodontal tissue (6mm or more) (OR = 2.63; 95% CI: 1.29-5.38). This study found an association between negative SROH and clinical indicators used to measure poor oral health status, suggesting that self-rated oral health is an indicator of oral health status. When planning dental healthcare programs, self-reported oral health should be considered a proxy measure for oral health status.

Socioeconomic inequality in health in older adults in Brazil

Objective

This study analyzed socioeconomic inequality in self-rated health for older adults (aged fifty or over) in Brazil.

Methods

Data from the 2015-2016 Brazilian Longitudinal Study of Aging (ELSI-Brazil). Socioeconomic inequality in self-rated health was measured using the concentration index, which was decomposed to analyze the contribution of different factors.

Results

This study revealed that 11.5% of the older adults interviewed reported their health as poor and very poor. For the complete sample, the estimated concentration index, -0.2434, indicated that there is a concentration of poor and very poor self-rated health among older and poorer adults. Income, education and having a private health insurance plan are the factors that contributed most to the observed inequality.

Discussion

The decomposition showed that there are avoidable inequalities in relation to socioeconomic status for older adults in Brazil. These factors can guide the formulation of social and health policies aimed at reducing health inequalities.

Oral health and depressive symptoms among older adults in urban China: a moderated mediation model analysis

Background

This study explored the association between oral health and depression occurs via daily dietary satisfaction as a mediator, and that body mass index could moderate the path between daily dietary satisfaction and depression.

Methods

Data for this research were derived from a community survey adopting quota sampling in the cities of Tianjin and Shijiazhuang in mainland China in 2020 (N = 781). The moderated mediation model was tested by using bootstrapping with resampling strategies, and the Johnson-Neyman technique was used to visualize the moderating effect of body mass index.

Results

A significant negative association between oral health and depression has been indicated (B = −0.22, SE = 0.11, 95%CI [− 0.44, − 0.01]), and dietary satisfaction partially mediated the relationship between oral health and depression (B = −0.04, SE = 0.02, 95%CI [− 0.09, − 0.002]). The path was moderated by body mass index, and the effect of dietary satisfaction on depression was much greater in people with relatively low body mass index.

Conclusions

This study present evidence for policymakers and researchers that strategies to enhance oral health and daily dietary satisfaction could be important for preventing depression in Chinese older adults, and especially for the relatively fitter older groups with lower body mass index.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03542-1.

Trends in Self-Rated Oral Health and Its Associations with Oral Health Status and Oral Health Behaviors in Japanese University Students: A Cross-Sectional Study from 2011 to 2019

Self-rated oral health (SROH) is a valid, comprehensive indicator of oral health status. The purpose of this cross-sectional study was to analyze how oral health behaviors and clinical oral status were associated with SROH and how they had changed over the course of nine years in Japanese university students. Data were obtained from 17,996 students who underwent oral examinations and completed self-questionnaires from 2011 to 2019. Oral status was assessed using the decayed and filled teeth scores, bleeding on probing (BOP), probing pocket depth, the Oral Hygiene Index-Simplified (OHI-S), oral health behaviors, and related factors. SROH improved from 2011 to 2019. The logistic regression model showed that university students who were female and had a high daily frequency of tooth brushing, no BOP, no decayed teeth, no filled teeth, and a low OHI-S score and were significantly more likely to report very good, good, or fair SROH. An interaction effect was observed between survey year and regular dental check-ups (year × regular dental check-ups). The improvement trend in SROH might be associated with changes in oral health behaviors and oral health status.

Oral health inequality among Indonesian workers in South Korea: role of health insurance and discrimination factors

Background

The health of migrant workers is becoming an important public health issue. Although there are an increasing number of migrant workers in Korea, the health status in migrant populations remains unknown. The aims of this study were (1) to evaluate the association between income and self-rated oral health (SROH), and (2) to assess the role of health insurance and self-perceived discrimination in the association between income and SROH among Indonesian migrant workers in Korea.

Methods

Information about self-reported income, SROH, coverage/utilization of health insurance (HI), living difficulties related to oral health (LDROH), oral health literacy (OHL), and discrimination were obtained from Indonesian migrant workers in Korea (n = 248). The main explanatory variable was income, and SROH was an outcome variable. Logistic regression analyses were performed controlling for age, gender, HI, LDROH, OHL, and discrimination. The paths from income to SROH were analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM).

Results

Among Indonesian migrant workers, the lower income group had the highest probability of a poor SROH compared to the higher income group. The variables showing a high explanatory power were discrimination among the low income group and HI among the middle income group. In PLS-SEM, the variables such as HI, LDROH, OHL, and discrimination contributed 11% to explaining the association between income and SROH.

Conclusion

A monotonic gradient was revealed among migrant workers according to the association between income and SROH. Discrimination and HI contributed to oral health inequalities.

Self-Rated Oral Health and Associated Factors among an Adult Population in Rural India-An Epidemiological Study

BACKGROUND

To determine the perception of oral health status and its associated factors among adults living in rural areas in Karnataka state, India.

METHODS

A cross-sectional study was conducted among adults in the age group of 35-54 years old residing in villages in a southern state in India. The main outcome measure was poor self-rated oral health (SROH) among adults in rural India.

RESULTS

About 873 adults participated in the study. The prevalence of poor SROH was 15.2%. Adults of age 40-44 years, females, those in lower socioeconomic conditions, and those with high caries experience (DMFT ≥ 4) and periodontal disease were associated with poor SROH. Those who had visited a dentist in the previous one year were 1.9 times more likely to report poor oral health.

CONCLUSIONS

Nearly 15% of rural people reported poor oral health. Socioeconomic conditions, sex, age, smoking, and dental visiting were associated with poor SROH. People's perception of poor oral health was associated with severe periodontitis and DMFT ≥ 4. A dose-response relationship was observed between experience with dental caries and poor SROH.

Dental attendance and behavioural pathways to adult oral health inequalities

BACKGROUND

While inequalities in oral health are documented, little is known about the extent to which they are attributable to potentially modifiable factors. We examined the role of behavioural and dental attendance pathways in explaining oral health inequalities among adults in England, Wales and Northern Ireland.

METHODS

Using nationally representative data, we analysed inequalities in self-rated oral health and number of natural teeth. Highest educational attainment, equivalised household income and occupational social class were used to derive a latent socioeconomic position (SEP) variable. Pathways were dental attendance and behaviours (smoking and oral hygiene). We used structural equation modelling to test the hypothesis that SEP influences oral health directly and also indirectly via dental attendance and behavioural pathways.

RESULTS

Lower SEP was directly associated with fewer natural teeth and worse self-rated oral health (standardised path coefficients, -0.21 (SE=0.01) and -0.10 (SE=0.01), respectively). We also found significant indirect effects via behavioural factors for both outcomes and via dental attendance primarily for self-rated oral health. While the standardised parameters of total effects were similar between the two outcomes, for number of teeth, the estimated effect of SEP was mostly direct while for self-rated oral health, it was almost equally split between direct and indirect effects.

CONCLUSION

Reducing inequalities in dental attendance and health behaviours is necessary but not sufficient to tackle socioeconomic inequalities in oral health.

Salutogenic factors for oral health among older people: an integrative review connecting the theoretical frameworks of Antonovsky and Lalonde

OBJECTIVE

The aim of this integrative review was to describe salutogenic factors associated with oral health outcomes in older people, from the theoretical perspectives of Antonovsky and Lalonde.

MATERIAL AND METHODS

This study was based on a primary selection of 10,016 articles. To organize reported salutogenic factors, the Lalonde health field concept and Antonovsky's salutogenic theory were cross tabulated.

RESULTS

The final analysis was based on 58 studies. The following oral health outcome variables were reported: remaining teeth, caries, periodontal disease, oral function and oral health related quality of life (OHRQoL). We could identify 77 salutogenic factors for oral health and OHRQoL. Salutogenic factors were identified primarily within the fields of Human Biology (such as 'higher saliva flow', 'BMI < 30 kg/m²' and 'higher cognitive ability at age 11'), Lifestyle (such as 'higher education level', 'social network diversity' and 'optimal oral health behaviour') and Environment (such as 'lower income inequality', 'public water fluoridation' and 'higher neighbourhood education level'). In the age group 60 years and over, there was a lack of studies with specific reference to salutogenic factors.

CONCLUSIONS

The results provide an overview of salutogenic factors for oral health from two theoretical perspectives. The method allowed concomitant disclosure of both theoretical perspectives and examination of their congruence. Further hypothesis-driven research is needed to understand how elderly people can best maintain good oral health.

What variables are associated with use of and need for dental prosthesis? A cross-sectional study

BACKGROUND

Population-based studies assessing the factors associated with use of and need for dental prosthesis among older adults are scarce.

OBJECTIVE

To evaluate the use of and need for dental prosthesis and associated factors in the older adult population of a southern city of Brazil.

MATERIAL AND METHODS

A cross-sectional study, involving community-dwelling older adults (≥60 years), was performed. A probabilistic per cluster sampling was used, and 282 participants from Veranópolis, Brazil, were included. A clinical oral health examination was performed, and a structured questionnaire was applied. Bivariate and multivariate analyses were performed to verify associations using Poisson regression with robust variance.

RESULTS

The prevalence of use of dental prosthesis was 87.2% (n = 246), while the prevalence of need for dental prosthesis was 27% (n = 76). Older adults with medium/high levels of education had 17.8% (P = .019) lower prevalence ratio (PR) for use of dental prosthesis. Unmarried and retired older adults had, respectively, 11.1% (PR:1.111; 95%CI:1.022-1.207) and 19.5% (PR:1.195; 95%CI:1.009-1.415) higher PR for use of prosthesis. Those without access to dental care had 11.8% (P = .012) higher PR for use of dental prosthesis. Older adults living in rural areas had 64.7% (PR:1.647; 95%CI:1.079-2.514) higher PR of need for dental prosthesis.

CONCLUSION

High and low prevalence of use of and need for dental prosthesis, respectively, were detected in this sample. Level of education, marital status, retirement status and access to dental care were associated with the use of dental prostheses. However, only residence area was associated with the need for oral rehabilitation.

Impact of oral health on nutritional status, self-perception of oral health and quality of life of institutionalized elderly

Background

This study aimed to investigate the influence of oral health on nutritional status, self-perception of oral health and health related quality of life of institutionalized elders.

Material and Methods

A cross-sectional study was conducted with 193 institutionalized elders living in the metropolitan region of João Pessoa (Brazil). The independent variables included were: 1) caries experience (DMFT index and its components); 2) use and need of dental prostheses; and 3) type of edentulism. The dependent variables included were related to nutritional status, self-perception of oral health and health-related quality of life. Data were submitted to a descriptive and comparative analysis, through correlation, association and difference tests, considering a significance level of 5% (p<0.05).

Results

No statistical significant correlations or associations between the oral health status and nutritional status and quality of life were found (p>0.05). Individuals who did not need prosthesis had higher scores for nutritional status. Self-perception of oral health and health-related quality of life did not vary significantly according to the studied variables.

Conclusions

The oral health status has a limited impact on the nutritional status, and does not impact the self-perception of oral health and quality of life of the institutionalized elders. Key words:Nursing homes, oral health, quality of life.

Factors associated with oral health-related quality of life of institutionalized elders

This study aimed to evaluate the correlation between two Oral Health-Related Quality of Life (OHRQoL) questionnaires (the Oral Health Impact Profile (OHIP-14) and the Geriatric Oral Health Assessment Index (GOHAI)) and to investigate the factors associated with the OHRQoL of institutionalized elderly individuals. A cross-sectional multicenter study was performed with 344 institutionalized elderly individuals residing in two Brazilian cities. Six trained researchers interviewed the elderly individuals. Sociodemographic data were collected from medical records. Dental caries experience and the use of and need for dentures were recorded through oral examination performed by two trained examiners. A Likert scale (1-5 points) was used to assess general health and self-perceived oral health. The number of chewing cycles needed to chew a portion of peanuts was used to assess the swallowing threshold. The OHIP-14 and GOHAI were used to evaluate OHRQoL, and statistically significant correlations were assessed using Spearman's correlation test (p < 0.05). Poisson regression (p < 0.05) was used to investigate the association of OHRQoL with independent variables. Scores on the OHIP-14 (7.57 ± 8.63) and GOHAI (32.46 ± 3.85) were strongly and inversely correlated (r2 = -0.671, p < 0.001), although these measures were associated with different factors. A higher OHIP-14 total score (worse OHRQoL) was associated with female gender, a greater number of healthy teeth, worse self-perceived general health and oral health, and a lower swallowing threshold (p < 0.05). A higher GOHAI total score (better OHRQoL) was associated with a greater number of filled teeth, better self-perceived oral health and a greater swallowing threshold (p < 0.05). In conclusion, worse OHRQoL among institutionalized elderly individuals is associated with worse self-perceived oral health and a greater swallowing threshold.

Subjective oral health status in an adult Korean population with asthma or allergic rhinitis

Oral health can affect or be a manifestation of general health. Although oral health assessment has been used as a proxy for general health, few studies have reported an association between oral health status and allergic diseases. This cross-sectional study aimed to investigate the relationship between subjective oral health status and asthma/allergic rhinitis in a nationwide representative sample of Korean adults.A total of 227,977 participants from the Korean Community Health Survey 2015 were enrolled. Participants were asked about their subjective oral health status (very good, good, normal, poor, very poor), periodontal status (mobility, swelling, calculus, bleeding), teeth brushing frequency, and scaling history within the past 12 months. Histories of physician-diagnosed asthma and allergic rhinitis throughout life were surveyed. The associations between subjective oral health status and allergic diseases were analyzed using multiple logistic regression analysis. Age, sex, economic level, educational level, region of residence, smoking, alcohol, obesity, subjective general health status, stress level, physical activity, periodontal status, teeth brushing frequency, and scaling history within the past 12 months were adjusted as covariates.A higher prevalence of asthma (3.6%) was reported in the poor oral health group than in the good (1.8%) and normal (2.1%) groups (P < .001). Poor oral health status was significantly related to asthma, with an adjusted odds ratio (aOR) of 1.19 (95% CI = 1.07-1.33, P = .002). Although the prevalence of allergic rhinitis was not higher in the poor oral health group (13.4%) than in the good (15.4%) and normal oral health groups (15.9%), the aOR for allergic rhinitis was 1.05 (95% CI = 1.00-1.11, P = .045) in the poor oral health group after adjusting for covariates.Subjective poor oral health status was significantly associated with asthma and allergic rhinitis in Korean adults.

Changes in income-related inequalities in oral health status in Ontario, Canada

OBJECTIVES

Oral health inequalities impose a substantial burden on society and the healthcare system across Canadian provinces. Monitoring these inequalities is crucial for informing public health policy and action towards reducing inequalities; however, trends within Canada have not been explored. The objectives of this study are as follows: (a) to assess trends in income-related inequalities in oral health in Ontario, Canada's most populous province, from 2003 to 2014, and (b) to determine whether the magnitude of such inequalities differ by age and sex.

METHODS

Data representative of the Ontario population aged 12 years and older were sourced from the Canadian Community Health Survey (CCHS) cycles 2003 (n = 36,182), 2007/08 (n = 36,430) and 2013/14 (n = 41,258). Income-related inequalities in poor self-reported oral health (SROH) were measured using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) and compared across surveys. All analyses were sample-weighted and performed with STATA 15.

RESULTS

The prevalence of poor SROH was stable across the CCHS cycles, ranging from 14.1% (2003 cycle) to 14.8% (2013/14 cycle). SII estimates did not change (18.7-19.0), while variation in RII estimates was observed over time (2003 = 3.85; 2007/08 = 4.47; 2013/14 = 4.02); differences were not statistically significant. SII and RII were lowest among 12- to 19-year-olds and gradually higher among 20- to 64-year-olds. RII was slightly higher among females in all survey years.

CONCLUSION

Absolute and relative income-related inequalities in SROH have persisted in Ontario over time and are more severe among middle-aged adults. Therefore, oral health inequalities in Ontario require attention from key stakeholders, including governments, regulators and health professionals.

Self-rated general and oral health and associated factors in independently-living older individuals

The aim of this study was to verify the association between sociodemographic, general health, and oral health data with self-rated general health (SRGH) and self-rated oral health (SROH) in independent-living older Brazilians. This cross-sectional study was part of a larger study with older individuals living independently in the city of Campinas, Brazil - the "Rede FIBRA" Study (the Frailty in Brazilian Elderly Study). A random sample of 688 older individuals responded the SRGH and 673, the SROH. SRHG and SROH were both assessed using a single item. The questionnaire included sociodemographic, general, and oral health data. The mean age was 72.28 ± 5.4 years. The adjusted analysis revealed that the probability of rating general health as bad was higher for illiterate participants (PR: 1.77, 95%CI: 1.13-2.77) or with low educational level (PR: 1.76, 95%CI: 1.17-2.65), those with depressive symptoms (PR: 1.45, 95%CI:1.21-1.74), participants that self-reported food limitation due to problems with denture or lack of it (PR: 1.29, 95%CI: 1.05-1.56), and those with xerostomia (PR 1.40, 95%CI: 1.17-1.67). The probability of rating general health as bad was lower for participants that presented 0-2 chronic diseases (PR: 0.64, 95%CI: 0.53-0.78) and were pre-frail (PR: 0.76, 95%CI: 0.61-0.96). With regard to SROH, the probability of rating oral health as bad was higher for participants with natural teeth (PR:1.61, 95%CI: 1.24-2.08), that reported xerostomia (PR: 1.44, 95%CI: 1.13-1.84), and food limitation due to problems with denture or lack of it (PR: 1.43, 95%CI: 1.07-1,91), and lower for participants that reported having enough money to cover daily expenses (PR: 0.78, 95%CI: 0.61-0.99). Oral health data and income seem to be related to self-perceptions of general and oral health.

Perceived xerostomia, stress and periodontal status impact on elderly oral health-related quality of life: findings from a cross-sectional survey

BACKGROUND

To investigate if self-perceived xerostomia and stress are significant variables on the Oral-Health Related Quality of Life (OHRQoL) of elderly patients, considering the periodontal status, oral hygiene habits and sociodemographic characteristics simultaneously.

METHODS

The study cohort included 592 participants (320 females/272 Males), aged 65 years or older, representing the elder inhabitants of the Study of Periodontal Health in Almada-Seixal (SoPHiAS). Patients answered a socio-demographic and oral hygiene habits questionnaire. The Oral Health Impact Profile-14 (OHIP-14), Summated Xerostomia Inventory-5 (SXI-5) and Perceived Stress Scale-10 (PSS-10) were used. Full-mouth circumferential periodontal inspection was carried out. Multivariable regression analyses were used considering the level of periodontitis, clinical characteristics, the number of teeth, SXI, PSS-10, age, gender and oral hygiene habits.

RESULTS

Self-perceived xerostomia and stress showed a positive significant correlation with OHRQoL and each of its domains. Multiple linear regression analysis demonstrated the significant impact of SXI-5 (B = 1.20, p <  0.001) and PSS-10 (B = 0.35, p <  0.001) on the OHRQoL. SXI-5 (Odds Ratio (OR) = 1.28, p <  0.001) and PSS-10 (OR = 1.03, p = 0.022) were associated with a more frequently affected OHRQoL. The number of missing teeth, being male, mean probing depth and mean clinical attachment loss were also significant towards a frequently affected OHRQoL. Conversely, age was negatively associated with a lower OHRQoL.

CONCLUSION

Self-perceived xerostomia and stress are significant variables towards OHRQoL in elderly patients. Future studies should consider these self-perceived xerostomia and stress when investigating the impact of periodontitis and missing teeth on quality of life of older adults.

Clinical Consequences of Untreated Dental Caries, Individual Characteristics, and Environmental Factors on Self-Reported Oral Health Measures in Adolescents: A Follow-Up Prevalence Study

BACKGROUND/AIMS

This study evaluated the relationships of clinical consequences of untreated dental caries, individual characteristics, and environmental factors on self-reported oral health measures in adolescents.

METHODS

A follow-up prevalence study was conducted involving 406 twelve-year-old adolescents selected from public schools in the eastern area of the city of Manaus, Brazil. Baseline data included clinical consequences of untreated caries (PUFA/pufa index), DMFT, sociodemographic characteristics (sex, parental schooling, and family income), psychosocial factors (sense of coherence [SOC-13 scale], oral health beliefs and self-esteem [Rosenberg Self-Esteem Scale]), and social support (SSA questionnaire). Oral health-related quality of life (OHRQoL [CPQ11-14]) and self-rated oral health were assessed at the 6-month follow-up. Structural equation modelling was used to explore the relationships between variables according to the Wilson and Cleary model.

RESULTS

The prevalence of PUFA/pufa was 17.8% and mean DMFT was 1.5. The number of teeth with clinical consequences of untreated caries predicted poor self-rated oral health at the 6-month follow-up. Low parental schooling predicted low family income and clinical consequences of untreated dental caries. Psychosocial factors predicted OHRQoL directly and self-rated oral health indirectly. OHRQoL was linked to self-rated oral health. Clinical consequences of untreated dental caries mediated the relationship of parental schooling with OHRQoL and self-rated oral health. OHRQoL mediated the relationship of psychosocial factors and sex with self-rated oral health. Clinical consequences of untreated dental caries was associated with adolescents' self-rated oral health. Furthermore, the former was an important mediator on the link between low parental education and adolescents' self-reported oral health measures.

CONCLUSIONS

Socioeconomic status, psychosocial factors, and social support were related to OHRQoL and self-rated oral health via direct and indirect pathways.

Immigrant Status, Resilience, and Perceived Oral Health Among Chinese Americans in Hawaii

OBJECTIVES

This study aims to examine the associations among immigrant status, resilience, and perceived oral health for Chinese American older adults in Hawaii.

METHOD

Data derived from 430 Chinese American adults aged 55 years and older residing in Honolulu, HI. We compared the self-rated oral health and oral health problems between U.S.-born Chinese Americans and foreign-born Chinese Americans by using ordered logistic regression and ordinary least squares regression models.

RESULTS

Findings suggest that immigrant status and lower levels of resilience are associated with poorer self-rated oral health and more oral health problems for Chinese American older adults in Hawaii. Resilience is more strongly associated with self-rated oral health for U.S.-born Chinese American than for foreign-born Chinese Americans, but this pattern was not evident for oral health problems.

DISCUSSION

Older Chinese American immigrants in Hawaii are disadvantaged in terms of their oral health. Understanding their susceptibilities may lead to targeted interventions.

Oral health-related quality of life and associated factors among older people in short-term care

Objectives

It is well known that oral health status is associated with oral health‐related quality of life (OHRQoL) in the general population. The aim of this study was to describe and analyse OHRQoL among older people in short‐term care and its associated factors.

Materials and Methods

This cross‐sectional study included 391 older people in 36 short‐term care units. Data were collected via clinical oral assessments, questions about self‐perceived oral and general health, Katz Index of Activities of Daily Living (Katz‐ADL) and the Revised Oral Assessment Guide (ROAG). OHRQoL was measured using the Oral Health Impact Profile (OHIP‐14). Multivariate logistic regression models were applied in the analysis.

Results

Poor OHRQoL was reported by 34% of the older people. Associated factors were swallowing problems according to ROAG; quite poor/poor self‐perceived physical, psychological and oral health; and being a woman.

Conclusions

There is an association between OHRQoL and older people's self‐perceived health according to the OHIP‐14. This indicates the importance of early detection of oral health problems in frail older people and to assess both oral health and swallowing problems among older people in short‐term care.

Self-rated oral health status and social and health determinants among community dwelling adults in Kenya

Background

The aims of this study were to estimate the self-rated oral health status and its associated factors in a national community dwelling population in Kenya.

Methods

A cross-sectional study based on a stratified cluster random sampling was conducted in 2015. The total sample included 4,459 individuals 18–69 years (M=40.4 years, SD=13.9). Questionnaire interview, blood pressure and anthropometric measurements, and biochemistry tests were conducted, including questions on the oral health status, general health status, oral health behaviour and socio-demographic information.

Results

Overall, 13.7% of participants reported poor self-rated oral health. In adjusted logistic regression analysis, older age (Odds Ratio-OR: 1.70, Confidence Interval-CI: 1.07, 2.69), having a lower number lover number of teeth (OR: 0.19, CI: 0.06, 0.62), having dentures (OR: 1.92, CI: 1.22, 3.03), having pain in the mouth or teeth (OR: 5.62, CI: 3.58, 8.90), impaired Oral Health Related Quality of Life (OR: 3.01, CI: 2.03, 4.47) and frequent soft drink consumption (OR: 3.62, CI: 1.89, 6.97) were associated with poor self-rated oral health.

Conclusion

High unsatisfied self-rated oral health status was found and several risk factors for poor self-rated oral health were identified that can help in guiding oral health care programming in Kenya.

Socioeconomic disadvantage across the life-course and oral health in older age: findings from a longitudinal study of older British men

Background

The influence of life-course socioeconomic disadvantage on oral health at older ages is not well-established. We examined the influence of socioeconomic factors in childhood, middle-age and older age on oral health at older ages, and tested conceptual life-course models (sensitive period, accumulation of risk, social mobility) to determine which best described observed associations.

Methods

A representative cohort of British men aged 71-92 in 2010-12 included socioeconomic factors in childhood, middle-age and older age. Oral health assessment at 71-92 years (n = 1622) included tooth count, periodontal disease and self-rated oral health (excellent/good, fair/poor) (n = 2147). Life-course models (adjusted for age and town of residence) were compared with a saturated model using Likelihood-ratio tests.

Results

Socioeconomic disadvantage in childhood, middle-age and older age was associated with complete tooth loss at 71-92 years-age and town adjusted odds ratios (95% CI) were 1.39 (1.02-1.90), 2.26 (1.70-3.01), 1.83 (1.35-2.49), respectively. Socioeconomic disadvantage in childhood and middle-age was associated with poor self-rated oral health; adjusted odds ratios (95% CI) were 1.48 (1.19-1.85) and 1.45 (1.18-1.78), respectively. A sensitive period for socioeconomic disadvantage in middle-age provided the best model fit for tooth loss, while accumulation of risk model was the strongest for poor self-rated oral health. None of the life-course models were significant for periodontal disease measures.

Conclusion

Socioeconomic disadvantage in middle-age has a particularly strong influence on tooth loss in older age. Poor self-rated oral health in older age is influenced by socioeconomic disadvantage across the life-course. Addressing socioeconomic factors in middle and older ages are likely to be important for better oral health in later life.

Self-Rated Oral Health Status And Social And Health Determinants Among 35-65 Year-Old Persons In One Region In Myanmar: A Cross-Sectional Study

BACKGROUND

Oral diseases may be a population health problem in Myanmar. Community-based surveys may help in the selection of risk groups that may require priority attention. The study aimed to estimate the prevalence and correlates of self-rated oral health (SROH) status in an adult community sample in Myanmar.

METHODS

The study design was a cross-sectional household survey in the Magway region Myanmar. In all, 633 persons aged 35 to 65 years, responded to questions on the oral health status, general health status, oral health knowledge and behaviour and socio-demographic information.

RESULTS

Overall, 13.6% of participants reported poor SROH, and 78.5% average or poor SROH. In adjusted logistic regression analysis, oral conditions (tooth loss, cavities, bleeding gums, and teeth that are sensitive to heat or cold), better oral health knowledge, dental care attendance, and skipping breakfast were associated with poor SROH.

CONCLUSION

A high proportion of poor or average SROH status was found and several associated variables were found that can facilitate in guiding oral health care programming in Myanmar.

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013

INTRODUCTION

Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored.

OBJECTIVE

To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population.

METHODS

Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older.

RESULTS

Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations.

CONCLUSION

Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.

Oral health profile among community-dwellingelderly and its association with self-rated oral health

INTRODUCTION

The use of dental prosthesis and the tooth loss in elderly people are associated with significant impact on the overall health and quality of life. Continuous assessment of oral health profile in this population is important for planning the actions and policies of the area.

OBJECTIVES

The aims of this study were to assess the prevalence of tooth loss and use of dental prosthesis among the elderly people in different periods, to evaluate the association between functional dentition (20 teeth or more) and socioeconomic factors, and to evaluate the impact of tooth loss and use of dental prosthesis on self-rated oral health.

METHODS

Thesample consisted of people aged 60 years and older who participated in the Health, Well-Being, and Aging Study (SABE). Data from the years 2000, 2006, and 2010 were used to assess the prevalence of tooth loss and use of dental prosthesis. Analysis of the factors associated with the functional dentition and self-rated oral health was based on the data collected in 2010. Comparison of oral health profile over the 3 years was done through descriptive analysis and comparison of confidence intervals. Multiple logistic regression models were used to assess the factors associated with functional dentition and self-rated oral health.

RESULTS

The prevalence of tooth loss and use of dental prosthesis remained constant over the three periods analyzed. Functional dentition was significantly associated with education, sex, and race/gender. Individuals in need of dental prosthesis and with periodontal pocket were more likely to report poor oral health.

CONCLUSION

There was no reduction in the prevalence of tooth loss and in the use of dental prosthesis over 10 years. Functional dentition is associated with socioeconomic inequalities. Self-rated oral health is associated with the need of dental prosthesis.

Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States

BACKGROUND

Socioeconomic inequalities are associated with oral health status, either subjectively (self-rated oral health) or objectively (clinically-diagnosed dental diseases). The aim of this study is to compare the magnitude of socioeconomic inequality in oral health and dental disease among adults in Australia, Canada, New Zealand and the United States (US).

METHODS

Nationally-representative survey examination data were used to calculate adjusted absolute differences (AD) in prevalence of untreated decay and fair/poor self-rated oral health (SROH) in income and education. We pooled age- and gender-adjusted inequality estimates using random effects meta-analysis.

RESULTS

New Zealand demonstrated the highest adjusted estimate for untreated decay; the US showed the highest adjusted prevalence of fair/poor SROH. The meta-analysis showed little heterogeneity across countries for the prevalence of decayed teeth; the pooled ADs were 19.7 (95% CI = 16.7-22.7) and 12.0 (95% CI = 8.4-15.7) between highest and lowest education and income groups, respectively. There was heterogeneity in the mean number of decayed teeth and in fair/poor SROH. New Zealand had the widest inequality in decay (education AD = 0.8; 95% CI = 0.4-1.2; income AD = 1.0; 95% CI = 0.5-1.5) and the US the widest inequality in fair/poor SROH (education AD = 40.4; 95% CI = 35.2-45.5; income AD = 20.5; 95% CI = 13.0-27.9).

CONCLUSIONS

The differences in estimates, and variation in the magnitude of inequality, suggest the need for further examining socio-cultural and contextual determinants of oral health and dental disease in both the included and other countries.

Association of Self-Perceived Oral Health and Function with Clinically Determined Oral Health Status among Adults Aged 35⁻54 Years: A Cross-Sectional Study

This study aimed to analyse the association of self-perceived oral health status (OHS) and functions with clinical OHS in Korean adults aged 35–54 years. The study was designed as a cross-sectional study using data from the Fourth Korea National Health and Nutrition Examination Survey (2007–2009). A total of 6605 subjects aged 35–54 years who completed the oral examination and questionnaires were included. An association of self-perceived OHS and functions with clinically determined OHS was confirmed by a complex-samples general linear model. Data on socioeconomic variables, i.e., household income and education level, self-perceived OHS and functions, such as chewing and speaking, were collected by trained interviewers. The clinical OHS was determined by trained dentists and included the number of untreated decayed teeth (DT); decayed, missing, and filled teeth (DMFT); prosthetic and periodontal status. The combined score was estimated as the sum of self-perceived OHS and functions. Based on the estimation coefficient, the clinical variables that were most strongly associated with self-perceived OHS and functions were, in order, periodontal status, prosthetic status, DT, and DMFT. In addition, the combined score for self-perceived OHS and functions was associated with household income, education, and clinically determined OHS.

Periodontal disease among older people and its impact on oral health-related quality of life

OBJECTIVE

The aim of the study was to evaluate the associations between degree of periodontal disease and number of teeth on oral health-related quality of life among older individuals.

MATERIAL AND METHODS

Randomly selected 804 participants aged ≥70 derived from two cohorts were included in the analysis. Dental examinations and evaluation of OHRQL using the OHIP-14 (Oral Health Impact Profile-14) were performed. After categorisation of the participants according to the extent of periodontitis in three groups (none, localised with <30% of teeth affected, generalised with ≥30% of teeth affected) and the number of teeth, associations between periodontal status and the number of teeth and the OHIP-14 scores were analysed. Multivariable regression analyses were used taking into account level of periodontitis, number of teeth, age and sex.

RESULTS

Among 70-year-old men and women, generalised periodontitis showed an association with poor OHRQL. However, a multivariable analysis failed to demonstrate this association (OR = 1.02, 95% CI: 0.72-1.44). In participants with 1-10 remaining teeth, the OHIP-14 score was significantly increased indicating poor OHRQL, compared with participants with ≥21 remaining teeth (OR = 1.57, 95% CI: 1.13-2.19). Similar findings were observed among women aged 70-92 years.

CONCLUSIONS

Periodontitis did not show an association with poor OHRQL, however, a significant association between the number of teeth and poor OHRQL was found.

Oral health literacy and its determinants among adults in Southeast Iran

OBJECTIVES

The present study aimed to assess oral health literacy level and its related factors among adult patients visiting Kerman Dental School.

MATERIALS AND METHODS

This cross-sectional study was conducted in Kerman Dental School clinic, among the first-time adult visitors. Individuals were selected randomly from volunteers who signed study consent forms. Background information and oral health literacy levels were acquired through the oral health literacy-adult questionnaire. Statistical analysis including the Chi-square test and independent t-test served for statistical evaluation of the study data.

RESULTS

Participants were 264 adults which consisted of 72.3% women and the mean age of 37 ± 8 years old. The mean oral health literacy score was 12.07 (out of 17), and 62.5% of the participants had an adequate oral health literacy level. There was a significant relationship between oral health literacy scores with gender, high level of education, and oral health behavior.

CONCLUSION

The study participants had a good level of oral health literacy which can be correlated with their educational status and oral health information sources. An oral health educational program for less educated people is recommended.

Fatores associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros

Resumo Este estudo teve como objetivo identificar fatores individuais e contextuais associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros. Foram utilizados dados secundários de 7.619 indivíduos idosos do levantamento epidemiológico SB Brasil 2010. As associações entre as variáveis dependentes e os fatores individuais e contextuais foram estimadas através da razão de chances (odds ratio – OR) e intervalo de confiança de 95%, obtidas por regressão logística multinível. Dos idosos avaliados pelo SB Brasil 2010, 3.848 (50,5%) afirmaram necessitar de tratamento odontológico e 4.236 (55,6%) acreditavam necessitar de prótese. Os resultados da regressão logística multinível mostraram que sexo, cor da pele autorreferida, renda e cobertura pelas equipes de saúde bucal na Estratégia de Saúde da Família estiveram associados à autopercepção. O presente trabalho evidenciou maior influência de fatores individuais na autopercepção da necessidade de tratamento odontológico e de prótese entre idosos brasileiros. Essas informações podem auxiliar na identificação de desigualdades que afetam essa parcela da população e na definição de prioridades para o planejamento dos serviços de saúde.

Influence of Poor Oral Health on Physical Frailty: A Population-Based Cohort Study of Older British Men

Objectives

To investigate the associations between objective and subjective measures of oral health and incident physical frailty.

Design

Cross‐sectional and longitudinal study with 3 years of follow‐up using data from the British Regional Heart Study.

Setting

General practices in 24 British towns.

Participants

Community‐dwelling men aged 71 to 92 (N = 1,622).

Measurements

Objective assessments of oral health included tooth count and periodontal disease. Self‐reported oral health measures included overall self‐rated oral health; dry mouth symptoms; sensitivity to hot, cold, and sweet; and perceived difficulty eating. Frailty was defined using the Fried phenotype as having 3 or more of weight loss, grip strength, exhaustion, slow walking speed, and low physical activity. Incident frailty was assessed after 3 years of follow‐up in 2014.

Results

Three hundred three (19%) men were frail at baseline (aged 71–92). Having fewer than 21 teeth, complete tooth loss, fair to poor self‐rated oral health, difficulty eating, dry mouth, and more oral health problems were associated with greater likelihood of being frail. Of 1,284 men followed for 3 years, 107 (10%) became frail. The risk of incident frailty was higher in participants who were edentulous (odds ratio (OR) = 1.90, 95% confidence interval (CI) = 1.03–3.52); had 3 or more dry mouth symptoms (OR = 2.03, 95% CI = 1.18–3.48); and had 1 (OR = 2.34, 95% CI = 1.18–4.64), 2 (OR = 2.30, 95% CI = 1.09–4.84), or 3 or more (OR = 2.72, 95% CI = 1.11–6.64) oral health problems after adjustment for age, smoking, social class, history of cardiovascular disease or diabetes mellitus, and medications related to dry mouth.

Conclusion

The presence of oral health problems was associated with greater risks of being frail and developing frailty in older age. The identification and management of poor oral health in older people could be important in preventing frailty.

See related editorial by https://doi.org/10.1111/jgs.15253.

Inequalities in oral health: Understanding the contributions of education and income

OBJECTIVE

To quantify the extent to which income and education explain gradients in oral health outcomes.

METHODS

Using data from the Canadian Community Health Survey (CCHS 2003), binary logistic regression models were constructed to examine the relationship between income and education on self-reported oral health (SROH) and chewing difficulties (CD) while controlling for age, sex, ethnicity, employment status and dental insurance coverage. The relative index of inequality (RII) was utilized to quantify the extent to which income and education explain gradients in poor SROH and CD.

RESULTS

Income and education gradients were present for SROH and CD. From fully adjusted models, income inequalities were greater for CD (RIIinc = 2.85) than for SROH (RIIinc = 2.75), with no substantial difference in education inequalities between the two. Income explained 37.4% and 42.4% of the education gradient in SROH and CD respectively, whereas education explained 45.2% and 6.1% of income gradients in SROH and CD respectively. Education appears to play a larger role than income when explaining inequalities in SROH; however, it is the opposite for CD.

CONCLUSION

In this sample of the Canadian adult population, income explained over one third of the education gradient in SROH and CDs, whereas the contribution of education to income gradients varied by choice of self-reported outcome. Results call for stakeholders to improve affordability of dental care in order to reduce inequalities in the Canadian population.

Oral health self-perception in quilombola communities in Rio Grande do Sul: a cross-sectional exploratory study

Objective:

There's a shortage of evidence on the oral health of quilombolas. This study aims to describe oral health self-perception, as well as to verify its associated factors in quilombola communities in the state of Rio Grande do Sul.

Methods:

The data for this cross-sectional health survey were collected by application of a questionnaire. Since this study was part of a survey on nutritional security, the probabilistic cluster sample was estimated for the outcome of nutritional insecurity, comprising 583 individuals across quilombola communities in Rio Grande do Sul. The association between the outcome of negative oral health self-perception and sociodemographic, general health, and oral health variables was measured by prevalence ratios obtained through Poisson regressions with robust variance and 95% confidence intervals.

Results:

Negative self-rated oral health was reported by 313 (53.1%) of the individuals. Satisfaction with chewing ability and satisfaction with oral appearance were associated with a higher prevalence of negative perception of oral health, while there was no association between the outcome and number of teeth. Use of alcohol had a borderline association with the outcome.

Conclusion:

Satisfaction with appearance and chewing ability are factors associated with oral-health self-perception of the quilombolas in Rio Grande do Sul.

Income-Related Inequalities in Access to Dental Care Services in Japan

Background: This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods: The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results: Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions: There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system.

Exploring patient satisfaction levels, self-rated oral health status and associated variables among citizens covered for dental insurance through a National Social Security Scheme in India

OBJECTIVE

To assess patient satisfaction, self-rated oral health and associated factors, including periodontal status and dental caries, among patients covered for dental insurance through a National Social Security Scheme in New Delhi, India.

METHOD

A total of 1,498 patients participated in the study. Satisfaction levels and self-rated oral-health scores were measured using a questionnaire comprising 12 closed-ended questions. Clinical data were collected using the Community Periodontal Index (CPI) and the decayed, missing and filled teeth (DMFT) index. Regression analysis was conducted to evaluate factors associated with dental caries, periodontal status and self-rated oral health.

RESULTS

Areas of concern included poor cleanliness within the hospital, extensive delays for appointments, waiting time in hospital and inadequate interpersonal and communication skills among health-care professionals. Approximately 51% of the respondents rated their oral health as fair to poor. Younger age, no tobacco usage, good periodontal status and absence of dental caries were significantly associated with higher oral health satisfaction, with odds ratios of 3.94, 2.38, 2.58 and 2.09, respectively (P ≤ 0.001).

CONCLUSION

The study indicates poor satisfaction levels with the current dental care system and a poor self-rated oral health status among the study population. Some specific areas of concern have been identified. These findings may facilitate restructuring of the existing dental services under the National Social Security Scheme towards creating a better patient care system.

Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model

INTRODUCTION

Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status.

OBJECTIVE

To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults.

MATERIALS AND METHODS

We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health.

RESULTS

A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20).

CONCLUSIONS

A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.

Impact of occlusal support and perceived chewing ability on oral health-related quality of life among patients attending a private dental institution in India

Purpose:

Presence of functional tooth units is essential for preserving masticatory function among individuals. Representing the essence of health promotion practice, demand to measure varied evaluation outcomes is highlighted.

Aim and Objectives:

(1) To assess the influence of occlusal support and perceived chewing ability on oral health-related quality of life (OHRQoL) among adults attending a private dental institution in Mangalore. (2) To evaluate occlusal support using Eichner index (EI), perceived chewing ability using a self-administered questionnaire and OHRQoL using Oral Health Impact Profile-14 (OHIP-14).

Materials and Methods:

Overall, 300 adults attending a private dental institution in Mangalore were included. EI was used to group participants into three groups. The chewing ability was assessed using a questionnaire on perceived difficulty while chewing eight common foods. OHRQoL was measured employing OHIP-14. Perceived general and oral health status and demographic information were collected.

Results:

The mean perceived chewing ability score was 12.98 ± 6.2 and the mean total OHIP score was 9.23 ± 8.9. EI showed a significant relation with perceived chewing ability, OHIP, and perceived general health status (P < 0.05). Perceived chewing ability and OHIP demonstrated a significant correlation (r = 0.31, P < 0.001). Age, gender, education, occupation, monthly income, family income, and number of family members demonstrated a significant association with EI (P < 0.05). Binary logistic regression analysis revealed that EI, perceived chewing ability, and perceived oral health emerged as significant predictors of OHRQoL (P < 0.05).

Conclusions:

Occlusal support was significantly associated with perceived chewing ability, OHRQoL, and perceived general health status.

Change in Quality of Life and Its Association with Oral Health and Other Factors in Community-Dwelling Elderly Adults-A Prospective Cohort Study

OBJECTIVES

To determine whether changes in oral health status were associated with decline in quality of life (QoL).

DESIGN

Prospective cohort study.

SETTING

Carlos Barbosa, southern Brazil.

PARTICIPANTS

A random sample of 872 community-dwelling individuals aged 60 and older was evaluated in 2004. The current study population consisted of 389 participants available for follow-up in 2012.

MEASURES

Change in QoL was assessed through the use of the short version of the World Health Organization QoL Assessment tool (WHOQOL-BREF) at baseline and follow-up. Each WHOQOL domain generates a score, with changes being calculated for each domain. Individuals with the same or higher scores at follow-up were categorized as having improved QoL, and those with lower scores were categorized as having a decline in QoL. Sociodemographic and health variables were assessed in an interview, and tooth loss, use of dental prostheses, and satisfaction with chewing ability and oral appearance were verified through oral examinations. Interviews and examinations were repeated. Risk ratios (RRs) relative to the outcome and independent variables were estimated using Poisson regression with a robust variance estimator.

RESULTS

Tooth loss was a risk factor for decline in the psychological domain of QoL (RR = 1.04, 95% confidence interval (CI) = 1.02-1.06). Improvement in satisfaction with chewing ability was a protective factor for decline in this same domain (RR = 0.69, 95% CI = 0.50-0.97). Greater satisfaction with oral appearance was a protective factor against decline in social (RR = 0.84, 95% CI = 0.72-0.98) and environmental (RR = 0.77, 95% CI = 0.61-0.97) domain scores.

CONCLUSION

Preventing tooth loss and recognizing and properly addressing concerns about chewing and dental appearance can affect the general well-being of community-dwelling elderly adults.

Association between self-reported and clinical oral health status in Belarusian adults

AIM

The aims of the present study were to determine characteristics of self-perception of oral health, and to investigate associations between self-reported status and clinical oral health status among Belarusian adults.

METHODS

A cross-sectional study, including a questionnaire survey and oral health examination, was conducted among 281 dental patients.

RESULTS

Of the participants, 74% were women; the mean ages of female and male participants were 35.9 ± 12.3 and 28.0 ± 10.3 years (P < 0.001), respectively. More than half of the participants (58%) described their oral health as negative. The number of decayed teeth (P < 0.001), missing teeth (P < 0.001), and teeth with bleeding on probing (P < 0.01) and deep periodontal pockets (P < 0.001) were significantly higher among participants who described their oral health as negative compared to their counterparts. Participants with better agreement between self-reported and clinical number of teeth had significantly lower numbers of decayed and missing teeth (P < 0.01). There was a significant relationship between participants' self-reported periodontal status and number of teeth with bleeding on probing and deep periodontal pockets (P < 0.05).

CONCLUSIONS

Self-perceived oral health was significantly associated with clinical oral health status in this study. Self-reporting methods could be useful for population-based oral health surveys in Belarus.

[Association between tooth root remains and self-reported oral health among the elderly]

The presence of tooth root remains is a common clinical finding among elderly patients and may reflect a need for treatment. The scope of this study sought to explore the association between the presence of tooth root remains and self-reported oral health among the elderly. Secondary data from two sanitary districts of Porto Alegre, State of Rio Grande do Sul, were analyzed. A conceptual theoretical model was used in the analysis to assess factors related to self-perceived oral health: gender, age, education, marital status, smoking habit, alcohol consumption, demand for oral health care, participation in community groups, family economic self-sufficiency, oral health service accessed, number of teeth and the presence of tooth root remains. The statistical data were analyzed using Chi-square and Poisson Regression tests (95% CI analysis; α 5%). The sample consisted of 849 elderly individuals with a mean age of 69.7 years (± 7.2); 14.5% of the elderly had tooth root remains and 60.7% reported good self-perceived oral health. According to the hierarchical analysis, the absence of tooth root remains was associated with good oral health perception. The qualification and expansion of health care provided should be considered in order to allow planning actions to ensure the maintenance of good oral health for the elderly.

Behaviors and Management of the Dental Problems by the Residents of Madinah, Saudi Arabia

INTRODUCTION

Dental problems are commonly encountered in our lives. Some of the common problems are toothache, bleeding gums and halitosis.

OBJECTIVES

How the dental problems were handled, and reasons of not seeking dental treatment by the patients.

MATERIALS AND METHODS

This was an observational analytical cross-sectional study on adult's age above 14 years from Madinah.

RESULTS

A total of 400 adults were included; 208 (52%) were males and 192 (48%) were females. Resident encountered toothache surprisingly only 49% sought dental treatment, while (41%) settled for taking medications. Among bleeding gum patients most of them (45%) went to the dentist, while (41%) settled for using the home care. And dealing with halitosis only (17%) went to the dentist. The most common reasons for not seeking dental treatment were fear and long appointments. And mostly they had fear because of dental drill and dental needle.

CONCLUSION

The most common problems for seeking treatment were toothache followed by bleeding gums and the least was halitosis. Number of people who sought treatment was still a low number. The most common reason that stopped patients from going to the dentist was fear and long appointments. There should be increase of dental clinics and patients should be given dental education.

Global self-rating of oral health as summary tool for oral health evaluation in low-resource settings

Objectives:

Global Self-Rating of Oral Health (GSROH) has numerous benefits, especially in resource-constrained environments with a paucity of dentists thereby potentially limiting administration of oral health surveys and monitoring of dental treatment. The aim of the study was to identify factors that could influence or predict poor self-ratings of oral health.

Materials and Methods:

The study was descriptive in design. Data were collected using structured interviewer-administered questionnaire, which had items on socio-demographic characteristics of the respondents and their GSROH. Oral examination was conducted to identify untreated dental caries, missing teeth, and mobile teeth. Data were analyzed using SPSS, and the P value was set at 0.05.

Results:

There were 600 participants; 400 were teachers constituting the non-patient population and 200 were dental patients with age ranging from 18 to 83 years. A total of 169 (28.1%) participants rated their oral health as poor, including 104 patients (52.0%) and 65 (16.2%) non-patients (P < 0.001). Having had toothache in the preceding 6 months (62.4% vs. 16.0%, P < 0.001), mobile teeth (46.7% vs. 24.2%, P < 0.001), decayed teeth (49.0% vs. 21.3%, P < 0.001), missing teeth (35.0% vs. 26.1%, P = 0.042), or DMFT score greater than zero (41.1% vs. 20.7%, P < 0.001) was associated with poor GSROH. Presence of mobile teeth [odds ratio (OR) = 2.68; 95% confidence interval (CI): 1.29, 4.23; P < 0.001] and carious teeth (OR = 2.25; 95% CI: 1.09, 4.65; P = 0.029) were independent predictors of GSROH.

Conclusion:

The GSROH was able to identify individuals with or without oral conditions in the studied population, and thus may be used in oral health surveys to assess the oral health status and in monitoring of treatment outcome.

Social, economic, and behavioral variables associated with oral health-related quality of life among Brazilian adults

The aim of this study was to investigate the association between sociodemographic, socioeconomic, psychosocial, and behavioral variables and oral health as assessed using the 14-question short version of the Oral Health Impact Profile (OHIP-14). A cross-sectional study was performed with 1095 adult residents from 38 census tracts in the municipality of São Leopoldo, State of Rio Grande do Sul, Brazil. Responses to the OHIP-14 were dichotomized, and bivariate (Chi-square) and multivariate analysis (logistic regression and Wald's test) were performed. In the bivariate analysis, the worse effects were reported by female individuals, the elderly, those with low family income, less schooling, those reporting a lower quality of life and social support, and smokers. In the multivariate analysis the following variables maintained their statistical significance: gender (female), age (50-59 years), family income (low), quality of life (low), social support (low, moderate), and smoking (smokers). Individuals' self-perception of their oral health was related to sociodemographic, socioeconomic, psychosocial, and behavioral variables, thus confirming that emphasis should be placed on social factors when addressing oral health problems.

Predictors of healthcare service utilization for mental health reasons

This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior) and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.