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Åstrøm AN, Özkaya F, Nasir E, Tsakos G. The dentist-patient relationship and oral health-related quality of life among older adults: A cohort study. Gerodontology 2023; 40:355-362. [PMID: 36329629 DOI: 10.1111/ger.12663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 10/16/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To assess the association between aspects of the dentist-patient relationship at age 65 and Oral Impacts on Daily Performances (OIDP) at ages 65 and 70 and to examine whether dental avoidance behaviours play a role in explaining that association. BACKGROUND Information about the quality of the dentist-patient relationship is important for dental care provision and healthy ageing. METHOD Secondary data analysis of a cohort study of Norwegians born in 1942. The participation rate in 2007 (age 65) and 2012 (age 70) was, respectively, 58.0% (n = 4211) and 54.5% (n = 3733). A total of 70.0% (n = 2947) of the baseline participants responded in 2012. Dentist-patient relationship aspects were assessed in terms of communication with the dentist, satisfaction with dental care, unpleasant experiences and changes of dentist. Generalised Estimating Equations (GEEs) were used to account for repeated measurements. RESULTS Prevalence of oral impacts (OIDP) was 29.0% in 2007 and 28.4% in 2012. Participants who received communication on oral hygiene during dental visits had a higher likelihood, whereas participants who reported satisfaction with dental care, no unpleasant experience and did not change dentist had a lower likelihood of reporting oral impacts over these 5 years. Corresponding odds ratios were: 1.2 (95% CI 1.0-1.5), 0.4 (95% CI 0.3-0.5), 0.6 (95% CI 0.5-0.7) and 0.5 (95% CI 0.3-0.6). Associations between dentist-patient relationship aspects and OIDP remained unchanged after adjustment for avoidance behaviours. CONCLUSION Training dentists in relationship skills might improve social interaction with patients and the oral health-related quality of life of older people in Norway.
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Affiliation(s)
- Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Oral Health Center of Expertise in Western Norway, Bergen, Norway
| | - Ferda Özkaya
- Department of Clinical dentistry, University of Bergen, Bexbach, Germany
| | - Elwalid Nasir
- Oral Health Center of Expertise in Western Norway, Bergen, Norway
- Department of Preventive Dentistry, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
| | - Georgios Tsakos
- Research Department of Epidemiology and Public Health, WHO Collaborating Centre for Oral Health Inequalities and Public Health, University College London, London, UK
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Rogers AA, Halvari AEM, Johnsen JAK, Solbakk AK. Executive functioning as a moderator of flossing behaviour among young adults: a temporal self-regulation theory perspective. Health Psychol Behav Med 2023; 11:2249972. [PMID: 37645514 PMCID: PMC10461502 DOI: 10.1080/21642850.2023.2249972] [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: 05/23/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023] Open
Abstract
Background Flossing among young adults is often infrequent and barriers not completely understood. One explanation concerns the capacity for executive functioning (EF) during the self-regulation of behaviour. Methods Using Temporal Self-Regulation Theory (TST) as a framework to explore EF, young adults from Norwegian universities completed a survey that measured monthly flossing frequency, flossing-related intentions and behavioural prepotency (BP), and EF using the Behaviour Rating Inventory of Executive Function - Adult Version (BRIEF-A). Results Data from 362 participants were analysed. The TST-model explained a substantial proportion of variance in monthly flossing (R2 = 0.74), and flossing was associated directly with intention and BP, and interactions between intention and both BP and global-EF. Sub-domains of EF were explored using the same model, revealing that behavioural regulation processes, specifically those related to emotional control and shifting between tasks, offered better fit. Simple slopes revealed that moderation effects were only present at lower levels of BP. Conclusion EF plays a role in moderating the translation of intentions into flossing behaviour. Specifically, emotional control and task-shifting appear to be influential, and this influence increases when habitual and environmental support (i.e. BP) is reduced. Overcoming EF-barriers may represent a key step in establishing flossing behaviours.
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Affiliation(s)
- Adam A. Rogers
- Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | | | - Jan-Are K. Johnsen
- Institute of Clinical Dentistry, UiT The Arctic University of Norway, Tromso, Norway
| | - Anne-Kristin Solbakk
- RITMO Centre for Interdisciplinary Studies in Rhythm, Time, and Motion, Department of Psychology, University of Oslo, Oslo, Norway
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Raittio E, Helakorpi S, Suominen AL. Age-Period-Cohort Analysis of Toothbrushing Frequency in Finnish Adults: Results From Annual National Cross-Sectional Surveys From 1978 to 2014. Int Dent J 2021; 71:233-241. [PMID: 33526244 PMCID: PMC9275030 DOI: 10.1016/j.identj.2020.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives No previous study has analysed age-, period-, and cohort-related long-term trends in toothbrushing frequency among adults using a nationally representative data set. Our aim was to study age, period, and cohort effects on toothbrushing among 15- to 64-year-olds in Finland from 1978 to 2014. Methods Data were gathered by nationally representative random cross-sectional samples of 15- to 64-year-old Finns annually from 1978 to 2014, during which response rates decreased from 84% to 53%. The final pooled sample size was 119,665. An age-period-cohort model was used to separate the effects of age, period, and cohort on trends in men's and women's toothbrushing frequency. Results From 1978 to 2014, the proportion of respondents who brushed at least twice a day or once a day increased from 42% to 66% and from 83% to 95%, respectively. The proportion of respondents who brushed at least twice a day increased from 27% to 53% among men and from 60% to 75% among women. Increases in at least once-a-day toothbrushing were smaller in both sexes, and in women the increase was minimal over the study years. The increase in toothbrushing frequency occurred particularly among those older than 40 years of age. In men, toothbrushing frequency increased steadily cohort by cohort (cohort effect) and within a single cohort as men in the cohort got older (longitudinal age trend). Instead, in women the cohort effect and longitudinal age trend in toothbrushing were smaller at both frequency thresholds. Conclusions On the population level, favourable changes in toothbrushing habits occurred among adult Finns from 1978 to 2014, especially in men.
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Affiliation(s)
- Eero Raittio
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
| | - Satu Helakorpi
- Department of Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland; Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL) Helsinki, Finland
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Åstrøm AN, Smith ORF, Sulo G. Early-life course factors and oral health among young Norwegian adults. Community Dent Oral Epidemiol 2020; 49:55-62. [PMID: 32918289 DOI: 10.1111/cdoe.12576] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Using a national sample of young Norwegian adults, we examined whether unpleasant experience with dental care during childhood is associated with tooth loss and oral health-related quality of life in adulthood after accounting for early- and later-life socio-behavioural circumstances and dental avoidance behaviour. METHODS 2433 individuals aged 25-35 years participated in an electronic survey. Oral quality of life was measured using the oral impact of daily performance (OIDP) inventory. Generalized linear models and negative binomial regression models were used to estimate the association of early unpleasant experiences with dental care and tooth loss and OIDP scores. Incidence rate ratio (IRR) and 95% confidence intervals (CI) were used to estimate the relative differences in prevalence of tooth loss and OIDP scores. RESULTS Adjusting for early-life characteristics only, the prevalence of tooth loss was 1.42 (IRR = 1.42, 95% CI: 1.24-1.64) and 1.96 (IRR = 1.96, 95% CI: 1.70-2.26) times higher among individuals who reported unpleasant experiences a few times or several times, than in individuals who did not report unpleasant experiences with dental care in childhood. Adjusting further for educational level, smoking and tooth brushing attenuated the relative differences (IRR = 1.40, 95% CI: 1.22-1.62 and IRR = 1.88, 95% CI: 1.62-2.17, respectively). Lastly, when adjusting for dental avoidance behaviour, the prevalence of tooth loss was 1.29 (IRR = 1.29, 95% CI: 1.11-1.50) and 1.58 (IRR = 1.58, 95% CI: 1.32-1.88) times higher among individuals who reported unpleasant experiences a few times or several times than in those who did not. Corresponding associations of early unpleasant experience with OIDP were (IRR = 1.41 95% CI: 1.22-1.63) and (IRR = 1.69, 95% CI: 1.42-2.01) when adjusting for early-life characteristics, and (IRR = 1.39, 95% CI: 1.20-1.60) and (IRR = 1.51, 95% CI: 1.27-1.80) when adjusting for education, smoking and tooth brushing. When adjusting for dental avoidance behaviour, the association of early unpleasant experience with OIDP became nonsignificant. CONCLUSION Unpleasant dental care experiences during childhood are associated with poor oral health in adulthood, independent of later-life socio-behavioural characteristics including negative dental care seeking. This highlights the importance of tailoring regular contacts with dental healthcare services in childhood to build confidence in children and thus has implications for healthcare policy.
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Affiliation(s)
- Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| | - Otto Robert Frans Smith
- Department of Health Promotion, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Gerhard Sulo
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway.,Division of Mental and Physical Health, Centre for Disease Burden, Norwegian Institute of Public Health, Oslo, Norway
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Leão MM, Garbin CAS, Moimaz SAS, Rovida TAS. Oral health and quality of life: an epidemiological survey of adolescents from settlement in Pontal do Paranapanema/SP, Brazil. CIENCIA & SAUDE COLETIVA 2017; 20:3365-74. [PMID: 26602714 DOI: 10.1590/1413-812320152011.00632015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 03/20/2015] [Indexed: 11/21/2022] Open
Abstract
This study aimed to verify oral health, treatment needs, dental service accessibility, and impact of oral health on quality of life (QL) of subjects from settlement in Pontal do Paranapanema/SP, Brazil. In this epidemiological survey, 180 10-to 19- years old adolescents enrolled in the school that attend this population in settlement underwent oral examination, to verify caries index (DMFT- decayed, missing and filled teeth) and periodontal condition (CPI), and were interviewed using the World Health Organization Quality of Life (WHOQOL-Bref) and Oral Impact Daily Performance (OIDP) instruments to evaluate QL, and the Global School-Based Health Survey (GSHS) about dental service accessibility. DMFT average was 5.49 (± 3.33). Overall, 37.2% of participants showed periodontal problems, mainly CPI = 1 (77.7%). Treatment needs were mainly restorations. GSHS showed that the last dental consultation occurred > 1 year previously for 58.3% of participants at a public health center (78.9%). The average WHOQOL-Bref was 87.59 (± 15.23). Social relationships were related to dental caries and health service type. The average OIDP was 6.49 (± 9.15). The prevalence of caries was high and observed periodontal problems were reversible. The social relationships of adolescents from settlement were influenced by caries and health services type.
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Affiliation(s)
- Milene Moreira Leão
- Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil,
| | - Cléa Adas Saliba Garbin
- Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil,
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Åstrøm AN, Gülcan F, Ekbäck G, Ordell S. Long-term healthy lifestyle patterns and tooth loss studied in a Swedish cohort of middle-aged and older people. Int J Dent Hyg 2015; 13:292-300. [PMID: 26294114 DOI: 10.1111/idh.12173] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2015] [Indexed: 02/02/2023]
Abstract
UNLABELLED The promotion of a healthy lifestyle has become an issue of public health importance in the context of ageing populations and increasing prevalence of chronic diseases. OBJECTIVE (i) To estimate changes in use of fluoridated tooth paste, use of tooth picks, smoking and alcohol consumption and (ii) to examine whether experience with incident or prevalent tooth loss predict healthy lifestyle transitions from age 50 to 70. METHOD In 1992, 6346 individuals born in 1942 agreed to participate in a prospective cohort study and 3585 completed follow-up questionnaires in 1997, 2002, 2007 and 2012. Statistical analyses were conducted by chi-square statistics, Cochran's Q and logistic regression. RESULTS In total, 15.7% and 74.0% reported incident (tooth loss only in 2012) and prevalent tooth loss (tooth loss in 1992 and 2012). Significant differences occurred between the 1992 and 2012 prevalence of using toothpicks (from 48.3% to 69.1%), smoking (from 26.9% to 10.1%) and alcohol consumption (from 41.5% to 50.5%), 29% and 15.6% increased use of toothpicks and alcohol consumption, whereas 15.5% stopped daily smoking. Increased use of fluoridated tooth paste, smoking cessation and failure to increase use of toothpicks was associated with prevalent tooth loss between age 50 and 70. CONCLUSION This study revealed positive and negative trends in oral health behaviours over a 20-year period in persons aged 50 at baseline. Mixed support was obtained for the assumption that oral health promoting lifestyle transitions follow experience with tooth loss. Older people with tooth loss experience could benefit from targeted counselling aimed at coping with oral diseases.
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Affiliation(s)
- A N Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - F Gülcan
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - G Ekbäck
- Örebro County Council, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - S Ordell
- Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden
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Johansson G, Östberg AL. Oral health-related quality of life in Swedish young adults. Int J Qual Stud Health Well-being 2015; 10:27125. [PMID: 26066517 PMCID: PMC4462826 DOI: 10.3402/qhw.v10.27125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 11/14/2022] Open
Abstract
The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL). The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21-29 years, were interviewed. The findings from the interviews were summarized under the theme "Young adults reflected on their OHRQoL in a time perspective" consisting of three categories: "Past experiences, Present situation, and Future prospects." The OHRQoL of young adults is dependent not only on their own experiences of oral health during childhood and their received dental care but also on their present self-perceived oral health, oral health habits, and social life; together with their expectations of future oral health. The findings in this study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up.
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Affiliation(s)
- Gunvi Johansson
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.,Department of Behavioural and Community Dentistry, Institution of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;
| | - Anna-Lena Östberg
- Department of Behavioural and Community Dentistry, Institution of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Public Dental Service, Region Västra Götaland, Sweden
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Gülcan F, Ekbäck G, Ordell S, Lie SA, Åstrøm AN. Inequality in oral health related to early and later life social conditions: a study of elderly in Norway and Sweden. BMC Oral Health 2015; 15:20. [PMID: 25881160 PMCID: PMC4328709 DOI: 10.1186/s12903-015-0005-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/30/2015] [Indexed: 11/13/2022] Open
Abstract
Background A life course perspective recognizes influences of socially patterned exposures on oral health across the life span. This study assessed the influence of early and later life social conditions on tooth loss and oral impacts on daily performances (OIDP) of people aged 65 and 70 years. Whether social inequalities in oral health changed after the usual age of retirement was also examined. In accordance with “the latent effect life course model”, it was hypothesized that adverse early-life social conditions increase the risk of subsequent tooth loss and impaired OIDP, independent of later-life social conditions. Methods Data were obtained from two cohorts studies conducted in Sweden and Norway. The 2007 and 2012 waves of the surveys were used for the present study. Early-life social conditions were measured in terms of gender, education and country of birth, and later-life social conditions were assessed by working status, marital status and size of social network. Logistic regression and Generalized Estimating Equations (GEE) were used to analyse the data. Inverse probability weighting (IPW) was used to adjust estimates for missing responses and loss to follow-up. Results Early-life social conditions contributed to tooth loss and OIDP in each survey year and both countries independent of later-life social conditions. Lower education correlated positively with tooth loss, but did not influence OIDP. Foreign country of birth correlated positively with oral impacts in Sweden only. Later-life social conditions were the strongest predictors of tooth loss and OIDP across survey years and countries. GEE revealed significant interactions between social network and survey year, and between marital status and survey year on tooth loss. Conclusion The results confirmed the latent effect life course model in that early and later life social conditions had independent effects on tooth loss and OIDP among the elderly in Norway and Sweden. Between age 65 and 70, inequalities in tooth loss related to marital status declined, and inequalities related to social network increased.
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Affiliation(s)
- Ferda Gülcan
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
| | - Gunnar Ekbäck
- Örebro County Council, Örebro, Sweden. .,School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
| | - Sven Ordell
- Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden.
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
| | - Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
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Åstrøm AN, Ekback G, Lie SA, Ordell S. Life-course social influences on tooth loss and oral attitudes among older people: evidence from a prospective cohort study. Eur J Oral Sci 2014; 123:30-8. [PMID: 25483593 DOI: 10.1111/eos.12160] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 12/13/2022]
Abstract
This study examined the relationship of trajectories in social condition with oral attitudes and major tooth loss, using the social mobility and accumulation life-course models in a cohort. Whether social-condition inequalities remained stable or changed from 65 yr of age to 70 yr of age was investigated. In 1992, 6,346 inhabitants born in 1942 and residing in two Swedish counties agreed to participate in a prospective survey. Of the participants in 1992, 3,585 (47.6% men) completed questionnaires in 1997, 2002, 2007, and 2012. In line with the social-mobility model, the prevalence of negative oral attitudes and major tooth loss in participants at 65 and 70 yr of age showed a consistent gradient according to social-condition trajectory, whereby it was lowest among those who were persistently high and highest among those who were persistently low, with the upwardly and downwardly mobile categories being intermediate. A linear graded association between the number of periods with disadvantaged social condition and oral health supported the accumulation model. Both the social mobility and accumulation life-course models were supported. Social-condition differentials in negative oral attitudes and tooth loss seem to remain stable or to narrow weakly after the usual age of retirement.
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Affiliation(s)
- Anne N Åstrøm
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Winterfeld T, Schlueter N, Harnacke D, Illig J, Margraf-Stiksrud J, Deinzer R, Ganss C. Toothbrushing and flossing behaviour in young adults--a video observation. Clin Oral Investig 2014; 19:851-8. [PMID: 25187263 DOI: 10.1007/s00784-014-1306-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 08/15/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Video observation studies of habitual oral hygiene from the 1970s revealed a striking neglect of brushing oral surfaces and unsystematic brushing patterns with frequent movements between areas. These findings were not systematically followed up; furthermore, nothing is known about whether subjects are able to floss sufficiently. Therefore, the aim of this video study was to analyse the performance of habitual toothbrushing and flossing. METHODS A random sample of 101 18-year-olds was included. Toothbrush and floss were provided; habitual brushing/flossing was videotaped in a standardised setting and analysed with the video coding software INTERACT. Parameters of interest were toothbrushing duration, type of brushing strokes, brushing patterns, flossed interproximal spaces and flossing technique. RESULTS The mean brushing duration was 156.0 ± 71.1 s; duration differed only slightly between the upper and lower jaw as well as between the right, left and anterior areas. However, oral surfaces were brushed distinctly shorter than vestibular surfaces (27.1 ± 27.8 s versus 72.1 ± 31.8 s; p ≤ 0.001). Participants brushed different areas of the mouth with different types of strokes, predominantly with horizontal and circular strokes. Brushing movements frequently alternated between areas (45.1 ± 22.4) not randomly but accumulated within a jaw with a tendency to move from the right to the left. Half of the participants flossed, but only one performed sufficiently. CONCLUSIONS There was a significant neglect of brushing oral surfaces and insufficient use of floss. Brushing patterns were similar to those observed in the 1970s. CLINICAL RELEVANCE Understanding habitual oral hygiene behaviour is essential for improving oral hygiene instruction strategies.
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Affiliation(s)
- T Winterfeld
- Department of Conservative and Preventive Dentistry, Dental Clinic, Justus-Liebig-University, 35392, Giessen, Germany
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