Oral health: perceptions of need in a rural Iowa county

Cohort differences among aging populations: An update

BACKGROUND

The US population is aging. Most older adults are retaining their natural teeth for longer, and fewer are becoming edentulous.

METHODS

Among people 65 years and older, there is greater heterogeneity than at any other time in the life cycle because these cohorts are influenced by historical experiences and the sociodental events during their life spans. These events and experiences have affected their health behaviors and, consequently, their systemic and oral health. This article is an update on 2 previous articles that described birth cohorts spanning from 1900 through 1945, whereas this article describes 5 specific cohorts born from 1920 through 1980.

RESULTS

The authors used data from the literature to describe the historical and socioeconomic influences, as well as the key events in the history of dentistry, that have affected each of these cohorts' attitudes and expectations toward the use of health care and dental care services.

CONCLUSIONS

The authors identified cohort differences regarding health behaviors, which included attitudes toward dentistry and dental care service use.

PRACTICAL IMPLICATIONS

Dentists should be aware of cohort differences in regard to dental care service use, in addition to modifiers that are specific to each patient, to offer the most customized and age-appropriate oral health care.

Gender-stratified models to examine the relationship between financial hardship and self-reported oral health for older US men and women

OBJECTIVES

We evaluated the relationship between financial hardship and self-reported oral health for older men and women.

METHODS

We focused on adults in the 2008 Health and Retirement Study (n = 1,359). The predictor variables were 4 financial hardship indicators. We used Poisson regression models to estimate the prevalence ratio of poor self-reported oral health.

RESULTS

In the non-gender-stratified model, number of financial hardships was not significantly associated with self-reported oral health. Food insecurity was associated with a 12% greater prevalence of poor self-reported oral health (95% confidence interval [CI] = 1.04, 1.21). In the gender-stratified models, women with 3 or more financial hardships had a 24% greater prevalence of poor self-reported oral health than women with zero (95% CI = 1.09, 1.40). Number of hardships was not associated with self-reported oral health for men. For men, skipping medications was associated with 50% lower prevalence of poor self-reported oral health (95% CI = 0.32, 0.76).

CONCLUSIONS

Number of financial hardships was differentially associated with self-reported oral health for older men and women. Most financial hardship indicators affected both genders similarly. Future interventions to improve vulnerable older adults' oral health should account for gender-based heterogeneity in financial hardship experiences.

Do the indonesians receive the dental care treatment they need? A secondary analysis on self-perceived dental care need

Increasing access for citizens to health services, including dental care, is one of the primary targets of the Indonesian Ministry of Health. To assess progress toward this goal, we sought to describe the magnitude of unmet needs for dental care among Indonesians. Secondary data of nationally representative surveys conducted from 2003 to 2007 were analysed to describe the associations between unmet needs for dental care in different demographic groups. In average, 2.28% of the Indonesian population reported perceiving need for dental care and 0.74% reported utilizing dental care. The average of unmet need was 72.04%. Logistic regression analysis indicated that respondents who lived in rural areas, who were uninsured, had higher odds ratios in reporting unmet dental care needs. Perceived need for and utilization of dental care among Indonesians was found to be low. Moreover, the unmet need for dental care is relatively high.

Quality of life related to oral health: contribution from social factors

Sociodental indicators have been widely used in epidemiological research related to oral health, as they add the dimension of the impact of oral health on the quality of life of individuals and populations. Various studies have been done in order to validate new instruments to assess these subjective perceptions, however, the association between social parameters and impact on oral health-related quality of life (OHRQoL) has not been systematically studied, thus there is still doubt as to the role of the main social variables as OHRQoL impact modulators. This study aims to systematically review the literature in order to evidence the association between six social parameters and OHRQoL. Based on six exclusion criteria, the literature search revealed 40 eligible publications for analyses. The frequency of expected (positive) association between the social parameters and OHRQoL was greater than the non-expected (negative) associations for the six parameters.

CONCLUSIONS

The social conditions most clearly associated with the perception of negative impact on OHRQoL were: women, with poor education and low income, immigrants or people belonging to minority ethnic groups.

Cognitive function and dental care utilization among community-dwelling older adults

OBJECTIVES

We sought to investigate the relationship between varying levels of cognitive function and dental care utilization.

METHODS

Using data obtained from the National Health and Nutrition Examination Survey (1999-2002), we performed weighted descriptive and multivariate logistic regression analyses on 1984 individuals with at least 1 tooth and who were 60 years and older.

RESULTS

Multivariate analyses suggested that level of cognitive function was associated with dental care utilization. At a higher level of cognitive functioning, individuals were more likely to have had more frequent dental visits. In addition, a higher level of socioeconomic status, healthy lifestyle, and worse self-rated oral health-related symptoms were more likely to indicate a higher frequency of dental care utilization. By contrast, poorer oral health status as determined by clinical examinations was negatively associated with frequency of dental visits.

CONCLUSIONS

The results suggest that community-dwelling older adults with low cognitive function are at risk for less frequent use of dental care. Oral health serves as a mediating factor between cognitive function and dental care utilization. There is a great need to improve oral health awareness and education among older adults, caregivers, and health care professionals.

Self-perceived oral health status and influencing factors of the elderly residents of a peri-urban area of La Paz, Bolivia

AIM

To assess the self-perceived oral health status of the elderly in Bolivia and explore the relationship between the socio-demographic and subjective factors that influence such perception.

DESIGN

A cross sectional study.

SETTING

Pampahasi, peri-urban area of La Paz, Bolivia.

PARTICIPANTS

A 22.5% (300) sample was selected randomly from the total population (1,336) of 60 years and above. Of the participants, 293 agreed to participate in the survey.

METHODS

Information was collected by interviews at home.

RESULTS

The mean age was 70 years (SD = 7.7), with more females (57%) than males. Sixty per cent of subjects categorised their oral health as poor. Logistic regression analysis showed that poor self-perceived oral health was associated significantly with not going to school, no/ fair satisfaction with economic status, poor chewing ability, perception of need for dental treatment, and poor self-perceived general health status.

CONCLUSIONS

Socio-economic factors seem to contribute to poor oral health among the elderly in Bolivia. Considering that these factors are associated with bad oral health behaviour and few visits to dental clinics, there is a need to design dental education programmes and enhance accessibility to dental clinics for elderly people living in the peri-urban areas of La Paz, Bolivia.

Tooth loss, the wearing of dentures and associated factors in Sri Lankan older individuals

OBJECTIVE

To determine tooth loss, wearing of dentures and associated factors in older individuals from Sri Lanka.

DESIGN

A cross-sectional survey where the data were collected by means of an oral examination and an interviewer administered questionnaire.

SETTING

Negambo within the Gampaha district of Sri Lanka.

SUBJECTS

A total of 630 subjects who were aged 60 years and above.

RESULTS

Only 11 subjects had all 32 teeth and 17% were edentulous. Age, gender and level of income were significantly associated with the number of missing teeth. Of those with missing teeth, 22% wore dentures. Only 16% of the non-denture wearers perceived a need for dentures. Among the non-denture wearers who perceived a need for dentures, a majority had cited 'cost' as the main barrier for obtaining dentures. Logistic regression analysis revealed that age, gender, levels of income and education and missing teeth were significant predictors of wearing of dentures.

CONCLUSIONS

Knowledge of factors that influence tooth loss and wearing of dentures may have implications for oral health care planners in the provision and delivery of oral health services to the older individuals.

Perceived Need for Dental Care Among Dentate Older Individuals in Sri Lanka

The authors assessed the perceived need for dental care among 585 older individuals, of whom 235 received a clinical oral examination. Of the 235 participants, only 171 were dentate. The present analysis is limited to this group. Of these 171 dentate adults, 43 percent perceived a need for dental care. Of this sample section, 53 percent perceived a need for dentures. Age, perceived oral health status, presence of mobile teeth, three impact items of the Oral Health Impact Profile-14 (OHIP-14) scale--namely "had a painful aching in the mouth, had difficulty in eating and that the diet had been unsatisfactory due problems with teeth, mouth or dentures"--and the total OHIP-14 score showed significant associations with perceived need for dental care in bi-variate analysis. Poor perceived oral health status emerged as the strongest predictor of perceived need for dental care in logistic regression.