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

Inequalities in Unmet Oral Health Care Need Among Adults in East Iran, a Cross Sectional Population-Based Study

Statement of the Problem:

Need assessment is considered as a key element of health care planning. Subjective measures can be useful tools in epidemiologic surveillances.

Purpose:

The aim of study was to evaluate inequality in perceived unmet oral health need (PUOHN) in adults in east of Iran.

Materials and Method:

In this cross-sectional population-based study, the target population included adult residents in the Mashhad and Kerman city. Data was collected through telephone interviews using a validated structured questionnaire. Phone numbers were obtained from telecommunication company. Participants were selected by stratified random sampling. Predisposing and enabling variables associated with PUOHN were included gender, age, educational level, job, insurance coverage, dental insurance, type of insurance, residential location, household size, and family economic indicators. Logistic regression was used to examine association of PUOHN and predisposing and enabling factors.

Results:

1475 individuals participated in the study (response rate of 63%). 52% of participants stated that their dental needs have not been met during the past year. The mean ages of respondents were 39 years old and 69.8% were female. Logistic regression analyses indicated living in rental house [OR=2 (95% CI 1.25-3.21), p Value=0.004] and higher household size [OR=1.19(95% CI 1.003-1.43), p= 0.04] significantly associated with PUOHN.

Conclusion:

The results of this study indicated high PUOHN in the adult population of East Iran. Effective strategies must be implemented to provide accessible dental services regardless of socioeconomic status.

Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study

The aim of this cross-sectional study was to explore sociodemographic, behavioral, and clinical factors associated with self-awareness of periodontal health. Data were collected from a representative sample of 736 adults (25–75 years old) in a city of Northern Italy who self-assessed gingival bleeding, oral malodor, and tooth mobility in a questionnaire and who underwent clinical periodontal examination and organoleptic evaluation. Approximately 50% of the subjects were aware of their actual gingival health status and oral odor. The logistic regression analysis revealed that females presented higher odds of correctly perceiving their gingival conditions and mouth odor, while those who were older and smokers had a greater probability of being less objective in reporting them. Tooth type and position in the dental arches were positively associated with self-perception of tooth mobility. These findings reflected a low level of self-awareness that may influence oral care-seeking behavior. Subjects may be unconcerned about their periodontal health condition or lack enough knowledge to be aware of it. This points to the need for planning strategies to improve education and knowledge about periodontal health, which, by enhancing self-perception of periodontal symptoms, could help everyone to seek treatment in the initial stage of the disease.

Factors associated with agreement between self-perception and clinical evaluation of dental treatment needs in adults in Brazil and Minas Gerais

This study sought to describe the agreement between self-perception and clinical evaluation of dental treatment needs in adults and analyze associated factors. The sample comprised adult individuals who took part in SBBrazil 2010 and SBMinas Gerais 2012. The study's outcome was agreement between self-perception and clinical evaluation of dental treatment needs. We used multiple Poisson regression in order to determine the factors associated with the outcome. Agreement between self-perception and clinical evaluation was 78.8% in Brazil and 73.8% in Minas Gerais. Clinical and self-reported oral health conditions that affect function and quality of life were associated with a higher agreement, while a recent visit to the dentist was associated with a lower agreement. Identifying associated factors may enable the development of questionnaires that favor correct self-perception regarding treatment needs.

Autopercepção da necessidade de prótese dentária total entre idosos brasileiros desdentados

Resumo Propõe-se estimar a prevalência da autopercepção da necessidade de prótese dentária total entre idosos (65 a 74 anos) brasileiros desdentados, assim como identificar seus fatores associados. Trata-se de estudo transversal com base no inquérito nacional das condições de Saúde Bucal da população brasileira, denominado SB Brasil – 2010. A variável dependente foi a autopercepção da necessidade de prótese dentária total, considerando a aquisição de prótese nova ou substituição da existente. Foram conduzidas análises descritivas, bivariadas e múltiplas. Foram incluídos 3514 idosos, destes, 2039 (55,0%) perceberam a necessidade de prótese total. A autopercepção da necessidade de prótese total foi maior entre os que necessitavam de prótese dentária inferior e que estavam insatisfeitos com as suas condições de saúde bucal. Além da alta prevalência da autopercepção da necessidade de prótese identificada, os resultados permitiram identificar que condições normativas e subjetivas de saúde bucal se mantiveram associadas a esta autopercepção entre idosos brasileiros.

Gaps in need, demand, and effective demand for dental care utilization among residents of Krishna district, Andhra Pradesh, India

AIMS

To identify the relation between need, demand, and effective demand for dental services in Andhra Pradesh, India.

MATERIALS AND METHODS

This is a cross-sectional study performed among populations residing in the rural and urban areas of Krishna district, Andhra Pradesh, India. Data were collected from 3102 individuals who were selected through multiphase random sampling. Data regarding self-perceived dental need, dental service utilization, and barriers for utilization were collected through s pretested questionnaire followed by type-III clinical examination to assess the normative need of the individuals. Chi-square test was used to compare independent and dependent variables, and further comparison was done with multivariate logistic regression analysis for significant variables.

RESULTS

Less than half (40%) of the participants perceived a need for dental care. Among the people who perceived need for care, only 21.4% utilized dental care and 78.6% of them had unmet dental needs. The two main reasons for not seeking dental care was lack of money, i.e., unaffordable dental treatment (48%) and having the perception that they do not have any dental problem (19.4%).

CONCLUSIONS

There is an enormous difference between normative need, demand, and actual utilization rates in dental care, and hindrances for effective demand need to be addressed to improve dental care delivery system.

Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service?

This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2 test) and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7%) evaluated the provided services negatively (very poor or poor). Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

Self-reported and clinically diagnosed dental needs among institutionalized adults in Vijayawada: A cross-sectional study

BACKGROUND

Frail and functionally dependent elderly people, living in institutions, have difficulties in accessing dental care. Hence, the present study aims to determine the relationship between subjective need and the equivalent clinical findings in an attempt to understand the factors that contribute to individual's perception of the need for dental care among institutionalized adults in Vijayawada.

MATERIALS AND METHODS

A cross-sectional study is conducted in all old age homes in Vijayawada. A total of 182 subjects were interviewed with a questionnaire consisting of demographic details, dental behavior (last visit, reason for the last visit), and self-rating of oral health and impact of oral problems, followed by the clinical examination for oral mucosal condition, dentition status and treatment needs, prosthetic status and treatment needs, and periodontal status by using World Health Organization proforma.

RESULTS

Results showed that normative needs of subjects are significantly more than the self-perceived needs. Response of subjects regarding their present condition of mouth and teeth is 65.4% of subjects reported good and 0.5% reported poor, with respective to perceived oral symptoms 61.9% of subjects' complaints of hypersensitivity and 23.1% of subjects were having toothache and 80.5% subjects are having difficulty in eating. The overall prevalence of complete Edentulous and require complete denture was 12.1%, and 60.4% required partial denture.

CONCLUSION

About half of the participants confirmed need for problem-oriented dental care. The main reason for the problems faced by the institutionalized people is due to lack of teeth which could be prevented by appropriate care.

Autopercepção de pessoas acometidas pela hanseníase sobre sua saúde bucal e necessidade de tratamento

A hanseníase é uma doença infecciosa que produz impacto do ponto de vista físico, social e psicológico. O propósito deste estudo foi avaliar a autopercepção sobre saúde bucal e a necessidade de tratamento em pacientes com hanseníase no Município de Fortaleza (CE), Brasil. Trata-se de um estudo transversal e descritivo, onde 100 pacientes com hanseníase foram submetidos a questionário semiestruturado. Os resultados da análise bivariada entre necessidade de tratamento e características socioeconômicas mostrou que apenas a escolaridade apresentou associação estatística (p = 0,000). Verificou-se associação entre a classificação da saúde bucal e autopercepção da necessidade de tratamento (p = 0,05). Com relação à autopercepção em saúde bucal, 36% dos sujeitos pesquisados classificaram sua saúde bucal como boa. A autopercepção do paciente com hanseníase quanto a sua saúde bucal e necessidade de tratamento deve, juntamente com uma avaliação clínica, servir de guia para a execução de políticas públicas que visem a favorecer um tratamento odontológico mais efetivo para esses pacientes.

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.

Fatores relacionados à autopercepção da necessidade de tratamento odontológico entre idosos

OBJETIVO: Analisar fatores associados à autopercepção da necessidade de tratamento odontológico entre idosos. MÉTODOS: Foram pesquisados 5.326 indivíduos incluídos em amostra dos idosos (65-74 anos) brasileiros do inquérito domiciliar de saúde bucal realizado em 2002/2003 pelo Ministério da Saúde. A análise foi baseada no modelo de Gift, Atchison & Drury e foi utilizada a regressão de Poisson para análise de inquéritos com amostras complexas. RESULTADOS: Do total da amostra, 2.928 (55%) idosos relataram necessitar tratamento odontológico. A autopercepção dessa necessidade foi menor entre aqueles com 70 anos ou mais (RP=0,94; IC 95%: 0,89;0,99), que não receberam informações sobre como evitar problemas bucais (RP=0,89; IC 95%: 0,83;0,95) e que eram edentados (RP=0,68; IC 95%: 0,62;0,74). Foi maior entre aqueles que autoperceberam: saúde bucal regular (RP=1,31; IC 95%: 1,21;1,41) ou ruim/péssima (RP=1,29; IC 95%: 1,19;1,41); aparência como regular (RP=1,23; IC 95%: 1,15;1,32) ou ruim/péssima (RP=1,28; IC 95%:1,18;1,39); mastigação como regular (RP=1,08; IC 95%: 1,01;1,15) ou ruim péssima (RP=1,13; IC 95%:1,05;1,21); os que relataram dor nos dentes ou gengivas nos seis meses anteriores ao inquérito (RP=1,27; IC 95%: 1,18;1,36); os que necessitavam de prótese em uma arcada (RP=1,29; IC 95%: 1,19-1,39) ou em ambas (RP=1,27; IC 95%: 1,16;1,40). CONCLUSÕES: Informação, condições de saúde bucal e questões subjetivas estiveram associadas à autopercepção da necessidade de tratamento odontológico. Os resultados reforçam a necessidade de capacitar os indivíduos para realizarem o auto-exame bucal e identificar precocemente os sinais e sintomas não dolorosos das lesões da mucosa, da cárie e da doença periodontal.

Oral health-related quality of life: a critical appraisalof assessment tools used in elderly people

OBJECTIVE

The purpose of this study was to undertake a critical appraisal of oral health-related quality of life (OHRQoL) measurements used for research in the elderly.

BACKGROUND

A variety of OHRQoL measurements have been developed in the past 20 years as a result of increased concern about the impact of oral conditions on a person's quality of life. There is need for an assessment aimed at prioritising the recommended measurements to be used for different purposes in the elderly.

MATERIALS AND METHODS

Original English language papers using measurements to assess OHRQoL in the elderly were identified from Web of Science, EMBASE, PubMed, Medline and Lilacs databases. The search included all papers published from 1985 to February 2007. The criteria of assessment were: (i) measurement criteria (number of items and domains, and classification of the results found for each measurement); (ii) quantitative-qualitative criteria (frequency, acceptability, reproducibility, reliability, sensitivity and capability of being reproduced in other language versions).

RESULTS

In a total of 152 papers selected, 20 measurements were identified. However, only seven fulfilled all the measurement and quantitative-qualitative criteria.

CONCLUSION

Geriatric Oral Health Assessment Index, Subjective Oral Health Status Indicators, Oral Health Impact Profile-49, Dental Impact on Daily Living, Oral Health Impact Profile-14, Oral Impact on Daily Performances and German Version of the Oral Heath Impact Profile were considered as instruments of choice to assess OHRQoL in the elderly. The other 13 instruments identified require further research aimed at a validation process and the use of a language other than English.

Perceived dental treatment need among older Tanzanian adults - a cross-sectional study

Background

Need perceptions for dental care play a key role as to whether people in general will seek dental care. The aim was to assess the prevalence of perceived need of problem based dental care, dental check-ups and any type of dental care. Guided by the conceptual model of Wilson and Cleary, the relationship of perceived need for dental care with socio-demographic characteristics, clinically defined dental problems and self-reported oral health outcomes was investigated. Partial prosthetic treatment need was estimated using a socio-dental approach.

Method

A cross-sectional survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. Information from interviews and clinical examination became available for 511 urban and 520 rural adults (mean age 62.9 yr).

Results

51.7% (95% CI 46.2, 57.0) urban and 62.5 % (95% CI 53.1, 70.9) rural inhabitants confirmed need for dental check-up, 42.9% (95% CI 36.9, 48.9) urban and 52.7% (95% CI 44.5, 60.6) rural subjects confirmed need for problem oriented care and 38.4% (95% CI 32.4, 44.6) urban versus 49.6% (95% CI 41.8, 57.4) rural residents reported need for any type of dental care. Binary and ordinal multiple logistic regression analyses revealed that adults who reported bad oral health and broken teeth were more likely to perceive need for dental care across the three outcome measures than their counterparts. Socio-demographic factors and clinically defined problems had less impact. Based on a normative and an integrated socio-dental approach respectively 39.5% and 4.7% were in need for partial dentures.

Conclusion

About half of the participants confirmed need for problem oriented care, dental check-ups and any type of dental care. Need perceptions were influenced by perceived oral health, clinically assessed oral problems and socio-demographic characteristics. Need estimates for partial denture was higher when based on clinical examination alone compared to an integrative socio-dental approach.