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van der Zande M, Exley C, Freeman R, Thetford C, Harris R. Is Dichotomization into Regular versus Irregular Dental Attenders Valid? A Qualitative Analysis. JDR Clin Trans Res 2023; 8:337-348. [PMID: 36032014 PMCID: PMC10504811 DOI: 10.1177/23800844221118515] [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] [Indexed: 11/15/2022] Open
Abstract
AIMS To discover whether dental visiting behavior can be understood as a dichotomy of planned versus problem based, or whether there were a range of different types of understanding and patient behavior, recognizable as patterns of dental visiting behavior. METHODS Secondary analysis drawing on 2 qualitative studies of patients' accounts of dental attendance and oral health, with 1) opportunistic interviews with people attending urgent dental care services (n = 43; including 19 with follow-up) and 2) home-based, in-depth interviews with people attending a dental practice with a mixture of improved or deteriorated/poor periodontal health (n = 25). RESULTS Four distinguishable patterns of dental visiting were identified in patients' accounts: Accepting and Active Monitoring, as well as Ambivalent and Active Problem-based dental visiting behavior. Individuals' patterns were relatively stable over time but could shift at turning points. Accepting Monitors were characterized as accepting dentists' recommendations and dental practice policies relating to oral health and visits, whereas Active Monitors were more independent in judging how often to attend for preventive appointments, while still valuing anticipatory care. Ambivalent Problem-based visitors placed a relatively low value on anticipatory care for oral health maintenance and drifted into lapsed attendance, in part because of service-related factors. This contrasted with Active Problem-based visitors, for whom using services only in an emergency was a conscious decision, with low value placed on anticipatory care. CONCLUSION This article demonstrates the dynamic nature of patterns of dental visiting where the dental system itself is partly instrumental in shaping patterns of utilization in an ecological way. Thus, service-related factors tend to combine with patients' behavior in expanding inequalities. This illuminates the reasons why risk-based recalls are challenging to implement as a dental policy. KNOWLEDGE TRANSFER STATEMENT The results of this analysis can be used by clinicians and policymakers to inform policy around supporting uptake of preventive health care visits, contributing in particular to understanding how risk-based preventive visiting policies may be better adapted to patients' understanding of the purpose of visits, taking into account that this is in part shaped by service-related factors in an ecological way, arising from patients' and dental teams' expectations.
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Affiliation(s)
- M.M. van der Zande
- Department of Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - C.E. Exley
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - R. Freeman
- School of Dentistry, University of Dundee, Dundee, UK
| | - C. Thetford
- School of Nursing, University of Central Lancashire, Preston, UK
| | - R.V. Harris
- Department of Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
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Sukalski JMC, Askelson NM, Reynolds JC, Damiano PC, Shi W, Xie XJ, McKernan SC. Perceived social status, socioeconomic status, and preventive dental utilization among a low-income Medicaid adult population. J Public Health Dent 2023; 83:363-370. [PMID: 37965907 DOI: 10.1111/jphd.12588] [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: 06/27/2022] [Revised: 08/29/2023] [Accepted: 09/15/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Perceived Social Status (PSS) is a measure of cumulative socioeconomic circumstances that takes perceived self-control into account. It is hypothesized to better capture social class compared to socioeconomic status (SES) measures (i.e., education, occupation, and income). This study examined the association between PSS and dental utilization, comparing the strength of associations between dental utilization and PSS and SES measures among a low-income adult Medicaid population. METHODS A cross-sectional survey was administered to a random sample of low-income adults in Iowa, United States with Medicaid dental insurance (N = 18,000) in the spring of 2018. Respondents were asked about PSS, dental utilization, and demographics. A set of multivariable logistic regression models examined the relative effects of PSS and SES measures on dental utilization, controlling for age, sex, health literacy, whether the respondent was aware they had dental insurance, transportation, and perceived need of dental care. RESULTS The adjusted response rate was 25%, with a final sample size of 2252. Mean PSS (range 1-10) was 5.3 (SD 1.9). PSS was significantly associated with dental utilization (OR = 1.11; CI = 1.05, 1.18) when adjusting for control variables, whereas other SES measures-education, employment, and income-were not. CONCLUSIONS PSS demonstrated a small positive association with dental utilization. Results support the relative importance of PSS, in addition to SES measures, as PSS may capture aspects of social class that SES measures do not. Results suggest the need for future research to consider the effects of PSS on oral health outcomes and behaviors.
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Affiliation(s)
- Jennifer M C Sukalski
- Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Natoshia M Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Julie C Reynolds
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Peter C Damiano
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Wei Shi
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Xian Jin Xie
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Susan C McKernan
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, Iowa, USA
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Ichihashi T, Goto A, Myagmar-Ochir E, Haruyama Y, Muto T, Kobashi G. Association between the interval of worksite dental check-ups and dental and medical expenditures: a single-site, 12-year follow-up study in Japan. BMJ Open 2022; 12:e063658. [PMID: 36223958 PMCID: PMC9562720 DOI: 10.1136/bmjopen-2022-063658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The purpose of this study was to identify the effective intervals of worksite dental check-ups to reduce cumulative dental expenditures (CDEs) and cumulative medical expenditures (CMEs), based on 12 years of follow-up dental check-ups. SETTING, DESIGN AND PARTICIPANTS A longitudinal study was conducted between 2002 and 2014 fiscal years. A total of 2691 full-time employees (2099 males and 592 females) aged 20-59 years in a manufacturing company in Japan were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES Based on the follow-up of 12-year dental check-ups, the interval of dental check-ups visits was classified into the following categories: 'Once per year' as the regular group, 'At least once per 2 years' as the subregular group and others as the irregular group. CDEs and CMEs per capita were examined by the three groups of dental check-ups interval after adjustment for sex, age, occupation and total CMEs at baseline. For sensitivity analysis, decayed teeth, missing teeth and Community Periodontal Index were added as adjustment factors. RESULTS Compared with the irregular group, the pooled CDEs (including dental check-ups fee) per capita in the subregular group (OR 0.91, 95% CI 0.85 to 0.98) and regular group (OR 0.87, 95% CI 0.81 to 0.93) were significantly lower overall. The younger adults in the subregular group and younger-aged and middle-aged adults in the regular group had significantly lower CDEs. Sensitivity analysis confirmed these findings. CONCLUSIONS Our findings suggest that regular and subregular worksite dental check-ups were related to reduction of CDEs. It is important to promote a yearly interval between dental check-ups.
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Affiliation(s)
- Toru Ichihashi
- Lion Foundation for Dental Health, Sumida-ku, Tokyo, Japan
- Department of Public Health, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Ayae Goto
- Lion Foundation for Dental Health, Sumida-ku, Tokyo, Japan
| | | | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Takashi Muto
- Department of Public Health, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
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Shmarina E, Ericson D, Franzén C, Götrick B. Self-perceived oral health-related salutogenic factors in orally healthy older Swedes. A qualitative interview study. Acta Odontol Scand 2022; 80:354-362. [PMID: 34893001 DOI: 10.1080/00016357.2021.2014068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed to explore oral health-related salutogenic factors in orally healthy older Swedish people, applying the three components of Antonovsky's Sense of Coherence (SOC) concept: comprehensibility, manageability and meaningfulness. MATERIAL AND METHOD Interviews were conducted with 12 orally healthy patients, aged 75 years and older, enrolled at public dental clinics. The interviews were subjected to qualitative content analysis, applying the SOC concept as the theoretical framework. RESULTS Three themes were formulated under the predefined SOC components, describing the central meaning of the informants' perception of factors favourable to their good oral health. The theme 'comprehension of cause and effect' consisted of three categories, for example importance of oral hygiene, and reflected the component comprehensibility. The theme 'living in confidence and trust in supporting society' consisted of five categories, for example self-esteem, and reflected the component manageability. The theme 'good oral health as a basis for satisfaction and social confidence' consisted of two categories, for example social norms, and reflected the component meaningfulness. CONCLUSION This study discloses how orally healthy elderly Swedish people perceive the lifelong impact of salutogenic factors in response to lifelong stressors on their oral health and highlights the important roles of their internal resources, dental professionals, family and society in supporting and reinforcing lifelong oral health.
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Affiliation(s)
- Elena Shmarina
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
- Kalmar County Council, Public Dental Service, Oskarshamn, Sweden
| | - Dan Ericson
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Cecilia Franzén
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Bengt Götrick
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Oral Hygiene Practices and Oral Health Knowledge among Students in Split, Croatia. Healthcare (Basel) 2022; 10:healthcare10020406. [PMID: 35207018 PMCID: PMC8872387 DOI: 10.3390/healthcare10020406] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Knowledge of oral health is a fundamental prerequisite for healthy behavior, allowing individuals to take measures to protect their overall health. This cross-sectional study aimed to examine the knowledge of oral health as well as to assess the oral hygiene habits among healthcare and non-healthcare students. Methods: The study was based on a questionnaire and was conducted among 1088 students. Most of the students, 67.6% were non-healthcare students. Data were processed by Mann–Whitney or Kruskal–Wallis one-way ANOVA test. Results: The correct median score and interquartile range were 11 (9–13) for all surveyed students, 11 (9–12) for students in non-healthcare programs and 13 (11–14) for students in healthcare programs. Students did not significantly differ in the knowledge of oral health by gender (p = 0.082) but did differ by age, study program, and year of study (p ≤ 0.001). Students whose family members work in the field of dental medicine also showed better oral health knowledge (p ≤ 0.001). Conclusion: The results showed good oral health knowledge among tested university students. However, it is important to emphasize that students who showed better knowledge more often used additional aids to maintain oral hygiene; therefore, the obtained data underline the importance of students’ further education in order to better understand and maintain oral health.
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Graça SR, Albuquerque TS, Luis HS, Assunção VA, Malmqvist S, Cuculescu M, Slusanschi O, Johannsen G, Galuscan A, Podariu AC, Johannsen A. Oral Health Knowledge, Perceptions, and Habits of Adolescents from Portugal, Romania, and Sweden: A Comparative Study. J Int Soc Prev Community Dent 2019; 9:470-480. [PMID: 31620380 PMCID: PMC6792312 DOI: 10.4103/jispcd.jispcd_194_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/25/2019] [Indexed: 01/04/2023] Open
Abstract
Aims The study aimed to assess and compare the self-reported oral health knowledge, habits, and perceptions of adolescents in Portugal, Romania, and Sweden and the factors that may affect them. Materials and Methods An oral health questionnaire with 25 questions was put together in English language and translated into Portuguese, Romanian, and Swedish language to investigate and compare oral health-related knowledge, habits, and perceptions of adolescents from the different countries. A voluntary sample of 879 teenagers completed it, mean aged 14.9 (±1.83) years, from Romania (n = 455), Portugal (n = 200), and Sweden (n = 224) as part of the EuHyDens project. The survey took place between November 2015 and June 2016. Results It showed some differences between the countries studied but more similarities between Portuguese and Romanian adolescents as related to perceptions of oral health and the use of oral services. Sweden and Portugal are more similar regarding oral health habits (toothbrushing and diet) as compared to Romanian adolescents. Portuguese adolescents have a higher oral health-related knowledge. Conclusion Assessment of knowledge, perceptions, and habits of a population is essential for the adequate understanding of the oral health-care needs of the society. From the data collected, several differences were found. These differences can be used for tailor interventions to minimize inequalities between countries.
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Affiliation(s)
- Sandra R Graça
- Dental Hygiene, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa Portugal, Leiria, Portugal
| | - Teresa S Albuquerque
- Dental Hygiene, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa Portugal, Leiria, Portugal
| | - Henrique S Luis
- Dental Hygiene, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa Portugal, ciTechCare - Center for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Victor A Assunção
- Dental Hygiene, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa Portugal, ciTechCare - Center for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Sebastian Malmqvist
- Division of Periodontology and Dental Hygiene, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Marian Cuculescu
- Preventive Dentistry Department, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Oana Slusanschi
- Preventive Dentistry Department, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Atena Galuscan
- Preventive Dentistry Department, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Angela C Podariu
- Preventive Dentistry Department, Faculty of Dentistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Annsofi Johannsen
- Division of Periodontology and Dental Hygiene, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Talakey AA, Bernabé E. Long-term regular dental attendance and tooth retention among British adults: A cross-sectional analysis of national survey data. Int J Dent Hyg 2018; 17:64-70. [DOI: 10.1111/idh.12373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/28/2018] [Accepted: 10/28/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Arwa Ameen Talakey
- Faculty of Dentistry; Oral & Craniofacial Sciences, King’s College; London UK
- Department of Periodontics and Community Dentistry; King Saud University Dental College; Riyadh Saudi Arabia
| | - Eduardo Bernabé
- Faculty of Dentistry; Oral & Craniofacial Sciences, King’s College; London UK
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