Oral health needs, dental care utilization, and quality of life perceptions among Oregonian seniors

Urban-rural differences in the prevalence of having a family dentist and their association with income inequality among Japanese individuals: a cross-sectional study

BACKGROUND

Few reported studies evaluate the status of those who have a family dentist (FD) by regional differences and the socioeconomic factors associated with this status. This study aimed to assess the prevalence of having an FD among Japanese individuals across three samples of municipality type: urban, intermediate, and rural areas, and determine the factors associated with having an FD.

METHODS

This was a cross-sectional study involving a web-based survey. In total, 2,429 participants (comprising men and women aged 20-69 years) were randomly selected from among the registrants of a web research company: 811 urban residents, 812 intermediate residents, and 806 rural residents. In each area, we categorized the participants into those who had an FD (FD group) and those who did not (non-FD group). A multivariate modified Poisson regression analysis was used to determine the factors associated with the FD group as compared to the non-FD group.

RESULTS

The proportion of the FD group was lowest in rural areas (42.3%), followed by intermediate (48.6%) and urban areas (49.7%). The regression analysis revealed a statistically significant tendency between associated factors in the two groups; that is, the higher the household income, the more likely that the family belonged to the FD group (prevalence ratio (95%CI), JPY 4-6 million: 1.43 (1.00-2.03), JPY ≥ 8 million: 1.72 (1.21-2.44)).

CONCLUSIONS

Rural areas have the lowest proportion of people with an FD among the three areas, and income inequality is associated with having an FD. Thus, when planning policies to encourage individuals to have an FD to manage their oral health, it is necessary to consider regional differences.

Oral health assessment in institutionalized elderly: a scoping review

When elderly become frail and in need for complex care, they can no longer live independently at home and may be admitted to nursing homes. Various studies have shown that oral health in this population is remarkably poor, which may lead to distressing situations and impacts quality of life. A variety of definitions or descriptions for oral health is used. Without a uniform parameter, it is impossible to determine whether oral health in institutionalized elderly is actually improving or deteriorating over time, as well as the effect of (preventive) interventions. In search for an adequate and clinically applicable parameter to determine oral health in this specific patient group, this scoping review aims to give an overview of the currently used parameters for determining oral health in institutionalized elderly. Ninety different parameters were identified, and 50 parameters were solely used by one study. Only 4 parameters were frequently used (in > 20 studies). The relevance of these parameters for this specific patient group is discussed. To aid the planning and commissioning of future research and patient care, there is an urgent need for an adequate and uniform parameter for oral health determination in institutionalized elderly.

Analysis of 5-Year-old children's oral health service utilization and influencing factors in Guizhou Province, China (2019-2020)

BACKGROUND

This study aimed to investigate the utilization patterns and factors related to oral health care for 5-year-old preschoolers based on Andersen's Behavioural Model in Guizhou Province, Western China.

METHOD

A cross-sectional study of 4,862 5-year-old preschoolers in 66 kindergartens was conducted in 2019 and 2020. A basic oral examination and a survey of parents and grandparents were conducted to gather data on oral health services. The results were analysed using chi-square tests and logistic regression analysis.

RESULT

The utilization rate of oral health services for children in Guizhou province was 20.5%. The dmft was 4.43, and the rate of caries was 72.2%. The average cost of a dental visit was higher in rural areas and higher for girls. Logistic regression analysis revealed that dmft ≥ 6 teeth, a history of toothache, starting toothbrushing at age ≤ 3 years and limited parental knowledge were the primary factors impacting dental visits.

CONCLUSION

Needs factors such as severe oral conditions and pain in children are the main reasons for the utilization of these services. This study underscores the urgency to actively promote the importance of oral health and expand insurance coverage for oral health services.

Characteristics of desirable ambulatory health and oral healthcare from the perspective of community-dwelling people aged 80 and over-a qualitative examination

BACKGROUND

people aged 80 and over frequently have diverse and complex health trajectories, which has been well studied. But their oral health is seldom included in care models. To realise comprehensive healthcare, both general and oral ambulatory (i.e. outpatient) healthcare need to be explored and conceptualised equally.

OBJECTIVE

to elicit what matters to very old people regarding ambulatory health and oral healthcare.

METHODS

interviews were conducted with non-institutionalised people aged 80 and over living in the area of Cologne, Germany. They were interviewed regarding their experiences of and views on ambulatory healthcare and oral healthcare care, respectively. Thematic analysis was performed to understand their motives and elicit relevant characteristics of desirable health services.

RESULTS

from the interviews with 22 participants, 16 characteristics of good healthcare were described. These were generally similar for both general and oral healthcare and had a particular focus on patient-provider interaction and the organisation of care. However, regarding oral healthcare, the participants focused more strongly on the technical-medical skills of professionals and the perceptible treatment results and were more concerned about costs. It was noticeable that older people had the urge to differentiate themselves from 'others unnecessarily using health services'. They were unaware of possible future oral health deterioration and the resulting future needs.

CONCLUSIONS

characteristics of good health and oral healthcare from the perspective of older people should be incorporated to ensure patient-centredness in care models. Older patients, as well as healthcare providers, need to be sensitised to their oral health needs to realise comprehensive healthcare.

Oral Health of Older Patients in Dental Practice: An Exploratory Study

BACKGROUND

Some older people stop visiting the dentist when they get older. This study aims to identify the characteristics and oral health status of older people who do visit community dental practices.

METHODS

In this exploratory cross-sectional study, the oral health of Dutch community-dwelling older people was assessed. A random sample of general dental practitioners and older people who visit the dental practice was drawn. The dentists were asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to complete a questionnaire. Data were described for 3 distinct groups of older people. Statistical measures for distribution and dispersion were used to describe the oral health of community-dwelling older patients in relation to the age.

RESULTS

A total of 373 (40.4%) dentist registration forms and 372 (40.3%) patient questionnaires were returned. Data were available for 364 (39.4%) dentist-patient couples. Amongst the patients, 52.8% were female and most had a high socioeconomic status. About 65.7% had one or more problems related to general health, and 75.2% used medication. Regarding the overall oral health status, the average number of teeth was 20, 3.5% were edentulous. Oral health problems were more common in the older patient group (aged 75+), in whom frailty was also most common.

CONCLUSIONS

Older people who visit community dental practices are still relatively healthy, non-frail, and highly educated.  Even in this group, there is a turning point in both general and oral health from the age of 75.

Oral health clinical training and dental referral program for nurses: An interprofessional collaborative project

INTRODUCTION

The overall objective of this study was to establish an interprofessional oral health training program for nursing personnel at Oregon Health & Science University.

METHODS

Fifteen registered nurses participated in didactic and clinical training and screened the oral health of patients. Nurses completed confidence assessments and patients completed satisfaction surveys. Data analysis included descriptive statistics and non-parametric tests for comparisons of mean scores.

RESULTS

Pre- and post-training surveys demonstrated significant increases in nurses' knowledge, confidence in discussing dental problems, performing dental screenings, and referring patients to dentists (p < 0.05). Patient satisfaction surveys (n = 89) denoted satisfaction with oral screenings and willingness for nurses to perform them.

CONCLUSIONS

Nurses participating in oral health and clinical screening training programs supervised by dentists significantly increased their confidence in providing dental referrals. Longitudinal studies are needed to determine the impact of such training programs on patient health.

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.

The Influence of Oral Health Factors on the Quality of Life in Older People: A Systematic Review

BACKGROUND AND OBJECTIVES

The number of people aged 65 years or older is growing substantially. As a result of increased health burden and tooth retention, more oral health problems are expected in this age group. A poor oral health-related quality of life (OHQoL) can compromise a person's psychological state, social relationships, personal beliefs, and physical health. The aim of this systematic review was to identify oral health factors associated with OHQoL in people aged 65 years or older and to give a comprehensive overview of the body of literature for each oral health factor separately.

RESEARCH DESIGN AND METHODS

A comprehensive search was performed in five databases. The following terms were used as index terms or free-text words: "Oral Health," "Quality of Life," "Older People." Two researchers independently assessed studies for eligibility based on predefined criteria.

RESULTS

Of 3,702 references retrieved from the databases, 68 studies were eligible and included (9 randomized clinical trials, 6 cohort studies, and 53 cross-sectional studies). All results were reported descriptively. OHQoL in people aged 65 years or older is positively associated with higher number of teeth, higher number of occluding pairs, implant-retained overdentures, and the shortened dental arch concept and negatively associated with xerostomia, orofacial pain, and poor chewing ability. In the current literature, there is no consensus on the association between edentulism, caries, and periodontal conditions and OHQoL.

DISCUSSION AND IMPLICATIONS

Having a functional dentition (either natural or prosthetic) is important for a good OHQoL, whereas painful or functional complaints are associated with impaired OHQoL.

Barriers and Facilitators of Dental Care in African-American Seniors: A Qualitative Study of Consumers' Perspective

Objective

To identify African-American seniors' perceptions of the barriers and facilitators to their dental care.

Materials and Methods

In this cross-sectional qualitative study, we conducted in-depth interviews with 16 community-based, self-identified African-American seniors from March 2017 to August 2017 in Oregon. We coded data in ATLAS. ti and used thematic analysis to identify emergent themes within the social ecological framework and a cross-case comparative analysis to explore variation by participant characteristics.

Results

Regardless of dental insurance status, cost and perceived urgency of treatment were the primary drivers of participant's ability and interest in seeking dental care. Participants identified four solutions to improve oral health care in African-American seniors: affordable/free care and vouchers for dental work, better oral health education at a younger age, onsite community dental services, and navigators who can educate patients about insurance and dental providers who see low-income patients.

Conclusions

Oral health decisions by African-American seniors were primarily driven by cost and perceived urgency irrespective of insurance coverage. Affordable dental care, early intervention, on-site services, and navigation may help to address key barriers and reduce oral health disparities faced by African-Americans.

Oral Health-Related Quality of Life Appraised by OHIP-14 Between Urban and Rural Areas in Kutai Kartanegara Regency, Indonesia: Pilot Pathfinder Survey

Background:

Health-Related Quality of Life (HRQoL) periphrastically has a significant impact on oral health. A recent study has shown the significant facts of the oral health-related quality of life based on many factors such as individual, social status, household management, daily habits, and local factors. The differences in the oral health status possibly occur in between countries, different regions, and topographical areas frequently and indirectly contributing to oral health status.

Objective:

The objective is to evaluate the difference of Oral Health-Related Quality of Life (OHRQoL) and to assess the main affected dimension between rural and urban areas in Kutai Kartanegara Regency.

Methods:

This study uses pilot pathfinder design. The respondents comprised of 214 adults who were elder than 18 years and were randomly selected from urban and rural areas in Kutai Kartanegara Regency, Indonesia. The data were collected by 103 samples from the rural area and 111 respondents from the urban area. Oral Health Impacts Profile (OHIP-14) has been translated to Bahasa (Indonesia version). OHIP-14 was used to assess the subjects’ oral health-related impact. Shapiro-Wilk and Mann Whitney tests were used to analyze the data, and p-value was set at P < 0.05.

Results:

The mean OHIP scores in the urban and the rural areas were 25.4 and 28.8, respectively. The overall OHIP-14 score showed a significant statistical difference P= 0,009 (P < 0.05) between rural and urban area.

Conclusion:

This study illustrates that oral health-related quality of life in the urban area is better than in the rural area. Physical pain components of the OHRQoL are the major oral problems associated with both the areas.