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Banihashem Rad SA, Esteves-Oliveira M, Maklennan A, Douglas GVA, Castiglia P, Campus G. Oral health inequalities in immigrant populations worldwide: a scoping review of dental caries and periodontal disease prevalence. BMC Public Health 2024; 24:1968. [PMID: 39044172 PMCID: PMC11267954 DOI: 10.1186/s12889-024-19354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 07/03/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Inequalities in immigrants' oral health are often masked in population-level data. Therefore, this paper was planned to assess the prevalence data on oral health diseases, namely dental caries, and periodontitis, among immigrants worldwide. METHODS Following a systematic search in Scopus, Embase, and PubMed for studies published between 2011 and 2023, 1342 records were identified. Following title and abstract screening, 76 studies remained for full-text eligibility-screening based on predefined inclusion criteria. Thirty-two studies were included in the review. RESULTS Dental caries figures were higher in immigrant populations compared to the local population, regardless of host countries, age, gender, or nationality. In children, the overall mean and standard deviation (SD) for decayed, missing, and filled teeth in the primary dentition (d3mft) was 3.63(2.47), and for D3MFT (permanent dentition), it was 1.7(1.2). Upon comparing overall mean caries counts in children and adults with their control groups in the included studies, untreated dental caries (D3T and d3t) constituted the dominant share of caries experience (D3MFT and d3mft) in immigrant children. For the local population, the highest proportion of caries experience was attributed to filled teeth (FT and ft). Dentin caries prevalence among immigrants ranged from 22% to 88.7% in the primary dentition and 5.6% to 90.9% in the permanent dentition. Gingivitis ranged from 5.1% to 100%. Oral health varied greatly between studies. Regarding oral health accessibility, 52% to 88% of immigrant children had never been to a dentist, suggesting a very limited level of accessibility to dental health services. CONCLUSION It is imperative to develop interventions and policies that have been customized to address the oral health disparities experienced by immigrant populations. Additionally, host countries should actively implement measures aimed at enhancing the accessibility of oral health care services for these individuals. The utilization of available data is crucial in establishing a hierarchy of objectives aimed at enhancing the oral health of immigrant populations. TRIAL REGISTRATION The Scoping review protocol was registered at OSF Registries with registration number ( https://doi.org/10.17605/OSF.IO/MYXS4 ).
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Affiliation(s)
- Seyed Ahmad Banihashem Rad
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, Bern, 3012, Switzerland.
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Marcella Esteves-Oliveira
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, Bern, 3012, Switzerland
- Department of Restorative Dentistry and Endodontology, Justus-Liebig-University Giessen, Giessen, Germany
- Department of Conservative Dentistry, Periodontology and Endodontology, Oral Medicine and Maxillofacial Surgery (UZMK), University Centre of Dentistry, University of Tübingen, Tübingen, Germany
| | - Anastasia Maklennan
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, Bern, 3012, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Gail V A Douglas
- Department of Dental Public Health, University of Leeds School of Dentistry, Leeds, UK
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, Bern, 3012, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- Department of Cariology, Saveetha Dental College and Hospitals, SIMATS, Chennai, 600077, India
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Lin PY, Lee YC, Hsu LY, Chang HJ, Chi LY. Association between sugary drinks consumption and dental caries incidence among Taiwanese schoolchildren with mixed dentition. Community Dent Oral Epidemiol 2021; 50:384-390. [PMID: 34312896 DOI: 10.1111/cdoe.12683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Dental caries is a multifactorial disease, and a sugary diet can generate an acidic plaque environment that advances its development. However, the specific effect of sugary drinks on the subsequent oral health of schoolchildren with mixed dentition is unclear. In this study, we investigated the association between the consumption of sugary drinks and 1 year incidence rate of caries in permanent teeth among Taiwanese schoolchildren with mixed dentition. METHODS A longitudinal 1 year follow-up study was conducted among Taiwanese schoolchildren aged 8-9 years. A questionnaire collected information regarding the parents' oral health status and their children's demographic background, oral health-related behaviours and consumption habits of sugary drinks, including handmade drinks (specifically bubble tea and pearl milk tea) and carbonated drinks. Dental caries was recorded through standardized oral examinations. The number of dental services received was retrieved from the Taiwan National Health Insurance Research Database. Multivariate Cox proportional hazards models and zero-inflated negative binomial models were used to estimate the association between the consumption of sugary drinks and the incidence rate of caries in permanent teeth after 1 year. RESULTS The study involved 494 children. During the 1 year follow-up period, 117 children developed new dental caries in their permanent teeth, yielding a caries incidence rate of 0.183 per person-year. After adjustments for confounding factors, children who preferred having sugar-rich beverages were associated with having a 4.3 times higher (95% confidence interval [CI] = 1.2-15.7) risk of developing caries than did those who preferred nonsugary drinks (P < .05). Additionally, children who often consumed handmade drinks were associated with having a 1.7 times higher (95% CI = 1.1-2.9) risk of developing caries than those who seldom consumed (P < .05). CONCLUSIONS The findings suggest that the consumption of sugary drinks during the mixed dentition stage might be a major etiological factor for caries in permanent teeth. These findings could be valuable to paediatricians, dentists, nutritionists and policymakers.
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Affiliation(s)
- Po-Yen Lin
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chin Lee
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Le-Yin Hsu
- Data Science Degree Program, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan
| | - Hong-Ji Chang
- Department of Dentistry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Lin-Yang Chi
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan.,Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
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Lin YC, Lin YC, Chen JH, Lin PL, Chen T, Huang HL. Long-term effects of a lay health advisor intervention on immigrant children's dental caries and maternal preventive behaviour: A randomized controlled trial. Community Dent Oral Epidemiol 2021; 50:280-291. [PMID: 34169539 DOI: 10.1111/cdoe.12670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES An oral health disparity exists between native and immigrant children in Taiwan. This study evaluated the long-term effectiveness of a lay health advisor (LHA) intervention on immigrant children's dental caries and maternal preventive behaviours. METHODS Fifty-one immigrant mother-child pairs were randomly assigned to LHA intervention (n = 23) and control (n = 28) groups. Mothers in the LHA group received a four-chapter one-on-one lesson plan, which included dental caries-related knowledge, brushing techniques, caries prevention and free preventive services, from the LHA over 4 weeks. Mothers in the control group received only a health brochure. Baseline and 1-week, 2-month, and 8-month follow-up information was collected using dental examinations and questionnaires. RESULTS The mean ages of the children in the LHA and control groups were 4.0 ± 1.4 and 4.2 ± 1.5, respectively. The decayed, missing due to caries, filled teeth (dmft) index in the LHA and control groups was 4.8 ± 6.0 and 5.4 ± 5.4, respectively, at baseline. At the 8-month postintervention follow-up, the number of filled teeth (ft) in the LHA group was higher than that in the control group (β = 8.3, P = .033). The effect size (ES) demonstrated an upward trend at 1-week, 2-month and 8-month follow-ups in ft (ES = 0.21, 0.50 and 0.59, respectively) and a decrease in the number of decayed teeth (dt) (ES = 0.30, 0.43 and 0.57, respectively). The mothers in the LHA group were observed to be 10.9 times more likely than control mothers to assist their children in toothbrushing for 3 min at the 1-week follow-up (95% CI = 1.98-59.40, P = .006). CONCLUSIONS The LHA intervention strategy had positive effects on the immigrant children's new dt and ft and on maternal preventive behaviour, such as assisting their children in toothbrushing.
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Affiliation(s)
- Yi-Ching Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Chun Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Dentistry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Pi-Li Lin
- Department of Nursing, School of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Ted Chen
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Kang SC, Lin CC, Tsai CC, Chang YC, Wu CY, Chang KC, Lo SS. The Primary Care of Immigrant Workers and Their Associated Characteristics within A Taiwanese Fishing Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193702. [PMID: 31581450 PMCID: PMC6801370 DOI: 10.3390/ijerph16193702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/26/2019] [Accepted: 09/29/2019] [Indexed: 11/16/2022]
Abstract
In Taiwan, immigrant workers play an important role in fisheries but they are easily ignored by society. The health problems and associated characteristics of immigrant workers in fisheries remain unclear. Descriptive and retrospective analyses were performed. Outpatient data were collected from a primary care clinic for six fishing villages in North Eastern Taiwan between 1 August 2016 and 31 July 2017. The data of immigrant workers was recorded and compared with that of natives. A total of 241 immigrant workers and 1342 natives were enrolled. Compared with the natives, the immigrant workers had a significantly younger age, male predominance, and fewer mean visits per year. The immigrant worker’s visits tended to be more highly focused during the third quarter of the year. Immigrant workers paid more registration fees and self-payment, but they paid less on diagnosis fees, oral medication, laboratory exams and had reduced total costs. The top five diagnoses for immigrant workers were respiratory diseases (38.3%), trauma (15.2%), musculoskeletal diseases (11.2%), skin-related diseases (9.5%), and digestive diseases (9.1%). Immigrant workers were positively correlated with infectious/parasitic diseases, and negatively correlated with medical consults and endocrine/metabolic diseases. Immigrant workers were also positively associated with registration fees and self-payment, but negatively correlated with diagnosis fees and total costs (all p < 0.05). The distribution of skin diseases and trauma were affected by age and sex as opposed to ethnic group. Immigrant status’ health issues should be given more attention.
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Affiliation(s)
- Shih-Chao Kang
- Daxi Clinic, Taoyuan, Taiwan.
- Division of Family Medicine; National Yang-Ming University Hospital, Yilan 26082, Taiwan.
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.
| | - Chun-Chi Lin
- Daxi Clinic, Taoyuan, Taiwan.
- Division of Occupational Medicine, National Yang-Ming University Hospital, Yilan 26082, Taiwan.
| | - Chia-Chen Tsai
- Daxi Clinic, Taoyuan, Taiwan.
- Center of Health Management, National Yang-Ming University Hospital, Yilan 26082, Taiwan.
| | - Yin-Chieh Chang
- Division of Family Medicine; National Yang-Ming University Hospital, Yilan 26082, Taiwan.
| | - Chi-Yi Wu
- Division of Family Medicine; National Yang-Ming University Hospital, Yilan 26082, Taiwan.
| | - Ke-Chang Chang
- Department of Otolaryngology, National Yang-Ming University Hospital, Yilan 26082, Taiwan.
| | - Su-Shun Lo
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.
- Department of Surgery, National Yang-Ming University Hospital, Yilan 26082, Taiwan.
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Lin YC, Chang CS, Ho PS, Lee CH, Chen JH, Huang HL. Immigrant⁻Native Differences in Sugar-Sweetened Beverage and Snack Consumption and Preventive Behaviors Associated with Severe Early Childhood Caries: A Large-Scale Survey in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061047. [PMID: 30909520 PMCID: PMC6466279 DOI: 10.3390/ijerph16061047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/11/2019] [Accepted: 03/20/2019] [Indexed: 12/04/2022]
Abstract
This study assessed the differences between immigrants and natives in terms of combined effects of sugar-sweetened beverage (SSB) or snack consumption and preventive behaviors for severe early childhood caries (SECC) through a large-scale survey of 31,565 native and 1046 immigrant child–parent pairs in Taiwan. Children aged 3–5 years underwent dental examinations, and parents completed structured questionnaires. Immigrants had a significantly higher SECC prevalence than native children (32.3% vs. 19.4%). A combined effect of SECC was observed in native children who did not receive assistance when brushing teeth at night before sleep and those who consumed SSBs more than four times weekly (adjusted odds ratio (aOR) = 4.8). Moreover, native children who did not use dental floss and who consumed snacks more than four times weekly had an aOR of 4.1 for SECC. The combined effects of children with immigrant parents who did not receive assistance when brushing their teeth at night before sleep and those who consumed snacks more than four times weekly had an aOR of 8.2 for SECC. The results suggest the necessity of cross-cultural caries prevention programs for immigrants. Parents must limit children’s SSB and snack intake, and implement preventive measures to reduce SECC development.
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Affiliation(s)
- Ying-Chun Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
| | - Chin-Shun Chang
- Taiwan Society of Oral Health, Keelung 201, Taiwan.
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Pei-Shan Ho
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| | - Chien-Hung Lee
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
- Department of Public Health and Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Department of Prosthodontics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
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Hsu YJ, Peng WD, Chen JH, Lin YC, Chang CS, Chen T, Hu CY, Ho PS, Chen FL, Lee CH, Huang HL. Evaluating the Effect of a Community-Based Lay Health Advisor Training Curriculum to Address Immigrant Children's Caries Disparities. Caries Res 2015; 49:147-56. [DOI: 10.1159/000363067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Accepted: 04/17/2014] [Indexed: 11/19/2022] Open
Abstract
Previous programs had not designed the culturally adequate Lay Health Advisor (LHA) oral health training curriculum for medically underserved population. We evaluated the effects of LHA training curriculum for addressing immigrant children's caries disparities in their access to dental care. We used a pre/post-test study design. Immigrant women were recruited from churches, schools, and immigrant centers in an urban area. Four training classes were held. Each training cycle lasted 15 consecutive weeks, consisting of 1 weekly 2-h training session for 12 weeks followed by a 3-week practicum. The curriculum included training in caries-related knowledge, oral hygiene demonstrations, teaching techniques, communication skills, and hands-on practice sessions. Thirty-seven LHA trainees completed the course and passed the post-training exam. The data were collected using self-report questionnaires. The level of oral health knowledge, self-efficacy and attitudes toward oral hygiene were significantly increased after LHA training. There was a significant and over twofold increase in trainees' oral hygiene behaviors. An increase of >20% in LHA and their children's dental checkup was observed following training. After training, LHAs were more likely to have 3+ times of brushing teeth [Odds Ratio (OR) = 13.14], brushing teeth 3+ minutes (OR = 3.47), modified bass method use (OR = 30.60), dental flossing (OR = 4.56), fluoride toothpaste use (OR = 5.63) and child's dental visit (OR = 3.57). The cross-cultural training curriculum designed for immigrant women serving as LHAs was effective in improvement of oral hygiene behaviors and access to dental care.
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Chen CC, Chiou SJ, Ting CC, Lin YC, Hsu CC, Chen FL, Lee CH, Chen T, Chang CS, Lin YY, Huang HL. Immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors: a cross-sectional study in Taiwan. BMC Oral Health 2014; 14:3. [PMID: 24423385 PMCID: PMC3898042 DOI: 10.1186/1472-6831-14-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 01/07/2014] [Indexed: 11/28/2022] Open
Abstract
Background With the growing number of transnational marriages in Taiwan, oral health disparities have become a public health issue. This study assessed immigrant-native differences in oral health behaviors of urban mothers and their children. Methods We used the baseline data of an oral health promotion program to examine the immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors. A cross-sectional study was conducted to collect data from mothers in urban area, Taiwan. A total of 150 immigrant and 440 native mothers completed the self-report questionnaires. Logistic regression models analyzed the racial differences in oral health behaviors. Results Approximately 37% of immigrant mothers used dental floss, 25% used fluoride toothpaste, and only 13.5% of them regularly visited a dentist. Less that 40% of immigrant mothers brush their children’s teeth before aged one year, 45% replaced child’s toothbrush within 3 months, and only half of the mothers regularly took their child to the dentist. Immigrant mothers had lower level of caries-related knowledge and attitudes than native mothers (p < .001). Compared to native group, the immigrant mothers were less likely to use of dental floss ([Adjusted odds ratio (aOR) =0.35], fluoride toothpaste (aOR = 0.29), visit a dentist in the past 2 years (aOR = 0.26), and take their children to regular dental check-up (aOR = 0.38); whereas, they were more likely to not consume sweeten beverages (aOR = 3.13). Conclusions The level of caries-related knowledge, attitudes and oral health behaviors were found lower in immigrant mothers than native ones. The findings suggested cross-cultural caries prevention programs aimed at reducing immigrant-native disparities in child oral health care must be developed for these immigrant minorities.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan.
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