Factors influencing perceived oral health of Japanese middle-aged adults

Trends in Self-Rated Oral Health and Its Associations with Oral Health Status and Oral Health Behaviors in Japanese University Students: A Cross-Sectional Study from 2011 to 2019

Self-rated oral health (SROH) is a valid, comprehensive indicator of oral health status. The purpose of this cross-sectional study was to analyze how oral health behaviors and clinical oral status were associated with SROH and how they had changed over the course of nine years in Japanese university students. Data were obtained from 17,996 students who underwent oral examinations and completed self-questionnaires from 2011 to 2019. Oral status was assessed using the decayed and filled teeth scores, bleeding on probing (BOP), probing pocket depth, the Oral Hygiene Index-Simplified (OHI-S), oral health behaviors, and related factors. SROH improved from 2011 to 2019. The logistic regression model showed that university students who were female and had a high daily frequency of tooth brushing, no BOP, no decayed teeth, no filled teeth, and a low OHI-S score and were significantly more likely to report very good, good, or fair SROH. An interaction effect was observed between survey year and regular dental check-ups (year × regular dental check-ups). The improvement trend in SROH might be associated with changes in oral health behaviors and oral health status.

Body mass index and self‐rated oral health in Korean adults in 2017

OBJECTIVE

To investigate the association between obesity and self-rated oral health (SROH). This study examined the cross-sectional associations between body mass index (BMI) and SROH in Korean adults.

MATERIALS AND METHODS

This study used data from 217 304 adults (100 110 men and 117 194 women aged > 19 years) from the 2017 Korean Community Health Survey. Participants were categorised into six ordinal groups based on BMI: underweight (<18.5 kg/m² ), normal weight (18.5-22.9 kg/m² ), overweight (23.0-24.9 kg/m² ), obese-I (25.0-27.4 kg/m² ), obese-II (27.5-29.9 kg/m² ) or obese-III (≥30.0 kg/m² ). SROH was assessed using responses to the question, "How do you rate your oral health, including your teeth and gums?" rated on a 5-point scale. SROH was categorised as "good" (reported as "fair," "good" or "very good") or "poor" or "very poor." Age- and sex-stratified associations between BMI categories and poor SROH were assessed using ordinal logistic regression analysis with sampling weights.

RESULTS

The age-adjusted odds ratio (OR) for poor SROH according to BMI levels was lowest in the overweight group in both men and women. In men, the OR for poor SROH was 2.03 (99% confidence interval [CI], 1.72-2.39) in the underweight group, 1.17 (99% CI, 1.17-1.25) in the normal group, 1.05 (99% CI, 0.98-1.13) in the obese-I group, 1.08 (99% CI, 0.98-1.18) in the obese-II group and 1.36 (99% CI, 1.20-1.55) in the obese-III group. In women, the OR was 1.18 (99% CI, 1.07-1.31) in the underweight group, 1.01 (99% CI, 0.95-1.07) in the normal group, 1.07(99% CI, 0.99-1.16) in the obese-I group, 1.16 (99% CI, 1.04-1.30) in the obese-II group and 1.39 (99% CI, 1.20-1.62) in the obese-III group. From the restricted cubic spline models in both sexes, BMI showed a J-shaped association with poor and very poor SROH in men and women. In a stratified analysis by age group and sex, men and older women in the underweight group had poorer SROH than those in overweight group.

CONCLUSION

In a nationally representative sample of Korean adults, there was a J-shaped association between BMI and poor SROH, with the highest risk in the underweight group amongst men and in the obese-III group amongst women. Furthermore, in men and women over 65 years of age, underweight and obesity were associated with poorer SROH.

Possible association between oral health and sleep duration: A cross-sectional study based on the Korean National Health and Nutrition Examination Surveys from 2010 to 2015

This study was performed to investigate the association between oral health and sleep duration in South Korean subjects using 2010-2015 data from the Korean National Health and Nutrition Examination Survey (KNHANES).Cross-sectional data on 35,599 adults over the age of 19 years who completed KNHANES were analyzed. All participants reported subjective oral health status and their daily average sleep duration using a self-reported questionnaire. Sleep duration and oral health status were divided into 3 categories: ≤5, 6-8, ≥9 h/day and good, fair, poor, respectively.The overall prevalence of poor oral health status was 43.8%. Univariate analysis demonstrated that poor oral health status was significantly associated with age, smoking, alcohol, diabetes, education, income, depression, marital status, and sleep duration. After adjusting for covariates (age, sex, diabetes mellitus, hypertension, obesity, smoking, income, education, marital status), sleep durations of ≤5 hours (OR = 1.42; 95% CI, 1.26-1.60) and ≥9 hours (OR = 1.21; 95% CI, 1.04-1.40) were significantly associated with poor oral health, compared to a sleep duration of 6-8 hours. Short or long sleep duration was more likely to have an impact on the development of poor oral health status in men than in women. A significant relationship between sleep duration and oral health status was found in participants younger than 60 years.This is the first report that both short and long sleep durations are significantly associated with the development of poor oral health status. The effect of short or long sleep duration on poor oral health was more significant in younger subjects and in men.

Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases

Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.

Self-Rated Oral Health and Associated Factors among an Adult Population in Rural India-An Epidemiological Study

BACKGROUND

To determine the perception of oral health status and its associated factors among adults living in rural areas in Karnataka state, India.

METHODS

A cross-sectional study was conducted among adults in the age group of 35-54 years old residing in villages in a southern state in India. The main outcome measure was poor self-rated oral health (SROH) among adults in rural India.

RESULTS

About 873 adults participated in the study. The prevalence of poor SROH was 15.2%. Adults of age 40-44 years, females, those in lower socioeconomic conditions, and those with high caries experience (DMFT ≥ 4) and periodontal disease were associated with poor SROH. Those who had visited a dentist in the previous one year were 1.9 times more likely to report poor oral health.

CONCLUSIONS

Nearly 15% of rural people reported poor oral health. Socioeconomic conditions, sex, age, smoking, and dental visiting were associated with poor SROH. People's perception of poor oral health was associated with severe periodontitis and DMFT ≥ 4. A dose-response relationship was observed between experience with dental caries and poor SROH.

Relationship between oral health-related knowledge, attitudes, practice, self-rated oral health and oral health-related quality of life among Chinese college students: a structural equation modeling approach

Background

This study aimed to evaluate the associations among oral health-related knowledge, attitudes, practice (KAP), self-rated oral health and oral health-related quality of life (OHRQoL) among Chinese college students.

Methods

Of the 2000 participants, 1751 (87.55%) students answered an online questionnaire between October 2019 and January 2020. The questionnaire included demographic characteristics, knowledge, attitudes, and practice related to oral health, self-rated oral health, and OHRQoL. Structural equation modelling was applied to assess the associations among study variables.

Results

Among the total students, oral health-related knowledge and attitudes were satisfactory, while the oral health practice was not optimistic. The final model showed satisfactory fitness to the data. Oral health knowledge was associated with attitudes directly and positively. Attitudes toward oral health had a direct and positive effect on practice. Oral health knowledge had an indirect effect on practice through attitudes. Oral health practice was directly associated with self-rated oral health. Oral health knowledge, practice, and self-rated oral health all affected OHRQoL directly and positively, while attitudes had a direct negative impact on OHRQoL.

Conclusions

OHRQoL was influenced by oral health knowledge, attitudes, practice, and self-rated oral health. Our findings support the KAP theory. Limitations of the KAP model were also found.

Structural equation modeling to detect predictors of oral health-related quality of life among Japanese university students: a prospective cohort study

PURPOSE

This prospective cohort study of Japanese university students aimed to identify factors that might affect oral health-related quality of life (OHRQoL) and longitudinal relationships over a period of 3 years.

METHODS

Students (n = 487) provided complete data before entering and 3 years later (before university graduation) participated in the present study. Decayed, missing, and filled teeth (DMFT) scores, community periodontal index, ratios (%) of teeth with bleeding on probing, and malocclusion were determined during oral examinations. The questionnaire addressed age, sex, self-rated oral health, oral health behavior, subjective oral symptoms, and OHRQoL determined using the oral health impact profile (OHIP)-14. Associations were analyzed using structural equation modeling (SEM).

RESULTS

The OHRQoL significantly worsened according to OHIP-14 total score (p = 0.001). The final model in the symptoms of SEM analysis showed that OHRQoL at follow-up positively correlated with OHRQoL at baseline. Self-rated oral health was directly associated with the OHRQoL at baseline (p < 0.05).

CONCLUSIONS

This study determined that OHRQoL at baseline was a direct predictor, and that self-rated oral health were indirect predictors of OHRQoL at follow-up among Japanese university students.

Validity of Self-perceived and Clinically Diagnosed Gingival Status among 12-15-year-old Children in Indonesia

A few studies have revealed the self-perceived gingival status using questionnaires among children. Perceived health is a crucial factor that has an impact on quality of life. The objective of the study was to assess self-perceived and clinically diagnosed gingival status among children in Indonesia. This was a cross-sectional study of 494 schoolchildren (aged 12-15 years). Periodontal status was recorded using the gingival index (GI) and plaque index (PI) based on the World Health Organization standards. Data were collected through a brief visual, non-invasive clinical oral examination and a self-administered questionnaire. The sensitivity and specificity of self-perceived assessment were calculated using normative assessment as the gold standard. This study showed that self-perceived need for dental treatment showed the highest sensitivity (86% using PI and 85% using GI) and self-perceived swollen gums showed the highest specificity (89% using PI and 88% using GI) for clinically diagnosed plaque (PI cut-off value: 0.74) and gingival problems (GI cut-off value: 0.51). In conclusion, both self-perceived variables showed significant discordance between their respective sensitivity and specificity. Self-perceived information is at a higher-level unawareness that does not reflect the current gingival status. Thus, public health strategies are needed to improve the awareness of better oral health among children by promoting, empowering, and advocating.

The level of salivary lactate dehydrogenase as an indicator of the association between gingivitis and related factors in Japanese university students

The aim of this study was to investigate the association between the presence of gingivitis estimated using the salivary level of lactate dehydrogenase (LD) and related factors in young Japanese adults. Data from 1,915 participants (21.4 ± 2.5 years) were analyzed. Unstimulated saliva was collected from each participant and the salivary LD level was evaluated using a commercially available test kit with an integer scale ranging from 1 to 10. Gingivitis was defined as the LD level of ≥8. The number of permanent teeth, the simplified oral hygiene index (OHI-S), the presence of partially erupted molars and body mass index were recorded. Additionally, participants answered a questionnaire. The percentage of male participants, the number of permanent teeth, the OHI-S and the presence of partially erupted molars were higher, whereas the proportion receiving dental check-ups was lower in the gingivitis group (n = 88, 4.6%) than in the healthy group. Logistic regression analysis showed that gingivitis was significantly associated with OHI-S (OR: 2.68, 95% CI: 1.94-3.69) and receiving dental checkups (OR: 0.31, 95% CI: 0.10-0.99). The present findings indicated that the OHI-S and receiving dental checkups were significantly associated with gingivitis, as assessed by the salivary LD level, in this cohort.

Associations among oral health-related quality of life, subjective symptoms, clinical status, and self-rated oral health in Japanese university students: a cross-sectional study

BACKGROUND

The present study aimed to elucidate the associations among self-rated oral health, clinical oral health status, oral health behaviors, subjective oral symptoms, and oral health-related quality of life (OHRQoL) in a group of Japanese university students.

METHODS

Of 2051 participants, 2027 (98.83%) students received an optional oral examination and answered a questionnaire including items regarding age, sex, self-rated oral health, oral health behaviors, subjective oral symptoms, and OHRQoL [The Oral Health Impact Profile (OHIP)-14]. On oral examination, the decayed, missing, and filled teeth (DMFT) score, Community Periodontal Index (CPI), the percentage of teeth showing bleeding on probing (%BOP), and malocclusion were recorded. Structural equation modelling (SEM) analysis was used to test associations.

RESULTS

The mean score (± SD) of OHIP-14 was 1.92 ± 5.47. In the SEM analysis, the final model showed that self-rated oral health, oral pain, malocclusion, and the DMFT score were directly associated with the OHRQoL, and subjective symptoms of temporomandibular disorders (TMD) and recurrent aphthous stomatitis were both directly and indirectly associated (p < 0.05). CPI, %BOP, and oral health behaviors were excluded from the final model.

CONCLUSIONS

OHRQoL was associated with self-related oral health, subjective symptoms of TMD, oral pain and stomatitis, DMFT, and malocclusion in this group of Japanese university students.

Association between self-reported and clinical oral health status in Belarusian adults

AIM

The aims of the present study were to determine characteristics of self-perception of oral health, and to investigate associations between self-reported status and clinical oral health status among Belarusian adults.

METHODS

A cross-sectional study, including a questionnaire survey and oral health examination, was conducted among 281 dental patients.

RESULTS

Of the participants, 74% were women; the mean ages of female and male participants were 35.9 ± 12.3 and 28.0 ± 10.3 years (P < 0.001), respectively. More than half of the participants (58%) described their oral health as negative. The number of decayed teeth (P < 0.001), missing teeth (P < 0.001), and teeth with bleeding on probing (P < 0.01) and deep periodontal pockets (P < 0.001) were significantly higher among participants who described their oral health as negative compared to their counterparts. Participants with better agreement between self-reported and clinical number of teeth had significantly lower numbers of decayed and missing teeth (P < 0.01). There was a significant relationship between participants' self-reported periodontal status and number of teeth with bleeding on probing and deep periodontal pockets (P < 0.05).

CONCLUSIONS

Self-perceived oral health was significantly associated with clinical oral health status in this study. Self-reporting methods could be useful for population-based oral health surveys in Belarus.

Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University

Background

Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults.

Methods

This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed.

Results

In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health.

Conclusion

Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students.