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Kutkut A, Knudsen H, Bush H, Studts J. Comparison of Implant-Retained Overdenture and Conventional Complete Denture: A Survey Study to Measure Patients' Satisfaction and Quality of Life in Dental School Clinics. J ORAL IMPLANTOL 2024; 50:266-276. [PMID: 38839070 DOI: 10.1563/aaid-joi-d-22-00096] [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] [Indexed: 06/07/2024]
Abstract
Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CDs) or implant-retained mandibular overdentures (IODs), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CDs and IODs are the 2 leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least 1 year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IODs had lower physical pain, limitations, and disability scores than males with CD. However, females with IODs reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IODs and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.
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Affiliation(s)
- Ahmad Kutkut
- Division of Prosthodontics, Department of Oral Health Practice, University of Kentucky, College of Dentistry
| | - Hannah Knudsen
- Department of Behavioral Science, University of Kentucky, College of Medicine
| | - Heather Bush
- Department of Biostatistics, University of Kentucky, College of Public Health
| | - Jamie Studts
- Division of Medical Oncology, University of Colorado, School of Medicine
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2
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Haider F, Bernabé E, Delgado-Angulo EK. Education mediates the relationship of parental socioeconomic status with subjective adult oral health. Health Qual Life Outcomes 2023; 21:86. [PMID: 37563734 PMCID: PMC10416478 DOI: 10.1186/s12955-023-02169-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Evidence shows that both socioeconomic status (SES) during childhood and education are associated with adult oral health. However, whether the range of opportunities families have regarding their children's education mediate the effect of childhood disadvantage on oral health later in life remains unknown. The aim of this study was to evaluate the mediating role of education in the association between parental SES and subjective oral health status in middle adulthood. METHODS Data from 6703 members of the British Cohort Study 1970 were analyzed. Parental SES was measured using the 7-class National Statistics Socio-Economic Classification (NS-SEC) at age 10 years. Five measures of education (type of high school, highest qualification, age left full-time education, status of institution and field of study) were obtained from ages 16 and 42 years. Subjective oral health was measured with a single global item at age 46 years. Causal mediation analysis was performed, using a weighting-based approach, to evaluate how much of the effect of parental SES on subjective oral health was mediated by the measures of education separately and jointly. RESULTS Overall, 23.6% of individuals reported poor oral health. Parental SES was associated with every measure of education, and they were also associated with subjective oral health in regression models adjusted for confounders. The effect of parental SES on subjective oral health was partially mediated by each measure of education, with a proportion mediated of 53.2% for the institution status, 46.5% for the field of study, 42.8% for the school type, 38.9% for the highest qualification earned and 38.4% for the age when full-time education was discontinued. The proportion of the effect of parental SES on subjective oral health jointly mediated by all measures of education was 81.1%. CONCLUSION This study found a substantial mediating role of education in the association between parental SES and subjective oral health in middle adulthood.
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Affiliation(s)
- Faten Haider
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Eduardo Bernabé
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Queen Mary University of London, Turner street, E1 2AD, London, UK.
| | - Elsa Karina Delgado-Angulo
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Lima, Perú
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3
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Hach M, Hvidtfeldt UA, Christensen LB, Lange T, Danielsen B, Osler M, Diderichsen F, Andersen I. Underlying pathways of social inequality in tooth loss: the mediating role of sugary beverages and diabetes. Scand J Public Health 2023:14034948231173744. [PMID: 37184274 DOI: 10.1177/14034948231173744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Previous studies show social inequality in tooth loss, but the underlying pathways are not well understood. The aim was to investigate the mediated proportion of sugary beverages (SBs) and diabetes and the association between educational level and tooth loss, and to investigate whether the indirect effect of SBs and diabetes varied between educational groups in relation to tooth loss. METHODS Data from 47,109 Danish men and women aged 50 years or older included in the Danish Diet, Cancer and Health Study was combined with data from Danish registers. Using natural effect models, SBs and diabetes were considered as mediators, and tooth loss was defined as having <15 teeth present. RESULTS In total, 10,648 participants had tooth loss. The analyses showed that 3% (95% confidence interval 2-4%) of the social inequality in tooth loss was mediated through SBs and diabetes. The mediated proportion was mainly due to differential exposure to SBs and diabetes among lower educational groups. CONCLUSIONS
The findings show that SBs and diabetes to a minor degree contribute to tooth-loss inequalities. The explanation indicates that individuals in lower educational groups have higher consumption of SBs and more often suffer from diabetes than higher educational groups.
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Affiliation(s)
- Maria Hach
- School of Oral Health Care, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ulla A Hvidtfeldt
- Diet, Genes and Environment, Danish Cancer Society Research Center, Denmark
| | - Lisa B Christensen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Theis Lange
- Section of Biostatistics, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Bo Danielsen
- School of Oral Health Care, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Frederiksberg/Bispebjerg Hospitals and Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Finn Diderichsen
- Department of Public Health, University of Copenhagen, Denmark and Oswaldo Cruz Foundation, Brazil
| | - Ingelise Andersen
- Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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4
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Miranda G, Bernabé E, Delgado-Angulo EK. Is social origin, destination or mobility what matters to adult self-rated oral health? Community Dent Oral Epidemiol 2023; 51:211-218. [PMID: 35084747 DOI: 10.1111/cdoe.12728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the independent contributions of parental socioeconomic position (SEP), own SEP and social mobility to explain adult self-rated oral health. METHODS Data from 6633 participants in the 1970 British Cohort Study were analysed. Parental SEP at the age of 10 years (social origin) and own SEP at the age of 46 years (social destination) were indicated by the 7-class National Statistics Socioeconomic Classification (NS-SEC). The study outcome was self-rated oral health (SROH) at the age of 46 years. Diagonal reference models (DRMs) were used to parse out the effects of parental SEP, own SEP and intergenerational mobility from childhood to middle adulthood, after adjusting for demographic characteristics (sex, ethnicity, country and area of residence). RESULTS Overall, 23.1% of participants reported poor SROH. A baseline DRM, with no indicators of social mobility, showed that the contribution of own SEP to explain variations in SROH was higher than that of parental SEP. However, they became almost equal after indicators of social mobility were introduced. Downward mobility was associated with poor SROH (odds ratio: 1.24, 95% CI: 1.01-1.51), but upward mobility was not (1.01, 95% CI: 0.83-1.23). Also, short-range downward mobility and long-range downward mobility (moving 1 and 2+ social classes down in NS-SEC, respectively) were associated with poor SROH (1.26, 95% CI: 1.01-1.58 and 1.39, 95% CI: 1.06-1.83, respectively) whilst short-range upward mobility (1.04, 95% CI: 0.84-1.28) and long-range upward mobility (0.88, 95% CI: 0.67-1.14) were not. CONCLUSIONS The contributions of parental and own SEP were similar once social mobility was accounted for. Only downward mobility was associated with poor SROH, with new evidence that long-range mobility was more strongly associated with poor SROH than short-range mobility.
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Affiliation(s)
- Gabriela Miranda
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Eduardo Bernabé
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Elsa Karina Delgado-Angulo
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Lima, Perú
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5
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Celeste RK, Eyjólfsdóttir HS, Lennartsson C, Fritzell J. Socioeconomic Life Course Models and Oral Health: A Longitudinal Analysis. J Dent Res 2020; 99:257-263. [PMID: 32077794 DOI: 10.1177/0022034520901709] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We compared socioeconomic life course models to decompose the direct and mediated effects of socioeconomic status (SES) in different periods of life on late-life oral health. We used data from 2 longitudinal Swedish studies: the Level of Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old. Two birth cohorts (older, 1925 to 1934; younger, 1944 to 1953) were followed between 1968 and 2011 with 6 waves. SES was measured with 4 indicators of SES and modeled as a latent variable. Self-reported oral health was based on a tooth conditions question. Variables in the younger and older cohorts were grouped into 4 periods: childhood, young/mid-adulthood, mid /late adulthood, late adulthood/life. We used structural equation modeling to fit the following into lagged-effects life course models: 1) chain of risk, 2) sensitive period with late-life effect, 3) sensitive period with early- and late-life effects, 4) accumulation of risks with cross-sectional effects, and 5) accumulation of risks. Chain of risk was incorporated into all models and combined with accumulation, with cross-sectional effects yielding the best fit (older cohort: comparative fit index = 0.98, Tucker-Lewis index = 0.98, root mean square error of approximation = 0.04, weighted root mean square residual = 1.51). For the older cohort, the chain of SES from childhood → mid-adulthood → late adulthood → late life showed the following respective standardized coefficients: 053, 0.92, and 0.97. The total effect of childhood SES on late-life tooth loss (standardized coefficient: -0.23 for older cohort, -0.17 for younger cohort) was mediated by previous tooth loss and SES. Cross-sectional effects of SES on tooth loss were observed throughout the life course, but the strongest coefficients were at young/mid-adulthood (standardized coefficient: -0.41 for older cohort, -0.45 for younger cohort). SES affects oral health cumulatively over the life course and through a chain of risks. Actions to improve socioeconomic conditions in early life might have long-lasting effects on health if they help prevent people from becoming trapped in a chain of risks.
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Affiliation(s)
- R K Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - H S Eyjólfsdóttir
- Aging Research Center, Karolinska Institutet / Stockholm University, Stockholm, Sweden
| | - C Lennartsson
- Aging Research Center, Karolinska Institutet / Stockholm University, Stockholm, Sweden
| | - J Fritzell
- Aging Research Center, Karolinska Institutet / Stockholm University, Stockholm, Sweden
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Åstrøm AN, Smith ORF, Sulo G. Early-life course factors and oral health among young Norwegian adults. Community Dent Oral Epidemiol 2020; 49:55-62. [PMID: 32918289 DOI: 10.1111/cdoe.12576] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Using a national sample of young Norwegian adults, we examined whether unpleasant experience with dental care during childhood is associated with tooth loss and oral health-related quality of life in adulthood after accounting for early- and later-life socio-behavioural circumstances and dental avoidance behaviour. METHODS 2433 individuals aged 25-35 years participated in an electronic survey. Oral quality of life was measured using the oral impact of daily performance (OIDP) inventory. Generalized linear models and negative binomial regression models were used to estimate the association of early unpleasant experiences with dental care and tooth loss and OIDP scores. Incidence rate ratio (IRR) and 95% confidence intervals (CI) were used to estimate the relative differences in prevalence of tooth loss and OIDP scores. RESULTS Adjusting for early-life characteristics only, the prevalence of tooth loss was 1.42 (IRR = 1.42, 95% CI: 1.24-1.64) and 1.96 (IRR = 1.96, 95% CI: 1.70-2.26) times higher among individuals who reported unpleasant experiences a few times or several times, than in individuals who did not report unpleasant experiences with dental care in childhood. Adjusting further for educational level, smoking and tooth brushing attenuated the relative differences (IRR = 1.40, 95% CI: 1.22-1.62 and IRR = 1.88, 95% CI: 1.62-2.17, respectively). Lastly, when adjusting for dental avoidance behaviour, the prevalence of tooth loss was 1.29 (IRR = 1.29, 95% CI: 1.11-1.50) and 1.58 (IRR = 1.58, 95% CI: 1.32-1.88) times higher among individuals who reported unpleasant experiences a few times or several times than in those who did not. Corresponding associations of early unpleasant experience with OIDP were (IRR = 1.41 95% CI: 1.22-1.63) and (IRR = 1.69, 95% CI: 1.42-2.01) when adjusting for early-life characteristics, and (IRR = 1.39, 95% CI: 1.20-1.60) and (IRR = 1.51, 95% CI: 1.27-1.80) when adjusting for education, smoking and tooth brushing. When adjusting for dental avoidance behaviour, the association of early unpleasant experience with OIDP became nonsignificant. CONCLUSION Unpleasant dental care experiences during childhood are associated with poor oral health in adulthood, independent of later-life socio-behavioural characteristics including negative dental care seeking. This highlights the importance of tailoring regular contacts with dental healthcare services in childhood to build confidence in children and thus has implications for healthcare policy.
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Affiliation(s)
- Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| | - Otto Robert Frans Smith
- Department of Health Promotion, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Gerhard Sulo
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway.,Division of Mental and Physical Health, Centre for Disease Burden, Norwegian Institute of Public Health, Oslo, Norway
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7
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Delgado-Angulo EK, Alshehri R, Scambler S, Bernabé E. Is grandparents' social class associated with adult grandchildren's oral health? Analysis of two British cohorts. Community Dent Oral Epidemiol 2020; 48:402-408. [PMID: 32463137 DOI: 10.1111/cdoe.12545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES No studies have taken a multigenerational approach to the study of oral health inequalities. This study investigated whether grandparents' social class was associated with adult grandchildren's oral health. METHODS Data from the 1958 National Child and Development Study (NCDS) and the 1970 British Cohort Study (BCS) were analysed. Cohort members' occupational social class and persistent trouble with mouth, teeth or gums in the past 12 months were reported at ages 33 years in the NCDS and 26 years in the BCS. Information on grandparents' and parents' social class was reported by the cohort members' mothers during childhood. The association between grandparents' social class and cohort members' report of persistent trouble with mouth, teeth or gums was tested in marginal structural models (MSMs). RESULTS Data from 9853 NCDS and 6487 BCS participants were analysed. Grandparents' social class was not associated with cohort members' report of persistent trouble with teeth, gums or mouth in the NCDS sample (odds ratios of 1.25 [95% Confidence Interval: 0.95-1.65] for social class IV/V and 1.12 [95% CI: 0.76-1.64] for social class IIINM-M relative to social class I/II) or the BCS sample (odds ratios of 0.98 [95% CI: 0.68-1.43] for social class IV/V and 0.88 [95% CI: 0.67-1.16] for social class IIINM-M relative to social class I/II). CONCLUSION This study provided no support for an independent association between grandparents' social class and adult grandchildren's oral health.
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Affiliation(s)
- Elsa K Delgado-Angulo
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Facultad de Estomatología Roberto Beltrán Neira, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Reem Alshehri
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Sasha Scambler
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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8
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Ramsay SE, Papachristou E, Watt RG, Lennon LT, Papacosta AO, Whincup PH, Wannamethee SG. Socioeconomic disadvantage across the life-course and oral health in older age: findings from a longitudinal study of older British men. J Public Health (Oxf) 2019; 40:e423-e430. [PMID: 29684223 DOI: 10.1093/pubmed/fdy068] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/04/2018] [Indexed: 12/16/2022] Open
Abstract
Background The influence of life-course socioeconomic disadvantage on oral health at older ages is not well-established. We examined the influence of socioeconomic factors in childhood, middle-age and older age on oral health at older ages, and tested conceptual life-course models (sensitive period, accumulation of risk, social mobility) to determine which best described observed associations. Methods A representative cohort of British men aged 71-92 in 2010-12 included socioeconomic factors in childhood, middle-age and older age. Oral health assessment at 71-92 years (n = 1622) included tooth count, periodontal disease and self-rated oral health (excellent/good, fair/poor) (n = 2147). Life-course models (adjusted for age and town of residence) were compared with a saturated model using Likelihood-ratio tests. Results Socioeconomic disadvantage in childhood, middle-age and older age was associated with complete tooth loss at 71-92 years-age and town adjusted odds ratios (95% CI) were 1.39 (1.02-1.90), 2.26 (1.70-3.01), 1.83 (1.35-2.49), respectively. Socioeconomic disadvantage in childhood and middle-age was associated with poor self-rated oral health; adjusted odds ratios (95% CI) were 1.48 (1.19-1.85) and 1.45 (1.18-1.78), respectively. A sensitive period for socioeconomic disadvantage in middle-age provided the best model fit for tooth loss, while accumulation of risk model was the strongest for poor self-rated oral health. None of the life-course models were significant for periodontal disease measures. Conclusion Socioeconomic disadvantage in middle-age has a particularly strong influence on tooth loss in older age. Poor self-rated oral health in older age is influenced by socioeconomic disadvantage across the life-course. Addressing socioeconomic factors in middle and older ages are likely to be important for better oral health in later life.
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Affiliation(s)
- Sheena E Ramsay
- Institute of Health & Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK.,Institute of Epidemiology and Health Care, UCL, London, UK
| | | | - Richard G Watt
- Department of Epidemiology & Public Health UCL, London, UK
| | - Lucy T Lennon
- Institute of Epidemiology and Health Care, UCL, London, UK
| | | | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
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9
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Bernabé E, Lie SA, Mastrovito B, Sannevik J, Astrom AN. Childhood negative dental experiences and tooth loss in later life: A 25-year longitudinal study in Sweden. J Dent 2019; 89:103198. [DOI: 10.1016/j.jdent.2019.103198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/31/2019] [Accepted: 09/07/2019] [Indexed: 12/20/2022] Open
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10
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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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11
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Vendrame É, Goulart MDA, Hilgert JB, Hugo FN, Celeste RK. Decomposing early and adult life social position effects on oral health and chronic diseases in a cross-sectional study of Southern Brazil. Community Dent Oral Epidemiol 2018; 46:601-607. [DOI: 10.1111/cdoe.12410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 07/05/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Édina Vendrame
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Mariél de Aquino Goulart
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Juliana B. Hilgert
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Graduate Program in Epidemiology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Fernando N. Hugo
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Research Center in Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Roger Keller Celeste
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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12
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Fantin R, Delpierre C, Kelly-Irving M, Barboza Solís C. Early socioeconomic conditions and severe tooth loss in middle-aged Costa Ricans. Community Dent Oral Epidemiol 2017; 46:178-184. [PMID: 29168897 DOI: 10.1111/cdoe.12351] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/19/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE A wide literature shows a strong social gradient in tooth loss according to income, education and occupation, in both developed and developing countries. It has been shown associations between tooth loss and parental education and occupation, independently of adult conditions. To explore the role of early socioeconomic circumstances on tooth loss, we used a lifecourse model. We analysed the direct and indirect links between early socioeconomic conditions and severe adult tooth loss. METHODS We used the Costa Rican Longevity and Healthy Aging Study 1945-1955 Retirement Cohort, a nationally representative longitudinal survey of Costa Rican residents born between 1945 and 1955. We used imputed data on 2796 individuals. Principal component analyses were run to integrate measures approaching the material circumstances during childhood and adulthood. We additionally examined the role of adult health behaviours and education level as potential mediators in the multivariable regression. RESULTS Early socioeconomic conditions were found strongly associated with severe tooth loss; 72.4% of the people who experienced the most deprived socioeconomic conditions during childhood (quartile 1) had severe tooth loss at the time of the interview; vs 43.3% in quartile 4 (most advantaged). This link diminished after adjustment for adult mediators. However, it remained a significant determinant of severe tooth loss in the final model. CONCLUSION The lifecourse model allowed to highlight that early socioeconomic conditions could have long-term consequences on severe tooth loss in middle ages via both direct and indirect mechanisms.
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Affiliation(s)
- Romain Fantin
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
| | - Cyrille Delpierre
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
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13
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Shim SH, Han DH. Association between height and periodontitis in Korean adults: Results from KNHANES IV and V. J Periodontal Res 2017; 53:345-352. [PMID: 29159808 DOI: 10.1111/jre.12519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Evidence shows that a short stature in adulthood is associated with chronic diseases. However, few studies have investigated the association between height and periodontitis. The purpose of this study was to examine the relationship between adult height and periodontitis and to assess the roles of covariates in different birth cohorts of Korea. MATERIAL AND METHODS This was a cross-sectional study using the data from the 4th and 5th Korea National Health and Nutritional Examination Survey. The subjects were grouped into 2 birth cohorts based on their historical and social context: born from 1946 to 1962 and from 1963 to 1978. The dependent variables were periodontitis and severe periodontitis, while the independent variable was the height quartile. Demographic factors (age and gender), socioeconomic position (own education, region and income), health behaviors (frequency of daily tooth brushing and smoking) and medical status (diabetes) were included. Logistic regression analyses estimated the association of adult height with periodontitis after sequential adjustments. RESULTS The sample size of the final analysis was 18 010. The shortest quartile was associated with severe periodontitis (OR = 1.55, 95% CI 1.11-2.16) in the 1963-1978 birth cohort. The association remained after full adjustment in the 1963-1978 birth cohort (OR = 1.41, 95% CI 1.01-1.97). CONCLUSION Our study shows that there is an inverse association between height and severe periodontitis only in the younger Korean birth cohort. Our results support the impact of height, as an early childhood environmental indicator, on severe periodontitis in adulthood.
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Affiliation(s)
- S-H Shim
- Department of Dental Hygiene, Kyungbok University, Namyangju, Korea
| | - D-H Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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Listl S, Broadbent JM, Thomson WM, Stock C, Shen J, Steele J, Wildman J, Heilmann A, Watt RG, Tsakos G, Peres MA, van der Heijden G, Jürges H. Childhood socioeconomic conditions and teeth in older adulthood: Evidence from SHARE wave 5. Community Dent Oral Epidemiol 2017; 46:78-87. [PMID: 28925509 DOI: 10.1111/cdoe.12332] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 08/02/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Dental diseases are the most common chronic diseases worldwide. Healthy teeth are vital for quality of life, particularly diet and nutrition. However, little information exists to inform health policymakers about potentially long-lasting influences of early-life conditions. The purpose of this study was to investigate the relation between early-life socioeconomic conditions and number of natural teeth at age 50 and above. METHODS Analyses were conducted on cross-sectional data from the Survey of Health, Ageing and Retirement in Europe (SHARE wave 5), which includes information on 41 560 respondents aged 50 years or older from 14 European countries and Israel. Using SHARE life history information, a series of regression models (OLS, Tobit) were estimated to analyse the relationship between socioeconomic conditions in earlier life and the number of teeth at age 50+. RESULTS Childhood socioeconomic background was associated with the number of natural teeth at age 50 and above, even after controlling for current determinants of oral health. Respondents who had had more than 25 books in their childhood household had a mean 1.4 (95% CI: 1.2-1.5) more teeth than respondents with fewer books. Respondents who reported poor financial conditions during childhood had a mean 0.6 (95% CI: 0.3-0.9) fewer teeth than respondents who reported better financial conditions in childhood. CONCLUSION These findings substantiate the association between socioeconomic conditions in the early years of life and tooth retention to older adulthood and highlight the long-lasting relation between childhood living conditions and oral health through the lifecourse.
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Affiliation(s)
- Stefan Listl
- Department of Quality and Safety of Oral Health Care, Radboud University Nijmegen, Nijmegen, The Netherlands.,Department of Conservative Dentistry, Translational Health Economics Group (THE Group), Heidelberg University, Heidelberg, Germany
| | - Jonathan M Broadbent
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - W Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Christian Stock
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Jing Shen
- Newcastle upon Tyne, Newcastle University, Newcastle, UK
| | - Jimmy Steele
- Newcastle upon Tyne, Newcastle University, Newcastle, UK
| | - John Wildman
- Newcastle upon Tyne, Newcastle University, Newcastle, UK
| | - Anja Heilmann
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Marco A Peres
- Australian Research Centre for Population Oral Health (ARCPOH), University of Adelaide, Adelaide, SA, Australia
| | - Geert van der Heijden
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, Netherlands
| | - Hendrik Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
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15
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Rozier RG, White BA, Slade GD. Trends in Oral Diseases in the U.S. Population. J Dent Educ 2017; 81:eS97-eS109. [PMID: 28765461 DOI: 10.21815/jde.017.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 02/21/2017] [Indexed: 01/01/2023]
Abstract
This article reviews trends in dental caries, periodontal disease, and tooth loss for the United States along with population dynamics and risk factors that might influence these trends going forward. Dental caries experience remains high in the primary dentition. Caries severity in permanent teeth of children has declined to historically low levels, and long-standing inequalities in untreated caries appear to be narrowing. Declines in caries severity of children's permanent teeth have stabilized at a low level, but likely will contribute to future reductions in dental caries severity in adults. The prevalence of periodontal disease is high in adults, and only a small percentage have severe forms of the disease. Countervailing trends in determinants would suggest little change in the prevalence of periodontal disease in the future, but the lack of an obvious trend over the last two decades makes projections uncertain. Tooth loss as a consequence of dental disease has declined markedly over the last half century and has been all but eliminated in high-income groups. However, notable exceptions to these favorable trends are evident. Progress in prevention policies and programs that affect disease experience appears slower than progress in meeting population-level caries treatment needs. Clearly, long-standing inequities related to political and social determinants remain for all dental diseases, and income disparities in dental disease are widening for some indicators. Growing inequalities raise ethical and public health concerns that should be prominent in discussions of dental workforce needs and strategies for the next 25 years. This article was written as part of the project "Advancing Dental Education in the 21st Century."
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Affiliation(s)
- R Gary Rozier
- Dr. Rozier is with the Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Dr. White is with the Department of Health Policy and Management, Gillings School of Global Public Health, and Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill; and Dr. Slade is with the Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill.
| | - B Alexander White
- Dr. Rozier is with the Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Dr. White is with the Department of Health Policy and Management, Gillings School of Global Public Health, and Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill; and Dr. Slade is with the Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill
| | - Gary D Slade
- Dr. Rozier is with the Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Dr. White is with the Department of Health Policy and Management, Gillings School of Global Public Health, and Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill; and Dr. Slade is with the Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill
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16
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Han DH, Khang YH. Lifecourse socioeconomic position indicators and tooth loss in Korean adults. Community Dent Oral Epidemiol 2016; 45:74-83. [DOI: 10.1111/cdoe.12262] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/07/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry; Seoul National University School of Dentistry; Seoul South Korea
- Dental Research Institute; Seoul National University; Seoul South Korea
| | - Young-Ho Khang
- Department of Health Policy and Management; Seoul National University College of Medicine; Seoul South Korea
- Institute of Health Policy and Management; Seoul National University Medical Research Center; Seoul South Korea
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17
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Henke C, Budweiser S, Jörres RA. Lung function and associations with multiple dimensions of dental health: a prospective observational cross-sectional study. BMC Res Notes 2016; 9:274. [PMID: 27184138 PMCID: PMC4869198 DOI: 10.1186/s13104-016-2079-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological data suggest an association between respiratory diseases and periodontal health. However, the link between the overall dental status and single lung function measures, within a practical clinical context, is not well studied. METHODS Following a prospective cross-sectional design, consecutive adult patients were evaluated. Next to spirometry, anthropometric data, profession, smoking status, symptoms, self-rated exercise performance, comorbidities, allergies and medication were determined. Assessment of dental status comprised carious lesions, dental fillings, missing teeth, dentures, insufficient fillings/dentures, implants, oral mucosa diseases, calculus, decayed-missed-filling-teeth (DMF-T)-index, periodontal screening-index, and orthopantomograms. RESULTS Among 587 adult patients considered, 206 were included (119 female; median age 42.0 years; 56 % smoking history). Most patients had dental fillings (86.9 %), fix/mobile dentures (66.5 %), missing teeth (56.8 %) and calculus (84.0 %), the overall DMF-T being 15 (9; 21). Periodontitis was present in 53.9 %, an abnormal orthopanthomogram in 47.9 % of subjects. Regarding spirometric indices expressed as % predicted, dentures, missing teeth, oral mucosal diseases and a DMF-T > 15 (median) were associated with lower maximal expiratory flows at 25 % of vital capacity (MEF25) (p < 0.05 each). In adjusted logistic regression analyses, only dentures were associated with low MEF25 % predicted and with the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC; p < 0.05 each). However, periodontitis and DMF-T were linked to age (p < 0.001) and packyears (p < 0.05) only. CONCLUSION Within a real-life clinical setting, only the presence of dentures showed weak associations with lung function, suggesting small airways dysfunction and obstruction. Most of the associations were explained by smoking habits and age.
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Affiliation(s)
| | - Stephan Budweiser
- />Department of Internal Medicine III, Division of Pulmonary and Respiratory Medicine, RoMed Clinical Centre, Rosenheim, Germany
| | - Rudolf A. Jörres
- />Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
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18
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Di Bernardi ER, Tsakos G, Sheiham A, Peres KG, Peres MA. Association of changes in income with self-rated oral health and chewing difficulties in adults in Southern Brazil. Community Dent Oral Epidemiol 2016; 44:450-7. [DOI: 10.1111/cdoe.12234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 03/29/2016] [Indexed: 12/01/2022]
Affiliation(s)
| | - Georgios Tsakos
- Department of Epidemiology and Public Health; University College London; London UK
| | - Aubrey Sheiham
- Department of Epidemiology and Public Health; University College London; London UK
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health; School of Dentistry; University of Adelaide; Adelaide SA Australia
| | - Marco Aurélio Peres
- Australian Research Centre for Population Oral Health; School of Dentistry; University of Adelaide; Adelaide SA Australia
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19
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Vered Y, Chetrit A, Sgan-Cohen HD, Amitai T, Mann J, Even-Nir H, Sadetzki S. Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood - The Tinea Capitis Cohort. Front Public Health 2016; 4:18. [PMID: 26942172 PMCID: PMC4763082 DOI: 10.3389/fpubh.2016.00018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/01/2016] [Indexed: 12/12/2022] Open
Abstract
While the impact of therapeutic levels of ionizing radiation during childhood on dental defects has been documented, the possible effect of low doses on dental health is unknown. The study aim was to assess the association between childhood exposure to low-moderate doses of therapeutic radiation and caries experience among a cohort of adults 50 years following the exposure. The analysis was based on a sample of 253 irradiated (in the treatment of tinea capitis) and 162 non-irradiated subjects. The decayed, missing, and filled teeth (DMFT) index was assessed during a clinical dental examination and questions regarding dental care services utilization, oral hygiene behavior, current self-perceived mouth dryness, socio-demographic parameters, and health behavior variables were obtained through a face-to-face interview. An ordered multivariate logistic regression model was used to assess the association of the main independent variable (irradiation status) and other relevant independent variables on the increase in DMFT. Mean caries experience levels (DMFT) were 18.6 ± 7.5 for irradiated subjects compared to 16.4 ± 7.2 for the non-irradiated (p = 0.002). Controlling for gender, age, education, income, smoking, dental visit in the last year, and brushing teeth behavior, irradiation was associated with a 72% increased risk for higher DMFT level (95% CI: 1.19-2.50). A quantification of the risk by dose absorbed in the salivary gland and in the thyroid gland showed adjusted ORs of 2.21 per 1 Gy (95% CI: 1.40-3.50) and 1.05 per 1 cGy (95% CI: 1.01-1.09), respectively. Childhood exposure to ionizing radiation (0.2-0.4 Gy) might be associated with late outcomes of dental health. In line with the guidelines of the American Dental Association, these results call for caution when using dental radiographs.
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Affiliation(s)
- Yuval Vered
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Angela Chetrit
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Harold D Sgan-Cohen
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Tova Amitai
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Jonathan Mann
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Hadas Even-Nir
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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20
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Murakami K, Kondo N, Ohkubo T, Hashimoto H. The effect of fathers’ and mothers’ educational level on adult oral health in Japan. Community Dent Oral Epidemiol 2016; 44:283-91. [DOI: 10.1111/cdoe.12216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 01/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Keiko Murakami
- Department of Hygiene and Public Health; School of Medicine; Teikyo University; Tokyo Japan
- Department of Health and Social Behavior; School of Public Health; The University of Tokyo; Tokyo Japan
| | - Naoki Kondo
- Department of Health and Social Behavior; School of Public Health; The University of Tokyo; Tokyo Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health; School of Medicine; Teikyo University; Tokyo Japan
| | - Hideki Hashimoto
- Department of Health and Social Behavior; School of Public Health; The University of Tokyo; Tokyo Japan
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21
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Sadetzki S, Chetrit A, Sgan-Cohen HD, Mann J, Amitai T, Even-Nir H, Vered Y. Long-Term Effects of Exposure to Ionizing Irradiation on Periodontal Health Status - The Tinea capitis Cohort Study. Front Public Health 2015; 3:226. [PMID: 26539423 PMCID: PMC4610133 DOI: 10.3389/fpubh.2015.00226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/22/2015] [Indexed: 12/19/2022] Open
Abstract
Studies among long-term survivors of childhood cancer who had received high-dose irradiation therapy of 4–60 Gy, demonstrated acute and chronic dental effects, including periodontal diseases. However, the possible effects of low to moderate doses of radiation on dental health are sparse. The aim of this study is to investigate the association between childhood exposure to low–moderate doses of ionizing radiation and periodontal health following 50 years since exposure. The study population included 253 irradiated subjects (treated for Tinea capitis in the 1950s) and, 162 non-irradiated subjects. The estimated dose to the teeth was 0.2–0.4 Gy. Dental examination was performed according to the community periodontal index (CPI). Socioeconomic and health behavior variables were obtained through a personal questionnaire. Periodontal disease was operationally defined as “deep periodontal pockets.” A multivariate logistic regression model was used for the association of irradiation status and other independent variables with periodontal status. The results showed that among the irradiated subjects, 23%, (95% CI 18–28%) demonstrated complete edentulousness or insufficient teeth for CPI scoring as compared to 13% (95% CI 8–19%) among the non-irradiated subjects (p = 0.01). Periodontal disease was detected among 54% of the irradiated subjects as compared to 40% of the non-irradiated (p = 0.008). Controlling for education and smoking, the ORs for the association between radiation and periodontal disease were 1.61 (95% CI 1.01–2.57) and 1.95 (95% CI 1.1–3.5) for ever never and per 1 Gy absorbed in the salivary gland, respectively. In line with other studies, a protective effect for periodontal diseases among those with high education and an increased risk for ever smokers were observed. In conclusion, childhood exposure to low-moderate doses of ionizing radiation might be associated with later outcomes of dental health. The results add valuable data on the long-term health effects of exposure to ionizing radiation and support the implementation of the ALARA principle in childhood exposure to diagnostic procedure involving radiation.
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Affiliation(s)
- Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center , Tel Hashomer , Israel ; Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel
| | - Angela Chetrit
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Harold D Sgan-Cohen
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University Hadassah Medical School , Jerusalem , Israel
| | - Jonathan Mann
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University Hadassah Medical School , Jerusalem , Israel
| | - Tova Amitai
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Hadas Even-Nir
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Yuval Vered
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University Hadassah Medical School , Jerusalem , Israel
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22
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Lee HJ, Han DH. Early-life socioeconomic position and periodontal status in Korean adults. Community Dent Oral Epidemiol 2015; 44:11-23. [DOI: 10.1111/cdoe.12184] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 06/15/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Hye-Ju Lee
- Department of Preventive and Social Dentistry; Seoul National University School of Dentistry; Seoul Korea
- Dental Research Institute; Seoul National University; Seoul Korea
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry; Seoul National University School of Dentistry; Seoul Korea
- Dental Research Institute; Seoul National University; Seoul Korea
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23
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Han DH, Khang YH, Lee HJ. Association between adult height and tooth loss in a representative sample of Koreans. Community Dent Oral Epidemiol 2015; 43:479-88. [PMID: 26083077 DOI: 10.1111/cdoe.12175] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 05/18/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Evidence suggests that taller individuals have better health than that of shorter individuals. However, evidence for links to tooth loss is scarce. The aim of this study was to examine the association between adult height and tooth loss and to examine the roles of covariates in explaining the association in different birth cohorts in Korea. METHODS Using data from the Fourth and Fifth Korea National Health and Nutritional Examination Survey (KNHANES IV and V), the subjects were grouped into two birth cohorts based on their historical context: born from 1920 to 1945 and 1946 to 1962. The dependent variables were loss of 8 or more teeth and total tooth loss (edentulism), while the independent variable was the height quartile. Demographic factors (survey year, age, and gender), early childhood/adult socioeconomic status (SES) (father's education, own education, income, and place of residence), health behaviors (cigarette smoking, binge drinking, frequency of toothbrushing, and regular dental visit), and health problems (diabetes and hypertension) were included in a series of analytical models. RESULTS The survey year-, age-, and gender-adjusted prevalence ratios (PR) of the loss of 8 or more teeth for the shortest quartile were 1.23 (95% confidence intervals, CI: 1.13-1.35) for the 1920-1945 birth cohorts and 1.39 (95% CI: 1.20-1.62) for the 1946-1962 birth cohorts. The PRs for edentulousness were 1.64 (95% CI: 1.34-2.02) for the 1920-1945 birth cohorts and 2.26 (95% CI: 1.31-3.91) for the 1946-1962 birth cohorts. These associations were moderately attenuated after adjusting for own education but still significant in the fully adjusted models. After full adjustment for the covariates, those in the shortest height quartiles in the relatively young birth cohorts (1946-1962 birth cohorts) had a 1.93 (95% CI: 1.09-3.43) times greater prevalence of edentulism than that of their tallest counterparts. CONCLUSIONS Given that adult height reflects early-life conditions, independent associations between height and tooth loss support the view that early-life circumstances significantly influence oral health outcomes in later life.
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Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Young-Ho Khang
- Department of Health Policy and Management, Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Hye-Ju Lee
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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24
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Han DH, Khang YH, Choi HJ. Association of parental education with tooth loss among Korean Elders. Community Dent Oral Epidemiol 2015; 43:489-99. [PMID: 26012559 DOI: 10.1111/cdoe.12172] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 04/30/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE There are few reports showing an association between childhood socioeconomic circumstances and tooth loss among the elderly. The purpose of this study was (i) to examine the association between early childhood socioeconomic position (parental education level) and tooth loss and (ii) to determine the relative effects of the subjects' education level, occupation, and income on tooth loss in Korean elders. MATERIAL AND METHODS Data from the fourth and fifth Korea National Health and Nutritional Examination Survey on 8814 Korean elders (age ≥65 years) were analyzed. Demographic factors (age, survey year, marital status, and residence area), health behaviors (dental check-up during the past year and cigarette smoking), and the presence of a somatic health problem (diabetes) were included in our gender-specific analyses. Tooth loss was defined as edentulism or severe tooth loss (<20 teeth). For our analyses, chi-square test and Student's t-tests and multiple logistic regressions were performed. RESULTS A low parental education level was associated with elevated odds of edentulism (OR = 1.87 for father's education and 1.52 for mother's education among male elders and OR = 1.73 for father's education and 1.55 for mother's education among female elders) and with severe tooth loss (OR = 1.58 for father's education and 1.53 for mother's education among male elders and OR = 1.25 for father's education and 1.48 for mother's education among female elders). The association between parental education level and tooth loss was attenuated after adjusting for the subject's education level, occupation, and income. Relative magnitude of attenuation varied with personal factors (education > income > occupation). In a fully adjusted model, father's education level was significantly associated with edentate status (OR = 1.96 for male elders and 1.46 for female elders), but not with severe tooth loss. CONCLUSION Our results indicate that early life socioeconomic circumstances measured by the father's education level were independently associated with the edentate status of Korean elders.
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Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Young-Ho Khang
- Department of Health Policy and Management, Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Ho-Jun Choi
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea
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25
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Shin BM, Ryu JI, Sheiham A, Do LG, Jung SH. Which life course model better explains the association between socioeconomic position and periodontal health? J Clin Periodontol 2015; 42:213-20. [PMID: 25581381 DOI: 10.1111/jcpe.12360] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2014] [Indexed: 11/28/2022]
Abstract
AIM To assess whether the relationship between socioeconomic position (SEP) and periodontal health fitted the Critical Period or the Social Mobility life course models. METHODS A nationally representative sample of 5570 Korean adults from KNHANES IV study. Log-binomial regression models adjusting for adulthood or childhood socioeconomic (SES) variables was used to assess independent effects of socioeconomic differences for childhood, adulthood and period of transition from child to adult in periodontal health. RESULTS In the Critical Period model, poorer periodontal status was associated with SES disadvantage in adulthood and not predicted by SES disadvantage in childhood. For the intergenerational Social Mobility model, prevalence of current periodontal disease was only different for females aged 30-39 and 40-49 years, after adjustment. Prevalence of periodontal disease in females was highest in the downwardly mobile group. CONCLUSIONS The Critical Period model was better at explaining association between socioeconomic position and periodontal health, such as the adulthood socioeconomic variables (SEP), had a stronger effect than childhood factors on periodontal disease. The Social Mobility model explained more of the variation in the association between SEP and periodontal health among women than among men.
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Affiliation(s)
- Bo-Mi Shin
- Gangneung-Wonju National University, Gangneung, Korea
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26
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Gülcan F, Ekbäck G, Ordell S, Lie SA, Åstrøm AN. Inequality in oral health related to early and later life social conditions: a study of elderly in Norway and Sweden. BMC Oral Health 2015; 15:20. [PMID: 25881160 PMCID: PMC4328709 DOI: 10.1186/s12903-015-0005-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/30/2015] [Indexed: 11/13/2022] Open
Abstract
Background A life course perspective recognizes influences of socially patterned exposures on oral health across the life span. This study assessed the influence of early and later life social conditions on tooth loss and oral impacts on daily performances (OIDP) of people aged 65 and 70 years. Whether social inequalities in oral health changed after the usual age of retirement was also examined. In accordance with “the latent effect life course model”, it was hypothesized that adverse early-life social conditions increase the risk of subsequent tooth loss and impaired OIDP, independent of later-life social conditions. Methods Data were obtained from two cohorts studies conducted in Sweden and Norway. The 2007 and 2012 waves of the surveys were used for the present study. Early-life social conditions were measured in terms of gender, education and country of birth, and later-life social conditions were assessed by working status, marital status and size of social network. Logistic regression and Generalized Estimating Equations (GEE) were used to analyse the data. Inverse probability weighting (IPW) was used to adjust estimates for missing responses and loss to follow-up. Results Early-life social conditions contributed to tooth loss and OIDP in each survey year and both countries independent of later-life social conditions. Lower education correlated positively with tooth loss, but did not influence OIDP. Foreign country of birth correlated positively with oral impacts in Sweden only. Later-life social conditions were the strongest predictors of tooth loss and OIDP across survey years and countries. GEE revealed significant interactions between social network and survey year, and between marital status and survey year on tooth loss. Conclusion The results confirmed the latent effect life course model in that early and later life social conditions had independent effects on tooth loss and OIDP among the elderly in Norway and Sweden. Between age 65 and 70, inequalities in tooth loss related to marital status declined, and inequalities related to social network increased.
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Affiliation(s)
- Ferda Gülcan
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
| | - Gunnar Ekbäck
- Örebro County Council, Örebro, Sweden. .,School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
| | - Sven Ordell
- Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden.
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
| | - Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
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Oral Health Over the Life Course. A LIFE COURSE PERSPECTIVE ON HEALTH TRAJECTORIES AND TRANSITIONS 2015. [DOI: 10.1007/978-3-319-20484-0_3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Åstrøm AN, Ekback G, Lie SA, Ordell S. Life-course social influences on tooth loss and oral attitudes among older people: evidence from a prospective cohort study. Eur J Oral Sci 2014; 123:30-8. [PMID: 25483593 DOI: 10.1111/eos.12160] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 12/13/2022]
Abstract
This study examined the relationship of trajectories in social condition with oral attitudes and major tooth loss, using the social mobility and accumulation life-course models in a cohort. Whether social-condition inequalities remained stable or changed from 65 yr of age to 70 yr of age was investigated. In 1992, 6,346 inhabitants born in 1942 and residing in two Swedish counties agreed to participate in a prospective survey. Of the participants in 1992, 3,585 (47.6% men) completed questionnaires in 1997, 2002, 2007, and 2012. In line with the social-mobility model, the prevalence of negative oral attitudes and major tooth loss in participants at 65 and 70 yr of age showed a consistent gradient according to social-condition trajectory, whereby it was lowest among those who were persistently high and highest among those who were persistently low, with the upwardly and downwardly mobile categories being intermediate. A linear graded association between the number of periods with disadvantaged social condition and oral health supported the accumulation model. Both the social mobility and accumulation life-course models were supported. Social-condition differentials in negative oral attitudes and tooth loss seem to remain stable or to narrow weakly after the usual age of retirement.
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Affiliation(s)
- Anne N Åstrøm
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Listl S, Watt RG, Tsakos G. Early life conditions, adverse life events, and chewing ability at middle and later adulthood. Am J Public Health 2014; 104:e55-61. [PMID: 24625140 DOI: 10.2105/ajph.2014.301918] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We sought to determine the extent to which early life conditions and adverse life events impact chewing ability in middle and later adulthood. METHODS Secondary analyses were conducted based on data from waves 2 and 3 of the Survey of Health, Ageing, and Retirement in Europe (SHARE), collected in the years 2006 to 2009 and encompassing information on current chewing ability and the life history of persons aged 50 years or older from 13 European countries. Logistic regression models were estimated with sequential inclusion of explanatory variables representing living conditions in childhood and adverse life events. RESULTS After controlling for current determinants of chewing ability at age 50 years or older, certain childhood and later life course socioeconomic, behavioral, and cognitive factors became evident as correlates of chewing ability at age 50 years or older. Specifically, childhood financial hardship was identified as an early life predictor of chewing ability at age 50 years or older (odds ratio = 1.58; 95% confidence interval = 1.22, 2.06). CONCLUSIONS Findings suggest a potential enduring impact of early life conditions and adverse life events on oral health in middle and later adulthood and are relevant for public health decision-makers who design strategies for optimal oral health.
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Affiliation(s)
- Stefan Listl
- Stefan Listl is with the Department of Conservative Dentistry, University of Heidelberg, Heidelberg, and the Munich Center for the Economics of Aging, Max-Planck-Institute for Social Law and Social Policy, Munich, Germany. Richard G. Watt and Georgios Tsakos are with the Department of Epidemiology and Public Health, University College London, London, UK
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Zhang S, Lo ECM, Liu J, Chu CH. A Review of the Dental Caries Status of Ethnic Minority Children in China. J Immigr Minor Health 2013; 17:285-97. [DOI: 10.1007/s10903-013-9916-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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How the Newcastle Thousand Families birth cohort study has contributed to the understanding of the impact of birth weight and early life socioeconomic position on disease in later life. Maturitas 2012; 72:23-8. [PMID: 22391388 DOI: 10.1016/j.maturitas.2012.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 02/03/2012] [Indexed: 11/22/2022]
Abstract
Much has been made of the potential influence of birth weight and early socioeconomic disadvantage in influencing adult health, but little has been published in terms of how important these associations may be with respect to exposures throughout the lifecourse. The objective of this review is to describe the contributions of the Newcastle Thousand Families Study in understanding the relative impacts of factors in early life, particularly birth weight and socio-economic position at birth, in influencing health in later life. The Newcastle Thousand Families Study is a prospective birth cohort established in 1947. It originally included all births to mothers resident in Newcastle upon Tyne, in northern England, in May and June of that year. Study members were followed extensively throughout childhood and intermittently in adulthood. At the age of 49-51 years, study members underwent a large-scale follow-up phase enabling an assessment of how early life may influence their later health, and also incorporating adult risk factors which enabled the relative contributions of factors at different stages of life to be assessed. While some findings from the study do support birth weight and early socio-economic position having influences on adult health status, the associations are generally small when compared to risk factors later in life. Using path analyses on longitudinal data of this nature enables mediating pathways between early life and later health to be assessed and if more studies were to take this approach, the relative importance of early life on adult disease risk could be better understood.
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Åstrøm AN, Wold B. Socio-behavioural predictors of young adults’ self-reported oral health: 15 years of follow-up in the The Norwegian Longitudinal Health Behaviour study. Community Dent Oral Epidemiol 2011; 40:210-20. [DOI: 10.1111/j.1600-0528.2011.00657.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Yiengprugsawan V, Somkotra T, Kelly M, Seubsman SA, Sleigh AC. Factors associated with self-reported number of teeth in a large national cohort of Thai adults. BMC Oral Health 2011; 11:31. [PMID: 22114788 PMCID: PMC3235054 DOI: 10.1186/1472-6831-11-31] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 11/24/2011] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Oral health in later life results from individual's lifelong accumulation of experiences at the personal, community and societal levels. There is little information relating the oral health outcomes to risk factors in Asian middle-income settings such as Thailand today. METHODS Data derived from a cohort of 87,134 adults enrolled in Sukhothai Thammathirat Open University who completed self-administered questionnaires in 2005. Cohort members are aged between 15 and 87 years and resided throughout Thailand. This is a large study of self-reported number of teeth among Thai adults. Bivariate and multivariate logistic regressions were used to analyse factors associated with self-reported number of teeth. RESULTS After adjusting for covariates, being female (OR = 1.28), older age (OR = 10.6), having low income (OR = 1.45), having lower education (OR = 1.33), and being a lifetime urban resident (OR = 1.37) were statistically associated (p < 0.0001) with having less than 20 teeth. In addition, daily soft drink consumptions (OR = 1.41), current regular smoking (OR = 1.39), a history of not being breastfed as a child (OR = 1.34), and mother's lack of education (OR = 1.20) contributed significantly to self-reported number of teeth in fully adjusted analyses. CONCLUSIONS This study addresses the gap in knowledge on factors associated with self-reported number of teeth. The promotion of healthy childhoods and adult lifestyles are important public health interventions to increase tooth retention in middle and older age.
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Affiliation(s)
- Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Tewarit Somkotra
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Sam-ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian C Sleigh
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
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Astrøm AN, Ekback G, Ordell S, Unell L. Social inequality in oral health-related quality-of-life, OHRQoL, at early older age: evidence from a prospective cohort study. Acta Odontol Scand 2011; 69:334-42. [PMID: 21627543 DOI: 10.3109/00016357.2011.568965] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES This study aimed to assess the long-term effect of socio-behavioral characteristics on oral impacts on daily performances (OIDP) at age 65 and the influence on OIDP at age 65 of changes in socio-behavioral characteristics between age 50 and 65. METHODS In 1992, all 50-year-olds in two counties of Sweden were invited to participate in a longitudinal survey. A total of 6346 responded and, of those, 4143 completed follow-ups at ages 55, 60 and 65 years. RESULTS At age 65, 26.9% had oral impacts. Subjects being immigrants, being unmarried, reporting economic barriers, bad general health, bad quality dental care, less than annual dental attendance, limited social network and smoking at age 50 experienced oral impacts at age 65 more frequently than their counterparts in the opposite groups. Compared to the stable advantaged groups, stable disadvantaged groups regarding marital status, health status, smoking and reported quality of care had increased ORs for oral impacts. Compared to the stable advantaged groups, those who experienced deterioration with respect to health status, dental attendance and quality of oral health care and those who quitted smoking had increased ORs for oral impacts. CONCLUSIONS Disadvantaged socio-behavioral condition at age 50 had a long lasting detrimental effect on OHRQoL at age 65. Deterioration in socio-behavioral circumstances was associated with increased oral impacts. Early protection against the effect of socio-behavioral adversity by imposing economic barriers, ensure provision of high quality care and by promotion of healthy lifestyles seems to have the potential to reduce oral impacts at older ages.
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Affiliation(s)
- Anne Nordrehaug Astrøm
- Institute of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway.
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Bernabé E, Watt RG, Sheiham A, Suominen AL, Vehkalahti MM, Nordblad A, Uutela A, Kivimäki M, Tsakos G. Childhood socioeconomic position, adult sense of coherence and tooth retention. Community Dent Oral Epidemiol 2011; 40:46-52. [DOI: 10.1111/j.1600-0528.2011.00633.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Yiengprugsawan V, Somkotra T, Seubsman SA, Sleigh AC. Oral Health-Related Quality of Life among a large national cohort of 87,134 Thai adults. Health Qual Life Outcomes 2011; 9:42. [PMID: 21668968 PMCID: PMC3125311 DOI: 10.1186/1477-7525-9-42] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 06/13/2011] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Oral health has been of interest in many low and middle income countries due to its impact on general health and quality of life. But there are very few population-based reports of adult Oral Health Related Quality of Life (OHRQoL) in developing countries. To address this knowledge gap for Thailand, we report oral health findings from a national cohort of 87,134 Thai adults aged between 15 and 87 years and residing all over the country. METHODS In 2005, a comprehensive health questionnaire was returned by distance learning cohort members recruited through Sukhothai Thammathirat Open University. OHRQoL dimensions included were discomfort speaking, swallowing, chewing, social interaction and pain. We calculated multivariate (adjusted) associations between OHRQoL outcomes, and sociodemographic, health behaviour and dental status. RESULTS Overall, discomfort chewing (15.8%), social interaction (12.5%), and pain (10.6%) were the most commonly reported problems. Females were worse off for chewing, social interaction and pain. Smokers had worse OHRQoL in all dimensions with Odds Ratios (OR) ranging from 1.32 to 1.51. Having less than 20 teeth was strongly associated with difficulty speaking (OR = 6.43), difficulty swallowing (OR = 6.27), and difficulty chewing (OR = 3.26). CONCLUSIONS Self-reported adverse oral health correlates with individual function and quality of life. Outcomes are generally worse among females, the poor, smokers, drinkers and those who have less than 20 teeth. Further longitudinal study of the cohort analysed here will permit assessment of causal determinants of poor oral health and the efficacy of preventive programs in Thailand.
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Affiliation(s)
- Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Tewarit Somkotra
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sam-ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian C Sleigh
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - The Thai Cohort Study Team
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
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Astrom AN, Ekback G, Ordell S, Unell L. Socio-behavioral predictors of changes in dentition status: a prospective analysis of the 1942 Swedish birth cohort. Community Dent Oral Epidemiol 2010; 39:300-10. [DOI: 10.1111/j.1600-0528.2010.00594.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pearce MS, Groom A, Relton CL, Peaston RT, Pollard TM, Francis RM. Birth weight and early socio-economic disadvantage as predictors of sex hormones and sex hormone binding globulin in men at age 49-51 years. Am J Hum Biol 2010; 23:185-9. [PMID: 21319247 DOI: 10.1002/ajhb.21099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 07/16/2010] [Accepted: 08/09/2010] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES A number of associations have been shown between early growth and later sex hormone levels in women, but less is known about this relationship in men. This study investigated life-course predictors of sex hormones in men in the Newcastle Thousand Families birth cohort. METHODS The Newcastle Thousand Families Study is a prospective study initiated in 1947. At age 49-51 years, 574 study members returned detailed self-completion questionnaires and 412 attended for clinical examination, including 172 men in whom blood samples were taken. Estradiol, follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and sex hormone binding globulin (SHBG) were measured. Free testosterone concentrations were also calculated. RESULTS Social class at birth independently predicted FSH and LH, with higher levels with increasing socioeconomic disadvantage. SHBG was higher with increasing standardized birth weight and lower with increasing contemporary body mass index (BMI). BMI also predicted LH, SHBG, and testosterone. None of the variables included within this analysis were significant predictors of estradiol. No other associations were seen with any of the variables included from across the life-course. CONCLUSIONS Our findings suggest that birth weight may be positively associated with SHBG and early socioeconomic status may be related to FSH and LH in men. These novel findings are independent of contemporary BMI. Given the links between sex hormones, SHBG and disease outcomes such as type II diabetes and osteoporosis, it is possible that sex hormones may play a mediating role in the associations between circumstances in early life and later risk of chronic disease.
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Affiliation(s)
- Mark S Pearce
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
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Bernabé E, Suominen AL, Nordblad A, Vehkalahti MM, Hausen H, Knuuttila M, Kivimäki M, Watt RG, Sheiham A, Tsakos G. Education level and oral health in Finnish adults: evidence from different lifecourse models. J Clin Periodontol 2010; 38:25-32. [PMID: 21058971 DOI: 10.1111/j.1600-051x.2010.01647.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To assess the relationship between education level and several oral health outcomes in Finnish adults, using three conceptual lifecourse models. MATERIALS AND METHODS This study analysed data from 7112 subjects, aged 30 years or over, who participated in the nationally representative Finnish Health 2000 Survey. Parental and own education levels were the childhood and adulthood socioeconomic measures, respectively. Oral health was indicated by edentulousness, perceived oral health and levels of dental caries and periodontal disease. Three conceptual lifecourse models, namely critical period, accumulation and social trajectories, were separately tested in regression models. RESULTS In line with the critical period model, parental and own education levels were independently associated with oral health after mutual adjustment. There was also a graded linear relationship between the number of periods of socioeconomic disadvantage and oral health, corresponding to the accumulation model. Gradual declines in oral health were evident between social trajectories from persistently high to upwardly mobile, downwardly mobile and persistently low groups. CONCLUSION There was similar support for the lifecourse models of critical period, accumulation and social trajectories. They collectively contribute to a better understanding of oral health inequalities.
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Affiliation(s)
- Eduardo Bernabé
- Department of Epidemiology and Public Health, University College London, London, UK.
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Paterson JE, Gao W, Sundborn G, Cartwright S. Maternal self-report of oral health in six-year-old Pacific children from South Auckland, New Zealand. Community Dent Oral Epidemiol 2010; 39:19-28. [PMID: 21029145 DOI: 10.1111/j.1600-0528.2010.00575.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine maternal and socio-demographic factors associated with oral health practices and experiences in six-year-old Pacific children. METHODS The longitudinal Pacific Islands Families (PIF) study is following a cohort of Pacific children born in Auckland, New Zealand in 2000. At approximately six years postpartum maternal reports (n = 1001) on child oral health practices and experiences of fillings and extractions were gathered. RESULTS Forty-five per cent of mothers reported that their child had experienced fillings or extractions. After adjusting for confounding factors, we found that Tongan children were almost twice as likely to have their teeth filled or extracted than Samoan children (OR, 1.93; 95%, 1.34-2.77). Differences between Samoan children and children of other ethnic groups were not significant. Children of mothers who had secondary qualifications were significantly less likely to have their teeth filled or extracted compared to children of mothers who had postsecondary qualifications (OR, 0.634; 95%, 0.44-0.90). Prolonged duration of breastfeeding was associated with an increased likelihood of filling or extraction experience. In terms of maternal oral hygiene, maternal tooth brushing frequency of less that once a day was significantly associated with increased odds of fillings and/or extractions in their children (OR, 1.35; 95% CI, 1.02-1.79). Children who were sometimes supervised for tooth brushing were significantly more likely to have fillings or extractions than children who were not provided supervision. CONCLUSIONS These findings highlight the role of cultural factors and maternal hygiene in child oral health outcomes and suggest that health promotion efforts should encompass the whole family and embrace a culturally appropriate approach.
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Affiliation(s)
- Janis E Paterson
- Pacific Islands Families Study, AUT University, Auckland, New Zealand.
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Ekbäck G, Nodrehaug-Åstrøm A, Klock K, Ordell S, Unell L. Satisfaction with teeth and life-course predictors: a prospective study of a Swedish 1942 birth cohort. Eur J Oral Sci 2010; 118:66-74. [DOI: 10.1111/j.1600-0722.2009.00702.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Pearce M, Thomson W, Walls A, Steele J. Lifecourse Socio-economic Mobility and Oral Health in Middle Age. J Dent Res 2009; 88:938-41. [DOI: 10.1177/0022034509344524] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Socio-economic variations in health exist for a wide range of health outcomes, including oral health and oral-health-related quality of life (OHRQoL). Less is known regarding how socio-economic trajectories may influence oral health and OHRQoL. This study examined whether social mobility is related to the number of teeth retained by age 50 years and OHRQoL measured at the same time, using data from the Newcastle Thousand Families Study, a birth cohort established in 1947. Women remaining in the non-manual class had the greatest tooth retention. While promotion of a healthier lifestyle and continued improvements in oral hygiene throughout life appear to be the public health interventions most likely to improve oral health into middle age, there may be sub-groups of the population on which different approaches in terms of public health interventions need to be focused.
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Affiliation(s)
- M.S. Pearce
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
- Department of Oral Sciences, School of Dentistry, University of Otago, Dunedin, New Zealand; and
- School of Dental Sciences, Newcastle University, UK
| | - W.M. Thomson
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
- Department of Oral Sciences, School of Dentistry, University of Otago, Dunedin, New Zealand; and
- School of Dental Sciences, Newcastle University, UK
| | - A.W.G. Walls
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
- Department of Oral Sciences, School of Dentistry, University of Otago, Dunedin, New Zealand; and
- School of Dental Sciences, Newcastle University, UK
| | - J.G. Steele
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
- Department of Oral Sciences, School of Dentistry, University of Otago, Dunedin, New Zealand; and
- School of Dental Sciences, Newcastle University, UK
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Pearce MS, Unwin NC, Parker L, Craft AW. Cohort Profile: The Newcastle Thousand Families 1947 Birth Cohort. Int J Epidemiol 2008; 38:932-7. [DOI: 10.1093/ije/dyn184] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Haugejorden O, Klock KS, Åstrøm AN, Skaret E, Trovik TA. Socio-economic inequality in the self-reported number of natural teeth among Norwegian adults – an analytical study. Community Dent Oral Epidemiol 2008; 36:269-78. [DOI: 10.1111/j.1600-0528.2007.00367.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Nicolau B, Thomson WM, Steele JG, Allison PJ. Life-course epidemiology: concepts and theoretical models and its relevance to chronic oral conditions. Community Dent Oral Epidemiol 2007; 35:241-9. [PMID: 17615010 DOI: 10.1111/j.1600-0528.2007.00332.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Etiological models that predominantly emphasize current adult life styles, such as smoking, diet and lack of exercise have recently been seriously challenged by a growing body of evidence that disturbed early growth and development, childhood infection, poor nutrition, and social and psychosocial disadvantage across the life-course affect chronic disease risk, including chronic oral disease. This relatively new area of research is called life-course epidemiology. The life-course framework for investigating the aetiology and natural history of chronic disease proposes that advantages and disadvantages are accumulated throughout life generating differentials in health along the life-course, but most importantly later in life. Furthermore, its dynamic framework brings together the effects of intrinsic factors (individual resources) with extrinsic factors (environmental factors). The aim of this paper is to give an overview of this new epidemiological approach and to discuss how the life-course framework has been applied to chronic oral conditions.
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Affiliation(s)
- B Nicolau
- Unité d'épidémiologie et biostatistique, INRS - Institut Armand-Frappier, Laval, QC, Canada.
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Adams J, Martin-Ruiz C, Pearce MS, White M, Parker L, von Zglinicki T. No association between socio-economic status and white blood cell telomere length. Aging Cell 2007; 6:125-8. [PMID: 17156082 DOI: 10.1111/j.1474-9726.2006.00258.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
It has been hypothesized that more socio-economically deprived individuals age faster and, thus, have shorter telomeres than their more affluent counterparts. A weak association between white blood cell telomere length and socio-economic status in a large heterogeneous sample of females has recently been reported. In 318 individuals from a homogeneous birth cohort, we found no evidence of an association between any measure of socio-economic status and peripheral blood mononucleocyte telomere length at age 50 after control for lifestyle variables, gender and paternal age at birth. The results of this, and the previous study, suggest that there is little evidence of a strong or consistent correlation between white blood cell telomere length and markers of socio-economic status.
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Affiliation(s)
- Jean Adams
- Institute of Health and Society, Newcastle University, 21 Claremont Place, Newcastle upon Tyne NE2 4AA, UK
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Jamieson LM, Koopu PI. Exploring factors that influence child use of dental services and toothbrushing in New Zealand. Community Dent Oral Epidemiol 2006; 34:410-8. [PMID: 17092269 DOI: 10.1111/j.1600-0528.2006.00291.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To explore factors contributing to dental service use and toothbrushing among Mäori, Pacific and New Zealand European or Other (NZEO) children in New Zealand. METHODS Data were obtained from the 2002 National Child Nutrition Survey. Models representing demographic, socio-economic status (SES), lifestyle, dietary, food security and oral health paradigms were tested using logistic regression. RESULTS Mäori and Pacific children were more likely to not attend for dental care (OR: 1.99 and 2.05 respectively) than NZEO children when age, sex and time lived in New Zealand were accounted for. The addition of household (OR: 1.93 and 2.05 respectively) or lifestyle (OR: 1.95 and 1.81 respectively) factors resulted in minimal OR changes for Mäori or Pacific child dental attendance, whereas addition of dietary (OR: 1.44 and 1.23 respectively) and food security (OR: 1.43 and 1.32 respectively) items reduced the ORs of Mäori and Pacific child dental attendance so they no longer differed significantly to NZEO children. Addition of dental factors increased the ORs of Mäori and Pacific children not utilizing dental services compared with NZEO children (OR: 2.30 and 2.13 respectively). Mäori and Pacific children were more likely to not brush teeth (OR: 3.86 and 1.49 respectively) than NZEO children when age, sex and time lived in New Zealand were accounted for. Addition of dietary factors resulted in a 36% OR reduction of Mäori children not brushing (OR: 2.57), while addition of household SES (OR: 1.06), lifestyle (OR: 1.14), dietary (OR: 0.71) or food security factors (OR: 1.19) reduced the ORs of Pacific children so they were no longer significantly different to NZEO children. CONCLUSIONS Mäori and Pacific children were more likely to have not received dental care (variance largely explained by dietary and food security factors) and Mäori children were more likely to not brush their teeth (variance largely explained by dietary items) than NZEO children.
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Affiliation(s)
- Lisa M Jamieson
- Australian Research Center for Population Oral Health, The University of Adelaide, SA, Australia.
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Mason J, Pearce MS, Walls AWG, Parker L, Steele JG. How do factors at different stages of the lifecourse contribute to oral-health-related quality of life in middle age for men and women? J Dent Res 2006; 85:257-61. [PMID: 16498074 DOI: 10.1177/154405910608500310] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The relative contributions of factors operating in fetal life, childhood, and adulthood to the risk of disease in middle age have become important research issues, but self-perceived oral health has rarely been considered in this context. This study investigated the impact of risk factors operating throughout life on self-perceived oral health, according to the Oral Health Impact Profile (OHIP), at age 50 yrs in 305 individuals from the Newcastle Thousand Families cohort. Factors from early and adult life contributed to the OHIP scores, but in men, self-perceived oral health was mostly explained by factors operating early in life. In women, the number of teeth retained in adulthood had a more prominent impact. Lifecourse influences on oral-health-related quality of life appear different for men and women, which may have implications for the effectiveness of public health interventions and health promotion.
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Affiliation(s)
- J Mason
- School of Dental Sciences, University of Newcastle upon Tyne, UK
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49
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Pearce MS, Unwin NC, Relton CL, Alberti KGMM, Parker L. Lifecourse determinants of fasting and post-challenge glucose at age 50 years: the Newcastle Thousand Families Study. Eur J Epidemiol 2006; 20:915-23. [PMID: 16284869 DOI: 10.1007/s10654-005-7925-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2005] [Indexed: 01/01/2023]
Abstract
Suboptimal nutrition in early life is suggested to influence plasma glucose levels in later life. This study aimed to determine and quantify influences on plasma glucose levels at age 50. We studied 169 men and 219 women from the Newcastle Thousand Families cohort who attended for clinical examination, including measurements of fasting and 2 h post oral glucose load) at age 50. A lifecourse approach was used to estimate proportions of variance in plasma glucose levels accounted for by each stage of the lifecourse. Birth weight significantly predicted two-hour glucose levels in men (adjusted p = 0.03). Body composition was a significant predictor of both glucose measures in both genders. Interactions existed between body composition and birth weight on fasting glucose in men and two-hour glucose in women and between gender and birth weight on both outcome measures. Fetal life factors directly explained little variation in either glucose measure (< 2%). Adult lifestyle and body composition directly explained larger proportions of the variances (8-13%) for fasting and two-hour glucose than early life measures. The significant effect of birth weight on two-hour glucose seen in men provides support for the fetal origins hypothesis, although adult factors may be more important. Any effect of birth weight on later plasma glucose levels may be compounded by additional effects of adult body composition.
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Affiliation(s)
- M S Pearce
- School of Clinical Medical Sciences, University of Newcastle upon Tyne, UK.
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50
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Pearce MS, Unwin NC, Parker L, Alberti KGMM. Life course determinants of insulin secretion and sensitivity at age 50 years: the Newcastle thousand families study. Diabetes Metab Res Rev 2006; 22:118-25. [PMID: 15977305 DOI: 10.1002/dmrr.573] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Suboptimal nutrition during fetal life and infancy is suggested to increase insulin resistance in adulthood. This study investigated the proportion of variance in insulin secretion and resistance accounted for by factors operating at different stages of life using a cohort of all 1142 births in the city of Newcastle, UK in May and June 1947. METHODS Detailed information was collected prospectively during childhood, including birth weight, growth and socio-economic circumstances. At age 50, 412 study members attended for clinical examination. Fasting and 30-min plasma insulin and glucose levels were determined and HOMA-IR and insulin secretion derived. RESULTS Birth weight was not a significant predictor of HOMA-IR after adjustment for percent body-fat and waist-hip ratio. Duration of breastfeeding was significantly negatively associated with HOMA-IR in men. For both genders, fetal life explained directly little variation in either HOMA-IR or insulin secretion (0.1-5.6%). Compared to early life, adult lifestyle and body composition directly explained larger proportions of the variances for insulin secretion and HOMA-IR for men (11 and 22% respectively) and women (5.9 and 34%). CONCLUSIONS Insulin secretion is largely unexplained by these data. For insulin resistance, the evidence suggests a limited impact of early life and a larger impact of adult factors.
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Affiliation(s)
- Mark S Pearce
- School of Clinical Medical Sciences, University of Newcastle upon Tyne, UK.
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