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Du S, Cheng M, Cui Z, Wang X, Feng X, Tai B, Hu D, Lin H, Wang B, Wang C, Zheng S, Liu X, Rong W, Wang W, Si Y. Decomposing Socioeconomic Inequality in Early Childhood Caries Among 3 to 5-Year-Old Children in China. Int Dent J 2024:S0020-6539(24)00106-0. [PMID: 38821780 DOI: 10.1016/j.identj.2024.04.001] [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: 02/20/2024] [Revised: 03/20/2024] [Accepted: 04/02/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION AND AIMS Early childhood caries (ECC) is a widespread oral disease that harms children's health in China. Although previous studies have linked ECC prevalence to socioeconomic status, few have measured the degree of socioeconomic inequality. This study aimed to evaluate the socioeconomic inequality of ECC in children aged 3 to 5 years in China and identify the contributor to the inequality. METHODS We extracted data on 3 to 5-year-old children from the fourth National Oral Health Survey. We measured the inequality of ECC by the average household income per capita. We used the average household income per capita to measure the inequality of ECC. To describe inequality both qualitatively and quantitatively, we used the following methods: concentration curve, Erreygers-corrected concentration index, relative index of inequality and slope index of inequality. We also applied a decomposition based on the probit model to identify the factors that contributed to inequality. RESULTS The prevalence of ECC in Chinese preschool children was 63.11% (95% CIs: 60.54%, 65.61%). The negative value of the Erreygers-corrected concentration index (-0.0459; 95% CIs: -0.0594, -0.0324), slope index of inequality (-0.0674; 95% CIs: -0.0876, -0.0471) and the positive value of relative index of inequality (0.7484; 95% CIs: 0.6856, 0.8169) all indicated that ECC prevalence was higher among children from low-income families. The main factors contributing to inequality were average household income, parents' educational level and living areas. CONCLUSION There is a pro-poor inequality in ECC among 3 to 5-year-old children in China. CLINICAL RELEVANCE To improve oral health equality, policymakers should focus more on children from low-income families, with less educated parents and living in rural areas.
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Affiliation(s)
- Shuo Du
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Menglin Cheng
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhiying Cui
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xing Wang
- Chinese Stomatological Association, Beijing, China
| | - Xiping Feng
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Baojun Tai
- School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Deyu Hu
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Huancai Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Bo Wang
- Chinese Stomatological Association, Beijing, China
| | - Chunxiao Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuguo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xuenan Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Wensheng Rong
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Weijian Wang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yan Si
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China.
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Keller EP, Lawson AB, Wagner CL, Reed SG. Bayesian modeling of spatially differentiated multivariate enamel defects of the children's primary maxillary central incisor teeth. BMC Med Res Methodol 2024; 24:88. [PMID: 38622506 PMCID: PMC11017560 DOI: 10.1186/s12874-024-02211-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The analysis of dental caries has been a major focus of recent work on modeling dental defect data. While a dental caries focus is of major importance in dental research, the examination of developmental defects which could also contribute at an early stage of dental caries formation, is also of potential interest. This paper proposes a set of methods which address the appearance of different combinations of defects across different tooth regions. In our modeling we assess the linkages between tooth region development and both the type of defect and associations with etiological predictors of the defects which could be influential at different times during the tooth crown development. METHODS We develop different hierarchical model formulations under the Bayesian paradigm to assess exposures during primary central incisor (PMCI) tooth development and PMCI defects. We evaluate the Bayesian hierarchical models under various simulation scenarios to compare their performance with both simulated dental defect data and real data from a motivating application. RESULTS The proposed model provides inference on identifying a subset of etiological predictors of an individual defect accounting for the correlation between tooth regions and on identifying a subset of etiological predictors for the joint effect of defects. Furthermore, the model provides inference on the correlation between the regions of the teeth as well as between the joint effect of the developmental enamel defects and dental caries. Simulation results show that the proposed model consistently yields steady inferences in identifying etiological biomarkers associated with the outcome of localized developmental enamel defects and dental caries under varying simulation scenarios as deemed by small mean square error (MSE) when comparing the simulation results to real application results. CONCLUSION We evaluate the proposed model under varying simulation scenarios to develop a model for multivariate dental defects and dental caries assuming a flexible covariance structure that can handle regional and joint effects. The proposed model shed new light on methods for capturing inclusive predictors in different multivariate joint models under the same covariance structure and provides a natural extension to a nested hierarchical model.
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Affiliation(s)
- Everette P Keller
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Andrew B Lawson
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
- School of Medicine, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Carol L Wagner
- Department of Pediatrics, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Susan G Reed
- Department of Pediatrics, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
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Anjum S, Mishra G, Kankane N, Khetan J, Mahajan N, Patel A, Chhabra KG. Link between individual resilience and aggressiveness in dental students and the mediating effect of spirituality: A path analysis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:10. [PMID: 38525214 PMCID: PMC10959263 DOI: 10.4103/jehp.jehp_709_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/21/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND The role of spirituality in people's lives, particularly the lives of health professionals, as well as its impact on mental health issues like anger and aggressiveness and resilience, are particularly significant. Therefore, the purpose of this study was to examine the link between the propensity for violence and personal resilience in dental students by taking into account the function of spirituality as a mediator. MATERIALS AND METHODS In this cross-sectional questionnaire survey, 211 volunteer dentistry students participated from a government institute in Jammu and Kashmir, India using a stratified sample procedure. The Spiritual Orientation Scale, Buss and Perry Aggression Questionnaire, and Connor-Davidson Resilience Scale were used to gather the data. SPSS version 20.0 was used for conducting a bivariate analysis to ascertain the directionality connection between the research variables. In addition; structural equation modelling analysis was conducted by Smart PLS. RESULTS According to the findings, resilience and spirituality have a substantial and positive link (r = 0.468 r = 0.023). Aggressiveness and resilience revealed a statistically significant inverse link (r = 0.325, P = 0.04), but aggression and spirituality had no significant correlation. Spirituality played a substantial mediation influence in the indirect pathway of violence on resilience (P = 0.001). CONCLUSION According to the study's findings, spirituality can help pupils become more resilient as individuals and can act as a helpful intermediary between aggressiveness and resilience.
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Affiliation(s)
- Shamim Anjum
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government College and Hospital, Jammu and Kashmir, India
| | - Gaurav Mishra
- Department of Public Health Dentistry, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Nishita Kankane
- Department of Public Health Dentistry, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Jitendra Khetan
- Department of Prosthodontics, Crown and Bridge and Implantology, NIMS Dental College and Hospital, NIMS University, Jaipur, Rajasthan, India
| | - Namrata Mahajan
- Department of Prosthodontics, Crown and Bridge and Implantology, NIMS Dental College and Hospital, NIMS University, Jaipur, Rajasthan, India
| | - Aditi Patel
- Department of Prosthodontics, Crown and Bridge and Implantology, NIMS Dental College and Hospital, NIMS University, Jaipur, Rajasthan, India
| | - Kumar G. Chhabra
- Department of Public Health Dentistry, NIMS Dental College and Hospital, NIMS University, Jaipur, Rajasthan, India
- Research and Developmental Cell, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
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Jiang K, Zhang L, Xie C, Li Z, Shi Z, Sharma M, Zhao Y. Understanding the Knowledge, Attitudes, and Practices of Healthy Eating among Adolescents in Chongqing, China: An Empirical Study Utilizing Structural Equation Modeling. Nutrients 2024; 16:167. [PMID: 38201997 PMCID: PMC10780587 DOI: 10.3390/nu16010167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Healthy eating is crucial for optimal growth, development, and the prevention of chronic diseases in adolescents. Our study aimed to develop a comprehensive structural equation model (SEM) to analyze the relationships between knowledge, attitudes, practices (KAP), and healthy eating among adolescents in Chongqing. An online questionnaire was administered to middle school students in 39 districts and counties of Chongqing, China from 2 December to 15 December 2021 to collect sociodemographic and KAP information. SEM models were constructed to examine the relationships between educational environment and healthy eating knowledge, attitudes, and practices. The Monte Carlo test was employed to assess the significance of the mediating effect of relevant variables. The study included 139,832 adolescents aged 14.8 ± 0.7 years, with a 14% rate of overweight and obesity. Health and nutrition knowledge averaged a score of 3.60 ± 1.50 (correct rate: 60%). Participants had positive attitudes (average score: 13.61 ± 2.29) and engaged in healthy eating practices (average score: 12.06 ± 3.08). The results of the SEM revealed a significant influence of the educational environment on adolescents' knowledge (β = 0.235, p < 0.001) and attitude towards healthy eating (β = 0.143, p < 0.001). Knowledge exhibited positive effects on both attitude (β = 0.225, p < 0.001) and practice (β = 0.054, p < 0.001), while attitude exhibited positive effects on practice behavior (β = 0.565, p < 0.001). The indirect effect of knowledge on practices through attitude was more substantial than the direct effect (ratio 2.361). Our study highlights the mediating role of attitude between healthy eating knowledge and practices. A significant association exists between a favorable educational environment and improved knowledge and positive attitudes toward healthy eating among adolescents. In the future, nutrition and health education should prioritize exploring effective ways to translate knowledge into practices.
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Affiliation(s)
- Ke Jiang
- School of Public Health, Chongqing Medical University, Chongqing 400331, China; (K.J.); (L.Z.); (Z.L.)
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing 400016, China
| | - Laixi Zhang
- School of Public Health, Chongqing Medical University, Chongqing 400331, China; (K.J.); (L.Z.); (Z.L.)
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing 400016, China
| | - Changxiao Xie
- Department of Nutrition and Food Hygiene, West China School of Public Health, Sichuan University, Chengdu 610041, China;
| | - Zhourong Li
- School of Public Health, Chongqing Medical University, Chongqing 400331, China; (K.J.); (L.Z.); (Z.L.)
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing 400016, China
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
| | - Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA;
- Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
| | - Yong Zhao
- School of Public Health, Chongqing Medical University, Chongqing 400331, China; (K.J.); (L.Z.); (Z.L.)
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing 400016, China
- Chongqing Key Laboratory of Child Nutrition and Heath, Children’s Hospital of Chongqing Medical University, Chongqing 401147, China
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Yan X, Sun T, Lu Y, Tan X, Wang Z, Li M. Prediction model of dental caries in 12-year-old children in Sichuan Province based on machine learning. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2023; 41:686-693. [PMID: 38597034 PMCID: PMC10722460 DOI: 10.7518/hxkq.2023.2023124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/14/2023] [Indexed: 04/11/2024]
Abstract
OBJECTIVES The machine learning algorithm was used to construct a prediction model of children's dental caries to determine the risk factors of dental caries in children and put forward targeted measures and policy suggestions to improve children's oral health. METHODS Stratified cluster random sampling was adopted in this study. In accordance with different policies and measures in Sichuan Province, 12-year-old students from 3-4 middle schools in eight cities of Sichuan Province were randomly selected for questionnaire survey, oral examination, and physical examination. Multivariate logistic regression analysis of risk factors for dental caries in 12-year-old children was conducted. The dataset was randomly divided into training set and validation set at a ratio of 7∶3. Four machine learning algorithms, including random forest, decision tree, extreme gradient boosting (XGBoost), and Logistic regression, were constructed using R version 4.1.1, and the prediction effects of the four prediction models were evaluated using the area under receiver operating characteristic curve (AUC). RESULTS A total of 4 439 children aged 12 years were included in this study. The incidence of permanent teeth caries was 50.93%. The results of multivariate logistic regression analysis showed that body mass index, highest educational background of the father, highest educational background of the mother, whether to brush teeth, how many times a day, use of toothpaste when brushing teeth, duration of brushing teeth, mouthwash after meals, eating before going to bed after brushing teeth, sweet drinks, snacks, going to dental clinic to examine teeth, and age of brushing teeth were the factors influencing children's dental caries (P<0.05). The AUC values predicted by random forest, decision tree, Logistic regression, and XGBoost were 0.840, 0.755, 0.799, and 0.794, respectively. In the random forest model, the variable with the highest contribution was eating before bed after brushing. CONCLUSIONS A prediction model of dental caries in children was established on the basis of random forest, showing good prediction effect. Taking preventive measures for the main factors affecting the occurrence of dental caries in children is beneficial.
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Affiliation(s)
- Xinmiao Yan
- School of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Taolan Sun
- School of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Yuhang Lu
- School of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Xin Tan
- School of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Zhuo Wang
- Sichuan Center for Disease Control and Prevention, Chengdu 610500, China
| | - Miaojing Li
- College of Health and Intelligent Engineering, Chengdu Medical College, Chengdu 610500, China
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Wang X, Chen H, Hou R, Yang T, Liu J, Li J, Shi X, Zhao B, Liu J. Effect of dietary patterns on dental caries among 12-15 years-old adolescents: a cross-sectional survey. BMC Oral Health 2023; 23:845. [PMID: 37946183 PMCID: PMC10633925 DOI: 10.1186/s12903-023-03566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Several factors can influence the risk of dental caries, among which dietary factors have a significance impact on the occurrence of dental caries. The limitation of current studies is that they only focus on the influence of individual foods on the risk of dental caries. This study use cluster analysis to examine the relationship between dietary patterns and dental caries experience among adolescents aged 12-15. METHODS Based on data from the first oral epidemic survey in Shanxi Province, a cross-sectional study was conducted among 11,351 adolescents aged 12-15 in Shanxi Province through oral examination and questionnaires. The questionnaire included the intake frequency of seven types of food. Descriptive statistics, cluster analysis, and multinomial logistic regression were used to analyze the association between dietary patterns and dental caries experience. RESULTS The prevalence rate of caries was 44.57% and the mean DMFT score was 0.98 ± 1.49 in adolescents aged 12-15 in Shanxi Province. The caries rate was higher in females than males (X2 = 103.59, P < 0.001). Adolescents who grow up in one-child families have a lower caries risk than those who grow up in families with more than one child (OR:0.91; 95%CI:0.84-0.97). The dietary patterns of adolescents aged 12-15 can be divided into eight types, among which refreshments-rich diet (OR:1.47; 95%CI,1.22-1.77) can increase the risk of caries, while the coarse-grains-rich dietery pattern (OR:0.90; 95%CI, 0.79-0.97) has a lower caries risk. CONCLUSIONS Social determinants of health such as sex, family size and dietary patterns influence the risk of dental caries. Certain dietary patterns could increase or decrease the risk of caries. The government, school canteens and news media should take dietary pattern factors seriously.
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Affiliation(s)
- Xiangyu Wang
- Department of Pediatric and Preventive Dentistry, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Hao Chen
- Department of Pediatric and Preventive Dentistry, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Ruxia Hou
- Department of Pediatric and Preventive Dentistry, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Tingting Yang
- Department of Pediatric and Preventive Dentistry, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Jiajia Liu
- Department of Pediatric and Preventive Dentistry, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Junming Li
- School of Statistics, Shanxi University of Finance and Economics, 696 Wucheng Road, Taiyuan, 030006, China
| | - Xiaotong Shi
- Department of Pediatric and Preventive Dentistry, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Bin Zhao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China.
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, 030001, China.
| | - Junyu Liu
- Department of Pediatric and Preventive Dentistry, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, 030001, China.
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China.
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Zhang X, Dai S, Jiang X, Huang W, Zhou Q, Wang S. The pathways from disadvantaged socioeconomic status in childhood to edentulism in mid-to-late adulthood over the life-course. Int J Equity Health 2023; 22:150. [PMID: 37553562 PMCID: PMC10408210 DOI: 10.1186/s12939-023-01865-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 03/04/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND This study aimed to examine the direct and indirect pathways from childhood socioeconomic status (SES) to the prevalence of edentulism in mid-to-late age Chinese individuals using structural equation modeling (SEM). METHODS This study analyzed data from 17,032 mid- to-late age Chinese individuals in the 2014 and 2015 China Health and Retirement Longitudinal Study (CHARLS). Childhood SES was determined based on the parents' education and occupation, financial situation of the family, primary residence, food availability, and medical convenience. Adulthood SES was established according to educational achievements of the individuals. Edentulism is defined as the loss of all natural teeth. SEM was used to examine the statistical significance of the association between childhood SES and edentulism, mediated by childhood health, adulthood SES, and adult health. RESULTS Childhood SES had significant indirect (β = -0.026, p < 0.01), and total (β = -0.040, p < 0.01) effects on edentulism. It was determined that 65% of the total effect of childhood SES on edentulism was indirect, and mainly mediated by adult SES. Also, the goodness-of-fit indices of the best-fitting model were acceptable. CONCLUSION This study revealed that childhood health, adult health and adult SES are mediators that explain the relationship between childhood SES and edentulism. The global attention to alleviate the inequality in edentulism should focus on exploring recommendations and intervention strategies from childhood to adulthood, by considering adult SES, childhood and adult health.
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Affiliation(s)
- Xiaoning Zhang
- School of Nursing, Hangzhou Normal University, Hangzhou, 311121, China.
- Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, China.
| | - Shuping Dai
- School of Marxism, Handong Women's University, Jinan, China
| | - Xue Jiang
- School of Stomatology, Xuzhou Medical University, Xuzhou, 221004, China
| | - Wenhao Huang
- School of Management, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, 221004, China
| | - Qiong Zhou
- Department of Nursing, Jiangsu Lianyungang College of Traditional Chinese Medicine, Lianyungang, 222007, China
| | - Sheng Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, 311121, China.
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Zhao C, Zhou H, Ge S, Zhan Z, Zhang S, Liao S. Associations of Attitudes and Practice Toward Oral Health, Socioeconomic Status, Self-Rated Oral Health, Subjective Oral Symptoms, and Oral Health-Related Quality of Life Among Residents in Eastern China: A Structural Equation Modeling Approach. Patient Prefer Adherence 2023; 17:1689-1703. [PMID: 37484742 PMCID: PMC10361281 DOI: 10.2147/ppa.s420513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023] Open
Abstract
Background and Purpose The purpose of this study was to investigate the relationships among attitudes and practice about oral health, socioeconomic status, subjective oral symptoms, self-rated oral health, and oral health-related quality of life (OHRQoL) in a group of people from eastern China. Methods Between January 2021 to February 2022, 2502 (87.4%) of the 2863 participants completed an online questionnaire. OHRQoL, Socio-demographics characteristics, attitudes and practice toward oral health, self-rated oral health and subjective oral symptoms were all covered by the questionnaires. Based on the hypothetical model, structural equation modeling with the bootstrap method was used to examine the interactions and the strength of the correlations between the measured variables. Results The final model demonstrated acceptable data fit. Socioeconomic status (β = -0.051), attitudes (β = -0.100) and practice (β = -0.127) toward oral health, self-rated oral health (β = -0.493) and subjective oral symptoms (β = 0.294) were all significantly correlated with OHRQoL. Socioeconomic status was directly linked to attitudes (β = 0.046) and practice (β =0.070) about oral health, and attitudes play the role of intermediary between practice and socioeconomic status (β = 0.018). OHRQoL was indirectly linked with attitudes mediated by practice (β = -0.092), practice mediated by subjective oral symptoms (β = -0.107), subjective oral symptoms mediated by self-rated oral health (β = 0.031). OHRQoL was correlated with income, educational level, and socioeconomic status. Self-rated oral health was related to educational level and socioeconomic status. Conclusion In a sample of eastern China residents, OHRQoL was influenced by socioeconomic status, attitudes and practice toward oral health, subjective oral symptoms, and self-rated oral health.
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Affiliation(s)
- Chen Zhao
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, People’s Republic of China
| | - Haoyun Zhou
- School of Public Health, Bengbu Medical College, Bengbu, 233030, People’s Republic of China
| | - Shaowen Ge
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, People’s Republic of China
| | - Zhaojun Zhan
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, People’s Republic of China
| | - Shunhua Zhang
- School of Medical Imaging, Bengbu Medical College, Bengbu, 233030, People’s Republic of China
| | - Shengkai Liao
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, People’s Republic of China
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Bittencourt JM, Martins LP, Paiva SM, Pordeus IA, Bendo CB. Psychosocial associated factors of early childhood caries and oral health-related quality of life: structural equation model approach. J Dent 2023; 133:104506. [PMID: 37028544 DOI: 10.1016/j.jdent.2023.104506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 03/21/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVE To identify a structural model for the identification of psychosocial associated factors of early childhood caries (ECC) and oral health-related quality of life (OHRQoL) in preschool children and their families. METHODS A population-based cross-sectional study was conducted with 533 preschool children from 4 to 6 years-old public and private preschools, from XXX, XXX. Parents/caregivers self-completed the Brazilian versions of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and Resilience Scale as well as a structured questionnaire addressing socioeconomic status and child's oral health behavior. Two dentists who had undergone training and calibration exercises for ICDAS-epi and pufa index (Kappa≥0.95) performed the examinations for ECC. Stages of ECC were classified as free of visible carious lesion, initial caries, moderate caries, extensive caries without pulp consequences and extensive caries with pulp consequences. Data were analyzed using structural equation modeling, using Mplus version 8.6. RESULTS Lower socioeconomic status (b=-0.250; p<0.001) and higher frequency of free sugar consumption (b=0.122; p=0.033) were directly associated with a more severe stage of ECC. Lower parental resilience had an indirect impact on more severe stage of ECC which was mediated by the variable 'frequency of free sugar consumption' (b=-0.089; p=0.048). ECC was associated with lower child's OHRQoL (b=0.587; p<0.001) and lower family's OHRQoL (b=0.506; p<0.001). CONCLUSION Structural modeling revealed that the severity of ECC negatively impacted the OHRQoL of preschoolers and their families. The main associated factors of the severity of ECC were lower socioeconomic status, higher frequency of free sugar consumption and lower parental resilience. CLINICAL SIGNIFICANCE T The findings indicate that psychosocial and behavior variables can be associated with the severity of ECC, and ECC can be associated with negative impact on wellbeing and ability to perform daily activities of preschoolers and their families.
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Affiliation(s)
- Jéssica Madeira Bittencourt
- Department of Paediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, MG 31270-901, Brazil.
| | - Letícia Pereira Martins
- Department of Paediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, MG 31270-901, Brazil
| | - Saul Martins Paiva
- Department of Paediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, MG 31270-901, Brazil
| | - Isabela Almeida Pordeus
- Department of Paediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, MG 31270-901, Brazil
| | - Cristiane Baccin Bendo
- Department of Paediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, MG 31270-901, Brazil
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Dalla Nora Â, Knorst JK, Comim LD, Racki DNDO, Alves LS, Zenkner JEDA. Factors associated with a cariogenic diet among adolescents: a structural equation modeling approach. Clin Oral Investig 2023; 27:213-220. [PMID: 36114389 DOI: 10.1007/s00784-022-04714-4] [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: 03/30/2022] [Accepted: 09/06/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To investigate the factors directly and indirectly associated with a cariogenic diet among southern Brazilian adolescents. MATERIALS AND METHODS This cross-sectional study included 15-19-year-old students attending high schools in Santa Maria, southern Brazil. The participants completed a questionnaire on sociodemographic and behavioral variables. The Oral Health Impact Profile-14 was applied to collect data on oral health-related quality of life (OHRQoL). Clinical examination was used to assess the dental caries status (decayed, missing, and filled teeth index). A cariogenic diet was considered a latent variable measured by the self-perception of a healthy diet and the frequency of consumption of sugary foods and drinks. Structural equation modeling was used to analyze the direct and indirect pathways to a cariogenic diet. RESULTS A total of 1197 adolescents were included. Low toothbrushing frequency (standardized coefficient (SC), 0.10; p < 0.05), cigarette smoking (SC, 0.15; p < 0.01), and alcoholic beverages (SC, 0.14; p < 0.01) were directly linked to a cariogenic diet, which, in turn, was directly linked to untreated dental caries (SC, 0.18; p < 0.01) and poor OHRQoL (SC, 0.16; p < 0.01). In addition, household income (via toothbrushing frequency) and age (via alcoholic beverages) were indirectly linked to a cariogenic diet. CONCLUSION A cariogenic diet was consistently associated with a range of unhealthy behaviors during adolescence as well as poor household income. CLINICAL RELEVANCE Health promotion strategies to restrict sugar consumption and encourage healthier lifestyles should be aware of the synergism observed among unhealthy behaviors during adolescence.
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Affiliation(s)
- Ângela Dalla Nora
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Letícia Donato Comim
- Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Luana Severo Alves
- Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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de Barros LVC, Vale MP, Tourino LFPG, Bittencourt JM, Bendo CB. Determination of dental caries, molar-incisor hypomineralization, and oral health-related quality of life in schoolchildren: A structural equation modeling approach. Int J Paediatr Dent 2022; 33:289-297. [PMID: 36510651 DOI: 10.1111/ipd.13038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/06/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Some oral conditions can have psychosocial consequences that affect children's daily life and well-being. AIM To create a structural model for the determination of dental caries, molar-incisor hypomineralization (MIH), and the impact of these conditions and socioeconomic status on schoolchildren's oral health-related quality of life (OHRQoL). DESIGN A representative cross-sectional study was conducted in Lavras, Brazil, with 1181 female and male schoolchildren 8-9 years of age. OHRQoL was measured using the Brazilian version of the CPQ8-10. Clinical examinations were performed by a calibrated dentist for the diagnosis of dental caries (WHO) and MIH (EAPD). Parents/caregivers answered questionnaires addressing the child's medical history and socioeconomic status. Data were analyzed using structural equation modeling. RESULTS The model revealed that greater MIH severity (β = .874; p < .001) and worse socioeconomic status (β = -.060; p = .001) were associated with a greater number of teeth with caries experience. The higher the number of teeth with caries experience (β = .160; p = .007) and worse socioeconomic status (β = -.164; p < .001), the greater the negative impact on OHRQoL. CONCLUSION The model created showed that dental caries and socioeconomic status had a direct negative impact on the OHRQoL of schoolchildren and MIH had an indirect impact mediated by the occurrence of caries experience.
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Affiliation(s)
| | - Miriam Pimenta Vale
- Department of Paediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Jéssica Madeira Bittencourt
- Department of Paediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Cristiane Baccin Bendo
- Department of Paediatric Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Babar MG, Andiesta NS, Bilal S, Yusof ZYM, Doss JG, Pau A. A randomized controlled trial of 6-month dental home visits on 24-month caries incidence in preschool children. Community Dent Oral Epidemiol 2022; 50:559-569. [PMID: 35138648 DOI: 10.1111/cdoe.12710] [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: 05/16/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES This paper reports on the effect of 6-month dental home visits compared to no dental home visits on 24-month caries incidence in 5- to 6-year-olds. METHODS 5- to 6-year-olds attending kindergartens were randomized to receive either 6-month dental home visits and education leaflets (Intervention group) or education leaflets alone (Control group) over 24 months. To detect a 15% difference in caries incidence with a significance level of 5% and power of 80%, 88 children were calculated to be needed in the Intervention group and 88 in the Control. Baseline clinical data included oral examinations at the kindergartens. Follow-up visits were made on the 6th, 12th and 18th month. At the end of the 24 months, both the Intervention and Control groups were visited for oral examinations. The primary outcome was caries incidence, measured by the number and proportion of children who developed new caries in the primary molars after 24 months. The secondary outcome was the number of primary molars that developed new caries (d-pms). Frequency distributions of participants by baseline socio-demographic characteristics and caries experience were calculated. The chi-square test was used to test differences between the caries experience in the Intervention and Control groups. The t test was used to compare the mean number of primary molars developing new caries between the Intervention Group and the Control Group. The number of children needed to treat (NNT) was also calculated. RESULTS At the 24-month follow-up, 19 (14.4%) developed new caries in the Intervention Group, compared to 60 (60.0%) in the Control Group (p = .001). On average, 0.2 (95% CI = 0.1-0.3) tooth per child in the Intervention Group was observed to have developed new caries compared to 1.1 (95% CI = 0.8-1.3) tooth per child in the Control Group (p = .001). The number of children needed to treat (NNT) to prevent one child from developing new caries was 2.2. CONCLUSIONS The present study has demonstrated that 6-month home visits to families of 5- to 6-year-olds are effective in caries prevention in 5- to 6-year-olds of low-income families in a middle-income country where access to health services, including oral health promotion services, is limited.
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Affiliation(s)
- Muneer Gohar Babar
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia
| | - Niekla Survia Andiesta
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia
| | - Sobia Bilal
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia
| | - Zamros Yuzadi Mohd Yusof
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Jennifer Geraldine Doss
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Allan Pau
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia
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Liu S, Chongsuvivatwong V, Zhang S, Thearmontree A. Effects of Parental Migration on Dental Caries of Six- to Eight-Year-Old Children Using Structural Equation Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13470. [PMID: 36294059 PMCID: PMC9602841 DOI: 10.3390/ijerph192013470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
This cross-sectional study aimed to document the relationship between dental caries, oral health behaviors, and the duration of parental migration in rural Yunnan, China, from September to December 2020. Seven rural primary schools with high parental migration were studied. The oral health status of 500 six- to eight-year-old students was assessed using clinical examination and caregivers' interviews. A total of 51.8% of the children had at least one parent absent for at least 6 months (left-behind children). Among those children with parental migration <6 months, 40.0% consumed sugar twice or more daily and 82.8% of those with parental migration from 6 to 12 months brushed once a day or less. The percentage of daily sugar consumption twice or more and brushing once or less among those without parental migration were 36.0% and 68.6%. Prevalence of caries in permanent teeth (DMFT) in children without parental migration and those whose parental migration <6 months, 6 to <12 months, and ≤12 months were 30.9%, 20.0%, 28.7% and 19.8%, respectively. Out of several other causal pathways between parental migration and dental caries, our structural equation model delineated that sugar consumption is the important mediator variable. Special education programs may be needed to educate caregivers on sugar consumption for the left-behind children in rural areas.
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Affiliation(s)
- Sichen Liu
- Improvement of Oral Health Care Research Unit, Community Dentistry Division, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla 90110, Thailand
| | | | - Shinan Zhang
- Department of Dental Public Health, School of Stomatology, Kunming Medical University, Kunming 650000, China
| | - Angkana Thearmontree
- Improvement of Oral Health Care Research Unit, Community Dentistry Division, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla 90110, Thailand
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Liu M, Song Q, Xu X, Lai G. Early childhood caries prevalence and associated factors among preschoolers aged 3-5 years in Xiangyun, China: A cross-sectional study. Front Public Health 2022; 10:959125. [PMID: 36052000 PMCID: PMC9424677 DOI: 10.3389/fpubh.2022.959125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/13/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose This study aimed to investigate the early childhood caries (ECC) prevalence among preschoolers aged 3-5 years in Xiangyun of Yunnan, China and explore the factors associated with the prevalence. Materials and methods A cross-sectional survey including 3-5-year-old children was conducted in Xiangyun County, China, between September and November 2020. According to the dental examination standard of the WHO 2013 criteria, the presence of ECC was recorded. Besides the dental examination for children, their parents completed questionnaires about caries-related factors, including demographic variables, family socioeconomic status, feeding, and oral health-related habits, parental dental knowledge, and the condition of dental service utilization. SPSS Statistics 25.0 (IBM, Chicago, IL, USA) was used for data analysis. Statistical significance was set at p < 0.05. Results The ECC prevalence among a sample of 1,280 children aged 3-5 years consisting of 665 boys and 615 girls in this study, was 74.3%, and the mean decayed-missing-filled teeth (dmft) was 4.9 ± 5.0. There were no statistically significant differences in the ECC prevalence between the sexes and among different ethnic groups. Children with different dietary and oral hygiene habits showed no significantly different prevalence of ECC. Logistic regression analysis showed that the most significantly associated factors were older age, lower family income, and worse parental perception of children's oral health status. Conclusion The ECC prevalence among 3-5-year-old preschool children in Xiangyun was higher than the average national ECC prevalence in China. This study implies that more attention should be given to children's caries prevention from early childhood; oral health education and promotion should be intensified to reduce the ECC prevalence and improve the oral health status of children in Xiangyun.
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Affiliation(s)
- Mingshan Liu
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Qianqian Song
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Xiaoqin Xu
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Guangyun Lai
- Department of Pediatric Dentistry, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China,*Correspondence: Guangyun Lai
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Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach. BMC Oral Health 2021; 21:564. [PMID: 34749711 PMCID: PMC8573976 DOI: 10.1186/s12903-021-01935-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 10/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background The aim of the current study was to (a) measure the socioeconomic inequalities in oral health and examine whether the inequalities are greater in disease experience or in its treatment and to (b) decompose the factors that influence oral health inequalities among the adults of Guangdong Province. Methods A cross-sectional study was conducted among 35- to 44-year-old and 65- to 74-year-old adults in Guangdong Province. All participants underwent oral health examinations and answered questionnaires about their oral health. We measured the concentration indices of the DMFT and its separate components, namely, decayed teeth (DT), missing teeth (MT), and filled teeth (FT), to explore the inequalities in oral health status; then, we analysed its decomposition to interpret the factors that influence the inequalities. Results The results showed that significant inequality was concentrated on FT (CI = 0.24, 95% CI = 0.14/0.33, SE = 0.05). The concentration indices for the DMFT (CI = 0.02, 95% CI = 0.02/0.06, SE = 0.02) and MT (CI = 0.02, 95% CI 0.03/0.08, SE = 0.03) were small and close to zero, while the concentration for DT (CI = − 0.04, 95% CI = − 0.01/0.02, SE = 0.03) was not statistically significant. The results from the decomposition analysis suggested that a substantial proportion of the inequality was explained by household income, high education level, regular oral examination and type of insurance (5.1%, 12.4%, 43.2%, − 39.6% (Urban Employee Basic Medical Insurance System) and 34.5% (New-Type Rural Medical Collaboration System), respectively). Conclusions The results indicated greater inequalities in dental caries than in caries experience. Among the included factors, household income, high education level, and regular oral health examinations had the greatest impact on the inequalities in the number of FT. In addition, the current medical insurance systems, including the Urban Employee Basic Medical Insurance System, Urban Resident Basic Medical Insurance System, and the New-Type Rural Medical Collaboration System, have not been effectively used in oral treatment. Policy-making and the implementation of interventions for tackling socioeconomic oral health inequalities should focus on reducing the burden of treatment and providing greater access to dental care for low-income groups. Welfare policies are skewed towards rural areas and low-income people.
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Reyes LT, Knorst JK, Ortiz FR, Mendes FM, Ardenghi TM. Pathways influencing dental caries increment among children: A cohort study. Int J Paediatr Dent 2021; 31:422-432. [PMID: 32965714 DOI: 10.1111/ipd.12730] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/25/2020] [Accepted: 09/03/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dentists should assess pathways influencing the increment of dental caries among children to guide the prevention and treatment of the disease. AIM Evaluate the pathways that influence the increment of carious lesions in pre-school children. DESIGN This is a 2-year cohort study was conducted with a random sample of 639 pre-school children in southern Brazil. Caries experience, socioeconomic status (SES), social capital, and psychosocial characteristics were obtained at baseline. Increment of dental caries was assessed at 2 years follow-up in 467 children (cohort retention rate of 73.1%). Previously calibrated examiners assess the caries through the International Caries Detection and Assessment System (ICDAS). Structural equation modeling (SEM) was performed to test the pathways influencing dental caries increment. RESULTS Dental caries at baseline was heavily influenced by children's age (SC: 0.381, P < .01), tooth plaque (SC: 0.077, P = .02), parent's perception child oral health (SC: 0.295, P < .01), and household (SC: 0.148, P < .01). Increment of dental caries was directly affected by dental caries at baseline (Standardized Coefficients [SC]: 0.377, P < .01). Indirect paths were not significant. CONCLUSIONS Dental caries experience was the main factor of direct influence on the increment of caries, reinforcing the theory of risk accumulation over time.
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Affiliation(s)
- Lilian Toledo Reyes
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fernanda Ruffo Ortiz
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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The correlation of altitude with gingival status among adolescents in western China: a cross-sectional study. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:3151-3167. [PMID: 33528681 DOI: 10.1007/s10653-021-00812-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/07/2021] [Indexed: 02/05/2023]
Abstract
Periodontal disease is common in Chinese adolescents. There is little information about the effect of different altitudes on gingival health. This study aimed to investigate the gingival status at different altitudes and to identify relative factors that affect adolescents' gingival status. A total of 1033 adolescents aged 12-14 years were included in this cross-sectional study in Ganzi (plateau, 1400 m, 2560 m, 3300 m) and Suining (plain, 300 m). Gingival status was assessed by the presence of gingival bleeding on probing (BOP) and dental calculus (DC). Demographic variables, socioeconomic status, dairy habits and oral health-related knowledge, attitudes and behaviors were obtained via questionnaire. Univariate and multivariate binary logistic regression analyses were performed to identify potential relative factors. A total of 64.09% and 77.15% of adolescents had BOP and DC, respectively. The prevalence rates of BOP and DC were higher in the plateau than the plain (P < 0.05). After adjusting for all other factors and interaction terms, residence altitudes of 2560 m [300 m as reference: P < 0.001, odds ratio (OR) = 4.072] and 3300 m (300 m as reference: P = 0.002, OR = 4.053) were significant relative factors of BOP, and an altitude of 2560 m (300 m as reference: P = 0.001, OR = 3.866, 1400 m as reference: P = 0.001, OR = 3.944) was an important relative factor of DC. Gingival bleeding and calculus deposits were common at different altitudes. High altitude was a significant relative factor of gingival bleeding and calculus deposits.
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Structural equation modelling of the complex relationship between toothache and its associated factors among Indonesian children. Sci Rep 2020; 10:13567. [PMID: 32782302 PMCID: PMC7419561 DOI: 10.1038/s41598-020-70104-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/23/2020] [Indexed: 12/22/2022] Open
Abstract
The Indonesian family life survey (IFLS) is used for formulating various government policies. Our preliminary study using data from the IFLS showed increase in the prevalence of toothache from 2007 to 2014. Hence, a need to analyse the factors associated with toothache using structural equation modelling (SEM) for identifying the direct and indirect association of factors with toothache was evident. The objective of this study is to analyse the complex relationships between toothache and its associated risk factors. This cross-sectional study was conducted on the data obtained from the IFLS in 2014. The IFLS data pertaining to toothache and its prevalence were analysed using the STATA software, and the multifaceted relationship was analysed using SEM. The prevalence of toothache among Indonesian children was 15.55% (1,959 of 12,595). SEM showed the direct association between toothache and age (p < 0.001) and parent awareness of children's health conditions (p < 0.005) and food consumption frequency (p < 0.001). Parents’ education level and residential area showed an indirect association with toothache, mediated by socio-economic status and parent awareness of children's health conditions (p < 0.001). We identified the multifaceted relationship between toothache and the social covariates. Parents’ awareness of their children’s health conditions mediated several indirect associations, highlighting its importance.
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Chen H, Zhang R, Cheng R, Xu T, Zhang T, Hong X, Zhao X, Wu Y, Cheng L, Hu T. Gingival bleeding and calculus among 12-year-old Chinese adolescents: a multilevel analysis. BMC Oral Health 2020; 20:147. [PMID: 32429918 PMCID: PMC7238592 DOI: 10.1186/s12903-020-01125-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 04/28/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Gingivitis is a common oral health problem, and untreated gingivitis can progress to periodontitis. The objectives of this study were to (1) explore associated factors of gingival bleeding and calculus among 12-year-old adolescents; (2) find predictive models for gingivitis management. METHODS Four thousand five hundred twenty-five subjects aged 12 in Sichuan Province were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Chinese adolescents' gingival bleeding and calculus. RESULTS 46.63% (95%CI: 40.71, 51.60) and 66.94% (95%CI: 56.85, 67.45) of the subjects presented gingival bleeding and calculus, respectively. For the gingival bleeding cases, the model showed the significant associated indicators were hukou (OR = 0.61, 95% CI: 0.52-0.72), family size (OR = 1.41, 95% CI: 1.19-1.68), parental educational level (father: OR = 0.53, 95% CI: 0.45-0.63; mother: OR = 0.71, 95% CI: 0.59-0.86), tooth-brushing frequency (OR = 0.35, 95% CI: 0.26-0.48), dental floss use (OR = 0.58, 95% CI: 0.41-0.83), sugar-containing drink consumption (OR = 2.11, 95% CI: 1.80-2.49), and dental visit (OR = 1.44, 95% CI: 1.19-1.74). It also confirmed that gender (OR = 1.32, 95% CI: 1.13-1.54), hukou (OR = 0.69, 95% CI: 0.59-0.82), family size (OR = 1.34, 95% CI: 1.12-1.59), parental educational level (father: OR = 0.46, 95% CI: 0.39-0.54; mother: OR = 0.65, 95% CI: 0.59-0.82), tooth-brushing frequency (OR = 0.57, 95% CI: 0.42-0.78), dental floss use (OR = 0.66, 95% CI: 0.48-0.90) and sugar-containing drink consumption (OR = 1.30, 95% CI: 1.11-1.53) were associated factors for dental calculus. CONCLUSIONS Gingival bleeding and calculus were common in western Chinese adolescents. Socio-demographic factors including gender, hukou and family factors are strong determinants of gingival health in Chinese adolescents. In addition, health-related lifestyle behaviors such as healthy diet, good hygiene care and more dental visits are good predictors of better gingival status.
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Affiliation(s)
- Hong Chen
- Graduate Student in Department of Preventive Dentistry, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Rui Zhang
- Graduate Student in Department of Preventive Dentistry, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Ran Cheng
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
- Associate Professor in Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Ting Xu
- Graduate Student in Department of Preventive Dentistry, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Tao Zhang
- Graduate Student in Department of Preventive Dentistry, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Xiao Hong
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
- Associate Professor in Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Xing Zhao
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Yunyun Wu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Li Cheng
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
- Associate Professor in Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China.
- Professor in Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, PR China.
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Jolanta A, María Del Carmen VV, Mónica AM. A cross sectional study of Mexican caregiver social status, dental knowledge, self-efficacy, and caregiver/child oral health. A structural equation model. J Public Health Dent 2020; 80:159-167. [PMID: 32130739 DOI: 10.1111/jphd.12362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 12/18/2019] [Accepted: 02/06/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To test hypothetical models relating caregivers' social status, knowledge, and self-efficacy to caregiver/child (C/C) oral health-related outcomes. METHODS One hundred fifty C/C pairs participated (recruitment = 87.7 percent). Three C/C outcomes were clinically assessed: "Oral self-care"; "Functional dentitions"; and "Dental treatment needs." Information about caregiver (CG) social status, knowledge, and self-efficacy was also gathered. Structural equation modeling tested measurement models (MMs) for CG social status, CG knowledge, and CG self-efficacy. The structural models (SMs) hypothesized causal paths among CG social status, CG knowledge, CG self-efficacy, and C/C oral health outcomes. RESULTS All three MMs had a good overall fit (nonsignificant χ2 estimates, Goodness of Fit Index >0.95, Normed Fit Index ~ >0.95, Confirmatory Fit Index >95, Root Mean Square Error Approximation <0.05). For the SMs, the best overall fit was for "Functional dentitions," while SMs for "Oral self-care," and "Dental treatment needs" required revisions. In all the SMs, the path between "Caregiver social status" and "Caregiver knowledge" was significant. In the "C/C Functional dentitions" SM, the significant path linked "CG self-efficacy" and "Child functional dentition." In the "C/C Dental treatment needs" SM, the significant path linked "CG self-efficacy" and "CG functional dentition." CONCLUSIONS Hypothetical models for three oral health-related outcomes were partly or fully validated.
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