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Krishnan N, Manresa-Cumarin K, Klabak J, Krupa G, Gudsoorkar P. Assessing the impact of oral health disease on quality of life in Ecuador: a mixed-methods study. FRONTIERS IN ORAL HEALTH 2024; 5:1431726. [PMID: 39092199 PMCID: PMC11291228 DOI: 10.3389/froh.2024.1431726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 06/24/2024] [Indexed: 08/04/2024] Open
Abstract
Introduction Globally, oral health diseases surpass all other non-communicable diseases in prevalence; however, they are not well studied in underserved regions, where accessibility to dental services and oral health education is disparately worse. In Ecuador, further research is needed to understand such disparities better. We aimed to assess the effect of oral health disease on individuals' quality of life and how social disparities and cultural beliefs shape this. Methods Individuals 18 or older receiving care at mobile or worksite clinics from May to October 2023 were included. A mixed-methods approach was employed, involving semi-structured interviews, Oral Health-Related Quality of Life (OHRQoL) measures, and extra-oral photographs (EOP). Results The sample (n = 528) included mostly females (56.25%) with a mean age of 34.4 ± 9.44. Most participants (88.26%) reported brushing at least twice daily, and less than 5% reported flossing at least once per day. The median OHRQoL score was 4 (min-max), significantly higher among individuals ≥40 years old, holding high school degrees, or not brushing or flossing regularly (p < 0.05). Identified barriers to good oral health included affordability, time, and forgetfulness. Participants not receiving care with a consistent provider reported fear as an additional barrier. Participants receiving worksite dental services reported these barriers to be alleviated. Dental providers were the primary source of oral hygiene education. Most participants reported oral health concerns, most commonly pain, decay, dysphagia, and halitosis - consistent with EOP analysis. Discussion Findings underscore a need for multi-level interventions to advance oral health equity.
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Affiliation(s)
- Nupur Krishnan
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Karem Manresa-Cumarin
- Department of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, United States
- Solidarity Dental Foundation, Quito, Ecuador
| | | | - Greg Krupa
- Solidarity Dental Foundation, Quito, Ecuador
| | - Priyanka Gudsoorkar
- Solidarity Dental Foundation, Quito, Ecuador
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
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Vieira RV, da Cruz CAG, Alencar GP, Gomes VE, Chalub LLFH, Soares ARDS, Fonseca MLV, Kawachi I, Ferreira RC. Experience of Discrimination and Oral Health Self-Perception: A Cross-Sectional Study among Brazilian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:743. [PMID: 38928989 PMCID: PMC11203647 DOI: 10.3390/ijerph21060743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
This cross-sectional study investigated the association between experiences of discrimination and oral health self-perception among a probabilistic cluster sample of Brazilian adults who participated in the 2013 National Health Survey. Oral health self-perception was categorized into three groups (very good + good; fair; poor + very poor). Reported experiences of discrimination included attributions based on the respondent's race/skin color, social class, income, occupation, illness, sexual orientation, religion, sex, and age. Covariates included sociodemographic data, oral health conditions, access to healthcare services, health habits, mental health, and participation in social and/or religious activities. Data were analyzed using ordinal logistic regression for non-proportional odds, considering sample weights and complex samples. Among 60,202 adults, 5.84% perceived their oral health as poor + very poor, with a significantly higher proportion among those experiencing discrimination (9.98%). Adults who experienced discrimination were 1.39 times more likely to report a "poor/very poor/fair" oral health self-perception compared to those who did not experience discrimination. Those who suffered discrimination were 1.28 times more likely to have a "very poor/poor" oral health self-perception than their counterparts who were not affected by discrimination. These findings underscore the importance of considering discrimination experiences as part of the social determinants influencing oral health.
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Affiliation(s)
- Renato Vitor Vieira
- Department of Social and Community Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (R.V.V.); (C.A.G.d.C.); (V.E.G.); (L.L.F.H.C.); (A.R.d.S.S.); (M.L.V.F.)
| | - Carlos Antonio Gomes da Cruz
- Department of Social and Community Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (R.V.V.); (C.A.G.d.C.); (V.E.G.); (L.L.F.H.C.); (A.R.d.S.S.); (M.L.V.F.)
| | - Gizelton Pereira Alencar
- Department of Epidemiology, School of Public Health, Universidade de São Paulo, São Paulo 05508-220, SP, Brazil;
| | - Viviane Elisângela Gomes
- Department of Social and Community Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (R.V.V.); (C.A.G.d.C.); (V.E.G.); (L.L.F.H.C.); (A.R.d.S.S.); (M.L.V.F.)
| | - Loliza Luiz Figueiredo Houri Chalub
- Department of Social and Community Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (R.V.V.); (C.A.G.d.C.); (V.E.G.); (L.L.F.H.C.); (A.R.d.S.S.); (M.L.V.F.)
| | - Anna Rachel dos Santos Soares
- Department of Social and Community Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (R.V.V.); (C.A.G.d.C.); (V.E.G.); (L.L.F.H.C.); (A.R.d.S.S.); (M.L.V.F.)
| | - Maria Luiza Viana Fonseca
- Department of Social and Community Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (R.V.V.); (C.A.G.d.C.); (V.E.G.); (L.L.F.H.C.); (A.R.d.S.S.); (M.L.V.F.)
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public, Boston, MA 02115, USA;
| | - Raquel Conceição Ferreira
- Department of Social and Community Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (R.V.V.); (C.A.G.d.C.); (V.E.G.); (L.L.F.H.C.); (A.R.d.S.S.); (M.L.V.F.)
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do Amaral Júnior OL, Fagundes MLB, Menegazzo GR, do Amaral Giordani JM. The mediating role of social capital in socioeconomic inequalities of oral health behaviours among Brazilian older adults. Community Dent Oral Epidemiol 2023; 51:879-886. [PMID: 35964240 DOI: 10.1111/cdoe.12780] [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: 08/13/2021] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Knowledge of the possible pathways linking socioeconomic status (SES) to oral health-related behaviours can improve the understanding of inequalities in oral health. Therefore, in this study, it was investigated whether social capital mediates the relationship between SES and oral health behaviours. METHODS Through a cross-sectional study, data were analysed from participants aged ≥60 years from the Brazilian National Health Survey 2019 (n = 21 575). Structural equation modelling was used to test the direct and indirect pathways from a latent variable for SES to a latent variable for oral health behaviours: daily flossing, toothbrushing frequency and the use of dental care services. RESULTS The maximum likelihood estimator was used for complex samples with robust standard errors, and the final model demonstrated an adequate fit. The findings demonstrated that a higher SES was directly associated with better oral health-related behaviours (standardized coefficient [SC]: 0.82; [90% CI: 0.78-0.85]) and indirectly via structural social capital (SC: 0.05; [90% CI: 0.02-0.07]). The total effect of SES on oral health-related behaviours was (SC: 0.87, [90% CI: 0.85-0.89]). CONCLUSION The findings demonstrate that structural social capital in older Brazilian adults might partly mediate the pathways to socioeconomic inequalities in oral health behaviours. However, there is a direct effect on oral health behaviours, reinforcing the hypothesis that SES is associated with oral health, based on paths that link income inequality to oral health.
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Affiliation(s)
- Orlando Luiz do Amaral Júnior
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria - UFSM, Santa Maria, Brazil
- Department of Oral Health, School of Dentistry, Centro Universitário FAI - UCEFF, Itapiranga, Brazil
| | | | - Gabriele Rissotto Menegazzo
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria - UFSM, Santa Maria, Brazil
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Lee CT, Zhang K, Li W, Tang K, Ling Y, Walji MF, Jiang X. Identifying predictors of tooth loss using a rule-based machine learning approach: A retrospective study at university-setting clinics. J Periodontol 2023; 94:1231-1242. [PMID: 37063053 DOI: 10.1002/jper.23-0030] [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: 01/10/2023] [Revised: 03/18/2023] [Accepted: 04/12/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND This study aimed to identify predictors associated with tooth loss in a large periodontitis patient cohort in the university setting using the machine learning approach. METHODS Information on periodontitis patients and 18 factors identified at the initial visit was extracted from electronic health records. A two-step machine learning pipeline was proposed to develop the tooth loss prediction model. The primary outcome is tooth loss count. The prediction model was built on significant factors (single or combination) selected by the RuleFit algorithm, and these factors were further adopted by the count regression model. Model performance was evaluated by root-mean-squared error (RMSE). Associations between predictors and tooth loss were also assessed by a classical statistical approach to validate the performance of the machine learning model. RESULTS In total, 7840 patients were included. The machine learning model predicting tooth loss count achieved RMSE of 2.71. Age, smoking, frequency of brushing, frequency of flossing, periodontal diagnosis, bleeding on probing percentage, number of missing teeth at baseline, and tooth mobility were associated with tooth loss in both machine learning and classical statistical models. CONCLUSION The two-step machine learning pipeline is feasible to predict tooth loss in periodontitis patients. Compared to classical statistical methods, this rule-based machine learning approach improves model explainability. However, the model's generalizability needs to be further validated by external datasets.
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Affiliation(s)
- Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Kai Zhang
- The University of Texas Health Science Center at Houston, McWilliams School of Biomedical Informatics, Houston, Texas, USA
| | - Wen Li
- Division of Clinical and Translational Sciences, Department of Internal Medicine, The University of Texas McGovern Medical School at Houston, Houston, Texas, USA
- Biostatistics/Epidemiology/Research Design (BERD) Component, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kaichen Tang
- The University of Texas Health Science Center at Houston, McWilliams School of Biomedical Informatics, Houston, Texas, USA
| | - Yaobin Ling
- The University of Texas Health Science Center at Houston, McWilliams School of Biomedical Informatics, Houston, Texas, USA
| | - Muhammad F Walji
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Xiaoqian Jiang
- The University of Texas Health Science Center at Houston, McWilliams School of Biomedical Informatics, Houston, Texas, USA
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Nakazawa N, Kusama T, Takeuchi K, Kiuchi S, Yamamoto T, Kondo K, Osaka K, Aida J. Co-Payments and Inequality in Gingival Bleeding and Dental Visits. Int Dent J 2023; 73:628-635. [PMID: 36642573 PMCID: PMC10509420 DOI: 10.1016/j.identj.2022.11.009] [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: 09/14/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES Japan's universal health insurance covers a wide range of dental treatments, and the co-payment rates differ by age. We investigated whether the inequality in gingival bleeding and dental visits was smaller amongst those with lower co-payment rates. METHODS This cross-sectional study used data from the 2019 Japan Gerontological Evaluation Study. The participants were functionally independent adults aged 65 years or older. The dependent variables were current gingival bleeding as a symptom of periodontal diseases and dental nonattendance for treatment in the past year. The independent variables were ridit scores of equivalent income and educational status. For covariates, we used age, sex, and the number of remaining teeth. To evaluate the inequalities, we used the slope index of inequality (SII) and the relative index of inequality (RII). We also conducted stratified analyses by co-payment rates (30%, 20%, and 10%) to clarify the difference in inequalities by co-payment rate. RESULTS A total of 15,389 participants were included in the analysis; their mean age was 71.8 (SD = 4.1) and 51.8% were women. There were significant absolute and relative inequalities in gingival bleeding and dental visits by equivalent income and education. With regards to educational status, inequalities were lower with a decrease in the co-payment rate. In particular, relative inequality by education in gingival bleeding was the largest amongst the 30% co-payment group (RII, 1.918; 95% confidence interval [CI], 1.386 to 2.656). For gingival bleeding, the absolute and relative inequality by equivalent income were not significant amongst the 10% co-payment group (SII, -0.003; 95% CI, -0.003 to 0.028; RII, 1.006; 95% CI = 0.676 to 1.498). CONCLUSIONS A low co-payment rate was associated with smaller inequalities in gingival bleeding and dental visits by equivalent income and educational status.
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Affiliation(s)
- Noriko Nakazawa
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - Taro Kusama
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan; Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan; Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan; Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Tatsuo Yamamoto
- Department of Dental Sociology, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
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Ferreira RC, Souza JGS, Soares ARDS, Vieira RV, Kawachi I. Income- and education-based inequalities of edentulism and dental services utilization in Brazil. Community Dent Oral Epidemiol 2023; 51:829-837. [PMID: 35801281 DOI: 10.1111/cdoe.12771] [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: 05/31/2021] [Revised: 06/05/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Tooth loss is a worldwide public health problem affecting mainly socioeconomically disadvantaged groups. Dental services utilization may increase access to preventive actions and conservative treatment, reducing the prevalence of tooth loss. This study evaluated the income- and education-based inequalities in edentulism according to the utilization of dental services among adults and older adults in Brazil. METHODS Data from the National Oral Health Survey (SB Brazil, 2010) of adults (ages 35-44 years, n = 9779) and older adults (ages 65-74 years, n = 7619) were analysed. Socioeconomic indicators (SES) included education and income. The magnitude of inequality in edentulism by education and income levels was estimated by the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). The changes in the RII and SII according to the utilization of dental services were estimated. Regression models estimated the association between SES and edentulism and whether dental services utilization modified this association. RESULTS Higher edentulism prevalence was observed among those with lower education and income levels. The utilization of dental services changed the education-based inequality index in edentulism for adults, with percentage changes of 17.4% (RII) and 56.8% (SII). For adults with low education (0-4 years of study), the odds of edentulism were 80% (OR 0.2; 95% CI 0.1-0.6) and 90% (OR 0.1; 95% CI 0.01-0.2) lower for those who had used dental services within the preceding year and within 1-2 years compared with those who had used such services within the preceding 3 or more years, respectively. CONCLUSION There was a social gradient in the prevalence of edentulism in adults and older adults, and the education-based inequalities in edentulism were lower among adults reporting utilization of dental services in the preceding year.
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Affiliation(s)
- Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - João Gabriel Silva Souza
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Dental Research Division, Guarulhos University, São Paulo, Brazil
- Dental Science School (Faculdade de Ciências Odontológicas - FCO), Brazil
| | - Anna Rachel Dos Santos Soares
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Renato Vitor Vieira
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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Bomfim RA, Constante HM, Cascaes AM. Explaining income inequities in tooth loss among Brazilian adults. J Public Health Dent 2023; 83:101-107. [PMID: 36700483 DOI: 10.1111/jphd.12556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/30/2022] [Accepted: 12/02/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To determine the extent to which individual and contextual variables explain income inequities in tooth loss in Brazilian adults. METHODS A nationally representative sample of 65,784 Brazilian adults aged 18-59 who participated in the Brazilian National Health Survey 2019 was analyzed. Self-reported tooth loss was the outcome. Per capita income was the main exposure, and minimum wage was the cutoff point. Individual covariates included sex, race, and schooling, dental visits, smoking status, use of dental floss, and self-reported chronic conditions. Contextual covariates included access to treated water and geographic region of residence. Blinder-Oaxaca decomposition analysis was used to estimate the share of each factor in income-related tooth loss inequities by age groups. RESULTS Age-standardized tooth loss showed large income inequities. The average difference in tooth loss related to income inequities in the 18-34-year-old group was 0.50 (95% CI 0.39; 0.60), increasing to 4.51 (95% CI 4.09; 4.93) in the 45-59 years. Individual and contextual covariates explained almost 90% of income inequities in the 45-59 year group. Use of dental floss, schooling, and geographic region of residence (a proxy for human development level) had a higher proportion of contribution to the inequities examined. CONCLUSIONS Individual and contextual covariates (proxy for human development level and water fluoridation coverage) explained a large share of income-related tooth loss inequities. Tailored strategies to act at both levels can help reduce tooth loss inequities among Brazilian adults.
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Affiliation(s)
- Rafael Aiello Bomfim
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Helena Mendes Constante
- Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Andreia Morales Cascaes
- Department of Public Health, Graduate Program in Dentistry and Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Jiang L, Li J, Yang Z, Huang X, Zhong X, Huang Y, Liu B, Wu L, Huang S, Fan W. Analysis of epidemiological trends of and associated factors for tooth loss among 35- to 44-year-old adults in Guangdong, Southern China, 1995-2015: a population-based cross-sectional survey. BMC Oral Health 2023; 23:74. [PMID: 36740667 PMCID: PMC9899388 DOI: 10.1186/s12903-023-02776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/27/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Tooth loss is a known marker of oral and systemic health, but large-scale population-based and cross-sectional multi-year comparative studies on tooth loss have yet to be much studied in China. This study explores the changing trends in tooth loss status and the associated factors influencing the prevalence of tooth loss over the past two decades in Guangdong, Southern China. METHODS Data from three cross-sectional, representative oral epidemiological surveys in Guangdong Province were analyzed, including 400 in 1995, 720 in 2005, and 288 in 2015, for a total of 1408 participants. Sample selection is based on the National Census of China published by the National Bureau of Statistics. In this study, each year, the number of missing teeth (MT) and the prevalence of tooth loss (MT > 0) were calculated. Basic demographic information, socioeconomic status, caries and periodontal status, personal lifestyle factors, and dental health care behaviors were analyzed by multivariate logistic regression to estimate their associations with tooth loss. Statistical significance was evaluated with 2-sided tests with a significance level of P < 0.05. RESULTS This study found that the mean number of missing teeth and the prevalence of tooth loss among adults aged 35-44 years in Guangdong Province did not change significantly in the first decade (1995-2005) but decreased significantly in the second decade (2005-2015) (0.94 and 40.8% in 1995, 0.99 and 42.9% in 2005, and 0.63 and 33.3% in 2015, respectively). The mean number of MT by tooth position was highest for the first and second molars, and both were larger in the mandible than in the maxilla. In 1995, populations with low educational attainment and the presence of caries or periodontal pocket (periodontal probing depth ≥ 4 mm) were associated with a higher chance of MT > 0. In 2005, those with low educational attainment, the presence of caries, and 40-44 years old were associated with a higher chance of MT > 0. Moreover, in 2015, females, rural residents, and those with caries or periodontal pocket were associated with a higher chance of MT > 0. CONCLUSIONS Although tooth retention has improved recently (2005-2015) and the preventive effect of education level on tooth loss has increased over time, efforts to prevent tooth loss in adults need to be strengthened. Particular attention should be given to preventive interventions for women, rural residents, and those suffering from caries or periodontal pocket.
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Affiliation(s)
- Linxin Jiang
- grid.284723.80000 0000 8877 7471Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Jianbo Li
- grid.284723.80000 0000 8877 7471Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Zijing Yang
- grid.284723.80000 0000 8877 7471Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Xiaoyan Huang
- grid.284723.80000 0000 8877 7471Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Xiong Zhong
- grid.284723.80000 0000 8877 7471Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Yi Huang
- grid.284723.80000 0000 8877 7471Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Bincheng Liu
- grid.284723.80000 0000 8877 7471Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Linmei Wu
- grid.284723.80000 0000 8877 7471Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Shaohong Huang
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
| | - Weihua Fan
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
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Crepaldi BVC, Okada LM, Claro RM, Louzada MLDC, Rezende LFM, Levy RB, Azeredo CM. Educational inequality in consumption of in natura or minimally processed foods and ultra-processed foods: The intersection between sex and race/skin color in Brazil. Front Nutr 2022; 9:1055532. [PMID: 36570160 PMCID: PMC9774479 DOI: 10.3389/fnut.2022.1055532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
Background It remains uncertain how the intersection between educational, gender, and race/skin color inequalities influences food consumption in Brazil. In this study, we examined the educational inequality in the consumption of in natura/minimally processed and ultra-processed foods by Brazilians with an intersectional perspective between sex and race/color. Methods We used cross-sectional data from the Telephone Surveillance System (VIGITEL 2019), comprising 52,443 participants ≥ 18 years. Daily food consumption was considered high when consumption of ≥5 foods for each food group was reported the day before the survey. Educational inequality in food consumption was assessed by the slope index of inequality (SII) and the relative index of inequality (RII) according to sex and race/color (White; Black/Brown). Positive SII and RII values > 1.0 indicate higher food consumption among more educated participants. Results The consumptions of in natura/minimally processed and ultra-processed foods were more prevalent in those with the highest level of education (≥12 years) and intermediate education (9-11 years), respectively. However, highly educated White women had higher consumption of in natura/minimally processed foods than Black women with the same education level, and White men in low and intermediate school levels had higher consumption of these foods than Black men with the same education levels. We found higher absolute educational inequality for in natura/minimally processed foods among White women (SII 21.8, 95% CI 15.3, 28.4) and Black/Brown men (SII 19.3, 95% CI 12.5, 26.1). Black/Brown men (SII 7.3, 95% CI 0.5, 14.0) and Black/Brown women (SII 5.6, 95% CI 1.0, 10.2) had higher absolute educational inequality than White men (SII -3.3, 95% CI -10.9, 4.3; P = 0.04) in the consumption of ultra-processed foods. Conclusion Educational inequalities influenced the consumption of in natura/minimally processed more than ultra-processed foods, and, for the latter, inequalities were greater among Black/Brown men and women than among White men.
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Affiliation(s)
| | - Letícia Martins Okada
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Rafael Moreira Claro
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Leandro F. M. Rezende
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Renata Bertazzi Levy
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Catarina Machado Azeredo
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil,*Correspondence: Catarina Machado Azeredo,
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Hartwig AD, Cademartori MG, Demarco FF, Bertoldi AD, Corrêa MB, Azevedo MS. Are maternal factors predictors of a child's first dental visit? A birth cohort study in Brazil. Braz Oral Res 2022; 36:e092. [PMID: 35830139 DOI: 10.1590/1807-3107bor-2022.vol36.0092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/11/2022] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to investigate the association between maternal factors and dental visits of children within their first year of life. This study used data from the 2015 Pelotas Birth Cohort and included pregnant women and their children at 12 months of age, followed-up between May 2014 and December 2015. Socioeconomic and demographic data, information on the use of dental services during the last year, and information on dental fear were collected by interviewing the mothers. Information regarding dental caries and periodontal disease were collected during the mother's clinical examination. The date of each child's first visit to the dentist was recorded. Crude and adjusted Poisson regression models with robust variance were used. The sample comprised 2,287 mother-child dyads, of which 10.1% of children visited the dentist during the first year of life. Children whose mothers visited the dentist within the last year for preventive reasons (RR: 1.51; 95%CI: 1.12-2.03) or curative reasons (RR: 1.47; 95%CI: 1.08-2.01) were more likely to have visited the dentist during the first year of life compared to those whose mothers had not used dental services during this period. Maternal tooth loss was inversely associated with a child's visit to the dentist during the first year of life (RR: 0.69; 95%CI: 0.54-0.89). Considering the mother's history of using dental services, as well as their dental caries history, is necessary to understand and improve patterns of dental health care utilization and implement public oral health policies for young children.
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Affiliation(s)
- Andréia Drawanz Hartwig
- Universidade Federal de Pelotas - UFPel, Post-Graduate Program in Dentistry, Pelotas, RS, Brazil
| | | | - Flávio Fernando Demarco
- Universidade Federal de Pelotas - UFPel, Post-Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas - UFPel, Post-Graduate Program in Epidemiology, Pelotas, RS, Brazil
| | - Marcos Britto Corrêa
- Universidade Federal de Pelotas - UFPel, Post-Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Marina Sousa Azevedo
- Universidade Federal de Pelotas - UFPel, Post-Graduate Program in Dentistry, Pelotas, RS, Brazil
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Kim SY, Lee CH, Yoo DM, Kwon MJ, Kim JH, Kim JH, Byun SH, Park B, Lee HJ, Choi HG. Is the Number of Missing Teeth Associated With Mortality? A Longitudinal Study Using a National Health Screening Cohort. Front Med (Lausanne) 2022; 9:837743. [PMID: 35801211 PMCID: PMC9253612 DOI: 10.3389/fmed.2022.837743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to estimate the risk of mortality related to the number of missing teeth in a South Korean population. The ≥ 40-year-old population of the Korean National Health Insurance Service-Health Screening Cohort 2002–2003 was analyzed. Participants were selected from a total of 220,189 participants and included in groups of 0 teeth lost, 1–2 teeth lost, and ≥ 3 teeth lost. Among the total population, 17,211 participants were included in no missing teeth, 1–2 missing teeth, and ≥ 3 missing teeth and were randomly matched 1:1:1 for age and sex. Mortality from specific causes and all-cause mortality were compared among the groups. The hazard ratio (HR) of the number of missing teeth for all-cause mortality or each cause of mortality was analyzed using Cox proportional hazard models. According to the cause of death, the HRs for metabolic disease, digestive disease, and trauma were greater in the group with ≥ 3 missing teeth than in the no missing teeth group. The group with ≥ 3 missing teeth indicated a 1.19-fold higher HR for all-cause mortality than the no missing teeth group [95% confidence intervals (95% CIs) = 1.12–1.27, P < 0.001]. The group with 1- 2 missing teeth did not show a higher HR for all-cause mortality. In the group with 1–2 missing teeth, the HRs for mortality from mental disease and digestive disease were higher than those in the no missing teeth group. The group with 1–2 missing teeth did not show a higher HR for all-cause mortality. The number of missing teeth was linked with a higher risk of mortality. For specific causes of mortality, mortality from metabolic disease, digestive disease, and trauma was higher in the participants with the number of missing teeth.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Chang Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea
| | - Mi Jung Kwon
- Department of Pathology, Hallym University College of Medicine, Anyang, South Korea
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University College of Medicine, Anyang, South Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Dentistry, Hallym University College of Medicine, Anyang, South Korea
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon, South Korea
| | - Bumjung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
| | - Hyo-Jeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
- *Correspondence: Hyo Geun Choi
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MIALHE FL, SANTOS BL, BADO FMR, OLIVEIRA JÚNIOR AJD, SOARES GH. Association between oral health literacy and dental outcomes among users of primary healthcare services. Braz Oral Res 2022; 36:e004. [DOI: 10.1590/1807-3107bor-2022.vol36.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
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Salim NA, Meyad FH, Al-Abdallah MM, Abu-Awwad M, Satterthwaite JD. Knowledge and awareness of dental implants among Syrian refugees: a cross sectional study in Zaatari camp. BMC Oral Health 2021; 21:442. [PMID: 34521403 PMCID: PMC8439005 DOI: 10.1186/s12903-021-01806-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background The popularity of implant dentistry is increasing dramatically, but the success of implant treatment depends on a patient’s knowledge and expectations. Methods This study aimed to assess dental implant knowledge among refugees as a treatment option (n = 565), using face-to-face interviews. The frequency distribution of the responses in general and according to age, gender and education was calculated. Results 81.8% of the interviewees had missing teeth, however, only 26.2% replaced them. 16.6% of participants had never/hardly heard about implants. Females who never heard of implants were more than males (P < 0.001). 51.3% of participants described dental implants as a screw, and only 35.4% knew implants were placed in jawbones. 6.2% of respondents reported that implants required more care than a natural teeth, with 47.6% believing that diseases affect implant success. Friends were the main source of information (61.4%). Highly educated participants showed higher knowledge about implants. Conclusions The surveyed sample revealed limited knowledge about dental implants with high cost being a major obstacle, warranting more strategies to increase awareness and to make implants more affordable for this population.
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Affiliation(s)
- Nesreen A Salim
- Prosthodontic Department, School of Dentistry, The University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan.
| | | | - Mariam Mohammad Al-Abdallah
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Motasum Abu-Awwad
- Prosthodontic Department, School of Dentistry, The University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
| | - Julian D Satterthwaite
- Division of Dentistry, School of Medical Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
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Abstract
Introduction Little is understood about the socioeconomic predictors of tooth loss, a condition that can negatively impact individual’s quality of life. The goal of this study is to develop a machine-learning algorithm to predict complete and incremental tooth loss among adults and to compare the predictive performance of these models. Methods We used data from the National Health and Nutrition Examination Survey from 2011 to 2014. We developed multiple machine-learning algorithms and assessed their predictive performances by examining the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and positive and negative predictive values. Results The extreme gradient boosting trees presented the highest performance in the prediction of edentulism (AUC = 88.7%; 95%CI: 87.1, 90.2), the absence of a functional dentition (AUC = 88.3% 95%CI: 87.3,89.3) and for predicting missing any tooth (AUC = 83.2%; 95%CI, 82.0, 84.4). Although, as expected, age and routine dental care emerged as strong predictors of tooth loss, the machine learning approach identified additional predictors, including socioeconomic conditions. Indeed, the performance of models incorporating socioeconomic characteristics was better at predicting tooth loss than those relying on clinical dental indicators alone. Conclusions Future application of machine-learning algorithm, with longitudinal cohorts, for identification of individuals at risk for tooth loss could assist clinicians to prioritize interventions directed toward the prevention of tooth loss.
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