Gender differences in the association between oral health literacy and oral health-related quality of life in older adults

Health literacy and falls among community-dwelling older people in China: is there a sex difference?

BACKGROUND

Health literacy is one of the important determinants of healthy aging, yet few studies have focused on the association between health literacy and falls.

AIMS

This study aims to explore the relationship between health literacy and falls, with a focus on sex differences among older people in China.

METHODS

This cross-sectional study enrolled 2,144 older people aged ≥ 60 years from Shandong Province, China in 2021. We used general health literacy screening scale to assess health literacy, and collected the incidence of falls in the past year. Logistic regression models were employed to analyze the relationship between health literacy and falls. We investigated the sex differences by subgroup analyses.

RESULTS

The prevalence of adequate health literacy and falls was 21.7% (95% CI: 20.0-23.5%) and 25.4% (95% CI: 23.6-27.3%), respectively. In a fully-adjusted model, adequate health literacy was associated with a lower prevalence of falls in older adults (OR = 0.71, 95%CI: 0.52-0.96). Subgroup analysis revealed sex differences in this relationship (Pfor interaction <0.05). Specifically, the female group showed no significant relationship between health literacy and falls (OR = 0.92, 95% CI: 0.59-1.44); however, the male group demonstrated a robust and significant relationship (OR = 0.58, 95% CI: 0.37-0.90).

CONCLUSIONS

Older people with adequate health literacy have lower prevalence of falls, which appears to differ by sex. This relationship was significant among men but not among women. These findings emphasize the need for policymakers and healthcare providers to consider sex differences when designing and implementing programs aimed at improving health literacy and preventing falls in the older population. Improving health literacy among older women could be a strategic component in bridging sex inequality in falls.

Association between age, gender, and oral traumatic ulcerative lesions: a retrospective study

BACKGROUND

Oral traumatic ulcerative lesions (OTUL) are commonly encountered in clinical practice, yet there is limited research on their clinical characteristics and traumatic etiological factors. This retrospective study aimed to analyze the age, gender, clinical characteristics, and traumatic etiological factors in a large cohort of patients with OTUL and provide valuable insights for dental clinicians to optimize patient care and prevention strategies.

METHODS

A total of 1543 patients with OTUL were enrolled in this study. Age, gender, medical history, clinical characteristics and traumatic etiological factors were collected and analyzed. Logistic regression analysis was performed to determine the significance of age and gender as factors related to OTUL.

RESULTS

The study revealed significant variations in clinical characteristics and traumatic etiological factors among different age groups and between genders. Logistic regression analysis demonstrated that both age and gender were significant factors related to OTUL.

CONCLUSION

The clinical characteristics of OTUL and traumatic etiological factors appear to be significantly different according to age and gender. More targeted prevention strategies should be implemented for all age and gender groups.

Differences in the association of oral health knowledge, attitudes, and practices with frailty among community-dwelling older people in China

BACKGROUND

Oral health and frailty are significantly related and should be well examined, especially in late life. Few studies have explored the relationship of oral health knowledge, attitudes, and practices with frailty and examined sociodemographic variations in this association. This study aimed to examine the association between oral health knowledge, attitudes, practices and frailty, with a special focus on comparing differences in their association among the Chinese community-dwelling older population.

METHODS

This study included 4218 community-dwelling older adults (aged ≥ 60 years) who participated in a cross-sectional survey. Sociodemographic characteristics, oral health knowledge, attitudes, practices, and frail status (non-frailty, pre-frailty, and frailty) were collected with a face-to-face questionnaire-based interview. Multivariate logistic regression models were used to evaluate the association of oral health knowledge, attitudes, and practices with frailty.

RESULTS

Of the 4218 participants, 36.2% (n = 1527) and 18.8% (n = 792) were classified as pre-frailty and frailty. Age, gender and educational attainments differences existed in the association of oral health knowledge with frailty. Urban-rural differences in the association of oral health knowledge and practices with frailty were also found. Specifically, oral health knowledge was significantly related to frailty only among participants aged 70-79 years (adjusted odds ratio [95% confidence interval]) (1.08 [1.02-1.15]), females (1.05 [1.00-1.10]), rural residents (1.06 [1.01-1.12]), and those who were primary school and lower education (1.06 [1.01-1.11]), whereas oral health practices were related to frailty only among urban participants (0.96 [0.92-1.00]).

CONCLUSION

This study confirmed the different associations of oral health knowledge and practices with frailty among community-dwelling older people in China. Further research is needed to better understand the abovementioned differences and public health strategies are required to improve oral health literacy and thereby contain the development of frailty in later life.

Comparison of the Oral Health-Related Quality of Life, Sleep Quality, and Oral Health Literacy in Sleep and Awake Bruxism: Results from Family Medicine Practice

Objectives

Bruxism is a common oral behaviour. This study aimed to compare oral health-related quality of life, sleep quality, and oral health literacy in patients with and without possible sleep bruxism (SB) and awake bruxism (AB).

Materials and Methods

A cross-sectional study including 249 volunteers was conducted in a family medicine clinic of a tertiary hospital in Istanbul, Turkey. The American Sleep Medicine Association Bruxism Diagnostic Criteria, Pittsburgh Sleep Quality Index (PSQI), Oral Health-Related Quality of Life (OHRQoL) tool, Decay Missing Filled Total Teeth (DMFT) score, and Health Literacy Dental Scale-Short Form (HeLD-14) were assessed by face-to-face interviews. Data were examined using Kruskal-Wallis and Mann-Whitney U tests, Spearman correlation, and logistic regression analysis.

Results

The presence of SB and AB was detected as 41.4% and 21.7%, respectively, among 91 males and 158 females, with a mean age of 36.64 ± 11.60 years. Sleep and awake bruxers had a lower oral health-related quality of life (odds ratio (OR): 0.816, 95% confidence interval (CI) = 0.770-0.864 and OR: 0.923, 95% CI = 0.956-0.982, respectively). Poor sleep quality was detected 1.28 times higher in sleep bruxism (OR: 1.277, 95% CI = 1.152-1.415) and 1.14 times higher in awake bruxism (OR: 1.141, 95% CI = 1.230-1.058). The DMFT score was found to be 1.13 times higher in SB (OR: 1.129, 95% CI = 1.043-1.223). A higher HeLD-14 score was associated with a lower DMFT score (p < 0.001; r = -0.240). The oral health literacy score was lower in AB and SB groups than in patients without bruxism, but it was not statistically significant (p = 0.267, p = 0.376).

Conclusion

A lower oral health-related quality of life and poor sleep quality would be expected in the presence of SB or AB. However, patients may not be aware of it unless asked by a physician regardless of oral health literacy level.

Factors in oral-related quality of life of betel quid users receiving oral mucosal screening: a cross‑sectional study in Taiwan

BACKGROUND

Betel quid (BQ) chewing is associated with poor oral hygiene, psychological impairment, and acute and long-term addictive effects, resulting in worse oral-related quality of life (OHRQoL). The purpose of this study was to characterize the factors associated with OHRQoL among BQ users receiving oral mucosal screening.

METHODS

A cross-sectional study was conducted. Data were collected by random sampling of BQ users who visited outpatient departments receiving oral mucosal screening in a medical center Taiwan. The oral health assessment tool, the state anxiety inventory, the betel quid dependence scale, and the oral health impact profile were used to measure oral health status, anxiety, BQ dependence, and OHRQoL, respectively. Pearson's product-moment coefficient was used to examine the relationship between OHRQoL and the selected independent variables. Independent-samples t-test was used to compare OHRQoL by annual family income, the presence of chronic disease, and BQ dependence. Hierarchical multiple linear regression analysis was used to identify factors associated with OHRQoL.

RESULTS

A total of 175 BQ users were surveyed. Factors associated with OHRQoL included oral health status, anxiety, and BQ dependence. BQ users reporting low oral health status, greater anxiety, and more BQ dependence were more likely to have worse OHRQoL.

CONCLUSIONS

Poor oral health status, anxiety, and BQ dependence negatively impact on OHRQoL among patients with BQ use receiving oral mucosal screening.

The relationship between oral health status, loneliness, and sleep quality among the migrant elderly following children in Weifang, Shandong Province, China: A comparative analysis on different migration types

Background

The migrant elderly following children (MEFC) are a vulnerable group that emerged during fast urbanization in China. The MEFC faced physical and psychological discomfort upon their arrival in the inflow city, particularly those who came from rural areas.

Objective

This study aimed to explore the relationship between oral health status, loneliness, and sleep quality among the MEFC in China and to clarify the disparities in the above mentioned relationship by migration type.

Methods

In 2021, a cross-sectional survey was conducted in Weifang, Shandong Province, using multistage cluster random sampling to collect data from the MEFC aged 60 years and over. In total, 613 respondents [525 rural-to-urban (RTU) and 88 urban-to-urban (UTU)] were included in the final database. The chi-square test, t-test, and structural equation modeling (SEM) were used to investigate the relationship between oral health status, loneliness, and sleep quality among the RTU and UTU MEFC.

Results

Total scores [mean ± standard deviation (SD)] for oral health status, loneliness, and sleep quality were 54.95 ± 6.47, 8.58 ± 3.03, and 4.47 ± 3.60, respectively. SEM revealed that, among the RTU and UTU MEFC, oral health status was positively and significantly related to sleep quality; however, the correlation was slightly stronger in the UTU MEFC. In both groups, there was a significant negative correlation between oral health status and loneliness, which was stronger in the UTU MEFC. In the RTU MEFC, a significant negative correlation between loneliness and sleep quality was observed, and in the UTU MEFC, no significant association between loneliness and sleep quality was observed.

Conclusion

The sleep quality among the MEFC in this study was higher compared to previous studies. Oral health status was negatively correlated with loneliness and positively associated with sleep quality, whereas loneliness was negatively correlated with sleep quality. These three associations differed significantly between the UTU and RTU MEFC. The government, society, and families should take measures to improve oral health and reduce loneliness among the MEFC to improve their sleep quality.

Gender Differences in Oral Health: Self-Reported Attitudes, Values, Behaviours and Literacy among Romanian Adults

A topic that has been less researched on, especially in Romania, is the identification of gender differences in oral health. The present scientific research used an online survey to assess the attitudes (dental beliefs survey-R/R-DBS), the values (oral health values scale/OHVS), the behaviours (dental neglect scale/DNS), and the literacy (oral health literacy scale/OHLS) related to oral health and to dental professional services in the case of a sample of 600 Romanian adults (Mean_age = 30.84). The relation between the level of knowledge as a predictor of attitudes and values related to oral health was analysed by the means of a structural equation based on the partial least square method (PLS-SEM). The results show that women have more positive attitudes towards dental medical services, higher oral health values, better self-care behaviours, and higher oral health literacy than men. In the case of men, attitudes and behaviours related to self-care are influenced by their oral health literacy and level of education; in the case of women, the latter are influenced only by their level of oral health literacy. The impact that knowledge in oral health has on attitudes, values, and behaviours was highlighted. The differences in attitudes and values related to oral health between the two genders can be accounted for by the differences in formal and informal education (studies and oral health literacy, respectively).

The Status, Need, and Influence of Dental Prosthetics on Oral Health-Related Quality of Life in the Geriatric Population: An Epidemiological Survey

Background

An epidemiological survey was conducted among the geriatric population to determine the status and need for dental prosthetics and their influence on oral health-related quality of life (OHRQoL).

Methodology

The study population consisted of 270 patients aged 60 or older. All pertinent demographic information, clinical data on prosthesis status and need, and the Oral Health Impact Profile (OHIP)-14 questions to assess OHRQoL were collected using a pretested structured questionnaire written in the patient’s native tongue. In addition, a type 3 oral examination was performed on a sample of the geriatric population.

Results

The OHRQoL was found to be unaffected by the prosthetic status. However, there was a strong correlation between the elderly study population’s OHRQoL and the need for a prosthetic. Of each variable in OHRQoL, physical pain, discomfort when eating, and loss of taste were the most affected in this population.

Conclusions

The prosthetic needs of the study population must be given high priority as there are many unmet needs. The concerned health departments need to seriously consider increasing facilities with an affordable system. There is a lack of appreciation for OHRQoL. However, given that a satisfactory clinical assessment of the mouth does not always indicate good oral health status, the justification for evaluating dental care with respect to oral well-being is compelling.