Health behaviors and tooth retention among older adults in China: findings from the 4th Chinese national oral health survey

Chewing ability and its associated factors among community-dwelling older adults in Chengdu, China: A cross-sectional study

AIM

To investigate the current status of chewing ability and analyze the risk factors among Chinese community-dwelling older adults.

METHODS

In this cross-sectional study, color-changeable gum and a color difference meter were used to assess chewing ability in the population. The statistical analysis employed multivariate logistic regression models to identify and quantify the factors influencing chewing ability.

RESULTS

A total of 373 community-dwelling adults aged 65 and older in Chengdu, in the west of China, were included in this study; 64 individuals (17.2%) exhibited signs of poor chewing ability. Female (odds ratio [OR]: 0.124, 95% CI: 0.057-0.268, p < .001), education level with college degree and above (OR: 0.114, 95% CI: 0.030-0.434, p = .001), number of teeth less than 20 (OR: 5.401, 95% CI: 2.509-11.626, p < .001), and decreased oral diadochokinesis (OR: 4.445, 95% CI: 1.775-11.132, p = .001) were significant factors in chewing ability in this study, after adjustment for potential variables.

CONCLUSIONS

The prevalence of decreased chewing ability among Chinese community-dwelling older adults was 17.2% and decreased chewing ability was associated with men, lower education level, less than 20 teeth and decreased oral diadochokinesis.

Oral hygiene behaviors and periodontitis among patients with chronic diseases and its impact on tooth loss and oral health-related quality of life: a cross-sectional study of data from the ComPaRe e-cohort

OBJECTIVES

Little is known about oral hygiene habits of patients suffering from chronic diseases. This study aims to describe oral hygiene behavior (OHB) in terms of tooth brushing and professional scaling frequency among patients with chronic diseases. Secondarily, it aims to assess the association between OHB and periodontitis, tooth loss, and oral health-related quality of life (OHRQoL).

MATERIALS AND METHODS

This is a cross-sectional analysis of data of adult participants in the ComPaRe e-cohort. Participants were classified into having good, moderate, and poor OHB according to self-reported frequency of toothbrushing and professional tooth scaling. Periodontitis was assessed using the PEriodontal Screening Score (PESS). Weighted binary regression models were used to estimate the association between OHB and the following outcomes: (i) periodontitis; (ii) number of missing teeth; and (iii) OHRQoL based on the Oral Health Impact Profile-14.

RESULTS

Overall, 8553 patients were included in the analyses (52.9% females, mean age of 56.3 ± 17 years). Of these, 2907 (34%), 3953 (46%) and 1693 (20%) were considered as having good, moderate, and poor OHB, respectively. Over half (54.1%) of the patients had a PESS ≥ 5 suggestive for severe periodontitis. Moderate OHB was associated with lower odds of PESS ≥ 5 compared to poor OHB (Adjusted Odds Ratio, OR = 0.81 [95%CI: 0.70-0.92]). Good and moderate OHB were significantly associated with lower odds of ≥ 10 missing teeth (OR = 0.26 [95%CI: 0.21-0.33] and OR = 0.47 [95%CI: 0.4-0.56], respectively) and better OHRQoL than poor OHB.

CONCLUSIONS

Although, most of patients with chronic diseases reported to have good or moderate OHB, severe periodontitis is highly prevalent among this patient population in France.

CLINICAL RELEVANCE

This study describes OHB in a representative sample of patients suffering from one or more chronic diseases and provides an estimate of the prevalence of self-reported severe periodontitis, missing teeth, and OHRQoL.

Prevalence of mild cognitive impairment and modifiable risk factors: A cross-sectional study in rural older adults with diabetes

To determine the prevalence and modifiable risk factors for MCI in older adults with T2DM in rural China. This cross-sectional study encompassed 96 villages, employing a cluster sampling approach to recruit eligible older adults with T2DM as study participants. Logistic regression analysis was utilized to identify modifiable risk factors associated with MCI. Average marginal effects were calculated. The discriminatory performance of these risk factors in identifying MCI was evaluated by plotting the receiver operating curve and calculating the value of the area under the curve. A total of 898 older adults with T2DM in our study. The overall prevalence of MCI was 50.22 %. Independent associations with MCI were found in poor self-management ability of diabetes (OR = 0.808, 95 % CI: 0.808, 0.766), depressive symptoms (OR = 3.500, 95 % CI: 1.933, 6.337), moderate (OR = 0.936, 95 % CI: 0.017, 0.075) and high (OR = 0.939, 95 % CI: 0.016, 0.100) levels of physical activity, poorer oral health (OR = 2.660, 95 % CI: 2.226, 3.179), and lower grip strength (OR = 0.913, 95 % CI: 0.870, 0.958). The AUC was 0.967 (95 % CI 0.508-0.470). The prevalence of MCI was high among older adults with T2DM in rural areas of China. The self-management ability of diabetes, depressive symptoms, physical activity, oral health and grip strength were modifiable risk factors of MCI. Targeted interventions should be developed and implemented to address these modifiable risk factors, aiming to enhance cognitive function and mitigate the incidence of MCI in older adults with T2DM.

Perceptions and experience of rural older people in oral health management in China: a qualitative study

BACKGROUND

To explore the perceptions and experience of oral health management among rural older people in China.

METHODS

Qualitative methodologies were used in this study. Face-to-face semi-structured interviews were conducted. Thirteen older adults in rural areas were purposively sampled at two metropolitan hospitals in Hunan, China. The data were transcribed and thematically analyzed, and MAXQDA software was used to assist with coding.

RESULTS

Three overarching major themes and ten sub‑themes capturing the perceptions and experience of oral health management among rural older people were identified. Three themes emerged from the thematic analysis: oral health cognitive bias, poor management behaviors, and limited oral health services. Oral health management as a whole is negative, oral health behaviors are poor, oral health service utilization is limited.

CONCLUSIONS

Based on these findings, there is great scope here for improving the current status of oral health for rural older people around awareness, behavior, and access. Oral health education, improved oral health services and primary oral health promotion are warranted.

Patterns and predictors of tooth loss among partially dentate individuals in Jordan: A cross-sectional study

Aim

This study aimed to examine the patterns of partial edentulism and the associated risk factors in Jordan.

Methods

A cross-sectional, epidemiological study was carried out across Jordan, and data was collected from adult partially dentate patients in various healthcare facilities. The data collected included sociodemographic data, dental and social history, and clinical examination findings for the jaw and teeth. Multivariate regression models were used to determine the predictors for the number of missing teeth.

Results

The sample consisted of 467 partially dentate participants. The leading cause of tooth loss was dental caries (85.4 %), followed by periodontal disease (13.7 %), and trauma (7.5 %). The mean number of missing teeth was significantly higher in the upper jaw (2.5 ± 3.1) compared to the lower jaw (2.2 ± 2.6, p = 0.02). In both jaws, the most prevalent Kennedy classification was Class 3, followed by Class 3/Modification 1 and Class 2/Modification 1. Increased age, smoking, lack of daily tooth brushing, and low education level were significantly associated with high tooth loss.

Conclusions

This study contributes to the understanding of partial edentulism in Jordan, reflecting broader oral health concerns and the factors influencing tooth loss. The findings, vital for future research and interventions, offer insights applicable to global oral health challenges, particularly for at-risk groups.

Relationships among oral hygiene behavior, toothache, and depressive symptoms in Chinese older adults

OBJECTIVES

The study aims to investigate the relationships among oral hygiene behavior, toothache, and depression among Chinese older adults.

METHODS

We used data came from the 2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS). The Center for Epidemiologic Studies Depression Scale was used to evaluate depression. Binary logistic regression was performed to analyze the relationships among oral hygiene behavior, toothache, and depression.

RESULTS

A total of 12,172 older adults were included in the study, of whom 27.2% had depression. Compared with those who did not brush their teeth daily, those who brushed their teeth at least once daily exhibited lower odds of having depressive symptoms (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.77-0.97 versus OR = 0.81, 95% CI = 0.71-0.93). Compared with those who did not have toothache, those who had toothache over the past 6 months exhibited higher odds of having depression (OR = 1.49, 95% CI = 1.33-1.68). Living arrangement had a significant effect on the correlation between toothache and depression (p = 0.049), who lived alone and had toothache exhibited higher odds of having depressive symptoms.

CONCLUSIONS

Oral hygiene behavior and toothache are associated with depression. Taking effective measures to maintain a daily toothbrushing pattern and reduce the occurrence of toothache may mitigate the risk of depression among older adults, especially among those living alone.

CLINICAL RELEVANCE

The present study reports that the potential relationship between different oral hygiene behavior, toothache, and depressive symptoms.

Knowledge, attitude, and practice toward self-control of dental plaque among patients with periodontal diseases: a cross-sectional study

BACKGROUND

The development of periodontal disease is closely linked to individual oral healthcare behaviors. This study aimed to investigate the knowledge, attitude, and practice (KAP) toward the self-control of dental plaque among patients with periodontal diseases.

METHODS

This cross-sectional study was conducted at Jinan Stomatological Hospital between July 2022 and September 2022 through a self-administrated questionnaire for patients with periodontal diseases.

RESULTS

A total of 563 participants were included. Among them, 147 (26.11%) had gingivitis and 416 (73.89%) had periodontitis. Participants' knowledge, attitude, and practice scores were 8.71 ± 2.81 (range 0-12), 39.82 ± 3.69 (range 10-50), 33.13 ± 5.91 (range 11-55), respectively. The multivariate logistic regression analysis showed that the knowledge [odds ratio (OR) = 1.212, 95% confidence interval (CI): 1.097-1.339, P < 0.001], attitude (OR = 1.132, 95% CI: 1.070-1.198, P < 0.001), occupation, especially in the commercial and service industry (OR = 0.488, 95% CI: 0.221-1.080, P = 0.007), and income of 10,000-20,000 yuan (OR = 0.476, 95% CI: 0.258-0.877, P = 0.017) were independently associated with good practice.

CONCLUSIONS

Chinese patients with periodontal diseases demonstrated satisfactory knowledge and attitudes regarding oral hygiene, but the practical aspects need more promotion and training, especially in daily brushing frequency, usage of oral irrigator and interdental brush. Individualized approach should consider patients' knowledge, attitudes, occupation and income level.

Factors of Dental Care Utilization in Foreign-Born Older Chinese Americans

Good oral health is essential for healthy aging. Regular dental care utilization is instrumental to good oral health. Older immigrants tend to experience poorer oral health and less dental care use as compared with their native-born counterparts in the host country. Older immigrants are particularly vulnerable to interrupted or lost social ties and acculturation challenges after immigration to a new country. This study examined whether and to what extent social relations, acculturation, and perceived oral health needs are associated with dental care utilization in foreign-born older Chinese Americans. Data came from the Population Study of Chinese Elderly in Chicago, which were collected between 2017 and 2019 (N = 3,000). Dental care utilization was dichotomized into "yes" versus "no" in the past 2 y. Social relations were measured by positive and negative relations with spouse, family, and friends. Acculturation was measured by length of stay, behavioral acculturation, and residence in Chinatown. Perceived oral health needs were measured by the presence of problems related to teeth, gums, or bleeding. As guided by the Andersen model, separate logistic regression models were used to investigate factors of dental care utilization. An overall 23.1% reported dental care utilization. Individuals with no negative relations with spouse, family, and friends were 31%, 36%, and 38% less likely to visit a dentist, respectively. Individuals with higher levels of behavioral acculturation were 4% more likely to visit a dentist; individuals living in Chinatown were 45% less likely; and individuals with perceived oral health needs were 2.5 times more likely. Findings illustrate the importance of understanding social relations, immigration-related factors, and perceived oral health needs in dental care utilization in older immigrants.

Dental Status and Oral Health Behaviors of Selected 45-74-Year-Old Men from Northeastern Poland

The aim of this study was to assess the dental status and oral health behaviors of selected 45-74-year-old men from northeastern Poland. A total of 419 men were included. A questionnaire on demographic data, socioeconomic status and oral health behaviors was conducted. Dental caries experience (DMFT index), oral hygiene (AP index) and a number of edentulous subjects were evaluated clinically. More than half of the respondents (53.2%) brushed their teeth once a day. Nearly half of respondents (45.6%) reported for check-up visits more rarely than once in two years. Active nicotinism affected 26.7% of males. The prevalence of decay, the mean DMFT, the mean API and the prevalence of edentulism were, respectively, 100%, 21.4 ± 5.5, 77% and 10.3%. Increased DMFT values and MT were significantly correlated with older age (p < 0.001). Subjects of high educational status showed significantly lower values of DMFT and MT (p < 0.001). An increase in per capita family income was accompanied by a significant decrease in the API (p = 0.024), and an increase in DMFT (p = 0.031). This study demonstrated low health awareness and unsatisfactory dental status among the examined males. Dental and oral hygiene status were associated with sociodemographic and behavioral determinants. The poor oral health condition of the study population indicates the need to intensify pro-health education among seniors about oral care.

Association between Social Participation and Remaining Teeth and Urban-Rural Difference among Older Adults in China

Oral health is an important part of older adults' general health. The study examined the association between social participation (formal and informal) and remaining teeth and the urban-rural difference based on a national survey of older adults in China. The data of older adults were extracted from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed. A total of 11,948 respondents were ultimately involved, including 6836 urban respondents and 5112 rural respondents. Informal social participation and formal social participation were used to assess social participation. The number of remaining natural teeth was measured. Social participation was significantly associated with remaining teeth among older adults, after adjusting for confounders, a one-level increase in the informal social participation was associated with a decrease in natural teeth by 0.152 (95% CI = -0.274; -0.030) and a one-level increase in the formal social participation was associated with a decrease in natural teeth by 0.370 (95% CI = -0.585; -0.156). In addition, the association between social participation (formal and informal) and remaining teeth was observed among urban older adults, but not rural older adults. A high level of social participation may effectively decrease the risk of oral-health problems for the Chinese older adults. The findings suggest recommendations for an older adults-targeted policy and the practice of oral-health promotion. However, the urban-rural difference should be taken into full consideration in social-participation-driven oral-health promotion interventions.

Oral Health Behaviors and Oral Health-Related Quality of Life Among Dental Patients in China: A Cross-Sectional Study

Background and Purpose

Oral health plays an important role in overall health. But little is known about the problems with oral health behaviors and oral health-related quality of life (OHRQoL) among dental patients in China. This study aimed to investigate oral health behaviors and OHRQoL, as well as to examine the effects of oral health behaviors and associated factors on OHRQoL among dental patients.

Methods

This cross-sectional study was conducted from June 2022 to July 2022 in the Department of Stomatology of the First Mobile General Hospital of Armed Police, Hebei, China. The five-item short form of the Oral Health Impact Profile (OHIP-5) was used to evaluate OHRQoL. Oral health behaviors were assessed by a 16-items oral health behavior questionnaire, and socio-demographic data were collected by a socio-demographic questionnaire. The t-test, one-way ANOVA, and multiple linear regression analysis were used to investigate the associations between the study variables.

Results

186 participants were included in the study. The average age of the participants was 24.62 years (SD = 10.67). The mean OHIP-5 score was 4.31 (SD =3.35). Oral health-related quality of life differed significantly by smoking history, history of alcohol consumption, work status, economic pressure, self-rated oral health status, daily brushing frequency, dental caries condition, and whether they take the initiative to learn about oral health. Multivariate analysis found that the self-rated oral health status and work status were significantly associated with the OHIP scores. The retired people and those with poor self-rated oral health displayed poor OHRQoL.

Conclusion

In general, dental patients' oral health needs to be improved, the majority of patients reported practicing poor oral health behaviors, among which the retired population and hose with poor self-rated oral health showed poor OHRQoL. OHRQoL in dental patients is a complex issue associated with social and behavioral factors.