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Chaffee BW. Self-perceived quality of social roles, activities and relationships predicts incident gingivitis. Community Dent Oral Epidemiol 2024; 52:716-722. [PMID: 38654403 DOI: 10.1111/cdoe.12966] [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: 01/04/2024] [Revised: 03/21/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES While physical health status is known to impact social functioning, a growing literature suggests that social well-being may affect oral health. This investigation evaluated whether self-perceived quality of social roles, activities and relationships (social well-being) influences gingival inflammation. METHODS Data were from the Population Assessment of Tobacco and Health Study, a nationally representative cohort of US adults, biennial waves 4 (2017) to 6 (2021). Social well-being was derived from the validated PROMIS Global-10 survey instrument, categorized for this longitudinal analysis as high, moderate or low. The main outcome was incident self-reported gum bleeding (dichotomous, proxy for gingivitis). Survey-weighted logistic regression modelling adjusted for overall health status, sociodemographic (e.g. age, sex, race/ethnicity), socioeconomic (e.g. income, education) and behavioural (e.g. tobacco, alcohol) confounders and was used to predict marginal mean gum bleeding incidence. RESULTS Cross-sectionally at wave 4 (N = 23 679), gum bleeding prevalence was higher along a stepwise gradient of decreasing satisfaction with social activities and relationships (extremely satisfied: 20.4%; not at all: 40.1%). Longitudinally, among participants who had never reported gum bleeding through wave 4 (N = 9695), marginal predicted new gum bleeding at wave 6 was greater with each category of lower wave 4-5 social well-being (high: 7.6%; moderate: 8.6%; low: 12.4%). Findings were robust to alternative model specifications. Results should be interpreted considering study limitations (e.g. potential unmeasured confounding; outcome by self-report). CONCLUSIONS Social functioning may affect physical health. Specifically, social roles, activities and relationships may influence inflammatory oral conditions, like gingivitis. Confirmatory research is warranted, along with policies and interventions that promote social well-being.
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Affiliation(s)
- Benjamin W Chaffee
- University of California San Francisco School of Dentistry, San Francisco, California, USA
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Hensel ALJ, Nicholson K, Anderson KK, Gomaa NA. Biopsychosocial factors in oral and systemic diseases: a scoping review. FRONTIERS IN ORAL HEALTH 2024; 5:1378467. [PMID: 38872985 PMCID: PMC11169703 DOI: 10.3389/froh.2024.1378467] [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: 01/29/2024] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
Background The association between chronic oral diseases and other major systemic health conditions, commonly referred to as the oral-systemic health connection, has been previously studied with several underlying common risk factors and pathways linking both groups of diseases. Psychosocial factors contribute to an increased susceptibility to chronic oral and non-oral diseases. The aim of this review is to summarize the current state of knowledge on the role of psychosocial stress in chronic oral and systemic diseases. Methods A search strategy was built and a literature search was conducted using four databases (CINAHL, Embase, Medline, PsycINFO). A combination of search terms related to psychosocial stress, systemic disease, and oral conditions were used. Studies were eligible for inclusion if they included human adults (aged 18 years and older), included psychosocial factors as an exposure measure, and outcome measures of both an oral and systemic condition. Only English-language articles were considered. Pilot testing of the data extraction form and calibration were conducted and data were extracted independently by one researcher. Results A total of fifteen articles out of eighty full-text articles screened were determined to be eligible for inclusion in this review. Periodontal disease was the most commonly studied oral disease, measured in 53% of included articles, with the most commonly studied systemic diseases being of mental health conditions (40%) and diabetes (47%). Psychosocial stress was measured using a range of psychometric indicators and/or biomarkers, including perceived stress, individual behaviours, childhood adversity, and cortisol. In total, fourteen studies found a positive association between measures of psychosocial stress and oral-systemic health. Conclusion Psychosocial stress may be a common contributor to both chronic oral and non-oral diseases.
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Affiliation(s)
- Abby L. J. Hensel
- Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kathryn Nicholson
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kelly K. Anderson
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Children's Health, Lawson Health Research Institute, London, ON, Canada
| | - Noha A. Gomaa
- Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Children's Health, Lawson Health Research Institute, London, ON, Canada
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Abouseta N, Gomaa N, Tassi A, Elzagallaai AA, Rieder MJ, Dixon SJ, Pani SC. Relationships among Cortisol, Perceived Stress, and Dental Caries Experience in Adolescents and Young Adults. Caries Res 2024; 58:421-430. [PMID: 38657570 DOI: 10.1159/000539041] [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: 11/24/2023] [Accepted: 04/20/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Stress can impact mental and physical health, especially during adolescence and young adulthood, but the extent of its contribution to dental caries is poorly understood. The present study assessed the association between perceived stress, cortisol levels (in hair and saliva), and overall caries experience of adolescents and young adults aged 15-25 years. METHODS Hair and saliva samples were obtained from 93 participants free of periodontal disease. Cortisol in hair and saliva was determined using a competitive enzyme-linked immunosorbent assay. Participants completed a perceived stress questionnaire and underwent full-mouth oral examination by a calibrated examiner. Dental caries experience was based on the decayed, missing, and filled teeth (DMFT) index. Sociodemographic variables were also recorded. RESULTS There were significantly higher hair cortisol levels and perceived stress scale (PSS) scores in individuals with dental caries experience (DMFT≥1) than in those without (DMFT = 0). However, there was no significant difference in salivary cortisol concentration. A binary logistic regression revealed that higher hair cortisol levels and greater scores on the perceived stress scale were associated with increased odds of having experienced dental caries. In contrast, no significant association was found between salivary cortisol concentration and dental caries. Using multivariable regression models, caries experience was found to be significantly associated with both hair cortisol levels and PSS scores. These associations remained statistically significant even after adjusting for sociodemographic variables. CONCLUSION Hair cortisol levels and perceived stress have a significant association with dental caries experience, whereas salivary cortisol concentrations do not.
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Affiliation(s)
- Naima Abouseta
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Noha Gomaa
- Oral Diagnostic Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Ali Tassi
- Graduate Orthodontics and Dentofacial Orthopaedics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Abdelbaset A Elzagallaai
- Drug Safety Lab, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Michael J Rieder
- Departments of Paediatrics, Physiology and Pharmacology, and Medicine, Schulich Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - S Jeffrey Dixon
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Sharat Chandra Pani
- Schulich Dentistry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
- Pediatric Dentistry, BC Children's Hospital, Vancouver, British Columbia, Canada
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Perpelea AC, Sfeatcu R, Tușaliu M, Tănase M, Meleșcanu Imre M, Ripszky Totan A, Funieru C, Nicolescu DN, Pițuru SM. Exploring the Threefold Viewpoint on Children's Oral Health in a Cross-Sectional Study. Healthcare (Basel) 2024; 12:883. [PMID: 38727440 PMCID: PMC11082952 DOI: 10.3390/healthcare12090883] [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: 03/01/2024] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Oral health is situated within the framework of the global health agenda, addressing facets pertaining to well-being and quality of life. The research is based on the need to address variables at the community level to improve schoolchildren's oral health and promote healthy behaviors and aims to carry out an in-depth analysis from the perspective of the factors that influence children's oral health. Step 1, designed by the World Health Organization, was utilized. An easy-to-use web interface was created for data collection. The statistical analysis consisted of using multinomial and binominal logistic regression models. The level of education of the adult has a high probability of influencing the consumption of unhealthy or healthy foods, it has a significant probability of exerting influence on social or medical problems and a correlation was found between the level of academic education and the pattern of dental visits. The development of health-promoting behaviors begins in childhood and involves parents, who have an essential role in the education of their children. Oral health promotion programs in schools need to target the child-adult-teacher-dentist relationships. Taking into consideration the aforementioned, a threefold viewpoint is necessary for the development of a national program aimed at promoting the oral health of schoolchildren in Romania.
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Affiliation(s)
- Anca-Cristina Perpelea
- Department of Organization, Professional Legislation and Management of the Dental Office, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania; (D.N.N.)
| | - Ruxandra Sfeatcu
- Department of Oral Health and Community Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-21 Calea Plevnei Street, 010221 Bucharest, Romania
| | - Mihail Tușaliu
- Department of Ophthalmology, ENT, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Mihaela Tănase
- Department of Pedodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-21 Calea Plevnei Street, 010221 Bucharest, Romania
| | - Marina Meleșcanu Imre
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Calea Plevnei, 010221 Bucharest, Romania
| | - Alexandra Ripszky Totan
- Department of Biochemistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania
| | - Cristian Funieru
- Department of Preventive Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania
| | - Dragoș Nicolae Nicolescu
- Department of Organization, Professional Legislation and Management of the Dental Office, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania; (D.N.N.)
| | - Silviu-Mirel Pițuru
- Department of Organization, Professional Legislation and Management of the Dental Office, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17-23 Plevnei Street, 020021 Bucharest, Romania; (D.N.N.)
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Kim SY. Lifestyle Changes Caused by COVID-19 Pandemic Increase Oral Disease Symptoms. Asia Pac J Public Health 2024; 36:104-110. [PMID: 38229236 DOI: 10.1177/10105395231225325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
The COVID-19 pandemic has led to severe restrictions on society worldwide, and social restrictions can lead to poor physical and oral health. This study investigated the association between oral disease symptoms and changes in lifestyle due to COVID-19. A multivariate logistic regression analysis was used to analyze data from the 2021 Korea Youth Risk Behavior Survey (N = 54 848). It showed that most households' economic conditions as "did not change at all" (adjusted odds ratio [aOR] = 1.00), "no change" (aOR = 1.10), "slightly worsened" (aOR = 1.21), and "very worsened" (aOR = 1.24). Information in a with "did not change at all" (aOR = 1.00), "no change" (aOR = 1.13), "slightly worsened" (aOR = 1.15), and "very worsened" (aOR = 1.18) economic conditions experienced heightened gingival pain and bleeding. In conclusion, the COVID-19 pandemic has caused a change in lifestyle and worsened socioeconomic status. In addition, as lifestyle changed and socioeconomic status declined, symptoms of deteriorating dental health emerged.
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Affiliation(s)
- So-Yeong Kim
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Myran L, Sen A, Willumsen T, Havnen A, Kvist T, Rønneberg A, Dahllöf G, Høvik H. Associations of adverse childhood experiences with caries and toothbrushing in adolescents. The Young-HUNT4 Survey. BMC Oral Health 2023; 23:760. [PMID: 37838651 PMCID: PMC10576322 DOI: 10.1186/s12903-023-03492-z] [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: 07/06/2023] [Accepted: 10/04/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with poor oral health. Using a life course theoretical framework, this study explored the associations of specific and cumulative ACEs with caries and toothbrushing frequency in a Norwegian adolescent population. METHODS Participants were adolescents (n = 6351) age 13-17 years from The Young-HUNT4 Survey. Clinical data were retrieved from dental health records. Oral health outcomes were toothbrushing frequency, dentine caries experience (Decayed, Missing, and Filled Teeth - DMFT), and enamel caries. ACE exposure variables were physical abuse, sexual abuse, witness to violence, parental separation/divorce, parental alcohol problems, and bully victimization. Negative binominal regression models (incident rate ratios, IRRs; 95% confidence intervals, CIs) were used to determine the associations of the various ACEs with caries; logistic regression analyses (odds ratios, ORs; 95% CIs) were used to estimate associations with toothbrushing frequency. Potential effect modification by age was assessed using likelihood ratio test. RESULTS Adolescents exposed to physical abuse by others, sexual abuse by peers, parental separation/divorce, bullying, or who had witnessed violence, were more likely to report non-daily toothbrushing compared with those with no exposure to the given ACEs. Each cumulative increase in ACE exposure was associated with a 30% higher likelihood of non-daily toothbrushing (OR 1.30, 95% CI 1.19-1.42). Similarly, increasing number of adversities were associated with both higher dentine caries experience (IRR 1.06, 95% CI 1.02-1.09) and higher enamel caries (IRR 1.07, 95% CI 1.03-1.11). This effect was modified by age (13-15 vs. 16-17 years) for dentine caries experience. Furthermore, there was evidence of effect modification by age with bully victimization for both toothbrushing frequency (Pinteraction = 0.014) and dentine caries experience (Pinteraction < 0.001). Specifically, bully victimization was associated with a higher likelihood of non-daily toothbrushing (OR 2.59, 95% CI 1.80-3.72) and higher dentine caries experience (IRR 1.30, 95% CI 1.14-1.50) among 16-17-year-olds. CONCLUSIONS Several specific ACEs were associated with non-daily toothbrushing and a higher caries experience among Norwegian adolescents in the Young-HUNT4 Survey.
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Affiliation(s)
- Lena Myran
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Abhijit Sen
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tiril Willumsen
- Department of Paediatric Dentistry, Behavioural Science and Forensic Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Audun Havnen
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Division of Psychiatry, Nidaros Community Mental Health Centre, St. Olavs University Hospital, Trondheim, Norway
| | - Therese Kvist
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Pediatric Oral Health Research, Stockholm, Sweden
- ME barnakutsjukvård, Astrid Lindgrens Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anne Rønneberg
- Department of Paediatric Dentistry, Behavioural Science and Forensic Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Göran Dahllöf
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hedda Høvik
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
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Yang M, Xu J, Chen X, Liu L, Kong D, Yang Y, Chen W, Li Z, Zhang X. Sex-based influential factors for dental caries in patients with schizophrenia. BMC Psychiatry 2023; 23:735. [PMID: 37817127 PMCID: PMC10566046 DOI: 10.1186/s12888-023-05256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Schizophrenia is a common mental disorder that seriously affects patients' daily lives and brings heavy psychological and economic burdens to their families and society. The oral problems of patients with schizophrenia are gradually gaining attention, among which dental caries are among the most common oral diseases. Sex differences may be related not only to the various clinical symptoms of schizophrenia but also to different oral hygiene statuses; therefore, the main purpose of this paper is to investigate sex differences related to influencing factors for dental caries in patients with schizophrenia. METHOD Inpatients with schizophrenia over 18 years old were included in this study, and multidimensional indicators such as demographics, symptom and cognitive impairment assessments, medications, and the caries index of decayed, missing, and filled teeth (DMFT) were collected. An analysis of sex-based influential factors for dental caries in schizophrenia patients was performed. RESULTS Four-hundred and ninety-six patients with schizophrenia were included, with a mean age of 46.73 ± 12.23 years, of which 142 were females and 354 were males. The mean DMFT was significantly higher in males (8.81 ± 8.50) than in females (5.63 ± 6.61, p < 0.001), and the odd ratio of caries in males to females was significantly higher as well (OR = 2.305, p < 0.001). The influential factors of caries in male patients were independently associated with age and smoking status, in which current smokers were at the highest risk for developing caries, and different smoking statuses had various influencing factors for caries. The influencing factors for caries in female patients were independently associated with age, antipsychotic dose, PANSS-positive symptoms, and MMSE levels. CONCLUSION Our findings suggest sex differences exist among influential factors for caries in patients with schizophrenia. These risk factors may even be associated with and affect the treatment and prognosis of psychiatric symptoms in patients. Therefore, oral hygiene management of patients with schizophrenia should be enhanced. These differential factors provide new visions and ideas for formulating individual interventions, treatments, and care priorities.
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Affiliation(s)
- Mi Yang
- Department of Psychiatry, The Fourth People’s Hospital of Chengdu, No.8 Huli-West 1st-Alley, Jinniu District, Chengdu, 610036 China
- MOE Key Lab for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Qingshuihe Campus: No.2006, Xiyuan Ave, West Hi-Tech Zone, Chengdu, 611731 China
- School of Life Science and Technology, University of Electronic Science and Technology of China, Qingshuihe Campus: No.2006, Xiyuan Ave, West Hi-Tech Zone, Chengdu, 611731 China
| | - Jingjing Xu
- Department of Psychiatry, Qingdao mental health center, No. 299, Nanjing Road, Qingdao, 266034 China
| | - Xiaoqin Chen
- Department of Psychiatry, Qingdao mental health center, No. 299, Nanjing Road, Qingdao, 266034 China
| | - Liju Liu
- School of Life Science and Technology, University of Electronic Science and Technology of China, Qingshuihe Campus: No.2006, Xiyuan Ave, West Hi-Tech Zone, Chengdu, 611731 China
| | - Di Kong
- Department of Psychiatry, The Fourth People’s Hospital of Chengdu, No.8 Huli-West 1st-Alley, Jinniu District, Chengdu, 610036 China
| | - Yan Yang
- Department of Psychiatry, The Fourth People’s Hospital of Chengdu, No.8 Huli-West 1st-Alley, Jinniu District, Chengdu, 610036 China
| | - Wei Chen
- Department of Psychiatry, The Fourth People’s Hospital of Chengdu, No.8 Huli-West 1st-Alley, Jinniu District, Chengdu, 610036 China
| | - Zezhi Li
- Department of Nutritional and Metabolic Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, 510370 China
- Department of Psychiatry, Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, 36 Mingxin Road, Liwan District, Guangzhou, 510370 China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province, Ministry of Education of China, Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, 510370 China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101 China
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Paszynska E, Gawriolek M, Hernik A, Otulakowska-Skrzynska J, Winiarska H, Springer D, Roszak M, Slebioda Z, Krahel A, Cofta S. Prevalence of oral complications in the course of severe SARS-CoV-2 infection under mechanical non-invasive ventilation. Eur J Med Res 2023; 28:293. [PMID: 37608339 PMCID: PMC10463896 DOI: 10.1186/s40001-023-01273-6] [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: 04/26/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The management of oral health during severe symptoms of Covid-19 is still a challenge, especially in intensive care units under invasive/noninvasive ventilation in hospital. Understanding the cause-and-effect relationships may allow for individual adjustment of oral care recommendations during Covid-19 disease. The study's objective was to assess Covid-19 patients' oral health status under hospital treatment due to pulmonary adverse Covid-19 outcomes. MATERIAL AND METHODS Covid-19 patients (mean age 74.4 ± 15.4; n = 120, male n = 50/female n = 70) were admitted to hospital in the acute phase of Covid-19 between January and March 2022 who required oxygen therapy due to pneumonia, rapid respiratory failure, low saturation. Blood and radiological tests were taken according to National Health Fund guidelines. The condition of teeth (Decayed, Missing, Filled teeth as DMFT index), dental hygiene (Plaque Control Record as PCR index), periodontal status (probing depth PD, clinical attachment CAL, bleeding on probing BOP) and oral mucosa (BRUSHED and Beck scores) were examined. RESULTS Charateristics of the teeth (dental caries 35.2%, DMFT Median 22), plaque retention (83.4%), advanced periodontitis (48.3%), xerostomia (74.2%), oral mucosa inflammation (80.8%), angular cheilitis (53.3%), hemorrhagic (21.7%) showed a high incidence of harmful oral conditions. BRUSHED model and Beck score indicated moderate oral dysfunction and need for oral care every 8 h. Spearman's analysis revealed a significant positive correlation between pneumonia and neutrophile, interleukin-6 IL-6, C-reactive protein CRP (p = 0.01, p < 0.001, p < 0.001), negative to lymphocyte count (p < 0.001). Multiple and logistic regressions selected the following risk predictors for pneumonia as IL-6, CRP, obesity and for severe COVID-19 symptoms D-dimer level and a lack of targeted vaccination (p < 0.001). Among oral predictors, the PCR index and Beck score were significant for both outcomes (respectively p < 0.001, p < 0.012). Patients who received oxygen therapy with face masks had more often angular heilitis and debris (p = 0.025, p = 0.035). CONCLUSIONS COVID-19 hospitalised patients with severe symptoms crossing with poor oral health-related conditions. This may exacerbate a response for COVID infection, and play a role in cytokine storm. For Covid-19 management, to inhibit extraoral/intraoral complications, it is recommended to adjust oral hygiene procedures, including antibacterial, protective, moisturising agents after individual oral health assessment.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland.
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Justyna Otulakowska-Skrzynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Hanna Winiarska
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
| | - Daria Springer
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences (PUMS), Rokietnicka st. 7, 60-806 Poznan, Poland
| | - Zuzanna Slebioda
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, 60-812 Poznan, Bukowska st. 70, Poland
| | - Anna Krahel
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Szczepan Cofta
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
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Hensel ALJ, Gomaa N. Social and economic capital as effect modifiers of the association between psychosocial stress and oral health. PLoS One 2023; 18:e0286006. [PMID: 37200290 DOI: 10.1371/journal.pone.0286006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/06/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To assess the extent of the association of psychosocial stress with oral health in an Ontario population stratified by age groups, and whether any association is modified by indicators of social and economic capital. METHODS We retrieved data of 21,320 Ontario adults, aged 30-74 years old, from the Canadian Community Health Survey (CCHS: 2017-2018), which is a Canada-wide, cross-sectional survey. Using binomial logistic regression models that adjusted for age, sex, education, and country of birth, we examined the association of psychosocial stress (indicated by perceived life stress) with inadequate oral health (indicated as having at least one of the following: bleeding gums, fair/poor self-perceived oral health, persistent oral pain). We assessed the effect measure modification of indicators of social (sense of belonging to the local community, living/family arrangements) and economic capital (household income, dental insurance, dwelling ownership) on the perceived life stress-oral health relationship, stratified by age (30-44, 45-59, 60-74 yrs). We then calculated the Relative Excess Risk due to Interaction (RERI) which indicates the risk that is above what would be expected if the combination of low capital (social or economic) and high psychosocial stress was entirely additive. RESULTS Respondents with higher perceived life stress were at a significantly higher risk of having inadequate oral health (PR = 1.39; 95% CI: 1.34, 1.44). Adults with low social and economic capital were also at an increased risk of inadequate oral health. Effect measure modification showed an additive effect of indicators of social capital on the perceived life stress-oral health relationship. This effect was evident across all three age groups (30-44, 45-59, 60-74 yrs), with the highest attributable proportion of social and economic capital indicators in the psychosocial stress-oral health relationship in older adults (60-74 yrs). CONCLUSION Our findings suggest an exacerbating effect for low social and economic capital in the relationship of perceived life stress with inadequate oral health among older adults.
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Affiliation(s)
- Abby L J Hensel
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Noha Gomaa
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
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10
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Oral health outcomes and shift working among male workers: A cross-sectional survey. PLoS One 2022; 17:e0275924. [PMID: 36251662 PMCID: PMC9576084 DOI: 10.1371/journal.pone.0275924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/26/2022] [Indexed: 11/19/2022] Open
Abstract
Working time outside routine daily working hours is known as shift working. Studies have shown adverse effects of shift working such as stress, obesity, and diabetes on the workers' health. The aim of the present study was to compare aspects of oral health in shift workers and non-shift workers of a cement factory in Shahroud, Iran. Study population comprised of 180 male workers of the factory in the year 2015. Convenience sampling was continued until recruiting 180 subjects of shift- and non-shift workers. Data collection included oral health questionnaire, health and safety executive (HSE) questionnaire, and clinical oral examination. The Chi-square test, Pearson correlation coefficient, and generalized Poisson model were employed for statistical evaluation. Mean age of the workers was 39.19 (±9.48); 53% had educational level of less than diploma. Their mean DMFT was 12.89 (±5.75) which correlated with number of years in shift work schedule (Pearson correlation coefficient: 0.41; p<0.001) but not correlated with job stress (Pearson correlation coefficient: -0.11; p = 0.12). Mean number of deep periodontal pockets among the workers was 5.03 (±1.84) that showed correlation with number of years in shift work schedule (Pearson correlation coefficient: 0.33; p<0.001) but no correlation with job stress (Pearson correlation coefficient: -0.03; p = 0.68). Adherence to various oral health behaviors was reported by less than half of the workers. Positive correlation of dental caries and periodontal diseases with shift working partly signals negative impact of working conditions on oral health among this group of workers which calls for modifications in their working environment to facilitate health practices.
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11
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Barranca-Enríquez A, Romo-González T. Your health is in your mouth: A comprehensive view to promote general wellness. FRONTIERS IN ORAL HEALTH 2022; 3:971223. [PMID: 36186536 PMCID: PMC9515542 DOI: 10.3389/froh.2022.971223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Even though various studies recognize the importance of the oral cavity to have general health, in multidisciplinary professional practice it is almost always excluded and on an individual basis, very commonly neglected. Oral diseases are preventable, still, they are highly prevalent. Although some studies consider oral health within integral health, currently, there is no model in which the mouth is integrated within other levels for the achievement of well-being. The objective of this article was to review the importance of oral health and its connection with well-being and, based on these findings, propose a complex and comprehensive perspective for approach and care. Methods The databases MEDLINE, PubMed, and Google Scholar were revised for randomized controlled trials and reviews that included search terms related to oral health and its relationship with the general health in its different levels (physical, psychological, social and environmental). Results The review shows that oral health is critical, as the teeth and mouth are not only an integral part of the body, but also, they also support and enable essential human functions. That is, oral health has a multidimensional nature, as it includes the physical, psychological, social, and environmental domains that are essential for overall health and well-being. Likewise, the mouth is the psychological seat of the first physiological needs and emotional gratifications, with it we take a taste of the world around us. Thus, the mouth plays an important role in the feeling of unity and in the constitution of the self. Based on these results we propose an integrative model in which the mouth is the first step for well-being and from this integrative model we build a multidisciplinary approach which could be used in the clinical practice for the promotion of oral care and general health. Conclusion The effort on the part of oral health professionals is essential for people's well-being and must be integrated as part of health promotion. Dental treatments alone cannot solve this problem, it requires a comprehensive and approach in which the bio-psychological, behavioral, and socio-environmental determinants are included to face this global oral health challenge. That is, without a comprehensive and multidisciplinary approach to medical science that includes dental and oral health, our public policies cannot provide the best answers to health promotion, disease prevention, early detection, and treatment.
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Affiliation(s)
| | - Tania Romo-González
- Área de Biología y Salud Integral, Instituto de Investigaciones Biológicas, Universidad Veracruzana, Xalapa, Mexico
- Correspondence: Tania Romo González
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12
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Giacaman RA, Fernández CE, Muñoz-Sandoval C, León S, García-Manríquez N, Echeverría C, Valdés S, Castro RJ, Gambetta-Tessini K. Understanding dental caries as a non-communicable and behavioral disease: Management implications. FRONTIERS IN ORAL HEALTH 2022; 3:764479. [PMID: 36092137 PMCID: PMC9448953 DOI: 10.3389/froh.2022.764479] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
New paradigms in caries conceptualization have emerged during the last decades, leading to intense debate and discussion on how to approach the disease, both from a preventive and a therapeutic perspective. Among many new ideas, research discoveries and technologies, one major concept can be highlighted that created a deep frontier between the old and the new paradigm in caries conceptualization; the non-communicable nature of the disease, firmly associated with behaviors and lifestyles. This article synthetizes the conceptual construction of dental caries as a non-communicable disease (NCD) based on the current evidence and discusses the appropriate management of the disease in this context. Dental caries has shifted from being considered transmissible and infectious to an ecological and non-communicable disease. Environmental factors such as frequent sugars intake, disrupt the symbiosis of the dental biofilm leading to a dysbiosis, which favors caries lesion initiation and progression. As an NCD, dental caries shares characteristics with other NCDs such as cardiovascular and chronic respiratory diseases, cancer and diabetes, including long duration and slow progression, not being transmissible from person-to-person, being strongly related to modifiable behavioral risk factors, and affecting preferentially disadvantaged populations with a strong inequality gradient. Given the high prevalence of dental caries, and its consequences on people's health and quality of life, a recognizable conceptual view of caries as a NCD is required to target an effective management. Current understanding of dental caries supports prevention through acting on the modifiable risk factors (behaviors) and involves management based on an interdisciplinary approach. Communicating these modern concepts among researchers, clinicians and policymakers is needed to decrease the global high burden of the disease.
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Affiliation(s)
- Rodrigo A. Giacaman
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
- *Correspondence: Rodrigo A. Giacaman
| | - Constanza E. Fernández
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Cecilia Muñoz-Sandoval
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Soraya León
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
| | - Natalia García-Manríquez
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Constanza Echeverría
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Sebastián Valdés
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Ramiro J. Castro
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
| | - Karla Gambetta-Tessini
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
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13
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A study of socio-economic inequalities in self-reported oral and general health in South-East Norway. Sci Rep 2022; 12:13721. [PMID: 35962044 PMCID: PMC9374767 DOI: 10.1038/s41598-022-18055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
This study assesses the association between socioeconomic determinants and self-reported health using data from a regional Norwegian health survey. We included 9,068 participants ≥ 25 years. Survey data were linked to registry data on education and income. Self-reported oral and general health were separately assessed and categorized into ‘good’/‘poor’. Exposures were educational level, personal income, and economic security. Prevalence ratios (PR) were computed to assess the associations between socioeconomic determinants and self-reported health using Poisson regression models. Participants with low education or income had poorer oral and general health than those with more education or higher income. Comparing the highest and lowest education levels, adjusted PRs for poor oral and general health were 1.27 (95%CI, 1.11–1.46) and 1.43 (95%CI, 1.29–1.59), respectively. Correspondingly, PRs for lowest income quintiles compared to highest quintile were 1.34 (95%CI, 1.17–1.55) and 2.10 (95%CI, 1.82–2.43). Low economic security was also significantly associated with poor oral and general health. There were socioeconomic gradients and positive linear trends between levels of education and income in relation to both outcomes (P-linear trends < 0.001). We found statistical evidence of effect modification by gender on the association between education and oral and general health, and by age group between income and oral health.
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14
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Khajavi A, Radvar M, Moeintaghavi A. Socioeconomic determinants of periodontitis. Periodontol 2000 2022; 90:13-44. [PMID: 35950737 DOI: 10.1111/prd.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Amin Khajavi
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Radvar
- Department of Periodontology, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Moeintaghavi
- Department of Periodontology, Mashhad University of Medical Sciences, Mashhad, Iran
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15
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Abstract
Advances in high-throughput technologies and the generation of multiomics, such as genomic, epigenomic, transcriptomic, and metabolomic data, are paving the way for the biological risk stratification and prediction of oral diseases. When integrated with electronic health records, survey, census, and/or epidemiologic data, multiomics are anticipated to facilitate data-driven precision oral health, or the delivery of the right oral health intervention to the right individuals/populations at the right time. Meanwhile, multiomics may be modified by a multitude of social exposures, cumulatively along the life course and at various time points from conception onward, also referred to as the socio-exposome. For example, adverse exposures, such as precarious social and living conditions and related psychosocial stress among others, have been linked to specific genes being switched "on and off" through epigenetic mechanisms. These in turn are associated with various health conditions in different age groups and populations. This article argues that considering the impact of the socio-exposome in the biological profiling for precision oral health applications is necessary to ensure that definitions of biological risk do not override social ones. To facilitate the uptake of the socio-exposome in multiomics oral health studies and subsequent interventions, 3 pertinent facets are discussed. First, a summary of the epigenetic landscape of oral health is presented. Next, findings from the nondental literature are drawn on to elaborate the pathways and mechanisms that link the socio-exposome with gene expression-or the biological embedding of social experiences through epigenetics. Then, methodological considerations for implementing social epigenomics into oral health research are highlighted, with emphasis on the implications for study design and interpretation. The article concludes by shedding light on some of the current and prospective opportunities for social epigenomics research applied to the study of life course oral epidemiology.
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Affiliation(s)
- N Gomaa
- Schulich School of Medicine and Dentistry, Western University, London, Canada.,Children's Health Research Institute, London, Canada
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16
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Sato Y, Yoshioka E, Takekawa M, Saijo Y. Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan. PeerJ 2022; 10:e13792. [PMID: 35891644 PMCID: PMC9308962 DOI: 10.7717/peerj.13792] [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: 04/22/2022] [Accepted: 07/05/2022] [Indexed: 01/17/2023] Open
Abstract
Background Psychological stress is a potential risk factor for oral diseases. However, evidence for the association between work stress and oral diseases is scarce. We aimed to examine the associations of work stress, according to the effort-reward imbalance model, with dental caries, periodontal status, and tooth loss. Methods This cross-sectional study included 184 regular employees at a medical university and 435 registrants of a web research company. Work stress was assessed using the effort-reward imbalance (ERI) ratio. Dental caries and tooth loss were assessed according to the number of decayed, filled, and missing teeth (DMFT) among the set of 28 teeth. Periodontal status was assessed using a self-administered questionnaire. For the DMFT, a linear regression model was used to estimate the unstandardised coefficients. A Poisson regression model was used to estimate the prevalence ratios (PRs) of poor periodontal status. Results Among medical university employees and employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was associated with -2.81 (95% CI [-4.70 to -0.92]; p-value = 0.004) and -0.84 (95% CI [-1.80 to 0.12]; p-value = 0.085) changes in the DMFT from adjusted linear regression models, respectively. In employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was also associated with 1.55 (95% CI [1.04-2.32]; p-value = 0.032) of the PR for poor periodontal status based on Poisson regression models. Conclusion ERI at work was associated with an increased risk of poor periodontal status.
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Affiliation(s)
- Yukihiro Sato
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Eiji Yoshioka
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Masanori Takekawa
- Department of Oral and Maxillo-Facial Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasuaki Saijo
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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17
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Costa CA, Vilela ACS, Oliveira SA, Gomes TD, Andrade AAC, Leles CR, Costa NL. Poor oral health status and adverse COVID-19 outcomes: A preliminary study in hospitalized patients. J Periodontol 2022; 93:1889-1901. [PMID: 35294780 PMCID: PMC9088593 DOI: 10.1002/jper.21-0624] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Most of the common risk factors for severe outcomes of coronavirus disease 2019 (COVID-19) are correlated with poor oral health, tooth loss, and periodontitis. This has pointed to a possible relationship between oral and systemic health in COVID-19 patients. Hence, this study aimed to assess the dental and periodontal status of hospitalized COVID-19 patients and their associations with the incidence of adverse COVID-19 outcomes. METHODS We included 128 hospital patients aged between 20 and 97 years and with diagnoses of COVID-19 in this prospective observational study. Dental and periodontal status was assessed using in-hospital clinical examinations, including the Decayed, Missing, and Filled Teeth index, periodontal status, and tooth loss patterns (Eichner index). Associations between oral health measures, the severity of COVID-19 symptoms, and hospitalization endpoints were tested using chi-square test and incidence rate ratio (IRR) estimation using a generalized linear model with log-Poisson regression. The regression models used a block-wise selection of predictors for oral health-related variables, comorbidities, and patients' ages. RESULTS Overall, poor oral health conditions were highly prevalent and associated with critical COVID-19 symptoms, higher risk for admission in the intensive care unit (ICU), and death. Periodontitis was significantly associated with ICU admission (IRR = 1.44; 95% confidence interval [95%CI] = 1.07-1.95; P = 0.017), critical symptoms (IRR = 2.56; 95%CI = 1.44-4.55; P = 0.001), and risk of death (IRR = 2.05; 95%CI = 1.12-3.76; P = 0.020) when adjusted for age and comorbidities. The Eichner index (classes B and C) was associated with ICU admission. CONCLUSION There was a positive association between deleterious oral health-related conditions, especially periodontitis, and severe COVID-19 outcomes in hospitalized COVID-19 patients.
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Affiliation(s)
- Camila Alves Costa
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | | | - Suzane Aparecida Oliveira
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | | | | | - Cláudio Rodrigues Leles
- Department of Oral RehabilitationSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | - Nádia Lago Costa
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
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Weninger A, Seebach E, Broz J, Nagle C, Lieffers J, Papagerakis P, Da Silva K. Risk Indicators and Treatment Needs of Children 2-5 Years of Age Receiving Dental Treatment under General Anesthesia in Saskatchewan. Dent J (Basel) 2022; 10:dj10010008. [PMID: 35049606 PMCID: PMC8775244 DOI: 10.3390/dj10010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND When compared to national averages in Canada, Saskatchewan has one of the highest rates of dental treatment under general anesthesia (GA) and average costs per child. Thus, the purpose of this cross-sectional study is to explore the risk indicators and treatment needs of children receiving dental treatment under GA in Saskatchewan. METHODS In this cross-sectional study, we recruited caregivers of children between 24 and 71 months of age in Saskatoon, Canada. Caregivers completed a 40-item questionnaire, which was supplemented with clinical data and then subject to statistical analysis (independent t-tests and one-way ANOVA). RESULTS A total of 90 caregiver/child dyads were enrolled with the mean age for children being 49.5 ± 12.3 months. The mean age of a child's first dental visit was 34.7 ± 15.3 months with only 37.9% of children having a dental home. The mean deft index was 11.7 ± 3.4, with an average of 10.9 ± 3.5 teeth receiving treatment. Additionally, location of primary residence (p = 0.03), family income (p = 0.04), family size (p = 0.01), parental education (p = 0.03), dental home (p = 0.04), and body mass index (p = 0.04) had a statistically significant association with a higher mean deft. CONCLUSIONS Our cross-sectional study confirms that children who require dental treatment under GA have a high burden of disease. While individual risk indicators such as diet and oral hygiene play a role in the progression of early childhood caries (ECC), we also demonstrate that children who do not have access to early preventive visits or a dental home are at a higher risk. In addition to improving motivation for oral hygiene at home and nutritional education, improving access to oral health care should be addressed in strategies to reduce ECC.
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Affiliation(s)
- Alyssa Weninger
- College of Dentistry, University of Saskatchewan, Saskatoon, SK S7N 5E4, Canada; (A.W.); (E.S.); (J.B.); (C.N.); (P.P.)
| | - Erica Seebach
- College of Dentistry, University of Saskatchewan, Saskatoon, SK S7N 5E4, Canada; (A.W.); (E.S.); (J.B.); (C.N.); (P.P.)
| | - Jordyn Broz
- College of Dentistry, University of Saskatchewan, Saskatoon, SK S7N 5E4, Canada; (A.W.); (E.S.); (J.B.); (C.N.); (P.P.)
| | - Carol Nagle
- College of Dentistry, University of Saskatchewan, Saskatoon, SK S7N 5E4, Canada; (A.W.); (E.S.); (J.B.); (C.N.); (P.P.)
| | - Jessica Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada;
| | - Petros Papagerakis
- College of Dentistry, University of Saskatchewan, Saskatoon, SK S7N 5E4, Canada; (A.W.); (E.S.); (J.B.); (C.N.); (P.P.)
| | - Keith Da Silva
- College of Dentistry, University of Saskatchewan, Saskatoon, SK S7N 5E4, Canada; (A.W.); (E.S.); (J.B.); (C.N.); (P.P.)
- Correspondence: ; Tel.: +1-306-966-5124
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19
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Abstract
OBJECTIVES Although psychological stress is a risk factor for oral diseases, there seems to be no review on work stress. This study aimed to review the evidence on the association between work stress and oral conditions, including dental caries, periodontal status and tooth loss. DESIGN A systematic review of published observational studies. DATA SOURCES A systematic literature search was conducted in PubMed and Scopus databases on 12 August 2020. STUDY SELECTION Articles were screened based on the following inclusion criteria: published after 1966; in English only; epidemiological studies on humans (except case studies, reviews, letters, commentaries and editorials); and examined the association of work stress with dental caries, periodontal status and tooth loss. DATA EXTRACTION Data were extracted from eligible studies. A quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS Of 402 articles identified, 11 met the inclusion criteria, and 1 study assessed the association of work stress with dental caries and periodontal status. Of 11 studies, 1 reported a non-significant association between work stress and dental caries; 8 of 9 studies reported a significant association between work stress and worse periodontal status; and 1 of 2 studies reported a significant association between work stress and tooth loss. Nine of 11 studies were cross-sectional, while the remaining 2 studies had unclear methodology. Only two studies were sufficiently adjusted for potential confounders. Eight studies assessed work stress but did not use the current major measures. Three studies were rated as fair, while eight studies had poor quality. CONCLUSIONS There is a lack of evidence on the association of work stress with dental caries and tooth loss. Eight studies suggested potential associations between periodontal status and work stress. Cohort studies using the major work stress measures and adjusting for the potential confounders are needed.
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Affiliation(s)
- Yukihiro Sato
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasuaki Saijo
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Eiji Yoshioka
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Kaura Parbhakar K, Farmer JW, Quiñonez C. The influence of living conditions and individual behaviors on the oral-systemic disease connection: a cross-sectional analysis. J Public Health Dent 2021; 82:220-228. [PMID: 33890301 DOI: 10.1111/jphd.12455] [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: 08/26/2020] [Revised: 02/27/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the extent to which living conditions and individual behaviors influence the association between oral health status and systemic disease outcomes in Ontario, Canada's most populated province. METHODS A secondary data analysis of Ontario data from the Canadian Community. Health Survey 2013/14 was undertaken. Separate analyses were conducted for participants aged 35-59 years (n = 11,858) and 60+ years (n = 11,273). A series of regression models were constructed to examine the association between self-reported oral health status and systemic disease outcomes (arthritis, diabetes, hypertension, heart disease, chronic obstructive pulmonary disease, and stroke). Models were adjusted by proxies of living conditions (income, education, ethnicity, country of birth, employment, and food security) and individual behaviors (smoking status, alcohol use, tooth brushing, life stress, physical activity, sense of belonging). Percent attenuation between models was calculated to determine the extent of the living condition-behavior impact. RESULTS In both age groups, the prevalence of arthritis and high blood pressure was the highest, followed by heart disease. There was variation in percent attenuation by age group and outcome. Among participants aged 35-59 years, living conditions had a greater impact on the oral-systemic relationship, while individual behaviors played a greater role in this association among adults aged 60+ years. CONCLUSION There is an association between oral and systemic diseases; however, after accounting for living conditions and individual behaviors, this relationship was attenuated. This highlights the need to address upstream and midstream factors that are common to oral and systemic conditions.
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Affiliation(s)
| | - Julie W Farmer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Carlos Quiñonez
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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Stein C, Cunha-Cruz J, Hugo FN. Is dietary pattern a mediator of the relationship between socioeconomic status and dental caries? Clin Oral Investig 2021; 25:5441-5447. [PMID: 33825968 DOI: 10.1007/s00784-021-03852-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 02/18/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate whether a healthy diet and added sugar mediate the relationship between socioeconomic status and oral health status in adults. METHODS This is a secondary cross-sectional analysis of adult participants from the 2015-2016 National Health and Nutrition Examination Survey from the United States (n=3367). Structural equation modeling tested direct and indirect pathways from a latent variable for socioeconomic status to oral health via healthy eating (Health Eating Index) and added sugar in a multiple-mediator multiple-outcome model. RESULTS Added sugar was directly associated with untreated dental caries [Standardized coefficient (SC)=0.10], and healthy eating was directly associated with both untreated dental caries (SC=-0.11) and tooth loss (SC=-0.05). Higher socioeconomic status was associated with lower untreated dental caries through direct (SC =-0.246) and small indirect paths via healthy diet (SC= -0.026), lower consumption of added sugar (SC=-0.007), and dental visits (SC=-0.162). Higher socioeconomic status was associated with fewer teeth lost through direct (SC =-0.306) and very small indirect paths via healthy diet (SC=-0.016), added sugar consumption (SC=-0.001), and untreated dental caries (SC=-0.094). CONCLUSIONS Both socioeconomic status and dietary pattern independently contributed to tooth loss and dental caries. The contribution of dietary factors as a mediator to socioeconomic inequities in oral health was small, and statistically significant. CLINICAL RELEVANCE A systems approach to socioeconomic inequities in oral health takes into account the complex relationships between socioeconomics, dietary patterns, oral health and health. Socioeconomic conditions and nutrition, as common risk factors to noncommunicable disorders, should be tackled in programs to improve oral health.
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Affiliation(s)
- Caroline Stein
- Postgraduate Program in Dentistry, Federal University of Rio Grande do Sul, Ramiro Barcelos, 2492, Santa Cecília, Porto Alegre, RS, Brazil.
| | - Joana Cunha-Cruz
- Department of Oral Health Sciences, School of Dentistry and Department of Health Services, School of Public Health University of Washington, Seattle, WA, USA
| | - Fernando Neves Hugo
- Postgraduate Program in Dentistry, Federal University of Rio Grande do Sul, Ramiro Barcelos, 2492, Santa Cecília, Porto Alegre, RS, Brazil.,Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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22
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Abstract
OBJECTIVE It has been suggested that adverse socioeconomic conditions "get under the skin" by eliciting a stress response that can trigger periodontal inflammation. We aimed to a) estimate the extent to which socioeconomic position (SEP) is associated with periodontal disease (PD) and proinflammatory oral immunity, and b) determine the contribution of psychosocial stress and stress hormones to these relationships. METHODS In this cross-sectional study (n = 102), participants (20-59 years old) completed financial and perceived stress questionnaires and underwent full-mouth periodontal examinations. SEP was characterized by annual household income and educational attainment. Cortisol, a biological correlate of chronic stress, was assessed in hair samples. Oral immunity was characterized by assessing oral inflammatory load and proinflammatory oral neutrophil function. Blockwise Poisson and logistic regression models were applied. RESULTS Compared with lower SEP, individuals in the middle- and higher-income categories had a significantly lower probability of PD (incidence rate ratio [IRR] = 0.5 [confidence interval {CI} = 0.3-0.7] and IRR = 0.4 [95% CI = 0.2-0.7]) and oral inflammatory load (IRR = 0.6 [95% CI = 0.3-0.8] and IRR = 0.5 [95% CI = 0.3-0.7]) and were less likely to have a proinflammatory oral immune function (odds ratio [OR] = 0.1 [95% CI = 0.0-0.7] and OR = 0.1 [95% CI = 0.0-0.9]). PD and oral immune parameters were significantly associated with financial stress and cortisol. Adjusting for financial stress and cortisol partially attenuated the socioeconomic differences in PD to IRR = 0.7 (95% CI = 0.5-0.8) and IRR = 0.6 (95% CI = 0.5-0.7) for the middle- and higher-income categories, respectively. Similar results were observed for proinflammatory immunity (OR = 0.2 [95% CI = 0.0-1.8] and OR = 0.3 [95% CI = 0.0-2.3]). CONCLUSION These findings suggest that psychosocial stress may contribute to a proinflammatory immunity that is implicated in PD pathobiology and provide insight into social-to-biological processes in oral health.
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23
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Divaris K, Slade GD, Ferreira Zandona AG, Preisser JS, Ginnis J, Simancas-Pallares MA, Agler CS, Shrestha P, Karhade DS, Ribeiro ADA, Cho H, Gu Y, Meyer BD, Joshi AR, Azcarate-Peril MA, Basta PV, Wu D, North KE. Cohort Profile: ZOE 2.0-A Community-Based Genetic Epidemiologic Study of Early Childhood Oral Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8056. [PMID: 33139633 PMCID: PMC7663650 DOI: 10.3390/ijerph17218056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023]
Abstract
Early childhood caries (ECC) is an aggressive form of dental caries occurring in the first five years of life. Despite its prevalence and consequences, little progress has been made in its prevention and even less is known about individuals' susceptibility or genomic risk factors. The genome-wide association study (GWAS) of ECC ("ZOE 2.0") is a community-based, multi-ethnic, cross-sectional, genetic epidemiologic study seeking to address this knowledge gap. This paper describes the study's design, the cohort's demographic profile, data domains, and key oral health outcomes. Between 2016 and 2019, the study enrolled 8059 3-5-year-old children attending public preschools in North Carolina, United States. Participants resided in 86 of the state's 100 counties and racial/ethnic minorities predominated-for example, 48% (n = 3872) were African American, 22% white, and 20% (n = 1611) were Hispanic/Latino. Seventy-nine percent (n = 6404) of participants underwent clinical dental examinations yielding ECC outcome measures-ECC (defined at the established caries lesion threshold) prevalence was 54% and the mean number of decayed, missing, filled surfaces due to caries was eight. Nearly all (98%) examined children provided sufficient DNA from saliva for genotyping. The cohort's community-based nature and rich data offer excellent opportunities for addressing important clinical, epidemiologic, and biological questions in early childhood.
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Affiliation(s)
- Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA; (G.D.S.); (J.G.); (M.A.S.-P.); (C.S.A.); (P.S.); (D.S.K.)
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC 27599-7400, USA; (P.V.B.); (K.E.N.)
| | - Gary D. Slade
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA; (G.D.S.); (J.G.); (M.A.S.-P.); (C.S.A.); (P.S.); (D.S.K.)
| | - Andrea G. Ferreira Zandona
- Department of Comprehensive Dentistry, School of Dental Medicine, Tufts University, Boston, MA 02111, USA;
| | - John S. Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC 27599-7400, USA; (J.S.P.); (H.C.); (Y.G.); (D.W.)
| | - Jeannie Ginnis
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA; (G.D.S.); (J.G.); (M.A.S.-P.); (C.S.A.); (P.S.); (D.S.K.)
| | - Miguel A. Simancas-Pallares
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA; (G.D.S.); (J.G.); (M.A.S.-P.); (C.S.A.); (P.S.); (D.S.K.)
| | - Cary S. Agler
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA; (G.D.S.); (J.G.); (M.A.S.-P.); (C.S.A.); (P.S.); (D.S.K.)
| | - Poojan Shrestha
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA; (G.D.S.); (J.G.); (M.A.S.-P.); (C.S.A.); (P.S.); (D.S.K.)
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC 27599-7400, USA; (P.V.B.); (K.E.N.)
| | - Deepti S. Karhade
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA; (G.D.S.); (J.G.); (M.A.S.-P.); (C.S.A.); (P.S.); (D.S.K.)
| | - Apoena de Aguiar Ribeiro
- Division of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA;
| | - Hunyong Cho
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC 27599-7400, USA; (J.S.P.); (H.C.); (Y.G.); (D.W.)
| | - Yu Gu
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC 27599-7400, USA; (J.S.P.); (H.C.); (Y.G.); (D.W.)
| | - Beau D. Meyer
- Division of Pediatric Dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA;
| | - Ashwini R. Joshi
- Division of Surgery, School of Medicine, University of North Carolina-Chapel Hill, NC 27599-7050, USA;
| | - M. Andrea Azcarate-Peril
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, and UNC Microbiome Core, Department of Medicine, School of Medicine, University of North Carolina-Chapel Hill, NC 27599-7555, USA;
| | - Patricia V. Basta
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC 27599-7400, USA; (P.V.B.); (K.E.N.)
| | - Di Wu
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC 27599-7400, USA; (J.S.P.); (H.C.); (Y.G.); (D.W.)
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina-Chapel Hill, NC 27599-7450, USA
| | - Kari E. North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC 27599-7400, USA; (P.V.B.); (K.E.N.)
- Carolina Center for Genome Sciences, University of North Carolina-Chapel Hill, NC 27514, USA
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24
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Dubar M, Clerc-Urmès I, Baumann C, Clément C, Alauzet C, Bisson C. Relations of Psychosocial Factors and Cortisol with Periodontal and Bacterial Parameters: A Prospective Clinical Study in 30 Patients with Periodontitis Before and After Non-Surgical Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207651. [PMID: 33092182 PMCID: PMC7588876 DOI: 10.3390/ijerph17207651] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/18/2022]
Abstract
(1) Background: The progression of periodontitis, induced by polymicrobial dysbiosis, can be modified by systemic or environmental factors such as stress or anxiety affecting host response. The purpose of this study is to evaluate the potential associations between psychosocial factors scores or salivary cortisol levels with clinical periodontal parameters and bacterial environment in patients with periodontitis; (2) Methods: Subgingival microbiota was collected in two pathological and one healthy sites from thirty diseased patients (before/after scaling and root planing (SRP)) and from one healthy site from thirty control patients. Usual clinical periodontal parameters were recorded, and a saliva sample was harvested. Patients completed stress and anxiety self-assessment questionnaires. Cortisol concentrations were determined by ELISA and bacteria were identified by PCR; (3) Results: No correlation between salivary cortisol and the stress-anxiety self-declared was found (p > 0.05), but high concentrations of this molecule were associated positively and linearly with periodontal pocket depth (p = 0.04). It appeared that certain psychosocial stressors are associated with a modulation of the bacterial colonization of pockets of diseased group (before/after SRP), notably concerning Tannerella forsythia (p = 0.02), Porphyromonas gingivalis (p = 0.03), Fusobacterium nucleatum (p = 0.049) and Campylobacter rectus (p = 0.01). (4) Conclusion: This study reveals associations between bacteria colonization and psychosocial parameters in periodontitis that needs to be further investigated.
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Affiliation(s)
- Marie Dubar
- Department of Periodontology, School of Dentistry, Lille University Hospital, 59000 Lille, France
- Stress Immunity Pathogens Unit (SIMPA), EA 7300, University of Lorraine, F-54000 Nancy, France; (C.A.); (C.B.)
- Correspondence:
| | - Isabelle Clerc-Urmès
- Department of Methodology, Promotion and Investigation, UMDS, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France; (I.C.-U.); (C.B.)
| | - Cédric Baumann
- Department of Methodology, Promotion and Investigation, UMDS, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France; (I.C.-U.); (C.B.)
| | - Céline Clément
- CHRU Nancy, Department of Public Health Dentistry, University Hospital, 54000 Nancy, France;
- “Interpsy” Laboratory, University of Lorraine, EA 4432, CEDEX 54015 Nancy, France
- «Health Systemic Process» Laboratory, University Lyon 1, EA 4129, 69008 Lyon, France
| | - Corentine Alauzet
- Stress Immunity Pathogens Unit (SIMPA), EA 7300, University of Lorraine, F-54000 Nancy, France; (C.A.); (C.B.)
- CHRU Nancy, Microbiology Department, University Hospital, F-54000 Nancy, France
| | - Catherine Bisson
- Stress Immunity Pathogens Unit (SIMPA), EA 7300, University of Lorraine, F-54000 Nancy, France; (C.A.); (C.B.)
- Department of Periodontology, Nancy University Hospital, Lorraine University, 54500 Vandoeuvre-lès-Nancy, France
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25
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Machado V, Botelho J, Proença L, Alves R, Oliveira MJ, Amaro L, Águas A, Mendes JJ. Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: a structural equation modelling analysis. BMC Oral Health 2020; 20:229. [PMID: 32819351 PMCID: PMC7441730 DOI: 10.1186/s12903-020-01219-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 08/13/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To determine if periodontal risk assessment (PRA), the number of missing teeth, diabetes mellitus (DM), perceived stress and interproximal cleaning are associated with oral health-related quality of life (OHRQoL), using Andersen's behavioral modelling (ABM). MATERIAL AND METHODS Data derived from 472 adults derived from a representative population of the Study of Periodontal Health in Almada-Seixal (SoPHiAS) was used. Socioeconomic status, perceived stress scale (PSS-10), oral health behaviors and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal conditions were assessed with a full-mouth periodontal examination. PRA was computed through behavioral and clinical information. Variables were grouped into Predisposing Factors, Enabling, Need, Oral Health Behaviors and Perceived Health Outcome latent variables. Confirmatory factor analysis, structural ABM and model fitness were conducted. RESULTS ABM applied to OHIP-14 showed acceptable model fit (χ2 = 2.75, CFI = 0.92, TLI = 0.90, RMSEA = 0.05, CI 90% [0.04-0.07]). The average of OHRQoL was 9.5 ± 11.3. Patient with periodontitis and with a high number of missing teeth experienced worse OHRQoL. Uncontrolled DM participants had more periodontal treatment necessity and poorer OHRQoL. Characteristic like aging and lower levels of education were directly associated with better OHRQoL, but in indirect path the OHRQoL was diminishes. Good oral hygiene and preventative measures were associated to lower periodontal treatment necessity. Lower periodontal treatment necessity was associated to higher OHRQoL. Age, tooth loss and interproximal cleaning were the most associated items to Predisposing, Need and Oral Health Behaviors, respectively. CONCLUSION ABM confirmed age, number of missing teeth, DM, interproximal cleaning and perceived stress as associated factors for OHRQoL. Uncontrolled DM was associated to higher Need and poorer OHRQoL. Good oral hygiene habits promote a healthy periodontium and, consequently, increases OHRQoL.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal.
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, Almada, Portugal
| | - Ricardo Alves
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal
| | - Maria João Oliveira
- Department of Anatomy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Luís Amaro
- Health Centers grouping (HCG) Almada-Seixal, Regional Health Administration of Lisbon and Tagus Valley (RHALTV), Lisbon, Portugal
| | - Artur Águas
- Department of Anatomy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
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26
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Lewis CW. Teeth: Small but Mighty and Mighty Important. A Comprehensive Review of Children's Dental Health for Primary Care Clinicians. Curr Pediatr Rev 2020; 16:215-231. [PMID: 32108010 DOI: 10.2174/1573396316666200228093248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/12/2019] [Accepted: 01/27/2020] [Indexed: 11/22/2022]
Abstract
Healthy teeth allow us to eat and stay well-nourished. Although primary care clinicians receive limited training about teeth, given the common nature of dental problems, it is important that they understand and recognize normal and abnormal dental conditions and can implement primary and secondary prevention of dental conditions in their practice. PubMed has been used to search the scientific literature for evidence on the following topics: normal dental development, dental abnormalities, malocclusion, teething, dental caries and related epidemiology and prevention, fluoride, dental injury and its management and prevention; and identification, prevention and treatment of gingivitis and periodontal disease. Literature review relied on randomized controlled trials, meta-analyses, systematic reviews, and Cochrane reviews when relevant and available. Other sources of evidence included cohort and case-control studies. Consensus statements and expert opinion were used when there was a paucity of high-quality research studies. The literature has been synthesized on these topics to make them relevant to pediatric primary care clinicians, and as available, the strength of evidence has been characterized when making clinical recommendations.
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Affiliation(s)
- Charlotte W Lewis
- Division of General Pediatrics, Department of Pediatrics, University of Washington School of Medicine,Seattle Children’s Hospital, Seattle, WA, USA
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27
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Gomaa N, Tenenbaum H, Glogauer M, Quiñonez C. The Biology of Social Adversity Applied to Oral Health. J Dent Res 2019; 98:1442-1449. [PMID: 31547748 DOI: 10.1177/0022034519876559] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Biological embodiment is a concept derived from Engel's biopsychosocial model to health, theorized as the process by which adverse social exposures trigger neuroendocrine and immune responses, leading to disease and/or increased disease susceptibility. This critical review discusses the biopsychosocial model as applied to oral health and its relevance to oral health policy while deciphering some of the pathobiological processes underlying social adversity. In periodontal disease, for example, such processes can occur via the activation of the hypothalamic-pituitary-adrenal axis and the consequent release of the chronic stress hormone cortisol. The latter contributes to a proinflammatory immune state that increases the risk for periodontal inflammation. Recent research shows that cortisol relates to an elevated oral inflammatory load, demonstrated as hyperactive neutrophils that are pivotal to periodontal tissue damage. Consistent with the biopsychosocial model, this relationship is amplified in those of lower income and higher financial stress. Similarly, among children from lower socioeconomic backgrounds, cortisol is linked to a higher cariogenic bacterial load. Such findings implicate the stress pathway as key in the oral pathogenic process, particularly under social/socioeconomic adversity. Collectively, this work emphasizes the importance of addressing social factors in alleviating oral disease burden and reducing the social gaps therein.
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Affiliation(s)
- N Gomaa
- Neuroscience and Mental Health, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.,Paediatrics, Faculty of Medicine, University of Toronto, ON, Canada
| | - H Tenenbaum
- Periodontology, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Advanced Dental Research and Care, Department of Dentistry, Mount Sinai Hospital, Toronto, ON, Canada
| | - M Glogauer
- Periodontology, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Dental Oncology, Princess Margaret Hospital, Toronto, ON, Canada
| | - C Quiñonez
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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28
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Pereira Dos Santos JD, Cunha E, Nunes T, Tavares L, Oliveira M. Relation between periodontal disease and systemic diseases in dogs. Res Vet Sci 2019; 125:136-140. [PMID: 31226571 DOI: 10.1016/j.rvsc.2019.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/16/2019] [Accepted: 06/11/2019] [Indexed: 02/01/2023]
Abstract
Periodontal disease (PD) is one of the most frequent and widespread inflammatory diseases in dogs. The onset of PD pathogenesis is prompted by the dental microbial biofilm combined with the animal immune-inflammatory response. Along with local effects, systemic consequences can occur secondary to dental plaque-associated bacteraemia, affecting distant tissues and organs. The main goal of this retrospective study was to access and evaluate the association between PD and systemic consequences (renal, hepatic and cardiac) in a group of 136 dogs. Clinical records of all animals were assessed for general and systemic information, further analysed by general linear model and Odds-Ratio. Animals were organized in two groups, PD group and control group, formed by animals without PD. In this population, increasing age was proven to be a risk factor (OR = 1.04, p < .01) for PD establishment. Small breeds (<10 Kg) were the most prevalent in the PD group, being more susceptible to this disease. On the other hand, no influence of gender or reproductive status in PD progression was observed. Regarding systemic diseases, a statistically significant association (p = .026) was obtained between PD and cardiac disease. Results show that PD can have a significant adverse impact on animals' health, being related with systemic consequences, which may increase morbidity and mortality rates of these animals. PD prevention, with focus on owner's information about this disease and its management, are essential points for an active PD control program.
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Affiliation(s)
- José Diogo Pereira Dos Santos
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Eva Cunha
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisbon, Portugal.
| | - Telmo Nunes
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Luís Tavares
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Manuela Oliveira
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisbon, Portugal
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29
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Barboza-Solís C, Porras-Chaverri M, Fantin R. Is tooth loss important when evaluating perceived general health? Findings from a nationally representative study of Costa Rican adults. Community Dent Oral Epidemiol 2019; 47:358-365. [PMID: 31074536 DOI: 10.1111/cdoe.12466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/11/2019] [Accepted: 04/19/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Although previous studies have shown that oral diseases can impact certain systemic conditions, dental care has been historically separated from medical healthcare organizations in middle-income countries. There is a lack of research approaches which test the independent relationship between oral health and multidimensional measures of general health. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relatively to certain morbidity conditions, tooth loss is a health condition associated with SRH. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relative to certain morbidity conditions, tooth loss is a health condition associated with SRH. METHODS Data were obtained from the Costa Rican Longevity and Healthy Aging Study 1945-1955 Retirement Cohort, a national representative longitudinal survey including residents born between 1945 and 1955. The association between severe tooth loss and SRH was analysed cross-sectionally using the first wave of the study conducted in 2010. A multivariable logistic regression, adjusted for potential confounders, was performed on 2797 participants. A counterfactual analysis was additionally performed to illustrate the theoretical change on SRH prevalence-if all the participants were not to have had severe tooth loss. RESULTS Severe tooth loss was associated with poor SRH, after adjustment for smoking, morbidity, biomarkers and performance-based physical measures. The counterfactual analysis showed that severe tooth loss was the fifth most important morbidity condition in determining poor SRH. Declaring a poor SRH would have been decreased by 2.0 percentage points if those participants having severe tooth loss had shared the same risk pattern of those who had not lost the majority of their teeth. CONCLUSION Individuals consider their oral health status to a similar extent as other morbidity conditions when evaluating their general health. A stronger focus on oral health, and its impact on general health, could lead to better planning of national resources, thereby improving accessibility to health care and modifying prevailing conceptions of health care in low- and middle-income countries.
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Affiliation(s)
| | - Mariela Porras-Chaverri
- Centro de Investigación en Ciencias Atómicas, Nucleares y Moleculares, Universidad de Costa Rica, San José, Costa Rica
| | - Romain Fantin
- Facultad de Medicina, Escuela de Salud Pública, Universidad de Costa Rica, San José, Costa Rica.,Facultad de Medicina, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
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30
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Pereira Cruvinel AF, Cusicanqui Méndez DA, Campos Chaves G, Gutierres E, Lotto M, Marchini Oliveira T, Cruvinel T. The Brazilian validation of a health literacy instrument: the newest vital sign. Acta Odontol Scand 2018; 76:587-594. [PMID: 30045650 DOI: 10.1080/00016357.2018.1484511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study aimed to perform the cross-cultural adaptation and validation of the NVS for Brazilian Portuguese. MATERIAL AND METHODS Two hundred and fifty adults responded to the adapted version of the NVS, the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), ten questions of the National Functional Literacy Index (NFLI), and a questionnaire about demographic and oral health-related aspects. Statistical analysis determined the internal consistency, stability, difficulty of items, and convergent/discriminant/predictive validities of the NVS. p < .05 was considered significant. RESULTS The NVS displayed a good internal consistency (Cronbach's alpha = 0.79) and a fair stability (ICC = 0.57; 0.39-0.70 95% CI). Seventy-two percent of participants answered the easier question (#5) correctly, whereas only 28.4% were successful in responding the most difficult question (#1). The convergent validity of the NVS was demonstrated by its significant correlation with the BREALD-30 (Rs = 0.601, p < .001) and NFLI (Rs = 0.544, p < .001). The observation of higher NVS scores among health professionals, white and more educated people confirmed the discriminant validity of the instrument. Moreover, health literacy was a significant predictor of self-reported oral health and reason for dental utilization. CONCLUSION The NVS demonstrated adequate psychometric properties to be applied in Brazilian oral health epidemiological surveys.
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Affiliation(s)
| | | | - Giuliana Campos Chaves
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Eliézer Gutierres
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Matheus Lotto
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Thaís Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Calvasina P, O'Campo P, Pontes MM, Oliveira JB, Vieira-Meyer APGF. The association of the Bolsa Familia Program with children's oral health in Brazil. BMC Public Health 2018; 18:1186. [PMID: 30340475 PMCID: PMC6194593 DOI: 10.1186/s12889-018-6084-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 10/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background Several studies have demonstrated that Conditional Cash Transfer (CCT) programs reduce poverty/inequity and childhood mortality. However, none of these studies investigated the link between CCT programs and children’s oral health. This study examines the association between receiving the Brazilian conditional cash transfer, Bolsa Familia Program (BFP), and the oral health of five-year-old children in the Northeast of Brazil. Methods We conducted a cross-sectional study with 230 caregivers/children randomly selected in primary health care clinics in the city of Fortaleza in 2016. Interviews and oral health examinations were performed. Descriptive statistics and multiple logistic regression analyses were conducted to identify factors associated with dental caries among five-year-old children enrolled in the BFP. Results Around 40% of children enrolled in the BFP had dental caries. However, those who received Bolsa Familia (BF) for a period up to two years (OR = 0.13, 95% CI 0.05–0.35) had substantially lower adjusted odds of having dental caries than those who had never received BF. In addition, the association of BF and dental caries was more prominent among extremely poor families (OR = 0.05, 95% CI 0.01–0.28). Conclusions Although initial enrolment in the BFP predicted low dental caries among five-year-old children, the prevalence of dental caries in this population is still high, thus, public health programs should target BF children’s oral health. An ongoing effort should be made to reduce oral health inequalities among children in Brazil.
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Affiliation(s)
- Paola Calvasina
- Young Talents for Science Program - CAPES, Oswaldo Cruz Foundation (FIOCRUZ-Brazil) Ceará Office, Fortaleza, CE, Brazil.
| | - Patricia O'Campo
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Research on Inner City Health, 209 Victoria Street, 3rd Floor, Toronto, ON, M5B1T8, Canada
| | - Mateus Mota Pontes
- University of Fortaleza, Av Washington Soares 1321, Edson Queiroz, Fortaleza, CE, CEP 60811-905, Brazil
| | - Jamille Barreto Oliveira
- University of Fortaleza, Av Washington Soares 1321, Edson Queiroz, Fortaleza, CE, CEP 60811-905, Brazil
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Sabbah W, Gomaa N, Gireesh A. Stress, allostatic load, and periodontal diseases. Periodontol 2000 2018; 78:154-161. [DOI: 10.1111/prd.12238] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Wael Sabbah
- Division of Population and Patient Health; Dental Institute; King's College London; London UK
| | - Noha Gomaa
- Faculty of Dentistry; University of Toronto; Toronto ON Canada
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Marquillier T, Trentesaux T, Gagnayre R. [Therapeutic education in pediatric dentistry: analysis of obstacles and levers to the development of programmes in France in 2016]. SANTE PUBLIQUE 2018; 29:781-792. [PMID: 29473392 DOI: 10.3917/spub.176.0781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Over recent years, therapeutic patient education has become part of dental medicine. Management of early childhood caries, known to be a very common chronic disease, has evolved to include an educational dimension. The objective of this study was to identify the levers and barriers to the development of formalized therapeutic education programmes and alternatives. METHODS A comprehensive exploratory qualitative study was conducted between November 2015 and June 2016 on a targeted sample of 15 people aware of the problem of TPE in dentistry. RESULTS The study showed that TPE training in dentistry is underdeveloped, despite its numerous benefits: change of the healthcare professional's approach, implementation of structured educational programmes, development of research, etc. There are many obstacles to the development of TPE programmes: insufficient resources, rigid legislation or lack of knowledge of TPE practices. The dental profession is an obstacle itself because of its lack of understanding and variable degrees of integration the medical community. There are multiple levers, but the main ones are changing attitudes of the profession and the provision of resources to develop TPE. Although alternatives to TPE programmes exist (accompanying measures, short educational strategies, connected health), they cannot replace TPE. CONCLUSION More educational strategies must be developed in the field of dentistry. However, the framework of TPE must be adapted to the profession to ensure good uptake.
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Gomaa N, Nicolau B, Siddiqi A, Tenenbaum H, Glogauer M, Quiñonez C. How does the social "get under the gums"? The role of socio-economic position in the oral-systemic health link. Canadian Journal of Public Health 2017; 108:e224-e228. [PMID: 28910242 DOI: 10.17269/cjph.108.5930] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 06/23/2017] [Accepted: 03/11/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the extent of association between systemic inflammation and periodontal disease in American adults, and to assess whether socio-economic position mediated this relationship. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES IV) (2001-2010). Systemic inflammation was defined by individual and aggregate (cumulative inflammatory load) biomarkers (C-reactive protein, white blood cell counts, neutrophil counts, and neutrophil:lymphocyte ratio). Loss of attachment and bleeding on probing were used to define periodontal disease. Poverty:income ratio and education were indicators of socio-economic position. Covariates included age, sex, ethnicity, smoking, alcohol, and attendance for dental treatment. Univariate and multivariable logistic regressions were constructed to assess the relationships of interest. RESULTS In a total of 2296 respondents, biomarkers of systemic inflammation and cumulative inflammatory load were significantly associated with periodontal disease after adjusting for age, sex, and behavioural factors. Socio-economic position attenuated the association between markers of systemic inflammation and periodontal disease in the fully adjusted model. CONCLUSION Socio-economic position partly explains how systemic inflammation and periodontal disease are coupled, and may thus have a significant role in the mechanisms linking oral and non-oral health conditions. It is of critical importance that the social and living conditions are taken into account when considering prevention and treatment strategies for inflammatory diseases, given what appears to be their impactful effect on disease processes.
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Affiliation(s)
- Noha Gomaa
- Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, 521A, 124 Edward Street, Toronto, ON, M5G 1G6, Canada.
| | - Belinda Nicolau
- Oral Health and Society Research Unit, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Arjumand Siddiqi
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Howard Tenenbaum
- Discipline of Periodontics, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Michael Glogauer
- Discipline of Periodontics, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Carlos Quiñonez
- Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, 521A, 124 Edward Street, Toronto, ON, M5G 1G6, Canada
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Chen YA, Quiñonez C. Basic income guarantee: a review of implications for oral health. J Public Health Dent 2017; 78:56-62. [PMID: 28771733 DOI: 10.1111/jphd.12239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 06/16/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To: a) Familiarize readers with the concept of a basic income guarantee (BIG) and its different forms; b) Consider how BIG could improve oral health and decrease oral health disparities; c) Motivate readers to advocate for the evaluation of oral health outcomes in BIG experiments. METHODS Published articles and book chapters that have analyzed and reviewed data from past BIG pilot projects were examined for their findings on health and socioeconomic outcomes. RESULTS Our findings suggest various areas and mechanisms whereby BIG can influence oral health-related outcomes, whether through impacts on work, illness and injury, education, a social multiplier effect, expenditure behavior, and/or mental illness and other health outcomes. CONCLUSION Our findings illustrate the importance of assessing oral health-related outcomes in future BIG pilot projects.
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Affiliation(s)
- Yi-An Chen
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Carlos Quiñonez
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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Vasiliou A, Shankardass K, Nisenbaum R, Quiñonez C. Current stress and poor oral health. BMC Oral Health 2016; 16:88. [PMID: 27590184 PMCID: PMC5010733 DOI: 10.1186/s12903-016-0284-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/24/2016] [Indexed: 11/28/2022] Open
Abstract
Background Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. Methods Data from a cross-sectional study of 2,412 participants between the ages of 25–64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and access to dental insurance were examined as effect modifiers. Results A positive relationship between current stress and poor oral health was observed for both outcomes (oral pain coefficient 0.32, 95 % CI 0.26–0.38; general oral health coefficient 0.28, 95 % CI 0.19–0.36). Effects on oral pain were stronger for the uninsured, while effects on general oral health were stronger with decreasing socioeconomic position. Conclusions Our findings suggest that individuals with greater perceived stress also report poorer oral health, and that this relationship is modified by dental insurance and socioeconomic position. These findings warrant a greater focus on the role of psychological stress in the development of oral disease, including how perceived stress contributes to health inequities in self-reported oral health status. Patients experiencing stressful lives may differentially require closer monitoring and more vigilant maintenance of their oral health, above and beyond that which is needed to achieve a state of health in the oral environment of less stressed individuals. There may be health promoting effects of addressing psychosocial concerns related to dental care - particularly for the poor and uninsured.
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Affiliation(s)
- A Vasiliou
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - K Shankardass
- Department of Health Sciences, Wilfrid Laurier University, 75 University Ave West, Waterloo, ON, N2L 3C5, Canada. .,Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - R Nisenbaum
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - C Quiñonez
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Trohel G, Bertaud-Gounot V, Soler M, Chauvin P, Grimaud O. Socio-Economic Determinants of the Need for Dental Care in Adults. PLoS One 2016; 11:e0158842. [PMID: 27441841 PMCID: PMC4956297 DOI: 10.1371/journal.pone.0158842] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 06/22/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Oral health has improved in France. However, there are still inequalities related to the socio-economic status. OBJECTIVES The aim of this study was to measure the prevalence of dental care needs in an adult population and to identify the demographic, socio-economic and behavioral variables that may explain variations in this parameter. METHODS A cross-sectional analysis of the French SIRS cohort (n = 2,997 adults from the Paris region; 2010 data) was carried out to determine the prevalence of self-reported dental care needs relative to demographic, socio-economic and behavioral variables. A logistic regression model was used to identify the variables that were most strongly associated with the level of need. RESULTS In 2010, the prevalence of the need for dental care in the SIRS cohort was 35.0% (95% CI [32.3-37.8]). It was lower in people with higher education levels (31.3% [27.9-34.6]), without immigrant background (31.3% [28.0-34.6]) and with comprehensive health insurance (social security + complementary health cover; 32.8% [30.2-35.4]). It decreased as the socio-economic status increased, but without following a strict linear change. It was also lower among individuals who had a dental check-up visit in the previous two years. In multivariate analyses, the socioeconomic variables most strongly associated with the need for dental care were: educational attainment (OR = 1.21 [1.02-1.44]), income level (OR = 1.66 [1.92-2.12]) and national origin (OR = 1.53 [1.26-1.86]). CONCLUSION These results confirm that the prevalence of dental care needs is higher among adults with low socio-economic status. Education level, income level and also national origin were more strongly associated with the need for dental care than insurance cover level.
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Affiliation(s)
- Gilda Trohel
- U1099, INSERM, Rennes, France
- LTSI, University of Rennes 1, Rennes, France
- Dental Surgery Department, University Hospital, Rennes, France
| | - Valérie Bertaud-Gounot
- U1099, INSERM, Rennes, France
- LTSI, University of Rennes 1, Rennes, France
- Dental Surgery Department, University Hospital, Rennes, France
| | - Marion Soler
- Research Team on Social Determinants of Health and Use of Care, UMRS 707, INSERM Paris, Paris, France
| | - Pierre Chauvin
- Research Team on Social Determinants of Health and Use of Care, UMRS 707, INSERM Paris, Paris, France
| | - Olivier Grimaud
- Epidemiology Bio-Statistics Department, EHESP, Rennes, France
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