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Nascimento GG, Machado FW, Cascaes AM, Silva AE, Boscato N, Demarco FF. Validity of self-reported oral conditions among Brazilian older women: Do socio-economic factors matter? Int J Dent Hyg 2024; 22:521-529. [PMID: 37183553 DOI: 10.1111/idh.12680] [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: 01/17/2022] [Revised: 02/06/2023] [Accepted: 04/02/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To validate the level of agreement between self-report and clinical examination for oral conditions and evaluate the effect of sociodemographic conditions on the validity of self-report among women aged 60 and older. METHODS A cross-sectional study was conducted in a social community center for seniors in Southern Brazil. Sociodemographic data (age, level of education, and income) were measured. Participants were interviewed and clinically examined for the number of teeth (DMF-T index) and the use of dental prostheses. The self-reported number of teeth in each arch and the use of dental prostheses were gathered through interviews. The level of agreement was estimated using the observed agreement, Kappa statistics, sensitivity/specificity (edentulism/prostheses) and Lin's concordance correlation coefficient, and related tests (number of teeth). The validity of the oral conditions was estimated according to sociodemographic information. RESULTS Ninety-nine women participated in the study. High levels of agreement were observed for edentulism (97.8%; 95%CI 92.8;99.7; Kappa 0.947) and the use of dental prostheses (97.0%; 95%CI 91.3;99.4; Kappa 0.922). In both conditions, despite achieving similar concordance correlation coefficients (ranging from weak to moderate), the mean number of upper teeth was lower in clinical examination (7.1 ± 5.2) compared with self-reported (8.6 ± 3.6), while the opposite was observed for lower teeth (clinical examination: 9.1 ± 3.4; self-reported: 6.6 ± 5.3). Larger differences were found among women of low income and educational levels. CONCLUSIONS Our findings suggest that the participants' socio-economic position might influence their self-reported number of teeth.
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Affiliation(s)
- Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore City, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore City, Singapore
| | - Fernanda W Machado
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Andréia M Cascaes
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Alexandre E Silva
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Noéli Boscato
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Pengpid S, Peltzer K. Poor Self-Rated Oral Health Status and Associated Factors Amongst Adults in Algeria. Int Dent J 2023; 73:701-708. [PMID: 36997423 PMCID: PMC10541454 DOI: 10.1016/j.identj.2023.02.003] [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: 10/11/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Understanding the proportion and correlates of self-rated oral health (SROH) can assist in prioritising interventions. The aim of this study was to assess the prevalence of poor SROH and associated factors in a national community survey amongst adults in Algeria. METHODS This World Health Organisation (WHO) STEPS cross-sectional survey in Algeria in 2016 and 2017 included 6989 people (18-69 years; median age, 37 years) selected by multistage cluster sampling. The assessment included questionnaire information, physical measures, and biochemistry tests. The measures included questions on SROH, oral conditions, oral health behaviour, general health behaviour, and measures of health status. RESULTS The sample included 6989 people aged 18 to 69 years. Of the total sample, 17.1% had removable dentures, 35.5% had 0 to 19 natural teeth, 43.9% had dental pain in the past year, 40.5% had impaired oral health-related quality of life (OHRQoL), 26.9% cleaned their teeth 2 times/d or more, 79.6% used toothpaste, and 41.2% had visited a dentist in the past year. The prevalence of poor SROH was 37.3%. In the final logistic regression model, older age (45-69 years) (adjusted odds ratio [AOR], 1.34; 95% confidence interval [CI], 1.09-1.65), having removable dentures (AOR, 1.46; 95% CI, 1.14-1.87), dental pain (AOR, 2.16; 95% CI, 1.82-2.57), impaired OHRQoL (AOR, 2.69; 95% CI, 2.26-3.20), current smokeless tobacco use (AOR, 1.45; 95% CI, 1.12-1.89), and inadequate fruit and vegetable intake (AOR, 2.69; 95% CI, 2.26-3.20) increased the odds of poor SROH. Men (AOR, 0.76; 95% CI, 0.65-0.90), having 20 or more teeth (AOR, 0.35; 95% CI, 0.28-0.42), twice or more a day teeth cleaning (AOR, 0.72; 95% CI, 0.60-0.86), and using toothpaste (AOR, 0.67; 95% CI, 0.55-0.82) were protective against poor SROH. CONCLUSIONS Adults in Algeria reported a high prevalence of poor SROH, and several associated factors (sociodemographic, oral conditions, oral and general health-compromising behaviour) were found that can guide in oral health promotion strategies in Algeria.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Psychology, University of the Free State, Bloemfontein, South Africa; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Reis LOB, Silva AER, Cascaes AM, Boscato N. Agreement between self-rated denture condition and clinical examination in older adults. Gerodontology 2023; 40:135-141. [PMID: 35416323 DOI: 10.1111/ger.12631] [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: 10/08/2021] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to compare differences between complete denture conditions self-rated by older adult wearers and clinically exanimated by a professional based on standardised aesthetics and functional criteria. MATERIALS AND METHODS Complete denture clinical examination was based on the functional (stability, retention, occlusion and articulation, vertical dimension of occlusion) and aesthetics criteria. Data on self-rated complete denture conditions were measured using the Patient's Denture Assessment (PDA) questionnaire based on standardised aesthetic and functional criteria (n = 122). Prevalence rates of clinical and self-rated complete denture condition, sensitivity, specificity, positive and negative predictive values, and absolute and relative bias were calculated. RESULTS The highest sensitivity (66.7% [95% CI 55.3-76.7]) was obtained for aesthetic criterion, whereas occlusion revealed the lowest sensitivity (14.9% [95% CI 6.2-28.3]). Stability had the highest specificity (91.3% [95% CI 72.0-98.9]) and aesthetics the lowest (21.4% [95% CI 8.3-41.0]). Stability also yielded the highest positive predictive value (83.3% [95% CI 51.6-97.9]), and vertical dimension of occlusion the lowest (26.3% [95% CI 9.1-51.2]). The vertical dimension of occlusion yielded the highest negative predictive value (71.2% [95% CI 58.7-81.7]). Self-rated data underestimated the complete denture condition in 6.5% compared with clinical examinations when the aesthetic criterion was excluded from the analysis and 7.6% when added. CONCLUSIONS Older adult wearers better identified the condition of their complete denture when the aesthetic criterion was excluded from examination. In contrast, considering functional criteria (retention, stability, occlusion and vertical dimension of occlusion), self-rated complete denture conditions underestimated clinical examination. CLINICAL RELEVANCE Using standardised aesthetic criteria in epidemiological studies for assessing complete denture conditions self-rated by wearers could avoid underestimating or overestimating the information regarding the use or need for dental prostheses.
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Affiliation(s)
- Luiz Otávio B Reis
- Graduate Program in Dentistry, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Andreia Morales Cascaes
- Department of Public Health, Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Noéli Boscato
- Graduate Program in Dentistry, Prosthodontics Division, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
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Menegazzo GR, Cunha ARD, Fagundes MLB, Amaral Júnior OLD, Giordani JMDA, Hilgert JB, Abreu LG, Hugo FN. Pathways that explain racial differences on edentulism among older adults: 2019 Brazil National Health Survey. Braz Oral Res 2023; 37:e40. [PMID: 37132727 DOI: 10.1590/1807-3107bor-2023.vol37.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/04/2022] [Indexed: 05/04/2023] Open
Abstract
This study aimed to evaluate the pathways that explain the association between race/skin color and edentulism in elderly Brazilians. This was a cross-sectional study using data from participants aged 60 years or older from the 2019 Brazilian National Health Survey, a nationally representative population-based sample. Data were obtained by a structured interview and participants were classified as edentulous if they reported having lost all natural teeth. Information on race, socioeconomic level, behavioral aspects, psychosocial aspects, and access to dental care was collected by interviewers using a questionnaire. The pathways between race/skin color and edentulism were analyzed using structural equation modeling. The final sample of the study included 22,357 participants. Most participants were white (51.5%; 95% confidence interval [CI]: 50.3-52.6), and 36.8% (95%CI: 35.7-37.9) were edentulous. Race/skin color was indirectly associated with edentulism via enabling factors. These findings suggest that socioeconomic inequalities are key in explaining racial inequalities in edentulism among Brazilian older adults.
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Affiliation(s)
| | - Amanda Ramos da Cunha
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | | | | | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG - School of Dentistry , Department of Child's and Adolescent's Oral Health , Belo Horizonte , MG , Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
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5
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Terra e Souza LH, Diaz-Quijano FA, de Azevedo Barros MB, Lima MG. Race (black-white) and sex inequalities in tooth loss: A population-based study. PLoS One 2022; 17:e0276103. [PMID: 36228031 PMCID: PMC9560604 DOI: 10.1371/journal.pone.0276103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 09/05/2022] [Indexed: 11/07/2022] Open
Abstract
The effect of health inequalities is determined by different socioeconomic, sex, and race conditions. This study aimed to analyze the association of tooth loss with race (defined by self-reported skin color) and sex. Based on the hypothesis that the association between tooth loss and race may be modified by sex, we also aimed to evaluate possible interactions between race and sex in association with this event, in a population-based study in the city of Campinas, Brazil. A directed acyclic graph was used to select covariates. The prevalence, of tooth loss was 19% higher in black women compared to white men (Prevalence ratio [PR]: 1.19; 95%CI: 1.05–1.34). Moreover, the prevalence of tooth loss in black women was 26% higher than in white women (PR: 1.26; 95%CI: 1.13–1.42); and, within the strata of black people, black women had 14% higher dental loss (PR: 1.14; 95%CI: 1.02–1.27) compared to black men. This study found a significant interaction between race and sex in tooth loss, with a disadvantage for black women. In addition, this work contributes to the discussion of health inequities and can support policies for the provision of universal dental care.
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Affiliation(s)
- Lívia Helena Terra e Souza
- Department of Collective Health, Collaborating Center for Health Situation Analysis (CCAS), School of Medical Science, University of Campinas, Campinas, São Paulo, Brazil
- * E-mail:
| | - Fredi Alexander Diaz-Quijano
- Department of Epidemiology, Laboratory of Causal Inference in Epidemiology [Laboratório de Inferência Causal em Epidemiologia], School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marilisa Berti de Azevedo Barros
- Department of Collective Health, Collaborating Center for Health Situation Analysis (CCAS), School of Medical Science, University of Campinas, Campinas, São Paulo, Brazil
| | - Margareth Guimarães Lima
- Department of Collective Health, Collaborating Center for Health Situation Analysis (CCAS), School of Medical Science, University of Campinas, Campinas, São Paulo, Brazil
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Anunciação D, Pereira LL, Silva HP, Nunes APN, Soares JO. Ways and detours in guarantee of health for the black population and the confrontation of racism in Brazil. CIENCIA & SAUDE COLETIVA 2022; 27:3861-3870. [PMID: 36134792 DOI: 10.1590/1413-812320222710.08212022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/21/2022] Open
Abstract
Institutional racism is prevalent in the health services in Brazil and is based on concrete power relations that subjugate, dominate and exclude blacks from having adequate access to health care and health institutions. This critical essay analyzes the importance of expanding the debate, and the production of knowledge about the health of the black population (HBP), focusing on two points: the role of the National Policy for the Integral Health of the Black Population (PNSIPN) and the importance of including the skin color item in the health information systems; and the need for a process of permanent training of professionals, including contents related to the understanding of racism as an element of the social determination of health/disease and heir effects. To demonstrate how structural and institutional racism have affected the black population, we bring also examples of the quilombola populations in the context of the Covid-19 pandemic in the country since 2020. It is concluded that the promotion of care, the reduction of inequities and the quality of health care need to undergo changes in several dimensions, such as the strengthening of the SUS, the daily fight against structural and institutional racism, among others.
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Affiliation(s)
- Diana Anunciação
- Programa de Pós-Graduação Mestrado Profissional em Saúde da População Negra e Indígena, Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. R. Rui Barbosa 710, Centro. 44.380-000 Cruz das Almas Bahia Brasil. .,Grupo Temático Racismo e Saúde, Associação Brasileira de Saúde Coletiva (ABRASCO). Rio de Janeiro RJ Brasil
| | - Lucélia Luiz Pereira
- Grupo Temático Racismo e Saúde, Associação Brasileira de Saúde Coletiva (ABRASCO). Rio de Janeiro RJ Brasil.,Programa de Pós-Graduação em Política Social, Departamento de Serviço Social, Universidade de Brasília. Brasília DF Brasil
| | - Hilton P Silva
- Grupo Temático Racismo e Saúde, Associação Brasileira de Saúde Coletiva (ABRASCO). Rio de Janeiro RJ Brasil.,Programa de Pós-Graduação em Saúde, Ambiente e Sociedade na Amazônia, Programa de Pós-Graduação em Antropologia, Universidade Federal do Pará. Belém PA Brasil
| | - Ana Paula Nogueira Nunes
- Grupo Temático Racismo e Saúde, Associação Brasileira de Saúde Coletiva (ABRASCO). Rio de Janeiro RJ Brasil.,Departamento de Ciências Básicas, Universidade Federal dos Vales do Jequitinhona e Mucuri. Diamantina MG Brasil
| | - Jaqueline Oliveira Soares
- Grupo Temático Racismo e Saúde, Associação Brasileira de Saúde Coletiva (ABRASCO). Rio de Janeiro RJ Brasil.,Coordenação da Política de Saúde da População Negra, Secretaria de Estado da Saúde do Rio Grande do Sul. Porto Alegre RS Brasil
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7
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Anunciação D, Pereira LL, Silva HP, Nunes APN, Soares JO. Ways and detours in guarantee of health for the black population and the confrontation of racism in Brazil. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-812320222710.08212022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Institutional racism is prevalent in the health services in Brazil and is based on concrete power relations that subjugate, dominate and exclude blacks from having adequate access to health care and health institutions. This critical essay analyzes the importance of expanding the debate, and the production of knowledge about the health of the black population (HBP), focusing on two points: the role of the National Policy for the Integral Health of the Black Population (PNSIPN) and the importance of including the skin color item in the health information systems; and the need for a process of permanent training of professionals, including contents related to the understanding of racism as an element of the social determination of health/disease and heir effects. To demonstrate how structural and institutional racism have affected the black population, we bring also examples of the quilombola populations in the context of the Covid-19 pandemic in the country since 2020. It is concluded that the promotion of care, the reduction of inequities and the quality of health care need to undergo changes in several dimensions, such as the strengthening of the SUS, the daily fight against structural and institutional racism, among others.
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Affiliation(s)
- Diana Anunciação
- Universidade Federal do Recôncavo da Bahia, Brazil; Associação Brasileira de Saúde Coletiva, Brazil
| | - Lucélia Luiz Pereira
- Associação Brasileira de Saúde Coletiva, Brazil; Universidade de Brasília, Brazil
| | - Hilton P. Silva
- Associação Brasileira de Saúde Coletiva, Brazil; Universidade Federal do Pará, Brazil
| | - Ana Paula Nogueira Nunes
- Associação Brasileira de Saúde Coletiva, Brazil; Universidade Federal dos Vales do Jequitinhona e Mucuri, Brazil
| | - Jaqueline Oliveira Soares
- Associação Brasileira de Saúde Coletiva, Brazil; Secretaria de Estado da Saúde do Rio Grande do Sul, Brazil
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Silveira ERD, Cademartori MG, Costa FDS, Hartwig A, Barros FC, Bertoldi AD, Azevedo MS, Demarco FF. Number of erupted teeth at the age of 12 and 24 months. BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8667095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: To verify the validity of maternal reports on the number of deciduous teeth erupted in their children. Methods: This cross-sectional study was performed with children enrolled in a Birth Cohort at the age of 12 months in the first stage and 24 months in the second stage. At both stages, children were clinically examined, and mothers reported the number of teeth of their children. Comparison between groups was performed using the Mann-Whitney non-paired Wilcoxon test. Level of agreement between two methods were estimated by the Observed Agreement, Weighted Kappa and Intraclass Correlation coefficients. Results: A total of 125 children were examined in the first stage, with mean number of reported teeth of 6.2. In the second stage, 149 children were examined, with mean number of reported teeth of 15.9. High level of agreement, kappa values and intraclass correlation coefficients were observed for both arches in both periods (p<0.001). Conclusions: Maternal report on the number of teeth erupted in children was reliable and valid. Thus, it seems to be a useful instrument for collecting data in population-based epidemiological studies targeting young children.
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Corassa RB, Silva CJDP, de Paula JS, de Aquino ÉC, Sardinha LMV, Alves PAB. Self-reported oral health among Brazilian adults: results from the National Health Surveys 2013 and 2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2021383. [PMID: 35920460 PMCID: PMC9897815 DOI: 10.1590/ss2237-9622202200014.especial] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/16/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate indicators of oral health conditions and behaviours among Brazilian adults in the 2019 National Health Survey (PNS) and analyse the evolution of those indicators compared to the 2013 PNS. METHODS Cross-sectional study. Prevalence ratios of oral health conditions and behaviours, in 2019, were estimated by demographic characteristics. Risk ratios were computed using Poisson regression, and absolute differences (Dif.) between indicators in 2013 and 2019 were calculated. RESULTS Prevalence of brushing teeth twice a day, using toothbrush/toothpaste/floss and edentulism were, respectively, 93.6% (95%CI 93.3;93.9), 63.0% (95%CI 62.3;63.6) and 10.3% (95%CI 9.93;10.7). There was increase in prevalence of brushing teeth ≥ 2 a day (Dif. = 4.5; 95%CI 3.9;5.1), using toothbrush/toothpaste/floss (Dif. = 10.0; 95%CI 8.6;11.3) and a decrease in prevalence of edentulism (Dif. = -0.7; 95%CI -1.3;-0.1). CONCLUSION Respondents who were younger, more educated, with higher income and lived in urban areas had better oral health indicators. Most indicators demonstrated positive improvement.
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Affiliation(s)
| | | | | | | | | | - Paula Aryane Brito Alves
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade
de Ciências Biológicas e da Saúde, Diamantina, MG, Brazil
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10
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Multimorbidity and tooth loss: the Brazilian National Health Survey, 2019. BMC Public Health 2021; 21:2311. [PMID: 34930189 PMCID: PMC8691078 DOI: 10.1186/s12889-021-12392-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/07/2021] [Indexed: 12/26/2022] Open
Abstract
Background Little is known about the presence of two or more chronic conditions (multimorbidity) on tooth loss between adults and older adults. Understanding the mechanisms of multimorbidity on tooth loss is essential to inform policy development. This study aims to investigate the association between multimorbidity and severity of tooth loss in Brazilian adults and older adults. Methods We analysed data from a nationally representative sample of 88,531 Brazilian individuals aged 18 and over who participated in the 2019 Brazilian Health Survey. Tooth loss was the outcome by two different classifications: functional dentition (lost 1–12 teeth) and severe tooth loss (lost 23–32 teeth). The presence of multimorbidity was the main exposure and based on 13 self-reported doctor-diagnosed chronic diseases that were further categorised into two groups, i.e., ≥2 or ≥ 3 comorbidities. Sociodemographic covariates included sex, age, race, income, level of education and tobacco smoking and geographic region of residency. Multivariate logistic regression models estimated the OR (Odds Ratios) and 95%CI of the associations between multimorbidity and tooth loss. Results For 65,803 adults (aged 18 to 59), the presence of multimorbidity (≥2) was associated with 32% higher odds of having severe tooth loss (95% CI, 1.17; 1.49) and 33% lower odds of having functional dentition (95% CI, 0.60; 0.75). For the 22,728 older adults (aged 60 and older), multimorbidity (≥2) was associated with a 17% higher odds of severe tooth loss (95% CI, 1.06; 1.29) and 23% lower odds of having functional dentition (95% CI 0.70; 0.85). The sensitivity analysis, excluding hypertension, confirmed our findings. Conclusions Brazilian adults and older adults with multimorbidity are more likely to have severe tooth loss and less likely to have functional dentition. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12392-2.
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11
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Melo EA, Probst LF, Guerra LM, Tagliaferro EPDS, De-Carli AD, Pereira AC. Indicators for dental appointment scheduling in primary health care: a national cross-sectional study. BMC Public Health 2021; 21:2234. [PMID: 34879828 PMCID: PMC8656053 DOI: 10.1186/s12889-021-12319-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background Integrated dental services within the Health System, particularly at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. However, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Therefore, factors associated with dental appointments scheduling can affect positively or negatively the use of dental services. The aim of the present study was to evaluate the indicators for dental appointment scheduling in Primary Health Care (PHC). Methods The present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user sought for a dental appointment at the Primary Health Care Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome. Results Only 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care. The variables with the greatest effect on the outcome were the patient’s age up to 42 years old (OR = 2.03, 95% CI: 1.96–2.10), at individual level, and ‘oral health teams that assisted no more than a single family health team (FHT)’ (OR = 1.29, 95% CI: 1.23–1.36) at contextual level. Other variables were also associated with the outcome, but with a smaller effect size. Conclusion In conclusion, users’ age and work process of OHT were indicators for dental appointment scheduling. Our results suggest that when OHT put the National Oral Health Policy guidelines into practice, by assisting only one FHT, the chance for PHC users seeking dental appointments is higher than OHTs that assist more than one FHT. Regarding age, patients aged up to 42 years are more likely to seek an appointment with a dentist. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12319-x.
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Affiliation(s)
- Estêvão Azevedo Melo
- Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Livia Fernandes Probst
- Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil. .,Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz (HAOC), São Paulo, Brazil.
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de Jesus CJ, Hillesheim D, Zucki F. Self-reported hearing difficulty in workers exposed to industrial dust in southern Brazil. Codas 2021; 34:e20200402. [PMID: 34669765 PMCID: PMC9886106 DOI: 10.1590/2317-1782/20212020402] [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: 12/04/2020] [Accepted: 02/28/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To investigate the association between self-reported hearing difficulties and occupational exposure to industrial dust in workers in southern Brazil. METHODS This is a cross-sectional analytical study conducted with data from the National Health Survey (Pesquisa Nacional de Saúde, 2013). The dependent variable was self-reported hearing impairment, and the primary independent variable was occupational exposure to industrial dust. The covariables were: sex, skin color, age in complete years, exposure to noise, and exposure to chemical substances. The variables of occupational exposure to noise and chemical substances were used as adjustment variables (confounding variables), and the analyses were stratified per state (Santa Catarina, Paraná, and Rio Grande do Sul) to verify the difference in magnitude results per region. For the crude and adjusted analysis, the odds ratio (OR) was used as a measure of association, estimated through the logistic regression analysis. The data were analyzed through the software Stata, version 14. RESULTS Regarding the main exposure, 10.1% of the sample (n = 490) reported being exposed to industrial dust in an occupational environment, while 7.0% reported hearing impairment. In the final analysis, workers exposed to industrial dust were 1.77 times more likely to report hearing impairment when compared to individuals not exposed to this agent. CONCLUSION There was an association between hearing impairment and exposure to industrial dust in workers in the southern region of Brazil.
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Affiliation(s)
- Caroline Janaina de Jesus
- Departamento de Fonoaudiologia, Universidade Federal de Santa Catarina – UFSC - Florianópolis (SC), Brasil.
| | - Danúbia Hillesheim
- Departamento de Fonoaudiologia, Universidade Federal de Santa Catarina – UFSC - Florianópolis (SC), Brasil.
| | - Fernanda Zucki
- Departamento de Fonoaudiologia, Universidade Federal de Santa Catarina – UFSC - Florianópolis (SC), Brasil.
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Krause L, Seeling S, Starker A. [Self-perceived oral health and associated factors among adults in Germany. Results from GEDA 2019/2020-EHIS]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:967-976. [PMID: 34232335 PMCID: PMC8316182 DOI: 10.1007/s00103-021-03376-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/11/2021] [Indexed: 10/29/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Information on the oral health of the population is important for the assessment of (preventable) disease burden, for the estimation and planning of health resources and costs, and for the evaluation of health inequalities. The aim of this work is to investigate for the first time self-perceived oral health, including associated factors, based on data from a nationally representative sample for the adult population in Germany. MATERIAL AND METHODS The data basis is the nationwide German Health Update study (GEDA 2019/2020-EHIS, n = 22,708 aged 18 years and older). In the telephone interview, the participants were asked how they would describe the state of their teeth and gums - "very good," "good," "fair," "bad," or "very bad." Sociodemographic, behavioral, and dental characteristics are examined as associated factors. Prevalences and results of multivariate binary logistic regressions (odds ratios, OR) are reported. RESULTS AND DISCUSSION Of the participants, 71.4% perceived their oral health as very good or good, 28.6% as fair to very bad. Difficulty in chewing and biting on hard foods (OR 4.0), unmet dental care needs (OR 2.3), male gender (OR 1.5), and not consuming fruits and vegetables daily (OR 1.2) were the most important associated factors for fair to very bad self-perceived oral health; for men, low education (OR 2,1), daily smoking (OR 1.6) and not receiving dental care annually (OR 1.4) were also important. From the results, starting points for promoting oral health can be derived.
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Affiliation(s)
- Laura Krause
- Abteilung für Epidemiologie und Gesundheitsmonitoring, FG 24 Gesundheitsberichterstattung, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
| | - Stefanie Seeling
- Abteilung für Epidemiologie und Gesundheitsmonitoring, FG 24 Gesundheitsberichterstattung, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Anne Starker
- Abteilung für Epidemiologie und Gesundheitsmonitoring, FG 27 Gesundheitsverhalten, Robert Koch-Institut, Berlin, Deutschland
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Moreira RDS, Mauricio HDA, Monteiro IDS, Marques MMMDR. Use of dental services by the Brazilian elderly: latent class analysis. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210024. [PMID: 34076090 DOI: 10.1590/1980-549720210024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the different profiles of dental service use by the Brazilian elderly and their possible association with sociodemographic factors, comorbidities, functionality and self-perception of oral health. METHODS Cross-sectional population-based study, using secondary data from the National Health Survey (PNS) of 2013. The sample size was 2,969 elderly individuals. Latent Class Analysis was used to construct the dependent variable "profile of dental service use" from questions related to this profile. The independent variables formed 3 blocks: sociodemographic; comorbidities; functionalities and self-perception of oral health. The Rao-Scott Test and Standardized Residue Analysis tested the association. To measure the effect of covariates, Odds Ratio was estimated using a multiple hierarchical model of multinomial logistic regression. Significance level was 5%. RESULTS Three latent classes were identified: Direct Disbursement Profile, Health Plan Profile and the Unified Health System (SUS) Profile. White elderly people were associated with the Direct Disbursement and Health Plans profile. The Health Plan profile was more associated with the married marital status or living with a spouse. In the multiple model, low schooling was associated with the profile of SUS users and elderly people diagnosed with cancer with the Health Plan profile. Self-perceiving oral health as bad or very bad increased the chances of belonging to the SUS profile. CONCLUSION Latent Class Analysis proved to be a powerful strategy for a subtle and detailed understanding of the profile of dental service use and its relationship with associated factors.
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Affiliation(s)
- Rafael da Silveira Moreira
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz - Recife (PE), Brasil.,Faculdade de Medicina, Universidade Federal de Pernambuco - Recife (PE), Brasil
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Pengpid S, Peltzer K. Self-rated oral health status and social and health determinants among community dwelling adults in Kenya. Afr Health Sci 2019; 19:3146-3153. [PMID: 32127891 PMCID: PMC7040341 DOI: 10.4314/ahs.v19i4.37] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The aims of this study were to estimate the self-rated oral health status and its associated factors in a national community dwelling population in Kenya. Methods A cross-sectional study based on a stratified cluster random sampling was conducted in 2015. The total sample included 4,459 individuals 18–69 years (M=40.4 years, SD=13.9). Questionnaire interview, blood pressure and anthropometric measurements, and biochemistry tests were conducted, including questions on the oral health status, general health status, oral health behaviour and socio-demographic information. Results Overall, 13.7% of participants reported poor self-rated oral health. In adjusted logistic regression analysis, older age (Odds Ratio-OR: 1.70, Confidence Interval-CI: 1.07, 2.69), having a lower number lover number of teeth (OR: 0.19, CI: 0.06, 0.62), having dentures (OR: 1.92, CI: 1.22, 3.03), having pain in the mouth or teeth (OR: 5.62, CI: 3.58, 8.90), impaired Oral Health Related Quality of Life (OR: 3.01, CI: 2.03, 4.47) and frequent soft drink consumption (OR: 3.62, CI: 1.89, 6.97) were associated with poor self-rated oral health. Conclusion High unsatisfied self-rated oral health status was found and several risk factors for poor self-rated oral health were identified that can help in guiding oral health care programming in Kenya.
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Affiliation(s)
- Supa Pengpid
- Asean Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhonpathom, Thailand
- Department of Research and Innovation, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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Jayasvasti I, Htun KCSS, Peltzer K. Self-Rated Oral Health Status And Social And Health Determinants Among 35-65 Year-Old Persons In One Region In Myanmar: A Cross-Sectional Study. Clin Cosmet Investig Dent 2019; 11:339-348. [PMID: 31807081 PMCID: PMC6857668 DOI: 10.2147/ccide.s227957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 09/11/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Oral diseases may be a population health problem in Myanmar. Community-based surveys may help in the selection of risk groups that may require priority attention. The study aimed to estimate the prevalence and correlates of self-rated oral health (SROH) status in an adult community sample in Myanmar. METHODS The study design was a cross-sectional household survey in the Magway region Myanmar. In all, 633 persons aged 35 to 65 years, responded to questions on the oral health status, general health status, oral health knowledge and behaviour and socio-demographic information. RESULTS Overall, 13.6% of participants reported poor SROH, and 78.5% average or poor SROH. In adjusted logistic regression analysis, oral conditions (tooth loss, cavities, bleeding gums, and teeth that are sensitive to heat or cold), better oral health knowledge, dental care attendance, and skipping breakfast were associated with poor SROH. CONCLUSION A high proportion of poor or average SROH status was found and several associated variables were found that can facilitate in guiding oral health care programming in Myanmar.
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Affiliation(s)
| | | | - Karl Peltzer
- Deputy Vice Chancellor Research and Innovation Office, North West University, Potchefstroom, South Africa
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Bastos TF, Medina LDPB, Sousa NFDS, Lima MG, Malta DC, Barros MBDA. Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22Suppl 02:E190015.SUPL.2. [PMID: 31596386 DOI: 10.1590/1980-549720190015.supl.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/19/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. OBJECTIVE To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. METHODS Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. RESULTS Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. CONCLUSION Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.
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Affiliation(s)
- Tássia Fraga Bastos
- Faculdade de Medicina São Leopoldo Mandic - Campinas (SP), Brazil.,Universidade Estadual de Campinas - Campinas (SP), Brazil
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Godoi H, Singh A, de Mello ALSF, Brennan DS, Peres MA. Area‐level social development and indicators of public dental services in Southern Brazil. Community Dent Oral Epidemiol 2019; 47:274-280. [DOI: 10.1111/cdoe.12455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 02/07/2019] [Accepted: 02/20/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Heloisa Godoi
- Post‐Graduation Program in DentistryFederal University of Santa Catarina Florianópolis Brazil
| | - Ankur Singh
- Centre for Health EquityMelbourne School of Population and Global HealthUniversity of Melbourne Melbourne Victoria Australia
| | | | - David S. Brennan
- Australian Research Centre for Population Oral Health (ARCPOH)The University of Adelaide Adelaide South Australia Australia
| | - Marco A. Peres
- Australian Research Centre for Population Oral Health (ARCPOH)The University of Adelaide Adelaide South Australia Australia
- Menzies Health Institute Queensland and School of Dentistry and Oral HealthGriffith University Gold Coast Queensland Australia
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Sousa JLD, Henriques A, Silva ZPD, Severo M, Silva S. Posição socioeconômica e autoavaliação da saúde bucal no Brasil: resultados da Pesquisa Nacional de Saúde. CAD SAUDE PUBLICA 2019; 35:e00099518. [DOI: 10.1590/0102-311x00099518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 02/06/2019] [Indexed: 11/22/2022] Open
Abstract
Resumo: Analisou-se a autoavaliação da saúde bucal da população adulta brasileira segundo a posição socioeconômica (região de residência, escolaridade, renda e classe social), explorando as variáveis com maior sensibilidade para medir tal associação. Estudaram-se 59.758 indivíduos com 18 anos ou mais de idade, que participaram da Pesquisa Nacional de Saúde 2013, um inquérito domiciliar de base populacional. A autoavaliação da saúde bucal (dentes e gengivas) foi analisada como positiva, regular e negativa. Com base na regressão logística multinomial, estimaram-se odds ratio (OR) brutos e ajustados e os respectivos intervalos de 95% de confiança (IC95%). Foram calculados os percentuais de concordância e o valor de kappa para comparar os valores obtidos pelos modelos de regressão e os valores esperados. A prevalência da autoavaliação da saúde bucal positiva foi 67,4%, 26,7% para regular e 5,9% para negativa. Após ajuste, a chance de autoavaliar a saúde bucal como negativa foi significativamente mais elevada entre os indivíduos com renda domiciliar per capita de até um salário mínimo (OR = 4,71; IC95%: 2,84-7,83), sem nível de escolaridade completo (OR = 3,28; IC95%: 2,34-4,61), da classe social destituídos de ativos (OR = 3,03; IC95%: 2,12-4,32) e residentes na Região Nordeste (OR = 1,50; IC95%: 1,19-1,89). Diversos indicadores de posição socioeconômica influenciam a percepção sobre a saúde bucal, mas a renda domiciliar per capita, a escolaridade e a classe social foram as responsáveis pelo maior gradiente na autoavaliação da saúde bucal de adultos no Brasil em 2013.
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Affiliation(s)
- Jailson Lopes de Sousa
- Instituto Brasileiro de Geografia e Estatística, Brasil; Universidade de São Paulo, Brazil
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NOGUEIRA JS, PEREIRA AC, FRIAS AC, AMBROSANO GMB, CORTELLAZZI KL, GUERRA LM, CAVALCANTE DDFB, BULGARELI JV. Social capital and factors associated with the caries experience in adults – a population-based study in Brazil. Braz Oral Res 2019; 33:e118. [DOI: 10.1590/1807-3107bor-2019.vol33.0118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/09/2019] [Indexed: 11/22/2022] Open
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Petti S. Elder neglect-Oral diseases and injuries. Oral Dis 2018; 24:891-899. [PMID: 29029370 DOI: 10.1111/odi.12797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 12/11/2022]
Abstract
Elder neglect (EN) is the failure of a designated caregiver to meet the needs of a dependent older person. World EN prevalence, meta-analyzed in this study, is 1.0% or 1.8% according to different statistical methods. Referring alleged EN cases to Adult Protective Services (APSs) by healthcare workers (HCWs) is mandatory in many countries. However, only few claims are substantiated, as EN could be confused with Self-Neglect, and neglect could be unintentional or due to caregiver unawareness. Screening tools are inaccurate, and their use is discouraged by public health organizations, because they lead to too many false positives, which engulf the already overwhelmed APSs. HCWs need effective tools with objective judgments, which do not hamper the HCW-caregiver-patient rapport and prevent lawsuits when allegations are unfounded. Orofacial EN manifestations (poor oral/denture hygiene, lack of needed/improper dentures, dry mouth, skin/mucosal rashes) are essential Forensic Markers of EN. I classified EN-associated oral diseases according to the unmet needs into four groups: (1) traumatic injuries due to lack of caregiver vigilance (e.g., maxillofacial fractures); (2) diseases due to oral hygiene deficiency (e.g., root caries); (3) diseases typical of the elderly with late/no diagnosis (e.g., oral cancer); and (4) diseases typical of the elderly exacerbated by psychological distress (e.g., oral lichen planus).
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Affiliation(s)
- S Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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