Self-perception of oral health in older adults from an urban population in Lisbon, Portugal

Assessment of treatment needs, barriers, and self-perception regarding oral health among female university students: a cross-sectional study

BACKGROUND

The study aimed to compare the self-perceived oral health status measured through a self-administered questionnaire with clinically determined oral health status measured by decayed-missing-filled teeth (DMFT) and community periodontal index of treatment need (CPITN) indices in university going females. In addition, access barriers to treatment related to oral healthcare were also determined.

METHODS

A 3-month analytical cross-sectional study was designed for consenting university going females (aged 18-22 years) in Islamabad, Pakistan. The self-perceived oral health was recorded through a questionnaire requesting information regarding socio-demographics, self-perception of oral health, frequency of dental visits and barriers to seeking oral health. Seven independent examiners performed intraoral clinical examination and assessed the oral health status using globally standardized oral health assessment indices (DMFT and CPITN).

RESULTS

A total of 400 students were included in the final sample. The study revealed a significant disparity between self-perceived oral health and clinical assessment. Although perceived oral health was considered "good" by 80.0% of the respondents, clinical examination revealed moderate DMFT scores (mean 2.95 ± 1.41) and periodontal disease requiring treatment in 89.5% of the individuals. The most common barriers in seeking dental care were lack of knowledge, dental phobia, affordability issue and false self-perception.

CONCLUSION

The present study demonstrated a notable discrepancy between self-perception of oral health and clinically assessed oral health. These results emphasize the importance of focused educational programs and community outreach programs, especially directed towards this demographic. Prioritizing such initiatives will help individuals to recognize their actual oral health condition thus encouraging positive oral health behaviors and outcomes.

Factors Associated with Self-reported Oral Health Among Community-Dwelling Older Adults in a Rural Province of Thailand

Background

Limited research has focused on self-reported oral health in older Thai individuals.

Objective

We explored the factors associated with self-reported oral health among older adults residing in rural Thailand.

Methods

This cross-sectional study included males and females aged ≥ 60 years living in Phon Thong district, Roi Et province, a rural area in northeast Thailand. This community-based study was conducted between May 2021 and December 2021. A trained interviewer administered a face-to-face interview questionnaire. Study data were analyzed using descriptive statistics, Pearson’s chi-squared test, and binary logistic regression.

Results

In total, 249 older individuals completed the interviews. Most study participants were aged ≥ 67 years (55.8%), with a mean age of 66.92 years. Pearson’s chi-squared test showed statistically significant associations between self-reported oral health and age (P = 0.035) and chewing ability (P = 0.005). The multivariate binary logistic regression analysis revealed significant associations between self-reported poor oral health and older age (AOR = 0.290, 95% CI: 0.091–0.925) and chewing discomfort (AOR = 4.032, 95% CI:1.119–14.56). We observed no significant associations between self-reported oral health and sex, toothbrushing frequency, and speaking ability.

Conclusion

Younger respondents with chewing discomfort were more likely to self-report poor oral health. In rural areas, nonprofessional health providers can use a single-item self-reported oral health question as a simple tool for evaluating oral health status in the elderly. Moreover, dental health education programs are needed to help older individuals improve their oral self-care, access dental services, and achieve appropriate oral function. Such programs are essential for promoting good oral health in this population, particularly among “younger” elders.

Functional dentition and associated factors

Studying the different indicators of functional dentition classification can contribute to the understanding of the associated factors, and thus help in the definition of strategies associated with oral health care. This approach has been little explored in the literature, especially when considering the older age group. Aim: The aim of this study is to evaluate the factors associated with three distinct functional dentition classification. Methods: Crosssectional exploratory study using secondary data from the Frailty in Older Brazilians (FIBRA) Project of 876 older adults living in Campinas, Brazil. The indicators of dental function assessed was number of natural teeth present, occluding pairs of teeth and the Eichner index, which were verified by trained dentists, following the World Health Organization criteria for epidemiological studies in oral health. The explanatory variable assessed was the selfperception of oral health-related quality of life measured by the Geriatric Oral Health Assessment Index (GOHAI) and its dimensions. It was also collected sociodemographic information such as age, gender, race/ethnicity, schooling, family income, smoking behavior and frailty status. The association was verified through Poisson regressions for number of teeth and pairs of teeth in occlusion and multinomial regression for the Eichner index, adjusted by sociodemographic and health variables. Results: Lower prevalence of participants with less than 21 teeth who negatively perceived GOHAI´s pain and discomfort dimension and higher prevalence of having less teeth among the ones that negatively perceived GOHAI´s physical and functional dimensions. No association was found between the perception of quality of life and occlusion pairs of teeth and the Eichner Index. Conclusion: Two out of three indicators assessed were associated with quality of life. Therefore, it is important to select sensitive indicators to be able to identify and better comprehend this relationship.

Oral Health Status of Adult Dysphagic Patients That Undergo Endoscopic Gastrostomy for Long Term Enteral Feeding

Background: Endoscopic Gastrostomy (PEG) is required to maintain a feeding route when neurological or cancer dysphagia impact oral intake. This study aimed to evaluate the oral health and oral changes of PEG-patients without oral feeding for three months. Methods: Prospective observational study, with a PEG-patients convenience sample. Data were obtained before PEG (T0) and 3 months after gastrostomy (T1). Initial oral hygiene habits were collected through a questionnaire. Intra-oral evaluation was performed using: Plaque Index (IP), Gingival Index (IG), Decayed, Missing and Filled Teeth Index (DMF), Community Periodontal Index (CPI), and Attachment Loss (AL). T0 and T1 were compared to evaluate oral health evolution. Results: Thirty-nine patients aged 65.3 ± 17.4 years were included. Initial (T0) oral health was worse than expectable. Between assessments period, oral indexes suffered a general deterioration with statistical relevance to the DMF. The frequency of deep periodontal pockets and attachment loss remained stable. Conclusions: PEG-patients presented poor oral health and insufficient oral hygiene habits, even before gastrostomy. After three months of PEG feeding, oral health suffered a general deterioration. This outcome was probably associated with the absence of oral feeding activity, which is beneficial to oral homeostasis, and further reduced oral hygiene. Improved oral daily care and dental appointments should become part of the PEG-patients follow-up.

Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals

Dental caries and periodontal disease represent a health problem and a social cost for the entire population, and in particular for socio-economically disadvantaged individuals who are less resistant to disease. The aim of this review is to estimate the prevalence and severity of the two dental pathologies, caries and periodontal disease, in the different classes of socio-economically disadvantaged subjects and to understand which of them are most affected. A systematic search of the literature was performed in MEDLINE (via PubMed), EMBASE and Web of Science after establishing a suitable search strategy for each database, using keywords related to socio-economically vulnerable classes and health outcomes. Socio-economically disadvantaged individuals are more susceptible to tooth decay and periodontal disease (with relative tooth loss) than non-vulnerable people. Additionally, when multiple vulnerabilities are combined in the same subject, these oral diseases worsen. There is no type of vulnerability more affected by caries and periodontitis than others, since overall they all have severe disease indices. The data from this systematic literature review might be useful for health policy makers looking to allocate more resources and services to socially disadvantaged individuals, resulting in making them more resilient to oral disease due to their social marginalization.

Self-perceived dental treatment need among adolescents: A hierarchical analysis

OBJECTIVES

The aim of the present study was to analyse the factors associated with self-perceived need for dental treatment among adolescents.

METHODS

A representative sample in the state of São Paulo, Brazil, comprising 5558 adolescents, was evaluated in 2015. The adolescents were selected by probabilistic sampling by conglomerates in two stages. The outcome evaluated was self-perceived treatment need measured via a validated questionnaire. Independent variables included sociodemographic factors, type, frequency and reason for last dental visit, and examination of oral conditions. Statistical analysis was based on the multiple hierarchical logistic regression model.

RESULTS

Of the total sample, 3340 (62.6%) adolescents reported needing dental treatment. After fitting the model, the self-perceived need for treatment was associated with adolescents with family income of up to $1,500 BRL (OR 1.39; [95% CI = 1.20-1.60]; P < .001), who sought dental services solely for curative treatment (OR 1.58; [95% CI = 1.46-1.72]; P < .001), reported toothaches in the previous six months (OR 2.88; [95% CI = 2.53-3.28]; P < .001), were dissatisfied with the appearance of their teeth and mouth (OR 5.94; [95% CI = 5.03-7.01]; P < .001), had caries in the posterior teeth only (OR 3.04; [95% CI = 2.77-3.33]; P < .001) or had caries in the anterior teeth (OR 4.75; [95% CI = 4.05-5.56]; P < .001).

CONCLUSIONS

The self-perceived need for dental treatment among Brazilian adolescents was associated with normative and subjective needs, and sociodemographic context factors. This finding provides important evidence for collective health planning.

Clinical and self-perceived oral health assessment of elderly residents in urban, rural, and institutionalized communities

OBJECTIVES

This study aims to evaluate the self-perception of oral health according to the physical, psychosocial and pain/discomfort dimensions related to clinical conditions and orofacial pain of elderly people living in three different environments.

METHODS

This was an observational, cross-sectional, quantitative study with a population-based approach and nonprobabilistic convenience sampling that included 81 elderly people: 27 resided in institutional homes for elderly individuals, 27 resided in an urban area and 27 resided in a rural area in the interior of Paraíba (PB) in northeastern Brazil.

RESULTS

The Geriatric Oral Health Assessment Index (GOHAI) was used to assess self-perception of oral health, while the Questionnaire for Screening of Patients with Temporomandibular Disorders (QST/TMD) was used to assess the influences of orofacial pain and the biofilm indexes of teeth and prostheses. There was a statistically significant difference in the GOHAI scores among the places of residence, with the worst values associated with the rural area. According to the QST/TMD, the majority of individuals were affected by TMDs, with statistical differences for both sex and income.

CONCLUSION

The biofilm analysis showed a higher incidence of clinical conditions in the rural population. The place of residence also influenced self-perception and the clinical oral health condition of elderly people; the rural population presented the worst results.