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Sadegh-Zadeh SA, Bagheri M, Saadat M. Decoding children dental health risks: a machine learning approach to identifying key influencing factors. Front Artif Intell 2024; 7:1392597. [PMID: 38952410 PMCID: PMC11215085 DOI: 10.3389/frai.2024.1392597] [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: 02/27/2024] [Accepted: 06/05/2024] [Indexed: 07/03/2024] Open
Abstract
Introduction and objectives This study investigates key factors influencing dental caries risk in children aged 7 and under using machine learning techniques. By addressing dental caries' prevalence, it aims to enhance early identification and preventative strategies for high-risk individuals. Methods Data from clinical examinations of 356 children were analyzed using Logistic Regression, Decision Trees, and Random Forests models. These models assessed the influence of dietary habits, fluoride exposure, and socio-economic status on caries risk, emphasizing accuracy, precision, recall, F1 score, and AUC metrics. Results Poor oral hygiene, high sugary diet, and low fluoride exposure were identified as significant caries risk factors. The Random Forest model demonstrated superior performance, illustrating the potential of machine learning in complex health data analysis. Our SHAP analysis identified poor oral hygiene, high sugary diet, and low fluoride exposure as significant caries risk factors. Conclusion Machine learning effectively identifies and quantifies dental caries risk factors in children. This approach supports targeted interventions and preventive measures, improving pediatric dental health outcomes. Clinical significance By leveraging machine learning to pinpoint crucial caries risk factors, this research lays the groundwork for data-driven preventive strategies, potentially reducing caries prevalence and promoting better dental health in children.
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Affiliation(s)
- Seyed-Ali Sadegh-Zadeh
- Department of Computing, School of Digital, Technologies and Arts, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Mahshid Bagheri
- Paediatric Dentistry, Population and Patient Health, King’s College London Dental Institute, London, United Kingdom
| | - Mozafar Saadat
- Department of Mechanical Engineering, School of Engineering, University of Birmingham, Birmingham, United Kingdom
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Nguyen TM, Lin C, Raichur A, Patterson A, Hall M, Aldrich R, Robinson S. Prioritizing population oral health through public policy in Australia: the Victorian experience. Health Promot Int 2023; 38:daad086. [PMID: 37555701 PMCID: PMC10411047 DOI: 10.1093/heapro/daad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Dental caries, a non-communicable disease, is one of the most prevalent diseases globally and share common modifiable risk factors with obesity such as excess sugar intake. However, prioritization by governments to improve population oral health has been limited and is typically excluded from the discourse of public health policy development. Therefore, interventions that target dental caries can have other co-benefits including obesity prevention. In Victoria, Australia, local government authorities have a regulatory requirement to develop their Municipal Health and Wellbeing Plans. The aim of this paper is to identify whether prioritization for oral health by local government authorities in Victoria has changed through the subsequent renewal of the Victorian Public Health and Wellbeing Plans 2011-2015 and 2019-2023. Three desktop audits for all publicly available Municipal Health and Wellbeing Plans by local government authorities in Victoria were conducted between 2014 and 2022. Key terms related to oral health was searched within these policy documents and categorized into six indicators: (i) included oral health as a priority, (ii) linked healthy eating and oral health, (iii) supported the Achievement Program, (iv) included the Smiles 4 Miles program, (v) advocated for fluoridated drinking water, and (vi) included other strategies related to oral health. Overall, there was statistically significant reduction in five of the six indicators, with the exception for prioritization of other strategies related to oral health such as targeting excess sugar intake and smoking. A multi-sectoral approach, that includes oral health would be advantageous to address the growing burden of non-communicable diseases.
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Affiliation(s)
- Tan Minh Nguyen
- Oral Health Economics Research Stream, Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Clare Lin
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Anil Raichur
- Community Based Health Services Policy & Improvement, Commisioning and System Improvement, Victorian Department of Health, State Government of Victoria, Melbourne, Victoria, Australia
| | - Amy Patterson
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Martin Hall
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | | | - Suzanne Robinson
- Oral Health Economics Research Stream, Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
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Najihah L, Wan Husin WZ, Marhazlinda J. Multivariable Projections of Caries-Free Prevalence and the Associated Factors from 2019 to 2030 among Schoolchildren Aged 6, 12 and 16-Year-Old in Malaysia. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1125. [PMID: 37508622 PMCID: PMC10378140 DOI: 10.3390/children10071125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 07/30/2023]
Abstract
This study identified caries-free associated factors and conducted multivariable projections of the caries-free prevalence until 2030 among six-, 12-, and 16-year-old schoolchildren in Malaysia. It was a secondary data analysis of caries-free prevalence and potential associated factors obtained from the Health Information Management System (HIMS), Department of Statistics Malaysia (DOSM), and Food Balance Sheets (FBS). Multiple linear regression and regression with ARMA errors were employed to determine the associated factors and predict the caries-free prevalence from 2019 or 2020 until 2030 for the six-, 12-, and 16-year-old groups, respectively. Gross Domestic Product (GDP) and household income, sugar consumption, and water fluoridation were significantly associated with caries-free status, with the most impactful in all age groups being water fluoridation. With the projected values of the associated factors, the caries-free prevalence in schoolchildren of all age groups in Malaysia is predicted to increase in the next decade. Similar to the past decade, the prevalence trend will remain the highest among the 12-year-olds and the lowest among six-year-olds. Caries-free prevalence was predicted to increase by 9.10%, 15.52%, and 15.10% in the six-, 12-, and 16-year-old groups, respectively. The prevalence multiplied the highest at four times greater than in the past ten years among 16-year-olds, compared with less than 2% in the six- and 12-year-old groups. In conclusion, by factoring in economic factors, sugar consumption, water fluoridation, and age groups, the caries-free prevalence of schoolchildren in Malaysia is projected to increase at different rates in the next decade until 2030. Thus, strategic oral health plans to recognise effective promotion programmes and strengthen others for each age group are crucial.
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Affiliation(s)
- Lokman Najihah
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Wan Zakiyatussariroh Wan Husin
- Mathematical Science Studies, College of Computing, Informatics and Media, Universiti Teknologi MARA Cawangan Kelantan, Machang 18500, Malaysia
| | - Jamaludin Marhazlinda
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
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Almaghaslah D, Almanasef M, Vasudevan R, Kandasamy G, Venkatesan K, Batool S, Alqadi KA, Alshehri RD, Alasmari SA. Community pharmacists' knowledge, attitude and practice of oral health care in Asir region, Kingdom of Saudi Arabia. Int J Dent Hyg 2021; 20:732-738. [PMID: 34689408 DOI: 10.1111/idh.12559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/05/2021] [Accepted: 10/20/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess community pharmacists' knowledge, attitude and practice towards oral health care in Asir region, Saudi Arabia. METHODS A prospective cross-sectional study was carried out using a self-administered structured questionnaire, targeting 254 community pharmacies across the Asir region. The questionnaire consisted of four domains: demographics, knowledge, attitudes and practice related to oral health care. Statistical analysis was performed using Social Sciences (SPSS) version 23.0. RESULTS Of the 254 pharmacists, 202 respondents completed the survey, yielding a response rate of 79.5%. Almost two-thirds (66%) of the community pharmacists exhibited good knowledge, 65% possessed a positive attitude, and 55% perceived a good practice towards oral health care. Pharmacists have shown a good understanding on dental care (p < 0.001) and oral conditions. Fifty-five per cent (n = 119) of pharmacists preferred to have dental-based subjects in Pharmacy curriculum. CONCLUSION Community Pharmacists possess overall good knowledge and attitude required for the provision of dental care counselling patients. They may participate in oral health development programmes to make a better practice.
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Affiliation(s)
- Dalia Almaghaslah
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Mona Almanasef
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Rajalakshimi Vasudevan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Krishnaraju Venkatesan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Sadia Batool
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Khawlah Awad Alqadi
- Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Rana Dhafer Alshehri
- Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
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Challenge and action of improving oral health inequities in the time of COVID-19 pandemic. J Formos Med Assoc 2021; 121:1024-1026. [PMID: 34548206 PMCID: PMC8445805 DOI: 10.1016/j.jfma.2021.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 12/19/2022] Open
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Bogale B, Engida F, Hanlon C, Prince MJ, Gallagher JE. Dental caries experience and associated factors in adults: a cross-sectional community survey within Ethiopia. BMC Public Health 2021; 21:180. [PMID: 33478460 PMCID: PMC7819221 DOI: 10.1186/s12889-021-10199-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 01/10/2021] [Indexed: 02/04/2023] Open
Abstract
Background Ethiopia is a developing sub-Saharan African country with increasing prevalence of non-communicable diseases (NCDs), including oral conditions. Oral health and dental care have been given little consideration, and there is limited information relating to population oral health and use of dental services in the country. The aim of this study was to examine the burden and associated factors of dental caries experience and investigate access to dental care amongst adults within Ethiopia. Methods This community-based oral health survey is a baseline study for the ASSET - Health System Strengthening in sub-Saharan Africa project undertaken in the Butajira area, south-central Ethiopia. A stratified random sample of households and individuals participated in the study. The survey instruments were mainly based on the WHO Oral Health Survey Methods manual (5th ed.). Face-to-face interviews and clinical dental examinations were conducted. The data were analysed for descriptive statistics; and Poisson regression models were built to assess the association of dental caries and predictor variables in adults (≥18 years). Results Most of the study population (n = 626) were female (63.9%), married (71.4%) and Muslim (76.0%). Just over half (53.2%) lived in rural areas and many (44.4%) had no formal education. A majority (74.0%) reported never utilising dental care services, and the main reason was never experiencing any dental problem (71.3%). Sixty percent (n = 377) of the adults had experienced dental caries, 88.0% (n = 332) of whom had untreated carious teeth. Pain or discomfort was reported by 16.5, and 7.2% had one or more PUFA component. Most (59.9%) adults with dental caries experience reported tooth pain or discomfort during the last year. In the fully adjusted Poisson regression model, increasing age, dental care utilisation and Khat chewing had positive significant associations with dental caries experience, whilst education status was negatively associated (p < 0.05). Conclusion This study demonstrated a high burden of dental caries and considerable consequences resulting from untreated disease in this population of adults. There was evidence of social inequity, limited utilisation of dental care and oral health awareness. This highlights the need for oral health system strengthening focusing on health promotion and expanding overall access to care. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10199-9.
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Affiliation(s)
- Birke Bogale
- Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, London, UK. .,Department of Dental and Maxillofacial Surgery, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - Fasikawit Engida
- Department of Dentistry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK.,College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, Ethiopia.,Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Martin J Prince
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK
| | - Jennifer E Gallagher
- Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, London, UK
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Tan YR, Tan EH, Jawahir S, Mohd Hanafiah AN, Mohd Yunos MH. Demographic and socioeconomic inequalities in oral healthcare utilisation in Malaysia: evidence from a national survey. BMC Oral Health 2021; 21:34. [PMID: 33468125 PMCID: PMC7816410 DOI: 10.1186/s12903-020-01388-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/28/2020] [Indexed: 11/15/2022] Open
Abstract
Background Throughout the years, oral healthcare utilisation in Malaysia has been low despite various efforts by the Ministry of Health Malaysia for improvement. This study aimed to determine the prevalence of oral healthcare utilisation and identify factors associated with oral healthcare utilisation among adults in Malaysia. Methods Secondary data analysis of adults aged 18 years and over from the National Health and Morbidity Survey 2019 was conducted in this study. Characteristics of respondents and those who utilised oral healthcare were described using complex sample descriptive statistics. Logistic regression analysis was performed to examine the association between the dependent and independent variables. Dependent variable was oral healthcare utilisation in the last 12 months. Independent variables were demographic and socioeconomic factors (predisposing, enabling and need characteristics) based on Andersen’s Behavioural Model. Results A total of 11,308 respondents, estimated to represent 21.7 million adults aged 18 years and over in Malaysia were included in the analysis. Prevalence of oral healthcare utilisation in the last 12 months was 13.2%. Demographic factors of sex, age, marital status, and socioeconomic factors of education level and occupation as well as health belief such as medical check-up were significantly related to oral healthcare utilisation. Enabling factor of household income quintile had significant association with oral healthcare utilisation. Inequalities were observed; females (OR = 1.57, 95% CI = 1.25, 1.96), younger adults (OR = 1.64, 95% CI = 1.15, 2.33), those who were married (OR = 1.65, 95% CI = 1.23, 2.22), those with higher education (OR = 2.21, 95% CI = 1.23, 3.99), those who had medical check-up in the last 12 months (OR = 1.86, 95% CI = 1.53, 2.25) and those with higher income (OR = 1.43, 95% CI = 1.04, 1.96) were more likely to utilise oral healthcare. Conclusion Understanding factors associated with utilisation of oral healthcare could help in formulating effective interventions to improve oral healthcare utilisation. Demographic and socioeconomic factors are strong determinants of oral healthcare utilisation in Malaysia. Appropriate interventions to strengthen the existing programmes aimed to promote regular and timely oral health check-ups are needed to improve oral healthcare utilisation.
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Affiliation(s)
- Yeung R'ong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Ee Hong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Suhana Jawahir
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Ainul Nadziha Mohd Hanafiah
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Muhammad Hafiz Mohd Yunos
- Tengkawang Dental Clinic, Terengganu Health Department, Ministry of Health Malaysia, 21700 Hulu Terengganu, Terengganu, Malaysia
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Gaio DC, Bastos FI, Moysés SJ, Moysés ST, Corrêa da Mota J, Nicolau B, Ignacio S, Cubas MR, Tozetto Vettorazzi ML, Gonçalves Dos Santos ZFD, Werneck RI. Assessing oral health of crack users in Brazil: Perceptions and associated factors, findings from a mixed methods study. Glob Public Health 2020; 16:502-516. [PMID: 32912074 DOI: 10.1080/17441692.2020.1809693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study explores associated factors and perceptions of oral health among crack users recruited in open drug scenes in Brazil. A mixed methods approach was used. The quantitative component analysed findings from a large (N = 7381), population-based survey. The outcomes under analysis were 'self-perception of oral health' and 'self-reporting of problems affecting the mouth, teeth and gingiva (gums)'. The qualitative component comprised a focus group, with 12 individuals recruited from a drug treatment clinic. Lower self-perception of oral health problems vis-à-vis a higher prevalence of problems affecting the mouth, teeth, and gingiva were found in users who had a lower level of education, used substances daily, had worse self-perception of physical health, did not receive health care and regularly used alcohol and/or tobacco. The results show an association between substance use and decline in oral health, as well as the lack of health services focusing on such issues. Oral health services should be emphasised as a gateway to the health system. So far, the putative cross-referral between services and professionals working in oral health and other health professionals working in the field of drug dependence has not been observed.
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9
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Bergeron DA, Talbot LR, Gaboury I. Oral Health Status of Schoolchildren Living in Remote Rural Andean Communities: A Cross-Sectional Study. J Int Soc Prev Community Dent 2020; 10:156-162. [PMID: 32670903 PMCID: PMC7339992 DOI: 10.4103/jispcd.jispcd_438_19] [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: 10/28/2019] [Revised: 12/29/2019] [Accepted: 01/06/2020] [Indexed: 11/04/2022] Open
Abstract
Objective Oral health promotion (OHP) was introduced in Peruvian primary schools in 2013, and no evaluation has been undertaken in rural areas since then. To measure OHP outcomes, this cross-sectional study aimed to assess the oral health (OH) status of schoolchildren living in a remote rural area of the Cusco region. Materials and methods Sixty-six children were recruited in three remote rural communities and in a rural district capital. Six dimensions of OH (knowledge, attitudes, behaviors, dental plaque, dental caries, and quality of life related to OH) were measured using self-administered questionnaires and dental examinations. Wilcoxon-Mann-Whitney tests were conducted to compare outcomes between two types of settings (remote rural community and district capital). Multiple linear regression models were fit to identify which variables can explain the variance observed in the decayed, missing, and filled teeth (DMFT) index. Results The median percentage of dental plaque in remote rural communities was 78.7+ (interquartile range [IQR] 71.5-82.8) and 78.6+ (IQR 72.7-82.2) in the district capital (P = 0.90). The prevalence of dental caries was estimated to be 94.1+ (95+ confidence interval [CI] 71.1->99.9) in the district capital and 98.0+ (95+ CI 88.3->99.9) in remote rural communities (P = 0.43). Conclusion These results suggested that OHP interventions had not reached their full potential. Identifying different factors that influence the reported outcomes would provide a more comprehensive understanding and help to tailor OHP interventions.
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Affiliation(s)
- Dave A Bergeron
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.,Department of Nursing, Université du Québec à Rimouski, Rimouski, Québec, Canada
| | - Lise R Talbot
- School of Nursing, Université de Sherbrooke, Sherbrooke, Longueuil, Québec, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
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Bergeron DA, Talbot LR, Gaboury I. Intersectoral oral health promotion interventions for schoolchildren living in remote rural Andean communities: a realist evaluation. Glob Health Promot 2019; 27:103-112. [PMID: 31818189 DOI: 10.1177/1757975919870160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Intersectoral oral health promotion entails the participation of local communities. IOHP interventions were introduced in Peru in primary schools in 2013 but oral health among schoolchildren living in rural Andean communities remains suboptimal. OBJECTIVES To understand the contextual elements and the underlying mechanisms associated with intersectoral oral health promotion interventions' current effects on schoolchildren living in remote rural Andean communities. METHOD A realist evaluation was carried out in three rural Andean communities where intersectoral oral health promotion interventions aimed at schoolchildren have been implemented. Following an evaluation of the effects among schoolchildren, contextual elements and mechanisms were explored with various stakeholders involved in intersectoral oral health promotion through focus groups and semi-structured interviews. Subsequently, an iterative data analysis and a validation process resulted in the identification of context-mechanism configurations. RESULTS Previous positive experiences of collaboration, a focus on communication, feelings of being respected and considered, and development of leadership and trust among stakeholders involved in intersectoral oral health promotion were elements of configurations that positively influence intersectoral oral health promotion. On the other hand, unfavorable physical, social and political environments, previous negative health experiences, feelings of not being respected or considered, demotivation, development of mistrust and insufficient leadership were shown to negatively influence outcomes. CONCLUSION This research highlights the complexity associated with the deployment of intersectoral oral health promotion interventions in rural communities. Local stakeholders should be further involved to build trust, to facilitate coordination processes among remote rural communities and oral health professionals, and to optimize deployment of intersectoral oral health promotion interventions.
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Affiliation(s)
- Dave A Bergeron
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.,Department of Nursing, Université du Québec à Rimouski, Rimouski, Québec, Canada
| | - Lise R Talbot
- School of Nursing, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
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Santos J, Antunes L, Namorado S, Kislaya I, João Santos A, Rodrigues AP, Braz P, Gaio V, Barreto M, Lyshol H, Nunes B, Matias Dias CM. Oral hygiene habits in Portugal: results from the first Health Examination Survey (INSEF 2015). Acta Odontol Scand 2019; 77:334-339. [PMID: 30712422 DOI: 10.1080/00016357.2018.1564839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Oral health is a determinant for quality of life and preventive behaviours such as regular tooth brushing can reduce the risk of a wide spectrum of oral diseases. Adopting preventive behaviours increases the likelihood of being healthy and can be conditioned by demographic and socio-economic factors. OBJECTIVE This study aims to describe preventive oral hygiene behaviours in the Portuguese population and assess their association with sociodemographic and socioeconomic factors. MATERIAL AND METHODS A cross-sectional epidemiologic study was developed using data from the first Portuguese National Health Examination Survey. The target population comprised Portuguese community-dwelling residents aged between 25 and 74 years old. The percentage of individuals who brushed their teeth at least twice a day, provided that once was before sleeping, was considered the indicator showing a preventive behaviour, as this is recommended by the General Directorate of Health in Portugal. Poisson regression was used to identify factors independently associated with this behaviour. RESULTS Sixty-five per cent of the participants reported tooth brushing as recommended. The prevalence of adoption of this preventive behaviour was higher among those living in urban areas and those who have higher educational level. Results show an association between being male and having low educational level with lesser adoption of preventive oral health behaviours. CONCLUSION These findings suggest a need for integrated approaches, from measures tackling social inequalities to actions focused on improving health literacy. It is also important to expand dental healthcare services and improve effective coverage to increase access for rural population.
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Affiliation(s)
- Joana Santos
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Liliana Antunes
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Sónia Namorado
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Irina Kislaya
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana João Santos
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ana Paula Rodrigues
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Paula Braz
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Vânia Gaio
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Marta Barreto
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Heidi Lyshol
- Norwegian Institute of Public Health, Oslo, Norway
| | - Baltazar Nunes
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Carlos Manuel Matias Dias
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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Momeni Z, Sargeran K, Yazdani R, Shahbazi Sighaldeh S. Perceived barriers to the preservation and improvement of children's oral health among Iranian women: a qualitative study. Eur Arch Paediatr Dent 2018; 20:95-103. [PMID: 30523583 DOI: 10.1007/s40368-018-0395-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
AIM To explore perceptions of Iranian mothers regarding barriers to preserving and improving oral health among their children. METHODS The present qualitative study was part of a larger sequential exploratory mixed-method study conducted in Tehran, Iran, from April to May 2015. Data were collected via 10 focus group discussions and semi-structured interviews to gain an understanding of the perception held by the mothers of school-aged children about barriers to oral health improvement. Sampling was purposive and was continued until data saturation was reached. The study population consisted of 58 Iranian women who had at least one child in school. Data were analysed using conventional content analysis. RESULTS Three key themes of oral health barriers were identified as follows: (1) barriers in the system or at the organisational level, (2) barriers at the provider level, and (3) barriers at the family level. Informants reported cost, lack of full-coverage insurance, low access to dental services, and fear and anxiety as the main barriers. CONCLUSIONS The major barriers to oral health care were fear and the cost of dental treatments. These predictors need to be addressed when designing programs to increase access of children to dental services.
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Affiliation(s)
- Z Momeni
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - K Sargeran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. .,Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - R Yazdani
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - S Shahbazi Sighaldeh
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Goldman A, Leal SC, de Amorim RG, Frencken JE. Treating High-Caries Risk Occlusal Surfaces in First Permanent Molars through Sealants and Supervised Toothbrushing: A 3-Year Cost-Effective Analysis. Caries Res 2017; 51:489-499. [DOI: 10.1159/000477822] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 05/26/2017] [Indexed: 11/19/2022] Open
Abstract
We conducted a 3-year cost-effectiveness analysis on the cavitated dentine carious lesion preventive capabilities of composite resin (CR) (reference group) and atraumatic restorative treatment (ART) high-viscosity glass-ionomer cement (HVGIC) sealants compared to supervised toothbrushing (STB) in high-risk first permanent molars. School children aged 6-7 years in 6 schools (2 per group) received CR and ART/HVGIC sealants or STB daily for 180 days each school year. Data were collected prospectively and cost estimates were made for sample data and a projection of 1,000 sealants/STB high-risk permanent molars. Although STB had the best outcome, its high implementation cost (95% of cost for supervisors visiting schools 180 days/school year) affected the results. ART/HVGIC was cost-effective compared to CR for the sample data (savings of USD 37 per cavitated dentine carious lesion prevented), while CR was cost-effective compared to ART/HVGIC for the projection (savings of USD 17 per cavitated dentine carious lesion prevented), and both were cost-saving compared to STB. Two STB scenarios were tested in sensitivity analyses with variations in caries incidence and number of supervision days; results showed STB had lower costs and higher savings per cavitated dentine carious lesion prevented than CR and ART/HVGIC. A major assumption is that both scenarios have the same high effectiveness rate experienced by STB under study conditions; however, they point to the value of further research on the benefits of adopting STB as a long-term venture in a general population of school children.
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Bergeron DA, Talbot LR, Gaboury I. Realist evaluation of intersectoral oral health promotion interventions for schoolchildren living in rural Andean communities: a research protocol. BMJ Open 2017; 7:e014531. [PMID: 28237962 PMCID: PMC5337730 DOI: 10.1136/bmjopen-2016-014531] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/20/2016] [Accepted: 01/25/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Intersectoral collaboration, known to promote more sustainable change within communities, will be examined in an oral health promotion program (OHPP). In Peru, an OHPP was implemented by the Ministry of Health, to reduce the incidence of caries in schoolchildren. In rural Andean communities, however, these initiatives achieved limited success. The objectives of this project are: (1) to understand the context and the underlying mechanisms associated with Peruvian OHPP's current effects among school children living in rural Andean communities and (2) to validate a theory explaining how and under which circumstances OHP intersectoral interventions on schoolchildren living in rural Andean communities produce their effects. METHODS AND ANALYSIS Through a realist evaluation, the context, underlying mechanisms and programme outcomes will be identified. This process will involve five different steps. In the first and second steps, a logic model and an initial theory are developed. In the third step, data collection will permit measurement of the OHHP's outcomes with quantitative data, and exploration of the elements of context and the mechanisms with qualitative data. In the fourth and fifth steps, iterative data analysis and a validation process will allow the identification of Context-Mechanism-Outcome configuration, and validate or refine the initial theory. ETHICS AND DISSEMINATION This research project has received approval from the Comité d'éthique de la recherche en santé chez l'humain du Centre hospitalier universitaire de Sherbrooke. The initial theory and research results will be published in relevant journals in public health and oral health. They will also be presented at realist evaluation and health promotion international conferences.
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Affiliation(s)
- Dave A Bergeron
- Department of Health Research Programs, Faculty of Medicine and Health Sciences,Université de Sherbrooke, Longueuil, Québec, Canada
- Department of Nursing, Université du Québec à Rimouski, Rimouski, Québec, Canada
| | - Lise R Talbot
- School of Nursing, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences,Université de Sherbrooke, Longueuil, Québec, Canada
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Sheiham A, Williams DM, Weyant RJ, Glick M, Naidoo S, Eiselé JL, Selikowitz HS. Billions with oral disease: A global health crisis--a call to action. J Am Dent Assoc 2017; 146:861-4. [PMID: 26610819 DOI: 10.1016/j.adaj.2015.09.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 09/22/2015] [Indexed: 11/26/2022]
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Silveira AD, Moysés SJ, Kusma SZ, Moysés ST. Potential effectiveness of strategies to promote oral health in primary health care: comparative study among Brazilian capitals and regions. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 19:851-865. [PMID: 28146173 DOI: 10.1590/1980-5497201600040014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/31/2016] [Indexed: 11/21/2022] Open
Abstract
Objective: To evaluate the potential effectiveness of strategies of Oral Health Promotion (OHP), which are carried out by teams in primary health care (PHC) in Brazilian capitals and regions. Methods: A sample of 1,848 dentists were interviewed (1,819 valid responses) working in the PHC of 26 capitals and the Federal District. The Effectiveness of the Assessment Tool for the Promotion of Oral Health Strategies was used. It is composed of 23 indicators grouped into three dimensions: oral health, health public policies, and human and social development. The answers were arranged in a Likert scale (1-5), and the final score obtained for each sample unit can range from 23 to 115. Higher score values indicate greater potential for the strategy to promote oral health. Results: Statistically significant differences were identified among the analyzed geopopulation units considering the study object. The Southeast and South regions had better performance for the OHP strategies in comparison to the other regions of Brazil (p ≤ 0.01). Conclusions: The OHP strategies identified in the study were heterogeneous, with better results favoring the Southeast regions, with disadvantages for people living in capitals from the Central-North-Northeast of Brazil. Efforts should be undertaken aiming to qualify the PHC teams, especially for those in disadvantageous regions. Therefore, an alignment of PSB strategies to the principles and values of health promotion is required, addressed to the social health determinants (SHDs) and in order to fight the inequalities in oral health.
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Paula JS, Lisboa CM, Meneghim MDC, Pereira AC, Ambrosano GMB, Mialhe FL. School performance and oral health conditions: analysis of the impact mediated by socio-economic factors. Int J Paediatr Dent 2016; 26:52-9. [PMID: 25752583 DOI: 10.1111/ipd.12158] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral problems can cause strong impact on functional, emotional, and social aspects of children and adolescents, as well as changes in school performance. AIM To evaluate the associations of subjective perceptions of parents, socio-economic factors, and oral clinical conditions of children with their school performance. DESIGN A case-control design was used with a sample of 1411 schoolchildren aged 8-10 years from city of Piracicaba, São Paulo, Brazil. Clinical conditions were evaluated using the DMFT and dmft indexes. Socio-economic data were obtained using a questionnaire sent to schoolchildren's parents. School performance was evaluated by the final scores of each schoolchild at the end of the 2011 school year. RESULTS According to the final logistic regression model, the schoolchildren who had carious lesions and underwent curative dental treatment at the beginning of the academic year presented 1.51 more chance of having low performance compared with schoolchildren who had no caries lesions. In addition, socio-economic and demographic variables were associated with a greater chance of poor school performance. CONCLUSION Socio-economic factors and presence of caries lesions, even if treated, were risk indicators for poor school performance.
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Affiliation(s)
- Janice Simpson Paula
- Department of Community Dentistry, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Cristina Martins Lisboa
- Department of Community Dentistry, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Antônio Carlos Pereira
- Department of Community Dentistry, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Fábio Luiz Mialhe
- Department of Community Dentistry, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
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Cunningham TJ, Eke PI, Ford ES, Agaku IT, Wheaton AG, Croft JB. Cigarette Smoking, Tooth Loss, and Chronic Obstructive Pulmonary Disease: Findings From the Behavioral Risk Factor Surveillance System. J Periodontol 2015; 87:385-94. [PMID: 26537367 DOI: 10.1902/jop.2015.150370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Cigarette smoking and tooth loss are seldom considered concurrently as determinants of chronic obstructive pulmonary disease (COPD). This study examines the multiplicative effect of self-reported tooth loss and cigarette smoking on COPD among United States adults aged ≥18 years. METHODS Data were taken from the 2012 Behavioral Risk Factor Surveillance System (n = 439,637). Log-linear regression-estimated prevalence ratios (PRs) are reported for the interaction of combinations of tooth loss (0, 1 to 5, 6 to 31, or all) and cigarettes smoking status (never, former, or current) with COPD after adjusting for age, sex, race/ethnicity, marital status, educational attainment, employment, health insurance coverage, dental care utilization, and diabetes. RESULTS Overall, 45.7% respondents reported having ≥1 teeth removed from tooth decay or gum disease, 18.9% reported being current cigarette smokers, and 6.3% reported having COPD. Smoking and tooth loss from tooth decay or gum disease were associated with an increased likelihood of COPD. Compared with never smokers with no teeth removed, all combinations of smoking status categories and tooth loss had a higher likelihood of COPD, with adjusted PRs ranging from 1.5 (never smoker with 1 to 5 teeth removed) to 6.5 (current smoker with all teeth removed) (all P <0.05). CONCLUSIONS Tooth loss status significantly modifies the association between cigarette smoking and COPD. An increased understanding of causal mechanisms linking cigarette smoking, oral health, and COPD, particularly the role of tooth loss, infection, and subsequent inflammation, is essential to reduce the burden of COPD. Health providers should counsel their patients about cigarette smoking, preventive dental care, and COPD risk.
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Affiliation(s)
- Timothy J Cunningham
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Paul I Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Earl S Ford
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Israel T Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
| | - Anne G Wheaton
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Janet B Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Kramer PF, Chaffee BW, Bertelli AE, Ferreira SH, Béria JU, Feldens CA. Gains in children's dental health differ by socioeconomic position: evidence of widening inequalities in southern Brazil. Int J Paediatr Dent 2015; 25:383-92. [PMID: 25323949 PMCID: PMC4401627 DOI: 10.1111/ipd.12140] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
UNLABELLED Oral health inequalities are the measures by which equity in oral health is tracked. Despite widespread improvement in children's dental health globally, substantial socio-economic disparities persist and may be worsening. OBJECTIVES Quantify 10-year changes in child caries occurrence by socio-economic position in a Southern Brazilian city and compare oral health inequalities over time. METHODS Representative surveys of dental caries in children (age <6 years) in Canoas, Brazil, were conducted in 2000 and 2010 following standardized methods. For each survey year, we calculated disparities by socio-economic position (maternal education and family income) in age- and sex-standardized caries occurrence (prevalence: dmft > 0; severity: mean dmft) using absolute measures (difference and Slope Index of Inequality) and relative measures (ratio and Relative Index of Inequality). RESULTS Comparing 2010 to 2000, caries occurrence was lower in all socio-economic strata. However, reductions were more pronounced among socio-economically advantaged groups, yielding no improvement in children's oral health disparities. Some disparity indicators were consistent with increasing inequality. CONCLUSIONS Overall, dental caries levels among children in Canoas improved, but inequalities in disease distribution endured. Concerted public health efforts targeting socio-economically disadvantaged groups are needed to achieve greater equity in children's oral health.
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Affiliation(s)
| | - Benjamin W. Chaffee
- Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, United States
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Cunha MAGDM, Lino PA, Santos TRD, Vasconcelos M, Lucas SD, Abreu MHNGD. A 15-Year Time-series Study of Tooth Extraction in Brazil. Medicine (Baltimore) 2015; 94:e1924. [PMID: 26632688 PMCID: PMC5058957 DOI: 10.1097/md.0000000000001924] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Tooth loss is considered to be a public health problem. Time-series studies that assess the influence of social conditions and access to health services on tooth loss are scarce.This study aimed to examine the time-series of permanent tooth extraction in Brazil between 1998 and 2012 and to compare these series in municipalities with different Human Development Index (HDI) scores and with different access to distinct primary and secondary care.The time-series study was performed between 1998 and 2012, using data from the Brazilian National Health Information System. Time-series study was performed between 1998 and 2012. Two annual rates of tooth extraction were calculated and evaluated separately according to 3 parameters: the HDI, the presence of a Dental Specialty Center, and coverage by Oral Health Teams. The time-series was analyzed using a linear regression model.An overall decrease in the tooth-loss tendencies during this period was observed, particularly in the tooth-extraction rate during primary care procedures. In the municipalities with an HDI that was lower than the median, the average tooth-loss rates were higher than in the municipalities with a higher HDI. The municipalities with lower rates of Oral Health Team coverage also showed lower extraction rates than the municipalities with higher coverage rates.In general, Brazil has shown a decrease in the trend to extract permanent teeth during these 15 years. Increased human development and access to dental services have influenced tooth-extraction rates.
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Affiliation(s)
- Maria Aparecida Goncalves de Melo Cunha
- From the Centro Universitário Newton Paiva, Av. Silva Lobo, 1718, Belo Horizonte, Minas Gerais, Brazil (MAGMC); and Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, Brazil (PAL, TRS, MV, SDL, MHNGA)
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22
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Medina-Solís CE, Pontigo-Loyola AP, Pérez-Campos E, Hernández-Cruz P, Ávila-Burgos L, Kowolik MJ, Maupomé G. Association between edentulism and angina pectoris in Mexican adults aged 35 years and older: a multivariate analysis of a population-based survey. J Periodontol 2013; 85:406-16. [PMID: 23895250 DOI: 10.1902/jop.2013.130186] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The possible association between oral infection and chronic inflammation and cardiovascular disease risk has been studied intensively. The present study is designed to determine the strength of association between edentulism and angina pectoris in Mexican adults aged 35 years and older. METHODS Using the tools and sampling strategies of the World Health Survey of the World Health Organization, cross-sectional data were collected in Mexico in the National Performance Assessment Survey (probabilistic, multistage, and cluster sampling). Dental information was available for 20 of the 32 states of Mexico. Angina and edentulism are self-reported in this study. Statistical analysis was performed using binary logistic regression adjusting for complex samples. RESULTS A total of 13,966 participants, representing a population of 29,853,607 individuals, were included. Of the complete study population, 3,052,263 (10.2%) were completely toothless, and 673,810 (2.3%) were diagnosed with angina pectoris. After adjusting for smoking, alcohol consumption, diabetes, body mass index, and sex, the effect of edentulism on angina was modified by age (interaction), being more marked in the younger age group (odds ratio [OR] = exp(2.5597) =12.93) than in the older individuals surveyed (OR = exp(2.5597 + (-0.0334)) =12.51). Additionally, low physical activity (OR = 1.51; 95% confidence interval [CI] = 1.03 to 2.22) and higher socioeconomic status (OR = 1.37; 95% CI = 1.00 to 1.90) were more likely to be associated with angina pectoris. CONCLUSIONS Overall, the results of this study, conducted in a representative sample of Mexican adults, suggest that an association exists between edentulism and angina pectoris. Additional studies are necessary to elucidate the underlying mechanism for this association.
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Affiliation(s)
- Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico
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