1
|
Paljević E, Brekalo Pršo I, Vidas Hrstić J, Božac E, Pezelj-Ribarić S, Peršić Bukmir R. Healing of apical periodontitis in type II diabetes mellitus patients: A prospective study. Oral Dis 2024; 30:3422-3430. [PMID: 37846439 DOI: 10.1111/odi.14772] [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] [Received: 08/31/2023] [Revised: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE This study aimed to compare the healing of periapical bone between type II diabetes patients and healthy patients after root canal treatment. SUBJECTS AND METHODS This study included 26 diabetic patients and the control group with healthy patients matching the diabetic group in age and sex. The study included only teeth with satisfactory coronal restoration. The periapical index system was used to evaluate the periapical status of treated teeth at follow-ups after 6 and 12 months. RESULTS Analysis of the results revealed a significantly higher healing rate in the control group compared to the diabetic group only at the 6-month follow-up (66.6 vs. 33.3%; Χ2 = 4.857; p = 0.0275). Analysis of the full-scale PAI index disclosed significantly higher PAI values in the diabetic subjects at 6- and 12-month follow-up. The regression analysis showed that the risk of apical periodontitis persistence increased significantly with female gender (OR = 3.92; 95% CI = 1.04-14.79; p = 0.043), diabetes mellitus (OR = 4.27; 95% CI: 1.18-15.50; p = 0.027) and higher household income (OR = 5.39; 95% CI = 1.33-21.89; p = 0.018). CONCLUSION Root canal treatment remains an effective means of conservative treatment in diabetic patients. While the healing is not compromised, regular follow-ups are necessary to monitor the healing process.
Collapse
Affiliation(s)
- Ema Paljević
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ivana Brekalo Pršo
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Jelena Vidas Hrstić
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Elvis Božac
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Sonja Pezelj-Ribarić
- Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Oral Medicine, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Romana Peršić Bukmir
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| |
Collapse
|
2
|
AlHumaid GA, Alshehri T, Alwalmani RM, Alsubaie RM, Alshehri AD, Aljoghaiman E, Gaffar B. Assessment of Oral Health Status and Pregnancy Outcomes Among Women in Saudi Arabia. Patient Prefer Adherence 2024; 18:1027-1038. [PMID: 38826504 PMCID: PMC11141704 DOI: 10.2147/ppa.s456721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/23/2024] [Indexed: 06/04/2024] Open
Abstract
Purpose Pregnant women witness many changes in the body as well as in the oral cavity with many factors influencing these changes. This study evaluated the relationship between oral health status, perceptions, and pregnancy outcomes. Methods A cross sectional study design was implemented to recruit a convenience sample of women attending Obstetrics and gynecology department in public hospitals in East and capital city of Saudi Arabia. To collect data, a validated self-administered questionnaire in English and Arabic was used. The questionnaire covered background information, perceived oral health status, and dental visits. Results About 64.4% of the 481 women recruited had dental problems, 49.7% reported deterioration in their oral health during pregnancy, and 17.5% reported adverse pregnancy outcomes. Only 40.7% of pregnant women rated their oral health as good, and only 22% visited a dentist during their pregnancy. Dentists were the most common source of oral health information (44.1%), followed by social media (38.9%). Dental problems during pregnancy were significantly associated with adverse outcomes (P=0.007). Oral health perceptions of pregnant women, not visiting the dentist during pregnancy, and gingival problems were also significantly associated with adverse pregnancy outcomes (P=0.001). Those with fair to poor oral health were twice as likely to experience adverse pregnancy outcome. Those who intended to visit the dentist during their pregnancy but did not do so, as well as those who did not visit the dentist at all were 12 and 9 times more likely to experience adverse pregnancy outcomes respectively. Conclusion Dental complaints during pregnancy, oral health perceptions, and a lack of dental visits were all linked to increased likelihood of adverse pregnancy outcomes. There is a need for interprofessional collaboration to dispel myths and encourage oral health care and regular dental visits during pregnancy.
Collapse
Affiliation(s)
| | - Turki Alshehri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | | | - Eman Aljoghaiman
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Balgis Gaffar
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
3
|
Zwick L, Schmitz N, Shojaa M. Oral health-related quality of life and depressive symptoms in adults: longitudinal associations of the English Longitudinal Study of Ageing (ELSA). BMC Oral Health 2023; 23:1029. [PMID: 38124069 PMCID: PMC10734100 DOI: 10.1186/s12903-023-03722-4] [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] [Received: 06/09/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Little is known about the relationship between oral health status and depressive symptoms in adults in England. The aim of this study was to examine the longitudinal association between oral health parameters and depressive symptoms in adults in England. METHODS Data were obtained from the English Longitudinal Study of Aging (ELSA), which included information on self-rated oral health, oral impairment in daily life (Oral Impacts on Daily Performances, OIDP), and depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) in 6790 adults aged ≥ 50 years. Wave 3 data were used as baseline, while Waves 5 and 7 were used for follow-up assessments. Logistic regression was used to determine whether depressive symptoms at baseline anticipated self-rated oral health and OIDP and whether oral health status (at baseline) was associated with the development of depressive symptoms at follow-up assessment. RESULTS Participants with poor self-rated oral health were at higher risk of developing depressive symptoms, even after adjusting for behavioral, clinical, and sociodemographic characteristics (OR = 1.69, 95% CI 1.38-2.07). Similarly, having oral impacts on daily performances were associated with the development of depressive symptoms: The OR for developing depressive symptoms at Wave 5 or 7 was 2.19 (95% CI 1.62-2.96) after adjustment for all covariates. Participants with depressive symptoms at baseline were more likely to report poor self-rated oral health (OR = 1.93, 95% CI 1.52-2.44) or one or more oral impacts (OR = 1.86, 95% CI 1.45-2.40) at follow-up than those without depressive symptoms at baseline, even after adjusting for confounders. CONCLUSIONS In the present study, a bidirectional association was found between depressive symptoms and poor oral health in older adults. Maintaining good oral health in older adults may be a protective factor against depressive symptoms. Therefore, more attention should be paid to promoting oral health awareness in older adults, including encouraging regular dental checkups, proper toothbrushing and flossing techniques, and healthy lifestyles.
Collapse
Affiliation(s)
- Luisa Zwick
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany
| | - Norbert Schmitz
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany
| | - Mahdieh Shojaa
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany.
| |
Collapse
|
4
|
Moltubakk SN, Jönsson B, Lukic M, Stangvaltaite-Mouhat L. The educational gradient in dental caries experience in Northern- Norway: a cross-sectional study from the seventh survey of the Tromsø study. BMC Oral Health 2023; 23:779. [PMID: 37875913 PMCID: PMC10594764 DOI: 10.1186/s12903-023-03487-w] [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] [Received: 05/08/2023] [Accepted: 10/04/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Although, studies from Norway indicate a reduction in dental caries experience, in Northern-Norway this non-communicable oral condition is still prevalent. There is conflicting evidence of presence of social inequalities in dental caries in an adult population. Therefore, the aim of this study was to assess an association between educational level and dental caries experience in adults in urban Tromsø municipality, Northern-Norway, using The World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) framework of health determinants. METHODS Data from 3752 participants having recorded dental caries status and educational level in the seventh survey of the Tromsø Study: Tromsø7 were included. Dental status was examined clinically as decayed-, missing-, filled-teeth (DMFT score). For statistical analyses DMFT score was grouped into lower (DMFT < 19) and higher (DMFT ≥ 20). Educational level was obtained from a questionnaire and categorized as primary/partly secondary education, upper secondary education, tertiary education, short and tertiary education, long. Data on social and intermediary determinants was also self-reported. Univariable and multivariable binary logistic regression analyses were applied. RESULT This study included 1939 (52%) women and the mean age of the participants was 57.11. The mean DMFT score was 18.03. The odds of having higher DMFT score followed a gradient based on educational level. Participants who reported lower than secondary education had 2.06 -fold increased odds of having higher DMFT score than those with tertiary education, long (OR: 2.06, 95% CI: 1.50-2.83). Those with upper secondary education had 60% higher odds of having higher DMFT score (OR: 1.60, 95% CI: 1.21-2.11), and those with tertiary education, short had 66% higher odds of having higher DMFT score (OR: 1.66, 95% CI: 1.24-2.22). CONCLUSION The current cross-sectional study suggested an educational gradient in dental caries experience in an adult population of Northern- Norway. Further studies validating our results and investigating mechanisms of educational inequalities in oral health are warranted.
Collapse
Affiliation(s)
- Silje Navjord Moltubakk
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marko Lukic
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | |
Collapse
|
5
|
Borgeat M, Espinoza I, Navarro K, Carvajal C, Carvajal P. Inequalities by sex on remaining teeth in adults: A decomposition analysis. Community Dent Oral Epidemiol 2023. [PMID: 37235482 DOI: 10.1111/cdoe.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 05/06/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To identify which social determinants of health explain the gap in the remaining teeth between men and women. METHODS A secondary analysis of data from the Chilean National Health Survey (CNHS) 2016-2017 was performed on the number of remaining teeth in adults. The explanatory variables were organized into structural and intermediate social determinants of health according to the WHO framework. The contribution of both groups and the contribution of each individual explanatory variable to the remaining teeth gap was estimated using the Blinder-Oaxaca decomposition analysis. RESULTS The predicted average number of remaining teeth for men was 23.4 and 21.0 for women, thus a mean difference of 2.4 teeth. 49.8% of the inequality between men and women was due to the different distribution (endowments) of the predictors in the model. Among them, structural determinants of health, namely education level (15.8%) and employment status (17.8%), contributed the most. Intermediate determinants had no relevant contribution to explain the gap. CONCLUSIONS Results revealed that the difference in the mean number of remaining teeth between men and women was mainly explained by two structural determinants: education level and employment status. The lack of explanatory power of intermediate determinants and the large explanatory power of structural determinants means that tackling oral health inequity in Chile requires strong political commitment. The role of intersectoral and intersectional public policies to address gender inequalities in oral health in Chile is discussed.
Collapse
Affiliation(s)
- Marjorie Borgeat
- Interdisciplinary Center for Health Studies, Faculty of Dentistry, University of Valparaíso, Valparaíso, Chile
- Interuniversity Center for Healthy Aging, Chile
| | - Iris Espinoza
- Interuniversity Center for Healthy Aging, Chile
- Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Santiago, Chile
| | - Karina Navarro
- Department of Sociology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | - Claudia Carvajal
- Department of Oral Health, Division of Prevention and Control of Diseases, Ministry of Health, Santiago, Chile
| | - Paola Carvajal
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| |
Collapse
|
6
|
Hu K, Da Silva K. Access to oral health care for children with fetal alcohol spectrum disorder: a cross-sectional study. BMC Oral Health 2022; 22:497. [DOI: 10.1186/s12903-022-02561-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Individuals with developmental disabilities, including Fetal Alcohol Spectrum Disorder (FASD), often suffer from poorer oral health than the general population as they experience challenges with accessing care. However, few studies have investigated access to oral health care specific to children diagnosed with FASD. Thus, the objective of this cross-sectional study is to examine the use of oral health care services by children diagnosed with FASD in Saskatchewan, Canada, and to identify perceived barriers that affect their access to oral health care.
Methods
Parents or caregivers for children with FASD under the age of 16 were recruited through community organizations. Between July 2020 and January 2021, 189 participants completed a 64-item questionnaire that assessed sociodemographic characteristics, oral health care utilization, and perceived barriers to care.
Results
Most children (85%) had visited the dentist within the last 24 months. 55% of children had required sedation for some treatment. 43% of caregivers experienced frustration trying to access care for their child. Common barriers were cost (63%), location (55%), the child’s behaviour (78%) and caregiver anxiety (60%). 35% of caregivers believed their dentist lacked adequate knowledge of FASD. Univariate analysis reveals that income, caregiver education, residence location, and insurance status were significantly associated with reporting barriers. Multivariate logistic regression analysis reveals that caregivers who reported a high school education (OR=1.23; 95% CI 1.03 – 1.38); or public insurance (OR=1.33; 95% CI 1.24 – 1.42) or out-of-pocket payments (OR=1.37, 95% CI 1.20 – 1.46); or rural (OR=1.19, 95% CI 1.07 – 1.26) or remote (OR=1.23; 95% CI=1.12 – 1.31) residences were more likely to report difficulties accessing oral health care.
Conclusion
Our findings indicate that children with FASD experience various barriers to accessing oral health care. Social determinants of health were significant variables that increased likelihood of barriers. Like other vulnerable populations, cost and clinic location are notable barriers. Oral health care providers’ assessment and management of children with FASD are noteworthy for future research.
Collapse
|
7
|
A study of socio-economic inequalities in self-reported oral and general health in South-East Norway. Sci Rep 2022; 12:13721. [PMID: 35962044 PMCID: PMC9374767 DOI: 10.1038/s41598-022-18055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
This study assesses the association between socioeconomic determinants and self-reported health using data from a regional Norwegian health survey. We included 9,068 participants ≥ 25 years. Survey data were linked to registry data on education and income. Self-reported oral and general health were separately assessed and categorized into ‘good’/‘poor’. Exposures were educational level, personal income, and economic security. Prevalence ratios (PR) were computed to assess the associations between socioeconomic determinants and self-reported health using Poisson regression models. Participants with low education or income had poorer oral and general health than those with more education or higher income. Comparing the highest and lowest education levels, adjusted PRs for poor oral and general health were 1.27 (95%CI, 1.11–1.46) and 1.43 (95%CI, 1.29–1.59), respectively. Correspondingly, PRs for lowest income quintiles compared to highest quintile were 1.34 (95%CI, 1.17–1.55) and 2.10 (95%CI, 1.82–2.43). Low economic security was also significantly associated with poor oral and general health. There were socioeconomic gradients and positive linear trends between levels of education and income in relation to both outcomes (P-linear trends < 0.001). We found statistical evidence of effect modification by gender on the association between education and oral and general health, and by age group between income and oral health.
Collapse
|
8
|
Novrinda H, Han DH. Oral health inequality among Indonesian workers in South Korea: role of health insurance and discrimination factors. BMC Oral Health 2022; 22:22. [PMID: 35090443 PMCID: PMC8799411 DOI: 10.1186/s12903-022-02050-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background The health of migrant workers is becoming an important public health issue. Although there are an increasing number of migrant workers in Korea, the health status in migrant populations remains unknown. The aims of this study were (1) to evaluate the association between income and self-rated oral health (SROH), and (2) to assess the role of health insurance and self-perceived discrimination in the association between income and SROH among Indonesian migrant workers in Korea. Methods Information about self-reported income, SROH, coverage/utilization of health insurance (HI), living difficulties related to oral health (LDROH), oral health literacy (OHL), and discrimination were obtained from Indonesian migrant workers in Korea (n = 248). The main explanatory variable was income, and SROH was an outcome variable. Logistic regression analyses were performed controlling for age, gender, HI, LDROH, OHL, and discrimination. The paths from income to SROH were analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM). Results Among Indonesian migrant workers, the lower income group had the highest probability of a poor SROH compared to the higher income group. The variables showing a high explanatory power were discrimination among the low income group and HI among the middle income group. In PLS-SEM, the variables such as HI, LDROH, OHL, and discrimination contributed 11% to explaining the association between income and SROH. Conclusion A monotonic gradient was revealed among migrant workers according to the association between income and SROH. Discrimination and HI contributed to oral health inequalities.
Collapse
|
9
|
Damaskinos P, Koletsi-Kounari C, Mamai-Homata H, Papaioannou W. Social, Clinical and Psychometric Factors Affecting Self-Rated Oral Health, Self-Rated Health and Wellbeing in Adults: A Cross-Sectional Survey. Health (London) 2022. [DOI: 10.4236/health.2022.141009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
10
|
Hussain A, Jaimes SB, Crizzle AM. Predictors of self-rated oral health in Canadian Indigenous adults. BMC Oral Health 2021; 21:430. [PMID: 34488726 PMCID: PMC8419983 DOI: 10.1186/s12903-021-01796-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 08/31/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The purpose of this study was to: (1) compare oral health indicators between Indigenous adults and the general population and (2) examine the predictors of poor self-rated oral health in the Indigenous population. METHODS Data from the 2017-2018 cycle of the Canadian Community Health Survey was used and included 943 Indigenous and 20,011 non-Indigenous adults. Independent variables included demographic information, lifestyle behaviours, dental concerns and care utilization, and transportation access. The dependent variable was self-rated oral health. A logistic regression was performed to determine predictors of poor self-rated oral health. RESULTS More than half of the Indigenous sample were aged between 35 and 64 years (57.3%); 57.8% were female. Compared to the general population, the Indigenous group were significantly more likely to have no partner, have less post-secondary education, and have an income of less than $40,000. Almost a fifth of the Indigenous sample self-rated their oral health as poor (18.5%) compared to 11.5% in the general population. Indigenous participants reported significantly poorer general health, had poorer oral care practices, and lifestyle behaviours than the general population (all p < .001). Indigenous adults having poor self-rated oral health was predicted by poorer general health, being a smoker, male, bleeding gums, persistent pain, feeling uncomfortable eating food, avoiding foods, and not seeking regular dental care. CONCLUSIONS There are many predictors of poor self-rated oral health, many of which are preventable. Providing culturally adapted oral health care may improve the likelihood of Indigeneous adults visiting the dentist for preventative care.
Collapse
Affiliation(s)
- Ahmed Hussain
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, S7N 5E4, Canada
| | - Sheyla Bravo Jaimes
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Alexander M Crizzle
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.
| |
Collapse
|
11
|
Bastani P, Mohammadpour M, Mehraliain G, Delavari S, Edirippulige S. What makes inequality in the area of dental and oral health in developing countries? A scoping review. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2021; 19:54. [PMID: 34446051 PMCID: PMC8394054 DOI: 10.1186/s12962-021-00309-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/14/2021] [Indexed: 11/29/2022] Open
Abstract
Background Equity in health is an important consideration for policy makers particularly in low and middle income developing country. The area of oral and dental health is not an exception. This study is conducted to explore the main determinants that make inequality in oral and dental health area in developing countries. Methods This was a scoping review applying the framework enhanced by Levac et al. Four databases of Scopus, PubMed, WOS and ProQuest were systematically searched applying to related keywords up to 27.11.2020. There restriction was placed in the English language but not on the study design. All the related studies conducted in the low or middle income developing countries were included. A qualitative thematic analysis was applied for data analysis and a thematic map was presented. Results Among 436 articles after excluding duplications, 73 articles were included that the number of publications from Brazil was greater than other developing countries (33.33%). Thematic analysis of the evidence has led to 11 determinants that may result in inequality in oral and dental health services in developing countries including personal characteristics, health status, health needs and health behaviours, social, economic, cultural and environmental factors, as well as insurance, policies and practices and provided related factors. Conclusion The policymakers in the low and middle income developing countries should be both aware of the role of inequality determinants and also try to shift the resources to the policies and practises that can improve the condition of population access to oral and dental services the same as comprehensive insurance packages, national surveillance system and fair distribution of dentistry facilities. It is also important to improve the population’s health literacy and health behaviour through social media and other suitable mechanisms according to the countries’ local contexts. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-021-00309-0.
Collapse
Affiliation(s)
- Peivand Bastani
- Health Human Resources Research Centre, School of Health Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | | | - Sajad Delavari
- Health Human Resources Research Centre, School of Health Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sisira Edirippulige
- Center for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| |
Collapse
|
12
|
Chang Q, Gao X, Xu M, Zhang C, Du S, Wang X, Feng X, Tai B, Hu D, Lin H, Wang B, Wang C, Zheng S, Liu X, Rong W, Wang W, Xu T, Si Y. Socioeconomic-related inequality in dental care utilization among preschool children in China. Community Dent Oral Epidemiol 2021; 49:505-512. [PMID: 34288037 DOI: 10.1111/cdoe.12681] [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: 02/18/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to investigate socioeconomic-related inequality in dental care service utilization in the past 12 months among Chinese preschool children and to explore the contribution of various factors to this inequality. METHOD A total of 40 305 children aged 3-5 years from 372 kindergartens who participated in the Fourth National Oral Health Survey in China were included in the final analysis. The method of data weighting in complex sampling was adopted to make the samples more representative. Erreygers-corrected concentration index (EI) was used to measure socioeconomic-related inequality in dental care service utilization. The horizontal inequality index (HI) was employed to analyse horizontal inequality. Decomposition analyses were conducted to explore the contributions of income level, need variables (dmft, caregiver-evaluated oral health status and toothache experience) and nonneed variables (caregiver education level, residential location, age, and sex) to the inequality of health service utilization. RESULT The utilization of oral health services within the past 12 months among the high-, middle- and low-income groups was 17.4% (95% CI: 15.6-19.3), 13.6% (95% CI: 12.2-15.1) and 9.4% (95% CI: 8.1-11.0) respectively. The concentration curve was below the line of equality, and the EI and HI were 0.072 and 0.078, respectively, indicating that dental care utilization in children aged 3-5 years was concentrated in those who were better off. The contribution of the need variables to socioeconomic-related inequality in dental services was minimal, and most dental care utilization inequality could be explained by household income, caregiver education attainment and urban-rural disparities, accounting for 32.0%, 49.4% and 20.4% respectively. CONCLUSION This study reveals the existence of pro-rich inequality in dental care utilization among preschool children in China. The decomposition analysis suggests that income, caregiver education background and urban-rural disparities are the main factors contributing to this outcome. Equity-oriented policies and programmes are needed to achieve equitable dental care utilization.
Collapse
Affiliation(s)
- Qing Chang
- Department of Second Clinical Division, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaoli Gao
- Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Mengru Xu
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Chunzi Zhang
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Shuo Du
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xing Wang
- Chinese Stomatological Association, Beijing, China
| | - Xiping Feng
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Baojun Tai
- School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Deyu Hu
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Huancai Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yetsen University, Guangzhou, China
| | - Bo Wang
- Chinese Stomatological Association, Beijing, China
| | - Chunxiao Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuguo Zheng
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xuenan Liu
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wensheng Rong
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Weijian Wang
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Tao Xu
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yan Si
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
| |
Collapse
|
13
|
Malocclusion of Molar Teeth Is Associated with Activities of Daily Living Loss and Delirium in Elderly Critically Ill Older Patients. J Clin Med 2021; 10:jcm10102157. [PMID: 34067550 PMCID: PMC8156973 DOI: 10.3390/jcm10102157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/29/2021] [Accepted: 05/13/2021] [Indexed: 01/27/2023] Open
Abstract
A single-center retrospective cohort study examined the association between molar malocclusion status at ICU admission and loss of activities of daily living (ADL) at hospital discharge among acutely ill patients. Patients were assigned to the bilateral occlusion group or malocclusion group (N = 227 and 93, respectively). The following data were collected from electronic medical records: age, sex, Clinical Frailty Scale (CFS) on admission, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score, confirmed diagnosis (neurological disorders or others), CFS at hospital discharge, and occlusion condition. Patients who were frail at admission (CFS > 5) were excluded from analysis, and ADL loss was defined as CFS > 5 at hospital discharge. Multivariate analysis showed malocclusion was independently associated with ADL loss [OR, 2.03; 95% CI, 1.13-3.64; p = 0.02]. For those aged 65 and older, malocclusion was significantly associated with both ADL loss [OR, 3.25; 95% CI, 1.44-7.32; p < 0.01] and the incidence of delirium [OR, 2.61; 95% CI, 1.14-5.95; p = 0.02]. Malocclusion on ICU admission was associated with ADL loss in critically ill patients, and was associated with ADL loss and the incidence of delirium in the elderly. Poor oral health was a poor prognostic factor among critically ill patients.
Collapse
|
14
|
Donos N, Suvan JE, Calciolari E, Nibali L, Rollnick S. The effect of a behavioural management tool in adults with mild to moderate periodontitis. A single-blind, randomized controlled trial. J Periodontal Res 2020; 56:46-57. [PMID: 32959898 DOI: 10.1111/jre.12790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To compare a behavioural management program (test) to a standard communication approach (control) to reduce plaque, improve clinical outcomes and patient's compliance with oral self-care. BACKGROUND Since psychological factors affect oral health-related behaviours, approaches directed at changing behaviours and improving compliance might improve the effect of oral health education. MATERIALS AND METHODS This was a randomized, single-blind, parallel-design trial involving 71 patients with mild to moderate periodontitis. During a run-in period, all participants began using a power toothbrush. Two sessions of non-surgical periodontal therapy were performed post-baseline, along with one of the two oral healthcare communication approaches. Plaque and bleeding scores, probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at the screening visit, baseline visit and at 8 and 14 weeks post-baseline. Patients were asked to fill in oral self-care diaries. Experience questionnaires were administered to both clinicians and patients to assess subjective experience of the clinician-patient interactions during the visits. RESULTS In both groups, a significant reduction in plaque and bleeding scores was observed from baseline to 8 weeks after baseline, which then remained stable at week 14, but no differences between the groups were noted. An improvement in CAL and PPD was recorded at week 8 post-baseline in the test compared to the control group. No inter-group differences in the clinician's and subject's experience questionnaires were observed. CONCLUSION Both approaches significantly promoted periodontal health. However, changing lifestyle requires repeated communication/engagement over time and a behavioural management program based upon two visits did not provide additional benefit compared to a standard approach.
Collapse
Affiliation(s)
- Nikolaos Donos
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jeanie E Suvan
- Unit of Periodontology, Eastman Dental Institute, University College London (UCL), London, UK
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Department of Medicine and Surgery, School of Dental Medicine, University of Parma, Parma, Italy
| | - Luigi Nibali
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centre for Host-Microbiome Interactions, Guy's Hospital, Kings College London, London, UK
| | - Stephen Rollnick
- Cochrane School of Primary Care & Public Health, Cardiff University, Cardiff, UK
| |
Collapse
|
15
|
Raphael D. Narrative review of affinities and differences between the social determinants of oral and general health in Canada: establishing a common agenda. J Public Health (Oxf) 2020; 41:e218-e225. [PMID: 30165524 DOI: 10.1093/pubmed/fdy152] [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: 04/21/2018] [Revised: 07/24/2018] [Accepted: 08/03/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND This article overviews Canadian work on the social determinants of oral and general health noting their affinities and differences. METHODS A literature search identified Canadian journal articles addressing the social determinants of oral health and/or oral health inequalities. Analysis identified affinities and differences with six themes in the general social determinants of health literature. RESULTS While most Canadian social determinants activity focuses on physical and mental health there is a growing literature on oral health-literature reviews, empirical studies and policy analyses-with many affinities to the broader literature. In addition, since Canada provides physical and mental health services on a universal basis, but does not do so for dental care, there is a special concern with the reasons behind, and the health effects-oral, physical and mental-of the absence of publicly financed dental care. CONCLUSIONS The affinities between the social determinants of oral health and the broader social determinants of health literature suggests the value of establishing a common research and action agenda. This would involve collaborative research into common social determinants of oral and general health and combined policy advocacy efforts to improve Canadians' living and working conditions as means of achieving health for all.
Collapse
Affiliation(s)
- Dennis Raphael
- School of Health Policy and Management, York University, Toronto 4700 Keele Street, Toronto, Ontario, Canada
| |
Collapse
|
16
|
Zivkovic N, Aldossri M, Gomaa N, Farmer JW, Singhal S, Quiñonez C, Ravaghi V. Providing dental insurance can positively impact oral health outcomes in Ontario. BMC Health Serv Res 2020; 20:124. [PMID: 32066434 PMCID: PMC7027064 DOI: 10.1186/s12913-020-4967-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/06/2020] [Indexed: 11/30/2022] Open
Abstract
Background Universal coverage for dental care is a topical policy debate across Canada, but the impact of dental insurance on improving oral health-related outcomes remains empirically unexplored in this population. Methods We used data on individuals 12 years of age and older from the Canadian Community Health Survey 2013–2014 to estimate the marginal effects (ME) of having dental insurance in Ontario, Canada’s most populated province (n = 42,553 representing 11,682,112 Ontarians). ME were derived from multi-variable logistic regression models for dental visiting behaviour and oral health status outcomes. We also investigated the ME of insurance across income, education and age subgroups. Results Having dental insurance increased the proportion of participants who visited the dentist in the past year (56.6 to 79.4%, ME: 22.8, 95% confidence interval (CI): 20.9–24.7) and who reported very good or excellent oral health (48.3 to 57.9%, ME: 9.6, 95%CI: 7.6–11.5). Compared to the highest income group, having dental insurance had a greater ME for the lowest income groups for dental visiting behaviour: dental visit in the past 12 months (ME highest: 17.9; 95% CI: 15.9–19.8 vs. ME lowest: 27.2; 95% CI: 25.0–29.3) and visiting a dentist only for emergencies (ME highest: -11.5; 95% CI: − 13.2 to − 9.9 vs. ME lowest: -27.2; 95% CI: − 29.5 to − 24.8). Conclusions Findings suggest that dental insurance is associated with improved dental visiting behaviours and oral health status outcomes. Policymakers could consider universal dental coverage as a means to support financially vulnerable populations and to reduce oral health disparities between the rich and the poor.
Collapse
Affiliation(s)
- Nevena Zivkovic
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada.
| | - Musfer Aldossri
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Noha Gomaa
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Julie W Farmer
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Sonica Singhal
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Carlos Quiñonez
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Vahid Ravaghi
- School of Dentistry, University of Birmingham, Birmingham, England
| |
Collapse
|
17
|
Singh A, Peres MA, Watt RG. The Relationship between Income and Oral Health: A Critical Review. J Dent Res 2019; 98:853-860. [PMID: 31091113 DOI: 10.1177/0022034519849557] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
In this critical review, we summarized the evidence on associations between individual/household income and oral health, between income inequality and oral health, and income-related inequalities in oral health. Meta-analyses of mainly cross-sectional studies confirm that low individual/household income is associated with oral cancer (odds ratio, 2.41; 95% confidence interval [CI], 1.59-3.65), dental caries prevalence (prevalence ratio, 1.29; 95% CI, 1.18-1.41), any caries experience (odds ratio, 1.40; 95% CI, 1.19-1.65), tooth loss (odds ratio, 1.66; 95% CI, 1.48-1.86), and traumatic dental injuries (odds ratio, 0.76; 95% CI, 0.65-0.89). Reviews also confirm qualitatively that low income is associated with periodontal disease and poor oral health-related quality of life. Limited evidence from the United States shows that psychosocial and behavioral explanations only partially explain associations between low individual/household income and oral health. Few country-level studies and a handful of subnational studies from the United States, Japan, and Brazil show associations between area-level income inequality and poor oral health. However, this evidence is conflicting given that the association between area-level income inequality and oral health outcomes varies considerably by contexts and by oral health outcomes. Evidence also shows cross-national variations in income-related inequalities in oral health outcomes of self-rated oral health, dental care, oral health-related quality of life, outcomes of dental caries, and outcomes of tooth loss. There is a lack of discussion in oral health literature about limitations of using income as a measure of social position. Future studies on the relationship between income and oral health can benefit substantially from recent theoretical and methodological advancements in social epidemiology that include application of an intersectionality framework, improvements in reporting of inequality, and causal modeling approaches. Theoretically well-informed studies that apply robust epidemiological methods are required to address knowledge gaps for designing relevant policy interventions to reduce income-related inequalities in oral health.
Collapse
Affiliation(s)
- A Singh
- 1 Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - M A Peres
- 2 Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - R G Watt
- 3 Research Department of Epidemiology and Public Health, University College London, London, UK
| |
Collapse
|
18
|
McLaren L, Figueiredo R. Special section on dental public health: A collaboration between the Canadian Journal of Public Health and the Canadian Association of Public Health Dentistry. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2017; 108:e219-e220. [PMID: 28910240 PMCID: PMC6972385 DOI: 10.17269/cjph.108.6347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/15/2017] [Indexed: 06/07/2023]
Affiliation(s)
| | - Raphael Figueiredo
- Canadian Association ofPublic Health Dentistry, Alberta Health Services, Edmonton, AB, Canada
| |
Collapse
|