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Broomhead T, Baker SR, Martin N, McKenna G, El-Dhuwaib B, Alavi A, Gibson B. Exploring experiences of living with removable dentures-A scoping review of qualitative literature. Gerodontology 2024. [PMID: 38247018 DOI: 10.1111/ger.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Examine the literature on the experiences of living with removable dentures (complete or partial) to identify any gaps and provide a map for future research. BACKGROUND Increasing proportions of society are living partially dentate with some form of restoration, including removable dentures. Previous studies have reported on the location, materials and usage of these prostheses, along with effects on oral-health-related quality of life (OHRQoL). However, less is known about experiences with removable dentures from a patient-centred perspective. METHODS A scoping review of the qualitative literature was undertaken using the framework of Arksey and O'Malley, updated by Levac et al. Literature searches were carried out using Medline and Web of Science. Papers were screened by title and abstract using inclusion and exclusion criteria. Remaining papers were read in full and excluded if they did not meet the required criteria. Nine papers were included in the final review. FINDINGS Key themes from these papers were: impact of tooth loss and living without teeth, and its impacts in relation to social position, appearance, confidence and function (chewing and speaking); social norms and tooth loss, including attitudes to tooth retention and treatment costs, and changes in intergenerational norms towards dentures; expectations of treatment, including patients being more involved in decision making, viewing the denture as a "gift" and dentures helping to achieve "an ideal"; living with a removable denture (complete or partial), including patient preparedness for a denture, adaptation and impacts on activities and participation; and the dentist-patient relationship, including issues with information and communication, and differing priorities between patients and dentists. CONCLUSION Little qualitative research exists on experiences of living with a removable denture. Existing literature demonstrates the importance of dispersed activities in differing social, spatial and temporal contexts when wearing removable dentures. Focusing on processes of positive adaptation to dentures and OHRQoL, rather than deficits, is also required to fully understand patients' experiences. Additionally, more complex technological advances may not always be in the best interest of every patient.
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Affiliation(s)
- T Broomhead
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - S R Baker
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - N Martin
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - G McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - B El-Dhuwaib
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - A Alavi
- Haleon (formerly GSK Consumer Healthcare), Weybridge, UK
| | - B Gibson
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Broomhead T, Gibson BJ, Parkinson C, Robinson PG, Vettore MV, Baker SR. Development and psychometric validation of the gum health experience questionnaire. J Clin Periodontol 2024; 51:33-42. [PMID: 37735867 DOI: 10.1111/jcpe.13878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/10/2023] [Accepted: 08/31/2023] [Indexed: 09/23/2023]
Abstract
AIM To develop and validate a new health-related quality of life measure to capture a wide range of gum-related impacts. MATERIALS AND METHODS The measure was developed using a multi-stage approach and a theoretical model. Development involved semi-structured interviews, pilot testing, cross-sectional analysis among a general population (n = 152) to assess psychometric properties and test-retest reliability among a subsample (n = 27). RESULTS Psychometric analysis supports the validity and reliability of the measure's impact scale. The measure has excellent internal reliability (nearly all item-total correlations above .4; Cronbach's alpha between .84 and .91 for subscales), with test-retest reliability also performing well (Intra-class correlation coefficient [ICC] of .91-.97 for subscales). Good content validity (indicated by large standard deviations for item and total scores) and construct validity (correlations of .54-.73 with global gum health rating for subscales, all p < .05) were also observed. Qualitative and quantitative data indicate that people with gum health-related symptoms experience different degrees of discomfort and impacts caused by their condition. CONCLUSIONS The gum health experience questionnaire holds substantial promise as a measure of gum-related quality of life in people across the gum health-disease continuum. Further face validity, refining and reducing the number of items and longitudinal studies to test evaluative properties are required before the measure can be used with confidence.
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Affiliation(s)
- T Broomhead
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - B J Gibson
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - P G Robinson
- Bristol Dental School, University of Bristol, Bristol, UK
| | - M V Vettore
- Department of Health and Nursing Sciences, Universitet i Agder, Kristiansand, Norway
| | - S R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Broomhead T, Ballas D, Baker SR. Neighbourhoods and oral health: Agent-based modelling of tooth decay. Health Place 2021; 71:102657. [PMID: 34543838 DOI: 10.1016/j.healthplace.2021.102657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/12/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022]
Abstract
This research used proof of concept agent-based models to test various theoretical mechanisms by which neighbourhoods may influence tooth decay in adults. Theoretical pathways were constructed using existing literature and tested in two study areas in Sheffield, UK. The models found a pathway between shops and sugar consumption had the most influence on adult tooth decay scores, revealing that similar mechanisms influence this outcome in different populations. This highlighted the importance of the interactions between neighbourhood features and individual level variables in influencing outcomes in tooth decay. Further work is required to improve the accuracy and reliability of the models.
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Affiliation(s)
- T Broomhead
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, S10 2TA, United Kingdom.
| | - D Ballas
- Department of Economic Geography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD, Groningen, the Netherlands
| | - S R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, S10 2TA, United Kingdom
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Brennan A, Buckley C, Vu TM, Probst C, Nielsen A, Bai H, Broomhead T, Greenfield T, Kerr W, Meier PS, Rehm J, Shuper P, Strong M, Purshouse RC. Introducing CASCADEPOP: an open-source sociodemographic simulation platform for us health policy appraisal. Int J Microsimul 2020; 13:21-60. [PMID: 33884027 DOI: 10.34196/ijm.00217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Largescale individual-level and agent-based models are gaining importance in health policy appraisal and evaluation. Such models require the accurate depiction of the jurisdiction's population over extended time periods to enable modeling of the development of non-communicable diseases under consideration of historical, sociodemographic developments. We developed CASCADEPOP to provide a readily available sociodemographic micro-synthesis and microsimulation platform for US populations. The micro-synthesis method used iterative proportional fitting to integrate data from the US Census, the American Community Survey, the Panel Study of Income Dynamics, Multiple Cause of Death Files, and several national surveys to produce a synthetic population aged 12 to 80 years on 01/01/1980 for five states (California, Minnesota, New York, Tennessee, and Texas) and the US. Characteristics include individuals' age, sex, race/ethnicity, marital/employment/parental status, education, income and patterns of alcohol use as an exemplar health behavior. The microsimulation simulates individuals' sociodemographic life trajectories over 35 years to 31/12/2015 accounting for population developments including births, deaths, and migration. Results comparing the 1980 micro-synthesis against observed data shows a successful depiction of state and US population characteristics and of drinking. Comparing the microsimulation over 30 years with Census data also showed the successful simulation of sociodemographic developments. The CASCADEPOP platform enables modelling of health behaviors across individuals' life courses and at a population level. As it contains a large number of relevant sociodemographic characteristics it can be further developed by researchers to build US agent-based models and microsimulations to examine health behaviors, interventions, and policies.
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Affiliation(s)
- Alan Brennan
- School of Health and Related Research, University of Sheffield (ScHARR), 30 Regent Street, Sheffield, S1 4DA, UK
| | - Charlotte Buckley
- Department of Automatic Control and Systems Engineering, University of Sheffield, Mappin Street, Sheffield, S1 3JD, UK
| | - Tuong Manh Vu
- School of Health and Related Research, University of Sheffield (ScHARR), 30 Regent Street, Sheffield, S1 4DA, UK
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, On M5S 2S1, Canada
| | - Alexandra Nielsen
- Alcohol Research Group (ARG), Public Health Institute, 6001 Shellmound St, Emeryville, CA, 94608, USA
| | - Hao Bai
- Department of Automatic Control and Systems Engineering, University of Sheffield, Mappin Street, Sheffield, S1 3JD, UK
| | - Thomas Broomhead
- School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK
| | - Thomas Greenfield
- Alcohol Research Group (ARG), Public Health Institute, 6001 Shellmound St, Emeryville, CA, 94608, USA
| | - William Kerr
- Alcohol Research Group (ARG), Public Health Institute, 6001 Shellmound St, Emeryville, CA, 94608, USA
| | - Petra S Meier
- School of Health and Related Research; University of Sheffield (ScHARR), 30 Regent Street, Sheffield, S1 4DA, UK
| | - JüRgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON M5S 2S1, Canada
| | - Paul Shuper
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON M5S 2S1, Canada
| | - Mark Strong
- School of Health and Related Research; University of Sheffield (ScHARR), 30 Regent Street, Sheffield, S1 4DA, UK
| | - Robin C Purshouse
- Department of Automatic Control and Systems Engineering, University of Sheffield, Mappin Street, Sheffield, S1 3JD, UK
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Abstract
Systems science methods offer an alternative way to approach problems within Dental Public Health by encouraging the consideration of the wider systems and structures in which oral health problems exist. Through such an approach, and consideration of interacting systems over multiple hierarchical levels, it may be possible to better understand the complexity associated with oral health related outcomes, and to improve theoretical understanding of these relationships. Simulation methods associated with systems science can also be used to help model and capture these real-world problems, and to help test the interactions associated with different elements of a system. The aim of this review is to summarise the concepts behind systems science approaches, and what they can offer the field of Dental Public Health. This will include an overview of the way systems science can approach problems associated with complexity, and the benefits these approaches can have. The main methods associated with the field will then be reviewed, along with examples of their application. This paper will then outline some of the main implications, both conceptual and methodological, that adopting systems science methods may have for Dental Public Health. Finally, the challenges associated with systems science will also be presented. It is hoped that this review will highlight the benefits of systems thinking, and how it can add to our conceptual knowledge of the contexts in which complex health problems are embedded.
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Affiliation(s)
- T Broomhead
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry University of Sheffield
| | - S R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry University of Sheffield
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Baker SR, Foster Page L, Thomson WM, Broomhead T, Bekes K, Benson PE, Aguilar-Diaz F, Do L, Hirsch C, Marshman Z, McGrath C, Mohamed A, Robinson PG, Traebert J, Turton B, Gibson BJ. Structural Determinants and Children's Oral Health: A Cross-National Study. J Dent Res 2018; 97:1129-1136. [PMID: 29608864 DOI: 10.1177/0022034518767401] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.
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Affiliation(s)
- S R Baker
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
| | - L Foster Page
- 2 Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Otago, New Zealand
| | - W M Thomson
- 2 Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Otago, New Zealand
| | - T Broomhead
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
| | - K Bekes
- 3 Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - P E Benson
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
| | - F Aguilar-Diaz
- 4 Department of Public Health, National Autonomous University of Mexico León Unit, León, Guanajuato, México
| | - L Do
- 5 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, Australia
| | - C Hirsch
- 6 Department of Paediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Z Marshman
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
| | - C McGrath
- 7 Periodontology & Public Health, Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - A Mohamed
- 8 Department of Dental Services, Ministry of Health, Brunei Darussalam
| | - P G Robinson
- 9 Bristol Dental School, The University of Bristol, Bristol, UK
| | - J Traebert
- 10 Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Santa Catarina, Brazil
| | - B Turton
- 11 Department of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - B J Gibson
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
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Marshman Z, Broomhead T, Rodd HD, Jones K, Burke D, Baker SR. Who attends a Children's Hospital Emergency Department for dental reasons? A two-step cluster analysis approach. Community Dent Oral Epidemiol 2016; 45:49-58. [DOI: 10.1111/cdoe.12258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 08/30/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Z. Marshman
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - T. Broomhead
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - H. D. Rodd
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - K. Jones
- Public Health England; Sheffield UK
| | - D. Burke
- Sheffield Children's NHS Foundation Trust; Western Bank; Sheffield UK
| | - S. R. Baker
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
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Broomhead T, Baker SR, Jones K, Richardson A, Marshman Z. What are the most accurate predictors of caries in children aged 5 years in the UK? Community Dent Health 2014; 31:111-116. [PMID: 25055609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To find the most accurate indicators of the distribution of dental caries in 5-year-olds in the city of Sheffield, UK, using a conceptual framework based on the social determinants of health. METHOD A list of structural and intermediary indicators was compiled based on the Commission on the Social Determinants of Health's (CSDH) conceptual framework. To quantify these indicators, existing data on dental caries were obtained from the NHS Dental Epidemiology Programme, while data on social position, education, employment, income, material circumstances, social cohesion, psychosocial factors and individual behaviours were obtained from the Public Health Intelligence Team at Sheffield City Council. These data were mapped onto a simplified framework of the social determinants of dental caries. Regression analysis was conducted on this simplified framework to determine the amount of variance each indicator contributed to the distribution of dental caries at neighbourhood level. RESULTS The total score for the 2010 Index of Multiple Deprivation contributed a significant amount of variance (60.4%) compared to the combined variance of the other 13 indicators (70.5%). CONCLUSION The total IMD score has the potential to be used as an indicator for the targeting of oral health improvement programmes where survey data are not available. A large prospective study is required in the UK to investigate the full range of factors in the CSDH model to develop a new index which might better predict dental caries experience than IMD.
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