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Anticona C, Suominen AL, Holgerson PL, Gustafsson PE. Impact of an oral care subsidization reform on intersectional inequities in self-rated oral health in Sweden. Int J Equity Health 2024; 23:63. [PMID: 38504240 PMCID: PMC10953229 DOI: 10.1186/s12939-024-02121-7] [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: 09/27/2023] [Accepted: 02/02/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Oral health in Sweden is good at the population level, but seemingly with persisting or increasing inequities over the last decades. In 2008, a major Swedish reform introduced universal partial subsidies to promote preventive care and reduce the treatment cost for patients with extensive care needs. This study aimed to apply an intersectional approach to assess the impact of the 2008 subsidization reform on inequities in self-rated oral health among adults in Sweden over the period 2004-2018. METHODS Data from 14 national surveys conducted over 2004-2018 were divided into three study periods: pre-reform (2004-2007), early post-reform (2008-2012) and late post-reform (2013-2018). The final study population was 118,650 individuals aged 24-84 years. Inequities in self-rated oral health were examined by intersectional analysis of individual heterogeneity and discriminatory accuracy across 48 intersectional strata defined by gender, age, educational level, income, and immigrant status. RESULTS Overall, the prevalence of poor self-rated oral health decreased gradually after the reform. Gender-, education- and income-related inequities increased after the reform, but no discernible change was seen for age- or immigration-related inequities. The majority of intersectional strata experienced patterns of persistently or delayed increased inequities following the reform. CONCLUSIONS Increased inequities in self-rated oral health were found in most intersectional strata following the reform, despite the seemingly positive oral health trends at the population level. Applying an intersectional approach might be particularly relevant for welfare states with overall good oral health outcomes but unsuccessful efforts to reduce inequities.
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Affiliation(s)
- Cynthia Anticona
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE-90187, Sweden.
- Department of Odontology, Umeå University, Umeå, SE-90187, Sweden.
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Teaching Unit, Kuopio University Hospital, Kuopio, Finland
| | - Pernilla Lif Holgerson
- Department of Odontology, Section of Pediatric Dentistry, Umeå University, Umeå, SE-90187, Sweden
| | - Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE-90187, Sweden
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Cozier YC, Heaton B, Robles Y, C Bond J, I Garcia R, Coogan P, Rosenberg L. Perceived racism associated with declines in self-rated oral health among U.S. Black women. Ann Epidemiol 2023; 84:54-59. [PMID: 37244316 PMCID: PMC10525027 DOI: 10.1016/j.annepidem.2023.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/09/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE Racial disparities in oral health are well-documented. Stress has been associated with both perceived racism and oral health, yet little research has directly investigated the association between perceived racism and oral health. METHODS We used data from the Black Women's Health Study, a longitudinal cohort study that includes a geographically diverse sample of Black women across the United States. Perceived exposure to racism was assessed via two scales, one assessing lifetime exposure and one everyday exposure. Self-rated oral health was subsequently assessed over multiple time points. We used Cox proportional hazard models to calculate adjusted incidence rate ratios estimating the association between higher levels of perceived racism and incident "fair" or "poor" oral health, and explored potential effect measure modification using stratified models. RESULTS The adjusted incidence rate ratios (n = 27,008) relating perceived racism to incident fair or poor oral health were 1.50 (95% confidence interval 1.35, 1.66) comparing the highest quartile of everyday racism to the lowest and 1.45 (95% confidence interval 1.31, 1.61) for the highest score of lifetime racism compared to the lowest. We did not see evidence of effect modification. CONCLUSIONS Higher levels of perceived racism documented in 2009 were associated with declines in self-rated oral health from 2011 to 2019.
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Affiliation(s)
- Yvette C Cozier
- Slone Epidemiology Center at Boston University, Boston, MA; Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Brenda Heaton
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA.
| | - Yvonne Robles
- Slone Epidemiology Center at Boston University, Boston, MA
| | - Julia C Bond
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA
| | - Raul I Garcia
- Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA
| | | | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, MA
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Sermsuti-anuwat N, Nampikul N, Suwannimit R, Panthueng W. Self-rated oral health among elderly patients attending a university dental hospital in Thailand: a telephone-based cross-sectional survey study. PeerJ 2022; 10:e14191. [PMID: 36248702 PMCID: PMC9558616 DOI: 10.7717/peerj.14191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/15/2022] [Indexed: 01/24/2023] Open
Abstract
Background Oral health perception is an influential predictor of both current and future health among the elderly. However, limited research has focused on self-rated oral health among older patients attending tertiary dental care. Therefore, this study aimed to explore the potential factors associated with self-rated oral health among elderly patients attending a university dental hospital in Thailand. Methods This telephone-based cross-sectional study was carried out among elderly patients older than 60 years who attended at least one dental visit at the university dental hospital in 2020. Hospital numbers (HN) were used to identify eligible candidates for this study. We calculated the sample size by assuming a finite population of 70,028 elderly patients with valid telephone numbers. The minimum sample required for this study was 398 participants. Trained interviewers conducted telephone calls between July 2021 and January 2022 using the validated modified oral health questionnaire. Self-rated oral health was assessed using a conventionally used global oral health question: "How would you describe your dental health?" with three response options: good, fair, and poor. Descriptive statistics, Fisher's exact test, and binary logistic regression were performed to analyze the data. Results A total of 836 telephone numbers were called. There were 402 (48.10%) elderly patients who agreed to and completed the telephone interview. Most of the study participants were women (61.4%) between 61-74 years of age (83.1%) with a mean age of 69.18 years. Bivariate analyses showed associations between poor self-rated oral health and lower subjective oral functions: chewing discomfort (p < 0.001) and speaking discomfort (p = 0.013). However, the multivariate regression model indicated a significant association between poor self-rated oral health and chewing discomfort (p < 0.001). Therefore, elderly patients with chewing discomfort were more likely to perceive poor oral health. Conclusions These findings indicate that difficulty chewing could be a potential factor influencing self-rated adverse oral health among older patients attending the university dental hospital. Furthermore, our study adds that the predictive power of a single-item self-measurement supports its value as a standard measure to predict oral health risk in tertiary care institutions, as well as primary care settings and community-based survey research. Therefore, healthcare providers should routinely evaluate self-rated oral health among elderly patients to detect early signs and symptoms of oral health problems, assess the success of dental treatments, and monitor general health and well-being.
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Affiliation(s)
- Nithimar Sermsuti-anuwat
- Academic Affairs Division of the Faculty of Dentistry, Chulalongkorn University, Bangkok, Wangmai, Pathumwan, Thailand
| | - Narongrit Nampikul
- Bachelor Programme in Doctor of Dental Surgery of the Faculty of Dentistry, Chulalongkorn University, Bangkok, Wangmai, Pathumwan, Thailand
| | - Rawitsara Suwannimit
- Bachelor Programme in Doctor of Dental Surgery of the Faculty of Dentistry, Chulalongkorn University, Bangkok, Wangmai, Pathumwan, Thailand
| | - Weerachon Panthueng
- Bachelor Programme in Doctor of Dental Surgery of the Faculty of Dentistry, Chulalongkorn University, Bangkok, Wangmai, Pathumwan, Thailand
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Zheng S, Zhao L, Ju N, Hua T, Zhang S, Liao S. Relationship between oral health-related knowledge, attitudes, practice, self-rated oral health and oral health-related quality of life among Chinese college students: a structural equation modeling approach. BMC Oral Health 2021; 21:99. [PMID: 33676475 PMCID: PMC7936478 DOI: 10.1186/s12903-021-01419-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 02/01/2021] [Indexed: 12/11/2022] Open
Abstract
Background This study aimed to evaluate the associations among oral health-related knowledge, attitudes, practice (KAP), self-rated oral health and oral health-related quality of life (OHRQoL) among Chinese college students. Methods Of the 2000 participants, 1751 (87.55%) students answered an online questionnaire between October 2019 and January 2020. The questionnaire included demographic characteristics, knowledge, attitudes, and practice related to oral health, self-rated oral health, and OHRQoL. Structural equation modelling was applied to assess the associations among study variables. Results Among the total students, oral health-related knowledge and attitudes were satisfactory, while the oral health practice was not optimistic. The final model showed satisfactory fitness to the data. Oral health knowledge was associated with attitudes directly and positively. Attitudes toward oral health had a direct and positive effect on practice. Oral health knowledge had an indirect effect on practice through attitudes. Oral health practice was directly associated with self-rated oral health. Oral health knowledge, practice, and self-rated oral health all affected OHRQoL directly and positively, while attitudes had a direct negative impact on OHRQoL. Conclusions OHRQoL was influenced by oral health knowledge, attitudes, practice, and self-rated oral health. Our findings support the KAP theory. Limitations of the KAP model were also found.
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Affiliation(s)
- Suge Zheng
- School of Medical Imaging, Bengbu Medical College, Bengbu, 233030, Anhui, China
| | - Lili Zhao
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, Anhui, China
| | - Nianting Ju
- School of Medical Imaging, Bengbu Medical College, Bengbu, 233030, Anhui, China
| | - Tiantian Hua
- School of Medical Imaging, Bengbu Medical College, Bengbu, 233030, Anhui, China
| | - Shunhua Zhang
- School of Medical Imaging, Bengbu Medical College, Bengbu, 233030, Anhui, China.
| | - Shengkai Liao
- Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, Anhui, China.
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Ju X, Hedges J, Garvey G, Smith M, Canfell K, Jamieson L. Poor self-rated oral health associated with poorer general health among Indigenous Australians. BMC Public Health 2021; 21:424. [PMID: 33648472 PMCID: PMC7919297 DOI: 10.1186/s12889-021-10426-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/10/2021] [Indexed: 01/01/2023] Open
Abstract
Background Oral diseases negatively impact general health, affecting physical, psychological, social and emotional wellbeing, and ability to give back to community. The relationship between poor oral health, and general health and wellbeing among Indigenous Australians has not been documented. Working in partnership with seven Indigenous communities in South Australia, this study aimed to: 1) quantify self-rated oral health and health-related quality of life and; 2) investigate associations between poor self-rated oral health and general health among Indigenous Australian adults. Methods Data was collected from a large convenience sample of Indigenous Australians aged 18+ years from Feb 2018 to Jan 2019. General health-related quality of life, as the main outcome variable, was measured by calculating disutility scores with the five individual EQ-5D dimensions (EuroQol instrument: EQ-5D-5L), then classified as ‘no problem’ and ‘at least one problem’. Self-reported oral health, as the main explanatory, was dichotomised into ‘fair or poor’ and ‘excellent, very good or good’. Multivariable log-Poisson regression models were used to estimate associations between poor self-rated oral health and general health by calculating mean rate ratios (MRR) for disutility scores and prevalence ratios (PR) for individual dimensions, after adjusting for social-demographic characteristics and health-related behaviours. Results Data were available for 1011 Indigenous South Australian adults. The prevalence of ‘fair or poor’ self-rated oral health was 33.5%. The mean utility score was 0.82 (95% CI: 0.81–0.83). Compared with those rating their oral health as ‘excellent or very good or good’, those who rated their oral health as ‘fair or poor’ had a mean disutility score that was 1.6 (95% CI: 1.1–2.2) times higher, and the prevalence of at least one problem ranged from 90 to 160% higher for individual EQ-5D dimensions. Conclusions Fair or poor self-rated oral health among Indigenous persons in South Australia was associated with poor general health as measured by EQ-5D-5L disutility. The relationship was especially evident with respect to mobility, self-care and anxiety/depression. The findings emphasise the importance of oral health as predictors of general health among Indigenous Australians. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10426-3.
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Affiliation(s)
- Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, 5005, Australia.
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, 5005, Australia
| | - Gail Garvey
- Menzies School of Health Research, Darwin, Australia
| | - Megan Smith
- Cancer Council of NSW, Woolloomooloo, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - Karen Canfell
- Cancer Council of NSW, Woolloomooloo, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, 5005, Australia
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Kim SY, Kim NH. Trends in Self-Rated Poor Oral Health Among all Age Populations in Korea from 2007 to 2015: Monitoring Expansion of Dental Insurance. Int Dent J 2021; 71:76-84. [PMID: 33616056 PMCID: PMC9275200 DOI: 10.1111/idj.12608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES This study explored trends in self-rated poor oral health (SRPOH) from 2007 to 2015 among all age groups to monitor changes after the expansion of dental insurance. METHODS Repeated cross-sectional data from 2007 to 2015 Korea National Health and Nutrition Examination Surveys were collected and analysed. The respondents (n = 20,199) were categorised into four age groups: 0-19, 20-44, 45-64, and ≥65 years. The outcome variable was SRPOH, with independent variables being socioeconomic factors, sex, household income, and education. The age-sex standardised prevalence rate was calculated to determine trends, and complex samples logistic regression analysis was performed to confirm the factors affecting SRPOH. RESULTS Self-rated poor oral health prevalence decreased significantly from 2007 to 2009 (25%) to 2013 to 2015 (14%) in the age groups of 0-19 and 20-44 years (P < 0.05), whereas the SRPOH prevalence in the age groups of 45-64 and ≥65 years did not undergo any significant changes. Although the prevalence decreased by 6% among older adults, over 40% older women still experienced SRPOH. A sex gap increased with age but did not change over time. SRPOH was strongly associated with sex, income, and education across all age groups; the association did not notably change from 2007 to 2015. CONCLUSIONS Self-rated poor oral health improved among younger people in Korea. The gender gap in the prevalence increased with age and persisted over time. However, income was the strongest determinant of SRPOH among all age groups, regardless of dental insurance expansion. Further studies should aim to draw causal inferences to explore the policy impact of dental insurance benefits.
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Affiliation(s)
- Song-Yi Kim
- Department of Dental Hygiene, The Graduate School, Yonsei University, Seoul, South Korea
| | - Nam-Hee Kim
- Department of Dental Hygiene, Wonju College of Medicine, Yonsei University, Wonju, South Korea.
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Silva MP, Vettore MV, Rebelo MAB, Rebelo Vieira JM, Herkrath APCDQ, Queiroz ACD, Herkrath FJ, Pereira JV. Clinical Consequences of Untreated Dental Caries, Individual Characteristics, and Environmental Factors on Self-Reported Oral Health Measures in Adolescents: A Follow-Up Prevalence Study. Caries Res 2020; 54:176-184. [PMID: 32294648 DOI: 10.1159/000506438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/12/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS This study evaluated the relationships of clinical consequences of untreated dental caries, individual characteristics, and environmental factors on self-reported oral health measures in adolescents. METHODS A follow-up prevalence study was conducted involving 406 twelve-year-old adolescents selected from public schools in the eastern area of the city of Manaus, Brazil. Baseline data included clinical consequences of untreated caries (PUFA/pufa index), DMFT, sociodemographic characteristics (sex, parental schooling, and family income), psychosocial factors (sense of coherence [SOC-13 scale], oral health beliefs and self-esteem [Rosenberg Self-Esteem Scale]), and social support (SSA questionnaire). Oral health-related quality of life (OHRQoL [CPQ11-14]) and self-rated oral health were assessed at the 6-month follow-up. Structural equation modelling was used to explore the relationships between variables according to the Wilson and Cleary model. RESULTS The prevalence of PUFA/pufa was 17.8% and mean DMFT was 1.5. The number of teeth with clinical consequences of untreated caries predicted poor self-rated oral health at the 6-month follow-up. Low parental schooling predicted low family income and clinical consequences of untreated dental caries. Psychosocial factors predicted OHRQoL directly and self-rated oral health indirectly. OHRQoL was linked to self-rated oral health. Clinical consequences of untreated dental caries mediated the relationship of parental schooling with OHRQoL and self-rated oral health. OHRQoL mediated the relationship of psychosocial factors and sex with self-rated oral health. Clinical consequences of untreated dental caries was associated with adolescents' self-rated oral health. Furthermore, the former was an important mediator on the link between low parental education and adolescents' self-reported oral health measures. CONCLUSIONS Socioeconomic status, psychosocial factors, and social support were related to OHRQoL and self-rated oral health via direct and indirect pathways.
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Affiliation(s)
| | - Mario Vianna Vettore
- School of Dentistry, Department of Social and Preventive Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil,
| | | | - Janete Maria Rebelo Vieira
- School of Dentistry, Department of Social and Preventive Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Fernando José Herkrath
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Brazil.,Superior School of Health Sciences, Amazonas State University, Manaus, Brazil
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Saho H, Ekuni D, Kataoka K, Taniguchi-Tabata A, Toyama N, Sugiura Y, Islam MM, Iwasaki Y, Morita M. Structural equation modeling to detect predictors of oral health-related quality of life among Japanese university students: a prospective cohort study. Qual Life Res 2019; 28:3213-3224. [PMID: 31359239 DOI: 10.1007/s11136-019-02251-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE This prospective cohort study of Japanese university students aimed to identify factors that might affect oral health-related quality of life (OHRQoL) and longitudinal relationships over a period of 3 years. METHODS Students (n = 487) provided complete data before entering and 3 years later (before university graduation) participated in the present study. Decayed, missing, and filled teeth (DMFT) scores, community periodontal index, ratios (%) of teeth with bleeding on probing, and malocclusion were determined during oral examinations. The questionnaire addressed age, sex, self-rated oral health, oral health behavior, subjective oral symptoms, and OHRQoL determined using the oral health impact profile (OHIP)-14. Associations were analyzed using structural equation modeling (SEM). RESULTS The OHRQoL significantly worsened according to OHIP-14 total score (p = 0.001). The final model in the symptoms of SEM analysis showed that OHRQoL at follow-up positively correlated with OHRQoL at baseline. Self-rated oral health was directly associated with the OHRQoL at baseline (p < 0.05). CONCLUSIONS This study determined that OHRQoL at baseline was a direct predictor, and that self-rated oral health were indirect predictors of OHRQoL at follow-up among Japanese university students.
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Affiliation(s)
- Hikari Saho
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Daisuke Ekuni
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Kota Kataoka
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Ayano Taniguchi-Tabata
- Departments of Preventive Dentistry, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Naoki Toyama
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yoshio Sugiura
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Md Monirul Islam
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yoshiaki Iwasaki
- Health Service Center, Okayama University, 2-1-1, Tsushimanaka, Kita-ku, Okayama, 700-8530, Japan
| | - Manabu Morita
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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Yamane-Takeuchi M, Ekuni D, Mizutani S, Kataoka K, Taniguchi-Tabata A, Azuma T, Furuta M, Tomofuji T, Iwasaki Y, Morita M. Associations among oral health-related quality of life, subjective symptoms, clinical status, and self-rated oral health in Japanese university students: a cross-sectional study. BMC Oral Health 2016; 16:127. [PMID: 27903265 DOI: 10.1186/s12903-016-0322-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 11/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study aimed to elucidate the associations among self-rated oral health, clinical oral health status, oral health behaviors, subjective oral symptoms, and oral health-related quality of life (OHRQoL) in a group of Japanese university students. METHODS Of 2051 participants, 2027 (98.83%) students received an optional oral examination and answered a questionnaire including items regarding age, sex, self-rated oral health, oral health behaviors, subjective oral symptoms, and OHRQoL [The Oral Health Impact Profile (OHIP)-14]. On oral examination, the decayed, missing, and filled teeth (DMFT) score, Community Periodontal Index (CPI), the percentage of teeth showing bleeding on probing (%BOP), and malocclusion were recorded. Structural equation modelling (SEM) analysis was used to test associations. RESULTS The mean score (± SD) of OHIP-14 was 1.92 ± 5.47. In the SEM analysis, the final model showed that self-rated oral health, oral pain, malocclusion, and the DMFT score were directly associated with the OHRQoL, and subjective symptoms of temporomandibular disorders (TMD) and recurrent aphthous stomatitis were both directly and indirectly associated (p < 0.05). CPI, %BOP, and oral health behaviors were excluded from the final model. CONCLUSIONS OHRQoL was associated with self-related oral health, subjective symptoms of TMD, oral pain and stomatitis, DMFT, and malocclusion in this group of Japanese university students.
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Abstract
BACKGROUND Oral health disparities exist in the USA. However, little is known of the relationship between oral health disparity and citizenship. The aims of this study were: (i) to describe the differences in self-rated oral health (SROH) between adult American citizens and non-citizens (>20 years of age); and (ii) to test whether factors such as frequency of dentist visits and socio-economic status (SES) are differently associated with SROH in these two groups. METHODS The data used in this study were drawn from the National Health and Nutrition Examination Survey conducted in 2011-2012. Weighted logistic regression models were used to detect the strengths of the association between a series of predictors and SROH. RESULTS More non-citizens (59.54%) than their citizen peers (26.24%) rated their oral health as fair/bad. All factors analysed in this study were differently associated with SROH based on citizenship. More specifically, natural characteristics, such as ethnicity and age, were significantly associated with SROH among non-citizens, and SES was significantly associated with American citizens. Among non-citizens, Hispanic, Non-Hispanic Black and Asian subjects were more likely than Non-Hispanic White subjects to report their oral health as being 'good'. Family poverty level, education and the frequency of dentist visits were significantly associated with SROH among citizens. CONCLUSION The findings of this study indicate that American immigrants report their oral health across most dimensions as being worse than do American citizens. Each explanatory factor may have a different strength of association with SROH in immigrants and citizens, which implies that different steps should be taken within these groups to reduce disparities in oral health.
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Affiliation(s)
- Ying Liu
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, Tennessee, USA
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Meredith P, Strong J, Ford P, Branjerdporn G. Associations between adult attachment and: oral health-related quality of life, oral health behaviour, and self-rated oral health. Qual Life Res 2016; 25:423-33. [PMID: 26238648 DOI: 10.1007/s11136-015-1089-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 02/06/2023]
Abstract
PURPOSE Although adult attachment theory has been revealed as a useful theoretical framework for understanding a range of health parameters, the associations between adult attachment patterns and a range of oral health parameters have not yet been examined. The aim of this study was to examine potential associations between attachment insecurity and: (1) oral health-related quality of life (OHRQoL), (2) oral health behaviours, and (3) self-rated oral health. In association with this aim, sample characteristics were compared with normative data. METHODS The sample in this cross-sectional study was comprised of 265 healthy adults, recruited via convenience sampling. Data were collected on attachment patterns (Experiences in Close Relationships Scale-Short Form, ECR-S), OHRQoL (Oral Health Impact Profile-14, OHIP-14), oral health behaviours (modified Dental Neglect Scale, m-DNS), and self-rated oral health (one-item global rating of oral health). Multivariate regression models were performed. RESULTS Both dimensions of attachment insecurity were associated with lowered use of favourable dental visiting behaviours, as well as decreased OHRQoL for both overall well-being and specific aspects of OHRQoL. Attachment avoidance was linked with diminished self-rated oral health. CONCLUSIONS This study supports the potential value of an adult attachment framework for understanding a range of oral health parameters. The assessment of a client's attachment pattern may assist in the identification of people who are at risk of diminished OHRQoL, less adaptive dental visiting behaviours, or poorer oral health. Further research in this field may inform ways in which attachment approaches can enhance oral health-related interventions.
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