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Diep MT, Skudutyte-Rysstad R, Sødal ATT, Young A, Hove LH. Caries experience and risk indicators of having decayed teeth among 65-year-olds in Oslo, Norway: a cross-sectional study. BMC Oral Health 2023; 23:726. [PMID: 37805466 PMCID: PMC10559471 DOI: 10.1186/s12903-023-03432-x] [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: 03/21/2023] [Accepted: 09/20/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Meeting the oral health needs of the increasing population of older adults presents a major challenge in dental care. Knowledge about the oral health status in the young-elderly age group is essential for the planning of future oral health education and prevention programs. The aims of the present study were therefore to investigate the caries experience among 65-year-olds in Oslo, Norway, and to explore associations between having decayed teeth and sociodemographic, behavioural, and biological factors. METHODS A random sample of 65‑year‑olds in Oslo answered a questionnaire and underwent clinical and radiographic examinations (n = 457, 52% men and 48% women) at the Research Clinic, Faculty of Dentistry, University of Oslo, between February and December 2019. Primary- and secondary coronal and root caries lesions, root remnants, and missing and restored teeth were recorded. Decayed teeth (DT) were defined as teeth with coronal- and root caries lesions that had progressed into dentine and root remnants, and the DMFT/S scores were calculated. RESULTS The mean number of teeth was 25 (SD: 4) and the mean DMFT was 19.4 (SD: 4.7). Thirty seven percent of the individuals had at least one decayed tooth (DT > 0), and the mean number of filled teeth (FT) was 16.1 (SD: 5.4). Multivariable logistic regression analysis showed that male gender (OR: 1.8, 95% CI: 1.2-2.8), basic level of education (OR: 1.9, 95% CI: 1.2-2.9), irregular dental attendance (OR: 2.2, 95% CI: 1.0-4.8), and hyposalivation (OR: 2.1, 95% CI: 1.0-4.4) were significant risk indicators for having decayed teeth (DT > 0) (p < 0.05). CONCLUSIONS In conclusion, 65-year-olds in Oslo had a low average number of decayed and missing teeth, and a high number of restored teeth. Irregular dental attendance and hyposalivation were the strongest risk indicators for having decayed teeth. Based on the present results, it will be important to ensure access to regular dental care and to increase the emphasis on caries preventive measures for individuals with hyposalivation in this age group.
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Affiliation(s)
- My Tien Diep
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, P.O. Box 1109, Oslo, N-0317, Norway.
| | - Rasa Skudutyte-Rysstad
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, P.O. Box 1109, Oslo, N-0317, Norway
- Oral Health Centre of Expertise in Eastern Norway, Sørkedalsveien 10A, Oslo, 0369, Norway
| | - Anne Thea Tveit Sødal
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, P.O. Box 1109, Oslo, N-0317, Norway
| | - Alix Young
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, P.O. Box 1109, Oslo, N-0317, Norway
| | - Lene Hystad Hove
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, P.O. Box 1109, Oslo, N-0317, Norway
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Faulks D, Scambler S, Daly B, Jamieson L, Hennequin M, Tsakos G. Measuring oral health-How can the International Classification of Functioning help? Community Dent Oral Epidemiol 2023; 51:153-164. [PMID: 35112389 DOI: 10.1111/cdoe.12732] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 01/07/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Abstract
There is a need for a theoretically informed, contextualized approach to measuring oral health from a multidisciplinary perspective that goes beyond the commonly used clinical indices and sociodental measures. This commentary aims to discuss the potential for the WHO's International Classification of Functioning, Disability and Health (ICF) to provide a model for the development of indicators for oral health. It is suggested that the ICF might provide both a theoretical model and an operational classification for indicators of oral health. The ICF model states that human experience of physical, cognitive and social functioning is universal and, thus, can be described and qualified. Human function is given social and environmental context within the model at both an individual and population level. The ICF can not only capture data regarding oral health and function at the physiological level (e.g. chewing) but also at the social level (e.g. sharing meals). It is able not only to capture aspects of preventive behaviour (e.g. caring for teeth) but also aspects of social facilitation (e.g. economic self-sufficiency) or ability to fulfil a social role (e.g. remunerative employment). It also includes aspects of social environment, such as healthcare services or political, economic and legal systems. Case studies are given as examples of the potential use of the ICF in the oral health domain. Examples are also given of the first steps that have been made towards operationalization of the ICF in data collection and oral health research. The challenges of encompassing such a comprehensive model into a practical oral health measure are discussed.
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Affiliation(s)
- Denise Faulks
- Service d'Odontologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Centre de Recherche en Odontologie Clinique (CROC) EA4847, Université Clermont Auvergne, UFR d'Odontologie, Clermont-Ferrand, France
| | - Sasha Scambler
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Tower Wing, Guy's Campus, London, UK
| | - Blánaid Daly
- Trinity College Dublin, School of Dental Sciences and Dublin Dental University Hospital, Dublin 2, Ireland
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Martine Hennequin
- Service d'Odontologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Centre de Recherche en Odontologie Clinique (CROC) EA4847, Université Clermont Auvergne, UFR d'Odontologie, Clermont-Ferrand, France
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, UCL, London, UK
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Tsakos G, Watt RG, Guarnizo-Herreño CC. Reflections on oral health inequalities: Theories, pathways and next steps for research priorities. Community Dent Oral Epidemiol 2023; 51:17-27. [PMID: 36744970 DOI: 10.1111/cdoe.12830] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 02/07/2023]
Abstract
Health inequalities, including those in oral health, are a critical problem of social injustice worldwide, while the COVID-19 pandemic has magnified previously existing inequalities and created new ones. This commentary offers a summary of the main frameworks used in the literature of oral health inequalities, reviews the evidence and discusses the potential role of different pathways/mechanisms to explain inequalities. Research in this area needs now to move from documenting oral health inequalities, towards explaining them, understanding the complex mechanisms underlying their production and reproduction and looking at interventions to tackle them. In particular, the importance of interdisciplinary theory-driven research, intersectionality frameworks and the use of the best available analytical methodologies including qualitative research is discussed. Further research on understanding the role of structural determinants on creating and shaping inequalities in oral health is needed, such as a focus on political economy analysis. The co-design of interventions to reduce oral health inequalities is an area of priority and can highlight the critical role of context and inform decision-making. The evaluation of such interventions needs to consider their public health impact and employ the wider range of methodological tools available rather than focus entirely on the traditional approach, based primarily on randomized controlled trials. Civil society engagement and various advocacy strategies are also necessary to make progress in the field.
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Affiliation(s)
- Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
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Rocha-Ortiz JA, Tepox-Puga SM, Borges-Yañez SA, Mendoza-Rodríguez M, Escoffié-Ramirez M, Minaya-Sánchez M, Casanova-Rosado JF, Casanova-Rosado AJ, Pontigo-Loyola AP, Medina-Solis CE. Tooth Loss and Associated Factors in Mexican Older Adults in Nursing Homes: A Multicenter Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2023; 2023:4169097. [PMID: 37096226 PMCID: PMC10122601 DOI: 10.1155/2023/4169097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/07/2023] [Accepted: 02/18/2023] [Indexed: 04/26/2023]
Abstract
The objective of this study was to determine the experience of tooth loss and associated factors in older adults and elderly residing in nursing homes. A cross-sectional study was conducted in Mexican older adults and elderly aged ≥60 years living in four nursing homes (two in Mexico City, Mexico: one in Cuernavaca, Morelos, and one in Oaxaca, Oaxaca). The data were collected at the facility (home nursing) by two dentists in 2019. To determine the number of tooth loss and DMFT, a clinical oral examination was performed. In addition, a questionnaire was applied to determine diverse independent variables (demographic, socioeconomic, and behavioral). The analysis was performed using nonparametric tests and negative binomial regression (p < 0.05). 257 subjects were included. The mean age was 81.25 ± 9.02 years, and 60.7% were women. The mean number of lost teeth was 18.78 ± 9.05 (women = 19.43 ± 8.59 and men = 17.77 ± 9.68; p > 0.05). In the multivariate negative binomial regression model, it was found that, for each one-year increase in age, the mean tooth loss increased 0.92% (p < 0.05). In current smokers (p < 0.01) and in those who brush their teeth < 2 times a day (p < 0.01), the average of tooth loss increased 22.04% and 61.46%, respectively. The experience of tooth loss in Mexican older adults and elderly was high. Demographic (age) and habit of behavior (tobacco use and less frequent tooth brushing) were associated with increased tooth loss. It is important to promote oral health programs for institutionalized older adults.
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Affiliation(s)
- Jesús Alberto Rocha-Ortiz
- Master and Doctoral Program in Medical, Dental and Health Sciences at the School of Dentistry, National Autonomous University of México, 04510 Mexico City, Mexico
| | - Sandra Manuela Tepox-Puga
- Master and Doctoral Program in Medical, Dental and Health Sciences at the School of Dentistry, National Autonomous University of México, 04510 Mexico City, Mexico
| | - S. Aída Borges-Yañez
- Dental Public Health Department, Graduate and Research Division at the School of Dentistry, National Autonomous University of México, 04510 Mexico City, Mexico
| | - Martha Mendoza-Rodríguez
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, 42160 Pachuca, Mexico
| | | | | | | | | | | | - Carlo Eduardo Medina-Solis
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, 42160 Pachuca, Mexico
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata” of School of Dentistry at Autonomous University State of Mexico, Toluca, Mexico
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Exploring Dental Health and Its Economic Determinants in Romanian Regions. Healthcare (Basel) 2022; 10:healthcare10102030. [PMID: 36292476 PMCID: PMC9602271 DOI: 10.3390/healthcare10102030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/04/2022] Open
Abstract
Sustainable dental health is reflected in the high quality of the medical act and the high quality of the medical service, which cannot be achieved without considering the existing social context, especially the economic development of a state, where certain economic variables can become real levers of influence. The goal of this paper is twofold-theoretical and empirical. Firstly, at the theoretical level, we provide the context and the development of the health legal framework and the state of the Oral Health System and the provision of dental medical services in the eight Romanian Regions of Development. The second aim is to evaluate the relationship between dental health and well-being for the case of regions of Romania over the period 2001-2015. To review the dental health care in Romania, we will use descriptive analysis as the methodology, and to explore the relationship between dental health and economic determinants, we will use an econometric model, the OLS model. Our working hypothesis is that dental health care is influenced by the economic variables in a country. The results show a positive and significant relationship between dental health care and the most important indicator of well-being, the level of income. Of course, an important role is played by the complexity of education, expressed by research and development, which determines a significant positive relationship with dental health in the development regions of Romania.
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Kanagasingam S, von Ruhland C, Welbury R, Chukkapalli SS, Singhrao SK. Porphyromonas gingivalis Conditioned Medium Induces Amyloidogenic Processing of the Amyloid-β Protein Precursor upon in vitro Infection of SH-SY5Y Cells. J Alzheimers Dis Rep 2022; 6:577-587. [PMID: 36275415 PMCID: PMC9535609 DOI: 10.3233/adr-220029] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/23/2022] [Indexed: 12/27/2022] Open
Abstract
Background: Cleavage of the amyloid-β protein precursor (AβPP) mediated by host secretase enzymes, releases several fragments including amyloid-β (Aβ40 and Aβ42). Objective: To determine if Porphyromonas gingivalis conditioned medium cleaved AβPP to release Aβ40 and Aβ42. Methods: The SH-SY5Y cell line was challenged, in vitro, with P. gingivalis (Pg381) conditioned medium in the presence/absence of cytokines. The cells and their supernatants were assessed for AβPP cleavage fragments by immunoblotting and transmission electron microscopy. Results: Western blotting of the cell lysates with the anti-AβPP C-terminal antibody demonstrated variable molecular weight bands corresponding to full length and fragmented AβPP in lanes treated with the following factors: Tryptic soy broth (TSB), Pg381, IL-6, Pg381 + IL-1β, and Pg381 + TNF-α. The low molecular weight bands corresponding to the C99 dimerized fragment were observed in the Pg381 and interlukin-6 (IL-6) treated groups and were significantly more intense in the presence of Pg381 with either IL-6 or TNF-α. Bands corresponding to the dimerized C83 fragment were observed with cells treated with TNF-α alone and with Pg381 combined with IL-1β or IL-6 or TNF-α. The anti-Aβ antibody detected statistically significant Aβ40 and Aβ42, levels when these two Aβ species were pooled across test samples and compared to the untreated group. Electron microscopic examination of the supernatants demonstrated insoluble Aβ40 and Aβ42. Conclusion: These observations strongly imply that AβPP is an infection responsive protein cleaved via the amyloidogenic pathway on exposure to conditioned medium and in the presence of pro-inflammatory mediators.
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Affiliation(s)
- Shalini Kanagasingam
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Christopher von Ruhland
- Electron and Light Microscopy Facility, College of Biomedical and Life Sciences, Cardiff University, Wales, UK
| | - Richard Welbury
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | | | - Sim K. Singhrao
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
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Nouraei N, Sabbah W. Health-risk behaviours co-occur among children with untreated caries. Int J Dent Hyg 2022. [PMID: 35922901 DOI: 10.1111/idh.12603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/09/2022] [Accepted: 07/31/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to examine whether an aggregate of health risk behaviours is associated with the number of untreated dental caries among 12- and 15-year-old children in England, Wales and Northern Ireland. MATERIALS AND METHODS Data were from the Children's Dental Health Survey (CDHS) 2013, a nationally representative sample of England, Wales and Northern Ireland. The survey included assessment of oral health and data on socioeconomic, demographic and behavioural factors pertaining to children aged 12-15 years. Tooth condition (decayed, missing and filled) was assessed by NHS dentists. The survey included questions on age, sex, country, index of multiple deprivation, smoking, alcohol consumption, frequent sugar consumption and sweetened sodas, infrequent dental visit, infrequent toothbrushing and infrequent consumption of fresh fruits. Health risk behaviours were summed up to create an aggregate variable of health risk behaviour. The association between number of untreated caries and the aggregate of health risk behaviours was assessed using negative binomial regression and adjusting for age, sex, country and deprivation. RESULTS The total number of children included in the analysis was 4414. The mean number of untreated caries was generally higher among children with health risk behaviours. The aggregate of risk behaviour was associated with greater prevalence of untreated dental caries with rate ratio (RR) 1.26 (95% confidence interval: 1.18, 1.36). CONCLUSION This study demonstrated an association between an aggregate of health risk behaviours and untreated caries. The findings highlight the importance of addressing multiple risk factors not only those directly related to dental caries.
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Affiliation(s)
- Nastaran Nouraei
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Fagundes MLB, Amaral Júnior OLD, Menegazzo GR, Bastos LF, Hugo FN, Abreu LG, Iser BPM, Giordani JMDA, Hilgert JB. Pathways of socioeconomic inequalities in self-perceived oral health. Braz Oral Res 2022; 36:e088. [PMID: 35703713 DOI: 10.1590/1807-3107bor-2022.vol36.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
Although there is a large body of evidence of the influence of social determinants on oral health, information on the mechanisms by which these determinants operate is poorly documented. Therefore, we aimed to investigate the pathways through which socioeconomic inequalities may influence self-perceived oral health (SPOH) in Brazilian adults. This cross-sectional study used data from the National Health Survey (NHS) of 2019, with a representative sample of adults aged 18 to 59 years (n = 65,803). The outcome was SPOH, assessed by a global self-item. Structural equation modeling was used to test direct and indirect pathways connecting a latent variable for socioeconomic position (SEP) to SPOH via psychosocial, behavioral, and biological factors. Higher SEP was directly associated with better SPOH [standardized coefficient (SC) = 0.069; p < 0.01)] fewer depressive symptoms (SC = -0.059; p < 0.01), fewer missing teeth (SC = 0.131; p < 0.01), and more healthy behaviors (SC = 0.643; p < 0.01). Fewer depressive symptoms (SC = -0.141; p < 0.01), more healthy behaviors (SC = 0.242; p < 0.01), and fewer missing teeth (SC = 0.058; p < 0.01) were directly associated with good SPOH. Among specific indirect effects of SEP on SPOH, the behavioral pathway was the one that best explained this association (SC = 0.155). Socioeconomic inequities in SPOH are mediate by psychosocial, behavioral, and biological factors. This has implications for positioning health strategies in the social context in which people live, to facilitate healthy choices and promote good oral health.
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Affiliation(s)
- Maria Laura Braccini Fagundes
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil
| | - Orlando Luiz do Amaral Júnior
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil .,Unidade Central de Educação FAI Faculdades - UCEFF , School of Dentistry , Department of Oral Health , Itapiranga , SC , Brazil
| | - Gabriele Rissotto Menegazzo
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil
| | - Lucelen Fontoura Bastos
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Child and Adolescent Oral Health , Belo Horizonte . MG , Brazil
| | - Betine Pinto Moehlecke Iser
- Universidade do Sul de Santa Catarina - Unisul, Post-Graduate Program in Health Sciences , Tubarão , SC , Brazil
| | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
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Araujo DAM, Carvalho RBND, Oliveira ASSD, Oliveira EAR, Machado ALG, Lima LHDO. Temporal trend of simultaneous risk factors for chronic non-communicable diseases: National School Health Survey 2009, 2012, 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220013. [PMID: 35674577 DOI: 10.1590/1980-549720220013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/13/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the temporal trend of simultaneous occurrence of behavioral risk factors for chronic non-communicable diseases in Brazilian school adolescents. METHODS Ecological time-series study that analyzed data from the three editions of the National Survey of School Health with students in the 9th year of public and private schools. Cluster analysis was performed to identify the simultaneity of the following factors: irregular consumption of fresh or minimally processed foods, regular consumption of processed and ultra-processed foods, insufficient level of physical activity during leisure time, consumption of alcoholic beverages, use of cigarettes and illicit drugs. The cluster trend was tested using simple linear regression. RESULTS The sample was composed of 173,310 school adolescents. Sixty-four possible combinations were evaluated, resulting in the formation of six clusters. The grouping formed by all factors showed the highest ratios observed/expected prevalence in the last two years of the series. The highest ratios were observed for combinations in which alcohol and cigarettes were present. These substances integrated five of the six clusters. One of the groups (insufficient level of physical activity during leisure time + consumption of alcoholic beverages + use of cigarettes and illicit drugs) had an upward trend throughout the series. CONCLUSION The trend analysis showed four out of six clusters remaining stable throughout the series, which shows that the factors are persistently present among school adolescents.
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Cardiovascular Diseases and Periodontitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:261-280. [PMID: 35612803 DOI: 10.1007/978-3-030-96881-6_14] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontitis is a chronic inflammatory disease of the tooth-supporting connective tissue and alveolar bone that is initiated by a bacterial biofilm in periodontal pockets. It affects about half of adults in the Western world, and is associated with a range of systemic comorbidities, e.g., cardiovascular disease (CVD), diabetes and rheumatoid arthritis, and these diseases share overlapping systemic and target tissue inflammatory mechanisms. Indeed, mounting evidence has indicated that their association is causal and built on the presence of systemic low-grade inflammation (LGI). Prior research linking periodontitis to CVD has mainly been derived from experimental studies, observational data, and small interventional trials with surrogate markers of CVD, e.g., endothelial dysfunction. However, recent data from randomised studies have demonstrated that intensive treatment of periodontitis can reduce blood pressure in patients with hypertension in conjunction with reduction of systemic inflammatory markers. Furthermore, targeted anti-inflammatory therapy has been shown to reduce recurrent events in patients with established CVD and LGI. Along this line, the concept of residual inflammatory risk has emerged as an independent new risk factor for atherothrombotic CVD. The present review summarizes translational evidence indicating that periodontitis is a risk factor for CVD dependent on LGI, and we conclude that treatment of periodontitis is likely to contribute importantly to reduction of residual inflammatory risk.
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Harding A, Kanagasingam S, Welbury R, Singhrao SK. Periodontitis as a Risk Factor for Alzheimer's Disease: The Experimental Journey So Far, with Hope of Therapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:241-260. [PMID: 35612802 DOI: 10.1007/978-3-030-96881-6_13] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis and Alzheimer's disease (AD) exist globally within the adult population. Given that the risk of AD incidence doubles within 10 years from the time of periodontal disease diagnosis, there is a window of opportunity for slowing down or preventing AD by risk-reduction-based intervention. Literature appraisal on the shared risk factors of these diseases suggests a shift to a healthy lifestyle would be beneficial. Generalised (chronic) periodontitis with an established dysbiotic polymicrobial aetiology affects the tooth supporting tissues with eventual tooth loss. The cause of AD remains unknown, however two neurohistopathological lesions - amyloid-beta plaques and neurofibrillary tangles, together with the clinical history, provide AD diagnosis at autopsy. Historically, prominence was given to the two hallmark lesions but now emphasis is placed on cerebral inflammation and what triggers it. Low socioeconomic status promotes poor lifestyles that compromise oral and personal hygiene along with reliance on poor dietary intake. Taken together with advancing age and a declining immune protection, these risk factors may negatively impact on periodontitis and AD. These factors also provide a tangible solution to controlling pathogenic bacteria indigenous to the oral and gastrointestinal tract microbioes in vulnerable subjects. The focus here is on Porphyromonas gingivalis, one of several important bacterial pathogens associated with both periodontitis and AD. Recent research has enabled advances in our knowledge of the armoury of P. gingivalis via reproduction of all clinical and neuropathological hallmark lesions of AD and chronic periodontal disease in vitro and in vivo experimental models, thus paving the way for better future management.
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Affiliation(s)
- Alice Harding
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Shalini Kanagasingam
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Richard Welbury
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Sim K Singhrao
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK.
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12
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The impact of the COVID-19 pandemic on oral health inequalities and access to oral healthcare in England. Br Dent J 2022; 232:109-114. [PMID: 35091614 PMCID: PMC8796193 DOI: 10.1038/s41415-021-3718-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/13/2021] [Indexed: 11/26/2022]
Abstract
While the impact of the coronavirus disease (COVID-19) pandemic on health inequalities is documented, oral health has been absent from this discussion. This commentary highlights the potential impacts of the COVID-19 pandemic on oral health inequalities in England in February 2021. It includes a literature review, Public Health England and Kantar Worldpanel sales data on health behaviours and analysis of NHS dental services data. Purchasing data indicate, except for smoking, increases in health-compromising behaviours. Since the resumption of dental services, NHS general dental service use modestly recovered among adults but not children by October 2020. There are clear inequalities among children and older adults, with more deprived groups having lower uptake of dental service use than more affluent groups. Oral cancer referrals and hospital admissions for tooth extractions in children dramatically declined, with the latter primarily affecting children in more deprived areas. Many oral health programmes in schools and care homes were disrupted or suspended throughout this period. All these indicate that oral health inequalities have widened due to the COVID-19 pandemic. An oral health plan of action requires prioritising long-term investment in public health programmes and transforming commissioning pathways to support those with the greatest needs to access oral healthcare services. People living in more deprived areas have fared worse than people living in less deprived areas, in terms of uptake of NHS primary dental care following the resumption of services in June 2020. The cessation of oral health improvement programmes in the community and the dramatic decline of hospital dental services due to the COVID-19 pandemic have also primarily impacted the more socially disadvantaged groups, further widening inequalities. Addressing the widened oral health inequalities requires long-term investment in oral health, prioritising public health programmes and supporting access to services.
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Araujo DAM, Carvalho RBND, Oliveira ASSD, Oliveira EAR, Machado ALG, Lima LHDO. Tendência temporal dos fatores de risco simultâneos para doenças crônicas não transmissíveis: Pesquisa Nacional de Saúde do Escolar 2009, 2012, 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220013.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Analisar a tendência temporal da ocorrência simultânea de fatores de risco comportamentais para doenças crônicas não transmissíveis em adolescentes escolares brasileiros. Métodos: Estudo ecológico de série temporal, que analisou os dados das três edições da Pesquisa Nacional de Saúde do Escolar dos alunos do 9º ano de escolas públicas e privadas. Realizou-se a análise de cluster para a identificação da simultaneidade dos seguintes fatores: consumo irregular de alimentos in natura ou minimamente processados, consumo regular de alimentos processados e ultraprocessados, nível insuficiente de atividade física no lazer, consumo de bebidas alcoólicas, uso de cigarro e de drogas ilícitas. A tendência dos clusters foi testada utilizando-se regressão linear simples. Resultados: A amostra constituiu-se de 173.310 escolares. Sessenta e quatro possíveis combinações foram avaliadas, havendo a formação de seis clusters. O agrupamento formado por todos os fatores apresentou as maiores razões entre prevalências observadas e esperadas para os dois últimos anos da série. As maiores razões foram verificadas para as combinações em que estavam presentes o álcool e o cigarro. Além disso, essas substâncias integraram cinco dos seis clusters. Um dos agrupamentos (nível insuficiente de atividade física no lazer + consumo de bebidas alcóolicas + uso de cigarro e drogas ilícitas) apresentou tendência crescente durante toda a série. Conclusão: A análise de tendência constatou que quatro de seis clusters mantiveram-se estáveis durante toda a série, demonstrando que os fatores continuam presentes de forma persistente entre os adolescentes escolares.
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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] [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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15
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BAKIR EP, KOKOZ ÇİTAKER Ö, BAKIR Ş. Relationship of socioeconomic status and oral-dental health in the Southeastern Anatolia. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.945517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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16
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Venturelli R, Ntouva A, Porter J, Stennett M, Crawford MJ, Britton A, Gratus C, Tsakos G, Heilmann A, Newton T, Redican C, Pikhart H, Watt RG. Use of AUDIT-C alcohol screening tool in NHS general dental practices in North London. Br Dent J 2021:10.1038/s41415-021-2964-5. [PMID: 33986481 DOI: 10.1038/s41415-021-2964-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/10/2020] [Indexed: 11/09/2022]
Abstract
Background The numerous health risks of excessive alcohol consumption are well documented. Individuals at risk of harm from alcohol consumption can be identified through alcohol screening tools; however, there is limited research regarding their use in general dental practices.Methods Data were collected as part of a feasibility trial evaluating delivery of brief alcohol advice in general dental practices in North London. Patient demographics and health-related behaviours were collected, and the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) tool was used to assess alcohol consumption patterns.Results The analytical sample comprised 552 dental patients, of whom approximately half (46%) were drinking alcohol at hazardous levels. Males, younger adults, those who consumed red meat weekly and smokers all had significantly increased risks of excessive alcohol consumption. Smokers were more likely to consume excessive levels of alcohol irrespective of smoking frequency. Notable sex differences in alcohol consumption were identified, with males being more likely to consume alcohol frequently and in larger quantities than females.Conclusion The AUDIT-C tool can be used in general dental practice to screen for harmful levels of alcohol consumption. Clear associations exist between patient demographics, health behaviours and excessive alcohol consumption.
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Affiliation(s)
| | | | - Jessie Porter
- Department of Epidemiology and Public Health, UCL, UK
| | | | | | - Annie Britton
- Department of Epidemiology and Public Health, UCL, UK
| | | | | | - Anja Heilmann
- Department of Epidemiology and Public Health, UCL, UK
| | - Tim Newton
- King's College London Dental Institute, King's College London, UK
| | - Caillin Redican
- , General Dental Practitioner and Health Education England, UK
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, UCL, UK
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17
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Guarnizo-Herreño CC, Scholes S, Heilmann A, O'Connor R, Fuller E, Shen J, Watt RG, Morris S, Wildman J, Tsakos G. Dental attendance and behavioural pathways to adult oral health inequalities. J Epidemiol Community Health 2021; 75:1063-1069. [PMID: 33893184 DOI: 10.1136/jech-2020-216072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/22/2021] [Accepted: 04/13/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND While inequalities in oral health are documented, little is known about the extent to which they are attributable to potentially modifiable factors. We examined the role of behavioural and dental attendance pathways in explaining oral health inequalities among adults in England, Wales and Northern Ireland. METHODS Using nationally representative data, we analysed inequalities in self-rated oral health and number of natural teeth. Highest educational attainment, equivalised household income and occupational social class were used to derive a latent socioeconomic position (SEP) variable. Pathways were dental attendance and behaviours (smoking and oral hygiene). We used structural equation modelling to test the hypothesis that SEP influences oral health directly and also indirectly via dental attendance and behavioural pathways. RESULTS Lower SEP was directly associated with fewer natural teeth and worse self-rated oral health (standardised path coefficients, -0.21 (SE=0.01) and -0.10 (SE=0.01), respectively). We also found significant indirect effects via behavioural factors for both outcomes and via dental attendance primarily for self-rated oral health. While the standardised parameters of total effects were similar between the two outcomes, for number of teeth, the estimated effect of SEP was mostly direct while for self-rated oral health, it was almost equally split between direct and indirect effects. CONCLUSION Reducing inequalities in dental attendance and health behaviours is necessary but not sufficient to tackle socioeconomic inequalities in oral health.
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Affiliation(s)
- Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Shaun Scholes
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Anja Heilmann
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rhiannon O'Connor
- School of Dental Sciences and Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
| | | | - Jing Shen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,GlaxoSmithKline, Wavre, Belgium (Although Jing Shen works now for GSK, the work associated with the paper was conducted during her time at Newcastle University)
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Steve Morris
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - John Wildman
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
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Watt RG, Serban S. Multimorbidity: a challenge and opportunity for the dental profession. Br Dent J 2020; 229:282-286. [PMID: 32918011 PMCID: PMC7485176 DOI: 10.1038/s41415-020-2056-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Indexed: 12/21/2022]
Abstract
Multimorbidity (the coexistence of two or more chronic conditions) is common, is likely to be on the increase and has a major impact on quality of life, increased risk of mortality, and significant financial costs to the health and social care system. Multimorbidity is strongly associated with increasing age and is also directly linked to socioeconomic status. A substantial body of scientific evidence has shown an association between specific oral diseases and a range of other health conditions. Less is known, however, about the inter-relationships between oral diseases and multiple other health conditions. As multimorbidity is increasingly becoming the norm, rather than the exception, a profound shift is now needed in the training of oral health professionals, and the practice and delivery of dental care. A more integrated and coordinated approach to training and care is needed, which will require radical system-level reform and redesign of how health and dental services are commissioned, delivered and financed. Truly multidisciplinary teamwork requires system reform to facilitate effective joint working. The pattern of disease in society is changing and the dental profession needs to respond accordingly.
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Affiliation(s)
- Richard G Watt
- Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Stefan Serban
- School of Dentistry, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK
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19
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Kaunein N, Singh A, King T. Associations between Individual-level and Area-level social disadvantage and oral health behaviours in Australian adolescents. Aust Dent J 2020; 65:286-293. [PMID: 32894571 DOI: 10.1111/adj.12792] [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] [Accepted: 08/18/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral health behaviours are significant determinants of oral health. There is evidence that socioeconomic position influences oral health behaviours, but little is known about this association during adolescence. This study aims to investigate the association between social disadvantage (individual and area level) and oral health behaviours among Australian adolescents. METHODS This study utilized data from the Longitudinal Study of Australian Children (LSAC). The sample consisted of 2877 adolescents. Exposure measures were area-level social disadvantage (Socioeconomic Indexes for Areas) and parent-reported household income from Wave 5. Outcomes, measured in Wave 6, were three different adolescent-reported oral health behaviours: frequency of brushing, consumption of sugar-sweetened beverages (SSB) and dental visits. Associations between quintiles of each exposure and each oral health behaviour were tested by fitting multivariable logistic regression models. RESULTS Household income and area-level disadvantage were associated with dental visits and brushing frequency. Associations between social disadvantage and consumption of SSBs were less apparent, with only the least disadvantaged adolescents having lower odds of consumption of SSBs compared to the most disadvantaged group. CONCLUSION Individual and area-level socioeconomic factors are associated with dental visits, and frequency of brushing.Broad population-based strategies must be adopted to reduce intake of SSBs, however, targeted strategies are needed among more disadvantaged populations to address infrequent toothbrushing and irregular dental visits among adolescents.
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Affiliation(s)
- Nadia Kaunein
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ankur Singh
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tania King
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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20
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Birch J, Petty R, Hooper L, Bauld L, Rosenberg G, Vohra J. Clustering of behavioural risk factors for health in UK adults in 2016: a cross-sectional survey. J Public Health (Oxf) 2020; 41:e226-e236. [PMID: 30192965 PMCID: PMC6785700 DOI: 10.1093/pubmed/fdy144] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 06/26/2018] [Indexed: 01/07/2023] Open
Abstract
Background Foods high in fat, sugar and salt (HFSS) are known to contribute to overweight and obesity. In addition to overweight and obesity, smoking, alcohol consumption and physical inactivity are known risk factors for non-communicable diseases, including several cancers and cardiovascular disease. Methods Secondary analysis of UK-representative cross-sectional survey data of 3293 adults aged 18+. Regression analyses were undertaken to understand the relationship between consumption of HFSS food and soft drinks, alcohol and tobacco and socio-demographics. Clustering analysis identified groupings of health risk factors. Results Males, those aged 18–24 and those from the more deprived groups consumed ready meals and fast food most frequently. Most of the sample (77.3%) engaged in at least one health risk behaviour. Six clusters were identified in the clustering analysis. Older (65+) female respondents were more likely to be inactive. Smokers exhibiting additional risk behaviours were more likely to be of working age from more deprived groups, and men over 65 were more likely to consume harmful levels of alcohol with additional risk factors. Conclusion Policies and services in the UK tend to focus on changing behaviour to address individual risk factors. This study shows that policies and interventions need to address multiple risk factors.
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Affiliation(s)
- Jack Birch
- Cancer Policy Research Centre (CPRC), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
| | - Robert Petty
- Cancer Policy Research Centre (CPRC), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
| | - Lucie Hooper
- Cancer Policy Research Centre (CPRC), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
| | - Linda Bauld
- Cancer Research UK, Angel Building, 407 St. John Street, London, UK.,University of Stirling, Stirling, UK
| | - Gillian Rosenberg
- Cancer Policy Research Centre (CPRC), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
| | - Jyotsna Vohra
- Cancer Policy Research Centre (CPRC), Cancer Research UK, Angel Building, 407 St. John Street, London, UK
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21
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Mathur MR, Singh A, Mishra VK, Parmar P, Nagrath D, Watt RG, Tsakos G. Socioeconomic Inequalities in Clustering of Health-Compromising Behaviours among Indian Adolescents. Indian J Community Med 2020; 45:139-144. [PMID: 32905194 PMCID: PMC7467189 DOI: 10.4103/ijcm.ijcm_349_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/19/2020] [Indexed: 11/04/2022] Open
Abstract
Background The simultaneous occurrence of health-compromising behaviors can accentuate the risk of noncommunicable diseases (NCDs). This study aimed to examine the existence and patterns of clustering of four NCD risk behaviors among adolescents and its association with social position. In addition, socioeconomic inequalities in the occurrence of clustering of NCD risk behaviors were also assessed. Methods A cross-sectional study was undertaken among 1218 adolescents (14-19 years old) in the city of New Delhi, India. An interviewer-administered questionnaire was used to assess health-compromising behaviors (tobacco and alcohol use, fruit/vegetable intake, and physical inactivity). Clustering was assessed using pairwise correlations, counts of clustering of health-compromising behaviors, comparison of observed/expected ratios, and hierarchical agglomerative cluster analysis. Multivariable logistic regressions were used to test the associations of clustering with social position (education and wealth). The relative and slope indices of inequalities in the presence of clustering of behaviors according to education and wealth were estimated. Results Three major clusters of health behaviors emerged: (a) physical inactivity + lower fruit and vegetable intake, (b) tobacco + alcohol use, and (c) lower fruit and vegetable intake + tobacco + alcohol use. Pronounced clustering of health-compromising behaviors was observed with lower educational attainment and wealth. Conclusion The presence of clustering of health-compromising behaviors was considerably higher among adolescents with lower educational attainment and wealth. The area of residence has an important influence on socioeconomic inequalities in clustering of NCD risk factors.
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Affiliation(s)
- Manu Raj Mathur
- Department of Non-Communicable Diseases and Health Policy, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Ankur Singh
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Melbourne, Adelaide, Australia
| | - Vijay Kumar Mishra
- Department of Non-Communicable Diseases and Health Policy, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Priyanka Parmar
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Deepti Nagrath
- Department of Non-Communicable Diseases and Health Policy, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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22
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Austregésilo SC, de Goes PSA, de Sena Júnior MR, Pazos CTC. Clustering of oral and general health risk behaviors among adolescents. Prev Med Rep 2019; 15:100936. [PMID: 31372328 PMCID: PMC6661380 DOI: 10.1016/j.pmedr.2019.100936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/19/2019] [Accepted: 06/27/2019] [Indexed: 11/06/2022] Open
Abstract
Since the co-occurrence of several health-risk behaviors is associated with an increase in chronic diseases, the study of clustering is relevant. The aim of this study was to evaluate how seven types of general and oral health-risk behaviors, cluster among adolescents. A cross-sectional analysis was performed with a sample of high school students from state public schools in São Lourenco da Mata, State of Pernambuco, Brazil (n = 1154). Data were obtained using a self-reported questionnaire. To identify cluster solutions of seven general and oral health-risk behaviors, Hierarchical Agglomerative Cluster Analysis (HACA) was performed. Most of the adolescents participating in the study was female (54.3%) and aged <16 years old (77.1%). HACA indicated two broad stable clusters for the seven health-risk types of behaviors. The first cluster included following behaviors: smoking, drinking and less frequent tooth brushing. The second cluster reveals the combination of high bread, pasta and snack intake; high intake of sweets; high intake of soft drinks; low intake of fruits and vegetables. Results provided by HACA identified two groups of health-risk behaviors. The first cluster mainly shows risk (problematic) behaviors, whereas the second cluster denotes the non-adhesion of preventive behavior (non-healthy diet). Health-compromising behaviors are common among teens and occur in distinct clusters. These findings could be used by schools, health promotion authorities and other stakeholders to design and implement tailored preventive interventions in Pernambuco, Brazil. Therefore, clustering of several types of behavior has important implications for a comprehensive strategy in health promotion policies and practices. Health-related behaviors tend to cluster in different patterns. Two broad stable clusters were indicated for the seven health-risk types of behaviors. Risk behaviors affect not merely oral health but also overall health. Clustering was similar for males and females. Clustering of behavior has important implications for a comprehensive plan in health promotion.
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Affiliation(s)
- Silvia Carréra Austregésilo
- Federal University of Pernambuco, Postgraduate Program in Child and Adolescent Health of the Federal University of Pernambuco, Recife, PE, Brazil
| | - Paulo Sávio Angeiras de Goes
- Federal University of Pernambuco, Department of Clinical and Preventive Dentistry of the Federal University of Pernambuco, Recife, PE, Brazil
| | | | - Carolina Thaiza Costa Pazos
- Federal University of Pernambuco, Postgraduate Program in Child and Adolescent Health of the Federal University of Pernambuco, Recife, PE, Brazil
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Mehra VM, Costanian C, Khanna S, Tamim H. Dental care use by immigrant Canadians in Ontario: a cross-sectional analysis of the 2014 Canadian Community Health Survey (CCHS). BMC Oral Health 2019; 19:78. [PMID: 31068166 PMCID: PMC6505204 DOI: 10.1186/s12903-019-0773-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 04/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ontario is home to the largest number of immigrants in Canada. However, very little is known about their dental care utilization patterns. The purpose of this study is to determine the prevalence of poor dental health care use among the immigrant population of Ontario and how various socio-demographic, socio-economic and health-related factors are associated with it. METHODS Analysis was performed on a total of 4208 Ontarian immigrants who participated in the dental care module of the 2014 cycle of the Canadian Community Health Survey. Poor dental care use was defined by the two variables: not visiting the dentist in the past year and/or visiting the dentist only for emergency purposes. Multivariable logistic regression was performed to assess the associations between the two outcomes and the socio-demographic, socio-economic and health-related factors. RESULTS Thirty three percent of immigrants reported not visiting the dentist in the past year and 25% reported visiting only for emergencies. The leading components associated with poor dental care utilization were being a new immigrant, of male gender, having low educational attainment, low household income and lacking dental insurance. CONCLUSIONS This study is the first to highlight oral health care use patterns amongst immigrants in Ontario. Given that a large proportion of the immigrant population in Ontario have poor dental care use, education and outreach programs informing incoming immigrants of preventative dental care may improve overall dental health.
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Affiliation(s)
- Vrati M Mehra
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Christy Costanian
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Siya Khanna
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Hala Tamim
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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24
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Duijster D, Oude Groeniger J, van der Heijden GJMG, van Lenthe FJ. Material, behavioural, cultural and psychosocial factors in the explanation of socioeconomic inequalities in oral health. Eur J Public Health 2019; 28:590-597. [PMID: 29272383 PMCID: PMC6051465 DOI: 10.1093/eurpub/ckx209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background This study aimed to assess the contribution of material, behavioural, cultural and psychosocial factors in the explanation of socioeconomic inequalities (education and income) in oral health of Dutch adults. Methods Cross-sectional data from participants (25-75 years of age) of the fifth wave of the GLOBE cohort were used (n = 2812). Questionnaires were used to obtain data on material factors (e.g. financial difficulties), behavioural factors (e.g. smoking), cultural factors (e.g. cultural activities) and psychosocial factors (e.g. psychological distress). Oral health outcomes were self-reported number of teeth and self-rated oral health (SROH). Mediation analysis, using multivariable negative binomial regression and logistic regression, was performed. Results Education level and income showed a graded positive relationship with both oral health outcomes. Adding material, behavioural, cultural and psychosocial factors substantially reduced the rate ratio for the number of teeth of the lowest education group from 0.79 (95% confidence interval (CI): 0.75-0.83) to 0.92 (95% CI: 0.87-0.97) and of the lowest income group from 0.80 (95% CI: 0.73-0.88) to 1.04 (95% CI: 0.96-1.14). Inclusion of all factors also substantially reduced the odds ratio for poor SROH of the lowest education group from 1.61 (95% CI: 1.28-2.03) to 1.12 (95% CI: 0.85-1.48) and of the lowest income groups from 3.18 (95% CI: 2.13-4.74) to 1.48 (95% CI: 0.90-2.45). Conclusion In general, behavioural factors contributed most to the explanation of socioeconomic inequalities in adult oral health, followed by material factors. The contribution of cultural and psychosocial factors was relatively moderate.
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Affiliation(s)
- Denise Duijster
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Geert J M G van der Heijden
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
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25
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Bernabé E, Knuuttila M, Suominen AL. Interdental cleaning and periodontal pocketing among finnish adults. J Clin Periodontol 2019; 46:310-320. [PMID: 30734957 DOI: 10.1111/jcpe.13081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 11/30/2022]
Abstract
AIM To investigate the relationship between frequency of interdental cleaning and 11-year change in teeth with periodontal pocketing in Finnish adults. METHODS Data from 1667 dentate adults, aged 30 to 82 years, who participated in the Health 2000 survey and were re-examined in 2004 and/or 2011 were analysed. Participants reported their frequency of interdental cleaning (either dental floss or interdental brush) at baseline. Teeth with periodontal pocketing (PD) ≥4 mm were counted in every survey and treated as a repeated outcome. The association between the frequency of interdental cleaning and the number of teeth with PD ≥4 mm was evaluated in linear mixed effects models, controlling for demographic factors, socioeconomic position, diabetes, smoking status, toothbrushing frequency, dental attendance and number of teeth. RESULTS Twelve per cent of adults reported daily interdental cleaning. Significant inverse linear trends in the number of teeth with PD ≥4 mm were found in every survey according to the frequency of interdental cleaning. However, this association was completely attenuated after adjustment for the full set of confounders. Contrarily, toothbrushing frequency was negatively associated with the baseline number of teeth with PD ≥4 mm and its rate of change over time. CONCLUSION Interdental cleaning was not associated with 11-year change in periodontal pocketing after accounting for other established risk factors for periodontal disease.
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Affiliation(s)
- Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna L Suominen
- Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Public Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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26
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Rabel M, Laxy M, Thorand B, Peters A, Schwettmann L, Mess F. Clustering of Health-Related Behavior Patterns and Demographics. Results From the Population-Based KORA S4/F4 Cohort Study. Front Public Health 2019; 6:387. [PMID: 30723712 PMCID: PMC6350271 DOI: 10.3389/fpubh.2018.00387] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 12/31/2018] [Indexed: 12/21/2022] Open
Abstract
Background: Health behaviors are of great importance for public health. Previous research shows that health behaviors are clustered and do not occur by chance. The main objective of this study was to investigate and describe the clustering of alcohol consumption, nutrition, physical activity and smoking while also considering the influence of sex, age and education. Methods: Using data from the population-based KORA S4/F4 cohort study, latent class regression analysis was undertaken to identify different clusters of health behavior patterns. The clusters were described according to demographics. Furthermore, the clusters were described regarding health-related quality of life at baseline and at a 7 year follow-up. Results: Based on a sample of 4,238 participants, three distinct classes were identified. One overall healthy class and two heterogeneous classes. Classes varied especially according to sex, indicating a healthier behavior pattern for females. No clear association between healthier classes and age, education or physical and mental health-related quality of life was found. Discussion: This study strengthens the literature on the clustering of health behaviors and additionally describes the identified clusters in association with health-related quality of life. More research on associations between clustering of health behaviors and important clinical outcomes is needed.
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Affiliation(s)
- Matthias Rabel
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Helmholtz Zentrum München–German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Michael Laxy
- Helmholtz Zentrum München–German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Barbara Thorand
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Helmholtz Zentrum München–German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany
| | - Annette Peters
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Helmholtz Zentrum München–German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany
| | - Lars Schwettmann
- Helmholtz Zentrum München–German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Filip Mess
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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Barrios-Rodríguez R, Gil-Montoya JA, Montero J, Rosel EM, Bravo M. Associated factors with health-compromising behaviors among patients treated for oral cancer. MEDICINA ORAL, PATOLOGIA ORAL Y CIRUGIA BUCAL 2019; 24:e20-e25. [PMID: 30573721 PMCID: PMC6344003 DOI: 10.4317/medoral.22655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/11/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND To improve eradication strategies of health-compromising behaviors between oral cancer survivors, this study aimed to explore the extent of clustering of risk behaviors and to assess possible factors associated. MATERIAL AND METHODS A cross-sectional study was carried out among oral cancer patients at least 6 months after treatment. They completed a questionnaire about smoking, alcohol consumption, oral hygiene habits and dental visits. Presence of clusters was evaluated through pairwise Pearson correlations and principal component analysis. Factors associated with each identified cluster were analyzed with multivariate models. RESULTS Among 142 patients, 14.8% smoked, 51.7% consumed alcohol, 52.1% performed oral hygiene less than twice a day, and 74.6% visited to dentist when there was a problem or never. There were two distinct clusters: smoking-alcohol consumption (general risk behaviors cluster) and oral hygiene-dental attendance (oral risk behaviors cluster). Multivariate analysis showed significant associations between males and both clustering patterns of health compromising behaviors, patients with clinical stage I or with longer follow-up and the presence of general risk behaviors cluster and worse social class and the presence of oral risk behaviors cluster. CONCLUSIONS A high proportion of patients treated for oral cancer presented health-compromising behaviors occurring in clusters which reinforce the need for health promotion strategies to target multiple behaviors. Factors analyzed suggest that chances of having detrimental behavioral clustering are higher in male, patients with clinical stage I, with lower social class and those with longer follow-up after treatment.
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Affiliation(s)
- R Barrios-Rodríguez
- School of Dentistry, Campus de Cartuja s/n, University of Granada, 18071 Granada, Spain,
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28
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Talakey AA, Bernabé E. Long-term regular dental attendance and tooth retention among British adults: A cross-sectional analysis of national survey data. Int J Dent Hyg 2018; 17:64-70. [DOI: 10.1111/idh.12373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/28/2018] [Accepted: 10/28/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Arwa Ameen Talakey
- Faculty of Dentistry; Oral & Craniofacial Sciences, King’s College; London UK
- Department of Periodontics and Community Dentistry; King Saud University Dental College; Riyadh Saudi Arabia
| | - Eduardo Bernabé
- Faculty of Dentistry; Oral & Craniofacial Sciences, King’s College; London UK
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Jordão LMR, Malta DC, Freire MDCM. Simultaneous oral health risk behaviors among adolescents: evidence from the National School-based Student Health Survey. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180019. [PMID: 30517470 DOI: 10.1590/1980-549720180019.supl.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 11/16/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of simultaneous oral health risk behaviors and associated factors among Brazilian adolescents. METHODS The study comprised data of 109,104 adolescents participating in the Brazilian National School-based Student Health Survey. The simultaneous presence of less frequent toothbrushing (E), current smoking (C), no visits to the dentist (D), low fruit intake (F), and high sugar intake (A) was assessed by comparison of observed/expected prevalence (OP/EP). Logistic regression was used to assess sociodemographic and family factors associated with the clustering patterns of oral health risk behaviors. RESULTS The simultaneous occurrence of two or more oral health risk behaviors was of 60.40%. The highest prevalence values were found for the following patterns with OP/EP over 1.20: EDF, CFA, and EDFA. The odds for two or more combined oral health risk behaviors were higher for adolescents whose parents did not participate in homework, from public schools, males, and of Asian or Indigenous ethnicity (OR > 1.00; p < 0.05). Low family affluence level (FAL) acted as a risk factor for the pattern ECDFA (OR = 2.58; p = 0.009), while low and mean FAL functioned as protection factors for the pattern CFA (OR = 0.71; p < 0.001, and OR = 0.76; p = 0.011). CONCLUSION The prevalence of simultaneous oral health risk behaviors was low and negatively associated with sociodemographic and family factors. Interventions aiming at reducing these behavior patterns should prioritize the groups that have been identified as being at most risk.
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Affiliation(s)
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
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30
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Guarnizo-Herreño CC, Watt RG, Garzón-Orjuela N, Tsakos G. Explaining oral health inequalities in European welfare state regimes: The role of health behaviours. Community Dent Oral Epidemiol 2018; 47:40-48. [DOI: 10.1111/cdoe.12420] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/10/2018] [Accepted: 08/12/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Carol C. Guarnizo-Herreño
- Department of Epidemiology and Public Health; University College London; London UK
- Departamento de Salud Colectiva; Facultad de Odontología; Universidad Nacional de Colombia; Bogotá Colombia
| | - Richard G. Watt
- Department of Epidemiology and Public Health; University College London; London UK
| | - Nathaly Garzón-Orjuela
- Hospital Universitario Nacional de Colombia; Grupo de Equidad en Salud; Facultad de Medicina; Universidad Nacional de Colombia; Bogotá Colombia
| | - Georgios Tsakos
- Department of Epidemiology and Public Health; University College London; London UK
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31
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Kim JA, Choi HM, Seo Y, Kang DR. Relations among obesity, family socioeconomic status, oral health behaviors, and dental caries in adolescents: the 2010-2012 Korea National Health and nutrition examination survey. BMC Oral Health 2018; 18:114. [PMID: 29929557 PMCID: PMC6013944 DOI: 10.1186/s12903-018-0576-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 06/06/2018] [Indexed: 12/18/2022] Open
Abstract
Background The purpose of this study was to examine the relationships among obesity, family socioeconomic status, oral health behaviors, and dental caries and to identify possible differences in factors related with dental caries according to gender among a representative sample of Korean adolescents. Methods Data were obtained from the Korean National Health and Nutrition Examination Survey, which was conducted between 2010 and 2012. This nationally representative cross-sectional survey included approximately 10,000 individuals, including adolescents, each year as a survey sample, and collected information on socioeconomic status, health-related behaviors, quality of life, healthcare utilization, anthropometric measures, biochemical and clinical profiles for non-communicable diseases, and dietary intake via three component surveys (health interview, health examination, and nutrition survey). The health interview and health examination were conducted by trained staff members. A total of 1646 adolescents of ages 13 to 18 years old were included in this study; there were 879 males and 767 females. Data were analyzed by t-test, X2-test, and univariate and multivariate logistic regression analyses using SAS 9.4 and ‘R’ statistical software for Windows to account for the complex sampling design. Results In males, significant associations between family income and dental caries on permanent teeth were noted after adjusting for confounding variables; the odds ratios and 95% confidence intervals thereof were 0.43(0.24–0.76), 0.41(0.24–0.70), and 0.28(0.16–0.49) for low-middle, middle-high, and high family income, respectively. Smoking experience showed a significant association with dental caries on permanent teeth in females. Oral health behaviors, such as tooth brushing frequency, were associated with dental caries in only male adolescents. There was no association between obesity and dental caries on permanent teeth in either male or female adolescents. Conclusion The present study demonstrated that factors associated with dental caries in adolescents differ according to gender. Therefore, gender-specific interventions may be warranted to improve dental health among adolescents.
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Affiliation(s)
- Jin Ah Kim
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | | | - Yunhee Seo
- Graduate School of Public Health, Ajou University, Suwon, Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science / Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do, 26426, Korea.
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Carter CJ, France J, Crean S, Singhrao SK. The Porphyromonas gingivalis/Host Interactome Shows Enrichment in GWASdb Genes Related to Alzheimer's Disease, Diabetes and Cardiovascular Diseases. Front Aging Neurosci 2017; 9:408. [PMID: 29311898 PMCID: PMC5732932 DOI: 10.3389/fnagi.2017.00408] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/27/2017] [Indexed: 12/13/2022] Open
Abstract
Periodontal disease is of established etiology in which polymicrobial synergistic ecology has become dysbiotic under the influence of Porphyromonas gingivalis. Following breakdown of the host's protective oral tissue barriers, P. gingivalis migrates to developing inflammatory pathologies that associate with Alzheimer's disease (AD). Periodontal disease is a risk factor for cardiovascular disorders (CVD), type II diabetes mellitus (T2DM), AD and other chronic diseases, whilst T2DM exacerbates periodontitis. This study analyzed the relationship between the P. gingivalis/host interactome and the genes identified in genome-wide association studies (GWAS) for the aforementioned conditions using data from GWASdb (P < 1E-03) and, in some cases, from the NCBI/EBI GWAS database (P < 1E-05). Gene expression data from periodontitis or P. gingivalis microarray was compared to microarray datasets from the AD hippocampus and/or from carotid artery plaques. The results demonstrated that the host genes of the P. gingivalis interactome were significantly enriched in genes deposited in GWASdb genes related to cognitive disorders, AD and dementia, and its co-morbid conditions T2DM, obesity, and CVD. The P. gingivalis/host interactome was also enriched in GWAS genes from the more stringent NCBI-EBI database for AD, atherosclerosis and T2DM. The misregulated genes in periodontitis tissue or P. gingivalis infected macrophages also matched those in the AD hippocampus or atherosclerotic plaques. Together, these data suggest important gene/environment interactions between P. gingivalis and susceptibility genes or gene expression changes in conditions where periodontal disease is a contributory factor.
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Affiliation(s)
| | - James France
- Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
| | - StJohn Crean
- Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
| | - Sim K Singhrao
- Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
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Harding A, Gonder U, Robinson SJ, Crean S, Singhrao SK. Exploring the Association between Alzheimer's Disease, Oral Health, Microbial Endocrinology and Nutrition. Front Aging Neurosci 2017; 9:398. [PMID: 29249963 PMCID: PMC5717030 DOI: 10.3389/fnagi.2017.00398] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 11/17/2017] [Indexed: 12/21/2022] Open
Abstract
Longitudinal monitoring of patients suggests a causal link between chronic periodontitis and the development of Alzheimer’s disease (AD). However, the explanation of how periodontitis can lead to dementia remains unclear. A working hypothesis links extrinsic inflammation as a secondary cause of AD. This hypothesis suggests a compromised oral hygiene leads to a dysbiotic oral microbiome whereby Porphyromonas gingivalis, a keystone periodontal pathogen, with its companion species, orchestrates immune subversion in the host. Brushing and chewing on teeth supported by already injured soft tissues leads to bacteremias. As a result, a persistent systemic inflammatory response develops to periodontal pathogens. The pathogens, and the host’s inflammatory response, subsequently lead to the initiation and progression of multiple metabolic and inflammatory co-morbidities, including AD. Insufficient levels of essential micronutrients can lead to microbial dysbiosis through the growth of periodontal pathogens such as demonstrated for P. gingivalis under low hemin bioavailability. An individual’s diet also defines the consortium of microbial communities that take up residency in the oral and gastrointestinal (GI) tract microbiomes. Their imbalance can lead to behavioral changes. For example, probiotics enriched in Lactobacillus genus of bacteria, when ingested, exert some anti-inflammatory influence through common host/bacterial neurochemicals, both locally, and through sensory signaling back to the brain. Early life dietary behaviors may cause an imbalance in the host/microbial endocrinology through a dietary intake incompatible with a healthy GI tract microbiome later in life. This imbalance in host/microbial endocrinology may have a lasting impact on mental health. This observation opens up an opportunity to explore the mechanisms, which may underlie the previously detected relationship between diet, oral/GI microbial communities, to anxiety, cognition and sleep patterns. This review suggests healthy diet based interventions that together with improved life style/behavioral changes may reduce and/or delay the incidence of AD.
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Affiliation(s)
- Alice Harding
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
| | - Ulrike Gonder
- Nutritionist, Freelance Science Writer, Hünstetten, Germany
| | - Sarita J Robinson
- Faculty of Science and Technology, School of Psychology, University of Central Lancashire, Preston, United Kingdom
| | - StJohn Crean
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
| | - Sim K Singhrao
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
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Haag D, Peres K, Balasubramanian M, Brennan D. Oral Conditions and Health-Related Quality of Life: A Systematic Review. J Dent Res 2017; 96:864-874. [DOI: 10.1177/0022034517709737] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to verify whether oral conditions (tooth loss, periodontal disease, dental caries) are negatively associated with health-related quality of life (HRQoL) in adults. A search was carried out on PubMed, EMBASE, Web of Science, Scopus, SciELO, and LILACS databases until the end of July 2016 with no date restrictions. Quantitative observational studies written in English were included and data extraction was performed independently by 2 reviewers. HRQoL was investigated as the outcome, and tooth loss, periodontal diseases, and dental caries were exposures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used and the quality of the selected studies was assessed by using the Joanna Briggs Institute Meta-Analysis of Statistics assessment and review instrument (JBI-MAStARI). Twenty-one studies were included. The sample sizes ranged from 88 to 15,501 subjects; 20 studies were cross-sectional designs, while 1 was a case-control study. Case definitions of the exposures were different across the studies, mainly for tooth loss, which was defined according to 11 different criteria. Fifteen studies were of “high” and 6 of “medium” quality. Eight HRQoL instruments were identified, and the most frequent was the EuroQol ( n = 8). Ten of 16 studies reported a negative impact of tooth loss on HRQoL. Four of 7 studies reported that periodontal disease impairs HRQoL, and 1 study showed that periodontal disease is positively associated with HRQoL. All studies that assessed dental caries reported a negative association between this condition and HRQoL. Despite the different definitions and measures of tooth loss and dental caries, the majority of the available evidence reported a negative impact of these conditions on HRQoL. Mixed and inconclusive findings were observed for the association between periodontal disease and HRQoL. Longitudinal prospective studies are suggested to improve the strength of the findings.
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Affiliation(s)
- D.G. Haag
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia
| | - K.G. Peres
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia
| | - M. Balasubramanian
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia
| | - D.S. Brennan
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia
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Haag DG, Peres KG, Brennan DS. Tooth loss and general quality of life in dentate adults from Southern Brazil. Qual Life Res 2017; 26:2647-2657. [PMID: 28484913 DOI: 10.1007/s11136-017-1587-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to estimate the association between the number of teeth and general quality of life in adults. METHODS A population-based study was conducted with 1720 individuals aged 20-59 years residing in Florianópolis, Brazil, in 2009. Data were collected at participants' households using a structured questionnaire. In 2012, a second wave was undertaken with 1222 individuals. Oral examinations were performed for number of teeth, prevalence of functional dentition (≥21 natural teeth), and shortened dental arch (SDA), which were considered the main exposures. General quality of life was the outcome and was assessed with the WHO Abbreviated Instrument for Quality of Life (WHOQOL-BREF). Covariates included sociodemographic factors, health-related behaviors, and chronic diseases. Multivariable linear regression models were performed to test the associations between the main exposures and the outcome adjusted for covariates. RESULTS In 2012, 1222 individuals participated in the study (response rate = 71.1%). Having more teeth was associated with greater scores on physical domain of the WHOQOL-BREF [β = 0.24 (95% CI 0.01; 0.46)] after adjustment for covariates. Absence of functional dentition was associated with lower scores on the physical domain [β = -3.94 (95% CI -7.40; -0.48)] in the adjusted analysis. There was no association between both SDA definitions and the domains of general quality of life. CONCLUSIONS Oral health as measured by tooth loss was associated with negative impacts on general quality of life assessed by the WHOQOL-BREF. There was a lack of evidence that SDA is a condition that negatively affects general quality of life.
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Affiliation(s)
- Dandara Gabriela Haag
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - David Simon Brennan
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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Park JB, Han K, Park YG, Ko Y. Association between socioeconomic status and oral health behaviors: The 2008-2010 Korea national health and nutrition examination survey. Exp Ther Med 2016; 12:2657-2664. [PMID: 27703514 DOI: 10.3892/etm.2016.3679] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/06/2016] [Indexed: 12/19/2022] Open
Abstract
Socioeconomic status (SES) has been reported to be associated with oral health behavior. Therefore, the present study was conducted to assess the relationship between SES and oral health behaviors in a large sample of the Korean population. Data from the Korea National Health and Nutrition Examination Survey, which was conducted between 2008 and 2010 by the Division of Chronic Disease Surveillance under the Korea Centers for Disease Control and Prevention and the Korean Ministry of Health and Welfare, were used in the present study. Daily tooth brushing frequency and the use of secondary oral products according to demographic variables and anthropometric characteristics of the participants were assessed. Multivariate logistic regression analyses were used to analyze the associations between daily tooth brushing frequency and the use of secondary oral products, and SES, urban/rural residence, body mass index (BMI), alcohol intake and smoking. An association between SES and tooth brushing frequency and the use of secondary oral products was detected after adjustment. Following adjustment for age, gender, BMI, smoking, drinking, exercise, energy intake, fat intake, periodontal treatment needs and education or income, the adjusted odds ratios and 95% confidence intervals (CI) of tooth brushing ≥3 per day in the highest income group were 1.264 (95% CI, 1.094-1.460) and 2.686 (95% CI, 2.286-3.155) for highest education level group. The adjusted odds ratios for the use of secondary oral products in the highest income and highest education groups were 1.835 (95% CI, 1.559-2.161) and 5.736 (95% CI, 4.734-6.951), respectively, after adjustment for age, gender, smoking, BMI, exercise, calorie intake, periodontal treatment requirements or income. The present study demonstrated an association between SES and oral health behaviors in a large sample of the Korean population. Within the limits of the present study, income and education were suggested as potential risk indicators for oral health behaviors; therefore, patients with a low SES should be investigated further, in relation to oral health.
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Affiliation(s)
- Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yong-Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Youngkyung Ko
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Meader N, King K, Moe-Byrne T, Wright K, Graham H, Petticrew M, Power C, White M, Sowden AJ. A systematic review on the clustering and co-occurrence of multiple risk behaviours. BMC Public Health 2016; 16:657. [PMID: 27473458 PMCID: PMC4966774 DOI: 10.1186/s12889-016-3373-6] [Citation(s) in RCA: 304] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 07/26/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Risk behaviours, such as smoking and physical inactivity account for up to two-thirds of all cardiovascular deaths, and are associated with substantial increased mortality in many conditions including cancer and diabetes. As risk behaviours are thought to co-occur in individuals we conducted a systematic review of studies addressing clustering or co-occurrence of risk behaviours and their predictors. As the main aim of the review was to inform public health policy in England we limited inclusion to studies conducted in the UK. METHODS Key databases were searched from 1990 to 2016. We included UK based cross-sectional and longitudinal studies that investigated risk behaviours such as smoking, physical inactivity, unhealthy diet. High heterogeneity precluded meta-analyses. RESULTS Thirty-seven studies were included in the review (32 cross-sectional and five longitudinal). Most studies investigated unhealthy diet, physical inactivity, alcohol misuse, and smoking. In general adult populations, there was relatively strong evidence of clustering between alcohol misuse and smoking; and unhealthy diet and smoking. For young adults, there was evidence of clustering between sexual risk behaviour and smoking, sexual risk behaviour and illicit drug use, and sexual risk behaviour and alcohol misuse. The strongest associations with co-occurrence and clustering of multiple risk behaviours were occupation (up to 4-fold increased odds in lower SES groups) and education (up to 5-fold increased odds in those with no qualifications). CONCLUSIONS Among general adult populations, alcohol misuse and smoking was the most commonly identified risk behaviour cluster. Among young adults, there was consistent evidence of clustering found between sexual risk behaviour and substance misuse. Socio-economic status was the strongest predictor of engaging in multiple risk behaviours. This suggests the potential for interventions targeting multiple risk behaviours either sequentially or concurrently particularly where there is evidence of clustering. In addition, there is potential for intervening at the social or environmental level due to the strong association with socio-economic status.
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Affiliation(s)
- Nick Meader
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Kristelle King
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Thirimon Moe-Byrne
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Mark Petticrew
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Power
- Population, Policy and Practice, UCL Institute of Child Health, London, UK
| | - Martin White
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Amanda J. Sowden
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
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Trohel G, Bertaud-Gounot V, Soler M, Chauvin P, Grimaud O. Socio-Economic Determinants of the Need for Dental Care in Adults. PLoS One 2016; 11:e0158842. [PMID: 27441841 PMCID: PMC4956297 DOI: 10.1371/journal.pone.0158842] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 06/22/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Oral health has improved in France. However, there are still inequalities related to the socio-economic status. OBJECTIVES The aim of this study was to measure the prevalence of dental care needs in an adult population and to identify the demographic, socio-economic and behavioral variables that may explain variations in this parameter. METHODS A cross-sectional analysis of the French SIRS cohort (n = 2,997 adults from the Paris region; 2010 data) was carried out to determine the prevalence of self-reported dental care needs relative to demographic, socio-economic and behavioral variables. A logistic regression model was used to identify the variables that were most strongly associated with the level of need. RESULTS In 2010, the prevalence of the need for dental care in the SIRS cohort was 35.0% (95% CI [32.3-37.8]). It was lower in people with higher education levels (31.3% [27.9-34.6]), without immigrant background (31.3% [28.0-34.6]) and with comprehensive health insurance (social security + complementary health cover; 32.8% [30.2-35.4]). It decreased as the socio-economic status increased, but without following a strict linear change. It was also lower among individuals who had a dental check-up visit in the previous two years. In multivariate analyses, the socioeconomic variables most strongly associated with the need for dental care were: educational attainment (OR = 1.21 [1.02-1.44]), income level (OR = 1.66 [1.92-2.12]) and national origin (OR = 1.53 [1.26-1.86]). CONCLUSION These results confirm that the prevalence of dental care needs is higher among adults with low socio-economic status. Education level, income level and also national origin were more strongly associated with the need for dental care than insurance cover level.
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Affiliation(s)
- Gilda Trohel
- U1099, INSERM, Rennes, France
- LTSI, University of Rennes 1, Rennes, France
- Dental Surgery Department, University Hospital, Rennes, France
| | - Valérie Bertaud-Gounot
- U1099, INSERM, Rennes, France
- LTSI, University of Rennes 1, Rennes, France
- Dental Surgery Department, University Hospital, Rennes, France
| | - Marion Soler
- Research Team on Social Determinants of Health and Use of Care, UMRS 707, INSERM Paris, Paris, France
| | - Pierre Chauvin
- Research Team on Social Determinants of Health and Use of Care, UMRS 707, INSERM Paris, Paris, France
| | - Olivier Grimaud
- Epidemiology Bio-Statistics Department, EHESP, Rennes, France
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Al-Sudani FYH, Vehkalahti MM, Suominen AL. Association of current employment status with oral health-related behaviors: findings from the Finnish Health 2000 Survey. Eur J Oral Sci 2016; 124:368-76. [DOI: 10.1111/eos.12276] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Fouad Y. H. Al-Sudani
- Department of Oral Public Health; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Miira M. Vehkalahti
- Department of Oral and Maxillofacial Diseases; Faculty of Medicine; University of Helsinki; Helsinki Finland
| | - Anna L. Suominen
- Department of Oral Public Health; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- The Living Environment and Health Unit; National Institute for Health and Welfare (THL); Kuopio Finland
- The Health Monitoring Unit; National Institute for Health and Welfare (THL); Helsinki Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
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Abadía-Barrero CE, Martínez-Parra AG. Care and consumption: A Latin American social medicine’s conceptual framework to comprehend oral health inequalities. Glob Public Health 2016; 12:1228-1241. [DOI: 10.1080/17441692.2016.1171377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Adriana Gisela Martínez-Parra
- División de Ciencias Biológicas y de la Salud, Metropolitan Autonomous University, Xochimilco Unit, México, DF, México
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Body mass index and dental caries in children aged 5 to 8 years attending a dental paediatric referral practice in the Netherlands. BMC Res Notes 2015; 8:738. [PMID: 26628264 PMCID: PMC4666203 DOI: 10.1186/s13104-015-1715-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/18/2015] [Indexed: 12/12/2022] Open
Abstract
Background Obesity and dental caries are widely-recognised problems that affect general health. The prevention of both dental caries and obesity have proven very difficult: children and their parents may need professional support to achieve behaviour change. To find out whether both dental caries and overweight in childhood can be targeted using a common risk factor approach, it is necessary to establish whether the two diseases are indeed linked. The aim of the present study was therefore to use anthropometric data obtained professionally to investigate the association between Body Mass Index and dental caries experience in children aged 5–8 years receiving treatment in a referral centre for paediatric dental care in the Netherlands. Methods Children’s dmft and dmfs scores were calculated using dental records and sociodemographic data were also extracted from these records. Dentists were trained to measure standing height and weight in a standardised way. Body Mass Index was calculated by dividing kilograms by height squared (kg/m2). Extended International (International Obesity Task Force) body mass index cut-offs were used to define ‘no overweight’ and ‘overweight’ (with the latter category including obesity). Results No statistically significant differences were found between the mean dmft or dmfs scores of the two groups (overweight and non-overweight), even after correction for the effect of the potential confounders sex, socio-economic status and ethnicity. The percentage of caries-active children in the non-overweight group was almost the same as in the overweight group. No statistically significant differences were found. Conclusions We hypothesised to find a positive association between body mass index and dental caries experience in children aged 5–8 years attending our practice. However, this study did not find a relationship of this kind. A common risk factor approach for the prevention of caries and overweight is therefore not supported by our study.
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Liu L, Zhang Y, Wu W, Cheng R. Characteristics of dental care-seeking behavior and related sociodemographic factors in a middle-aged and elderly population in northeast China. BMC Oral Health 2015; 15:66. [PMID: 26070786 PMCID: PMC4465149 DOI: 10.1186/s12903-015-0053-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 06/03/2015] [Indexed: 12/04/2022] Open
Abstract
Background The etiologies of oral disease are generally progressive and cumulative, such that compared with younger individuals, middle-aged and elderly people are at greater risk of active dental caries and periodontal disease risk. They usually suffer from multiple oral diseases, and obstacles to their use of dental care services are numerous. Objectives The objectives of this study were to investigate the characteristics of dental care-seeking behaviors and related sociodemographic factors in a middle-aged and elderly population in northeast China. Methods This was a cross-sectional study of 1188 subjects, including 792 middle-aged (35–44 years-old) and 396 elderly (65–74 years-old) residents of northeast China. Information on dental care-seeking behaviors and sociodemographic characteristics was collected during face-to-face structured interviews conducted between May and June 2010. Chi square tests, Ridit scoring, and multivariate logistic regression analysis were employed to characterize dental care-seeking behaviors and their associations with sociodemographic factors. Results A greater proportion of middle-aged participants reported a need for dental visits compared with the elderly participants (75.8 % vs. 60.9 %; P < 0.01), as did more urban that rural residents (P < 0.05). The majority of individuals in both the middle-aged and elderly groups obtained for dental care at their own expense, and they predominantly chose private dental clinics. Ridit analyses showed that education level and income were significantly associated with oral care in both middle-aged and elderly people (Ps < 0.05). In addition, logistic regression analysis indicated that rural residence was negatively associated with dental visits in both middle-aged (odds ratio = 0.649, 95 % confidence interval: 0.447–0.884) and elderly (odds ratio = 0.604, 95 % confidence interval: 0.394–0.924) individuals. Conclusion The rate of dental care visits is low in the middle-aged and elderly populations of northeast China. Among sociodemographic factors, education level and income are positively associated with dental care visits, and rural residence is negatively associated with the frequency of such visits.
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Affiliation(s)
- Lu Liu
- Department of Preventive Dentistry, School of Stomatology, China Medical University, Shenyang, 110002, China.
| | - Ying Zhang
- Department of Preventive Dentistry, School of Stomatology, China Medical University, Shenyang, 110002, China.
| | - Wei Wu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110001, China.
| | - Ruibo Cheng
- Department of Preventive Dentistry, School of Stomatology, China Medical University, Shenyang, 110002, China.
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Asgari F, Majidi A, Koohpayehzadeh J, Etemad K, Rafei A. Oral hygiene status in a general population of Iran, 2011: a key lifestyle marker in relation to common risk factors of non-communicable diseases. Int J Health Policy Manag 2015; 4:343-52. [PMID: 26029893 DOI: 10.15171/ijhpm.2015.18] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/28/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND To estimate Oral Hygiene (OH) status in the Iranian population in 2011, and to determine the influence of socio-economic characteristics on OH, and its interrelation with common risk factors of Non-Communicable Diseases (NCDs). METHODS Data including a total of 12,105 individuals aged 6-70 years were obtained from the sixth round of the surveys of NCDs risk factors in Iran. OH was recorded through a structured questionnaire measuring daily frequencies of tooth brushing and dental flossing. Descriptive analyses were performed on demographic characteristics in the complex sample survey setting. We also employed weighted binary logistic regression to compute Odds Ratio (OR) as a measure of association between the response and explanatory factors. Furthermore, to construct an asset index, we utilized Principal Component Analysis (PCA). RESULTS The percentage with minimum recommended daily OH practices was 3.7% among men and 7.7% among women (OR= 2.3; P<0.001). Urban citizens were more likely to have their teeth cleaned compared to rural people (OR= 2.8; P<0.001). For both genders, a relatively better condition was observed in the 25-34 age group (male: 5.6%; female: 10.3%). In addition, OH status improved significantly by increase in both level of education (P<0.001) and economic status (P<0.001). There were also apparent associations between self-care practices and specific behavioral risk factors, though the correlation with dietary habits and tobacco use could be largely explained by socio-economic factors. CONCLUSION OH situation in Iran calls for urgent need to assign proper interventions and strategies toward raising public awareness and reducing disparities in access to health facilities.
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Affiliation(s)
- Fereshteh Asgari
- Center for Disease Control and Prevention, Deputy for Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Azam Majidi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Jalil Koohpayehzadeh
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health, Shahid-Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Rafei
- National Program for Disease Registries and Health Outcomes, Deputy for Research, Ministry of Health and Medical Education, Tehran, Iran
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Listl S, Watt RG, Tsakos G. Early life conditions, adverse life events, and chewing ability at middle and later adulthood. Am J Public Health 2014; 104:e55-61. [PMID: 24625140 DOI: 10.2105/ajph.2014.301918] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We sought to determine the extent to which early life conditions and adverse life events impact chewing ability in middle and later adulthood. METHODS Secondary analyses were conducted based on data from waves 2 and 3 of the Survey of Health, Ageing, and Retirement in Europe (SHARE), collected in the years 2006 to 2009 and encompassing information on current chewing ability and the life history of persons aged 50 years or older from 13 European countries. Logistic regression models were estimated with sequential inclusion of explanatory variables representing living conditions in childhood and adverse life events. RESULTS After controlling for current determinants of chewing ability at age 50 years or older, certain childhood and later life course socioeconomic, behavioral, and cognitive factors became evident as correlates of chewing ability at age 50 years or older. Specifically, childhood financial hardship was identified as an early life predictor of chewing ability at age 50 years or older (odds ratio = 1.58; 95% confidence interval = 1.22, 2.06). CONCLUSIONS Findings suggest a potential enduring impact of early life conditions and adverse life events on oral health in middle and later adulthood and are relevant for public health decision-makers who design strategies for optimal oral health.
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Affiliation(s)
- Stefan Listl
- Stefan Listl is with the Department of Conservative Dentistry, University of Heidelberg, Heidelberg, and the Munich Center for the Economics of Aging, Max-Planck-Institute for Social Law and Social Policy, Munich, Germany. Richard G. Watt and Georgios Tsakos are with the Department of Epidemiology and Public Health, University College London, London, UK
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Richards W, Filipponi T, Roberts-Burt V. Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public. Br Dent J 2014; 216:E7. [DOI: 10.1038/sj.bdj.2014.100] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2013] [Indexed: 01/22/2023]
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