Dental caries experience, tooth loss, and factors associated with unmet needs of Haitian immigrants in New York City

Immigrant Status, Resilience, and Perceived Oral Health Among Chinese Americans in Hawaii

OBJECTIVES

This study aims to examine the associations among immigrant status, resilience, and perceived oral health for Chinese American older adults in Hawaii.

METHOD

Data derived from 430 Chinese American adults aged 55 years and older residing in Honolulu, HI. We compared the self-rated oral health and oral health problems between U.S.-born Chinese Americans and foreign-born Chinese Americans by using ordered logistic regression and ordinary least squares regression models.

RESULTS

Findings suggest that immigrant status and lower levels of resilience are associated with poorer self-rated oral health and more oral health problems for Chinese American older adults in Hawaii. Resilience is more strongly associated with self-rated oral health for U.S.-born Chinese American than for foreign-born Chinese Americans, but this pattern was not evident for oral health problems.

DISCUSSION

Older Chinese American immigrants in Hawaii are disadvantaged in terms of their oral health. Understanding their susceptibilities may lead to targeted interventions.

Use of dental services by immigration status in the United States

BACKGROUND

There is limited research with mixed findings comparing differences in oral health outcomes and the use of dental services by immigration status. The authors conducted a study by reviewing nationally representative data to describe differences in dental care among noncitizens, naturalized citizens, and US-born citizens in the United States.

METHODS

The authors used nationally representative data from the 2008-2012 Medical Expenditure Panel Survey to examine dental care for US-born citizens, naturalized citizens, and noncitizens 18 years and older. Total analytical sample size was 98,107 adults. They used multivariate logistic regression to model dental service use adjusting for confounding factors.

RESULTS

Naturalized citizens and noncitizens were significantly less likely to have at least 1 dental visit within 12 months (39.5% and 23.1%, respectively) compared with US-born citizens (43.6%; P < .001). Among users, a smaller proportion of comprehensive examination visits were for naturalized citizens and noncitizens (75.9% and 71.4%, respectively) compared with US-born citizens (82.8%; P < .01). Noncitizen visits to dentists were also more likely to involve tooth extraction compared with those of US-born citizens (11.3% versus 8.8%; P < .01). Multivariate logistic regression suggests both non- and naturalized citizens had lower adjusted odds of having a comprehensive examination compared with US-born citizens during a visit (P < .01).

CONCLUSIONS

Noncitizens and naturalized citizens had a lower rate of dental service use, and noncitizens were more likely to have had tooth extraction compared with US-born citizens.

PRACTICAL IMPLICATIONS

Increased outreach efforts tailored to noncitizens and naturalized citizens who are at high risk of experiencing dental problems are needed, particularly to address misperceptions on the necessity of preventive dental visits.

Dental health and disease determinants among 35-year-olds in Oslo, Norway

OBJECTIVE

The aim of the present study was to identify non-biological determinants associated with the number of sound teeth (ST) and presence of decayed surfaces (DS) among 35-year-old Oslo citizens.

MATERIAL AND METHODS

Randomly selected participants (n=149, response rate 64%) completed a self-administered questionnaire and were examined clinically and radiographically. Dental caries was registered clinically following World Health Organization (WHO) diagnostic criteria for caries registration, and the findings were combined with radiographic caries recordings. The number of sound teeth and the presence of two or more dentine caries lesions (D(3)S > or = 2) were selected as dependent variables. Associations between selected dependent variables and possible determinants were assessed by linear and logistic regression analyses, taking into account the hierarchical relationships between the independent variables.

RESULTS

On average, 35-year-olds had 17.1 (SD=5.6) ST. Half of the participants had no DS and 26% had D(3)S > or = 2. Non-Western region of birth, being single, and having a university education were significantly associated with higher numbers of ST. Low family income, presently a smoker, and irregular dental visits were significantly associated with the presence of dentine caries.

CONCLUSIONS

The results of this study indicate that several non-biological determinants operating at different levels are important for health and disease in this adult population.

The association of immigration and acculturation attributes with oral health among immigrants in New York City

OBJECTIVES

We examined associations between immigration and acculturation attributes and oral disease among immigrants.

METHODS

We conducted a large cross-sectional study of 1318 immigrants in New York City. We performed comprehensive interviews and oral examinations of the participants and used linear regression models to assess differences in oral disease levels among immigrant subgroups. We also constructed proportional odds models to evaluate the association of oral disease level with length of stay in the United States, age at immigration, and language preference.

RESULTS

After we controlled for most known risk factors, country of birth and age at immigration were associated with variations in oral disease prevalence and need for oral health care. Length of stay was inversely associated with need for treatment of dental caries but not with any other indicator of oral disease. Language preference was not associated with any indicator of oral disease.

CONCLUSIONS

Immigrants' country of birth, length of stay in the United States, and age at immigration played important roles in their oral disease prevalence, independently of most known risk factors for oral diseases. Our findings emphasize the need for more studies to elucidate the complex relationships of ethnicity, socioeconomic status, and culturally influenced factors that impact immigrants' oral health.

Dental Caries in Twelve- and Fifteen-Year-Olds: Results from the Basic Oral Health Survey in Haiti

OBJECTIVE

Reports on oral health investigations in Haiti are sparse. There are only three peer-reviewed published articles on oral health in Haiti. In order to construct a national dataset useful for public health planning, a representative dental caries survey of Haitian school attending children was conducted in 1999.

METHODS

This survey was conducted using a modified version of the World Health Organization (WHO) Basic Oral Health Survey (BOHS) pathfinder method. Children ages 12 and 15 years old attending public or private schools in both rural and urban regions were targeted in seven of the nine geographic Departments of Haiti: each Department constituted a strata that was further stratified into the major urban center and one or more rural towns. Four trained examiners, calibrated to WHO caries criteria, conducted the survey

RESULTS

Of the total 1,218 examined 12- and 15-year-olds, 31% of the 12-year-olds and 46% of the 15-year-olds had a DMFS of 1 or more, i.e., these percentages are the simple prevalence levels of dental caries for those age groups in Haiti. Mean DMFS scores were 1.01 (SE 0.09) and 2.52 (SE 0.02) for the 12- and 15-year-olds, respectively. No difference was observed between gender, while differences were found by geographical classification. Less than 1% of the children had any dental restorations.

CONCLUSIONS

The findings from this investigation suggest that at the population level, permanent dentition caries in early adolescence is a minimal health problem, relative to dental caries in other neighboring Caribbean countries, as well as to other health conditions in Haiti. However, at the individual level, those children afflicted with decay are without dental services for all practical purposes.

Childhood maltreatment and mental and physical health in Haitian adults

PURPOSE

To describe the prevalence of childhood maltreatment among Haitian adults and to examine its relationship to depression, general physical health, and quality of life.

DESIGN

Descriptive exploratory. Participants were men and women 18 years of age or older who were seated in the waiting area of a hospital-based medical clinic in a medium-sized city in Haiti. The author collected these data while on a Fulbright fellowship to Haiti in 2003.

METHODS

Two hundred fifty-eight participants completed the Childhood Trauma Questionnaire, Cohen-Hoberman Inventory of Physical Symptoms, Center for Epidemiologic Study-Depression Scale, and a visual analogue quality of life scale. Data were analyzed using descriptive statistics, Pearson's correlation, multiple regression, and Student's t test.

FINDINGS

Over half (60%) of the women and 85.7% of the men reported at least one type of childhood maltreatment at the moderate to severe level. Of the total sample, 53.9% had scores indicative of major depression and 43.9% reported an average score of "somewhat bothered" by 37 physical symptoms. Childhood maltreatment (each of five types) was related to physical symptoms and depression.

CONCLUSIONS

Rates of childhood maltreatment were high in this sample of Haitian adults, and their childhood maltreatment was related to physical and mental health symptoms in adulthood.

Effect of acculturation on objective measures of oral health in Haitian immigrants in New York City

Acculturation is a complex phenomenon that can serve as a proxy for cultural norms and behaviors affecting care-seeking, prevention behaviors, and, ultimately, health outcomes. The purpose of this study was to assess the effect of acculturation on the oral health of Haitian immigrants in New York City. We hypothesized that acculturation would be a predictor of the oral health status of the participating individuals. An acculturation scale was specifically developed and validated for this study. A sample of 425 adult Haitian immigrants living in NYC was obtained through outreach activities. Oral health examinations were conducted, and a questionnaire was administered to the participants. After adjustment for age, sex, education, income, and marital status, acculturation was negatively associated with measures of decayed teeth, periodontal attachment loss of > or = 4 mm, and the number of missing teeth. Results suggest a positive impact of acculturation on the oral health status of these individuals.