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Cai Y, Zeng S, Hu Y, Xiao L, Liao Y, Yan Z, Zha W, Gu J, Wang Q, Hao M, Wu C. Factors associated with oral health service utilization among young people in southern China. BMC Oral Health 2024; 24:289. [PMID: 38418980 PMCID: PMC10903069 DOI: 10.1186/s12903-024-03994-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVES To identify the patterns and influencing factors of oral health service utilization among college students, and further to provide scientific evidence for policy making on oral health education and behavioral interventions for the college population. METHODS The study population was college students in Southern China. Totally 678 students participated in the survey. A self-designed questionnaire based on Anderson's model (predisposing factors, enabling factors, need factors) was used to survey college students. Descriptive statistics, χ2 test, and logistic regression were used to analyze influence factors of oral health service utilization among college students. RESULTS The utilization rate of oral health service in the past 12 months was 30.2%. The primary type of oral health service was treatment (59.6%), and only 12.8% were for prevention. There were 39% of the participants having oral health diseases, of which dental caries (25.7%) and oral bleeding (22.2%) were the main problems. The results from logistic regression analysis revealed that students with better beliefs (OR = 1.84, 95% CI:=1.02-3.43), frequent consumption of sugary drinks (OR = 2.90, 95% CI:=1.90-4.47), teeth brushing frequency > = 2 times per day (OR = 2.09, 95% CI = 1.24-3.61), frequent floss utilization (OR = 2.63, 95% CI = 1.21-5.76), dental caries (OR = 2.07, 95% CI = 1.35-3.17) used oral health services higher, while those lived in rural areas (OR:0.52, 95% CI = 0.34-0.80), and had only a fair concern (OR = 0.48, 95% CI = 0.31-0.74) or no concern (OR = 0.26, 95% CI = 0.08-0.67) on oral health utilized oral health services lower. CONCLUSIONS Chinese college students demonstrate some knowledge and attitudes towards oral health. However, they tend to neglect oral hygiene and have limited understanding of their own oral issues. Furthermore, the utilization of oral services, such as treatment, remains remarkably low, despite the availability of long-term and favorable health insurance policies. The utilization of oral health services among college students is influenced by various factors, including residing in rural areas, consuming sugary beverages on a daily basis, brushing teeth at least twice a day, and practicing flossing.
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Affiliation(s)
- Yunquan Cai
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
| | - Shaobo Zeng
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China
| | - Yimei Hu
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
| | - Lingfeng Xiao
- School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yanqing Liao
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
| | - Zihui Yan
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
| | - Wenxiang Zha
- Department of Public Health Surveillance, Linping Center for Disease Control and Prevention, Hangzhou, 311103, China
| | - Junwang Gu
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China
| | - Qi Wang
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China
| | - Ming Hao
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China
| | - Chunmei Wu
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China.
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China.
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Luo H, Moss ME, Basu R, Grant FT. Rural-Urban Differences in Use of Dental Services and Procedures Among Medicare Beneficiaries in 2018. Public Health Rep 2023; 138:788-795. [PMID: 36239470 PMCID: PMC10467503 DOI: 10.1177/00333549221128336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVE Medicare beneficiaries in rural areas may face challenges in access to dental care. This study assessed rural-urban differences in the use of dental services and dental procedures by Medicare beneficiaries. METHODS We obtained data from the 2018 Medicare Current Beneficiary Survey cost and use files. Outcome variables examined in this study were (1) dental visits (yes/no), whether the Medicare beneficiary had ≥1 dental visit in the past year, and (2) dental procedures-preventive (yes/no), restorative (yes/no), and surgical procedures (yes/no)-whether the beneficiary had the procedure in a dental visit. The independent variable was the beneficiary's residence (rural vs urban). We used multiple logistic regression to analyze data and accounted for the survey design of the Medicare Current Beneficiary Survey. The analytic sample included 7377 respondents aged ≥65 years. RESULTS Approximately 57.0% (95% CI, 54.9%-59.0%) and 46.4% (95% CI, 41.6%-51.2%) of Medicare beneficiaries in urban and rural communities in the United States had a dental visit in 2018, respectively. Rural beneficiaries were significantly less likely than their urban counterparts to have preventive procedures (adjusted odds ratio = 0.51; 95% CI, 0.36-0.72) but significantly more likely to have restorative procedures (adjusted odds ratio = 1.30; 95% CI, 1.05-1.62). CONCLUSION We found significant disparities in use of dental services by Medicare beneficiaries in rural communities. When Medicare beneficiaries in rural areas used dental care, they were less likely than beneficiaries in urban areas to have preventive procedures but more likely to have restorative procedures, suggesting a greater burden of oral health needs among them. Policy research is needed to identify models that can incentivize prevention and improve access to dental care for Medicare beneficiaries in rural communities.
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Affiliation(s)
- Huabin Luo
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Mark E. Moss
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, NC, USA
| | - Rashmita Basu
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Ford T. Grant
- Ahoskie Community Service Learning Center, School of Dental Medicine, East Carolina University, Ahoskie, NC, USA
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Chandel T, Alulaiyan M, Farraj M, Riedy CA, Barrow JR, Brennan L, Thompson L, Bass MB, Chamut S. Training and educational programs that support geriatric dental care in rural settings: A scoping review. J Dent Educ 2022; 86:792-803. [DOI: 10.1002/jdd.12885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/08/2022] [Indexed: 12/18/2022]
Affiliation(s)
- Tejasvita Chandel
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Mohammed Alulaiyan
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Malik Farraj
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Christine A. Riedy
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Jane R. Barrow
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Leonard Brennan
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Lisa Thompson
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Michelle B. Bass
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Steffany Chamut
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
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Factors Affecting Dietary Improvements in Elderly Residents of Long-Term Care Institutions Receiving Domiciliary Dental Care. MEDICINES 2021; 8:medicines8110062. [PMID: 34822359 PMCID: PMC8622908 DOI: 10.3390/medicines8110062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/21/2022]
Abstract
Background: Oral disabilities occur due to tooth loss. This study aimed to investigate oral and systemic factors related to diet in elderly residents receiving domiciliary dental care. Methods: The subjects were 74 consenting residents. Survey items included whether subjects could eat independently and diet type. Subjects were examined by the dentist for the number of teeth, occlusal support index, and wearing dentures. Contingency table analysis was performed to determine what levels of decline in general and oral functions led to difficulties eating a normal diet. Results: There was a significant difference in the mean number of activities of daily living (ADL) requiring assistance evident between subjects eating a normal diet and those eating fluid boiled rice (p < 0.01). A comparison of occlusal support and diet type showed that most subjects who ate a soft diet or gruel had no occlusal support. Almost all subjects who ate a normal diet wore dentures. However, only 38% of subjects eating a soft diet and 40% of those eating gruel did wear dentures; both group differences were significant (p < 0.01). Conclusions: Future studies need to further investigate oral factors related to the type of diet and their relationships to domiciliary dental care in older adults.
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Alhozgi A, Feine JS, Tanwir F, Shrivastava R, Galarneau C, Emami E. Rural-urban disparities in patient satisfaction with oral health care: a provincial survey. BMC Oral Health 2021; 21:261. [PMID: 33992110 PMCID: PMC8122552 DOI: 10.1186/s12903-021-01613-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Identifying spatial variation in patient satisfaction is essential to improve the quality of care. Thus, the objective of this study was to investigate rural–urban disparities in patient satisfaction and to determine the factors that could influence satisfaction with oral health care. Methods Data from 1788 parents/caregivers of children who participated in the Quebec Ministry of Health clinical study were subject to secondary analysis. The Perneger model of patient satisfaction was used as the conceptual framework for the study. Satisfaction with oral health care was measured using the WHO-sponsored International Collaborative Study of Oral Health Outcomes (ICS-II). Explanatory variables included predisposing factors and enabling resources. Statistical analyses included descriptive statistics, as well as bivariate and linear regression models. Results Individuals with higher income, dental insurance coverage, having a family dentist, reporting ease in finding a dentist, and having access to a private dental clinic were more satisfied with oral health care (p < 0.001). There were statistically significant differences between rural and urban Quebec residents in their ratings of patient satisfaction on four items, including dental office location (p = 0.013), dental equipment (p = 0.016), cost of dental treatment (p < 0.001), and cleanliness of dental office (p = 0.004), with greater satisfaction for urban dwellers. The multiple linear regression model showed that major determinants of patient satisfaction were being born in Canada, income ≥ 40,000$ CAD, having a family dentist, and having visited the dentist in the last year for regular checkups. However, ethnicity, having difficulty finding a dentist, and being in need of dental treatment negatively influenced patient satisfaction with oral health care. Conclusions These findings suggest that Quebec rural–urban disparity exists in patient satisfaction with care and that determinants of health influence this outcome. Intensive and powerful knowledge dissemination activities are needed to mobilize policymakers in implementing public health strategies to reduce this disparity.
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Affiliation(s)
- Abdalgader Alhozgi
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Jocelyne S Feine
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Farzeen Tanwir
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Richa Shrivastava
- Sri Aurobindo College of Dentistry, Sanwer Road, Indore, India.,Faculty of Dentistry, Université de Montréal, C.P. 6128, succursale centre-ville, Montreal, QC, H3C 3J7, Canada
| | - Chantal Galarneau
- Institut National de Santé Publique du Québec, 190 Boul Crémazie E, Montreal, QC, H2P 1E2, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada.
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Bhuvaneshwari NG, Usha GV, Lakshminarayan N. Perceived dental needs and barriers to utilization of dental services among elders in India – A cross-sectional survey. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2021. [DOI: 10.4103/jiaphd.jiaphd_174_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lee YH, Auh QS, Chun YH, An JS. Age-related radiomorphometric changes on panoramic radiographs. Clin Exp Dent Res 2020; 7:539-551. [PMID: 33305888 PMCID: PMC8404498 DOI: 10.1002/cre2.375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/17/2020] [Accepted: 11/22/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives We aimed to analyse age‐related anatomical changes in teeth and mandibular structures using panoramic radiographs. Materials and Methods We included 471 subjects aged 13–70 years (mean, 35.12 ± 18.72 years). Panoramic radiographs were used to record intraoral condition and radiomorphometric parameters. After grouping the subjects by age decade, descriptive statistics and analysis of variance were performed to assess age‐related patterns. Results The number of missing teeth, endodontically treated teeth, full veneer crowns, and implant prosthesis increased with age (all p < .05). The prevalence of periodontitis significantly increased after the 40s and was the highest in the 60s (57.1%). The maxillary canine root was the longest in the 10s and 20s (p < .001). With age, the mandibular canal and mental foramen moved towards the alveolar bone crest, on the opposite side of the mandibular inferior border. The pulp area and pulp‐to‐tooth ratio of maxillary/mandibular first molars were significantly higher in the 10s and 20s than in other age groups (all p < .05). Conclusions We provided comprehensive information on age‐related anatomical changes in teeth and mandibular structures based on panoramic radiographs. Various radiographic parameters showed specific changes with increasing age. Assessing these age‐related changes can be useful in determining an individual's age, and may aid in medico‐legal and forensic judgments.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Seoul, South Korea
| | - Q-Schick Auh
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Seoul, South Korea
| | - Yang-Hyun Chun
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Seoul, South Korea
| | - Jung-Sub An
- Department of Orthodontics, Seoul National University Dental Hospital, Seoul, South Korea
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Simon L, Ahern J, Fox K, Barrow J, Palmer N. Variation in dental services by rurality among privately insured adults in the United States. J Public Health Dent 2020; 81:50-56. [PMID: 32918758 DOI: 10.1111/jphd.12398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/30/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Rurality is associated with reduced dental access and worse oral health outcomes. It is unknown whether there is variation in dental services received by rural adults who visit a dentist. METHODS This was a retrospective analysis of claims data from a large private insurer. All individuals who had at least one dental visit in 2018 were included. Patient demographics, whether or not a patient's ZIP code was rural as defined by the Federal Office of Rural Health Policy, as well as ZIP code demographics were collected. Differences in the frequency of dental services received were evaluated using χ2 tests. Multilevel logistic regressions were used to evaluate the individual and ZIP code-level correlates of receiving a preventive dental procedure, a tooth extraction, or a denture-related dental procedure. RESULTS Rates of preventive, oral and maxillofacial surgery, and denture-related procedures were higher among rural adults. Accounting for individual age and gender, and ZIP code average income and dentist density, rural dwellers were more likely to receive a preventive procedure [odds ratio (OR) 1.15, P < 0.0001] or tooth extraction (OR 1.08, P < 0.0001), and less likely to have a denture-related procedure (OR 0.94, P = 0.015) compared to nonrural dwellers. Female gender was the strongest predictor of receiving a preventive procedure (OR 1.30, P < 0.0001). CONCLUSIONS Even among privately insured individuals with known access to dental care, rurality was associated with significant differences in the frequency of various dental procedures. Rural dental patients may have higher needs for oral surgical procedures, even when they have access to preventive care.
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Affiliation(s)
- Lisa Simon
- Harvard School of Dental Medicine, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| | - John Ahern
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Kathe Fox
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Jane Barrow
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Nathan Palmer
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
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Mehr K, Olszanecka‐Glinianowicz M, Chudek J, Szybalska A, Mossakowska M, Zejda J, Wieczorowska‐Tobis K, Grodzicki T, Piotrowski P. Dental status in the Polish senior population and its correlates—Results of the national survey PolSenior. Gerodontology 2018; 35:398-406. [PMID: 30051927 DOI: 10.1111/ger.12364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 06/21/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Katarzyna Mehr
- Department of Oral RehabilitationPoznan University of Medical Sciences Poznan Poland
| | - Magdalena Olszanecka‐Glinianowicz
- Health Promotion and Obesity Management UnitDepartment of PathophysiologyMedical Faculty in KatowiceMedical University of Silesia in Katowice Katowice Poland
| | - Jerzy Chudek
- Department of Internal Medicine and Oncological ChemotherapyMedical Faculty in KatowiceMedical University of Silesia in Katowice Katowice Poland
| | | | | | - Jan Zejda
- Department of EpidemiologyMedical Faculty in KatowiceMedical University of Silesia in Katowice Katowice Poland
| | | | - Tomasz Grodzicki
- Department of Internal Medicine and GerontologyJagiellonian University Medical College Krakow Poland
| | - Paweł Piotrowski
- Department of Oral RehabilitationPoznan University of Medical Sciences Poznan Poland
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Abstract
The purpose of this paper is to examine factors that are associated with tooth loss in older adults living in the San Luis Valley (SLV), Colorado, which is a rural and large geographical area (roughly the size of Connecticut) that has a large population age 60 years or older. Data used in this manuscript were collected as a part of the SLV Community Health Survey. The analyzed sample included 308 adults over the age of 65 years who completed the survey. Basic descriptive statistics and a series of step-wise binary logistic regression analyses were conducted; the dependent variable was the number of permanent teeth removed because of tooth decay or gum disease. Fifty-two percent of the participants were male, Hispanic participants made up 40 % of the sample and 76 % of the participants had at least a high school education. Tooth loss was significantly associated with older age (OR = 1.09; p = 0.02), lower income (OR = 0.01; p = 0.00), less than high school education (OR = 0.32; p = 0.01), being Hispanic (OR = 2.15; p = 0.05), self-reported fair-poor health status (OR 2.94; p = 0.02), consumption of one or more than one sweet beverage per day (OR = 4.52; p = 0.00), no dental insurance (OR = 4.70; p = 0.01) and length of time since last dental visit (OR = 0.21; p = 0.01). The findings of the present study suggest possible causes for tooth loss in rural adults and underscore the need for in-depth research to study the overall oral health of rural older adults living in SLV.
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Gaber A, Galarneau C, Feine JS, Emami E. Rural-urban disparity in oral health-related quality of life. Community Dent Oral Epidemiol 2017; 46:132-142. [PMID: 28940682 DOI: 10.1111/cdoe.12344] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 08/22/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The objective of this population-based cross-sectional study was to estimate rural-urban disparity in the oral health-related quality of life (OHRQoL) of the Quebec adult population. METHODS A 2-stage sampling design was used to collect data from the 1788 parents/caregivers of schoolchildren living in the 8 regions of the province of Quebec in Canada. Andersen's behavioural model for health services utilization was used as a conceptual framework. Place of residency was defined according to the Statistics Canada Census Metropolitan Area and Census Agglomeration Influenced Zone classification. The outcome of interest was OHRQoL measured using the Oral Health Impact Profile (OHIP)-14 validated questionnaire. Data weighting was applied, and the prevalence, extent and severity of negative oral health impacts were calculated. Statistical analyses included descriptive statistics, bivariate analyses and binary logistic regression. RESULTS The prevalence of poor oral health-related quality life (OHRQoL) was statistically higher in rural areas than in urban zones (P = .02). Rural residents reported a significantly higher prevalence of negative daily-life impacts in pain, psychological discomfort and social disability OHIP domains (P < .05). Additionally, the rural population showed a greater number of negative oral health impacts (P = .03). There was no significant rural-urban difference in the severity of poor oral health. Logistic regression indicated that the prevalence of poor OHRQoL was significantly related to place of residency (OR = 1.6; 95% CI = 1.1-2.5; P = .022), perceived oral health (OR = 9.4; 95% CI = 5.7-15.5; P < .001), dental treatment needs factors (perceived need for dental treatment, pain, dental care seeking) (OR = 8.7; 95% CI = 4.8-15.6; P < .001) and education (OR = 2.7; 95% CI = 1.8-3.9; P < .001). CONCLUSION The results of this study suggest a potential difference in OHRQoL of Quebec rural and urban populations, and a need to develop strategies to promote oral health outcomes, specifically for rural residents. Further studies are needed to confirm these results.
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Affiliation(s)
- Amal Gaber
- Faculty of Dentistry, McGill University, Montréal, QC, Canada.,Faculty of Dentistry, Université de Montréal, Montréal, QC, Canada
| | | | | | - Elham Emami
- Faculty of Dentistry, McGill University, Montréal, QC, Canada.,Faculty of Dentistry, Université de Montréal, Montréal, QC, Canada.,School of Public Health, Public Health Research Institute, CRCHUM, Université de Montréal, Montréal, QC, Canada
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Caldwell JT, Lee H, Cagney KA. The Role of Primary Care for the Oral Health of Rural and Urban Older Adults. J Rural Health 2017; 33:409-418. [DOI: 10.1111/jrh.12269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/18/2017] [Accepted: 07/27/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Julia T. Caldwell
- Department of Hospital Medicine; University of Chicago; Chicago Illinois
| | - Haena Lee
- Department of Sociology; University of Chicago; Chicago Illinois
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Olofsson H, Ulander EL, Gustafson Y, Hörnsten C. Association between socioeconomic and health factors and edentulism in people aged 65 and older – a population-based survey. Scand J Public Health 2017; 46:690-698. [DOI: 10.1177/1403494817717406] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: To study edentulism and use of dental services in a population-based sample of people aged 65 years and older from northern Sweden and western Finland. Methods: In 2010, people aged 65, 70, 75 and 80 years who were living in one of 32 municipalities in northern Sweden and western Finland were invited to answer a questionnaire as part of the Gerontological Regional Database (GERDA) study ( n = 6099). The questionnaire contained items related to socioeconomic status, general health and edentulism. Results: The prevalence of edentulism was 34.9% in Finland, compared with 20.6% in Sweden ( p < 0.001), 31.9% in rural areas, compared with 20.9% in urban areas ( p < 0.001), and 25% overall. The prevalence of edentulism rose from 17.8% in 65-year-olds, 23.8% in 70-year-olds, 33.5% in 75-year-olds and 37.3% in 80-year-olds ( p < 0.001), and was 23.8% in women, compared with 27% in men ( p < 0.001). In multivariate models, edentulism was associated with lower educational level (odds ratio (OR) 2.87, 95% confidence interval (CI) 2.31–3.58), low income level (OR 1.7, CI 1.09–1.47), residence in a rural area (OR 1.43, CI 1.23–1.66), male sex (OR 1.30, CI 1.12–1.52), dependence in instrumental activities of daily living (OR 1.48, CI 1.25–1.74), social isolation (OR 1.52, CI 1.17–1.98) and poor self-experienced health (OR 1.38, CI 1.17–1.62). Conclusions: One-quarter of the total sample was edentulous, with a higher prevalence of edentulism in Finland than in Sweden and in rural than in urban areas. Edentulism was associated with socioeconomic, psychological and health-related factors. These findings could be used to inform preventive measures and identify people aged 65 years and older who are in need of oral care.
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Affiliation(s)
- Hanna Olofsson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Sweden
| | - Eva Lena Ulander
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Sweden
| | - Yngve Gustafson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Sweden
| | - Carl Hörnsten
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Sweden
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Ruospo M, Palmer SC, Wong G, Craig JC, Petruzzi M, De Benedittis M, Ford P, Johnson DW, Tonelli M, Natale P, Saglimbene V, Pellegrini F, Celia E, Gelfman R, Leal MR, Torok M, Stroumza P, Bednarek-Skublewska A, Dulawa J, Frantzen L, Del Castillo D, Schon S, Bernat AG, Hegbrant J, Wollheim C, Gargano L, Bots CP, Strippoli GF. Periodontitis and early mortality among adults treated with hemodialysis: a multinational propensity-matched cohort study. BMC Nephrol 2017; 18:166. [PMID: 28532432 PMCID: PMC5440912 DOI: 10.1186/s12882-017-0574-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/05/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Periodontitis is associated with cardiovascular mortality in the general population and adults with chronic diseases. However, it is unclear whether periodontitis predicts survival in the setting of kidney failure. METHODS ORAL-D was a propensity matched analysis in 3338 dentate adults with end-stage kidney disease treated in a hemodialysis network in Europe and South America designed to examine the association between periodontitis and all-cause and cardiovascular-related mortality in people on long-term hemodialysis. Participants were matched 1:1 on their propensity score for moderate to severe periodontitis assessed using the World Health Organization Community Periodontal Index. A random-effects Cox proportional hazards model was fitted with shared frailty to account for clustering of mortality risk within countries. RESULTS Among the 3338 dentate participants, 1355 (40.6%) had moderate to severe periodontitis at baseline. After using propensity score methods to generate a matched cohort of participants with periodontitis similar to those with none or mild periodontal disease, moderate to severe periodontitis was associated with a lower risk of all-cause (9.1 versus 13.0 per 100 person years, hazard ratio 0.74, 95% confidence interval 0.61 to 0.90) and cardiovascular (4.3 versus 6.9 per 100 person years, hazard ratio 0.67, 0.51 to 0.88) mortality. These associations were not changed substantially when participants were limited to those with 12 or more natural teeth and when accounting for competing causes of cardiovascular death. CONCLUSION In contrast to the general population, periodontitis does not appear to be associated with an increased risk of early death in adults treated with hemodialysis.
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Affiliation(s)
- Marinella Ruospo
- Diaverum Medical Scientific Office, Lund, Sweden.,Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | | | | | | | - Massimo Petruzzi
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy
| | - Michele De Benedittis
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy
| | | | - David W Johnson
- University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | | | | | - Valeria Saglimbene
- Diaverum Medical Scientific Office, Lund, Sweden.,University of Sydney, Sydney, Australia
| | | | | | | | | | | | | | | | - Jan Dulawa
- Diaverum Medical Scientific Office, Lund, Sweden.,SHS, Medical University of Silesia, Katowice, Poland
| | - Luc Frantzen
- Diaverum Medical Scientific Office, Lund, Sweden
| | | | | | | | | | | | | | - Casper P Bots
- Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Giovanni Fm Strippoli
- Diaverum Medical Scientific Office, Lund, Sweden. .,University of Sydney, Sydney, Australia. .,Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy. .,Diaverum Academy, Lund, Sweden.
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15
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Feng X, Sambamoorthi U, Wiener RC. Dental workforce availability and dental services utilization in Appalachia: a geospatial analysis. Community Dent Oral Epidemiol 2016; 45:145-152. [PMID: 27957773 DOI: 10.1111/cdoe.12270] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 11/10/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES There is considerable variation in dental services utilization across Appalachian counties, and a plausible explanation is that individuals in some geographical areas do not utilize dental care due to dental workforce shortage. We conducted an ecological study on dental workforce availability and dental services utilization in Appalachia. METHODS We derived county-level (n = 364) data on demographic and socioeconomic characteristics and dental services utilization in Appalachia from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) using person-level data. We obtained county-level dental workforce availability and physician-to-population ratio estimates from Area Health Resources File and linked them to the county-level BRFSS data. The dependent variable was the proportion using dental services within the last year in each county (ranging from 16.6% to 91.0%). We described the association between dental workforce availability and dental services utilization using ordinary least squares regression and spatial regression techniques. Spatial analyses consisted of bivariate local indicators of spatial association (LISA) and geographically weighted regression (GWR). RESULTS Bivariate LISA showed that counties in the central and southern Appalachian regions had significant (P < 0.05) low-low spatial clusters (low dental workforce availability, low percent dental services utilization). GWR revealed considerable local variations in the association between dental utilization and dental workforce availability. In the multivariate GWR models, 8.5% (t-statistics > 1.96) and 13.45% (t-statistics > 1.96) of counties showed positive and statistically significant relationships between the dental services utilization and workforce availability of dentists and dental hygienists, respectively. CONCLUSIONS Dental workforce availability was associated with dental services utilization in the Appalachian region; however, this association was not statistically significant in all counties. The findings suggest that program and policy efforts to improve dental services utilization need to focus on factors other than increasing the dental workforce availability for many counties in Appalachia.
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Affiliation(s)
- Xue Feng
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - R Constance Wiener
- Department of Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA
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16
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Han DH, Khang YH. Lifecourse socioeconomic position indicators and tooth loss in Korean adults. Community Dent Oral Epidemiol 2016; 45:74-83. [DOI: 10.1111/cdoe.12262] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/07/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry; Seoul National University School of Dentistry; Seoul South Korea
- Dental Research Institute; Seoul National University; Seoul South Korea
| | - Young-Ho Khang
- Department of Health Policy and Management; Seoul National University College of Medicine; Seoul South Korea
- Institute of Health Policy and Management; Seoul National University Medical Research Center; Seoul South Korea
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17
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Ren C, McGrath C, Yang Y. Edentulism and associated factors among community-dwelling middle-aged and elderly adults in China. Gerodontology 2016; 34:195-207. [PMID: 27709661 DOI: 10.1111/ger.12249] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the prevalence of self-reported edentulism and its associated risk factors among community-dwelling adults aged 45 years and older in China. MATERIALS AND METHODS Data from the national baseline survey (2011-2012) of the China Health and Retirement Longitudinal Study (CHARLS) were used for this study (N = 17 167). Bivariate and multivariate logistic regressions were conducted to assess the predictors of edentulism. Models 1 and 2 were based on the whole sample. Models 3 and 4 were based on the subsample (N = 9933) from whom anthropometric and blood biomarker data were available. RESULTS The prevalence of edentulism was 8.64% among Chinese adults aged 45 and above. As shown by Model 1, older age was a robust predictor for edentulism (odds ratio [OR] = 3.81 for people aged 55-64; OR = 11.22 for people aged 65-74; OR = 24.05 for people aged 75 and above). Other factors positively associated with edentulism included being female (OR = 1.25), rural residence (OR = 1.30), asthma (OR = 1.48), depression (OR = 1.20), reduced physical function (OR = 1.37) and current smoking status (OR = 1.36). People with higher educational levels (OR = 0.75 for people who can read and write; OR = 0.64 for people who obtained a junior high school education or above) and better-off economic status (OR = 0.80) were less likely to be edentate. The association between edentulism and age, educational level, economic status and physical function remained significant in Model 3, and in addition, being underweight appeared as another strong predictor (OR = 1.93). CONCLUSIONS The estimated prevalence of edentulism and the identified associated factors will provide epidemiologic evidence for future research and interventions in the target population in China.
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Affiliation(s)
- Chong Ren
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Colman McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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18
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Kailembo A, Preet R, Stewart Williams J. Common risk factors and edentulism in adults, aged 50 years and over, in China, Ghana, India and South Africa: results from the WHO Study on global AGEing and adult health (SAGE). BMC Oral Health 2016; 17:29. [PMID: 27465011 PMCID: PMC4964081 DOI: 10.1186/s12903-016-0256-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 07/15/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Edentulism (loss of all teeth) is a final marker of disease burden for oral health common among older adults and poorer populations. Yet most evidence is from high-income countries. Oral health has many of the same social and behavioural risk factors as other non-communicable diseases (NCDs) which are increasing rapidly in low- and middle-income countries with ageing populations. The "common risk factor approach" (CRFA) for oral health addresses risk factors shared with NCDs within the broader social and economic environment. METHODS The aim is to improve understanding of edentulism prevalence, and association between common risk factors and edentulism in adults aged 50 years and above using nationally representative samples from China (N = 11,692), Ghana (N = 4093), India (N = 6409) and South Africa (N = 2985). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). Multivariable logistic regression describes association between edentulism and common risk factors reported in the literature. RESULTS Prevalence of edentulism: in China 8.9 %, Ghana 2.9 %, India 15.3 %, and South Africa 8.7 %. Multivariable analysis: in China, rural residents were more likely to be edentulous (OR 1.36; 95 % CI 1.09-1.69) but less likely to be edentulous in Ghana (OR 0.53; 95 % CI 0.31-0.91) and South Africa (OR 0.52; 95 % CI 0.30-0.90). Respondents with university education (OR 0.31; 95 % CI 0.18-0.53) and in the highest wealth quintile (OR 0.68; 95 % CI 0.52-0.90) in China were less likely to be edentulous. In South Africa respondents with secondary education were more likely to be edentulous (OR 2.82; 95 % CI 1.52-5.21) as were those in the highest wealth quintile (OR 2.78; 95 % CI 1.16-6.70). Edentulism was associated with former smokers in China (OR 1.57; 95 % CI 1.10-2.25) non-drinkers in India (OR 1.65; 95 % CI 1.11-2.46), angina in Ghana (OR 2.86; 95 % CI 1.19-6.84) and hypertension in South Africa (OR 2.75; 95 % CI 1.72-4.38). Edentulism was less likely in respondents with adequate nutrition in China (OR 0.68; 95 % CI 0.53-0.87). Adjusting for all other factors, compared with China, respondents in India were 50 % more likely to be edentulous. CONCLUSIONS Strengthening the CRFA should include addressing common determinants of health to reduce health inequalities and improve both oral and overall health.
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Affiliation(s)
- Alexander Kailembo
- Elite Dental Clinic, 6th Floor, Oasis Office Complex, Plot No. 14/15, Haile Selassie Road, P.O Box 38394, Masaki, Dar es salaam Tanzania
| | - Raman Preet
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Jennifer Stewart Williams
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
- Research Centre for Generational Health and Ageing, Faculty of Health, University of Newcastle, Newcastle, Australia
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19
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Kamberi B, Koçani F, Begzati A, Kelmendi J, Ilijazi D, Berisha N, Kqiku L. Prevalence of Dental Caries in Kosovar Adult Population. Int J Dent 2016; 2016:4290291. [PMID: 27516774 PMCID: PMC4969505 DOI: 10.1155/2016/4290291] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/18/2016] [Accepted: 06/26/2016] [Indexed: 11/18/2022] Open
Abstract
Objectives. The aim of this study was to assess the prevalence of dental caries in the Kosovar adult population. Materials and Methods. A cross-sectional study in Kosovo was conducted examining 9387 patients, aged 18 upwards, between January 2010 and December 2011. Clinical evaluation was done using WHO criteria for evaluation of dental health status and data collection. Results. The prevalence of caries for the whole study was 72.80%. The mean DMFT index was 9.61 (±5.12) in the 18-34-year age group, 11.6 (±6.42) in the 35-44-year age group, 13.68 (±8.12) among the 45-64-year age group, 17.98 (±9.81) in the 65-74-year age group, and 23.19 (±9.41) in the age group of 75+ years, respectively. A significant difference of mean DMFT and its each component was observed between the ages (P < 0.001). Conclusion. This study comes out with the significant levels of dental caries among young Kosovar population (18-34 years old).
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Affiliation(s)
- Blerim Kamberi
- Department of Dental Pathology and Endodontics, University Dentistry Clinical Center of Kosovo, 10000 Prishtina, Kosovo
| | - Ferit Koçani
- Department of Dental Pathology and Endodontics, University Dentistry Clinical Center of Kosovo, 10000 Prishtina, Kosovo
| | - Agim Begzati
- Department of Pediatric and Preventive Dentistry, University Dentistry Clinical Center of Kosovo, 10000 Prishtina, Kosovo
| | - Jeta Kelmendi
- Department of Orthodontics, University Dentistry Clinical Center of Kosovo, 10000 Prishtina, Kosovo
| | | | - Nora Berisha
- Department of Orthodontics, University Dentistry Clinical Center of Kosovo, 10000 Prishtina, Kosovo
| | - Lumnije Kqiku
- Division of Preventive and Operative Dentistry, Endodontics, Pedodontics and Minimally Invasive Dentistry, Department of Dentistry and Maxillofacial Surgery, University of Graz, 8010 Graz, Austria
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20
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Nieman CL, Marrone N, Szanton SL, Thorpe RJ, Lin FR. Racial/Ethnic and Socioeconomic Disparities in Hearing Health Care Among Older Americans. J Aging Health 2016; 28:68-94. [PMID: 25953816 PMCID: PMC4826391 DOI: 10.1177/0898264315585505] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Hearing impairment is highly prevalent, but little is known about hearing health care among older minority adults. METHOD We analyzed nationally representative, cross-sectional data from 1,544 older adults ≥ 70 years with audiometry and hearing care data from the 2005-2006 and 2009-2010 National Health and Nutritional Examination Surveys. RESULTS After adjusting for age and speech frequency pure tone average, Blacks (odds ratio [OR] = 1.68, vs. Whites) and those with greater education (OR = 1.63, ≥ college vs. < high school) were more likely to report recent hearing testing, while White older adults and those with greater socioeconomic status were more likely to report regular hearing aid use (all ps < .05). Based on a multivariate analysis, Blacks were not more likely than Whites to use hearing aids despite being more likely to have had recent hearing testing. DISCUSSION Racial/ethnic and socioeconomic disparities exist in hearing health care and represent critical areas for research and intervention.
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Affiliation(s)
- Carrie L Nieman
- Johns Hopkins School of Medicine, Baltimore, MD, USA The Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | | | - Sarah L Szanton
- University of Arizona, Tucson, USA Johns Hopkins School of Nursing, Baltimore, MD, USA Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J Thorpe
- University of Arizona, Tucson, USA Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Frank R Lin
- Johns Hopkins School of Medicine, Baltimore, MD, USA University of Arizona, Tucson, USA Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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21
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McNeil DW, Hayes SE, Randall CL, Polk DE, Neiswanger K, Shaffer JR, Weyant RJ, Foxman B, Kao E, Crout RJ, Chapman S, Brown LJ, Maurer JL, Marazita ML. Depression and Rural Environment are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia. Behav Modif 2015; 40:325-40. [PMID: 26643277 DOI: 10.1177/0145445515615353] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers.
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Affiliation(s)
- Daniel W McNeil
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Sarah E Hayes
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Cameron L Randall
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Deborah E Polk
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Kathy Neiswanger
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - John R Shaffer
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Robert J Weyant
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Betsy Foxman
- Center for Oral Health Research in Appalachia University of Michigan, Ann Arbor, USA
| | - Elizabeth Kao
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Richard J Crout
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Stella Chapman
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Linda J Brown
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Jennifer L Maurer
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Mary L Marazita
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
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22
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Han DH, Khang YH, Lee HJ. Association between adult height and tooth loss in a representative sample of Koreans. Community Dent Oral Epidemiol 2015; 43:479-88. [PMID: 26083077 DOI: 10.1111/cdoe.12175] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 05/18/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Evidence suggests that taller individuals have better health than that of shorter individuals. However, evidence for links to tooth loss is scarce. The aim of this study was to examine the association between adult height and tooth loss and to examine the roles of covariates in explaining the association in different birth cohorts in Korea. METHODS Using data from the Fourth and Fifth Korea National Health and Nutritional Examination Survey (KNHANES IV and V), the subjects were grouped into two birth cohorts based on their historical context: born from 1920 to 1945 and 1946 to 1962. The dependent variables were loss of 8 or more teeth and total tooth loss (edentulism), while the independent variable was the height quartile. Demographic factors (survey year, age, and gender), early childhood/adult socioeconomic status (SES) (father's education, own education, income, and place of residence), health behaviors (cigarette smoking, binge drinking, frequency of toothbrushing, and regular dental visit), and health problems (diabetes and hypertension) were included in a series of analytical models. RESULTS The survey year-, age-, and gender-adjusted prevalence ratios (PR) of the loss of 8 or more teeth for the shortest quartile were 1.23 (95% confidence intervals, CI: 1.13-1.35) for the 1920-1945 birth cohorts and 1.39 (95% CI: 1.20-1.62) for the 1946-1962 birth cohorts. The PRs for edentulousness were 1.64 (95% CI: 1.34-2.02) for the 1920-1945 birth cohorts and 2.26 (95% CI: 1.31-3.91) for the 1946-1962 birth cohorts. These associations were moderately attenuated after adjusting for own education but still significant in the fully adjusted models. After full adjustment for the covariates, those in the shortest height quartiles in the relatively young birth cohorts (1946-1962 birth cohorts) had a 1.93 (95% CI: 1.09-3.43) times greater prevalence of edentulism than that of their tallest counterparts. CONCLUSIONS Given that adult height reflects early-life conditions, independent associations between height and tooth loss support the view that early-life circumstances significantly influence oral health outcomes in later life.
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Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Young-Ho Khang
- Department of Health Policy and Management, Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Hye-Ju Lee
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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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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De Marchi RJ, dos Santos CM, Martins AB, Hugo FN, Hilgert JB, Padilha DM. Four-year incidence and predictors of coronal caries in south Brazilian elderly. Community Dent Oral Epidemiol 2015; 43:452-60. [DOI: 10.1111/cdoe.12170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 04/22/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Renato José De Marchi
- Department of Preventive and Social Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Camila Mello dos Santos
- Department of Preventive and Social Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Aline Blaya Martins
- Department of Preventive and Social Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
- Postgraduate Studies Program in Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
- Faculty of Dentistry; Center of Community Oral Health Research; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
- Postgraduate Studies Program in Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
- Postgraduate Studies Program in Epidemiology; Faculty of Medicine; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Dalva Maria Padilha
- Department of Preventive and Social Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
- Postgraduate Studies Program in Dentistry; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
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25
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Prevalence of loss of all teeth (edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11308-24. [PMID: 25361046 PMCID: PMC4245614 DOI: 10.3390/ijerph111111308] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 10/08/2014] [Accepted: 10/14/2014] [Indexed: 12/05/2022]
Abstract
Little information exists about the loss of all one’s teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO’s) Study on global AGEing and adult health (SAGE) Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367), Ghana (N = 4724), India (N = 7150), Mexico (N = 2315), Russian Federation (N = 3938) and South Africa (N = 3840). Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%–21.7%) than China, Ghana, and South Africa (3.0%–9.0%). In multivariate logistic analysis sociodemographic factors (older age, lower education), chronic conditions (arthritis, asthma), health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption) and other health related variables (functional disability and low social cohesion) were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention.
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Guo Y, Logan HL, Dodd VJ, Muller KE, Marks JG, Riley JL. Health literacy: a pathway to better oral health. Am J Public Health 2014; 104:e85-91. [PMID: 24832423 DOI: 10.2105/ajph.2014.301930] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES We examined whether health literacy was associated with self-rated oral health status and whether the relationship was mediated by patient-dentist communication and dental care patterns. METHODS We tested a path model with data collected from 2 waves of telephone surveys (baseline, 2009-2010; follow-up, 2011) of individuals residing in 36 rural census tracts in northern Florida (final sample size n = 1799). RESULTS Higher levels of health literacy were associated with better self-rated oral health status (B = 0.091; P < .001). In addition, higher levels of health literacy were associated with better patient-dentist communication, which in turn corresponded with patterns of regular dental care and better self-rated oral health (B = 0.003; P = .01). CONCLUSIONS Our study showed that, beyond the often-reported effects of gender, race, education, financial status, and access to dental care, it is also important to consider the influence of health literacy and quality of patient-dentist communication on oral health status. Improved patient-dentist communication is needed as an initial step in improving the population's oral health.
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Affiliation(s)
- Yi Guo
- Yi Guo and Keith E. Muller are with the Department of Health Outcomes and Policy, College of Medicine, and Henrietta L. Logan, Virginia J. Dodd, John G. Marks, and Joseph L. Riley III are with the Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville
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Liang J, Wu B, Plassman B, Bennett J, Beck J. Racial disparities in trajectories of dental caries experience. Community Dent Oral Epidemiol 2013; 41:517-25. [PMID: 23465078 DOI: 10.1111/cdoe.12045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 02/06/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study charted the trajectories of dental caries, including decayed teeth, missing teeth and filled teeth among older Americans over a 5-year period. In particular, it focused on racial differences in the levels of and rates of change in dental caries experience. METHODS Data came from the Piedmont Dental Study. The sample included 810 older Americans who were dentate at the baseline with up to 4 repeated observations between 1988 and 1994. Hierarchical linear models were employed in depicting intrapersonal and interpersonal differences in dental caries experience. RESULTS Different measures of caries outcomes exhibited distinct trajectories. On average, the number of decayed teeth decreased over time, whereas missing teeth increased. In contrast, the number of filled teeth remained stable during a 5-year period. Relative to their white counterparts, older black Americans had more decayed teeth and missing teeth but fewer filled teeth. Blacks and whites differed in the levels of dental caries but not in their rates of change except for missing teeth. Even when demographic and socioeconomic attributes were adjusted, racial variations in dental caries experience remained significant. CONCLUSIONS Although significantly correlated, various dental caries outcomes move along different paths over time. In view of the persistent racial disparities in dental caries trajectories, future interventions to minimize such variations among older Americans in the levels of and the rates of change in dental caries experience are clearly warranted.
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Mamai-Homata E, Topitsoglou V, Oulis C, Margaritis V, Polychronopoulou A. Risk indicators of coronal and root caries in Greek middle aged adults and senior citizens. BMC Public Health 2012; 12:484. [PMID: 22734655 PMCID: PMC3487738 DOI: 10.1186/1471-2458-12-484] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 06/11/2012] [Indexed: 11/29/2022] Open
Abstract
Background Dental caries is the result of a complex interplay of multiple determinants which may change overtime. Therefore, periodic surveys of caries experience and redetermination of the risk indicators of the disease are needed. The aim of this study was to assess the prevalence and severity of coronal and root caries in Greeks aged 35-44 and 65-74-year-old in relation to socio-demographic parameters. Furthermore, trends in coronal caries experience of the 35-44-year-olds were investigated. Methods A sample of 1188 35-44-year-old and 1093 65-74-year-old individuals was selected in 2005 according to WHO guidelines for national pathfinder surveys. Caries was assessed in dentate subjects using the DMFT, DMFS, RDFS and RCI indices. Socio-demographic data were also collected. Univariate and multivariate regression analyses were performed to identify the effect of socio-demographic parameters. Results The mean DMFT and DMFS scores of the adults were 14.06 and 45.78 respectively, while those of the senior citizens were 20.63 and 89.82. Among the 35-44-year-ods, men and those having a higher educational attainment had significantly lower DMFS values (women OR = 1.679, CI: 1.243-2.267 and >12 years of education OR = 0.321, CI: 0.193-0.535 respectively), while educational level was the only predictor of DMFS in senior citizens (OR = 0.279, CI: 0.079-0.992). The mean DMFT score of the 35-44-year-olds has not improved since 1985, but there was a remarkable reduction in the number of DT related to a simultaneous increase in the number of FT. The mean RDFS rose from 0.39 in adults to 2.66 in senior citizens. The mean RDFS score of the middle aged adults was significantly correlated with education (OR = 0.346, CI: 0.180-0.664). The RCI was almost four times greater in seniors (9.73) than in adults (2.53). There were significant differences in caries experience between the surveyed regions. MS and RDS were the major components of the DMFS and RDFS indices respectively, in both age groups. Conclusions Caries experience in Greek adults is similar to what is observed in most industrialized countries. The mean DMFT score of the 35-44-year-olds has not improved since 1985, but a great improvement in restorative care has been observed. Senior citizens had a high percentage of untreated coronal and root surfaces. Region and education were the strongest predictors of caries experience. An increase in oral care utilization and effective prevention over the whole lifespan are needed to improve the dental health of the Greek adult population.
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Affiliation(s)
- Eleni Mamai-Homata
- Department of Preventive and Community Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece.
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Northridge ME, Ue FV, Borrell LN, De La Cruz LD, Chakraborty B, Bodnar S, Marshall S, Lamster IB. Tooth loss and dental caries in community-dwelling older adults in northern Manhattan. Gerodontology 2012; 29:e464-73. [PMID: 21718349 PMCID: PMC3189437 DOI: 10.1111/j.1741-2358.2011.00502.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine tooth loss and dental caries by sociodemographic characteristics from community-based oral health examinations conducted by dentists in northern Manhattan. BACKGROUND The ElderSmile programme of the Columbia University College of Dental Medicine serves older adults with varying functional capacities across settings. This report is focused on relatively mobile, socially engaged participants who live in the impoverished communities of Harlem and Washington Heights/Inwood in northern Manhattan, New York City. MATERIALS AND METHODS Self-reported sociodemographic characteristics and health and health care information were provided by community-dwelling ElderSmile participants aged 65 years and older who took part in community-based oral health education and completed a screening questionnaire. Oral health examinations were conducted by trained dentists in partnering prevention centres among ElderSmile participants who agreed to be clinically screened (90.8%). RESULTS The dental caries experience of ElderSmile participants varied significantly by sociodemographic predictors and smoking history. After adjustment in a multivariable logistic regression model, older age, non-Hispanic Black and Hispanic race/ethnicity, and a history of current or former smoking were important predictors of edentulism. CONCLUSION Provision of oral health screenings in community-based settings may result in opportunities to intervene before oral disease is severe, leading to improved oral health for older adults.
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Affiliation(s)
- Mary E Northridge
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY 10003-1402, USA.
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dos Santos CM, Martins AB, de Marchi RJ, Hilgert JB, Hugo FN, Padilha DMP. Assessing changes in oral health-related quality of life and its factors in community-dwelling older Brazilians. Gerodontology 2012; 30:176-86. [DOI: 10.1111/j.1741-2358.2012.00656.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Vela C, Samson E, Zunzunegui MV, Haddad S, Aubin MJ, Freeman EE. Eye care utilization by older adults in low, middle, and high income countries. BMC Ophthalmol 2012; 12:5. [PMID: 22471351 PMCID: PMC3378437 DOI: 10.1186/1471-2415-12-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 04/03/2012] [Indexed: 11/15/2022] Open
Abstract
Background The risk of visual impairment increases dramatically with age and therefore older adults should have their eyes examined at least every 1 to 2 years. Using a world-wide, population-based dataset, we sought to determine the frequency that older people had their eyes examined. We also examined factors associated with having a recent eye exam. Methods The World Health Surveys were conducted in 70 countries throughout the world in 2002-2003 using a random, multi-stage, stratified, cluster sampling design. Participants 60 years and older from 52 countries (n = 35,839) were asked "When was the last time you had your eyes examined by a medical professional?". The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank website. Prevalence estimates were adjusted to account for the complex sample design. Results Overall, only 18% (95% CI 17, 19) of older adults had an eye exam in the last year. The rate of an eye exam in the last year in low, lower middle, upper middle, and high income countries was 10%, 24%, 22%, and 37% respectively. Factors associated with having an eye exam in the last year included older age, female gender, more education, urban residence, greater wealth, worse self-reported health, having diabetes, and wearing glasses or contact lenses (p < 0.05). Conclusions Given that older adults often suffer from age-related but treatable conditions, they should be seen on a regular basis to prevent visual impairment and its disabling consequences.
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Affiliation(s)
- Claudia Vela
- Hôpital Maisonneuve-Rosemont Recherche ophtalmologie, F131 5415 boulevard de l'Assomption, Montreal, QC H1T 2M4, Canada
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Bell RA, Arcury TA, Anderson AM, Chen H, Savoca MR, Gilbert GH, Quandt SA. Dental anxiety and oral health outcomes among rural older adults. J Public Health Dent 2011; 72:53-9. [PMID: 22316247 DOI: 10.1111/j.1752-7325.2011.00283.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The objective of this study is to determine the degree to which rural older adults are able to complete a measure of dental anxiety and to assess the prevalence, as well as the demographic and oral health characteristics, of individuals reporting high dental anxiety. METHODS A population-based sample of 635 African American, American Indian and White older adults (age ≥ 60 years) completed an in-home survey, and 362 dentate participants completed an oral examination. Dental anxiety was measured using the four-item Corah's Dental Anxiety Scale (DAS). Gender, ethnicity, age, education, and oral health outcomes were compared between those who completed all four DAS questions (completers) and those who did not (noncompleters) as well as, among completers, those with high versus low DAS scores. RESULTS There were 94 (14.8%) noncompleters. Noncompletion was associated with older age, lower education, being edentulous, and having gingival recession. 12.4% of DAS completers had high DAS scores, which was more common among those aged 60-70 years, women, and those with oral pain and sore or bleeding gums. In logistic regression analysis, only sore and bleeding gums had a significant association with a high DAS score (odds ratio = 2.40, 95% confidence interval 1.09-5.26). CONCLUSIONS About one in eight rural older adults have high dental anxiety, which is associated with poor oral health outcomes. Identifying new approaches to measure dental anxiety among a population with limited interaction with dental care providers is needed.
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Affiliation(s)
- Ronny A Bell
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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Oulis CJ, Berdouses ED, Mamai-Homata E, Polychronopoulou A. Prevalence of sealants in relation to dental caries on the permanent molars of 12 and 15-year-old Greek adolescents. A national pathfinder survey. BMC Public Health 2011; 11:100. [PMID: 21320343 PMCID: PMC3048527 DOI: 10.1186/1471-2458-11-100] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 02/14/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of sealants as an effective measure for the prevention of pit and fissure caries in children has been well documented by several studies; either they are used on an individual or on a public health basis. In order to plan and establish a national preventive program with sealants in a community, it is mandatory to know the epidemiological pattern of caries along with other variables influencing their use and effectiveness. AIMS To assess the utilization and distribution pattern of pit and fissure sealants on the first and second permanent molars of Greek adolescents and to evaluate whether the existing usage of sealants and some socio-demographic factors are correlated to caries prevalence on the population examined METHODS A stratified cluster sample of 2481 Greek adolescents was selected according to WHO guidelines (1224 twelve and 1,257 fifteen-year-old), living in urban and rural areas in 11 districts within the country. Five calibrated examiners carried out clinical examinations, recording caries experience at the dentine threshold (BASCD criteria) and presence or absence of sealants along with Socio-demographic indicators associated with oral health. Mann Whitney and Pearson's chi-square non parametric tests were utilized for assessing the data. The level of significance was p < 0.05. RESULTS Sealants utilization varied considerably within the different districts, with 8,3% of the 12 and 8,0% of the 15-year-old adolescents having at least one sealed molar. Sealants reduced DMFS scores by 11% in the 12-year-olds and by 24% in the 15-year-olds, while 15-year-old adolescents from rural areas had a statistically significant (p = 0.002) less chance of having sealants (71%) compared to children from urban areas. Girls had higher chance to receive sealants in both age groups (26% for the 12 and 19% for the 15-year-old) as well as patients that visited the dentist for prevention compared to those visiting the dentist because they thought they needed a restoration or because they were in pain. CONCLUSIONS The finding that sealants reduced DMFS scores despite their very low utilization, along with the high prevalence of dental caries found on the occlusal surfaces of the posterior teeth of Greek adolescents, is calling for a national preventive program with sealants which could eliminate caries to a larger extent.
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Affiliation(s)
- Constantine J Oulis
- Associate Professor, Department of Paediatric Dentistry Dental School, University of Athens, Athens, Greece
| | - Elias D Berdouses
- Paediatric Dentist, Clinical Instructor, Department of Paediatric Dentistry, Dental School, University of Athens, Athens, Greece
| | - Eleni Mamai-Homata
- Associate Professors, Department of Preventive and Community Dentistry, Dental School, University of Athens, Athens, Greece
| | - Argyro Polychronopoulou
- Associate Professors, Department of Preventive and Community Dentistry, Dental School, University of Athens, Athens, Greece
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Savoca MR, Arcury TA, Leng X, Chen H, Bell RA, Anderson AM, Kohrman T, Gilbert GH, Quandt SA. Impact of denture usage patterns on dietary quality and food avoidance among older adults. J Nutr Gerontol Geriatr 2011; 30:86-102. [PMID: 23286643 PMCID: PMC3545413 DOI: 10.1080/01639366.2011.545043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study categorizes older adults living in rural areas by denture status, assesses the frequency of wearing dentures during meals, and determines whether denture status or use is associated with dietary quality or the number of foods avoided. A multi-ethnic population-based sample of adults ≥60 years (N = 635) in the rural United States was interviewed. Survey included denture use, removing dentures before eating, and foods avoided due to oral health problems. Dietary intakes were converted into Healthy Eating Index-2005 scores. Sixty percent wore removable dentures of some type; 55% never, 27% sometimes, and 18% always removed dentures when eating. More frequent removal was associated with lower dietary quality and more foods avoided. Those with severe tooth loss had the lowest dietary quality and avoided the most foods. Many rural older adults wear dentures. Learning how they adapt to denture use will offer insight into their nutritional self-management and help explain differences in dietary quality.
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Affiliation(s)
- Margaret R Savoca
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, North Carolina 27402, USA.
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Skillman SM, Doescher MP, Mouradian WE, Brunson DK. The challenge to delivering oral health services in rural America. J Public Health Dent 2010; 70 Suppl 1:S49-57. [PMID: 20806475 DOI: 10.1111/j.1752-7325.2010.00178.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This review identifies the challenges to oral health in rural America and describes areas of innovation in prevention, delivery of dental services, and workforce development that may improve oral health for rural populations. METHODS This descriptive article is based on literature reviews and personal communications. RESULTS Rural populations have lower dental care utilization, higher rates of dental caries, lower rates of insurance, higher rates of poverty, less water fluoridation, fewer dentists per population, and greater distances to travel to access care than urban populations. Improving the oral health of rural populations requires practical and flexible approaches to expand and better distribute the rural oral health workforce, including approaches tailored to remote areas. Solutions that involve mass prevention/public health interventions include increasing water fluoridation, providing timely oral health education, caries risk assessment and referral, preventive services, and offering behavioral interventions such as smoking and tobacco cessation programs. Solutions that train more providers prepared to work in rural areas include recruiting students from rural areas, training students in rural locations, and providing loan repayment and scholarships. Increasing the flexibility and capacity of the oral health workforce for rural areas could be achieved by creating new roles for and new types of providers. Solutions that overcome distance barriers include mobile clinics and telehealth technology. CONCLUSIONS Rural areas need flexibility and resources to develop innovative solutions that meet their specific needs. Prevention needs to be at the front line of rural oral health care, with systematic approaches that cross health professions and health sectors.
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Unmet dental needs in rural primary care: a clinic-, community-, and practice-based research network collaborative. J Am Board Fam Med 2010; 23:514-22. [PMID: 20616294 PMCID: PMC2989533 DOI: 10.3122/jabfm.2010.04.090080] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Oral health is an essential component of general health and well-being, yet barriers to the access of dental care and unmet needs are pronounced, particularly in rural areas. Despite associations with systemic health, few studies have assessed unmet dental needs across the lifespan as they present in primary care. This study describes the prevalence of oral health conditions and unmet dental needs among patients presenting for routine care in a rural Oregon family medicine practice. METHODS Eight primary care clinicians were trained to conduct basic oral health screenings for 7 dental conditions associated with International Statistical Classification of Diseases and Related Health Problems 9-Clinical Modification codes. During the 6-week study period, patients older than 12 months of age who presented to the practice for a regularly scheduled appointment received the screening and completed a brief dental access survey. RESULTS Of 1655 eligible patients, 40.7% (n = 674) received the screening and 66.9% (n = 1108) completed the survey. Half of the patients who were screened (46.0%, n = 310) had oral health conditions detected, including partial edentulism (24.5%), dental caries (12.9%), complete edentulism (9.9%), and cracked teeth (8.9%). Twenty-eight percent of the patients reported experiencing unmet dental needs. Patients with dental insurance were significantly more likely to report better oral and general health outcomes as compared with those who had no insurance or health insurance only. CONCLUSIONS Oral health diseases and unmet dental needs presented substantially in patients with ages ranging across the lifespan from one rural primary care practice. Primary care settings may present opportune environments for reaching patients who are unable to obtain regular dental care.
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Manrique-Espinoza B, Salinas-Rodríguez A, Mojarro-Íñiguez MG, Téllez-Rojo MM, Pérez-Núñez R, Ventura-Alfaro CE. Tooth Loss and Dental Healthcare Coverage in Older Rural Mexican Adults Living in Poverty. J Am Geriatr Soc 2010; 58:804-5. [DOI: 10.1111/j.1532-5415.2010.02785.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Quandt SA, Chen H, Bell RA, Anderson AM, Savoca MR, Kohrman T, Gilbert GH, Arcury TA. Disparities in oral health status between older adults in a multiethnic rural community: the rural nutrition and oral health study. J Am Geriatr Soc 2009; 57:1369-75. [PMID: 19563519 PMCID: PMC3400086 DOI: 10.1111/j.1532-5415.2009.02367.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare oral health status according to ethnicity and socioeconomic status in African-American, American-Indian, and white dentate and edentulous community-dwelling older adults. DESIGN Cross-sectional study; data from self-reports and oral examinations. PARTICIPANTS A multistage cluster sampling design was used to recruit 635 participants aged 60 and older from rural North Carolina counties with substantial African-American and American-Indian populations. MEASUREMENTS Participants completed in-home interviews and oral examinations. Self-reported data included sociodemographic indicators; self-rated oral health status; presence or absence of periodontal disease, bleeding gums, oral pain, dry mouth; and fit of prostheses. Oral examination data included number of teeth and numbers of anterior and posterior functional occlusal units. RESULTS African Americans and American Indians had significantly lower incomes and educational attainment than whites. Self-rated oral health was significantly better in whites than in African Americans and American Indians. Prevalence of self-reported periodontal disease and bleeding gums was lower in whites. Of dentate participants, African Americans were significantly more likely than whites to have 11 to 20 teeth and one or two posterior occlusal contacts. Oral health deficits remained associated with ethnicity when adjusted for socioeconomic variables. CONCLUSION Oral health disparities in older adults in a multiethnic rural area were largely associated with ethnicity and not socioeconomic status. Clinicians should be aware of these health disparities in oral health status and their possible role in disparities in chronic disease. Further research is necessary to understand whether these oral health disparities reflect current or lifetime access to care, diet, or attitudes toward oral health care.
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Affiliation(s)
- Sara A Quandt
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
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Jablonski RA, Swecker T, Munro C, Grap MJ, Ligon M. Measuring the Oral Health of Nursing Home Elders. Clin Nurs Res 2009; 18:200-17. [DOI: 10.1177/1054773809335306] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The primary purposes of this descriptive and prospective pilot study was to test the feasibility of a nursing and dental hygiene team to measure specific oral health indices in a sample of older adults residing in nursing homes (NHs). The secondary purpose was to determine the relationship between plaque and dentate status. Oral health indicators, functional status scores, and behavioral scores were collected and analyzed from 38 female NH residents from two geographically, organizationally, and economically diverse NHs. Persons with dentures had significantly lower plaque scores than those with natural dentition. Rural NH residents and African American NH residents had fewer filled teeth, indicating a potential lack of access to dental care. Oral health indicators were collected safely and efficiently from NH residents using a nursing and dental hygiene collaborative approach. Nursing and dental hygiene collaborations hold promise for improving the oral health in institutionalized elders.
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Seirawan H. Parsimonious prediction model for the prevalence of dental visits. Community Dent Oral Epidemiol 2008; 36:401-8. [DOI: 10.1111/j.1600-0528.2007.00420.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mitchell J, Bradley D, Wilson J, Goins RT. The Aging Farm Population and Rural Aging Research. J Agromedicine 2008; 13:95-109. [DOI: 10.1080/10599240802125383] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Reed DB, Rayens MK, Winter K, Zhang M. Health Care Delay of Farmers 50 Years and Older in Kentucky and South Carolina. J Agromedicine 2008; 13:71-9. [DOI: 10.1080/10599240802202711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Meng X, Gilbert GH, Litaker MS. Dynamics of satisfaction with dental appearance among dentate adults: 24-month incidence. Community Dent Oral Epidemiol 2008; 36:370-81. [DOI: 10.1111/j.1600-0528.2007.00409.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wu B, Plassman BL, Crout RJ, Liang J. Cognitive Function and Oral Health Among Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci 2008; 63:495-500. [DOI: 10.1093/gerona/63.5.495] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Onder G, Liperoti R, Soldato M, Cipriani MC, Bernabei R, Landi F. Chewing Problems and Mortality in Older Adults in Home Care: Results from the Aged in Home Care Study. J Am Geriatr Soc 2007; 55:1961-6. [DOI: 10.1111/j.1532-5415.2007.01453.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chia-Hui Chen C, Chyun DA, Li CY, McCorkle R. A Single-Item Approach to Screening Elders for Oral Health Assessment. Nurs Res 2007; 56:332-8. [PMID: 17846554 DOI: 10.1097/01.nnr.0000289504.30037.d8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Oral health contributes significantly to overall health. Finding a single item that can be used by primary care providers to screen elders who are in need of oral care is important. OBJECTIVES The objective of this article was to evaluate usefulness of the item: "Do you have regular dental checkups?" as a means to decide whether an oral health assessment or further referral is indicated. Answering no is postulated as a positive predictor of poor oral health and need for care. METHODS This study was a secondary analysis of a nutritional survey of 240 community-dwelling elders. Examiner-rated Kayser-Jones Brief Oral Health Status Examination; self-reported General Oral Health Assessment Index; number of remaining teeth; and pattern of checkups (regular vs. irregular) were evaluated by a trained gerontological nurse practitioner during an in-home assessment. RESULTS A dental visit within the past year for any reason was reported by 132 subjects (55.0%), but only 81 (33.8%) reported some sort of regular dental checkups. For dentate elders (n = 147), an irregular checkup was associated with lower educational level, Protestant faith, and Black race. People with irregular checkups scored significantly lower on all three oral indices. The negative predictive values and likelihood ratio negative values ranged 98.7-100.0% and 0.00-0.98, respectively, indicating that this item of interest is valid for ruling-out dentate subjects with good oral health. For edentulous elders (n = 93), the item was less effective. DISCUSSION A single item, "Do you have regular dental checkups?" can be used effectively to rule out dentate elders with good oral health and identify those who are in need of further oral health assessment or referrals.
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Musacchio E, Perissinotto E, Binotto P, Sartori L, Silva-Netto F, Zambon S, Manzato E, Corti MC, Baggio G, Crepaldi G. Tooth loss in the elderly and its association with nutritional status, socio-economic and lifestyle factors. Acta Odontol Scand 2007; 65:78-86. [PMID: 17453425 DOI: 10.1080/00016350601058069] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Tooth loss impacts on general health and is a risk factor for malnutrition, disability, loss of self-sufficiency, and deterioration in quality of life. The present study was carried out to evaluate the prevalence of edentulism and its association with social and lifestyle factors in a population of elderly Italians. MATERIAL AND METHODS Dental, social, and disease conditions were evaluated in a large community-based cohort (3054) of elderly subjects (> or =65 years) of both sexes in northern Italy. Logistic regression analyses with stepwise forward selection were performed to estimate the independent contribution of nutritional, socio-economic, and lifestyle variables to dental status. Adjusted ORs and 95% CI were estimated for variables significantly associated with edentulism. RESULTS The prevalence of edentulism was about 44.0%. It was more pronounced in females and it was twice as prevalent in the 90+ years age group. Among edentulous subjects, 17.5% wore no prostheses. Difficulties in chewing and in swallowing were reported by 47.6% and 13.7% of the subjects, respectively. Multivariate analysis indicates that edentulism was associated with age in both sexes. For women, independently associated risk factors were: years since menopause >23 (OR = 1.81; 95% CI: 1.37-2.40), number of children >3 (OR = 1.95; 95% CI: 1.36-2.80), and living alone (OR = 1.47; 95% CI: 1.15-1.88). For men, these were serum albumin <40 g/l (OR = 1.79; 95% CI: 1.22-2.63), current smoking (OR = 4.01; 95% CI: 2.59-6.20), and former smoking (OR = 3.42; 95% CI: 2.42-4.82). CONCLUSIONS The prevalence of edentulism among the elderly Italian population studied was at the high end among Western countries, and higher in women than in men. In women, tooth loss correlated with aging, female events (pregnancies, menopausal status), and living alone. In men, aging and smoking are important determinants of edentulism, which is associated with the risk condition of hypoalbuminemia. Difficulty in chewing was associated with dentition type. In our study, the high prevalence of edentulous subjects without prostheses suggests a need for educational and social measures to improve patients' attitudes to dental care and to encourage the use of prostheses among the elderly.
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Affiliation(s)
- Estella Musacchio
- Department of Medical and Surgical Sciences, University of Padova, Padova, Italy.
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Linden A, Adams JL. Evaluating disease management programme effectiveness: an introduction to instrumental variables. J Eval Clin Pract 2006; 12:148-54. [PMID: 16579823 DOI: 10.1111/j.1365-2753.2006.00615.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This paper introduces the concept of instrumental variables (IVs) as a means of providing an unbiased estimate of treatment effects in evaluating disease management (DM) programme effectiveness. Model development is described using zip codes as the IV. Three diabetes DM outcomes were evaluated: annual diabetes costs, emergency department (ED) visits and hospital days. Both ordinary least squares (OLS) and IV estimates showed a significant treatment effect for diabetes costs (P = 0.011) but neither model produced a significant treatment effect for ED visits. However, the IV estimate showed a significant treatment effect for hospital days (P = 0.006) whereas the OLS model did not. These results illustrate the utility of IV estimation when the OLS model is sensitive to the confounding effect of hidden bias.
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Affiliation(s)
- Ariel Linden
- Linden Consulting Group, Portland, OR 97124, USA.
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Solomon E, Murray J, Dodge WW, Redding SW, Valenza JA, Flaitz CM, Cole JS, Kalkwarf KL. Scope of Practice Comparison: A Tool for Curriculum Decision Making. J Dent Educ 2006. [DOI: 10.1002/j.0022-0337.2006.70.3.tb04079.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Eric Solomon
- Institutional Research; Texas A&M Health Science Center
| | | | - William W. Dodge
- University of Texas Health Science Center at San Antonio Dental School
| | | | - John A. Valenza
- University of Texas Health Science Center at Houston Dental Branch
| | | | - James S. Cole
- Baylor College of Dentistry; Texas A&M Health Science Center
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Pallegedara C, Ekanayake L. Tooth loss, the wearing of dentures and associated factors in Sri Lankan older individuals. Gerodontology 2006; 22:193-9. [PMID: 16329226 DOI: 10.1111/j.1741-2358.2005.00079.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine tooth loss, wearing of dentures and associated factors in older individuals from Sri Lanka. DESIGN A cross-sectional survey where the data were collected by means of an oral examination and an interviewer administered questionnaire. SETTING Negambo within the Gampaha district of Sri Lanka. SUBJECTS A total of 630 subjects who were aged 60 years and above. RESULTS Only 11 subjects had all 32 teeth and 17% were edentulous. Age, gender and level of income were significantly associated with the number of missing teeth. Of those with missing teeth, 22% wore dentures. Only 16% of the non-denture wearers perceived a need for dentures. Among the non-denture wearers who perceived a need for dentures, a majority had cited 'cost' as the main barrier for obtaining dentures. Logistic regression analysis revealed that age, gender, levels of income and education and missing teeth were significant predictors of wearing of dentures. CONCLUSIONS Knowledge of factors that influence tooth loss and wearing of dentures may have implications for oral health care planners in the provision and delivery of oral health services to the older individuals.
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Affiliation(s)
- C Pallegedara
- Dental Unit, Sri Lanka Air Force, Katunayake, Sri Lanka
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