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Park SA, Lim JN, Lee JY. Evaluation of the Effectiveness of Children's Dental Care Programs: A Retrospective Study. Healthcare (Basel) 2024; 12:721. [PMID: 38610144 PMCID: PMC11011933 DOI: 10.3390/healthcare12070721] [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] [Received: 02/08/2024] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024] Open
Abstract
This study aimed to evaluate the long-term impact of children's dental care programs on children and adolescents to reduce oral health inequalities. It measured and assessed the improvement effects of children's dental care programs on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and children's dental care program between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. A frequency analysis was conducted for demographic characteristics, and a binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. The data were analyzed using PASW Statistics with the statistical significance level set at α = 0.05. Regarding oral health status based on the frequency of participation in children's dental care program for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health status in children's dental care program between primary and adolescent age groups, individuals under continuous oral health care showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, a binary logistic regression analysis revealed significant influences (p < 0.05) of the developmental stage and frequency of program participation on dental caries prevalence. Children's dental care programs are essential for alleviating oral health inequalities among children and adolescents and preventing oral diseases. Furthermore, the developmental stage of children and the frequency of program participation are crucial factors in preventing oral conditions, such as dental caries.
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Affiliation(s)
- Soo-Auk Park
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan 31116, Republic of Korea;
| | - Ji-Na Lim
- Department of Public Health Science, Graduate School, Dankook University, Cheonan 31116, Republic of Korea;
| | - Jae-Young Lee
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan 31116, Republic of Korea;
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Costa LR, Vettore MV, Quadros LN, Vieira JMR, de Queiroz Herkrath APC, de Queiroz AC, Pereira JV, Herkrath FJ, Bessa Rebelo MA. Socio-economic status, psychosocial factors, health behaviours and incidence of dental caries in 12-year-old children living in deprived communities in Manaus, Brazil. J Dent 2023; 133:104504. [PMID: 37019267 DOI: 10.1016/j.jdent.2023.104504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVES This study examines the relationships between socio-economic status, psychosocial factors, health-related behaviours and the incidence of dental caries among 12-year-old schoolchildren living in deprived communities in Manaus, Brazil. METHODS A longitudinal study involving 312 children aged 12 years was conducted in the city of Manaus, Brazil. Baseline data including socio-economic status (number of goods, household overcrowding, parents' schooling, family income), psychosocial factors (sense of coherence [SOC-13], social support [Social Support Appraisals questionnaire]) and health-related behaviours (frequency of toothbrushing, sugar consumption, sedentary behaviour) were collected through structured questionnaires. The number of decayed teeth was clinically assessed at baseline and one-year follow-up. A hypothesised model evaluating the direct and indirect pathways between the variables was tested using confirmatory factor analysis and structural equation modelling. RESULTS The incidence of dental caries at the one-year follow-up was 25.6%. Sugar consumption (β = 0.103) and sedentary behaviour (β = 0.102) directly predicted the incidence of dental caries. A higher socio-economic status was directly linked with lower sugar consumption (β = -0.243) and higher sedentary behaviour (β = 0.227). Higher social support directly predicted lower sugar consumption (β = -0.114). Lower socio-economic status (β = -0.046) and lower social support (β = -0.026) indirectly predicted the incidence of dental caries via sugar consumption and sedentary behaviour. CONCLUSIONS In the population studied, sugar consumption and sedentary behaviour are meaningful predictors of the incidence of dental caries among schoolchildren living in deprived communities. Indirect pathways of lower socio-economic status and low social support with dental caries incidence via sugar consumption and sedentary behaviour were detected. These findings should be considered in oral interventions and oral health care policies to prevent dental caries among children living in deprivation. CLINICAL SIGNIFICANCE Social conditions, social support, sedentary behaviour and sugar consumption directly influence dental caries in children.
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Nery NG, Jordão LMR, Freire MDCM. Educational quality and oral health promotion in Brazilian schools: a multilevel analysis of national data. Braz Oral Res 2022; 36:e040. [PMID: 35293505 DOI: 10.1590/1807-3107bor-2022.vol36.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 09/10/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate whether educational quality is associated with schools' potential support for oral health promotion in Brazil, using a multilevel model. An ecological study was carried out using data from 940 public schools (school level) from the 27 Brazilian state capitals (city-level). The explanatory variable was educational quality, measured by the Basic Education Development Index (IDEB) for each city, and the four dependent variables referred to the Oral Health Promotion School Environment (OHPSE) indicator and its dimensions: Dimension 1 (In-school aspects), Dimension 2 (Aspects of the school surroundings), and Dimension 3 (Prohibitive policies at school). The OHPSE was developed using categorical principal components analysis (CATPCA) of data from the 2015 National Adolescent School-Based Health Survey (PeNSE). Covariates were human development index and oral health care coverage of cities. Multilevel Poisson regression models with robust variance were undertaken (p < 0.05). Bivariate associations were found between the IDEB and each Total OHPSE and OHPSE-Dimension 1 (In-school aspects: sale of foods with added sugar and health promotion actions/programs). After adjustment, IDEB (PR: 1.38, 95%CI: 1.01-1.90; p = 0.045) and oral health care coverage (PR: 1.01; 95%CI: 1.00-1.02; p = 0.001) remained associated with the OHPSE Dimension 1. It was concluded that educational quality measured by the IDEB was associated with schools' potential support for oral health promotion regarding the sale of foods with added sugar and health promotion actions/programs in schools.
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Affiliation(s)
- Newillames Gonçalves Nery
- Universidade Federal de Goiás, School of Dentistry, Postgraduate Program in Dentistry, Goiânia, GO, Brazil
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Quality of education and adolescents’ oral health-related behaviours: a multilevel analysis. Eur Arch Paediatr Dent 2022; 23:547-556. [DOI: 10.1007/s40368-022-00700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
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Costa F, Wendt A, Costa C, Chisini LA, Agostini B, Neves R, Flores T, Correa MB, Demarco F. Racial and regional inequalities of dental pain in adolescents: Brazilian National Survey of School Health (PeNSE), 2009 to 2015. CAD SAUDE PUBLICA 2021; 37:e00108620. [PMID: 34190752 DOI: 10.1590/0102-311x00108620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/18/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of the study is: (a) investigate the racial inequalities as one specific dimension that affects dental pain in Brazilian adolescents; and (b) investigate the regional variations of dental pain. This cross-sectional study used data from Brazilian National Survey of School Health (PeNSE), carried out with adolescents in 2009, 2012 and 2015. Dental pain was evaluated through the question: "Did you have dental pain in the last six months?". The main exposures were race and Brazilian regions, used to evaluate inequalities related to the outcome. Sex, age, school type and maternal education were used as covariables. The statistical significance of the trends in dental pain was tested using linear regression. The analysis was conducted in Stata 13.0 statistical package using the svy command. The standard prevalence of dental pain was 18.8%, 21.1% and 23.7%, showing an increasing trend over time (p < 0.001). We observed absolute inequalities in dental pain related to race and regions. A higher prevalence was found in non-white girls of public schools and in the Northern Region. The indexes of inequalities increased in the group of black girls, related to an increase of dental pain predominantly in girls whose mothers had lower educational level. It was observed that the prevalence of dental pain in Brazilian adolescents increased over time as well as its inequalities, which remained in marginalized populations and linked to Brazilian regions.
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Affiliation(s)
| | - Andrea Wendt
- Universidade Federal de Pelotas, Pelotas, Brasil
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Does the Registered Dentists' Program Alleviate the Socioeconomic Gap in the Use of Dental Sealants? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217828. [PMID: 33114677 PMCID: PMC7662614 DOI: 10.3390/ijerph17217828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022]
Abstract
Many countries provide preventive dental care for children to reduce inequalities. In Korea, the registered dentists' program was implemented to promote oral health and prevent oral diseases in primary school students. This study aimed to evaluate the registered dentist program through the sealant utilization rate using national cohort data and to compare the socioeconomic gap of the cohorts by participation. The sample cohort data were obtained from the National Health Insurance Sharing Service (NHISS) in South Korea. The utilization of dental sealants was analyzed using the chi-square test according to the independent variables of each year. To identify the independent effects of participation in the registered dentists' program, a panel logistic regression analysis of the utilization of dental sealants was performed. The participants were 1.35 times more likely to have dental sealants than non-participants. The significance of income quintiles disappeared in the case groups. The gap became more obvious in the employees of the control group even after adjusting for all variables. Implementing oral health programs can alleviate inequality with a relative increase in utilization in vulnerable populations.
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Kaunein N, Singh A, King T. Associations between Individual-level and Area-level social disadvantage and oral health behaviours in Australian adolescents. Aust Dent J 2020; 65:286-293. [PMID: 32894571 DOI: 10.1111/adj.12792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral health behaviours are significant determinants of oral health. There is evidence that socioeconomic position influences oral health behaviours, but little is known about this association during adolescence. This study aims to investigate the association between social disadvantage (individual and area level) and oral health behaviours among Australian adolescents. METHODS This study utilized data from the Longitudinal Study of Australian Children (LSAC). The sample consisted of 2877 adolescents. Exposure measures were area-level social disadvantage (Socioeconomic Indexes for Areas) and parent-reported household income from Wave 5. Outcomes, measured in Wave 6, were three different adolescent-reported oral health behaviours: frequency of brushing, consumption of sugar-sweetened beverages (SSB) and dental visits. Associations between quintiles of each exposure and each oral health behaviour were tested by fitting multivariable logistic regression models. RESULTS Household income and area-level disadvantage were associated with dental visits and brushing frequency. Associations between social disadvantage and consumption of SSBs were less apparent, with only the least disadvantaged adolescents having lower odds of consumption of SSBs compared to the most disadvantaged group. CONCLUSION Individual and area-level socioeconomic factors are associated with dental visits, and frequency of brushing.Broad population-based strategies must be adopted to reduce intake of SSBs, however, targeted strategies are needed among more disadvantaged populations to address infrequent toothbrushing and irregular dental visits among adolescents.
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Affiliation(s)
- Nadia Kaunein
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ankur Singh
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tania King
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Nery NG, Antunes JLF, Jordão LMR, Freire MDCM. Can the school environment influence oral health-related behaviours? A multilevel analysis of the Brazilian National Adolescent School-Based Health Survey 2015. Community Dent Oral Epidemiol 2020; 49:23-32. [PMID: 32815223 DOI: 10.1111/cdoe.12569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 06/06/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the association between the potential support of schools for oral health promotion and a set of oral health-related behaviours among adolescent students in Brazilian state capitals. METHODS A cross-sectional study using individual and school environment data from the 2015 Brazilian National Adolescent School-Based Health Survey (PeNSE) was conducted. The sample consisted of 51 192 students from 1339 public and private schools in the 27 Brazilian State Capitals, aged 11-19 years old. The outcomes were six oral health-related behaviours: dental visits; toothbrushing frequency; soft drink and sweets consumption; smoking and alcohol consumption. The explanatory variable was the Oral Health Promotion School Environment index (OHPSE). Covariates were the adolescents' sociodemographic characteristics and organizational aspects of the schools. A two-level multilevel mixed-effects Poisson regression analysis with fixed slopes and random intercepts was performed, considering the complex sample design. RESULTS The prevalence of risk behaviours was 28.0% for 'low frequency of annual dental visits', 6.9% for 'low daily toothbrushing frequency', 28.8% for 'high weekly soft drink consumption', 41.7% for 'high weekly sweet consumption', 18.9% for 'cigarette experimentation' and 52.6% for 'alcoholic beverage experimentation'. The schools were classified as low (36.3%), intermediate (30.4%) and high (33.3%) OHPSE. In the adjusted model, schools with 'high OHPSE' had lower prevalence of 'low frequency of annual dental visits' (PR = 0.94 [95% CI 0.90; 0.99]), 'high weekly frequency of soft drink consumption' (PR = 0.94 [95% CI 0.89; 0.99]) and 'sweet consumption' (PR = 0.96 [95% CI 0.93; 1.00]) than those with 'low OHPSE'. In addition, schools with 'intermediate OHPSE' had higher prevalence's of 'low daily toothbrushing frequency' (PR = 1.12 [95% CI 1.03; 1.23]) and 'cigarette experimentation' (PR = 1.08 [95% CI 1.01; 1.16]) than those with 'low OHPSE'. 'Alcoholic beverage experimentation' was not associated with OHPSE. CONCLUSIONS The potential support of schools for oral health promotion was associated with most of the oral health-related behaviours among adolescent students. Those attending schools with higher OHPSE scores reported a higher annual frequency of dental visits and a lower weekly frequency of soft drink and sweet consumption, while those in schools with intermediate OHPSE had a lower daily toothbrushing frequency and a higher rate of cigarette experimentation.
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Massignan C, Moro J, Moccelini B, de Vasconcelos FMT, Cardoso M, Bolan M. Socio-economic characteristics, acid drinking patterns and gastric alterations associated with erosive tooth wear in children: a cross-sectional study. Eur Arch Paediatr Dent 2019; 21:573-579. [PMID: 31808110 DOI: 10.1007/s40368-019-00498-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022]
Abstract
AIMS Assessing the influence of socio-economic characteristics, acid drinking patterns and gastric alterations considering erosive tooth experience in children. METHODS Cross-sectional study to assess 08-10-year-old children enrolled in the primary education in public schools in Florianopolis, Brazil (n = 1085). Caregivers have answered questionnaires comprising independent variables (head of the household education frequency consumption of sports drinks, acid juice/soda, chewing gum, recurrent vomiting, gastric disorders and vomiting after overeating). Four trained dental surgeons have examined the children for the erosive tooth wear-dependent variable (O'Sullivan index), as well as collected dental caries (DMFT) and dental crowding (DAI index) information. A two-stage cluster-sampling plan was conducted. Unadjusted and adjusted logistic regression models were applied (Odds ratio, OR; 95% Confidence interval, CI and 5% significance level). RESULTS The prevalence of erosive tooth wear was 15.67%. Erosive tooth wear was positively associated with high consumption of sports drinks (OR 3.42; 95% CI: 1.18-9.23). Children whose caregivers' educational level was equal or less than four years of study were less likely to have erosive tooth wear (OR 0.39; 95% CI: 0.17-0.88). CONCLUSION High consumption of sports drinks is positively associated with erosive tooth wear. Children whose caregivers' educational level is low are less likely to present erosive tooth wear.
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Affiliation(s)
- Carla Massignan
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil. .,Departamento de Odontologia, Universidade Federal de Santa Catarina, UFSC, Campus Universitário, CCS-ODT, Trindade Florianópolis, SC, 88040-900, Brazil.
| | - Juliana Moro
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Bárbara Moccelini
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | | | - Mariane Cardoso
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Michele Bolan
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Freire MC, Jordão LM, Peres MA, Abreu MH. Six‐year trends in dental pain and maternal education inequalities among Brazilian adolescents. Community Dent Oral Epidemiol 2019; 47:454-460. [DOI: 10.1111/cdoe.12483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/14/2019] [Accepted: 06/11/2019] [Indexed: 12/01/2022]
Affiliation(s)
| | | | - Marco A. Peres
- Menzies Health Institute Queensland and School of Dentistry and Oral Health Griffith University Gold Coast‐QLD Queensland Australia
| | - Mauro H.N.G. Abreu
- School of Dentistry Federal University of Minas Gerais Belo Horizonte‐MG Brazil
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Erbe C, Klees V, Ferrari-Peron P, Ccahuana-Vasquez RA, Timm H, Grender J, Cunningham P, Adam R, Farrell S, Wehrbein H. A comparative assessment of plaque removal and toothbrushing compliance between a manual and an interactive power toothbrush among adolescents: a single-center, single-blind randomized controlled trial. BMC Oral Health 2018; 18:130. [PMID: 30075780 PMCID: PMC6091059 DOI: 10.1186/s12903-018-0588-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/12/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Many adolescents have poor plaque control and sub-optimal toothbrushing behavior. Therefore, we compared the efficacy of an interactive power toothbrush (IPT) to a manual toothbrush (MT) for reducing dental plaque and improving toothbrushing compliance. METHODS In this randomized, parallel single-blind clinical study, adolescents brushed twice daily with either a MT (Oral-B® Indicator soft manual toothbrush) or an IPT (Oral-B® ProfessionalCare 6000 with Bluetooth). Subjects brushed for 2 min, plus an additional 10 s for each 'Focus Care Area'. At screening and Week 2, afternoon pre-brushing plaque was assessed via the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI), and supervised brushing duration was measured. RESULTS Sixty subjects were randomized; 98% completed. At Week 2, the mean reduction in whole mouth plaque relative to baseline was 34% (p < 0.001) for the IPT versus 1.7% (p = 0.231) for the MT. For Focus Care Areas, the IPT yielded a 38.1% mean TMQHPI reduction (p < 0.001) versus 6.2% for the MT (p < 0.001). Mean brushing time versus baseline increased 34 s in the IPT group (p < 0.001) while remaining flat in the MT group (p = 1.0). CONCLUSIONS Over 2 weeks, adolescents using an IPT experienced superior plaque reduction and increased overall brushing time versus those using a MT. TRIAL REGISTRATION This trial was retrospectively registered ( ISRCTN10112852 ) on the 18th, June 2018.
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Affiliation(s)
- Christina Erbe
- Department of Orthodontics and Dentofacial Orthopedics, University Medical Center of the Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany.
| | - Violetta Klees
- Department of Orthodontics and Dentofacial Orthopedics, University Medical Center of the Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | - Priscila Ferrari-Peron
- Department of Orthodontics and Dentofacial Orthopedics, University Medical Center of the Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | | | - Hans Timm
- Oral Care Department, Procter & Gamble Company, Kronberg, Germany
| | - Julie Grender
- Global Oral Care Department, Procter & Gamble Company, Mason, OH, USA
| | - Pamela Cunningham
- Global Oral Care Department, Procter & Gamble Company, Mason, OH, USA
| | - Ralf Adam
- Oral Care Department, Procter & Gamble Company, Kronberg, Germany
| | - Svetlana Farrell
- Global Oral Care Department, Procter & Gamble Company, Mason, OH, USA
| | - Heinrich Wehrbein
- Department of Orthodontics and Dentofacial Orthopedics, University Medical Center of the Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
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Jordão LMR, Malta DC, Freire MDCM. Clustering patterns of oral and general health-risk behaviours in Brazilian adolescents: Findings from a national survey. Community Dent Oral Epidemiol 2017; 46:194-202. [PMID: 29168590 DOI: 10.1111/cdoe.12354] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/24/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate how oral and general health-risk behaviours cluster among Brazilian adolescents. METHODS The study comprised a total of 109 104 adolescents (52.2% female) participating in the Brazilian National School-based Student Health Survey (PeNSE). Seventeen behaviours (including diet; oral and hand hygiene; frequency of dental visits; tobacco, alcohol and drug use; sexual behaviour; physical activity, and risk for external causes) were measured using a self-reported questionnaire. Pairwise correlations between the health-risk behaviours were performed, and clustering was assessed by the hierarchical agglomerative cluster analysis (HACA), which was used to identify stable cluster solutions of the health-risk behaviours. RESULTS All health-risk behaviours were correlated with at least 1 behaviour (P < .01). HACA indicated 2 broad stable clusters (n = 105 604). The first cluster included current smoking, illegal drug use, no hand washing before meals, unprotected sex, no helmet use, less frequent toothbrushing, no seatbelt use, physical fighting, skipping breakfast, current drinking, high sugar intake and, at the final stage, no dental visits. The second cluster included insufficient physical activity, eating while watching TV or studying, and low fruit intake. CONCLUSIONS The health-risk behaviours clustered into 2 specific patterns among Brazilian adolescents. One cluster gathered a combination of lack of adherence to preventive behaviours and the undertaking of risky conduct, while the second reflected an unhealthy lifestyle (sedentary habits and low fruit diet). Knowledge about the clustering patterns of oral and general health behaviours in adolescents can better direct the integration of oral and general health promotion interventions.
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Affiliation(s)
- Lidia M R Jordão
- School of Dentistry, Federal University of Goiás, Goiânia-GO, Brazil
| | - Deborah C Malta
- School of Nursing, Federal University of Minas Gerais, Belo Horizonte-MG, Brazil
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Safiri S, Kelishadi R, Heshmat R, Rahimi A, Djalalinia S, Ghasemian A, Sheidaei A, Motlagh ME, Ardalan G, Mansourian M, Asayesh H, Sepidarkish M, Qorbani M. Socioeconomic inequality in oral health behavior in Iranian children and adolescents by the Oaxaca-Blinder decomposition method: the CASPIAN- IV study. Int J Equity Health 2016; 15:143. [PMID: 27628496 PMCID: PMC5024445 DOI: 10.1186/s12939-016-0423-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/17/2016] [Indexed: 12/03/2022] Open
Abstract
Background The present study set to describe the socioeconomic inequality associated with oral hygiene behavior among Iranian pediatric population. Methods A representative sample of 13486 school students aged 6–18 years was selected through multistage random cluster sampling method from urban and rural areas of 30 provinces in Iran. Principle Component Analyses (PCA) correlated variables summarized as socioeconomic status (SES). Association of independent variables with tooth brushing was assessed through logistic regression analysis. Decomposition of the gap in tooth brushing between the first and fifth SES quintiles was assessed using the counterfactual decomposition technique. To assess the relation between tooth brushing and each socioeconomic category, Concentration Index (C) and the slope index of inequality (SII) were used, representing the linear regression coefficient. Results The participation rate was 90.6 % (50.7 % boys and 75.6 % urban inhabitants). The mean age of participants was 12.47 ± 3.36 years. The frequency of tooth brushing increased across SES quintiles, prevalence of tooth brushing between the first and fifth quintile, under 20 % difference, increased from 58.22 (95 % CI: 56.24,60.20) to 78.61 (95 % CI: 77.00,80.24). Only 3 % of the difference is explained by the factors considered in the study, and 17 % remained unknown. Residence area, family size, and smoking status made a significant contribution to the gap between the first and last SE groups. Residence area [ −2.01 (95 % CI: −3.46, −0.55)] was along the maximum levels of gaps between SE categories. Conclusions The findings revealed a socio-economic inequality in oral health behavior in Iranian children and adolescents. Also, factors influencing oral health are addressed to develop and implement complementary public health actions.
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Affiliation(s)
- Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.,Road Traffic Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roya Kelishadi
- Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rahimi
- School of Humanities and Tourism Management, Bangkok University, Bangkok, Thailand
| | - Shirin Djalalinia
- Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, Shahid Beheshti University of Medical Science, Tehran, Iran
| | | | - Gelayol Ardalan
- Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Morteza Mansourian
- Department of Health Education, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Mahdi Sepidarkish
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Centre, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Science, Karaj, Iran. .,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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