Self-Rated Oral Health as a Valid Measure of Oral Health Status in Adults Living in Rural Australia

Association between oral health and bowel habits: a cross-sectional study

BACKGROUND

Oral diseases affect approximately 3.5 billion people worldwide, disproportionately burdening populations in developing countries. Chronic diarrhea and constipation, as common intestinal disorders, may interact bidirectionally with oral health, though their population-level associations remain unexamined.

METHODS

We analyzed data from the National Health and Nutrition Examination Surveys (NHANES) 2005-2008, selecting participants based on inclusion criteria. Chronic diarrhea and constipation were defined based on the bowel health questionnaire. Oral health indicators (teeth condition and oral pain frequency) were derived from the oral health questionnaire. Covariates selected by Lasso regression were analyzed through adjusted logistic regression to examine associations between bowel habits and oral health. Restricted cubic splines (RCS), subgroup stratification, and sensitivity analyses were also used.

RESULTS

A total of 7512 participants aged ≥ 20 with complete information were included. Multivariable logistic regression revealed a significant association between chronic constipation and poor teeth condition (OR:1.45, 95% CI: 1.05-2.01, P = 0.029). A U-shaped dose-response relationship was observed between stool frequency and poor teeth condition (nonlinear P-value = 0.002) using RCS analysis, with both abnormally low and high bowel frequencies correlating with increased oral health risks. No significant association was identified between oral pain frequency and abnormal bowel habits after full covariate adjustment. Stratified analyses indicated that daily dietary fiber intake ≥ 25 g was associated with reduced risks of poor teeth condition (chronic diarrhea OR: 0.40, 95% CI: 0.12-0.98; chronic constipation OR: 0.44, 95% CI: 0.13-1.09), whereas higher income (PIR > 3.5) correlated with elevated risks (chronic diarrhea OR: 2.38, 95% CI: 1.35-3.98; chronic constipation OR: 2.18, 95% CI: 1.22-3.70). Sensitivity analyses supported the stability of associations between abnormal bowel habits and poor teeth condition.

CONCLUSIONS

Both chronic constipation and diarrhea were associated with higher risk of poor teeth condition. In the general population and subgroup analyses, individuals with stool frequency around 8-10 times per week demonstrated the lowest risk of poor teeth condition. Stratified analysis indicates that dietary fiber intake and PIR might modify the observed relationship between abnormal bowel habits and teeth condition.

Oral Health Status and Dental Services Utilisation Among a Vulnerable Sample of Pregnant Women

INTRODUCTION AND AIMS

Oral health conditions during pregnancy can negatively impact both mother and fetus, highlighting the importance of maintaining dental care. In Canada, significant disparities exist between general and dental healthcare access, with limited evidence on oral health status and dental care utilisation among pregnant women. This study aimed to provide initial insights into self-perceived oral health status and dental utilisation patterns among a vulnerable sample of pregnant women in southwestern Ontario.

METHODS

This cross-sectional study recruited a convenient sample of pregnant women referred to the Family Medicine and Obstetrics Clinic, serving those without a family physician. Data were collected using a self-administered questionnaire adapted from the Canadian Health Measure Survey, the Canadian Community Health Survey, and the Survey of Maternal Health. Andersen and Newman's framework for health service utilisation was used as the theoretical framework. Descriptive and univariable analyses were conducted, followed by a forward stepwise selection of variables with p-values < 0.1 from the univariable analyses.

RESULTS

One-hundred-fifty patients were approached and 130 (86.7%) completed the questionnaire. Of these, 96 (73.9%) reported their oral health as good/excellent while 34 (26.2%) reported having poor/fair oral health. Education level and quality of life were the strongest predictors of oral health status. While 101 (77.7%) visited a dentist within the last 2 years, only 35 (26.9%) had a dental visit during pregnancy. Toothbrushing frequency was the main predictor of time since last dental visit, with no other predictive factors once toothbrushing was considered.

CONCLUSION

The study sample showed relatively positive self-perceived oral health and dental visit patterns. However, the low rate of dental visits during pregnancy highlights the need for better integration of dental care into prenatal care. To ensure maternal and child health, pregnant women should be a high priority in policies aimed at improving access to dental care.

The association of social determinants of health with oral health status among patients of health resources and services administration funded health centers in the United States

OBJECTIVES

This study examined the association of social determinants of health (SDOH) domains on oral health status.

METHODS

We used the nationally representative 2022 Health Center Patient Survey and the 2021-2022 Area Health Resource File. We constructed seven domains on burden of SDOH disadvantage: (1) oral health behavior, (2) dental service use and access, (3) general health service use and access, (4) social, (5) economic, (6) contextual or physical environment, and (7) health condition indicators, and calculated a score per domain. We assessed the association between SDOH domains and four oral health measures: (1) poor self-assessed oral health, (2) low functional dentition, (3) acute dental need, and (4) chronic symptoms in logistic regressions.

RESULTS

SDOH domains had different degrees of association with outcomes. Oral health behavior, health condition, and economic indicators were positively associated with all outcomes. General health service use and access, and contextual or physical environment were positively associated with all outcomes except for low functional dentition. Dental service use and access indicators were associated with higher likelihood of poor oral health (7.3%) and low functional dentition (2.5%). Social indicators were associated with higher likelihood of poor oral health (3.1%).

CONCLUSIONS

Findings highlight the importance of measuring the burden of SDOH disadvantage and including it in care provision. Findings indicate the need for more access through better integration of oral health within primary care, provision of nonclinical services to link patients with social services to promote oral health, and further support of these approaches by payer.

Associated factors of dental caries among middle-aged adults in Guizhou Province, China (2019-2020)

BACKGROUND

The Fourth National Oral Health Epidemiological Survey (FNOHES) reported an 89% caries prevalence among adults aged 35-44 in China. This study explored the current prevalence and determinants of dental caries in Guizhou Province, where socioeconomic conditions have changed. We aimed to identify factors influencing dental caries to inform future oral health policies and preventive strategies tailored to the region.

METHOD

A total of 2,040 middle-aged adults from 11 districts and counties in Guizhou participated. Categorical variables were analyzed using chi-squared tests, and logistic regression identified key factors. Quantitative measures, such as the DMFT index, were used to assess the overall dental health of the participants.

RESULT

The statistical analysis showed a caries prevalence of 79.6% and a mean DMFT of 3.11. Caries were more prevalent in urban areas and among females. Significant factors associated with caries included gender, residence, ethnicity, smoking status, toothpick use, dental visits, and self-rated oral health.

CONCLUSION

The prevalence of dental caries remains globally high, as reflected in both developing and developed countries. Targeted interventions, particularly for females, urban residents, and ethnic minorities, are recommended. Public health initiatives should prioritize promoting safer oral hygiene practices and smoking cessation programs, including education on managing post-cessation cravings for sugary foods. Further research, including longitudinal studies, is needed to evaluate intervention effectiveness.

Effects of Self-Perceived Oral Health and Stress Levels on Subjective Oral Symptoms and Lifestyle of University Students in South Korea: A Cross-Sectional Survey

Background

Self-perceived oral health is related to clinical and subjective oral factors, socioeconomic factors, perceived stress, and oral health behavior. However, limited studies have examined whether self-perceived oral health is related to dry mouth, salivary viscosity, or lifestyle factors. Accordingly, this study aimed to verify the effect of self-perceived oral health and stress levels on subjective oral symptoms and lifestyle.

Methods

The responses of 644 university students who agreed to participate in the study were analyzed. A chi-square test was used to determine whether self-perceived oral health and stress levels showed significant differences based on subjective oral symptoms and lifestyle. Logistic regression was used to analyze the effect of subjective oral symptoms and periodontal disease diagnosis on self-perceived oral health.

Results

Subjective oral symptom factors that showed significant differences depending on self-perceived oral health included gingival bleeding or pain, dry mouth, and saliva viscosity, and depending on lifestyle factors included the frequency of tooth brushing and beverage consumption. Additionally, subjective oral symptoms influenced self-perceived oral health. Self-perceived oral health was negative when there was gingival bleeding, pain (odds ratio (OR)=0.594, p=0.002), and dry mouth (OR=0.577, p=0.001).

Conclusions

This study's results showed that self-perceived oral health significantly impacts gingival bleeding, pain, and dry mouth. Therefore, government intervention must provide and manage innovative and efficient education programs that promote self-perceived oral health management habits and maintenance and improvement of oral health.

Self-reported oral health status, edentulism and all-cause mortality risk in 12 809 Australian older adults: a prospective cohort study

OBJECTIVE

To investigate the association between oral health status and all-cause mortality in older adults using prospective cohort study design.

SETTING AND PARTICIPANTS

In total, 12 809 adults aged ≥70 years (54.3% females) were participants of the ASPREE Longitudinal Study of Older Persons (ALSOP).

METHODS

Participants self-reported the presence of natural teeth and oral health status. The association of self-reported oral health, edentulism and the integrative measure of the two with all-cause mortality were explored using the Cox-regression models adjusted for age, gender, socio-economic status, health-related behaviours, weight status, aspirin and polypharmacy. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported.

RESULTS

In total, 22.2% of participants reported edentulism and 13.8% had fair/poor oral health. After adjustment for confounders, risk of all-cause mortality was higher among those with edentulism (vs. no edentulism) HR (95% CI) 1.43 (1.18, 1.73); and those with edentulism and reporting poor/fair oral health HR (95% CI) 1.69 (1.02, 2.82), or with no edentulism but reporting poor/fair oral health HR (95% CI) 1.46 (1.19-1.80) vs. no edentulism and reporting good/very good/excellent oral health. No association was observed between self-reported oral health alone and all-cause mortality.

CONCLUSIONS

The risk of all-cause mortality was 69% higher among older adults reporting both edentulism and poor/fair oral health compared with those with teeth and more favourable self-reported oral health. © 2023 Australian Dental Association.

Metal mixtures and oral health among children and adolescents in the National Health and Nutrition Examination Survey (NHANES), 2017-2020

INTRODUCTION

Dental caries is the most common non-communicable human disease, yet little is known about the role of environmental metals, despite teeth consisting of a hard matrix of trace elements. We conducted a cross-sectional study of associations between environmental metals and objective assessment of dental caries and subjective assessments of oral health among a representative sample of U.S. children and adolescents.

METHODS

Data were from the 2017-March 2020 pre-pandemic data file of the National Health and Nutrition Examination Survey (NHANES). To account for metal mixtures, we used weighted quantile sum (WQS) regression to estimate the joint impact of multiple trace elements assessed in blood and urine with oral disease outcomes.

RESULTS

The blood metal mixture index was associated with a 32% (95% CI: 1.11, 1.56) increased risk of decayed surfaces while the urine metal mixture index was associated with a 106%, RR (95% CI = 2.06 (1.58, 2.70) increased caries risk. For both blood and urine, Mercury (Hg) had the largest contribution to the mixture index followed by Lead (Pb). The WQS blood metal mixture index was also significantly associated with poorer self-rated oral health, although the magnitude of the association was not as strong as for the objective oral disease measures, RR (95% CI) = 1.04 (1.02, 1.07).

DISCUSSION

Increased exposure to a metal mixture was significantly related to poorer objective and subjective oral health outcomes among U.S. children and adolescents. These are among the first findings showing that metal mixtures are a significant contributor to poor oral health.

Oral health's role in diabetes risk: a cross-sectional study with sociodemographic and lifestyle insights

Introduction

Diabetes, a key chronic non-communicable disease, poses a substantial public health burden. The role of oral health as a determinant in the epidemiology of diabetes mellitus, particularly in the Central Eastern European region, remains underexplored. This research aims to examine the impact of specific oral health parameters, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on diabetes prevalence. Additionally, it seeks to clarify the moderating effects of socio-demographic and lifestyle variables on this relationship.

Materials and methods

Data were extracted from the 2014 and 2019 datasets of the Hungarian European Health Interview Survey, comprising a combined nationally representative sample of 11,429 participants. Descriptive statistics were presented as weighted proportions and unweighted counts, and weighted Pearson's chi-squared tests were employed for assessing associations and goodness-of-fit. Significant predictors were integrated into weighted multiple logistic regression models for analysis. Sensitivity analysis was then conducted to confirm the robustness of the findings.

Results

The study identified 'Bad' self-perceived oral health as a diabetes risk (OR=1.35; 95% CI: [1.04-1.75]), with filled teeth being protective (0.65 [0.51-0.84]). Subgroup analysis revealed higher diabetes odds among individuals with primary education (1.41 [1.02-1.96]) and rural residents with tooth loss from decay (3.54 [1.36-9.19]). The bootstrap analysis with 1,000 iterations reaffirmed the model's stability and predictive accuracy for diabetes.

Discussion

Enhanced oral health is associated with lower risk factors for diabetes. This research highlights the importance of including oral health measures in comprehensive diabetes management approaches.