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Tan SHX, Lee GKY, Goh CE, Tong HJ, Chuang JCP, Ang KY, Lim DGX, Gao X. Impact of income and financial subsidies on oral health care utilization among persons with disabilities in Singapore. Community Dent Oral Epidemiol 2024; 52:336-343. [PMID: 38644526 DOI: 10.1111/cdoe.12962] [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: 07/25/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND/AIM(S) Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore. METHODS Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD. RESULTS Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08-1.52), 1.48 (95% CI 1.14-1.92) and 1.36 (95% CI 1.09-1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies. CONCLUSION Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.
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Affiliation(s)
- Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Charlene Enhui Goh
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Huei Jinn Tong
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | | | | | - David Guang Xu Lim
- Tzu Chi Singapore Free Clinic, Buddhist Compassion Relief Tzu Chi Foundation, Singapore, Singapore
- National Dental Centre Singapore, Singapore, Singapore
| | - Xiaoli Gao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Selvaraj D, Agarwal N, Albert JM, Nelson S. Barriers to dental utilization among Medicaid-enrolled young children from primary care practices in Northeast Ohio. Community Dent Oral Epidemiol 2024. [PMID: 38647184 DOI: 10.1111/cdoe.12964] [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: 08/03/2023] [Revised: 03/21/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES To evaluate the individual and community factors that contribute to dental utilization among young children on Medicaid utilizing the Anderson Model and the Socio-Ecological Framework. METHODS This observational cross-sectional study was conducted using baseline data (socio-demographics, clinical dental need) from a cluster-randomized hybrid effectiveness-implementation trial among 1021 child-parent dyads recruited from primary care practices across northeast Ohio. The baseline data were then linked to dental Medicaid claims data (categorized as any dental visit, volume, and type in the past 12 months) and ICD-10 codes from the child's EHR data (individual-level) together with Dental Health Provider Shortage Area (HPSA) status and Area Deprivation Index (ADI) which were obtained at the neighbourhood-level using home address of each dyad (community-level). Multivariable analyses using generalized estimating equations (GEE) accounted for clustering by practice, and models included individual-level alone, and individual + community-level factors to evaluate their effects on dental utilization. RESULTS Medicaid claims data indicated that among the 1021 children (mean age: 4.3 ± 1.1 years; 54.4% males; 43.8% Black, Non-Hispanic), a majority of children were seeing the dentist at least once a year by the age of 4 (56.1%). The mean ADI of their neighbourhoods was 109.22 (20.2) and 27.5% lived in a HPSA area. The GEE analyses revealed that individual factors such as older children, parents being married, and continuous Medicaid enrollment were associated with significantly higher dental utilization. Among community factors, being in a HPSA had an OR = 1.53 (CI: 1.03, 2.27) associated with higher dental utilization. CONCLUSIONS Being in a HPSA was associated with higher dental utilization possibly due to dentists or safety net dental clinics in these areas accepting Medicaid-eligible children.
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Affiliation(s)
- David Selvaraj
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Neel Agarwal
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
| | - Jeffrey M Albert
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Suchitra Nelson
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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de Vasconcellos NBT, Fagundes MLB, Menegazzo GR, do Amaral Júnior OL, Hilgert JB, do Amaral Giordani JM. Association between frailty and oral health services use in Brazilian older adults. Gerodontology 2024; 41:46-53. [PMID: 37750043 DOI: 10.1111/ger.12716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To assess the association between frailty and oral health services use in Brazilian older adults. METHODS This cross-sectional study analysed the baseline data from the Longitudinal Study on Brazilian Ageing (ELSI-Brazil) representative of Brazilians aged 50 or over. The outcome was oral health services used in the year prior to the interview. The main exposure variable was Frailty defined by the frailty phenotype. Age, skin colour, wealth, sex, education, type of service, health insurance, number of teeth and self-perceived oral health were included as covariates. Prevalence ratios (PR) with their respective 95% confidence intervals (CI) were estimated using Poisson regression with robust variance. RESULTS 8405 individuals were included in this study. The prevalence of frailty was 7.5%. Regarding frailty status, the prevalence of dental service use was 47.0%, 48.5% and 4.5% for robust, pre-frail and frail individuals, respectively. Frail individuals had a 7% higher prevalence of not using dental (PR: 1.07; 95% CI: 1.01-1.13) than robust individuals. Frailty was independently associated with not using oral health services. CONCLUSION Given the complexity of the determinants of dental service use, frailty adds another dimension to be examined in older adults. Public health strategies considering a common risk factor approach should be endorsed.
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Affiliation(s)
| | | | | | | | - Juliana Balbinot Hilgert
- Departament of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Almutairi M, McKenna G, Alsumaih I, Alhazzaa R, O’Neill C. Factors influencing the likelihood of dental service checkup: results from a survey in Saudi Arabia. FRONTIERS IN ORAL HEALTH 2023; 4:1208929. [PMID: 38161345 PMCID: PMC10755011 DOI: 10.3389/froh.2023.1208929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Background The funding and delivery of healthcare including dental care in the Kingdom of Saudi Arabia (KSA, or Saudi Arabia) is undergoing a process of reform. To inform this process, it is important that policymakers are aware of the relationships between service use, specific types of use, and the factors that influence this. Currently, there is a paucity of research in this area in KSA that examines dental service use for checkups at a national level and none that examines differences in this use across regions or that examines explicitly the role of income. Aims This study uses the most recent version of the Saudi Health Interview Survey (SHIS) to examine the relationships between the use of dental services for a checkup and socio-demographic characteristics of respondents. Particular focus is given to the differences between regions in service use and the role of socio-demographics within regions. Methods Data were taken from SHIS 2013. Descriptive statistics (means and standard errors) were used to characterize the sample. Logistic regression analyses were used to examine the relationship between checkups in the past 12 months and a range of covariates including income and region. The analysis was repeated for sub-samples based on specific regions. No attempt was made to impute missing values. Results A sample of 7603 respondents provided complete data for analysis. Fifty-one per cent of the respondents were male, 29% were educated at least to degree level, 25% reported that they floss at least once per day, 69% reported that they brushed their teeth at least once per day, and 11% reported that they had visited the dentist for a checkup in the preceding 12 months. Logistic regression analyses revealed income, region, and oral hygiene habits to be among the significant determinants of the likelihood of dental checkup in the preceding 12 months. In logistic regression analyses at the regional level, different relationships were evident between checkups and socio-demographic characteristics across regions. Conclusion Region and income are significant determinants of dental service use for checkups. Differences exist between regions in the relationship between socio-demographic characteristics and the likelihood of getting checkups. Policy changes should reflect the potential differences they might have across regions for which the role of socio-demographic characteristics varies.
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Affiliation(s)
- Majed Almutairi
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Public Health Department, School of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Gerry McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Ibrahim Alsumaih
- Department of Medical Support Services, King Fahad Hofuf Hospital, Ministry of Health, Hofuf, Saudi Arabia
| | - Rasha Alhazzaa
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Health Informatics Department, School of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
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Yekkalam N, Storm Mienna C, Stoor JPA, San Sebastian M. Social determinants of self-reported oral health among Sámi in Sweden. Community Dent Oral Epidemiol 2023; 51:1258-1265. [PMID: 37489613 DOI: 10.1111/cdoe.12894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/07/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES To investigate the prevalence of poor self-reported oral health and to identify socio-demographic, socio-economic and cultural-related risk factors associated with poor oral health among Sámi in Sweden. METHODS A Sámi sample frame was constructed drawing from three pre-existing registers. All identified persons aged 18-84 were invited to participate in the study during February-May 2021. Among the 9249 invitations, 3779 answered the survey. The frequencies of the independent variables in terms of socio-economic, socio-demographic and cultural-related factors as well as the outcome, self-reported oral health, were calculated first. Prevalence ratios (PRs) and their 95% confidence interval (95% CI) were estimated to assess the relationship between the independent variables and the outcome. RESULTS Overall, 32.5% of the participants reported a poor oral health with a higher prevalence among men compared to women. Among the socio-demographic factors, being old (PR: 1.99; 95% CI: 1.59-2.51), unmarried (PR: 1.17; 95% CI: 1.03-1.33) and divorced or widow-er (PR: 1.27; 95% CI: 1.09-1.46) were statistically associated to poor self-reported oral health. Among the socio-economic factors, a low education level (PR: 1.56; 95% CI: 1.29-1.89), belonging to the poorest quintile (PR: 1.63; 95% CI: 1.35-1.96), and experiencing difficulties to make ends meet several times during the last 12 months (PR: 1.74; 95% CI: 1.51-1.99) were statistically significant related to poor oral health. CONCLUSIONS The self-reported oral health among Sámi in Sweden appears to be worse than that of the general Swedish population. Several socio-economic and socio-demographic factors were found to be strongly associated with poor self-reported oral health. Targeted interventions addressing these social determinants are needed to reduce inequalities in oral health among the Sámi population.
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Affiliation(s)
- Negin Yekkalam
- Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - Christina Storm Mienna
- Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden
- Várdduo-Centre for Sámi Research, Umeå University, Umeå, Sweden
| | - Jon Petter Anders Stoor
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
| | - Miguel San Sebastian
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
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Aljohani M, Donnelly M, Al Sumaih I, O'Neill C. The relationship between region of residence, socio-demographic factors, and healthcare utilization among Saudi citizens: insights from the 2013 Saudi Health Interview Survey. Front Med (Lausanne) 2023; 10:1252340. [PMID: 38020173 PMCID: PMC10657865 DOI: 10.3389/fmed.2023.1252340] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background There is a dearth of research on the nature and extent of variation in patterns of health service use in Saudi Arabia. This is an important gap in knowledge, given ongoing efforts to improve service provision and delivery. This study examined the relationship between the region of residence and socio-demographic factors and patterns of health service use in Saudi Arabia. Methods Data were taken from the 2013 Saudi Health Interview Survey (SHIS), a national multistage survey of individuals aged 15 years and above in Saudi Arabia. Data included measures of service use, respondent health, socio-demographic characteristics, and region or area of residence. Descriptive statistics, Chi-square tests, and multivariable logistic regression analyses were used to describe the data and examine the likelihood of a respondent visiting a doctor or healthcare professional in the preceding 12 months. In addition, the analyses examined the role of health and socio-demographic characteristics within selected regions. Results The increased likelihood of using health services in terms of visiting a doctor or healthcare professional was related to poor health status, being female, married, having a low income, and residing in particular regions. Respondents aged <65 and who lived furthest from service providers were less likely to visit a doctor or other health professionals (p < 0.01). Residents who lived in Riyadh, Al Medina, Baha, or Aseer demonstrated a higher likelihood of service utilization compared to respondents residing in other regions (p < 0.05). In sub-group analyses, there was variation between regions with respect to socio-demographic status and distance to service. Conclusion Region of residence and income level, in particular, may help to explain the likelihood of primary care use in Saudi Arabia and the distinct patterns of service use in relation to regional and socio-demographic characteristics. The relationship between regional variation in service utilization and the socio-demographic characteristics of respondents may reflect differences with respect to population need, enabling, and predisposing factors as represented in Anderson's Behavioral Model (ABM) of health service use. The findings from this study underscore the importance of considering region or area of residence when seeking to understand the utilization of health services, particularly primary care services.
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Affiliation(s)
- Motab Aljohani
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
- Public Health Department, College of Health Science, Saudi Electronic, Riyadh, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Ibrahim Al Sumaih
- Medical Supportive Services, King Fahad Hospital, Ministry of Health, Hofuf, Saudi Arabia
| | - Ciaran O'Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
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Rieth K, Sy A, McIntosh S, Ikerdu E, Cupertino A, Dye TD, Martina CA. Dental Health Utilization in Palau: Feasibility of an Oral Cancer Screening Program. Ann Glob Health 2023; 89:60. [PMID: 37745775 PMCID: PMC10516142 DOI: 10.5334/aogh.4174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023] Open
Abstract
Background Cancer is the second leading cause of death in the Western Pacific region. The prevalent tradition of chewing betel nut in Palau, an island nation in this region, is a risk factor in the development of oral cancer. Oral cancer is the fifth most common cancer in Palau, and the prognosis can be improved with early detection facilitated by visual inspection of the oral cavity by dentists. The purpose of this study is to assess the feasibility of oral cancer screening using existing dental health infrastructure in Palau. Methods A mixed methods approach was used to explore topics related to the use of dental care resources in Palau. Primary outcome measures were collected using an electronic survey with closed- and open-ended questions addressing dental health utilization as well as barriers and facilitators to accessing dental care. Secondary measures assessed knowledge, attitudes, and beliefs about betel nut use and oral cancer. Open-ended survey questions were analyzed and coded to develop themes based in grounded theory. Results Two hundred twenty-three surveys were completed. The mean age was 42.7 years, 80% identified as female, and most (94.3%) report having seen a dentist in Palau. Dental care is seen as important (mean score 82.3/100), and 57.9% reported it was easy to access a dentist. Themes regarding facilitators include multilevel resources and transportation. Themes regarding barriers include cost and availability of dentists/appointments. Approximately half of the respondents were current users of betel nut. Conclusion Our results suggest facilitators are in place to promote seeking and obtaining dental care; however, existing infrastructure may not support an oral cancer screening program. These data provide important areas to address that can improve access and support the implementation of oral cancer screening through existing dental care in the future.
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Affiliation(s)
- Katherine Rieth
- Department of Otolaryngology, University of Rochester Medical Center, Rochester, NY, USA
| | - Angela Sy
- John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Edolem Ikerdu
- Division of Primary & Preventive Health, Palau Bureau of Public Health, Koror, PW
| | | | - Timothy D. Dye
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | - Camille Anne Martina
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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Menoncin BLV, Crema AFDA, Ferreira FDM, Zandoná AF, Menezes JVNBD, Fraiz FC. Parental oral health literacy influences preschool children's utilization of dental services. Braz Oral Res 2023; 37:e090. [PMID: 37672423 DOI: 10.1590/1807-3107bor-2023.vol37.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 04/24/2023] [Indexed: 09/08/2023] Open
Abstract
Parental behavior towards their children's oral health is strongly influenced by parent's Oral Health Literacy (OHL) level. This study evaluated the impact of parental OHL on preschool children's utilization of dental services. A cross-sectional study was conducted with parents of 419 children aged 3 to 5 years who answered a self-administered questionnaire about their perception of their children's oral health and whether their children had already been to a dental visit. Parental OHL level was assessed by the validated version of the Oral Health Literacy Adult Questionnaire (OHL-AQ) translated into Brazilian Portuguese. Univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis (α = 0.05). Most children had already been to a dental visit (73%). Overall, 31.7% of the parents or guardians reported that their children had experienced dental pain or dental caries. Parental OHL level was classified by tercile as low, medium, and high. The final model showed independent associations between children who had already been to a dental visit and higher parental OHL level (PR = 1.16; 95%CI = 1.00-1.35) when compared to the lowest OHL level, higher parental educational level (PR = 1.39; 95%CI = 1.03-1.87) when compared to lower educational level, the report of children's pain and dental caries (PR = 1.22; 95%CI = 1.09-1.36) and married parents or parents in a common-law marriage (PR = 1.17; 95%CI = 1.03-1.93). The prevalence of children who had already been to a dental visit was higher among those parents with a higher OHL level when compared to those with a lower OHL level.
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Affiliation(s)
| | | | - Fernanda de Morais Ferreira
- Universidade Federal de Minas Gerais - UFMG, Department of Oral Health for Children and Adolescents, Belo Horizonte, MG, Brazil
| | | | | | - Fabian Calixto Fraiz
- Universidade Federal do Paraná - UFPR, Department of Stomatology, Curitiba, PR, Brazil
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Wu J, Chen L, Guan M, Dai T, Friedrich RE, Sun J, Yang W. Analysis of 5-Year-old children's oral health service utilization and influencing factors in Guizhou Province, China (2019-2020). BMC Oral Health 2023; 23:627. [PMID: 37660033 PMCID: PMC10475195 DOI: 10.1186/s12903-023-03350-y] [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: 02/23/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND This study aimed to investigate the utilization patterns and factors related to oral health care for 5-year-old preschoolers based on Andersen's Behavioural Model in Guizhou Province, Western China. METHOD A cross-sectional study of 4,862 5-year-old preschoolers in 66 kindergartens was conducted in 2019 and 2020. A basic oral examination and a survey of parents and grandparents were conducted to gather data on oral health services. The results were analysed using chi-square tests and logistic regression analysis. RESULT The utilization rate of oral health services for children in Guizhou province was 20.5%. The dmft was 4.43, and the rate of caries was 72.2%. The average cost of a dental visit was higher in rural areas and higher for girls. Logistic regression analysis revealed that dmft ≥ 6 teeth, a history of toothache, starting toothbrushing at age ≤ 3 years and limited parental knowledge were the primary factors impacting dental visits. CONCLUSION Needs factors such as severe oral conditions and pain in children are the main reasons for the utilization of these services. This study underscores the urgency to actively promote the importance of oral health and expand insurance coverage for oral health services.
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Affiliation(s)
- Juanjuan Wu
- Department of Preventive Dentistry, Guiyang Stomatological Hospital, Guiyang, China
| | - Liming Chen
- Department of Preventive Dentistry, Guiyang Stomatological Hospital, Guiyang, China
| | - Min Guan
- Department of Preventive Dentistry, Guiyang Stomatological Hospital, Guiyang, China
| | - Taiming Dai
- Department of Preventive Dentistry, Guiyang Stomatological Hospital, Guiyang, China
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jiangling Sun
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Science and Education, Guiyang Stomatological Hospital, Guizhou, China.
| | - Wei Yang
- Medical College, Guizhou University, Guiyang, Guizhou, China.
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Galvão MHR, Roncalli AG. Explaining public dental service utilization: A theoretical model. PLoS One 2023; 18:e0290992. [PMID: 37656715 PMCID: PMC10473501 DOI: 10.1371/journal.pone.0290992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVES Constructing and validating a theoretical model of relationships between dental services use and socioeconomic characteristics, oral health status, primary care coverage, and public dental services. METHODS The first stage of the study consisted of developing a theoretical-conceptual model to demonstrate the expected relationships between variables based on the literature. In the second stage, we tested the proposed theoretical model using the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique, using data from the Brazilian National Health Survey conducted in 2019 with a sample of 41,664 individuals aged 15 or older. RESULTS This study successfully defined a theoretical model that explains the systematic relationships involving public dental services utilization. Socioeconomic status was negatively associated with oral health status (β = -0.376), enrollment in primary care facilities (β = -0.254), and the use of public dental consultations (β = -0.251). Being black, indigenous, or living in a rural area was directly associated with lower socioeconomic status and greater use of public dental services. CONCLUSIONS The identified relationships, establishing a theoretical basis for further investigations, also provide evidence of a public access policy's effect on oral health services on equity, supporting the construction of more effective and equitable public policies.
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Affiliation(s)
- Maria Helena Rodrigues Galvão
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil
| | - Angelo Giuseppe Roncalli
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Qin S, Cheng Y, Zhang H, Ding Y. Home/Community-Based Medical and Elderly Care Services Utilization in China: A Cross-Sectional Study from the Middle-Aged and Elderly Population. Healthcare (Basel) 2023; 11:2431. [PMID: 37685465 PMCID: PMC10486956 DOI: 10.3390/healthcare11172431] [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: 08/02/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Few studies have analyzed the acceptance of home/community-based medical and elderly care services in China. Therefore, we conducted a cross-sectional study to describe the acceptance of five services among people aged ≥ 45 years in the China mainland, and their influencing factors. The data were obtained from the database China Health and Retirement Longitudinal Study 2018. For each service, a binary logistics regression was adopted. A total of 9719 people were included, of whom 20.12% received services. The numbers of recipients (acceptance rates) of the five services, namely, comprehensive aged care services, regular physical examinations, onsite visits, health management, and entertainment, were 107 (1.10%), 1640 (16.87%), 323 (3.32%), 156 (1.61%), and 245 (2.52%), respectively. About 4% of people had received two or more services. The elderly aged 65-74 and those who were satisfied with the local medical services had higher acceptance of services. Urban hukou having health insurance, two or more chronic diseases, provincial economic welfare, and social welfare were positively associated with the acceptance of regular physical examination services. It is suggested that the government should gradually improve satisfaction with local medical services, and pay more attention to the needs of elderly people aged 65-74 for all kinds of home/community-based medical and elderly care services.
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Affiliation(s)
- Shangren Qin
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, China; (S.Q.); (Y.C.); (H.Z.)
| | - Yenuan Cheng
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, China; (S.Q.); (Y.C.); (H.Z.)
| | - Hangjing Zhang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, China; (S.Q.); (Y.C.); (H.Z.)
| | - Ye Ding
- School of Public Health, Hangzhou Medical College, Hangzhou 311399, China
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Gupta A, Salway T, Jessani A. Cost-related avoidance of oral health service utilization among lesbian, gay, and bisexual individuals in Canada. J Public Health Dent 2023; 83:254-264. [PMID: 37329179 DOI: 10.1111/jphd.12574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/12/2023] [Accepted: 05/17/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES This study estimates the frequency of cost-related oral health service avoidance (CROHSA) among lesbian, gay, and bisexual (LGB) individuals in Canada relative to heterosexual persons. METHODS Heterosexual and sexual minority individuals in Canada were compared using the national probability-based Canadian Community Health Survey 2017-2018. Logistic regression was used to quantify associations between LGB status and CROHSA. Mediators were tested following Andersen's behavioral model of health service utilization and included partnership status, oral health status, presence of dental pain, educational attainment, insurance status, smoking status, general health status, and personal income. RESULTS From our sample of 103,216 individuals, 34.8% of LGB individuals reported avoiding oral health care due to cost compared to 22.7% of heterosexual persons. Disparities were most pronounced among bisexual individuals (odds ratio [OR] 2.29 95% confidence interval [CI] 1.42, 3.49). Disparities persisted despite adjustment for confounding using age, gender/sex, and ethnicity (OR 2.23 95% CI 1.42, 3.49). Disparities were fully mediated by eight hypothesized mediators namely, educational attainment, smoking status, partnership status, income, insurance status, oral health status, and the presence of dental pain (OR 1.69 95% CI 0.94, 3.03). In contrast, lesbian/gay individuals did not have elevated odds of experiencing CROHSA compared to heterosexual individuals (OR 1.27 95% CI 0.84, 1.92). CONCLUSION CROHSA is elevated for bisexual individuals relative to heterosexual individuals. Targeted interventions should be explored to improve oral healthcare access among this population. Future research should assess the role of minority stress and social safety on oral health inequities among sexual minority groups.
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Affiliation(s)
- Amit Gupta
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Travis Salway
- British Columbia Centre for Disease Control, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
| | - Abbas Jessani
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
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Garcés-Elías MC, Del Castillo-López CE, Beltrán JA, León-Manco RA. Time elapsed since peruvian children's last dental care and head of household educational attainment: findings from a national database. BMC Oral Health 2023; 23:376. [PMID: 37296392 PMCID: PMC10252166 DOI: 10.1186/s12903-023-03083-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND It has been documented that the parents' highest level of education has an impact on their children's access to oral health services and the frequency of their use.This study aimed to determine the association between time elapsed since peruvian children's last dental care and head of household educational attainment. METHODS Cross-sectional study using a database of children aged 0 to 11 years, with a final sample of 8012 participants. The dependent variable in this study was the time elapsed since last dental care and the independent variable was the head of household educational attainment. Other covariates considered were natural region, area of residence, place of residence, altitude, wealth index, health insurance coverage, sex and age. Descriptive, bivariate and multivariate statistical analyses were applied. RESULTS Time elapsed since last dental care in the year 2021 was 5.68 years (SD = 5.25). A hierarchical multiple linear regression analysis was performed, analyzing the variables dimensions by separate and joint models. When head of household educational attainment was analyzed, there was no statistical significance (p = 0.262); however, other models did (p < 0.05). Model 4, which addresses all dimensions, was significant (p < 0.001) with an R2% of 0.011 and constant equal to 5.788; it showed significance with place of dental care, health insurance, altitude and age. CONCLUSIONS No association was found between head of household educational attainment and time elapsed since last dental care; however, the latter was associated with place of care, health insurance coverage, altitude and age in Peruvian children.
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Affiliation(s)
- María Claudia Garcés-Elías
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, Lima, 15102, Peru.
| | - César Eduardo Del Castillo-López
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, Lima, 15102, Peru
| | - Jorge A Beltrán
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, Lima, 15102, Peru
| | - Roberto A León-Manco
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, Lima, 15102, Peru
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Liu Y, Adeniran E, Wang K. Changes in Prevalence Over Time and Determinants of Dental Care Visits Amongst Tennessee Seniors. Int Dent J 2023:S0020-6539(23)00035-7. [PMID: 36813622 DOI: 10.1016/j.identj.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 02/22/2023] Open
Abstract
INTRODUCTION Rates of dental visits of older adults in the United States, particularly in Tennessee, are rapidly increasing, coupled with the growing complexity of older adults' dental treatment. Notably, increased dental visits help detect and treat dental disease and offer opportunities for preventive care. This longitudinal study aimed to examine the prevalence and determinants of dental care visits amongst Tennessee seniors. METHODS This observational study combined multiple cross-sectional studies. Five even years of Behavioral Risk Factor Surveillance system data were used, including 2010, 2012, 2014, 2016, and 2018. Our data were limited to Tennessee seniors (60 years or older). Weighting was conducted to account for the complex sampling design. Logistic regression analysis was performed to determine the factors associated with dental clinic visits. A P value < .05 was considered statistically significant. RESULTS The current study comprised 5362 Tennessee seniors. Older individuals visiting dental clinics within 1 year gradually decreased from 76.5% in 2010 to 71.2% in 2018. The majority of participants were female (51.7%), White (81.3%), and located in Middle Tennessee (43.5%). Logistic regression showed that those more likely to visit dentists or dental clinics included females (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8), never-smokers and former smokers (OR, 2.2; 95% CI, 1.5-3.4), individuals with some college education (OR, 1.6; 95% CI, 1.1-2.4), college graduates (OR, 2.7; 95% CI, 1.8-4.1), and those with high incomes (eg, >$50,000; OR, 5.7; 95% CI, 3.7-8.7). Conversely, Black participants (OR, 0.6; 95% CI, 0.4-0.8), participants with fair/poor health (OR, 0.7; 95% CI, 0.5-0.8), and those who have never married (OR, 0.5; 95% CI, 0.3-0.8) were less likely to report dental visits. CONCLUSIONS Rates of Tennessee seniors visiting dental clinics within 1 year have gradually decreased from 76.5% in 2010 to 71.2% in 2018. Several factors were associated with seniors seeking dental treatment. Effective interventions to improve dental visits should take the identified factors into account.
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Affiliation(s)
- Ying Liu
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA.
| | - Esther Adeniran
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Kesheng Wang
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
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Raittio E, Torppa‐Saarinen E, Sokka T, Lahti S, Suominen A, Suominen AL, Heikkinen AM. Association of service use with subjective oral health indicators in a freedom of choice pilot. Clin Exp Dent Res 2023; 9:134-141. [PMID: 36263738 PMCID: PMC9932228 DOI: 10.1002/cre2.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES A freedom of choice pilot provided access to private oral health care services without queuing and with fixed public service-fees for participants in Tampere region, Finland in 2018-2019. The aim of this study was to investigate how use of oral health care services differed by demographics, socioeconomic status, dental fear, and self-reported oral health in this pilot. MATERIAL AND METHODS SMS-messages including a link to online questionnaire were sent to participants who had booked an appointment, and to those who had not booked an appointment despite registering to pilot. We categorized participants to (1) those who had booked their first appointment before receiving SMS (visitors), (2) those who booked an appointment after receiving the SMS-message (late-visitors), and (3) those who had not booked an appointment during pilot (nonvisitors). We used regression analysis to estimate the association of age, gender, dental fear, economic situation, Oral Health Impact Profile-14-severity (oral health-related quality of life [OHRQoL]), self-reported oral health and need for oral health care (exposures) with oral health care service use during the pilot (outcome). RESULTS Out of 2300 participants, 636 (28%) responded. Late-visitors were more likely older and reported more likely need for oral health care, poorer oral health and OHRQoL than visitors or nonvisitors. Nonvisitors were younger and had better OHRQoL than the others. The differences in the service use by gender, economic situation, and dental fear were small. CONCLUSIONS Service use during the pilot depended on the subjective oral health. Our findings highlight the potential of reminders in increasing care use among those with perceived need for services.
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Affiliation(s)
- Eero Raittio
- Oral Health Care ServicesTampereFinland
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Department of Dentistry and Oral HealthAarhus UniversityAarhusDenmark
| | | | - Taru Sokka
- The Council of Tampere RegionTampereFinland
| | - Satu Lahti
- Department of Community DentistryUniversity of TurkuTurkuFinland
| | - Auli Suominen
- Department of Community DentistryUniversity of TurkuTurkuFinland
| | - Anna Liisa Suominen
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Oral Health Teaching Clinic, Kuopio University HospitalKuopioFinland
| | - Anna Maria Heikkinen
- Oral Health Care ServicesTampereFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
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Almutairi M, McKenna G, O’Neill C. A comparative examination of the role of need in the relationship between dental service use and socio-economic status across respondents with distinct needs using data from the Scottish Health Survey. BMC Public Health 2023; 23:159. [PMID: 36694144 PMCID: PMC9872289 DOI: 10.1186/s12889-023-15078-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Disparities in oral health and distinct patterns in service use related to socio-economic status have been shown to exist in the United Kingdom. A number of studies have used the Andersen behavioural model to better understand the factors that influence utilization and thereby inform policies aimed at improving service uptake. As the nature of need may differ across distinct types of patients, however, so too may the distribution of enabling and pre-disposing factors and observed relationships between need, other factors and service use. In this study we compare samples with distinct self-assessed needs in terms of their characteristics and patterns of service use to compare application of the Andersen model to dental services among respondents to a population based survey. MATERIALS AND METHODS Data were taken from the Scottish Health Survey, for 2019. Data on service use, oral hygiene habits, perceived treatment need, and socio-demographic characteristics were extracted. Data were analysed using descriptive statistics, t-tests and ordered logistic regression analyses. RESULTS Two thousand one hundred forty-eight usable responses were obtained from the survey, 74.95% of the sample had visited the dentist less than a year ago, 11.82% between 1 year and up to 2 years ago, 7.12% between 2 and 5 years ago and 6.10% more than 5 years. Descriptive statistics, t-tests and ordered logistic regression analyses revealed distinct patterns of service use when the sample was partitioned based on perceived treatment need. Specifically those with self-assessed treatment need were older, more likely to smoke, be male and be less likely to have a degree than those who did not. While service use was positively related to age (predisposing) among those who did not have self-assessed treatment need, it was negatively related for those with perceived treatment need. Distinct patterns were also evident with respect to sugar exposure (need) and ease with which time off work could be organised (enabling). DISCUSSION The study shows common and distinct patterns of service use related to enabling and predisposing factors across groups differentiated by self-perceived treatment need. If inequalities in health and healthcare use are to be addressed, it is important to understand their origins. Conflation of distinct types of need that may correlate with predisposing and enabling factors complicates this. CONCLUSION In applying the Andersen model, it is important to take account of potential differences in the types of need expressed where possible to understand the role of other variables in service use.
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Affiliation(s)
- Majed Almutairi
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. .,Public Health Department, School of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia.
| | - Gerry McKenna
- grid.4777.30000 0004 0374 7521Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Ciaran O’Neill
- grid.4777.30000 0004 0374 7521Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
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Constance Wiener R. Smokeless Tobacco Use and Dental Care Utilization, Using a National Dataset. Addict Behav Rep 2022; 16:100472. [DOI: 10.1016/j.abrep.2022.100472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
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Gillone A, Martinez Luna AA, Wu Q, Camargo G, Moss ME, Murata RM, Pardi V, Paquette DW. Racial and ethnic disparities in periodontal health among adults seeking dental care in rural North Carolina communities: A retrospective study. J Periodontol 2022; 94:364-375. [PMID: 36321899 DOI: 10.1002/jper.22-0137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 08/16/2022] [Accepted: 09/20/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Population studies consistently demonstrate a greater prevalence of chronic diseases, including oral diseases, among underrepresented minorities. This retrospective study aimed to measure and describe the prevalence and extent of periodontitis among adults seeking dental care within an academic practice-based network in rural North Carolina. METHODS This study used de-identified electronic health record (EHR) data from 2011 to 2017 of adult dentate patients (aged ≥30 years) seeking dental care who received a comprehensive periodontal examination at one of nine networked clinical centers. Periodontitis prevalence was calculated using CDC/AAP case definitions, along with extent (%) scores for periodontal parameters. Comparisons focused on age, sex, race, ethnicity, tobacco use, diabetes status, payer or insurance status, plaque scores, and the number of teeth. RESULTS EHR data for 10,544 adult patients (60.5% female) indicated 79.8% had some form of periodontitis. This patient population was diverse: 22.6% Black, 4.4% American Indian, and 53.8% White, with 4.8% self-identified as Hispanic. Patients 50 years and older showed greater mean extent scores for clinical attachment levels relative to patients 30 to 49 years. Males exhibited greater periodontitis than females (p = 0.001). Blacks showed significantly (p < 0.001) greater periodontitis prevalence relative to Whites. Hispanics also showed a greater prevalence of periodontitis (p < 0.001) relative to non-Hispanics. Significantly greater periodontitis was also noted for tobacco users (p < 0.001) but not for diabetes or payer status. A multiple logistic regression analysis of periodontitis prevalence confirmed significant associations for periodontitis for age, sex, race, ethnicity, tobacco use, high plaque scores, and the number of teeth (p < 0.001), but not diabetes or payer status. CONCLUSIONS The data document that racial and ethnic inequalities in periodontal health occur within the population of adults residing in rural communities in North Carolina and seeking dental care.
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Affiliation(s)
- Alex Gillone
- Department of Surgical Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Acela A Martinez Luna
- Department of Surgical Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Qiang Wu
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Gerard Camargo
- Office of Business Operations and Financial Affairs, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Mark E Moss
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Ramiro Mendonca Murata
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Vanessa Pardi
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - David W Paquette
- Department of Surgical Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
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Qin S, Zhao J, Zhou M, Cheng Y, Ding Y. Self-medication and its typology in Chinese elderly population: A cross-sectional study. Front Public Health 2022; 10:954305. [PMID: 36339244 PMCID: PMC9627487 DOI: 10.3389/fpubh.2022.954305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/26/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose This paper aims to evaluate the prevalence of self-medication and its associated factors among the Chinese elderly. Also, according to whether the elderly communicate with doctors (no matter before or after self-medication), we aimed to categorize self-medication and explore the associated factors. Methods It was a cross-sectional study. Data were derived from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). According to whether communicate with doctors or not, self-medication was reclassified as "self-medicate and NOT communicating with a doctor," and "self-medicate and communicate with a doctor." A binary logistic regression was used to identify which elderly were more likely to self-medicate, and a multinomial logistic regression was applied to explore the associated influencing factors of self-medication classifications. Results A total of 17,445 individuals aged ≥45 years were enrolled. The prevalence of self-medication was 58.60%. Self-medication was strongly associated with sex, education level, pension, self-reported general health status, chronic illness, satisfaction with local medical services, and three province-level socioeconomic welfare variables. About 19.64% of self-medication populations had communicated with a doctor. Higher education level and younger age were significantly associated with a higher probability of "self-medication and communication with a doctor." Conclusion The prevalence of self-medication among the Chinese elderly is increasing over the year. Health education on appropriate medication use targeting elder adults with low education levels is highly recommended. The typology of self-medication and its factors are new research entry points and could be meaningful for future studies.
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Affiliation(s)
- Shangren Qin
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Junjie Zhao
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Mengqiu Zhou
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yenuan Cheng
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Ye Ding
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China,*Correspondence: Ye Ding
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Lucas AS, Fagundes MLB, do Amaral OL, Menegazzo GR, Giordani JMDA. Association between integrative and complementary health practices and use of dental services among older adults in Brazil: a cross-sectional study, 2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2022314. [PMID: 36259891 PMCID: PMC9887975 DOI: 10.1590/s2237-96222022000300007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/01/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To analyze association between participation in integrative practices and regular use of dental services in Brazilian older adults. METHODS This was a cross-sectional study based on secondary data from the 2019 National Health Survey. All older adults aged 60 years and over were included. The study outcome was regular dental service use. Poisson regression models were used to estimate crude and adjusted prevalence ratios (PRs) and their respective at confidence intervals 95% (95%CI). RESULTS A total of 22,728 older adults were analyzed. Most were female (55.5%), reported that they were White (51.3%), had incomplete primary education (47.0%); 7.0% (95%CI 6.8;7.5) had used some form of integrative practice and 34.3% (95%CI 33.2;35.4) had used their dental service regularly. Individuals who used integrative practices had higher prevalence of dental service use even after adjusting the model (PR = 1.15; 95%CI 1.07;1.23). CONCLUSION Among Brazilian older adults use of integrative practices was associated with regular use of dental services.
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Affiliation(s)
- Aneiza Simoní Lucas
- Universidade Federal de Santa Maria, Departamento de
Estomatologia, Santa Maria, RS, Brazil
| | | | - Orlando Luiz do Amaral
- Universidade Federal de Santa Maria, Departamento de
Estomatologia, Santa Maria, RS, Brazil
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The Big Five personality traits and regularity of lifetime dental visit attendance: evidence of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Aging Clin Exp Res 2022; 34:1439-1445. [PMID: 34964080 PMCID: PMC9151578 DOI: 10.1007/s40520-021-02051-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/07/2021] [Indexed: 01/22/2023]
Abstract
Background Regular dental visits are essential for the prevention, early detection and treatment of worldwide highly prevalent oral diseases. Personality traits were previously associated with treatment compliance, medication adherence and regular doctor visits, however, the link between personality traits and regular dental visit attendance remains largely unexplored. Thus, the objective of this study is to clarify this link. Methods Data (wave 7) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used, focusing on Germany (n = 2822). Personality was assessed using the 10-item Big Five Inventory (BFI-10). Regular dental visits were assessed. Multiple logistic regressions were used, adjusting for various covariates. Results Majority of the participants (84%) reported to attend regular dental visits during lifetime. Regularity of lifetime dental visit attendance was positively and significantly associated with increased extraversion [OR 1.13, 95% CI (1.01–1.26)], increased conscientiousness [OR 1.26, 95% CI (1.10–1.44)], and increased openness to experience [OR 1.12, 95% CI (1.01–1.26)]. However, there was a lack of association with agreeableness and neuroticism. Moreover, the outcome measure was positively associated with younger age, being female, born in Germany, being married, higher education, being retired (compared to being homemaker), whereas it was not associated with obesity or chronic diseases. Conclusions Identification of personality traits that are associated with regular dental visits can support prevention, screening and clinical management of oral diseases. Further research in this field may facilitate the development and increase the incorporation of individualized concepts to enhance patient compliance and attendance, and thus the provision of oral and dental care services. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-02051-2.
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Sahab DA, Bamashmous MS, Ranauta A, Muirhead V. Socioeconomic inequalities in the utilization of dental services among adults in Saudi Arabia. BMC Oral Health 2022; 22:135. [PMID: 35448991 PMCID: PMC9027487 DOI: 10.1186/s12903-022-02162-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/04/2022] [Indexed: 11/22/2022] Open
Abstract
Background This study used the Anderson Behavioral Model to assess the socioeconomic inequalities in dental services utilization among adults in Saudi Arabia, along with other predictors of utilization, to inform future planning of dental care services. Methods This cross-sectional study was a secondary analysis using national data from the 2019 Kingdom of Saudi Arabia World Health Survey (KSAWHS). The survey consisted of two interviewer-administered questionnaires: one household and one individual interview. The questions covered predisposing factors (age, gender, marital status, nationality, education, employment), enabling factors (income, household wealth, area-based socioeconomic class, health insurance, eligibility for free governmental health care, transportation and region of residence) and self-reported need for dental treatment. The main outcome was dental utilization in the past year; predisposing, enabling and need factors were independent variables. Hierarchical logistic regression analyses identified significant predictors of dental utilization, applying survey weights to adjust for the complex survey design. Adjusted odds ratios with 95% confidence intervals and p values were reported in the final model. Results The final dataset included 8535 adults (response rate = 95.4%). Twenty percent of adults had visited the dentist at least once in the past year (95% CI 18–21%). There were socioeconomic inequalities in dental utilization. High household income (OR 1.43, p = 0.043), second and middle household wealth status (OR 1.51, p = 0.003 and OR 1.57, p = 0.006) and access to free governmental health care (OR 2.05, p = 0.004) were significant predictors in the final regression model along with perceived need for dental treatment (OR 52.09, p < 0.001). Conclusion Socioeconomic inequalities in the utilization of dental services exist in Saudi Arabia. The need for treatment was the strongest predictor suggesting predominantly symptomatic attendance. Increasing awareness about the importance of preventive dental visits rather than symptomatic attendance could be an important policy implication to improve oral health and optimize dental care expenditure. Further research should explore the drivers for adults to seek preventive care in the absence of any recognized dental problems.
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Affiliation(s)
- Deema A Sahab
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. .,Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Mohamed S Bamashmous
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amitha Ranauta
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Vanessa Muirhead
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Bas AC, Azogui-Lévy S. Socio-Economic Determinants of Dental Service Expenditure: Findings from a French National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031310. [PMID: 35162334 PMCID: PMC8835070 DOI: 10.3390/ijerph19031310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: This study investigated how individual enabling resources influence (i) their probability of using dental services and (ii) consumers’ expenditure on dental treatment. (2) Methods: Data were derived from a self-administered national health survey questionnaire and from expenditure data from national health insurance. Multiple linear regression methods were used to analyze entry into the dental health system (yes/no) and, independently, the individual expenditure of dental care users. (3) Results: People with the highest incomes were more likely to use dental service (aOR = 1.59; 95% CI = 1.28, 1.97), as were those with complementary health insurance and the lowest deprivation scores. For people using dental services, good dental health status was associated with less expenditure (−70.81 EUR; 95% CI = −116.53, −25.08). For dental service users, the highest deprivation score was associated with EUR +43.61 dental expenditure (95% CI = −0.15; 87.39). (4) Conclusion: Socioeconomic determinants that were especially important for entry into the dental health service system were relatively insignificant for ongoing service utilization. These results are consistent with our hypothesis of a dental care utilization process in two steps. Public policies in countries with private fees for dentistry should improve the clarity of dental fees and insurance payments.
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Affiliation(s)
- Anne-Charlotte Bas
- Dental Public Health Department, Faculty of Dentistry, Paris University, 75006 Paris, France;
- Inserm U1018, Centre de Recherche en Épidémiologie et Santé des Populations, 94807 Villejuif, France
- Correspondence:
| | - Sylvie Azogui-Lévy
- Dental Public Health Department, Faculty of Dentistry, Paris University, 75006 Paris, France;
- Educations and Health Practices Laboratory (LEPS EA 3412), Faculty of Medicine, Paris 13 University, 93017 Bobigny, France
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Drachev SN, Puriene A, Aleksejuniene J, Stankeviciene I, Stangvaltaite-Mouhat L. Prevalence of and factors associated with dental service utilization among early elderly in Lithuania. BMC Health Serv Res 2022; 22:16. [PMID: 34974840 PMCID: PMC8721987 DOI: 10.1186/s12913-021-07388-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/07/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is no recent information about dental service utilization (DSU) among elderly in Lithuania. We examined DSU and its associated factors in Lithuanian early elderly based on the Andersen's behavioural model. METHODS The cross-sectional study conducted in 2017-2019 included a nationally representative stratified sample of 370 Lithuanian early elderly aged 65-74 years (response rate of 54.5%). Information on predisposing factors (age, sex, nationality and education), enabling factor (residence), need-based factors (status of teeth, oral pain or discomfort, and dry mouth), general health, personal health practices and perceived stress was obtained from a structured, self-administered questionnaire. Clinically-assessed need-based factors included number of missing teeth and dental treatment need. Multivariable Poisson regression with robust variance estimates was used. RESULTS A total of 239 study participants (64.6%) reported a dental visit during the last year and 338 (91.4%) needed dental treatments. A higher level of education (adjusted prevalence ratio [aPR] = 1.21, 95% confidence interval [CI]:1.04-1.40), pain or discomfort in teeth/mouth (aPR = 1.35, 95%CI: 1.13-1.62) and lower number of missing teeth (aPR = 0.99, 95%CI: 0.98-1.00) were associated with DSU. CONCLUSIONS Even though majority of early elderly needed dental treatments, only two-thirds visited a dentist during the last year. Predisposing and need-based factors were significant predictors of having a dental visit in the last year. A national oral health program for Lithuanian elderly with the focus on regular preventive dental check-ups is needed. More studies, both quantitative and qualitative, are warranted to investigate in depth the barriers for DSU among elderly in Lithuania.
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Affiliation(s)
- Sergei N Drachev
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037, Tromsø, Norway. .,Department of Prosthodontics, Northern State Medical University, Arkhangelsk, Russia.
| | - Alina Puriene
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jolanta Aleksejuniene
- Department of Preventive and Community Dentistry, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - Indre Stankeviciene
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Lina Stangvaltaite-Mouhat
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.,Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway
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de Abreu MHNG, Cruz AJS, Borges-Oliveira AC, Martins RDC, Mattos FDF. Perspectives on Social and Environmental Determinants of Oral Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413429. [PMID: 34949037 PMCID: PMC8708013 DOI: 10.3390/ijerph182413429] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/18/2021] [Accepted: 12/19/2021] [Indexed: 11/16/2022]
Abstract
Most oral conditions have a multifactorial etiology; that is, they are modulated by biological, social, economic, cultural, and environmental factors. A consistent body of evidence has demonstrated the great burden of dental caries and periodontal disease in individuals from low socioeconomic strata. Oral health habits and access to care are influenced by the social determinants of health. Hence, the delivery of health promotion strategies at the population level has shown a great impact on reducing the prevalence of oral diseases. More recently, a growing discussion about the relationship between the environment, climate change, and oral health has been set in place. Certainly, outlining plans to address oral health inequities is not an easy task. It will demand political will, comprehensive funding of health services, and initiatives to reduce inequalities. This paper sought to give a perspective about the role of social and physical environmental factors on oral health conditions while discussing how the manuscripts published in this Special Issue could increase our knowledge of the topic.
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Hajek A, Kretzler B, König HH. Determinants of healthcare use based on the Andersen model: a study protocol for a systematic review of longitudinal studies. BMJ Open 2021; 11:e044435. [PMID: 34011591 PMCID: PMC8137164 DOI: 10.1136/bmjopen-2020-044435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION A previous systematic review published in 2012 focused on the use of health services based on the Andersen model. Extending this review, we will exclusively focus on systematically synthesising longitudinal studies examining the determinants of healthcare use based on the Andersen model. Therefore, our aim of this systematic review is to provide an overview of longitudinal observational studies investigating the predictors of healthcare use explicitly using this model. METHODS AND ANALYSIS We will search three electronic databases (Medline, PsycINFO and CINAHL). Furthermore, reference lists will be searched manually. Longitudinal observational studies will be investigating the determinants of healthcare use (in terms of use of outpatient physician services (like general practitioner's visits or specialist visits in total) and hospitalisation). We will exclude disease-specific samples. Data extraction will focus on methods (eg, assessment of healthcare use), sample characteristics and main findings. A suitable tool will be used to assess the study quality. Study selection, data extraction and evaluation of study quality will be conducted by two reviewers. The findings will be presented by means of figures, summary tables, narrative summaries and meta-analysis (if possible). ETHICS AND DISSEMINATION No primary data will be collected. Therefore, approval by an ethics committee is not required. Our findings are planned to be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020193198.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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