Common Perceptions of Periodontal Health and Illness among Adults: A Qualitative Study

Association between dental visit behavior and mortality: a nationwide longitudinal cohort study from NHANES

OBJECTIVES

The benefits of professional dental treatment for oral diseases have been widely investigated. However, it is unclear whether professional dental treatment provides additional benefits for improving general health.

MATERIALS AND METHODS

Data were obtained from the US National Health and Nutrition Examination Survey (NHANES) 1999 to 2004 and 2011 to 2018 cycles. A total of 36,174 participants were included and followed-up for mortality until December 31, 2019. Dental visit behavior was defined as the time interval of last dental visit (TIDV, < 0.5 year, 0.5-1 year, 1-2 years, 2-5 years, and > 5 years) and the main reasons of the last dental visit (treatment, examination, and other reasons). The Cox proportional risk model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI).

RESULTS

Compared with participants with time interval of less than 0.5 year, the multivariate-adjusted HRs and 95%CI for participants with time interval of more than 5 years were 1.45 (1.31, 1.61) for all-cause mortality (P trend < 0.0001), 1.49 (1.23, 1.80) for cardiovascular diseases mortality (P trend = 0.0009) and 1.53 (1.29, 1.81) for cancer mortality (P trend = 0.013). Compared with dental visit for examination, participants who had their dental visit for treatment had higher risk for mortality. For participants with dental visit for examination, TIDV of less than 1 year showed lower risk for mortality, whereas TIDV of less than 0.5 year is recommend for population with dental visit for treatment.

CONCLUSIONS

Poor dental visit behavior is associated with an increased risk of mortality. Further well-designed studies are needed to confirm the association between professional dental visit and mortality.

CLINICAL RELEVANCE

This study highlights the potential benefits of regular dental visits in maintaining general health.

Oral health in an urban slum, Nigeria: residents' perceptions, practices and care-seeking experiences

BACKGROUND/INTRODUCTION

One of the key recommendations for the new WHO global strategy for oral health is inclusion of disadvantaged populations and their engagement in policy dialogues such that their needs and views are addressed in policy decisions.

OBJECTIVES

This study explored oral health perceptions, practices and care-seeking experiences of slum residents in Ibadan, Nigeria.

METHOD

Focus group discussions (FGD) were conducted with family health-decision makers in an urban slum site. Oral health perceptions, practices, and care-seeking experiences were discussed. FGDs were recorded, transcribed, and translated. ATLAS.ti qualitative research software was deployed for analysis using thematic analysis.

RESULTS

Six FGD sessions, divided by gender and age, were conducted between September-October 2019, (N = total 58 participants, aged 25 to 59 years). Common dental ailments mentioned were dental pain, tooth sensitivity, bleeding gums, tooth decay, mouth odor, gum disease, and tooth fracture. Perceived causes of dental conditions included poor dental hygiene and habits, sugary diets, ignorance, and supernatural forces. Mouth cleaning was mostly done once daily using toothbrush and paste. Other cleaning tools were ground glass, wood ash, charcoal, "epa Ijebu" (a dentrifice), and "orin ata" (a type of chewing stick). Remedies for relieving dental pain included over-the-counter medicines, warm salted water, gin, tobacco (snuff/powdered), cow urine/dung, battery fluid, and various mixtures/ concoctions. Visits to the dentists were mentioned by a few but this was usually as last resort. Main barriers to accessing care from dental care facilities were unaffordability of service charges and fear of extreme treatment measures (extraction). Suggested measures to improve timely access to dental health care included reducing/subsidizing costs of treatments and medications, offering non-extraction treatment options, and oral health education programmes.

CONCLUSION

The slum residents experience various forms of dental ailments mostly pain-related. The residents perceived formal dental clinics as unaffordable, thereby engaging in self-care remedies and harmful oral health practices before seeking professional help. Policymakers and decision-makers may leverage this empirical evidence for the people's education on early dental care and address challenges to affordable, available, and acceptable oral healthcare services among slum residents to improve access to care facilities.

A public health approach for prevention of periodontal disease

Upwards of 1 in 10 adults worldwide may be affected by severe periodontitis, making the disease more prevalent than cardiovascular disease. Despite its global scope, its impact on pain, oral function, and the wellbeing of individuals, and the disproportionate burden of disease and the socioeconomic impact on communities, the perception that periodontal disease is a public health problem remains low. Although there have been substantial improvements in our understanding of the etiology of periodontal disease and how we can prevent and control it, these advances have been primarily focused on individual, patient-focused approaches. The prevention of periodontal disease depends on improving currently available individual interventions and on determining what public health interventions can be effective and sustainable under real-life conditions. Currently, public health approaches for periodontal disease prevention and control are lacking. This review traces the historical strategies for prevention of periodontal disease in an epidemiologic transition context, using a modified model developed for cardiovascular disease, and presents a possible public health approach. Improving periodontal disease prevention and control will need to take into consideration the core activities of a public health approach: assessment, policy development, and assurance.

Perceived barriers to the preservation and improvement of children's oral health among Iranian women: a qualitative study

AIM

To explore perceptions of Iranian mothers regarding barriers to preserving and improving oral health among their children.

METHODS

The present qualitative study was part of a larger sequential exploratory mixed-method study conducted in Tehran, Iran, from April to May 2015. Data were collected via 10 focus group discussions and semi-structured interviews to gain an understanding of the perception held by the mothers of school-aged children about barriers to oral health improvement. Sampling was purposive and was continued until data saturation was reached. The study population consisted of 58 Iranian women who had at least one child in school. Data were analysed using conventional content analysis.

RESULTS

Three key themes of oral health barriers were identified as follows: (1) barriers in the system or at the organisational level, (2) barriers at the provider level, and (3) barriers at the family level. Informants reported cost, lack of full-coverage insurance, low access to dental services, and fear and anxiety as the main barriers.

CONCLUSIONS

The major barriers to oral health care were fear and the cost of dental treatments. These predictors need to be addressed when designing programs to increase access of children to dental services.

Perception of Iranian Mothers About Oral Health of Their School-Children: A Qualitative Study

OBJECTIVES

Oral health is an important aspect of general health and well-being for children. Understanding the viewpoint of mothers about children's oral health provides a basis for the development of interventions to improve oral care and disease prevention. The purpose of this study was to explore the perception of Iranian mothers regarding the oral health of their children.

MATERIALS AND METHODS

This descriptive qualitative study was the first phase of an exploratory mixed method design and collected data from April to May 2015 in Tehran, Iran. The qualitative data were collected through seven focus group discussions and three semi-structured interviews. The participants were 58 Iranian women who had a first grader. Data were analyzed using conventional content analysis.

RESULTS

The main themes identified from the data were: (I) the definition of oral health, (II) the importance of maintaining oral health and dental treatment, (III) the effect of nutrition on children's oral health, (IV) the role of oral health behaviors, (V) the causes of dental caries and malocclusion/crowding, (VI) the symptoms and causes of gum disease, (VII) the causes of halitosis.

CONCLUSIONS

According to the mothers' perception, the main factors influencing children's oral health were: nutrition and oral health behaviors such as daily tooth brushing and flossing. The results of this study can be used to develop a model of oral health education and a prevention program for improving oral health among Iranian school-children.