Associations and discrepancies between global self-ratings of oral health and general health: a Bayesian approach

OBJECTIVE

To estimate the discrepancies between global ratings of oral health and general health and investigate the factors associated with self-rated oral health (SROH) and self-rated general health (SRGH).

METHODS

Data were collected from 502 participants aged 18 to 81 years. A structured questionnaire was used to obtain data regarding sociodemographic characteristics and self-reported conditions. Global self-ratings of oral health and general health were the main outcomes. Discrepancies between self-ratings of oral health and general health were stratified by independent variables. Bayesian ordinal logistic regression models were fitted to estimate the posterior distributions of parameters and 95% credible intervals (95% CrI).

RESULTS

The proportion of participants who rated their oral health worse than general health was 28.6% (95% CrI: 24.7-32.3). Negative discrepancies between SROH and SRGH were associated with being men, reporting gingivitis, and lower income. Sex (95% CrI: 1.12-2.25) impacted only on SRGH. Income (SROH - 95% CrI: 1.52-6.40; SRGH - 95% CrI: 1.08-4.56), tertiary education (SROH - 95% CrI: 1.13-2.53; SRGH - 95% CrI: 1.01-2.32), self-reported missing teeth (SROH - 95% CrI: 1.57-3.46; SRGH - 95% CrI: 2.21-4.92), self-reported gingivitis (SROH - 95% CrI: 1.10-2.40; SRGH - 95% CrI: 1.71-3.82), and self-reported chronic health problem (SROH - 95% CrI: 1.38-3.08; SRGH - 95% CrI: 1.61-3.59) impacted on both outcomes.

CONCLUSIONS

Substantial discrepancies between self-rated oral health and self-rated general health were found and were associated with being male, reporting gingivitis, and having lower income.

Application of an ancestrality estimate method through morphoscopic analysis of Brazilian skulls

The objective of the investigation was to test a technique originating in the United States to verify the accuracy of the ancestry estimate in a sample of Brazilian skulls. The sample consisted of 120 skulls of Brazilian adults from the collection of the Institute of Education and Research in Forensic Sciences (IEPCF), Guarulhos-SP, Brazil, with ancestry determined by routine examination. In the skull, the following structures were analyzed: anterior nasal spine (ANS), inferior nasal aperture (INA), interorbital breadth (IOB) nasal aperture width (NAW), nasal bone structure (NBS), and post bregmatic depression (PBD). The Hefner and Ousley technique was applied to classify ancestry. Data were registered and correctness percentage was obtained. To improve ancestry prediction, Machine Learning techniques were used. Regarding the error of the studied method and the correctness of the complete sample, the study presented a percentage above 50%, with values such as 56.33% for whites and 53.07% for non-whites. The most frequent ANS parameter was marked (37.5%), INA straight (31.7%), IOB wide (38.3%), NAW medium (32.5%) NBS triangular (29.2%), and PBD present (78.3%). The application of the method in the sample of the study showed a limitation to estimate ancestry, suggesting a need for adaptation for its applicability in the Brazilian population.

A Psychometric Network Analysis of OHIP-14 across Australian and Brazilian Populations

OBJECTIVES

The aim of this study was to assess the structural validity of the Oral Health Impact Profile-14 (OHIP-14) instrument in Indigenous and non-Indigenous populations from Australia and Brazil using a network analysis approach.

METHODS

Cross-sectional data collected using OHIP-14 were obtained for Indigenous and non-Indigenous populations from Australia and Brazil. Networks were estimated using the Gaussian graphical model. Items of the OHIP-14 instrument are represented as nodes and the partial correlations between items as edges. Dimensionality was assessed using exploratory graph analysis. Structural consistency and item stability were computed using a bootstrap sampling method. Standardized node strength across each dimension was also calculated.

RESULTS

Four dimensions were identified across all samples, although the item arrangement of most dimensions presented variation. Similarities with the theoretical domains of the instrument were found. Items from the conceptually derived OHIP-14 domains formed separated clusters or blended with other items in a single dimension. Most dimensions across all samples showed an acceptable structural consistency. Item stability revealed some discrepancies among items of dimensions of both Indigenous networks.

CONCLUSION

The psychometric network perspective adopted in this study provides validation of the OHIP-14 structure in Indigenous and non-Indigenous populations. The structural consistency and item stability analyses showed that both Indigenous networks present a higher number of cross-domain items and less defined boundaries between dimensions. These findings indicate that OHIP-14 does not measure attributes in the same extent among different cultures.

KNOWLEDGE TRANSFER STATEMENT

This study demonstrates a new analytical framework from which to conceptualize and interpret the construct oral health-related quality of life using the Oral Health Impact Profile (OHIP-14). Network graphs facilitate knowledge translation of findings to professionals with no expertise in psychometric methods. OHIP-14 is a valuable tool to oral health research and clinical practice. Differences in conceptions of health may influence the extent that the instrument measures oral health impacts. Consequently, dimension scores do not always provide appropriate measures and should be avoided in research reports and assessments of treatment outcomes.

Influence of school environment on occurrence of traumatic dental injuries in 12 years old children

BACKGROUND/AIM

Since children spend most of their time in school, some environmental characteristics of the schools may influence the occurrence of traumatic dental injuries (TDI). Therefore, the aim of this cross-sectional study was to assess the prevalence of TDI in 12 years old children in Quito, Ecuador, and its association with some school environmental aspects.

MATERIAL AND METHODS

Six calibrated examiners evaluated 998 children from 31 public schools of Quito, to evaluate the occurrence of TDI in anterior teeth. School coordinators answered questionnaires on school physical conditions, promotion of health practices and the occurrence of negative episodes in school. The occlusion and socioeconomic status of the participants were also evaluated. Prevalence of TDI, unadjusted and adjusted by the design effect was calculated. Association between individual and contextual explanatory variables and presence of TDI were evaluated using multilevel Poisson regression analysis (P < .05).

RESULTS

TDI prevalence adjusted by design effect was 20.7%. Children studying in schools with patio floor of grass and with access ramps had significantly lower prevalence of TDI than children studying in schools with patio floor of cement and with only stairs, respectively. The prevalence of TDI was also lower in children from schools that offered healthy meals or that had a proper place for oral hygiene.

CONCLUSIONS

Schools with adequate physical structures and that promote health practices to their students have a lower prevalence of TDI.

Tooth crown mesiodistal measurements for the determination of sexual dimorphism across a range of populations: A systematic review and meta-analysis

OBJECTIVE

The aim of this study was to determine whether the tooth crown sexual dimorphism pattern reported in previous small studies can be generalized for a broader range of populations.

LITERATURE REVIEW

A systematic literature review was performed by two independent examiners. The following databases were searched from October 2015 to July 2016: PubMed, Scopus, Lilacs, ScienceDirect, Medline, and Cochrane Reviews. No language restrictions were applied to the search.

SELECTION CRITERIA

The inclusion criteria comprised original studies investigating mesiodistal permanent teeth that reported the sample population and standard deviation. All right-sided teeth, except the third molars, were measured and separated by sex in the included studies. Thirty-one studies were included in the quantitative data synthesis and meta-analysis. Studies of non-human teeth, skeletal remains, or an overly specific study population were excluded.

MAIN RESULTS

Thirty-one trials, involving 6481 participants, provided data for the meta-analysis of teeth. Sexual dimorphism in mesiodistal crowns was found in all teeth across a range of populations, principally in lower canines (5.73%) and maxillary canines (4.72%), followed by the lower second molars (3.54%) and upper second molars(3.20%), and finally in the lower first molars(3.14%) and upper first molars(2.64%).

CONCLUSIONS

A small degree of sexual dimorphism exists in all human teeth. Second molars and canines show the greatest sexual dimorphism. Additionally, smaller racial differences are present in mesiodistal crowns among groups living in different geographic areas; however, it is not possible to establish a single value applicable for all populations.

Radiographic evaluation of dental and cervical vertebral development for age estimation in a young Brazilian population

Age estimation is guided by the evaluation of events that happen during the processes of bone and dental development. The purpose of this study was to validate the method of age estimation proposed by Lajolo et al. (2013) through oro-cervical radiographic indices in Brazilians. The study aimed to verify the effectiveness of age estimation equations through dental and cervical vertebrae examinations, in addition to including dental and cervical vertebrae data in new age estimation equations. The sample consisted of panoramic radiographs and teleradiographs from 510 subjects (8-24.9 years). Age estimation methods were applied by assessing the development of seven mandibular teeth, cervical vertebrae and third molars. Techniques used previously have been combinations of radiographic indices: Oro-Cervical Radiographic Simplified Score (OCRSS) and Oro-Cervical Radiographic Simplified Score without Wisdom Teeth (OCRSSWWT). In the second phase of the study, dental maturation, vertebral measurements, and real age were estimated by regression equations. OCRSS and OCRSSWWT had success rates of 67.4% (R2=0.64) and 70.8% (R2=0.62), respectively. When age estimation equations for tooth evaluations were applied, the average error was 1.3 years, and for cervical vertebrae measurements, the error was 1.9 years. When dental variables and the measurements of cervical vertebrae were included, the average error of equations was 1.0 year. Radiographic indices were easy to perform, and after adequate training, are reliable and can be used in forensic practice. The use of the new equations presented in this study is recommended because including cervical vertebrae and dental data provides greater accuracy for age estimation.