Oral Health-Related Quality of Life Among Non-institutionalized Elderly in Malaysia: A Teaching Hospital-Based Survey

Background In Malaysia, the Geriatric Oral Health Assessment Index (GOHAI) has been recognized as a vital instrument for evaluating oral health-related quality of life among the elderly population. Its integration into the National Health and Morbidity Survey (NHMS) in 2018 demonstrates the country's dedication to understanding and addressing the unique oral health challenges faced by older individuals. The NHMS, led by the Ministry of Health Malaysia, serves as a crucial platform for identifying and addressing healthcare needs, while also working towards achieving sustainable development goals. This study aimed to provide valuable information for stakeholders and researchers by investigating the relationship between quality of life related to oral health and demographic factors, with the ultimate goal of enhancing oral healthcare for older individuals. Objective The objective of this research was to identify the variables that impact the Oral Health-Related Quality of Life (OHRQoL) of non-institutionalized elderly individuals who visit the Klinik Pergigian Manipal University College Malaysia (MUCM). By utilizing the OHRQoL, dental practitioners can gain insight into the elderly's oral health-related quality of life, which is crucial information for dental healthcare providers to effectively reach out to and cater to the elderly at the institution. Methodology A cross-sectional design was employed, utilizing a non-probability sampling method to select eligible elderly individuals at the clinic. A validated questionnaire comprising 18 items covering sociodemographic details and the Geriatric Oral Health Assessment Index (GOHAI) was distributed to individuals above 60 years via printed forms. One way ANOVA, unpaired t-test and multiple linear regression analysis were performed to analyze the data. Results The overall mean GOHAI score among non-institutionalized elderly attending Klinik Pergigian MUCM was 48.38±9.33, indicating poor OHRQoL. The psychosocial impact domain had a mean score of 19.33±5.21, surpassing the pain and discomfort domain with a score of 10.73±2.82, highlighting the significant impact of psychosocial factors on poor oral health-related quality of life. Multiple linear regression analysis revealed no significant associations between OHRQoL and factors such as ethnicity, living arrangements apart from spouse and family, or tertiary education among older individuals after adjusting for confounding variables. Conclusions This study indicates that sociodemographic aspects have minimal impact on the OHRQoL of seniors. Further examination is needed to understand the economic aspects of tooth replacement options and preventive measures in this age group. To enhance the OHRQoL of older adults, especially those not living in facilities like nursing homes or assisted living centers, tailored oral healthcare plans and strategies are crucial. Interdisciplinary collaboration among mental health professionals, geriatric experts, and oral healthcare providers is crucial for empowering both healthcare practitioners and seniors to maintain optimal oral health.

Epidemiological Study of Oral Health among Children and Adolescent Schoolchildren in Melilla (Spain)

Dental epidemiological studies are essential for analysing and evaluating the population's health state and dental treatments provided, as well as for planning future oral health programme activities and interventions based on their findings. In order to determine the health condition of children and adolescents in connection to the prevalence of caries, caries indices (decayed and filled teeth (dft) for primary teeth and decayed, missing and filled teeth (DMFT) in permanent teeth) and periodontal indices (community periodontal index (CPI)), oral exams of children and adolescents aged 6, 12 and 15 from selected schools were conducted. To assess the achievement of the oral health objectives set for Spain in 2020, these data were compared with those acquired at the national level. At 6 years of age, 278 children were examined, the prevalence of caries was 55.6%, the dft index was 2.77 (±3.44), the DMFT was 0.19 (±0.16), the restorative index (RI) was 4.62%, and the significant caries (SiC) index was 8.40 (±2.07). At 12 years of age, 208 students were examined, the prevalence of caries found was 65.86%, the DMFT index was 1.85 (±2.22), the RI was 36.63%, the SiC index was 5.43 (±2.07), and children without the presence of periodontal pathology was 59.13%. At 15 years of age, 165 students were examined, the prevalence of caries was 70.06%, the DMFT was 3.08 (±3.39), the RI was 42.42%, the SiC index was 8.10 (±2.55), and adolescents without periodontal disease was 47.90%. Conclusions: Melilla-born children and adolescents had higher caries indicators and indices than the corresponding national averages for Spain. Teenagers under the age of 15 have a particularly high frequency of dental caries. The investigation of the children's origin is where there is the most disparity. Children of Berber descent have much higher values than children of European heritage.

Assessment of Oral Health Status and Treatment Needs of School Teachers in Indore City, Madhya Pradesh, India: A Cross-Sectional Study

INTRODUCTION

Teachers are central to the well-being of a community. Being an influential part of society, their role can be broadened to promote oral health and healthy oral hygiene habits. This study was aimed at the assessment of the oral health status and treatment needs of school teachers in Indore City.

METHOD

A descriptive cross-sectional study was carried out over a period of five months on 470 school teachers working in various government schools of Indore city selected through random sampling technique. The modified WHO Oral Health Assessment Form for Adults 2013 was used to record oral health status and treatment needs, while the WHO Questionnaire for Adults 2013 was used to document oral hygiene practices, dietary habits, and deleterious habits. Data was analyzed using IBM SPSS Version 25 (IBM Corp., Armonk, NY). Chi-square test, independent t-test, and one-way ANOVA were used.

RESULTS

The gender distribution of the representative sample showed female predominance. The prevalence of smokeless tobacco consumption was 5.1% among the study subjects. The mean number of Decayed, Missing, and Filled Teeth (DMFT) was 3.45 ± 3.10, and the mean number of 1.52 ± 2.40 teeth showed the presence of bleeding. Around 37.2% had shallow pockets of 4-5 mm. A mean number of 4.26 ± 1.97 sextants showed 0-3 mm attachment loss. There was a significant association between the frequency and technique of toothbrushing with a decayed number of teeth (p<0.001).

CONCLUSION

High proportion of dental caries and periodontal disease was seen which could be related to their oral health care-seeking behavior and the impairment related to age changes.

Inequalities in dental service utilization among Thai adults from 2000 to 2017

OBJECTIVES

The Universal Coverage Health Scheme (UCS) was implemented in Thailand in 2002 to increase access to health services among the Thai population. This study aimed to evaluate socioeconomic inequalities in dental service utilization (DU) before and after UCS implementation and to assess factors associated with DU among Thai adults.

METHODS

This study is based on secondary data from four Thai national oral health surveys in 2000-2001, 2006-2007, 2012 and 2017. Whether an individual from a nationally representative sample of Thai adults aged 35-44 went to see the dentist during the past year was used to define DU. The slope index of inequality (SII) and relative index of inequality (RII) were used to assess and compare education and income-related inequalities in DU. Poisson regression was used to assess factors associated with DU. Income inequalities were not reported for the year 2001 (Income data not available).

RESULTS

Although DU increased after UCS implementation, socioeconomic inequalities persisted. DU was concentrated among high-education and income groups. Absolute educational inequalities were 0.16 (95% CI: 0.09-0.22), 0.21 (95% CI: 0.10-0.32), 0.26 (95% CI: 0.14-0.38) and 0.25 (95% CI: 0.18-0.32) in 2001, 2007, 2012 and 2017, respectively. Absolute income inequalities were 0.15 (95% CI: 0.04-0.26), 0.07 (95% CI: -0.04-0.18) and 0.12 (95% CI: 0.05-0.19) in 2007, 2012 and 2017, respectively. Occupation, type of health insurance scheme, sex and oral health-related behaviour were associated with DU.

CONCLUSION

UCS has improved accessibility to dental services, but UCS alone might not narrow the inequalities gap for Thai adults.

Temporomandibular disorders in an adult population in northern Norway: A cross-sectional study

Objectives

The aim of the study was to assess the prevalence of symptoms indicative of temporomandibular disorders (TMD) in an adult population in Troms County in Northern Norway, as well as the associations between TMD and socio‐demographic factors, dental status, self‐reported general, and oral health as well as oral health related quality of life (OHQoL).

Methods

Data were collected from a structured questionnaire and a clinical examination of a random sample of almost 2000 adults, 20–79‐year‐old, in Troms County in Northern Norway.

Results

Women had a higher prevalence of all self‐reported and clinical signs of pain and dysfunction in the temporomandibular complex compared to men. For both genders, sounds from the temporomandibular joint (TMJ) upon clinical examination was the most common symptom, followed by pain to palpation of jaw muscles. Headache was the most common of the self‐reported symptoms and sounds from the TMJ the second most common. Young women had a higher prevalence of self‐reported headache and jaw‐ and face pain compared to middle‐aged and elderly women. TMD‐related symptoms of pain were significantly associated with poor self‐reported general health and correlated with OHQoL as assessed by the oral health impact profile 14 questionnaire.

Conclusion

Being women and having moderate to poor self‐reported general health were associated with clinical signs and self‐reported symptoms of pain in the jaw, face and head region. Self‐reported symptoms of TMD correlated more strongly with OHQoL than clinical signs.

Status of Tooth Loss and Denture Restoration in Chinese Adult Population: Findings from the 4th National Oral Health Survey

OBJECTIVE

To investigate the status of tooth loss and denture restoration in Chinese adults, analyse the changing trend and provide fundamental data for oral health policy.

METHODS

According to the protocol of the 4th National Oral Health Survey, a multistage stratified random cluster-sampling method was used to enrol adult subjects aged 35 to 44, 55 to 64 and 65 to 74 years in all 31 provinces, municipalities and autonomous regions of the mainland of China. The status of tooth loss and denture restoration was investigated. SPSS20.0 software was used for statistics analysis.

RESULTS

Among the 13,464 subjects investigated, 13.8% had complete dentition, 84.4% had dentition defects, and 1.8% was edentulous. Urban subjects showed a significantly higher proportion of complete dentition than those in rural (P = 0.02), and males showed the statistically higher proportion of complete dentition than females (P = 0.01). The mean of remaining teeth was 26.1 ± 6.90, which in urban areas was significantly higher than in rural areas (P < 0.01). The means of remaining teeth were 29.6 ± 2.3, 26.3 ± 6.1, and 22.5 ± 8.7 in the 35 to 44, 55 to 64 and 65 to 74 age groups, respectively. The detection rate of fixed partial dentures (FPD) was statistically higher in urban than in rural areas and in males than that in females (P < 0.01). The detection rate of removable partial dentures (RPD) was statistically higher in urban areas than in rural locations (P < 0.01). However, the detection rates of irregular denture and unrepair of tooth loss were both significantly lower in urban than in rural areas (P < 0.01). The rate of restoration of tooth loss was 41.6% in Chinese adults.

CONCLUSION

Although the tooth loss and denture restoration status recorded in the survey was improved compared with the results of 10 years ago, more efforts need to be made on strengthening oral health promotion, particularly for elderly people and those living in rural areas.

Dental and periodontal health in Finnish adults in 2000 and 2011

OBJECTIVE

We assessed dental and periodontal health in adults aged ≥30 years living in southern and northern Finland as part of the Health 2000/2011 Surveys (BRIF8901).

MATERIAL AND METHODS

Clinical findings in 2000 (n = 2967) and 2011 (n = 1496) included the presence of teeth and number of teeth with caries, fillings, fractures or periodontal pockets.

RESULTS

Edentulousness decreased in all age groups. The prevalence of those with no caries increased from 67% to 69% in men and from 80% to 85% in women, and of those with no periodontal pocketing from 26% to 30% in men and from 39% to 42% in women. In 2011, the mean number of decayed teeth was 0.8 in men and 0.3 in women, and the corresponding mean numbers of teeth with deepened periodontal pockets 5.6 and 3.7. The gender difference had levelled concerning edentulousness, number of teeth and DMF teeth, but still existed in the occurrence of caries and periodontal pocketing.

CONCLUSION

The findings were in line with other population-based reports in the 2000s. However, periodontal health in Finland seems not to be as good as in many European countries and in the USA.

Oral and Dental Health Status among Adolescents with Limited Access to Dental Care Services in Jeddah

The purpose of this study was to assess the prevalence and associated factors of dental caries and periodontal diseases among 14–19-year-old schoolchildren with limited access to dental care services. A cross sectional study design was conducted during field visits to seven governmental schools in Al-Khomrah district, South Jeddah, over the period from September 2015 to May 2016. Clinical examinations and administered questionnaires were carried out in mobile dental clinics. The dentists carried out oral examinations using the dental caries index (DMFT), the simplified oral hygiene index (OHI-S), and the community periodontal index for treatment needs (CPITN). Statistical analyses were performed using SPSS 20. A total of 734 schoolchildren were examined. The prevalence of decayed teeth was 79.7% and was significantly higher among boys (88.9%) than girls (69.0%). About 11% of students had missing teeth, with a significantly higher figure among females than males (15.9% versus 7.3%); 19.8% of students had filled teeth. Moreover, a DMFT of seven or more was significantly more prevalent among males (43.3%) than females (26.8%), while the percentage of females with sound teeth was significantly higher than for males (20.4% and 9.6% respectively). The CPITN revealed 0, 1 and 2 scores among 14.6%, 78.2%, and 41.6% respectively. Males had a significantly higher percentage of healthy periodontal condition (23.8%) than females (3.8%). Dental caries prevalence was moderate to high, calculus and gingival bleeding were widespread among schoolchildren, and were more prevalent among students with low socioeconomic status.

Epidemiology of dental caries among adolescents in Tamil Nadu, India

OBJECTIVE

Economic and dietary changes in the Indian state of Tamil Nadu have led to compromised oral health status of the adolescent population. Adequate epidemiological data are not available to address the prevention or treatment needs in this region of India. The aim of this study was to measure the prevalence and severity of dental caries among adolescents of Tamil Nadu, a southern state of India.

METHODS

The study sample included 974 adolescent school students (12-15 years of age) from both rural and urban areas of Tamil Nadu, India. The decayed, missing and filled teeth (DMFT) index of these students was measured using the World Health Organization oral health survey method, in a quantitative cross-sectional study.

RESULTS

The oral health survey indicated that the prevalence of dental caries among adolescents in rural and urban areas of Tamil Nadu was 61.4%, with an average DMFT score of 2.03. Multiple regression analyses indicated factors such as gender, mother's education, type of school and caste as significant predictors of dental caries.

CONCLUSION

Female gender, Scheduled Caste and Tribes attending public schools in rural areas were identified as the more vulnerable populations to be affected by dental caries. Oral health policies should be targeted to these adolescent populations in the Tamil Nadu region.