Risk factors for oral diseases among workers with and without dental insurance in a national social security scheme in India

Objectives: The target population for this cross sectional study comprises subjects with and without social security in a national social security scheme. The study aimed to compare and assess the risk factors for oral diseases among insured (organised sector) and non-insured workers (unorganised sector) in New Delhi, India. Methods: The sample comprised a total of 2,752 subjects. Of these, 960 workers belonged to the formal or organised sector with a social security and dental health insurance and 1,792 had no social security or dental insurance from the informal or unorganised sector. Results: Significant differences were noted between the two groups for literacy levels, between-meal sugar consumption, tobacco-related habits and utilisation of dental care. Bleeding/calculus and periodontal pockets were present among 25% and 65.4% of insured workers, respectively. Similarly, 13.6% and 84.5% of non-insured workers had bleeding/calculus and periodontal pockets, respectively. The mean DMFT (decayed, missing, filled teeth) value among the insured workers and non-insured workers was 3.27 ± 1.98 and 3.75 ± 1.80, respectively. The association between absence of health insurance and dental caries was evident with an odds ratio (OR) of 1.94. Subjects with below graduate education were more prone to dental caries (OR = 1.62). Subjects who cleaned their teeth two or more times a day were less likely to have dental caries (OR = 1.47). Utilisation of dental care was inversely related to dental caries (OR = 1.25). Conclusion: The major risk factors for oral diseases in both the groups with similar socio-economic status were the lack of social security and health insurance, low literacy levels, high tobacco consumption and low levels of dental care utilisation.Key words: Dental insurance, oral health, organised sector, risk factors, social security     

Adult oral health inequalities described using area-based and household-based socioeconomic status measures

OBJECTIVES: To describe adult oral health inequalities using an area-based and household-based measure of socioeconomic status (SES). METHODS: Self-report questionnaires (seeking information on sociodemographic, oral health and oral self-care) were sent to a random sample of adults from the Dunedin South Electorate, New Zealand. Household- and area-based SES measures were collected. The main outcome measures were edentulism prevalence, average-poor self-rated oral health and not having visited a dentist for 2+ years. Data were weighted to produce population-based estimates. RESULTS: The response rate was 78.2%; the sample mean age was 47 years (sd, 17; range 18-92 years) and females comprised 54.0%. Edentulism was most prevalent among those from low-SES households who were resident in high-deprivation areas (P<0.0001). Poor self-rated oral health (P<0.0001) and 2+ years since the last dental visit (P<0.0001) were also most prevalent among these same individuals. In contrast, respondents from high-SES households located in the least deprived areas had the lowest prevalence of edentulism, poor self-reported oral health or 2+ years since their last dental visit. Those from the other household/area SES combinations occupied intermediate positions. CONCLUSIONS: There may be added value to dental public health in using a dual socio-economic measurement approach to population research, with greater oral health gains perhaps being possible by concentrating resources and clinical effort on people living in low-SES households in highly-deprived areas, rather than those living in low-SES households in areas that are not deprived.     

Predictors of dental care utilization among working poor Canadians

Abstract – Objective: This study used the Gelberg–Andersen Behavioral Model for Vulnerable Populations to identify predictors of dental care utilization by working poor Canadians. Methods: A cross‐sectional stratified sampling study design and telephone survey methodology was used to collect data from a nationally representative sample of 1049 working poor individuals aged 18 to 64 years. Working poor persons worked ≥20 h a week, were not full‐time students and had annual family incomes <$34 300. A pretested questionnaire included sociodemographic items, self‐reported oral health measures and two dental care utilization outcomes: time since their last dental visit and the usual reason for dental visits. Results: Hierarchical stepwise logistic analyses identified independent predictors associated with visiting the dentist >1 year ago: male gender (OR = 1.63; P = 0.005), aged 25–34 years (OR = 2.05; P = 0.02), paying for dental care with cash or credit (OR = 2.31; P < 0.001), past welfare recipients (OR = 1.65; P = 0.03), <21 teeth (OR = 4.23; P < 0.001) and having a perceived need for dental treatment (OR=2.78; P < 0.001). Sacrificing goods or services to pay for dental treatment was associated with visiting the dentist within the past year. The predictors of visiting the dentist only when in pain/trouble were lone parent status (OR = 4.04; P < 0.001), immigrant status (OR = 1.72; P = 0.006), paying for dental care with cash or credit (OR = 2.71; P < 0.001), a history of an inability to afford dental care (OR = 1.62; P = 0.01), a satisfactory/poor/very poor self‐rated oral health (OR = 2.10; P < 0.001), number of teeth <21 (OR = 2.58; P < 0.001) and having a perceived need for dental treatment (OR = 2.99; P < 0.001). Conclusions: This study identified predisposing and enabling vulnerabilities that jeopardize the dental care‐seeking practices of working poor persons. Dental care utilization was associated with relinquishing spending on other goods and services, which suggests that dental care utilization is a competing financial demand for economically constrained adults.     

Third molor extractions among Australian adults: findings from the 2013 National Dental Telephone Interview Survey

Objectives: To identify, over the previous 12 months, whether: (i) dental insurance is associated with a higher number of third molar extractions (TME); (ii) single versus multiple TME is associated with self-rated oral health; and (iii) TME when 18–25 years of age is associated with fewer days absent from work because of dental problems. Methodology: Australia’s 2013 National Dental Telephone Interview Survey, which included: socio-demographics; and number of extractions, reasons for extractions, self-rated oral health and days absent from work because of dental problems, all in the past 12 months. Results: The majority of TME recipients were female [56.6%, standard error (SE) = 6.0%], 18–25 years of age (63.0%, SE = 5.4%), held a tertiary qualification (73.9%, SE = 5.4%), had a total annual household income of ≥$60,000 (58.3%, SE = 6.4%), were dentally insured (52.6%, SE = 6.2%) and received multiple TME (60.9%, SE = 8.5%). Number of TME was associated with having dental insurance [B = 0.97: 95% confidence interval (95% CI): 0.5–1.5] and days of work absence because of dental problems (B = 1.10; 95% CI: 0.26–1.94). Receiving single TME versus multiple TME was not associated with self-rated oral health (B = −0.25; 95% CI: −0.76 to 0.25). Receiving TME when 18–25 years of age versus when older than 25 years of age was not associated with days absent from work because of dental problems (B = 0.48; 95% CI: −0.37 to 2.33). Conclusion: Dental insurance was associated with a higher TME count without improving self-reported oral health in the short-term. Using age as a justification for prophylactic TME might be questionable because, receiving TME when 18–25 years of age versus when older than 25 years of age did not reduce days absent from work because of dental problems.Key words: Third molar, wisdom teeth, National Dental Telephone Interview Survey, dental insurance, Australia, self-rated oral health, extraction and over-management     

High educational attainment moderates the association between dental health‐care supply and utilization in Europe

In line with the theory of supplier‐induced demand, an increased physician density often goes along with a higher utilization of medical services, including dental services. This study aimed to assess whether dentist density and self‐employment are related to dental care use, and whether these relationships are moderated by patients' educational attainment. We used data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from over 20,000 respondents, 50 + yr of age, in 13 countries. We conducted multilevel logistic regressions with probability and type of dental treatment on individual education, country‐specific dentist density, and dentist remuneration, and their cross‐level interaction. Patients with a high educational level were more likely to report a dentist visit (OR = 2.1, 95% CI: 1.912–2.305) and to receive preventive care (OR = 1.9, 95% CI: 1.697–2.043) than those with a low educational level (reference category). Cross‐level interaction effects indicated that high dentist density decreases dental care utilization differences between patients with high (OR = 0.996, 95% CI: 0.993–0.999), medium (OR = 0.995, 95% CI: 0.991–0.999), and low education levels. This was also true for prevention use (OR = 0.996, 95% CI: 0.992–0.999 for patients with a high education level, and OR = 0.996, 95% CI: 0.993–1.000 for patients with a medium education level). The findings suggest that although dentist density is positively associated with dental care utilization, patients have differing susceptibilities to dental care supply.     

Evaluating Components of Dental Utilization among Adults with Diabetes and Matched Controls via Hurdle Models

ABSTRACT: BACKGROUND: About one-third of adults with diabetes have severe oral complications. However, limited previous research has investigated dental care utilization associated with diabetes. This project had two purposes: to develop a methodology to estimate dental utilization using claims data and to use this methodology to compare utilization of dental care between adults with and without diabetes. METHODS: Data included secondary enrollment and demographic data from Washington Dental Service (WDS) and Group Health Cooperative (GH), clinical data from GH, and dental-utilization data from WDS claims during 2002-2006. Dental and medical records from WDS and GH were linked for enrolees continuously and dually insured during the study. We employed hurdle models in a quasi-experimental setting to assess differences between adults with and without diabetes in 5-year cumulative utilization of dental services. Propensity score matching adjusted for differences in baseline covariates between the two groups. RESULTS: We found that adults with diabetes had lower odds of visiting a dentist (OR=0.74, p < 0.001). Among those with a dental visit, diabetes patients had lower odds of receiving prophylaxes (OR=0.77), fillings (OR=0.80) and crowns (OR=0.84) (p < 0.005 for all) and higher odds of receiving periodontal maintenance (OR=1.24), non-surgical periodontal procedures (OR=1.30), extractions (OR=1.38) and removable prosthetics (OR=1.36) (p < 0.001 for all). CONCLUSIONS: Patients with diabetes are less likely to use dental services. Those who do are less likely to use preventive care and more likely to receive periodontal care and tooth-extractions. Future research should address the possible effectiveness of additional prevention in reducing subsequent severe oral disease in patients with diabetes.     

The New York State Minority Health Survey: determinants of oral health care utilization

OBJECTIVES: To determine the factors associated with visits to a dentist and more specifically the role of dental insurance coverage and to explore the reasons for not visiting a dentist among minorities in New York State. METHODS: The Minority Health Survey was a one-time, statewide, random digit-dialed telephone survey. We drew a directed acyclic graph (DAG) of the potential determinants of oral health care utilization for our population of interest and modeled the independent variables as determinants of oral health care utilization. The data for this study were analyzed in SUDAAN using appropriate weights and variance adjustments that accounted for the complex sampling design. Hence, this report is generalizable to the New York State adult "minority" population. RESULTS: About 63 percent respondents had visited a dentist in the past one year. Having dental insurance (adjusted odds ratio [adj OR]=2.5), having more than high school education (adj OR=1.9), being younger (adj OR=2.3 for 18-25 years vs age 40 years or older), being married (adj OR=1.7), being dentate (adj OR=0.3 for edentulousness), and having higher income (adj OR=0.5 for middle vs high income) were significantly associated with having visited a dentist in the past year. Cost and awareness-related factors were the most common reasons for not visiting a dentist. Most of the year 2000 oral health objectives measurable in this survey were not met. CONCLUSION: Increasing dental insurance coverage and increasing awareness about oral health care would be the two biggest factors in meeting the goals of year 2010.     

Who has difficulty in registering with an NHS dentist?--A national survey.

AIMS: The aims of this paper are first, to determine the extent of difficulties the public are experiencing in obtaining a dentist undertaking NHS dental care. Second, to describe the personal and socio-demographic details of these groups using data from a national study. METHOD: The vehicle for this study was the Office for National Statistics Omnibus Surveys, undertaken in June and July of 1999. A random probability sample of 5,385 addresses was selected from the British Postcode Address File. Respondents were interviewed in their homes about how difficult they found it to obtain an NHS dentist. RESULT: A total of 3,739 adults took part in this study and the response rate was 69%. Nineteen per cent (705) claimed they found it difficult to get an NHS dentist. Bivariate analysis revealed that difficulty in obtaining an NHS dentist [excluding those who claimed they did not seek NHS dental care (781) and those who refused to answer or did not know (66)] was associated with age group (P < 0.01), gender (P < 0.05), social class (P < 0.01) and area of residency (P < 0.01). Moreover, difficulty in obtaining NHS dental care was also associated with time since last dental visit (P < 0.01), method of payment for last dental visit (P < 0.01) and use of 'out of hours' emergency dental services (P < 0.01). Further analysis revealed that among the socio-demographic variables, area of residency emerged as the most important factor in determining difficulty in obtaining an NHS dentist. Those who lived in the South of England (London, South-East or South West) were more than twice as likely to experience difficulty in obtaining an NHS dentist, OR = 2.40, 95% CI 2.00-2.88 compared with those who lived elsewhere in Great Britain. CONCLUSION: One in five adults in Britain claim that they are experiencing difficulties in finding a dentist who will provide NHS dental care. In particular, those using private dental services and residents of the South of England have experienced such difficulties.     

Factors influencing dental utilisation in Greece

OBJECTIVE: To identify factors that influence utilisation of dental services in Greece. METHODS AND MATERIALS: Data was obtained through the "WHO Multi-Country Survey Study on Health and Responsiveness", a survey organised by the WHO and locally executed by the National School of Public Health. A national random sample of 5,000 prospective participants was selected through the national phone directory. Of those, half (2,500 participants) were mailed the self-administered questionnaire designed to assess the general health status of the Greek population, while the other half were mailed the questionnaire designed to assess responsiveness of the Greek healthcare system. Both research instruments contained a question related to utilisation of dentists during the last month, and several potential predictors. 1,819 individuals answered the questions and participated in the analysis. Two main outcomes were identified: a) reporting of any utilisation vs. none, statistically analyzed using Logistic Regression, and b) frequency of utilisation (number of visits), analyzed using Poisson Regression. RESULTS: 25.1% reported at least one dental visit, while the mean number of visits during the last month was 0.48. Income gave an odds ratio of 1.139 (95% CI:1.038, 1.251). Dental visit frequency increased with increased income (b = 0.11, p = 0.004) and decreased whith improved self-rated health (b = 0.15, p = 0.003) and age (b = -0.006, p = 0.026). CONCLUSIONS: Income is an important determinant of dental utilisation in Greece; it influences both the percentages and the frequency of such utilisation. Additionally, increased age and high self-rated health are associated with less frequent dental utilisation.     

Age of first dental visit and predictors for oral healthcare utilisation in preschool children

Purpose: To assess the age the of the first dental visit and the association of self-perceived oral health, socioeconomic and clinical indicators with healthcare utilisation in Brazilian preschool children. Materials and Methods: An epidemiological survey with 455 5- to 59-month-old children was conducted on National Children's Vaccination Day in Santa Maria, RS, Brazil. Data about age and reasons for the first dental visit, healthcare utilisation, socioeconomic status and self-perceived oral health were collected by means of a parental semi-structured questionnaire. Calibrated examiners evaluated the prevalence of dental caries (WHO) and dental trauma. The assessment of the association used Poisson regression models (prevalence ratio; 95% confidence interval [CI]). Results: A total of 24.2% (95% CI: 20.3% to 28.4%) of the study sample had already had a first dental visit. Older children, those with dental caries and dental trauma and whose mothers had a higher level of education were more likely to have gone to the dentist. Children of low socioeconomic status were more likely to have visited public than private healthcare services. The reasons for the first dental visit were associated with clinical indicators of the sample. The distribution of utilisation of the types of oral healthcare services (public or private) varied across the socioeconomic groups. Non-white children with dental caries and dental trauma tended to visit a dentist only for treatment reasons. Conclusion: Socioeconomic and clinical indicators are associated with the use of dental services, indicating the need for strategies to promote public health and reorientation of services that facilitate dental access for preschool children.     

Are Oral Health Status and Care Associated with Anxiety and Depression? A Study of Portuguese Health Science Students

The relationship between oral health and anxiety/depression were assessed in a cross-sectional study conducted in 388 Portuguese students from the Health Sciences (age: 21 +/- 3 years, 75% women). Oral health included prevalence of reported tooth pain/gum bleeding, dentist attendance, and dentifrice and dental floss use. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. Subjects with anxiety or depression had a higher frequency of perceived gum bleeding and reported a higher dentist attendance than normal subjects. On multivariate analysis, anxiety was significantly and independently related to perceived toothache (OR = 2.90, 95% CI: 1.25-6.72) and dentist attendance (OR = 2.15, 95% CI: 1.18 - 3.91) whereas depression was associated with perceived gum bleeding (OR = 4.96, 95% CI: 1.68 - 14.59), and no differences were found regarding teeth brushing or dental flossing. The author concludes that anxiety and depression are related to perceived toothache and gum bleeding, but this association cannot be explained by decreased dental care.     

Is trust a predictor of having a dental home?

BACKGROUND: Developing a better understanding of sociodemographic variables that predict having a dental home may aid in reducing the disparities in oral health among minorities in the United States. METHODS: The authors used data from a telephone survey of 1,005 randomly selected low-income residents (403 men, 602 women) aged 18 or older in two Florida counties--Miami-Dade and Duval--to examine the sociodemographic characteristics of people who reported having a regular dentist. RESULTS: Bivariate analyses showed that respondents' levels of trust in physicians and dentists were strongly associated with having a dental home. After adjusting for other variables in a multiple logistic regression model, the authors found that respondents with a moderate level of trust in physicians and dentists were 52 percent less likely (odds ratio, or OR, = 0.48; 95 percent confidence interval, or CI, 0.26 to 0.89) and those with low trust were 54 percent less likely (OR = 0.46; 95 percent CI, 0.28 to 0.75) than those with high trust to have a regular dentist. Race/ethnicity, sex, age, education level and employment status remained significant correlates of having a regular dentist in the multivariate model. CONCLUSIONS: The results of this study suggest that efforts to reduce disparities in access to dental care and establish dental homes should include programs to increase patients' trust in dental professionals. CLINICAL IMPLICATIONS: While policy-makers consider ways to improve access to dental care, dental professionals should work at the community level to increase the level of trust of the community in the dental health provider.     

The Influence of Dental Insurance on Institutionalized Older Adults in Ranking Their Oral Health Status

To assess whether dental insurance influences how institutionalized older adults ages 65 and older rank their oral health status, a census survey was designed for residents of Durham's (Canada) Municipal Homes for the Aged. The odds ratio (OR) and the Cochran & Mantel‐Haenszel's OR were used to estimate the crude and adjusted effect of dental insurance on oral health status, respectively. Overall, 64 percent participated in the interview. Oral health status was ranked as “good,”“very good” or “excellent” by 57 percent of the participants. This ranking was clearly unrelated to the residents having dental insurance, as only 28 percent had dental coverage. Significant effect modifiers included age, dental status and whether the participant had visited the dentist within the last year. Dental insurance positively influenced how dentate participants ranked their oral health status (OR = 2.26; 95 percent CI 1.19; 4.28). In edentulous participants, age and visiting the dentist within the last year modified the effect of dental insurance on oral health status. Having dental insurance reduced the odds of reporting “good,”“very good” or “excellent” oral health (OR = 0.20; 95 percent CI = 0.08; 0.49) among the participants ages 85 and older who did not visit the dentist within the last year; however, the opposite was true for their younger counterparts who visited the dentist within the last year (OR = 7.20; 95 percent CI = 1.08; 47.96). In this population, therefore, dental insurance was associated with higher oral health status rank among the dentate, but its effect on the edentulous population depended on age and the pattern of visiting the dentist.     

Dental care utilization among North Carolina rural older adults

Objectives: This analysis delineates the predisposing, need, and enabling factors that are associated with regular and recent dental care in a multiethnic sample of rural older adults. Methods: A cross-sectional, comprehensive, oral-health survey conducted with a random, multiethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Logistic regression models assessed the simultaneous associations of dental care with predisposing, enabling, and need factors. Results: Almost no edentulous rural older adults received dental care; 27.1 percent of dentate rural older adults had received regular dental care, and 36.7 percent had received recent dental care. Predisposing (less than high-school education, dental anxiety), enabling (no regular place for dental care), and need factors (no filled teeth) reduced the odds of regular dental, while predisposing (dental anxiety), enabling (no regular place for dental care), and need factors (no filled teeth) reduced the odds of recent dental care. Having excellent, very good, or good self-rated oral health increased the odds of receiving regular and recent dental care. Conclusions: Regular and recent dental care are infrequent among rural older adults. Contrary to expectations, those not receiving dental care are those who most need care; this has been referred to as the Paradox of Dental Need. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public-health policy to improve the health and quality of life of older adults in rural communities.     

Income or education,which has a stronger association with dental implant use in elderly people in Japan?

Objectives: Although inequalities in dental implant use based on educational level have been reported, no study has used income as a proxy for the socioeconomic status. We examined: (i) income inequalities in implant use; and (ii) whether income or education has a stronger association with implant use in elder Japanese. Methods: In 2016, a self-reported questionnaire was mailed to participants aged 65 years or older living across Japan as part of the ongoing Japan Gerontological Evaluation Study. We used data from 84,718 respondents having 19 or fewer teeth. After multiple imputation, multi-level logistic regression estimated the association of dental implant use with equivalised income level and years of formal education. Confounders were age, sex, and density of dental clinics in the residential area. Results: 3.1% of respondents had dental implants. Percentages of dental implant use among the lowest (≤ 9 years) and highest (≥ 13 years) educational groups were 1.8 and 5.1, respectively, and among the lowest (0 < 12.2 ‘1,000 USD/year’) and highest (≥ 59.4 ‘1,000 USD/year’) income groups were 1.7 and 10.4, respectively. A fully adjusted model revealed that both income and education were independently associated with dental implant use. Odds ratios for implant use in the highest education and income groups were 2.13 [95% CI = 1.94–2.35] and 4.85 [95% CI = 3.78–6.22] compared with the lowest education and income groups, respectively. From a model with standardised variables, income showed slightly stronger association than education. Conclusion: This study reveals a public health problem that even those with the highest education but low income might have limited accessibility to dental implant services.Key words: Dental implant(s), access to care, dental services research, dental public health, epidemiology     

Determinants of oral health care utilization among diverse groups of immigrants in New York City

BackgroundFew studies have examined utilization of oral health care services among immigrants. The authors examined the determinants of utilization of oral health care among a diverse group of immigrants in New York City.MethodsThe authors examined and interviewed 1,417 foreign-born people, aged 18 to 65 years, who were residents of New York City. They conducted examinations by using criteria established by the National Institute of Dental and Craniofacial Research, Bethesda, Md. The authors used unconditional logistic regression to estimate odds ratios (ORs) and 95 percent confidence intervals for having visited a dentist within the previous year for each of the independent variables.ResultsMore than 70 percent of the participants lacked dental insurance and only about 31 percent reported that they had visited a dentist within the previous year. Flossing (OR = 1.18), dental insurance (OR = 1.58), having a regular source of dental care (OR = 4.76) and more filled teeth (1.33) were independent predictors of utilization of services.ConclusionsHaving a regular source of dental care and having dental insurance are important predictors of immigrants' utilization of oral health care services in New York City.Clinical ImplicationsThe study results suggest the importance of establishing affordable, culturally appropriate, community-based oral health care services to improve the oral health of vulnerable populations.     

Risk indicators for severe impaired oral health among indigenous Australian young adults

Background  

Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1) estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years); (2) compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3) ascertain the independent contribution of those risk indicators to severe oral health impairment in this population.     

Oral health behaviour and its determinants amongst Iranian dental students.

OBJECTIVES: To study the oral health behaviour (OHB) of Iranian senior dental students in relation to their gender, background characteristics, knowledge of preventive care, and attitudes towards preventive dentistry. MATERIALS AND METHODS: Using a cluster random sampling approach, a questionnaire survey was conducted with 327 senior dental students in seven dental schools. The questionnaire covered age, gender, parents' employment in dentistry, previous academic education in dental hygiene, oral self-care, most recent dental check-up, knowledge of preventive dentistry and attitudes towards it. Attending a dental check-up by a dentist or a classmate within the last year was defined as preventive care use. Chi-square test and logistic regression models were used for statistical analyses. RESULTS: Women reported significantly higher frequencies of tooth brushing (P < 0.001), fluoridated toothpaste use (P = 0.001) and flossing (P < 0.001) compared with men. Respondents who had been previously educated as dental hygienists had lower frequencies of eating sugary snacks (P < 0.001) and paid more attention to preventive care (P = 0.03) than others. Those with more extensive knowledge of preventive care reported higher frequencies of using fluoridated toothpaste (P = 0.05). Reported frequencies of brushing were higher amongst those with more positive attitudes (P = 0.03). In logistic regression models, having at least one parent employed as a dentist was significantly associated with higher frequencies of eating sugary snacks (P = 0.047, OR = 0.3) and more frequent preventive care use (P = 0.048, OR = 2.9). CONCLUSION: Education and training in preventive measures should be effective enough to overcome background characteristics. There is room for improving the OHB of Iranian dental students.     

Dental fear in Australia: who's afraid of the dentist?

BACKGROUND: This study aimed to describe both the prevalence of dental fear in Australia and to explore the relationship between dental fear and a number of demographic, socio-economic, oral health, insurance and service usage variables. METHODS: A telephone interview survey of a random sample of 7312 Australian residents, aged five years and over, from all states and territories. RESULTS: The prevalence of high dental fear in the entire sample was 16.1 per cent. A higher percentage of females than males reported high fear (HF). Adults aged 40-64 years old had the highest prevalence of high dental fear with those adults aged 80+ years old having the least. There were also differences between low fear (LF) and HF groups in relation to socioeconomic status (SES), with people from higher SES groups generally having less fear. People with HF were more likely to be dentate, have more missing teeth, be covered by dental insurance and have a longer time since their last visit to a dentist. CONCLUSIONS: This study found a high prevalence of dental fear within a contemporary Australian population with numerous differences between individuals with HF and LF in terms of socioeconomic, socio-demographic and self-reported oral health status characteristics.     

Social, demographic, clinical and lifestyle determinants of dental care visits in an urban sample of Portuguese adults

PURPOSE: To describe the use of dental care services in an urban sample of adults from Porto, and to quantify the association between dentist visits and social, demographic, clinical and lifestyle factors. MATERIALS AND METHODS: Participants were selected by random digit dialling, and interviewed with a structured questionnaire to obtain information on socio-demographic, clinical and lifestyle variables. Crude, and age- and education-adjusted Odds Ratios (ORadj) were computed by unconditional logistic and multinomial logistic regression to quantify the association between the use of dental care and each exposure. RESULTS: In the year preceding the interview, 51.1% of the subjects visited a dentist at least once. Dental visits were less frequent in subjects aged > or =70 years compared to those aged 18-29 years (ORadj = 0.66, 95% Confidence Interval [CI]: 0.45-0.98), and increased with education (from 23.8% in subjects with 0-3 school years to 67.9% in those with > 12 years of education, p < 0.001 for trend). The use of dental care services at least once in the previous year was more frequent in white-collar workers (ORadj = 0.69, 95% CI: 0.52-0.91), when a private doctor was the usual source of medical care (ORadj = 1.38, 95% CI: 1.06-1.79) and in those who visited a medical doctor in the previous year (ORadj = 1.96, 95% CI: 1.57-2.45). Diabetics were less likely to seek dental care (ORadj = 0.67; 95% CI: 0.48-0.93). CONCLUSION: Nearly half the adults from Porto had not visited a dentist in the previous year. Education was the factor most strongly associated with dentist attendance. No differences were observed regarding the determinants of one or two or more dental visits in the previous year.