Assessment of predictors of global self‐ratings of oral health among Korean adults aged 18‐95 years

Objectives: The aims of this study were to assess predictors of global self‐ratings of oral health (GSROH) and to examine whether they varied by age among Korean adults aged 18‐95 years. Methods: Data from 4,546 adults aged 18‐95 years completing the Korean National Oral Health Survey 2006 were included in the analysis. Results: Subjects' mean age was 43.5 years, with 12.1 percent aged ≥65 years; 47.8 percent were men; and 2.5 percent were edentulous. The predictors of GSROH in adults were number of missing teeth, concern about oral health, and difficulty in chewing. While wearing removable dentures was associated only in elders, perceived treatment need was associated in younger age groups. The number of decayed and filled teeth was significant only in the 18‐44 age group. Conclusions: GSROH status was associated with measures of oral disease, oral functional problems, oral health behaviors, concerns, and perceived treatment needs, and it varied by age.     

Self-assessed oral health, cognitive vulnerability and dental anxiety in children: testing a mediational model

Carrillo‐Díaz M, Crego A, Armfield JM, Romero M. Self‐assessed oral health, cognitive vulnerability and dental anxiety in children: testing a mediational model. Community Dent Oral Epidemiol 2012; 40: 8–16. © 2011 John Wiley & Sons A/S Abstract – Objective: To explain the association between children’s self‐perceived oral health status and dental anxiety, by considering their levels of cognitive vulnerability. Methods: Participants were 161 children (47.8% female; mean age = 11.93 years) who filled in a questionnaire comprising self‐assessed oral health‐related status, dental treatment‐related cognitive vulnerability and dental anxiety measures. Gender, age and number of decayed, missing and filled permanent teeth were controlled for. Bivariate correlations, hierarchical regression analyses and structural equation modelling were conducted to test the hypotheses. Results: Subjective oral health status, cognitive vulnerability variables and dental anxiety were strongly correlated. Regression and structural models testing the mediating effects of cognitive vulnerability variables on the relationship between perceived oral health and dental anxiety were supported. Conclusions: The activation of the cognitive vulnerability schema, as a mediating variable, is a mechanism by means of which children’s self‐perceptions of a poor oral health might lead to dental anxiety. Both components of vulnerability analysed (threat and disgust) contribute decisively to this potential process.     

Oral health impacts among adults in Finland: competing effects of age, number of teeth, and removable dentures

The aims of the present study were to evaluate the prevalence and severity of oral health impacts among adults and to analyse the effects of age, gender, level of education, number of teeth, and removable denture wearing on these impacts. Nationally representative data ( n  = 5,987) on Finnish adults aged 30+ yr were gathered in an interview, in a clinical examination, and by a questionnaire including the 14-item Oral Health Impact Profile. Subject age and the number of teeth were significantly associated with oral impacts (occurring fairly or very often) when the effects of gender, educational level, and removable dentures were considered. When subjects ≥ 75 yr of age were used as the reference group, the odds ratios (95% confidence interval) were 0.5 (0.3–0.8) and 0.7 (0.5–0.9) for 30–34-yr-old and 34–74-yr-old subjects, respectively. The odds ratios for those with 1–9 teeth and for those who were edentate were 3.4 (2.4–4.9) and 4.0 (2.6–6.3), respectively (20+ teeth as reference). Number of teeth modified the effect of denture wearing, and age modified the effect of educational level on oral impacts. Impaired subjective oral health related to many missing teeth might be improved by wearing removable dentures. Population groups needing special attention are young people with low education and those for whom only a few missing teeth are replaced with removable dentures.     

What contributes to self‐rated oral health among community‐dwelling older adults? Findings from the ElderSmile program

Objectives: As part of ongoing efforts by the Columbia University College of Dental Medicine to devise community‐based models of health promotion and care for local residents, we sought to answer the following query: “What contributes to self‐rated oral health among community‐dwelling older adults?” Methods: The present study is cross sectional in design and centrally concerned with baseline data collected during community‐based screenings of adults aged 50 years and older who agreed to participate in the ElderSmile program in northern Manhattan, New York City. The primary outcome measure of interest is self‐rated oral health, which was assessed as follows: “Overall, how would you rate the health of your teeth and gums – excellent, good, fair, or poor?” Results: More than a quarter (28.5 percent) of ElderSmile participants aged 50 years and older reported that their oral health was poor. After adjustment for age (in years), place of birth, educational level, and dental insurance status in a logistic regression model, recent visits to the dentist (within the past year versus more than a year ago) contributed to better self‐rated oral health and non‐Hispanic Black race/ethnicity, dentate (versus edentulous) status, tooth decay as measured by decayed missing filled teeth, and severe periodontal inflammation contributed to worse self‐rated oral health in this population. Conclusions: Recent dental care contributed to better self‐rated oral health among community‐dwelling older adults living in northern Manhattan. Significant gradients were evident in the caries experience and periodontal inflammation of dentate adults by self‐rated oral health, suggesting that untreated oral disease contributes to poor self‐rated oral health.     

Income gradients in oral health according to child age

This study aimed to confirm whether the well‐known income disparities in oral health seen over the life course are indeed absent in 9‐ to 11‐yr‐old children, and to explore the role of access to dental care in explaining the age‐profile of the income gradient in child oral health. We used data from the 2007 United States National Survey of Children's Health. Income gradients in parental reports of children's decayed teeth or cavities, toothache, broken teeth, bleeding gums, and fair/poor condition of teeth were assessed in stratified analyses according to age of child (1–5, 6–8, 9–11, 12–14, and 15–17 yr), using survey logistic regression to control for family‐, parental‐, and child‐level covariates. Health insurance status and use of preventive dental care were the indicators for children's access to dental care. The adjusted ORs for the effect of family income on having decayed teeth or cavities, toothache, and fair/poor condition of teeth were not significant in 9‐ to 11‐yr‐old children. Different age‐patterns were found for broken teeth and bleeding gums. The attenuation of the income gradients in having decayed teeth or cavities, toothache, and fair/poor condition of teeth, previously seen in 9‐ to 11‐yr‐old children, was also seen in 15‐ to 17‐, 12‐ to 14‐, and 6‐ to 8‐yr‐old children, respectively, after controlling for children's access to dental care. This study supports the attenuation of income inequalities in oral health in 9‐ to 11‐yr‐old children. Access to dental care could attenuate income gradients in oral health in other age groups.     

Oral health in SFR Yugoslavia in 1986

A pilot oral health epidemiological survey using WHO assessment forms was conducted in Yugoslavia in the year 1986. The study population consisted of 2600 persons aged 6, 12, 15, 18, 35-44, and over 65 yr. The survey included 22 towns (11 developed and 11 underdeveloped) in the six Republics and two Provinces of Yugoslavia. The results showed the prevalence of dental caries in the Yugoslav population to be very high (98.7% in 12-yr-olds). The mean decayed, missing, and filled teeth (DMF) scores were as follows: 6.1 at age 12 yr, 9.6 at age 15, 10.9 at age 18, 18.0 at age 35-44, and 28.0 in persons aged over 65 yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr, while loss of sextants prevailed in persons aged over 65 yr.     

Relative oral health outcome trends between people inside and outside capital city areas of Australia

Background: The aim of this study was to evaluate relative change over 17 years in clinical oral health outcomes inside and outside capital city areas of Australia. Methods: Using data from the National Oral Health Survey of Australia 1987–88 and the National Survey of Adult Oral Health 2004–06, relative trends in clinical oral health outcomes inside and outside capital city areas were measured by age and gender standardized changes in the percentage of edentate people and dentate adults with less than 21 teeth, in mean numbers of decayed, missing and filled teeth, and mean DMFT index. Results: There were similar reductions inside and outside capital city areas in the percentage of edentate people (capital city 63.7%, outside capital city 60.7%) and dentate people with less than 21 teeth (52.5%, 50.1%), in the mean number of missing teeth (34.3%, 34.5%), filled teeth (0.0%, increase of 5.5%), and mean DMFT index (21.2%, 19.2%). The reduction in mean number of decayed teeth was greater in capital city areas (78.0%) than outside capital city areas (50.0%). Conclusions: Trends in four of the five clinical oral health outcomes demonstrated improvements in oral health that were of a similar magnitude inside and outside capital city areas of Australia.     

Oral health‐related quality of life of removable partial denture wearers and related factors

This study aims to investigate the oral health‐related quality of life (OHRQoL) in a group of removable partial denture (RPD) wearers in Shiraz (Iran), using the Persian version of the Oral Health Impact Profile (OHIP‐14). Two hundred removable partial denture wearers had completed a questionnaire regarding patients' demographic characteristics and denture‐related factors. In addition, the OHIP‐14 questionnaire was filled out by interviewing the patients. Two measures of interpreting the OHIP‐14 scales were utilised: OHIP‐14 sum and OHIP‐14 prevalence. The relationship of the patients' demographic characteristics and denture‐related factors, with their OHRQoL was investigated. The mean OHIP‐14 sum and OHIP‐14 prevalence of RPD wearers were 13·80 (±10·08) and 44·5%, respectively. The most problematic aspects of OHIP‐14 were physical disability and physical pain. Twenty‐seven percentage and 24% of participants had reported meal interruption and eating discomfort, respectively. OHIP‐14 prevalence and OHIP‐14 sum were found to be significantly associated with factors representing RPD wearer's oral health such as self‐reported oral health and frequency of denture cleaning. Furthermore, OHIP‐14 prevalence and OHIP‐14 sum were significantly associated with factors related to frequency of denture use such as hours of wearing the denture during the day and wearing the denture while eating and sleeping. Therefore, it can be concluded that the OHRQoL of the patients of the study was generally not optimal and found to be strongly associated with oral health.     

The oral status of elderly removable partial denture wearers

A random sample of 1019 elderly home dwelling persons participated in this study. There were 809 dentate respondents, 28.6% of whom wore removable partial dentures. They were examined for coronal and root caries, gingival recession, pocket depth and loss of gingival attachment. The removable partial dentures were also evaluated. Abutment teeth were found to be more likely to have caries and periodontal disease than all other teeth. Using a manova statistical procedure, the analysis indicated that the partial denture itself, irrespective of any professionally determined problems with the denture, appears to affect coronal and root caries on the teeth of partial denture wearers. Partial dentures judged to need repair or adjustment were related to periodontal status. The data on adverse effects of partial dentures suggest a need for patient education by the dentist and through public health measures, and good oral self care and regular professional recall for people who wear removable partial dentures.     

402名老年人口腔健康调查

目的：调查金山区敬老院内老年人的口腔健康状况,描述其现状,为老年人口腔护理提供相关依据。方法：采用分层整体抽样方法,收集金山区6家敬老院共402名老年人牙缺失、义齿修复以及刷牙次数等情况,采用SPSSl3．0软件包进行统计学分析。结果：金山区敬老院402名老年人中牙缺失人数为390人,失牙率达到97．01％,而义齿修复率仅为25．64％;其中全口无牙颌人数为102名,全口义齿修复率为72．54％;每天不刷牙的人数为180人,占到44．77％。结论：目前金山区老年人口腔健康自我重视程度不够,且缺乏保健意识,口腔状况不容乐观。建议金山区牙防所进一步加强辖区老年人的龋病和牙周病防治的宣教力度,提升居民口腔保健意识,减少失牙,改善老年人的缺牙修复水平,提高生活质量。     

Oral health conditions and denture treatment needs in institutionalized elderly people in Japan

Oral health conditions, including dental conditions, temporomandibular joint (TMJ) conditions, denture status, and oral hygiene status, were assessed on 1908 institutionalized elderly people 65 yr of age and older at 29 of the 30 existing institutions in the city of Kitakyushu, Japan. The percentage of edentulous people was 27% in the 65-74-yr-old group, and increased with age to 56% in the 85 yr and older group. In dentate persons, the mean number of remaining teeth and DF teeth were 13.4 and 8.6, 9.5 and 6.8, and 8.4 and 6.5 in the groups aged 65-74 yr old, 75-84 yr old, and 85 yr and older, respectively. 81% of all the persons examined had no unusual symptoms in their TMJ. A clicking sound was the most frequent symptom (17%). Hygiene of both their teeth and dentures was very poor. Of all the subjects, 36% needed new full and/or partial denture(s), and 41% needed only repair. When the institutionalized elderly people were compared according to their general health condition, no clear differences were observed in percentage of edentulousness, mean number of remaining teeth and DF teeth, and TMJ conditions. However, a higher level of both untreated teeth and denture treatment needs, and poorer oral hygiene, was found in elderly people having poor general health than was observed in those with better health.(ABSTRACT TRUNCATED AT 250 WORDS)     

402名老年人口腔健康调查

目的：调查金山区敬老院内老年人的口腔健康状况,描述其现状,为老年人口腔护理提供相关依据。方法：采用分层整体抽样方法,收集金山区6家敬老院共402名老年人牙缺失、义齿修复以及刷牙次数等情况,采用SPSSl3．0软件包进行统计学分析。结果：金山区敬老院402名老年人中牙缺失人数为390人,失牙率达到97．01％,而义齿修复率仅为25．64％;其中全口无牙颌人数为102名,全口义齿修复率为72．54％;每天不刷牙的人数为180人,占到44．77％。结论：目前金山区老年人口腔健康自我重视程度不够,且缺乏保健意识,口腔状况不容乐观。建议金山区牙防所进一步加强辖区老年人的龋病和牙周病防治的宣教力度,提升居民口腔保健意识,减少失牙,改善老年人的缺牙修复水平,提高生活质量。     

The T-Health index: a composite indicator of dental health

The aim of this study was to determine the most appropriate set of weights with which to calculate the number of sound-equivalent teeth (T-Health index) against perceived oral health, which was used as a proxy of oral health status. This study used data from 5,057 dentate subjects, ≥ 30 yr of age, who were participating in the Finnish Health 2000 Survey. Subjects provided information on socio-demographic characteristics, behaviours and perceived oral health, and had a clinical examination. The T-Health index was calculated by assigning different weights to missing, decayed, filled, and sound teeth. Thirty-six alternative sets of weights were evaluated. The most appropriate set of weights was judged by the strength of the adjusted association between the T-Health index and levels of perceived oral health in ordinal logistic regression models and by the invariance of this association according to the extent of restorative treatment (non-significant statistical interaction). Among the 36 sets of weights used to calculate the T-Health index, assigning twice the weight of a decayed tooth to a filled tooth whilst keeping the weight for a filled tooth ≤ 0.20 provided the strongest association with levels of perceived oral health and did not vary according to the extent of restorative treatment.     

Oral health status of prison inmates--New South Wales, Australia

BACKGROUND: This paper assesses the oral health status in a prison population and identifies risk factors associated with oral health. METHODS: Cross-sectional stratified random sample of 789 prisoners (657 males and 132 females) from 27 correctional centres across New South Wales, stratified by sex, age and aboriginality. A face to face interview was used to collect information on health status and behavioural risk factors. A subset of participants (312 males and 22 females) received an oral examination which enabled the decayed, missing or filled permanent teeth (DMFT) score to be calculated. RESULTS: In the last 12 months 391 (50 per cent) inmates had visited a dentist. Reports on treatment received at this last visit were mainly for dental examinations, (62 per cent), dental fillings, (38 per cent), and dental extractions (28 per cent). Self-reported dental needs indicated that 42 per cent perceived the need for a check-up; the perceived need for dental fillings was highest in females compared with males. The mean DMFT for the population was 20.4 and 3.4 for decayed teeth. CONCLUSIONS: This survey demonstrates that the standard of past oral health care for prison inmates is low. There is a need to be more attentive to oral health promotion as eventually respondents will be returning to the community.     

Oral health status and dental needs of autistic children and young adults

Aim: Children with autism might need more dental care than non‐autistic, healthy children. The aims of this study were: (a) to describe the caries experience and treatment needs of autistic children aged 6–16 years in the United Arab Emirates; and (b) to provide baseline data at national and regional levels to enable comparisons and future planning of dental services for children with autism. Methods: All children attending a day centre in Sharjah, United Arab Emirates, for autism were selected for the study. Sixty‐one autistic children aged 6–16 years (45 males and 16 females) were included in the study. Each patient received a complete oral and periodontal examination using codes and criteria as described by the World Health Organization. Results: The overall mean for Decayed, Missing, and Filled Teeth/decayed, missing, and filled teeth was 2.4. Female autistic children had significantly higher mean Decayed, Missing, and Filled Teeth/decayed, missing, and filled teeth scores (4.4) than males (1.63). The percentage of decayed, missing, and filled teeth increased with increasing age. The restorative index and met need index for the autistic children aged 11–15 years were 0.02 and 0.10, respectively. Conclusion: Effective oral health promotion strategies need to be implemented to improve the oral health status of autistic children.     

Dental status of pregnant women attending a Brisbane maternity hospital

A sample of 314 consecutive women attending for their first antenatal visit at a public hospital were examined according to the WHO survey procedure. The women's age ranged from 16 to 42 yr with a mean of 23.5 yr. Only 3% were edentulous in both jaws, but 13% had some form of denture. A quarter had pocketing in at least one sextant and only 16% were free of gingivitis. The average number of DMF teeth was 15.8, comprising 2.7 decayed, 4.5 missing and 8.6 filled teeth; 70% had teeth needing restoration and 10% had at least one tooth needing extraction. There were significant relationships between DMF score and age (positive) and between number of teeth needing restoration and age, educational level, and the woman's own perception of her dental health (all inverse). Some form of dental attention was needed by 86% of the women; 12% had conditions needing immediate attention. By comparison with a 1971 study of pregnant women in Brisbane, there has been a marked decline in DMFT score (from 19.1 to 15.8).     

Validity of self‐reported tooth counts and masticatory status study of a Japanese adult population

Self‐reported measures of oral health are often used to assess oral health in populations or groups, but their validity or reliability needs repeated confirmation. The objective of this cross‐sectional study was to evaluate the validity of self‐reported tooth counts and masticatory status, using data obtained from a sample of Japanese adults. A total of 2356 adults aged 40 to 75 years participated in a questionnaire survey and a clinical oral examination from 2013 through 2016. Self‐reported measures were compared with clinically measured values. For tooth counts, mean clinical and self‐reported tooth counts in all participants were 23.68 and 23.78 teeth, and no significant difference was detected. Spearman's, Pearson's and intra‐class correlation coefficients between clinical and self‐reported tooth counts were 0.771, 0.845 and 0.843, respectively. According to the Bland‐Altman analysis, the mean difference between clinical and self‐reported tooth counts was ?0.098 (95% CI : ?0.242, 0.047). The upper limit of agreement was 6.919 (95% CI : 6.669, 7.169), and the lower limit of agreement was ?7.115 (95% CI : ?7.365, ?6.865). No significant fixed or proportional bias was observed. For masticatory status, the crude or age‐ and gender‐adjusted mean numbers of total teeth, posterior teeth and 3 kinds of functional tooth units significantly decreased with the deterioration of masticatory status. This study indicated that self‐reports were within an acceptable range of clinical measures. Therefore, self‐reports were considered valid alternatives to clinical measures to estimate tooth counts and masticatory status in a current Japanese adult population.     

Is poor access to dental care why people outside capital cities have poor oral health?

Background : Why oral health status outside capital cities is poorer than that in capital cities has not been satisfactorily explained. The aim of this study was to determine if the reason was poorer access to dental care. Methods : Data were obtained from the Australian National Survey of Adult Oral Health (2004–06). Oral health status was measured by DMFT Index, and numbers of decayed, missing and filled teeth. A two‐step analysis was undertaken: comparing the dependent variables by location, socio‐demographic confounders and preventive dental behaviours, and then including six access to dental care variables. Results : Of the 14 123 people interviewed, 5505 were examined, and 4170 completed the questionnaire. With socio‐economic parameters in the first regression model, non‐capital city people had higher DMFT (regression coefficient = 1.15, p < 0.01), more decayed (0.42, p < 0.01) and missing teeth (0.85, p < 0.01), but not filled teeth (?0.11, p = 0.71), than capital city based people. In the second step analysis, non‐capital city people still had a greater DMFT (1.01, p < 0.01), more decayed (0.27, p = 0.03) and missing teeth (0.74, p < 0.01), but not filled teeth (0.00, p = 0.99) than capital city based people. Conclusions : Access to dental care was not the only reason why people outside capital cities have poorer oral health than people living in capital cities.     

Prevalence of root caries in a selected population of older adults in Japan

In this study, the prevalence of root caries in a sample of Japanese elders was investigated along with various aetiological factors. Two hundred and eighty-seven independently living elderly people over the age of 60 years were examined for the prevalence of active, inactive, and filled root lesions as well as the number of teeth. General health, oral status and brushing habits were surveyed, and salivary flow was determined in terms of flow rate and subjective feeling of dry mouth during eating. About 39% of the subjects had one or more decayed roots and 53.3% had at least one decayed or filled lesion. Root caries was seen most frequently on canine teeth followed by the first premolar. The number of decayed or filled lesions increased with increasing number of residual teeth (Kruskal-Wallis test, P = 0.033), however, there was no association between the proportion of teeth with root decay and the number of teeth. For subjects with 20 or more teeth, the number of decayed roots is likely to be lower in subjects who reported brushing frequently (P = 0.058), and higher in subjects with low salivary flow (P = 0.059) or subjective feeling of dry mouth (P = 0.052) (Chi-squared). The presence of decayed lesions is likely to be related to dry mouth (P = 0.057, odds ratio 3.13) and brushing frequency (P = 0.088, odds ratio 1.76) (Multiple logistic regression analysis). The results indicate a high frequency of root surface caries in this Japanese community-dwelling older population. Oral hygiene status and low salivary flow or perceived dry mouth were potential risk factors for disease.     

The impact of the National Denture Service on oral health-related quality of life among poor elders

The objective of this study was to assess the effects of the Korean National Denture Service (NDS) for poor elderly people requiring dentures on oral health-related quality of life (OHRQOL). Data from follow-up studies were collected from 439 subjects at eight public health centres who answered every question of a questionnaire, and the OHRQOL was measured at the baseline and at 3-month follow-up after receiving the NDS according to the type of denture provision. The multivariate linear mixed model with a public health centre as a random effect for the score change of Oral Health Impact Profile (OHIP)-14K was carried out to confirm the factors related to the improvement in OHRQOL. The mean OHIP-14K was 28.60 at the baseline time points, and there was a decrease in the OHIP-14 scores to 21.14 ± 12.52 at the 3-month follow-up of the removable partial denture beneficiaries. The changes in OHIP-14K among complete denture beneficiaries were 21.53 ± 12.01 for previously dentate subjects and 22.54 ± 11.12 for edentate subjects. The multivariate linear mixed model of dentate subjects demonstrated that the improvement in the OHRQOL was associated with the number of remaining teeth, satisfaction with denture and self-reported oral health status after 3 months. In the case of the edentate model, satisfaction with denture was the only factor related to the improvement in OHRQOL. This study revealed considerable improvement in OHRQOL among poor elderly people after NDS. Satisfaction with provision of dentures was associated with improvement in the OHRQOL.