Dental health behaviour among 25-44-year-old Danes

The purpose of the present investigation was to describe dental health behaviour in an adult Danish population and to study whether oral hygiene habits and consumption of sweets were affected by living conditions. The study group comprised 749 persons in the age group 25-44 years (82% of the original sample) and data on general health behaviour and dental health behaviour were collected by interviews. Regular dental visits were reported by 86%, 83% declared that they brush their teeth at least twice a day and toothbrushing after breakfast was reported by 51%. Regular use of toothpicks was reported by 45%, while dental floss was used by 22%. Dental visits varied according to education, income, work in shifts, sex, and self-assessment of dental health, while toothbrushing habits were affected by urbanization, sex, education, number of children in family, and self-assessment of dental health. Daily consumption of cakes/pastry was reported by 10%, six per cent consumed chocolate/liquorice every day, while soft drinks were drunk every day by 10%. Consumption of sweets varied according to education, shift work, sex, strained life situations, and the number of children in family. Among the regular dental visitors, oral hygiene habits were also influenced by living conditions. Thus, the challenges to general dental practice as regards dental health education are great.     

General and dental health in relation to life-style and social network activity among 67-year-old Danes

The present study was performed in order to plan and evaluate dental health care for a cohort of 67-year-olds in a Danish municipality. The purpose was to study general and dental health and the effect of life-style and social network relations. A total of 216 persons (71% of the persons selected) were interviewed in 1987; measurement of life-style was based on information about how often the respondents participated in social, cultural, and spare time activities. Family network activity was measured from information on the frequency of contact with family members, while data about relations with friends and neighbours were intended to measure the quality of contact. Moreover, the participants were asked about the presence of various symptoms of ill health, regular use of drugs, and dental symptoms. Additive indices on lifestyle and social networks were constructed. Symptoms were frequent among less active people; e.g. 36% of the participants with very low activity reported at least five complaints of ill health against 10% in the group with an active lifestyle. Among less active persons, 51% were edentulous, against 34% among active persons. Most symptoms of ill health occurred relatively often among persons with weak social networks. Ill health seems to be related to a passive lifestyle and non-supportive social network.     

Sociodemographic correlates of tooth pain among adults: United states, 1989

This study presents the sociodemographic distribution of tooth pain and the dental care utilization of affected individuals. Data for adults 20 years of age and over were derived from the 1989 National Health Interview Survey's supplements on dental health, orofacial pain, and health insurance (n=33073). Prevalence of tooth pain by socioeconomic status (SES) and adjusted odds ratios of reporting tooth pain in the past 6 months and of having no dental visits in the past year among persons reporting pain in the previous 6 months were computed taking into account the survey's complex sample design. Tooth pain in the past 6 months was reported by 14.5% (95% CI 14.0, 15.0) of adults aged 20-64 years and by 7.0% (95% CI 6.1, 7.9) of those 65 years and over. In the younger age group, tooth pain was more likely to be reported by those with low SES than it was by those with high SES; in the older age group, tooth pain was more likely reported by non-Hispanic blacks than it was by non-Hispanic whites or Hispanics. Of those reporting pain, younger and older non-Hispanic blacks and persons with lower educational attainment were more likely not to have a dental visit in the previous 12 months. Persons with low SES characteristics were more likely to report tooth pain and to endure their pain without the benefit of dental care while the pain was present.     

Preventive techniques in infant dental care

Dental caries is the most prevalent disease among young people in the United States today. Yet, most parents don't realize that early dental care is the best insurance against adult dental disease. Because prevention should begin at birth, long before the first dental visit, nurse practitioners can play an important role in educating parents about the need for early attention to their children's dental health. This article presents to the nurse practitioner an overview of preventive dental techniques, including the effectiveness and application of fluorides, the value of early and regular oral cleaning habits and the importance of early and regular consultations with health care professionals.     

糖尿病牙种植患者定期复诊的影响因素及针对性护理措施实施效果研究

目的 探讨影响糖尿病牙种植患者定期复诊的相关因素及针对性护理措施的应用效果.方法 选取2014年1月~2015年3月该院完成口腔种植义齿修复半年以上的糖尿病牙种植患者50例为研究对象,采用自拟问卷调查表调查患者遵医行为,分析影响患者定期复诊的相关因素.按随机数字表法分为对照组和观察组各25例.对照组采用常规护理,观察组采用针对性护理,探讨针对性护理措施对糖尿病牙种植患者的干预效果.结果 糖尿病牙种植患者各医嘱执行合格率较低,合格率排列最低前3位为自我监测、饮食控制、日常口腔护理行为;年龄、文化程度、病程、家庭月收入、患者个人因素、就医环境均为影响糖尿病牙种植患者定期复诊的相关因素;观察组干预6个月SBI、PLI 0级所占比例均高于对照组,但仅SBI比较差异有统计学意义(P<0.05);干预6个月,观察组患者PD低于对照组(P<0.05),而日常口腔护理行为、定期复诊、按时服药、自我监测合格率高于对照组(P<0.05).结论 糖尿病牙种植患者定期复诊合格率受多因素影响,加强对患者的针对性护理,强化健康教育及口腔护理,可促进患者口腔功能恢复.     

Health habit counseling amidst competing demands: effects of patient health habits and visit characteristics.

OBJECTIVE: This study assesses the effects of competing demands, such as poor health habits or new medical problems, on health-habit counseling during a primary care visit. METHODS: We surveyed a consecutive sample of 1,259 patients visiting primary care clinicians at an academic VA medical center. Before the visit, patients reported their health status, health habits, and sociodemographics; immediately after the visit, patients reported reasons for the visit and whether they had been counseled about specific health habits. We scored visit acuity ranging from visits for unscheduled walk-in care or new medical problems to scheduled visits for check-ups or old problems. We defined counseling "triggers" as clinical indications for counseling about particular health habits (e.g., smoking). We developed a logistic model predicting primary care provider counseling during a visit. RESULTS: Over two-thirds of patients (68.9%) received some health habit counseling. Controlling for other independent variables, patients with more triggers were more likely to report being counseled. Counseling rates went up as visit acuity went down; patients with the lowest visit acuity having 67% greater odds of being counseled than patients with the highest visit acuity. CONCLUSIONS: Physicians set priorities for health-habit counseling during a visit based on patients' health habit problems or triggers; whether the visit is scheduled or walk-in; and whether the patient has new or acute problems. Future research about primary care performance of health habit counseling should account for these patient and visit characteristics, and prevention-oriented health care organizations should ensure access to scheduled "check-up" visits.     

Access to dental care: a comparison of medicine/dentistry and the role of a regular source.

Recent studies have found more equal access to physicians, both in terms of volume of visits and having a regular source. This paper compares physician care with dental care, looking particularly at a regular source of dental care. A regular source should be very important in dental care, given the emphasis on prevention and regular visits. This paper examines data from a statewide sample of 1,329 Rhode Island residents in 1974 to determine what percentage of the population has a regular source and what the relationship is with socioeconomic variables. Most persons (91 per cent) report a regular source of medical care. The figure is somewhat lower (73 per cent) for reporting of a regular source of dental care. Socioeconomic differentials are still important, as only one-half of those in families earning less than $5,000 and 59 per cent of those in families where the head of the household has less than an eighth grade education have a regular source of dental care. The relationship held when controlling for variety of social and demographic variables and partial correlation analysis was used to determine that income, as compared with education, is the more important variable in explaining differentials. Using discriminant function analysis, age, sex, race, education and income allowed one to correctly predict 70.7 per cent of those who have a regular source of dental care and 61.5 per cent of those without a regular source of dental care.     

Dental and other health care visits among U.S. adults with diabetes

OBJECTIVE: This study compared yearly dental visits of diabetic adults with those of nondiabetic adults. For adults with diabetes, we compared the frequency of past-year dental visits with past-year visits for diabetes care, dilated eye examinations, and foot examinations. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional study using a sample of 105,718 dentate individuals aged > or =25 years, including 4,605 individuals with diabetes who participated in the 1995-1998 Behavioral Risk Factor Surveillance System in 38 states. RESULTS: Dentate adults (i.e., those with at least some natural teeth) with diabetes were less likely than those without diabetes to have seen a dentist within the preceding 12 months (65.8 vs. 73.1%, P = 0.0000). Adults with diabetes were less likely to have seen a dentist than to have seen a health care provider for diabetes care (86.3%); the percentage who saw a dentist was comparable with the percentage who had their feet examined (67.7%) or had a dilated eye examination (62.3%). The disparity in dental visits among racial or ethnic groups and among socioeconomic groups was greater than that for any other type of health care visit for subjects with diabetes. CONCLUSIONS: Promotion of oral health among diabetic patients may be necessary, particularly in Hispanic and African-American communities. Information on oral health complications should be included in clinical training programs. Oral and diabetes control programs in state health departments should collaborate to promote preventive dental services, and the oral examination should be listed as a component of continuous care in the American Diabetes Association's standards of medical care for diabetic patients.     

Efficacy of Penicillin for Dental Pain without Overt Infection

OBJECTIVES: Dental pain is a common presenting symptom in the acute care setting. Even in the absence of overt infection, many physicians routinely prescribe antibiotics such as penicillin. The authors sought to test the hypothesis that penicillin is not necessary or beneficial in the treatment of undifferentiated dental pain without overt infection. METHODS: This prospective, randomized, double-blind, placebo-controlled trial was conducted at an urban teaching hospital with approximately 105,000 emergency department visits per year. A convenience sample of adult emergency department patients presenting with dental pain and no clinically overt infection was randomized to receive penicillin or placebo. A structured evaluation was performed at enrollment and again at a 5- to 7-day follow-up visit. The main outcome measure was evidence of overt dental infection at the 5- to 7-day follow-up visit. RESULTS: A total of 195 patients were enrolled. Ninety-eight (50%) were randomized to treatment with penicillin. A total of 125 patients (64%) were followed up. Outcome data were identified for nine additional study patients, who returned to the dental clinic or emergency department outside of the scheduled follow-up period and were included in the final analysis. Overall, 13 of 134 patients (9%) developed signs of infection: six of 64 (9%) from the penicillin group and seven of 70 (10%) from the placebo group (p = 0.90). There was no significant difference between the penicillin and placebo groups in baseline characteristics, medication compliance, or visual analog scale pain scores at enrollment. CONCLUSIONS: These data support the hypothesis that penicillin is neither necessary nor beneficial in the treatment of undifferentiated dental pain in the absence of overt infection.     

A controlled national survey in France of health-related challenges for persons with Down syndrome

Despite recent research on the impact of disability on function, little information is available to evaluate the need for daily support in persons with Down syndrome. The aim of this study was to evaluate the prevalence and relative degree of difficulty experienced by this population in routine hygiene and health care when compared to their siblings. A proxy French language questionnaire was used for this cross-sectional survey of 199 persons with Down syndrome and 153 siblings (mean age 12.3 years, range < or = 1-48). Individuals in the study group had significantly more difficulty performing all activities related to routine hygiene and health care, and were 2-22 times more likely to need help than the control group. Certain acts of routine health care were performed more regularly by those in the study group (6/12 items), and specialist medical and paramedical visits were more regular (OR = 7-44). Increased difficulty and need for help in performing acts of basic self-care may reduce autonomy and social integration for persons with Down syndrome. Recommendations are made in relation to the training of caregivers and health professionals.     

A population‐based cohort study of ambulatory care service utilization among older adults

Rationale, aims and objectives Age‐related effects on ambulatory care service utilization are not well understood. We aim to measure the utilization patterns of ambulatory health care services (i.e. family physician visits, specialist physician visits and emergency room visits) in the late life course (65 years and older). Methods A population‐based retrospective cohort study was conducted for the period 1 April 2005 to 31 March 2006. All Ontario, Canada, residents aged 65+ and eligible for government health insurance were included in the analysis. Results This population‐based cohort study demonstrates considerable increase in utilization rates and variability of ambulatory services as age increases. Variations in utilization were observed by gender as overall women were more likely to consult a family physician, and men more likely to visit specialists and the emergency room. A small group of high users, constituting 5.5% of the total population, accounted for 18.7% of total ambulatory visits. Finally, we report socio‐economic status (SES) based disparity for specialist services in which high users were more likely to have higher SES. Conclusions There is increasing utilization and variability in ambulatory service utilization with increase in age. Further research is required to explain the gender and SES differences reported in this study.     

Dental needs of persons with developmental disabilities in Orange County

Because developmentally disabled individuals, in general, have poorer dental health than other populations, and because developmentally disabled individuals face more situations which contribute to dental patholoy, it is important to understand their special dental needs. A dental program developed for persons with developmental disabilities in rural Northern California has proven to be modestly successful to date. The present study was undertaken to ascertain whether similar unmet dental needs characterized the developmentally disabled population in urban Southern California. For this study, 730 families with a developmentally disabled individual residing in Orange County were survyyed using a 10-item questionnaire. The results of the survey suggest a need for increased preventative dental care for persons with developmental disabilities. Results also suggest that if dental services were made more available, any increases in services would be completely utilized It appears that the Northern California dental program, designed to serve developmentally disabled persons in a rural area, would also benefit developmentally disabled persons in an urban area of the state.     

Dental needs of persons with developmental disabilities in orange county

Because developmentally disabled individuals, in general, have poorer dental health than other populations and because developmentally disabled individuals face more situations which contribute to dental pathology, it is important to understand their special dental needs. A dental program developed for persons with developmental disabilities in rural Northern California has proven to be modestly successful to date. The present study was undertaken to ascertain whether similar unmet dental needs characterized the developmentally disabled population in urban Southern California. For this study, 730 families with a developmentally disabled individual residing in Orange County were surveyed using a 10-item questionnaire. The results of the survey suggest a need for increased preventative dental care for persons with developmental disabilities. The results also suggest that if dental services were made more available, any increases in services would be completely utilized. It appears that the Northern California dental program, designed to serve developmentally disabled persons in a rural area, would also benefit developmentally disabled persons in an urban area of the state.     

华东地区某市辖区一年级儿童患龋状况及其影响因素分析

目的 调查上海市奉贤区一年级儿童的患龋状况,分析相关影响因素,为预防儿童龋齿提供依据。方法 采用整群随机抽样方法,对上海市奉贤区22所小学1 141名的一年级儿童进行临床检查,由校医发放小学生口腔健康调查表进行问卷调查。结果 奉贤区一年级儿童患龋率为60.74%、充填率18.27%、龋均2.25±2.72。儿童口腔健康状况一般或较差是儿童患龋的危险因素（P<0.01）;以无牙科诊治经历儿童为参照,前次看牙时间在12个月内是一年级儿童患龋的危险因素（P<0.05）;以12个月内经常牙痛儿童为参照,无牙痛是患龋的保护因素（P<0.05）。结论 上海市奉贤区一年级儿童患龋状况不容乐观,应加强家庭、学校、社会多方面的口腔健康教育,提高父母对儿童口腔健康状况的重视程度,帮助儿童建立良好的口腔健康行为、定期带孩子进行口腔检查等,提高儿童口腔健康状况,进而预防儿童龋病的发生。     

Dental insurance and dental service use by U.S. women of childbearing age

ABSTRACT Objectives: Oral health has a significant effect on health, and for women, poor oral health can lead to poor birth outcomes and can affect their child's health. Nursing interventions to improve the oral health of at‐risk women have the potential to increase maternal and child systemic and oral health. The identification of women at a high risk for poor oral health is a necessary to develop and evaluate these interventions. Design and Sample: This study examined the factors related to dental insurance and dental service use for women of childbearing age in the United States. A secondary analysis of the 2003–2004 National Health and Nutrition Examination Survey was completed to examine the predisposing, enabling, and need variables associated with dental insurance status and dental service use in a representative random sample of 1,071 women. Results: The results showed that over 40% of women had no dental insurance. Women with less education, lower income, and dental need were significantly less likely to have dental insurance. Dental utilization by the uninsured was low and a racial/ethnic disparity was noted. Conclusion: A lack of dental insurance and dental service utilization is a significant concern. Nurses working with low‐income women should educate the population about oral health and advocate for policies to increase dental insurance coverage.     

Epidemiology of chronic non-malignant pain in Denmark

A series of health surveys are conducted every sixth to seventh year in Denmark. In the most recent survey of 2000, a national random sample (>16 years) was drawn from the Danish Central Personal Register. Out of the original sample 12,333 (74%) were interviewed and of these 10,066 returned a completed questionnaire (SF-36). The present study includes only those who both took part in the interview and the postal questionnaire. Cancer patients were excluded. Persons suffering from chronic pain (PG) were identified through the question 'Do you have chronic/long lasting pain lasting 6 months or more'? An overall chronic pain prevalence of 19% was found -16% for men and 21% for women. Prevalence of chronic pain increased with increasing age. Persons >/=67 years had 3.9 higher odds of suffering from chronic pain than persons in the age group 16-24 years. Compared with married persons, divorced or separated persons had 1.5 higher odds of chronic pain. Odds for chronic pain were 1.9 higher among those with an education of less than 10 years compared with individuals with an education of 13 years or more. During a 14-day period reporters of chronic pain had an average of 0.8 days (range 0-10) lost due to illness compared with an average of 0.4 days (range 0-10) for the control group (CG) (Odds Ratio (OR)) 2.0). Persons with a job which required high physical strain were more likely to report chronic pain compared with those with a sedentary job (OR 2.2). The odds of quitting one's job because of ill health were seven times higher among people belonging to the PG. A strong association between chronic pain and poor self-rated health was also demonstrated. The PG had twice as many contacts with various health professionals compared with the CG, and the health care system was, on average, utilised 25% more (overall contacts) by the PG than by the general population. Among the persons in the PG, 33% were not satisfied with the examinations carried out in connection with their pain condition and 40% were not satisfied with the treatment offered. Nearly 130,000 adults, corresponding to 3% of the Danish population, use opioids on a regular basis. Opioids are used by 12% of the PG.     

Characteristics and Trends of Emergency Department Visits in the United States (2010–2014)

Background

It is important that policy makers, health administrators, and emergency physicians have up-to-date statistics on the most common diagnoses of patients seen in the emergency department (ED).

Youth and young adults with cerebral palsy: their use of physician and hospital services

OBJECTIVES: To examine patterns of health care utilization among youth and young adults who have cerebral palsy (CP) and to provide information to guide the development of health services for adults who have CP. DESIGN: This study analyzed health insurance data for outpatient physician visits and hospital admissions for a 4-year period. SETTING: Six children's treatment centers in Ontario, Canada. PARTICIPANTS: The sample included 587 youth and 477 adults with CP identified from health records. Youths were 13 to 17 years of age, and adults were 23 to 32 years of age at the end of the data range. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We computed the annual rates of outpatient physician visits and hospitalizations per 1000 persons and compared these with rates for the general population. RESULTS: Annual rates of outpatient physician visits were 6052 for youth and 6404 for adults with CP, 2.2 times and 1.9 times higher, respectively, than rates for age-matched peers (P<.01). Specialists provided 28.4% of youth visits but only 18.8% of adult visits. Annual hospital admission rates were 180 for youth and 98 for adults with CP, 4.3 times and 10.6 times higher, respectively, than rates for age-matched peers (P<.01). CONCLUSIONS: It appears that youth and adults with CP continue to have complex care needs and rely heavily on the health care system. Comprehensive services are essential to support their health as they move into youth and adulthood. However, there appear to be gaps in the adult health care system, such as limited access to specialist physicians.     

Patterns of physician follow-up among young cancer survivors: report of the Childhood, Adolescent, and Young Adult Cancer Survivors (CAYACS) research program

Objective

To describe the frequency and pattern of physician visits in 1998 to 2000 among childhood and adolescent cancer survivors in British Columbia (BC), to compare their use of physician services with use in the general population, and to examine the effects of clinical and sociodemographic factors on care.

Design

Retrospective, observational, population-based cohort study, with a comparison group. Cohort records from population registries were linked to physician claim data and oncology visit records for 1998 to 2000.

Setting

Outpatient physician care in BC.

Participants

All (N = 1157) survivors of cancer diagnosed before age 20 years in BC between 1970 and 1992 who survived at least 5 years after diagnosis, and an age-sex frequency–matched population sample of 11 570 individuals.

Main outcome measures

Probability of a physician visit and frequency of physician visits.

Results

Approximately 97% of survivors saw at least 1 physician in the 3-year period, compared with 50% of the general population sample. The probability of a GP visit was 96% higher (adjusted 95% confidence interval [CI] 1.8 to 2.1), and the likelihood of a specialist visit was 157% higher (adjusted 95% CI 2.4 to 2.8) than for the general population. Survivors were more than twice as likely to see GPs at least 10 times (adjusted relative risk 2.23, 95% CI 2.0 to 2.4) and had 49% more visits than the general population. Cancer diagnosis and treatment affected visit patterns, but socioeconomic status and rural residency did not significantly affect the probability of a visit.

Conclusion

Demand for physician care among childhood and adolescent cancer survivors is considerably greater than for the general population, and this need persists many years after diagnosis. Physicians need information on the unique health care requirements of this patient group in order to provide appropriate care.