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.     

Should dentistry be part of the National Health Information Infrastructure?

BACKGROUND: The National Health Information Infrastructure, or NHII, proposes to improve the effectiveness, efficiency and overall quality of health in the United States by establishing a national, electronic information network for health care. To date, dentistry's integration into this network has not been discussed widely. METHODS: The author reviews the NHII and its goals and structure through published reports and background literature. The author evaluates the advantages and disadvantages of the NHII regarding their implications for the dental care system. RESULTS: The NHII proposes to implement computer-based patient records, or CPRs, for most Americans by 2014, connect personal health information with other clinical and public health information, and enable different types of care providers to access CPRs. Advantages of the NHII include transparency of health information across health care providers, potentially increased involvement of patients in their care, better clinical decision making through connecting patient-specific information with the best clinical evidence, increased efficiency, enhanced bioterrorism defense and potential cost savings. Challenges in the implementation of the NHII in dentistry include limited use of CPRs, required investments in information technology, limited availability and adoption of standards, and perceived threats to privacy and confidentiality. CONCLUSIONS: The implementation of the NHII is making rapid strides. Dentistry should become an active participant in the NHII and work to ensure that the needs of dental patients and the profession are met. Practice Implications. The NHII has far-reaching implications on dental practice by making it easier to access relevant patient information and by helping to improve clinical decision making.     

Salivary and Serum Chromogranin A and α-Amylase in Periodontal Health and Disease

Background: Salivary stress-related biomarkers in connection with periodontal disease have not been extensively studied. In addition to cortisol as a well-known marker of stress loading, chromogranin A (CgA) and α-amylase (AA) are supposed to link the activity of the neuroendocrine system to local and systemic immune functions and to be related to periodontitis. This study aims to determine CgA and AA in saliva and serum in periodontal health and disease to assess their potential relationship to periodontitis. Methods: Patients with aggressive (AgP) (n = 24) and chronic periodontitis (CP) (n = 34) as well as healthy control (CO) (n = 30) individuals participated in this study. CgA and AA were determined in saliva and serum with enzyme-linked immunosorbent assay and an adapted clinical amylase test; salivary cortisol was determined using mass spectrometry. Clinical parameters of periodontal disease were evaluated, and their possible correlations with stress-related biomarkers were assessed. Results: Significantly higher CgA levels were found in the saliva of patients with AgP compared with those in patients with CP and CO individuals (P <0.001). Salivary cortisol levels were higher in the AgP group compared with those in patients with CP (P <0.05). No differences in serum CgA levels and salivary and serum AA activities were found among all groups. A positive correlation was revealed between salivary AA activity or salivary CgA levels and the extent of periodontitis (P <0.05). Conclusion: The results suggest an association of CgA and cortisol levels as well as AA activity in saliva with periodontitis, especially a significant relationship of salivary CgA and cortisol to AgP.     

Are Dental Hygienists Prepared to Work in the Changing Public Health Environment?

Health care reform, the changing public health environment, and a lack of clarity about what defines a ‘public health professional’ create challenges as well as opportunities for dental hygienists who wish to pursue positions or careers in public health.BackgroundAlthough many studies have been conducted about dental hygienists in clinical practice, there are few describing dental hygienists working in public health positions, particularly in non-clinical roles, or how well their education and other resources prepared them for these roles. Competency statements and the 10 Essential Public Health Services to Promote Oral Health in the U.S. provide a public health framework to assess what skills will be required for future opportunities that may emerge for dental hygienists.MethodsPublished literature, recent unpublished survey data, selected professional health care reform documents, competency statements, accreditation standards, and the 10 Essential Public Health Services to Promote Oral Health in the U.S. were analyzed. Competencies in public health/dental public health provide an overview of skills needed by dental hygienists who will be seeking public health positions. Health reform statements describe the need for more leadership and workforce models in public health, while the 10 Essential Services can serve as a framework for career preparation/transition.ConclusionsThe literature does not provide a comprehensive historical review or current profile of dental hygienists who work in various public health positions or their various roles, especially non-clinical roles. More research is needed regarding current positions, degree and experience requirements, and role responsibilities. Additionally, the credentials and public health background of the faculty teaching community/public health courses in dental hygiene programs requires exploration. Follow-up studies of dental hygiene program graduates could help determine how well courses prepare students for public health activities or careers and what resources aid in transitioning from clinical to public health positions. Dental hygienists need more information about education, continuing education and employment opportunities related to pursuing a career in public health.     

Nurses’ Perceptions of Oral Health Care Provision After the COVID-19 Lockdown

ObjectiveThis study aimed to investigate nurses’ perceptions of oral health care provision to inpatients in Japanese hospitals and the infection control measures taken by them after the coronavirus disease 2019 (COVID-19) lockdown to promote collaborative oral health care.MethodThe participants were 1037 nurses working in inpatient wards at 4 hospitals in Fukuoka Prefecture, Japan. Data were collected through a questionnaire survey approximately 6 months after the first COVID-19 lockdown.ResultsMore than 90% of the 734 nurses participating in this study positively perceived the preventive effect of oral health care on aspiration pneumonia, ventilator-associated pneumonia, and viral infection. However, approximately half of them had negative perceptions about their knowledge and confidence regarding the control of COVID-19 with oral health care provision, and 84.7% expected to be provided with the necessary information by oral health professionals. Further, 537 nurses (73.2%) provided oral health care to their patients; 9 nurses (1.7%) responded that those patients who received oral health care decreased after the lockdown; and 12 (2.4%) responded that they could no longer collaborate with oral health professionals because of the lockdown. Additionally, 41.7% of them used neither protective glasses nor face shields even after the lockdown began.ConclusionsThis study showed that almost all the nurses perceived the benefcial effect of oral health care for the prevention of viral infection and pneumonia. However, some nurses perceived that their oral health care provision and collaborative oral health care were negatively affected. It also showed that most nurses’ knowledge, confidence, and use of infection control measures were insufficient. The results indicate that oral health professionals should support nurses in providing oral health care by providing them with information on COVID-19 infection control measures to prevent infection transmission.     

Factor analyses of the Oral Health Impact Profile – Overview and studied population

PurposeA desideratum of oral health-related quality of life (OHRQoL) instruments – such as the Oral Health Impact Profile (OHIP) – is that they accurately reflect the structure of the measured construct(s). With this goal in mind, the Dimensions of Oral Health-Related Quality of Life (DOQ) Project was proposed to investigate the number and nature of OHRQoL dimensions measured by OHIP. In this report, we describe our aggregate data set for the factor analyses in the project, which consists of responses to the 49-item OHIP from general population subjects and prosthodontics patients from 6 countries, including a large age range of adult subjects and both genders.Materials and methodsThe DOQ Project's aggregate data set combines data from 35 individual studies conducted in Croatia, Germany, Hungary, Japan, Slovenia, and Sweden.ResultsThe combined data set includes 10778 OHIPs from 9348 individuals (N = 6349 general population subjects, N = 2999 prosthodontic patients). To elucidate the OHIP latent structure, the aggregated data were split into a Learning Sample (N = 5173) for exploratory analyses and a Validation Sample (N = 5022) for confirmatory analyses. Additional data (N = 583) were assigned to a third data set.ConclusionThe Dimensions of Oral Health-Related Quality of Life Project contains a large amount of international data and is representative of populations where OHIP is intended to be used. It is well-suited to assess the dimensionality of the questionnaire.     

Factors Affecting Oral Health–Related Quality of Life Among Elderly Croatian Patients

Objective of work

Oral health–related quality of life (OHRQoL) as a multidimensional concept is affected by many factors. Therefore, the aim of this study was to determine which demographic and subjective factors are significantly affecting the OHRQoL among the elderly people wearing complete removable dental prostheses (CRDP).

Materials and Methods

This questionnaire-based study included 301 participants, residents of elderly care homes (in Zagreb and Slavonski Brod, Croatia) wearing maxillary and/or mandibular CRDP. The questionnaire used in this study consisted of two sections; the first section included questions giving general information and in the second section the Croatian version of Oral Health Impact Profile (OHIP)-49 questionnaire with 49 items representing seven OHIP domains was used.

Results

Participants were aged between 60–99 years, with average age of 74 ± 12.1 years. OHIP summary score was 26.5. The highest average OHIP mean values in the domain of functional limitation amounted to 6.7, physical pain 5.1, and physical disability 5.9. The participants’ age, education, profession, residence place size, type of CRDP, and the time of denture wearing period all statistically significantly affected OHRQoL (p < 0.05).

Conclusions

General and sociodemographic factors had a significant influence on the participant’s subjective perception of oral health and OHRQoL. Younger participants, participants from rural places, those with lower levels of education, and shorter period of denture wearing demonstrated a higher impact on OHRQoL.Key words: elderly, dental prosthesis, oral health, quality of life     

National Study of Adult Oral Health 2017–18: participation and representativeness

The National Study of Adult Oral Health (NSAOH) 2017–18 collected information from a sample of the Australian population aged 15 years and over. The Study comprised an interview questionnaire, completed by telephone or online, and an oral epidemiological examination among dentate participants. Participation in the Study was voluntary and therefore relied on the goodwill of selected participants. This paper provides a summary of participation rates for the Interview and Examination phases of the study. The potential for biased population estimates due to variation in participation rates is explored. The weighting procedure implemented to ensure the sample is representative of the target population is described and a comparison of the estimated population distributions derived from the weighted sample and the actual population distributions is provided for a range of socioeconomic characteristics. In summary, it can be concluded that estimates derived from the weighted Interview and Examination samples are valid estimates of the Australian population aged 15 years and over.     

Why Patients Visit Dentists – A Study in all World Health Organization Regions

ObjectiveThe dimensions of oral health–related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions.MethodsDentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated.ResultsFor every 100 dental patients with current oral health problems, 96 had problems related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact. For every 100 dental patients who wanted to prevent future oral health problems, 92 wanted to prevent problems related to these 4 OHRQoL dimensions. Both numbers increased to at least 98 of 100 patients when experts analyzed dentists' explanations of why some oral health problems would not fit the four dimension. For the remaining 2 of 100 patients, none of the dentist-provided explanations suggested evidence against the OHRQoL dimensions as the concepts that capture dental patients' suffering.ConclusionOral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact capture dental patients' oral health problems worldwide. These 4 OHRQoL dimensions offer a psychometrically sound and practical framework for patient care and research, identifying what is important to dental patients.     

The PedsQL™ Oral Health Scale in Iranian children: reliability and validity

International Journal of Paediatric Dentistry 2011 Objective. The primary objective of the study was to translate and evaluate the psychometric properties of the Pediatric Quality of Life Inventory? (PedsQL?) Oral Health Scale in over 1000 Iranian children. Methods. A standard forward and backward translation procedure was used to convert the US English dialect version of the PedsQL? Oral Health Scale into the Iranian language (Persian). The Iranian version of the PedsQL? Oral Health Scale, in combination with the PedsQL? 4.0 Generic Core Scales, was then subsequently administered to 1053 Iranian children and 1026 parents. The reliability of the PedsQL? Oral Health Scale was evaluated using internal consistency and test‐retest methods. Known‐groups discriminant validity, exploratory factor analysis (EFA) of the Oral Health and the four Generic Core Scales combined, and confirmatory factor analysis (CFA) of the Oral Health Scale alone were conducted. The Benjamini–Hochberg procedure was used to correct P‐values for multiple comparisons. Results. Good to excellent internal consistency and test‐retest reliabilities were demonstrated. The PedsQL? Oral Health Scale demonstrated discriminant validity for subgroups of children across different decayed, missing and filled teeth (DMFT) index categories and gender. The EFA supported the a priori factor model of the combined five scales. The CFA analysis confirmed the unidimensional factor structure of the Oral Health Scale. Conclusions. The PedsQL? Oral Health Scale demonstrated excellent psychometric properties in combination with the PedsQL? 4.0 Generic Core Scales. These five scales combined can be utilized to assess the multidimensional oral‐health‐related quality of life of Iranian children.     

柯达医疗集团2007年5月1日正式更名为Carestream Health公司

Onex公司在2007年5月已经完对伊士曼柯达公司医疗集团的收购，并于2007年5月1日起以Carestream Health公司的名义开始正式独立运营。作为Onex公司的独立子公司，Carestream Health公司是一家拥有8100多位员工并为全球150个国家的数万客户提供服务的公司，公司产品将继续使用柯达的商标，拥有柯达医疗集团所有以前的子品牌，如Carestream、DirectView、Softdent、Industrex、X—Sight和Practice Works等。同时，该公司在中国成立的锐珂（上海）医疗器材有限公司和锐珂（厦门）医疗器材有限公司也于同日正式开始运营。     

National Study of Adult Oral Health 2017–18: Study design and methods

The National Study of Adult Oral Health (NSAOH) is Australia’s third national oral examination survey of a representative sample of Australian adults. The study was undertaken primarily to describe levels of oral health in the population and to describe trends since the first survey, conducted in 1987–88. The aim of the study was to complete 7,200 examinations, necessitating approximately 15,200 completed interviews. Survey participants were selected using a multi-stage probability sampling design that began with the sampling of postcodes within states/territories in Australia. Individuals within selected postcodes were then selected by the Australian Government Department of Human Services (DHS) from the Medicare database. Following an initial opt-out period, participants were given the option to either complete the questionnaire online or to complete the questionnaire via a computer-assisted telephone interview. Participants were asked a series of questions about their oral health and dental service use and those who reported having one or more of their own natural teeth were invited to undergo a standardised oral examination. Examinations were conducted by state/territory dental practitioners who underwent prior training and calibration in survey procedures by the Australian Research Centre for Population Oral Health (ARCPOH), The University of Adelaide.