Study of Health in Pomerania (SHIP): Relationship among socioeconomic and general health factors and dental status among elderly adults in Pomerania.

OBJECTIVE: The aim of this study was to evaluate associations among the dental status, socioeconomic factors, and general health of 1,877 subjects between the ages of 55 and 79. METHOD AND MATERIALS: Socioeconomic information (age, sex, education level) and questions on smoking and alcohol abuse were taken from an interview; income and medical information (number of diseases) were taken from a self-administered questionnaire; and HbA1C and CDT (diabetes and alcoholism markers) were taken from blood analyses. RESULTS: Of the subjects, 73% had a low education level, and 27% of the subjects had a monthly income of < 1,000 Euro and 13% of > 2,000 Euro. Twenty-six percent of the subjects were edentulous, and 29% had 20 or more teeth. The odds ratio of edentulism increased to 9.0 (95% confidence interval = 7.0-11.5) at the ages of 75 to 79 years compared to ages 55 to 79. Logistic regression analyses showed that edentulism was significantly associated with age, low education level, low income, smoking, and alcohol abuse. However, the retention of more than 20 teeth was associated with age. CONCLUSIONS: Age, low income, low education level, smoking, and alcohol abuse seemed to be risk markers for edentulism; whereas, the number of diseases, diabetes, and gender were not.     

Prosthodontic status among old adults in Pomerania,related to income,education level,and general health (results of the Study of Health in Pomerania,SHIP)

PURPOSE: The aim of the study was to evaluate associations among prosthetic status, socioeconomic factors, and general health of subjects aged 55 to 79 years. The data were taken from the Study of Health in Pomerania (SHIP). MATERIALS AND METHODS: Socioeconomic information (age, sex, education level), medical information (number of diseases), and details on smoking and alcohol consumption were obtained. Prosthetic status in the maxilla and mandible was classified into complete denture (CD), removable partial denture (RPD), > or = 10 natural teeth or teeth replaced with fixed prosthodontics (10T+), and < or = nine natural teeth including fixed prosthodontics (9T-). RESULTS: The data of 1,877 subjects were evaluated. CDs in the maxilla were more frequent than in the mandible. RPDs were more frequent in the mandible and in the group aged 65 to 74 years. Of the individuals with a low education level, 47% had a CD in the maxilla, and only 21% had 10T+. However, of subjects with a high education level, 22% had a CD in the maxilla, and 54% had 10T+. The odds ratio of having a CD in the maxilla increased to 11.9 at the age of 75 to 79 years, compared to 0.6 at the age of 55 to 59 years. Logistic regression analyses showed that the risk of wearing a CD was significantly associated with old age, low education level, low income, smoking, and alcohol abuse, whereas the number of diseases (used as an indicator of general health) was not. CONCLUSION: Alcohol abuse, smoking, low education level, low income, and old age were significant predictors of wearing CDs.     

The impact of oral health on the quality of life in the elderly

Demographic developments indicate both an increasing proportion of the elderly in the population and an augmenting life expectancy. The elderly tend to retain their natural teeth for longer, and the first removable denture is inserted more often later in life. Oral health-related quality of life (OHRQoL) is influenced by functional parameters such as pain and discomfort, but also by psychological and social aspects. Dental care may restore oral function and alleviate pain and discomfort, e.g. caused by xerostomia. Dental treatment could further improve oral appearance of the elderly individual, which might provide self-esteem and thus contribute to the psychological well-being. Even social aspects like communication and social interactions could be positively influenced by dental care. Thus oral health and dental care have a significant impact on the quality of life (QoL) of elderly adults.     

The sensitivity and responsiveness of an oral health related quality of life measure to tooth whitening

OBJECTIVES: To assess the sensitivity and responsiveness of an oral health related quality of life measure to tooth whitening. METHODS: Following screening at a clinic, 87 subjects were given an array of tooth whitening products to use at home and reviewed 8 weeks later. Subjects self-completed the 49-item Oral Health Impact Profile (OHIP) at baseline and follow-up, and rated their satisfaction with the whiteness of their teeth compared to baseline on a global transition scale. RESULTS: In terms of sensitivity, observed changes were apparent in overall OHIP scores (P<0.05) and across several domains, notably functional limitation (P<0.01). However, the magnitude of change (effect size) was generally small except for the functional domain. There was an observed gradient in observed change in OHIP scores and in the magnitude of such changes (effect sizes) in relation to global rating of satisfaction with the outcome, supporting the responsiveness of the measure. CONCLUSION: The OHIP scale is sensitive and responsive to the effects of tooth whitening. Greatest sensitivity and responsiveness was in relation to functional limitations. These findings have implications for the use of oral health related quality of life measures as an outcome measure of interventions aimed at improving dental aesthetics through tooth whitening.     

Relationship between oral health and its impact on quality of life among adolescents

The aim of this study was to assess oral health status and its relationship with quality of life. A household population, cross-sectional study was carried out; participants were between 15 and 17 years of age (n = 247) and were examined by two calibrated dentists. Socio-economic status was classified according to ANEP-ABIPEME criteria. Clinical examinations to observe DMFT, CPI and Dean indices were performed as per WHO criteria. The Significant Caries Index (SiC) was used to evaluate polarization of the occurrence of caries among participants of the tercile with higher DMF-T. The OHIP instrument was used to measure quality of life. The Spearman and Mann-Whitney tests were used for assessing correlations (5% significance level). Examinations were carried out in 117 (47.37%) females and in 130 (52.63%) males. Of the examined participants, 45.75% were classified as belonging to socio-economic class C. Caries occurrence was observed in 218 subjects (88.26%); the mean DMFT was 5.40. The SiC index was 9.97. Almost half (47.77%) of the participants examined did not present sextants affected by periodontal disease. Of the participants examined, 80.16% presented absence of fluorosis. The mean OHIP was 3.95. The following correlations were observed: a positive and statistically significant correlation between the highest score in the OHIP and decayed teeth; a positive correlation with threshold significance between OHIP and DMFT; an inverse correlation between intact teeth and OHIP; and a positive and non statistically significant correlation between SiC and OHIP (correlation coefficient = 0.13, p = 0.245). Association between the mean OHIP and the terciles was not significant (p = 0.146); there were also no associations between periodontal condition and OHIP nor were there associations between the presence of fluorosis and mean OHIP.     

Measuring the impact of oral health on quality of life in Britain using OHQoL-UK(W)

OBJECTIVES: This study assessed the impact of oral health on quality of life (OHQoL) in Britain and identified disparities in OHQoL among subgroups of the population. METHODS: A national survey involved a random probability sample of 2,667 households. Participants were interviewed about their oral health status and sociodemographic information was collected. The impact of oral health on life quality was measured utilizing the OHQoL-UK(W). RESULTS: The response rate was 68 percent. Most people in Britain (73%) claimed their oral health did affect their life quality, most frequently through physical influences rather than social or psychological. Disparities in perceived influences of oral health on life quality among subgroups of the population were apparent by age, sex, and social class; OHQoL also was influenced by oral health status (self-reported). CONCLUSION: Most Britons claim their oral health affects their life quality and OHQoL was associated with sociodemographic and oral health factors.     

The impact of oral health on quality of life of Dutch adults

As part of a large-scale oral health/epidemiological research project among adults in 's-Hertogenbosch, the impact of a number of clinical and demographic variables on quality of life was studied. Quality of life was measured with the help of the Dutch version of the abridged Oral Health Impact Profile. Half of those questioned appeared to experience no negative impact at all from their oral health on their quality of life. Those with poor oral health and a low level of education were especially likely to have a high score on the Oral Health Impact Profile. The average score of 2.8 was lower than the revealed averages in research in Australia (7), England (5) and New Zealand (8). It was concluded that oral health appears to have an impact on the quality of life of a population although the correlational research format did not permit causational judgements.     

Prevalence and demographic correlates of tooth loss among the elderly in the United States

The aging of the United States population and the contribution of tooth loss to oral health make it important to describe tooth loss among the elderly in this country. Data from the National Survey of Oral Health in US Employed Adults and Seniors: 1985–1986, conducted by the National Institute of Dental Research, were analyzed to examine the prevalence and demographic correlates of tooth loss among the elderly.
Results show that there were important differences in tooth loss among subgroups of the elderly sample (overall n = 5,649 persons aged 65+ years attending senior centers). The oldest seniors and those with the least education or income were the most likely to be edentulous. The oldest dentulous seniors, blacks, those with the least education or income, and those who lived in New England or the Northeast had the fewest number of teeth present.
These findings suggest that efforts to reduce tooth loss among the elderly should target those with the least education and income.     

Sentiments expressed in relation to tooth loss: a qualitative study among edentulous Saudis

PURPOSE: The objective was to explore and gain insight into the sentiments surrounding tooth loss in a group of edentulous Saudis. MATERIALS AND METHODS: Using a qualitative methodology, 44 edentulous patients who were receiving complete denture treatment were interviewed in private, in the Arabic language. Interviews were tape recorded and semistructured, following a list of predetermined and piloted topics, but dialogue also took place, with the freedom for both interviewer and interviewee to explore areas of interest. All recordings were transcribed, translated into English, and interpreted independently by two members of the team to identify the core themes associated with tooth loss. RESULTS: The mean age of participants was 58.9 years (range 35 to 72 years), and they had been edentulous for a mean of 7.1 years (range 3 months to 22 years). The main themes related to tooth loss were unqualified acceptance, inevitability with old age, behavior changes with respect to eating comfort, aged appearance, self-responsibility, positively perceived benefits, high prosthetic expectations and reduced level of denture satisfaction, and some need for privacy. CONCLUSION: The lack of any outward indication that participants experienced bereavement suggests that outlook on life can influence the impact of tooth loss. Participants' unqualified acceptance of their edentulous fate, yet their clear need to "normalize" oral function, reflects a degree of pragmatism toward life events. The strong influence of religion in Saudi society is a possible factor in the sentiments expressed.     

Sentiments expressed in relation to tooth loss: a qualitative study among edentulous Saudis

Purpose

The objective was to explore and gain insight into the sentiments surrounding tooth loss in a group of edentulous Saudis.

Materials and Methods

Using a qualitative methodology, 44 edentulous patients who were receiving complete denture treatment were interviewed in private, in the Arabic language. Interviews were tape recorded and semistructured, following a list of predetermined and piloted topics, but dialogue also took place, with the freedom for both interviewer and interviewee to explore areas of interest. All recordings were transcribed, translated into English, and interpreted independently by two members of the team to identify the core themes associated with tooth loss.

Results

The mean age of participants was 58.9 years (range 35 to 72 years), and they had been edentulous for a mean of 7.1 years (range 3 months to 22 years). The main themes related to tooth loss were unqualified acceptance, inevitability with old age, behavior changes with respect to eating comfort, aged appearance, self-responsibility, positively perceived benefits, high prosthetic expectations and reduced level of denture satisfaction, and some need for privacy.

Conclusion

The lack of any outward indication that participants experienced bereavement suggests that outlook on life can influence the impact of tooth loss. Participants’ unqualified acceptance of their edentulous fate, yet their clear need to “normalize” oral function, reflects a degree of pragmatism toward life events. The strong influence of religion in Saudi society is a possible factor in the sentiments expressed.     

Population based norming of the UK oral health related quality of life measure (OHQoL-UK)

OBJECTIVES: The aims of this study were to establish normative age-gender values for the UK oral health related quality of life measure (OHQoL-UK) in Britain and to provide a local reference for its interpretation. In addition, to identify key factors associated with oral health related quality of life in the UK. MATERIALS AND METHODS: A national survey conducted with the assistance of the Office for National Statistics involving a random probability sample of 2,718 households. Participants were interviewed about their oral health status. The impact of oral health on quality of life was measured using the 16 item OHQoL-UK measure. RESULTS: The response rate was 68% (1,838/2,718). The majority (75%, 1,378/1,838) perceived their oral health as affecting their life quality and did so across a wide range of domains. Age-gender norm values are presented. Variations in OHQoL-UK scores were apparent in relation to socio-demographics: age (P<0.05), social class (P<0.01), and self-reported oral health status: number of teeth possessed (P<0.01). CONCLUSIONS: The impact of oral health on the life quality of Britons was substantial, in both positive and negative ways and associated with socio-demographic and oral health (self-reported) factors. National norm values presented should provide a reference source for meaningful interpretation of similar data and local studies.     

The impact of orthodontic treatment on the quality of life in adolescents: a case-control study

The aim of this case-controlled study was to assess the effect of orthodontic treatment on the quality of life of Brazilian adolescents. Two hundred and seventy-nine 'cases' (106 males and 173 females) and 558 controls (246 males and 312 females) were randomly selected from 15- to 16-year-old adolescents attending all secondary schools in Bauru, S?o Paulo, Brazil. A case was defined as having at least one condition-specific impact (CSI) attributed to malocclusion during the previous 6 months, based on the Oral Impact on Daily Performances index. Conversely, a control was defined as having no CSI attributed to malocclusion during the same period. Adolescents were also clinically examined for orthodontic treatment need using the Index of Orthodontic Treatment Need (IOTN) and asked about previous orthodontic treatment. Binary logistic regression was used for statistical analysis. Females and adolescents with a definite normative orthodontic treatment need were more likely to report CSI than males and adolescents with no normative need [odds ratio (OR) = 1.48, 95 per cent confidence interval (CI) = 1.08-2.02 and OR = 2.02, 95 per cent CI = 2.09-4.47, respectively], whereas adolescents with a history of orthodontic treatment were less likely to report CSI than their counterparts (OR = 0.15, 95 per cent CI = 0.07-0.31). Furthermore, there was an interaction between a history of orthodontic treatment and the current level of normative need. Brazilian adolescents with a history of orthodontic treatment were less likely to have physical, psychological, and social impacts on their daily performances associated with malocclusion than those with no history of orthodontics. Gender was a confounding factor, whereas current level of normative orthodontic treatment need was an effect modifier. Prospective studies are needed to corroborate the present findings.     

Patients' perception of the financial impact of head and neck cancer and the relationship to health related quality of life

The aim of this cross-sectional survey was to ask patients about the financial burden of having head and neck cancer, and to explore its relation with health-related quality of life (HRQoL). In the Mersey region 447/752 eligible patients (59%) responded to the questionnaire. There was no obvious response bias. The most notable financial costs of head and neck cancer that were a moderate or large burden to patients were petrol (25%, 112), home heating (24%, 108), change in the type of food (21%, 95), and loss of earnings (20%, 88). During the previous week 15% (63/423) had lost a moderate or large amount of income because of their medical condition. In terms of taking care of their financial needs, 10% (40) were moderately dissatisfied and 15% (61) very dissatisfied. Patients with worse physical and social emotional functioning experienced more notable financial burden, more difficult life circumstances in the past month and greater financial difficulty and loss in income due to their condition in the previous week, more dissatisfaction with how well they took care of their own financial needs and were more likely to have sought statutory benefits. Cancer of the head and neck has a serious impact on financial aspects of patients' lives and seems to be associated with a poor HRQoL. Multidisciplinary teams can do much more to address the cost of having treatment by recognising need earlier, and giving advice and access to appropriate benefits.     

The impact of periodontitis on oral health‐related quality of life: a review of the evidence from observational studies

Modern population based oral health management requires a complete understanding of the impact of disease in order to provide efficient and effective oral health care and guidance. Periodontitis is an important cause of tooth loss and has been shown to be associated with a number of systemic conditions. The impact of oral conditions and disorders on quality of life has been extensively studied. However, the impact of periodontitis on quality of life has received less attention. This review summarizes the literature on the impact of periodontitis on oral health‐related quality of life (OHRQoL). Relevant publications were identified after searching the MEDLINE and EMBASE electronic databases. Screening of titles and abstracts and data extraction was conducted. Only observational studies were included in this review. Most of the reviewed studies reported a negative impact of periodontitis on OHRQoL. However, the reporting standards varied across studies. Moreover, most of the studies were conducted in developed countries.     

Associated factors to erosive tooth wear and its impact on quality of life in children with cerebral palsy

To evaluate the presence and associated factors of erosive tooth wear (ETW) in children with cerebral palsy (CP), as well as its impact on the oral health‐related quality of life (OHRQoL). Parents of 60 CP children, between 6 and 14 years of age, answered the Brazilian version of the parental‐caregivers perception questionnaire (P‐CPQ). The ETW diagnosis was performed by a single calibrated examiner according to the O'Brien´s modified index. Associated factors such as family income, behavioral factors, and type of CP were also collected. OHRQoL was measured through P‐CPQ domains and total score, and Poisson regression was used to correlate ETW to associated factors and to the scores. ETW was present in 48.3% of the children. The multivariate adjusted model showed that the presence of ETW was associated with more than 2 days of soft drink intake per week (p = 0.003), daily intake of powdered juice (p = 0.002) and reported gastroesophageal reflux (p = 0.016). The family income higher than one Brazilian minimum wage showed a positive impact on the CP children's OHRQoL (RR = 0.53; p ≤ 0.001). ETW in CP children is associated to frequent consumption of soft drinks, powdered juices, and reported gastroesophageal reflux; however, ETW has not a negative impact on the OHRQoL.