Efficacy of stabilisation splint treatment on the oral health‐related quality of life–A randomised controlled one‐year follow‐up trial

The aim of this randomised controlled trial was to assess the efficacy of stabilisation splint treatment on the oral health‐related quality of life OHRQoL during a 1‐year follow‐up. Originally, the sample consisted of 80 patients (18 men, 62 women) with temporomandibular disorders (TMD) who had been referred to the Oral and Maxillofacial Department, Oulu University Hospital, Finland, for treatment. Patients were randomly designated into splint (n = 39) and control group (n = 41). Patients in the splint group were treated with a stabilisation splint. Additionally, patients in both groups received counselling and instructions on masticatory muscle exercises. The patients filled in the Oral Health Impact Profile‐14 (OHIP‐14) questionnaire before treatment and at 3 months, 6 months and 1 year. At total, 67 patients (35 in the splint group vs. 32 in the control group) completed the questionnaire at baseline. The outcome variables were OHIP prevalence, OHIP severity and OHIP extent. Linear mixed‐effect regression model was used to analyse factors associated with change in OHIP severity during the 1‐year follow‐up, taking into account treatment time, age, gender and group status. OHIP prevalence, severity and extent decreased in both groups during the follow‐up. According to linear mixed‐effect regression, decrease in OHIP severity did not associate significantly with group status. Compared to masticatory muscle exercises and counselling alone, stabilisation splint treatment was not more beneficial on self‐perceived OHRQoL among TMD patients over a 1‐year follow‐up     

Clinical factors and self‐perceived oral health

Self‐perceived oral health is affected not only by awareness of the clinical status but also by comparisons with people of a similar age. This study explored the relative contributions of clinical variables assessing caries, periodontal status, and prosthetic status to self‐perceived oral health within two age groups. Data of 891 adults (35–44 yr of age) and 760 older people (65–74 yr of age) from the Fourth German Oral Health Study (DMS IV, 2005) were evaluated. Self‐perceived oral health was obtained from questionnaires. Numbers of decayed, filled, and unreplaced teeth, mean attachment loss, bleeding on probing (BOP), the presence of a fixed denture, and the presence of a removable denture were assessed. Multinomial logistic regression models were developed for both age groups, separately, using stepwise methods. For adults, unreplaced teeth, filled teeth, decayed teeth, the presence of a removable denture, and mean attachment loss were added to the final model. For older people, the presence of a removable denture, unreplaced teeth, decayed teeth, mean attachment loss, filled teeth, and BOP were included in the final model. Awareness of the relative contributions of clinical variables to self‐perceived oral health is important for obtaining a clearer understanding of patients' subjective and objective self‐perceptions of oral health.     

Self‐rated oral health and associated factors in Brazilian elders

Pattussi MP, Peres KG, Boing AF, Peres MA, da Costa JSD. Self‐rated oral health and associated factors in Brazilian elders. Community Dent Oral Epidemiol 2010; 38: 348–359. © 2010 John Wiley & Sons A/S Abstract – Objective: Self‐rating provides a simple direct way of capturing perceptions of health. The objective of this study was to estimate the prevalence and associated factors of poor self‐rated oral health among elders. Methods: National data from a cross‐sectional population‐based study with a multistage random sample of 4786 Brazilian older adults (aged 65–74) in 250 towns were analysed. Data collection included oral examinations (WHO 1997) and struct‐ured interviews at elderly households. The outcome was measured by a single five‐point‐response‐scale question dichotomized into ‘poor’ (fair/poor/very poor) and ‘good’ (good/very good) self‐rated oral health. Data analyses used Poisson regression models stratified by sex. Results: The prevalence of poor self‐rated oral health was 46.6% (95% CI: 45.2–48%) in the whole sample, 50.3% (48–52.5) in men and 44.2% (42.4–46) in women. Higher prevalence ratios (PR) were found in elders reporting unfavourable dental appearance (PR = 2.31; 95% CI: 2.02–2.65), poor chewing ability (PR = 1.64; CI: 1.48–1.8) and dental pain (PR = 1.44; CI: 1.04–1.23) in adjusted analysis. Poor self‐perception was also associated with being men, black, unfavourable socioeconomic circumstances, unfavourable clinical oral health and with not using or needing a dental prosthesis. Conclusion: Assessment and understanding of self‐rated oral health should take into account social factors, subjective and clinical oral symptoms.     

Oral health status among low‐income people admitted to Osaka Socio‐Medical Center in Japan

Objective : To examine the dental condition, perceived oral symptoms, and frequency of dental visits among low‐income people admitted to Osaka Socio‐Medical Center (OMSC) and to compare with Japanese national survey respondents. Methods : Oral health examinations for inpatients admitted to OMSC were performed from August to November 2004. In total, 113 inpatients who were in the recovery period without acute symptoms, were selected. Results : 109 inpatients received dental examination. All participants were male. About half of the subjects (49%) did not have any medical insurance, and the percentage of subjects who had 20 or more teeth was smaller than in a national survey in all age groups. The subjects had a higher reported frequency of oral symptoms compared with respondents to the national survey. Accessibility to dental clinics among subjects was notably low. Conclusion : Dental condition and perceived oral symptoms among the subjects were poor compared to national survey respondents. Dental care to improve the oral health condition of this segment of the population is needed.     

Psychosocial factors and self‐reported transitions in oral and general health

Psychosocial factors may explain variance in health beyond conventional indicators, such as behaviours. This study aimed to examine changes in health associated with perceived stress, social support, and self‐efficacy, controlling for sociodemographic characteristics and health behaviour. A random sample of 45‐ to 54‐yr‐old subjects was surveyed in 2004–2005, with a follow‐up 2 yr later. The outcomes were self‐reported changes in oral and general health. Explanatory variables included stress, social support, and perceived health competence with covariates of income, gender, dentition status, toothbrushing, and smoking. Responses were collected from 986 persons (response = 44.4%). At the 2‐yr follow‐up, 25.6% reported worsening in oral health and 15.3% reported worsening in general health. Prevalence ratios (PR) from adjusted log‐binomial regression showed an association between worsening oral health and higher perceived health competence (PR = 0.75, 95% CI: 0.57–0.99), and worsening general health was associated with perceived health competence (PR = 0.82, 95% CI: 0.72–0.94) and stress (PR = 1.17, 95% CI: 1.03–1.32). Worsening oral and general health were seen for male subjects (PR = 1.33, 95% CI: 1.06–1.68 and PR = 1.14, 95% CI: 1.01–1.29) and low income (PR = 1.40, 95% CI: 1.04–1.89 and PR = 1.20, 95% CI: 1.03–1.40). Health‐related self‐efficacy representing psychosocial resilience was associated with oral and general health, while stress was associated with general health. Psychosocial factors were independent predictors of change in health after controlling for sociodemographic characteristics and health behaviours.