Oral health‐related quality of life among rural‐dwelling Indigenous Australians

Background: There is limited information on the impact of poor oral health on Indigenous Australian quality of life. This study aimed to determine the prevalence, extent and severity of, and to calculate risk indicators for, poor oral health‐related quality of life among a convenience sample of rural‐dwelling Indigenous Australians. Methods: Participants (n = 468) completed a questionnaire that included socio‐demographic, lifestyle, dental service utilization, dental self‐care and oral health‐related quality of life (OHIP‐14) factors. Results: The prevalence of having experienced one or more of OHIP‐14 items ‘fairly often’ or ‘very often’ was 34.8%. The extent of OHIP‐14 scores was 1.88, while the severity was 15.0. Risk indicators for having experienced one or more of OHIP‐14 items ‘fairly often’ or ‘very often’ included problem‐based dental attendance, avoiding dental care because of cost, difficulty paying a $100 dental bill and non‐ownership of a toothbrush. An additional risk indicator for OHIP‐14 extent was healthcare card ownership, while additional indicators for OHIP‐14 severity were healthcare card ownership and having had 5+ teeth extracted. Conclusions: Risk indicators for poor oral health‐related quality of life among this marginalized population included socio‐economic factors, dentate status factors, dental service utilization patterns, financial factors and dental self‐care factors.     

Oral health-related quality of life in a birth cohort of 32-year olds

Abstract – Objectives: To describe oral health‐related quality of life (OHRQoL) among New Zealand adults and assess the relationship between clinical measures of oral health status and a well‐established OHRQoL measure, controlling for sex, socioeconomic status (SES) and use of dental services. Methods: A birth cohort of 924 dentate adults (participants in the Dunedin Multidisciplinary Health and Development Study) was systematically examined for dental caries, tooth loss, and periodontal attachment loss (CAL) at age 32 years. OHRQoL was measured using the 14‐item Oral Health Impact Profile questionnaire (OHIP‐14). The questionnaire also collected data on each study member’s occupation, self‐rated oral health and reasons for seeing a dental care provider. SES was determined from each individual’s occupation at age 32 years. Results: The mean total OHIP‐14 score was 8.0 (SD 8.1); 23.4% of the cohort reported one or more OHIP problems ‘fairly often’ or ‘very often’. When the prevalence of impacts ‘fairly/very often’ was modeled using logistic regression, having untreated caries, two or more sites with CAL of 4+ mm and 1 or more teeth missing by age 32 years remained significantly associated with OHRQoL, after adjusting for sex and ‘episodic’ dental care. Multivariate analysis using Poisson regression determined that being in the low SES group was also associated with the mean number of impacts (extent) and the rated severity of impacts. Conclusions: OHIP‐14 scores were significantly associated with clinical oral health status indicators, independently of sex and socioeconomic inequalities in oral health. The prevalence of impacts (23.4%) in the cohort was significantly greater than age‐ and sex‐standardized estimates from Australia (18.2%) and the UK (15.9%).     

The influence of dental attendance on change in oral health-related quality of life

Crocombe LA, Brennan DS, Slade GD. The influence of dental attendance on change in oral health–related quality of life. Community Dent Oral Epidemiol 2012; 40: 53–63. © 2011 John Wiley & Sons A/S Abstract – Background: Few longitudinal studies have investigated the association between dental attendance and oral health–related quality of life (OHRQoL). These studies were limited to older adults, or to study participants with an oral disadvantage and did not assess if dental attendance had a different effect on OHRQoL for different people. Objective: This project was designed to test whether routine dental attendance improved the OHRQoL of survey participants and whether any patient factors influenced the effect of dental attendance on change in OHRQoL. Methods: Collection instruments of a service use log book and a 12 month follow‐up mail self‐complete questionnaire were added to the Tasmanian component of the National Survey of Adult Oral Health 2004/06. The dependent variable was change in OHIP‐14 severity and the independent variable was dental attendance. Many putative confounders/effect modifiers were analysed in bivariate, stratified and three‐model multivariate analyses. These included indicators of treatment need, sociodemographic characteristics, socioeconomic status, pattern of dental attendance and access to dental care. Results: None of the putative confounders were associated with both dental attendance and the change in mean OHIP‐14 severity. The only statistically significant interaction for change in OHIP‐14 severity was observed for dental attendance by residential location (P < 0.01). In multivariate analysis, there was a statistically significant association of dental attendance with change in mean OHIP‐14 severity. It also showed that the difference in association of attendance between Hobart, the capital city of Tasmania, and other places was statistically significant based on the interaction between residential location and attendance (P < 0.05). Conclusion: The effect of dental attendance on OHRQoL was influenced by a patient's residential location.     

To what extent do oral disorders compromise the quality of life?

Locker D, Quiñonez C. To what extent do oral disorders compromise the quality of life? Community Dent Oral Epidemiol 2011; 39: 3–11. © 2010 John Wiley & Sons A/S Abstract – Objective: Most measures of ‘oral health‐related quality of life’ assess the presence and frequency of functional and psychosocial impacts rather than explicitly documenting their impact on the quality of life. The aim of this study was to evaluate Prutkin and Feinstein’s suggestion for addressing the issue of quality of life in health outcome research by the use of global ratings. Methods: Data were collected from a national sample of Canadian adults by means of a telephone interview survey based on random digit dialing. Participants completed the OHIP‐14. Those reporting one or more impacts in the previous year were asked three questions concerning the extent to which these impacts bothered them, affected their life as a whole, and affected their quality of life. These items were scored on a scale ranging from ‘Not at all’ to ‘A great deal’. All participants were asked to rate the quality of their life using a six‐point scale ranging from ‘Very poor’ to ‘Excellent’. Results: Interviews were completed with 2027 participants, and 2019 were included in the analysis. Overall, 19.5% reported one or more impacts ‘fairly often’ or ‘very often’. Of these, 48.3% reported being bothered by these impacts, 40.3% that their life overall was affected, and 36.0% that their quality of life was affected. These individuals represent 9.4%, 7.8%, and 6.9% of the sample as a whole. Among those reporting impacts, there was a significant association between OHIP‐14 extent and severity scores and the three ratings. Those with impacts that bothered them, that affected their life overall or affected their quality of life, rated their overall quality of life less favorably than those with impacts that did not. Analysis by household income indicated that low‐income participants were more likely to be OHIP‐14 ‘cases’. Moreover, among the ‘cases’, low‐income participants were more likely to report an impact on the quality of life. Conclusions: The addition of global ratings of oral health‐related quality of life and quality of life provides information of use in understanding the negative consequences of oral disorders.     

Impact of dental visiting trajectory patterns on clinical oral health and oral health-related quality of life

Background: Previous studies have shown variation in long‐term dental visiting but little is known about the oral health outcomes of such variation. Objective: The objective of this study is to determine the association of different dental visiting trajectories with dental clinical and oral health‐related quality of life (OHRQoL) indicators. Methods: This study utilized data from the Dunedin Multidisciplinary Health and Development Study, a continuing longitudinal study of 1,037 babies born in Dunedin (New Zealand) between April 1, 1972 and March 31, 1973. Data presented here were collected at ages 15, 18, 26, and 32 years. Three categories of dental attendance were identified in earlier research, namely: regulars (n = 285, 30.9 percent of the cohort), decliners (441, 55.9 percent), and opportunistic users (107, 13.1 percent). Results: There was a statistically significant association between opportunistic dental visiting behavior and decayed missing and filled surfaces score (Beta = 3.9) as well as missing teeth because of caries (Beta = 0.7). Nonregular dental visiting trajectories were associated with higher Oral Health Impact Profile (OHIP‐14) scores (Beta = 2.1) and lower self‐rated oral health scores (prevalence ratio = 0.8). Conclusion: Long‐term, postchildhood dental attendance patterns are associated with oral health in adulthood, whether defined by clinical dental indicators or OHRQoL. Improving dental visiting behavior among low socioeconomic status groups would have the greatest effect on improving oral health and reducing oral health impacts.     

Oral health‐related quality of life and its relationship with health locus of control among Indian dental university students

Objectives: The objectives of this study were to assess the relationship between Oral Health‐Related Quality of Life (OHRQoL) and Health Locus of Control (HLC) among students in an Indian dental school. Materials and methods: A cross sectional study design was used. Three hundred and twenty‐five dental students returned completed forms containing the 14 item Oral Health Impact Profile (OHIP‐14) and the 18 item Multidimensional Health Locus of Control Scale (MHLC). Results: The results showed that the perceived OHRQoL differed among students studying in different stages of the dental course. The OHRQoL dimensions of ‘Social Handicap’ and ‘Handicap’ were significantly (P < 0.01) lower among the later years of the course than the freshman year students. There was a sharp increase in Self‐reported dental problems, in particular, Malocclusion, Tooth decay, Calculus among the third year and final year students respectively. The OHIP‐14 scores were significantly higher among those with self‐reported oral problems. Correlation analysis between the OHIP‐14 and the MHLC scores also showed a statistically significant (P < 0.01) correlation between the ‘Chance’ dimension of the MHLC and OHIP‐14 scores. Conclusions: The results of this study underscored the relationship between the OHRQoL and HLC and of importance of assessing health attitudes and their impact on OHRQoL among the dental student community.     

Dental anxiety and quality of life: the effect of dental treatment

Abstract – Objective: The aim of the present study was to determine the association between dental anxiety and quality of life (QoL) and to test the hypothesis that treatment of highly anxious patients would significantly enhance QoL. Material and methods: Subjects were 35 highly anxious dental patients of a Dutch dental fear clinic who were assessed on dental trait anxiety (DAS and S‐DAI) and QoL (oral health‐related QoL with the use of OHIP‐14, dental anxiety‐related QoL with the SADAS, and general aspects of QoL using Global Assessment of Functioning, while five different aspects of life satisfaction were quantified on a VAS‐scale) both prior to and after treatment (an average of six sessions of 45–60 minutes each). Also, both objective (DMFT and dentists’ judgement) and subjective (patients’ judgement) indices of oral health status were recorded. Results: Higher dental anxiety was significantly associated with lower OH‐QoL as indexed by the OHIP‐14 (r = 0.51–0.56, P < 0.01). Treatment was associated with marked improvement on oral health status, reduction of dental anxiety, and improvements regarding a variety of aspects of QoL (all Ps < 0.001). Reduction of dental anxiety, rather than improved oral health, was found to predict enhanced OH‐QoL. Conclusion: The results underline the importance of applying effective treatment methods for dentally anxious patients, not only with the purpose to alleviate their dental anxiety and to improve their oral health, but also because it contributes to an enhancement of their QoL.     

Dental fear and adult oral health in Australia

Abstract– Objective: This study aimed to investigate the association between dental fear and both dental caries and periodontal indicators. Methods: A three‐stage stratified clustered sample of the Australian adult population completed a computer‐assisted telephone interview followed by a clinical examination. Oral health measures were the DMFT index and its components, periodontitis and gingivitis. A total of 5364 adults aged 18–91 years were dentally examined. Results: Higher dental fear was significantly associated with more decayed teeth (DT), missing teeth (MT) and DMFT. There was an inverted ‘U’ association between dental fear and the number of filled teeth (FT). Periodontitis and gingivitis were not associated with dental fear. The association between dental fear and DMFT was significant for adults aged 18–29 and 30–44 years, but not in older ages. Dental fear was significantly associated with more DT, MT, and DMFT but with fewer FT after controlling for age, sex, income, employment status, tertiary education, dental insurance status and oral hygiene. Conclusion: This study helps reconcile some of the conflicting results of previous studies and establishes that dental fear is associated with more decayed and missing teeth but fewer FT. That people with higher dental fear have significantly more caries experience underlines the importance of identifying and then reducing dental fear as important steps in improving adult oral health.     

Dental anxiety in children and its relationship to dental caries and gingival condition

The aim of this study was to determine the levels of dental anxiety, dental caries and gingivitis among 12–15‐year‐old schoolchildren, in Irbid Governorate/northern Jordan, and to evaluate the correlation between these variables. Two schools were selected by a simple random method from each of the five geographic areas in Irbid Governorate. All children (1021), from the 10 selected schools, who participated in this study completed a questionnaire modified from Kleinknecht's Dental Fear Survey (DFS questionnaire). Children underwent oral examination for dental caries and gingival condition, using Decayed, Missing and Filled Teeth (DMFT) Index and Löe and Silness Gingival Index (GI), respectively. Results of this survey showed that the prevalence of low to moderate ‘general dental fear’ among the study population was 43% while that of ‘high dental fear’ was 10%. The self‐reported ‘general fear of dental treatment’ was higher among girls than boys. Fear of specific stimuli (pain) was the most common source of dental fear. The sight and sensation of the anaesthetic needle and the sight, sound and sensation of the drill were rated the most fear‐eliciting stimuli. The mean DMFT (2.89) and GI (1.80) of boys was not significantly different from the DMFT (3.37) and GI (1.53) of girls (P > 0.05). Spearman's correlation test demonstrated no association between ‘general dental fear’ and dental caries (r = 0.06) or gingivitis (r = 0.007).     

Will improving access to dental care improve oral health‐related quality of life?

Background

The aim of this study was to determine if Australian Defence Force (ADF) members had better oral health‐related quality of life (OHRQoL) than the general Australian population and whether the difference was due to better access to dental care.

Methods

The OHRQoL, as measured by OHIP‐14 summary indicators, of participants from the Defence Deployed Solomon Islands (SI) Health Study and the National Survey of Adult Oral Health 2004–06 (NSAOH) were compared. The SI sample was age/gender status‐adjusted to match that of the NSAOH sample which was age/gender/regional location weighted to that of the Australian population.

Results

NSAOH respondents with good access to dental care had lower OHIP‐14 summary measures [frequency of impacts 8.5% (95% CI = 5.4, 11.6), extent mean = 0.16 (0.11, 0.22), severity mean = 5.0 (4.4, 5.6)] than the total NSAOH sample [frequency 18.6 (16.6, 20.7); extent 0.52 (0.44, 0.59); severity 7.6 (7.1, 8.1)]. The NSAOH respondents with both good access to dental care and self‐reported good general health did not have as low OHIP‐14 summary scores as in the SI sample [frequency 2.6 (1.2, 5.4), extent 0.05 (0.01, 0.10); severity 2.6 (1.9, 3.4)].

Conclusions

ADF members had better OHRQoL than the general Australian population, even those with good access to dental care and self‐reported good general health.     

Anxiety and depressive disorders and dental fear among adults in Finland

Pohjola V, Mattila AK, Joukamaa M, Lahti S. Anxiety and depressive disorders and dental fear among adults in Finland.
Eur J Oral Sci 2011; 119: 55–60. © 2011 Eur J Oral Sci We studied the association between dental fear and anxiety or depressive disorders, as well as the comorbidity of dental fear with anxiety and depressive disorders, controlling for socio‐demographic characteristics, dental attendance, and dental health. Nationally representative data on Finnish adults, ≥ 30 yr of age (n = 5,953), were gathered through interviews and clinical examination. Dental fear was measured using the question: ‘How afraid are you of visiting a dentist?’ Anxiety and/or depressive disorders were assessed using a standardized structured psychiatric interview according to criteria presented in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM‐IV).Those with depressive disorders, generalized anxiety disorder or social phobia more commonly reported high dental fear than did those without these disorders. When age, gender, education, dental attendance, and the number of decayed, missing, and restored teeth were considered, those with generalized anxiety disorder were more likely to have high dental fear than were participants with neither anxiety nor depressive disorders. The comorbidity of depressive and anxiety disorders also remained statistically significantly associated with dental fear; those with both depressive and anxiety disorders were more likely to have high dental fear than were those without these disorders. Our findings support the suggestion that some individuals may have a personality that is vulnerable to dental fear.     

Oral health-related quality of life in patients with dental anxiety

OBJECTIVES: To investigate the frequency of impaired oral health-related quality of life (OHRQoL) in patients with dental anxiety. METHODS: OHRQoL was measured with the German version of the 14-item Oral Health Impact Profile (OHIP) developed by Slade and Spencer (1994) in 173 adult patients with dental anxiety [Dental Anxiety Scale (DAS) score 15 or above and Dental Fear Survey (DFS) score 60 or above]. The OHIP summary scores were characterized with an empirical cumulative distribution function and compared with the level of impaired OHRQoL in the general population (n = 2026, age: 16-79 years). In addition, OHIP item prevalences (responses 'fairly often'/'very often') were compared between patients and population subjects. The correlation between DAS, DFS and OHIP scores was calculated using the Pearson correlation coefficient. RESULTS: A median value of 1 and a 90th percentile value of 13 were observed for general population subjects. In contrast, patients with phobic dental anxiety had a median OHIP-14 of 21 and the 90th percentile of 40. All problems mentioned in the OHIP-14 were more prevalent in patients than in population subjects. The most frequently occurring items in patients were 'self-conscious', 'life in general was less satisfying', and 'feeling tense' with prevalences of 50% or greater. In contrast, these items had prevalences of only 1-3% in the general population. A low to moderate relationship between OHRQoL and both dental anxiety measures (DAS and DFS) was observed (r = 0.25/0.26, P < 0.01). CONCLUSIONS: Patients with dental anxiety/fear suffer considerably from impaired OHRQoL and the degree of this impairment is related to the extent of dental anxiety/fear.     

Possible predictors of discontinuation of specialized dental treatment among children and adolescents with dental behaviour management problems

Gustafsson A, Broberg AG, Bodin L, Berggren U, Arnrup K. Possible predictors of discontinuation of specialized dental treatment among children and adolescents with dental behaviour management problems. Eur J Oral Sci 2010; 118: 270–277. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci This study aimed to identify potential predictors of non‐attendance among children and adolescents with dental behaviour management problems (DBMP). A group of 179 patients, 7.5–19 yr of age, was grouped into 56 ‘non‐attenders’ (discontinued treatment, missed appointments, or ≥ 20% cancellations) and 123 ‘attenders’. In addition to data from an introductory interview and dental recordings, baseline data from psychometric measures of fear and other personal and parental characteristics were included in logistic regression analyses and tree‐based modelling. The non‐attenders had higher scores on impulsivity and sociability and lower socio‐economic status (SES) than the attenders, and they lived more often in single‐parent families. Logistic regression analyses and tree‐based modelling point to SES and parental anxiety as important predictors for non‐attendance within this group of children and adolescents. To predict, and possibly to prevent, non‐attendance among children and adolescents referred for specialized dental care because of DBMP, we must consider their lives and family situations as well as their personal characteristics and oral health status. Further research should focus on whether the observed associations between non‐attendance and factors such as personal characteristics, family and psychosocial factors, and previous dental experiences, also hold for those who remain in regular dental care.     

Dental fear affects adolescent perception of interaction with dental staff

The main purpose of this study was to explore whether subjective perception of interaction with dental staff is associated with dental fear in a population‐based sample of 18‐yr‐old adolescents (n = 773). The interaction was measured using the Patient Dental Staff Interaction Questionnaire (PDSIQ), validated with exploratory and confirmatory factor analyses, which yielded the factors of ‘kind atmosphere and mutual communication’, ‘roughness’, ‘insecurity’, ‘trust and safety’, and ‘shame and guilt’. Dental fear was measured using the Modified Dental Anxiety Scale (MDAS). Gender and sense of coherence (SOC) were included as potential confounding variables. Adolescents with high dental fear more often perceived their interaction with dental staff negatively and more often felt insecure than others. This difference persisted after adjustment for gender and SOC. In conclusion, adolescents with high dental fear may perceive their interaction with dental staff more positively if the staff succeed in creating a positive, trusting, approving, and supportive atmosphere with kindness, calmness, and patience. The communication and interaction skills of dental staff may play a particularly important role when encountering highly fearful dental patients.     

Why is there heterogeneity in the effect of dental checkups? Assessing cohort effect

Celeste RK, Nadanovsky P. Why is there heterogeneity in the effect of dental checkups? Assessing cohort effect. Community Dent Oral Epidemiol 2010; 38: 191–196. © 2010 John Wiley & Sons A/S Abstract – Objectives: To evaluate age as a potential effect modifier of the relation between frequency of dental check‐up and oral health. Methods: Data from a Brazilian oral health survey carried out in 2002–2003 was obtained for three age groups: 15–19‐year‐old (n = 16411); 35–44‐year‐old (n = 13 269); and 65–74‐year‐old (n = 5 300). Individuals were examined by dentists and followed to an interview. Self‐reported time since last dental visit was measured as ‘less than 1 year’; ‘from 1 to 2 years’; ‘3 or more years’ or ‘never’. Outcomes modelled with negative binomial regression were DMFT index and DT, MT and FT. Results: Visiting the dentist more recently was associated with fewer teeth with untreated dental caries (DT) and more teeth with fillings (FT) across all age groups. Among the 15–19‐year‐old, the longer the time since last visit the lower the DMFT and MT. On the other hand, among the 35–44 and the 65–74‐year‐old the longer the time since last dental visit the higher the DMFT and MT, though this trend reverted in the ‘never visited’ group. Conclusions: Age modified the effect of dental visits on DMFT and MT. In younger cohorts, the low frequency of dental check‐up among those with good oral health may reflect the fact that these young people do not feel they need to go to the dentist very often, while in older cohorts, the current low frequency of dental check‐up associated with bad oral health may be a reflection of a lifetime of high disease incidence coupled with access barriers. Questions regarding the time and frequency of dental visits may capture different dimensions of utilization of dental services, and so pooled estimates are not appropriate. Our results may help explaining contrasting results in previously published studies.     

A multi‐country comparison of reasons for dental non‐attendance

The purpose of this study was to describe differences across countries with respect to the reasons for dental non‐attendance by Europeans currently 50 yr of age and older. The analyses were based on retrospective life‐history data from the Survey of Health, Ageing, and Retirement in Europe and included information on various reasons why respondents from 13 European countries had never had regular dental visits in their lifetime. A series of logistic regression models was estimated to identify reasons for dental non‐attendance across different welfare‐state regimes. The highest proportion of respondents without any regular dental attendance throughout their lifetime was found for the Southern welfare‐state regime, followed by the Eastern, the Bismarckian, and the Scandinavian welfare‐state regimes. Factors such as patients’ perception that regular dental treatment is ‘not necessary’ or ‘not usual’ appear to be the predominant reason for non‐attendance in all welfare‐state regimes. The health system‐level factor ‘no place to receive this type of care close to home’ and the perception of regular dental treatment as ‘not necessary’ were more often referred to within the Southern, Eastern, and Bismarckian welfare‐state regimes than in Scandinavia. This could be relevant information for health‐care decision makers in order to prioritize interventions towards increasing rates of regular dental attendance.     

Validation of a Hebrew version of the Oral Health Impact Profile 14

OBJECTIVE: This study determined the validity of a Hebrew version of the Oral Health Impact Profile in a cross-sectional study of a general dental practice in Israel. METHODS: The original English version of a short-form oral health impact profile (OHIP-14) was translated into Hebrew using the back-translation technique. Participants were interviewed and examined clinically by a calibrated dentist. Information on the subjects' sociodemographic background and oral health conditions was collected. RESULTS: A total of 142 persons were interviewed and clinically examined. The Cronbach's alpha and the standardized item alpha for OHIP-14 were both 0.88. Cronbach's alpha of the translated OHIP-14 subscales ranged from 0.48 to 0.76. Construct validity of the translated Hebrew version was supported by the finding that the total OHIP score correlated with the number of decayed teeth, missing teeth, need for prosthodontic treatment, and pattern of dental attendance. Participants with oral pain were more likely to report impact on one of the OHIP subscales and to have more impacts than participants who were pain free. CONCLUSIONS: The Hebrew version of OHIP-14 presented acceptable validity and reliability. Further research is needed to assess the value of this measure in Israel.     

Differences between Racial Groups in the Impact of Oral Disorders among Older Adults in North Carolina

Objectives : This study investigated variations in impact of oral disorders between older black adults and older white adults living in North Carolina. Methods : Using the Oral Health Impact Profile (OHIP) questionnaire, 440 participants aged 70 and older provided data on their perceptions of the impact of oral disease on aspects of their lives during the previous 12 months. Results : For 22 of the 49 items queried in the OHIP questionnaire, older blacks reported more frequent impact than older whites (P<. 05). For none of the OHIP items did whites report more frequent impact. The impacts reported were diverse and included items reflecting pain, physical disability, psychological disability, and social disability. When the number of items occurring fairly often or very often were summed for dentate participants, blacks reported more items than did whites (3.7 vs 1.1 , P<. 0001). This difference decreased to 2.7 vs 2.0 (P<. 346) after controlling statistically for greater mean periodontal pocket depth, more unreplaced missing teeth, and more episodic dental visits among blacks. Conclusions : Older dentate blacks reported more impact from oral problems than older dentate whites. The differences in reported impact likely are linked to differences in oral status and dental visit history between these two racial groups in North Carolina.     

Long‐term patterns of dental attendance and caries experience among British adults: a retrospective analysis

There is inconclusive evidence on the value of regular dental attendance. This study explored the relationship between long‐term patterns of dental attendance and caries experience. We used retrospective data from 3,235 adults, ≥16 yrs of age, who participated in the Adult Dental Health Survey in the UK. Participants were classified into four groups (always, current, former, and never regular‐attenders) based on their responses to three questions on lifetime dental‐attendance patterns. The association between dental‐attendance patterns and caries experience, as measured using the decayed, missing, or filled teeth (DMFT) index, was tested in negative binomial regression models, adjusting for demographic (sex, age, and country of residence) and socio‐economic (educational attainment, household income, and social class) factors. A consistent pattern of association between long‐term dental attendance and caries experience was found in adjusted models. Former and never regular‐attenders had a significantly higher DMFT score and numbers of decayed and missing teeth, but fewer filled teeth, than always regular‐attenders. No differences in DMFT or its components were found between current and always regular‐attenders. The findings of this study show that adults with different lifetime trajectories of dental attendance had different dental statuses.