Oral health status of male prisoners in Italy

OBJECTIVES: To determine the prevalence of dental and root caries, periodontal conditions, and prosthetic status of prison inmates. DESIGN: Cross-sectional survey. SETTING: Penal institutions in the Calabria region (Italy). PARTICIPANTS: A random sample of 544 prisoners. METHODS: Participants underwent a structured interview by trained interviewers and a dental examination. RESULTS: Only 2% had no history of caries. Mean DMFT and DMFS were 9.8 and 37.6 and missing teeth was the most prevalent component of the DMFT. Higher DMFT was found among older prisoners, having regular dental attendance, higher plaque index, and in those with a lower frequency of a tooth brushing habit. Conservative care and extractions were required by 61.9% and 33.3%. The mean plaque and gingival indices were 0.74 and 0.75; 10.5% had healthy periodontal tissues. The highest number of individuals was classified as having a CPI of 2, whereas 5% had at least one sextant with a CPI score of 4. Deep pockets were more likely in older subjects and in those with a lower frequency of a tooth brushing habit. A minimum of oral hygiene instruction was needed by 89.6%. Seven subjects were edentulous and 85.1% had a prosthetic treatment need. CONCLUSIONS: This survey emphasises the need for programmes to improve the oral health of prisoners.     

Oral health status of prison inmates--New South Wales, Australia

BACKGROUND: This paper assesses the oral health status in a prison population and identifies risk factors associated with oral health. METHODS: Cross-sectional stratified random sample of 789 prisoners (657 males and 132 females) from 27 correctional centres across New South Wales, stratified by sex, age and aboriginality. A face to face interview was used to collect information on health status and behavioural risk factors. A subset of participants (312 males and 22 females) received an oral examination which enabled the decayed, missing or filled permanent teeth (DMFT) score to be calculated. RESULTS: In the last 12 months 391 (50 per cent) inmates had visited a dentist. Reports on treatment received at this last visit were mainly for dental examinations, (62 per cent), dental fillings, (38 per cent), and dental extractions (28 per cent). Self-reported dental needs indicated that 42 per cent perceived the need for a check-up; the perceived need for dental fillings was highest in females compared with males. The mean DMFT for the population was 20.4 and 3.4 for decayed teeth. CONCLUSIONS: This survey demonstrates that the standard of past oral health care for prison inmates is low. There is a need to be more attentive to oral health promotion as eventually respondents will be returning to the community.     

Oral health status of children and adults in urban and rural areas of Burkina Faso, Africa

OBJECTIVES: To analyse the oral health status of children and adults in rural and urban areas of Burkina Faso; to provide epidemiological data for planning and evaluation of oral health care programmes. DESIGN: Cross-sectional survey including different ethnic and socio-economic groups. SAMPLE AND METHODS: Multistage cluster sampling of households in urban areas and random samples of participants selected based on the recent population census in rural areas. The final study population covered four age groups: 6 years (n = 424), 12 years (n = 505), 18 years (n = 492) and 35-44 years (n = 493). Clinical oral health data collected according to WHO methodology and criteria. RESULTS: At age 6, 38% of children had caries, with prevalence higher in urban than rural areas. At age 12, the mean DMFT was 0.7 with prevalence significantly higher among urban than rural children. Mean DMFT was 1.9 in 18-year-olds and 6.3 in 35-44-year-olds and figures were higher for women than men. In adults, no differences in caries experience were found by location whereas the caries index was significantly affected by ethnic group and occupation. CPI score 2 (gingivitis and calculus) was dominant for all ages: 6 years (58%), 12 years (57%), 18 years (58%), 35-44 years (49%). In addition, 10% of 35-44-year-olds had CPI score 4. Rural participants had more severe periodontal scores than did urban individuals. CONCLUSIONS: Health authorities should strengthen the implementation of community-based oral disease prevention and health promotion programmes rather than traditional curative care.     

Prosthetic Status and Treatment Needs of Prisoners in Central Prison, Chennai

Prisoners who are entangled in legal matters and imprisonment are isolated from family members and other social activities and rarely give attention to their general health and oral health. The present study aims to assess the prosthetic status and treatment needs of prisoners in Central Prison, Chennai. A cross-sectional epidemiological survey was conducted in Central Prison, Chennai. The study population consisted of 1,060 prisoners from three divisions of the Central Prison. A single examiner assessed the prosthetic status of the prisoners according to WHO specifications. The present study shows that among males, 2.3 % of the subjects had bridge, 1.2 % had partial denture in the upper jaw, 0.8 % had bridge and 0.4 % had partial denture in the lower jaw. Among females, 8.6 % had partial denture in the upper jaw and 5.7 % had partial denture in the lower jaw. This study shows that edentulousness was a common problem among the prisoners. The prosthetic needs of this group of people should be delivered with the services of a prosthodontist in the prison settings. Oral health care facilities should be incorporated in prison settings which would intercept the progress of dental diseases and thus minimize tooth loss.     

Oral health assessment of Hungarian adult population based on epidemiologic examination

A representative national survey by the dentists of the Department of Prosthodontics, Semmelweis University was performed to assess oral health conditions of Hungarian adult population before joining the European Union. The aim of this study was to evaluate periodontal conditions of the population from data collected in the survey and to investigate the associations between gender, age and demographic regions and the prevalence of periodontal problems. The 2 years long nationwide investigation followed the WHO criteria (World Health Organization, 1997) and assessed 4606 person throughout all regions of the country. Periodontal conditions and treatment needs of 4153 person were assessed in intraoral examinations by Community Periodontal Index (CPI) method. Age, gender, demographic regions were recorded on questionnaires. According to our findings CPI 2 was the most frequent finding in all age groups which primarily reflected poor oral hygiene. When we consider gender differences, CPI 3 and CPI 4 were more frequent among males while women had CPI 0 and CPI 2 with higher frequency. Our findings reflect regional differences of periodontal health conditions as 16% of the population of the capitol and its surroundings had healthy periodontal condition however we could find CPI 0 only in 5-8% of Middle and South-Danubium population. Findings of our epidemiologic survey call attention on poor oral hygene of the population. There is a need in Hungary for better oral health education of the population, more preventive programs and action plans to promote regular dental office attendance.     

Trends in oral health from childhood to early adulthood: a life course approach

Lu HX, Wong MCM, Lo ECM, McGrath C. Trends in oral health from childhood to early adulthood: a life course approach. Community Dent Oral Epidemiol 2011; 39: 352–360. © 2011 John Wiley & Sons A/S Abstract – Objectives: The aims of this study were to investigate trends in oral health in a cohort from late childhood through adolescence to early adulthood and to describe how the oral health of young adults was affected by their family sociodemographic characteristics, oral health status, and utilization of dental services during adolescence using life course approach. Methods: A cohort of 638 students was followed from late childhood (12 years old) through adolescence (15 years old) to early adulthood (18 years old) in Hong Kong. Dental examinations included the assessment of caries experience (DMFT score) and periodontal conditions (Community Periodontal Index, CPI) according to WHO criteria. Information on utilization of dental services, parental education attainment, and monthly household income was collected. Path analyses were performed to investigate oral health trends and the relationships between oral health (DMFT scores and highest CPI values) at age 18 years and the sociodemographic characteristics at age 12 years, oral health, and utilization of dental services during adolescence. Results: In 2004 and 2007, 395 (62%) and 324 (51%) subjects of the original sample were followed up when they reached the age of 15 and 18 years, respectively. The mean DMFT score gradually increased from 0.62 at age 12 to 1.52 at age 18 (P < 0.001). The proportion of subjects with calculus or shallow periodontal pockets (highest CPI score 2 or 3) also increased with age, from 58% at age 12 to 96% at age 18 (P < 0.001). The oral health trend path models showed that DMFT score and highest CPI value at age 18 years were positively associated with DMFT score and highest CPI value at younger ages (P < 0.05). Results of the two extended path models showed that household income had positive effect on the utilization of dental services (β > 0.29, P < 0.05) and the utilization of dental services had positive effect on DMFT score (β > 0.12, P < 0.05) but not for highest CPI value (P > 0.05). However, parental education attainment had no significant effect on either DMFT score or highest CPI value (P > 0.05). Conclusions: Oral health status had become worse from childhood to early adulthood in the study cohort. Economic circumstance of the subjects was found to be positively related to their utilization of dental services and through this contributed to the subjects’ caries experience. Oral health at younger ages was positively associated with succeeding oral health conditions.     

Oral health and its impact on the life quality of homeless people in Hong Kong

OBJECTIVES: To report on the oral health status and its impact on the life quality of homeless people in Hong Kong. DESIGN: A cross sectional epidemiological survey involving clinical oral examinations and face-to-face interviews with 147 homeless participants. Clinical examinations were carried out following WHO criteria. The impact of oral health on quality of life was assessed with the short form of Oral Health Impact Profile, OHIP-14. RESULTS: Over 90% had caries experience and most related to untreated decay. The mean DMFT score for dentate subjects was 8.1 (DT = 3.4, MT = 4.0, FT = 0.7). Periodontal disease was highly prevalent, 96% having periodontal pockets. The burden of oral health on their daily lives was common, 88% reporting an oral health impact within the past year. A multiple regression analysis indicated that the OHIP-14 score had significant associations with self-rated oral health, dental pain, employment status and length of time being homeless (p < 0.05). Those who assessed rated oral health as 'poor/very poor', reported dental pain in the past year, were unemployed, and homeless for more than one year had poorer oral health related quality of life (significantly higher OHIP scores) than their counterparts. CONCLUSION: Among the homeless population studied, oral health status was poor and its impact on their life quality was substantial. The oral health impact was associated with socio-demographics and perceived dental problems.     

Periodontal health of an adult population in Hungary: findings of a national survey

Objectives: To estimate the levels of periodontal health conditions of Hungarian adults.
Material and Methods: Periodontal data on 4153 adults in 304 survey locations from all Hungarian regions were analysed. The Community Periodontal Index (CPI) was used to report the occurrence of probing pocket depth, calculus, and gingival inflammation.
Age, gender, socioeconomic and health status, oral hygiene and lifestyle habits, dental office attendance, level of education, and fixed partial denture (FPD) treatment were evaluated for their association with periodontal conditions. CPI score as an outcome was dichotomized using an accepted threshold as low (<3) and high (3, 4) for multiple logistic regression modelling.
Results: CPI2 was the most prevalent score in all age groups. CPI scores were also strongly associated with the independent variables. Approximately 66% of subjects visited a dentist only in the case of an emergency. Lack of periodontal aspects of restorative care was demonstrated by the result of CPI0 among 16% of non-FPD wearers compared with only 9% of individuals treated with FPD.
Conclusion: The present survey indicates that oral hygiene standards and periodontal health conditions need improvement in Hungary. Effective intervention programme for the prevention and control of periodontal disease are recommended at a national level.     

A program review of a community-based oral health care program for socially vulnerable and underserved citizens in Denmark

Objectives: To describe the oral health and oral health-related quality of life among social vulnerable adults enrolled in a special oral care program, and to evaluate the effect of oral care on their oral health-related quality of life.

Method: Social workers identified social vulnerable persons in social centres and referred them to the program. Dental clinics were arranged including a well-motivated staff to be special responsive to these clients. The participants, (n?=?235, mean age 43.5 years) with drug abuse, being homeless, permanently unemployed, or with mental problems were offered low-cost treatment services. Data collection was made by clinical registration and questionnaires. Oral health-related quality of life was measured by means of the Oral Health Impact Profile-14 index (OHIP-14).

Results: 94% of the participants had actual decayed teeth (mean 9.5). Forty-four per cent had not visited a dentist within 5 years and less than one-third reported tooth brushing twice a day, 17% even less frequent. One hundred and forty-six completed the dental program within the program period. Mean OHIP-14 score was 28.6 at baseline. Among those who fulfilled the program, the OHIP-14 score was reduced to 9.9 (p?<?.001).

Conclusion: Oral health among the study population was very poor. However, oral problems in this group can be solved, and their oral health-related quality of life can be increased although it requires special arrangements and special clinical environment.     

The oral health of a group of prison inmates

The oral health of prison inmates in England has come under increased scrutiny with the arrival of joint responsibility between the Home Office and the NHS for prison healthcare. This brief study indicates very high levels of oral disease amongst a group of prisoners attending for treatment in an English prison. Further study of the oral health of prisoners seems timely, as does the exploration of effective oral health promotion for this group of people.     

Comparison of the GOHAI and OHIP-14 as measures of the oral health-related quality of life of the elderly

OBJECTIVES: This paper compares the performance of the GOHAI and the OHIP-14 as measures of the oral health-related quality of life of the compromised elderly. METHODS: Data were obtained from a cross-sectional survey of 225 participants, most of whom lived in a large geriatric care centre. RESULTS: The mean age of subjects was 83 years and the majority had one or more chronic medical conditions and physical disabilities. Their main oral problems were high rates of tooth loss and xerostomia. Additive and simple count methods were used to derive GOHAI and OHIP-14 scores. Using the additive method, 8.4% had a GOHAI score of zero and 30.3% an OHIP-14 score of zero. Using the simple count method the percentage with a score of zero was 15.1% and 45.8%. Both measures discriminated between dentate subjects with and without one or more dentures, with and without a chewing problem and with and without dry mouth. Both also showed significant associations with self-rated oral health and satisfaction with oral health status. Associations tended to be stronger between GOHAI scores and these variables. The measures were equally good at predicting overall psychological well-being and life satisfaction. Although the GOHAI identified more oral functional and psychosocial impacts than the OHIP-14, neither was markedly superior to the other when used as discriminatory measures. However, the high prevalence of subjects with zero scores may compromise the ability of the OHIP-14 to detect within-subject change.     

Oral health status and treatment needs in institutionalized psychiatric patients: one year descriptive cross sectional study.

BACKGROUND AND OBJECTIVES: Psychiatric patients are one of the special groups requiring attention as they are often neglected. Oral health is an major determinant of general health for psychiatric patients and may have a low priority in the context of mental illness. The present study was conducted to assess the oral health status and treatment needs of institutionalized psychiatric patients of Davangere. METHODS: 220 psychiatric patients admitted in two general hospitals of Davangere during the period of one year were included in the study. The oral health status was evaluated with respect to caries, oral hygiene, and periodontal status. RESULTS: Of the 180 examined with the response rate of 81.8%. 58.3% were males, mean age was 36.7 years, 57.8% had < 1 year of mental illness with a mean of 2.2 years, and 90% were self-sufficient. The multiple logistic regression analysis showed that the mean DMFT (0.92) increased with age, duration of mental illness, and irregularity of oral hygiene habits (P<0.001). Mean OHI-S score was 3.3 and multiple logistic regression analysis showed that the mean OHI-S score increased with age (P<0.001). The multiple logistic regression analysis showed that the CPI score increased with age, duration of mental illness, and degree of helplessness (P<0.001). INTERPRETATION AND CONCLUSION: The findings of this study demonstrates low caries prevalence, poor oral hygiene, and extensive unmet needs for dental treatment.     

Risk assessment of periodontal disease in Hungary

In this study, risk determinants were assessed for periodontal disease in the oral health survey of a representative Hungarian adult population sample. 4153 individuals participated in the study after formal consent. Participants were questionned on level of education, dental office attendance, smoking habits, oral hygiene habits and general health conditions. Quality of fixed partial dentures (FPD) were evaluated. Periodontal health status was assessed with the CPI method according to WHO criteria. When the prevalence of CPI scores was assessed by educational level, significant differences were found between groups. With increasing levels of education, a significantly higher percentage of subjects visited the dental office regularly. Higher prevalence of CPI 0 was found among those with higher level of education but there was also high prevalence of CPI 2, representing bad oral hygiene in the highly educated group. Findings of our study showed high percentage (66%) of the population attending the dental office only in case of emergency. The investigation revealed destructive effect of unsatisfactory construction of FPD on the periodontium. Healthy periodontium (CPI 0) was found among 16% of those wearing no FPD and 9% among FPD-wearers. The prevalence of deep periodontal pockets (CPI 4) was 1,6 times higher among smokers as non-smokers. Oral health statistics play an important role in planning for improvement of dental health care. Hungary needs effective prevention programs and emphasize on regular dental office attendance of individuals to improve the nation's oral health status.     

Oral health care needs and oral health‐related quality of life (OHIP‐14) in homeless people

Daly B, Newton T, Batchelor P, Jones K. Oral health care needs and oral health‐related quality of life (OHIP‐14) in homeless people. Community Dent Oral Epidemiol 2010. © 2009 John Wiley & Sons A/S Abstract – Objectives: The aim of this study was (i) to determine the oral health status and oral health care needs of this population, (ii) to assess oral health‐related quality of life using OHIP‐14 and (iii) to explore whether there is a relationship between oral health status and oral health‐related quality of life. Methods: A convenience sample was drawn from eight facilities catering for homeless people in south east London. Participants were invited to attend an outreach dental clinic and receive a clinical oral health and treatment needs assessment. The impact of oral disease was assessed using OHIP‐14. Results: There were 102 people from a range of vulnerable housing situations invited to participate in the study. The mean age was 39.5 (SD ± 12.3) and 92% (n = 92) were men. The mean DMFT of dentate participants (n = 94) was 15.5 (SD ± 7.6), mean DT was 4.2 (SD ± 5.2), mean MT was 6.8 (SD ± 6.0) and mean FT was 4.6 (SD ± 4.8). Normative needs were extensive with 76% having a restorative need, 80% having a need for oral hygiene measures and periodontal treatment and 38% having a prosthetic treatment need. Ninety one per cent of homeless people experienced at least one impact and the mean number of impacts (n = 90) was 5.9 (SD ± 4.8).The most commonly experienced oral health‐related quality of life impacts were in the dimension of pain, with aching in the mouth having a prevalence of 65% and discomfort while eating foods having a prevalence of 62%. Forty‐four per cent felt handicapped by their oral condition. The experience of oral impact had only a slight relationship with clinical status and there were no differences in clinical status or oral impact by vulnerability of housing situation. Conclusions: Oral health care needs were extensive and greater than that of the general population in the UK, although disease levels were similar. While homeless people experienced many more oral impacts (as measured with OHIP‐14) compared with adults of the same age in the general population in the UK, there was only a slight relationship with clinical status and oral health‐related quality of life.     

Association between diet, social resources and oral health related quality of life in edentulous patients

To assess whether there was an association between diet, oral health related quality of life and social resources in a population of older edentulous adults, and, to assess the impact of provision of new complete replacement dentures. This study was carried out at Cork University Dental Hospital in Ireland. In this prospective clinical study, 35 edentulous adults who requested new complete dentures completed pre-treatment questionnaires which included validated oral health status, social resources and nutritional assessment questionnaires. New dentures were provided and the impact of treatment on oral health related quality of life, diet and ability to chew food was assessed. Satisfaction with dentures and oral health related quality of life improved following provision of new dentures. However, food choice remained similar to pre-treatment choice, and subjects were rated as medium risk for poor nutritional status on the Mini Nutritional Assessment (MNA) score. Oral health related quality of life and diet were not correlated. Three quarters of the sample felt they had no nutritional problems. However, approximately 70% reported that they had changed their food choices because of dental problems and that financial cost was a barrier to dental treatment. Food selection among the group studied was not ideal, and not improved by the provision of new dentures. There was no association between diet and oral health related quality of life. Further research is needed to improve our understanding of the relationship between oral health and diet.     

A baseline survey: oral health status of prisoners--Western Cape.

South African prison populations continue to grow because of the escalating crime and an overstretched judicial system. The aim of this study was to assess the oral health status of prison inmates in the Western Cape (Pollsmoor, Goodwood, Paarl and Worcester). A cross-sectional epidemiological survey involving a clinical oral examination and face-to-face interviews was used to collect information on DMFT, periodontal health, perceived needs and the knowledge, attitudes and behaviour of inmates to oral health. Clinical examinations were carried out using WHO criteria. Of the 340 study participants, 264 were male and 76 were female. The prevalence of oral disease was high. The mean DMFT was 15.45 and the total DMFT increased with age. There was a reported impact on oral health quality of life, with many citing problems with eating, drinking and pain. Self-reported dental needs indicated a perceived need for dentures, scaling and fillings. Over two thirds of the sample (72%) reported that the dental services that they presently receive are poor. This study found a high prevalence of dental caries and periodontal disease among the correctional service populations. There is an urgent need for the development of a basic oral health care package that should be offered to all inmates as eventually many of them will be returning to the community.     

在沪西藏学生口腔健康状况调查

目的：调查上海医药高等专科学校在校藏族学生的口腔健康状况，为指导该人群的口腔卫生干预措施提供参考依据。方法：参照WHO《口腔健康调查基本方法》和人民卫生出版社《口腔预防医学》制定调查表，调查评价牙龈指数GI、社区牙周指数CPI、龋失补牙数DMFT和龋失补牙面数DMFS等指标。结果：藏族学生122人，GI平均为0．726±0．413；CPI结果1分占25-4％，2分占67．2％；患龋率高达86．1％，人群的龋齿充填率仅为2．7％；122人中，失牙人数46人，失牙率为37．7％；总人群龋均3．62±2．84，龋面均5．61±5．27；总人群DMFT均数为4．8±3．5，DMFS均数为6．9±5．8。结论：藏族青少年龋病流行状况较严重，牙龈健康状况处于平均水平，121腔卫生工作以防治龋病和卫生宣教为主。     

Status of oral healthcare in long-term care facilities

Oral health is a fundamental component in the overall well-being and quality of life for elders living in long-term care facilities. Effective oral care interventions must not only involve recognising the importance of oral health in this population, but giving oral hygiene the same priority as other care practices in long-term care settings.     

Is Cognitive Status Related to Oral Hygiene Level and Appropriate for Determining Need for Oral Hygiene Assistance?

Background: With declining general health, the maintenance of oral health becomes increasingly difficult. Unfortunately, health care resources are limited. An assessment tool for detecting a patient’s need for oral health care assistance would promote its adequate distribution. The aim of this study is to evaluate if the Shulman clock‐drawing test score is a suitable assessment tool for determining the need for oral hygiene assistance. Methods: Data collected from recent dental checkups of 126 inhabitants of five Austrian residential care facilities were analyzed. The Shulman clock‐drawing test score was used as a measure for cognitive abilities and related to tooth and denture hygiene indices, which were assessed using the approximal space plaque index (API) and the denture plaque index (DPI). Results: Shulman score values were distributed almost evenly in the study population. The mean API was 83.6% (SD 20.2%) for the maxilla and 94.9% (SD 15.6%) for the mandible. The mean DPI was 43.9% (SD 31.4%). Cognitive impairment was not statistically related to the dental or denture hygiene index. Conclusions: A high Shulman clock‐drawing test score indicates the need for oral hygiene assistance, but it is not suitable as a single tool to assess this need. Patients with other disabilities might equally qualify for assistance. Dentures, however, can be cleaned quickly and efficiently independently of patient compliance; therefore, cleaning the patients’ dentures should be part of nursing personnel’s daily care routine for every patient.