Non-institutionalized elderly dental patients in Israel: socio-demographics, health concerns, and dental anxiety

The purpose of this study was to evaluate which factors might Influence health care attitudes such as anxiety about dental care by older adults in Israel. The study population consisted of 103 non-institutionalized patients (46 men and 57 women) over the age of 65 who attended a dental clinic that provided services for older adults during a one-year period. Socio-demo-graphic Information and Information about the subjects' general health and their level of concern about health problems were obtained from self-reported questionnaires, while the dental anxiety level was found by means of a dental anxiety scale (DAS). Ninety-nine percent of the patients suffered from a major systemic disease such as diabetes, hypertension, atherosclerosis, respiratory disease, and rheumatic disease. Both umnarried and first-time patient expressed high anxiety scores. Patients with 12 or fewer years of formal schooling demonstrated significantly higher dental anxiety. Among patients who regularly attended a synagogue or a social club, concern about oral health was significantly higher than for the rest (p < 0.02). No association was found between having dentures and gender, or between having dentures and level of education. The reason for visiting the clinic (inability to eat, pain, or esthetics) was not associated with any other health concern or with dental anxiety levels. This study determined that patients who were unmarried, less educated, or attending the facility for the first time were more likely to experience dental anxiety. These patients merit special consideration.     

Dental caries prevalence among adults in Denmark--the impact of socio-demographic factors and use of oral health services

OBJECTIVES: To measure the prevalence of dental caries in the Danish adult population and to analyse how the risk of dental caries is affected by age, gender, region, area, and socio-economic factors. Furthermore to assess the impact on dental caries experience of use of oral health services during childhood and adult life. BASIC RESEARCH DESIGN ANDPARTICIPANTS: A cross-sectional study of a random sample of 1,115 Danish adults in ages 35-44 years and 65-74 years. Data were collected by means of personal interviews and by clinical examinations according to criteria of the World Health Organization. Dental caries was recorded at tooth and tooth surface levels. RESULTS: At age 35-44 years the mean caries experience was 46.6 DMF-S against a mean of 104.1 DMF-S in the total sample of 65-74-year-olds. The D-component was low (35-44 years D-S = 0.9; 65-74 years D-S = 1.5). The M-component was three times higher in the elderly than in the younger age group. The multivariate analysis showed that significantly more untreated decay was found among men, in rural areas and in low income groups. A significantly higher score of filled surfaces were found among older adults and in the group with more education (12-13 years) whereas the F-component was low in the low income group. The total DMF-S was significantly higher among the elderly, persons living in Jutland and in groups with less education, while men had low DMF-S compared to women. CONCLUSION: Reducing social inequality in dental caries experience remains a challenge to oral health services in Denmark; strengthening community-oriented oral disease prevention and health promotion is needed to improve the oral health in the Danish adult population.     

Communication about dental health in Norwegian adults

The present study describes the amount and distribution of communication on dental health issues in Norwegian adults. The empirical data stem from a representative sample of Norwegians aged 15 and above, and were collected by means of personal interviews by the poll organization Norges Markedsdata in 1983. Edentulous subjects were excluded, and the study group finally comprised 1225 subjects. The dependent variable - dental communication - was a dichotomy based upon whether or not the respondents had communicated with friends about dental health during the last 6 months. The following independent variables were used: age, sex, marital status, education, use of dental services, number of teeth, knowledge of prevention, information about dental health from dentists and media, use of dental floss and toothpicks. The empirical analysis was performed using contingency table analysis and Multiple Classification Analysis (MCA). Separate analyses were performed for men and women. Significantly more women (27.6%) than men (14.5%) reported dental communication. In addition, the model provided a better fit to the data on women compared to men in terms of R2 (12.5% and 8.9%). These observations can to some extent be accounted for by the existing sex-role pattern. The only predictor which showed a consistent direct effect across sex was whether the respondents had received information about dental health from media. This means that reference to the interpersonal context of mass communication perhaps best describes the complex transactional interplay of media and interpersonal sources in dental health matters.     

Irregular users of dental services among Norwegian adults

In 1979-80 a nationwide random sample of 1511 Norwegians, aged 16-79 years, were asked a series of questions about dental health and related factors (behavior, attitude, knowledge, social network, interpersonal communication, and 'health locus of control'). The purposes of the study were to describe the irregular users of dental services and to find mutable factors that could distinguish the regular from the irregular users. 17.4% of the dentate women and 21.7% of the men reported visiting the dentist less than once a year. Among the background variables, age and income/education were the most powerful predictors of use of dental services. Different patterns of behavioral characteristics were found among women as compared with men. The mutable factors that made a significant distinction between the regular and irregular users were use of interdental remedies, use of fluoride, social network, and health attitude (only among women). To a great extent, sociopsychologic and behavioral factors seemed to act through the demographic and economic variables in predicting the regularity of dental attendance.     

Number of remaining teeth and rehabilitation with removable dentures in psoriatics

The aim of this investigation was to study associations between the state of dentition and socio-medical aspects in psoriatics. It was found that the number of remaining teeth in subjects under 65 years of age was higher in psoriatics with skin symptoms (P-group) than in psoriatics with skin and joint symptoms (PA-group) (P less than 0.01), this rate being higher than that found among the general population in Finland. In younger subjects, women in the P-group wore removable dentures more frequently than did women in the PA-group (P less than 0.05), whereas among older subjects men in the PA-group wore removable dentures more frequently than did men in the P-group (P less than 0.001). In the log-linear model that was applied, more advanced age, lower level of education and infrequent dental visits were associated with a low number of remaining teeth in both the P-group and the PA-group. A poor general state of health in the P-group and a high number of teeth, indicating that there is an association between severity of general disease and dental health status.     

Dental health behavior in a migrant perspective: use of dental services of Pakistani immigrants in Norway

The purpose of the present study was to assess the utilization pattern of dental services in a group of Pakistani immigrants in Norway. Use was related to sociodemographic characteristics, level of urbanization in Pakistan, knowledge and belief about dental diseases and evaluated and perceived dental health. A total of 160 immigrants were clinically examined and interviewed by a structured questionnaire. The effect change analysis was performed, and separate analyses were performed for men and women. Altogether 60% had visited the dentist during the last 3 yr. While 69% coming from the cities had been to the dentist in Norway, this was the case for only 38% of those from the villages of Pakistan. Pain was given as the main reason for dental visits, and the data indicated insufficient ability to perform self-assessment of own dental health. The independent variables could explain more of the variance in use of dental services among the Pakistani men (R2 = 40%) than among the women (R2 = 21%). While number of decayed teeth and level of urbanization were among the strongest predictors among the men, dental behavior in Pakistan and number of years in Norway were of importance among the women. The latter variable indicated that the women in terms of dental behavior had a higher degree of acculturation than the men, leading to a change in traditional health behavior.     

Increased lifetime prevalence of dental trauma is associated with previous non-dental injuries, mental distress and high alcohol consumption

Abstract – The purpose of the study was to assess the lifetime prevalence of dental injuries and risk factors involved in a general population-based birth cohort. The study population consisted of 5737 subjects who had participated in a health survey at the age of 31 years. Altogether 52% of the participants were women. This partly computer-based health survey included two questionnaires on previous dental and non-dental injuries, general health, occupational status and lifestyle. The current study was based on these questionnaires. The lifetime prevalence of dental fractures was 43% and the lifetime prevalence of dental luxations and exarticulations 14%. Men more commonly had dental injuries than women. Particularly mental distress and a history of previous injuries were shown to increase the risk for dental injuries. Furthermore, overweight and high alcohol consumption were positively associated with a high lifetime prevalence of tooth trauma. Regular physical activity decreased trauma occurrence. Socioeconomic status further affected the lifetime prevalence of dental injuries. The conclusion of the study was that personal, social and physical factors played a role in the occurrence of dental trauma.     

Dental health and parity in three 70-year-old cohorts

In three cohorts of 70-yr-olds in Gothenburg, Sweden, born in 1901/02, 1906/07 and 1911/12, the relationship between oral health and parity was studied in 713 women and between oral health and the reported number of children in 660 men of the same cohorts. For women in all three cohorts, the number of teeth decreased in relation to increasing number of children that they had given birth to. Significantly more women with high parity were edentulous in one or both jaws compared to the other groups. Among parous compared to nulliparous women the age for becoming edentulous occurred earlier. The number of intact teeth was lower in parous compared to nulliparous women. Among the men no relation was found between oral health and the number of their children. When socioeconomic factors were taken into consideration the above described relations between declining dental health and increasing parity remained on about the same level of significance. Although pronounced cohort differences were found, a relationship between parity and dental health was found in all cohorts, indicating a general biological influence of repeated pregnancies.     

Dental diseases and loss of teeth in a group of Finnish alcoholics: a radiological study

A total of 85 Finnish alcohol-dependent subjects and 53 controls were studied with panoramic radiography. The aim was to study the possible associations between prolonged alcohol consumption and dental health. The mean number of teeth, caries lesions, endodontic treatments, periapical lesions, marginal bone loss, and periodontal infrabony pockets was studied. The subjects met the diagnostic criteria of alcohol dependence as set out in DSM-IV and ICD-10. The control group comprised social drinking volunteers with an AUDIT score &#104 8. For the final results the subjects were divided into groups on the basis of sex and age. The social backgrounds of the subjects were similar, except for employment and smoking. The results show significantly fewer teeth and more caries in the alcoholic group. There was a tendency for the alcoholics <45 years of age to have more endodontically treated teeth than the controls, but no difference in the number of periapical lesions in endodontically treated teeth was found. Horizontal bone loss and the presence of calculus were more frequent in alcoholic men than in alcoholic women. Significantly more horizontal bone loss was observed in the group of alcoholic nonsmokers than in nonalcoholic nonsmokers. In the nonsmoking groups alcoholics had significantly more periodontal destruction than the nonsmoking controls. We conclude that radiological dental health among individuals dependent on alcohol is weakened by more caries, more horizontal bone loss, and more numerous vertical infrabony pockets than social drinkers.     

Dental diseases and loss of teeth in a group of Finnish alcoholics: a radiological study

A total of 85 Finnish alcohol-dependent subjects and 53 controls were studied with panoramic radiography. The aim was to study the possible associations between prolonged alcohol consumption and dental health. The mean number of teeth, caries lesions, endodontic treatments, periapical lesions, marginal bone loss, and periodontal infrabony pockets was studied. The subjects met the diagnostic criteria of alcohol dependence as set out in DSM-IV and ICD-10. The control group comprised social drinking volunteers with an AUDIT score < or =8. For the final results the subjects were divided into groups on the basis of sex and age. The social backgrounds of the subjects were similar, except for employment and smoking. The results show significantly fewer teeth and more caries in the alcoholic group. There was a tendency for the alcoholics <45 years of age to have more endodontically treated teeth than the controls, but no difference in the number of periapical lesions in endodontically treated teeth was found. Horizontal bone loss and the presence of calculus were more frequent in alcoholic men than in alcoholic women. Significantly more horizontal bone loss was observed in the group of alcoholic nonsmokers than in nonalcoholic nonsmokers. In the nonsmoking groups alcoholics had significantly more periodontal destruction than the nonsmoking controls. We conclude that radiological dental health among individuals dependent on alcohol is weakened by more caries, more horizontal bone loss, and more numerous vertical infrabony pockets than social drinkers.     

Variation in dental health in 70-year old men and women in G?teborg, Sweden. A cross-sectional epidemiological study including longitudinal and cohort effects

Within the framework of an epidemiological, initially cross-sectional and subsequently longitudinal, population study of 70-year-old people, a representative sample of 386 subjects were subjected to odontological investigation. Forty six per cent of the men and 55% of the women were edentulous in both jaws and 20% of the men and 19% of the women were edentulous in one jaw. In dentulous subjects the mean number of teeth was 13.6 (men) and 13.5 (women). The tooth mortality rate was higher in the upper than in the lower jaw and higher in the lateral segments of the jaws than in the frontal region. The mean number of carious teeth was 3.2 for men and 2.4 for women and the mean number of intact teeth was 4.8 in men and 3.4 in women (p less than or equal to 0.05). Fifty four per cent of remaining teeth had been restored in men and 73% in women (p less than or equal to 0.01). Significantly more upper teeth were restored than lower teeth. Half of the dentulous subjects had worn their dentures for more than 10 years and only 14% had satisfactorily functioning dentures and acceptable occlusion. Poor retention and poor stability were very common in unsatisfactory dentures, more so in the upper than in the lower jaw. The proportion of dentures with these faults increased with increasing age of the dentures. The degree of dental invalidity was classified according to Eichner's index. This index was strongly correlated to the number of teeth and tooth contacts (p less than or equal to 0.001). The Eichner index covaried with frequency of visits to the dentist and special background factors such as income, education, marital status and past and present smoking habits. Married men tended to have a better level of dental health than other men (p less than or equal to 0.01), while the reverse was true for women. About half of the dentulous subjects were in need of prosthetic treatment and slightly less than half of them needed conservative dental treatment. Sixty per cent of edentulous subjects needed new dentures. The longitudinal comparisons between the ages of 70 and 75 showed small changes in dental invalidity. In a new cohort of 70-year-olds examined 5 years later the proportion of edentulous was significantly lower than in the first 70-year-old cohort.     

Self perceived oral health, oral treatment need and the use of oral health care of the adult population in Skåne, Sweden

The aim was to describe how the adult population in Sk?ne, Sweden, perceived their oral health, dental status, oral treatment need and use of oral health care. A questionnaire was sent to a randomly selected sample of 10 000 persons in Sk?ne, Sweden. The individuals were between 20 and 89 years old and registered as residents of the region during 2006. After excluding those no longer living in the region, 9 690 individuals remained. The response rate to the questionnaire was 63%, of which 57% were women and 43% men.A majority was satisfied with their teeth and with their teeth's appearance, 65% and 62% respectively. Of the respondents, 35% considered their dental health to be better than others in their age group. Symptoms associated with periodontitis were experienced by 40%. 7% were missing more than ten teeth while 7% had no dental fillings. 30% rated their need of dental treatment as high and most expected their treatment need to increase in the future. Most of the respondents, 60%, received their oral care at a private practice, whereas 13% did not see a dentist regularly for check-ups. More women than men perceived a high dental treatment need, 32% compared to 28%. CONCLUSIONS: A majority of the adult population in Sk?ne have a positive attitude towards their oral health. Most individuals had lost few teeth and removable dentures were uncommon.A third rated their dental treatment need as high and most expected their treatment need to increase in the future..     

Prevalence of teeth and dentures among elderly in Norway receiving social care

The aim of this study was to estimate the prevalence of teeth and dentures in individuals aged 67 years and over receiving social care in Norway. A representative sample of 2893 individuals was selected from all 19 counties of Norway. In all, 1910 individuals (1358 living in institutions, 552 living at home) could be interviewed and examined by calibrated local dental teams in 1996-97. Overall response rate was 66%. Out of the examined, 1359 (71%) were women and 551 (29%) were men. The mean age was 85.1 years for women and 82.2 years for men. In all, 19.6% had 'own teeth only', 21% 'own teeth and dentures', 54% 'dentures only', and 5.3% 'neither teeth nor dentures'. Previous findings in a random sample of elderly Norwegians from three regions with markedly different dental health were confirmed by using plychotomous logistic regressin. Three regions of Norway could be identified with respect to the occurence of teeth and dentures: region A (South-East counties of Norway including the capital Oslo), region B (West-Central counties), and region C (Northern counties). Significant differences existed between them and non-significant differences between them. A mean number of 12.3 teeth were observed in 773 (40.5%) dentate individuals, 13.4 in reion A, 11.4 in region B, and 9.0 in region C, respectively. In conclusion, there are large geographic disparities with respect to dental/denture status also in individuals receiving social care in Norway. When the data were collected (1996-97), the oral health goal for the year 2000 suggested by WHO/FDI aiming at 50% of people aged 65 years and above having a minimum of 20 remaining functional teeth was not fulfilled for individuals receiving social care in large parts of Norway.     

Disparities in self reported oral health problems among a young Syrian adult population

OBJECTIVE: To describe the prevalence of dental pain and other oral health problems among a young Syrian adult population and to identify socio-demographic factors associated with these experiences. Subjects: An industrial sample of 400 men and women aged 18-34 years from Damascus, Syria. METHODS: Study participants were interviewed about their experience of oral health problems in the previous year (1998). Socio-demographic information was collected. RESULTS: 93% (369) of the interviews were completed. The prevalence of oral health problems was high, with 96% (353) of respondents claiming that they experienced one or more problems in the previous year. Two thirds of participants (65%, 239) claimed they had dental pain in the previous year. Analysis revealed that dental pain experience was significantly associated with age and gender. Analysis considering all factors revealed that the odds of experiencing dental pain were higher amongst the younger age group (18-24 compared to 25-34 year-olds). CONCLUSION: The prevalence of oral health problems was high among the population studied. Socio-demographic variations in experience of dental pain were apparent, with young men of lower education having the greatest odds of dental pain experience in the previous year.     

Self-reported health complaints among general dental practitioners, orthodontists, and office employees

Studies in the Scandinavian countries have shown that orthodontists run an equal or even greater risk of contracting dermatitis compared to other dental personnel. The aim of the study was to find out whether the self-reported occupation-related health problems of general dental practitioners and orthodontists differ from those of office employees in Finland. The subjects were 147 general dentists, 81 orthodontists and 99 office employees (77% women and 23% men). The data were collected using a mailed questionnaire. Within the past year, 42% of the subjects had had occupational health problems, while 51% had experienced symptoms in the previous year or earlier. The complaints of hand dermatoses, musculoskeletal, as well as respiratory symptoms were significantly more common among women than among men. Musculoskeletal complaints were the most common symptoms in all occupational groups, but the odds ratio of having them were significantly higher for dental professionals compared to office employees. The frequency of self-reported hand dermatoses was 42% for dental professionals and 26% for office employees, but the difference did not reach statistical significance. The odds of having hand dermatoses were higher for atopic subjects and for women. Orthodontists did not differ from general practitioners in respect of any of the complaints reported. Materials used in dentistry were mentioned as the cause of symptoms by 49 (21.5%) of the dental professionals. The present results show an increased risk of self-reported musculoskeletal symptoms for the dental professionals. Also, a tendency towards increased occurrence of skin symptoms was noted for the dental professionals compared to office employees of this study.     

A follow-up study of patients with subjective symptoms related to dental materials

OBJECTIVES: The extent to which substances released from dental materials cause adverse health effects and whether removal of dental materials results in improvement of health is a matter of dispute. The aim of the study was to investigate changes in the intensity of subjective symptoms after replacement of dental materials in patients referred for adverse reactions related to dental materials, and to compare the profiles of symptoms with those found in the general population. METHODS: Information was obtained from 142 patients referred to the Dental Biomaterials Adverse Reaction Unit in Bergen, Norway. At the time of examination, all patients completed a questionnaire regarding a range of subjective symptoms. A follow-up questionnaire was sent to all patients 1 to 2 years later. Similar questionnaires were sent to a reference group of 800 persons drawn from the general population. RESULTS: The follow-up questionnaires were completed and returned by 84 patients, and 441 persons in the reference group. The patient group presented higher symptom indices than the reference group (P<0.001). Generally, there was some decrease in the intensity of different symptoms in patients who had replaced dental materials. The decrease was evident regarding intraoral symptoms (P=0.022) and total symptom index (P=0.041). The group of patients who had replaced materials still had significantly higher symptom indices than those of the reference group. Patients who had not replaced dental materials did not present any reduction in symptom indices. CONCLUSION: The pattern of symptoms was similar for the groups investigated. At the group level, the intensity of local and some general subjective symptoms was reduced after replacement of the materials, but not to the level found in the general population.     

Utilization of dental services in relation to socioeconomic and health factors in the middle-aged and elderly Swedish population

The aims of this study were to describe the change in reported time since the latest visit to a dentist between the years 1980/81 and 1988/89 and the reported use of dental services in relation to age, dental state, and socioeconomic and health characteristics in a sample of the Swedish population in 1988/89. The studies are based on interviews by Statistics Sweden about the living conditions. In the investigations in 1980/81, 14,964 inhabitants between 16 and 84 years of age participated, and in 1988/89, 13,309 inhabitants. In all age groups there was a significantly higher frequency of reported visits to a dentist last year in 1988/89 than in 1980/81. In the age group 50-64 years old this figure increased from 54% to 75%, and in the age group 65-84 years old it increased from 26% to 39%. In the investigation in 1988/89 about 75% of the dentulous women in all age groups up to 75 years reported visiting a dentist last year. The relative risk for not visiting a dentist last year, adjusted for age, gender, and dental state, was higher in dentulous subjects with low income and education, not married, not native-born, living in rural areas, smoking, and low social and physical activity. The results of the logistic regression analysis showed that, among the elderly, functional ability and general health factors have lower significance for time since last visit to a dentist than socioeconomic, social support, and life-style factors.     

Risk indicators for missing teeth in working-age Pomeranians--an evaluation of high-risk populations

OBJECTIVE: The goal of this study was to examine whether psychosocial conditions for general health described in the public health literature are also reflected in tooth loss. METHODS: The relation of psychosocial factors to missing teeth was evaluated among 2,501 individuals aged 25 to 59 years from the population-based cross-sectional Study of Health in Pomerania using logistic regression analyses. The case group included 15 percent of participants of each 5-year age group with the highest number of missing teeth. RESULTS: Unemployment, dose-dependent current and former smoking, a poor general health status, and a longer time since the last dental appointment were significant risk indicators for missing teeth. Alcohol consumption, use of interdental cleaning products, and checkup as the reason for the last dental visit were protective. Women with low education and low income were identified as a high-risk group for missing teeth by the three-way interaction between gender, school education, and household income. The effect of marital status was modified by gender: being single was a risk indicator for men but it was protective for women. CONCLUSIONS: The study supports the hypothesis that psychosocial conditions that affect health status as described in the general public health literature also have an effect on tooth loss. Strategies to prevent tooth loss may be expeditiously implemented in combination with approaches to prevent other health-related problems.