Finger osteoarthritis and differences in dental work tasks

Mechanical load has been proposed as a risk factor for hand osteoarthritis. Dentists produce high manual forces in their work tasks. We studied whether the pattern of dental work tasks was associated with finger osteoarthritis. Radiographs of both hands of 291 middle-aged female dentists were examined for the presence of osteoarthritis. Patterns of dental work tasks during work history were empirically defined by cluster analysis. Three patterns emerged reflecting high, moderate, and mild task variation. Age, specialization, years in clinical work, various activities requiring hand use, family history of Heberden's nodes, body mass index, and smoking were accounted for in logistic regression analyses. The dentists with a history of low task variation had a greater prevalence of osteoarthritis in the thumb, index, and middle fingers compared with dentists with high variation (OR 2.22; 95%CI 1.04-4.91). The pattern of dental work task history is associated with the localization of osteoarthritis in the fingers.     

Changes in division of labour and tasks within public dentistry: relationship to employees work demands,health and work ability

Objective: By 2023, fewer dentists are expected in Sweden, at the same time as the demand for dental care is expected to increase. Older people, in particular, are expected to require more dental health than previous generations. To meet this demand, the public sector dentistry in Sweden is moving towards changes in division of labour among dental professionals, including dentists, dental hygienists and dental nurses. However, the impact of this reallocation on the physical and psychosocial wellbeing of employees is unknown. The aim of this study was to compare workplaces with an equal or larger proportion of dental hygienists than dentists (HDH) with workplaces with a larger proportion of dentists than dental hygienists (HD) on the physical and psychosocial work load, musculoskeletal and psychosomatic disorders and sickness presence.

Material: A total of 298 persons employed in the Public Dental Service in a Swedish County Council participated in this study.

Conclusion: The medium large clinics HDH reported 85% of employee’s with considerably more high psychosocial demands compared to employees in medium HD (53%) and large HD (57%). Employees in medium large clinics HDH also reported sleep problems due to work (25%) compared with employees in medium large clinics HD (6%), large clinics HD (11%) and small clinics HDH (3%). Clinic size does not seem to influence the outcome of the HD and HD clinics to any great extent. Of all employees, about 94–100% reported high precision demands and 78–91% poor work postures.     

Oral health,general health,and quality of life in older people

The purpose of this report is to review the interrelationship between poor oral health conditions of older people and general health. The impact of poor oral health on quality of life (QOL) is analyzed, and the implications for public health intervention and oral health care are discussed. Findings from the current research may lead to the following conclusions: The available scientific evidence is particularly strong for a direct relationship between diabetes and periodontal disease; the direct relationship between periodontal disease and cardiovascular disease is less convincing. General and associated oral health conditions have a direct influence on elder people's QOL and lifestyle. The growing number of elderly people challenges health authorities in most countries. The evidence on oral health–general health relationships is particularly important to WHO in its effort to strengthen integrated oral health promotion and disease prevention around the globe.     

Tooth loss, denture wearing and oral health-related quality of life in elderly Chinese people

OBJECTIVES: To investigate the relationship between tooth loss, denture wearing and oral health-related quality of life (OHQoL) among community-dwelling elderly people in Hong Kong. METHODS: A questionnaire study of elderly people aged 60-80 years who were recruited at neighborhood social centres for the elderly. The Chinese version of the General Oral Health Assessment Index (GOHAI) was used and information about natural tooth number and denture wearing were obtained. RESULTS: 233 elderly subjects were recruited and interviewed. Around 20% of the partially dentate subjects had their last tooth loss within the previous year and a quarter within the last five years. Significantly fewer edentulous subjects had their last tooth loss within the previous year (3%) and within the last five years (12%, p < 0.001). Twenty two percent of the subjects had difficulty in accepting tooth loss. More edentulous subjects (69%) were satisfied with their dentures than partially dentate denture wearers (37%, p < 0.001). Edentulous elderly subjects had a higher mean GOHAI score (53.0) than partially dentate denture wearers (49.1, p < 0.001). Results from a multiple factor ANOVA revealed that elderly subjects who had loose teeth, difficulty in accepting tooth loss and were not satisfied with their removable dentures had a lower mean GOHAI score. CONCLUSIONS: In general, tooth loss and denture wearing did not have a major impact on OHQoL in elderly Chinese people. However, partially dentate denture wearers experienced a greater adverse impact on OHQoL than edentulous subjects most probably due to less satisfaction with their dentures and discomfort associated with loose teeth.     

上海市老年人牙缺失、义齿修复与口腔健康相关生命质量的现状研究

目的：以Eichner分类法代表牙缺失状况,研究上海市老年人牙缺失、修复情况及口腔健康相关生命质量的现状,同时探讨生命质量与牙缺失、义齿修复与否的相关性。方法：以65~74岁年龄组为研究对象,采用多阶段分层抽样方法抽取747名受试者纳入研究。使用第四次全国口腔流行病学调查的检查方法及问卷,收集受试者的缺牙状况、生命质量等数据。采用SPSS 19.0软件包进行非参数检验、二元logistic回归分析等。结果：79.1%的受试者存在牙缺失,35%的受试者未曾接受义齿修复。Eichner分组后,仅A1、A2和C3组受试者的老年口腔健康评价指数（general oral health assessment index,GOHAI）得分高于平均分,B组得分最低。GOHAI得分与受试者修复与否,全身健康状况及Eichner分组有显著相关性（P<0.05）。Eichner分组中,除C2组因样本量原因出现偏差外,其余Eichner组中,未修复受试者的GOHAI得分均低于已修复受试者。而在有缺牙未修复的人群中,81.2%的受试者认为自己牙没有问题或牙病不重。结论：上海市65~74岁老年人中牙缺失问题严重,但进行义齿修复的老人少。老年人的口腔健康相关生命质量与牙缺失状况、义齿修复与否及全身健康相关。应加强对缺牙老年人的口腔健康宣教,及时修复缺失牙,提高老年人的生命质量。     

Work environment factors affecting quality work in Swedish oral and maxillofacial surgery

The aim of this study was to investigate how work environment influenced attitudes to and knowledge of quality among employees of Oral and Maxillofacial Surgery (OMFS) clinics in Sweden. Data were collected with a questionnaire of 67 questions, related to quality management at the clinic, working situation, content of "good work", physical environment and health. 22 clinics with 297 employees responded, 65% of the clinics and 86% of the employees. A multiple regression analysis with the dependent variable "Attitude towards quality work" showed that only "work environment" (p = 0.010) revealed a significant association (p < 0.05). The personnel will have a more favourable attitude to quality work if they regard work environment to be important. Dental nurses and assistant nurses had more than four times more knowledge of the used quality management system than had the maxillo-facial surgeons. Women had nearly four times more knowledge of quality management than men. Clinic size was important, with better knowledge of quality management in bigger clinics. Soft demands were defined as demands for "flexibility, creativity, quality, service, engagement/commitment and ability to work together, and competence". Hard demands included economy as important, and emphasis on efficiency and productivity. There was a weak association with knowledge of quality management systems if soft demands increased, but negative if hard demands increased. In conclusion, mainly work environment was of significance for the attitude towards quality work among the employees of OMFS clinics in Sweden. Profession, gender, clinic size, and the hard demands were significantly associated with knowledge of the quality management system used.     

Tooth surface loss among people exposed to cement and stone dust in the work environment in Tanzania

The effect of cement and stone dust on teeth was explored in a cross-sectional study, using blind dental examinations. The sample consisted of 36 workers who had been exposed to to the dust and 62 control workers. Tooth surface loss was observed in 72.2 per cent of the exposed workers and in 48.4 per cent of the controls (P less than 0.03). In both the maxillae (P less than 0.001) and the mandible (P less than 0.02) the amount of tooth surface loss was greater in the exposed workers than in the controls. Both anterior and posterior teeth were affected. These findings indicate that tooth surface loss caused by work-related dust should be considered an occupational hazard.     

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.     

Oral health and quality of life of people living with human T-cell leukemia virus-1 in Salvador,Brazil: a cross-sectional study

Clinical Oral Investigations - To compare the oral health status and oral health-related quality of life (OHRQoL) in symptomatic and asymptomatic patients with human T-cell leukemia virus-1...     

The impact of educational level on oral health-related quality of life in older people in London

There are socioeconomic inequalities in oral health, but the relationship between education and oral health-related quality of life (OHRQoL) among older adults has not been adequately studied. This study assessed whether there is an educational gradient in OHRQoL among older people in London. We employed secondary analysis of baseline data ( n  = 1,090) from a randomized controlled trial of health-risk appraisal on community-dwelling non-disabled people 65 yr of age and older, registered with three group medical practices in suburban London. Multiple linear regressions were used to analyze the association between OHRQoL [measured using the Geriatric Oral Health Assessment Index (GOHAI)] and education, adjusted for age, gender, pension status, and denture wearing. Overall, 30.6% reported low levels of OHRQoL. Eating discomfort was the most frequent problem (24% reported 'often/always'), while concerns about appearance were also prevalent. Significant variations in OHRQoL existed between socioeconomic groups. In adjusted analyses, there was a clear education gradient in OHRQoL, with worse perceptions at each lower level of education. Low educational level has an independent negative impact on OHRQoL in older people, which is not explained by differences in income or in denture wearing between educational groups. Policies targeting lower educated groups should be complemented with whole-population strategies for the reduction of oral health inequalities.