Relationship between dental care and oral health in institutionalized elderly people in Japan

This study examined the relationship between dental care and dental health status in institutionalized elderly people in Japan through a 6-year prospective cohort study. All the 719 subjects received both baseline and follow-up surveys. The uptake of dental care was examined at the follow-up survey. We examined the relationship between baseline variables and the provision of dental care, and the relationship between dental care and change of oral health status. About 47% of the subjects and about 60% of the baseline dentate subjects received some dental treatment during the 6-year follow-up period. The subjects who were in better systemic and dental health at baseline used dental services frequently. The number of teeth needing extraction decreased in the subjects who received dental treatment, and increased in the untreated subjects. Denture status was better in the treated subjects than in the untreated subjects. Dental care appears to be an important factor in maintaining a healthy oral status for the institutionalized elderly.     

Oral health knowledge, attitudes and behaviour of children and adolescents in China

Objectives : A national representative study to describe oral health behaviour, illness behaviour, oral health knowledge and attitudes among 12‐year‐old and 18‐year‐old Chinese, to analyse the oral health behaviour profile of the two age groups in relation to province and urbanisation, and to assess the relative effect of socio‐behavioural risk factors on dental caries experience. Methods : The total number of 4,400 of each age group were selected and data were collected by clinical examinations (WHO criteria) and self‐administered structured questionnaires. Results : 44.4% of the respondents brushed their teeth at least twice a day but only 17% used fluoridated toothpaste. Subjects who saw a dentist during the previous 12 months or two years were 31.3% and 35.3% for 12‐year‐olds and 22.5% and 20.2% for 18‐year‐olds, respectively. Nearly one third (29%) of 12 year‐olds and 40.5% of 18‐year‐olds would visit a dentist in case of signs of caries but only when in pain. Nearly half of the participants (47.2%) had never received any oral health care instruction. Significant variations in oral health practices were found according to province and regular dental care habits were more frequent in urban than in rural areas. The risk of dental caries was high in the case of frequent consumption of sweets and dental caries risk was low for participants with use of fluoridated toothpaste. Conclusion : Systematic community‐oriented oral health promotion programmes are needed to target lifestyles and the needs of children, particularly for those living in rural areas. A prevention‐oriented oral health care policy would seem more advantageous than the present curative approach.     

Dental status and satisfaction with oral function in a sample of community-dwelling elderly people in Japan

The purpose of this study was to determine the influence of dental status on oral function and satisfaction among a group of independently living elderly persons in an urban area of Japan. The study sample consisted of participants of the Senior Citizens' College from 1995 to 1999. Their dental status and oral satisfaction were measured by a questionnaire. The number of usable questionnaires was 3967, or 80.8% of the total sample. The mean age of the subjects was 66.5 ± 4.3 years, and 52.2% were male. Twenty‐nine percent of them had a natural dentition, and 7.0% were edentulous in both jaws. The prevalence of edentulism in the study sample was significantly lower (p<0.01) than that for the national survey. Overall, 66.4% of the subjects were satisfied with their ability to chew, 56.2% with the appearance of their teeth, 63.1% with their ability to speak clearly, and 76.5% with their ability to taste food. For complete‐denture wearers, the greatest dissatisfaction was with speech (28.5%); however, for the RPD wearers, it was with chewing ability (21.7%). Sixty‐one percent of complete‐denture wearers reported that they were satisfied with their chewing ability, but only 11% of them could eat all three of the evaluated foods without difficulty. The multiple stepwise logistic regression analyses showed that both dental status and self‐assessed general health had a significant association with dissatisfaction with all four oral functions and self‐assessed impairment of chewing ability. There were significant associations between the elderly subjects' dental status and oral function.     

Geriatric oral health issues in India

An overview of the demographics and oral health status of the elderly population of India is presented. India is a vast country with a population of one billion people. Of this, people older than 60 years constitute 7.6%, which in actual number is 76 million. There are several factors that affect the oral health of elderly. The dentist:population ratio is 1:27,000 in urban areas and 1:300,000 in rural areas, whereas 80% of the elderly population reside in rural India. Forty per cent of the elderly live below the poverty line and 73% are illiterate. Ninety per cent of the elderly have no social security and the dependency ratio is 12.26. Incidence of oral cancer, which is considered an old‐age disease, is highest in India, 13.5% of all body cancers are oral cancers. Preventive dental care is almost nonexistent to the rural masses and very limited in urban areas. Above all, there is no orientation of dental graduates towards the special needs of the geriatric population. Recommendations include: the establishment of Continuing Dental Education programmes on geriatric oral care; inclusion of a geriatric component in undergraduate and postgraduate curricula; initiation of a diploma, certificate and degree courses in geriatric dentistry; research on various aspects of ageing and age‐related oral health problems; provision of preventive and curative treatment for various oral diseases to the elderly.     

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

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

北京市城乡人群六个年龄组恒牙龋病抽样调查报告

目的：本文对1994年第二次全国口腔健康流行病学调查中,北京地区六个年龄组人群的恒牙患龋及治疗需要情况进行统计学分析。方法：采用整群抽样方法,对北京市六个年龄组的城乡人群12792人（城市8520人,农村4272人）进行了口腔检查,诊断标准根据世界卫生组织1987年第三版《口腔基本调查方法》一书。结果：各年龄组的患龋率及龋均基本是城市高于农村,12岁年龄组的患龋情况处于很低水平,12岁年龄组恒牙充填率为15．42（城）和3．23（乡）,结论：本结果离2000年目标有一定差距,提示我们应加强口腔健康教育,提高居民口腔保健意识。另外,随年龄的增长牙齿治疗的复杂程度逐渐增高,因此,应在人群中开展初级口腔卫生保健,做到早发现,早诊断,早治疗。     

Oral health status of older rural adults in the United States

BACKGROUND: Little is known about the oral health care of older rural residents. The authors describe oral health indicators for the older adult population by place of residence in the United States. METHODS: The authors analyzed data from the Third National Health and Nutrition Examination Survey and the 1995, 1997 and 1998 National Health Interview Surveys. Oral health indicators included perceived oral health (self-reported dental status and unmet dental needs) and dental status (untreated caries; decayed, missing and filled permanent teeth, or DMFT; and edentulism). Dental care utilization and access were measured by number of dental visits, frequency of dental visits and dental insurance status. RESULTS: Older rural adults were more likely than their urban counterparts to be uninsured for dental care (72.1 percent versus 66.1 percent, respectively) and were less likely to report dental visits in the past year (46.9 percent versus 58.4 percent, respectively). A higher proportion of rural residents than urban residents were edentulous (36.7 percent versus 28.2 percent, respectively) and reported poor dental status (50.7 percent versus 42.2 percent, respectively). There were no differences in unmet dental needs, percentage of people with untreated caries or in mean DMFT by place of residence. CONCLUSIONS: Older rural residents inadequately utilize dental care and have less favorable oral health indicators than do older urban residents. CLINICAL IMPLICATIONS: This article shows the need for more dental practitioners in rural areas. With the low density of dentists per person and the high need for care, rural America offers an excellent opportunity for oral health professionals to provide much needed services.     

广东省3~5岁人群乳牙龋病抽样调查报告(2015—2016年)

目的 了解广东省3~5岁人群乳牙龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省3、4、5岁城乡常住人口各864人,男女各半,城乡各半.按照第四次全国口腔健康流行病学调查方案牙列检查方法和标准,使用CPI探针检查全口乳牙牙冠龋病情况.计算患龋率、龋均、充填率等.结果 3、4、5岁人群乳牙患龋率分别为58.33%、68.40%、78.47%,龋均分别为3.03、4.34、5.69,龋齿充填率分别为0.92%、1.47%、1.26%.3、4、5岁人群患龋率和龋均在城乡及年龄组间的差异有统计学意义,农村高于城市,随年龄增长,患龋状况加重;患龋率在不同性别间的差异无统计学意义,3岁人群龋均女性高于男性(t=2.04,P=0.042),4岁人群(t=0.15,P=0.882)、5岁人群(t=1.00,P=0.317)龋均在不同性别间的差异无统计学意义;5岁儿童患龋率(x2=23.123,P<0.001)和龋均(t=6.290,P<0.001)高于2005年,龋齿充填率提升不明显(x2=0.481,P=0.488).结论 广东省3~5岁儿童乳牙龋病患病状况较严重,98%以上的龋齿未经治疗,是龋病预防的重点人群,特别是农村儿童.     

阿勒泰哈萨克族人群口腔健康知识态度调查分析

目的了解新疆阿勒泰地区哈萨克不同族群口腔健康相关知识、态度现况。方法按照第三次全国口腔健康流行病学调查标准和方法,采用分层随机抽样方法,对阿勒泰地区城市和农村哈萨克族人群489人进行调查。结果 18.1%的人群能够正确答对牙齿的数目,56.6%的人能够正确认识到刷牙出血不正常,51.5%的人认为吃糖是引发龋齿的原因之一,在这3个问题中农村人群的正答率均明显低于城市人群,差异具有统计学意义(P<0.05)。"牙菌斑是引发牙周炎的原因之一"和"含氟牙膏的作用"这2个问题的正答率分别为6%和28%,虽然城市人群的正答率高于农村人群,但是差异无统计学意义(P>0.05)。在"定期检查牙齿有必要","牙齿好坏是天生的,与保养无关系不大"及"预防牙齿疾病主要靠自己"这3个问题中,正答率分别为70.5%,58.2%,67.7%,但是农村人群的正答率明显低于城市人群,差异有统计学意义(P<0.05)。而85.7%的人群都认为口腔健康知识很重要,城市人群虽略高于农村人群,但差异无统计学意义(P>0.05)获得口腔健康知识的途径中广播/电视占到的比例最高(67.6%),而医院宣传所占到的比例最低(6%)。结论阿勒泰地区哈萨克族不同人群口腔健康健康知晓率均较低,应采取多种途径开展口腔健康教育工作,提高口腔健康知识水平。     

吉林省12岁儿童龋病和牙周健康状况调查分析

目的：了解吉林省12岁儿童人群恒牙龋病和牙周病患病状况及分布,为口腔疾病防治策略提供依据。方法：根据全国第三次口腔健康流行病学调查的方法,对吉林省城乡788名12岁儿童的龋病和牙周病进行了调查。采用SPSS13．0软件包进行数据的统计分析,以龋均、患龋率和牙石、牙龈出血检出率作为统计指标,两样本均数的比较使用t检验,率的比较使用X2检验。结果：12岁儿童的恒牙患龋率43．65％,龋均为1．07,龋均和患龋率男女之间均有高度显著性差异（P〈0．01）,农村地区患龋率高于城市地区,但经检验差异无显著性意义,吉林省12儿童的显著性龋均指数为2．89;牙龈出血检出率为53．46％,牙结石检出率和平均检出区段数为76．40％和1．94。牙龈出血检出率和牙结石检出率城乡之间均有高度显著性差异（P〈0．01）。结论：12岁年龄组儿童患龋较高,牙周健康状况不良,应加强口腔卫生服务,以促进该人群口腔健康水平。     

北京市城乡居民口腔医疗服务利用与费用分析

目的 对北京市城乡居民口腔医疗服务利用和费用进行定量研究，为口腔医疗保障制度的制定提供依据。方法 采用分层、整群、随机抽样方法抽取城区人口1517人，农村人口1878人，利用人户调查方式进行口腔医疗服务利用和费用的调查。结果 城乡居民口腔疾病就诊率均处于较低水平，但次均费用较高。农村居民就诊率为城区居民的1／3，次均费用约为城区居民的1／2。农村居民口腔费用支出占年收入的2．07％，城区居民为1．77％。不同人口、社会经济学背景的人群费用支出差异有显著性。结论 北京市居民的口腔医疗费用水平较高，在收入中占相当比重，并且农村居民的费用负担要重于城区居民。本研究中所调查的费用水平可为北京市口腔医疗保险覆盖提供一定参考依据。     

Coronal and root caries in Southern Chinese adults.

Southern China is the most prosperous part of China, but information useful for oral care planning is very limited. A large-scale epidemiological survey was conducted in 1996-97. The objectives of this report were to describe the coronal and root caries of the adult Southern Chinese and to analyze the influence of selected demographic and socio-economic factors on the disease pattern. A total sample of 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds from 8 urban and 8 rural survey sites in Guangdong Province participated in an oral health interview and underwent clinical examination. World Health Organization examination procedures and diagnostic criteria were used. The weighted mean DMFT scores of the middle-aged and the elderly subjects were 4.8 and 16.1, respectively. People living in rural areas had a higher DMFT score than those living in urban areas (4.9 vs. 4.3 in the 35- to 44-year-olds and 16.5 vs. 14.7 in the 65- to 74-year-olds). In both age groups, MT was the major component of the DMFT score. Analysis of covariance showed that women and those who were economically less well off had higher DMFT scores in both age groups. The weighted prevalence rates of decayed/filled roots were 12% and 37%, with a mean of 0.2 and 0.7 teeth affected, in the middle-aged and the elderly, respectively. In conclusion, socio-economic factors had a considerable effect on the dental caries status of adults in Southern China.     

The oral health of homeless adolescents and young adults and determinants of oral health: preliminary findings

A survey was administered to 55 homeless adolescents and young adults aged 14 to 28 years who presented for care at a community health center in Seattle, Washington in 2005. Forty‐five valid surveys were analyzed. The aim of the study was to identify factors associated with self‐reported oral health. The most common self‐reported dental problem was sensitive teeth (52.6%), followed by discolored teeth (48.6%), toothache (38.5%), or a broken tooth (37.8%). Dental problems were associated with lower self‐reported oral health, while non‐high school graduates, mixed race youths, and methamphetamine users had significantly higher self‐reported oral health. Among homeless youths, addressing dental problems with direct dental care may improve self‐perceived oral health. The relationships between methamphetamine use and education level, on the one hand, and self‐reported oral health, on the other, are complex and may be modified by age.     

Epidemiology of dental caries among adolescents in Tamil Nadu,India

Objective: Economic and dietary changes in the Indian state of Tamil Nadu have led to compromised oral health status of the adolescent population. Adequate epidemiological data are not available to address the prevention or treatment needs in this region of India. The aim of this study was to measure the prevalence and severity of dental caries among adolescents of Tamil Nadu, a southern state of India. Methods: The study sample included 974 adolescent school students (12–15 years of age) from both rural and urban areas of Tamil Nadu, India. The decayed, missing and filled teeth (DMFT) index of these students was measured using the World Health Organization oral health survey method, in a quantitative cross-sectional study. Results: The oral health survey indicated that the prevalence of dental caries among adolescents in rural and urban areas of Tamil Nadu was 61.4%, with an average DMFT score of 2.03. Multiple regression analyses indicated factors such as gender, mother’s education, type of school and caste as significant predictors of dental caries. Conclusion: Female gender, Scheduled Caste and Tribes attending public schools in rural areas were identified as the more vulnerable populations to be affected by dental caries. Oral health policies should be targeted to these adolescent populations in the Tamil Nadu region.Key words: Prevalence of dental caries, severity of dental caries, Thanjavur, Chennai, oral health survey     

2005年天津市12岁人群氟牙症抽样调查报告

目的了解天津市城、乡12岁人群氟牙症流行状况。方法按照第三次全国口腔健康流行病学调查方案,对天津市城、乡12岁人群进行氟牙症流行病学抽样调查。调查项目包括氟牙症患病率和氟牙症指数。调查样本量为774人,其中男391人（城区197人、农村194人）,女383人（城区188人、农村195人）。结果天津市12岁人群氟牙症患病率为63.6%（城区56.6%,农村70.4%）,社区氟牙症指数为1.53,属氟牙症中度流行地区。城区以轻度及轻度以下氟牙症为主,农村以中度氟牙症为主,城、乡重度氟牙症患者较少见。结论天津市为氟牙症中度流行区,并有农村重于城区的趋势,今后应加强饮水除氟工作。     

Oral health status of rural adults in the United States

BACKGROUND: Many sociodemographic indicators of oral health disparity in the United States have been documented. Rural residence, however, has not been researched thoroughly, though it has been considered to be a potential indicator of disparity. The authors conducted this study to present information on the effects of rural residence on oral health in the United States. METHODS: The authors conducted their analyses using data from adults aged 18 to 64 years from the 1995, 1997 and 1998 National Health Interview Surveys and the Third National Health and Nutritional Examination Survey, 1988-94. The authors present national estimates for various oral health status indicators including dental insurance coverage, unmet care needs, frequency of dental visits, caries experience and prevalence of edentulism by rural/urban residence. RESULTS: The authors found that adults living in rural areas were more likely to report having unmet dental care needs and were less likely to have had a dental visit in the past year compared with adults living in urban areas. The prevalence of edentulism among rural adults was 16.3 percent-almost twice that of urban adults. Caries experience also was more likely to be greater among adults residing in rural areas. CONCLUSIONS: Oral health disparities exist among U.S. adults living in rural and urban areas. Compared with urban residents, rural residents were less likely to report a dental visit in the past year and were more likely to be edentulous. PRACTICE IMPLICATIONS: By understanding the rural/urban differences in adult oral health status, practitioners, policy-makers and rural health advocates will have better information to use to promote activities that better meet the needs of rural adults in the United States.     

Oral healthcare for elderly: identifying the needs and feasible strategies for service provision.

The aim of the present study was to assess the oral health practices, status and treatment needs of the rural elderly in national capital territory of Delhi. An effort was also made to identify patterns of utilization of dental services and test alternate strategies for service provision. A total of 96 elderly subjects (47 males and 49 females) in 5 rural areas were interviewed and clinically examined using Basic Oral Health Survey criteria of W.H.O. This was followed by a community trial in which the 5 villages were divided into control and test groups. Results of the survey found that both traditional as well as modern oral health practices co-exist in the rural community. Dental services were available to a majority (mostly through private sector), and edentulousness was a condition of primary concern among the elderly as a result of unmet treatment needs for dental caries and periodontal diseases. Age was a variable that was statistically significantly associated with edentulousness (p=0.005). Results of the community trial showed that higher utilization of care can be achieved by providing on-site dental care as compared to referring cases to tertiary care centers. Nevertheless provision of treatment alone is not a suitable policy recommendation since many elderly did not avail care even at on-site community dental health programmes that were operated free of cost. This emphasizes the need of health education over treatment in order to empower the elderly, especially the non-ambulatory patients, to practice prevention and develop favourable attitudes towards accepting prompt treatment at primary health care level.     

Past and present geographic location as oral health markers among older adults

OBJECTIVES: This study evaluated the association between oral health status of community-dwelling elderly adults visiting day health centers in Israel and geographic living location. METHODS: Oral status was assessed through clinical examination, with additional data obtained using a questionnaire addressing demographic characteristics, dental utilization, and perceived oral health needs. RESULTS: A representative sample of 338 subjects was examined. Fifty-four percent of the sample was edentulous. Higher rates of edentulism were found among subjects living in urban areas compared to subjects living in rural areas (P<.01). More edentate subjects were found among European immigrants than among immigrants from North Africa or subjects born in Israel (P<.01). Among dentate subjects, the mean number of remaining teeth was 10.4. The mean periodontal loss of attachment was 5.8 mm. Less than 10 percent had mean attachment loss <4 mm. Among subjects living in rural areas, mean attachment loss was higher than among those living in urban areas (P=.05). The mean DF score was 1.9. Forty-seven percent had at least one tooth with untreated caries. Subjects living in urban areas tended to utilize dental services more than subjects living in rural areas (P<.01). CONCLUSION: Results indicate that present (urban or rural) and past (country of origin) geographic location represented a significant oral health risk marker. The implementation of a comprehensive program for this target population was clearly indicated.     

Oral health issues of Spanish adults aged 65 and over

Objectives : The aim of this survey was to investigate the oral health and nutritional status of elderly men and women, including those living in institutions, representative of Spanish adults aged 65 years old and over. Design : Cross‐sectional oral health survey in an elderly population. Subjects : 3,460 adults (1,433 men and 1,996 women) aged 65 and older (mean age 73.2 (± 6.4)). Setting : Randomly selected primary care clinics and institutions. Intervention : The oral health survey included a questionnaire and an oral examination conducted by calibrated dentists. A structured interview on socio‐economic status, oral health habits, a Mini‐Nutritional Assessment, and a clinical evaluation of oral and dental health, were performed. Results : 31 % of the population were edentulous. The dentate subjects had an average of 15 teeth. 73% of the dentate sample brushed their teeth once or less a day. Mean DMFT value was 21.8. Risk of malnutrition was present in 43% of the edentulous and 39% of the dentate, and in 53% of institutionalised and 40% of non‐institutionalised subjects. Malnutrition was present in 5% of edentulous and 4% of dentate adults. Discussion : Despite the low level of edentulousness, the oral health of Spanish adults aged 65 and older is poor. There is also a need to ensure that the overall balance of the diet is not impaired because of the state of the dentition.     

The opinions and attitudes of dental school academic staff towards oral healthcare education for older adults

The term ‘oral health care for older adults’ has various interpretations, and its meaning is not clear among dental school academic staff. Additionally, there are no theoretical or practical stand‐alone courses on oral health care for older adults in Japanese dental schools. To improve oral health care education, we investigated the opinions and attitudes toward oral health care education for older adults among academic staff in dental schools. Data were collected in seven dental schools from May to September 2013 via an online questionnaire survey. Five‐hundred‐fifty‐eight academics (428 male, 130 female) participated (response rate 57%). The average number of years since they had completed a university degree was 20.2 (SD 10.2) years. The majority (Over 90%) of participants perceived that oral health care should be provided in nursing facilities, hospitals, and at home. Its treatments and instructions should include, not only methods of keeping good oral hygiene, but also improvement of oral function such as swallowing training and salivary glands massage. The majority (84.2%) suggested oral health care education should be combined as a one‐credit, stand‐alone course. Findings indicate that dental academics have an understanding the need for a course in oral health care for older adults. Participants supported the need for further development of education in oral health care for older adults’ in Japan, as a separate course on its own right. However there were some different views about content by teaching field. The need for a national core program for teaching oral health care education was suggested.